Unprotected sex without STD testing first?
August 29, 2010 8:47 AM Subscribe
Girlfriend of more than a year recently went on the Pill. I said we should get STD tested before having unprotected sex; my tests came back negative but she's reluctant to get one. Should I compromise?
My girlfriend went to get tested but was only offered cervical swab tests which she doesn't want to do and nearly fainted when they showed her the needle for the blood tests. They apparently don't do any urinalysis tests, which surprised me. She's extremely low-risk, having had one other partner years ago and never having had unprotected sex.
But then again, I'm zero-risk, having never had a sexual partner before her! I took the test, even though it was completely academic, because I don't think it would have been right for me to put her in the position of having to trust my assurances that I was STD-free.
She reckons it'll be fine to just go bareback. The health worker even said to her, "look, you're low riskâwe don't have to do this if you don't want to." I'm almost certain she doesn't have anything, but I don't feel that's the point. It's that I shouldn't have to take it on faith that she's telling the truth when it comes to making health decisions, just like I got the test done so she wouldn't have to trust my accurately reporting my sexual history.
Should I compromise on this?
Oh, and does anyone have experience managing STD tests for people who are self-conscious?
Throwaway email: M8R-fsxaw11@mailinator.com
My girlfriend went to get tested but was only offered cervical swab tests which she doesn't want to do and nearly fainted when they showed her the needle for the blood tests. They apparently don't do any urinalysis tests, which surprised me. She's extremely low-risk, having had one other partner years ago and never having had unprotected sex.
But then again, I'm zero-risk, having never had a sexual partner before her! I took the test, even though it was completely academic, because I don't think it would have been right for me to put her in the position of having to trust my assurances that I was STD-free.
She reckons it'll be fine to just go bareback. The health worker even said to her, "look, you're low riskâwe don't have to do this if you don't want to." I'm almost certain she doesn't have anything, but I don't feel that's the point. It's that I shouldn't have to take it on faith that she's telling the truth when it comes to making health decisions, just like I got the test done so she wouldn't have to trust my accurately reporting my sexual history.
Should I compromise on this?
Oh, and does anyone have experience managing STD tests for people who are self-conscious?
Throwaway email: M8R-fsxaw11@mailinator.com
Do not compromise on this. I faint EVERY time I have blood drawn, so I understand where she's coming from, but I also have gotten my act together and gotten STD tests when necessary. If she refuses to do this, she's putting her silly phobia over your health and you should consider whether you want to be with this person or not.
Also, no matter how low risk you are, it is really really nice to KNOW you are negative.
posted by juliapangolin at 8:53 AM on August 29, 2010 [5 favorites]
Also, no matter how low risk you are, it is really really nice to KNOW you are negative.
posted by juliapangolin at 8:53 AM on August 29, 2010 [5 favorites]
I can't believe that the "health worker" would tell her that. Is that hearsay, or were you in the room for it?
Don't do anything until she gets the test. Have her take an Ativan. There's really only one big reason someone refuses to get STD tested: they're afraid of what it may show.
(HIV, at least, can be done with a cheek swab. If she's not up for even that, i would worry that she's been less than forthcoming.)
posted by supercres at 8:56 AM on August 29, 2010 [2 favorites]
Don't do anything until she gets the test. Have her take an Ativan. There's really only one big reason someone refuses to get STD tested: they're afraid of what it may show.
(HIV, at least, can be done with a cheek swab. If she's not up for even that, i would worry that she's been less than forthcoming.)
posted by supercres at 8:56 AM on August 29, 2010 [2 favorites]
I have never heard of a good reason to accept that your partner does not want an STD test.
posted by griphus at 8:57 AM on August 29, 2010 [31 favorites]
posted by griphus at 8:57 AM on August 29, 2010 [31 favorites]
Put it this way: you have a choice between having a low risk of contracting a health- or life-threatening disease, or having a risk that is statistically equivalent to zero. If your girlfriend is not willing to get a checkup, which she ought to have anyway for her own peace of mind, she's not mature enough to be having sex. Do not compromise with your health.
posted by decathecting at 8:57 AM on August 29, 2010
posted by decathecting at 8:57 AM on August 29, 2010
I should clarify: the cheek-swab HIV test shouldn't be the end of it. You still have to worry about herpes, for one. More that it can be an insight to her motives.
Don't compromise. I think it's ridiculous that she won't do this for you.
posted by supercres at 9:02 AM on August 29, 2010
Don't compromise. I think it's ridiculous that she won't do this for you.
posted by supercres at 9:02 AM on August 29, 2010
You sound like a smart person. You know you have zero-ris, and you're reasonable and inteligent and consider her incredibly low risk. You know the chances are probably next to zero, so did the health worker (which, really, WTF? I can't believe a health worker would say that). I reckon it would be fine to go bareback as well. You also seem smart enough to realize: NEXT TO ZERO != ZERO.
Ask her to get the test again. Go with her and get retested with her. If she doesn't want to take responsibility then she shouldn't have sex and you shouldn't have sex with her. Being afraid of needles [while totally legit; I can't watch having my blood drawn or I'll faint] isn't an excuse. I'm not a woman, but I don't see what's wrong with the swab tests - seems straight forward and relatively painless to me? You could also see about going to another doctor or clinic that will offer urinalysis tests.
