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If there’s anything you’ve Googled more than “how to cook chicken breast” and “lesbian sex” (just me??), money says it’s “do I have an STI?” or some other question about these hard-to-understand infections.
That’s why we put together this handy sexual health guide.
From how to reduce your risk of STI transmission to how long you need to wait before getting tested after possible exposure, scroll down for the answers to the STI questions we know you’ve been Googling.
If you were lucky enough to have some semblance of sex education — did you know only 30 of the 50 United States mandate it? Atrocious! — chances are your instructor called things like gonorrhea and herpes “sexually transmitted diseases,” or STDs for short.
But somewhere between then and now, the acronym got a makeover.
Now, it seems like everyone is calling them sexually transmitted infections, or STIs.
- sexually transmitted infections = infections caused by sexual contact that are asymptomatic
- sexually transmitted diseases = infections caused by sexual contact that are symptomatic
“If a vulva owner has HPV but is currently carrying no symptoms, that’s an STI. But in the case [they] begin to develop symptoms, that would now be called an STD,” explains Dr. Earim Chaudry, MRCGP, general practitioner and medical director at men’s wellness platform Manual.
“These terms are still used synonymously in most places,” says Dr. Kristy Goodman, OB-GYN and co-founder and CEO of PreConception. “And some organizations like the CDC have simply stuck with calling them STDs.”
They only test for some genital STIs
Different genital STIs are tested for through different means.
- Chlamydia and gonorrhea are tested through a urine sample.
- Hepatitis, herpes (HSV), HIV, and syphilis are tested for with a blood sample.
- Human papillomavirus (HPV), HSV, trichomoniasis (“trich”), molluscum contagiosum, and scabies are tested for through cell-scraping, either by swapping the affected area or by swapping a visible sore or wart.
To get tested for all of these genital STIs, you’d need to get a blood, urine, and swab test.
And (!) you also need to explicitly tell your doctor that you’d like to get tested for all STIs, including herpes, HPV, and HIV.
Same goes for pubic lice (“crabs”) and scabies, which women’s health expert Dr. Sherry A. Ross, author of “She-ology” and “She-ology, The She-quel,” says most doctors won’t test for unless there’s reason to believe you have it (aka one of your sexual partners has it).
According to the CDC, “diagnosing genital herpes in someone without symptoms has not shown any change in their sexual behavior (e.g., wearing a condom or not having sex) nor has it stopped the virus from spreading.”
They also add that it’s possible to receive a false-positive result.
HIV testing is often left out for folks who aren’t deemed as “higher risk.” According to the
- a penis and has had sex with another person who has a penis
- had anal or vaginal sex with a person who has HIV
- had sex with more than one person since their last HIV screening
- has shared needles or used intravenous drugs
- engaged in sex work
Unfortunately, many doctors don’t have the necessary conversations to determine whether someone is at high risk or not. This ultimately means that fewer people get tested than should be.
Beyond that, due to the stigma of HIV and HIV discrimination, some patients don’t want their HIV status on their medical records and therefore won’t sign the consent slip required before testing someone for HIV.
HPV testing is often left out because the recommendation is that vulva owners between the ages of 30 to 65 only have a Pap smear combined with an HPV test done every 5 years.
If your 5 years aren’t up, many doctors won’t test.
They won’t test for nongenital STIs unless you explicitly ask
That’s right, nongenital STIs are a thing!
“STIs can show up in mucosal surfaces such as the mouth, lips, throat, or the anus,” says board certified urologist and female pelvic medicine specialist Dr. Michael Ingber, with The Center for Specialized Women’s Health in New Jersey.
Most doctors won’t do a throat or anal swab unless you tell them the specific sex acts that you’ve been engaging in and ask to be tested.
For anal, vaginal, and oral sex between two folks with penises, or between one person with a penis and one person with a vagina, “latex condoms are the best way to help prevent STI transmission during sexual activity,” says Ross.
However, they aren’t 100 percent protective against infections.
The same goes for any accidental skin-to-skin contact before the barrier was put in place.
Any STI transmitted through bodily fluids — like HPV, gonorrhea, chlamydia, HIV, and hepatitis B — can be transmitted through any bodily fluid exchange that might have occurred before the condom was donned.
For instance, if the tip of a penis with pre-cum rubbed up against a vulva or anus prior to the condom going on, STI transmission can have occurred.
