Safe sex: How to protect yourself from STIs

by Dr. Anne Högemann, MD, Former Medical Doctor at Clue
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Every day, more than one million sexually transmitted infections (STIs) are acquired worldwide. But what do you know about STIs? Did you know the majority of STIs have no, or only mild, symptoms and may not be recognized? Or that some infections like genital herpes (herpes simplex virus type 2) and syphilis increase the risk of getting infected with other STIs like human immunodeficiency virus (HIV) (1)? Knowing some STI basics may change the way you take precautions around sex and symptoms in your own life.

First of all—what are we talking about?

STIs are a versatile group of infections that includes more than 30 different bacteria, viruses and parasites. Eight infections are by far more common than others, and four of these eight are currently curable. STIs are mostly spread through sexual contact (including all different forms of sex), but can also be transmitted non-sexually, for example through blood (transfusions, unclean needles, etc.), and during birth and pregnancy via the placenta. Curable STIs include syphilis, gonorrhoea, chlamydia and trichomoniasis which can all be treated with different antibiotics. The incurable four are HIV, hepatitis B, human papillomavirus (HPV) and herpes. What differentiates these from the curable infections is that the incurable infections are all viral. Although there is currently no therapy to eliminate these viral pathogen from the body, there are certain strategies to reduce or modify the symptoms (1).

How does someone know they have a STI?

The symptoms and progression of STIs differ a lot. Most important to know is that all of them can cause serious harm when they remain untreated. Gonorrhea and chlamydia, for example, are major causes of infertility (1). Certain STIs can also lead to a higher risk of extrauterine pregnancy and miscarriage, and can cause damage to various organs. In some cases, such as with acquired immune deficiency syndrome (AIDS), they can be life threatening. The difficulty is that someone can be infected with an STI for a long time, without experiencing any symptoms. That means a lot of people spread diseases unknowingly. And trusting an untested partner to tell you if they have a STI also means trusting all their untested ex-partners and all the untested ex-partners of your ex-partner and so on…

What can I do to protect myself?

  • Currently, barrier methods are the best option to protect yourself, and they don’t decrease the risk completely (1).
  • Condoms (internal and external) are the most broadly studied method, but dental dams and gloves should also be considered when you touch a partner’s genitals or share sex toys, although there is not much research done around them.
  • It’s important to use barrier methods with untested or new sexual partners. - Getting regular STI tests after new sexual partners is also important to minimize the risk of leaving any infection untreated.
  • If you are avoiding pregnancy, it’s advised to use a contraceptive method in addition to a barrier method, as the typical-use failure rate of barrier methods tends to be high.
  • Consider the influence of sexual arousal on your risk-taking behavior. Several studies have shown people can be pretty sure they won’t have sex without a barrier method, but then change their mind in the moment (2,3). It can be helpful to have barrier methods close at hand and a strong understanding of how to use them (it takes legitimate practice). Minimize the opportunities for reconsideration in the heat of the moment.

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