Sex shouldn’t be scary. In fact, when done correctly, it should feel the exact opposite of scary. Still, the threat of getting an STI is enough to make anyone a little gun-shy. (And hey, if you're choosing to not have sex, that's fine too! After all, it's the only foolproof way to prevent pregnancy and STDs.)
But let's get real: You shouldn't let the possibility of getting an STI scare you off from having sex. While some are harder to catch than others, staying safe is mostly a matter of common sense and, well, condoms. Whether you're in a monogamous relationship or dating around, there are a number of steps you can take to keep yourself healthy.
Talk to Your Partner
There’s no government-mandated instruction manual on how to talk about STIs with your partner. It's probably going be awkward. But you know what’s more awkward than asking about gonorrhea? Getting gonorrhea.
“Millennials are more accustomed to using condoms and having the ‘STI conversation’ before jumping into bed,” says Sherry Ross, M.D., a gynecologist and women's health expert based in Santa Monica.
As we mentioned before, the only way to guarantee you won’t get an STI is to not have sex. But there are options.
"Every day, I counsel women of all ages on the importance of safe-sex practices," Ross says. "The conversation always includes how condoms can help prevent the most common STIs—though it is not a guarantee.”
It's true: Condoms are not an ironclad way to stay safe, especially if you’re using the lambskin kind, which only protect against pregnancy. But chances of staying protected with latex and polyurethane condoms are high (just not perfect).
“Most men do not have symptoms, and there is not a test to know if men carry HPV,” says Yvonne Bohn, M.D., a gynecologist with over 17 years of experience. “That’s something that separates HPV from harder-to-get STIs like HIV. HPV can be spread easily even with a condom, making protected vaginal, anal, or oral sex just as risky.”
What about other forms of protection? Well, despite what some people think, douching does not protect against STIs. Same goes for urinating after sex, showering, or taking Plan B. A female condom is around 95 percent effective when used correctly (pretty close to the 98 percent success rate of male condoms), so there's no reason to skip safety even if penises aren't involved.
Need a refresher in how to put on a condom? Watch this video on the right and wrong ways to do it:
We get how embarrassing it can be to request a test from your doc, but believe us, doctors have seen everything. Some are even working to change the process so that the patient must explicitly say no to getting tested rather than the other way around. Sayonara, uncomfortable questions!
"Some health care providers and some in the CDC are pushing for a more universal approach to chlamydia," says Cherrell Triplett, M.D., an OB/GYN and women's health expert. "So when a patient comes in for her annual exam, you just do a screening if they're in that target population [i.e., under 25 years old]."
But until that becomes the standard, it's on you to ask your health care provider. The CDC and Planned Parenthood recommend getting testing at least once per year, but like most things in the realm of sexuality, it's up to you.
"I leave it to my patient," says Gil Weiss, M.D., an assistant professor of clinical medicine at Northwestern Medical. "But whenever you're finishing a relationship and starting a new relationship, it's not a bad idea to get tested." Same goes for if you suspect you were being cheated on; just be honest with yourself and get tested.
Some STIs are easy to test for: Chlamydia, gonorrhea, and trichomoniasis only require a swab of the genital area or a urine sample. HIV, herpes, and syphilis can be found with a blood test. And a few STIs with visible symptoms—like a herpes outbreak—can occasionally be diagnosed on the spot.
Where to Get Tested
Planned Parenthood is probably the best-known spot, and it’s easy to find a nearby location via its website. A complete guide to free or nearly free testing sites can also be found on the CDC’s website.
Will my parents find out? Will people label me if they know?
Confidentiality goes hand in hand with STI testing.
"If a patient is under their parent’s insurance, sometimes they ask, 'Will my parents find out?' or, 'Will people label me if they know?'" Triplett says.
The reality is: Most of the time no one will know except you, your doc, and (hopefully) your partner, even if you're covered by Obamacare or on your parents' insurance.
That said, laws do vary from state to state. Only one state (Iowa) requires physicians to notify parents if a minor has a positive HIV result. In several states, physicians may inform parents, but they're not required to. And as soon as you're over 18, you're on your own.
If You Have an STI
First, don't freak out. Not every STI diagnosis is the end of the world. STIs do make it easier to contract HIV—and can lead to more serious health complications if left untreated—but many (chlamydia, gonorrhea, and syphilis, for example) are treatable with antibiotics.
HPV is slightly more complicated. Some strains will clear up on their own; others (more rarely) can cause cervical or anal cancer. But the fact is around 80 million Americans are currently infected with HPV, so it's nearly unavoidable. Fortunately there are now multiple vaccines that protect against the strains that commonly cause cancer and genital warts.
HIV, on the other hand, is actually very hard to contract. People used to believe that HIV could be easily contracted through kissing, sharing gum, and getting tattooed, but today we know none of that is true. If you do become infected with the virus—or you're with someone who has it—it's possible to still have a sex life using a combination of condoms and PrEP—a preventive medicine for people at high risk of contracting HIV.
Almost 40 states allow something called expedited partner therapy, which is a way to treat an STI-positive person and their partner, without having to examine the partner. It's currently only allowed for gonorrhea and chlamydia, but it helps.
"If a person is positive, then I can say, put your boyfriend or partner on the line, and I can call in some antibiotics, most of the time, right away," Weiss says. No extra doc appointment, no added embarrassment.
The number of people infected with three major STDs is at an all-time high (yikes!). We're tackling common misconceptions about STIs and STDs to help #ShattertheSTIgma. Because getting tested should be NBD.