This is part two in a three-part series related to recent news about treatment resistant gonorrhoea. You can read the first part here.
I can say this much: without diligent practice, it is not easy, or simple. Even if you're someone who does not have an STI that stays with you, talking to people and partners about STIs is complicated by centuries of marginalization squared at the people who happen to carry them. Though many other infections and ailments are contagious, none* are treated with the same revulsion as STIs, which gat wrapped up in sexual shame. We are in an era where most STI are treatable or at the very least manageable, if not all curable. We have preventative measures like PReP, education around barriers and safer sex practices, and a swell of sex positive education that understands that people who have STIs aren't dirty.
Despite all of this, shame stubbornly persists.
That shame is part of the problem: it's what leads to people avoiding getting testing, avoiding talking about it, and avoiding getting treatment. Most of the people I know who do talk publicly about STIs are those who are sexuality educators and those who have an STI themselves: they have to. We all have to, but not everyone recognizes that; STI prevention isn't about not having sex, or not talking about it, or avoiding it. The solution can only be found through constant conversation and research on the subject.
It's the beginning of an era where there's an understanding that people who contract STIs, especially those that can't be cured, only treated, can have a fulfilling sex life. Not only can people with STIs have a fulfilling sex life: they deserve one. However, progress is slow: those conversations can still be dangerous as many would prefer to ignore the existence of STIs until it's their problem, while simultaneously stubbornly believing it can't be their problem because only those without "virtue" or whatever get STIs. Regardless of religious belief or non-belief, this sort of thinking is entrenched in our subconsciouses.
Moving past the idea that STIs are a moral failing or a punishment is another important part of making the conversation easier, and talking about it is the only way we can slowly inch our way past the shame that means folks aren't properly preventing or treating STIs in their sex life. In a world where STIs weren't seen as so shameful, prevention would be easier and treatment more immediate.
First step: get tested. Regularly. We'll talk more about how to get testing in part three, but this is still important to add here. In a world where many people are dating on Tinder, having casual sex, in open relationships... and even in a world where people are monogamous, testing is a necessity. Your risk level will determine how frequently it should happen: if you're only having intercourse with one person, yearly is fine. If you're dating more frequently, it's a good idea to get tested at least every 6 months and anytime you may have been exposed: if a condom broke or something else that may have put you at risk happened? Get tested as soon as you can. Many cities have free testing sites and some wellness centers even have apps to document and share your testing history.
Bring it up early. If you're dating, you should try to ask someone if they're aware of their status, have been tested recently, and if there are any risk factors you should be aware of as soon as you think you might be planning to hook up. Before you move from Tinder to real life, if you can: it's just going to be easier to bring it up sooner. Ask if they can provide some sort of documentation if they seem shaky on delivery or vague on details: while it can make some defensive, your comfort and well-being are more important. If they haven't been tested, keep some information about local testing options for your local bangs on hand, if you're able. Try to resist the urge to let it slide.
If you're in a relationship or have a frequent sexual partner who you haven't had the conversation with, it's never too late to start talking about it.
Another tip: absolutely do not bring it up just before sex or as it's about to happen. It's better to talk about safer sex practices you engage with in a low-pressure environment. The same goes for things like hard limits or sexual practices you're interested in trying with that person: it'll be better to talk about well before, when you aren't quite so distracted with wanting to get it on.
Remain firm. This is difficult for a lot of people, myself included. Talking about STIs is no easy task; it's awkward to bring up, but you get more confident with practice. Asking for a status report and supporting evidence is about prevention, safety, and pleasure.
Remember that it's also about the pleasure of everyone involved. Knowing there's nothing to worry about on that front can help everyone involved to feel more relaxed, one of the most important ingredients for sexual pleasure. Reminding someone made uncomfortable by a question that's unfamiliar and embarrassing that it could help you and them feel more comfortable, and therefore have a better time, might help release some tension.
Do some research, and practice talking about it with people you aren't planning on fucking. Learn about different risk factors related to different STIs: how they're transmitted, what their effects are, how to identify and test for them, how to determine risk, and even what one can expect from treatment if you want to be especially thorough. Knowledge is one of the great fighters of shame, and the more you know about something, the more confident you'll feel when you talk about it. I'm also dead serious when I say you should talk about STIs with everyone, not just sexual partners: friends, family members, I've been known to start conversations with near strangers about treatment resistant STIs and testing recently. Making the conversation a regular part of your life has two benefits: it makes you more comfortable talking about it, and it helps transmit knowledge and skills to have that conversation to others.
Even the World Health Organization said in their statement about treatment resistant gonorrhoea that stigma is a big part of why treatment-resistant STIs are on the rise. We can all make the world a better place by learning, and talking about STIs without fear.
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*some infections and illnesses are marginalized, though often less than they were before the rise of modern medicine in western societies.