Overview

More than 30 different bacteria, viruses and parasites are known to be transmitted through
sexual contact, including vaginal, anal and oral sex. Some STIs can also be transmitted from
mother-to-child during pregnancy, childbirth and breastfeeding. Eight pathogens are linked to
the greatest incidence of STIs. Of these, 4 are currently curable: syphilis, gonorrhoea, chlamydia
and trichomoniasis. The other 4 are incurable viral infections: hepatitis B, herpes simplex virus
(HSV), HIV and human papillomavirus (HPV).

In addition, emerging outbreaks of new infections that can be acquired by sexual contact such
as monkeypox, Shigella sonnei, Neisseria meningitidis, Ebola and Zika, as well as re-emergence
of neglected STIs such as lymphogranuloma venereum. These herald increasing challenges in
the provision of adequate services for STIs prevention and control.

A sexually transmitted infection (sexually transmitted disease) is a serious condition that can
develop after you have sex. Common STI symptoms include itching and burning around your
genital area. The good news is that most STI treatments can cure the infection, but not all types.
You can get an STI again, even after treatment to cure it.

Symptoms and Causes Diagnosis and Tests Management and Treatment Prevention Outlook /
Prognosis Living With

OVERVIEW

What is a sexually transmitted infection (sexually transmitted disease)?

Sexually transmitted infections (STI) are infections or conditions that you can get from any kind
of sexual activity involving your mouth, anus, vagina or penis. Another common name for STIs is
sexually transmitted diseases, or STDs. There are several types of STIs. The most common
symptoms are burning, itching or discharge in your genital area. Some STIs are asymptomatic,
meaning you may not have any symptoms.

Sexually transmitted infections are highly contagious. If you’re sexually active, you can have
(and pass on) an STI without even knowing it. The Centers for Disease Control and Prevention
(CDC) recommends regular STI screenings or testing if you’re sexually active.

STIs are serious illnesses that need treatment. Some, like the human immunodeficiency virus
(HIV), have no cure and can be life-threatening without treatment.
What is the difference between a sexually transmitted infection and a sexually transmitted
disease?

A sexually transmitted infection is the same as a sexually transmitted disease. STI is the most
accurate term to describe the condition.

What are the types of sexually transmitted infections?

The most common types of sexually transmitted infections include:

Chlamydia.

Genital herpes.

Genital warts.

Gonorrhea (clap).

Hepatitis B.

HIV/AIDS.

Human papillomavirus (HPV).

Pubic lice (crabs).

Syphilis.

Trichomoniasis (trick).

Vaginitis.

How common are sexually transmitted infections?

Sexually transmitted infections are common. More than 25 million sexually transmitted
infections occur each year in the United States. Around the world, an estimated 374 million
sexually transmitted infections occur each year. According to the CDC, there were
approximately 2.5 million cases of chlamydia, gonorrhea and syphilis in the U.S. in 2021. About
half of these cases occur in people ages 15 to 24.

SYMPTOMS AND CAUSES

What are the symptoms of sexually transmitted infections?

Symptoms of sexually transmitted infections (sexually transmitted diseases) vary by type. You
might not have any symptoms. If you do have symptoms, they may appear around your genital
region and could include:

Bumps, sores or warts on or near your penis, vagina, mouth or anus.

Swelling or severe itching near your penis or vagina.

Discharge from your penis.

Vaginal discharge that has a bad odor, causes irritation or is a different color or amount than
usual.

Vaginal bleeding that’s not your period.

Painful sex.

Painful urination or frequent urination.

In addition, you may also have symptoms throughout your body, including:

A skin rash.

Weight loss.

Diarrhea.

Night sweats.

Aches, pains, fever and chills.

Jaundice (yellowing of your skin and whites of your eyes).

What causes sexually transmitted infections?

Sexually transmitted infections develop when various bacteria, viruses or parasites infect your
body. You can get these microorganisms from bodily fluids (like blood, urine, semen, saliva and
other mucous-lined areas) during sex — usually vaginal, oral and anal sex or other sexual
activities.

Are sexually transmitted infections contagious?

