How to talk about sexual health for the first time
A guide for sexually active folks, teens, and their parents
Storytime: I contracted HPV (the Human Papilloma Virus) from one of the first people I had sex with at 16. Huge bummer. And at the tender young age of 38, I contracted Herpes. Sweet.
To say that getting warts at 16 put a damper on my budding sex life would be an understatement. Casual, carefree sex was entirely off the table. I was petrified, horrified, and mortally embarrassed, and I had no idea how to move forward.
I didn’t tell anyone or talk about it except with the nurses, doctors, and clinicians who treated my outbreaks. I had a lot of treatments, and even many healthcare professionals weren’t that great at talking about STIs.
I showed HPV symptoms on and off for about ten years, which means that if I wanted to have a semi-normal sex life as a young man, I had to learn to talk about STIs.
That said, I’d had a couple of hookups early in my budding sex life where I didn’t disclose my status and felt terrible about not coming clean about my symptoms, and vowed never to do that again (I eventually contacted those I could to have the much-needed conversation about sexual health finally).
So, I got good at talking about sexual health and developed a script I’ve used hundreds of times over my 25 years as a sexually active adult.
If you want a dose of courage and the script on sexual health or have kids who are going to be having sex soon, read on, my friend.
Deal with it
STIs are part of being a sexually active adult. If you don’t want to risk getting an STI, then don’t engage in any sexual activity that involves touching another person.
Simple as that.
And that’s not gonna fly for most people because you probably love sex and see it as a fun, playful, and connected way to develop a deeper intimacy with someone. Cool, me too.
That means you need to accept that sex is inherently risky, and there’s no guaranteed way to make it risk-free, especially in the context of hookups or when you first start sleeping with someone. So, it comes down to risk management.
The best way to mitigate risk is to get tested often, know how to talk about your sexual health status and safer sex practices, and make informed decisions about who you choose to have sex with.
But I don’t wanna talk about sexual health.
We’re scared of what we don’t have experience doing, and if you don’t practice talking about sexual health, it’ll always be scary and awkward.
If you have an STI, you might be scared that your new potential lover won’t want sex with you if you disclose it. Bringing up that you have or have had a sexually transmitted infection can be terrifying (trust me, I know).
What if your partner decides they don’t want to have sex with you anymore? What if your new crush screams in horror when you tell them you have herpes?
Both of these scenarios, while possible, are highly unlikely. And if they decide they don’t want to risk getting an STI by having sex with you, that’s their choice, and you have to respect it.
Your job is to give them all the information you have and let them make an informed and conscious decision as to whether they want to hook up with you.
And let me assure you: I’ve had this conversation countless times, and I can count on one hand the number of times a lover decided they didn’t want to risk having sex with me.
Won’t talking about sexual health ruin the mood?
You know what ruins the mood? Getting an STI and then having to talk about that STI with every new partner you have for the rest of your life (if it’s not curable and only treatable).
So, while I’m comfortable having ‘the talk,’ I don’t necessarily find it enjoyable to discuss my STI(or STIs) in detail. And while most STIs are pretty benign these days (having relatively harmless and treatable effects on the body), I don’t necessarily enjoy collecting them.
Not only won’t it ruin the mood, but being able to have ‘the talk’ is sexy as fuck and can 100% enhance the mood, not ruin it. And it shows maturity and confidence, which we could all use more of in our sex life.
No matter how serious or casual, your hookup will benefit from having a frank and open conversation about sex. You’ll bring clarity and compassion to the encounter and leave knowing that you did the right thing, no matter how scary.
And here’s another little tidbit about the state of hooking up these days: if you don’t bring it up, there’s a good chance they won’t either.
I spoke to the University of Oregon (go Ducks) students recently, and when I asked them what their experience talking about sexual health was, most said that if they don’t talk about it, they assume the other person is healthy or harmful.
And I think this is more common than on college campuses.
You are responsible for your sexual health, and no one else
If you don’t discuss sexual health with your new partner before the first hookup, that talk probably won’t happen.
It’s too bad, but it’s been my experience that if I don’t stop the action before getting naked to talk about sexual health, my new partner won’t either. Unfortunately, we don’t live in a world where this is an automatic conversation, so it’s up to you to do it.
And when you bring it up, you create a safe environment for an honest conversation about your sexual health and the sexual health of your partner to take place. That’s something to be damn proud of. Remember this: You’re 100% accountable for your sexual health. If you don’t take care of yourself, who will?
Are you willing to risk getting a sexually transmitted infection because you were too shy to talk about it? I’m not, that’s for sure.
So, what’s your sexual health status?
You can’t talk about your sexual health if you don’t know your status. It seems basic, but whatever. Here we are.
If you’re sexually active and not in a monogamous relationship (with known test results on both sides), getting screened for STIs every three to six months is a good idea. The more partners you have, the more often you should get tested.
Knowing your status is sexy and will reduce the likelihood of spreading STIs. Win-win all around if you ask me.
Make an appointment with your doctor or go online and find a local health clinic specializing in sexual health. Many clinics will test you for free or for a low fee. Planned Parenthood is also an excellent resource for quality sexual healthcare and testing. The easiest way to find a clinic is to Google “your location” + sexual health clinic.
Whatever you do, ask for every test available, especially if you haven’t been tested in a while.
By the way, a comprehensive STI panel consists of HIV, Syphilis (Rapid Plasma Reagin test), Oral Herpes (HSV-1), Genital Herpes (HSV-2), HPV, Gonorrhea, Chlamydia, Hepatitis B, and Hepatitis C.
OK, ready to talk about it?
How do I bring up my sexual health?
