STD Awareness Week kicks off this Sunday, April 10th and runs until April 16th in the United States. Observed during the second week of April annually and aims to raise awareness about sexually transmitted diseases or infections. The week focuses on education about the different STIs and how they impact our lives and communities, reducing STD-related stigma, and creating more access to care, treatment, and support.
And while this awareness week is based in America, STDs/STIs impact people globally. Thankfully, over the years, there has been an increase in the information and resources available to help people learn more, get tested, and understand how to practice safe sex to help keep themselves and those they love safe.
STI Prevalence Rates in Different Regions
The CDC estimates that about 20 percent of the US population had an STI on any given day in 2018, or approximately one in five people. With 26 million new STIs in 2018, this cost the American health system nearly $16 billion in direct healthcare costs alone (not including lost productivity or social losses of those impacted).
In Canada, for the same year, the STI rate continued to rise, as it has done over the past decade, increasing public health concerns in the country. Rates of gonorrhea nearly doubled from 2013 to 2018 (over five years), and infectious syphilis rates have more than tripled in the past decade, with the highest increase of all STIs in Canada at 259.5%.
In the United Kingdom, similar trends are occurring. Like the US, the UK saw a decrease in STI diagnoses by 32% in 2020 compared to 2019 due to a disruption of sexual health services such as testing. In 2019 (pre-pandemic), England saw a 5% increase in STI diagnoses from 2018, showing a steady rise similar to Canada and the US. Another concern is the decrease in testing for STIs such as HIV or chlamydia in young people, which saw an increase in chlamydia infections of 2% in the same period.
The WHO estimates that sub-Saharan Africa bears 40% of the global STI burden, with women and young people at most risk for STIs.
Different STIs and Symptoms
While the list of symptoms below may help create more awareness of the different STIs, you cannot rely on symptoms to tell you if you have an STI – the only way to know for sure is to get tested. Below is a table of some common STIs and their symptoms for reference taken from the WHO, the CDC, HIV.gov (US), and Planned Parenthood. Please keep in mind that this list is not exhaustive, and any concerns should be discussed with a doctor or medical professional.
HIV (Stage 1 Acute Infection)
Within 2-4 weeks after infection with HIV, about 2/3 of people will have a flu-like illness, which is the body’s natural response to the disease.
The symptoms can include:
· Muscle aches and joint pain
· Swollen lymph glands
· Sore throat
· Night sweats
· Mouth ulcers
Symptoms may last for a few days to a few weeks, and they may be so mild that they may not be noticed. And some people do not get any symptoms during this early stage of HIV. However, the viral load during this time is quite high and may spread more easily at this stage.
HIV (Stage 3 AIDS)
AIDS is the final and most severe stage of HIV infection. Due to the severe damage to the immune system from HIV, the body cannot fight off opportunistic infections. These infections occur more frequently or are more severe in people with weakened immune systems. Some of the symptoms at this stage include:
· Rapid weight loss
· Recurring fever or profuse night sweats
· Extreme and unexplained fatigue or tiredness
· Prolonged swelling of the lymph glands in the armpits, groin, or neck
· Diarrhea that lasts for more than a week
· Sores of the mouth, anus, or genitals
· Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids
· Memory loss, depression, and other neurologic disorders
Following an initial hepatitis C (or HCV) infection, approximately 80% of people do not exhibit any symptoms. Those who are acutely symptomatic may show:
· Decreased appetite
· Abdominal pain
· Dark urine
· Pale feces
· Joint pain
Syphilis (Primary Stage)
A syphilis sore called a chancre can show where the infection entered the body. They are usually firm, round, painless, or sometimes open and wet. There is often only one sore, but there may be more.
Sores can appear on the vulva, vagina, anus, penis, scrotum, and rarely, the lips or mouth. They can also be found in hard-to-see places such as inside the vagina or under a foreskin.
The sores are incredibly contagious and can easily pass the infection to other people during sex.
Chancres are easy to mistake for an ingrown hair, pimple, or harmless bump. As they are often not painful – they can be easy to miss.
Syphilis (Secondary stage)
This stage can include rashes on the palms of the hands, soles of the feet, or other body parts. This rash is hard to see and usually doesn’t itch. There may be flu-like symptoms such as:
· Sore throat
· Swollen glands
· Muscle aches (including headaches)
These symptoms can last 2 to 6 weeks at a time and may come and go for up to 2 years. Symptoms may go away with or without treatment, but treatment is necessary to rid the disease and prevent it from moving into dangerous later stages.
