Beginning in your 20s (or earlier), an OB/GYN or specialized nurse practitioner may ask questions about your sexual health. While this discussion may feel personal and private, a provider’s questions are intended to discover whether you are sexually active, if you are at risk for an unplanned pregnancy, or at risk for sexually transmitted diseases or infections (STDs/STIs). 

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For sexually active people, 25 years of age and older, the CDC (Centers for Disease Control and Prevention) recommends yearly STD/STI tests if you are at an increased risk, such as having new or multiple partners. This is most commonly a blood or urine test.

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What is a sexually transmitted infection (STI)/sexually transmitted disease (STD)?  

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An STI/STD is acquired during sexual intercourse with an infected partner. It can be due to any of the following:

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STI/STDs and Their Cause

Bacteria 

• Chlamydia
• Gonorrhea
• Mycoplasma genitalium (Mgen) 
• Syphilis

Parasites

• Trichomonas

Viruses

• Human papillomavirus (HPV)
• Human immunodeficiency virus (HIV) 
• Herpes (HSV)
• Hepatitis B (HBV)

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Chlamydia 

‍What causes chlamydia? A bacteria, chlamydia trachomatis, through contact with an infected partner by oral, vaginal, or anal intercourse.

Symptoms? Often there are no symptoms or there can be vaginal discharge and/or pain with urination. If left untreated, chlamydia can lead to pelvic inflammatory disease, infertility, higher risk for ectopic pregnancy, and pelvic pain.

Who should be tested? Pregnant women and sexually active individuals should test every year until 24 years old. For those 25 and older, yearly screening is recommended if they have a new partner, multiple partners, or a partner who tests positive for an STI.

Treatment? Antibiotics - oral pills

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Gonorrhea

What causes gonorrhea? A bacteria, neisseria gonorrhoeae, through contact with an infected partner by oral, vaginal, or anal intercourse.

Symptoms? Often there are no symptoms or there may be vaginal discharge, abnormal bleeding, pain with urination. If left untreated gonorrhea can lead to pelvic inflammatory disease, infertility, higher risk for ectopic pregnancy, and pelvic pain.

Who should be tested? Pregnant women and sexually active individuals should test every year until 24 years old. For those 25 and older, yearly screening is recommended if they have a new partner, multiple partners, or a partner who tests positive for an STI.

Treatment? Antibiotics - intramuscular injection/shot

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Mycoplasma genitalium (Mgen)

What causes Mgen? A bacteria, mycoplasma genitalium, through contact with an infected partner by vaginal or anal intercourse. It is not yet known if Mgen is acquired orally.

Symptoms? Often there are no symptoms or there may be vaginal discharge, abnormal bleeding, or pain with urination. If left untreated, Mgen can lead to pelvic inflammatory disease, infertility, higher risk for ectopic pregnancy, and pelvic pain.

Who should be tested? Individuals with any of the above symptoms, those with a partner with symptoms, or a known exposure to Mgen.

Treatment? Antibiotics - oral pills

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Syphilis

‍What causes syphilis? A bacteria, treponema pallidum, through contact with an infected partner by oral, vaginal, or anal intercourse. 

Symptoms? There are four stages each with different symptoms, plus congenital syphilis.

1. Primary syphilis: usually causes firm round painless lesion(s) in the area of the body where infection occurred. These lesions will go away in 3-6 weeks even if you are not treated. 
2. Secondary syphilis: symptoms vary from a non-itchy rash, sores, or feeling sick with fever, aches, sore throat, fatigue, etc. These symptoms will also go away within weeks even if you are not treated.
3. Latent syphilis: a phase without any symptoms that can last years.
4. Tertiary syphilis: occurs when symptoms return after the latent phase, sometimes decades after the initial infection. It can affect the heart, blood vessels, brain, or nervous system.  
5. Congenital syphilis: rates have been increasing in the past few years affecting newborns who are born to those with syphilis. Risks include stillbirth, preterm birth, low birth weight, and other health complications if not treated right after delivery.

Who should be tested? Pregnant women, individuals with any of the above symptoms, those with a partner with symptoms, or a known exposure to syphilis.

Treatment? Antibiotics - usually an intramuscular shot, but dosing will vary depending upon the stage of disease.

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Trichomonas

What causes trichomonas? A parasite, trichomonas vaginalis, through contact with an infected partner by oral, vaginal, or anal intercourse.

