We at Bustle love giving you tips for how to tap into your sexual potential and troubleshoot when things aren’t going your way in the bedroom. But what about finding solutions to those stressful sexual health situations that inevitably crop up when you’re getting down? Emma Kaywin, a Brooklyn-based sexual health writer and activist, is here to calm your nerves and answer your questions. No gender, sexual orientation, or question is off limits, and all questions remain anonymous. This week’s topic: when you should get tested for STDs.
Q: I have questions about testing. I just got out of a long-term monogamous relationship where I didn’t really have to think about testing, but now that I’m single I realize I don’t know how often to get tested. I’m chatting with all these guys on dating sites and I want to get out there, but I also want to be safe and be able to tell them real information about being clean. Do I need to get tested before each new person if we're using condoms?
A: Sexually transmitted infections (STIs) are a pretty broad topic, because there are a lot of them and they all behave differently. However, there are some broad rules you can follow to protect yourself from getting one, and getting tested regularly enough is definitely one of them.
First, some definitions: an STI is an infection that you get from another person during sexual activity. Often this means that the virus, parasite, or bacteria is living in your sexual partner’s semen or vaginal fluid and gets into your body through your vagina, the urethra of your penis, your anus, or your mouth, but some are transmitted through skin to skin contact. So really, it’s an infection that you can get from having sex or, um, heavy spooning. It may seem obvious, but you can only get an STI if the person you’re having sex with already has it. And just because they have it doesn’t mean you’ll necessarily get it too — having sex with someone who is positive just puts you at risk for becoming infected.
And an important note for vagina-owners who sleep with other vagina-owners: you can get STIs too. I've written a guide for the STIs you can get from various sexual acts.
Are STI Tests Always Accurate?
Before you think about getting tested, it's important to understand how these tests actually work. STIs only show up on the tests a few weeks after a potential incident. This is because these tests often aren’t looking for the virus or bacteria in your body. Instead, they search for the antibodies your immune system has created to fight off the invading infection. It takes your body a few days to create these antibodies, which means it takes time for the test to pick up on them. This means that if the condom breaks on Saturday night, you unfortunately can’t rush to Planned Parenthood first thing Monday morning to find out if you are positive for an STI.
Each STI has a different lag time between when you get it and when it will show up on a test. You can test positive for gonorrhea or chlamydia in two weeks. Syphilis can show up in one week or take three months to surface on a test. HIV and Hepatitis B and C can show up as early as one month on a rapid test (the one that takes 20 minutes to get results), but in certain cases it can take six months to show. Whenever you get your STI results, you're really getting them for a previous version of yourself.
When Should I Get Tested?
Everyone should be getting tested for STIs routinely. What “routinely” means really depends on your lifestyle, but it can be anywhere from every year to every three months. It depends on how many sexual partners you have — if you’re only sleeping with one person and you don’t have any slip-ups with other people, then you’re probably on the annual testing routine. If you’re having sex with several people, you’re probably more on the every three months track. Talk to your doctor about how often you should be getting tested based on the type of relationships you have.
2. Before (Or After) You Sleep With Someone New
If you are too shy or nervous (or excited) to stop and have this conversation before you have sex the first time, it's not the end of the world. You can have this conversation at any time — the earlier in the relationship the better, because if you find out six months in that you've been having sex with someone who knows they have an STI and has been exposing you to it, you might feel betrayed.
3. ... Even If You Use Condoms
Even if you use condoms, you still need to get tested to know your status. That's because condoms aren't 100 percent effective. There are a couple of reasons why condoms don't provide complete protection. First off, even if you use condoms correctly every time you have sex, they are only 98 percent effective against pregnancy, and most people don't use them correctly every time (hey, no one's perfect), so the typical use efficacy rate is 82 percent. While we don't have an easy percentage to talk about STIs, research has found that condoms are very effective in preventing STIs spread by body fluids (mainly semen, pre-cum, and vaginal fluid). They also reduce your risk for getting STIs spread through skin contact, because they cover the skin of the penis. So if infected skin in question happens to be covered by the condom, then you're more likely to not get an STI if you use a condom.
