What do you plan to give your valentine this February 14^th – a bouquet of flowers, a heart-shaped box of chocolates, a candlelit dinner? If celebration plans include any type of sexual activities, then perhaps it is worth considering how to avoid giving or receiving one of the most-unwanted gifts: a sexually transmitted disease (STD).

The reality is that several STDs have reached epidemic proportions here in the U.S. and have become pandemics throughout the rest of the world. Therefore, a day that celebrates love, romance, and sexuality is a good reason to focus on sexual health. While researchers have discovered a lot of useful information about STDs, many people continue to come up with reasons to avoid learning the truth about these socially taboo infections. So, whether or not sex is part of your plans for this Valentine’s Day, consider these myths and facts about STDs:

1. Virgins do not have to worry about STDs. The validity of this argument depends solely upon one’s definition of virginity. Many define virginity as not having had penile-vaginal intercourse, but this definition does not necessarily include abstinence from the full range of behaviors that can transmit STDs: e.g., oral sex, anal sex, and non-penetrative skin-to-skin contact. Recent studies of college students reveal that 24% considered anal intercourse to be an “abstinent behavior”, and less than 50% consider oral sex to be “sex.” Unfortunately, half of American adults have oral herpes infections (which can also be transmitted during kissing and oral sex), and unprotected oral sex can also transmit the STD known as HPV (human papillomavirus) which increases the risk of oral cancer.

2. Only certain types of people have STDs. STDs are ‘equal opportunity’ pathogens, infecting a wide range of people: from ‘technical virgins’ to those who have had many sexual partners. While researchers have found that STD-infected women face more stigma than infected men, new analysis from the CDC shows that the yearly number of new infections is equal among young men and young women (ages 15-24) who make up half of all new STDs in the U.S. However, researchers have documented the consistency and strength of the stigmatizing STD stereotype: people often link infection status with promiscuity and other undesirable traits (e.g., irresponsibility, unintelligence, immorality, and uncleanliness). Belief in this myth leads many to assume that ‘screening’ their partners for these traits will automatically eliminate STD risk. Lynn Barclay, President and CEO of the American Social Health Association recently warned against anyone thinking that, “STDs happen to ‘other’ people,” and the CDC estimates that, “there are about 20 million new infections in the United States each year.”

3. People know if they are infected. One might have no idea of her/his infection-status because many STDs are asymptomatic. High-school health classes typically feature slideshow photos of the worst-case infections, leaving many thinking that the absence of an oozing sore or a cauliflower-shaped growth of warts means the absence of any infection. According to the CDC, each year in the U.S., an estimated 820,000 people contract Gonorrhea and 2.86 million contract Chlamydia infections. These infections are usually asymptomatic and, if left untreated, may have serious consequences for women: pelvic inflammatory disease (PID), chronic pelvic pain, ectopic pregnancy, and, ultimately, infertility.

4. Regular annual medical exams and HIV testing eliminates the need to worry about STDs. Do not assume that you are being tested for all STDs when you go in for your exam. A survey of US physicians found that less than one-third conducted routine STD screenings of their patients. In addition, many people treat a negative HIV test result like a clean bill of sexual health: approximately 50% of U.S. adults (18-44 years old) have only been tested for HIV and not for any other STD. When one does go in for testing, it is important to understand the limitations: there are no definitive tests for either human papillomavirus (HPV) or herpes simplex virus (HSV) in the absence of noticeable symptoms. Even the most accurate HSV blood test is not able to distinguish between a genital or oral herpes infection, testing with HSV via viral cultures has a high rate of false negatives, and a pap smear can only detect some cervical HPV infections. An in-depth visual inspection for genital warts, involving the application of acetic acid and use of a magnifying colposcope, is a practitioner’s best way to detect smaller warts or lesions but may still produce false negatives. In other words, there is no way to be 100% sure of one’s genital HSV or HPV infection status.

5. Correct and consistent use of use condoms eliminates the need to worry about STDs. HIV/AIDS public health campaigns and educational programs have succeeded in promoting the use of latex (male) condoms as the ‘safer sex’ norm. However, two medically incurable STDs, HPV and HSV, are transmitted by skin-to-skin contact, which can occur even when latex condoms are used correctly. So, how prevalent are these viruses? Estimates are that about 75% of adult Americans have genital HPV infections. The good news is that HPV vaccines are effective and recommended for boys/men and girls/women. For HSV, about 20% have genital herpes infections: the ASHA predicts that will increase by 2025 to 40-50% of all men and women being infected with genital herpes.
   

6. Having the ‘STD talk’ is unromantic. Contracting a STD, especially a medically incurable one, is far less romantic than even the most uncomfortable conversation about sexual health. Communicating honestly with one’s partner about past sexual experiences and sexual health issues is the foundation of a healthy sexual relationship. The ‘STD talk’ is ultimately about sharing existing medical information, determining what additional testing is needed, and talking through the health risks of different sexual behaviors.

Setting the stage for a romantic Valentine’s Day requires more than flowers or chocolates – a sexually healthy celebration of love requires education, testing, and communication. Perhaps the best gifts for this February 14^th are the gifts of knowledge, getting as thoroughly tested as possible for all STDs, and true intimacy – sharing test results and talking through the ways to incorporate healthy behaviors into one’s sex life.

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Other resources:

On definitions of virginity –

Bersamin, M. et al. (2007). Defining Virginity and Abstinence: Adolescents’ Interpretations of Sexual Behaviors. Journal of Adolescent Health, 41(2): 182-188.

On STD stereotypes and stigma –

Nack, A (2002). Bad Girls and Fallen Women: Chronic STD Diagnoses as Gateways to Tribal Stigma. Symbolic Interaction, 25 (4): 463-485.

http://www.ashastd.org/news/news_pressreleases_CDCsurveillancereport.cfm.

On U.S. STD rates of infection –

http://www.cdc.gov/std/stats/STI-Estimates-Fact-Sheet-Feb-2013.pdf

On U.S. STD and HIV testing methods and rates –

http://www.ashasexualhealth.org/stdsstis/statistics/ http://www.ashasexualhealth.org/stdsstis/get-tested/

St Lawrence JS et al. (2002). STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians. American Journal of Public Health, 92: 1784-1788.

Facts about HSV and HPV –

http://www.ashasexualhealth.org/stdsstis/herpes/fast-facts-and-faqs/

http://www.ashasexualhealth.org/stdsstis/herpes/herpes-testing/

http://www.ashasexualhealth.org/stdsstis/hpv/fast-facts/

http://www.ashasexualhealth.org/stdsstis/hpv/genital-warts/

This fact sheet was updated January 2015.

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