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Be Informed: Testing + Disclosing STI Status

By: Lisa Finn

stiFor the purpose of this blog, we will be referring to all sexually transmissible conditions, sexually transmitted diseases (STDs) and sexually transmitted infections (STIs) under one umbrella as “STIs”.

Let’s start off with something important: STIs are way more common than many people think – and having a positive STI status doesn’t mean that you’re “dirty”, doesn’t mean that you’re “irresponsible”, and certainly doesn’t mean that you have to give up or miss out on a fulfilling and pleasure-filled sex life.

Risk Assessment
One of the ways we often talk about safety with sex and play is about being aware of risk and knowing how to mitigate them accordingly. If you’re less familiar with this practice in the bedroom you may have recently learned some of the tools throughout the COVID pandemic. Practices such as limiting unprotected (maskless) contact to a select few, negotiating how much exposure we’ve had recently, when we were last tested, have we been vaccinated, and whether we would like to use a barrier to proceed – these all have a parallel to conversations around safer sex. 

Why is it so important to test often?
Not every STI causes noticeable symptoms (aka asymptomatic STIs) – but just because there’s no symptoms doesn’t mean that there’s no risk, and you can still pass the infection onto your partners. The longer that your STI goes undiagnosed, the longer you’re going without treating it (such as with antibiotics or antivirals) and putting yourself at a higher probability for the STI to cause long-term complications and lead to other medical conditions or risks.

Many STIs will have noticeable symptoms, but even of those that usually do, some still have the potential to show very few or no indications of a positive status, such as (but not limited to):

    • Chlamydia
    • Gonorrhea
    • HIV*
    • Genital Herpes
    • HPV

*HIV can go undetected for weeks to years, and without treatment has a much higher likelihood to develop into AIDS. (Mayo Clinic)

Even if you haven’t had a new partner in a while, it’s still important to regularly test, since STIs - despite their name - aren’t only transmitted through sexual activity. (It’s also important to note that how people define sex can differ person to person – most often sex as it’s defined when related to information on STI prevention is referring to vaginal or anal penetration with a penis.)

Many STIs are contracted through skin-to-mucosa contact – i.e. contact with mucous membranes like on the lips, tongue, inside of the mouth, tissues of the vulva and vagina, and anal canal. Some STIs can also be transmitted through skin-to-skin contact, or even through something as innocuous as sharing lip makeup. Oral herpes for example is often contracted for many during adolescence, though its more commonly referred to as a “cold sore” vs HSV-1. 

How do I ask a partner about their STI status / talk about testing?
While testing is super important, not everyone does it as often as they should. The best way to go about this conversation is to be direct. Offer your information while asking for theirs to make sure that they know that this trust and disclosure goes both ways, and to let them know that there’s no pointing fingers or assumptions being made about anyone’s status.

"So you know, my most recent test was last week and I did not test positive for anything transmissible. Have you tested recently?"

"Since my last test, I haven’t had unprotected sex or been with a new partner. What about you?"

Regardless of their answer, this is also the perfect time to set expectations about using safer sex barriers, whether it’s for the purpose of comfort, STI prevention, contraception, or a combination of any of those.

"I know we’ve both tested recently, but I still would feel best if we still used a barrier."

"I’ve been vaccinated for HPV, Hep A & B. Monkey Pox, and am on PrEP to prevent contracting HIV. I also have an IUD so I am not worried about pregnancy. If you’re confident in your status, I’m comfortable with unprotected sex."

"We don’t have to use protection for oral if you don’t want, but if we are going to have any other type of penetrative sex, you need to use a condom."

To learn more about safer sex barriers, read our blog here.

How do I tell a partner that I have an STI / how do I disclose my status?
The stigma surrounding STI status is a heavy one – many folks still use the term “clean” to refer to someone that does not have an STI, which is not only depreciative but inaccurate. There’s nothing dirty about having an STI. But, because of this social stigma, it can be intimidating to disclose status to a partner – especially at the beginning of a relationship, or before a casual sexual encounter like a one-night stand.

Disclosing your status to someone is a way of letting them know that you care about them and trust them - and that their health and comfort is important to you. Be honest and be confident, there’s nothing shameful about a medical condition, regardless of how it came about.

Disclosure of status can be as simple as stating it plainly. It’s also important in this moment to let your partner know that how they would like to proceed – whether it’s omitting certain acts, using toys or tools instead of body-to-body play, or using protection – is up to them. Informed consent is non-negotiable, so you need to be as clear and specific as possible, and offer options.

"So you know, I have had unprotected sex since my last STI screening earlier this year, so I do not know my current status."

"When I was last tested, I had a positive result for HPV, so I think it’s best we use protection."

"Before we do anything, you should know that I have oral herpes. I’m not currently having any symptoms of an outbreak, but we don’t have to do anything involving my mouth if the risk makes you uncomfortable."

"I have been HIV positive since 2019, and have been on an antiretroviral medication since 2021, and have an undetectable viral load. Undetectable means untransmittable, or U=U, though I still prefer to play with partners who are on PrEP; are you?"

Learn what you can about your STI when you are diagnosed. This will not only help you to best take care of yourself and manage symptoms and risks, but can be really helpful when it comes to sharing medically accurate information to a partner. Much of STI stigma is rooted in misinformation, so having this info at the ready can help make the conversation much more comfortable.

Where can I get tested for STIs?
Thankfully, there are many places where you can get tested for STIs, and many of them offer these services for free, even if you don’t have health insurance – clinics, public health centers, Planned Parenthood locations, and mobile testing units are some examples. If you’re a student, some colleges and universities even offer free testing in their medical offices. Many primary care physicians can provide testing or screening, so tacking that on to your regular physical and other health appointments should be an option as well. A simple web search for “STI testing near me” can help you find the closest location.