Gone are the days when a syphilis infection would often end with a prolonged, painful and young death; during the worst period of the epidemic in Europe most of those infected would die by their early 30s. Frequent treatment of minor conditions with antibiotics often means this bacterial infection does not stay around long enough to do damage, and STDs that are more recently-discovered (Chlamydia, HPV, and herpes) tend to be much more common. But just because syphilis is no longer the number one STD, doesn't mean the other new kids on the block aren't potentially very serious.

Not to sound alarmist, ladies, but did you know that 1 in 3 women has been exposed to HPV (human papilloma-virus), which causes genital warts? Genital warts and the virus itself are not in and of themselves lethal, but there are over a dozen different strains of the virus, some of which can lead to cervical dysplasia, or abnormal cell growth; and that can lead to cervical cancer if not caught in its early stages. Left untreated, HPV can go away on its own, and there is some evidence that a healthy lifestyle (eating plenty of vegetables, exercising, plenty of rest and exercise) can help it clear up fairly quickly. But the prevalence of this disease, and the fact that some women may never exhibit symptoms, means we need to ask our doctors to test us for it.

Chlamydia is another one to worry about: it is a bacterial infection that attacks the cervix and urethra. It can easily be cleared up with antibiotics, but left untreated it can lead to pelvic inflammatory disease (PID) which may result in infertility. (See our article on PID for more information) Chlamydia is fairly common these days; 1 in 24 adults aged 18 to 26 has it, according to the Journal of the American Medical Association. But unfortunately women rarely exhibit any symptoms, so asking for a test is the only way to really be sure is to ask your MD for a test, or get one at your local Planned Parenthood (this is an excellent option if your GP is male and you want a female doctor to check you out for these things; but bear in mind all doctors are very familiar with this stuff so don't be shy about speaking up about your concerns). The test for urethral Chlamydia is fast and easy, but can be somewhat uncomfortable, so ask about the procedure so you will know what is going on.

If you are in your late 30s or older, you may remember the explosion of herpes infections in the 1980s. This virus also causes cold sores, and the outbreaks can be as frequent as 3-4 times a year, or once every couple of years, lasting for a few days to several weeks at a time. After the initial outbreak of sores after infection, most people will have a second outbreak within a year, and after that rates of reoccurrence vary greatly. There is nothing dangerous about herpes, but it is a chronic condition which can be bothersome, and even though cold sores can be passed through non-sexual means, the fact that genital herpes is so easily passed via sexual contact leaves those infected with it feeling the embarrassing social stigma that comes with having a chronic STD. The virus can also be spread even when there are no visible sores. The Centers for Disease Control in Atlanta estimates that 1 in 5 adults has genital herpes, with 16 percent of cases affecting women in their 20s.

Okay, so that you are totally freaking out about the STDs you didn't even know you had (!!!), let's look at some of the risk factors for women, high versus low-risk behaviors, and what you can do to help prevent infection. (Also, check out the other articles in this section for advice on specific STDS)

Risky Business: Do You Need to Make Changes?

First off, let's address some of the ways you CAN'T get an STD, and some of the common myths about them.

Toilet seats: This urban myth just won't die. Toilets, even filthy ones, are absolutely no risk whatsoever, because the bacteria cannot live long enough in the open air to be a risk. So all of you who are paranoid about public toilets who squat or stand over the seat to pee and leave a big mess for the next person, or who flush with your foot on the handle, depositing all sorts of nasty germs onto it from the floor, stop! The toilet seat of a public restroom is usually one of the cleanest surfaces there, with the sink handles and door handles being much more likely to harbor bacteria. Do the rest of us a favor: if the seat is clean and dry, sit on it, and wash your hands thoroughly before leaving the restroom.

Hot Tubs: Bacteria thrive in moist areas, but the standard temperature of most hot tubs (at least 102F) will readily kill all germs. Plus the water is usually kept pure with chlorine or bromine (the latter is less irritating to skin and mucus membranes, so if your friends have a tub pass along the tip), so it is highly unlikely you'd catch anything. No documented case of STD infection from hot tub use has ever been recorded, so go ahead and have a nice long soak; but watch out for encounters that get too heated: expelling your fluids into a tub used by others is just plain rude and nasty.

"Dry Humping": This fun activity has made a comeback in recent years since it is considered safer than oral sex or intercourse, has no risk of accidental pregnancy, and can be satisfying for both partners. If you keep your clothes on, it is risk-free. But if you do this with only flimsy undies or with bare flesh, bear in mind that some STDs such as HPV and herpes (as well as some parasites like crab lice or scabies) can be transmitted simply through skin-to-skin contact.

Are You at Risk?

Lots of partners/casual hook-ups: Maybe you have a lot of casual protected sex. Maybe you only do it with friends/fuck-buddies with whom you usually use a condom; but if you run out and your birth control option is in place, you don't worry too much. Some polyamorous couples (who maintain a primary committed relationship but have sexual partners on the side) will have what has been called a "condom contract" in which everyone in a group of lovers gets tested for STDs on a regular basis and anyone new or untested who joins in must use condoms. But unprotected sex is unprotected sex. It turns out BOTH of these behaviors, protected sex with a lot of random partners, or unprotected sex with known partners, are very risky. Here's why: Condoms do not protect the entire genital area and therefore, you can still be at risk for picking up a herpes or HPV infection. Not using condoms, even with partners you know are "clean", is very risky because your partner could pick up an infection without having any symptoms, and pass it on to you before he finds out about it. By then, it is too late for him, you and any other partners you've both had.

Just Making Out or Mutual Masturbation: You may think you're at very low or no risk with this, but herpes can be transmitted through kissing, and herpes and HPV can both be spread skin to skin, even if that only means you have your hands down each other's pants. In casual encounters, check to see if the person has any visible cold sores. Good rule: don't touch their bare genital region without protection if you don't know then too well. That's what latex gloves are for, and if they turn their nose up at that, you don't really need to continue this liaison, do you?

Oral Sex: Oral to genital contact can spread most STDs from one person to another. Additionally, HPV is found in small amounts in semen and vaginal fluids, so if either of you have small cuts or tears in your gums or chancre sores in the mouth, the virus can enter the bloodstream this way. Play it safe and use condoms or dental dams. Good hygiene can cut the risk somewhat, but the best bet is a latex barrier of some kind. Swallowing semen is riskier than not.

Recreational Drug Use or Binge Drinking: Okay, not trying to sound like your high school health teacher here, but it's a known fact that heavy social drinking and casual drug use increases the risk of STDs, primarily because you just don't use the same level of discretion and judgment when you're impaired by alcohol or drugs. Alcohol especially can cause poor decision making, and unfortunately the use of Rohypnol ("roofies" often referred to as "date rape drugs") continues to be a danger in social situations. Keep a close eye on your drink at parties or in clubs, limit yourself to one drink per hour and only three per night. As for drugs, know that using drugs to enhance your good time is never a good idea. Ecstasy, crystal meth, Quaaludes, poppers, or various other substances are not only habit forming (or in the case of meth, highly addictive) but can seriously affect your ability to stay clear-headed and in control. Let sex be its own "high" and stick to a glass of wine or maybe a toke of marijuana, both of which will leave you feeling good but still very much in control of your behavior.

Medical Dislaimer

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