Episode 46: STI Risk
How worried should you be about STI risk if you are immunocompromised?
That’s what’s on this week’s episode of Non-Monogamy Help.
Discussion Topic: Why do you think your parents are the way they are? What were the pressures and difficulties they were under?
Listen below. You can also find the podcast on Spotify, Apple, and other providers.
https://anchor.fm/non-monogamy-help/episodes/Episode-46---STI-Risks-e1cgbff
This episode is sponsored by BetterHelp. Use our affiliate link for 10% off your first month.
Thank you to Chris Albery-Jones at albery-jones.com for the theme music and a big thanks for the podcast art to Dom Duong at domduong.com.
Podcast transcript
Letter:
My partner and I have been together and have been mostly monogamous for over a year - and fluid bonded for the majority of that. Our deal is that we give a heads up before sleeping with someone else and that we use condoms. After my partner had a slip up, I realized that despite talking about safer sex practices in the beginning of our relationship... he didn’t really retain much of that information, and we definitely needed to have a deeper conversation about STI risks, safe sex practices, condoms for toys/oral, etc. I’m also immunocompromised so it’s a little bit of a bigger deal to me than it may be to others.
After bringing up some of my concerns, he told me that he doesn’t think he can do condoms for oral, but he can definitely ask about recent STI panels and condoms on toys. Welll... glad he’s being honest about it. But... if he has partners who frequently have “oopsie, got drunk and had sex without a condom!” experiences, an STI panel from 3 months ago doesn’t really provide me with a whole lot of reassurance.
So... I feel like my options here are to go back to condoms all the time until he comes back with a clean(sic) STI test (and doesn’t have any other partners at the time) and not do oral... and I guess no kissing either?!? Orrrr, just deal with the risk and if I end up with something because of his less-than-safe practices, hope that it is something that a quick course of antibiotics will take care of.
Both of us were already seeing other people when we first got together, but we became the only person the other was seeing within a couple of months. There have only been two occasions when he has hooked up with someone else - the first time was a one-time thing, but this last one (where I didn’t get a heads up and he didn’t use a condom... but he did tell me about it the morning after) he plans to continue to keep seeing. So... that’s another issue I have.
I’m super hurt because I basically feel cheated on. Our whole agreement was totally “forgotten” in the heat of the moment and now I have to figure out how to deal with him continuing to see a person that, from my emotional perspective, he cheated with.
I don’t feel like I have the right to tell him he can’t continue to see her. It’s his choice. I’ve told him how I feel about it. He doesn’t see things the same way I do. He just sees it as “got drunk, didn’t plan on having sex, so didn’t give heads up. Whoops. As long as I give heads up in the future it’s all good.”
I’m really trying not to be too emotional and I’m trying to apply logic and rationality to the whole situation. What’s your take?
Response:
So I can totally relate to your situation in so many ways. First of all, I'm more or less immunocompromised. I'm not really sure how immunocompromised I am, but I need to be careful about getting sick, and sometimes when I'm sick I can be sick for weeks on end for things that it would take normal people— or people who are not immunocompromised rather. Shouldn’t say “normal”. It takes them less time to get over some things. So I have always always always been very very paranoid about STIs.
And part of that comes from stigma, and I think that that's something that you kind of have to realise. We are— unless you grew up in a different culture and apologies if you did— but I know that the culture I grew up in has basically terrified me with the idea that STIs are these horrible cursed things. And they do terrible things and they can cause— you know we're very hyped on all of the horrible things that can happen if we get STIs.
And yes, there are permanent STIs like HPV and like HSV that can be permanent. But even those— and HIV as well— But even those are… First of all it's different now than it was 20 to 30 years ago, when it comes to HIV, and even in the case of those like such in the case of herpes like a lot of people have it and most people will agree like yes there are drawbacks to it but much of the problem is stigma. So, what helped me kind of cope with this because I also had a partner that was very casual, and we tried to be fluid bonded and we tried to come up with agreements that made me feel better.
I still felt incredibly terrified every time they had a new partner because I was just afraid there was going to be some STI risk, but when you actually learn about— more about STIs and also about the different risks of different acts, and also that there's some STIs that you won't know if you have it unless you have a physical visible symptom. Like HPV, for example, a lot of— it's very very common, but you can have it and it won't show up on an STI panel unless you have a physical symptom like a wart or you, or HPV, you have a pap smear and it comes back with HPV on it like an abnormal pap, you could otherwise have it.
