Don’t let the title of this piece scare you!
By the time you get to the end, you’ll know exactly what you need to do in order to protect yourself against the transmission of sexually transmitted infections (STIs), as well as how to know what your actual STI status is.
Yes, it is possible to contract a STI from someone who tested negative (for the STIs that they were tested for)… if (and only if!) they were positive for an STI that they weren’t tested for.
Or if they were positive for an STI in a location that didn’t get tested, such as in the mouth and throat.
For example, someone might have tested negative for genital gonorrhea but not been tested for oral or anal gonorrhea, and potentially transmit the STI through anal or oral intercourse.
STDs vs. STIs
STI stands for sexually transmitted infection and STD stands for sexually transmitted disease. Scientifically speaking, the difference between diseases and infections is that diseases present with symptoms and infections typically do not.
majorityof sexually transmitted conditions are asymptomatic. Because of this, many experts have pushed to refer to these as STIs (and not as STDs) to simultaneously improve accuracy while reducing stigma.
There are a number of sexually transmitted infections, including:
- Molluscum contagiosum
- Pubic lice
- Herpes simplex virus (HSV)
- Hepatitis A
- Hepatitis B
But when people get tested for STIs they typically aren’t tested for all of the above. No, not even if they say “test me for everything.”
“Dirty” vs. “Clean”
Quick terminology check: When we’re talking about whether someone has an STI, we use the language “STI positive” and “STI negative” — we don’t use the phrases “dirty” or “clean.” Why? Because the latter set of words perpetuates STI stigma.
“Typically, when you ask a doctor to test for everything, they’ll only test for gonorrhea, chlamydia, syphilis, and HIV,” explains Dr. Felice Gersh, author of “PCOS SOS: A Gynecologist’s Lifeline To Naturally Restore Your Rhythms, Hormones and Happiness.”
Further, when they test for gonorrhea and chlamydia, they typically only test for genital gonorrhea and chlamydia — not anal or oral gonorrhea or chlamydia.
(Yes, anal STIs and oral STIs are a thing).
If you actually want to get tested for e-v-e-r-y-t-h-i-n-g that you might be at risk for, it’s important to talk with a healthcare professional about all the sex acts that have ever made an appearance on your sex “I Tried It” list.
There’s a massive misconception that STIs can only be transmitted through one type of sex: penis-in-vagina sex.
But an STI can actually be transmitted during any kind of sexual play that involves skin-to-skin contact or body fluid exchange with a person who has an STI.
This includes any kind of play that involves:
- the mouth, such as kissing, nipple stimulation, cunnilingus, analingus, and oral sex
- internal or external genitals
- internal or external anus
As well as any kind of play that involves bodily fluids:
- vaginal lubrication
- anal secretions
- breast milk
An STI test is only able to test for the STIs that are currently beyond their latency period. Meaning, they’ve been in the body long enough for the body to create antibodies.
Sometimes known as the incubation period, the latency period is the amount of time between when a person has been exposed to an infection and when they can test positive for it.
Antibodies are what STI tests are looking for to determine if an STI is present. If antibodies are present, you test positive for the STI. If antibodies aren’t present, you test negative for the STI.
An STI test can’t detect an infection that has not yet surpassed its latency period, nor any STI you were exposed to after the test.
And remember: It’s possible to be exposed to an STI during any sexual activity.
So… you made the decision to engage in sex in some way, shape, or form… fun!
How high the risk of STI transmission was during those sextivities varies based on what safer sex practices you used, if any. As well as if you used them correctly when you used them.
“Finger cots and sex gloves can help reduce transmission of STIs during any kind of hand sex,” says Andy Duran, the education director for Good Vibrations, a pleasure product company. “Condoms on a penis or sex toy can reduce the risk during penetrative or pleasure product play.”
And using a dental dam can help reduce the risk of transmission during cunnilingus or analingus.
How to use a barrier correctly:
- Make sure it isn’t expired.
- Store it correctly.
- Put it on the right way (and dispose of it if you put it on incorrectly).
- Use it with lubrication (and avoid oil-based lubrication if the barrier is latex).
- Dispose of it as soon as the act is done.
You can’t rely on the presence (or absence) of symptoms as a marker of your STI status. The only way to know if you have an STI is to get STI tested!
It’s best to have this conversation before sex has happened, or is right about to happen, says Duran.
Why? Because it gives everyone involved time to get tested and get their results back, and time to process any information they may have just learned about a partner’s STI status.
That said, an STI conversation at some point is better than no STI conversation at all.
(Especially if you do know if the people you’re having it with are having sex with other people, or don’t know what safer sex precautions they’re using, if any).
“It’s best to talk to a partner about STI status while also talking about your own status,” he says.
“If you’re just asking your partner a ton of questions about their status without bringing up your own, it can feel accusatory.” Fair point.
Here are some ways you might bring it up:
- “Hey, I know that we’ve been having sex without barriers, but until we both get STI tested to learn about our current STI status, I’d like to start using barriers. Are you open to getting tested?”
- “Before we meet up later, I want to be transparent about the fact that I haven’t been tested since my last partner. Do you know your current STI status?”
- “I just wanted to let you know that I made an appointment for next week to get my annual STI exam. I’d love to ask you to get tested, too. Is that something you’d be open to?”
Duran adds that “if you haven’t yet had sex with someone but you’re planning to, another option is to ask them what their preferred dental dam brand or condom is.”
Gersh recommends that people get tested once a year, or after every new partner — whichever comes first!
It’s also good practice to get site-specific STI tests before engaging in sex acts that incorporate a new part of the body.
For example, if you and your partner have never had anal sex and now want to, it’s a good move to get anal STI tested first.
To get tested, find an STI clinic that tests for all the STIs you’re interested in getting tested for.
If you don’t know which STIs you want to get tested for and are looking for a doctor to breakdown what STIs you’re most at risk for given what sex acts are part of your sex life, it’s best to go to a clinic that *doesn’t* specify one or two or three STIs in their online marketing.
Some clinics, for example, only test for HIV or only test for gonorrhea and chlamydia.
The only way to know your current STI status is to get STI tested after any new sex partner.
But in order to get the most complete picture of your STI status, you need to know exactly what STIs to test for, as well as the latency period of any STI you may have been exposed to.
Gabrielle Kassel (she/her) is a queer sex educator and wellness journalist who is committed to helping people feel the best they can in their bodies. In addition to Healthline, her work has appeared in publications such as Shape, Cosmopolitan, Well+Good, Health, Self, Women’s Health, Greatist, and more! In her free time, Gabrielle can be found coaching CrossFit, reviewing pleasure products, hiking with her border collie, or recording episodes of the podcast she co-hosts called Bad In Bed. Follow her on Instagram @Gabriellekassel.