I'm really not one that jumps on this bandwagon usually: but this seems like some tip-of-the-iceberg-shit right here. If she won't take an STD test for the relationship [its for you, but its also and more importantly for BOTH OF YOU] then DTMFA. People need to be responsible about their sexual health. Not being responsible for this (which is easy to do) is a worrisome sign to me.
posted by ish__ at 9:02 AM on August 29, 2010
Ask her to get the test again. Go with her and get retested with her. If she doesn't want to take responsibility then she shouldn't have sex and you shouldn't have sex with her. Being afraid of needles [while totally legit; I can't watch having my blood drawn or I'll faint] isn't an excuse. I'm not a woman, but I don't see what's wrong with the swab tests - seems straight forward and relatively painless to me? You could also see about going to another doctor or clinic that will offer urinalysis tests.
I'm really not one that jumps on this bandwagon usually: but this seems like some tip-of-the-iceberg-shit right here. If she won't take an STD test for the relationship [its for you, but its also and more importantly for BOTH OF YOU] then DTMFA. People need to be responsible about their sexual health. Not being responsible for this (which is easy to do) is a worrisome sign to me.
posted by ish__ at 9:02 AM on August 29, 2010
I agree with the answers so far, but I'm also concerned that she refused the cervical swab test. They certainly aren't fun and I can understand her reluctance - but I hope that her refusal doesn't mean she also avoids getting pap tests.
To speak more directly to the question, I honestly think that people who are not willing to be responsible about their sexual health should not be sexually active. Since she is, and intends to be, a sexually active person, she needs to take responsibility for her sexual health, and that means regular visits to the gynecologist, including paps, and STD testing when necessary.
posted by insectosaurus at 9:09 AM on August 29, 2010 [3 favorites]
To speak more directly to the question, I honestly think that people who are not willing to be responsible about their sexual health should not be sexually active. Since she is, and intends to be, a sexually active person, she needs to take responsibility for her sexual health, and that means regular visits to the gynecologist, including paps, and STD testing when necessary.
posted by insectosaurus at 9:09 AM on August 29, 2010 [3 favorites]
She needs to go to a different clinic that will work with her needle phobia, and you BOTH need to become more knowledgeable healthcare consumers.
Other than tests that are specific for herpes and HIV, blood tests should not be super critical here. As said above, a cheek swab for HIV should suffice, and some places won't even do the blood test for herpes until you have symptoms or a known exposure. Cervical swabs will detect chlamydia and gonorrhea, both of which are far more common, and some strains of HPV, and maybe more things that I am forgetting. What exactly are you expecting of her? What exactly did you get tested for yourself? If you just walked in and said you wanted 'the works' you may not have gotten tested for absolutely everything. If she needs help finding a place to do HIV testing via cheek swab instead of blood, help her find one. You sound like you're arguing with her about this in principle, but you need to keep it contained to a practical discussion of exactly what you're both being tested for, or it ends up sounding like you're afraid she's 'dirty' or something from her prior sexual experience. You should both do some reading about this together.
posted by slow graffiti at 9:19 AM on August 29, 2010 [4 favorites]
Other than tests that are specific for herpes and HIV, blood tests should not be super critical here. As said above, a cheek swab for HIV should suffice, and some places won't even do the blood test for herpes until you have symptoms or a known exposure. Cervical swabs will detect chlamydia and gonorrhea, both of which are far more common, and some strains of HPV, and maybe more things that I am forgetting. What exactly are you expecting of her? What exactly did you get tested for yourself? If you just walked in and said you wanted 'the works' you may not have gotten tested for absolutely everything. If she needs help finding a place to do HIV testing via cheek swab instead of blood, help her find one. You sound like you're arguing with her about this in principle, but you need to keep it contained to a practical discussion of exactly what you're both being tested for, or it ends up sounding like you're afraid she's 'dirty' or something from her prior sexual experience. You should both do some reading about this together.
posted by slow graffiti at 9:19 AM on August 29, 2010 [4 favorites]
She may be assuming that since you've tested negative for your tests, she is probably in the clear too. Well, she's not. She still needs to get tested.
posted by Xere at 9:24 AM on August 29, 2010
posted by Xere at 9:24 AM on August 29, 2010
Just so this isn't all one-sided: she may be upset that you're even considering that in spite of what you know about her, she might instead be a lying diseased whore.
I think she should get the test, and that you should insist on it before doing anything risky. Still, there's emotional factors. Not everyone is all cool and hip to the unromantic realities of sex these days.
posted by ctmf at 9:24 AM on August 29, 2010 [1 favorite]
I think she should get the test, and that you should insist on it before doing anything risky. Still, there's emotional factors. Not everyone is all cool and hip to the unromantic realities of sex these days.
posted by ctmf at 9:24 AM on August 29, 2010 [1 favorite]
Insist that she get tested. You really are better safe than sorry. Even if she's only had one partner, it still could have been the wrong partner.
posted by BZArcher at 9:26 AM on August 29, 2010
posted by BZArcher at 9:26 AM on August 29, 2010
I will add that she definitely needs to get used to the cervical swabs though, if only for her own health. They're pretty standard for any annual women's health exam and they detect cervical cancer, and she should be having them for at least the rest of her fertile years, regardless of sexual status. Help her find a clinic that will go slow and talk her through that part instead of shoving a cold speculum up there without so much as a 'how was your day?'
posted by slow graffiti at 9:26 AM on August 29, 2010
posted by slow graffiti at 9:26 AM on August 29, 2010
But then again, I'm zero-risk, having never had a sexual partner before her! I took the test, even though it was completely academic, because I don't think it would have been right for me to put her in the position of having to trust my assurances that I was STD-free.
