Mayo Clinic Health Manager

Get free personalized health guidance for you and your family.

Get Started

Free

E-Newsletter

Subscribe to receive the latest updates on health topics. About our newsletters

  • Housecall
  • Alzheimer's caregiving
  • Living with cancer

Prevention

By Mayo Clinic staff

Screening
Testing for a disease in someone who doesn't have symptoms is called screening. Most of the time, STD screening is not a routine part of health care. But there are exceptions:

  • Everyone. The one STD screening test suggested for everyone between the ages of 13 and 65 is a blood or saliva test for human immunodeficiency virus (HIV), the virus that causes AIDS. Most health care settings in the United States offer a rapid HIV test with same-day results.
  • Pregnant women. Screening for HIV, hepatitis B, chlamydia, gonorrhea and syphilis generally takes place at the first prenatal visit. A blood test to detect HSV type 2 infection is recommended for pregnant women with current or past partners who have genital herpes.
  • Young women who are sexually active. All sexually active women under age 25 should be tested for chlamydia infection. The chlamydia test uses a sample of urine or vaginal fluid you can collect yourself. Some experts recommend repeating the chlamydia test three months after you've had a positive test and been treated. The second test is needed to confirm that the infection is cured, as reinfection by an untreated or undertreated partner is common. A bout of chlamydia doesn't protect you from future exposures. You can catch the infection again and again, so you should get retested when you have a new partner.
  • Women ages 21 to 66. The Pap test screens for cervical abnormalities, including inflammation, precancerous changes and cancer, which is caused by certain strains of human papillomavirus (HPV). From ages 21 to 66, women should have a Pap test at least every three years. Women who start having sex before age 21 should have a Pap test within three years of first intercourse.
  • Men who have sex with men. Compared with other groups, men who have sex with men run a much higher risk of catching STDs. Many public health groups recommend annual or more frequent STD screening for these men. Regular tests for HIV, herpes, gonorrhea, chlamydia and syphilis are particularly important.
  • People with HIV. If you have HIV, it dramatically raises your risk of catching other STDs. Experts recommend frequent syphilis, gonorrhea, chlamydia and herpes tests for people with HIV. Women with HIV may develop aggressive cervical cancer, so they should have Pap tests twice a year to screen for HPV. Some experts also recommend regular HPV screening of HIV-infected men who risk anal cancer from HPV contracted anally.

Vaccination
Vaccines are available to prevent two viral STDs that can cause cancer — human papillomavirus (HPV) and hepatitis B. The HPV vaccine is recommended for all girls between ages 9 and 26, and the hepatitis B vaccine is usually given to newborns.

Partner notification and preventive treatment
If tests show that you have an STD, your sex partners — including your current partners and any other partners you've had over the last three months to one year — need to be informed so that they can get tested and treated if infected. Public health regulations require doctors to report all cases of syphilis and HIV to the local or state health department, which employs trained disease intervention specialists who will work with you — and sometimes with your doctor — to identify your partners, inform them of their exposure and get them tested and treated. In some states and counties, the health department also notifies partners exposed to gonorrhea and chlamydia.

Official, confidential partner notification effectively limits the spread of STDs, particularly syphilis and HIV. The practice also steers those at risk toward appropriate counseling and treatment. Finally, since you can contract some STDs more than once, partner notification reduces your risk of getting reinfected.

Depending on your circumstances, you might prefer to be the one who breaks the bad news to your partner, and that's certainly an option. Your disease intervention specialist may help you prepare and make a contract with you to go through with the conversation within a set amount of time. If your partner hasn't been treated by that time, the health department picks up with its usual partner notification procedure.

In an approach called expedited partner treatment, the staff at an STD clinic will treat an exposed partner without doing a full medical evaluation. When you're diagnosed with chlamydia, gonorrhea or trichomoniasis, your doctor may prescribe enough medication to treat both you and your partner. This approach is called patient-delivered partner treatment.

