351 - Safer Sex Part 1
Nothing without risks
Sexual health is an important topic that spans many more things besides simply condoms and abstinence. Sex, like everything, has risks, and the more informed we are about what they are and how to keep ourselves and everyone else healthy.
A few terms and clarifications first:
An STI is any sexually transmitted infection. Infections are a common thing in humans. STIs are just a term for certain viral, bacterial, or other infections that tend to be transmitted through the exchange of bodily fluids. Some STIs can be contracted through non-sexual situations. Similarly, it’s possible to have an infection from something like the common cold virus in your urethra that can seem like an STI.
An STI may develop into an STD (sexually transmitted disease), which happens when pathogens disrupt normal body function or damage structures in the body. Not all STIs will develop into STDs. For instance, the human papilloma virus (HPV) is an STI, and if it develops into genital warts or cervical cancer, it is then considered an STD.
Safer sex is preferred over the term safe sex, because it’s not about removing 100% of the STI risk from sex (that would be impossible). It is statistically more likely that people are 20 times more likely to die on a car trip than from contracting HIV. Instead, safer sex refers to anything we do to lower the risk of STIs, including selecting sexual activities or using barriers.
Understanding common STIs
HPV - Human Papillomavirus
The most common STI with an estimated 90% of people being infected at some point in their life.
There are no tests to determine “HPV status,” only tests to screen for related cervical cancer in cervix-possessing people over 30 or by doing a biopsy on a wart.
Many different strains, many of which have no symptoms.
Some strains have been linked to certain types of cancer.
Some strains can cause genital warts.
Symptoms may not show up for years so it can be very hard to identify its source.
There is a vaccine:
Generally only given to people under 26 but you may be able to get one up to age 45 if you talk to your doctor about it.
Only prevents a few strains of HPV, but they are the ones the cause most HPV-related cancers.
HPV rates have decreased significantly since the vaccine was introduced in 2006.
HSV - Herpes Simplex Virus
Related to chickenpox and mononucleosis, both of which are also super common and also stay in your body for the rest of your life.
Transmitted by contact, which includes kissing.
There are two strains of herpes, HSV-1 and HSV-2:
HSV-1 is most often found in oral herpes but can also be transmitted genitally.
Estimated at over 60% of the population and most never know it.
HSV-2 is genital.
Both strains often have no symptoms or may have a small number of outbreaks in life.
Symptoms involve outbreaks, which generally start as a tingling sensation around the genitals, anus, thighs, or mouth, and then lead to blisters or sores. An outbreak generally lasts 2-7 days.
While it can be transmitted even when dormant, it is much less likely to do so.
Treatments exist, which can keep outbreaks to a minimum or even eliminate them. Talk to your doctor about the pros and cons of medical treatment based on your experience.
The CDC does not recommend testing for people without symptoms because:
The rate of false positives in tests is somewhat high.
Studies have not shown that diagnoses actually increase barrier usage.
“The harm of a possible false positive test may be a greater concern than the benefits of an actual diagnosis.”
You can get tested, though, you just need to convince your doctor.
Trichomoniasis
The most common curable STI.
It is a protozoan parasite that generally infects the lower genital tract in AFAB bodies (vulva, vagina, cervix, or urethra) and the urethra in AMAB bodies.
70% of infected people have no symptoms.
Symptoms include inflammation, itching, irritation, redness, burning after urination or ejaculation, and discharge from penis or vagina.
Can be cured with antibiotics.
It may also go away on its own but will likely last much longer and might develop a more severe infection.
Scabies and Pubic Lice
Small parasitic mites that can cause irritation and infection (very similar to head lice, chiggers, and fleas in that they are an actual creature, rather than a virus, bacteria, or fungus).
Can last a long time without treatment and are contagious.
Generally easy to cure and often doesn’t even involve prescription drugs.
Syphilis
Bacterial infection.
Symptoms usually show up 10-90 days after infection.
Starts with one or more sores, which can look like many other diseases.
Very easy to test for and can be cured with antibiotics if identified.
If untreated, can lead to incredibly serious health consequences and can infect a baby in the womb.
Get tested regularly and take your full course of antibiotics if contracted.
Hepatitis
There are three types of hepatitis viruses: A, B, and C.
Affects the liver.
No sure-fire cure exists but there are treatments.
Most cases don’t cause symptoms and will resolve on their own but it can become chronic so it’s important to have your doctor monitor your liver and look into treatments.
Vaccines exist for A and B and most children in the US born after 1991 have already been vaccinated.
Hep C is usually transmitted via blood to blood contact, such as sharing needles, but it can be transmitted sexually less commonly. According to the CDC, over 90% of people with chronic Hep C can be cured with treatment.
Chlamydia & Gonorrhea
Very similar to each other in their symptoms and risks.
More than half of people don’t experience any symptoms.
Symptoms generally include discharge, pain, or a burning sensation when peeing.
Has potential to cause more serious or permanent health problems if left uncured.
Can be cured with antibiotics.
Condoms protect very well against them both.
HIV - Human Immunodeficiency Virus
For much more in-depth info, check out episode 197 about HIV/AIDS.
Virus that weakens the immune system and if left untreated can develop into AIDS (Acquired Immune Deficiency Syndrome), where the immune system is weakened to the point where severe infections, called opportunistic infections, are more and more common, eventually resulting in death if untreated.
Cannot be cured but very effective treatments exist now.
PEP and PrEP are two different pills that can help prevent but not cure:
Pre-Exposure Prophylaxis is called PrEP:
Taken by HIV-negative people who are at risk of being exposed.
Taken once daily. Can reduce risk of sexually transmitted HIV by more than 90%.
Requires prescription but in the US almost all health plans cover it 100%. Also many state and federal programs exist to help uninsured people.
Post-Exposure Prophylaxis is called PEP:
Must start taking it within 72 hours of possible HIV exposure (sooner is better).
Treatment is taken for 4 weeks.
Financial support options are available (hiv.gov is a resource for this information).
The science is clear with HIV: Undetectable = Untransmittable.
If someone with HIV follows their treatment and maintains an undetectable viral load, they cannot transmit the virus to others. Many studies have recreated these findings.
Your risk of HIV infection from someone who knows they have it and maintains an undetectable viral load is 0, while sex with someone who doesn’t know their status is a potential risk.
Knowledge is power
Some overall main points to remember:
STIs and STDs are extremely common, much like chicken pox and strep throat.
The majority of people with STIs don’t have symptoms and can pass it to others.
All STIs are treatable, meaning there is some kind of medical intervention to improve symptoms or possibly keep it under control completely.
Most STIs are even curable with antibiotics or antiviral medications.
