How to Avoid Getting an STD: A Doctor’s Tips
Welcome to the Sensate Health blog! While I am a physician, this blog is for educational purposes only and does not constitute medical advice or a doctor-patient relationship. Please see your healthcare provider for any medical concerns.
I have to admit something upfront: this title can’t fully deliver on its promise. It may be unsettling to hear, but most sexually active people will get at least one sexually transmitted infection (STI) in their lifetime. The CDC states that about 85% of people will get human papillomavirus/ HPV, and 12% of adults (or one out of every eight adults) in the United States have herpes simplex virus type 2/ HSV-2, commonly referred to as genital herpes. Most STIs are asymptomatic, meaning you may not notice any symptoms and therefore may not know you have it. While abstinence is the only fail-proof way to prevent an STI, abstinence isn’t feasible or desirable for many people. In this article, I’ll share five things you can do to help protect yourself, some of which may surprise you. Hint: there’s much more to it than just condoms (summary available at the end of the article).
#1: An Ounce of Prevention
Okay, I know you’re eager to get down to business, but there are some steps you should take before you set foot in someone else’s bedroom or wherever else you like to get freaky. Vaccines are the pinnacle of prevention, and we’re fortunate to have vaccines for several infections that can be sexually transmitted: HPV, hepatitis B, hepatitis A, and Mpox (formerly known as monkeypox). The easiest way to get most of these vaccines is to go to your local pharmacy - if you have insurance, they should be offered free of charge. Otherwise, you can inquire about them at your primary care provider or local health department. Mpox vaccines aren’t recommended for everyone, so check your eligibility here first. Also of note, the HPV vaccine Gardasil is routinely given up to age 26, but you’re still eligible up to age 45. It can take up to six months to complete these vaccinations, so go ahead and get started today!
There are also preventive medications that can be used to reduce your chances of getting two other STIs. This first one involves some cooperation from your partner, but if they have herpes and you don’t, they can take a daily medication like valacyclovir to reduce the risk of transmitting the virus to you. If you’re at risk of exposure to HIV, you can ask your healthcare provider for pre-exposure prophylaxis, also called PrEP, to prevent HIV infection. PrEP doesn’t prevent other STIs, so we’re just getting started - keep reading for more tips.
#2: Know Your Status
While testing doesn’t “prevent” you from getting an STI per se, it’s still an essential part of a healthy sex life. Not only can you minimize the negative effects of an STI by getting early treatment when needed, but you’ll also be well-informed and ready to have conversations and share your status with new potential partners. For some people, getting tested for STIs yearly is sufficient, while others with more frequent or higher risk exposures should be tested as often as every 3 months. Talk to your healthcare provider to make sure you’re being tested where you need to be, which may include oral, genital, and/ or anal swabs.
Some STIs like gonorrhea and chlamydia need to be treated right away, and it’s important to get clearance from your healthcare provider before engaging in sexual activity again. Other STIs like HPV and herpes aren’t treated in the same way - HPV usually resolves on its own after a period of months or years, while the frequency of herpes outbreaks and viral shedding decreases over time. It’s important to avoid sexual contact while herpes blisters are present. With regular treatment, HIV becomes undetectable, meaning it can’t be transmitted to a new partner.
#3: Communicate
Once you’ve found a potential partner, the next step in preventing STIs is: ask! You are much less likely to get an STI from someone who knows their status, communicates it to you, and uses protective measures than from someone who hasn’t been tested and doesn’t even know they have an STI. It’s important that we destigmatize these conversations to make it easier and safer for folks to share this information with potential partners. This doesn’t mean you need to have sex with someone who says they have an STI if you feel uncomfortable with it. There’s nothing wrong with thanking someone for sharing that information with you and saying you need some time to do your own research before figuring out what you’re comfortable with.
That being said, finding out your potential partner has an STI doesn’t mean the night has to end if you don’t want it to. Masturbating with a partner is a highly underrated activity - you can make out until you’re both sufficiently aroused, then you can each pleasure yourself. If you’re masturbating to avoid getting an STI, be sure not to touch your partner’s affected area (usually the genitals) or any genital fluids. You can even bring your own toys if you’re into that, but don’t share them - shared toys can transmit STIs too. Once you’re both satisfied, you can clean up, cover the affected areas by putting on underwear or clothing, and have a nice cuddle session.
