S is for SEXUAL HEALTH (and self love)

Making crystallized ginger. Also, incidentally, a “fig” — though that’s for another post.

I am making crystallized ginger in my kitchen, I started some fermented honey garlic the other day, and there’s newly portioned homemade lentil & barley vegetable soup in the freezer. I just bought a new vibrator to replace the one I use most which was failing. I also recently had a full STI panel done (including blood work for lyme disease, ’cause summer in Albany = bites by ticks). Each of these actions are forms of self love, partner care, and respect for my communities. Each of these things contributes to my emotional, psychological, and physical health this winter, and so the health of those I’m around as well.

Instead of simply reminding my readers to go out and get tested today, I’m going to write about how to have some of the hard conversations (even with ourselves) which need to be had for sexual and sensual health to be maintained actively between testings. Truthfully, even though I’ve been talking about sexual health for decades personally and professionally, even I need to remind myself to be more thoughtful about my health and the risks I’m taking when I play sometimes. It’s easy to get lulled into a false sense of comfort when you’re healthy for awhile or have ongoing monogamous partnerships. It’s in these places of comfort that the opportunity for mistakes or the unexpected to happen finds its way.

It’s complex to know your sexually transmitted infection status: It is not how often you get tested which is the most important detail to consider, but the window of time it takes a bacteria or virus to incubate to show up as positive. For example, according to STDCheck.com, Chlamydia has an incubation period of 1-5 days before it will show up on a test as positive (though another online source cites 1-3 weeks), whereas HIV has an incubation period of 9 days-3 months depending on the type of test given. This doesn’t take into account bad testing conditions and people who are more likely to test false negative. I once tested positive for Chlamydia and none of the other people I was sleeping with at the time, or for three months prior (since the test before that one) tested positive. It’s more common for people with penises to test false negative than people with vulvas in certain tests, and most doctors don’t inform their patients that drinking a lot of water before being tested might skew results, or to abstain from peeing for one hour before certain tests.

I try to get tested for STIs every three months unless I’m in a monogamous relationship — though perceived monogamy and exposure to STIs are certainly not mutually exclusive, and cheating and lying percentages are high in our world. Three months because that seems to be the magic number than most STIs have for a max incubation period, and three months because that seems to be about how long I’m interested in most people I’m frequently having sex with. Having an STI check after a breakup feels great! If I’m in a monogamous relationship I make sure my partner and I have been tested before we become sexually active with one another, or that we’re both tested near the beginning of our sexual relationship and we discuss our results. After that I get tested every 6 months or at my yearly doctor’s visit. If I am having sex with more than one person or a partner of mine is, we talk about the risks involved and what our agreements around safer sex and disclosure with one another are, and what we promise to do if/when someone fucks up.

I don’t have sex with people without talking about STI’s first. This means if we’re getting hot ‘n heavy and we haven’t spoken about our sexual histories with one another in detail before, we’re going to stop and take a talk break before we get too risky and carried away. Have I ever messed up and not done so? Yes, though we did have the talk afterward and that situation makes me feel really shitty. Each time was due to being intoxicated. Also not good, but good to see the pattern and make note. Also, I must say that in almost every single sexual experience I’ve had I’ve been the one to broach the subject. This leads me to believe that if I don’t take the responsibility to talk about sexual health, that many many people would just never talk about STIs at all. This is VERY concerning to me.

Talking to others about sexual contact and evaluating risks: It’s hard to do until it isn’t anymore. Practice makes perfect, and figuring out how you best like to start the conversation will dramatically help you feel prepared. There are a lot of questions to ask, and it’s important that you’re getting the information you need from your potential sex partner to feel safe about moving forward into risky territory. If a potential partner gets angry about being asked to talk about sex and STI status, if they don’t answer your questions fully, or try to breeze through the conversation and downplay its importance, consider that a risky behavior in itself. How upfront is this person and how upfront have they been with other partners — if they’ve even had this conversation at all — and what does that mean about their knowledge of their own body or what risks they’ve engaged in historically? Though it may be emotionally hard to talk about your sexual past and current risk factors, do you really want to have sex with someone who won’t care for your body at the very minimum by talking before fucking? Here are some questions and phrases to open up a conversation:

  • I’m really into this, can we pause and have “the talk” before going any further?
  • What talk? Oh, STI history, other relationships or sex partners, and safer sex practices. Who wants to go first?
  • Have you ever had an STI?
    • What have you tested positive for?
    • When was your last outbreak?
    • Were you treated for it?
    • Is your outbreak still active?
    • Have you been tested since treatment (and if so what was the result)?
      • Keep in mind that if the infection was bacterial (Chlamydia, Gonorrhea, Syphilis, etc.) there is still a window of time after treatment where a retest will not prove effective, so make sure you retest within the recommended timetable for each treatment.
      • As for viral infections (HSV 1 and 2 [Herpes], HPV [Warts], HIV, Hepatitis [A, B, C]), the virus will remain suppressed in your system after exposure and between outbreaks, so retesting isn’t as useful as you will test positive from that point forward even when no outbreak is occuring.
      • Decide how you feel about exposure to a virus if your partner has tested positive for one or has had an outbreak of a viral infection in the past. Ask more questions if you have them.
  • When was your last STI test, and what were you tested for?
    • What were your test results?
    • Have you had sex with anyone since your last test or sex with anyone directly before your last test who might not have been covered by the last test?
    • Are you having sex with other people currently — are they regular or casual partners?
      • What are your safety agreements with these people?
      • What are their statuses or known risks associated with them?
      • Are you having protected sex with these people every time you have sex or just sometimes?
  • What safer sex methods do you use (if any)?
    • Do you use barrier methods for PIV (penis in vagina)?
    • Anal?
    • Oral?
    • Toys?
    • Every time?
    • Any time recently you haven’t?
    • Do you share toys?
    • How do you clean toys between uses?
    • Do you have this talk with everyone you have sexual contact with?
    • Do you engage in risky sexual behavior when you feel you are having an outbreak of any sort (safer or not)?
    • Have you ever had a cold sore? If so, recently? Can you tell when one is coming on?
  • Anything else you think of, or questions that arise as you’re having this talk are great! Ask away!

