The Pitt Prescription: Staying safe while getting steamy

The Pitt Prescription is a bi-weekly blog where student pharmacist and Senior Staff Writer Elizabeth Donnelly provides tips on how to stay healthy in college. This edition was reviewed by Karen S. Pater, PharmD, CDCES, BCACP.

Each year, there are almost 20 million new diagnoses of sexually transmitted infections, and the CDC reports that half of them are among adolescents and young adults aged 15 to 24 years. Compared to older adults, 15- to 24-year-olds have a higher risk of obtaining a STI due to behavioral, biological and cultural reasons.

This high prevalence of STIs — sometimes referred to as sexually transmitted diseases, or STDs — may also be a result of obstacles present in the lives of adolescents and young adults. These include the lack of access to STI prevention or management services, inability to pay, lack of transportation, conflict between clinic and school/work times and embarrassment resulting from the stigmatization of sexual health.

While there are a multitude of infections that can be transmitted through sexual contact, there are three common nationally notifiable STIs in the United States — chlamydia, gonorrhea and syphilis. Nationally notifiable diseases are conditions in which frequent and timely information about individual cases is necessary to help prevent and control the disease.

Sexually transmitted infections: How common are they?

According to the CDC, in 2018, a total of almost 1.8 million cases of chlamydia were reported, marking the condition as the most common notifiable condition in the United States, beating more than 100 others on the nationally notifiable list. Gonorrhea came in second place with almost 600,000 cases and syphilis fell much lower with about 115,000 cases reported in 2018.

In recent years, STI rates have been steadily rising, with a 2.9% increase in chlamydia, a 5.0% increase in gonorrhea and a 14.9% increase in syphilis from 2017-18 among all genders, races and regions in the United States. Not only has the national rate been rising, but Pitt has seen similar trends within its own student population.

Although rates are increasing among all demographics, the reality is that adolescents and young adults account for half of these diagnoses. The primary demographic within this age range are college students. Proper education and access to resources are vital to help reduce the STI rate in this group. 

Promoting sexual health: Preventative methods and safe sex practices

One out of every two sexually active youths will contract an STI before the age of 25. This startlingly high statistic may seem daunting, but there are methods that can help prevent STIs and promote safe sexual practices. The CDC has many different recommendations for STI prevention including abstinence, vaccinations and other forms of protection.

As someone who attended Catholic school for 13 years, I am very familiar with abstinence-based sex education — teaching that avoiding sex of all kinds, including oral and penetrative, is the only way to ensure you will not receive an STI. While this is technically true, it is unrealistic to believe that adolescents and young adults will completely abstain from participating in sexual activities. Not only is it unrealistic, but it is proven that abstinence-based education does not reduce accidental pregnancy or STI rates.

The next best way to prevent the spread of STIs is to use protection. Vaccinations against hepatitis B and HPV are available as protective methods against receiving these through sexual contact. Pitt Student Health offers these through its vaccination service along with many other important immunizations for young adults. There are also physical forms of protection that can be used during sex like condoms and dental dams.

For those who have penetrative sex, condoms are an excellent option to prevent genital fluid exchange. Condoms, specifically latex, are proven to significantly reduce the risk of STI transmission when used correctly and consistently. Just one instance of intercourse without a condom can be the difference between a positive or negative STI result. The CDC reports that the failure of condoms preventing STIs is usually the result of inconsistent or incorrect use. Their website has multiple resources for those who use condoms, including instructions on proper use.

For those who participate in nonpenetrative sex, condoms may not be the best secondary protection. Dental dams can replace condoms in many nonpenetrative situations, especially during oral sex. The main objective of both dental dams and condoms is to prevent the sharing of genital fluids, which are often the main carriers of STIs.

In cases where the infection is present on the skin around the genitals, as seen with herpes or syphilis, these preventative methods will likely not be effective since these infections are spread via skin to skin contact. Dental dams and condoms often do not cover enough surface area to completely prevent skin to skin contact, so if you or your partner have sores, rashes or any other skin infection, it is recommended to abstain from sexual contact.

Other recommendations from the CDC include lowering the number of sexual partners you have or practicing mutual monogamy. The logic here is that as long as you and your partner(s) are negative for STIs, the chance for transmission is significantly lessened if you exclusively have sexual relations with each other. There are faults with this — if you have a cheating or lying partner, you’re in trouble — so other forms of protection are much more reliable.

Last, but certainly not least, any person who is sexually active — this includes all forms of sexual activity, not just penetration — should get tested for STIs. The CDC has many guidelines for the testing of different STIs. It is recommended that anyone who is sexually active should get tested for STIs at least once annually if you have multiple partners or practice unprotected sex.

Getting tested regularly is extremely important since many STIs are asymptomatic — they don’t show any symptoms of infection. Other STIs may present symptoms such as painful urination, pain during intercourse, genital discharge and/or skin irritation, like bumps, rashes or sores. If you experience any of these symptoms and/or you’re unsure about your STI status, visit your doctor or local clinic to get tested and ensure good sexual health.

There are many resources around Pitt’s campus that promote sexual health. The University Health Center offers STI screenings to any full-time Pitt student. Concentra Urgent Care, located behind the Wyndham, also offers STI screening and walk-in appointments. There’s oftentimes a negative stigma surrounding STI testing and safe sex, however, practicing healthy sexual habits is nothing to be ashamed of and will benefit you in the long run.