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By V. Hauschild, MPH, Defense Centers for Public Health–Aberdeen Public Affairs
Sexually transmitted infections, or STIs, include both sexually transmitted diseases, known as STDs, and the many infections that don’t progress to disease. STIs are caused by more than 30 different organisms, including bacteria, viruses, and parasites, which are transmitted through skin-to-skin and bodily fluid contact during intimate sexual encounters.
The most commonly tracked STIs are chlamydia, gonorrhea, and syphilis. The Department of Defense has had an ongoing battle with them for decades.
“STIs are much more common than many realize,” says Francis Obuseh, a senior epidemiologist and Defense Health Agency–Public Health STI expert. “STIs are estimated to be experienced by about 1 in 5 people in the U.S. every year – this includes service members. Symptomatic infections and long-term complications can compromise service member readiness and well-being.”
Obuseh says the effects of STIs can show up days, weeks or even months after exposure in those who experience signs and/or symptoms. Before they develop symptoms, they may unknowingly pass the infection to other sexual partners.
But those who are symptomatic and seeking care don’t capture the full risk, he says.
“Especially concerning are asymptomatic STI cases, who are people who do not have symptoms but are ‘carriers’ who can still give the infection to others,” says Obuseh. “Unfortunately, many people, both men and women, fall in this asymptomatic category. Since they don’t have symptoms, these infected people typically don’t seek testing and treatment, continuing sexual activity and increasing STI spread.”
The case of chlamydia
Data from the Centers for Disease Control and Prevention (https://www.cdc.gov/sti-statistics/annual/summary.html) continue to show chlamydia is a significant public health concern among civilians, and military STI surveillance has indicated chlamydia rates among service members are almost two times higher than among civilian U.S. adults (https://pubmed.ncbi.nlm.nih.gov/34075000/).
Current U.S. military STI surveillance reports show that rates of chlamydia declined between 2015 and 2023, but chlamydia remains the most commonly detected STI among service members (https://www.health.mil/News/Articles/2024/06/01/MSMR-STIs-2023?type=Fact+Sheets). The highest rates of chlamydia were observed in the Army and Marine Corps. Service members under 25 years of age were the most commonly infected.
According to recent DHA-PH data, the chlamydia infection rate of female service members is approximately three times higher than that of their male counterparts. However, the higher rates seen in females are thought to be mostly due to the routine testing required among young military women.
“Because many service members who have chlamydia are unaware that they are infected, practicing safe sex and routine testing for chlamydia are essential to preventing further transmission and severe disease outcomes,” says Obuseh.
Obuseh answers several common questions about chlamydia:
How can I prevent chlamydia?
The only way to completely avoid chlamydia is to abstain from vaginal, anal or oral sex. If you are sexually active, you can lower your chances of getting chlamydia by—
• Engaging in a long-term, mutually monogamous relationship with a partner who has been tested and does not have chlamydia.
• Using condoms the right way (https://www.cdc.gov/chlamydia/about/index.html%09/condomeffectiveness/male-condom-use.html%09https:/www.cdc.gov/condom-use/#cdc_health_safety_special_topic_how-how-to-use-condoms-and-other-barriers), consistently and correctly, every time you have sex.
How do I know if I have chlamydia, and what are the effects?
Most chlamydia infections are asymptomatic, meaning they do not cause noticeable symptoms but can still lead to serious health complications. If symptoms occur, they may not appear until several weeks after exposure.
Women:
• Even without symptoms, chlamydia can cause permanent damage to a woman's reproductive system. This can include pelvic inflammatory disease, ectopic (outside the womb) chronic pelvic pain, and may make getting pregnant difficult or even impossible (known as infertility). Chlamydia can also cause a potentially fatal ectopic pregnancy.
• Symptoms, if present, may include abnormal or smelly vaginal discharge, a burning sensation when urinating, and/or bleeding between periods.
• If pregnant, a woman with chlamydia can give the infection to her baby during delivery, potentially causing serious health problems for the baby.
Men:
• Men can be asymptomatic carriers.
• Symptoms, if present, may include penile discharge, painful urination and – in some cases – swollen testicles.
Chlamydia can also infect the rectum of men or women. While these infections often cause no symptoms, they can cause rectal pain, discharge and/or bleeding.
Doesn’t the DOD require routine STI screenings for chlamydia?
The DOD does require annual chlamydia testing, which often includes a panel of tests for other STIs such as gonorrhea and syphilis, but the testing is only required for women under 25 years of age. This practice is based on U.S. Preventive Medicine Task Force recommendations, which don’t include routine screening for men since the most serious effects of STIs impact women. The higher rate of chlamydia among women may reflect higher rates of required testing.
Since most male service members do not voluntarily seek STI testing unless they or their partner is experiencing symptoms, they may unknowingly be spreading STI infections, such as chlamydia, to others.
What do I do if I think I might have chlamydia?
See your health care provider if you notice any of the symptoms. You should also see a provider if your partner has an STI or symptoms of one.
Cases may also be more likely to be detected among soldiers because they tend to have more health care access and required STI screening tests than the general population.
Can chlamydia be treated?
Chlamydia is easily detected and treated with antibiotics.
With proper treatment, the infection should resolve within one to two weeks; however, testing may still show positive results for up to four weeks.
Recovery doesn’t mean a person can’t be re-infected, however. A negative test doesn’t mean a future infection won’t develop if a person is exposed to an infected partner again. Since concerns about antibiotic resistance are increasing, especially after repeated treatments, it’s very important to practice safe sex to avoid infections in the first place.
But when in doubt – get tested for treatment before your health is permanently damaged.
Additional information sources:
• Military Health – TRICARE (STIs): https://tricare.mil/HealthWellness/Public-Health/SexualHealth/SexuallyTransmittedInfections
• Centers for Disease Control and Prevention – Chlamydia: https://www.cdc.gov/chlamydia/about/index.html
The Defense Health Agency supports our Nation by improving health and building readiness–making extraordinary experiences ordinary and exceptional outcomes routine.
NOTE: The mention of any non-federal entity and/or its products is for informational purposes only, and is not to be construed or interpreted, in any manner, as federal endorsement of that non-federal entity or its products.
| Date Taken: | 05.06.2025 |
| Date Posted: | 05.06.2025 10:54 |
| Story ID: | 497115 |
| Location: | US |
| Web Views: | 57 |
| Downloads: | 1 |
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