How to discuss STI status, sexual history, and safer sex with your partner

“How can I effectively communicate my STI [status] to my sexual partner(s)?”

—Fourth-year graduate student, Mount Royal University, Alberta, Canada

Get the facts straight

This is a question I hear often. The first step is knowing your status so you can communicate it to others. This would mean fully understanding any STIs you may have and how they are transmitted. Getting tested and then asking your health care provider questions about it is a great first step. Looking up information using credible sources, such as the Centers for Disease Control and Prevention (CDC) and Planned Parenthood websites, is another great way to fully understand your status. Once you understand any STIs you may have, how to reduce risk of transmission, and how to protect yourself and others, you can determine a way to discuss this with your partner(s).

Figure out where and how to say it

It is super important to disclose our status to our partner(s), but we often struggle with how and where to do so. Deciding where is the easier part. Talking about STI status is better discussed outside of any sexual interactions or activities—such as over coffee or lunch—rather than in the heat of the moment. Taking it outside of the bedroom can help people feel less awkward and possibly more open.

Next is deciding how. If you can practice by disclosing to a friend you trust, that could help prepare you for disclosing to a partner. One way to begin? Start the conversation by showing care and concern for keeping your partner safe (e.g., “I care about your health, and I think it’s important that we talk about testing and STIs.”). Your partner may find it helpful if you share your status and how you’re managing the STI, including treatment. When talking with a partner, think about the information you want to share and assess how they react to the information as you go. Too much information all at once can be intimidating and overwhelming, so start with the basics and then let them ask questions.

Give them time to process

Be prepared; sometimes people may need space or time to process this information. While some partners may appreciate and accept your disclosure, others may not want to continue a relationship or have sexual interactions. Rejection is never easy, but keep in mind that you’re trying to protect both of you. If they can’t handle this, think about other situations or hardships that could come up over time and might be more difficult to handle. Where would they be then? By being honest and armed with factual information, you can answer any questions your partner has about their potential risk of exposure. You can also provide them with the credible resources you use, or offer to have them talk with your health care provider.

“My husband says that as a younger man, for 10 years, he had sex with men. Should I be concerned?”

—Doctoral student, Ashford University, California

There are some misperceptions of risk in the queer community, and there are stigmas associated with men who have sex with men (MSM) in particular. Risk is not about who a person has sex with; it’s about the sexual act. For example, with anal sex, the receptive partner (whether the person identifies as male, female, gender fluid, gender nonconforming, etc.) is at a greater risk of contracting STIs than when having sex using other body parts or with other sex acts.

It’s great that your husband could be open and share his sexual history with you. What’s important for both of you to know now, regardless of who you’ve each had sex with in the past, is what your current STI status is. The CDC recommends that everyone between 13 and 64 years old get tested for HIV at least once as part of their routine health care. Since most people have a sexual history, it is important to always take precautions, even in monogamous relationships. It would be great for you and your husband to get tested for STIs together if you haven’t already done so, or if you are not monogamous. That way, you can protect and support one another if one or both of you is found to have an STI.

In terms of his risk relating to his past sexual history, if your husband used safer-sex strategies, such as condoms and lubrication, then he would have decreased his risk of contracting STIs. He may have also gotten tested regularly, or he may have been tested prior to or during his relationship with you. His exposure will also depend on how he defined “sex” when he was younger. While STIs can be contracted through any sexual act, there are some acts that put a person in a higher risk category. For example, for contracting HIV, receptive anal sex is considered the riskiest sex to have due to the thin layer of mucous membranes in the anus. Oral sex may be less risky than anal and vaginal sex, although STIs can still be transmitted through oral sex.

“What are good STI protective methods for sex between two women? I’ve never had any queer sex ed. Protected sex also does not seem to be widely accepted or cared about in the community of women who have sex with women, so do you have suggestions for how to talk about protection with partners?”

—Third-year undergraduate, Stanford University, California

While women who have sex with women (WSW) may be at lower risk for contracting some STIs, such as HIV, chlamydia, or gonorrhea, there’s still a risk of contracting other STIs, such as HPV, herpes, trichomoniasis, or bacterial vaginosis. Additionally, sharing sex toys with different partners without cleaning them in between each partner can put women at risk for contracting STIs.

Dental dams and other barrier methods

To reduce risk of infections, WSW can use dental dams, condoms, and lubrication, and make sure to clean their sex toys between partners. Dental dams can be used for oral sex on the vulva or anus. Condoms can also be used as dental dams if dental dams aren’t handy; or you can use food-grade gloves (latex, nitrile, or plastic can be found on Amazon) as a dental dam.

How to use a condom as a dental dam

Cut the elastic at the base and then cut the condom down the side so that it opens into a square.

How to use a latex, nitrile, or plastic glove as a dental dam

Cut off the elastic at the wrist and then cut off all of the fingers but the thumb. Cut opposite the thumb down the glove and it will open to a square. The remaining thumb can be used for tongue or finger insertion.

Lubrication can help too

Using lubrication can reduce risk by helping to decrease the chance of microscopic tears in the vagina or anus. These tears can make a person more susceptible to STIs if their partner has an infection. Using lubrication on gloves, dental dams, and condoms will help decrease microscopic tears and can increase pleasure (which matters too!).

Keeping sex toys clean and safe

Cleaning sex toys after each use and between partners is important. Condoms can be used on sex toys to help reduce the chance of infection and make for easier cleanup. If going between two orifices, such as the vagina and the anus, a new condom should be used for each orifice to decrease the risk of introducing any harmful bacteria.

Silicone sex toys can be boiled for cleaning, while rubber sex toys may need to have a cleaning solution applied. Cleaning solutions can be found online or even at some national chain stores. Look for antibacterial products specifically made for sex toys, or go to a trusted sex toy store to talk with an employee. Be sure to test a patch on the toy prior to spraying it down to ensure that the cleaning solution is compatible. Another way to reduce risk of STIs from toys is to use the same toy with each person rather than share.

Discussing risk among women who have sex with women

In a community that perceives there is less risk, it may seem cumbersome or awkward to bring up a safer-sex conversation. But understanding your risk as a WSW and discussing it with your partner(s) allows you to explain why it’s important for everyone to protect themselves. You can suggest getting tested together, make the conversation about caring for your partner, and make decisions together about how to protect each other. Knowing that oral herpes (HSV1) can be spread to the genitals, whether there are symptoms or not, may also help the conversation feel pertinent. Bringing up safer-sex strategies in a fun and playful way can keep things lighthearted. For example, introducing lubrication and dental dams as something new and exciting to try may help your partner get on board.

“How soon after having sex with a new partner should we test for STIs?”

—Fourth-year undergraduate, Mount Royal University, Alberta, Canada

Great question! Especially since, according to the CDC, college-age students are at higher risk of contracting STIs than other age groups. Planned Parenthood suggests getting tested:

• Once a year, as part of your routine health care
• Before having sex with a new partner, or if you didn’t do that, then about 10 days after you first have sex with them (or any time thereafter if 10 days have passed)
• Anytime you have symptoms

Some STIs (e.g., chlamydia and gonorrhea) can be diagnosed within one to three weeks, while other STIs (e.g., syphilis or HIV) may take longer to show up on a test. Most important, it’s great that you want to get tested. Finding a place to get tested—such as your school health center, a local health clinic, or Planned Parenthood—and beginning the discussion about what tests you want to get is the next step. Keep in mind that the majority of STIs don’t have any symptoms, so it’s important to get tested even if symptoms aren’t present.