Having dipped somewhat during the pandemic, sexually transmitted infections (STIs) are on the rise again around the world. In England and Ireland in 2022, rates of chlamydia, gonorrhoea and syphilis exceeded levels recorded before COVID. The number of gonorrhoea diagnoses recorded in England was in fact the highest since annual records began.
Untreated STIs can result in serious health complications for both men and women including infertility, increased risk of miscarriage and stillbirth, various cancers and reduced life expectancy, among others.
So what do you do if you find out you’ve got an STI? Disclosing the infection is a double-edged sword. On one hand you are being honest, responsible and respectful to your partner (or partners), and protecting their health.
On the other hand, you may risk being shamed, discriminated against or isolated for disclosing your sexual activities, behaviours or preferences. This might be related to having multiple sexual partners, engaging the services of sex workers, or your sexual orientation, to name just a few.
While navigating these conversations can be difficult, cultural and societal attitudes towards sex and sexuality should not discourage you from disclosing your STI status. Letting sexual partners know if you have an STI is essential to the prevention, treatment and control of these infections.
Honesty is the best policy
If you receive a positive test, don’t panic. Consult with a healthcare provider as soon as possible. There are effective treatments available for several STIs. For example, a single course of antibiotics will often clear chlamydia, gonorrhoea, syphilis and 'trich' (trichomoniasis).
While it’s not possible to cure HIV or herpes, drugs called antiretrovirals can alter the course of the disease and reduce the risk of transmission.
Disclosing an STI can be an uncomfortable and often embarrassing conversation. It’s totally normal to be anxious about your partner’s response and the potential effect on your relationship, whether casual or long term.
After you’ve told them, consider discussing how sexually active you have been in recent times, whether you have had sexual encounters with men, women, or both, and if you’ve sought medical treatment for the STI. Encourage your partner to ask questions, and give them time to think and process the news.
If you and your partner have been sexually active (with or without a condom) and you’re concerned about transmission, you could also provide them with information on where to seek STI testing (GP or local STI clinic) or direct them to reputable websites where they could access a home testing kit.
If you are uncomfortable telling a sexual partner you have an STI, a healthcare professional can undertake contact tracing to maintain your anonymity.
It’s also important to disclose if you have an STI before starting a sexual relationship with someone new.
What if a partner discloses that they have an STI?
You will probably have lots of questions in relation to your partner’s STI disclosure as it may pre-date or overlap with your relationship. When asking these questions, try to be mindful of the language you use, and avoid placing blame.
Most importantly, get tested as soon as possible. An early STI diagnosis is the best opportunity for effective treatment, and prevention of health complications and further transmission. Visit your GP or local health centre for a physical exam and STI screening or alternatively, order an at-home testing kit online.
Depending on the complexity of the testing required, you may have a number of days to wait for your results. Since STIs spread by skin-to-skin contact or through transmission of bodily fluids, it’s best to abstain from sex while you await results.
If you do decide to have sex, it’s advisable to use a physical barrier such as a condom or dental dam to protect your partner. When used correctly and consistently, condoms offer one of the most effective methods of protection against STIs, including HIV.
Make this an opportunity
Low health literacy can often instil unnecessary fear in circumstances like these. Whether it’s you or your partner who have an STI – or both – use this opportunity to do some research on sexual health. Educating yourself on suitable contraceptive methods, vaccines, signs and symptoms of STIs and the benefits of regular STI check-ups is vital to keeping yourself and others safe when sexually active.
Focus on evidence-based advice from trusted sources such as the US Centers for Disease Control and Prevention, the World Health Organization, and the NHS, where you can find up-to-date fact sheets on STI symptoms and treatment guidelines.
If we think back to the height of the pandemic, disclosure of a positive COVID test was often associated with fear of judgement, social exclusion, discrimination and blame – much like an STI disclosure. However, as the pandemic progressed, so too did attitudes.
The COVID pandemic has also shown us the crucial role of early detection, rapid testing, and importantly, public health communication and education. All of these lessons should be applied to the global fight against STI transmission.
Stigma, embarrassment, guilt, taboo and shame are words still too often associated with STIs. Overcoming STI stigma, much like COVID stigma, requires education, improving access to STI testing and treatment, and the promotion of inclusive conversations about sexual health.
Dr Zara Molphy is Head of Research Programmes, Department of Obstetrics and Gynaecology, RCSI University of Medicine and Health Sciences.
RCSI is committed to achieving a better and more sustainable future through the UN Sustainable Development Goals.