When I got out of the car and checked my phone, I saw I had a missed call from Colette. I felt a jolt of excitement just seeing her name on my phone, and a bit of surprise—we had communicated exclusively on text, and never when the sun was up. I called her back.
“Hey…butt dial?” I asked, trying to sound casual.
“No,” she replied. “This is weird, and it’s probably nothing, but I, uh, I have gonorrhea.”
I tried to modulate my tone, to sound serious but not too serious. We exchanged a few more awkward words before she said, “Ok, I gotta go.” She sounded like she would rather say she had gonorrhea on CNN than talk to me for another minute.
“Ok, uh, feel better, I guess?” I said. It came out like a question, and I was glad to realize she had already hung up. I knew I’d probably never hear from her again.
I felt gross, a little ashamed, and sad that a new, exciting sexual and romantic relationship was over before it ever had a chance to go anywhere. I didn’t have symptoms, but I ended up testing positive for gonorrhea. I got a shot of ceftriaxone the same day, and I took a single pill of azithromycin. Both were common antibiotics, cheap even with my crappy insurance. Practically speaking, my experience was virtually painless. I’d rather have gonorrhea again than a cold.
I thought back to middle school health class, hearing from the gym teacher who looked like he never took off his khaki shorts, about the unholy pantheon of STIs: Gonorrhea! Chlamydia! Crabs! Herpes! And the scariest one: HIV! We thumbed through handouts full of flash photography of oozing sores on penises and vaginas. We nervously giggled with a mix of fascination and horror. The message I received about STIs was that they were Very Bad, could kill you, and getting them should be avoided at any cost, even through abstinence. It was essentially what the gym teacher infamously espoused in Mean Girls: “Don’t have sex, otherwise, you’ll get pregnant and die.”
Which is why, when I actually got one, I was shocked that it was no big deal. The worst part of it was that call with Collette, and the fact that it ended what we had. If only we’d been able to get past the shame and talk about it, we could have realized together that it was nothing, and didn’t need to come between us.
Talk about your sexual histories together instead of asking “Do you have an STI?”
Even though we’ve come a long way with safer sex, having a sexually transmitted disease still holds a huge amount of stigma. In reality, talking frankly about sexual health can build trust and intimacy, if done the right way. I talked with Cassandra Corrado, a sex educator and writer, about this stigma and how to discuss sexual health with your partners, both preventively and if you already have an STI.
Why Is There Such a Stigma?
Like most social stigma, the taboo around STIs is a mix of practicality, culture, and religion. For nearly all of human history, STIs were not treatable at all, so the stigma developed out of a very real danger. In the west, this understandable social fear of STIs became intertwined with Christian notions of chastity and purity. If you’re being a good Christian, Corrado told me, “You’re only having sex with your cisgendered, heterosexual partner. Under that model, there would be no transmission of STIs, because how could you possible get one if you’re only having sex with your spouse?” Essentially, getting an STI means you sinned, you committed adultery, and you’re being punished.
We teach young people about STIs by only talking about the scariest possible outcomes, and making no mention of the fact that the vast majority of STIs are curable and every single one is treatable.
How to Start Talking About STIs
So how should we actually talk about STIs? The key here is a shift from “you” and “I” to “we.” If you want to ask someone you have or are going to have sex with, talk about your sexual histories together instead of asking “Do you have an STI?” Maybe you go get a test together. Put yourselves on a team with the common goal of having safe sex, rather than putting one person in the hot seat. “This approach really lays the groundwork for having a much more open sexual relationship with less judgment,” says Corrado.
How to React When a Partner Has an STI
But what if someone just up and tells you they have an STI, like Colette did? Corrado was very clear on this one: “The first thing you should do is take a breath.” Try to delay your reaction. When we react reflexively, we tend to show our unconscious biases, all the messages we’ve absorbed from the culture. If you can take a breath, you have a much better chance at not just regurgitating toxic cultural messages.
The second thing you should do is say “thank you.” This person just did an extremely brave thing, in order to protect you. Not only that, they are entrusting you with very personal and sensitive information. You should feel honored, and now it’s your job to make them feel safe having told you.
After these two steps, you can ask some questions. But the kinds of questions you ask are important, according to Corrado: “By key questions, I don’t mean ‘How did you get this?’ ‘How long have you had it?’ ‘Who did you get it from?’” Those questions make people feel like they’re on trial in Salem in the 1600s.
What you should ask about is what safe sex would look like given their STI status. “What does this mean for our boundaries?” “What are the risks for me?” “What barrier methods work for you?” Those are all good places to start. Of course, if you don’t feel comfortable escalating a sexual encounter, it’s always OK to end it, for any reason, including learning that your potential partner has an STI. However, it is important to ask yourself why you’re ending it. Do you really know what the risks of transmission are, given precautions like condoms, or is your middle school sex ed teacher whispering in your ear?
Do everything you can to prevent your partner from having a knee-jerk, shaming reaction.
Cassandra explained that the amount of risk you expose yourself to by having sex with someone with an STI varies very widely: “In the case of somebody having herpes, they may have not had a outbreak for a very, very long time,” she says. “Transition risk goes down. Somebody with HIV could technically be undetectable and therefore untransmittable.”
How to Tell Someone You Have an STI
When you need to tell someone you have an STI, the most important thing is to make sure you’re understood. That means invoking a sense of seriousness before you disclose. Corrado recommends saying things like “Hey, I need to tell you something,” or “Do you have a second to talk?”
The guiding principle here is to do everything you can to prevent them from having a knee-jerk, shaming reaction. A great way to follow up your disclosure is asking if they have any questions. This flips their mindset from judging to learning, from closed to open. Cassandra takes that idea even further: “You could ask ‘Do you want to go for a walk together and do something else for a little bit while you think about it?’ Or ‘Do you want to take a little bit and we can come back later and, and reconnect after you’ve had some chance to do research?’”
If you’re concerned that this person is going to react badly, a great tip to feel them out is to ask them if they want to talk about STI status. If that offends them or makes them visibly uncomfortable, then maybe they’re not worth trusting your own STI situation with, or having sex with for that matter.
If you have an STI, and you’ve already had sex with someone in a way that has exposed them to it, it’s important to try to tell them your STI status, regardless of how you think they’ll react. Again, invoke a space of calm and seriousness, then tell them your status, and that they should get tested. If you can, try not to speculate about how likely it is that transmission occurred. If you knew you had it before you had sex, apologize. It isn’t wrong to have sex with an STI, but it is wrong to knowingly expose someone to it without telling them.
When In Doubt, Stop and Think
Because many people haven’t critically examined the cultural message they’ve unconsciously absorbed about STIs, the best thing you can do is to take a moment and create space for that examination to happen. Looking back on my conversation with Colette, what strikes me now is how fast it all went. We probably only talked for about 30 seconds. There was no space to think. We were both just reacting, so it’s no surprise that we both came away from that conversation too uncomfortable to ever talk again. “If you can create that space to think,” Corrado says, “you’re much more likely to have a productive and healthy conversation rather than a conversation that’s based in unconscious stigma.”