What makes it hard to talk about STI status is the same thing that makes it hard to talk about sex: cultural stigmas, lack of practice, internalized feelings of shame, and fear of repercussions. If you’re positive for various viruses or have had a bacterial infection recently, don’t let that stop you from asking questions of your partners and sharing your own experiences upfront. Take responsibility for your health and the health of your partner. In my opinion the number one reason it’s important to have these conversations is that being clear about health risks associated with sexual behavior contributes to consensual sex. If you’re in the middle of having “the talk” and realize you don’t want to expose yourself to a risk that person poses, you have the right to say no and change your behavior with them. There are a lot of incredibly sexy things people can do with each other without putting themselves at risk of various infections. This same opportunity to consent or decline to risks should be given to anyone you engage in sex with. If you knowingly risk giving someone an STI without disclosing your history or status, you are taking away someone’s right to consent to those risks on their own terms. You do not have the right to make decisions for anyone else’s body, just as no one has the right to make decisions for yours. Only through openly and honestly talking do we respectfully come to a place of “what next?”.

Some helpful ideas about non-judgmentally thinking and communicating about STIs and sexual health:

  • Using the words “Positive” and “Negative” rather than “clean” in regards to test results. Just because someone has tested positive for an STI does not mean they are dirty or unhygienic, just as testing negative for certain infections certainly does not mean they are “clean” or even negative of all health concerns. It’s false terminology which contributes to stigmatization. Anyone who is sexually active can test positive for an STI, and in fact 50% of adults test positive for at least one STI in their lives. We don’t consider ourselves “clean” because we haven’t caught the flu yet this season. It is more medically accurate to use the term “negative” in reference to a test, and it’s more likely to put someone at ease if they aren’t being asked if they are “clean”. People who are less worried about judgement are less likely to lie or shut down in a conversation which is best executed openly and honestly.
  • Avoiding words like “slut”, “promiscuous”, “sleep around” when asking about someone’s sexual history. Asking “how many partners have you had since your last test?” will give you a more accurate answer, and will not make you look like a judgemental jerk while asking. Remember too that everyone has a different idea about what constitutes promiscuity — usually “more sexually active than I am” is what ends up fitting the bill, which is no way to measure another person’s experiences meaningfully, lovingly, or helpfully.
  • Let your partner know that you’re happy to answer any questions they have, and that waiting or refraining from certain activities is totally ok with you. People who are less experienced may feel afraid to ask questions, or may think that because they perceive you to be more experienced that they should just go with the flow and trust blindly. This is especially true if there’s a power dynamic differential in play. People may feel pressure to “do X now or never” regardless of needing some time to process the conversation you’ve just had about risks and histories. Letting people know that more conversation is always welcome, that there’s no pressure to engage in anything anyone’s uncomfortable with, and that “no” is always an appreciated boundary when put on the table, is not only responsible and appropriate it’s the behavior of a more tuned in partner. Who doesn’t want that?
  • Remember that testing positive for an STI is not the end of the world. You’re in good company — millions of normal, everyday, sexy people are diagnosed with various sexually transmitted infections every year. Many STIs are 100% treatable, and others are easily supressible. Even HIV is not the death sentence it was 20 years ago, and lots of people who are currently HIV negative treat themselves against exposure with PrEP.
  • Learning you are positive for an STI or have been exposed to one is not a finger pointing “whose fault is it” moment. STIs exist, and by having sexual contact with other people you are putting yourself at risk. When you catch the flu you don’t hunt down the people who might have given it to you so you can yell at them (at least I hope you don’t), you let the people around you know that you’re sick so that you don’t pass the flu along unnecessarily. When you test positive for an STI it’s important to let all of your relevant past partners know they have been exposed or might have exposed you, and that they need to talk with their other partners and seek treatment and testing. By caring for ourselves, and our partners we care for the larger community as a whole. Do your part, and don’t assume anyone you had sexual contact with knowingly meant you harm. If you are adult enough to have sex, you should be adult enough to talk about it even when the conversation isn’t sexy or ideal. It’s time to clean up the mess, not point fingers in judgement of everyone around so you avoid taking responsibility yourself.

There is always so much more I can write, but I think this is a good stopping point for now. I hope you have some great conversations with partners about sex, and if the unexpected ever does come up that you feel empowered to talk about it with past and present companions. Educate yourself on how STIs are contracted, treated, their incubation windows, and test times. Understand in your bones that people have their own lives, desires, and demons and aren’t always 100% honest about their behaviors. Take responsibility for your decisions and your body. I hope my words have helped you feel more comfortable speaking up on behalf of your health and so the health of everyone.

Play On My Friends,
~ Creature

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~Thank you.

 

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