STD Awareness: How Do I Tell Someone I Have Herpes? Or HPV? Or HIV?

Pictured above: Herpes Comic. Image provided by Katie to Vice.

Of all the novel ways to jump-start a difficult conversation, presenting someone with a hand-drawn comic about herpes is among the most creative. A couple of weeks ago, Vice shared the story of Katie, a millennial with genital herpes who struggled to find the optimal way to disclose her status to potential partners. In a fit of inspiration, she wrote and illustrated a pamphlet that not only shared her history and status — it also included important stats and other facts about genital herpes, a highly stigmatized and widely misunderstood condition. Her pamphlet has been received well by potential partners, dispelling myths while also lightening the mood during what can be a highly fraught conversation.

Begin your relationship with transparency and respect.

Katie’s struggle is shared by a lot of people with treatable — but incurable — STDs, such as genital herpes, human papillomavirus (HPV), and HIV. (Herpes and HIV stay in the body for life, but 9 out of 10 times HPV will be defeated by the immune system. But sometimes, HPV lingers for years or even life.) Most of us don’t want to disclose too early, when we haven’t yet established trust, but we also might be wary of waiting too long, lest we be accused of dishonesty. And disclosing before it seems like sex is in the cards might seem presumptuous. It can be a fine line to walk.

Whether you design your own comic like Katie did, or try another route, the ability to disclose your STD status to a potential partner is an important communication skill to develop. Healthy relationships are built on a foundation of honesty and respect, and your potential partners need to make their own decisions when it comes to their comfort with possible exposure. To make an informed decision, they must be armed with all the facts — and you can help them!

Step 1: Get Educated

Due to social forces like stigma, and political forces like lack of support for comprehensive sex education, there is a lot of misinformation about STDs floating around. Counter those myths by doing your own research. Planned Parenthood, the Centers for Disease Control and Prevention, and the San Francisco Department of Public Health have fantastic webpages that break STDs down into simple language, with valuable information about transmission and risk reduction.

STD myths can make diagnosis even scarier than it has to be. But good information can empower us with facts, not cripple us with fear:

• A young man with genital warts is sick with anxiety over the thought of “giving” his future wife cancer. But genital warts are caused by different strains of HPV than those that cause cancer, and HPV is vaccine-preventable. With this knowledge, he learns how to manage his warts and encourages partners to get vaccinated if they haven’t already.
• A young woman with sores around her genitals is diagnosed with herpes. She doesn’t know anyone else with herpes and thinks that no one will ever want to be with her again. When she learns how common herpes actually is, she knows she isn’t alone. She is further relieved to find out that most people who have herpes don’t even know it, because they don’t get serious symptoms. She empowers herself by reducing transmission risk with medication and recognizing signs from her body.
• Someone just diagnosed with HIV imagines they’ve been given a “death sentence” and wonders if they will have to break up with the great guy they recently started dating. After learning more about their diagnosis, they understand that the correct and consistent use of condoms and antiretroviral drugs can virtually eliminate HIV transmission within “serodiscordant” couples, and that with medication HIV is no longer a death sentence.

Step 2: Get Ready

Plan what you will say to your potential partner, and practice it until the words feel comfortable in your mouth. Try to maintain a calm and positive attitude, and remember that you’re discussing a health issue, not inviting judgment over your value as a person. If any of your friends are aware of your status, you can ask them to role-play the conversation with you.

Think about how your partner might respond. If they express fears or repeat common myths about your STD, remember the things you learned when you were getting educated. Confront fears with facts, and confront myths with reality.

It’s best to disclose before sexual contact — any sexual contact. Herpes and HPV are both transmitted by skin-to-skin contact, which means that simply rubbing genitals together, even without penetration, can pass the virus from one person to another. Both of these viruses can also be transmitted by oral sex.

sexually charged situation. Make sure you both have ample time to talk, in case the conversation stretches out. Make sure you both have privacy so you can talk honestly with as little inhibition as possible.

Because STDs are so stigmatized, a lot of people think it’s best to make sure conversations around disclosure take place in a safe environment. You might prefer to have this conversation either over the phone, by video chat, or through email or text messages. Other people prefer a face-to-face meeting, but opt to do so in a safe environment with an accessible exit in case they need to beat a hasty retreat.

Pay attention to your partner’s response. Listen to their questions and concerns. If they clam up, gently ask them how they feel. Remind them that sex can be difficult to talk about, but it’s OK to admit that. Unfortunately, not everyone will react to your disclosure in the way you hoped, and you have to be prepared for rejection, anger, fear, or judgment. Give yourself permission in advance to leave the conversation if it gets too intense, and give your prospective partner time to absorb the information. Call 1-800-799-SAFE or visit the National Domestic Violence Hotline website if you think you might be in danger.

With your partner’s participation, you can lay the groundwork for a plan. Tell your partner how you are managing your infection and what steps the two of you can take to reduce transmission risk. Respect your partner’s boundaries. If they want to take sex off the table until they’ve had time to complete the HPV vaccination series, you can find other ways to be intimate for now. If they want to start PrEP to reduce their risk of HIV and use condoms each and every time you have sex, learn about PrEP with them, and make sure you always have condoms ready and know how to use them properly.

Once you’ve started this difficult conversation, you have set the stage for your prospective partner to share their history and status with you as well. You can ask them if they have ever been tested for STDs. You can ask them if they are currently having unprotected sex with anyone else. You can suggest that you both get tested together, to start your relationship on the right foot — with total transparency and respect for one another’s health and bodily autonomy.

You can learn more about disclosing to a partner from Planned Parenthood. Health care providers at a Planned Parenthood health center can also give you pointers for a successful conversation with your partner, and can be there for them if they want to get tested, too.