We’ve been talking a lot on this blog about the importance of good and clear communication around sex. Thus far, we’ve primarily talked about consent. But communication is equally important for safe sex. As it happens, April is STD awareness month, and today is National Youth HIV and AIDS Awareness Day. So I’d like to take a moment and consider how we can talk more openly about Sexually Transmitted Infections (STIs) and safer sex protocols.
The United States currently has higher rates of STIs than any other developed country. And it’s absolutely a feminist issue. The burden of STIs falls disproportionately on women—women are more at risk for catching an STI, less likely to have or correctly identify symptoms, more at risk for long-term consequences from STIs, and more stigmatized for having an STI. Moreover, good safer sex protocols are important for preventing pregnancy as well, which I’d wager looms larger as a concern for many women than any STI.
The problem is: we don’t know how to talk about STIs. How many times have you had a clear talk with a partner about STIs and Safer Sex before the first time you two had sex? When was the last time a sex ed class in high school—or sometimes, even college—talked about how to have this discussion? God forbid!
But… it’s hella awkward, right? What if trying to talk about it kills the mood? What if they don’t want to have sex with me because of what I say? What if they think I’m a slut? What if I have an STI and they reject me because of it? What if they think I’m weird or obsessive or paranoid?
This stuff IS hard. No doubt about it. It takes practice. And support. Some people have told me that my vision on STI / Safer Sex communication is unrealistic, or at least too advanced. That the onus for disclosure of an STI risk should be on the person who has an STI, or that it’s weird to proactively ask about STIs. But I think we have to aspire to a higher standard. After all, the only way we’re going to break down the stigma and shame around this topic is if we talk about it openly, and if we support each other in doing so. And I do see it working.
In kinky and polyamorous circles over the past few years, I’ve encountered friends and lovers who have modeled some best practices in safer sex and communication around STIs. And their example has pushed me to try to rise to a higher standard myself, and encourage others to do the same. So I’m going to talk about what I try to do and why, and what I’ve learned. Including disclosing a bunch of personal details.
So…talking leads to flirting leads to foreplay, and sooner or later, we get to the point where it’s clear—because someone asked and someone else said yes—that I want to have sex with the person (or people) I’m with, and they feel similarly. Then I’ll say something like this:
“So, before we play, I’m thinking we should check-in briefly about STDs and safer sex first? I can go first.
Let’s see…I get tested for STIs about twice a year. My last test was in February—around February 5th, I think? I tested negative for HIV, Syphilis, Chlamydia, Gonorrhea, Herpes, and Hepatitis C. (I’m vaccinated against Hep A & B.)
My standard safer sex protocols these days are to use condoms for all vaginal and anal sex, gloves for manual internal vagina/anal contact whenever possible. I also prefer to use condoms/dams for oral sex with any non-regular partners. Oh, and I am not allergic to latex, but I have latex-free alternatives on hand if you are.
So that’s me. How about you?”
[Note: If I’d had any risky sexual encounters–like unprotected vaginal or anal sex–since the last test, I might choose to disclose that as well.]
In saying something like, you’ve laid out a script for the other person to use. This makes talking about it for them much easier! I realize my rendition seems rather buisness-like. What can I say? I, um, get lots of practice. You might have your own style for talking about this. Even if its full of awkward pauses the first couple times, it’s still good to have it. And the more you talk about it, and the more people around you who talk about it, the easier it will get.
As in my real-life-example above, these are the key points to hit:
- When were you last tested?
- What were you tested for? And don’t say “everything.” Because at different clinics, “everything” means different things. It almost certainly won’t include Herpes, Hepatitis, or HPV, for example.
- What were the results? If you did test positive or have a history, do you have symptoms now?
- What safer sex practices do you want to use? More on this below, but if you and your partner disagree, please go with the most protective approach.
