“We have a simple message for all countries: test, test, test.” When the Director General of the UN spoke these words in March, he was referring to the COVID-19 pandemic, not sexually transmitted infections (STI), but the message rings true. Despite the stay-at-home orders and quarantines that have swept the world all throughout 2020, rates of STIs remain at levels comparable to this time last year. As one team of Italian researchers put it: the lockdown does not stop sexual infections.
The researchers compared data from 12 health clinics in Provincia Autonoma di Trento from March to May of 2020. They found that the incidence of STI-related visits was nearly identical to that of the same period in 2019, sparking the statement that, “risky behaviours do not seem to decrease during the pandemic.”
This statement is even more impactful in communities where the members already experience elevated rates of STIs, including college towns like Bloomington. According to the Centers for Disease Control, young people between 15-24 acquire half of all new STIs. A tendency for high rates of STIs coupled with social interaction after months of isolation creates a unique recipe for STI transmission.
Dr. Stephanie A. Sanders, Provost Professor and department chair of Gender Studies at IU and Senior Scientist at the Kinsey Institute, describes the phenomenon of sexual relationships in the pandemic era: “The normal interactions that would occur are curbed. So it leaves people with a choice: stay abstinent or create a “pod” with a preexisting partner. But even with that, there have been reports of “cheating”, not even in a sexual sense, but going outside of your pod. We’re going to have to watch how these notions of cheating or being deceptive towards one’s partner related to COVID also interact with people’s willingness to reveal the true nature of their sexual relationships.”
The shame or stigma that results from these difficult situations may prevent people from being honest to themselves about the nature of their sexual interactions. And, as with any transmissible health condition, honesty and transparency with oneself and one's partner are the key to prevention, diagnosis, and treatment. But, as Dr. Sanders notes, some people may not intentionally be hiding anything from their partner: they may simply not know that they have an STI.
“A lot of times when people learn about STIs, they’re shown horrible images of sores and spots, which not only adds to stigma, but also creates a deceptive idea that if they don’t see that, they don’t have STIs,” says Sanders, “some of the most dangerous STIs don’t have those physical markers.” So how, then, can people make up for poor sex-ed and maintain good sexual health? The answer is twofold: condoms and testing.
Sanders’ team has conducted extensive research on condom use with the idea that the key to curbing STIs is to make condom use more pleasurable. Their programs, called HIS, HERS, and THEIRS are at-home kits that help participants find the condoms that work best for them. The most common reasons for incomplete use of condoms are late application and early removal, so finding condoms that do not cause discomfort can be the key to preventing STI transmission.
The second part of the strategy is STI testing. Just as the CDC has released guidelines for COVID-19 testing, they also have recommendations for how frequently to get tested for STIs, noting that it is “one of the most important things you can do to protect your health.” All adults and adolescents from ages 13-64 should be tested at least once for HIV, while sexually active gay and bisexual men may benefit from more frequent testing. The CDC also recommends that sexually active women younger than 25 years be tested for gonorrhea and chlamydia every year. Although not as accessible or widespread as COVID-19 testing, the Student Health Center offers STI testing for all IU students. And Culture of Care at IU works to normalize conversations about sexual wellbeing.
As Sanders notes, the topic of sex, particulalry the role of pleasure in sexual health, is still seen as unmentionable, even amongst STI researchers. Any steps campuses can make towards lessening this stigma are paramount; free STI testing and a greater variety of condoms are steps in the right direction.
- “WHO Director-General's Opening Remarks at the Media Briefing on COVID-19 - 16 March 2020.” World Health Organization, World Health Organization, 16 Mar. 2020, www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---16-march-2020.
- Balestri, R et al. “STIs and the COVID-19 pandemic: the lockdown does not stop sexual infections.” Journal of the European Academy of Dermatology and Venereology : JEADV, 10.1111/jdv.16808. 11 Jul. 2020, doi:10.1111/jdv.16808
- Satterwhite CL, Torrone E, Meites E, et al. Sexually transmitted infections among US women and men: Prevalence and incidence estimates, 2008. Sex Trans Dis 2013; 40(3): 187–193.
- Schnabel, Rose, and Stephanie A Sanders. “STIs and Condom Use.” 4 Nov. 2020.
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