contact with infective sources which causes infection varies with each pathogen but in all cases, a disease may result from even light contact from fluid carriers like venereal fluids onto a mucous membrane. some stis such as hiv can be transmitted from mother to child either during pregnancy or breastfeeding. healthcare professionals suggest safer sex, such as the use of condoms, as a reliable way of decreasing the risk of contracting sexually transmitted diseases during sexual activity, but safer sex cannot be considered to provide complete protection from an sti. the transfer of and exposure to bodily fluids, such as blood transfusions and other blood products, sharing injection needles, needle-stick injuries (when medical staff are inadvertently jabbed or pricked with needles during medical procedures), sharing tattoo needles, and childbirth are other avenues of transmission. these different means put certain groups, such as medical workers, and haemophiliacs and drug users, particularly at risk. it is possible to be an asymptomatic carrier of sexually transmitted diseases. in particular, sexually transmitted diseases in women often cause the serious condition of pelvic inflammatory disease. diagnosis world war ii us army poster warning of venereal disease testing may be for a single infection, or consist of a number of tests for a range of stis, including tests for syphilis, trichomonas, gonorrhea, chlamydia, herpes, hepatitis, and hiv. no procedure tests for all infectious agents. sti tests may be used for a number of reasons: as a diagnostic test to determine the cause of symptoms or illness as a screening test to detect asymptomatic or presymptomatic infections as a check that prospective sexual partners are free of disease before they engage in sex without safer sex precautions (for example, when starting a long term mutually monogamous sexual relationship, in fluid bonding, or for procreation). as a check prior to or during pregnancy, to prevent harm to the baby as a check after birth, to check that the baby has not caught an sti from the mother to prevent the use of infected donated blood or organs as part of the process of contact tracing from a known infected individual as part of mass epidemiological surveillance early identification and treatment results in less chance to spread disease, and for some conditions may improve the outcomes of treatment. there is often a window period after initial infection during which an sti test will be negative. during this period, the infection may be transmissible. the duration of this period varies depending on the infection and the test. diagnosis may also be delayed by reluctance of the infected person to seek a medical professional. one report indicated that people turn to the internet rather than to a medical professional for information on stis to a higher degree than for other sexual problems. classification a poster from the office for emergency management, office of war information, 1941–1945 until the 1990s, stis were commonly known as venereal diseases, an antiquated euphemism derived from the latin venereus, being the adjectival form of venus, the roman goddess of love. however, in the post-classical education era the euphemistic effect was entirely lost, and the common abbreviation "vd" held only negative connotations. other former euphemisms for stis include "blood diseases" and "social diseases". the present euphemism is in the use of the initials "sti" rather than in the words they represent. the world health organization (who) has recommended the more inclusive term sexually transmitted infection since 1999. public health officials originally introduced the term sexually transmitted infection, which clinicians are increasingly using alongside the term sexually transmitted disease in order to distinguish it from the former. prevention main article: safe sex strategies for reducing sti risk include: vaccination, mutual monogamy, reducing the number of sexual partners, and abstinence. also potentially helpful is behavioral counseling for sexually active adolescents and for adults who are at increased risk. such interactive counseling, which can be resource-intensive, is directed at a person's risk, the situations in which risk occurs, and the use of personalized goal-setting strategies. the most effective way to prevent sexual transmission of stis is to avoid contact of body parts or fluids which can lead to transfer with an infected partner. not all sexual activities involve contact: cybersex, phone sex or masturbation from a distance are methods of avoiding contact. proper use of condoms reduces contact and risk. although a condom is effective in limiting exposure, some disease transmission may occur even with a condom."syphilis is a dangerous disease, but it can be cured". poster encouraging treatment. published between 1936 and 1938.both partners can get tested for stis before initiating sexual contact, or before resuming contact if a partner engaged in contact with someone else. many infections are not detectable immediately after exposure, so enough time must be allowed between possible exposures and testing for the tests to be accurate. certain stis, particularly certain persistent viruses like hpv, may be impossible to detect. some treatment facilities use in-home test kits and have the person return the test for follow-up. other facilities strongly encourage that those previously infected return to ensure that the infection has been eliminated. novel strategies to foster re-testing have been the use of text messaging and email as reminders. these types of reminders are now used in addition to phone calls and letters. after obtaining a sexual history, a healthcare provider can encourage risk reduction by providing prevention counseling. prevention