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Flip the narrative and make the process much easier
We never know how things will go when we’re not engaging in small talk about our weekends or the weather. With more serious subjects, our emotions can run high and we might not always receive what the other person has to say. It’s no wonder so many of us struggle with having those tough conversations. But if you have a sexually transmitted infection (STI) — also known as a sexually transmitted disease (STD) — it’s important to find a way to power through. This is especially if you’ve possibly exposed a partner to it.
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Ob/Gyn Oluwatosin Goje, MD explains why it’s important to disclose your status and gives some tips for how to tell someone that you have an STI.
You might have seen or heard STD and STI used interchangeably. While many have embraced STI to erase the stigmas surrounding having a sexually transmitted infection, the term STDs is still also commonly used. The reality is there’s really no difference between STI and STD. They both refer to an infection that stems from sexual intercourse.
It’s important to note that you might not experience any symptoms or you might have very mild ones when you have an STI. This doesn’t mean that STIs are no big deal. If left untreated, some can lead to an increased risk of HIV, pelvic inflammatory disease, infertility or severe pregnancy complications.
Common STIs that can be cured include chlamydia, genital herpes, warts, gonorrhea and syphilis. Others that are incurable, but can be managed if you stay on top of them, are herpes, HIV/AIDS, Hepatitis B and HPV.
When you have an STI, you might notice symptoms like:
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Testing is important to diagnose STIs early so they can be treated.
Before we dive into how to tell someone that you have an STI or STD, let’s start by emphasizing this — please know that you’re not alone.
Based on recent data published by the CDC, in 2018, 1 in 5 people had an STI on any given day. That averages out to about 68 million people. The data also shows that there were 26 million newly acquired cases (incident STIs) and that nearly 1 in 2 of these incident cases were acquired by 15- to 24-year-olds. Also, nearly $16 billion went to direct lifetime medical costs resulting from STIs acquired in 2018.
These numbers illustrate just how common STIs are. Accepting that is a good place to start in the disclosure process.
Before you start worrying about how the news will be received, Dr. Goje advises that you learn all that you can about your diagnosis. When you’re well-versed and know what you’re dealing with, it’s easier to explain everything to a partner or family members.
“The first step is to have a good understanding of the disease. When you have a good understanding of the disease, those feelings of shame and guilt will ease up. And when you how to control it and how to manage it, you’re able to convey the diagnosis to your family or partner with the knowledge you have. Our family members and partners care and they love us. They’re just afraid because they don’t know what everything means.”
Dr. Goje suggests being open, honest and realistic about your conversation. There are a lot of variables and a lot of emotions involved. Sure, you want to hope for the best, but you also might want to brace for the worst.
“Be open when you have the conversation — and be ready for them to judge you. Expect them to be confused or to walk away. Many times, whether it’s your family or your partner, you can tell them, ‘I don’t expect you to like anything I say today. It’s fine. It’s a lot for you to digest. But I respect you enough to tell you what is going on.’”
Dr. Goje urges you to still be upfront about your diagnosis even if your relationship is new or casual. When you think about it, if your partner found out that they had an STI, you’d want them to tell you so you could take the necessary steps to protect your health, right? Extend that same courtesy to them — especially if the relationship has the potential to become serious.
“Normally, you acquire gonorrhea and chlamydia within three months after a sexual encounter. So if you have an STD or STI, talk to any partners that you’ve been in contact with for the past three months. Whether they transmitted it to you or you transmitted it to them, you both have to think about the long-term consequences.”
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When it’s time to tell your partner that you have an STI:
“People are so worried about telling their partners that they often don’t consider that their partners might be the source of the STI. But because they’ve never had the conversation about each other’s histories, they don’t have a clue,” Dr. Goje says.
While some partners will be a rock through everything, other partners might get angry or a little petty. Dr. Goje says these feelings can come from shame (if they truly were the source) or fear. If you think your partner could become extremely upset, threatening or violent, put your safety first. Dr. Goje suggests talking to your partner in a public space with a lot of people around. You can also have someone you trust with you when you speak to them.
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“If you’re not in a very steady relationship with the person, please don’t disclose your diagnosis in the bedroom. That is a very confined space. Go to a safe space or a very public place. By doing so, if your partner reacts in a way that you’re not expecting, you won’t be putting yourself in harm’s way.”
And if the situation is abusive, reach out for help. You can call the National Domestic Violence Hotline at 800.799.7233 or contact local law enforcement.
You talked to your partner or family. Things maybe didn’t go well.
Now what?
Dr. Goje stresses that blaming yourself is never the answer. Also, keep in mind that while you might think your recent diagnosis is a newer issue, there’s always the possibility that it’s not.
“The STD that you’re diagnosed with today might be something you’ve had before and it’s just coming to the surface now. Many times, a diagnosis is met with shame or with the question of ‘How did this happen to me?’ But it’s possible to be exposed to herpes at a younger age, it stays dormant for decades and then, later on, something like rheumatoid arthritis now brings a reoccurrence,” says Dr. Goje.
“All that person is thinking is ‘Where did I get this? Where did I go wrong?’ I often reiterate that STDs can be acquired at a young age or it’s possible to be asymptomatic and changes in health bring on the symptoms. Trying to lessen the shame that the person who has the STD might feel is very important to me. When you can handle that, you’ll know this is something that you shouldn’t keep blaming yourself for.”
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Being diagnosed with an STI is no walk in the park.
It doesn’t have to be a death sentence, either.
While some of these conditions are lifelong, they can be properly managed. Dr. Goje adds that if you happen to be the one receiving the news from a partner, ask questions. If they can thoroughly explain what they have and tell you about how they’re managing their STI, this will let you know that they’re taking management seriously.
“If you have a partner who is HIV positive and they tell you that their numbers are controlled, ask what those numbers are. When we talk about numbers, we’re talking about two numbers — the CD4 cell count that shows if their immunity is good and the HIV viral load that shows if the virus is still high in their body.”
She continues: “There are a lot of HIV-positive patients who are on the correct medication and because of that, their viral loads aren’t detectable. So, if your partner wears condoms and their viral load is undetectable, the risk of transmission is almost down to nil as long as neither one of you has other inflammatory infections like trichomoniasis, gonorrhea or chlamydia. That is where the honesty and the open-ended questions come in. And if it’s a meaningful relationship to you, go do your research about HIV and about the medications that people take to manage it. This way, if your partner throws out the name of a medicine that possibly isn’t an HIV medication, you’ll know they aren’t being honest.”
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