By Ella Dawson
According to the Center for Disease Control, one in five people in the United States have a sexually transmitted infection (STI). Even though STIs are incredibly prevalent, somehow most conversations about safe sex focus on STI prevention, rather than what happens after you test positive. How should you approach your love life when you are one of the millions of folks living with a common—but stigmatized—virus like HIV, HPV, or herpes?
According to the experts, dating with an STI is not all that different from dating without one. Here’s what to expect as you navigate relationships as an STI-positive person.
Taking care of yourself is priority one
It’s important to set aside time to learn about your STI—and unlearn the stereotypes you may have absorbed about people who test positive. Viruses like herpes, HPV, and HIV are heavily stigmatized, which means they’re commonly associated with irresponsibility, deception, and disturbing physical symptoms. In the U.S., abstinence-only sex education often paints an STI as a consequence of poor decision-making, as opposed to a common and manageable infection. That negative perception is reinforced by pop culture, where mean-spirited herpes jokes are frequent and actual storylines about STIs are far and few between.
For many people with STIs, the stigma is worse than the actual infection. “When it comes to STIs that can endure for years (e.g., HPV) or last for a lifetime (herpes, HIV), the impact on folks’ mental health can far outweigh any effects on physical health,” says Dr. Ina Park, professor at the University of California, San Francisco School of Medicine. “The stigma, both real and imagined, can prevent people from getting tested, disclosing their status, and generally taking care of their sexual health.”
One of the best ways to balance out the negative messages we receive about STIs is to arm yourself with accurate information. Don’t be afraid to talk to your doctor about what to expect from your infection and how to manage any symptoms that may occur. You can also turn to trustworthy, compassionate sources like sex education website Scarleteen, or follow publicly STI-positive influencers on Instagram like Jennifer Vaughan and Courtney Brame. Remember that your STI status is just one detail in your life; you are not your STI, and your body deserves love and respect.
Learn how to share your STI status with potential partners
Before you have sex with a new person, you need to share your STI status. This step is called disclosure, and it’s a critical part of obtaining informed consent. It is also a great way to build trust and open communication in a new relationship, whether it’s a casual fling or a committed, monogamous connection.
When and how you choose to have that conversation is ultimately up to you. Camille, 27, chooses to mention that she is herpes-positive in her dating app profiles. After listing her hobbies and other basics, her bio closes with the line, “I also have genital HSV-1 (herpes) so looking for someone who’s open to chatting about safe sex and unlearning stigma.”
“I include it because when I’m looking for something casual, I want to be as upfront as possible,” she says. “While some experiences were more positive than others, I found a great casual partner who was willing to educate themselves. Plus, I’ve only, to my knowledge, been outright rejected once!”
Some folks prefer to share their status via text message. Disclosing in a text lets you choose your words carefully, and gives you both the opportunity to process your emotions in private. This method also lets you share links to resources where your partner can educate themselves on STI stigma, transmission rates, and prevention methods.
Then there is the tried and true method: disclosing your STI in person. If you feel comfortable telling your date face to face, remember that your energy sets the tone for the conversation. If you approach the topic with warmth and generosity, as opposed to embarrassment and anxiety, you’re more likely to put your partner at ease and get a positive reaction.
Don’t forget that you’re not the only person with an STI status! This conversation is a two-way street: you should ask about the timing and results of your partner’s last STI screening, too. If they don’t know their status, this is an opportunity to change that.
Navigate having safe sex, together
Once you’ve swapped your STI statuses and decided to take your relationship to the next step, it’s time to talk about safe sex. There are a range of protection methods available depending on your specific virus.
HPV and herpes are both spread through direct skin contact. Barrier methods like condoms and dental dams significantly reduce the risk of transmission, but they don’t eliminate it entirely. If you have HPV, your partner can consider getting the Gardasil vaccine. If you are herpes-positive, you can talk to your doctor about suppressive therapy, a once-a-day pill that lessens your risk of outbreaks and transmission. In the event that you think you might be having a herpes outbreak, it’s best to wait at least seven days after sores have healed before you have sex.
If you are HIV-positive, talk to your doctor about antiretroviral therapy, or ART, a medicine that reduces the amount of HIV in your blood. Once you reach an undetectable viral load, you are effectively at zero risk of transmitting HIV through sex. Meanwhile, your partner should consider pre-exposure prophylaxis, or PrEP, a once-daily medicine that prevents HIV transmission. When in doubt, use a condom, preferably latex. Natural membrane condoms like lambskin should not be used for HIV or STI prevention.
It can be nerve-racking to ask your doctor about how to have safe sex, but remember: your medical provider wants to help you live a healthy, informed life. If you ever feel judged by a healthcare professional, it might be time to seek out care elsewhere. You can also learn more about navigating safe sex with an STI from Planned Parenthood.
Create your testing routine
It is possible to be STI-positive and asymptomatic, or not to show symptoms for quite some time after infection. That makes it important to build a testing routine with your partner so that they can get diagnosed quickly if transmission does occur. You can ask your general practitioner for an STI test, or find a local clinic on the CDC website.
When it comes to knowing your STI status, keep careful track of the tests you’ve recently taken. For example, the standard urine sample does not test for herpes, HPV, or HIV. The CDC does not currently recommend herpes testing for people without possible symptoms, which can make it difficult to learn your herpes status if your doctor doesn’t determine a test necessary.
HPV testing is only available for people with vaginas and involves gently scraping or brushing the cervix to remove cells for testing. “Partner testing is not recommended,” Park says of couples where HPV is present. But, notably: “There are some folks who should get screened for HPV-related precancer or cancer anyway, and these are folks with a cervix who are above age 21, regardless of the gender of their sex partners.”
Meanwhile, HIV is usually diagnosed with a blood test or swab of cells taken from inside of your cheek. “For an HIV-negative partner, if they are taking HIV PrEP, they should test every three months for HIV and STIs per the national CDC recommendation,” says Park.
Once you and your partner have your test results in hand, pay attention to the language you use to describe your STI statuses. According to herpes-positive sex educator Emily Depasse, “If you’re STI-negative, labeling yourself as ‘clean’ implies and reinforces the narrative that you are not ‘dirty.’”
After all, your STI status isn’t a reflection of your value or your character. It’s how you handle your STI as a sexually-active person that truly matters.