How can you prevent STIs?

Over 60% of Canadians report never having STI testing, which means there are a lot of people walking around who may not know their status. Even if you’re in a monogamous relationship and don’t have a number of sexual partners, it’s a good idea to speak to your partner about whether they’ve been tested for STIs before. Here’s everything you need to know about STIs, from how to mitigate your risk to how to speak to your teen about them.

What are STIs, and what causes them?

An STI (sexually transmitted infection) or STD (sexually transmitted disease) is an infection that spreads through sexual contact. You likely know that this includes oral, anal, and vaginal intercourse. You may not know that STIs also spread through contact with the mucous membranes of an infected person. This means that you can get an STI without having sex. Actions like mutual masturbation and sharing certain items — like sex toys — can be a source of transmission.

STIs are on the rise in Canada. Gonorrhea rates almost tripled between 2010 and 2019 and cases of chlamydia grew over 30% in the same period. While those under 30 account for the largest number of cases, rates of STI transmission went up in every age group.

There are dozens of different STIs, but the most common STIs in Canada are:

Who should get tested for an STI?

Three-quarters of chlamydia cases and more than half of all gonorrhea infections are in individuals between the ages of 15 to 29. This makes annual STI testing especially important for anyone in this age range. But, STI screening isn’t limited to this group.

Gay, bisexual, and other men who have sexual intercourse with men (MSM) should also arrange for annual STI screenings. There are higher rates of HIV among MSM. And these individuals may be more likely not to use condoms regularly and engage in anal sex, which has a higher risk of STI transmission.

Additionally, sex workers and anyone with multiple sexual partners should participate in regular STI screening due to their increased risk of exposure.

Being in a so-called “high-risk” group isn’t the only reason for testing, however. Prenatal care involves STI screening as these infections can be dangerous during pregnancy. Syphilis, for example, can be transmitted from a mother to her baby in utero, potentially resulting in miscarriage or stillbirth. This means the sooner it or other STIs are treated during pregnancy, the better the prognosis.

Beyond these groups, the truth is that everyone who is sexually active should have an STI test at some point in their life. Many STIs can be asymptomatic — women with gonorrhea, for example, often have mild, non-specific, or no symptoms. Other infections — like genital warts — can crop up months or even years after exposure. And HIV can take weeks before it shows up on a test.

Now might be the time if you haven’t been tested for STIs recently (or ever). Talk to your healthcare provider about your options. And, if you notice any signs or symptoms of an STI, stop having sex and get tested immediately.

How frequently should a person take an STI test?

If you’re in the 15 to 29 age group, gay, bisexual, or part of the MSM community, you should arrange for annual STI testing. If you change sexual partners frequently or engage in sex work, speak to your healthcare provider about how often to test. They may suggest testing more frequently — like every few months or on a monthly basis.

Even if you don’t fit into any of these categories, it’s worth testing when you change partners or if you or your partner has sex with someone else. Furthermore, you should arrange a follow-up test within six months if you test positive for an STI.

Which STI tests should I get?

STI testing usually has two parts. The first is a swab of the affected area, and the second is a blood test.

Blood tests can turn up HIV and asymptomatic herpes and syphilis, while swab tests can identify infections like gonorrhea and chlamydia. A swab is also administered for sores resulting from syphilis or herpes.

Some other infections require a physical exam. Your healthcare provider will diagnose genital warts, for instance, with a visual examination.

HPV, however, is tougher to look for in men. Unless it causes genital warts or precancerous lesions, there’s no way of testing for it. On the other hand, women can send a culture of their cervical cells for testing to determine if they have it. This can be done as part of a pelvic exam at your doctor’s office, although at-home testing kits are also available for purchase in some provinces.

As for how long it takes to get STI results, this depends on where you get tested. But, swabs and urine tests typically come back within a week, and blood work may take as long as two weeks. You should also avoid having sex until you get your results. Even then, you should speak with your doctor about when it’s safe to resume having sex.

How can I protect myself from STIs?

Since abstinence isn’t a realistic option for most people, practicing safer sex is the best way of protecting yourself from STIs.

Birth control methods like an IUD, diaphragm, or the pill are excellent ways of preventing pregnancy. But, none of them protect you from STIs.

Fortunately, condoms do. Whether latex, lambskin, or glow-in-the-dark, condoms are your best bet for reducing your chances of contracting an STI during sex. Dental dams are another good option for oral sex.

Condoms aren’t perfect though. They only cover a small part of the genitals, so they can’t protect you from STIs that transmit via skin-to-skin contact, like genital herpes or warts.

