Talk to Your Partner About Sexually Transmitted Infections

How to Ask a New Partner About STIs

The overall goal is to have great sex

Mengxin Li If you haven't dated for a decade or two, you're in for some surprises — HIV is now so treatable, they advertise medications for it in the theater before the latest Avengers movie. If, like me, you hit puberty during the height of the AIDS epidemic, that might make casual sex seem a tiny bit less scary, especially in the age of Tinder and stealthing (nonconsensual condom removal during sex) and super gonorrhea But don't throw caution — or condoms — to the wind just yet. Rates of in recent years. "There is no age limit on acquiring sexually transmitted infections,” said Peter Leone, professor of medicine in the division of infectious diseases at the University of North Carolina School of Medicine at Chapel Hill. “But in these second-half-of-life dating situations, a lot of times you aren't thinking in terms of risk after being in a mutually monogamous relationship for years.” Having a conversation about status and sexual history is important, and it should happen before you have sex. ... Any kind of sex. ... With anyone. "There's a perception that oral sex is less risky, but transmission of certain diseases is high when one person is infected,” Leone said. “And this advice isn't only for people in heterosexual relationships. If you're going out to have sex with another woman for the first time, you still need to be concerned about oral-genital transition.” Even toys can carry pathogens. Leone recommends using a condom on anything that's getting inserted anywhere and cleaning them with diluted bleach. Until you confirm that you are in a mutually monogamous relationship and know each other's STI status, condoms or another barrier method are your best bet. And yes, confirming means you're going to have to talk about it. “It's a hard conversation to have, because in our culture, somehow it is more acceptable to just let sex happen than to talk about it and plan for it,” Leone said. “But this is all part of good sexual health." Treat it like any other health issue. Broach the topic outside of the bedroom, and be matter of fact. Your goal isn't to shame your partner or pry into his or her past. It's just to get the information you need to be safe. It may be easier to start the discussion by disclosing your recent sexual history or results of your last test (if you've had one) first. One other way to avoid potential awkwardness: Volunteer to get tested together. But be aware that “getting tested” can mean different things. There is no standard panel, so you should make your own checklist: HIV, HPV, syphilis, gonorrhea, chlamydia (though according to Leone, 85 percent of the cases in the U.S. occur in individuals 25 or younger); and for women, trichomoniasis, the second-most prevalent infection outside of herpes in women (and one for which men can't be tested). You also want to make sure you're both getting tests in all the sites you plan on having genital contact. That means the penis and vagina, but also the mouth — and, if it's your thing, the anus. There are different swabs for those sites, and if you don't specifically request all of them, your results won't tell the whole picture, Leone said. Finally, it matters when you and your partner last got tested. “The majority of STIs are asymptomatic,” Leone said. “So you may not even know you have it.” If either of you has had sex with a new person since your last test, you could have contracted something that won't show up on an STI panel. "Think of it like changing the oil in your car,” Leone said. “It's based on use or time. If you are engaging in high-risk behavior” — changing partners frequently, not using condoms — “you need to get screened every three to four months. Otherwise, once a year is standard.” If all this sounds overwhelming, there is good news. “All these diseases are treatable,” Leone said. “In the case of herpes, we don't have a cure, but we can suppress infection and reduce the risk of transmission. But that requires daily therapy and knowing your status.” Which means that having an STI doesn't have to be a deal breaker. With , for example, Leone said, “There is a 90-plus percent chance if you do nothing, you won't contract the disease.” And the risk of transmission goes down the longer you've had the disease. The bigger issue, he says, is people not really knowing whether they've got an STI or not. “Never assume status,” he said. Not your partner's or your own. A whopping 85 percent of people with genital herpes don't know they have it. "Disclosing puts you in the category of being a risk,” Leone said. But someone who is aware and actively treating the disease is less of a risk of transmission than someone who doesn't know and isn't using proper precautions. Overall, he added, the goal is to . And having the best sex possible means thinking about it, talking about it and planning it. “Think about what you want, have your eyes open, and know what risk you're willing to take or not take. Not knowing doesn't protect you."

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