But treatment or a cure won’t help you if you don’t know you have it, which can lead to much worse symptoms (not to mention passing it to others).
Certain STIs like HSV and HIV can have varying levels of risk based on preventative medication or presence of an outbreak. The risk of transmission is not equal all the time but you need to know you have it and learn about it in order for that to help you.
Testing for STIs
The standard STI panel given by most clinics only includes screening for 4 STIs:
Gonorrhea, Chlamydia, Syphilis, and HIV because these are ones that can be asymptomatic or easily missed but can have serious or fatal consequences if undetected.Some expanded screening tests may also include trichomoniasis and Hepatitis B & C.
Doctors generally won’t test you for herpes unless you have an active infection or you specifically tell them to (and even then you may have to convince them you can handle the info).
Any time you’re getting tests done, be sure to ask which ones they are testing for and understand what that means.
Free and low cost testing is available in most US cities through clinics.
Consider setting up a personal testing schedule to make sure you’re up to date on your health.
Talking about it with others
Fight against the stigma:
The stigma of STIs potentially causes more harm than the actual STIs do, or at least makes them more dangerous.
Don’t make STI jokes. There are other, better ways to be funny.
Don’t use “clean” to refer to a negative test result:
To say you are “clean” of STIs means you think anyone who has them is dirty.
Getting sick is part of life. We’ve all had colds, chicken pox, rashes, flus, or other infections. They don’t make us unclean.
There is no STI panel that tests “for everything,” so this is literally impossible to know.
Share your negative status when appropriate, not as a status symbol:
It supports stigma against people with STIs.
It is relevant to discuss with a partner before a sexual encounter, not on your dating profile
For many of us, if we see someone say this, it immediately makes us less likely to trust them because it signals that they don’t really understand STIs.
Sexual Health does not mean absence of infection:
Sexual health refers to many things, including mental health, awareness and access to treatment of STIs, freedom from coercion and stigma, sexual healthcare, pregnancy or birth control, and many other things.
Don’t assume anyone’s STI status:
Always talk about STIs as if someone with an STI is listening (because they probably are).
Almost everyone will have at least one in their life and the emotional impact can be more devastating than the actual infection could ever be.
Studies have shown that while most people assume polyamorous or consensually non-monogamous folks have more STIs, on average they have a lower rate of STI transmission despite having equal or more sexual partners.
This is attributed entirely to the fact that they are more likely to be more informed, talk more openly about their sexual health practices, and more likely to practice safer sex.
Those traits are not exclusive to non-monogamous people and can be adopted by anyone.
Share this information!
The only cure for STI stigma is education and increasing the number of people in the world who bother to learn about them and talk about STIs in a matter-of-fact way.
Transcript
This document may contain small transcription errors. If you find one please let us know at info@multiamory.com and we will fix it ASAP.
Jase: On this episode of The Multiamory Podcast, we're covering part one of a two part series on sexual health. Over the course of these two episodes, we're going to cover a lot of information but do it in a way that's practical, informative and maybe even fun. In this first episode, we're going to be talking about STIs, STDs and how we can have better more informed conversations that help reduce stigma and help keep us and others healthy both physically and mentally when it comes to sexual health.
Then in part two, we're going to get a little bit more personal and explore a more personal connection to sexual wellness, discussing options available for practicing safer sex, understanding what your options even are there, which is much more than just condoms or abstinence. We're also going to cover examples of how to have more effective safer sex talks with your partners as well as some tips for making those conversations easier. It's been several years since we've covered this topic and I'm really excited to take the time to do these two episodes on it.
Dedeker: Yes. Sometimes, Jase, you joke about making The Multiamory Lectionary.
Jase:
Dedeker: Like The Catholic Church follows sometimes, this cycle of the year where we know exactly what topic we're going to hit at what time of the year and sexual health does feel like one that should come back once a year. Just as good refresher
Emily: This is your annual-- Exactly. Your annual exam, your annual refresher, something along those lines.
Dedeker: Your annual Multiamory sexual health podcast. Yes, perfect.
Jase: Yes. This is also a subject that's been requested quite a bit. Specifically, requests to get into more of the specifics of like, yes it's all well and good to say you should talk about it but how do you talk about it? It's all well and good to say inform yourself, but what is some information that we should know to start out? That's the idea here is to answer those requests by doing this bigger dive into the subject.
Dedeker: Of course, we need to start out with a disclaimer that we ain't doctors, not yet anyway.
Dedeker: The information that we're covering this episode has been compiled from a lot of different medical sources. We've worked to put together the most relevant information, the most important information but of course, we did not do the original research ourselves, we're not qualified to give personalized medical advice. Our research is about availability of testing and drug approval or test approval is based on the situation in the US. It may be different in your country wherever you are.
Of course, use this as a starting point. Always ask your doctor, hopefully, find a good doctor that you trust. Do your research before making any major decisions about your health. Short of that, we're not your doctor but we can be your friend.
Emily: Yes.
Dedeker: We can be a cool friend.
Emily: We'll hold your hand.
Dedeker: It's cool to talk about sex and sex stuff.
Jase: Yes. A cool friend.
Dedeker: I feel like we just keep sounding like an after school program. lead into this.
Jase: You're right.
Emily: This is a part of sex stuff but that's the thing is that after school programs, I think in general, we try to make all of this stuff really fear-based, and we're here to move away from that to just be information-based, hopefully, and reduce some stigma around a lot of these things because I think there's stigma, there's fear, there's all of that stuff.
Jase: Misunderstanding, a lot of misinformation, assumptions.
Emily: Yes.
Dedeker: Yes. I think we like to bring ourselves this topic from a place of sex neutrality, let's say, and body neutrality.
Emily: Sure.
Jase: Yes.
Dedeker: Just really looking at the fact that all of our bodies have an ecosystem of bacteria and pathogens and when we put our bodies next to other bodies, whether that's sexually or not, sometimes those ecosystems affect each other and that's all it is. That's really all it is.
Emily: Let's start out with some terms and clarifications and the first big ones is the difference between an STD and an STI because probably, a lot of you out there hear both terms floating around in the abyss and it's like, "Wait, which one is it? Do I call this an STD? Do I call this an STI?" I think one has--
Dedeker: I'll be frank.
Emily: Yes.
Dedeker: I thought that STD was what we called it before 2011 or so-
Emily: No, truly. I agree with you, yes.
Dedeker: -and STI is what we called it since then. I thought that was really the only difference.
Emily: It felt like STD was more, I guess, like a negative term and STI is not glossing it over but making it a little bit more neatly packaged perhaps, or just nicely air packaged.
