Three myths about sexually transmitted infections

More than a million people across the world contract a sexually transmitted infection (STI) every day, according to the World Health Organization (WHO). And Europe is currently facing a historic peak in infection rates, as has been pointed out by the European Centre for Disease Prevention and Control (ECDC). Information about how these infections are transmitted is often very confusing. That’s why we’re going to debunk three myths about them!

“If you’re monogamous, you don’t have to use condoms”

STIs can affect anyone who engages in sexual activity (including oral sex). Therefore, the mere fact of engaging in such activity exposes us to these infections. The main strategy for preventing infection, as recommended by Spain’s Ministry of Health, is the correct and consistent use of prevention methods, such as the condom, in conjunction with testing when infection is suspected and open communication with sexual partners.

“While monogamy does reduce the risk of contracting an STI, it does not eliminate the risk altogether”, says Mireia Alberny, doctor of family and community medicine and STI expert in the Directorate General for Health Planning and Research of the Catalan Department of Health. One good preventive measure is to test for STIs at the beginning of a relationship, but not even that is a guarantee for avoiding transmission. “In a scenario involving two people who do not have any STIs, present or past, absolute monogamy could mean you don’t have to use condoms, but this is a very unlikely situation”, adds Josep Mallolas, head of the HIV-AIDS unit of the Hospital Clínic in Barcelona.

Several studies have analysed the real-life practice of monogamy in the population (such as this one from 2015 or this one from 2020) and seen that the strategy has just as many flaws as other prevention methods such as the condom.

“The human papillomavirus only affects women“

The human papillomavirus (HPV) is a group of over 200 viruses, 40 of which affect the genitals, where they can cause health issues, such as warts or cancer, in one of every ten people infected. “It is estimated that around 90% of people have a papilloma virus at some point in their life; however, the virus is often eliminated naturally by the immune system”, explains Alberny of the Catalan Department of Health. Despite the existence of many different HPV variants, only two genetic variants are the main causes of most cases of cancers.

HPV infections are highly prevalent all over the world in people of both sexes. “We men can also get infected”, says Ander Pazos to Verificat. Pazos is a project coordinator of Gais Positius, a Barcelona-based LGTBI association. “Even though the vast majority of cases of HPV infections, both in men and women, do not turn into cancer,” he explains, “we must also consider other factors that, in conjunction with the infection, could facilitate this progression, such as the absence of periodic controls, living habits, and the consumption of alcohol and tobacco, etc.”.In 2018, most of Spain’s autonomous communities started subsidising the HPV vaccine for people of various risk groups, including men. Catalonia announced in May 2022 that it would include the HPV vaccine for boys in the vaccine schedule, making it the first autonomous community to do so. This programme began in September 2022 and the rest of the regions are set to incorporate it into their schedule by the end of 2024.

“If I had an STI I’d know it because I’d have symptoms“

STIs do not produce symptoms in most people, especially in women, and in most cases they can be non-specific (such as secretions from the urethra or unusual vaginal bleeding). This makes them harder to detect and delays diagnosis. “STIs are often diagnosed when the internal organs have already deteriorated”, explains Sílvia Agramunt, assistant doctor at the Obstetrics and Gynaecology Department of Hospital del Mar, Barcelona.

Asymptomatic cases are a challenge for health systems. When people are infected by an STI without knowing it, they have a higher risk of suffering more long-term effects, such as infertility, cancer or perinatal death, among others. In addition, it is more likely for those people to transmit the disease to others because they do not know they are infected.

So how can we diagnose an STI before it’s too late if we are not showing any symptoms? “The idea is for sexually active people to get tested regularly”, explains Alberny of the Catalan Department of Health. These tests “are a tool for prevention and early detection. That way we can catch the infections in time […] and avoid complications, as well as transmission to others”, she concludes.