STI Education

Talking about testing and STIs can be intimidating because of stigma and a general unease around sex but talking about sex doesn’t need to be awkward. If you’re comfortable enough to get naked and rub your bodies against one another, hopefully you’ll also cultivate a connection that allows you to talk about your desires, needs, boundaries and expectations around safer sex, which includes STI testing.

If a partner doesn’t want to talk about STIs and testing, don’t assume that it’s a red flag. Shame and stigma around sex make talking about sex challenging, so don’t assume that their discomfort talking about STIs is an indication that they don’t want to practice safer sex. They may simply be uncomfortable with the conversation itself, so ask them what you can do to put them at ease — it may be a matter of timing, language or location.​

It’s up to you. Some people do it while chatting online and others wait until you meet in person. I would strongly recommend disclosing before you’re physically intimate.

Have the mindset of knowing what you want and need going in. This is about getting the information across, so focus on your own needs so you’re able to articulate them. It can go something like: “I tested positive X years ago. I take X medications, so to reduce transmission and outbreaks.”​

Know that you’re imagining worst case scenario. I’ve talked to hundreds of people who have disclosed, and they get so many positive responses. It’s also a way for the new partner to disclose that they’re positive too.​

The only way to tell if you have an STI is from getting screened. Most STIs don’t typically show symptoms which is why it is so important to get screened regularly. I’d recommend getting screened after any unprotected sexual activity. If you do experience any abnormal discharge, painful urination or pain with sex – these can all be an indication that you may have an STI and a medical evaluation including STI testing would be recommended.

When you go for an STI test, you may be asked to provide a urine sample, blood sample, and/or a swab of your throat, vagina, or anus. If providing a urine sample for STI testing, it is recommended not to urinate for at least an hour prior to the urine sample. There is nothing you really need to ask your clinician beforehand, but make sure you are honest with them about your sexual history. Knowing your full sexual history and what types of sex you have can help them order the correct tests for STI screening.

Absolutely! STIs can be transmitted through any type of sexual contact including oral sex, anal sex, vaginal sex, sharing sex toys, and even genital touching.

I’d recommend screening for STIs after any unprotected sexual encounter. It is important to discuss your sexual activity with your healthcare provider so they can help determine your risk and how often you should be tested.

Speak with your partner or partners about their STI status before sexual activity. Be sure to use condoms for vaginal or anal sex, as well as a dental dam or other barrier for oral sex. I’d also recommend using lubrication! Lubrication reduces the risk of small tears in the vagina or anus that can increase the risk for STIs.

Bacterial STIs such as Gonorrhea, Chlamydia, and Syphilis can be treated and cured with antibiotics. Viral STIs such as herpes and HIV cannot be cured at this time, but we can prescribe medications that can help lessen symptoms and reduce the risk of transmission to your partner.

The popular media reinforces STI stigma in several ways, but one of the most common is by making STIs the frequent punchline of jokes or by using STIs as an insult. The result is that, if you have an STI, it’s easy to worry about being mocked, shamed, or blamed for your status, which makes it all the more likely that people won’t have open conversations about the topic.

Different people take different approaches. Some seek to date others with the same status in order to mitigate infection risk. However, you don’t necessarily have to limit yourself to partners of the same status as long as you take appropriate precautions.

This includes communicating up front about your status and taking preventative measures to minimize infection risk, which could include using condoms, taking medications that suppress the infection, avoiding intimate contact during symptomatic periods, and/or the uninfected partner getting a vaccine (e.g., for HPV) or taking medication to lower infection risk (e.g., PrEP for HIV prevention).

It all depends on the specific circumstances, but incurable STIs don’t have to be the end of your sex and love life by any stretch of the imagination!

The keys to managing a herpes infection are education and support, communication, and safer-sex practices. Partners need to be willing to communicate and take some safety precautions to minimize risk of transmitting the virus. Preventative measures include taking daily antivirals to reduce symptom occurrence, using condoms and dental dams, and placing limits on physical activity when symptoms appear or when they are anticipated (infected persons can often tell in advance when an outbreak is about to occur).

The most common STI symptom is having no symptoms at all. Being asymptomatic does not necessarily mean that one is unable to transmit an infection (just like with COVID—some people don’t develop symptoms, but can still potentially pass the infection along). Thus, you cannot necessarily tell whether someone has an STI simply by looking at them or their genitals.

This answer may surprise you: no! Research has found that rates of STIs don’t differ when you compare people in monogamous and consensually non-monogamous relationships. Of course, monogamy in theory should prevent STIs, but monogamy is often implemented imperfectly.

For example, people may enter a monogamous relationship without getting tested first, which means they could be bringing an STI into the relationship.

Likewise, many monogamous people cheat, and when infidelity occurs, people often don’t use protection or tell their partner about it afterwards, which creates more opportunities for STIs to spread.

By contrast, people in open relationships take more precautions: they practice safer sex more often, communicate more about their sexual activities with others, and get tested more frequently.

We often hear that STIs are at a “record high” these days, but it’s important to consider their historical context. For example, while gonorrhea and syphilis have risen lately, they are still well below their historical peak years ago because we have better treatments today. So they’re certainly more common than they were a few years ago, but far less common than they were decades ago.

Also, with increasing rates of many infections, it’s not always clear if they’re becoming more common, or if we’re just doing more testing and surveillance, which gives the appearance of a rise. Of course, it’s also possible that STIs are truly increasing due to changes in sexual behavior, such as the decline in condom use that has been reported in recent years. The short answer is that it’s complicated!

Education is the first step. Many of us received fear-based sex ed that taught us that STIs are just about the worst possible thing that can possibly happen to you. In reality, however, many common STIs (e.g., syphilis, chlamydia, gonorrhea) are curable, so once you complete your course of treatment and test negative, it’s over and done—nothing to fret over.

Also, for STIs that aren’t curable, they are usually manageable (e.g., HIV, herpes) and, with appropriate precautions and treatment, you can resume a pretty normal sexual and romantic life. However, when distress remains, seeking social support (e.g., through an online support group) can be beneficial in terms of reducing feelings of shame and stigma.