Today, attitudes towards sexual health are more enlightened than they’ve ever been. Experts understand how STDs occur, how they are transmitted, and even how to cure many of them efficiently. Yet, according to the CDC, cases of syphilis gonorrhea, and chlamydia reached an all-time high in 2018.

Rising cases of STDs aren’t necessarily a bad thing. On the one hand, it means that more people are getting tested and treated on a regular basis. However, the figure is also a reminder of the stigma that still surrounds STDs and how underreported they may still be.

In today’s world, getting tested and treated for an STD is easier than ever, at least in terms of the medicine involved. At the same time, STDs still suffer from a stigma — and that stigma can be as damaging as the infection itself.

Each year, the CDC issues a report on various communicable diseases, including STDs. And for the last five years running, the rates for syphilis, gonorrhea, and chlamydia in the U.S. have continued to climb. Even the number of babies born with syphilis is growing.

What’s interesting about STD reporting is that it very likely represents only a fraction of the actual cases. Unlike heart attacks, stroke, or cancer, people are less likely to report STDs.

STDs often go unreported because it’s possible to carry infection and not experience symptoms, but still be able to transmit it to others. The lack of symptoms is a problem for syphilis, in particular, as the CDC says young women are contracting it at a higher rate and the number of women who pass it on to their babies is growing, too. Although syphilis only requires antibiotics to cure, newborns can die from the infection.

So, while it’s clear that more people are being checked and treated, some still aren’t and it’s having a detrimental effect on their health.

STDs are incredibly common. According to the American Sexual Health Association, one in two people contract an STD before their 25th birthday and again, those are only the cases that get reported. More importantly, most (but not all) people now receive some form of sexual education (in varying degrees) as part of their secondary-level education.

However, the stigma still exists, and it could be informing the STD epidemic in two ways. First, there is the embarrassment factor. The sense of shame related to sex and to disease can get in the way of people seeking out testing and care. But misinformation about STDs can play a role too.If people don’t feel they are personally at risk for STDs and they find the whole concept generally embarrassing, it keeps them away from being tested and getting treatment. Even if they experience symptoms (and they might not), they could ignore them or write them off entirely.

Today, curing most common STDs is simple. Even prevention is easier thanks to vaccines, like the vaccine for human papillomavirus (HPV), a virus that is spread through intercourse, has no symptoms and can cause cervical cancer. Major medical breakthroughs have even made preventing and treating HIV, once one of the most destructive STDs, more accessible through drugs like Truvada.

At the same time, the stigma surrounding STDs could be as harmful as the infection itself. For example, even though genital herpes is a common infection, the combination of the misconceptions surrounding herpes along with the prevalence can lead those diagnosed with it to feeling anxiety and isolation. People worry about passing it on to others, and they worry about what it means for their relationships if they have to disclose their infection to new partners. What’s worse, the stress that comes from the stigma can actually cause more frequent herpes outbreaks.

The healthcare community has a particularly big role to play in reducing the stigma surrounding STIs. The medical community’s focus on preventative care needs to extend itself beyond education about condoms and other barriers. Doctors and nurses can also provide informed and sensitive care that acknowledges sexual health as an integral part of patients’ overall health — and even as a human right. Even if patients don’t feel they can tell their friends or family, they should feel comfortable enough to tell a doctor or nurse.

Most people who contract an STD won’t have symptoms, which makes it even more important that everyone not only understands what safe sex is but also understand the importance of regular STD tests as well. Why is it that people on both sides of the abortion debate are happy to start a conversation, but people still shy away from STDs?

One way to make the switch is to change the D for an I and call them sexually transmitted infections. The term STI is less loaded and less likely to carry stigma. For example, the HPV virus is biologically incredibly similar to the mononucleosis virus (EBV). Both are contagious and can be contracted through intimate contact, but only one is associated with shame.

Even still, it will take more than a different acronym for people to shrug of decades (and centuries) of the shame used to coerce and control. So, correcting misinformation is another way forward: the more people know about STIs, the more empowered they are to take control of their own health. And that’s what it’s all about.