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Sex is a part of many college students’ lives. Whether you are currently sexually active or not, understanding the risk factors for sexually transmitted infections (STIs) and diseases (STDs) can empower you to think about what you do and don’t want to do, and make safer choices.

What's the difference between STIs and STDs?

The abbreviation STI refers to Sexually Transmitted Infection, and STD means Sexually Transmitted Disease. But what’s the difference? Some people use the two terms interchangeably, while others use them to refer to specific groups of illnesses that are transmitted via sexual contact, including vaginal, anal, and oral sex.

As explained by the University of Wisconsin, Madison’s UWire Web site, there are at least two ways in which STIs and STDs can be seen as different:
  • Curability: The term STD is often used to refer to illnesses that can’t be cured (like genital warts), while STI is used for those that can be (like Chlamydia).
  • Symptoms: Some people use STI when there is evidence of infection but no symptoms are present in a particular individual, and STD if and when symptoms develop. It’s important to understand that even if symptoms aren’t present, STIs can be contagious.
Many health professionals have moved to only using STI when discussing these illnesses, to make things simpler. For more information, check out these resources:

University of Wisconsin, Madison, UWire, Your Sex Life, You Say STD, I Say STI, We Say STD/STI

American Social Health Association, STDs/STIs

What Are Students Doing?

According to the American College Health Association’s National College Health Assessment II (NCHA), Spring 2012 Reference Group Executive Summary, among more than 25,000 students across the U.S., 30 percent of male students and 29 percent of female students reported having no sexual partners in the last 12 months. (This meant not having oral sex, vaginal, or anal intercourse.) Among those who had at least one sexual partner, the average was 2 partners each, for men and women.

According to the Centers for Disease Control and Prevention (CDC), 15-24-year-olds represent 25 percent of the people who are sexually active in the U.S., but nearly half of all new STI and STD diagnoses. In Sexually Transmitted Disease Surveillance, 2010, the CDC notes, “Compared with older adults, sexually active adolescents aged 15–19 years and young adults aged 20–24 years are at higher risk of acquiring STDs.”

Davis Smith, MD, an internist at Trinity College in Hartford, Connecticut, explains, “Higher rates of infection are not a function of age so much as behavior. Younger people tend to have more partners and higher-risk sex, more often.”

What’s Your Number…of Partners?

STIs and STDs don’t discriminate based on who you are, your sexual identity, or any other demographic description. What matters is what you do. Janine B., a student at the University of Nebraska-Lincoln, is HIV positive. She speaks to students at colleges and universities around the country to raise HIV awareness.

Janine says that one of the biggest misconceptions is that people who are infected look a certain way, or don’t have much education. “Because I look or carry myself in a certain fashion, or because I am educated and articulate, I “shouldn’t” have HIV,” she shares.

Mutual Monogamy

Dr. Smith notes that the number of people with whom you are (or have been) sexually active is correlated with your risk for contracting an STI or STD. “There is a probability function at play here.” Mathematically, with more partners comes more risk.

More about Mutual Monogamy

Dr. Donna McCree, associate director for health equity in the CDC’s HIV/AIDS Prevention division, says, “Abstaining from sex and [participating in] monogamy are the best ways to protect yourself.”

Mutual monogamy means that you and your partner agree to only be sexually active with one another. Mutual monogamy is built on trust, so it’s essential that you are each knowledgeable about your health, and completely honest with one another.

Non-Monogamy

Having one long-term partner isn’t what everyone chooses. The 2012 NCHA data found that nearly 20 percent of male and 14 percent of female college students had 3 or more partners over the last 12 months.

More about Non-Monogamy

If you have multiple sexual partners, it’s essential to have an understanding of your own health, and have frank discussions with partners. Dr. Smith explains, “Sex with one infected partner can be much more risky than sex with many uninfected partners, but reliable knowledge [about a person’s health] can be hard to come by.”

Steve Lux, senior health educator at Northern Illinois University in DeKalb, Illinois, says, “A CDC survey found that about 80 percent of college-aged men and women admitted that they would lie to a current sexual partner about past sexual involvement. Taking active prevention steps, such as using barriers, is necessary.”

3 Steps to Safer Sex

No matter how many partners you have (or have had), there are three major steps to safer sex:

1: Communication Is Key

Open and honest communication with sexual partners is critical. This starts with making sure you have active consent for any and all sexual activities, whether with a new partner or someone you know well. If someone is intoxicated by alcohol or other drugs, he or she isn’t able to give active consent.

Take the time to talk with your partner before things heat up, and when you’re both sober. Dr. Smith explains, “Sex under the influence of alcohol or other drugs increases the risk of not following through on intentions to not have sex or use barriers.”

