The subject of sexually transmitted infections, or STIs, is one that many people try to avoid. Perhaps hoping it won’t happen to them. But in fact, STIs are incredibly common. The Center for Disease Control and Prevention (CDC) reported in 2020 that 1 in 5 people in the US had an STI – nearly 68 million people.
While almost half of new infections appear in 15-24 year olds, older adults aren’t immune. The CDC suggests STIs in the 65 plus category have more than doubled in the past decade.
Unfortunately there is still a great stigma attached to sexually transmitted disease, and STD or STI related shame can not only get in the way of speedy treatment but also impact on mental health, self esteem and healthy relationships.
Here, we’re looking to bust some common myths about STIs and talk a bit about perceived STD-related stigma. Because the more we talk about these things, the more we normalize them.
When we’re at high school or university, the importance of looking out for our sexual health is drummed into us. After all, if we’re prone to changing sexual partners relatively regularly, or we’re not quite sure whether current sex partner has been tested,it makes sense to take precautions and keep up-to-date on tests.
But did you know that it’s just as important to visit the sexual health clinic regularly when you are in a longer term relationship? In fact, we’d go as far to say you should go every year, just to make sure there’s nothing to worry about.
FALSE We are usually told to expect symptoms such as unusual discharge, rash or itchiness. But perhaps one of the best reasons it’s worth getting checked out regularly is that you may not even know you have an STI. In fact, the World Health Organisation says that the “majority” are asymptomatic. Chlamydia, HPV and gonorrhoea, for example, can be present without causing any day to day issues. Unfortunately though, if they’re left untreated over the long term, these bacterial infections could cause a number of problems ranging from ectopic pregnancy and damage to fallopian tubes in women, to epididymitis (including fever, scrotal pain and swelling) and reactive arthritis in men, and even potentially infertility for both.
FALSE While most STIs are easy to treat – with a course of antibiotics, for example – identifying them as soon as possible and starting treatment early is important. STIs do not clear up on their own and can cause health issues that could affect your later sex life or fertility if left untreated.
FALSE The use of contraception has no bearing on whether you will or won’t catch an STI. The contraceptive pill is only effective at preventing pregnancy. Condoms are the best solution for preventing sexual transmission of a disease, but even they cannot be relied on fully. Genital herpes, genital warts and syphilis, for example, could still be passed on while using condoms, although the risk is reduced. This is why regular testing is the only sure way.
FALSE Any intimate contact can lead to transmission of an STI. This doesn’t just mean genital contact. In fact, genital warts or herpes, for example, can spread simply through skin to skin contact with an area that is affected such as lips.
Open, or polyamorous relationships, tend to rely on a series of agreements between partners about what is or isn’t acceptable. This often means that people in these relationships are more practiced at having open conversations about things like sexual health and may be more proactive when it comes to protection too.
That said, the greater number of sexual partners you have, the greater the statistical probability of a situation arising where infection risk increases e.g. a condom splitting.
For the sake of your sexual health, it’s important that you discuss the subject of STIs up front and put some boundaries in place around testing and sexual behaviors. First up, agree to get tested often and make sure you hold one another to account. If you or your partner do pick up an infection following sexual contact with someone else, talk to eachother so that you can decide on the best course of action for everyone.
In every relationship it’s important to discuss the subject of STI risk and sexual health. Try to speak openly about this kind of thing as early in the relationship as you feel comfortable. It’s always sensible to make sure you both get tested before you stop using barrier protection to reduce the likelihood of infection spreading.
Remember that STIs don’t just happen to people who have a higher than average number of sexual partners. You can have sex once and still get an infections. So being honest about having - or having had - an STI shouldn’t carry any stigma.
Likewise, some STI symptoms can arise years after the actual infection has occurred. So if you’ve been in a relationship for some and suddenly discover that you have, for example, HPV, this isn’t an indicator that someone has been unfaithful.
If you feel nervous or awkward talking to a relatively new partner about STDs, we understand. Communication about sex can be hard. Perhaps talk about it in the context of health in general or a discussion about your value systems.
We’ve previously written about our therapists’ advice on how to tell an ex you have an STI without shame. But, when you’re dealing with a current partner, it can feel like a very different prospect.
Our best advice is to opt for total honesty. Educate yourself about the infection so you can answer any questions they might have with facts. Then put in some safeguards for the future. Practice safe sex, agree clear boundaries in your relationship, commit to regular testing and go easy on yourself.
Unfortunately, however much we talk about STI-related shame, levels of stigma still continue to be an issue. An STI diagnosis can therefore still be difficult for people to accept and may negatively impact their mental health, leading to isolation and even depression or anxiety.
If you’re struggling with poor mental health because of a diagnosis of an STI, it’s important to get support, either from a partner, friend or family member or from a therapist or other health professional.
If you’re struggling with feelings of shame, try to tackle the issue head on by opening up to your partner or to friends and family. The more you talk, the more comfortable you’ll find yourself with conversations like this.
Education is also important. You’re already taking a great step in the right direction by reading this article. The more you can do to understand the facts about STIs and how frequently they actually occur, the better you will be able to manage negative feelings.
An STI, just like any other illness or disease, doesn't say anything about you as a person. It is no reflection on your personality, behavior or morals. It is simply a medical issue that you will need to treat and learn about so that you can manage it appropriately.
Remember: Most STIs are curable, all are treatable and it is ALWAYS better to know than to not know.
That said, we know this isn’t easy. If you find that after six months you’re still not feeling comfortable and confident enough to get back into relationships, consider seeking additional help through counseling.
Go easy on yourself and put your physical - not to mention mental - health first.