Featured image from webcomic by Sarah Winifred Searle
Talking about STIs (sexually transmitted infections) is tricky. We live in a culture that tends to obscure and shame straightforward conversations about sexuality. Most people don’t’ realize how common STDs are – 50 percent of sexually active youths will contract an STD by 25, and 1 in 5 people have genital herpes. Despite how common they are, it can still feel hard to talk about them openly without stigma. In addition to STIs, sexual activity also increases the risk of other common irritations and infections like yeast infections, bacterial vaginosis, and UTIs. So, I want to begin by saying that I absolutely understand that talking to a doctor about your sex life can feel pretty uncomfortable at any age, particularly as a teen. When I first became sexually active, I was terrified by the idea of talking openly to a doctor about my sexuality. I dreaded the wait between getting tested and hearing the results. I obsessed over every bump. But, I can say that with years of practice, I finally feel comfortable speaking openly with medical professionals and sexual partners.
And having those conversations leads to less stress and a better understanding of what risks sexual activity can potentially pose to your health. Communicating clearly and honestly with medical professionals and your sexual partners is key to making sure you stay healthy, sexually, throughout a long, and happy sex life.
Is It An STI?
At any visit to an OB-GYN, you can ask to get tested for STIs. If you are presenting symptoms (soreness, strange bumps, pain during urination) your doctor will likely recommend testing for both STIs and other common infections. Before assuming your discomfort is caused by a communicable infection, remember that yeast infections, bacterial vaginosis, and UTIs are frequently caused or exacerbated by sexual contact. Many of these conditions can cause vaginal irritation and unusual discharge. They are astonishingly common, but quite uncomfortable. Your doctor can usually identify the cause by examining your vaginal fluids under a microscope. For more information on vaginitis, check out this resource here. Several of these types of infections require prescription medications to be treated properly, so always see a medical professional for a diagnosis before beginning treatment.
When To Get Tested
Whenever you switch sexual partners, begin to consider becoming fluid-bonded to a new partner, or experience any symptoms, you should consider getting tested for STIs. A number of common infections do not have any symptoms at all, or may not be noticeable for a number of months. The CDC has a very specific rundown of how often they recommend getting tested that you can find here, but basically at least once per year. And remember that you can develop STIs up to three months from the time of exposure, so you might want to get re-tested if you are at a high risk for exposure.
Testing for common STIs protects you from the complications of an untreated illness (which in a few cases can lead to infertility or serious illness like P.I.D.). And yes, it’s daunting to ask to be tested. But remember that STIs are incredibly common and the vast majority of them are treatable. Yes, there are a few that cannot be cured (predominantly HIV, herpes, and HPV), but across the board medical treatments are available to ease the symptoms and reduce the risk of infecting your partner. Your specific exposures and risk factors will guide what tests the doctor might recommend, but you can also do research beforehand to see if there are any infections you are particularly concerned about. Another reason to get tested is if any of your current or past sexual partners have been treated for a particular infection. Planned Parenthood has a handy chart available here. Generally speaking, the most common tests are for: chlamydia, gonorrhea, hepatitis A, B, & C, HIV, and syphilis. Each test varies, but is generally collected as a swab from your genitals, a urine sample, or a blood sample. Depending on your risk factors, they may recommend other tests. Results vary but tend to take 2-10 days to come back from the lab. If you test positive for any of the STI’s your doctor will talk to you about a specific treatment plan. Again, remember that all of these diseases and infections are completely treatable and very common.
How Much Will It Cost?
Most insurance plans cover reasonable screening for STIs as preventative care. However, be aware that lab or office charges may show up on the bills to the policyholder, so if privacy is a concern, consider who may see the bill. If you don’t have insurance and live in Texas and are between the ages of 18 and 44, you can apply for coverage through Healthy Texas Women. But if you’re concerned about privacy or cost, you can visit a clinic that offers financial support (like Planned Parenthood) or you can call your insurance company in advance to ask about the cost of common STI tests (if that feels daunting, ask the front desk at your doctor’s office to help!). In addition, if privacy is a concern, there are also many community health clinics that provide STI testing for free or on a sliding scale. This website provides a helpful tool for locating such clinics near you, as does this map of Title X clinics. You can also check with your local community health centers, universities, and family planning clinics to find accessible, affordable care. Texas laws says that minors can consent to their own STI testing, so you can choose who you want to bring with you to any of these appointments – or go by yourself.
Talking About STI Status With Partner(s)
I strongly recommend try talking to your potential sexual partner about STI risk and exposures well before you begin to engage in physical intimacy. I know this can be tough. But at this point, I have a hard and fast rule that if I don’t feel comfortable talking to someone about our sexual health then I’m not ready to go beyond making out.
These conversations can be awkward, but it helps to acknowledge that it is strange and keep the conversation moving. If possible, begin that conversation well before sexy-times begin. Have the conversation at dinner or on a walk, or in a context where you aren’t about to get naked. Maybe begin by saying, “I know this is really hard to talk about, and I’m not sure how, but if we’re going to continue to be intimate, I’d love to know more about your health”. Ask them if they’ve ever been tested or when their last test was, how they feel about practicing safer sex, and how they’d like to proceed. Here’s a helpful page with ideas on how to communicate openly about STIs.
If you’ve been tested and are positive for an STI that can be treated, but not cured (like herpes, HIV, or HPV) always be sure to talk with any and all future, current, and past partners about your status. And again, remember that these are very common and very treatable infections that many, many folks have. Here’s a wonderful web comic about being diagnosed with HPV.
Practicing Safer Sex
Always consider practicing safer sex when possible to decrease your risk of exposure to STIs and to avoid unwanted pregnancy. Consider condoms and physical barrier methods to protect yourself and your partner (condoms are the only method that prevents both pregnancy and STIs). Remember to use plenty of lube to make condoms a more enjoyable experience for both partners. Experiment with various kinds and brands to find the one that feels best. And be aware that even with physical barriers, it is possible to expose yourself to sexually transmitted infections. If you are considering having unprotected sex with a partner (becoming fluid-bonded), that requires a whole other set of conversations and potentially another round of tests. I strongly urge caution in deciding to have unprotected sex with any partner.
Birth control can also be a wonderful tool, but remember that birth control (in any form) only prevents pregnancy and does not protect against STIs. For more details on choosing the right birth control for your body, check out our past blog post here.
Talking with doctors and your partners about STIs can be rough at first, but knowing your status and taking pro-active steps to manage your sexual health will benefit you and future partners for years to come. And I promise that with time, these conversations (with partners or with doctors) will feel easier to have.