#4: Use Protection - the right way!
Alright. So you’re vaccinated and tested, you and your partner have shared your status, and you’ve each consented to play. At this point, using a condom (for sex involving a penis) or dental dam (over a vulva or anus) throughout your playtime is the most important thing you can do to protect yourself - and make sure the protection is in place before your genitals (or genitals and mouth) come into contact. If there’s a penis involved, make sure the condom fits properly, and if you happen to place it wrong-side-down so it doesn’t roll on the way it should, be sure to discard that condom and use a new one. Using plenty of water-based lube during sex will help keep the condom from breaking, and for that same reason avoid using more than one condom at a time!
If you’re having a hard time getting excited about condom use, I highly recommend shopping around. Each condom has a different fit and a different feel, and it may take some trial and error before you find your Cinderella slipper. Try on new condom brands alone before introducing them with a partner to ensure everything goes smoothly. It’s also important not to ignore the need for protection during oral sex - in recent years, more people are getting herpes type 1/ HSV-1 infections in their genital area from oral sex. Flavored condoms can make protection during oral more fun, and you can cut off the tip of a condom and then cut the condom lengthwise from base to tip to create a dental dam.
#5: Have Fewer Partners
Mutual monogamy means you only have one partner, and your partner also doesn’t have any other partners. While it doesn’t work for everyone and isn’t a guarantee that you won’t get an STI from your partner if they’ve had previous partners, limiting your sexual activity to one person allows you to know each other’s STI status without new partners (and potential exposures) being introduced. Mutual monogamy isn’t just for folks in committed relationships - you can also be mutually monogamous with a casual partner. Rather than framing this as a rule, think of it as a boundary: “I don’t want to have sex with someone who is also currently having sex with someone else. Is that a boundary you can support?” Your partner’s boundaries are likely different from yours, so be prepared to support their autonomy (and part ways if needed) if they tell you that arrangement no longer works for them. Even if monogamy isn’t feasible or doesn’t appeal to you, you can still reduce your STI risk by limiting your number of partners.
Of note, HPV and herpes aren’t always included in routine STI testing for reasons that are outside the scope of this article, but I include this point to illustrate that getting an STI from your partner, after being told they didn’t have any, doesn’t necessarily mean that they’ve lied to you or cheated on you. Furthermore, these two STIs are sometimes spread through genital contact in areas that aren’t covered by a condom during sex, so they may still be passed to a new partner despite consistent use of protection. Please talk to a trusted, sex-positive healthcare provider to help understand what a new STI means for your health and your relationship.
Summary
If you’re sexually active then STIs aren’t completely avoidable, but there are many highly effective steps you can take to protect yourself and your partners. Protection first starts outside the bedroom with vaccination, preventive medication if needed, and STI testing to know your own status. Once you have a potential partner, have an open and honest conversation about STIs and protective measures, consider masturbating together if you’re not ready for sexual contact, and be sure to use protection consistently and correctly for all types of sexual play. Lastly, limiting your number of partners is a way to reduce STI risk when mutually agreed upon and negotiated in a way that supports consent and autonomy.
TLDR:
An ounce of prevention
Vaccines: HPV/ Gardasil, Hepatitis B, Hepatitis A, Mpox if recommended
Medications: Valacyclovir (taken by a partner with herpes to reduce transmission to a partner who does not have herpes) and pre-exposure prophylaxis/ PrEP (taken by someone who does not have HIV to prevent infection)
Know your status
Get tested for STIs!
Frequency and types of testing: talk to your healthcare provider
Communicate
Talk to your potential partner about STIs and protective measures
Consider masturbating together as a safer way to play
Use protection
Use every time, the whole time
Importance of trying different brands to find the right fit and feel
Don’t forget to use protection (especially flavored) during oral sex
Have fewer partners
Monogamy reduces STI risk when mutually agreed upon
Limiting number of partners is an alternative
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