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You’ve just started dating someone new, and things are heating up when you realize you haven’t asked them about their sexual health status.
Maybe you don’t want to ruin the moment or make the other person feel judged. And since they haven’t said they have a sexually transmitted infection, they’re probably fine, right?
Maybe not.
Sexual health is an important and natural part of our overall health, so much so that bringing it up as you’re getting to know a potential love interest or hookup should feel as normal as talking about our favorite foods or hobbies, said Dr. Janet Brito, a psychologist and sex therapist at the Hawaii Center for Sexual and Relationship Health in Honolulu.
However, “how to bring it up is tricky because any topic related to sexual health is so taboo and so value-based,” Brito said. There may be fears about how a person may perceive you for asking, or about the possibility of them feeling shamed for their sexual choices.
But regardless, “it’s important for you to be assertive about your own health,” Brito said, especially as rates of STIs have been rising over the last several years. “It’s better to do things for yourself and take matters into your own hands instead of leaving this to someone else to decide for you.”
Some of the most common STIs are HPV, chlamydia, gonorrhea and herpes.
You also can’t assume that your partner never having mentioned an STI or there not being visible symptoms mean you’re in the clear, said Dr. Germaine Earle-Cruickshanks, an ob-gyn at Mount Auburn Hospital in Cambridge, Massachusetts. Whether it’s due to shame or selfishness, not everyone is forthcoming about their sexual health status. And for a while, many STIs — including gonorrhea, chlamydia and herpes — won’t always have symptoms, she added.
Additionally, it’s easier to be proactive and prevent contracting STIs than it is to have to handle a health problem. That’s especially true since some STIs are incurable — including HIV, hepatitis B and HPV —and can lead to health problems including infertility or be life-threatening, Earle-Cruickshanks said.
All things considered, here are some tips for talking about STI status and testing.
For starters, the setting you have the conversation in matters, experts said. Try to do it in a calm environment instead of saving the discussion for the moments right before sexual activity.
At that point “you’re in the heat of the moment, (so) you’re probably not going to be thinking clearly,” Brito said. Mentioning it then could also make things awkward, which could make you more likely to say never mind and think about the consequences later.
Regarding what you say, avoid accusatory or shameful statements such as asking whether the person is “clean,” experts said.
The word has derogatory connotations because of “the idea that if you aren’t clean, you’re dirty,” Earle-Cruickshanks said. The term also isn’t the most scientifically mindful, as “some of the things that are transmitted are pretty much universal,” she added. “It’s no longer the case that you necessarily have an STI because of your behavior.”
Instead, speak kindly in a way that encourages open discussion and understanding that you’re taking ownership of your own health rather than blaming them.
Using the sandwich method for tackling challenging conversations can be helpful, Brito said — you might say something such as, “I like you and I’m excited to do this with you, but getting tested is something I like to do for my health, so nothing comes up later. When’s the last time you got tested?”
What can make the discussion feel even more normal is if you get tested beforehand and have your results ready and visible for your partner, Earle-Cruickshanks said. If you’ve felt nervous about bringing up the topic, sharing that can help, too.
Handling a partner’s responseIf your new boo says they have been tested, don’t automatically take that as a green light to proceed. You both need to elaborate on the date, extent and results of the tests, and on whether either of you have engaged in sexual activity with anyone between then and your time together.
If they tested negative for STIs at one point but had sex with someone else right before the test, “the best thing to do is to get retested three months later — in high-risk situations if there have been multiple partners — to ensure that nothing has developed, usually HIV, things like that,” Earle-Cruickshanks said.
If they say they haven’t been tested, you can ask that they do so before progressing sexually. Depending on the nature of your relationship, you could offer to get tested together, then discuss when and where you both are comfortable doing so, Brito said.
Pausing until then is the safest, experts said. But if you decide to keep going in the heat of the moment, use as much protection as possible — such as condoms or dental dams — or do activities involving only your hands so that mouths or genitals don’t have to encounter bodily fluids.
What you should do when a partner’s unreceptive to getting tested depends on their reasons for feeling that way. You might express that you’re noticing some hesitancy and wondering where it’s coming from, Brito said. Maybe they’re nervous about being seen there or don’t have the money or know where to go. In that case, you can suggest alternative places and even offer to cover the cost.
Whether your partner’s test happened before or during your relationship, you should absolutely see the official documented and dated proof of the results, Brito said. It’s great if they show you those results voluntarily, but if you have to ask, it shouldn’t be a problem.
If anyone does give you a hard time about trying to protect your health or drags their feet on getting tested, those are red flags that could also signify something bigger in terms of how they feel about trust and respecting a partner’s wishes, Earle-Cruickshanks said.
“Do you really want to engage in a relationship with someone who is dismissive of what’s important to you?” Brito said. “Listen to … your intuition of like, ‘This doesn’t feel right.’ Because normally people know.”
If you need to end things, you could say, “It sounds like this is something you’ve been having a hard time doing. As much as I care about you and like you, I’m not going to be able to move forward with you because I’m not comfortable being sexual with you without us both being tested.”
If one of you does test positive for an STI, it doesn’t have to be the end of the world, Brito said.
“There are many … STIs that have really bad stigmas that actually don’t cause any long-term problems,” Earle-Cruickshanks said.
Both people should talk to a doctor about the diagnosis, effects and what treatments are available, she added. Read this story for advice on how to tell someone about your diagnosis and for other information on dating with an STI.
Not needing to end the relationship can be especially true if your partner’s “track record is that they have been honest with you and you all have been engaging in open communication and you saw the results and you went together,” Brito said.
Though a positive test can be scary and bring up a lot of negative feelings, that history can make navigating the situation together worthwhile.