Yes, sexually transmitted infections (sexually transmitted diseases) are contagious. Most STIs
pass from person to person by sexual contact through bodily fluids or from skin-to-skin contact
by touching the infected part of a person’s body, usually the genitals. Some STIs, like syphilis,
can spread while giving birth to a baby.
If you have an STI, it’s important to visit a healthcare provider to receive treatment. Some STIs
are curable. You can prevent the spread of STIs by getting tested regularly if you’re sexually
active, talking to your sexual partners about your diagnosis and using protection during sex.

What are the risk factors for sexually transmitted infections?

If you’re sexually active, you’re at risk of developing a sexually transmitted infection (sexually
transmitted disease).

You can also get an STI if you share personal items like needles that contain your blood. This
may occur in the following instances:

Unregulated tattoos.

Unregulated piercings.

Sharing needles while using intravenous drugs (substance use disorder).

A lack of communication due to stigma or shame about having an STI can put you and your
partner(s) at a greater risk of spreading the infection. Before having sex, you should ask your
partners the following questions:

Do you have an active STI?

When was your last STI test?

Are you currently being treated for an STI?

Do you consistently use protection with your sexual partners?

Asking these questions can help you protect yourself.

It’s common to feel strong emotions after an STI diagnosis. You might want to avoid telling your
sexual partner because you feel embarrassed. Being open and honest with your sexual partners
helps build trust and understanding. If you have an STI, you can reduce the risk of spreading the
infection to your sexual partner(s) by talking it over with them before engaging in sexual
activities.
What are the complications of sexually transmitted infections?

Sexually transmitted infections can cause lifelong complications if left untreated. Common
complications from untreated STIs include the following:

HIV can lead to AIDS.

Syphilis can damage your organs, nervous system and infect a developing fetus.

Risk of spreading STIs to your sexual partners.

STI complications for women or people assigned female at birth (AFAB) include:

Pelvic inflammatory disease (PID), which can damage your uterus and cause infertility.

Ectopic pregnancy.

Infertility.

Chronic pelvic pain.

In men or people assigned male at birth (AMAB), untreated STIs can lead to:

Infections in the urethra and prostate.

Swollen, sore testicles.

Infertility.

DIAGNOSIS AND TESTS

How are sexually transmitted infections diagnosed?

A healthcare provider will diagnose a sexually transmitted infection (sexually transmitted

disease) after a physical exam and testing. Your provider will ask about your symptoms and
your medical and sexual history — answer honestly, so you can get the help you need. After a
positive STI diagnosis, you need to notify your sexual partner(s) that they should also get tested.
This can be a very emotional process, but telling your partners can help them get the care they
need and prevent the spread of the infection.
What is STI testing?

A sexually transmitted infection test is a medical test to determine if you have an STI. A
healthcare provider will review your symptoms and offer a test or tests to determine the cause.
There are different tests for each type of STI. Your provider will talk to you about what test(s)
you need. STI testing could include:

Urine test.

Cheek swab.

Blood test.

A fluid sample from skin sores.

A discharge or cell sample from your body (usually the vagina, urethra, cervix, penis, anus or
throat).

STI testing is mostly painless. You might feel a small pinch during a blood test or a sting from a
swab touching a sore.

How often should I get tested for STIs?

Most healthcare providers recommend annual sexually transmitted infection testing. You may
choose to get tested more often, like every 3 to 6 months, if you have multiple sexual partners.
Some providers recommend testing before having sex with a new partner. Regular testing helps
find and treat STIs you may not even know you have. Talk to a healthcare provider about a
testing schedule that makes sense for you.

MANAGEMENT AND TREATMENT

How are sexually transmitted infections treated?

The goal of sexually transmitted infection (sexually transmitted disease) treatment is to:

Cure many (not all) STIs.

Lessen your symptoms.

Reduce your likelihood of spreading the infection.

Help you get healthy and stay healthy.

Treatment for STIs could include taking medications like:

Antibiotics.

Antivirals.

You can take these medicines orally (by mouth), or a provider will give you an injection.

Should I get the HPV vaccine?

The human papillomavirus (HPV) is the most common viral STI in the U.S. People with HPV may
have no symptoms, or they may develop warts or bumps around the genitals. High-risk HPV can
even cause cervical cancer.

