Beyond X & Y

Beyond X & Y: Sexually Transmitted Infections

According to the CDC, there's about 20 million new STIs each year, and half of them are among 15-24 year olds

November 30, 2020
The letters "se" and "xy" moving toward each other horizontally, pressing together, and then separating as "s" and "x" move upward and "e" and "y" move downward out of frame
Gender and sex beyond X & Y. [Credit: Niko McCarty | CC BY-NC-ND 2.0]

Conventional wisdom tells us prevention is the best medicine, but sometimes even the best laid plans (ha-ha) fail. Sexually transmitted infections (STIs) are extremely common and very easy to treat — and if left untreated, STIs can cause permanent damage, such as infertility. Lots of people who contract them often don’t show symptoms, so it’s important to get tested regularly. Equally important is the ability to seek and receive help if you do learn you have one. 

Find the nearest U.S. testing site to you here.


  • Very common STI, more than 3 million cases in the U.S. per year
  • Symptoms:
    • Painful urination
    • Abnormal discharge from genitals
    • Testicular pain
    • Lower belly pain, near uterus
    • Infected people might not show symptoms but can still transmit
  • Infection treated with antibiotics
    • Combination of injectable ceftriaxone and oral azithromycin (Zithromax)
    • Or, for those allergic to antibiotics such as ceftriaxone, one can use oral gemifloxacin (Factive) or injectable gentamicin and oral azithromycin
  • Also called: The Clap



  • Common STI, more than 200,000 cases in the U.S. per year
  • Symptoms:
    • Genital pain
    • Discharge
    • Infected people might not show symptoms but can still transmit
  • Infection treated with antibiotics
  • Pop culture appearance: Mean Girls (2004)



  • Less common STI, fewer than 200,000 cases in U.S. per year
  • Symptoms:
    • Painless sore on genitals, rectum or mouth
    • Rash
    • Damage to eyes, nerves, brain or heart — which can occur years later if left untreated
  • Infection treated and cured with penicillin injection
  • Some believe Friedrich Nietzsche died from an infection in his brain caused by syphilis, though this opinion is disputed



  • Human immunodeficiency virus
    • Left untreated, can cause AIDS (acquired immunodeficiency syndrome)
  • Less common STI, an estimated 36,400 new HIV infections occurred in 2018
    • About 1.2 million people in the U.S. live with HIV today — 14% of them don’t know it
  • Treatment as Prevention (TasP)
    • For those with HIV:
      • Antiretroviral therapy (ART), started right after diagnosis
        • Can reduce the amount of HIV in blood in a process called viral suppression
        • If the amount of HIV in blood is so low that it’s undetectable, then the infected person has effectively no risk of transmitting the virus to a partner through sex
    • Pre-exposure prophylaxis (PrEP)
      • Preventative once-daily pill that reduces contracting HIV sexually by more than 90%
      • Two FDA-approved PrEP medications
        • Truvada
        • Descovy
    • Post-exposure prophylaxis (PEP)
      • Brief regimen of medicines taken soon after possible exposure to prevent viral spread within body
      • Should be used in emergency situations only, not meant for regular use
  • Pop culture appearance: Scrubs (Season 8, Episode 13: “My Full Moon” 2009)


Genital Herpes/Warts 

  • Herpes Simplex 2 (HSV-2)
    • Causes genital herpes
    • HSV-1 causes oral herpes
    • About 67% of people globally have an HSV-1 infection
    • 11% have an HSV-2 infection
  • Very common – more than 3 million cases in the U.S. per year
  • Symptoms
    • Appearance of sores on genitals
    • Formation of ulcers and scabs
    • Sores may last two to six weeks
    • Pain and itching
    • Fever
    • Swollen lymph nodes
  • Treatment
    • Cannot be cured, but treatment can relieve symptoms and lower risk of spread to other partners
    • Antiviral medications can prevent or shorten outbreaks
    • Over-the-counter herpes treatments, often creams, can subdue pain and itching
  • Pop culture appearance: Saturday Night Live (1982) (“Tough day at the orifice, dear?” ft. Eddie Murphy)



  • Human papillomavirus
  • Very common — more than 3 million cases in the U.S. per year
    • Most sexually active people will contract it at some point
    • 90% of HPV infections go away on their own within two years
  • Many people don’t develop symptoms, but can still infect others
    • HPV can be transmitted by skin-to-skin contact, and intercourse isn’t necessary
  • There are over 100 types of HPV, and more than 40 are sexually transmitted
  • Symptoms
    • Warts on various parts of body
  • Can cause cervical cancer, and is linked to other cancers of genitals, head, neck and throat
  • Treatments
    • Medications can treat genital warts, which are only a symptom of the virus
    • Preventative vaccine
      • Two-dose inoculation in children (between ages nine and twelve)
      • Three-dose inoculation after 15th birthday over course of six months
  • Pop culture appearance: Saturday Night Live (2011)


Shaming those who get STIs helps no one. If anything, fear of being shamed might prevent people from asking crucial questions that could lead to crucial treatment. Not discussing STIs will inevitably cause more harm than anything else.


About the Author

Elana Spivack

Elana Spivack is a science writer in New York City. When not on deadline, she enjoys salsa dancing, bike riding and befriending bodega cats.


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