Have you said this, or some form of this, to her? It might unintentionally come off as an 'I'm better than you' to her ears if she's in any way insecure or afraid you don't trust her.
That said, there is no reason why she should be refusing to get this test if she wants you two to continue to have sex. But maybe there's a better way to broach the subject.
posted by cmgonzalez at 9:35 AM on August 29, 2010
Have you said this, or some form of this, to her? It might unintentionally come off as an 'I'm better than you' to her ears if she's in any way insecure or afraid you don't trust her.
That said, there is no reason why she should be refusing to get this test if she wants you two to continue to have sex. But maybe there's a better way to broach the subject.
posted by cmgonzalez at 9:35 AM on August 29, 2010
You guys sound like you're working against each other instead of working together. She's scared and self-conscious (your word) of getting a cervical swab, terrified of needles, and on top of this is feeling defensive that you don't trust her to accurately recount her sexual history. Sure, she should get tested since it's obviously very important to you. But putting your foot down and simply saying "I insist and refuse to compromise" is not the way to get out of this wrangle.
Which STDs were you tested for? Which ones do you need her to be tested for, for your peace of mind? How did you arrive at this conclusion? What methods of testing are available for the tests you would like her to get? Would she feel more comfortable in a traditional doctor's office? Are there treatments she can seek to alleviate her needle phobia (which is a fairly serious thing, since there are many reasons why she might need injections or blood drawn in the future). Research this from a stance of togetherness, rather than a stance of "we shouldn't have to take it on faith that we're truthful with one another." Learning more about all of this might serve both to ease her uncomfortableness with the whole process (and also hopefully let her realize how important annual PAP smears are, which I'm assuming she probably doesn't get since she didn't want the cervical swab).
she's putting her silly phobia over your health
I'm sure it's been said before on metafilter, but phobias aren't silly. If a needle phobia is what she has, that's a big thing to work with and not something to be brushed aside as just stubbornness.
posted by frobozz at 9:44 AM on August 29, 2010 [7 favorites]
Which STDs were you tested for? Which ones do you need her to be tested for, for your peace of mind? How did you arrive at this conclusion? What methods of testing are available for the tests you would like her to get? Would she feel more comfortable in a traditional doctor's office? Are there treatments she can seek to alleviate her needle phobia (which is a fairly serious thing, since there are many reasons why she might need injections or blood drawn in the future). Research this from a stance of togetherness, rather than a stance of "we shouldn't have to take it on faith that we're truthful with one another." Learning more about all of this might serve both to ease her uncomfortableness with the whole process (and also hopefully let her realize how important annual PAP smears are, which I'm assuming she probably doesn't get since she didn't want the cervical swab).
she's putting her silly phobia over your health
I'm sure it's been said before on metafilter, but phobias aren't silly. If a needle phobia is what she has, that's a big thing to work with and not something to be brushed aside as just stubbornness.
posted by frobozz at 9:44 AM on August 29, 2010 [7 favorites]
I had to have a blood transfusion. Even though the risk was practically zero that I might contract something (a fraction of a fraction of a percent) and I am not only afraid of needles I get sick from having blood drawn, I still got tested.
I got tested because I care deeply about my husband and I would never want to put him at risk. Even if that risk was minuscule. I did what I could to make sure that my loved one was safe.
posted by TooFewShoes at 9:46 AM on August 29, 2010
I got tested because I care deeply about my husband and I would never want to put him at risk. Even if that risk was minuscule. I did what I could to make sure that my loved one was safe.
posted by TooFewShoes at 9:46 AM on August 29, 2010
You are now coping with the odd phenomenon of people freely engaging in sex while having but a passing acquaintance with their reproductive system.
It's easy to understand why this happens. Sex feels good. Pap smears don't. Also, for some young women with limited experience with their own sex organs outside of sexual intercourse (I was once such a woman, as I grew up in an entirely sex negative household), having a full gynecological exam is frightening because one is so physically vulnerable. You are literally lying with your legs open in front of someone you don't know and having instruments inserted into your body. Add into that general body image issues, hang-ups about past sexual experiences, lack of proper sexual education, fear of needles, and any number of sensitivities, and you're looking at someone who would prefer to put their head in the sand rather than be an adult and take control of their sexual health.
I would advise having some compassion for your girlfriend while setting a very firm boundary for yourself. No, you will not have unprotected sex without her being tested for STDS. You will, however, talk with her about her fears. You will, however, seek out the most current information about STDS, their transmission and prevention, and what proper testing involves. You will go with her for her tests. You will understand if she freaks out. You will support her whatever the results. You will be a friend to her during the process. But, if she won't get tested, you will not be having sex with her without a condom because you are not willing to take the risk. That is the deal and, if she won't accept your terms, you're either going to have to resign yourself to sex with condoms for the duration of your relationship or break up with her and find someone who is less fearful and more mature.
posted by TryTheTilapia at 9:48 AM on August 29, 2010 [17 favorites]
It's easy to understand why this happens. Sex feels good. Pap smears don't. Also, for some young women with limited experience with their own sex organs outside of sexual intercourse (I was once such a woman, as I grew up in an entirely sex negative household), having a full gynecological exam is frightening because one is so physically vulnerable. You are literally lying with your legs open in front of someone you don't know and having instruments inserted into your body. Add into that general body image issues, hang-ups about past sexual experiences, lack of proper sexual education, fear of needles, and any number of sensitivities, and you're looking at someone who would prefer to put their head in the sand rather than be an adult and take control of their sexual health.
