No, Operation Shield is not a current military operation, nor is this article going to tell you about any hotly anticipated Marvel movies. The title was designed to capture your attention about a very important problem that significantly impacts our communities and to inform you of ways to shield yourself from it. That nemesis is sexually transmitted infections or STIs.

STIs present a substantial public health challenge in the United States and abroad. The Centers for Disease Control and Prevention estimates that over 110 million STIs occur annually in the U.S., and the World Health Organization estimates that global infections exceed one billion each year. The most common STIs are human papillomavirus, chlamydia, gonorrhea, trichomoniasis, herpes simplex virus, syphilis, hepatitis B, and human immunodeficiency virus. Left untreated, these infections can lead to long term complications such as infertility and even death. Identifying STIs can be challenging because many do not cause symptoms in the early stages of infection. Other obstacles such as increasing antibiotic resistance can make treatment less effective. Additionally, new emerging infections such as Ebola and Zika viruses have also been shown to spread through sexual contact, though that is not their primary mode of transmission.

The good news is that STIs are preventable, many are curable and all can be treated to manage symptoms. The first step towards prevention is education -- knowing your risk, recognizing symptoms, and learning how to detect, prevent and treat STIs are key.

Who is at risk? Anyone who engages in sexual activity - oral, anal, genital with an infected partner is at risk. Because it is not always possible to tell who is infected, practicing safe sex is crucial. Understanding high-risk behaviors and who is at highest risk can also be helpful in managing risk. Within the U.S., high risk groups include sexually active individuals younger than 25 years of age, men who have sex with men, ethnic minorities, those in low socioeconomic status, residents of the southern U.S. and persons engaging in high-risk behaviors such as having unprotected sex, inconsistent condom use, multiple partners, anonymous casual partners and alcohol or drug use.

Around half of all people infected with an STI are young people aged 15 to 24. Historically, higher rates of STIs have been reported among members of the U.S. military, especially Army Soldiers, as compared with civilians. The higher STI burden is not too surprising given that more than one-third of Army active duty soldiers are younger than 25. Luckily, the Army also has greater access to medical care, which increases the likelihood of detecting and treating infections.

What are the symptoms? Unfortunately, recognizing the symptoms of an STI can be harder than you think. Initial symptoms of an STI can include: discharge, pain during urination, sudden and desperate urges to urinate, pain during intercourse, ulcers with or without pain, nausea and fever and abdominal pain. Many people will never experience symptoms, which make it harder to identify and treat infections and to break the transmission cycle. When left untreated, STIs can cause permanent damage. For example, STIs such as chlamydia and gonorrhea can potentially lead to persistent and chronic pelvic pain, infertility, pelvic inflammatory disease and ectopic pregnancy. Untreated syphilis can lead to problems with the heart, brain and nerves that can result in paralysis, blindness, dementia and even death. Additionally, having an STI puts you at increased risk of acquiring other STIs such as HIV.

What can you do to prevent infection? There are many effective ways to prevent STIs or decrease your risk.
1) Practicing abstinence
2) Using condoms consistently and correctly EVERY TIME you have oral, anal or vaginal sex
3) Practicing mutual monogamy between uninfected partners
4) Getting the HPV and Hepatitis B vaccines
5) Talking to your partner about STIs and staying safe before having sex
6) Getting tested
7) Getting treated if you test positive

Military Treatment Facilities offer free and confidential testing, treatment and counseling for all TRICARE beneficiaries and can also provide vaccine recommendations. Low cost testing and treatment is also available through local public health departments and at-home tests are also available for some STIs.

For more information about STIs, please visit
http://phc.amedd.army.mil/topics/healthyliving/wh/Pages/Women.aspx or http://www.cdc.gov/std/default.htm.