Every year, the Merriam-Webster comes out with their list of words newly added to the dictionary. Those words can include pop culture references, slang, and abbreviations used prolifically enough to warrant their own entry or new definitions for previously defined terms. Some of the more recent additions have included Latinx, hangry, adorbs, and flight (of beers).
Inevitably when the list gets announced a cacophony of reactions follow from, “that’s not a word and shouldn’t be added” to “it’s about time, we’ve been using that for years.” Not surprisingly, the nuance and debate around STD (sexually transmitted disease) and STI (sexually transmitted infection) is no different.
The History of STD and STI
Long before the acronym STD was popularized, VD (venereal disease) was the common term, used for hundreds of years before it got an update, no less. Venereal originating from Latin and meaning “arising from or connected to sexual intercourse” made sense.
In the late 1970s, STD (sexually transmitted disease) emerged in medical and public health circles, because VD was seen as too restrictive—having referenced infections transmitted through intercourse alone (as opposed to other sexual activities), and primarily only gonorrhea and syphilis.
The term STD now included a number of new infections identified as being sexually transmitted, along with some infections that could be transmitted both sexually and non-sexually, like HPV and hepatitis C. However, it wasn’t until the mid to late 1980s that government publications and educational institutions adopted the updated STD term, and even then, the general public used VD well into the 1990s.
In the last few years, the term STI (sexually transmitted infection) has entered our vernacular. Just like STD was more inclusive than VD, so is STI to STD. The only difference between the two terms is the word infection versus disease. Saying that someone has an STI is slightly more inclusive because someone can have an infection without showing signs or symptoms of disease. Only some STIs become an STD.
Infection vs. Disease
What that means is all STDs start as an STI, an infection, and then some proceed further to a disease, an infection that has signs and symptoms. It’s important to note, though, even if someone is not experiencing signs or symptoms (meaning they have an STI and not an STD), they can still transmit their infection to others.
That is one of the reasons why STIs are so prominent. Most people don’t know they are infected, because they don’t have any noticeable signs or symptoms, yet they are still passing the infection on to other people. And because all of our bodies and immune systems are different, one person can have an infection without symptoms and then transmit it to someone else who does end up experiencing signs or symptoms.
Read: just because your partner doesn’t have symptoms doesn’t mean you will also not have symptoms.
Which Term is Correct?
Technically, STI is the most accurate term. And STD should only be used when someone has signs or symptoms. For example, if someone has herpes and gets outbreaks (like me), then they have an STD. However, a lot of people with herpes don’t ever get outbreaks. Those people have an STI. But both people have herpes. And both people can transmit their infection to someone else. See where this gets a little unnecessarily tricky?
The majority of educators and public health authorities are aware of the nuance and aren’t overly picky about the usage. Even though many organizations are beginning to update their STD terminology to STI, many are using the terms interchangeably. For example, The Centers for Disease Control (CDC) is still using STD, The World Health Organization (WHO) has updated to STI, Positive Singles still uses STD, and both The American Sexual Health Association (ASHA) and The STD Project use the two terms together—sometimes opting for STD and sometimes choosing STI.
Neither term is completely inaccurate, just like VD wasn’t completely inaccurate, but some feel that embracing the updated term STI is both more inclusive and carries a little less stigma. The idea of someone having an infection is perceived as less scary than someone having a disease.
While there’s certainly some truth to that, the general public still doesn’t recognize the term STI. So many organizations and public health centers opt to stick with STD or use both terms to make sure their resources are accessible to the layperson.
Which Term Should I Use?
It’s likely that over the next couple of decades, or maybe in as little as a few years time, we’ll solely refer to these infections as STIs, but for now, there’s nothing wrong with saying STD or STI, and it’s simply a matter of preference.
The UN notes: “Although one might think that there are two distinct terms here – STI for infections and STD for diseases – the two seem to be used interchangeably and without particular attention being paid to whether the focus is on infection or disease.”
Maybe you’re familiar with the annual induction of toys into the hall of fame? Things like alphabet blocks, Barbie, and the Slinky have all been added in recent years, much to the chagrin of Cabbage Patch Kids, the Magic 8 Ball, and My Little Pony, who’ve been unceremoniously left out of the mix.
Progress, culture, language, innovation, and education will forever leave us asking: what is historical and antiquated, and what is current and relevant? In so far as STD vs. STI is concerned, that decision is still up to you.