Last Updated on June 4, 2020 by Shuvani Sanyal, MD
We’ve noticed a lot of people asking and answering the same question lately: Is mono an STD? So, we thought we’d do some research to help better answer that question for you.
The short answer is: it doesn’t matter. (Explanation at bottom)
The longer answer, which we’ll substantiate, of course, is, yes, generally, mono is an STD.
Although some people have written otherwise and have chosen to exclude it from their grouping of STDs, that doesn’t alter the factual information or the supported research.
To better understand why mono often borders the land of STDs and is placed into that confusing grey area, we have to start with the basics.
Mononucleosis (also called ‘Mono’, and, colloquially, the ‘kissing disease’), is a disease most commonly caused by the Epstein-Barr virus (EBV). EBV affects the white blood cells involved in the immune system. The disease can be found in anyone but is most commonly contracted by adolescents and young adults ages 15–35.
Mononucleosis can also be caused by Cytomegalovirus (CMV), a herpes virus most commonly found in bodily fluids. While CMV can cause mononucleosis, 85%-90% of all cases are associated with EBV. A person becomes infected with CMV by direct contact with infected bodily fluids. CMV is most commonly transmitted through kissing and sexual intercourse.
That being said, EBV is a member of the herpes virus family as well. It is one of the most commonly found viruses and epidemics throughout the world. Contrary to common belief, EBV is not highly contagious. It can only be contracted through direct contact with an infected person’s saliva and sometimes through vaginal, cervical, and penile secretions.
So, what does all that mean? To start, it means, when mono occurs as a result of CMV, it’s an STD.
It also means, mono is not as contagious as the common cold or flu – generally, infections which are easily transmittable non-sexually or which are primarily transmitted non-sexually are not classified as STDs. Transmission of EBV requires intimate contact with the saliva, blood or genital secretions of an infected person. Kissing or having sex with someone with mono makes you much more likely to get the infection.
Moreover, a recent study of more than 2,000 entrants to Edinburgh University has established that EBV is sexually transmitted. An accompanying editorial notes that of the eight human herpes viruses, four – HSV, CMV, KSHV, and EBV – are now known to be sexually transmitted. However, the authors doubt EBV will be ‘given much priority in STD clinics anytime soon’ despite its ‘still-unfolding virological, oncological, and sociological fascinations.’
And lastly, a cohort study among 510 university students suggests that acquisition of EBV is enhanced by penetrative sexual intercourse, although transmission could occur through related sexual behaviors, such as ‘deep kissing’, an increased dose of EBV is transmitted by deep kissing during penetrative sexual intercourse and that enhances virus transmission in young adults.
The researchers point to data that confirms far higher concentrations of EBV in saliva than in genital secretions, and they surmise that intercourse is actually a surrogate marker for deep kissing that facilitates viral transmission. However, for all practical purposes, EBV infection behaves like a sexually transmitted disease.
Then Why Did I Say It Doesn’t Matter?
Clearly there’s data backing infectious mononucleosis as a sexually transmitted disease/infection, however, there are still numbers of people adamantly denying the correlation.
Because sexually transmitted diseases carry a stigma. As a clinician, it’s much easier to communicate a diagnosis sans the STD label. And as an infected individual, it’s far simpler to explain contracting a common non-stigmatized infection to your loved ones and potentially significant other(s) than it is to tell people you have an STD. It just makes sense people are reticent to relate the two.
Despite leading you to the articles that say otherwise, I actually don’t care if you want to move forward with not calling mono an STD.
Now you can understand why we’ve included mono in our list of infections, of course, but from there, how you label it is your business.
I’m more concerned you take care of yourself while waiting for your body to heal and that you are mindful of the ways in which your infection is transmitted, lest you spread the infection unwittingly.
And lastly, please make sure to tell any respective partners before putting them at risk. Whether you want to call it an STD is up to you, but it is contagious should you engage in any kind of sexual activity involving saliva or other bodily fluids. So, the ethical thing to do is to let the individual know in advance of the aforementioned activity.
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Did you learn something new from this post? Were you also of the mindset mono is not an STD? Share your thoughts in the comments section below!