The United States Centers for Disease Control (CDC) estimates that there were 2.6 million new cases of STD infection in the U.S. in 2019 alone. Unfortunately, the CDC is seeing some troubling trends in STD cases in recent years, with cases rising by nearly a million reported between 2014 and 2019. [Español]
An uptick in gonorrhea rates and low numbers of young women being screened for chlamydia are worrying to public health experts. For example, while gonorrhea rates were at historically low levels in the early 2000s, an uptick in reported cases was seen in 2010, and that trend lasted through 2019.
In the years 2020 and 2021, the numbers are less clear, as the COVID-19 pandemic has masked a lot of the statistics. For example, any declines reported may be due to less screening due to the rise in “virtual” office visits.
No matter how we look at the numbers, there is evidence that gonorrhea may be developing treatment resistance.
Chlamydia rates have increased steadily over the past couple of decades, yet fewer than half of young women who are sexually active are screened for chlamydia, which can cause infertility.
Following is a discussion of the worst 5 STDs to live with, in terms of quality of life for a typical American. This list is subjective, but it looks at STDs in terms of the effects they can have on quality of life.
A generation ago, this disease would have easily been at the top of the list. While AIDS cannot be cured, it is no longer the death sentence it was in the 1980s and early ‘90s. People with HIV and AIDS cope with complex treatment regimens in order to remain healthy, but many people with HIV lead otherwise-healthy, productive lives.
The changes in treatment for HIV/AIDS over the past two decades have been revolutionary. Today, men and women with the virus are planning for their retirements rather than their funerals.
Usually, when people in the U.S. are diagnosed with HIV, they are put on drug therapy right away. Though taking a variety of drugs like Reyataz, Emtriva, Norvir, Viread, and Videx can be a bit overwhelming at first, many people living with HIV find that they cope with the drugs with minimal side effects.
Those living with HIV who have partners without the virus still have to be vigilant about avoiding disease transmission, but people who have HIV often say that the biggest problem with having HIV is that there is still a social stigma associated with the virus.
As far as activities of day-to-day living, chlamydia often has very little effect. It is most common in people who are under age 25 and is caused by a bacterium called Chlamydia trachomatis. The problem with living with chlamydia is that so many people who have it don’t realize it; most people who have chlamydia have no symptoms at all.
The reason chlamydia is one of the worst STDs to have is that it can cause infertility, which may not be evident until a couple is actively attempting pregnancy years later.
What’s more, chlamydia symptoms in women can mimic other problems. For example, one symptom of chlamydia is heavier periods, and another is bleeding between periods. These can easily be brushed off as resulting from stress, or worse, suspected to be conditions requiring surgery.
This can be doubly devastating because many of the women who unknowingly contract chlamydia are young and believe they have many years in which to plan a family. Sexually active people under age 25 should be tested for chlamydia every year. When caught early, it can be easily cured, and fertility problems can be avoided.
3. Human Papillomavirus (HPV)
Before the introduction of vaccines against HPB, it was estimated that 75% to 80% of sexually active people will get HPV at some point in their lives. There are more than 40 types of HPV, and the virus affects both males and females.
Fortunately, most people with HPV don’t develop symptoms, and many people’s immune systems clear out the virus within two years. However, if you’re infected with HPV, there’s no way of knowing whether this will be the case with you.
The most common symptom of HPV is genital warts, which also causes significant psychological distress. The most serious problem with HPV transmission is that some types of HPV cause cervical cancer in females and other types of cancer in both men and women — including cancer of the vagina, penis, anus, or throat. These cancers may not produce symptoms until they are in advanced stages.
Fortunately, there are two vaccines that prevent the types of HPV that cause most cervical cancers. One of the vaccines, Gardasil, also prevents the types of HPV responsible for most genital warts. The vaccines are given in a series of three shots over six months.
The U.S. CDC recommends HPV vaccination for everyone aged 11 and 12, though it can be given to older people who have not yet been vaccinated. Both males and females who are already sexually active may benefit from the vaccine, but ideally, vaccination should take place before a person becomes sexually active.
