How to Broach the STD question

Blane gives free relationship advice on how to have that dreaded STD talk without scaring away your catch.

Q: I am a very careful guy. I buy my condoms, I have two girlfriends who are both tested and me as well, but when it comes to meeting a new woman the first thing is that she must be tested. My girlfriends do whatever they will do and live in different cities, but I demand they are honest with me, and I think they are. I'm certainly honest with them. I have a new playmate, but I have no idea where she has been. I have health/life insurance and I can show medicals records of no chlamydia, Hep A, B, C, syphilis, herpes, HIV, gonorrhea, genital warts, let's see what else ... What is the etiquette for requesting a woman get tested off the bat? -- STD-Free

Funny condoms
One crazy condom a day may help keep those STDs away. (Photo Credit: Flickr/Andrei Niemimäki)

A: Unless you met in a XXX chat room, bringing it up right off the bat could be a little off-putting: (“It’s so nice to meet you, too! You’re disease-free down under, right?”). And instead of waving your medical records in her face and demanding doctor-issued proof of her status, I recommend starting an honest, adult conversation when it becomes clear that things are headed toward the bedroom.

Of course, some people lie. And others may not even know they are carrying something.

Which brings me to another “what else” to add to your lovely list of goodies: HPV, or human papillomavirus, the little bugger that can cause genital warts (which you do count among your don’t haves). But consider this: A recent study, funded by the National Cancer Institute, revealed that about half of American men are infected with HPV — and most are unaware they have it. Researchers focused on HPV 16, one of the most common of the approximately 40 types, and found evidence that it causes cancer of the mouth, in the base of the tongue and tonsils, and in the penis and anus in men.

Hear that, guys? I bring up this news not as a scare tactic but to point out the general tendency to overlook HPV and pooh-pooh it as a women-only problem (thanks, social conservatives!), since it can cause cervical cancer. The good news is that there are HPV vaccines for both gals and guys (the latter, between 9-26 years old). Maybe now that this eye-opening study is out, the “Why-bother?” attitude surrounding male vaccination will disappear and they’ll take an active role in prevention.

As for you, STD-free, if you’re over 26, you don’t qualify for the vaccine. But keep up the good work, both in communicating with your partners and covering your love muscle. Condoms aren’t 100 percent safe at preventing STDs, of course, but they’re pretty darn effective when they’re used properly. (You’re filling those cherished Magnum XLs so they’re snug enough not to slide off, right?)

Q: I'm a mid-30s male with herpes. At what point am I obligated to tell the women I'm dating that I have it? -- Hate Saying I Have Herpes

A: I’m really glad you asked me “at what point am I obligated” instead of just “am I obligated.” According to experts, only about half of people who are knowingly infected with genital herpes divulge their status to regular sex partners. And when it comes to casual hookups, that figure drops to a dismal 20 percent. I’m no statistician, but I’d say that’s part of the reason the vast majority (some experts say up to 90 percent) of those who have herpes (and 1 in 5 people has it) don’t know it.

With herpes, genital flare-ups come and go, then largely subside after the first year. With planning, awareness and possibly medication (like Valtrex), it’s possible to minimize outbreaks and your partner’s exposure to them. At exactly what point you disclose your status with someone new is up to you, but it does need to be discussed before you’re intimate. Yes, some people won’t stick around. But if you keep the conversation mature, unemotional and direct, while making sure you’re armed with the facts (WebMd does a nice job with FAQs in this article, you’ll have a much better chance of moving forward.

It’s a shame herpes still has a stigma attached to it; indeed, when you key “I have herpes” into Google, the phrase “I want to die” appears as the third-highest option. Herpes is not akin to a death sentence; it’s, as one healthcare professional put it, a hassle.

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