Written by Kyle Stockard, Health Educator at Planned Parenthood
The thought of sexually transmitted infections (STIs) undeservedly strikes fear in the hearts of many sexually active individuals, and this fear often contributes to a stigma. This stigma, which typically stems from a lack of knowledge regarding sexual health, has the power to wreak more havoc than you may be privy to. The stigmatization of STIs may prevent some from getting tested and knowing their status if they’re too scared of potentially testing positive. For those who have a confirmed diagnosis, STI stigma could result in shame that makes it difficult to navigate relationships and causes anxiety about sharing their status with potential partners.
In both instances and more, it’s clear that stigmatizing STIs gets us nowhere—but education does. Because knowledge is power, I want to share some info on how to prevent STI transmission, how STIs are managed, and where to turn if you’re dealing with stigma yourself.
Lingo Goes A Long Way
“Why are you saying STIs instead of STDs?”
It’s a question sex educators like me get a lot. And don’t get me wrong, it’s a good question! The acronym “STD” has been popular ever since the (arguably worse) term “venereal disease” went out of style. Part of the shift in language is to reflect a scientific reality—not all infections will progress into diseases, and STIs are often asymptomatic infections. The other part of this shift is a conscious effort to destigmatize STIs. While neither “infection” nor “disease” have warm, fuzzy connotations, “infection” tends to sound less scary and more manageable. That’s the goal: STIs shouldn’t sound all that scary because they don’t have to be! They’re super common—on any given day, around 1 in 5 people in the U.S. have one—and modern treatments can cure most and manage the rest.
Transmission Is Easily Preventable
Even if you know for a fact that a partner has an STI, you can reduce transmission risk or even prevent transmission entirely. We have the technology!
Prevention While Sleeping With Someone With An STI
Prevention doesn’t have to be limited to abstinence or condoms. There are tons of ways to avoid transmission when having sex. For example, you might already be vaccinated for HPV and Hepatitis A and/or B. If not, you can still seek those vaccines out at your local health clinic. While the HPV vaccine is primarily given to children and adolescents, folks up to age 45 may be eligible to receive it. The same goes for the Hepatitis A and B vaccines, which are usually given in infancy but are totally okay for adults to get, too!
If you have a partner who is HIV+ or whose status is unknown, pre-exposure prophylaxis, aka PrEP, might be an option for you. I often simplify the explanation of PrEP as “birth control, but for HIV” because it’s a daily pill someone can take to lower their risk of getting HIV. PrEP is even an option for folks who share needles with others to reduce their HIV risk.
For someone who isn’t on PrEP, post-exposure prophylaxis, aka PEP, is on the table for HIV transmission prevention after exposure. Following along the lines of the birth control analogy, it’s sort of like the morning after pill. I say “sort of” because it’s around a month-long regimen of antiretroviral pills instead of a single dose, but the idea is similar. If you have sex or share needles with somebody who is HIV+ or whose status is unknown, you can seek out PEP within 72 hours of potential exposure to reduce your risk of HIV.
A newer HIV-related term you might not have heard is undetectable=untransmittable (or U=U). If someone with HIV takes their meds as directed, they’ll reach a point where their viral load is so suppressed that they won’t even test positive for HIV. This means that they won’t transmit HIV to sexual partners as long as they maintain that level, or lower, of suppression.
General Safe Sex Practices For STI Prevention
Knowledge is the most powerful tool we have for STI prevention. Knowing what behaviors and fluids put you at risk is especially important. Semen, vaginal fluid, blood, and some skin-on-skin contact are the primary vectors of STI transmission. This means that unprotected anal/oral/vaginal sex, naked body rubbing (dry humping, grinding, frottage, whatever you wanna call it), and sharing needles are the primary behaviors that are going to put a person at risk for an STI. As long as you avoid fluid contact, everything else is totally on the table. Give all the handjobs you want! Get fisted! Make out and mutually masturbate! Draw your own boundaries around sex and what you want it to look like.