There’s a vaccine to prevent HPV and genital warts. Healthcare providers advise children ages
11 to 12 to receive it because it’s most effective before you become sexually active. Providers
recommend the vaccine for everyone up to age 26, and updated information shows people up to
the age of 45 years may benefit from the HPV vaccine. Talk to your healthcare provider to see if
it’s right for you.

What is expedited partner therapy?

Expedited partner therapy (EPT) is where your healthcare provider gives you a prescription for
your partner without examining them when you’re diagnosed with chlamydia or gonorrhea.
Typically the healthcare provider would wait to examine your partner before providing a
prescription. But the logical assumption is that if you have one of these STIs, then your partner
probably does, as well. This prevents reinfection and stops additional transmission as soon as
possible.

How soon after treatment will I feel better?

If your provider gave you antibiotics or antivirals to treat a sexually transmitted infection, you
should start feeling better within a few days. Make sure to complete all the medicine as directed,
even if you’re feeling better. And never share medicines — don’t give your medicine to others,
and don’t take someone else’s medication for your symptoms.
Care at Cleveland Clinic

Sexually Transmitted Infections Treatment

Find a Doctor and Specialists

Make an Appointment

PREVENTION

Six tips to reduce your risk of developing a sexually transmitted infection.

There are steps you can take to protect yourself and your partner from sexually transmitted
infections.

How can I lower my risk of developing a sexually transmitted infection?

The only way to reduce the risk of sexually transmitted infections is to abstain from sex (not
have sex). If you’re sexually active, you can:

Use a latex condom whenever you have any kind of sex. If you or your partner has a vagina, use
a dental dam for oral sex.

Choose sex partners carefully. Don’t have sex if you suspect your partner has an STI.

Get checked for STIs regularly. Doing so helps prevent the spread of STIs to other people. Ask
any new sex partner to get tested before having sex for the first time.

Avoid alcohol or drugs before having sex. People who are under the influence may engage in
sexual activities without taking safety precautions.

Learn the signs and symptoms of STIs. If you notice symptoms, visit a healthcare provider
quickly.

Educate yourself about STIs. The more you know, the better you can protect yourself and your
partners.

Can the spread of sexually transmitted infections be prevented?

You can take steps to protect yourself and others from sexually transmitted infections:

If you have symptoms of an STI, don’t have sex until you see a healthcare provider and receive
treatment. You can resume sex when your healthcare provider says it’s OK.

Follow your healthcare provider’s instructions for treatment.

Return to your healthcare provider to get rechecked after completing treatment.

Be sure your partner(s) know about your positive diagnosis and also receive treatment.

Use condoms whenever you have sex, especially with new partners.

Get vaccinated for certain STIs (HPV) to prevent complications.

OUTLOOK / PROGNOSIS

What can I expect if I have a sexually transmitted infection?

Most STIs go away after treatment. Some may require lifelong management with medications.
You can develop the same STI after it goes away if you get infected with it again.

People who get an STI diagnosis may feel embarrassed or ashamed. But STIs can happen to
anyone — millions of people have them. Statistics show that most people will get an STI at least
once. If you’re experiencing anxiety or stress about your STI diagnosis, consider reaching out to
a friend, loved one or mental health professional for support.

What if I have an STI and I’m pregnant?

If you’re pregnant and have an STI, talk to your healthcare provider right away. They’ll discuss
treatment options to keep you and the fetus safe.

What’s the outlook for sexually transmitted infections?

Many sexually transmitted infections (sexually transmitted diseases) can be cured.

Unfortunately, there isn’t a cure for all STIs. Conditions like HIV require lifelong care and
treatment. You can get an STI again, even after treatment to cure it.

LIVING WITH

How do I take care of myself if I have a sexually transmitted infection?

If your healthcare provider gave you a sexually transmitted infection diagnosis, take steps to
keep yourself healthy:

Take all of the medication your provider prescribed as instructed.

Don’t have sex while you’re getting STI treatment. Wait until your healthcare provider gives you
the all-clear.

Let your sexual partners know you have an STI so that they can talk to their healthcare provider
about testing and treatment.

When you resume having sex, use a condom. If you or your partner has a vagina, be sure to use
a dental dam while having oral sex.

When should I see a healthcare provider?