When the action gets hot and heavy, before either of you touches any genitals, slowly pull back and take a breath. Look your partner square in the eyes, and say,
“I don’t want to be presumptuous about what may or may not happen between us right now, but this feels like a good time to talk about our sexual health. I’ll go first.”
Note: If you’ve had oral HSV (Herpes) symptoms before, you might consider bringing it up before the first kiss because HSV can be transmitted orally. This strategy is cautious, respectful, and considerate.
Your partner might need a second to switch gears, and a look of relief might follow it. Most people want to have this conversation but struggle to bring it up.
At this point, share:
The last time you were tested
The results of that test
Any information you have
Your sexual health practices
Your recent sexual history
Talk about the last time you had an STI test and what the results were. If you have an STI, share what you know about it, the risk of transmission, and if you’re contagious.
“My last test was two months ago. The results came back negative for all STIs, though I have had warts in the past, which are a symptom of HPV. I don’t currently have any warts; I had them treated about six months ago, and I haven’t had any since.”
Share your sexual health practices, how you protect yourself, and if you’ve had unprotected sex since your last test.
“I’ve had two partners since my last test. I always use condoms for penetrative sex and rarely use barriers when performing oral sex. I had this conversation with both those partners, and as far as I know, they were both negative for STIs.
After that, offer to answer any questions, and then ask them to share their status and practices with you.
“Do you have any questions I might answer for you? If you want or need more information about HPV, I’m happy to share it. If not, would you care to share your sexual health with me, your last STI screening, and what your safer sex practices are?”
OK, now what?
How you move forward depends on what information you receive and what you want to do about it.
And how your partner moves forward depends on the information they have and what they want to do with it.
Your options for moving forward are:
Accept it and hook up
Ask for clarity and then decide
Negotiate a less risky sexual activity
Decide to pass on continuing the hookup
If everything you hear sounds groovy and you’re comfortable moving forward, have fun.
“That all sounds great to me. Where were we?”
If you receive information about your partner’s sexual health that gives you pause, you can either ask for more details at the moment or take some time to think about it.
“Thank you so much for sharing that with me. I’m not familiar with Chlamydia. Do you mind sharing what you know about it, its effects, and how contagious it is?”
Or,
“Oh, great. Thank you for the extra clarification. I’m totally comfortable with continuing to play if you are.”
Or maybe you receive information you’re uncomfortable moving forward with; if that’s the case, say so.
“Oh, thank you for the extra information. I’m not comfortable with having the kind of sex that exposes me to that right now. I’d totally be open to continuing to make out if that’s something you’d be into.”
Or,
“Oh, thank you for the extra information. I’m not sure how I feel about this right now, and I’d really love some time to think about it and do a bit of research before we continue. Are you open to doing something else for the rest of the night until I feel more comfortable and informed?”
And if these are your options for moving forward, your partner also has the same options.
The “new” way of staying safe
That’s what it takes these days to stay protected, live in clarity and honesty, and give people the information to make fully informed decisions about having sex with you.
Hoping and praying that your new partner doesn’t have an STI or takes their sexual health seriously doesn’t work anymore. You are 100% responsible for your sexual health and the sexual health of your partner.
Trust me when I say that the more you have this conversation, the easier it gets. I’ve stopped ‘the action’ to talk about my sexual health status and practices and my experiences growing up with HPV and warts more times than I can count, and my partners received me with kindness and graciousness nearly every time.
Also, most of my sexual partners breathed a sigh of relief when they realized I was taking the lead in talking about this.
Most said they felt even more connected and turned on, knowing they were about to hook up with a conscientious lover who cares about the health and pleasure of everyone involved.
Some tips for parents
If you’re like me, your parents didn’t really talk to you about the birds and the bees, and you’d like to approach this differently with your kids. Awesome.
First, you can send them this article with brief notes saying, “Hey, I thought this was interesting. Let me know if you want to talk about it.”
Secondly, you probably need to start thinking about helping them with birth control unless you’re into being a real young grandparent (nothing wrong with that). That usually means getting them scheduled to talk to a sexual health provider at Planned Parenthood, your local sexual health clinic, or your kid’s family physician.
That said, I’ve found that folks who work in a sexual health clinic are generally more knowledgeable and have a less judgmental demeanor than many doctors in the United States. Of course, your mileage may vary, but just a tip.
Talking about sex can be awkward between adults and even more awkward with your kids, but the more you do it, the better you’ll get at it.
Even saying, “Hey, if you want to talk about sex, I’m here for you,” can go a long way to letting your kid know that you’re around if they need you.
So, let’s get to it
Great info! Appreciate this discussion as someone who’s also had HPV (the asymptomatic, cancer-causing, surgery-requiring kind) in my early 20s and contracted HSV2 at the age of 30. After my HSV2 diagnosis, I was devastated - sobbed in my OBGYN’s arms and for several days after. But, 10 yrs. later, I can honestly say it’s mostly just an occasional annoyance in my life. Sure HSV2 can be uncomfortable (literally & figuratively), but it’s far from the death knell of my romantic/sexual life that I thought it would be. And I absolutely agree that having a loosely prepared “script” when initiating the STI conversation with a new partner is immensely helpful/confidence boosting.
Hi Shaun! My name is Kate, and I'm a flirting instructor/therapist/etc. in Seattle. I was reading your work and meant to reach out to you because it looks like we're doing a lot of the same stuff. I wanted to bring something to your attention from this article. It's actually not recommended to screen people for HSV if they aren't experiencing symptoms because there's a really high likelihood of false positive test responses. If a person is experiencing symptoms, like lesion or outbreak, swabbing the lesion can give a clear answer, but outside of that, any other testing is not very accurate. Here's a link for more information: https://www.cdc.gov/herpes/testing/?CDC_AAref_Val=https://www.cdc.gov/std/herpes/screening.htm. Thanks for writing this article!