Ahh, St. Louis. Home to the Gateway Arch, the Saint Louis Cardinals, Ted Drewes and… more people with itchy, uncomfortable crotches than anywhere else in the country, at least according to the CDC. If their numbers are right, and I’m betting they are, we lead the nation in gonorrhea and chlamydia cases per capita. Our numbers of reported HIV and syphilis cases aren’t far behind – we’re number five in the nation.

I’m not so proud. But what can we do about it?

1. Know the enemy.

STDs (Sexually Transmitted Diseases) or STIs (Sexually Transmitted Infections) are just what their names imply, diseases or infections that spread through sexual contact, including those oral activities we all love so much. STDs can also be spread through skin-on-skin activity, where open sores are present. Blood-borne infections can be contracted when instruments that come into contact with blood (needles, tattoo guns, etc.) are shared without being sterilized or disinfected between uses. So, if you’re getting inked, make sure the guy you’re allowing to repeatedly puncture your skin has a way with rubbing alcohol and a fresh supply of needles.

There are many different kinds of STDs and STIs. To cover them all completely would take someone with far more medical expertise and patience than I possess. So, I’m going to hit the biggies and hope for the best.

• Chlamydia – Symptoms of chlamydia include vaginal discharge, painful urination, pain when having sex, lower abdominal pain and bleeding between menstrual cycles. Unfortunately, St. Louis’ favorite plague is often asymptomatic. In fact, 85% of women don’t even know they have chlamydia until they get tested. Chlamydia is bacterial in nature and can be cured with antibiotics. Non-treatment can result in PID (Pelvic Inflammatory Disease), ectopic pregnancies, urethral infection (NGU) and/or infertility.
• HPV (Human Papilloma Virus)/Genital Warts – This is a scary mother, mostly because it is so common and so insidiously sneaky. It’s estimated that as many as five million (!) people contract HPV per year. HPV is sometimes referred to as genital warts, but only 2 of the 100+ types of HPV actually cause visible bumps. So how do you know you have it? Make nice with your gyno, invasive and strangely intimate though he/she may be. Your annual Pap smear will detect internal bumpage. And if you see a sore or skin irregularity south of the border, immediately go see a doctor. HPV is not curable, but it is treatable, so you have some options if irregularities are detected. Without treatment, HPV can morph into cervical cancer and cause infertility.
• Gonorrhea – Another of St. Louis’ faves, gonorrhea can result in burning/pain when peeing, painful bowel movements, increased vaginal discharge (sometimes yellow or bloody), bleeding between menstrual cycles, abdominal pain, lower back pain or fever and/or pain during sex. It can affect areas of your body not commonly associated with the horizontal mambo, such as the eye, mouth or throat. Gonorrhea doesn’t always display symptoms, so get yourself tested. And then cure the crap out of it, because untreated gonorrhea can result in Disseminated Gonococcal Infection (DGI), which occurs when the disease spreads to the skin, heart, blood, and joints. As per the usual STD modus operandi, untreated gonorrhea can also result in infertility and PID.
• Herpes – Those Valtrex commercials, the one that talk about how easy it is to live with herpes? They’re spot on. Because herpes is incurable, you’ll be living with it. Forever. Symptoms include blisters, bumps, or pimples on the infected area that crust over, fever, headache and pain while urinating. Herpes sometimes looks like bug bites, rash, jock itch, razor burn, irritation from sex, or a yeast infection. Sores are not always present – outbreaks typically occur one to five times per year. It’s a skin disease, so it can be spread through contact with that icky sore on your lover’s lip, as well as through intercourse. You can spread herpes when no outbreak is present, though your chances dip significantly. If you go to get tested when the virus is dormant, ask for a “herpes type-specific IgG” test to ensure accurate results.
• HIV/AIDS (Human Immuno-deficiency Virus/Acquired Immuno-deficiency Syndrome) – The terror of the 80’s is still here, and it’s quite comfortable in the STL. The myths still abound. You can’t get HIV/AIDS from a mosquito that bit an infected person, nor can you get it from kissing. You CAN get it through all other sexual contact and HIV also spreads through the blood, so anything needle or injury related is a possibility. Mothers, beware – HIV can be transmitted in childbirth and through breast milk. HIV is usually asymptomatic until the advanced stages of the disease (AIDS) kicks in and the immune system begins to fail. Don’t forget to request a test when you go to your doctor, as the process is different from typical screening panels. There’s no cure for HIV/AIDS, but advances in medicine are making it possible for those infected to live longer and in better health than ever before. Thank you, Bono. Not to mention those awesome medical professionals that work tirelessly to keep us safe and healthy.
• Syphilis – Syphilis comes on like the ocean, in waves. Here’s how it goes down: in the primary stage, sores are often present. They are usually firm, round, small and don’t cause pain. They may go away on their own, but the bacteria is still present in the body. In the secondary stage, a reddish brown rash may develop on the body and fever, swollen glands or hair loss may ensue. In the latent stage, symptoms are dormant. This stage can last awhile, up to 30 years. The real pain in the butt is late-stage syphilis. In this stage, the bacteria attacks all body systems, often resulting in blindness or brain damage. Don’t let it get that far. After all, the disease that killed Al Capone is now entirely curable thanks to the magic of penicillin and testing is an easy route to detection.

2. Find the enemy.

If you haven’t noticed a theme throughout this post, you haven’t been paying attention. I’ll say it again – get tested! Please! At least once a year, maybe more if you like no-strings sex a lot. Say, “He doesn’t LOOK like he has an STD!” and you’re doing yourself and your body a grave disservice. You can’t always tell. In fact, you usually can’t. Here’s another brain-buster. People cheat. So that fabulous and committed relationship you’re in? Not necessarily a guarantee that your man won’t bring something other than a hangover home from that bachelor party. I’m begging you, get tested when you go for your annual exam, or use one of the many clinics that offer free or inexpensive testing. Your woman parts will thank you.

3. Kick the enemy’s ever-lovin’ butt!

Abstinence is the only sure-fire way to avoid an STD or STI. But awareness comes a close second. Knowing what to look for, arming yourself with the means to protect yourself from it (that means condoms, dental dams, clean needles, the ability to talk openly and honestly with your partner and, of course, regular testing), and taking care of problems before they become bigger problems is the key to a safe and healthy sex life. You can also help to raise awareness by talking to your girlfriends (or guy friends, if you’re that comfortable with them) about what you read here. I don’t look forward to topping the STD lists again, so let’s lose the stigma that STD’s are a dirty, hush-hush kind of subject. By the age of 25, one in four people will have contracted one. The only way to combat that is through education and preparation. Think about it – you may save your friends’ cervix. Hell, you may save her life. Don’t be afraid to discuss or get involved.

I don’t mean to scare anyone with this article, but I do hope that I made you think. Sex is a beautiful, fulfilling and downright fun activity. You don’t have to be terrified to the point where you stop making with the love altogether, but you do have to have a healthy respect for what you are doing to and for your body. You are the guardian and gatekeeper of your sexual health. Don’t screw it up!