Dear Lucy: My partner and I are monogamous, have an honest and trusting relationship, and neither of us has ever done anything sexual with anyone else. However, I am haunted by the feeling that we should have gotten STI tests before hooking up. But since we were both virgins... do we really need to? I mean, how would either of us have gotten anything to expose each other to? At what point should we get tested? —Monogamous Ex-virgin
Dear Ex-virgin: Lucy thanks you for asking this question about sexually transmitted infections (STIs). When to get tested and what to get tested for are frequent topics of discussion among MIT students and other young people, so Lucy is very glad to have the chance to share some information on the subject.
For an answer to your specific question, Lucy turned to MIT Medical primary care provider and nurse practitioner Colleen McDonald, who thinks that you can probably stop worrying. “In the absence of sexual activity,” she tells Lucy, “one is unlikely to have an STI.”
Of course, it’s not impossible, she adds. “Individuals who share needles for drug injection can also share STIs like HIV and hepatitis. This happens as infected blood on a needle breaks the protective skin barrier and is routed directly into the blood stream.” But if neither you nor your partner have been sexually active with other people or have engaged in intravenous drug use and needle sharing, you’re extremely unlikely to be infected with an STI at this point. And when it comes to STIs, there’s no need for “baseline testing.”
Going forward, your healthcare provider can help you make testing decisions based on your age, gender, and sexual activity. McDonald tells Lucy that she begins this kind of discussion with “a detailed assessment of the individual’s risk for having an STI.” This involves questions like:
- Are you sexually active?
- Have your partners been male, female, or both?
- Have you had STI testing before? When? What were the results?
- How many partners have you had since your last STI testing?
- What types of sexual activity do you engage in (oral, vaginal, anal, other)?
- Do you use barrier protection for all sexual activity, some sexual activity, or none?
- How do you decide when to use barrier protection and when not to use barrier protection?
- Have all of your sexual experiences been consensual?
- Have you had any sexual encounters you are worried about—ones you think may have exposed you to a STI? If so, tell me about it.
- Do you any symptoms of a STI, such as rash, fever, change in discharge, or pain when urinating?
“As you can see,” she continues, “these are very personal questions. But they are also very important. When a healthcare provider gets honest answers to these questions, they are able to recommend the right test, at the right time, to assess your health status and provide appropriate treatment, if necessary.”
Lucy hopes this answer puts your mind at ease for now. More importantly, Lucy encourages you to make an appointment with an MIT Medical healthcare provider to discuss your individual concerns. Our clinicians aren’t here only to provide treatment when you’re sick; they are also available to answer all your questions and give you the information you need to have a safe and healthy sex life. —Lucy