We don’t want to accept the basic facts about STIs (that they are common, often silent, and morally neutral) because we’re busy denying that we are the kind of people who have the kind of sex that has consequences. The reality is that all sex has consequences.
Didn’t STI rates go down during the pandemic?
It would be reasonable to assume that STI cases have gone down during the pandemic. Most people have at least curbed their socializing, even if social distancing hasn’t been embraced across the board.
But a couple of major factors of pandemic living spell public health catastrophe: One is that many people have avoided routine checkups, including the kind of doctor visit where you would get a quick STI screening. Even if you were willing to risk it, testing was less available—a survey by the National Coalition of STD Directors found that during the pandemic, 60% of clinics had reduced capacity to treat STIs. Many clinics shuttered. And, Park points out, in the second half of 2020 there was actually a shortage of STI testing materials, since items like swabs were being redirected toward COVID testing. Even though early 2020 statistics show that STI case numbers have gone down, experts think that just doesn’t reflect the reality.
And STI numbers are only likely to get worse. As social distancing restrictions lift, people will likely have more sex partners. And after more than a year spent avoiding human contact, some may have a sense that surviving a disaster means they’re invincible. “They’re going to feel a sense of freedom,” says Park. “And a sense of ‘I deserve to have condom-less sex because I’ve held out for so long.’” But that just doesn’t make scientific sense—syphilis doesn’t care that you have spike protein antibodies.
Yeah, but I won’t get an STI, because I’m careful
Oh, I know. You only have sex with people you trust! “Most STIs are asymptomatic,” says Park. “Most of the time people don’t even know that they have something when they pass it on to you.” This is something I would like to print on business cards and pass to people when I hear nonsense about STIs. It’s not a matter of knowing or trusting your partner.
Fewer people are using condoms than you may think. “Some students say, ‘Oh, I always use a condom,’ and others almost never,” says Wade. “Often it’s the woman who wants to use them and then men will make it weird, and then women don’t ask because they don’t want men to push back.”
But of course, this doesn’t apply to you! You’re smart. You use condoms! And that’s hugely important. But keep in mind: Condoms protect from some STIs, not all of them. And condoms don’t protect at all from STIs passed during oral sex (unless you use a barrier for oral sex, which most people don’t). “A lot of people think of oral sex as safer sex, but we know that oral sex can also transmit gonorrhea, chlamydia, and syphillis,” says Park.
So what am I supposed to do if I don’t want to be a nun?
“Living in fear of catching an STI is no way to conduct your sex life,” says Park. “Because it’s futile.” Instead, you should follow best practices. Ideally, she says, you should have one partner at a time, use barriers (like condoms), and get tested between partners. “Having concurrent partners is one of the easiest ways to spread both STIs and HIV,” she says.
In the context of modern dating, that’s not always realistic for many people. The next best thing is always using barriers and getting tested regularly. That way, you reduce your risk of contracting an infection, and you make sure that you catch an infection if you do get one. “I have patients who change partners really rapidly and have a lot of concurrent relationships, and they test every two months,” says Park. Getting an STI test is quick and easy—much easier than dealing with long-term health effects if it later turns out you’ve had a silent STI for months or years.
How bad is it if I do get a common STI?
For the more common STIs—syphilis, gonorrhea, or chlamydia—“the prognosis is fantastic if you can catch it early,” says Park. “We have really effective antibiotic treatment, some of which can be given with one dose and then cured. The thing is, for folks who have a silent infection, especially women, it can climb up into the fallopian tubes and into the uterus and can cause scarring or pelvic inflammatory disease. And repeated infections increase the risks of all those complications.”