And it's really hard not to learn about that kind of stuff and it not freak you out, because I have lifelong disabilities. I am really scared of having another condition to manage. It is a thought, which really stresses me the hell out. I mean even just today. I haven't had my medication filled that I need to take. I put in my prescription order to the pharmacy 10 days ago. My GP still hasn't approved it and I'm playing medium between, even in a country where I get free health care, I'm having to call my GP, “Why haven't you sent me a prescription?”. It's stressful the life admin of having chronic conditions is exhausting.
If you're immunocompromised because you have a chronic condition, it's okay to be like I just don't want another thing that I have to manage. That is stressful and I get that, but all sex comes with risk. And the thing of it is, even with the rules that you have in place where he always use condoms even for oral. If he's using condoms and having penis in vagina sex, then you're still at risk for herpes. You're still at risk for HPV. You're still at risk for things that have a skin to skin contact, and sometimes dormant periods, like you say three months but actually some things can be dormant for six months.
Everything just comes with a risk and the thing of it is is, we'd like to think that it's simple math that the more people you have sex with the higher risk that you have, and even the example that you give of him getting involved with someone who kind of gets drunk and have sex without a condom. The thing is, is— you could have tons of one night stands with someone and never get something you could also have sex for the first time, with someone else, and get something. It just isn't that simple. STIs don't care if you've had an STI panel or not.
They don't care if someone's drunk or not. And some STI that are transferred to skin to skin contact don't care if you’re using a condom or not. I get that you want to have these barriers to protect yourself. But in my situation, being fluid bonded and having all this like we— We tried to come up with some rules about asking people if they had recent STI test, getting an idea of whether or not they were responsible about their own sexual health, but I still had to come to the conclusion— because originally, what I wanted to do is for my partner, not to sleep with someone the first time they met them or not to have casual sex. I only wanted them to have sex with people that they had known for a few months.
And my partner brought up the the sort of very valid point that whether they've known someone or not for a month doesn't change their STI risk level. Knowing someone doesn't necessarily change the STI risk level and that was really hard for me to contend with. But it's really kind of the truth. Either someone takes charge of their sexual health and gets STI checks. And even if they do that doesn't mean they're never going to get an STI, or they don't. People can lie about it. There's nothing you can do about it/ There's so much stuff you can't control.
And in the end, like— you know, my partner didn't necessarily want to have these overdrawn conversations with every single person. Their level of sexual health risk was different than my level of sexual health risk. And what I ended up doing instead, because fluid bonding doesn't mean anything emotionally to me and I don't need to be fluid bonded with anyone. That was just kind of a thing that we wanted to try. I decided, “Okay, how about this? Instead of you using super amount of barriers and protection with everyone else, you just use all the barriers, you can with me”.
And even though maybe that's less fun, it actually makes me feel loads better. I know that I'm still— like even with all the barriers that I use, I know that I'm still not completely eliminating my risk because there's just no way. You know, if I don't want to ever ever get an STI than I just shouldn't ever have sex, and even then there… I'm not going to go into those situations but there are— there’s still a risk. Like I… you know through sexual violence, I was put at risk of STIs before I had sex willingly so there's just no way for me to, you know— it’s a risk. Especially if I actually want to engage in with in sexual relationships with people, it's just a risk that I have to accept.
So I do think that what you might want to consider is thinking about the barriers that you can use on your end that make you feel better, because you're never going to be able to completely control all the circumstances. People can lie about getting an STI panel. If you want to make sure that you're as protected as you want to be, then have— use those barriers with your partner, and let them decide what their risk is what other people.
The other thing that's happened here I can also relate to I've been in situations where I assumed that our discussion about sexual health was understood and actually this exact— almost this exact kind of thing happened, except the partner that I was with had oral sex with someone without a condom, and I was like “Uh, I said use condoms” and they were like, “Oh, but I thought that was just for penetrative sex”.
So people do— that’s the problem is that “safe sex” is— Well “safe sex”— completely “safe sex” doesn't exist, and safer sex is you know— what is safer? It really depends on the person, and what they want to risk. So, you know, your partner doesn't see condomless oral as a huge risk for that they feel is risky for them. And that's valid and legit, but you kind of have to you know, you said it yourself. There needs to be a deeper discussion about what specific barriers should be used in specific situations.