Dedeker: As it turns out, there's a much more neutral take on the difference.
Emily: Yes. Okay, here it is. Any sexually transmitted infection is an STI. Pathogens enter the body and they multiply, that just happens if you get sick in a variety of ways.
Jase: It's what an infection is, yes.
Emily: Exactly, That's an infection. It only becomes an STD if the infection becomes a disease which happens when pathogens disrupt normal body function or damage structures in the body. Just so you all out there are aware, some STIs may never develop into diseases. For example, most HPV cases go away on their own without causing health problems. For example, a pap smear, you might find an irregularity, then your doctor tells you, "Okay, six months later, let's come back and do another pap smear," then all of a sudden, it's a normal pap the next time, then it goes away. In these instances, the HPV is an STI but then, if the HPV infection develops into general warts or cervical cancer, then it is considered an STD.
Jase: Basically, just the infection is all of them and they could become a disease. All right, next one that we want to cover is the term safe sex and safer sex. It's funny because this is one of those ones where safe sex is what we talked about all the time and then like we thought happened with STD to STI, there was this thing of oh, suddenly, you can't say safe sex anymore, you have to say safer sex. What's funny to me about it is that the idea behind it is just too implied that there's no such thing as 100% safe sex, so it's safer sex. It's safer than other ways of doing sex, it's emphasizing but it's on a spectrum. What's funny to me is we used to have safe sex but now, we have safer sex. It's even more
Dedeker: Then we'll safest sex.
Jase: Exactly, yes.
Dedeker:
Emily: Which is absence, I am assuming.
Jase: I guess. Basically, the whole point of safer sex is just, any step that we might take to lower our risk of STIs and things like pregnancy. Any unwanted consequences from the sex that we're having, anything we do to reduce that risk makes it a little bit safer than it was before doing that. The point is it's on a spectrum. It's not like, if you do X, then it is safe, and if you don't, then it's not, it's all a whole bunch of different choices and that's what we're going to get into in the next episode a lot when we look at specifically what some of those choices are.
Side note here. When we talk about sex, there's such an emphasis everywhere of this whole thing of like, there is no such thing as safe sex, it's always a risk, whatever. That's absolutely true and I think that's important for people to realize. Yet at the same time, what if we treated driving a car in the same way? Every DMV in the world would have to have signs up everywhere, it's like there's no such thing as safe driving.
According to The US Center For Disease Control and Prevention and The US National Highway Traffic Safety Administration, they reported that you are 20 times more likely to die on a car trip than you are to die from being infected with HIV. We take risks every day and that's something we're going to come back to through this in the next episode a lot is that it's all about what's your level of comfort with certain types of risks and of course, being safer is always great but also, let's keep it in perspective and not do the sensational, "Sex is the most dangerous thing you can do," because it's not.
Dedeker: What if it's dangerous for your heart though, Jase?
Jase: Sure, that's fair.
Emily: For your heart? Oh, you mean from emotional level?
Dedeker: As my Christian purity culture upbringing told me, a condom can't protect your heart.
Emily: Oh, okay.
Jase: You know what though? Seeing what road rage does to people, I would say driving is also dangerous for your hear.
Emily: There you go.
Dedeker: Okay. Sure, sure, yes, yes. I guess, yes, the other thing to bear in mind is just that also, as human beings, we're really bad objectively assessing risk as well.
Jase: Yes. It's true.
Dedeker: Hence, why there's so many people that have an extreme phobia of flying versus getting in a car, when getting in a car is so much more likely to--
Jase: Way more dangerous.
Emily: Yes.
Dedeker: Yes. Okay. Let's back it up even further and zoom out even further, just what is an infection? This speaks a little bit to the ecosystem metaphor that I laid that infections are a super common thing in human beings in general. Our immune system does its best to protect us but it's also not perfect. STIs, they're just a term for any kind of viral, bacteria or other kind of infection that tend to be transmitted through the exchange of bodily fluids.
However, there are some STIs that can be contracted through non-sexual situations. Also, it's possible to get an infection from something like a common cold virus but it gets infected somewhere in your genitals, like in your urethra, that can seem like an STI because your genitals are involved but maybe it's not actually what we tend to count as an STI.
Emily: Now we're going to move on to a broader understanding of STIs in general. This is not a comprehensive list but it covers most of the STIs that people are concerned with and probably covers more than you find in most resources out there. Maybe more than you found in your high school sex ed class for example. We're not going to show you a bunch of scary pictures. Instead, we're just going to try to present these facts in a neutral fashion. Let's start out with the most common one, which is HPV. Human papillomavirus. The most common STI is HPV and an estimated 90% of people are infected with it at some point in their life.
Dedeker: I have.
Emily: Yes, I've been infected .
Jase: I have. Yes.
Emily: Yes. I just want to say initially, the first time that I had I did it, I did freak out. Jase, you were there.
Jase: Yes. I was there.
Emily: I lost my mind and I think that is just a testament to how much stigma we have about something that 90% of people literally might get in their lifetime and yet, it causes such emotional strife I think, to people, because they're just simply uninformed about it. Listen, there's no tests out there to really determine HPV status but there's only test to screen for related cervical cancer in women over 30 or by doing a biopsy on a wart.
For me, for example, both times that I had a pap smear and my Obgyn told me, "Okay, you have not a normal pap smear." I went in, I did a biopsy on the irregularities in my cervix, then six months later, both times, they went away. That was it. The biopsy was not big deal, it really wasn't and it was chill. That's what happened. There are many, many different strains of this, many of which have no symptoms. Then some strains, yes, are linked to certain types of cancer.
Jase: Yes. Then some other strains can cause genital warts, which I think, when most people think of HPV, they think of genital warts, that's the image that comes to mind. It's just the fact that it's actually a virus that usually doesn't any have symptoms at all, but might have worked. Again, like Emily said, a lot of times, just clears up on its own. It's also possible that you might have it for years and not have symptoms until several years afterward, so it's also hard to pin down. It's not like, "Oh, I got them now, therefore, it's these people's fault," it's really very hard to
Dedeker: Unfortunately, I have seen a lot of that, of people being very, very angry with someone because, "Oh, clearly, this person gave me HPV when I'm ."
Emily: You really have no idea.
Dedeker: There isn't really a definitive way to be able to prove that. Just know that.
Jase: Yes. There is no cure for it, or treatment, but it tends to be fairly harmless. The main concern is that there are some cancers that have been linked to it, so avoiding it could help decrease your risk of developing some of those cancers. Toward that, the good news is that there is a vaccine. There's a vaccine that protects against a few different strains of HPV.
Emily: I have it.