Visit a healthcare provider if you notice that you or your partner has symptoms of an STI. You
should also regularly visit a healthcare provider for annual or more frequent STI testing if you’re
sexually active.

What questions should I ask my doctor?

If you’re sexually active or you’ve had an STI, ask your healthcare provider:

How can I prevent STIs?

Will the STI cause any complications or problems in the future?

Should I get checked regularly for STIs?

Should my partners get checked?

Sexually transmitted infections are common. If you feel uncomfortable burning or itching
around your genitals or other signs of a possible STI, talk to a healthcare provider. Antibiotics
can usually treat the infection successfully. Most of the time, you can cure an STI without long-
term complications. In some instances, like with HIV, you may need lifelong treatment. Using a
condom or other STI preventative measures when you’re sexually active can reduce your risk of
STIs.

Scope of the problem

STIs have a profound impact on sexual and reproductive health worldwide.

More than 1 million STIs are acquired every day. In 2020, WHO estimated 374 million new
infections with 1 of 4 STIs: chlamydia (129 million), gonorrhoea (82 million), syphilis (7.1 million)
and trichomoniasis (156 million). More than 490 million people were estimated to be living with
genital herpes in 2016, and an estimated 300 million women have an HPV infection, the primary
cause of cervical cancer and anal cancer among men who have sex with men. An estimated 296
million people are living with chronic hepatitis B globally.

STIs can have serious consequences beyond the immediate impact of the infection itself.

STIs like herpes, gonorrhoea and syphilis can increase the risk of HIV acquisition.

Mother-to-child transmission of STIs can result in stillbirth, neonatal death, low-birth weight and
prematurity, sepsis, neonatal conjunctivitis and congenital deformities.

HPV infection causes cervical and other cancers.

Hepatitis B resulted in an estimated 820 000 deaths in 2019, mostly from cirrhosis and
hepatocellular carcinoma. STIs such as gonorrhoea and chlamydia are major causes of pelvic
inflammatory disease and infertility in women.

Prevention of STIs

When used correctly and consistently, condoms offer one of the most effective methods of
protection against STIs, including HIV. Although highly effective, condoms do not offer
protection for STIs that cause extra-genital ulcers (i.e., syphilis or genital herpes). When
possible, condoms should be used in all vaginal and anal sex.

Safe and highly effective vaccines are available for 2 viral STIs: hepatitis B and HPV. These
vaccines have represented major advances in STI prevention. By the end of 2020, the HPV
vaccine had been introduced as part of routine immunization programmes in 111 countries,
primarily high- and middle-income countries. To eliminate cervical cancer as a public health
problem globally, high coverage targets for HPV vaccination, screening and treatment of
precancerous lesions, and management of cancer must be reached by 2030 and maintained at
this high level for decades.

Research to develop vaccines against genital herpes and HIV is advanced, with several vaccine
candidates in early clinical development. There is mounting evidence suggesting that the
vaccine to prevent meningitis (MenB) provides some cross-protection against gonorrhoea.
More research into vaccines for chlamydia, gonorrhoea, syphilis and trichomoniasis are needed.
Other biomedical interventions to prevent some STIs include adult voluntary medical male
circumcision, microbicides, and partner treatment. There are ongoing trials to evaluate the
benefit of pre- and post-exposure prophylaxis of STIs and their potential safety weighed with
antimicrobial resistance (AMR).

Diagnosis of STIs

STIs are often asymptomatic. When symptoms occur, they can be non-specific. Moreover,
laboratory tests rely on blood, urine or anatomical samples. Three anatomical sites can carry at
least one STI. These differences are modulated by sex and sexual risk. These differences can
mean the diagnosis of STIs is often missed and individuals are frequently treated for 2 or more
STIs.

Accurate diagnostic tests for STIs (using molecular technology) are widely used in high-income
countries. These are especially useful for the diagnosis of asymptomatic infections. However,
they are largely unavailable in low- and middle-income countries (LMICs) for chlamydia and
gonorrhoea. Even in countries where testing is available, it is often expensive and not widely
accessible. In addition, the time it takes for results to be received is often long. As a result,
follow-up can be impeded and care or treatment can be incomplete.

