By Laura McGuire
Greetings queers and allies! It’s time for your monthly dose of comprehensive sex education from me, Dr. Laura McGuire. So let’s talk about sex, baby—safe sex, that is. October may be a month filled with spooks and scares, but one of those scares doesn’t have to be from an STI. This month, we received the following question:
I know I’m supposed to get tested for STIs regularly and, while I do get tested at my annual well woman’s exam, I feel like maybe that’s not enough? I’m not in a monogamous relationship right now, sometimes have casual sex, and when [I do], it’s with other women and isn’t always “protected” sex. How often should I be getting tested for STIs? Also, I’ve never been tested outside of my annual exam. Are there free STI testing centers I can find?
Oh STIs, the bane of so many people’s experience going to the doctor! Asking for an STI test is something that can feel shameful, especially if you need to get tested a couple of times a year. About a year ago, I went to my family doctor because I was between sexual partners and wanted to get up to date on my testing. The doctor advised me that I shouldn’t be getting tested too often because I shouldn’t be having that many sexual partners. I told her my current partner had HPV, and she immediately responded to use a condom. When I explained my partner was a woman, her face went white. Fortunately, I’m a point in my life where I comfortably identify as both a queer and a slut, so I could laugh off her discomfort. What makes me furious, however, is that so many of my students and clients are going to similar types of healthcare providers and receiving misinformation about or being shamed for their sexual choices. This type of incompetent feedback can turn people off to seeking care in the long term. Please, please, please continue to fight to find a good healthcare provider who will support your needs and identity—whether you’re celibate, a sex worker, or fall somewhere in between.
First, let’s discuss your well woman exam. These visits usually include a pap smear where a doctor or nurse scrapes a few cells off the cervix (the end of the vaginal canal and beginning of the uterus). You can actually feel your cervix if you want—simply put two fingers inside your vagina, at least as deep as your second knuckle. Your cervix feels similar to the tip of your nose with a dimple in the center. The scrape taken by the doctor allows them to look for any changes that might indicate an HPV infection, which could be the starting sign of cervical cancer. Other than looking for pre-cancerous/cancerous cells, a pap smear tests for no other STIs. For real. So unless you specifically ask for a culture and blood test to specifically test for STIs, your well woman exam won’t cut it. This is a super common misconception, so I’m glad you brought it up—not enough doctors properly explain this.
So how often should you get tested? Many STIs can have few or no symptoms for months (or even years), so don’t make your decision based off of symptoms (or the lack thereof) alone. If you are a serial-monogamist like me, I suggest getting tested in between new partners. If you are polyamorous or having casual sex, I recommend every three months and using protection (including dental dams) as much as possible. It can take a few weeks to months after sexual contact for certain STIs to show up in blood tests, so getting tested every three months should give you a consistent picture of your sexual health. Some healthcare providers may suggest getting tested every month (especially if you’re having very high-risk sex such as unprotected anal sex), while others say every six months is fine (if you’re having very low-risk sex such as manual vaginal sex). Therefore, every three months is a good rule of thumb.
The only free testing that is widely available is for HIV, which is great, but you need to get tested for more than that. Every medical office tests for different STIs, so make sure to ask what tests they will be running and discuss any additional tests you may need. Planned Parenthood is an amazing place to get regular, shame-free testing. I’d also recommend researching other public health clinics in your area to see what’s available.
When it comes to prioritizing sexual safety, I always tell my students the same thing: there is only one relationship that I can guarantee will last forever, and that’s your relationship with yourself. Put that person first and protect them with everything you have. No can replace you—you will always be your best advocate and ally.
In sex positivity,
Dr. Laura McGuire
Sexually curious? Email your queer sex questions anonymously to [email protected]. Don’t worry, we know you’re just Asking For A Friend.