Jase: Again, there's tons of them. It protects against a few of them, and specifically, protects against the biggest ones that have been linked to both cancer and to genital warts. The ones that have some sort of adverse symptoms that are more likely to become an STD and not just an STI. It's generally only given to people under the age of 26, but you may be able to get it up to the age of 45 if you talk to your doctor about the risks and your situation and they decide that it would be okay for you to get it.
Since 2006 when they introduced that vaccine, overall, HPV rates have decreased significantly because that's how vaccines work. They help us eliminate viruses, not just knock at them but big picture, they help everybody.
Dedeker: Amen.
Jase: Okay. Then the next one that we're going to talk about is HSV. I think this confuses a lot of people because they hear HPV and they hear HSV, and they go, "It's letters with an H and a V, I don't know, or is that the same thing?"
Dedeker: HIV also gets roped in there sometimes as well.
Jase: Yes, absolutely. HPV is the Human papillomavirus, like Emily said. HSV is the herpes simplex virus, also just called herpes. I've actually noticed, for a while, there was this move where I noticed a lot of people talking about it as HSV to try and move away from the stigma that's associated with the word herpes, a bit more clinical.
Dedeker: Right, because the word herpes has now become a punchline of a joke in so many contexts.
Jase: Yes, right. Absolutely.
Emily: Just watched an Office episode where that was--
Dedeker: Oh, all the time.
Jase: Oh, yes. Constantly
Emily: Which really made me cringe.
Dedeker: Yes, still to this day, it's just constantly-- It's still a low-hanging fruit of a joke for people, and now that I have done so much more reading and had so much more I guess, experience with real living people with HSV and just how many people there are, I'm just like, "How do you do that?" Because it means that you tell that joke and it's like someone in the writers room or someone who is an actor, someone has it, right? I think it's just the epidemic of silence and shame and stigma around it. That means that we all get to believe that, "Oh, it's only a tiny fraction of people who have this bad infection, but I'm okay, so we can make jokes about it."
Jase: Yes, absolutely. What I've noticed though, in researching for this episode is that actually, I noticed a lot of sources using the word herpes, I think to try to do the opposite of instead leaning into, "Let's make awareness about this word and say it enough that it's not just this punchline." That the only time you hear this word is not in that misinformed context. Some fun facts about herpes simplex virus, one is that it's actually a pretty closely related virus to chicken pox and mono, mononucleosis-
Dedeker: Also, shingles.
Jase: -and shingles. Yes, Dedeker loves that one.
Dedeker: That's my virus of choice that's living and it's taken up residence in my body.
Jase: Yes. What's funny about this too is just that chicken pox and mono are things that a lot of us have had, I've had both of them and it's just like, yes, it's a part of life, there's not a lot of shame involved in either of those. Yet, we do put shame on this other really closely related virus that actually works in very much the same way. That's interesting. It's transmitted by contact, that includes kissing or other kinds of touch potentially. There's two different strains, and you may have heard this. There's HSV-1 and HSV-2. Some people will talk about HSV-1 is like the harmless one and HSV-2 as the bad one. Really, they're not, they're just two different stains of the same virus.
One of the main differences is that HSV-1 is more often found in oral herpes. That's something about some of these viruses, it's that they will infect a particular set of nerves in your body, it's how they work, so they'll be localized to a part of your body rather than something like chicken pox where it's all over, your body reacts all at the same time. You can get localized chicken pox or things like that but just interesting thing about it. HSV-1 is generally found in oral herpes but it can also be genital as well, it could be either of those.
Around 60% of the population have it and most never know it. Just like we were talking about with HPV, where it's just like, basically everyone has it. With this, not as much but still, 60%. That thing Emily and Dedeker, you were talking about, someone in that writer's room, someone on the cast, someone on the crew and a whole bunch of someones in your audience all have the potential to be made feel really shitty by that comment. Because there's so much shame, they're not going to speak up because then, everyone is going to think they're the awful person, but it's not, it's just like having chicken pox or mono.
HSV-2, on the other hand, is pretty much only found in genital herpes. That could also be your anus or things like that, but generally, it's only found there. People tend to associate one with one and one with the other, but they technically both could be infected in different parts of the body. Most often, both strains have no symptoms at all. Or maybe you'll have one outbreak shortly after being infected and then never have one again in your life. Or they might be recurring. Again, it's not this doom and gloom thing all of the time. The symptoms of it includes an outbreak, which starts like a tingling sensation around the area, whether that's your lips or genitals or maybe your thighs even. Then they can lead to little sores or blisters, and lasts generally two to seven days when you have an outbreak. When you're having an outbreak, you're more likely to spread it. It can spread even if you're not having an outbreak but it's a lot less likely.
Dedeker: I feel the need to jump in just for a couple of things. We didn't do a deep dive on this in particular in this episode, but there's a lot of resources out there that explained the link between HSV not being really a big deal until it became a point of pain for marketing.
Emily: Oh, geez. Yes.
Jase: I think we talked about that a few years ago.
Emily: Probably, yes.
Dedeker: Yes, until there was actually a company trying to develop a treatment for it, then they had to market it to be this terrible thing that you don't want to have. This terrible, awful, dirty, filthy-
Jase: This shameful thing, yes.
Dedeker: -shameful thing so that we can sell you the cure. Basically, we picked that up and ran with that and have been unfortunately, suffering from the stigma ever since. There's a lot of really good podcasts and blogs out there who talk about that history, so definitely Google that. I also just wanted to say, speaking from personal experience of now having been in a relationship for several years with someone who has HSV-2, it's to the point where-- to be totally frank, I sometimes completely forget. There's a lot of people in our audience who are very out and proud about their HSV status and are very comfortable with this, and other people who are not and this is totally new.
I think that's the thing I often try to drive home for people is that this is-- Of all the infections in the world you could be getting, this is one of the most manageable and livable with that you could get, which is the polar opposite of how it's often pitched to us. It is pitched to us as your dating life is over, your sex life is over, your romantic relationships are always going to be affected. That's not true.
Jase: I've also found-- I've dated several different people with HSV-1 or 2 and all of them have been very conscientious about it too. They're like, "I know what it feels like if I'm going to have an outbreak, then I take medication to make that go away but just, we won't do stuff during that time." It's just being responsible about it. I've just had nothing but good experiences with people, as long as they know that, they've done their research and they've learned about it. I know that's emotionally hard and we've talked about that too. It's hard to accept that fact. We'll talk about this a little bit later with testing as well.
