Help!  How to talk to your partner about STDs

One of the most frequent questions people ask me is how to talk to a partner about std testing, or how to tell a partner that they have an std.

I can help.  :)

A new relationship -

You are just starting a new relationship, and want to talk to a partner about testing, in general, but don't know how to bring it up.  Will he think you are "easy"?  Will she think you've had a lot of partners?  Well, maybe, but that's not the point of testing.

You should bring this up before things start getting all hot and heavy, and NOT while you are in the bedroom, half naked.  Pick a quiet spot where you won't be interrupted.  DO NOT TEXT THIS.  If you find it easier to do over email, that's ok too.  But texting is often done in abbreviations, etc., and this is a discussion that deserves every chance to not be misunderstood.  :)

A good way to start this is to tell your partner that you can see things are headed towards sex (and you can insert your own terms here - it doesn't have to sound clinical), and you want to make sure both of you stay healthy, and want to test.  

Do not say things like "I know you were with that nasty girl, and we all know she gets around, so you need to test" or "I've heard rumors that you've slept with a ton of guys, so I want you to test".  This isn't about that.  This is about both partners making sure they test so that if they have anything, they can get treated, or they can take steps to manage an infection.  Do not talk about numbers of past partners.  First, its not really any of your partner's business at this point, and it doesn't make a huge difference, medically speaking.  If you've had 5 partners, and your partner has had 10, who cares?  Medically speaking, that's not a huge difference.  

Find a clinic, and go together.  Or, if you'd rather, go to your own doctor, but make sure you get copies of your test results to show your partner, and have your partner do the same.  This isn't to say your partner will lie, but you do want to make sure you were both tested for the same things.  

A word about people who don't want to test:  If someone doesn't want to test, then they don't want to have sex with you very badly, do they?   I ask all my partners to test, and I haven't ever had anyone refuse.  I figure sleeping with me is worth them going to pee in a cup and getting a little blood drawn.  ;)

Telling a partner you have an std -

This doesn't have to be as painful as you might think.  The important things are to be honest, factual, and remain calm.

I'll use herpes as an example, but this could also be the same for HPV, molluscum, HIV, etc.

When you tell a partner you have herpes, its important to remember this is NOT A CONFESSION.  Having an std is not a dirty, shameful secret.  Its an infection, much like the chicken pox, strep throat, etc.  It is NOT a moral statement or a value judgment, and it in no way reflects on you as a person.  

That's important to remember because telling a person you have herpes opens the door for the std discussion I talked about before.  It is as important for you to know what your partner has as it is for your partner to know what you have.  This is a DISCUSSION, with both partners having equal power.  

Have information handy, like transmission rates for the type of herpes you have, prevention information, etc.  Let your partner know if you would be willing to take suppressive therapy in order to reduce the risk.  Its ok if your partner asks questions.  That's a good thing - it means he/she is willing to find out more, rather than just running with no real information.

DOs:
* Have this conversation in person, if possible, or by phone if not.  Some people do it by email, and that's ok too, if you aren't ready to face this person.  However, it will probably help to be able to see your partner, and your partner might really want to support you, or hug you, and that can really help.

* Be calm.

* Have info handy to show your partner.  There are several good websites for info, and one of the best is www.ashastd.org

* Be able to answer questions.

* Remember that this is a DISCUSSION, not a confession.

DON'Ts:

* DO NOT, under any circumstances, text this to a partner.  I don't care how scared you are, this is not information you should be texting.  Can you imagine getting this in a text:  "I hve hrps, need to tlk."  Yeah, not a good thing.  With email, cell phones with email, blackberrys, IPhones, etc., you can at least TALK to or email the person.  

* DO NOT offer your partner "an out."  Your partner can leave this relationship at any time, for any reason, and doesn't need the reminder.  If you say that, you make it sound worse than it is.

* DO NOT use words like "terrible", "awful", "horrifying", "shameful", "hideous", etc.  STDs are none of those things, no matter how awful you feel about it.  Look at the difference in these examples:

"Hey hon, we need to talk about STDs.  Have you ever been tested?  Well, I have herpes type 2.  I've had it for awhile, and know when I'm getting an outbreak.  I take suppressive therapy, which means your risk is really low.  I'd like you to test for it, so we know what, if any, precautions we'd need to take, and I'm ok with answering any questions you might have about it."

or...

"Hey hon, I need to talk to you.  I don't know how to begin to tell you this, and I have no idea what you are going to think because its just awful.  I wouldn't blame you if you leave me, and you might, because this is horrible.  I know you are going to think I am a terrible person for this, and I can't blame you for that, either.  (break for crying and heavy breathing)  I can't believe I'd ever have to tell anyone something so horrifying, but..."  (more crying, heaving breaths, etc)  "...I have herpes."

By the time you got to the end of that, your partner is probably thinking you've cheated on him, or worse, something like you are a convicted ax-murdering child sex offender.  As your partner listens, he/she has now equated herpes with something terrible, and that's not an incredibly accurate thought.

Talking about STDs isn't easy at first, but its an important part of being sexually healthy.  If you can't talk about sex, maybe you shouldn't be having it.  :)

Aj