Demystifying Sexually Transmitted Infections

This week I will attempt to demystify STIs! Wooow, I’ll tell you; what a task. I work in sexual health in education and wellbeing, but not in the clinic. This took a lot of trawling through ins and outs of symptoms, treatments etc. (I knew a big proportion of it but definitely scrubbed up on some new facts).

For context, in 2018 (the most recent data), there were 447,694 STIs diagnosed in the UK, of which 16-24 year olds were the most at risk age-group (PHE, 2019). Research in 2017 found that 47% of young people often don’t use condoms, and 10% have never used one before either (same study). Treating sexual health infections costs the NHS £620m pounds a year; this is no small issue.

Because there is so much information on this topic, I have dealt with some social/cultural stipulations on the main post, but please refer to the STI type, symptoms and testing post. If you are concerned you might have an STI, refer to the resources at the bottom of the blog and seek help from a medical professional. 

What are ‘Sexually Transmitted Infections’?: 

“Any kind of bacterial or viral infection that can be passed on through unprotected sexual contact. It doesn’t matter how many times you’ve had sex or how many partners you’ve had; anyone can get an STI” (Brook, 2020). These “can pass to another person through unprotected vaginal, anal or oral sex, by genital contact and through sharing sex toys” (FPA, 2019). 

Situating STIs

The idea of diseases creates more stigma than necessary, so let’s stick with calling them infections. Longer term, sex education can hope to eliminate shame, and notions of ‘dirtiness’ that are associated with STIs. I won’t lie. Having an STI when you are unsure whom you got it from, and how to treat it can be a terrifying experience. It doesn’t, however, mean there is something wrong with you, or that you are dirty. These ideas have been culturally constructed. It is, predominantly, one of the least discussed parts of sex, from casual conversation to films and media. 

Even in music! You wouldn’t hear a rap or love song about a couple queuing at the STI clinic, or doing a home testing kit together. It’s hard to market sexual health as sexy or romantic, when we have heard such negative discourses concerning STIs. Big up the recent Normal People series: in episode 2, they discuss and use a condom. Yay! – although this should be much more commonplace in media…

Given that infections are rising in the UK (most recent data shows a 5% increase), and sexual health funding continues to be cut, the prevalence of STIs and the need to treat them remains increasingly urgent. The experience of waiting for a clinic or not being able to get an appointment is unfortunately becoming too familiar.

STIs IRL

It is beneficial for everyone, not just for public health professionals, to talk about and promote sexual health. Especially as many STIs such as chlamydia and gonorrhoea (incidentally the two most common in the UK), can be asymptomatic. 

Far from ‘ruining’ the fun by pulling a condom/dental dam out (whoever you are, let’s get rid of the ‘boys have condoms girls are on the pill’ assumptions), you can rest assured (provided the condoms are in date, don’t break etc.) that you will have the headspace to fully immerse yourself in the safe sexual situation you’ll find yourself in. 

Just a top tip: external condoms (and internal condoms, otherwise known as femidoms, are inserted into the vagina or used for anal sex although not as popular) are barrier methods of contraception that protect against STIs and pregnancy. So you might as well use them given their dual benefits. With perfect usage, they are 98% effective. That means that 2 out of 100 people with vaginas using them will get pregnant across one year. Dental dams are used for oral sex on vulvas, as not only people with penises enjoy safer oral sex (pun intended, lots of people enjoy oral sex), although these were unfortunately discontinued in the EU. See here how people make their dental dams from external condoms.

Talking about STIs

If you’re finding yourself in the situation where you are about to engage in sexual activity and someone offers excuses such as: 

• “They don’t feel nice for me”
• “They’re too tight”
• “They kill the mood”
• “I don’t need one, you are/I am clean”
• Etc…

You can do a few things:

