Your Guide to Dealing with a Positive STI Diagnosis
There's no need to go into a stress/shame spiral.
You'll find no shortage of explanatory pieces on the web about how to have safer sex with a partner of any gender, the most common STI signs and symptoms, and even how to talk to someone about their STI status before having sex. Yet, the internet is a pretty barren place when it comes to what to do if you get a positive STI diagnosis.
That's why, with the help of healthcare providers and an STI educator, we've put together this guide on what to do if you've tested positive for an STI. Here you'll learn more about the STI testing process, how to tell your recent partner(s), and tips for overcoming any internalized STI stigma or shame you may be feeling.
Note: If you already know you have an STI, go ahead and skip down to step two. Otherwise, start with a little explainer on how (and how often) to get tested.
1. Get tested.
You can't self-diagnosis an STI—period! Most STIs don't have any symptoms at all. So please, please, please don't wait for scary green discharge or pee that burns to get tested. (Related: A Shocking Number of Men Have HPV)
The Centers for Disease Control and Prevention (CDC) recommends that you get tested for gonorrhea and chlamydia once a year, but many healthcare professionals consider the CDC recommendations outdated. Instead, docs might recommend you get tested after every new partner, says G. Thomas Ruiz, M.D., ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley. (Here are 5 Things You Should Know Before Your Next Pap Smear.)
That goes for whether you have symptoms or not. Another option is to get tested with every new partner before having sex—especially if you're planning to romp without a condom or dental dam. says Dr. Ruiz. (Related: Can You Get Gonorrhea By Kissing?)
To get tested, you can visit your local health clinic, Planned Parenthood, or doctor's office. Or, you can also try an at-home STI test.
"If you get tested by a healthcare provider, it will usually take about a week to get your results back," says Dr. Ruiz. Results from at-home STI tests may take a little bit more time—usually 10 to 14 days after you drop it in the mail.
If your results are negative, cool. It's still important to talk to any future partner(s) about their STI and sexual health history. This guide on how to talk to your partner about their STI status might be helpful.
And if the results came back positive? First, don't panic. Second, that's where this guide comes in. Keep reading.
2. Remember: All STIs Are Treatable or Curable
"The first thing I like to do when telling a patient they've tested positive for an STI is to remind them that every STI is either curable or treatable," says Dr. Ruiz. Yes, there's a difference between the two: Curable STIs will go away with the right course of action and treatable STIs cannot be cured but can be managed with antibiotics and antivirals so you can continue living the life you want. (Seriously. The life expectancy of folks with HIV taking antivirals is the same as the general population.) Below is a quick look at some of the most common curable and treatable STIs.
This is also a good time to point out the difference between STIs and STDs: They're largely used interchangeably, but technically, STI means "sexually transmitted infection" and STD stands for "sexually transmitted disease". There's been a slow shift among the medical and sex education community toward calling them STIs because not all sexually transmitted health issues are truly diseases—the concept of disease suggests a clear medical problem, usually with obvious signs or symptoms, according to the American Sexual Health Association. Plus, the term "disease" can present more stigma. No matter which word you use, the advice is the same.
4. Then Get Treated
Most curable STIs will go away with a course of antibiotics. Chlamydia, for example, will go away after a seven-day dose of antibiotics, according to Dr. Ruiz. While the exact course of action for treatable, but not curable, STIs like herpes, HIV, and hepatitis B will vary depending on the STI, they're usually managed with a daily antiviral.
Regardless of which STI you tested positive for, it's important to get treated. If you don't (or delay) getting treatment, you risk spreading the infection and making the STI worse. Yepppp. For example, if left untreated, gonorrhea and chlamydia can lead to pelvic inflammatory disease, and HPV can lead to cervical cancer.
Remember: Just like you can't tell that you have an STI just by looking between your legs, you also can't tell if/when it's gone away by looking down there either, so don't stop your treatment just because things are starting to appear normal again.
5. Pick Your Doctor's Brain
Usually, an STI diagnosis will be accompanied by some face or phone time with a doc. This is your opportunity to ask every single question you can think of. "We've heard everything," promises Dr. Ruiz.
Want to know if unprotected manual sex (aka hand stuff) can pass the STI to partner? Ask. Want to know if sharing a towel with someone can spread the STI? Ask. Want to know if oral sex can spread the STI? Ask! "No question is silly, small, or dumb," he says.
If you feel your doctor is being judgemental, insensitive, or doesn't know the facts, it's completely within your right to ask to speak to another healthcare provider. And if you later realize you forgot to ask something, try not to fall down the black hole that is Dr. Google. Instead, stick to legit sites like Planned Parenthood, Scarleteen, and The STD Project, or just call your M.D. back.
6. Tell Your Recent Partner(s)—and Have Them Get Treated
The truth is, anyone you've been sexual with since your last negative STI test could have the same STI. "Once diagnosed, it's best for your partner(s) be notified so that they can be tested and treated if they also test positive," says Kecia Gaither, M.D., M.PH., F.A.C.O.G., ob-gyn, maternal-fetal medicine doctor, and director of perinatal services at NYC Health + Hospitals/Lincoln.
