Secondary stage syphilis sores (lesions) on the palms of the hands.CDC Image

Secondary stage syphilis sores (lesions) on the palms of the hands.

Sexually transmitted infections still a cause for concern

By Chris Jennings
June 3, 2024

In 2022, the Centers for Disease Control and Prevention (CDC) released a report that said sexually transmitted infections (STI) cases were the highest they’ve been since the 1950s. One possible cause is that the treatment options now available, such as antibiotics, antivirals, and pre-exposure prophylaxis, have affected sexual behavior.

These diminished concerns of long-term complications from STIs have led to a decrease in condom use and an increase in the practice of polyamory, which is having romantic relationships with more than one partner with the informed consent of all partners involved.

The COVID-19 pandemic can also be attributed to some of the rise in STIs. The pandemic lead to a reduction of sexual health screenings either from fear of exposure or from difficulty finding a place to test.

There are eight common STIs, also known as sexually transmitted diseases. Choctaw Nation Community Health Nurse Brandi Burris said, “A person can come in contact with any of these if they have unprotected oral, vaginal, or anal sex with an infected person.” Syphilis can also be spread by having direct contact with the infected person’s syphilis sore.

Chlamydia, gonorrhea, syphilis, and trichomonas are curable with antibiotics.

Hepatitis B, Herpes, Human Immunodeficiency Virus (HIV), and Human Papillomavirus (HPV) can be managed with medications. HPV is by far the most common sexually transmitted infection. Hepatitis B and HPV can be prevented with a vaccination. “It’s great that we can medically manage them [STIs]. However, prevention is still as important as the cure,” said Burris.

Burris says it’s not just yourself or your partner you need to worry about. According to the CDC, there has been a sharp increase in the number of babies born with congenital syphilis in the United States.

Congenital syphilis (CS) is a disease that occurs when a mother with syphilis passes the infection on to her baby during pregnancy. “Congenital syphilis is a preventable disease that has been on the rise in the United States. It can cause devasting health problems to a fetus or a newborn,” Burris said.

Congenital syphilis can cause miscarriage, fetal death, premature delivery, blindness, deafness, meningitis, bone deformities, and liver problems.

Testing and treatment are available during prenatal visits with the Choctaw Nation. “Prenatal visits can help prevent and lower the risk of spreading the infection to the baby,” Burris said.

The Choctaw Nation also provides prevention, treatment and testing for tribal members at all the outlying clinics and the Choctaw Nation hospital in Talihina. Burris says Appointments can be made via the app or by calling your clinic. Many clinics also see patients as walk-ins.

Burris says some people may not know they need to be tested because they are asymptomatic or have symptoms that resemble something else, such as itchy genitals, burning while urinating, or vaginal discharge.

Often, people’s reluctance to get tested can come down to one thing.

“They can feel embarrassed and uncomfortable talking about their sexual health with their healthcare provider. I encourage everyone not to feel embarrassed; your provider is trained to treat all parts of the human body,” Burris said.

Robbie Bright, a public health specialist from the Southern Plains Tribal Health Board, says Oklahoma has two options for at-home testing.

The programs are Native Test and I Want the Kit (IWTK). Both offer free, accurate, and confidential in-home specimen collection and lab-based testing for STIs, Chlamydia and Gonorrhea, as well as Trichomoniasis testing for those assigned female at birth.

These tests are also available for residents of Alaska, Kansas, New Mexico, Utah, Arizona, Nevada, Nebraska, Iowa, North Dakota, South Dakota, Oregon, Idaho and Baltimore City.

Syphilis, HIV, Hepatitis B, Hepatitis C and Pregnancy testing has been initiated in Oklahoma, Kansas, Nebraska, Iowa, Oregon, Idaho, Washington, South Dakota and North Dakota.

If internet access is a problem, you can request an HIV self-test kit by texting NATIVE TEST to 55291 to get a rapid HIV and STI self-test kit mailed for free.

“Native Test is a nationwide reaching project coordinated by the Oklahoma Area Tribal Epidemiology Center and is for anyone 13 years or older,” said Bright.

The program can also provide individuals with access to information on HIV preventative care and links to free STI testing in select areas.

“Most STIs are treatable, and for the ones that are not curable, there are treatment options available for management. The sooner you know, the sooner you can begin preventing long-term complications,” Burris said.

If treatment is needed, being open and honest with your healthcare provider and following their instructions is important.
“Talk with your health care provider…Complete your treatment plan as your healthcare provider instructed. Follow-up care is also important; most people will need to be retested again after they complete their treatment,” said Burris.

If left untreated, STIs can cause problems with your heart, nervous system, and reproductive system, increasing your risk for other infections. “Prevention, testing and treatment are all provided at no cost to the tribal members,” Burris said.

There are several common misconceptions or myths when it comes to STIs.

  • Most people do not realize that condoms do not protect from every STI.
    HPV and Herpes can both be spread by skin-to-skin contact
  • They do not have any symptoms, so they must not have an STI.
    You cannot tell by looking who has an STI. That is just not true. Signs such as drainage, herpes lesion, wart, or a sore may not be present at the time; however, someone can still have the disease and spread it to others.
  • You can only get an STI once.
    A person can become infected with many STIs more than once. Each time will require treatment.
  • You can’t get an STI from oral sex.
    You can get an STI from any kind of sex. Male condoms and a dental dam can provide some protection during oral sex.
  • Using a male and female condom together is double protection.
    They should never be used together. This can cause them to break or fall out of place. The best protection is a male condom.
  • I can get an STI from a toilet seat or eating after someone.
    They cannot be spread through casual contact, such as eating, drinking, hugging, holding hands, or sitting on a toilet seat.
  • The best place to carry a condom is in your wallet or purse.
    Condoms should be kept in a place that is dry and cool. They should not be used if they are expired, discolored, look old or have a hole.
  • Douching can protect against getting an STI.
    Douching or showering after sex does not prevent STIs.

Burris says anyone can get an STI. Abstinence from all types of sexual relationships is the only 100% assurance of never contracting some kind of STI. However, a few ways exist to reduce risk and protect yourself and your partner.

  • Getting vaccinated: Hepatitis B and HPV are two common STIs that can be prevented with a vaccine.
  • Reduce your number of sex partners.
  • Get tested and share your test results before having sex.
  • Use condoms correctly, and every time you have any type of sex.

Burris urges everybody not to be complacent in how they think of STI, saying, “STIs can have a serious effect on your health and quality of life… It’s great that we can medically manage them; however, prevention is still as important as the cure.”