Safer sex
Thanks to improved testing and treatment, most people with access to health care no longer face all the dreadful consequences of STDs. Still, there is no room for complacency. One risky encounter is unlikely to cost you your life, but it could really mess up your future. These guidelines offer the greatest possible margin of safety.

  • Don't have sex in any way that puts you and your partner in direct contact with each other's blood, semen or other body fluids.
  • Avoid vaginal and anal intercourse with new partners until you have both been tested for STDs. Oral sex is less risky, but use a latex condom or dental dam to prevent direct contact between the oral and genital mucosa.
  • Use a latex condom every time you have intercourse.
  • Never use an oil-based lubricant, such as petroleum jelly, with a latex condom.
  • Don't drink alcohol or use drugs. If you're under the influence, you're more likely to take sexual risks.
  • Don't look for sex partners online or in bars or other pickup places.
  • Before any serious sexual contact, communicate with your partner about practicing safer sex. Reach an explicit agreement about what activities will and won't be OK.
  • Stay with one sex partner who doesn't have any STDs and who won't have sex with anyone but you.
Coping and support
References
  1. Dorland's Illustrated Medical Dictionary. 31st ed. Philadelphia, Pa.: W.B. Saunders; 2007.
  2. Swygard H. Screening for sexually transmitted diseases. http://www.uptodate.com/home/index.html. Accessed Feb. 9, 2009.
  3. Holmes KK. Sexually transmitted infections: Overview and clinical approach. In: Fauci AS, et al. Harrison's Principles of Internal Medicine. 17th ed. New York, N.Y.:  McGraw-Hill Medical; 2008.  http://www.accessmedicine.com/content.aspx?aid=2893718. Accessed Jan. 15, 2009.
  4. Global strategy for the prevention and control of sexually transmitted infections: 2006-2015. Breaking the chain of transmission. World Health Organization. http://www.who.int/reproductive-health/publications/stisstrategy/index.html. Accessed Jan. 15, 2009.
  5. Basic information: HIV. Centers for Disease Control and Prevention. http://www.cdc.gov/hiv/topics/basic/index.htm. Accessed Feb. 9, 2009.
  6. CDC fact sheet: Genital herpes. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Herpes/herpes-Fact-Sheet.pdf. Accessed Feb. 9, 2009.
  7. CDC fact sheet: Genital HPV infection. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Hpv/hpv-fact-sheet.pdf. Accessed Feb. 9, 2009.
  8. CDC fact sheet: Syphilis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Syphilis/syphilis-fact-sheet.pdf. Accessed Feb. 9, 2009.
  9. CDC fact sheet. Chlamydia. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Chlamydia/chlamydia-fact-sheet.pdf. Accessed Feb. 9, 2009.
  10. CDC fact sheet. Gonorrhea. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Gonorrhea /gonorrhea-fact-sheet.pdf. Accessed Feb. 9, 2009.
  11. Centers for Disease Control and Prevention, et al. Sexually transmitted diseases treatment guidelines, 2006. MMWR Recommendations and Reports. 2006;55:2. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5511a1.htm. Accessed Feb. 9, 2009.
  12. CDC fact sheet: Bacterial vaginosis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/bv/BV-Fact-Sheet.pdf. Accessed Feb. 9, 2009.
  13. CDC fact sheet. PID (pelvic inflammatory disease). Centers for Disease Control and Prevention. http://www.cdc.gov/std/PID/pid-fact-sheet.pdf. Accessed Feb. 9, 20009.
  14. CDC fact sheet. Trichomoniasis. Centers for Disease Control and Prevention. http://www.cdc.gov/std/Trichomoniasis/trichomoniasis-fact-sheet.pdf. Accessed Feb. 9, 2009.
  15. Centers for Disease Control and Prevention, et al. Shigella flexneri serotype 3 infections among men who have sex with men - Chicago, Illinois, 2003-2004. MMWR. 2005;54:820. http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5433a2.htm. Accessed Feb. 9, 2009.