Emily: Yes. Speaking of all that, just treatments out there do exist and they can keep the outbreaks to a minimum or even eliminate them. You can talk to your doctor about the pros and cons of medical treatment based on your experience. The CDC does not recommend testing for people without symptoms, because there's a really high rate of false positives in tests. Also, studies have not shown that diagnosis increase barrier usage. It doesn't really matter whether or not you're diagnosed or not, it doesn't necessarily increase usage of condoms, for example.
They say the harm of a possible false positive test may be a greater concern than the benefits of an actual diagnosis. That's really interesting. You can get tested if you want to, you just need to convince your doctor of that.
Jase: Your doctor will probably fight you on it.
Emily: He'll be like, no.
Jase: He'll probably try to convince you not to get tested for it.
Dedeker: Based on these statistics, I can understand the doctor's perspective, which the doctor probably has to deal with a lot of people having freak-outs about being diagnosed with HSV when the doctor knows that maybe it's not as big of a deal. They maybe would prefer to just not have to deal with that. I'm like, that's fair, that makes sense but also, I think our party stance on the show tends to be more of, you should probably know rather than just not know and we recommend you doing your best to be polite yet assertive with your doctor when getting tested.
Jase: Right. In my experience, if you can whip out some of this information on your doctor, they're going to be more likely to give you the test because they understand that you get it. If you come in going, "I know that I probably have at least one of them, I would just like to know because that's important to me, but I get that it's super common." That will help convince them. I had to do that to convince my doctor to give me the test and he just kept being like, "I don't know. I just--" Then finally, he's like, "All right, fine. We'll give you the test but what you do with it is up to you."
I found out that I did have antibodies for HSV-1. I've never had any symptoms that I know of, so I don't know where that infection might be but did have those antibodies, so I'm one of that 60% who has HSV-1 and never knew about it until I had my doctor test me. Once we got the test results back, he was like, "Okay, you have antibodies for HSV-1. It's not acute, you weren't just infected or anything but you've had it at some point in your life and it's in your body and you don't have HSV-2 yet."
Emily: There you go.
Jase: He had a sense of humor but
Dedeker: Yes. It's fair. Moving on to trichomoniasis. Trich is the most common curable STI. This is a little protozoa. It's a little parasite. It's just another little animal in the ecosystem.
Emily: Crawling around.
Dedeker: Crawling around just trying to survive. It just wants to survive and have a good time. It doesn't want to suffer, like all of us, right?
I'm trying to generate some compassion for the protozoa, yes.
Jase: Okay. Some compassion. Right.
Emily: Some compassion for the little guy crawling around.
Dedeker: At the end of the day, it's just trying to survive also. That's what all these viruses are doing.
Emily: Yes. Like a Coronavirus or whatever.
Dedeker: It's doing the same rat race that all of us are doing.
Emily: Indeed.
Dedeker: This sweet little parasite generally infects the genital tract in women, the urethra in men. 70% of people infected have no symptoms but if you do have symptoms, that can include some inflammation, itching, redness, discharge. Generally, it can't be cured with antibiotics. This is another one that may also go away on its own, but it's likely that it could last a lot longer, it might develop into a more severe infection so it's good to get that checked out because we do care about the good sweet little protozoa, but maybe it would be better served elsewhere.
Jase: There's no catch and release program for curing that.
Emily: No, it's on a daddy-longlegs.
Dedeker: Yes, maybe trying to anthropomorphize this protozoa right at the top. What's a daddy-longlegs, Emily?
Emily: That I gently grab and then--
Dedeker: Grab out of your vulva.
Emily: Yes.
Jase: Just put it outside in the garden, ?
Emily: Exactly.
Dedeker: No, no, no. Go home. Go to your home.
Emily: I'll do that with a bug or a spider in the house, but perhaps, not with this particular STI. Speaking of other creatures, scabies and pubic lice, that's another fun one. These are small parasitic mites that can cause irritation and infection. They're very similar to head lice, which I have had many times when I was a youth, and then chiggers and fleas and they are an actual creature rather than a virus, bacteria or fungus. They can last a long time without treatment. They are contagious and they are generally easy to cure and often doesn't even involve prescription drugs.
Jase: Yes. A lot of times your doctor will just tell you-- They might prescribe it to you, but it's something you could also get.
Emily: Like the lice medication or the lice comb?
Jase: There's specific ones made for this.
Emily: Got it.
Jase: Yes, it's another one of those ones that's just so easy to treat but you've got to get tested to know so you can get it taken care of.
Dedeker: I never had a lice situation growing up.
Emily: Wow. I did.
Dedeker: I had a tick situation because I grew up in the woods, running around in the woods like a feral child.
Jase: For me, when I was in summer day camps in Iowa, it was always like you'd come home from your field trip or whatever-
Dedeker: With lice.
Jase: -forests or the fields of grain or whatever, and you'd come back, your parents would have to check you for-
Emily: de-lice you.
Jase: -ticks and chiggers specifically. You'd have to go around.
Emily: What's a chigger? It's like--
Dedeker: I was going to search for it then I was like, nope.
Jase: They're little creatures like lice that bite you but the bite will get red and painful. I think they're like lice in that they can stay stuck on you and you've got to carefully remove them so they don't get you infected, or whatever.
Emily: The lice down the hair follicle.
Dedeker: Like ticks.
Jase: Like ticks. I'm sorry. Yes, like a tick
Dedeker: Okay. I will say. I am trying really hard to offer compassion for these living creatures that also want to live and not die and not suffer.
Emily: No, they can go
Dedeker: Also, I'm a little heebie-jeebied--
Emily: scorpions.
Dedeker: Just a little bit heebie-jeebied by the bugs. I'm trying to hold both of those things in my heart at once, the compassion and the heebie-jeebies.
Jase: I feel that way every time there's a spider in the house, and I try to capture it and take it outside so I don't kill it but I'm very freaked out and upset at the same time. I understand all good freak-outs.
Emily: Thank you for not killing them.
Jase: Yes. Moving on to syphilis. If you lived in Shakespeare's time, this was the butt of the joke like herpes is in our time. Syphilis was his one to make fun of people about at the time.
Emily: Syphilis could definitely kill you back then, right?
Jase: Yes.
Dedeker: Well, so could a lot of things. For a lot of infections.
Emily: I suppose you're right.
Jase: Syphilis, compared to these other ones that we've been talking about, which are viruses or low creatures, this one's a bacteria. The symptoms might show up 10 to 90 days after infection. It could be one or more little sores or something like that, which you might think is something else. You might be like, "Oh, is this herpes, is this genital warts? I don't know. There's these things, I can't tell what it is." It's super easy to test for and we've very well established our testing for syphilis. It's one of the standard pack of tests when you go for your physical, if they do any kind of STI panel, this one's on it because it's not treated, can be really serious.