2. Genital Herpes
Genital herpes is caused by two types of herpes simplex viruses, HSV-1 and HSV-2, with HSV-2 causing most STI infections. Typically, the first outbreak is the worst, and though the herpes virus remains in the body indefinitely, the number of outbreaks tends to decrease over time. In the U.S., around 12% of people aged 14 to 49 have the HSV-2 infection. Rates of infection have remained stable over the past 10 years or so.
HSV-2 is more common in women, and transmission from an infected male to a female is more likely than from a female to a male. There is no cure, but antivirals can shorten outbreaks and prevent them in some cases.
Herpes doesn’t usually cause complications, but like HIV/AIDS, it carries a stigma. This makes it one of the worst STDs to have. Many people diagnosed with herpes experience anger at whoever transmitted the infection, and many people still think, incorrectly, that herpes can’t be transmitted when the infected person isn’t having an outbreak.
Dating and relationships can be difficult for people who have herpes, particularly when the partner is uninfected. What’s more, herpes is very serious in newborns, even life-threatening. Women with active lesions during labor often undergo C-section to avoid transmission to the baby during delivery.
Condoms can reduce transmission of herpes, but they aren’t a sure preventative measure. Education and consistent disease management is the key to having a healthy sex life for people with herpes.
1. Hepatitis C
About the only “good” news about hepatitis C is that the risk of transmission from sexual contact is considered low. However, the risk is higher in people who have had multiple sex partners and in people who have other sexually transmitted diseases. In the U.S, 2.4 million people are believed to have chronic hepatitis C, and many people who have it don’t know they have it.
Around 75-85% of people infected with hepatitis C develop a chronic infection. Long-term problems from hepatitis C may include liver damage, liver failure, and liver cancer.
Hepatitis C is a leading cause of cirrhosis and liver cancer and is the most common reason that people need liver transplants. Around 15,000 people die each year due to hepatitis C complications.
Psychiatric disorders are also more common in people with chronic hepatitis C, and top researchers are studying the links between hepatitis and brain dysfunction. Around 20-30% of people with hepatitis C develop life-threatening complications due to the disease.
Use Self-Testing to Get Help Quickly
As you’ve likely noticed, many of these STDs don’t present with symptoms until months or even years later, if they do at all. That’s part of the reason these are the worst STDs to live with; they lurk behind the scenes, causing problems.
The best way to stay safe if you’re sexually active is to get tested, and you can do it yourself at home. These tests are shipped discreetly and can be ordered online, can generally be done and put in the mail in a few minutes, and results are posted on a secure website.
- TotalBox Test Kit: This 13-test panel combines finger-prick, urine sample, and genital swab. It tests for trichomoniasis, Mycoplasma genitalium, HIV-1 and HIV-2, hepatitis C, herpes, syphilis, chlamydia, and gonorrhea. This kit will check for 71% of common STDs and may be your best option if you’re sexually active but have never been tested.
- Uber Box Test Kit: This eight-test panel collects blood, urine, and a genital swab to test for chlamydia, gonorrhea, trichomoniasis, herpes, HIV, hepatitis C, and syphilis.
- V-Box: Designed for women, this genital swab kit tests for common causes of abnormal vaginal discharge, including chlamydia, gonorrhea, bacterial vaginosis (BV), yeast, and trichomoniasis.
- HIV/AIDS: This test uses a simple finger stick to collect blood. You’ll receive results in two to five days, and it comes with a free consultation with a doctor to help you understand your results.
- Chlamydia and gonorrhea: This urine-testing kit tests for both chlamydia and gonorrhea. Depending on your results, you may need a follow-up, in-person appointment with a doctor.
- Herpes: If you’ve ever been sexually active, this finger-stick test can quickly tell you if you have been exposed to HSV-2, genital herpes.
Be Informed on Your Sexual Health
The best way to protect your sexual health is to be informed and be your own best advocate. Follow the eDrugstore blog to get the latest news on erectile dysfunction and other men’s health issues.
Dan is a long-time freelance writer focusing on technology, science, health, and medicine, with a lifelong interest in physics, biology, and medicine. His work has taken a particular focus on scientific studies “beyond the headlines,” reading the study to more closely examine the results.