Written by Denise Schipani
You might think that not getting tested for sexually transmitted diseases (STDs) is an ignorance-is-bliss situation — especially for a host of infections that, at least initially and often for long periods of time, have no symptoms. [1] What’s the harm? Plenty.
Many of the most common STDs can do serious long-term damage when not identified and treated. [1] And prompt testing can help you and your current and future partners avoid the worst of them, says Kevin Ault, M.D., an obstetrician/gynecologist at the University of Kansas Hospital in Kansas City. [2] “Almost all the diseases caused by STDs will result in less damage if the underlying infection is caught and treated early,” he says.
Detecting any infection requires frequent, regular testing. [3] And according to the most recent data from the Centers for Disease Control and Prevention (CDC), some of the most common sexually transmitted diseases (chlamydia, gonorrhea, and syphilis) are on the rise and are going undiagnosed. [3] This could be due to things like decreased condom use, increases in poverty and drug use, as well as cuts to sexual disease prevention and education programs. [3] The CDC also notes that numbers for other STDs, including human papillomavirus (HPV) and herpes simplex virus, aren’t always reported, [4] which means their statistics don’t adequately capture what may be an epidemic of STDs.
Clearly, not enough people are being tested for STDs—and they should be. [3] “Annual screenings for HIV [human immunodeficiency virus] and other STDs are very important for anyone who is sexually active and under age 25,” says Savita Ginde, M.D., a family planning expert and chief healthcare officer at Stride Community Health Center in Denver, [5] “across the board whether you’re in a monogamous relationship or not.” Fortunately, it’s easier than ever to make sure you get your screenings. You can even get tested for many common STDS right at home, with online results in just a few days.
Here’s what you need to know about potential longer-term effects, as well as testing recommendations for the most common STDs.
Long-Term Risks of Chlamydia and Gonorrhea
While these STDs often don’t have symptoms, if left untreated, they can lead to serious health problems with both short and long-term consequences. This includes pelvic inflammatory disease (PID) in women, [6; 7] which can permanently damage the fallopian tubes, [6; 7; 8] says Dr. Ault. (About 10 to 15 percent of women with chlamydia will develop PID, which can occur from a few days to a few weeks after an infection.)
Men aren’t exempt from the serious long-term consequences of an untreated case of chlamydia or gonorrhea either. In some rare cases, it may cause a particularly painful prostate infection. [8]
When to get tested: The current CDC recommendation is that all sexually active women under age 25 get tested annually for chlamydia and gonorrhea. The same goes for women older than 25, if they have had sexual contact with multiple partners or a partner who has an STD. There are no similar routine screening recommendations for men, but they should discuss their risk factors with their healthcare provider to see if they should be tested. This is especially crucial for men who know they’ve been exposed by a partner. [6; 7; 9]
Test for chlamydia and gonorrhea at home now.
Long-Term Risks of Syphilis
An untreated syphilis infection is highly dangerous for women even in the short-term, especially those of childbearing age. If a woman becomes pregnant or attempts to conceive while infected with syphilis, or contracts the STI while pregnant, she risks passing the virus to her child. There is also a significant risk of birth defects or stillbirth. Women often don’t know they have it when infected. [10]
For men, “there’s generally a penile lesion, so they know they have it,” says Dr. Ault. However, many men either don’t get symptoms or don’t recognize them. If left untreated for many years, syphilis can, in rare cases, lead to blindness, organ damage, dementia, and other serious issues in both men and women. [10] Just as concerning, the infection, along with its complications, can spread to unsuspecting partners.
“If you have a syphilis lesion, you are more apt to give or get HIV,” says Dr. Ault. The good news is that syphilis is highly responsive to antibiotics. [10]
What is concerning, however, is that the rates of syphilis, including untreated syphilis, have been increasing for women and men), according to 2018 statistics from the CDC, the latest information available. [3] There’s also been a distressing increase in babies born with the disease (congenital syphilis), which can cause problems such as blindness, deafness, facial deformities, and nervous system problems. [3; 10; 11]
When to get tested: The U.S. Preventive Services Task Force recommends testing for all pregnant women [12] and anyone who is at an increased risk of HIV, which includes men who have sex with men as well as men and women who are living with HIV. [13]
Long-Term Risks of Human Immunodeficiency Virus (HIV)
HIV has now become a chronic, rather than fatal, infection, thanks to highly effective treatment. [14]
“Many people who have HIV can be asymptomatic for a few years, so finding it early means you can reduce the spread of infection,” explains Dr. Ault. The obvious potential long-term consequence of untreated HIV, aside from spreading it further, is AIDS (acquired immune deficiency syndrome), a late stage of HIV infection during which the body’s immune system is so badly damaged that you’re prone to opportunistic and often fatal infections. [14]
When to get tested: If you’re undergoing prenatal care, there’s a good chance you’ll be tested for HIV. Any man who has sex with other men should get tested yearly, [15] and anyone with multiple or anonymous partners should be screened at least every three months, says Dr. Ginde.
Long-Term Risks of Human Papillomavirus (HPV)
Unvaccinated sexually active people are likely to get a HPV infection at some point in life, Dr. Ginde says, adding that while the majority of HPV infections resolve on their own, others linger and can eventually cause several types of cancer — chiefly cervical cancer (though it can also cause vaginal, vulval, penile, or anal cancer, or cancers of the head/neck). [16] There are both high and low risk HPV types. In fact, two specific types of HPV infection are responsible for more than 70 percent of all cervical cancers. [17] Oral HPV, spread via oral sex, is also implicated in oropharyngeal cancers (such as throat cancer). [18]
Nearly 80 million Americans are currently infected with some type of HPV, making it a fairly common STD. But it can be prevented with a vaccine — one that’s usually administered to boys and girls before they’re sexually active. [16; 19]
When to get tested: Currently only women are routinely tested for HPV, at annual gynecological exams (because the chief consequence is cervical cancer, and routine HPV screening can effectively reduce a woman’s chance of developing it). [20] Although more frequent and widespread HPV testing could uncover potential cervical cancer cases at much earlier and more treatable stages, it could also uncover strains of HPV that will go away on their own. This might lead to unnecessary distress and cost, says Dr. Ault. Your healthcare provider can advise on the most suitable screening tests for you. While there is no recommended screening for men, [20] talk to your doctor if you’re concerned.
