Sexually transmitted infections are more common – and more easily managed – than you might think . ELNA MCINTOSH responds to readers’ queries
Dear Dr Elna
Q: I am interested in becoming sexually intimate with someone, and I am having a hard time finding out more about sexually transmitted diseases. Can you give me some information about things I should be thinking about?
A: I talk to people every day who are unclear about the potential for sexually transmitted infections. Some people are reluctant to protect themselves from something that they can’t see or “believe”. Others are terrified at the possibility of becoming infected or passing an infection on to someone else. There are elements of truth in both positions, and it’s hard to make decisions with little (or no) information.
Q: Why do you refer to “sexually transmitted infections”, instead of “STDs” or sexually transmitted diseases?
A: It’s because I think we need to leap out of history and confront reality: these aren’t diseases that we’re talking about, they’re infections. A long time ago, before science knew anything about bacteria or viruses, some people would “get diseases” and it was thought that Venus – goddess of love – had something to do with it. (This is where the old term “venereal disease” or “VD” came from.) Now that we know that people are being intimate and contracting infections (in the same way that we catch a cold), rather than being cursed by a disease, I think we should talk about sexually transmitted infections (STIs) instead.
I like to think of STIs in a different way. Consider this from a microbe’s point of view: they’re just looking for a good home. A microbe wants to find just the right environment where they can survive, set up a home, eat, and raise a family. Maybe set up the farm for their kids.
The problem with this is, of course, you don’t want to have a virus or bacteria (or whatever), setting up home in your urethra, cervix, skin, spinal cord, etc. Live and let live only goes so far when there are consequences for your health, or your partner’s or family’s health. (Maybe you had other plans for your body.) Any infectious particle or microbe is looking for opportunity, and if you provide it with a passage to a nice place to grow and thrive, it takes advantage of that opportunity. If you don’t want something living with or in you, you should make decisions about your behaviour that can make it difficult to become a condo complex for sexually transmitted infections.
Q: So what does it mean to have a “sexually transmitted infection”?
A: Many people don’t have a sexually transmitted infection. On the other hand, though, many people who think that they don’t have an infection actually do. For instance, we don’t often think of “mono” (Epstein Barr Virus Infection) as a potentially sexually transmitted infection, yet it is popularly known as the “kissing disease”. Infections such as Cytomegalovirus (CMV), Herpes and EBV are often passed between people through kissing (“oral contact”).
It’s also important to realise that not everyone who has a particular infection acquired it through sexual contact. Infections such as warts – yes, those same ones on your hand or eyelid – are transmitted by contact between humans. Is this “sexually transmitted”? Not necessarily: it depends on what you were doing when you touched another human. Genital warts (HPV) are transmitted between people who touch, although they are caused by different subtypes of the same virus (HPV) that causes the warts on your fingers. The warts are called “genital warts” only because the infection involves the genitals. Herpes Zoster (shingles) is often not contracted sexually (rather, someone had chicken pox as a child), but it’s on this list because it can be sexually transmitted as well.
Q: I thought you could tell if someone had a sexually transmitted infection by looking for sores or discharges.
A: While this is sometimes true, you usually cannot tell if someone has a sexually transmitted infection just by looking at them. Most people do not know that they are infected (they do not have symptoms) unless they have laboratory testing. Some infections are more noticeable (men often have severe urethral burning with gonorrhoea, while women sometimes have vulvar itching and increased vaginal fluid with trichomonas), but most people find out if they have an STI by having a test done by a healthcare professional.
Next issue: More on STIs
Elna McIntosh is a sexologist and has for the past 30 years helped couples and individuals to explore their sexuality “outside of the box”. Her greatest claim to fame – surviving breast cancer … twice.