counseling is most effective if provided in a nonjudgmental and empathetic manner appropriate to the person's culture, language, gender, sexual orientation, age, and developmental level. prevention counseling for stis is usually offered to all sexually active adolescents and to all adults who have received a diagnosis, have had an sti in the past year, or have multiple sex partners. vaccines vaccines are available that protect against some viral stis, such as hepatitis a, hepatitis b, and some types of hpv. vaccination before initiation of sexual contact is advised to assure maximal protection. the development of vaccines to protect against gonorrhea is ongoing. condoms condoms and female condoms only provide protection when used properly as a barrier, and only to and from the area that they cover. uncovered areas are still susceptible to many stis. in the case of hiv, sexual transmission routes almost always involve the penis, as hiv cannot spread through unbroken skin; therefore, properly shielding the penis with a properly worn condom from the vagina or anus effectively stops hiv transmission. an infected fluid to broken skin borne direct transmission of hiv would not be considered "sexually transmitted", but can still theoretically occur during sexual contact. this can be avoided simply by not engaging in sexual contact when presenting open, bleeding wounds. other stis, even viral infections, can be prevented with the use of latex, polyurethane or polyisoprene condoms as a barrier. some microorganisms and viruses are small enough to pass through the pores in natural skin condoms but are still too large to pass through latex or synthetic condoms. proper male condom usage entails: not putting the condom on too tight at the tip by leaving 1.5 centimetres (0.6 in) room for ejaculation. putting the condom on too tightly can and often does lead to failure. wearing a condom too loose can defeat the barrier avoiding inverting or spilling a condom once worn, whether it has ejaculate in it or not if a user attempts to unroll the condom, but realizes they have it on the wrong side, then this condom may not be effective being careful with the condom if handling it with long nails avoiding the use of oil-based lubricants (or anything with oil in it) with latex condoms, as oil can eat holes into them using flavored condoms for oral sex only, as the sugar in the flavoring can lead to yeast infections if used to penetrate in order to best protect oneself and the partner from stis, the old condom and its contents are to be treated as infectious and properly disposed of. a new condom is used for each act of intercourse, as multiple usages increase the chance of breakage, defeating the effectiveness as a barrier. in the case of female condoms, the device consists of two rings, one in each terminal portion. the larger ring should fit snugly over the cervix and the smaller ring remains outside the vagina, covering the vulva. this system provides some protection of the external genitalia. other the cap was developed after the cervical diaphragm. both cover the cervix and the main difference between the diaphragm and the cap is that the latter must be used only once, using a new one in each sexual act. the diaphragm, however, can be used more than once. these two devices partially protect against stis (they do not protect against hiv). researchers had hoped that nonoxynol-9, a vaginal microbicide would help decrease sti risk. trials, however, have found it ineffective and it may put women at a higher risk of hiv infection. there is evidence that vaginal dapivirine probably reduces hiv in women who have sex with men, other types of vaginal microbicides have not demonstrated effectiveness for hiv or sti's. there is little evidence that school-based interventions such as sexual and reproductive health education programmes on contraceptive choices and condoms are effective on improving the sexual and reproductive health of adolescents. incentive-based programmes may reduce adolescent pregnancy but more data is needed to confirm this. screening specific age groups, persons who participate in risky sexual behavior, or those have certain health conditions may require screening. the cdc recommends that sexually active women under the age of 25 and those over 25 at risk should be screened for chlamydia and gonorrhea yearly. appropriate times for screening are during regular pelvic examinations and preconception evaluations. nucleic acid amplification tests are the recommended method of diagnosis for gonorrhea and chlamydia. this can be done on either urine in both men and women, vaginal or cervical swabs in women, or urethral swabs in men. screening can be performed: to assess the presence of infection and prevent tubal infertility in women during the initial evaluation before infertility treatment to identify hiv infection for men who have sex with men for those who may have been exposed to hepatitis c for hcv management in the case of rape, the person can be treated prophylacticly with antibiotics. an option for treating partners of patients (index cases) diagnosed with chlamydia or gonorrhea is patient-delivered partner therapy, which is the clinical practice of treating the sex partners of index cases by providing prescriptions or medications to the patient to take to his/her partner without the health care provider first examining the partner. in term of preventing reinfection in sexually transmitted infection, treatment with both patient and the sexual partner of patient resulted in more successful than treatment of the patient without the sexual partner. there is no difference in reinfection prevention whether the sexual partner treated with medication without medical examination or after notification by patient. epidemiology