Long-Term Risks of Herpes
Though herpes itself (either herpes simplex 1, HSV-1; or herpes simplex 2, HSV-2) [20] isn’t life-threatening, it can cause recurrent and painful sores in the mouth or genitals that can worsen over time. Both HSV-1 and HSV-2 can cause either oral or genital herpes (where the sores show up gives it its name). However, HSV-1 tends to cause more oral types of infections, while HSV-2 causes more genital types. [21]
A recent report by the World Health Organization found that people with the HSV-2 infection are more prone to HIV if they are exposed to the virus (likely because a herpes infection leads to inflammation and small breaks in genital and anal skin, leaving you prone to infection). [22]
Roughly 90 percent of people with genital herpes have no symptoms, says Dr. Ault. “For some people medication to help manage flares or to make it less likely that you’ll spread it may be prescribed.”
When to get tested: There’s no current recommendation for widespread screening for herpes. [21] That said, anyone who shows symptoms, in the form of blisters around genitals, anus or mouth should visit their healthcare provider.[21] You may also want to ask your doctor or a family planning clinic for a test if you’ve recently had (or have) a new partner, if you are pregnant — or if you are just concerned. [21]
It’s important to know that some blood tests for herpes cannot tell if you were exposed to the herpes infection in the past or if you have a current infection now. If you suspect that you have an active herpes infection, a swab by a healthcare provider may be required.
References
-
National Institutes of Health
National Institute of Allergy and Infectious Disease
Sexually Transmitted Diseases (STDs) Diagnosis
https://www.niaid.nih.gov/diseases-conditions/std-diagnosis -
University of Kansas Medical Center
Kevin A. Ault, M.D., FACOG
http://www.kumc.edu/school-of-medicine/ob-gyn/faculty/kevin-ault-md-facog.html -
Centers for Disease Control and Prevention
Reported STDs in the United States, 2018
https://www.cdc.gov/nchhstp/newsroom/docs/factsheets/STD-Trends-508.pdf -
Centers for Disease Control and Prevention
Sexually Transmitted Disease Surveillance 2018
Other STDs
https://www.cdc.gov/std/stats18/other.htm -
Stride Community Health Center
Directory
Savita Ginde MD, MPH
https://stridechc.org/directory/pg/2/ -
Centers for Disease Control and Prevention
Chlamydia - CDC Fact Sheet (Detailed)
https://www.cdc.gov/std/chlamydia/stdfact-chlamydia-detailed.htm -
Centers for Disease Control and Prevention
Gonorrhea- CDC Fact Sheet (Detailed)
https://www.cdc.gov/std/gonorrhea/stdfact-gonorrhea-detailed.htm -
Centers for Disease Control and Prevention
Pelvic Inflammatory Disease (PID) - CDC Fact Sheet
https://www.cdc.gov/std/pid/stdfact-pid-detailed.htm -
Centers for Disease Control and Prevention
Which STD Tests Should I Get?
https://www.cdc.gov/std/prevention/screeningreccs.htm -
Centers for Disease Control and Prevention
Syphilis- CDC Fact Sheet (Detailed)
https://www.cdc.gov/std/syphilis/stdfact-syphilis-detailed.htm -
U.S. National Library of Medicine
Medline Plus
Congenital Syphilis
https://medlineplus.gov/ency/article/001344.htm -
U.S. Preventative Services Task Force
Syphilis Infection in Pregnant Women: Screening
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-in-pregnancy-screening -
U.S. Preventative Services Task Force
Syphilis Infection in Nonpregnant Adults and Adolescents: Screening
https://www.uspreventiveservicestaskforce.org/uspstf/recommendation/syphilis-infection-in-nonpregnant-adults-and-adolescents -
Centers for Disease Control and Prevention
About HIV
https://www.cdc.gov/hiv/basics/whatishiv.html -
Centers for Disease Control and Prevention
Getting Tested HIV
https://www.cdc.gov/hiv/basics/hiv-testing/getting-tested.html -
Centers for Disease Control and Prevention
About HPV
https://www.cdc.gov/hpv/parents/about-hpv.html -
World Health Organization
Human papillomavirus (HPV) and cervical cancer
https://www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical-cancer -
Centers for Disease Control and Prevention
HPV and Oropharyngeal Cancer
https://www.cdc.gov/cancer/hpv/basic_info/hpv_oropharyngeal.htm#:~:text=HPV can infect the mouth,cancers in the United States. -
National Institutes of Health
National Cancer Institute
Human Papillomavirus (HPV) Vaccines
https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-vaccine-fact-sheet -
American Cancer Society
HPV and HPV Testing
https://www.cancer.org/cancer/cancer-causes/infectious-agents/hpv/hpv-and-hpv-testing.html -
Centers for Disease Control and Prevention
Genital Herpes - CDC Fact Sheet (Detailed)
https://www.cdc.gov/std/herpes/stdfact-herpes-detailed.htm -
World Health Organization
Massive proportion of world’s population are living with herpes infection
https://www.who.int/news/item/01-05-2020-massive-proportion-world-population-living-with-herpes-infection
