What to know about sexually transmitted infections

With rates of some STIs on the rise, it’s never been more important to understand the risks, symptoms and treatments.

5:00 AM

Author | Annie Clarkson

orange yellow cells floating green blue
Justine Ross, Michigan Medicine

While the pandemic delayed many routine screenings, rates of some common sexually transmitted infections didn't slow. Rather, rates of syphilis and congenital syphilis continued to surge, as did gonorrhea cases, according to a recent report from the United States Centers for Disease Control and Prevention of 2020 data.

Chlamydia infections declined though that may have been due to pandemic-related decreases in screening, rather than an actual drop in cases, the CDC notes.

Overall, rising cases of many STIs—including congenital syphilis—highlight the need for people to be aware of the risks, prevention strategies, and treatment options, says Okeoma Mmeje, M.D., M.P.H., an obstetrician-gynecologist at University of Michigan Health Von Voigtlander Women's Hospital who has expertise in reproductive infectious diseases.

Who is at risk for STIs?

More than 50% of new STIs in the U.S. are in people aged 15 to 24. Generally, if you're in this age group and sexually active, it's recommended that you be screened at least once a year whether that's at a student health center, a pediatrician or a gynecologist. The CDC also recommends that everyone between the ages of 13 and 64 be screened for HIV at least once.

In Michigan, anyone over the age of 13 can access reproductive services without parental consent, which can help make accessing services easier for young people.

Like Podcasts? Add the Michigan Medicine News Break on Spotify, Apple Podcasts or anywhere you listen to podcasts.

"Testing is important because we know that untreated or recurrent STIs can be associated with reproductive harm, especially in those who have chronic pelvic pain, pelvic inflammatory disease or damage to their fallopian tubes, which increases their risk for ectopic pregnancy or infertility in the future," says Mmeje.

People should be particularly aware of rising syphilis rates among heterosexual women. In recent years, syphilis hasn't affected women as much as men. But a change in incidence means women need to know about the risk, including the worrying increase in congenital syphilis.

SEE ALSO: Why Aren't More STD Patients Getting This Proven Treatment?

Congenital syphilis is still relatively rare—there were 2,148 cases in 2020, which amounts to 57.3 cases per 100,000 live births in the U.S. But that's a staggering increase of 254% over 2016 numbers. And it can be deadly to newborns. Most people can be screened for STIs during pregnancy, so it's thought the rise in cases is due to a lack of access to prenatal care.

"If someone misses appointments or has no prenatal care at all, that's where we see these incidents of people falling through the cracks," Mmeje says.

Preventing and treating STIs

Mmeje wants people to feel empowered and not judged when it comes to STIs. It's important to have conversations about risks with sexual partners to understand your risk. Barrier methods, like male or female condoms, can help prevent STIs.

If you know you're at a higher risk for HIV, there are medications you can take to help prevent infection. Risk factors for HIV include multiple sexual partners and intravenous drug use. Other STIs, including chlamydia, gonorrhea, and trichomoniasis, can be associated with an increased risk of HIV infection.

I want people to understand and know that an STI is not the end of the world. You can be treated to prevent recurrent infection and complications.
Okeoma Mmeje, M.D., M.P.H.

If you do contract an STI, most can be easily treated. In most states, your partner can get medication too without a visit to a health care provider. It's called expedited partner therapy. A physician can prescribe medication to a person's sexual partner without doing a separate clinical evaluation.

Mmeje says that clinicians would prefer that sexual partners of a person diagnosed with an STI come in for their own evaluation. But expedited partner therapy can help in cases when it's not possible for the sexual partner to come in and be seen.

COVID-19 and STI testing

At the beginning of the COVID-19 pandemic, public health resources were redirected to pandemic-related efforts. As a result, STI clinics were shut down and a decrease in sexual health screening and testing followed, according to a study from the National Coalition of STD Directors. People receiving treatment at student health centers may have been particularly impacted.

While this caused many people—particularly those in economically and/or socially marginalized populations—to lose access to these critical health care services, the pandemic forced innovation too.