It’s also worth noting that animal skin condoms don’t protect against STIs. They have holes in them that are big enough for infectious particles to travel through.
Condoms won’t protect against STI transmission during sex between two vulva owners, or for oral sex performed on vulva owners.
Barriers like nitrile gloves and finger cots should be used for things like fisting and fingering.
“Getting tested right after sex won’t give you information about whether you were exposed to an STI from the partner(s) you just had sex with,” says Goodman.
“Although it could give you information about whether or not you were exposed to an STI from a previous partner.”
That’s because STIs have an incubation period. This is the time between when you first contact the infection and when your body recognizes and produces antibodies in response to the disease.
These antibodies are necessary in order for a test to show a positive result.
That said, if you have reasons to believe you were exposed to an STI — for instance, you had sex without a barrier with someone who has an STI, or the barrier broke — talk to a healthcare provider.
If you were or might have been exposed to HIV, your provider may prescribe antiretroviral postexposure prophylaxis (PEP).
If taken within 72 hours of possible exposure, PEP can help prevent you from contracting HIV.
If you might have been exposed to chlamydia, gonorrhea, or syphilis, your provider can prescribe a prophylactic dose of antibiotics to help prevent transmission to other partners.
And if you were exposed to HSV, your doctor may prescribe prophylactic acyclovir or valacyclovir.
These medications can’t prevent transmission of the herpes infection, but they can reduce the risk of a symptomatic outbreak.
“It’s best to get tested for STIs once a year, after unprotected sex, or after every new partner — whichever comes first,” says Ross.
The most common symptom of an STI is no symptom at all, so this rule stands whether you are experiencing symptoms or not.
Yes! There are a bunch of direct-to-consumer healthcare companies offering STI testing that you can do from the privacy of your own home.
“Many of the high-quality home kits have the same accuracy as you would find in a doctor’s office,” says Ross.
Here’s how they work. You’ll:
- Answer some questions online.
- Order the test the site recommends.
- Follow the instructions (aka prick your finger for a blood test, pee into a tube, or swab the inside of your vagina or anus).
- Send the sample back in the mail.
- Get your results online in a few days.
If you receive a positive result, most of these companies will give you access to a healthcare professional to discuss your next steps.
Popular options include kits from:
While these kits are great for folks who don’t have access to an IRL doc, Ross emphasizes that the human contact you have with a doctor is invaluable.
“When you go a doctor, you’re also given a comprehensive [pelvic] exam, appropriate counseling for birth control and safer sex, and are able to have a conversation about common questions you may have about STIs and other health issues,” says Ross.
“A Pap smear is a screening test done on folks with vaginas to check for cervical abnormalities that may progress into cervical cancer and also check for HPV,” says Ross.
There are 2 vaccines available for STIs.
One is for hepatitis B, which is typically given right at birth.
“And one for HPV, called Gardasil-9, which can protect against 9 different strains of HPV that cause 90 percent of all HPV infections,” explains Ross.
The vaccine is for folks of all genders between the ages of 9 and 45, and it’s administered in a two- or three-shot dose.
It’s recommended that children get the vaccine at age 11 or 12, so they’re fully protected before they become sexually active.
You can’t on your own! To find out, you need to go to a healthcare provider.
“Your symptoms could be indicative of another illness, which is why it is important to consult a doctor who will be able to help you figure out what’s going on,” says Chaudry.
Most STIs are curable. This means that as long as you catch them early and treat them properly, they go away forever.
An STI isn’t like the chickenpox. Getting it once doesn’t mean you’re immune from getting it again.
“STIs such as HPV, herpes, hepatitis B, and HIV aren’t curable and will live in your body indefinitely,” says Ross.
However, all of these STIs can be managed with medication. This will help ease any symptoms and decrease the risk of transmitting it to your partner(s), says Goodman.
STIs happen! The only way to know if you have one is to get tested.
And hey, if you opt for the in-office testing route, go ahead and ask your doctor for some freebie barriers. Most clinics have condoms and dental dams that they give out for no cost.
Gabrielle Kassel is a New York-based sex and wellness writer and CrossFit Level 1 Trainer. She’s become a morning person, tested over 200 vibrators, and eaten, drunk, and brushed with charcoal — all in the name of journalism. In her free time, she can be found reading self-help books and romance novels, bench-pressing, or pole dancing. Follow her on Instagram.