If you use condoms every time you have sex and you put them on correctly every time, you're doing the best you can to protect yourself from both pregnancy and STIs — but because condoms aren't completely effective, you're still dealing with a bit of risk if your sexual partner has an STI. So if you're hooking up with someone whose status you don't know, even if you used a condom, it's a good idea to get tested. Just remember about the lag time for STI tests — if you have sex with a new lover on Sunday morning, you need to wait a couple weeks to get tested to get an accurate result for anything you could have gotten from that new person.
If you want a refresher on how to use condoms correctly, check out my guide here.
4. After Unprotected Sex
In addition to getting tested routinely, it’s important to get tested after you have an incident that you think could have exposed you to an STI. This can be a condom breaking, having unprotected sex (it happens to the best of us), or being the victim of sexual assault. If, whether intentionally or unintentionally, you have protected sex, you may have put yourself at risk for getting an STI. If this is you, don't panic. Tell your doctor, and she'll let you know when to come in for testing.
If you think you might be at risk for getting HIV, you can go immediately to your clinic (or the emergency room) to get Post-Exposure Prophylaxis. PEP is basically like Plan B for HIV, except it's nearly a month of pills instead of just one. PEP can help protect you against HIV infection.
5. If You're Not Feeling Great
I don’t want you going down the rabbit hole of Internet self-diagnosis, but here we go. All STIs have potential side effects, such as genital redness or itching, pain during urination, pain during sex, or flu-like symptoms. I say potential because a lot of people are asymptomatic, which means they don’t feel any different even though they have an infection. If you’re feeling not-great, particularly in your nether region, describe your symptoms to your doctor. You could have an STI (or just about a million other things). She will test you to make sure, and then give you the treatment you need to feel better.
If your partner starts showing symptoms that sound like they could be an STI, you might want to accompany them to the clinic, and also get tested yourself. If your partner is positive for an STI, it doesn't mean you are too — but it could. Knowing earlier means you can get treatment earlier. For more highly communicable STIs, sometimes providers will give treatment to the person testing positive and their sexual partner(s), so that their patient doesn't get cured only to get reinfected the next time they have sex.
Does The Standard Test Cover All STIs?
Once you get to the clinic, it can be hard to advocate for yourself to make sure you're getting all the tests you need to know your STI status. If you're worried about a particular STI, make sure to ask your doctor for it explicitly. Routine STI testing is usually limited to chlamydia, gonorrhea, HIV, syphilis, and hepatitis, with genital herpes and the parasite trichomoniasis only tested for if you come in with symptoms and human papillomavirus (HPV) tested for during your routine pap smear (there’s no screening test for men). If you're worried about an STI that isn't on the routine test list, make sure your doctor knows — and make sure she tests you for it. If she protests, tell her that you're worried about such-and-such STI and that you deserve to know your status.
What Happens If I Test Positive For Something?
If you end up getting an STI, it’s really not the end of the world. I promise. Most STIs are curable with correct treatment. Your body can actually fight off human papillomavirus aka genital warts all by itself. And even for those STIs that are incurable (on that list right now are HIV and both oral herpes and genital herpes), you can take medication to manage your symptoms and make it less likely for you to transmit the infection to someone else. If you end up positive for something, work with your doctor to get treatment, and work with yourself to feel comfortable with your status, especially if it’s for an incurable STI.
You also need to talk to your sexual partners about it. I know this can be the scariest thing imaginable, but it’s respectful to your lover’s body (or bodies if you’re seeing more than one). And often, the conversation goes way better than you think it will. I’ve written some tips elsewhere for how to disclose to a partner.
The Bottom Line
Finding out your status can be stressful, but it’s a critical part of being a sexually active adult. Once you know it, whatever it is, you can take action to take care of your body. Knowing you don’t have any STIs means you can honestly tell your sexual partners that. Knowing that you have a curable STI means you can get cured so you can go back to being negative. Knowing that you have an incurable STI means that you can get the treatment you need to keep your body healthy.
Some people don’t get tested on purpose because they feel that ignorance is bliss and if they don’t know their status they won’t have to deal with it. This is not good for your body or the bodies of those you love (or like to f*ck, or whatever you want to call it)! Knowing your status, whatever it may be, means that you can get treatment and stay healthy. So please, get tested. Your body deserves it, and so do your sexual partners.
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