2: Practice Safer Sex

Human Immunodeficiency Virus (HIV) and some other STIs and STDs, like chlamydia and gonorrhea, are passed through the exchange of bodily fluids—particularly blood, semen, and vaginal secretions. This occurs most often during vaginal, anal, and oral sex. Maryanne Y.*, a senior at Rice University in Houston, Texas, says, “There’s a myth that you can’t get STIs or STDs from oral sex. This isn’t true!”

Some STIs and STDs, such as human papillomavirus (HPV) and herpes, can be passed through skin-to-skin contact.

The 2012 NCHA data about what kinds of sex students are having.

Use Barriers and Lube 
Use barriers every time you have anal, vaginal, or oral sex. Condoms, dental dams, and gloves come in so many shapes, sizes, and flavors that you’re sure to find some that you and your partner like.

Latex, polyurethane, and polyisoprene condoms are the safest, and are available for men and also for women.

Information about the female condom.

Lux explains, “Condoms made from natural animal material are good for pregnancy prevention, as they block sperm, but have small pores, through which smaller viral and bacterial organisms can pass.”

Dental dams, or “dams,” can be used during oral stimulation of the vulva or anus. You can make a dam out of a condom, by cutting down the side of one that’s been unrolled. Latex gloves can also be used as dams. Cut off the fingers and elastic, leaving the thumb for insertion purposes.

Make safer sexy sexy

Gloves and Lube

Gloves and finger cots are great for stimulating your partner with your hands. During sex, STIs or STDs can be transmitted between partners when small cuts are present, as they often are on fingers and hands (hangnails, for example). Latex and polyurethane gloves are available in most drugstores and even some groceries.

Using lubrication will increase sensation and also make movement smoother during any kind of sex, reducing the likelihood of a protective barrier—or skin or membrane—tearing.

Only use lubricants that are water- or silicone-based. Latex is degraded by oil, so avoid lubes like petroleum jelly, butter, lotions, etc. (Polyurethane and polyisoprene barriers can be used with any kind of lubrication.)

Joleen Nevers, health education coordinator at the University of Connecticut in Storrs, says, “Lubrication can be added to one or both sides of barriers, depending on the preference of the individuals.”

3: Get Tested

Symptoms of an STI aren’t always present, so you may not be able to tell just by looking. Lux explains, “Women are especially asymptomatic compared to men. Roughly 80 percent of women have no symptoms, while about 20 percent of men show none.” When you know your status, if necessary, you can take steps to receive treatment and also to protect your partners.

Details on Testing for STIs and STDs

Testing for STIs and STDs is likely available at your campus health center, though you may need to ask specifically to have certain ones performed.

If testing isn’t available on campus, the staff can direct you to local health care providers or a low-cost clinic like Planned Parenthood. You can also find a nearby facility through the Centers for Disease Control and Prevention’s National HIV and STD Testing Resources Web site.

Some tests require you to give a blood sample. For others, the clinician will collect some cells and examine them under a microscope.

Steve Lux, senior health educator at Northern Illinois University in DeKalb, explains that a test that is negative (meaning, it doesn’t find evidence of infection) is only good for that specific point in time, and only for those STIs or STDs that were tested for. Therefore, active prevention measures are still important and it’s a good idea to get re-tested often if you continue to be sexually active.

It can be overwhelming and scary to find out you have an STI or STD, or that a partner does. But if you are concerned—due to having unprotected sex, symptoms, multiple partners, a partner whose STI or STD status you don’t know, or sharing needles used for intravenous drugs—getting tested allows you to start treatment early if needed. STIs are curable, and STDs can sometimes be kept in remission, reducing the risk of transmitting them to a partner.

Regularly visit your health care provider for an exam and discussion of your sexual health. Sexually active women should have a pap smear at least annually, and the HPV vaccine is now available for both men and women. According to the NCHA data, 42 percent of college students reported receiving vaccination against HPV, and 27 percent reported ever being tested for HIV infection.

Sex can be exhilarating. Understanding how to reduce its risks, and how to communicate about it all, is essential to enjoying sexual activity with less worry.

* Name has been changed for privacy.

Take Action!

  • Not all students are sexually active. Understand that abstinence is the only way to be 100 percent safe.
  • Always get active consent before any sexual activity.
  • Talk with your partner(s) about your sexual history.
  • STDs and STIs don’t discriminate. Understand your personal level of risk.
  • Use condoms, dams, gloves, and lube during vaginal, anal, and oral sex.
  • Get tested for STIs and STDs regularly.
  • Consider the HPV vaccine, now available for both men and women.

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