Your Honest-to-God Guide to STDs 1

                   

Chances are, if you’re reading this, you’re scared by the idea of catching some sort of STD. Or at least you have been in the past. That night you got drunk and didn’t have a condom but went for it anyway. Or maybe you hooked up with someone who had a reputation for sleeping with every third person in the phone book.

Perhaps you freaked out and rushed to get tested the next morning. Maybe you started Googling around frantically to convince yourself that you’re OK, only to find horrifying images and statistics about how people lost internal organs, limbs and never, ever had sex again because they were so hideously deformed by some pesky infection… Your mind begins racing, your liver DOES hurt, you think to yourself. It must be an early onset of AIDS. Obviously… (more after the cut)

The unfortunate thing about STD “education” is that it focuses on very specific information: symptoms, treatments, and every worst-case scenario. The real world experiences and probabilities are absent. Down-to-earth guidance on how this information should affect your behavior is usually glossed over — telling you to abstain from having sex (yeah right) and to use a condom (even though it doesn’t prevent everything).

As a result, people start getting paranoid and some serious social stigmas develop.

What’s never discussed is the actual prevalence of STDs, the realistic chance of catching these STDs, or what the experience of catching them would be like.

I still remember the night a girl I was dating told me that she had HPV. I felt like I was going to vomit. I immediately imagined that my penis had morphed into a giant tumor, shooting pellets of cancer into girl’s cervices. Or the time one of my best friends told me over the phone that he had what appeared to be a herpes breakout. I nearly cried for the guy. Holy shit. What was he going to do? No woman would ever date him again.

But as I learned more, got tested more, spoke to more doctors and did more research, I realized that the truth about STDs is more complicated than previously assumed, and that getting many of them would be a far more benign experience than I ever imagined. For instance, there are over 100 strains of HPV, and only four of them lead to most cervical cancers in women, and that’s assuming it’s left untreated for a period of years or decades, and THAT is assuming she hasn’t already been vaccinated, and then even if she does get cervical cancer it’s very unlikely to be fatal. So what I assumed was my cancer-laden pee-shooter in my pants actually had something like a 1/100 x 1/100 x 1/2 x 1/100 chance of actually killing a girl.

The more I’ve learned about STDs, the more I’ve encouraged people to relax a little bit about them. I know that sounds crazy, but seriously, relax. Use a condom. Get tested periodically. Stay away from the people with crack habits. Do that, and you’re going to be fine. Seriously.

For instance, about 1 in 1800 people is diagnosed with syphilis in the United States each year. By contrast, you have a 1 in 84 chance of dying in a car accident in your lifetime, just to give you some perspective. And the difference is syphilis can be cured with a little penicillin. Car accidents are another story.

The reason most STD information is absolutely terrifying is because 1) terrifying information sells in the media and 2) religious nuts don’t want anybody to have fun.

We do a dismal job of sex education in our culture. And one product of ignorance is fear.

What I aim to do with this article is to break down the most common STDs in the most realistic way possible. Statistics, symptoms and treatments are listed. Sources are included. But I’m also going to list a couple of other things that you won’t find anywhere else: 1) what the experience of actually contracting that STD would be like; and 2) how likely you are to catch each STD if you had rampant unprotected sex.

In fact, I’ve put together a statistic of my own for each STD, the RAW Score. The RAW Score is a rough estimation of the average number of single Americans you would have to have unprotected vaginal sex with to contract that particular STD. For STDs which are cureable, I did this by taking the estimated number of cases per year (which is higher than the reported number, obviously), and then factored it into the number of single individuals in the US (approximately 102 million²) to get a percentage of single individuals who contract said STD each year. For STDs which are incurable, I simply take the percentage of the American population (about 319 million) with that STD. I realize this method is ridiculous and flawed, but the numbers are so stark that it gets the point across nicely: you’re not likely to catch anything serious any time soon.

And finally, I will say this again and again: use fucking protection. Don’t be an idiot. Use protection, get tested regularly. And one more time, in case some people can’t read: USE PROTECTION, GET TESTED REGULARLY

Chlamydia

Living With It: Uncomfortable…then you take some pills and it’s gone.
Curable: Yes (2-4 Weeks)
US Prevalence (new cases annually): 2.86 million
RAW Score: 36 Partners
Condom Protects: Yes

Chlamydia is a relatively minor bacterial infection, mostly transferred through intercourse. In men it’s uncomfortable and generally harmless. In women, there’s a chance that if untreated, it can cause pelvic inflammatory disease, which can lead to complications with pregnancies or even infertility.

Symptoms include burning pee and, dudes, your balls might ache. While 25% of men don’t experience symptoms, a full 70% of women do not experience any symptoms, which actually makes it more dangerous for women (most doctors recommend women screen for chlamydia at least once a year).

Gonorrhea

Living With It: Painful. Hope for no pus. Then you take some pills and it’s gone.
Curable: Yes (within a month)
US Prevalence (new cases annually): 570,000
RAW Score: 179 Partners
Condom Protects: Yes

Gonorrhea is Chlamydia’s big brother. In fact, the two often occur together. The difference is that gonorrhea can be transferred via any orifice: penis, vagina, anus, mouth. It often takes a few weeks for symptoms to show up, and it’s even more unpleasant to deal with.

