Safer sex—comprehensive safer sex, that is—includes more than just using barriers consistently and correctly. You also need to talk about risk in advance of any sexual activity.
That’s where most people get stuck. As soon as someone utters the letters S-T-I (short for sexually transmitted infection) in sequence, people run for the hills. It can be especially daunting to bring up STIs with someone you don’t know very well. And even if you’ve known the person for forever, that conversation can still be awkward.
Whatever the scenario, having this conversation is crucial, so don’t let these 4 common misconceptions get in the way of your healthy sex life.
1. An STI won’t happen to me.
Think you don’t need to go there? Think again. The most common myth about STIs is that they won’t happen to you—they only happen to certain kinds of people, right? Not right. STIs don’t categorize people like we do.
The truth is, 1 in 2 people will contract an STI by the time they reach the age of 25—some curable, some not. An astounding 20 million people in the U.S. contract an STI every year, and those are only the STIs which get reported. That number is likely much higher due to under-reporting and many STIs not getting reported at all—some are diagnosed visually, and others are not documented by the Centers for Disease Control and Prevention (CDC). Of the 30-plus STIs out there, the CDC only reports on about 8 of them. Things like pubic lice, scabies, and HPV infections among guys are not part of those numbers.
In so far as HPV is concerned, outside of the visual symptoms of genital warts caused by low-risk HPV strains, there’s no way to know if a man has it since he can’t be tested for it. This is shocking, I know—and it’s one of the reasons why by the age of 50, at least 80% of women will have acquired the infection.
Keep in mind, HPV is transmitted via skin-to-skin contact, so even the most careful barrier-user is still at risk of contracting HPV, because barriers do not always cover all contact areas. If you’re under 26, another good option for preventing HPV is Gardasil, a vaccine that protects against the four most common HPV strains.
2. I’ll know if I get an STI—or if someone I’m seeing has one.
It’d be great if you could tell who had an STI and who didn’t, if we (I’m living with genital herpes) wore some kind of warning label or if you knew just by the type of person we were. On the other hand, I’m not a big fan of "scarlet-lettering"; it didn’t bode well for Hester Prynne, and it doesn’t suit the vast number of people living with an STI, especially since most are actually entirely unaware they have one.
The most common symptom of all STIs is no symptom at all. STIs are often asymptomatic or display such mild symptoms they go unnoticed and/or are mistaken for something else. For that reason, most people with an STI are unaware they have one.
When STIs are asymptomatic or exhibiting mild symptoms, they’re still transmittable to others—and there’s no guarantee the STI will remain asymptomatic in the newly infected individual. Recognizable symptom or not, STIs can wreak havoc internally long before we’re aware of their effects; untreated asymptomatic STIs can pose long-term health risks like liver damage (eg. Hepatitis) and infertility (eg. Chlamydia and gonorrhea).
Contrary to popular belief, things like appearance and cleanliness are not indicators of infection—outside the obvious visible symptoms when they’re present. Hygiene is still important to help safeguard you against things like the common cold and the flu, of course, but some traditional practices such as douching after sex or brushing your teeth after a make-out session can actually make you more susceptible to STIs.
3. If I just do oral/anal sex or have sex with a virgin, I’m safe.
Anal sex might seem like a viable option if you’re concerned about pregnancy or losing your virginity in the traditional vaginal penetration sense; however, unprotected anal sex poses one of the highest STI risks. The anal cavity is comprised of permeable mucous membranes which can provide an entry point for infection. Due to the nature of sexual activity involving the anus, small tears and cuts are common—especially if you’re not using enough lube—so, additional points of entry present infection opportunities.
Choosing to have oral sex or engaging in activities with someone who’s only had oral sex might also seem like a way to lower your risk, but the risk of contracting an STI is still high. The mouth too is made up of mucous membranes, and something as common as a cold sore—herpes (usually HSV1)—can be transmitted to the genitals or vice versa.
4. We’ve both been tested, so we’re safe.
Getting tested is really important. But even if someone says they’ve been tested—and definitely if they say they’ve been tested for all STIs—it’s important to ask additional questions.
Anyone who says they’ve been tested for all STIs and is "clean" is giving you incorrect information right off of the bat. Not all STIs can be tested for—for some there just aren’t tests, or they can only be diagnosed if there are visual symptoms. Even most comprehensive STI tests only test for a handful of STIs—usually HIV, syphilis, chlamydia, and gonorrhea.
Pap smears test for cervical abnormalities caused by high-risk types of HPV. They don’t detect any other STIs—or low-risk strains of HPV for that matter.
If you have fallen prey to one or more of these myths, don’t beat yourself up. Most people think they know about STIs because they’ve heard a lot of misleading information. I was one of them. Before I contracted genital herpes at a young age, I thought STIs only happened to certain types of people. I thought I was practicing "safe" sex by getting on the pill and I had no idea of the level of risk involved in my sexual activities while I was still a virgin in the traditional sense—and even later, once I became "officially" sexually active. To hear more of my story and to gather some practical tips about how to practice comprehensive safer sex, check out my 3-part series about it!