I would advise having some compassion for your girlfriend while setting a very firm boundary for yourself. No, you will not have unprotected sex without her being tested for STDS. You will, however, talk with her about her fears. You will, however, seek out the most current information about STDS, their transmission and prevention, and what proper testing involves. You will go with her for her tests. You will understand if she freaks out. You will support her whatever the results. You will be a friend to her during the process. But, if she won't get tested, you will not be having sex with her without a condom because you are not willing to take the risk. That is the deal and, if she won't accept your terms, you're either going to have to resign yourself to sex with condoms for the duration of your relationship or break up with her and find someone who is less fearful and more mature.
posted by TryTheTilapia at 9:48 AM on August 29, 2010 [17 favorites]
"I can't believe that the "health worker" would tell her that. Is that hearsay, or were you in the room for it?"
I have had to talk health workers into giving me certain STD tests. Given the girls' history, it's entirely possible the health worker said that exactly; it's very similar to things which have been said to me.
posted by endless_forms at 10:33 AM on August 29, 2010 [1 favorite]
I have had to talk health workers into giving me certain STD tests. Given the girls' history, it's entirely possible the health worker said that exactly; it's very similar to things which have been said to me.
posted by endless_forms at 10:33 AM on August 29, 2010 [1 favorite]
I have to agree fully with TryTheTilapia.
Without knowing your ages, and where and when all this was done - she probably needs to speak to her GP about this instead of a clinic if the ability of where she's been for this is in question (she'll have to mention she's on the pill to her GP at some point anyway). You have time before the pill kicks in and can be considered effective anyway, perhaps - and while you may need to work on the compassionate part as was said - this is all part of having a yearly checkup when you're a sexually active person (or heck, an adult woman) and for her own sake, it's just time to grow up about that. Don't compromise because of the bareback option - compromise because it's important to take care of one's health in general and it's the right thing to do in general.
Just looking at what's here, I'm reminded of exactly how silently or mildly Chlamydia presents itself - and how both parties need to be treated, and how it's far more uncomfortable to be tested for that for the guy. And, how low-risk HPV can manifest itself nearly fifteen years into a very devoted, monogamous relationship likely due to youthful indiscretions on either side.
And remember - even though she only had one partner years ago and never had unprotected sex, STI's and STD's aren't transmitted only through intercourse, and there's this ad to consider.
As to how better to encourage her? If her doctor or the clinic she's been to aren't places where she's comfortable, she's got to look further for one where she gets not just the tests, but the care she needs. And it is too bad that sometimes it's that much work, but such are the perils and privileges of being a sexually active person.
posted by peagood at 10:36 AM on August 29, 2010
Without knowing your ages, and where and when all this was done - she probably needs to speak to her GP about this instead of a clinic if the ability of where she's been for this is in question (she'll have to mention she's on the pill to her GP at some point anyway). You have time before the pill kicks in and can be considered effective anyway, perhaps - and while you may need to work on the compassionate part as was said - this is all part of having a yearly checkup when you're a sexually active person (or heck, an adult woman) and for her own sake, it's just time to grow up about that. Don't compromise because of the bareback option - compromise because it's important to take care of one's health in general and it's the right thing to do in general.
Just looking at what's here, I'm reminded of exactly how silently or mildly Chlamydia presents itself - and how both parties need to be treated, and how it's far more uncomfortable to be tested for that for the guy. And, how low-risk HPV can manifest itself nearly fifteen years into a very devoted, monogamous relationship likely due to youthful indiscretions on either side.
And remember - even though she only had one partner years ago and never had unprotected sex, STI's and STD's aren't transmitted only through intercourse, and there's this ad to consider.
As to how better to encourage her? If her doctor or the clinic she's been to aren't places where she's comfortable, she's got to look further for one where she gets not just the tests, but the care she needs. And it is too bad that sometimes it's that much work, but such are the perils and privileges of being a sexually active person.
posted by peagood at 10:36 AM on August 29, 2010
I think the best way to approach this with her would be to take yourself out of it entirely and give her the friend-to-friend advice that this is something that is a part of being a sexually active adult. If she is sexually active she needs to be having annual well-woman exams, which include a pap smear. Pap smears aren't scary or painful or anything to be self conscious about. Additionally, as an adult there are going to be times that she is going to have to give blood samples, STD test or not. It's something she needs to get used to, in general.
I find that STD tests are much less scary, btw, if I can schedule them as part of my annual trip to the gynecologist. That way they're doing a whole list of different kinds of pokings and proddings, and it doesn't feel like OMG YOU ARE DISEASED!!!!! More like just a thing you do every year. I also like to take myself out to lunch after said annual gyno slog and order a nice glass of wine with lunch to celebrate and feel like a healthy responsible grownup.
Is she afraid of doctors and medical stuff in general? It sounds like she might be. I don't think this is a reason not to take care of yourself by any means, but it something that you, as someone who cares about her, should be aware of and somewhat sympathetic to.
posted by Sara C. at 10:51 AM on August 29, 2010 [4 favorites]
I find that STD tests are much less scary, btw, if I can schedule them as part of my annual trip to the gynecologist. That way they're doing a whole list of different kinds of pokings and proddings, and it doesn't feel like OMG YOU ARE DISEASED!!!!! More like just a thing you do every year. I also like to take myself out to lunch after said annual gyno slog and order a nice glass of wine with lunch to celebrate and feel like a healthy responsible grownup.
