Steering Clear of STIs
from the online Back-to-School Health Guide for College-Age Women

We know… it's not a topic you're thrilled to talk or think about, but you need to be informed! The reality is most college students are or have been sexually active, and many have had multiple partners. That means sexually transmitted infections (STIs)—those passed from person-to-person through intercourse or other sexual activity, including oral or anal sex—are common on college campuses.

The rates of chlamydia, gonorrhea and human papillomavirus (HPV) are highest among female adolescents. Adolescents and females are biologically more susceptible to STIs, so as a college-age woman, you need to be especially careful.

There are about 19 million new infections each year in this country, and nearly half of these are among those 15 to 24 years of age. Despite awareness efforts, the U.S. has the highest rates of infection among developed countries.

STIs on Campus

The following STIs are common to college campuses:

• Chlamydia
• Gonorrhea
• Herpes
• HPV
• Syphilis
• Hepatitis B
• Hepatitis C
• HIV

STIs can be caused by a virus (Hepatitis B, HPV, herpes) or bacteria (chlamydia, gonorrhea and syphilis).

How to Steer Clear of STIs

The most effective way to avoid getting an STI is abstaining from all sexual activity (i.e. oral, vaginal or anal sex). While some students make this choice, many more are sexually active and, therefore, need to know how best to protect themselves and their partners.

Here are some do's and don'ts for reducing your chances of infection.

Do...

• Only engage in sexual activity with one partner.
• Adopt safe sex habits. For example, always use a latex condom. When used properly and consistently, condoms can protect against unwanted pregnancy and are your best bet for guarding against some STIs, including HIV. Be sure to use condoms and/or dental dams during oral sex, too.
• Only use water-based lubricants.
• Discuss your sexual health and history with your partner and decide whether one or both of you should be tested for STIs before having sex.
• Increase the length of time from ending a relationship to having sex with your new partner. Waiting six months (or more) can provide time for any undiagnosed STI to resolve itself.
• Refrain from sexual activity if you or your partner is being treated for an STI.
• Get regular checkups and talk with your health care professional about best options for contraception and STI screening.s

Remember: Some STIs, including herpes and HPV, can be contracted through skin-to-skin contact alone. That means even if you avoid intercourse or you use a condom, you're still at risk. HPV, which is the leading cause of genital warts and cervical cancer, is most rampant among college students. The good news is there's now a vaccine approved to prevent HPV infection and is recommended by the Centers for Disease Control and Prevention (CDC) and other leading health experts for women your age and younger who are not infected. Immunization is also available to protect against Hepatitis B infection.

Don't …

• Have unprotected sex.
• Have sex if your partner has any signs or symptoms of an STI.
• Let alcohol or drug use cloud your judgment.
• Use spermicides with nonoxynol-9. These can irritate your vagina and cervix, making infection easier.
• Hesitate to talk with a would-be partner about your sexual histories and ways to stay healthy.

How to Steer Clear of STIs

While you should look out for common signs and symptoms of STIs, remember not all STIs have noticeable symptoms. If you think you might have an STI or think you were exposed to one, call your student health service right away to be screened. Don't take a "wait and see" attitude, because some STIs can cause serious health problems including infertility and cervical cancer, among others.

Common symptoms:

• Itching and/or unusual discharge around and from the vagina
• Pain during sex or when urinating; general pelvic cramping
• Blisters, flesh-colored warts or sores on or around your genital area, or chancre sores on tongue or throat
• A scaly rash on the palms of your hands and soles of your feet
• Fever and swollen glands

Broaching the Subject

If you're somewhat uncomfortable talking about sexual health with a would-be partner, join the club! It can be difficult, but remember eight in 10 students at college are sexually active and many have multiple partners and are at risk for STIs. So, it's important to be honest and know where each of you stands. If your partner seems disinterested or annoyed that you want to talk about your sexual histories, you may want to rethink whether this is the right choice for you. Getting Screened

If you've had an STI before, or if you or your partner has had multiple sex partners, you may need to be screened for other STIs. Remember: Be sure to ask your health care professional about STI screenings; don't assume you're getting one automatically during your exam. Your health care professional will perform a physical exam, which may include blood work and/or getting a sample of vaginal fluid. In most parts of the country, STI testing is confidential.

Here are some other questions you might want to ask:

1. What contraception should I be using?
2. What type of spermicide is recommended, and is that enough to prevent STIs?
3. Should I get vaccinated against HPV or Hepatitis B?
4. Are there other campus resources or places to get free condoms?
5. Can you walk me through how to use this contraceptive correctly?

References

U.S. Centers for Disease Control and Prevention (CDC). "Sexually Transmitted Diseases Treatment Guidelines 2002." http://www.cdc.gov/STD.

U.S. Centers for Disease Control and Prevention (CDC). "Health Topics: Sexual Risk Behaviors." Last reviewed June 26, 2006.

U.S. Centers for Disease Control and Prevention (CDC) National Prevention Information Network (NPIN). "STD Prevention Today." http://www.cdcnpin.org/scripts/std/prevent.asp. Last updated 2002.

Rimsza ME. Sexually Transmitted Infections: New Guidelines for an Old Problem on the College Campus. Pediatr Clin North Am. 2005 Feb;52(1)L217-28.

American Academy of Family Physicians. "STIs: Common Symptoms & Tips on Prevention." www.familyhealthcareprofessional.org. Last updated July 2005.

Nevzina NV, Diclemente RJ. Prevalence and incidence of human papillomavirus infection in women in the USA: a systematic review. Int J STD AIDS. 2005 Aug;16(8):528-37.

Advisory Committee on Immunization Practices. HPV Vaccine Questions and Answers. http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine.htm. Last updated June 2006.

© 2006 National Women's Health Resource Center, Inc. (NWHRC) All rights reserved. Reprinted with permission from the NWHRC. 1-877-986-9472 (tollfree). On the Web at: www.healthywomen.org.