SEE ALSO: Did the pandemic interrupt your health care? Time to get back on track!

At-home tests for STIs are more available now than ever before.

"Almost overnight, there were all these platforms available for ordering STI tests online that can be done at home," Mmeje says.

These home-based tests can be expensive and aren't covered by insurance. But the privacy and convenience can't be beat, especially for young people or college students who may not regularly visit a primary care physician or OB-GYN, or for individuals with sexual partners who do not want to seek care in a traditional clinical setting.

Trichomoniasis in women

Most people know about syphilis, gonorrhea, and chlamydia, but trichomoniasis—known as "trich"—isn't as well known among the general population. But it's extremely common: there were an estimated 2.6 million cases of it in 2018, according to the CDC. That works out to infections in about 2.1% of women between the ages of 14 and 59.

Trich is a parasitic infection. About 70% of people with it don't have symptoms. But for those who do, the signs include itching, burning and irritation, discharge from the penis or vaginal area, and discomfort while urinating.

In pregnant people, trich can be associated with early birth or a low birth weight.

Like other common STIs, it's easily treatable after diagnosis.

Overall, Mmeje wants to reduce stigma around STIs to help more people access STI screening and treatment services.

"I want people to understand and know that an STI is not the end of the world," says Mmeje. "You can be treated to prevent recurrent infection and complications."

Live your healthiest life: Get tips from top experts weekly. Subscribe to the Michigan Health blog newsletter

Headlines from the frontlines: The power of scientific discovery harnessed and delivered to your inbox every week. Subscribe to the Michigan Health Lab blog newsletter

More Articles About: Preventative health and wellness Womens Health Gynecology Urology Health Screenings Community Health Von Voigtlander Women's Hospital Sexual Health Sexually Transmitted Infections (STI)
Health Lab word mark overlaying blue cells
Health Lab

Explore a variety of health care news & stories by visiting the Health Lab home page for more articles.

Media Contact Public Relations

Department of Communication at Michigan Medicine

[email protected]


Stay Informed

Want top health & research news weekly? Sign up for Health Lab’s newsletters today!

Featured News & Stories shoes red and yellow and blue background and feet emerging out of them looking too big - this image moves so feet go in and out from behind shoes
Health Lab
Are your kids wearing the right shoes?
In a national poll some parents acknowledged a lack of confidence in ensuring their children are wearing properly fitting shoes – which experts say is necessary to support growth and prevent injuries. One in seven parents also say they’ve had concerns about their child’s feet or the way they walk while one in 10 parents report their child has complained of foot pain, according to the University of Michigan Health C.S. Mott Children’s Hospital National Poll on Children’s Health.
doctor with patient talking
Health Lab
Considering the patient’s perspective in inducible laryngeal obstruction care
Exploring the main topic of concern patients have when it comes to the results of their treatment for inducible laryngeal obstruction can help to increase effective treatment methods.
Text over image of University of Michigan Health aerial campus
News Release
U-M Health ranked among nation’s best in more specialties than any other Michigan hospital by U.S. News & World Report
University of Michigan Health ranks among the nation’s best hospitals in more specialties than any other Michigan hospital, according to U.S. News and World Report’s Best Hospitals Rankings for 2024-2025.
woman sitting at table in stripe shirt stressed seeming white background window
Health Lab
An unequal toll of financial stress
Inflation rates may have cooled off recently, but a poll shows many older adults are experiencing financial stress – especially those who say they’re in fair or poor physical health or mental health
sunscreen blue people outside
Health Lab
Sunscreen dispensers make skin cancer prevention easier
Medical students have worked to place dispensers at parks, pools and golf courses around Washtenaw County to give people easy access to sunscreen.
mom sitting at end of bed with child laying down moon outside purple bedroom green covers tan pillow
Health Lab
Bedtime battles: 1 in 4 parents say their child can’t go to sleep because they’re worried or anxious
Many bedtime battles stem from children’s after dark worries, suggests a national poll.