Giving your new boss a hug only to realize she was going in for a handshake? Awkward. So is scrolling through an ex’s Facebook profile and accidentally liking a picture from three years ago.
But mentioning sexually transmitted infections (STIs) to someone you’re hoping to get down with? Awkward level 100.
Whether you’re in a long-term committed relationship or simply committed to having fun for as long as possible, talking about STIs is a whole lot of uncomfortable. Still, that doesn’t mean you should let your initial embarrassment prevent you from having this vital conversation.
“When engaging in sexual contact, it’s important to think about the risks, and STIs are a risk,” says Susannah Herrmann, A.R.N.P., a nurse practitioner at the Public Health Seattle & King County STD Clinic at Harborview Medical Center.
Here are her tips on how to talk about all things STI with your past, current and potential partners. You know, so you can spend less time worrying about antibiotic-resistant gonorrhea and more time enjoying yourself in the bedroom.
Why you should discuss STIs
Sexually transmitted infections in the United States are rising at an alarming rate, with a 22 percent increase in chlamydia, a 67 percent increase in gonorrhea and a 76 percent increase in syphilis between 2013 and 2017.
It’s not just a national-level problem, either. During that same time period, syphilis and gonorrhea cases doubled in King County, and the rate of chlamydia increased by more than 40 percent.
Then there are HIV/AIDs, HPV, herpes, hepatitis and dozens of other STIs, some of which don’t require sexual intercourse to spread from partner to partner. (Yep, you can get herpes, HPV and crabs from intimate skin-on-skin contact alone.)
Keep in mind, STIs do not discriminate based on your sexual orientation. If you’re engaging in sexual activity, you’re at risk.
This is why, Herrmann notes, it’s so important to get tested and to talk to your partner about getting tested, too.
“In an ideal world, you have this talk before becoming sexually active with someone,” she says. “But we’re all only human, so after the fact is better late than never.”
Herrmann also cautions that it’s not enough to say you’re clean and move forward. Some STIs are asymptomatic, meaning you could feel completely fine but still have one. When left untreated, these STIs can lead to pelvic inflammatory disease and even infertility.
“We see folks who say, ‘I got tested for everything’ or their partners say that,” Herrmann says. “It’s not enough to hear that from a partner. You need to find out what they got tested for, when and what kind of sexual exposures they’ve had since.”
How to talk to your partner about getting tested
OK, so you get why discussing STIs is important for your sexual health (and your partner’s, for that matter). Now what’s the best way to have “the talk” with each other?
Start by approaching the conversation from a place of mutual respect — it’s not about trust issues, cheating suspicions or what someone’s sex number is. Keep things focused on your health and, together, reach a decision about STI testing.
Yes, it can be embarrassing to discuss this with someone you don’t know extremely well. And, no, it’s probably not the best thing to bring up when you’re in the middle of a heavy make-out session.
Instead try to find a moment when you can calmly and directly chat about your sexual history and shared wishes. In the end, you and your partner may end up feeling closer than ever before.
If your partner is resistant to testing, though, it can help to try and find out why.
“Sometimes they’re too afraid or embarrassed to come to the STD clinic,” Herrmann says. “We never turn away anyone based on their ability to pay, and we try our best to put you at ease. This is what we talk about all day, every day. But if your partner simply doesn’t think it’s important, I would have doubts about whether that partner is right for me.”
That’s not to say that if your partner doesn’t agree to get tested that you should forgo testing, too.
In those situations, or any others where you might have a greater chance of getting an STI, Herrmann says it’s best to try and mitigate your own risk. Use condoms, when possible, and avoid high-risk sexual activities like vaginal or anal intercourse.
At the very least, she encourages patients who don’t know their partners’ STI status to come and get tested every three months so they can receive any necessary treatment.
How to tell partners that you have an STI
Remember that whole ideal world versus human reality thing? Well, let’s say you didn’t have a chance to chat before you had sex with someone and you just found out that you have an STI. No judgment — it happens.
The most important thing to do is to tell your past and current partners.
“I try to encourage people to be as matter-of-fact as possible,” Herrmann says. “It’s helpful to be as specific as you can: what you tested positive for, in what area and on what date. Tell them that they should see a doctor.”
There’s also something called Expedited Partner Therapy, which allows you to get medication for chlamydia or gonorrhea and give it directly to your partner without them having to see a doctor.
“We’d ideally like to see all partners involved for STD treatment, but this way you’re both treated and you’re less likely to bounce the infection back and forth,” Herrmann explains.
What about those situations where you want to avoid talking to an ex or don’t know how to get in touch with someone? (Again, no judgment.)
Your doctor’s office or the clinic where you were tested can notify your ex confidentially, without revealing who you are, and they can also help find and inform former flings.
“We have a team of disease investigators who can track partners down,” Herrmann says. “They never share information about who the original infected partner was.”
What to do after a positive STI test
If you do test positive for an STI, refrain from sexual activity until you’ve completed treatment and all your symptoms are gone, usually about a week or so. This helps prevent you from inadvertently passing the infection on to your partner.
But in those situations where abstaining from sex just isn’t possible, like if you’re a sex worker or in an abusive relationship, Herrmann says try and do whatever you can to lower your risk.
If you tested positive in one area, keep sexual activity contained to areas that tested negative. Mutual masturbation also works and condoms, while imperfect, can help, too.
If you’re in a mutually monogamous relationship and you both test negative, rest easy and have fun. But if you have different sexual partners, be sure to keep getting tested at least once a year. And, again, if you’re unsure about your partner’s STI status, get tested every three months for peace of mind.
Either way, if you focus on what’s best for your health and your partners’ health, you’ll be able to do the right thing.
“It’s a hard conversation to have,” Herrmann says. “No one wants to be on either side of a positive test scenario, but in my experience, the large majority of partners who are told they were exposed to an STI are really glad that the other person had the courtesy to tell them.”