Syphilis (Late Stage)
This stage causes serious health problems, and if treated late, it will still treat the disease and stop future damage but will not reverse previous damage from this stage. The symptoms include:
· Damage to the nervous system, brain, and other organs
· Possibly leading to death
The complications from this stage can happen 10-20 years after someone is first infected.
This infection does not always have symptoms. Or they can be so mild they go unnoticed or are mistaken for something else.
Gonorrhea can lead to serious complications, including fertility, if left untreated. Some symptoms which often show up within a week of being infected include:
· Burning during urination
· Abnormal discharge from the vagina that may be yellowish or bloody
· Bleeding between periods
If the anus is infected, either through anal sex or wiping after the bathroom, the symptoms can include:
· Itching in and around the anus
· Discharge from the anus
· Pain during defecation
For women, the symptoms include:
· An abnormal vaginal discharge
· A burning sensation when peeing
· A discharge from the penis
· Burning sensation when peeing
· Pain and swelling in one or both testicles (although less common
Any gender can also get chlamydia in the rectum, and those symptoms include:
· Rectal pain
With the exception of HIV (though there is currently a human trial for an HIV cure using CRISPR), there is treatment for each of these diseases if caught early, which is why testing is so important.
Preliminary data for 2020 indicated that reported STDs in the US dropped as clinics and healthcare offices were closed. However, the infection rates surged when they reopened again, showcasing the importance and critical need for rapid and regular testing to identify and help reduce the transmission of infections. This was seen in various countries and showcases the need for consistent, regular, and accessible rapid testing.
At bioLytical, we use our testing platform INSTI® to help get everyone access to a test that needs one. We believe that testing is the first step to ensuring better health outcomes – the only way to know is to get tested, and we want to help contribute to helping the world make informed health choices.
Where Can I Get Tested?
In Canada, you can find STI testing near you at Action Canada for Sexual Health & Rights by entering your address, city, province, or postal code. Or using Smart Sex Resource using the same information. The INSTI® HIV-1/2 Antibody Self Test is also available in Canada through our website for purchase directly to your home. The test takes 1 minute to both take and get your results and comes with everything you need directly in the kit.
In the US, you can find a test through Planned Parenthood or with the CDC resource using your address, city, state, or zip code to find a place near you.
In the UK, there is a similar service through the NHS using your postal code, city, or town. The INSTI® HIV-1/2 Antibody Self Test is also available in the UK through our HIV Home Test for purchase directly to your home. The test takes 1 minute to both take and get your results and comes with everything you need directly in the kit.
In Europe, you can use the European Test Finder from the ECDC to find a testing site throughout Europe.
Of course, the INSTI® lineup includes the HIV-1/2 Antibody Test, the Hepatitis C Antibody Test, and the combination HIV-1/2 + Syphilis Multiplex Test – check out our product page for more info, or get in touch through our contact form if you want to learn more.
So, What’s Next?
Globally, with tight resources, governments need to assess the risk and develop and implement programs that help address these needs so that those who are most at risk can get access to testing, treatment, and support.
In Africa, young people and women are most at risk for STIs and should be a focus of future interventions, especially given the additional complications and risks of untreated STIs in pregnant women.
In all countries, it is essential that we work on building increased and equitable access to testing, creating programs that support different demographics that speak to their unique challenges, and addressing mental health, especially concerning depression and anxiety.
Finally, it is vital that communities continue to talk about sexual health and STIs to help break down and eliminate the stigma relating to STIs. By creating an open and safe place to talk about sexual health or other concerns and increasing access to and normalizing regular testing, we can work together as a society to reduce transmissions and help those who need care can get access to it.
BMC Public Health: https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-021-10762-4#:~:text=The%20WHO%20estimates%20that%20sub,and%20pregnancy%20complications%20%5B3%5D.
Health Canada: https://www.canada.ca/en/public-health/services/publications/diseases-conditions/report-sexually-transmitted-infections-canada-2018.html
Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/hiv-aids/symptoms-causes/syc-20373524
Planned Parenthood: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/syphilis/what-are-the-symptoms-of-syphilis#:~:text=They%20include%20body%20rashes%20that,%2C%20headache%2C%20and%20muscle%20pains.
Planned Parenthood: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/gonorrhea/what-are-symptoms-gonorrhea
Terrance Higgins Trust: https://www.tht.org.uk/news/rise-stis-underlines-need-urgent-action
UK Government: https://www.gov.uk/government/news/sti-rates-remain-a-concern-despite-fall-in-2020