Worse, they sometimes break or fall off. If you or your partner is experiencing signs or symptoms of an STI, don’t rely on a condom for protection. Instead, abstain from sex and get tested immediately.

When it comes to STIs like HPV and Hepatitis B, another layer of protection is available — vaccines. Both the HPV vaccine and the Hepatitis B vaccine are offered for free to middle school students in most parts of the country. And, since the HPV vaccine protects against cervical and anal cancers, it’s definitely worth getting.

If you’ve missed your dose of either though, it’s not too late. Reach out to your healthcare provider to discuss your options.

How do I know if I have an STI?

It’s not always possible to know if you have an STI. If you do experience symptoms of an STI, however, they’ll most likely include:

Unusual vaginal, penile, or anal discharge
Pain or burning during urination
Sores, lesions, or growths around your genital or anal area
Itching in your genital or anal area
Pain and swelling in the testicles
Vaginal bleeding after sex or between periods

How do I talk to my teenager about STIs?

The idea of talking to your teenager about sex and STIs can feel uncomfortable. But, it doesn’t have to be. And, the more information you share, the more you empower your teen to make good choices. Take a deep breath and keep the following tips in mind:

Think about what you want to say beforehand and use the proper names of body parts instead of euphemisms. The more straightforward you are, the less awkward it’ll be.
Keep your conversation respectful and judgment-free. Let your teen know that you’re talking to them about this because you want to keep them safe.
Don’t expect your teen to abstain from sex until they’re married or in a committed relationship. Saying something along the lines of, “If you’re having sex, you’re always welcome to talk to me about it. But, either way, I want to make sure that you’re being safe.”
Address the need for wearing a condom in a sexual relationship and for undergoing regular STI screening. Tell them that STIs like gonorrhea and chlamydia are very common in their age group and that not everyone has obvious symptoms.
If an opportunity to have a conversation about STIs presents itself, try not to shy away from it. Once they turn nine, your child becomes eligible for their HPV vaccination. This is a great time to start the conversation on STIs in an age-appropriate way.
Above all, remember that this isn’t a one-shot deal. You’ll speak to your teen about sex and STIs multiple times. If you feel like your first talk goes poorly, know that you’ll have another chance — and another, and another.

How do you avoid spreading an STI?

If you’ve just been diagnosed with an STI it can feel pretty overwhelming. Thankfully, STIs are treatable with the right interventions.

But until you’ve fully recovered, you must avoid spreading the infection to others. Since STIs like chlamydia and gonorrhea are curable with antibiotics, refrain from having sex until you’ve finished your full course of antibiotics and are completely symptom-free. And, for STIs with high recurrence rates — like chlamydia — you’ll want to schedule follow-up testing.

Other STIs like genital warts and herpes are treatable, but the underlying virus causing them stays in your system. This means that you must wait until you have no visible signs of an outbreak before you resume having sex. When you do start having sex again, you should use a condom to avoid asymptomatic transfer to your partner.

For infections like HIV, speak to your doctor about when and under what circumstances you can safely continue having sex. HIV is highly transmissible, and your partner should be taking PrEP before you resume having sex.

Where can you be tested for STIs?

STI testing is available at a number of different locations. While your doctor’s office is a great option, it isn’t your only one. Sexual health clinics across the country provide free and anonymous testing. Most of them offer walk-in services, although you should call ahead to double-check.

Can you get STI medications over the counter (OTC)?

Almost all medications for STIs require a doctor’s prescription for antibiotics or antivirals. You can, however, get docosanol cream OTC to treat oral herpes caused by HSV-1. Keep in mind though that this won’t prevent future breakouts, nor does it stop you from passing along the infection. Docosanol cream can simply help the duration of your outbreak.

When to see a doctor for your sexual health

Unusual discharge, itching, pain, and sores in your genital area are all good reasons to speak to a doctor right away. STIs can lead to complications including infertility, and in some cases may even be life-threatening. Ignoring your symptoms won’t make them go away, and can actually give the condition time to worsen.

Discussing your sexual health can feel embarrassing, but it doesn’t have to be. With Maple, you can message with a doctor for comfort and privacy during your conversation. And, if necessary, they can provide a prescription to treat your condition.

Most STIs are highly treatable; the sooner you get a diagnosis, the sooner you can start addressing the issue. If you’re concerned that something isn’t right, make seeing a doctor your next step. When it comes to sexual health, waiting doesn’t pay.

This blog was developed by our team and reviewed by a medical professional.