The Silent Spreaders: Why Most People With STIs Don’t Know They Have One

A 32-year-old patient came in for a routine physical. No complaints, no symptoms. Just a standard checkup. Screening for sexually transmitted infections was almost an afterthought. A few days later, her lab results came back positive for chlamydia.

She had no idea.

Cases like hers aren’t rare, they’re more typical than you think. In the Caribbean, about 1 in 10 sexually active adults is carrying an STI right now, often without a single symptom. Chlamydia, gonorrhea, and syphilis circulate quietly, while viral infections like herpes (HSV-2) and HIV continue to spread beneath the surface. The biggest symptom of chlamydia and gonorrhea is no symptom at all.

When symptoms do appear, they can be unmistakable:

Men may notice urethral discharge that is white, yellow, or green and painful urination.

Women might experience foul-smelling, yellow vaginal discharge, pelvic pain, or bleeding between periods.

But in most cases, there are no warning signs:

• 70% of women with chlamydia show no symptoms.

• 50% of men with chlamydia are asymptomatic.

• 80% of women with gonorrhea don't realize they're infected.

• HSV-2 often presents no recognizable symptoms.

• HIV can remain undetected for years without testing.

Silent infections are dangerous. They allow diseases to spread unchecked, and can lead to complications such as pelvic inflammatory disease and infertility in women. In addition both men and women can experience damage to internal organs, and increasing susceptibility to other infections like HIV. Most people falsely believe that feeling "healthy" means being "clean." It doesn't.

Condoms help but don’t eliminate risk, especially for skin-to-skin transmitted viruses like HSV. Routine testing is the only defense—and yet, most people skip it until symptoms force their hand. By then, damage is often already done.

In sexual health, ignorance isn’t just risky. It’s contagious.

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