If I had to distill the vibe of this summer down into one sentence, it would be, “I want to kiss everyone.” The thrill of other people is higher than I could’ve imagined! We should all embrace, if we want to, the impulse to kiss and then some this summer (and fall, and every season after). But—and not to be a bummer—it would be even more amazing if we could do so safely.
Marcus Sandling, clinical director of sexual health at Callen-Lorde in New York City, knew exactly what I was calling about the other day, before I could even explain it: “Hot vax summer, I know!” Sandling said, when I awkwardly tried to explain, You know, this summer… when everyone is trying to date… and hook up! But as the summer heats up in more ways than one, keep in mind that STI rates hit their sixth consecutive all-time high in 2019. That sounds ominous, until you remember that STIs are easily preventable with barrier methods and, most importantly, comprehensive, routine testing.
VICE spoke with Sandling and Rebecca Brightman, a gynecologist in New York, about all the nitty gritty details of STI testing: how often you should do it, what you should ask for, and whether there’s such a thing as “overkill.” Whether you’re newly single, newly monogamous, or somewhere in the big, fun middle, we’ve got you covered.
I’m single and extremely ready to mingle. Like, I am actively mingling with multiple people. How often should I get tested?
A great starting place: Get tested now, and then again in a few months, at the end of the summer, Sandling said.
A great way to enter hot vax summer with a clear conscience is to break the chain, so to speak, by going ahead and getting tested now, before you embark on the flings of your dreams. The same applies outside of this context, like in those moments when you’re newly single and just starting to get back out there, are opening up a relationship, or are in some way heading into the zone of having new partners.
“STIs happen because you don’t break the chain,” Sandling said. “Most of these things have no additional reservoir; like, syphilis doesn’t sit on a doorknob, it only happens because people have sex with each other and don’t know they have it and don’t wear condoms. That’s it! That’s literally it.”
Even if you were in a monogamous relationship for the entire pandemic and were tested at the onset, it’s still not a bad idea to get tested now. What you want is to be able to tell new partners, confidently, that your last test was recent (meaning: sometime in 2021) and came back with such-and-such results. And if you’re living true to horny/hot vax summer’s name, getting tested again at the beginning of the fall is a good way to check whether you picked up something along the way. As Sandling said, even with 100-percent consistent condom use, STIs can still spread. Few people think or care to use a barrier method during oral sex, for example.
You don’t get it: I mean I plan on having as many partners as possible. Do I need to get tested between every single one?
Go for it if you feel safer, but it’s not really necessary.
This is a bit counterintuitive, right? While neither Sandling nor Brightman would ever discourage someone from getting tested as often as they please, getting tested more than once a month veers slightly into overkill territory.
As Sandling explained, STI testing operates on a bit of a bell curve. Assuming you use a barrier method every single time you have sex: Those who have two or three new partners per month can responsibly get tested every three to six months. This isn’t a hard-set rule, but Sandling generally advised that the only folks who should consider getting tested more often than that—like, on a monthly basis—are those who have upwards of five new partners per month.
Getting tested between every partner might feel like the most responsible way to have sex, but as we know from our experience living with COVID, all infectious diseases have an incubation period, meaning they won’t show up on tests right away. That period for each STI is slightly different (this chart shows a good, easy-to-read breakdown), but the far end for the most commonly reported STIs (chlamydia and gonorrhea) is between 14–21 days. Getting tested more often than that risks returning a negative result while an infection is still incubating.
“I have some patients who have five to 10 partners in the course of a month, and a lot of them have the understanding that they just come in and get tested monthly,” Sandling said. “So except for the most highly active people, every three to six months is a reasonable alternative. If you're having somewhere between two to three partners, that's totally reasonable.”
Come to think of it, I don’t remember the last time I was tested for herpes. Should I be doing that more?
Not necessarily! It depends on your exposure level.
Unless you specifically ask to get checked for herpes, most comprehensive STI tests check for chlamydia, gonorrhea, syphilis, and HIV. But herpes is e v e r y w h e r e!, you might be thinking. True! It is, and that’s why Sandling said most practitioners won’t check for it unless you believe you’ve been exposed, or are experiencing symptoms.
“We usually only check herpes when patients request it because herpes simplex one and two are so ubiquitous,” Sandling said. “A lot of people will have it and have the antibodies against it, but will never have symptoms and have a low risk for transmission to other partners.”
Herpes is one of few STIs that isn’t currently curable (though researchers are actively working on it). The CDC doesn’t even recommend testing for herpes regularly, because there’s no demonstrable change in how people who test positive approach sex. While it’s possible to transmit herpes outside of any symptoms, most infections are spread during outbreaks.
TL;DR: You should be tested for herpes if you’re experiencing symptoms (which often appear as painful, itchy sores on your genitals), or if you were exposed via a recent partner.
How do I know if I got a good, comprehensive STI test?
Your doc swabbed all the sex-having areas and made you pee in a cup.
As Sandling said, most practitioners won’t just swab your genitals and call it good. A comprehensive STI test for the big three bacterial STIs (chlamydia, gonorrhea, and syphilis) should be site specific, meaning your throat, genitals, and ass get swabbed. (The throat element is particularly important, given how rare it is for most folks to use a barrier method during oral sex.)
While urine testing is a quick, easy way to check for bacterial STIs, it totally misses the throat and rectum, putting you at risk for letting an STI go undetected.
I keep hearing that HPV is the most common STI. How often should I be tested for it?
HPV, or human papillomavirus, is technically the most common STI in the United States, and is a scary one, because it leads to about 36,000 cases of cancer annually. But let’s take a few steps back, and consider some key facts: Almost everyone will get HPV at some point in their lives and never know it; 90 percent of HPV infections are low level and clear themselves within two years; and HPV is the only STI that has a preventative vaccine.
All that said, Brightman said all women over the age of 21 should be tested for HPV. If your test comes back with no abnormalities or signs of infection, your doctor may not tell you to come back again for three to five years, depending on your age and your medical history.
And while men can become infected with and spread HPV, there’s currently no approved test. Men can monitor their HPV status by looking for signs of infection, like “warts, or unusual growths, lumps, or sores on your penis, scrotum, anus, mouth, or throat.”
I haven’t been tested in a while and I’m freaked out that my doc will judge me. Any advice?
Go straight to your local health department, Sandling said.
Or look for a local clinic that caters to sex workers or LGTBQ folks, like Callen-Lorde in New York City, where Sandling works, or Planned Parenthoods throughout the United States. The Out Center also has a state-by-state list of queer-friendly STI clinics. STI testing should be free, accessible, and as low stress as possible. The past 18 months have shown, in real time, how valuable regular, effective testing for infectious disease can drastically slow their spread; it should be no different for STI testing.
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