Sexual health without shame

An STI is not a punishment

Sexually transmitted infections such as chlamydia, gonorrhoea, syphilis, herpes, HPV and HIV are common and happen to all kinds of people, in steady or casual relationships. Having an STI says nothing about your character. What gets in the way most is shame, because it makes people put off testing and treatment.

Many STIs cause no symptoms at all for months, which is why only a test will show them. When signs do appear, the most common are burning when you pee, unusual discharge, sores, warts or blisters around the genitals, anus or mouth, and pain during sex. Any of these is a reason to see someone, without waiting for it to pass. Most STIs can be treated, and many can be cured.

Testing as routine

Getting tested is routine care, like going to the dentist. A practical guide: test at least once a year if you are sexually active, and every three to six months if you have new partners or several at once. It also makes sense to test at the start of a relationship, before you stop using condoms. Rapid tests for HIV, syphilis and hepatitis give a result in a few minutes.

At the appointment, say clearly what kind of sex you have: oral, vaginal, anal. For the person seeing you, this is working information, not something embarrassing. It also changes which tests are done, because some infections sit in the throat or the anus and do not show up in a urine test.

Condoms, PrEP and PEP

Condoms, external or internal, protect against HIV and greatly reduce the risk of other STIs and pregnancy. They work best when they are the right size, go on from the start and are used with water-based or silicone-based lubricant, which makes them less likely to tear.

PrEP is pre-exposure prophylaxis: an HIV medicine taken beforehand, on an ongoing basis, by people with a higher chance of exposure. Used as advised, it greatly lowers the risk of getting HIV, but it does not protect against other STIs. It needs follow-up with regular tests, and in many places it is free through public health services.

PEP is post-exposure prophylaxis: emergency treatment after a risky situation, such as a condom that split, sex without protection with someone whose status you do not know, or sexual violence. It needs to start as soon as possible, ideally within hours and at the latest within 72 hours, and it lasts about a month. If this has happened to you, go to an emergency department or a sexual health clinic today.

Vaccines and contraception

The HPV vaccine prevents most cervical cancers and also protects against genital warts and cancers of the anus, penis and throat. It works best when given before someone becomes sexually active, but it can still be worth having later, depending on age and advice. The hepatitis B vaccine is part of the same care. Ask a health service whether your vaccines are up to date.

If pregnancy is possible, there are many methods: the pill, the injection, the patch, the ring, the hormonal or copper coil and the implant. Only condoms protect against pregnancy and STIs at the same time. After sex without protection, emergency contraception works better the sooner it is used, and a professional can help you choose an everyday method.

Talking with a partner

Talking about testing before sex is not an accusation, it is care on both sides. A simple sentence does the job: "I get tested routinely, my last one was in March, what about you?". If someone reacts badly to that kind of question, that is useful information about them too.

If one of your tests came back positive, give yourself time for the shock, ask the professional to explain the treatment and ask how to let recent partners know. Many services can help with this, sometimes anonymously. A person with HIV who is on treatment and has an undetectable viral load does not pass the virus on through sex. A diagnosis changes your routine, but it does not take away anyone’s right to a sexual and loving life.