Is she afraid of doctors and medical stuff in general? It sounds like she might be. I don't think this is a reason not to take care of yourself by any means, but it something that you, as someone who cares about her, should be aware of and somewhat sympathetic to.
posted by Sara C. at 10:51 AM on August 29, 2010 [4 favorites]
Do not have sex with someone without protection without first being screened (both of you) for STDs. And, even when it's "all clear", wait another six weeks and test again (if you want to rule out false negatives and how long it actually takes for HIV to show up in a test).
posted by marimeko at 11:12 AM on August 29, 2010
posted by marimeko at 11:12 AM on August 29, 2010
Unless you have reason to believe your girlfriend is at especially high risk and may have contracted HIV in the weeks prior to meeting you, I don't think the second round of tests is necessary.
posted by Sara C. at 11:19 AM on August 29, 2010
posted by Sara C. at 11:19 AM on August 29, 2010
Should I compromise on this?
The "do not compromise" is covered, so I'll add this about the kind of test to get: It is worth considering using a testing service that allows others to see the results of the test (rather than requiring partners to rely on an infected person's self-reporting of STIs). Most services have ways of doing this, from emailing results to providing phone codes.
It seems likely that your girlfriend is just working through some virgin/whore dichotomy bullshit and uncomfortable with the idea that even "good" girls need to get STIs, but it is also possible that this is just the tip of the iceberg.
She wouldn't be the first person to delude herself into thinking that if she doesn't know for certain, she doesn't count as infected. You wouldn't be the first person to get infected by someone who doesn't count, either.
posted by Marty Marx at 11:30 AM on August 29, 2010
The "do not compromise" is covered, so I'll add this about the kind of test to get: It is worth considering using a testing service that allows others to see the results of the test (rather than requiring partners to rely on an infected person's self-reporting of STIs). Most services have ways of doing this, from emailing results to providing phone codes.
It seems likely that your girlfriend is just working through some virgin/whore dichotomy bullshit and uncomfortable with the idea that even "good" girls need to get STIs, but it is also possible that this is just the tip of the iceberg.
She wouldn't be the first person to delude herself into thinking that if she doesn't know for certain, she doesn't count as infected. You wouldn't be the first person to get infected by someone who doesn't count, either.
posted by Marty Marx at 11:30 AM on August 29, 2010
If this is important to you, by all means insist she get tested. That said, were I in your position (and obviously I'm not), and I believed her about her low-risk sexual history, I can't say this would really bother me. Pointing out that low risk is not zero risk has no substance, in my view. It sounds like there's a greater chance she's going to kill/injure you in a car accident than with an STD.
posted by deadweightloss at 11:39 AM on August 29, 2010 [1 favorite]
posted by deadweightloss at 11:39 AM on August 29, 2010 [1 favorite]
Unless you have reason to believe your girlfriend is at especially high risk ..
I would find reluctance to get tested reason to believe that they have no idea if they have STDs. When it comes to your health (your life), reason to believe simply isn't the desired negative result.
posted by marimeko at 11:42 AM on August 29, 2010
I would find reluctance to get tested reason to believe that they have no idea if they have STDs. When it comes to your health (your life), reason to believe simply isn't the desired negative result.
posted by marimeko at 11:42 AM on August 29, 2010
Does your GF ever want kids? Because cervical swabs and blood tests are routine when you are pregnant. Yeah, they're not fun, but it involves putting the big-girl pants on and dealing. This is what I think she should do here. You both know she's extremely, extremely low risk for most STDs - but HPV exists in more than 50% of the population. To me, this is less about the risk to you (as far as HPV) and more the risk that she could be at risk for cancer if she doesn't get a pap regularly and doesn' t know if she contracted HPV from that prior guy.
posted by kpht at 12:03 PM on August 29, 2010
posted by kpht at 12:03 PM on August 29, 2010
You say she's only had one other partner. Does this mean she's only ever participated in any sort of sexual activity with one other person, or does it mean she's only had PIV sex with one other person? As others have mentioned, some STDs/STIs can be transmitted through oral or even manual sex, not just vaginal or anal sex.
As a datapoint: I had the misfortune of contracting HPV as a (technical) virgin, when I was too young and stupid to know certain activities were risky (I blame abstinence-only education). At that point in my life, I'd only had 2 partners, and I hadn't had PIV sex with either. It happens. If somebody asked me how many people I'd had sex with, I would've said zero, since at that point in my life I thought anything other than PIV sex didn't "count." Yet I had an STD.
I encourage you to do whatever you can to help her get tested, whether that's holding her hand when they draw her blood, or supporting her in some other way. It's important for both of you - not just for your physical health, but for the health of your relationship, since her refusal to be tested has affected your trust in her.
posted by pecanpies at 12:06 PM on August 29, 2010 [1 favorite]
As a datapoint: I had the misfortune of contracting HPV as a (technical) virgin, when I was too young and stupid to know certain activities were risky (I blame abstinence-only education). At that point in my life, I'd only had 2 partners, and I hadn't had PIV sex with either. It happens. If somebody asked me how many people I'd had sex with, I would've said zero, since at that point in my life I thought anything other than PIV sex didn't "count." Yet I had an STD.
