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) or a sexually transmitted disease (STD), it’s important to find a way to power through — 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 STD or STI.
The difference between an STD and 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, STDs are still relevant and very real.
What is an STI?
An STI is an infection that stems from sexual intercourse. However, someone might not experience any symptoms or they might have very mild ones when they 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.
What is an STD?
STDs evolve from STIs. When you have an STD, you might notice symptoms like:
- Bumps, sores or warts on or near your penis, vagina, mouth or anus.
- Painful or frequent urination.
- Swelling, redness or severe itching around your penis or vagina.
- Discharge that has a bad odor, irritates or is a different color or amount than usual.
- Vaginal bleeding outside of a period.
- Painful sex.
But these STDs can be managed if you stay on top of them.
How many people have STIs in the U.S.?
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.
Understand what you’re up against
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.”
Be open — and prepared for some judgment
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.’”
How to tell a new partner that you have an STD
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 STD or 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.”
When it’s time to tell your partner that you have an STI or STD:
- Meet them in a comfortable and safe space to have the conversation.
- Be open and prepared to answer any questions they might have.
- Try to remain calm and not get defensive. It’s normal for people to be confused or panicked when they recieve unfortunate news. However, if everyone is upset, you won’t be able to come to terms with the situation.
- If your partner needs time or a little space to process things, be respectful and give them what they need.
- If your partner is calm and understanding, take the time to ask about their sexual history. You might discover that they have a past history of STIs or STDs. Once you know this, you can take steps forward together to manage your health.
“People are so worried about telling their partners that they often don’t consider that their partners might be the source of the STD or STI. But because they’ve never had the conversation about each other’s histories, they don’t have a clue,” Dr. Goje says.
How to deal with an STD in an unstable relationship
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.
“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.”
After disclosing that you have an STD/STI, don’t keep blaming yourself
You talked to your partner or family. Things maybe didn’t go well.
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.”
An STD or STI is not the end of the world
Being diagnosed with an STD or 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 STD or 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.”