The term “STD” (sexually transmitted disease) is increasingly replaced by “STI” (sexually transmitted infections). Is this change (which started as early as the late 1990s) a matter of political correctness? An effort to reduce stigma affiliated with disease? Or are there real distinctions between infection and disease, hence adopting a more medically accurate term?
The correct answer: all of the above.
Usage can be confusing because the medical distinctions between infection, illness, disorder and disease often overlap. In general, however, “infection” is only considered an illness or disease when symptoms occur. Many sexually transmitted bacteria and viruses are contagious without causing symptoms (or may have asymptomatic periods). Just a handful of these include chlamydia, gonorrhea, herpes simplex, HPV, hepatitis and HIV.
Most STIs are treatable. Some strands of HPV can be wiped out by the immune system alone (but not always). But some STIs are not curable, like herpes and HIV (as of today). Contrary to popular confusion, it is not correct to differentiate STIs as “curable” and STDs as “incurable”.
The major distinction is that all STDs are caused by infections. However, not all infections develop into illness or disease. Also, a disease is always associated with symptoms; an infection is not so consistent.
Does this mean it’s wrong to use “STD” in the twenty first century? I would argue no. In many instances, STI and STD are used interchangeably and refer to the same thing.
Why I Say “STI”
I think it boils down to semantics and meaning. Some people feel that dropping the word “disease” only reinforces stigma. Why not just face the fear head on? The more we speak of “disease” the more normalized it becomes, right? Well, not necessarily. “STD” eventually replaced the more euphemistic term “venereal disease” by the 1980s, yet stigma firmly remains.
Personally, I prefer the term STI for two reasons. Firstly, “STI” is a broader term thus more inclusive. Secondly, using the term STI helps raise awareness that physical symptoms are not a reliable way to determine your status. A person can be infected with no symptoms and pass on the infection to others without having a disease.
Serious point here: According to the CDC, 1 in 5 people who are living with HIV today in the United States do not know their status (CDC 2013). In fact, people who do not experience symptoms and/or are not tested are the ones most likely to pass on infection to others. There are serious consequences when STIs are left unknown and untreated. It increases the risk of infection for other STIs and disease. In short, ignorance (RE: stigma) of getting tested and assuming you won’t get an STI is the greatest cause of infection.
Resources: Here are just a few smart spaces we recommend to learn more about STIs and prevention, stigma and facts. Visit Planned Parenthood, The STD Project, the SexEd Library, the NMAC (National Minority AIDS Council), the Guttmacher Institute, the Canadian HIV/AIDS Legal Network.
The fabulous sex educator, Andrea Renae (@theandrearenae), recommends the Judgement Free Health Care Providers directory, which is inclusive of LGBT and Queer people, Asexuals, Demisexuals, Polyamorous relationships, sex workers and people living with HIV. There is also the safer sex video Pleasure Rush initiative (NSFW) by GALAEI.
Ask questions on the InformedAboutSex forum.