Teens and STIs: A Check-up on Sexually Transmitted Infections

By Dr. Kristen Kurtz, pediatric resident at CHOC Children’s

It’s important for parents to educate themselves on the prevalence of teens and STIs, and what they can do for prevention. Sexually transmitted infections (STIs), also known as STDs, are infections that can be passed from person to person during sexual contact including oral, vaginal and anal sex. Some of the most common STIs include chlamydia, gonorrhea, syphilis, genital herpes, human papillomavirus (HPV) and HIV. About half of all new sexually transmitted infections are diagnosed in teenagers each year. It is important for all sexually active people, including sexually active adolescents and young adults, to be tested for these infections each year. Early detection is critical because some of the infections do not cause symptoms. The CDC and AAP recommend annual screening for ghonnerea and chalamydia for people who are sexually active. We recommended regular HIV screening for anyone who is sexually active.


The most common STI is caused by a bacterium that is passed from person to person in bodily fluids. Most people who are infected do not have any symptoms, but symptoms can include:

  • discharge (abnormal fluid) from the vagina or penis
  • pain or burning with urination
  • abdominal pain
  • pain during intercourse
  • swelling or pain in the testicles

Serious consequences include chronic abdominal pain, infertility and abnormal pregnancy that can be dangerous for mother and child. Chlamydia is curable with a single dose of antibiotics. If any symptoms appear, it’s important to seek medical attention immediately.


Gonorrhea is caused by a bacterium that lives in warm, wet body parts (such as the mouth, anus and reproductive tracts). It is passed from person to person during contact between these body parts, and does not require a transfer of bodily fluids (ejaculation) to be spread. Most people who are infected do not have any symptoms, which may include:

  • discharge from the vagina, penis or anus
  • pain or itching during urination
  • abdominal pain
  • pain during intercourse
  • swelling or pain in the testicles

Serious consequences can include chronic abdominal pain, infertility and abnormal pregnancy that can be dangerous for mother and child. Gonorrhea is a little harder to treat but is curable. Treatment is often given in the doctor’s office and includes an antibiotic injection plus a single dose of antibiotic tablets.


Bacteria spread by direct contact (touching) with an open sore can cause syphilis. Syphilis bacteria can even infect healthy skin. Sores most commonly occur on the external genitals, vagina, anus or rectum, but they can also occur on the mouth or lips and be spread during oral, anal or vaginal sex.

Symptoms of syphilis appear in three stages:

  • Stage 1: a painless, reddish-brown sore on the genitals, mouth, anus or rectum
    • Sometimes the sore is in a place that is hard to see on your own. This makes it more important to have routine medical exams.
  • Stage 2: flu-like illness with fever, decreased energy, rash and sore throat
  • Stage 3: complications occur, including brain damage, mental illness, heart disease, and/or death

Syphilis is curable with a single dose of an antibiotic injection if caught early enough. More prolonged treatment is needed for stage 2 or 3 syphilis. This means that getting tested routinely is important, even if you feel fine. Getting additional testing immediately is important if any symptoms appear.


Genital and oral herpes are caused by a virus that is passed from person to person during direct skin contact, usually during sexual contact. It can be transmitted even when there are no visible sores. Genital herpes causes itching at first, followed by the appearance of painful blisters that can cause burning in the genitals. There is no cure for herpes. The herpes blisters will go away without medication, but the infection is not gone and will be spread during unprotected sex, even if no blisters are present at the time.

To help manage herpes, an antiviral medication can be taken to prevent or shorten outbreaks (recurrence of herpes bumps). The medication also helps prevent viral shedding – the process by which someone with herpes but no bumps can pass it to others. The medication can be used for oral or genital herpes.

Human Papillomavirus (HPV)

HPV is a virus that is passed from person to person during skin contact. It can cause genital warts, cervical cancer, penile cancer and anal cancer. HPV is the only vaccine-preventable cause of cancer. There is no cure for HPV, but there is a vaccine available to help prevent infection with the most common cancerous strains of the virus. Learn more about the HPV vaccine.


HIV (human immunodeficiency virus) is a virus that suppresses the immune system, and ultimately leads to AIDS (acquired immunodeficiency syndrome). HIV can cause a wide variety of symptoms, from those of the common cold to severe infections and mental illness. It is very important for sexually active individuals to be tested for HIV regularly, due to the variable nature of its symptoms and progression. Although there is medication available to manage symptoms, the is currently no cure for HIV.

Tips for preventing infection with STIs

It is important to know that some forms of birth control (the pill, patch, ring, implant, shot and IUD) all work to prevent pregnancy, but do not protect against STIs. There are, however, several ways to help prevent STIs.

First, talk to your partner about how you want to practice safe sex. This can include waiting to have sex until you both get STI testing. Once you’re both negative, use condoms with every sexual act. Using condoms is the most effective way to prevent the spread of STIs during sexual contact, including oral, anal and vaginal sex.

It is important to remember that condoms only protect against:

  1. infections that are transmitted in bodily fluids, and
  2. infections that are transmitted by direct contact only if the area is covered by the condom.

If a person has bumps or sores on a body part that is not covered by a condom, the infection can spread to another person. One other option available to prevent STI spread is the dental dam. The dental dam is a sheet of latex that can be used to cover the vaginal or anal area during oral sex to prevent spread of infection.

Learn more about adolescent medicine at CHOC.

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