  16. Quick answers: Sexually transmitted diseases. McGraw Hill's Access Medicine. http://www.accessmedicine.com/popup.aspx?aID=3271836. Accessed Feb. 5, 2009.
  17. Klausner JD. Screening guidelines for sexually transmitted diseases, including HIV. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=3025000. Accessed Jan. 19, 2009.
  18. Swygard H, et al. Gonorrhea. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=3025486. Accessed Feb. 9, 2009.
  19. Ward H. Prevention strategies for sexually transmitted infections: Importance of sexual network and epidemic phase. Sexually Transmitted Infections. 2007;83:i43. http://sti.bmj.com/cgi/content/full/83/suppl_1/i43. Accessed Feb. 9, 2009.
  20. Trends in reportable sexually transmitted diseases in the United States, 2007. Centers for Disease Control and Prevention. http://www.cdc.gov/std/stats07/trends.htm. Accessed Jan. 28, 2009.
  21. Arrington-Sanders R, et al. Sexually transmitted diseases in adolescents. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=3026189. Accessed Jan. 28, 2009.
  22. Wong W. Sexually transmitted diseases in men who have sex with men. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/content.aspx?aid=3026252. Accessed Jan. 19, 2009.
  23. Peterman TA. Partner notification and management. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/popup.aspx?aid=3026470. Accessed Feb. 9, 2009.
  24. Klausner JD. The sexual history. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/popup.aspx?aid=3026901. Accessed Feb. 9, 2009.
  25. Safer sex ("Safe sex"). Planned Parenthood. http://www.plannedparenthood.org/health-topics/stds-hiv-safer-sex/safer-sex-4263.htm. Accessed Feb. 9, 2009.
  26. Reitmeijer CA. Principles of risk reduction counseling. In: Klausner JD, et al. Current Diagnosis and Treatment of Sexually Transmitted Diseases. New York, N.Y.: The McGraw Hill Companies; 2007. http://www.accessmedicine.com/popup.aspx?aid=3026470. Accessed Feb. 9, 2009.
  27. Viral hepatitis: A through E and beyond. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/viralhepatitis/index.htm. Accessed Jan. 20, 2009.
  28. Centers for Disease Control and Prevention, et al. Antiretroviral postexposure prophylaxis after sexual, injection-drug use, or other nonoccupational exposure to HIV in the United States. MMWR Recommendations and Reports. 2005;54:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5402a1.htm. Accessed Feb. 9, 2009.
  29. Kung HC, et al. Deaths: Final data for 2005. National Vital Statistics Reports. 2008;56:10. http://www.cdc.gov/nchs/data/nvsr/nvsr56/nvsr56_10.pdf. Accessed Feb. 9, 2009.
  30. Centers for Disease Control and Prevention, et al. Revised recommendations for HIV testing of adults, adolescents, and pregnant women in health-care settings. MMWR Recommendations and Reports. 2006;55:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5514a1.htm?s_cid=rr5514a1_e. Accessed Feb. 6, 2009.
  31. Centers for Disease Control and Prevention, et al. Recommendations for partner services Programs for HIV infection, syphilis, gonorrhea, and chlamydial infection. MMWR Recommendations and Reports. 2008;57:1. http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5709a1.htm. Accessed Feb. 9, 2009.

DS01123

Feb. 25, 2009

© 1998-2009 Mayo Foundation for Medical Education and Research (MFMER). All rights reserved. A single copy of these materials may be reprinted for noncommercial personal use only. "Mayo," "Mayo Clinic," "MayoClinic.com," "EmbodyHealth," "Reliable tools for healthier lives," "Enhance your life," and the triple-shield Mayo Clinic logo are trademarks of Mayo Foundation for Medical Education and Research.

Print Share Reprints

Text Size: smaller largerlarger