Reid Mihalko (an awesome sex educator and major slut) calls his version of this script his “Safer Sex Elevator Speech.” And that’s a useful way to think about it, I think. That said, Reid’s even more comprehensive model puts discussion of one’s relationship status and what one might want to do (or avoid) sexually in the “elevator speech” too. But for me, that’s a whole separate conversation—and one I’ve hopefully already had, at least in part, by the time I get to the point of discussing STIs! And those negotiations are really a whole separate blog post anyway.
Do I talk this talk before every sexual encounter? I wish I could say yes. But, no, in a number of cases I’ve forgotten. I’m a human. (And an ADD one to boot.) And if the sex in question is sufficiently low risk—fingering/fisting, or oral sex, or playing with toys—then so long as proper barriers are used, I don’t feel a need to also discuss STIs. But overall, I’m trying to do better at this, and I’m finding its gets easier each time I do it.
(You may also have noticed I haven’t used the word “clean” in my script or in this blog post. Yes, that’s intentional. I think a shame-free approach to sex and sexuality has to move away from implying that some things or people are “clean” and others are “dirty.” Or that having an STI is a mark of shame. We’ll come back that point.)
Good Barriers Make Good Lovers?
When I first became sexually active, I used condoms + lube for vaginal and anal penetration, and that was about it. And that worked pretty well for a while. But since I began practicing ethical non-monogamy, I’ve gained some awesome partners who’ve encouraged me to up my game when it comes to Safer Sex barriers.
After all, when it comes to safer sex, condoms for vaginal and anal sex really ought to be the beginning of the conversation, not the end. You can also use condoms for fellatio! Now, most lubricated condoms taste like crap, but you can use non-lubricated condoms, or flavored condoms, or find a flavored lubricant you like and add that to the condom. And then there are Dams for cunininglingus. Or just use non-microwavable saran wrap. And though many people don’t use them, I’m a huge fan of latex or nitrile gloves! Not only do gloves make your hands less rough for penetration, reducing the risk of cuts from nails and making it easier to slide deeper, they also make cleanup really simple! And if they’re black, they can be fucking sexy. Women should also be aware of nifty innovations like the female condom, which puts agency for barrier protection in the woman’s hands. Barriers for toys are also important! I try to either use silicone toys, which are sterilizable, or put a condom over my toys–which, once again, helps with cleanup.
Also, remember that people have allergies and sensitivities, so it makes sense to stock:
- latex-free condoms: Skyn and Skyn Large are good polyisoprene condoms (a synthetic rubber/latex that people are allergic to the natural components in latex are usually fine with); to be super safe, use polyurethane condoms (though polyurethane doesn’t stretch as well, and so may not fit all cocks). [Edited in response to comments from LongEaredOwl]
- Nitrile gloves
- Lubricant that doesn’t have glycerin, paraben, or other additives: Sliquid is one good brand.
Using this level of barrier protection takes work. And it may or may not be practical or important for you. But I want to talk about it because I know it doesn’t even occur to many people. I also find it helpful because it forces me to slow down and make conscious decisions about who I’m rubbing bits with and in what ways. Oh, and if you’re having group sex, remember to switch barriers between partners, including on toys! Yes, I did once go through over 20 gloves and 8 condoms in less than an hour this way. Good thing my house buys safer sex supplies in bulk?
But what if I have an STI? Or what if they do? What then?
For starters, there’s a huge difference between different STIs.
HIV is of course the threat everyone focuses on. And rightly so! These days, I think we’ve gotten ourselves into a complacency wherein HIV seems on the back burner and managed. But it’s still a very real threat, especially in Washington, DC, which has an infection rate of ~2.7%, one of the highest in the nation. Meanwhile, lesser infections are also growing in concern. Take Gonorrhea, the second-most common STI in the US, which is growing resistant to the only antibiotic that is still effective against it. But you know all about this already, I bet. And this blog is going to have another follow-up post soon with more info on all the major STIs!