Symptoms? About 70% of the time there are no symptoms. If symptoms are present it’s often a thin vaginal discharge, vaginal itching/odor, or pain with urination. If left untreated the symptoms will usually persist.

Who should be tested? Individuals with any of the above symptoms, those with a partner with symptoms, or a known exposure to trichomonas.

Treatment? Antibiotics - oral pills

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Human Papillomavirus (HPV)

What causes HPV? HPV is most commonly transmitted from one person to another through vaginal, anal, or oral sex. 

Symptoms? HPV is often asymptomatic, making it very easy for someone to pass it on to someone else without knowing. 

Who should be tested? Therefore, it is important to make sure you are getting screened when appropriate and medically recommended. All women and people with a cervix should be screening regularly per medical guidelines for cervical cancer screening.

Treatment? HPV usually clears on its own within two years, however a persistent infection with a high-risk type of HPV can cause cancer and therefore needs to be monitored through cervical cancer screening. 

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For more information, see our detailed article on HPV.

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Human Immunodeficiency virus (HIV)

What causes HIV? Human immunodeficiency virus, through contact with an infected partner by vaginal or anal intercourse or by sharing needles. Bodily fluids which transmit the virus include blood, semen, rectal fluid, vaginal fluid, and breast milk. The virus can also be transmitted to the unborn child during pregnancy.

Symptoms? 

• Stage 1: includes flu-like symptoms for days to weeks, and are very contagious.
• Stage 2: chronic infection occurs often without symptoms but people are still contagious.
• Stage 3: without treatment, some will progress to having acquired immunodeficiency syndrome (AIDS), people get very sick with a damaged immune system, and are still contagious.

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Who should be tested?   

• All individuals should be tested at least once between the ages of 13-64 years old.  
• Pregnant individuals for each pregnancy.
• You've had anal or vaginal sex with someone who has HIV.
• You've had more than one sex partner since your last HIV test.
• You've shared needles, syringes, or other drug injection equipment (for example, cookers).
• You've been diagnosed with or treated for another sexually transmitted infection, hepatitis, or tuberculosis (TB).

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Treatment? Antiretrovirals - (ART) oral pills will treat those with the virus. Antiretrovirals can also be used to prevent getting HIV (PrEP).

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Herpes Simplex Virus (HSV 1 & HSV 2)

What causes herpes? A virus, HSV 1 or HSV 2, through contact with an infected partner by oral, vaginal, or anal intercourse. The virus is spread by skin-to-skin contact - for example kissing someone with active viral shedding or a blister on the lip could spread the infection. This also includes active lesions on other parts of the body, viral shedding without lesions, infected saliva, or genital discharge. Condoms may not fully protect, as there can still be exposed skin.  

Symptoms? Much of the time there are no symptoms. If symptoms are present it usually starts as one or more blisters which turn into painful sores. Initial outbreaks also often cause fever, aches, and enlarged lymph nodes. Outbreaks can recur at random times or with stress. HSV 1 more often causes oral herpes (cold sores), HSV 2 more often causes genital herpes, though either type can occur in both locations.

Who should be tested? Individuals with the above symptoms.   

Treatment? Antivirals - oral pills to treat each outbreak or daily to suppress future outbreaks and reduce transmission to partners.

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Hepatitis B (HBV)

What causes Hepatitis B? A virus, HBV 1, through contact with an infected partner by oral, vaginal, or anal intercourse.   

Symptoms? Many have no symptoms. Some will have fever, fatigue, dark urine, clay-colored stool, nausea, vomiting, loss of appetite, or yellow skin/eyes.

Who should be tested? Every pregnant person, each pregnancy. Infants born to infected mothers. Every adult should be tested at least once in their life. Those at high risk should be tested regularly. Here are some examples of those at high-risk:

• A history of sexually transmitted infections or multiple sex partners
• A history of past or current HCV infection
• Having human immunodeficiency virus (HIV) infection
• Having current or former household contacts of people with known HBV infection
• Having shared needles with or engaged in sexual contact with people with known HBV infection

Treatment? There is no medical treatment for acute infection, just rest, hydration, and good nutrition. For chronic hepatitis B there is no cure, but antiviral treatment is available to reduce viral counts. Prevention with the HBV vaccine is recommended for infants or anyone not vaccinated up to age 59, and those at high risk over age 60 (see list above).

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What can I do to avoid getting an STI/STD?

Use condoms each time you have sex to reduce the risk of getting infections and get yourself and your partner tested prior to starting a sexual relationship.

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