I encourage you to do whatever you can to help her get tested, whether that's holding her hand when they draw her blood, or supporting her in some other way. It's important for both of you - not just for your physical health, but for the health of your relationship, since her refusal to be tested has affected your trust in her.
posted by pecanpies at 12:06 PM on August 29, 2010 [1 favorite]
Let's look at this from the girlfriend's perspective for a moment. She, presumably, knows her true risk profile. Let's say that she has indeed never had unprotected sex before, and let's also assume that her previous sex partner was someone with a low-risk profile. The doctor is right that she's extremely low risk, such that unprotected sex with her is much, much less risky than all sorts of things that you do every day without thinking twice. For someone with that low of a risk profile, testing may even be more likely to turn up a false positive than a true positive. So for her to feel that it's not worth the intense discomfort is not unreasonable.
So your girlfriend has done something that's primarily going to make your sex life better (in my experience as a woman, condoms vs. no condoms is pretty much unnoticeable), and you've responded to her in a way that makes it seem like you think she might be lying about her past. If she trusts you to accurately report your past history, she may be doubly hurt that you don't return that trust.
Yes, your girlfriend should probably be tested, but there are all sorts of things we should do for our health that many, many of us don't. Do you floss? Get a flu shot every year? Take your vitamins? Ever talk on your cellphone while driving? Eat undercooked eggs? I could go on...
Bottom line, I would suggest you do some research on STD prevalence and transmission methods. The CDC website is a good place to start. Then you might find it helpful to think about which STD risks genuinely concern you, and how your girlfriend could be tested for those in a way that makes both her and you comfortable. And, when you do bring the subject up again with your girlfriend, I would suggest making it clear that you're asking her to do you a favor, not that she's being unreasonable.
posted by psycheslamp at 12:07 PM on August 29, 2010 [8 favorites]
So your girlfriend has done something that's primarily going to make your sex life better (in my experience as a woman, condoms vs. no condoms is pretty much unnoticeable), and you've responded to her in a way that makes it seem like you think she might be lying about her past. If she trusts you to accurately report your past history, she may be doubly hurt that you don't return that trust.
Yes, your girlfriend should probably be tested, but there are all sorts of things we should do for our health that many, many of us don't. Do you floss? Get a flu shot every year? Take your vitamins? Ever talk on your cellphone while driving? Eat undercooked eggs? I could go on...
Bottom line, I would suggest you do some research on STD prevalence and transmission methods. The CDC website is a good place to start. Then you might find it helpful to think about which STD risks genuinely concern you, and how your girlfriend could be tested for those in a way that makes both her and you comfortable. And, when you do bring the subject up again with your girlfriend, I would suggest making it clear that you're asking her to do you a favor, not that she's being unreasonable.
posted by psycheslamp at 12:07 PM on August 29, 2010 [8 favorites]
If you're in the US, she will not have a choice about the cervical swabs (for gonorrhea/chlamydia) if she wants to continue being on birth control. You have to get them annually, sexually active or not, for your doctor to prescribe.
This isn't necessarily true, especially if she got her pills at a Planned Parenthood that offers the HOPE (Hormones with Optional Pelvic Exam) program. Granted, this is an option meant for women who want to start birth control but have no history of sexual activity, not the OP's girlfriend.
posted by thisjax at 1:11 PM on August 29, 2010
This isn't necessarily true, especially if she got her pills at a Planned Parenthood that offers the HOPE (Hormones with Optional Pelvic Exam) program. Granted, this is an option meant for women who want to start birth control but have no history of sexual activity, not the OP's girlfriend.
posted by thisjax at 1:11 PM on August 29, 2010
It's sad to say, but even in 2010 there are clinics and doctors who are still really clueless about pelvic exams, and if your girlfriend's experience with a speculum is of the cold-and-abruptly-inserted variety, that could explain a lot of her reluctance.
I'd suggest that she find a different place to get both regular checkups and get tested. As others have noted, cervical swabs are part of responsible sexually active womanhood, and she's going to have to deal with that. That does not mean that it has to be in any way unpleasant or scary. When I was in college I had the opportunity to go to a feminist health collective for my care, and one of the things that was different about it is that their policy was to give the speculum to the patient for her to insert herself. It can make a world of difference to be in control of that part of it, especially when it's not a particular familiar thing. If she's uncomfortable with pelvic exams, it's well worthwhile to find a place that won't be super-clinical about it, because it is something that she's going to have to deal with regardless.
posted by ambrosia at 1:59 PM on August 29, 2010
I'd suggest that she find a different place to get both regular checkups and get tested. As others have noted, cervical swabs are part of responsible sexually active womanhood, and she's going to have to deal with that. That does not mean that it has to be in any way unpleasant or scary. When I was in college I had the opportunity to go to a feminist health collective for my care, and one of the things that was different about it is that their policy was to give the speculum to the patient for her to insert herself. It can make a world of difference to be in control of that part of it, especially when it's not a particular familiar thing. If she's uncomfortable with pelvic exams, it's well worthwhile to find a place that won't be super-clinical about it, because it is something that she's going to have to deal with regardless.
posted by ambrosia at 1:59 PM on August 29, 2010
"was to give the speculum to the patient for her to insert herself"
I'm all for anything that makes people more comfortable, because as a guy speculums sound horrific, but isn't that a little dangerous? Depends on the type, of course, but if they're the bladed kind?
