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Genital Herpes: Intimate Conversations

with Terri Warren, RN, ANP

This blog has been retired.

Thursday, January 17, 2008

STD Testing – Who is at Fault?

I wonder how many times I’ve heard someone say to me as I’m diagnosing them with an STD, “But I asked my partner before we had sex and they said they were clean!”

On one hand, its good that the topic of sexual health came up at all. But on the other, how do people really know if they are “clean” anyway? And do you think that we could use some other term for not being infected with an STD? Because the opposite of “clean” is “dirty” and I would really love to see THAT concept go away somewhere and never return. Is it any wonder STDs are stigmatized in our society when that’s how we define someone who is infected?

STDs spread largely because people don’t know they have them. If someone knew, for example, that they had chlamydia, a bacterial STD, they would get it treated and it would not be spread to anyone else. But about 2/3 of women who have chlamydia don’t know they have it, and perhaps a third of men, so it just keeps moving from person to person, not because anyone is “dirty” but because the bacteria stays inside people, unrecognized, even for years, until someone diagnoses it and treats it.

The same is true with genital herpes. Ninety percent of those infected with herpes have no clue. They infect someone else who notices, and then all hell breaks loose – who gave what to whom and how dare you! But its nowhere near that malicious.

Perhaps the irresponsible part relates more to not getting tested before having sex with a new partner. If people did get tested for STDs more often, there would likely be less of them. So whose fault is that? I think the blame falls on both clinicians and sexually active people. Spur of the moment sex with a new partner is hot and interesting and fun, but it really doesn’t allow for the time it takes to sort out STDs, does it? Is there a middle ground somewhere in there?

And clinicians – how receptive are they to patients requesting full STD screening? And how good are they at including all the possible STDs that someone might reasonably have? They are notoriously not great about including herpes testing in an STD screen, and that’s the most prevalent STD in the US!

I think the burden must fall on the sexually active person who holds off on penetrative sex until testing has been done or least uses condoms for everything until testing can be done.

Or maybe its me. Maybe if I could figure out how to make testing hot and interesting and fun, people would do it more! But that’s a whole different blog.


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Posted by: Terri Warren, RN, ANP at 6:25 pm