On the other hand, inexpensive, rapid tests are available for syphilis, hepatitis B and HIV. The
rapid syphilis test and rapid dual HIV/syphilis tests are used in several resource-limited settings.

Several other rapid tests are under development and have the potential to improve STI diagnosis
and treatment, especially in resource-limited settings.

Treatment of STIs

Effective treatment is currently available for several STIs.

Three bacterial (chlamydia, gonorrhoea and syphilis) and one parasitic STIs (trichomoniasis) are
generally curable with existing single-dose regimens of antibiotics.

For herpes and HIV, the most effective medications available are antivirals that can modulate
the course of the disease, though they cannot cure the disease.

For hepatitis B, antivirals can help fighting the virus and slowing damage to the liver.
AMR of STIs – in particular gonorrhoea – has increased rapidly in recent years and has reduced
treatment options. The Gonococcal AMR Surveillance Programme (GASP) has shown high rates
of resistance to many antibiotics including quinolone, azithromycin and extended-spectrum
cephalosporins, a last-line treatment (4).

AMR for other STIs like Mycoplasma genitalium, though less common, also exists.

STI case management

LMICs rely on identifying consistent, easily recognizable signs and symptoms to guide
treatment, without the use of laboratory tests. This approach – syndromic management – often
relies on clinical algorithms and allows health workers to diagnose a specific infection based on
observed syndromes (e.g., vaginal/urethral discharge, anogenital ulcers, etc). Syndromic
management is simple, assures rapid, same-day treatment, and avoids expensive or unavailable
diagnostic tests for patients with symptoms. However, this approach results in overtreatment
and missed treatment as the majority of STIs are asymptomatic. Thus, WHO recommends
countries to enhance syndromic management by gradually incorporating laboratory testing to
support diagnosis. In settings where quality assured molecular assays are available, it is
recommended to treat STIs based on laboratory tests. Moreover, STI screening strategies are
essential for those at higher risk of infection, such sex workers, men who have sex with men,
adolescents in some settings and pregnant women.

To interrupt transmission and prevent re-infection, treating sexual partners is an important

component of STI case management.

Controlling the spread

Behaviour change is complex

Despite considerable efforts to identify simple interventions that can reduce risky sexual
behaviour, behaviour change remains a complex challenge.

Information, education and counselling can improve people’s ability to recognize the symptoms
of STIs and increase the likelihood that they will seek care and encourage a sexual partner to do
so. Unfortunately, lack of public awareness, lack of training among health workers, and long-
standing, widespread stigma around STIs remain barriers to greater and more effective use of
these interventions.

Health services for screening and treatment of STIs remain weak

People seeking screening and treatment for STIs face numerous problems. These include
limited resources, stigmatization, poor quality of services and often out-of-pocket expenses.

Some populations with the highest rates of STIs – such as sex workers, men who have sex with
men, people who inject drugs, prison inmates, mobile populations and adolescents in high
burden countries for HIV – often do not have access to adequate and friendly health services.

In many settings, STI services are often neglected and underfunded. These problems lead to
difficulties in providing testing for asymptomatic infections, insufficient number of trained
personnel, limited laboratory capacity and inadequate supplies of appropriate medicines.

WHO response

Our work is currently guided by the Global health sector strategy on HIV, Hepatitis and Sexually
Transmitted Infections, 2022–2030. Within this framework, WHO:

develops global targets, norms and standards for STI prevention, testing and treatment;

supports the estimation and economic burden of STIs and the strengthening of STI surveillance;

globally monitors AMR to gonorrhoea; and

leads the setting of the global research agenda on STIs, including the development of
diagnostic tests, vaccines and additional drugs for gonorrhoea and syphilis.

As part of its mission, WHO supports countries to:

develop national strategic plans and guidelines;

create an encouraging environment allowing individuals to discuss STIs, adopt safer sexual
practices, and seek treatment;

scale-up primary prevention (condom availability and use, etc.);

increase integration of STI services within primary healthcare services;

increase accessibility of people-centred quality STI care;

facilitate adoption of point-of-care tests;

enhance and scale-up health intervention for impact, such as hepatitis B and HPV vaccination,
syphilis screening in priority populations;

strengthen capacity to monitoring STIs trends; and

monitor and respond to AMR in gonorrhoea.