Anyway, as was said above, it certainly is worth considering that in a low-risk individual, the risk of a false positive could be significant and therefore multiple tests might be required but that emphatically doesn't mean she shouldn't have them at all. I understand why people can be offended when asked to have an STD test, but this is the modern world, and it's non-negotiable in any serious relationship. Once you catch certain things you catch them, and you only have one body, so take care of it!
posted by mattkh at 2:16 PM on August 29, 2010
I'm all for anything that makes people more comfortable, because as a guy speculums sound horrific, but isn't that a little dangerous? Depends on the type, of course, but if they're the bladed kind?
Anyway, as was said above, it certainly is worth considering that in a low-risk individual, the risk of a false positive could be significant and therefore multiple tests might be required but that emphatically doesn't mean she shouldn't have them at all. I understand why people can be offended when asked to have an STD test, but this is the modern world, and it's non-negotiable in any serious relationship. Once you catch certain things you catch them, and you only have one body, so take care of it!
posted by mattkh at 2:16 PM on August 29, 2010
STDs are frequently spread because one partner says s/he is clean and the other partner believes him/her.
posted by sageleaf at 2:20 PM on August 29, 2010 [1 favorite]
posted by sageleaf at 2:20 PM on August 29, 2010 [1 favorite]
isn't that a little dangerous?
No. Speculums are perfectly safe medical instruments for nonspecialists to use. They're not "horrific", either. Just kind of weird.
Also, "the bladed kind"???? What precisely do you think goes on in your average gynecological exam?
Going back on topic, I think the suggestions to find a different doctor are kind of useless in this context. I would be extremely creeped out if my boyfriend and the internet took it upon themselves to tell me what sort of gynecologist I should be seeing. If this were a question from the girlfriend, that would be great advice. But the search for a good OBGYN is not relevant here.
posted by Sara C. at 2:24 PM on August 29, 2010 [1 favorite]
No. Speculums are perfectly safe medical instruments for nonspecialists to use. They're not "horrific", either. Just kind of weird.
Also, "the bladed kind"???? What precisely do you think goes on in your average gynecological exam?
Going back on topic, I think the suggestions to find a different doctor are kind of useless in this context. I would be extremely creeped out if my boyfriend and the internet took it upon themselves to tell me what sort of gynecologist I should be seeing. If this were a question from the girlfriend, that would be great advice. But the search for a good OBGYN is not relevant here.
posted by Sara C. at 2:24 PM on August 29, 2010 [1 favorite]
I'm all for anything that makes people more comfortable, because as a guy speculums sound horrific, but isn't that a little dangerous? Depends on the type, of course, but if they're the bladed kind?
Please relate the last time that you inserted a speculum into your vagina. Then you can judge whether they are "horrific" or not. This is not going to help the OP help his girlfriend, nor do you sound like a sympathetic sex partner.
posted by micawber at 2:37 PM on August 29, 2010 [2 favorites]
Please relate the last time that you inserted a speculum into your vagina. Then you can judge whether they are "horrific" or not. This is not going to help the OP help his girlfriend, nor do you sound like a sympathetic sex partner.
posted by micawber at 2:37 PM on August 29, 2010 [2 favorites]
--never having had unprotected sex--
So technically speaking, if this statement about your gf is true, then she's not low risk, she's approximately no risk. That's not zero risk but it's not the same as long ago unprotected sex. I'm not going to tell you what to do but the risk here, in the absence of symptoms (even though people can be infected with few or no symptoms), would appear to be negligible.
posted by peacay at 3:33 PM on August 29, 2010 [1 favorite]
So technically speaking, if this statement about your gf is true, then she's not low risk, she's approximately no risk. That's not zero risk but it's not the same as long ago unprotected sex. I'm not going to tell you what to do but the risk here, in the absence of symptoms (even though people can be infected with few or no symptoms), would appear to be negligible.
posted by peacay at 3:33 PM on August 29, 2010 [1 favorite]
In the short run: keep using condoms. There's no reason not to stick with them for the moment. If she really wants to stop using them, she needs to seriously up the personal responsibility first.
posted by you're a kitty! at 3:44 PM on August 29, 2010 [1 favorite]
posted by you're a kitty! at 3:44 PM on August 29, 2010 [1 favorite]
Yes, you should compromise. Keep using condoms, and be supportive of her work on becoming more comfortable with routine medical procedures. Because she should work on it.
posted by Salamandrous at 4:58 PM on August 29, 2010
posted by Salamandrous at 4:58 PM on August 29, 2010
In the short run: keep using condoms. There's no reason not to stick with them for the moment. If she really wants to stop using them, she needs to seriously up the personal responsibility first.
Nailed it.
posted by InsanePenguin at 5:11 PM on August 29, 2010 [2 favorites]
In the absence of symptoms or high-risk status, there are only a few STDs that it is worth testing for. It's good to check for chlamydia and gonorrhea because they can lurk and cause infertility, and of course HIV because it is deadly without treatment. Most of the rest you test for only if there are symptoms or if you have been engaging in high risk behaviors that make exposure likely. So even though people are always talking about "OMG Get tested for EVERYTHING!!" that can actually be a pretty short list when your risk is so low.
Personally -- and this is pure personally, not medical or legal or any other kind of "real" advice -- I'd want her to go get an HIV test (which shouldn't even need a needle these days, now that the cheek swab tests are so common) just because that's a scary disease with permanent implications. Beyond that, I honestly wouldn't worry too much. There are a ton of risks in life; unprotected sex with her sounds like it is going to be a lot less risky than crossing the road every day on your way to work.
