Sexually transmitted infections are here to stay. In 2019, the number of STIs reported by the CDC hit historic highs and continues to climb. The threats of multi-drug resistance for bacteria like gonorrhea and the discovery of new viruses like Zika which can linger in semen for months make it clear that we need to rethink our approach to the truth that sex and sexual infections are clearly inseparable. In fact, our recent experience with COVID-19 could be instructive in helping us think about sexually transmitted infections.
Just as the pandemic is indiscriminate, STIs also spread among those of all ages and backgrounds – often without people’s knowledge. And as with COVID-19, it is when we are close to people that the risk is greatest. We have come to understand the risk of transmission as a responsibility. We expect each other to take precautions to protect each other through social distancing and mask-wearing. This agreement has forced us to recognize that we are all connected in ways that were once easier to overlook.
Eliminating the Shame & Stigma
According to the World Health Organization, an average of 1 million people are diagnosed with an STI every day. Infections are not only prevalent, but also difficult to detect. We believe that a better way to think about a positive STI status is to view it the same as any other medical conditions, free of shame or judgment. Rethinking our responsibility to each other with will help turn the tide in the increasing number of infections we’re seeing today. Understanding that most STIs are transmitted without the person knowing they have it calls for us to be responsible for our own status and sharing it.
As we come to understand that sexual infections are a normal part of sexual engagement – not some shameful part of ourselves – we might just start to make a dent in the unrelenting transmission numbers.
The biggest impression that my earliest sexual experiences had on me was wondering if I had gotten an STI. Likewise, the only thing I remember about my earliest sex education was how deeply fear and shame were tied to the experience of sex, the proof of which was getting some kind of disease. These memories are decades old and, surprisingly or not, this fear and shame-based approach to educating about sexually transmitted infections has remained intact, as has the unchecked spread of diseases.
I recently had the chance to speak with Dr. Ina Park after the release of her new book, Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs. Dr. Park is a breath of fresh air in a conversation that desperately needs a new perspective. Separating sexual shame and fear from the conversation about what makes sexual encounters safe is long overdue. In addition to being a physician and faculty member at UCSF, she consults on sexually transmitted infections at the CDC. But, maybe her most meaningful credential is the way she uses this information with humor as a sexual health educator, making her new book exceptionally impactful.
In her many roles, she has heard stories of women angry about the betrayal of their partners for infecting them, as well as those of the guilt-ridden for not knowing they were infecting their partners. Most challenging for her is how the oldest, most commonly known infections like gonorrhea, genital herpes, chlamydia, and genital warts (or human papillomavirus) are continuing to grow and that by and large, people still feel compelled to keep their STI history secret as if sharing it makes them un-loveable.
3 Tips for Discussing STIs with Your Partner
The thought of asking someone you’ve just started dating about their STI status can be scary for a lot of reasons. You might be worried they won’t want to continue seeing you or that they’ll make judgments about your sexual history. You might even avoid this kind of conversation because you think it takes the spontaneity and romance out of sex. But, it’s important to keep in mind that you (or your partner, or any of your former partners) could have an STI without knowing it. In fact, several infections have no symptoms at all and unless you get tested, you won’t know.
We believe the best time to broach the subject of STI status is before you have sex.
1. Get Tested
You’ll first want to get tested at your primary care doctor, gynecologist, or at a local clinic. Not sure if/when you need to get tested? Ask your medical provider or read these recommendations from the CDC. Your age, sexual history, and other health factors will affect how frequently you should be tested and which tests you should be given.
2. Be Honest
This is not the time to hold back or keep secrets. Given the prevalence of STIs and the health risks to you and your partner if left untreated, it is crucial to have an honest conversation about your history and status before having sex. You can start by simply asking “Have you ever been tested?”, and follow up with “Can I see the results?” If you have a positive status to share, be sure to have all the facts about your STI and be prepared for questions.
3. Reserve Judgment
Once you’ve both shared your status, you and your partner should weigh the implications without judgment. You will want to consider what protection you want to use (like condoms or latex dental dams), the risks of potentially testing positive for your partner’s STI(s) if you choose to have unprotected sex in the future, or even whether or not you want to have sex. Keep in mind that many STIs are treatable or have few long-term health risks once managed by medication.
Sexual health infections are part of what happens when people have sex. There is no shame or blame in it, except for not taking responsibility for knowing about your own health and sharing the information freely.