Cystic Fibrosis: Sexually Transmitted Infections (STIs)

Deciding to have a sexual relationship is a big deal for everyone for many reasons, including the possible risks of getting a sexually transmitted infection and/or becoming pregnant.

What are sexually transmitted infections (STIs)?

Sexually transmitted infections (STIs) (sometimes called sexually transmitted diseases or STDs) are passed from person to person through contact with infected body fluids such as blood, vaginal fluids, or semen. They can also be spread through contact with infected skin or mucous membranes, such as sores in the mouth. You may be exposed to infected body fluids and skin during sexual contact. Sexual contact includes any sexual act with another person involving contact with the vulva, clitoris, vagina, mouth, anus, penis, or testicles. STIs can be spread with or without intercourse (penetration). Anyone who has sexual contact with another person is at risk of getting a STI. This includes different-sex couples and same-sex couples.

People with CF have the same risk of getting STIs as people without CF.

STIs include:

Frequently Asked Questions about STIs

What are the symptoms of an STI?

Symptoms vary depending on the type of sexually transmitted infection. Many STIs have no symptoms, or are “asymptomatic.” Symptoms can include a different type of discharge than usual from the penis or vagina, genital sores, pain or itching of the vagina or penis, lower stomach pain, pain or burning when you pee, pain during sex, or bleeding other than your menstrual period.

If you think you have had sexual contact with someone who might have an STI or if you have any new symptoms, talk to your health care provider or CF team right away. It might not be anything serious, but it’s best to get checked out to be safe. Be sure to get checked for STIs at least once a year and also if you change partners or have symptoms.

How can I prevent getting an STI?

The best way to prevent getting an STI is to not have sex. Some STIs can’t be cured, so you should always practice safe sex or find ways to be close in a romantic relationship without having sex. You can lessen your risks of STIs by using a barrier method EVERY time you have sex. 

Barrier methods prevent direct oral, anal and genital contact, and the passing of body fluids (blood, semen, and vaginal fluids) from one person to another.  Barrier methods include male condoms, female condoms, and/or dental dams (for mouth to genital/anal contact). Barrier methods provide protection against most STIs, but not all. For example, HPV (human papillomavirus) can be spread from skin to skin contact around the genital area, not covered by condoms. It is important to remember that other types of contraceptives (such as IUDs or birth control pills) do NOT protect against STIs but are effective in lowering the risk of pregnancy.

If you are having or plan to have sex, you should:

  1. Understand the possible risks and benefits that are involved before becoming sexually active.
  2. Talk with your partner about ways you can protect yourselves from STIs. Make a plan and agree to use the method you have chosen.
  3. Always tell your medical providers (including your CF team) if you have had any sexual contact or are sexually active so that you are given important and necessary information to stay healthy.
  4. Use a barrier method of protection (condoms/dental dams) 100% of the time. You need to make sure that you use a new latex condom or dental dam correctly every time you have oral, anal, or vaginal sex.
  5. Change condoms in between different types of sexual activity such as from anal to vaginal sex. If you are allergic to latex, use polyurethane male or female condoms or silicone dental dams. Do not use lamb-skin condoms or plastic wrap for sexual intercourse.
  6. Use a water-based lubricant with condoms (such as KY Jelly®). The lubricant will keep the condom from breaking. Never use lubricants that contain oil or fat, such as petroleum jelly or cooking oil. These products weaken latex and can cause the condom to break.
  7. Do NOT have sexual contact with anyone who has signs of an STI (sores, blisters, rashes, or discharge from the mouth/genital area).
  8. Get tested for HIV and STIs and encourage your partner to be tested before you have sexual contact. You should do this with each new sexual partner.
  9. Limit the number of people you have sex with. The more partners you have, the greater your risk of being exposed to an STI.

Can vaccinations protect me from getting STIs?

Yes. Some STIs can be prevented through vaccination such as human papillomavirus (HPV) and hepatitis BIt is especially important that people with CF get vaccinated.  If you have a lung transplant someday and are immunosuppressed, STIs, such as HPV, can cause cancers of the skin and genital area.

What should I do if I think I have an STI?

If you have any symptoms of an STI (sores, rashes, or discharge from the genital area), any unexplained problems, or you think you may have been exposed to an STI (even if you don’t have symptoms), see your primary care provider or CF team right away to get tested. Some STIs may not show up on the test right away, so if you think you have been exposed and get a negative result back, it’s important to ask your health care provider if you should get tested again a few weeks or months later. Ask your CF team or primary care provider when you should come back for testing.

