The Std Chat

By Vicky Katz Whitaker

October 30, 2009 5 min read

Having a sexually transmitted infection can make a dent in a relationship, but it doesn't have to wreck it.

That may be one of the few bright spots for each of the millions of people in the United States, Canada and elsewhere who suffers from one of more than a dozen common infections acquired through sexual contact, including chlamydia, gonorrhea and genital herpes.

Health experts predict that 19 million people in the U.S. will be infected this year -- 50 percent of them 25 or younger. Sexually transmitted infections, or STIs, are also on the rise in Canada, particularly among young people.

But statistics tell only part of the story. Not all types of STIs diagnosed by doctors or laboratories are legally required to be reported to state or federal agencies.

At least 45 million people have non-reportable conditions, such as herpes and HPV (the name of a group of more than 100 strains of human papillomaviruses, more than 30 of which are transmitted sexually and can cause genital warts and cervical cancer). Some health professionals believe that the number of people infected with herpes or HPV is significantly higher.

Infections acquired through sexual contact used to be described as "venereal disease," or "VD," and later "sexually transmitted diseases," or STDs. "STD" and "STI" still are used interchangeably, but STD is transitioning to STI because "it is more accurate and descriptive of the real problem," says Fred Wyand, spokesman for the American Social Health Association and editor of its HPV News. "Today when people talk about a disease, they mean a condition that has signs and symptoms and is associated with being sick or ill. We now know that many sexually transmitted conditions can be asymptomatic or silent for a lengthy period of time. Even though they do not cause any signs or symptoms, they can be causing silent problems and can be transmitted to other sexual partners."

Revising the terminology from STD to STI "clearly states that the process of infections may or may not be associated with signs or symptoms and can be transmitted to other people," Wyand points out.

"The only sure way to avoid getting an STI is to be abstinent, period," declares Terri Warren, an internationally recognized author and speaker on STIs and the online adviser for the WebMD herpes message board. Warren, a registered nurse and adult nurse practitioner, owns the Westover Heights Clinic, in Portland, Ore., a private clinic specializing in the diagnosis and treatment of STIs. An expert on herpes simplex, she has written several books on the subject, including "The Good News About the Bad News: Herpes: Everything You Need to Know," "The Updated Herpes Handbook" and "Tender Talk: A Practical Guide to Intimate Conversations," all available on Amazon.com.

Warren recommends discussing STIs early in the dating game, "certainly before having sex!" One way to broach the topic, she says, is to say, "It looks as if our relationship is going to become sexual, and before it happens, I'd like to talk about any concerns that either of us has about STDs, and I also would like us both to get tested to see where we stand."

Another health professional, certified disease intervention specialist and community health educator Jessica McNaboe -- who, as "Aunt Jessie," moderates the chlamydia, STD and herpes forums at http://www.MedHelp.org -- says the biggest mistake someone with an STD can make is not discussing it with partners. "They may feel ashamed or embarrassed or worry about rejection, but not discussing this can lead to long-term consequences for partners with untreated STDs. While many people won't reject someone because of an STD, they certainly won't be happy to discover a partner has lied or not told them."

McNaboe -- who also serves as an administrator of The Original Herpes Home Page, the oldest and most accessed Web site on the subject -- suggests that you be neutral, factual and calm when you bring the topic up. Also, she says, you should have the talk face to face -- or at least on "a phone call, e-mail or instant message. This shouldn't be texted." And keep in mind, she adds, that "this is not about morals, sexual preferences and the like. This is about health."

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