If you don't tell your partner and continue having sex with them, it's possible that they will re-transmit the STI to you (if it's a curable STI that you previously got rid of), or that they will get the STI from you if they haven't already. "There are a fair number of couples who end up passing STIs like gonorrhea or chlamydia back and forth between each other because one doesn't undergo treatment," says Dr. Ruiz. (That's why, if you test positive for gonorrhea or chlamydia, doctors will usually have you come in a few weeks later to get tested again.)
If you're telling someone you're either not currently seeing or aren't committed to, sexologist and STI educator Emily Depasse, creator of The Resilience Deck (a deck of cards created to help you refine the narrative around STIs), offers the following templates, which you can use either in person or via text:
"Hey, I just want to let you know that I had some symptoms, so I got a full STI panel and I tested positive for [insert STI here]. I'm sharing this with all of my recent sex partners so that they can get tested and help their current partners make informed decisions around protection."
"Hi! I'm reaching out to let you know that I just tested positive for [insert STI here]. There's no way for me to know when I got it since I was last tested, so I'm letting all of my recent sexual partners know."
Depasse adds that if you feel compelled, you can also drop a link or two to any content (like Ella Dawson's Ted Talk, for example) that you found particularly helpful. But, she says, "don't feel pressured into doing all the educating for this person." They can ask their questions to a doctor when they go to get tested, just as you did.
Telling a partner you're more committed to can be a little more emotional. That's why "as long as you're not concerned that telling your partner will result in an unsafe environment for you, this is best done in person," says Depasse.
When you do this, try to keep it as simple as possible. Her suggestions:
"There's something I want to talk to you about. As you know I went and got STI tested last week, and I tested positive for [insert STI here]."
"I went to the doctor last week for my annual gynecological exam, and it turns out I have [insert STI here]. I know that this might make you question whether or not I've been faithful to you. But I want you to know that I have been completely faithful to you, and because I had no symptoms, I didn't know I had it before we started seeing each other."
"I got a call from my ob-gyn today and I have herpes. I know that this might make you question whether or not I've been faithful to you. But my doctor told me that herpes can lie dormant in the body for years and that I probably had it long before I met you."
"It's important to be mindful of your language when disclosing a positive STI diagnosis," she says. "There's a tendency for people with chlamydia or gonorrhea to say something like, 'At least it's not [insert herpes or HIV here],' but that's STI-shaming and creates a false hierarchy of amongst the STIs."
Once you've said it, give your partner time to process the information, respond, and ask questions. Again, don't feel pressured to pretend you're an expert in your STI. You might explore the Planned Parenthood website together so you can learn more as a couple. But still, they should plan to make an appointment with their doctor so that you and the internet aren't their only knowledge source.
Hopefully, they'll respond like the caring, warm, and loving person you know them to be. But if they don't (think: yelling, shaming, blaming, name-calling, or worse), that may be a reason to rethink the relationship.
7. Seek Out a Sex-Positive Therapist
"When someone gets an STI diagnosis, typically the healthcare provider will go over the logistics of what to take, and how long for, and what protection to use moving forward. But there's typically no focus on the emotional stuff that can come up with an STI diagnosis," says Depasse. That's why talking to a therapist can help. (See More: Why Everyone Should Try Therapy At Least Once)
If you're already seeing a therapist, you likely already have a pretty good sense of whether they use shame-y language around sexuality. "If there's an established base of trust and you've been able to talk about sex with them in the past, you might have a really compassionate experience sharing your STI status and feelings about it with them," says Depasse, who recently conducted a survey on Instagram and found that the majority of people had positive experiences sharing diagnoses with a therapist. Good to know, right?
If you don't currently have a therapist, know that any feelings of shame, unworthiness, dirtiness, or self-hatred are internalized STI-stigma talking, and the right therapist can help you work through them.
"Your best bet is to find a sex-positive therapist or sex therapist because they're likely to be trained in responding with compassion in response to an STI diagnosis," says Depasse. This finder by the American Association of Sexuality Educators, Counselors, and Therapists can help you find a sex therapist located near you.
If a therapist isn't an accessible option for you, Depasse recommends an online support group such as HSV In The City, Positive.Results.Us, or any of the support groups for HIV, HPV, and hepatitis linked here.
8. Follow STI Educators and STI-Positive People On Social
Getting an STI diagnosis can be a really lonely experience because, even though more than fifty percent of people will have contracted an STI in their lifetime, it's not usually something people talk about. That's why Depasse recommends following people on the internet who are talking about it:
9. Start Having (Safer) Sex Again—When You're Ready
"You're going to want to wait to have sex again until the bacterial STI is gone, any sores or warts have disappeared, or until your doctor gives you the okay," says Dr. Ruiz. But after that, go ahead and start having (and enjoying) sex again.
Of course, keep it safe: "The best course of action is to use protection unless you've both been recently tested and were negative," he adds.