This leads to neurological problems and can even lead to death. It's also very easy to cure with antibiotics. That's why it's one of those ones they test for because after that initial outbreak, it goes dormant for a while and you might not know. Which is again, why it's important to get tested for things regularly even if you're not seeing symptoms because it's easier to fix it earlier than later.
Dedeker: Now, moving on to hepatitis. There's three types of hepatitis virus. There's A, B, and C. Most of them affect the liver. There's no surefire cure that exists but there are treatments. Both my parents had hepatitis C so I saw them through this.
Emily: So did mine. So did my dad's doctors so he got it from that.
Dedeker: Most cases don't cause symptoms and they will resolve on their own but it can become chronic so it is important to have your doctor monitor your liver, look into treatments. There are vaccines for A and B. Most children in the US that were born after '91 probably have already been vaccinated. Then Hepatitis C is usually transmitted via blood-to-blood contact but it also can be transmitted sexually, although that is less common. According to the CDC, over 90% of people with chronic Hep C can be cured with treatment.
Emily: Chlamydia and gonorrhea. They're very, very similar to each other in their symptoms and their risks. More than half of people don't experience any symptoms at all but if you do experience symptoms, then they're generally discharge, pain, burning sensation with peeing, stuff like that. It has the potential to cause more serious or permanent health problems if left uncured or untreated but it can be cured totally with antibiotics, and condoms protect very well against both of them.
Jase: Yes. Then the last one to talk about in this episode is HIV. We mentioned that earlier, the ones that start with H and end with the V. We’ve got HPV, Human papillomavirus, we have HSV which is the Herpes simplex virus, then HIV, which is the Human Immunodeficiency Virus. For more information about this, we actually did an episode. 197 was totally dedicated to learning about HIV and AIDS, which is related to it. What this is, is it's a virus that weakens the immune system and if left untreated, develops into AIDS. AIDS stands for Acquired Immune Deficiency Syndrome, where the immune system gets weakened to the point where it's very easy to get sick with things.
Things like a common cold could become this devastating or potentially even a deadly disease. That's if it gets all the way to that point. That's where death comes from. You don't actually die from it but from these opportunistic infections. However, today, we have really, really good treatments. There's a lot of treatments out there. If you have HIV, and you take your medication regularly, and you're monitoring your levels, you can get them to the level as if it's not there at all. That’s something we're going to talk about a little more in just a second here. Another thing to know is that there are two different preventative measures besides using condoms, not sharing needles, things like that.
There's two different medical prophylactics. There's PEP and PrEP. PEP stands for Post-exposure Prophylaxis. This means after you think you may have been exposed to HIV, you start taking PEP and it will keep the virus from multiplying and taking hold but you have to catch it early. You need to start it within 72 hours after possibly being infected. Sooner is better. Then you continue taking it for four weeks is the whole course for that.
The other one is PrEP, which is Pre-exposure Prophylaxis instead of Post-exposure. This is one that if you are HIV negative, it’s a pill that you can take daily that will reduce the risk of potentially being infected by HIV. Reduces your risk by more than 90%. It does require a prescription but almost all health plans in the US cover it 100%. Also, many state and federal programs exist to help uninsured or underinsured people get access to it.
These are two great resources if you are potentially in a higher-risk group. Specifically, men who have sex with men, their doctor will be more likely to advise taking PrEP, especially if they're riskier in their sexual health practices. That's something again, that you can talk to your doctor and evaluate that. Now to go back to the treatment part of it, if you have HIV and you know it, and you take your treatment and you maintain that, they refer to how much of the virus is in your body as your viral load.
If you're taking the treatment regularly, you can get your viral load down to where it's undetectable. You could take a test and it won't show any of that virus in your system if you're taking this treatment regularly. There have been tons of studies now that have shown if you can get your viral load to that undetectable level, it is also untransmittable. They have literally never ever found a case of someone who's gotten their load to that undetectable who has transmitted HIV to anyone else.
Like we had that lightbulb moment in episode 197, having sex with someone with HIV who's taking treatment and knows that their viral load is undetected, you have a 0% risk. With anyone else, it's who knows? Because they might not know, they might have it and not know regardless of what protection. Again, with the whole stigma thing of like, "Ooh, you can't ever have sex with someone in that situation," it's like, "No. Actually, in a way that might be your safest." Just really turns that on your head.
Dedeker: I think with all of these, when you're navigating those early days of figuring out if you're going to have sex with someone, talking about sexual health, talking about sexual history, it is that weird thing that someone who's upfront with you like, "I have this ongoing infection," or "I had this ongoing infection," or "I'm sleeping with someone who has this particular type of STI and this is how I manage or they manage it," or things like that, versus not having that conversation whatsoever with somebody, it is the weird thing that yes, you're probably in safer hands with someone who's aware of their own health and are aware of the whole ecosystem that they're interacting with, not just their bodies, but the bodies of other people that they're sleeping with who has that in their mind, and they're very proactive and mindful about the ways that they deal with that.
You're probably just in better hands more likely than someone who doesn't think about those things or doesn't talk about those things or just isn't aware of those things or is too ashamed to talk about them.
Jase: Doesn’t think they need to care about them.
All: Yes.
Jase: All That.
Emily: No, you do.
Dedeker: You do. As it turns out, you do.
Jase: Now we're going to talk a little bit more about the importance of this knowledge and what we can do to change these conversations within our communities at large to help reduce that stigma and allow people to have more effective, more informed conversations about this kind of stuff. Before we do that, we're going to take a quick break to talk about our sponsors for this show, which really, really go a long way to helping us bring you this information every week for free. Please take a moment, check them out, and we will see you after the break.
Emily: Welcome back everyone. As Jase and Dedeker were talking about before the break, something to think about with all of this is that knowledge is power. This is our little reading rainbow segment right here.
Jase:
Dedeker: More after school, more and more.
Emily: Oh, that’s right, yes.
Dedeker: Just keep on.
Emily: The more you know, exactly.
Jase: Knowing is half the battle. That was the .
Dedeker: Exactly.
Emily: There you go. Yes. This is awesome. No, absolutely. I think there's so much stigma out there and so much fear around all of this that just people think to themselves like, "I don't want to know because that's going to be easier for me than going and getting tested, facing that reality and then making an action plan as to what to do next with my doctor." Just so everyone is aware and we talked about this multiple times throughout the episode, STIs are super-duper normal much like chicken pox or strep throat or that sinus infection that I had a couple weeks ago-
Jase:
Emily: -all of that, it happens. Most people will acquire at least one strain of HPV in their lifetime. If you're like me, you had at least two. 50% to 90% of people carry a strain of herpes and 1.5 million cases of chlamydia are in the US every single year. The majority of people with STIs, they don't have symptoms, they can pass it to others but all STIs are treatable, meaning there is some kind of medical intervention to improve symptoms or possibly keep it under control completely.
