Living with STI’s

Understanding and analyzing your own risk should lead to the knowledge base needed to empower you and your assets.

Health Sexual Health Dr. Evan Goldstein

It’s not if—it’s when. All of us will not only encounter sexually transmitted infections (STI’s), but also, unfortunately, contract some as well. While STI’s are undoubtedly undesirable and harmful to one’s mind, body, and spirit, society tends to lean toward the notion that an STI means the end of one’s sex life as you know it.  While lifestyle alterations do need to be made, in the case of STI contraction, educating oneself on not only preventative approaches, but also the most up to date chronic treatment regimens, allows one’s day-to-day sex life and/or long-term relationships to still carry on without jeopardizing you or your partner’s wellness. So pay attention.

Living with STI’s

First off, understanding and analyzing your own risk should lead to the knowledge base needed to empower you and your assets. Make sure you hold your physicians accountable—that they are performing annual evaluations, if not more frequently (depending on your sexual habits), with serial testing that encompasses blood work, urine screening, and anal and oral swabs for all STIs each time. Yes, we can test for HPV. Yes, for herpes, Syphilis, and the like. You name it—we have the tools for assessment. And remember: many of these diseases can go unnoticed, so regular screenings are paramount in receiving quality healthcare for your own and the community’s betterment. It’s one thing for you to test positive, but another to be diagnosed a carrier, and not attempt to mitigate or minimize the situation, especially since it affects us all.

So what happens after you’ve been diagnosed? Treatments can consist of oral and/or topical medications, surgical treatments, vaccinations, and intramuscular antibiotics, to name a few. But take the time to do research on the topic at hand. The Centers for Disease Control should be the go-to for all information pertaining to your new diagnosis. The questions that should be inherently analyzed focus on its immediate treatment for eradication and/or if a chronic carrier state is noted, the best course of action to prevent recurrence and transference to others.

This article focuses on the specifics of living with chronic STI’s, but I do think it’s worth highlighting one STI, as an example, for how I would approach the new diagnosis.

Human Papilloma Virus (HPV) is the most prevalent sexually transmitted infection in the U.S., with up to 14 million people infected yearly. Most people get exposed at some point in their lives yet are not even aware of it. This occurs through skin to skin contact—like licking, rubbing, and anal—and even though condoms may mitigate contraction, it’s not without failure. Most go unnoticed as being a chronic carrier, since no true physical signs develop. Some do indeed get anal warts and/or cancerous changes, with bleeding, itching, and localized irritation being some of the symptoms that call for a physician visit. From there, swabs are taken to confirm which subtypes of HPV one potentially harbors, and a full internal and external evaluation should be done, utilizing a microscope for appropriate high-level diagnostics. This should be extended to all your sexual partners as well, since it does have the propensity to have a “ping-pong effect” and not nipping this in the bud, across all parties, can lead to a prolonged course of treatment without full eradication. And don’t be surprised when the “Trust me—I’m a total top” guy has the disease internally. Don’t assume, my dear. You know the drill.

During this, one should be instructed on the advances of the HPV vaccine, Gardisil, and how it may decrease one’s recurrence of sequelae from that specific subtype or minimizing contraction of others when engaging. It allows one’s body to create an immune response as a defense against recurrence and the possibility of cancer development. Also, having partners get the vaccine may also prove worthy of decreasing transmission and/or symptom development. Once treatment has been completed, serial follow-up is critical. In the immediate period following infection, standard evaluation should occur every one-to-three months (depending on the extent of disease burden) for continued surveillance. Then, over time, this can be reduced to only once a year.

The HPV diagnosis is not a blame game and should be taken quite seriously. Its narrative plays to most STIs in terms of confirming the diagnosis, undergoing treatment if necessary for you and all of your partners, and then a reconvening of the minds on its chronic sequelae and the mitigation or chronic eradication plan. Coming at this with a “it’s gonna happen” in your mind will allow you to move quickly through all these steps, while being nonjudgmental of the occurrence. Having this knowledge allows one to truly press on sexually with a better understanding of their own, their partners, and the community’s risk at large.

What can you do.

Like all things sex related, communication is key. But you cannot communicate effectively without the proper knowledge on the subject matter at hand—or in the ass. Use key resources to assist in gathering information, call on your physicians to take more responsibilities on preventative measures and treatment algorithms, and through risk assessment on you and your partners’ exposures, come up with an appropriate testing schedule on all things related to your sex life. Keeping all partners aware of your situation as well as educating them on proper protocol to prevent contraction is vital to you, your partner’s, and our community’s wellbeing. All STIs should follow the same approach with minor alterations in treatments to effectively eradicate or minimize harmful effects.

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