But it's your body, not mine. If you aren't comfortable, keep using the condoms until either you change your mind or she gives in and gets tested. I don't see any reason there needs to be a rush; your feelings are important and you can take all the time you need to be comfortable.
posted by Forktine at 8:40 PM on August 29, 2010
Personally -- and this is pure personally, not medical or legal or any other kind of "real" advice -- I'd want her to go get an HIV test (which shouldn't even need a needle these days, now that the cheek swab tests are so common) just because that's a scary disease with permanent implications. Beyond that, I honestly wouldn't worry too much. There are a ton of risks in life; unprotected sex with her sounds like it is going to be a lot less risky than crossing the road every day on your way to work.
But it's your body, not mine. If you aren't comfortable, keep using the condoms until either you change your mind or she gives in and gets tested. I don't see any reason there needs to be a rush; your feelings are important and you can take all the time you need to be comfortable.
posted by Forktine at 8:40 PM on August 29, 2010
If you're in the US, she will not have a choice about the cervical swabs (for gonorrhea/chlamydia) if she wants to continue being on birth control. You have to get them annually, sexually active or not, for your doctor to prescribe.
This is not true. While most doctors in the US, link pelvic exams and pap tests with birth control, there is no medical reason to do so. There is no medical relationship between any kind of cervical swab (STI screening or cervical cancer screening) and the safety of using hormonal contraception. Neither the US Food and Drug Administration, the World Health Organization,Planned Parenthood Association, or the American College of Obstetricians and Gynecologists believe that a pelvic exam or pap smear should be required for hormonal birth control. The current US guidelines are to start pap testing THREE YEARS AFTER first sexual intercourse but not before age 21, but it's not a requirement for using the pill any more than getting your cholesterol checked or going to the dentist is.
Plus, they're done as part of the cervical cancer screening, which is also something she has to do. One day, she probably won't be as low risk anymore, so she HAS to do it sometime. Honestly, they're not fun, but I would describe them as mildly uncomfortable, not painful.
No, of course she doesn't HAVE to do this. It her choice to be screened or not, and that goes for any kind of health screening--you may disagree with her choice, but it's her body and she can do whatever she wants with it. It's a CHOICE, just as you can choose not to have sex with someone who chooses not to be screened.
At any rate, you and she both know that chlamydia and gonorrhea can be tested with urinalysis and HIV with a cheek swab, so it seems to me that if she WANTS to be tested, the best thing to do would be to go to a provider who offers urinalysis and cheek swabs. Why on earth would you not use less invasive testing, since it's available?
posted by Violet Hour at 9:10 PM on August 29, 2010 [2 favorites]
This is not true. While most doctors in the US, link pelvic exams and pap tests with birth control, there is no medical reason to do so. There is no medical relationship between any kind of cervical swab (STI screening or cervical cancer screening) and the safety of using hormonal contraception. Neither the US Food and Drug Administration, the World Health Organization,Planned Parenthood Association, or the American College of Obstetricians and Gynecologists believe that a pelvic exam or pap smear should be required for hormonal birth control. The current US guidelines are to start pap testing THREE YEARS AFTER first sexual intercourse but not before age 21, but it's not a requirement for using the pill any more than getting your cholesterol checked or going to the dentist is.
Plus, they're done as part of the cervical cancer screening, which is also something she has to do. One day, she probably won't be as low risk anymore, so she HAS to do it sometime. Honestly, they're not fun, but I would describe them as mildly uncomfortable, not painful.
No, of course she doesn't HAVE to do this. It her choice to be screened or not, and that goes for any kind of health screening--you may disagree with her choice, but it's her body and she can do whatever she wants with it. It's a CHOICE, just as you can choose not to have sex with someone who chooses not to be screened.
At any rate, you and she both know that chlamydia and gonorrhea can be tested with urinalysis and HIV with a cheek swab, so it seems to me that if she WANTS to be tested, the best thing to do would be to go to a provider who offers urinalysis and cheek swabs. Why on earth would you not use less invasive testing, since it's available?
posted by Violet Hour at 9:10 PM on August 29, 2010 [2 favorites]
I have never had sex, I don't plan on having it before getting married, and by the way getting an STD test for me and him first. Because you don't ask someone to do that in an age where you know how disease spreads and what kinds of awful things are out there. And I faint at needles and will have to bribe myself with all kinds of stuff to get near my gynecologist's office next time I'm up.
Do not compromise on the condoms. Seriously. Ugh.
posted by SMPA at 7:58 AM on August 30, 2010
Do not compromise on the condoms. Seriously. Ugh.
posted by SMPA at 7:58 AM on August 30, 2010
If it's worth anything the comments up-thread were gratefully received. And it's true, I have never had gynaecological exam -- I was just going based on photos of what speculums looked like and, of course, the knowledge that they use them on guys even if for slightly different reasons. Perhaps it's just projection on my part, and apologies for going off topic.
posted by mattkh at 10:22 AM on August 30, 2010
posted by mattkh at 10:22 AM on August 30, 2010
And, since you seem curious, I didn't mean to suggest that speculums were sharp when I mentioned the "bladed kind." I was referring to the type that consist of two "blades" so that the radius can be adjusted, and they seemed to me that there'd be a risk of trapping skin, etc., if you couldn't see what you were doing. Evidently I was mistaken, but I just wanted to clear up the confusion. I maybe clueless, but not quite that clueless!
posted by mattkh at 10:31 AM on August 30, 2010
posted by mattkh at 10:31 AM on August 30, 2010
This thread is closed to new comments.
posted by roomthreeseventeen at 8:51 AM on August 29, 2010 [13 favorites]