Jase: Yes. I want to reiterate that, that all the STIs we talked about are treatable in one way or another. Not knowing doesn't help you at all because you're not going to get treated if you don't know. Then, most STIs are even curable. We talked about that a lot as well, with antibiotics or antiviral medications or other sorts of topical creams or whatever, a lot of them can be cured completely. The ones that can't, can be treated. If you don't know you have it, you're not going to get any of that and it could end up much worse. It's just so much easier to find out, to just get tested and know.
I know that this is something that I struggled with a lot in the past of like, "Okay, I know that I need to get tested because I'm told that's what I should do, but I only see downsides when I think about it." Because it's like, "Well, I get tested and I find out I have something, then my sex life is over. I guess I get some kind of treatment but it's just terrible, it's a life sentence and I'm doomed." I think a lot of people still feel that way about it.
It's like, "Oh, I know I should get tested but I don't have any reason to want to." I hope that what we're able to impress here is, the reason why you'd want to is because they all have treatments, and a lot of them have cures but you've got to know before you can get those things.
Dedeker: Let’s spend a little bit of time talking about testing because I think it is very easy to just say, "Oh, just go get tested. Easy." It's not always easy and it's not always super accessible. You should know that there is a standard STI panel that's given by most clinics. It only includes screening four STIs. For gonorrhea, chlamydia, syphilis, and HIV, because these are the ones that they can be asymptomatic, they can be easily missed, and if they are missed they can have really serious consequences if they're undetected or if they're untreated. This is something that no one ever, ever told me growing up.
Jase: Yes, me neither.
Dedeker: It was always like a statement, "Go get tested for STIs." That's it. "Just go get tested." You go to the doctor and you're like, "I want to get tested for STIs," and they're like, "Great, we'll test you for STIs." You just think like-
Emily:
Dedeker: "Cool all the STIs, great."
Jase: Right.
Dedeker: That's the standard panel. Of course, anytime you're getting a test, ask what's in it, ask what you're going to be testing for. Ask if there's particular things that you want to get tested for and make a request of your doctor. There are some expanded screening tests that may include Trichomoniasis testing for Hepatitis B and C. Again, like we said, a lot of doctors won't test you for HSV unless you have an active infection or if you tell them that you know that you just had contact with somebody who has an active infection. If you don't have a compelling reason, you just may have to convince them that you can handle the information.
A trick that I like to use that may not work for everybody but has worked for me in the past, if a doctor is turning down a test, I will ask my doctor to make a note of that in my chart, that I asked me to test on this date and they said no. Often, that's just convincing enough, especially in the US where so many doctors are just trying to cover their own asses, that they'll be like, "Okay, whatever. Fine. Sure."
Jase: Yes, that’s a good strategy too.
Dedeker: Again, just do what you can to keep yourself informed, figure out how the tests are being done, what exactly it is, and understanding what the results mean as well. There's fortunately, in a lot of major US cities, access to free and low-cost testing. Just do a search online, a bunch of resources will come up. There's of course, a whole new market of at-home testing that is becoming more and more popular, where you can order tests to be sent to your home.
Of course, you still want to make sure that if you get a result that's confusing or something that you don't quite understand, that you have access to an expert or access to a doctor who can help clarify those things for you. Now, I get asked a lot by listeners of the show and by clients sometimes, "What kind of testing schedule do you go on? Is it before every single new sex partner? Is it afterwards? What if I don't have sex partners, is okay if I go 10 years without getting a test, things like that?"
Generally, for myself, I tend to go for testing after new sexual partners. Now, I've not had any new sexual partners in a while now. For me, that it tends to default to just in case, getting a test usually about every six months or so. Some people make a practice out of every three months or so, depending on what's going on in their lives.
Jase: I think ultimately, it comes down to a lot of factors. How much of a risk do you think you're at for different ones, how concerned are you, what does your insurance cover or how much access to the tests do you have or what can you afford? There's a lot of factors that go into it. I do think that that idea of just setting up a regular schedule, whether that's every six months, every three months, just makes a lot of sense because then, there's less of this.
We've talked about this before but there can be this weaponizing of STI tests as a way of limiting other non-primary relationships or complicating things, especially if you're in multi-partner relationships where your network, your web from there is very big. I think we're a little bit lying to ourselves if we think we can just control it with, "Well, this person has to get tested before this type of interaction or whatever." I would actually argue for have everyone in your network, if they're able to, get tested every three months, for example.
Might actually be a more sustainable and effective way than closely manage specific test results before sex with certain partners. It can just get really complicated at scale. That’s just my opinion though. I know a lot of people have other solutions that work for them.
Emily: We've discussed this a lot on the show but undoing personal bias or learned behaviors or internalized fear over a variety of subjects, including this one, it can be challenging. We're going to get into about how to talk about it, how to discuss these types of things with your potential partners, with partners that you already have, just like, out there in the blue in general, how to get less fearful about these types of things. Maybe change the narrative about it in your head.
The first one, we've talked about this a lot throughout the entire episode, but fight stigma, do it. Potentially the stigma of STIs actually causes more harm than the actual STI itself does. Or at least, it can make them more dangerous. It could make them sound more scary at the very least.
Jase: It makes us not talk about it.
Emily: That's true, yes.
Jase: It makes us not get tested and isolate us from support if we have them. It's like, overall, the stigma is not helping anyone.
Emily: No.
Jase: Maybe some people would think, "Oh, shaming people is going to keep them from having riskier sex," but it doesn't. That's just not how it works and stigma is only hurting everyone.
Emily: Also, along with stigma, don't make an STI a joke. Just don't do it. There are other better ways to be funny than talking about somebody's herpes or something. It's just a shitty thing to do so don't do it. Okay?
Jase: We're talking to you, TV writers. Listen up.
Emily: Yes, exactly.
Jase: We know you all listen to our podcast.
Emily: Like in The Office, Jesus.
Dedeker:
Jase: Do better.
Emily: Yes. Also, don't use the word "clean" to refer to a negative test result. I think this still is a thing out there a lot. How do you know that the person that you're sleeping with is clean or whatever? You hear people saying things like that.
Jase: Or you'll see people put like, "Tested and clean" on the profile or something like that.
