The U.S. Centers for Disease Control and Prevention estimates that more than 20 million new sexually transmitted infections occur annually in the United States, contributing to roughly 110 million total infections and $16 billion in medical costs each year. Common STIs include human papillomavirus, or HPV, chlamydia, trichomoniasis, gonorrhea, herpes simplex virus, or HSV, syphilis, hepatitis B and human immunodeficiency virus, or HIV. About half of new STIs occur in youth who are 15-24 years old.

STIs are also common among the military active duty population, where more than a third of service members are under 25. Risk factors for infection and disease trends tend to mirror those observed nationally.

Depending on the STI, symptoms can include painful urination, itching, discharge, painful or swollen testicles, bleeding between menstrual cycles, painful intercourse, abdominal or pelvic pain or rashes. More often, an STI may not have noticeable symptoms. Chlamydia, for example, is known as the "silent infection," and fails to show symptoms in about 80 percent of infected women and 50 percent of infected men. Likewise, syphilis is another STI that often goes unnoticed in early stages. It is on the rise in both civilian and military communities, especially among men who have sex with men (MSM). And having an STI can make it easier to get another. In several major U.S. cities, about half of MSM with syphilis are co-infected with HIV. Periodic STI testing is often the best way to identify infections.

Common high-risk behaviors include having unprotected sex, inconsistent condom use, multiple partners, one night stands, soliciting sex and being under the influence of alcohol or drugs. Technology such as "hook-up" apps has also increased STI risk by linking anonymous partners for casual sex. Online profiles can be deceptive, setting you up for a dangerous situation and leave lingering uncertainty about STIs. The anonymous encounters make it challenging to notify a partner of a positive STI test.

All STIs are preventable, many are curable and all can be treated to manage symptoms. Prevention starts with communicating with intimate partners and taking charge of one's sexual health. Effective ways to reduce your risk include:

• Using a condom correctly every time when engaging in oral, vaginal or anal sexual activity
• Reducing the number of sexual partners and the number of high-risk partners, situations and sex acts
• Being in a mutually monogamous relationship with an uninfected partner
• Talking to a medical provider about getting tested (every three to six months)
• Getting the HPV and Hepatitis B vaccines

If you are concerned about your STI risk, you can request testing through your primary care clinic. Military treatment facilities offer free, confidential testing, treatment and counseling for TRICARE beneficiaries. Local public health departments also offer low cost testing and treatment. In some cases you can even collect the sample at home.

For additional information regarding STIs or HPV and Hepatitis B vaccination, contact your primary care provider, Preventive Medicine, or follow any of the links provided.

Remember, prevention starts with you.