The symptoms for gonorrhea include painful urination, aching balls for guys, swollen urethra, sore throat, and pus coming out of your genitals. Yes, that was pus coming out of your genitals.

Apparently there’s a new strain of gonorrhea which does not react to antibiotics. So this STD has made a bit of a comeback in terms of riskiness. Be careful.

Syphilis

Living With It: Itchy. Then 15 years later you go insane and kill yourself… (no, seriously.)
Curable: Yes
US Prevalence (new cases annually): 55,400
RAW Score: 1841 partners (no, that’s not a typo)
Condom Protects: No

The famous philosopher Nietzsche was a bit of a lush and had a fondness for prostitutes. Somewhere along the way, he contracted syphilis and his body began to wither from the inside out. Over the course of this torturous process, he famously proclaimed “God is dead” and slowly slipped into dementia and died.

Syphilis was the 19th century’s version of the AIDS epidemic. It was famously cured by Alexander Fleming in 1928 and even though it hasn’t been much of an issue since, it is back on the rise, especially among gay men.

Syphilis plays itself out in stages. The first stage is you develop a sore or sores (usually just one, but not always). This happens a few weeks after contracting the infection and the sore is generally painless. From there, after a few months, you break out into rashes. These rashes go on for weeks or months and eventually subside. From there, the you have no symptoms. Then 15-20 years later your internal organs start bleeding, you lose control of your motor functions, and you start losing your mind.

So the moral of the story? Get tested sometime in the next 15 years…ya know, whenever you get a chance.

HPV (High-Risk Strains)

Living With It: A nuisance. A few years of awkward conversations. Hopefully just one painful operation for women.
Curable: No, but it typically leaves on its own after a few years. There is also a vaccine for women and men now (get it!).
US Prevalence: 78 million
RAW Score: 4 Partners
Condom Protects: No

HPV is where things begin to get interesting. HPV is the latest STD freakout in the media. If all you’ve heard is the few tidbits that get passed around, it sounds horrifying. Most sexually active men and women will get it at some point in their lives, it causes cancer, condoms don’t protect it, and warts are going to cover your face and you’re going to suffocate to death.

This is all true. OK, the warts on the face and suffocation part isn’t, but the rest is. But what’s more important is the information you DON’T hear. And here it is: there are over 100 strains of HPV. All except for about six of them are basically harmless. For men, all but two have no symptoms. Feeling a little better? Good, let’s keep going…

The two that cause symptoms in men cause genital warts. Warts sound terrible, but they’re completely harmless and can be removed within the matter of days with basic surgery (or a few weeks to few months with a self-applied chemical treatment). The other four high-risk strains can, if left untreated, lead to cervical cancer in women. Actually, HPV is the leading cause of cervical cancer in women. New studies are also showing that oral sex with someone who has these strains can potentially lead to throat cancer down the road. But HPV throat cancer rates are still insanely low and the other rare types of cancers caused by HPV are insanely uncommon and almost never fatal.

The good news is that women are getting checked more and more for lesions and/or abnormal cells on their cervix these days. Also, women who do get lesions can have a procedure that prevents them from getting cervical cancer, but it’s pretty painful and follow ups with your doctor are necessary. That said, you shouldn’t freak out too much about it as it can at least be managed if not completely “cured.”

Also, the HPV vaccine is being given to just about every girl under 26, and again, men can get it now too. And when you factor in that HPV usually leaves your body naturally after a few years (assuming you’re healthy) chances are this is going to be almost a non-issue 5-10 years from now.

If you’re sexually active, chances are you’ve already got at least one strain of HPV. But again, only six out of over 100 are considered high-risk, and you’re far less likely to have those. Women should get regular screening for HPV, assuming they see their doctor regularly. Unfortunately, most places are unable to test men for HPV. The only way men can know if they have it is if someone you’re dating tells you they have it, or if you happen to find a wart. Either way, it sucks, kind of ruins your week, causes a lot of awkward conversations… but you move on and everything ends up being fine.

Genital Herpes

Living With It: There’s a good chance you already have it.
Curable: No, but who cares?
US Prevalence: 24.1 million
RAW Score: 13 Partners
Condoms Protect: No

So I have good news and bad news. The bad news is that a shit-ton of people have herpes (including probably myself). The good news is that the vast majority of people never show symptoms and don’t have the viral load required for it to show up in their blood levels.

I have to admit, herpes was the big one I was terrified of getting (the reason I’m not worried about HIV is below). Then I started researching it for this article and realized I probably already have it. And chances are you have it too!

See, there are two types of Herpes: HSV-1 and HSV-2. HSV-1 usually causes breakouts around the mouth — we just call them cold sores or fever blisters. Over 80% of the population has HSV-1, although at any given time almost none of us have a break out. HSV-2 causes breakouts around the genitals. The majority of people never get breakouts or get such minor breakouts that they don’t even realize that it’s herpes. My friend who has had a breakout said that he originally thought his was just a bug bite. It wasn’t until a second one showed up that he decided to get it checked out. It’s been over three years and he hasn’t had another breakout since. He’s also in a monogamous relationship and his girlfriend has never had a break out.

Herpes never goes away, but it’s relatively harmless. In fact, even if you do get breakouts, most people stop getting them after a couple years. And if you’re one of the unlucky few who actually does get bad break outs, you can take medication to suppress them. So there. Not worried about herpes anymore… After all, I probably already have it, and so do many of you.

continued next week