1. Initially, don’t shut them down. They might not have much experience using condoms, or have absorbed cultural assumptions that they make sex less enjoyable. Pleasure is personal; although condoms may affect pleasure, there are a plethora of brands to try out. Skyn condoms are very popular (a thinner feel, latex-free), and if you are under-25 and live in London, you can sign up for a ComeCorrect card scheme which runs in most boroughs: entitling you to 6 free condoms a week. If people don’t feel comfortable going to get them for free, they can always bulk buy them online.
2. Express your feelings around sexual health, and that you are unwilling to consent to sexual activity without a condom. If someone removes a condom during sex, this is called stealthing, is illegal and a form of sexual assault. If they vehemently protest, or are rude to you, and it’s possible, try and remove yourself from the situation. You only want to be having sex with people that respect your sexual health. I’ll cover consent properly at a later point, as before safety and contraception, consent is needed for all and every form of sexual activity. It’s also important to disclose your sexual health status so that people can give their informed consent. 
3. If you are on contraception and both get tested regularly, you can discuss this at the time (or before), and then you’ll know your sexual health status before sexual activity (the goal!)
4. You choose not to have sex, get tested individually, and maybe go condom shopping together (dams are no longer on the market 😦 ). Get a selection to try, and have some fun!

It is important to avoid naming/shaming/judging others sexual health. The ‘human error’ element of sexual health means that drinking, improper use, forgetfulness, spontaneity, awkwardness etc. can affect the praxis of it. However, even if young people are notoriously ‘worse’ at their sexual health, this doesn’t have to be the fixed tale. The truth is that many people will get STIs in their lifetime. We all might forget about our sexual health from time to time. Even if your partner has a negative result, you could still carry an infection (FPA, 2019). So if you get an STI, notify your partners ASAP; some clinics can even do anonymous partner notification on your behalf. 

Inevitably, sexual health should be a shared responsibility. If you are using longer acting contraception, but have multiple new partners: always use condoms until there is some guarantee of exclusivity. Otherwise, you could still transmit an infection. If exclusivity isn’t your thing, then do some me-search and stock up on your favourites to have on hand. 

Ultimately, the more open we are with our sexual health status, the more it becomes normalised! 

Main lessons: 

1. Diagnoses alone, a young person in the UK is diagnosed with an STI every 4 mins (PHE, 2018). Considering that most people think they are less at risk of STIs, it is imperative to get sexual health testing, use condoms/dams, know your body and check for anything away from its ‘norm’. 
2. Most people at some point at their lives will have put themselves at risk, or will get an STI infection. Respond to people who disclose their STI status to you with care.

3. If you feel internal judgement/shame/fear towards STIs, read more or listen to podcasts. Hearing people speak about them free of shame can be music to the ears. 

Resources

Reading:

• Online testing if you don’t have symptoms (if you do, go to a medical professional ASAP for treatment) you can use online testing. I’d suggest pre-ordering so you have one at home in case: Free STI home testing kits – you can view services in your local area 
• Find A Service tool for your local clinic
• Brook symptom checker: Sexually Transmitted Infections (STIs) 
• I Caught Gonorrhea – And It Was No Big Deal 
• Some pieces of work on Daye, a new CBD tampon company that also has an amazing women’s health section: HPV: Everything You Need To Know; What’s The Difference Between BV And Thrush?; Why STI Tests Don’t Depend On Promiscuity 

Listening:

• Hannah Witton and Oloni discuss STIs 
• Project Pleasure podcast on STIs
• @comecurious interview @rukiat 
• Dr. Zhana discusses female condoms on the Science of Sex podcast 

Watching:

NHS Highland – Condom demo: in case you didn’t see at school/forgot 

References

Brook. (2020). Sexually Transmitted Infections. Topics Webpage. (Accessed online: https://www.brook.org.uk/topics/stis/ 27/04/2020) 

FPA. (2019). STIs Overview. STIs Webpage. (Accessed online: https://www.sexwise.fpa.org.uk/stis/stis-overview 27/04/2020)

PHE. (2018). An STI is diagnosed in a young person every 4 minutes in England. News Webpage. (Accessed online: https://www.gov.uk/government/news/an-sti-is-diagnosed-in-a-young-person-every-4-minutes-in-england 27/04/2020)

PHE. (2019). Sexually transmitted infections and screening for chlamydia in England, 2018. (Accessed online: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/806118/hpr1919_stis-ncsp_ann18.pdf 27/04/2020)