Editor’s Note: *name and identifying details have been changed to protect the privacy of the individual

*Jane, a 22-year-old senior at South Dakota State University, had been exposed to a Sexually Transmitted Infection from her ex-boyfriend without ever having sex.

She was embarrassed and terrified to tell her parents.

Cases much like Jane’s are common. STIs can go unnoticed without testing and knowledge of the most common infections.

Over the past decade, STIs have continued to rise in South Dakota, with the most common tested for and reported being chlamydia, gonorrhea, Human Immunodeficiency Virus (HIV) and syphilis.

According to the South Dakota Department of Health, from Jan. 1–Sept. 30 of 2019, there were 3,420 cases of chlamydia, a 5% increase, and 1,539 cases of gonorrhea, a 67% increase.

The most commonly tested STIs at SDSU are chlamydia and gonorrhea.

At SDSU, the Wellness Center provides students with access to STI screenings and also has treatment available even though Family Planning has moved out of the Student Health Clinic to Sanford Health in Brookings.

“The most common one is chlamydia by far,” Janae Jacobsen, a family nurse practitioner at the Wellness Center said.

Chlamydia and gonorrhea are bacterial infections that are treated with antibiotics.

For the most common STI, chlamydia, there aren’t always symptoms right away but potential symptoms could include burning with urination, discharge, or itching and irritation. Jacobsen said it can be silent, and someone can get tested with no symptoms and still be positive.

Although numbers aren’t available through the Student Health Clinic because of confidentiality reasons, Jacobsen said that the number of students coming into the clinic varies day to day, and it can be a very common visit for students.

In Jane’s situation, she had been with her ex-boyfriend for a total of about three years off and on.

Jane made a deal with her dad: if she abstained from sex, drugs or alcohol until 21 years of age, she would get $3,000.

“I would avoid actual intercourse, but then he (her dad) said a new rule where I couldn’t go below the belt, but I disregarded it and did it anyway,” Jane said.

Jane eventually had her boyfriend get tested since he had been with other people during their breaks.

“I made him go in before we had actual intercourse not knowing that everything I had done before, like oral sex or any kind of touching, I didn’t realize I could get it,” Jane said.

Her boyfriend said he didn’t have HIV or syphilis, but later said he was positive for chlamydia.

Jane recalls having bad tonsillitis during that time but wasn’t sure if that was because of the infection or because it had occurred naturally.

She went into Family Planning when it was still in the Wellness Center and got tested. She tested positive and was then treated with antibiotics.

“It was an easy process actually, but I was terrified. And I went through that [Family Planning] so my insurance wouldn’t know and my parents wouldn’t know,” Jane said.

At first, Jane kept it from her parents, but when Family Planning mistakenly called her parents’ house, she told them it was for birth control before eventually telling the truth.

“I was getting so paranoid and felt so guilty for lying. My dad really values trust and not lying,” she said.

Jane told her dad first and he had already assumed that she had broken their deal.  Then she told her mom.

“They were way more cool about it than I thought they would’ve been, so I guess anyone who is scared to tell their parents, chances are they’re not going to be as mad as you think they are,” Jane said.

Before she went to her parents or to get tested, she spent a lot of time researching. She found that part of sexual health is getting tested.

At a typical testing through the Student Health Center, a nurse will ask why the student is there, go through vitals and blood pressure procedures and then ask other questions about sexual history, any previous infections, how many  previous partners and discuss the risks.

According to Jacobson, chlamydia and gonorrhea are tested for through urine samples or the use of a vaginal swab for females.

HIV and syphilis are tested through blood draws and the results come back within an hour. Chlamydia, gonorrhea and syphilis are tested at the state lab and the results take about two days to get back.

Treatment is also available through the Student Health Clinic.

According to Jacobsen, chlamydia is treated with antibiotics like azithromycin or doxycycline. Gonorrhea is also treated with antibiotics like azithromycin and a shot of ceftriaxone which is an injection. Both are bacterial and curable. Jane took the two antibiotics and hasn’t been positive since.

Through Family Planning, the treatment was free since Jane didn’t reach the level of income necessary as a college student.

At the Student Health Clinic, the price varies since it’s billed through the student’s insurance.

There are also cash-pay options available for students who don’t want their parents to know. That price is different as well.

“It’s reduced cost compared to other clinics in town, but we never give people exact (amounts) just because it can vary from month to month,” Jacobsen said.

There can be a negative stigma to getting tested. Students sometimes feel embarrassed, ashamed or scared, but Jacobsen says staff at the Student Health Clinic are very open.

“We’ve all worked in college health… We want you to get tested and we want you to get treated if it is positive because otherwise it could lead to further reproductive issues down the road if you’re not treating it,” Jacobsen said.

According to the DOH, gonorrhea and chlamydia, if untreated in women, can cause infertility, pelvic inflammatory disease and more. In men, it can cause sterility and sexually reactive arthritis.

“We end up seeing more women just because women come in for their yearly women exams, maybe to get birth control or talk about their menstrual cycle. Whereas maybe the men come in because they’re having symptoms or because they are having concerns,” Jacobsen said.

Jane frequently gets tested now and says it takes less than an hour.

According to the Centers for Disease Control and Prevention, all adults and adolescents ages 13–64 should be tested for HIV at least once and sexually active women younger than 25 should be tested for chlamydia and gonorrhea every year.

It’s also recommended by the CDC that pregnant women be tested for syphilis, HIV and hepatitis B early in the pregnancy. Also, all sexually active gay and bisexual men should be tested once a year for syphilis, chlamydia and gonorrhea.

Jacobsen says that if a person is with the same partner and has always been with them, yearly screening is recommended. Whereas if a person has multiple partner changes, screening after every partner is recommended. Whether someone says they don’t have an STI or not, people should still ensure that preventative measures are taken.

Jacobsen says abstinence is one way to avoid STIs, otherwise using a condom 100% of the time and using it correctly will help avoid getting infected.

“Obviously, yes, you’re sleeping with that person but you’re also sleeping with every other person that person has had sex with,” Jacobsen said.

Another option is to have open conversations with a person’s partner about having sex with other people, how many previous partners and whether either partner may have or have had an STI.

Now, Jane has these types of conversations with her partners. She asks if they’ve been tested before and whether or not they say they have been, she gets tested regardless.

Having this experience has taught her to be more open about sexual health with her friends and encourage them to get tested. Because of it, she doesn’t think of it as something society has taught her to be scared of.

“It’s a good way to be healthy and you don’t want that to lay dormant for how many years and then pay the consequences in the future,” Jane said. “That would suck if the one time I screwed up when I was 22-years-old and then I had to pay for it when I was 30 trying to have a kid and I couldn’t.”