  • You can’t test or diagnose yourself with an STI. Only a health care provider can do that. Most STIs can be treated, and the earlier you get treatment, the better. More serious problems can develop if you wait. Whenever possible, treatment is given in a single dose, but sometimes you’ll need to take medication longer.
  • If you are diagnosed with an STI, call your CF team and let them know what you are being treated for and the name and dose of the medicine you are taking.

What should I do if my partner or a past partner tells me that he/she has an STI?

Ask your partner the name of the STI and what medication they took. Tell your health care provider or CF team right away so that you can get tested and treated.

Are all STIs curable?

No. Some STIs, such as herpes or HIV, stay with a person forever. These infections can be controlled with medications, but cannot be cured. Other STIs, such as chlamydia and gonorrhea, can be cured, but it’s important to be treated right away to avoid complications and fertility problems later.

How are you tested for STIs?

STI screening means your blood or body fluid is tested for STIs. Screening tests may include blood tests, urine tests, or vaginal swabs. If you have an infected body part or sore, your health care provider may use a swab (Q-Tip) to take a sample for testing. Blood tests require a quick needle stick. Urine tests and swabs are usually painless.

The test is sent to a laboratory to check whether you have a STI and your medical team is notified of the results.

Where can I get tested for STIs?

You can be tested for HIV and STIs at your primary care provider’s office, your CF clinic, Planned Parenthood and other family planning clinics, or at special clinics for HIV and STI testing.

Do I need a Pap test or a pelvic exam?

Most health care providers agree that you should have your first pelvic exam when you have symptoms such as discharge, pain, or irregular periods, when you want an IUD, or when you turn 21. You should get your first Pap test earlier if your immune system doesn’t work well, such as if you have HIV or if you are taking meds for a transplant. Pap tests help detect pre-cancerous/cancerous lesions of the cervix (inside of the vagina) that are most often caused by human papilloma virus (HPV). If you have already had a lung transplant, you should have a pelvic exam and Pap test when you start to have sex regardless of your age or if you have symptoms. Your CF team can help you figure out if you need a pelvic exam or Pap test.

What about confidentiality? What if I don’t want my parents to know that I’m having sex?

What you tell your primary care provider or CF team about your sexual behavior is confidential.

It’s okay for you and your CF team to ask that your parents or family members step out of the room for parts of your visit with your medical providers or CF team. Ask your CF team and PCP about their confidentiality policies and if the health care provider’s notes from your medical visit can be viewed by your parents through the online portal. Your medical providers should not talk about confidential information to anyone else unless he/she seriously believes there is danger to you or to others, that you are being abused, or that you are not able to make safe decisions. Although your medical providers do their very best to keep your information private, there is a chance your health insurance company or pharmacy may send information to your home. Many teens find it helpful to talk to their parents about their health and their worries.

When you are eighteen or older, all of your health care and decisions are confidential. If you are younger than 18, confidentiality laws vary from state to state; however, in all states STI testing and results are confidential.

Find someone on your CF team you can talk with if you have questions about STIs or if you need to be screened. They can help get you the care you may need. 

Here are some specific talking points and tips that may help you discuss STIs:

  • Tell your CF team if you are sexually active and ask about STI screening. Screening is recommended for everyone who is sexually active, so don’t hesitate bringing it up!
    • Examples: “I am having sex and I know that I should be screened for STIs. Can I get STI testing in this clinic today? Or can you recommend when and where I can get confidential testing?”
  • Ask about a referral to a women’s health specialist or other doctor if you are interested.
    • Example: “Is it okay to ask for a female health provider?(such as an adolescent medicine specialist or a gynecologist) Is there a local clinic you would recommend?”
  • If you are diagnosed with an STI, don’t be afraid to ask if the health care provider has more time to talk or if there is someone else you can talk to. It can be hard to hear that you have a STI. It’s also important to let your CF team know right away if you are prescribed a medication to treat your STI and who prescribed the med(s).
    • Examples: “It is hard to hear that I have an STI. Do you have more time to talk about this? Or is there someone else I could talk to about how to handle this information?”
    • “I was diagnosed with an STI and I was prescribed [this medication]. Does this drug have any interactions with my regular CF medications?”

There is a lot of information to consider when you have CF and are having sex. You can print this guide or have your provider access the webpage during your visit.