Sexually Transmitted Infections Beyond HIV: Knowledge is Power

Although HIV is a primary health concern for men who have sex with men, as most sexually active people know, it is only one of many sexually transmitted infections (STIs) that can affect personal choices around sexual behavior. The American Social Health Association, a non-profit dedicated to improving health with a strong focus on sexual health and STI prevention, states that there are over 19 million new cases of STIs every year in the United States. Most sexually active people will contract an STI at least once in their lifetime. Whatever your sexual and gender identity may be, if you are sexually active it pays to be accurately informed about STIs so you can stay healthy and still have fun.

STIs are opportunistic infections that can cause symptoms from the uncomfortable to the life threatening. While some of these infections are easily treated and resolved, others do not have a cure and can have a long-lasting, serious impact on your health. The four most common STIs are trichomoniasis, human papilloma virus (HPV), Chlamydia and herpes simplex virus (HSV). After that come gonorrhea, hepatitis B virus, HIV, and syphilis. These infections can be caused by bacteria, fungus, protozoa or parasites or they may be viral in nature. They can be transmitted through a wide range of sexual activities, and can threaten gay men, bisexual, transgender and lesbians alike.

The risk of catching a particular STI depends on many factors beyond sexual behavior such as gender, age, race and where you live. Data from the Centers for Disease Control and Prevention (CDC) from 2010 highlights how these factors shift the risk for a particular disease. For example, women have a much higher chance of being infected by Chlamydia, whereas men have a higher risk of syphilis infection.

Young people under the age of 24 have four times the risk of catching Chlamydia and gonorrhea, and people between the ages of 20-44 have twice the risk of becoming infected with syphilis. When comparing African American and white populations, African Americans had much higher rates of Chlamydia, gonorrhea and syphilis across the board -- most strikingly, up to 20 times the rate of gonorrhea infection.

Lesbians Are Also At Risk for STIs

This isn't the only place that inequality in healthcare information and services can be seen to affect sexual health. Within the LGBT community, women who have sex with women (WSW) face their own challenges in being informed and staying healthy. Lesbian, bisexual and queer women can find it difficult to get accurate information about STIs that pass between women. Finding healthcare to prevent or treat these infections without facing active prejudice from healthcare providers can also be difficult.

While activists have worked diligently to improve the healthcare environment for WSW, the challenges still exist. A lot of it depends on the healthcare provider, who may have personal prejudices that come into play. Many providers are simply ignorant about the healthcare needs of this population. Because it's such a sensitive topic, sexual orientation may not even come up during an intake session.

Seeing uneducated or hostile providers can cause lesbian, bisexual and queer women to avoid routine exams or to delay going to the doctor when sick. It's exhausting to have to continually fight prejudice or to have to educate a provider about your own healthcare needs. All of these factors can affect how much a sexually active WSW knows about STI prevention and treatment.

Contrary to popular belief, sex between women is not risk-free. Women can transmit STIs to each other in many different ways while being intimate. Skin to skin contact, oral sex, sharing sex toys and contact with vaginal fluids and menstrual blood all have their own risks. Knowing and understanding these risks is important. Having a knowledgeable and supportive healthcare provider is key for good health and informed sexual practices between WSW.

Based on current medical information, all women, regardless of sexual orientation or practices, should be screened for common STIs and cervical cancer. Seeing a provider who believes that WSW are at lower risk for common STIs such as Chlamydia and syphilis can endanger that woman's health.

Some STIs Can Raise Your Risk for HIV

Whether you're having sex with men, women, or transgender people, another healthcare consideration is the fact that some of these STIs can make it easier to become infected with HIV or to pass it to your partner if you are already positive. The CDC explains that people who have an STI are up to five times more likely to become infected with HIV if they are exposed to the virus.

If the STI creates sores in the genital area, it can be easier for the virus to enter and infect the body. Even without these sores, inflammation caused by the STI can increase the number of certain types of cells that are targets for HIV infection, thereby increasing the risk of contracting the virus. When a person is HIV positive, having an STI can cause increased viral presence in the genitals and the semen.

For example, if a man has HIV and gonorrhea, his semen can have a significantly higher concentration of HIV -- up to ten times greater than an HIV-positive man without gonorrhea. These factors make it likelier that an HIV-positive man will transmit the virus to a sex partner. Because of these risk factors, it's essential that people get tested and treated for STI infection, regardless of HIV status.

Having an informed partner who is willing to communicate openly about sexually transmitted infections can help any sexual experience stay fun and healthy. While learning about STIs can feel less than sexy, take the step to stay informed and learn how to talk about it with potential partners. The more you know and the more you put this into practice, the easier it will get. Knowledge is power and can keep you from making poor choices out of fear or ignorance. Get out there, get educated, have fun, and stay healthy!

Here are some online resources to help you get started:

For queer, lesbian and bisexual women:

http://womenshealth.gov/publications/our-publications/fact-sheet/lesbian-bisexual-health.cfm

For everyone:

http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex-101.htm

http://www.cdc.gov/std/

http://www.ashastd.org/std-sti/reduce-your-risk.html

http://www.pridelines.org/resources/hivsti-resources-info/stdsti-education