So I want to focus on the STI you most likely to deal with, and the only one I have personal experience with, Herpes Simplex Virus (HSV)
Herpes is certainly a problem, and oh boy am I glad I don’t have it. Honestly, though, I don’t think Herpes is actually as big a deal as we make it out to be. I’ve probably upset some public health advocates, and even fellow editors on this blog, with this statement. Feel free to sound off in the comments!
Let’s clear up some confusion, first. There are two strains of Herpes Simplex, HSV-1, and HSV-2, which are colloquially referred to as oral and genital herpes, respectively. But this is a misnomer. There’s very little difference between the two strains, and either can infect either location. I have friends who get cold sores caused by HSV-2 on their mouths, and friends who get sores in their genital area caused by HSV-1. And people confuse canker sores, which are ulcers inside the lips, with cold sores, the external fever blisters caused by HSV-1, all the time. (This caused a brief scare for one of my partners just last fall!)
Herpes is extremely common. Close to 80% of all Americans have Herpes Simplex 1 or 2! (It’s rare to have both.) You may have it. And yes, you can get it from sex or making out. But you can get it from anywhere, including a loving peck from grandma when you were a little kid! And while the risk of transmission is highest when there is a sore, HSV can shed asymptomatically as well.
Yet despite this, we have a lot of stigma around herpes, and genital herpes in particular. We see someone with a cold sore outbreak on their face and think it is some scarlet letter or symbol of their sluttiness! And people freak out when they really don’t need to—even sex-positive, polyamorous folks. I’ve had to come to a more measured view of this virus after I started dating someone who has HSV-1, and realized I didn’t actually care. And you know what? We’ve been kissing for over a year now and I’m still testing negative for HSV-1. When she has a cold sore, we just don’t make out. We can still fuck. It’s frustrating, but it’s not the end of the world. (And when the temptation to make out is just too strong, I have a sexy, kinky solution.) Getting tested for Herpes is also tricky–the test is an antibody only test, which means it can give a positive result even if you don’t have the virus, and most people has antibodies, so it can be hard to get a doctor or clinic to test you. If you do get a negative result though, it should be somewhat easier to get the test in the future.
What Can You Do?
Stigma around STIs of all varieties doesn’t just make it harder for people to talk about STIs. It also makes it harder for people to get regular testing as well, and to access or insist on using appropriate barrier protections. I’ve had many a female friend tell me how they were slut-shamed by their Doctor when they asked for STI tests too frequently. Which is sucky, because I think that sexually active adults should aim to get tested for STIs every six months. And while the Affordable Care Act has made access to STI testing cheaper and easier, I’m skeptical that the medical and insurance establishments are supporting sufficiently frequent STI testing. I’ll admit that I haven’t had to deal with this issue much myself, because I’ve traditionally sought out STI testing from organizations that are sex-positive or already assume promiscuity on the part of their target population (such as Whitman Walker in DC, or many University health centers). Testing for things other than HIV also often costs money. Especially if you want non-standard tests, like Herpes. Which is why clinics that offer free or sliding-scale testing are so valuable! You can find some on the resource lists linked to below.
Here at DDP, we often like to end the posts with ways we can support each other and take positive actions. Which is kind of what this whole post is about, right?
- Get tested! Look up your closest testing sites on the CDC or Planned Parenthod Websites. Take a friend! Take Three! (If you’re in a major city, there may also be LGBT-focused options, such as the Whitman Walker in Washington, DC (where I always go))
- Talk about getting tested in casual conversation! Post on social media about it!
- Talk to new (and old) lover(s) about STIs and barriers!
- Try out new methods for barrier protections and see what works for you!
- Don’t shame others for STIs.
- And most of all, please don’t shame yourself.
How About You?
 A note on language: The most common mainstream term is Sexually Transmitted Disease (STD). But many sex educators prefer the term Sexually Transmitted Infection (STI), because you can be infected with an STI and not have any symptoms of the disease. So I’m going to use STI from here on out. I’m also using the term “Safer Sex” instead of “Safe Sex,” because no sex (save for phone/cyber/solo sex) is ever 100% safe.