Dating with an STI: How to Manage the Conversation

Sep 15, 2015   ·  Chicago Tribune   ·  Link to Article

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Sexually transmitted infections can be difficult to discuss when starting a new relationship. Experts advise you to keep the conversation straightforward and drama-free. (Tetra Images)

Alison BowenContact Reporter Chicago Tribune

STIs and relationships: Some believe 'they will never be able to date again'

Bringing up sex before, well, having sex can be awkward.

There's the potential of being presumptuous — maybe the person sitting across from you stirring her cocktail has plans to go home and watch Netflix, not continue the night with you.

And talking about sex inevitably brings with it a fleet of other personal topics. Add a sexually transmitted disease to the equation, and that conversation can seem impossible to imagine.

Dating with a sexually transmitted infection, or STI, can be difficult. But it also might be getting easier as the stigma slowly ebbs, experts say.

(The CDC reports that the terms STD and STI are often used interchangeably but that, medically, infections are only called diseases when they cause symptoms. Many STIs don't.)

Jenelle Marie Davis, founder of The STD Project, which aims to eradicate the stigma, said people often call her organization after a diagnosis, worried about what it means for their dating life.

"Folks just believe that they will never be able to date again," Davis said. "It's terrifying initially."

But in reality, they are not alone — according to the Centers for Disease Control and Prevention, about 110 million sexually transmitted infections exist in the U.S.

In more than 20 years as a San Diego licensed marriage and family therapist, Sarah Cook Ruggera said nearly everyone she encounters has some type.

"They're hesitant to disclose, share, because of the shame factor," she said. But as more people are talking openly about it, she added, "it can be more normalized."

Honesty rules

Honesty, trust and communication are key components in a relationship — and having an STI doesn't change that, Ruggera said.

Telling a partner about health concerns that can affect him or her is always an imperative, experts said. But how much to disclose, or when, can depend on the case. There's a big difference between a past infection that has been treated and cured, and something lifelong, said Susan Gilbert, communications director for the National Coalition for Sexual Health, which provides sexual health information and aims to encourage dialogue about the topic.

"I really think that's an individual choice," Gilbert said. "What is important is (asking), is this an STI that you currently have?"

For example, chlamydia, syphilis or gonorrhea might have been encountered and addressed, the NCSH notes, but viral infections like HIV or genital herpes are lifelong health issues.

"If you follow the treatments (and) the doctor said it's safe for you to engage in sexual activity, then I think you can go about your life," Gilbert said.

In other words, if you were successfully treated for gonorrhea six years ago, you might be in the clear to leave that out of small talk. But if it's something that sticks around, you need to bring it up.

Getting past your fears

First, get over the fear, said Davis, who has herpes. Never, she said, has that stopped someone from wanting to have sex with her.

But the stigma can create nervousness, she acknowledged, not helped by persistent stereotypes and misinformation.

"It's often used as a punch line," she said. "It's used as a way to defame someone: 'That person sleeps around — I'm sure they have an STD.'"

And, despite growing awareness, negative reactions can't be ruled out.

"The first and most negative reaction that ends up hurting people's feelings is (being asked), 'How many people have you slept with?'" Davis said.

Like anything else — your physical appearance, your income, your job — know that someone who isn't OK with what you bring to the table isn't for you, Davis added.

Those anxious about addressing the topic with a potential suitor might want to consider dating sites that cater to those with STDs, including PositiveSingles.com and STDFriends.com. Ruggera said her clients often gravitate toward those.

Davis agreed that these sites can be a good step into the dating pool. But, she cautioned, "I do not think that we need to self-segregate."

Having the conversation

As for telling a partner about your situation? It's a must before anything progresses to the sexual realm. Just don't panic — it doesn't need to be a first-date conversation, experts agreed.

Some people might not want to invest emotional energy just to find out someone is turned off by their disclosure. (Besides, there's no guarantee you'll want to get past the first date.) But others, like Davis, are willing to take that risk in the interest of getting to know someone better.

"Nobody puts all their cards out on the table on a first date," Davis said.

But on the flip side, don't have the conversation the same time you're breathlessly debating whether you need a condom.

"It can be obviously very awkward and kill the moment if you disclose that in the heat of the moment," said Lisa Guiterman, communications consultant with the National Coalition for Sexual Health.

Dr. Edward W. Hook, director of the Division of Infectious Diseases at the University of Alabama at Birmingham Medical Center, said this conversation should be as simple as discussing the flu.

"We take vitamins for our health, we go to the doctor's office for checkups, and nobody has any trouble talking about that," Hook said.

Just keep it short, sweet and drama-free — which starts with choosing the proper setting.

"You definitely don't want to do it at dinner in a public place," Davis advised. "You're putting someone on the spot, and then they don't know how to react."

Experts agree that maintaining normalcy and simplicity is key.

"It seems more of a doom and gloom if you make it this big, drawn-out conversation, when it's really an exchange of information," Davis said.

The Los Angeles HELP support center for people with herpes suggests language like, "I really feel I can trust you, and I want to tell you something very personal. Last year, I found out I have genital herpes. It's not as serious as it sounds. Can I tell you about it?"

For those tempted to skim over the topic, consider that you're affecting your partner's health as well as your own — and that it could backfire.

"It's going to be risky if you don't say it right away," Ruggera said. If someone discovers it later, she noted, "then it becomes an integrity issue."

Safe sex still matters

Experts urge both patients and partners to take precautions. The National Coalition for Sexual Health advises that, after abstinence, condoms are the best method to reduce the risk of transmitting STDs. If you don't know your own status, or that of your partner, use condoms every time, Gilbert said.

Bacterial infections like chlamydia, gonorrhea and syphilis are usually easily cured with simple antibiotics, Gilbert said. Similar simple steps can help with parasitic infections, like pubic lice, scabies and Trichomonas.

Trickier are viral infections like herpes, which can't be cured, but where the focus is treatment and medication.

And take extra precautions — for example, if you have herpes and have an outbreak, refrain from sex to lessen the risk to your partner.

If you have a bacterial infection, Gilbert added, make sure you and your partner are both finished with treatment before sex, so that you don't pass it back and forth.

Ruggera said challenges in dating might change depending on age. Older daters might be more hesitant to share that they have an STD, she said, especially after divorce.

"Between the husband and wife, the STD was kept private, confidential," she said. "When you get divorced, all of a sudden you have to share that part of you, that information, with someone else."

But taking precautions — and losing the stigma — remains the same no matter the age.

Sexual health begins with getting tested, experts said. Then, openness with your partner.

"That's hard to do, but it's very helpful, and it's a great basis for starting a relationship," Hook said.

abowen@tribpub.com

Twitter @byalisonbowen

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