When and if you decide to have penetrative sex, bring a barrier method into the equation for maximum protection. External condoms are your average, everyday, goes-on-a-penis-or-toy condoms. They are often free at clinics and come in tons of colors, textures, flavors (for oral only!), and sizes. Internal condoms, while less common, give the receptive partner the opportunity to be in charge of safety. Dental dams, which are simply thin latex sheets, are for oral on vulvas and anuses only but offer protection and flavor at the same time. The possibilities are endless!
If you’re looking to prevent HIV contraction specifically, you have a ton of options at your disposal. If you’re engaging in anal sex, you can try being the top or insertive partner to reduce your risk—this is called strategic positioning. If that’s not your style, remember that PrEP and PEP have your back if you’d like!
Oh, and make sure you’re using lube every time you have sex, regardless of your position. Lube reduces the risk of condoms breaking and anuses and vaginas tearing during sex. Make sure you’re using the right lube for you, though! Oil-based lubes will cause condom breakage, and spermicidal lubes can actually irritate a vagina to the point of increasing the risk of STIs. Lube can also be used as a tool for increasing pleasure—placing a little bit inside of a condom before putting it on can enhance sensation for the wearer.
It’s also important to remember that STIs cannot be spontaneously created. If sexual partners are mutually monogamous or practicing polyfidelity in the context of polyamory, there’s no risk of STIs as long as everyone tests negative. However, humans make decisions, and infidelity happens sometimes. Communicating honestly about any new partners is important for STI prevention in these cases.
Symptoms Are Manageable
Living with an STI doesn’t have to be scary, difficult, or isolating. It’s totally natural to fear rejection from future partners and judgment from society, but those don’t have to be permanent setbacks. Simply talking about STIs more is the first step toward a brighter future for everyone.
While not all STIs are curable, they are all 100% treatable. For most infections, a course of antibiotics or antivirals (in the case of Hep C—it’s curable now!) prescribed or administered by a clinician will clear you up in no time. Pubic lice can even be treated over-the-counter with topical medication! For folks with herpes, medication can help suppress the frequency of outbreaks, therefore reducing the risk of transmission to partners. Similarly, people with genital warts from HPV can have them clinically treated and removed. HPV may also clear up on its own, and herpes outbreaks (both oral and genital) tend to lessen in frequency and severity over time.
Given the effectiveness of today’s STI treatments, STI-related stigma and shame can actually be more harmful to a person than the infection itself can. The mental health impact can be intense. From the idea that people with STIs are “dirty” (which is implicit when people say they’re “clean” after an STI test, for example) to the prevailing idea that they’re a “punishment” for promiscuity, it can seem like society is hell-bent on making people with STIs feel like shit. But it doesn’t have to be that way! You can do a lot to overcome STI stigma by just being informed and spreading your knowledge.
If you’re struggling with STI stigma, please know you’re not alone. There are awesome resources out there, like the American Sexual Health Association, POZ, and The STI Project, just to name a few. Hell, even if you aren’t living with an STI, you should check these places out. There are so many wonderful voices advocating for folks with STIs, and they absolutely deserve to be heard.
STIs shouldn’t be the boogeyman they were made out to be in health class. They’re common, extremely treatable infections that just happen to be spread via sex instead of sneezes. Armed with facts and some empathy, you can easily fight STI stigma! Just use your voice to speak out.
If you’re worried about your risk, if it’s been a while, or if you simply want to know your status, head out and get tested. If you know your status, fuck yeah! Positive or negative, you’re a human being deserving of all the love in the world.
Kyle Stockard is a Health Educator with Planned Parenthood of Tennessee and North Mississippi. You can usually catch him delivering condom orders, running his peer education group, and teaching sex ed classes. After hours, he’s probably hanging out with Milton the dog, and being ignored by Luanne the cat.