Emily: Totally. Saying that word, saying that you're clean of STIs, it makes you think about anyone who might be STI positive as dirty. If somebody has an STI, then all of a sudden they become dirty, which is a shitty thing to think of, a shitty thing to say. Getting sick is a part of life. It is. We all get sick. Like I said, I had a really shitting cold a couple of weeks ago and it happens. It sucks but it does. It happens. We have colds, chickenpox, rashes, flu, other infections, they don't make us unclean.
There's no STI panel out there that tests for absolutely everything, so it's literally impossible to know whether or not you have an STI or not at any given time. Also, share your negative status when it's appropriate, maybe with a potential partner, maybe don't like flaunt it all over the place on your dating profile. It's not a freaking status symbol. Okay?
If you see that out there like, "I have a negative status" on some of this dating profile, it might make somebody who looks at your dating profile less likely to trust you because it signals that you probably don't even really understand STIs, understand how they work, understand all the things that we discussed today.
Jase: 100%. If I ever see someone use the word "clean", or "STI-free", or something like that, I'm just like, "Ooh, this is a dangerous, risky person because they don't get it. They don't actually know how this works."
Emily: They're perpetuating that stigma.
Jase: They're perpetuating the stigma, which makes me sad. Then also, I would bet that someone who talks that way and thinks that way is also going to then be less were of safer sex, less careful, less informed, they’re just perpetuating this misinformation. While they might think it makes them a more attractive partner, I would actually argue it makes them less attractive. If you have that on your dating profile, don’t worry, you didn’t know until you listened to this episode but just go right now and just delete that, just get rid of it. It's relevant when it's relevant, and not before that.
Another thing that we wanted to talk about is sometimes when people talk about sexual health, they assume that being sexually healthy means not having infection. That's not the case. Sexual health is not just an absence of infection. It refers to this whole host of things which includes mental health around sex, awareness and access to treatment and testing for STIs. Not the absence of them, but awareness and access to treatment for them. Freedom from coercion and stigma when it comes to your sexual identity and your sexual activity, access to sexual health care, pregnancy care, birth control, all those sorts of things, that sexual health is this much bigger thing than just that. Be sure that you're aware of that when you're having those conversations.
Another thing that can come up is, just don't assume anyone else's STI status. Emily, we mentioned this earlier with the writers of The Office not realizing that probably, people in their writer's room even, of 10 people, probably up 60% of those have one or the other strain of herpes. One really good principle to keep in mind is, just always assume, anytime with anybody that you're talking with, that someone with an STI is listening because based on the stats we've talked about today, they probably are. If they are, and you make a joke, or say something disparaging about it, they will never tell you that fact and you will never know that you hurt this person, made them feel uncomfortable.
Maybe lost a friend, maybe lost a business relationship, maybe had a worse relationship with a co-worker, all these things that could have happened, just because you assumed, "Oh, anyone who works here or who I'm friends with must not have any STIs." It's not the case.
Dedeker: There are some studies that have shown that most people assume that a polyamorous person or consensual non-monogamous person is going to have more STIs. The reality is that on average, this community tends to have a lower rate of STI transmission despite having equal or more sexual partners compared to the average monogamous person. This is attributed entirely to the fact that they're more likely to be informed, talk more openly about their sexual health practices, and also, more likely to practice safer sex. Of course, these are traits that are not exclusive to non-monogamous people. These are traits that can be adopted by anyone.
I do think that is a little bit part of the "polyamory PR" work that often has to be done is that everyone assumes that we're just a bunch of sex-addicted maniacs, just going fast and loose-
Jase: We're irresponsible and don't walk our dogs.
Emily: -with our genitals everywhere. We don't walk our dogs. We don't take our vitamins.
Dedeker: Fast and lose genitals-
Dedeker: We don't get our taxes all the time.
Emily: -waving them around.
Dedeker: When the reality is that this is a group of people who are more likely to be clued into healthy ways of talking about these things. Ideally, even more accepting. I know just to speak, anecdotally, from my personal experience and especially seeing the conversations that take place, for instance, in our own Patreon community, so many people who are just really well-informed about the science, about the fact, very compassionate, very non-judgmental, and also, very intelligent and creative when it comes to managing and communicating, talking about sexual health and talking about STI status and things like that. We're the best, is just what I'm saying.
Jase: Long story short, we're great.
Dedeker: Last but not least, share this information and share information like this. Really, the only cure for STI stigma is education and increasing the number of people in the world who even bother to learn about this stuff and talk about STIs in a matter-of-fact way. What that looks like is, it could be you talking openly with a close friend about your own STI status, whatever that may be, and talking about it in a very matter-of-fact way or even just talking about getting tested in a very matter-of-fact way. Or it could be calling someone out who just made a herpes joke. Something like that. There are very, very, in my opinion, easy, accessible, day-to-day approaches that we can take to help reduce stigma.
Jase: Just this episode, I think is also a good gateway for that. If you don't trust this friend to not try to shame you in front of other people or you feel like that's too much of a risk or too scary, you could also bring it up in a much more neutral way by like, "Oh my gosh, I just listened to the most interesting episode of this amazing podcast with three super cool hosts, where they talked about all this information. I had no idea. This was so cool, you should check it out." Or maybe just tell them some of the information or whatever, just start getting more of that matter-of-fact information out there. You can do it even in a way that doesn't put yourself at any risk of social fallout or something like that.
This is the end of part one of this two-part series. In part two, we're going to be talking about different ways of practicing safer sex, what some of those options are, how those work, then we're going to get into some examples of how to actually have those conversations. It can be hard and awkward to actually have that conversation. We're going to go over some ways to actually do that, how to make those conversations easier, as well as looking at some possible scenarios of how you might decide to manage your amount of risk in terms of your sex life.
For our bonus, for this week, we're going to be talking about talking to your doctor about STI testing. We're going to get into some more specifics about that like we mentioned in the episode today. We want to hear from you. What is the most important thing that you have learned about STIs and STDs? It could have been something in this episode. Maybe it's something you learned before, but we're interested to hear that and we're posting that question on our Instagram stories. Go there to check that out. Also, if you want to talk about this episode some more, the best place to share your thoughts with other listeners is on this episode's discussion thread in our private Facebook group or Discord chat.
You can get access to these groups and join our exclusive community by going to patreon.com/multiamory. In addition, you can share publicly on Twitter, Facebook, or Instagram. Multiamory is created and produced by Emily Matlack, Dedeker Winston and me, Jase Lindgren. Our episodes are edited by Mauricio Balvanera. Our research for this episode was by Em Mais. Our social media wizard is Will McMillan. Our production assistants are Rachel Shenork and Carson Collins. Our theme song is Forms I Know I Did by Josh & Anand from the Fractal Cave EP. The full transcript is available on this episode's page on multiamory.com