Sexually transmitted infections (STIs) are a widespread public health concern. While many STIs can be treated and cured, a distinct category cannot be entirely eradicated from the body. Understanding these persistent infections is important for managing individual health and preventing further transmission.
What “Not Curable” Means
“Not curable” signifies that an STI, once acquired, remains in the body for life. This does not mean the infection is untreatable or that symptoms cannot be managed. Medical interventions can control the virus or bacteria, suppress its activity, and reduce the frequency or severity of symptoms, but they cannot remove it completely.
Common Non-Curable Sexually Transmitted Infections
Several sexually transmitted infections persist in the body for a lifetime. These include Human Immunodeficiency Virus (HIV), genital herpes, Human Papillomavirus (HPV), and chronic Hepatitis B.
Human Immunodeficiency Virus (HIV) is caused by a retrovirus that targets and weakens the body’s immune system. Early symptoms can resemble a flu-like illness, though some people have no initial symptoms. HIV is primarily transmitted through contact with infected bodily fluids such as blood, semen, vaginal fluids, and breast milk, typically via unprotected sexual contact or sharing needles.
Genital herpes is caused by the Herpes Simplex Virus (HSV-1 and HSV-2). HSV-1 commonly causes oral herpes, but can also cause genital herpes, while HSV-2 is the primary cause. Symptoms often involve painful blisters or open sores on or around the genitals, rectum, or mouth. Many individuals experience no symptoms or very mild ones, leading them to be unaware of their infection. Transmission occurs through skin-to-skin contact, often during vaginal, anal, or oral sex, even when no visible sores are present.
Human Papillomavirus (HPV) is a group of over 200 related viruses, some of which are sexually transmitted. Certain low-risk types of HPV (e.g., types 6 and 11) cause genital warts, which are small, fleshy growths or bumps on or around the genitals or anus. High-risk HPV types (e.g., types 16 and 18) typically do not cause symptoms but can lead to cell changes that may develop into certain cancers, including cervical, anal, and oropharyngeal cancers, if the infection persists. HPV is transmitted through intimate skin-to-skin contact, including vaginal, anal, or oral sex.
Hepatitis B (HBV) is a liver infection caused by the Hepatitis B virus. While some infections are acute and resolve, others become chronic, meaning the virus remains in the body long-term. Chronic Hepatitis B can lead to serious liver problems like cirrhosis or liver cancer. Many people with chronic HBV have no symptoms, but if they occur, they can include fatigue, nausea, vomiting, abdominal pain, dark urine, and yellowish skin or eyes (jaundice). HBV is transmitted through contact with infected bodily fluids such as blood, semen, and vaginal fluids, often through unprotected sex, sharing needles, or from mother to baby during birth.
Living with a Lifelong Infection
Managing a lifelong STI involves ongoing medical care and adherence to treatment plans to maintain health and reduce transmission risks.
For HIV, antiretroviral therapy (ART) involves taking daily medications that significantly reduce the amount of HIV in the blood, often to an undetectable level. Achieving an undetectable viral load not only allows individuals with HIV to live long, healthy lives but also prevents sexual transmission of the virus. Regular monitoring of viral load and immune cell counts is part of this management.
For genital herpes, suppressive antiviral medications can reduce the frequency, severity, and duration of outbreaks by over 90%. These medications can also lower the risk of transmitting the virus to partners.
While there is no cure for HPV, regular screenings, such as Pap tests for cervical cancer, are important for early detection and management of precancerous changes caused by high-risk HPV types. Chronic Hepatitis B can be managed with antiviral medications that help control the virus and prevent liver damage, though these do not cure the infection. Beyond medical treatment, addressing the emotional and psychological aspects of living with a lifelong condition, including seeking support and open communication with healthcare providers, is also beneficial.
Protecting Yourself and Others
Preventing the acquisition and transmission of STIs involves a combination of informed choices and protective measures. Consistent and correct use of barrier methods, such as condoms, during vaginal, anal, and oral sex significantly reduces the risk of transmission. However, condoms may not cover all areas of potential skin-to-skin contact for infections like herpes and HPV.
Regular STI testing is important for sexually active individuals, as many STIs, including non-curable ones, often present with no symptoms. Early detection allows for timely management and can prevent long-term health complications and further spread.
Vaccination offers protection against certain non-curable STIs; the HPV vaccine can prevent infections from high-risk HPV types that cause cancer and some low-risk types that cause genital warts, while the Hepatitis B vaccine protects against HBV. Open and honest communication with sexual partners about STI status and testing history is also a step towards shared sexual health and informed consent.