So, I don’t— I think it's hard not to feel as though you were— that you were cheated on because you did have these rules when they were broken. But I think that in this situation, you know his reasoning does kind of make sense. Like, he didn't know he was going to sleep with someone, so he didn't give you a heads up about it because he didn't know it was going to happen. He did tell you the next morning, and he misunderstood the safer sex rules. So, as hard as it might be to like not feel betrayed— like you can feel betrayed but his reasoning kind of does check out, and I think that it's worth…
You know, I think that the the previous suggestion about you know you deciding what barriers you want to use with your husband or, sorry boyfriend, and then you know that helping you address the level of your risk rather than you know kind of trying to control his behaviour as well and then trying to control the behaviour of everyone he sleeps with, which is going to be really really hard for you might actually solve this problem.
Another thing that I want to kind of point out, which isn't part of your original question, but one of your rules is, is the heads up rule. And I think that this is a good reason why that doesn't that rule doesn't always work out very well and I think what that rule is trying to do and the reason that you've put it in place is because what you want to have this discussion maybe about… maybe you want to know that you have more of an STI risk or maybe, I don't know why is it that you think having a heads up before he sleeps with someone else changes something for you?
Because, I mean, what if it's like three o'clock in the morning and he wants to sleep with someone do you want him to text you? Do you want him to call you and wake you up? Like I feel like this heads up thing is… it's designed to try and help you emotionally deal with a situation. I could be wrong, but when I had a kind of similar rule it was like, “Okay, I have a heads up so I know. So I can like batten down the hatches and prepare”. But actually, I don't think that that helps always.
I think that, you know— what you want is you want a partner who talks to you about the new situations developing their life, who doesn't hide things from you. And he didn't hide things from you. He did tell you the next morning, but the rule is trying to prevent someone from being dishonest to you but a person who is dishonest to you, isn't going to care about a rule. So I think you should kind of rethink this heads up rule, and think about okay what am I actually trying to prevent?
Because you could have a bad reaction, regardless of whether or not he gives you a heads up, like… And the thing about this is, as well as that the heads up thing kind of. It's not an overt rule that says, “I have to give you permission to sleep with someone”, but it does kind of imply that. Because, basically, if he calls you and say “Oh I'm going to sleep with someone”, you can only kind of say yes or no to that situation or you can kind of have a reaction, which he would then interpret as a no.
So, in a way, it is kind of you giving him permission. And the thing about permission is that when you're forced— when you're in a position to give someone permission or not in a polyamorous type of setup, you're going to want to say yes, even when you don't feel that great about it because you don't want to tell your part— I mean you don't even feel like you have the right to tell him not to see a person who you don't feel great about now. So, you're always going to be— if you're going to be given permission, you're always going to feel pressured to say yes.
And then if you say no, it's like, okay, then maybe he'll have resentment? Like it just puts you in a weird situation. It puts him in a weird situation. It's also, if it is an actual permission situation it's not really fair for that other person as well. So like, yeah, kind of think about this rule, because if you want a partner who communicates to you and keeps you up to date with what's going on with them and cares about your feelings, that's legit and I understand that, but this rule in and of itself isn't going to create that. And actually what this rule has done is create more problems for you than it's actually helped.
Because now you're in a situation where like well he didn't give me a heads up but for him it's like well I didn't plan on having sex with someone. So now is he supposed to like text you in the middle of the night, if he wants to have sex with someone new? Do you really want to be woken up at three o'clock in the morning? I don't know I'm saying three o'clock, but it could not be three— but you know what I mean like do you want to be woken up? Or maybe you're having a really terrible night. Like, one time my partner, wanted to tell me about something, but it was just after the Orlando thing had happened.
And I was so upset and I was so not in a good place. And even though we have a rule of not hiding things from one another, my partner waited until, at least a day after that to tell me something, not because they wanted to hide something from me, but because I wasn't in the right state at the time, and that would have just been more shit on top of the already shit sandwich, and I was already really upset. So stuff like this, like…
He absolutely should tell you about new developments especially where your STI risk is now more, but now that you've created this kind of immediate thing of “you have to tell me before”, it does create this kind of problem, and it doesn't have to be kind of a problem. And because you've kind of set this expectation up, it's now made you feel like shit because that expectation hasn't been met when you don't have to do that. One time my partner made a rule about something that I didn't ask for. It was just like “I’m not going to do this” and then my partner ended up doing it.
And then I was actually upset, even though I didn't care about it, and didn't ask for the rule, but because they set that rule up and because they set up this expectation with me when they didn't meet that expectation it freaked me out and I was like, “Well, if you're not going to keep a promise that you set, are you're not going to keep any promise?” Like, it made me freak out a lot so sometimes when you make these kind of really specific things, they can hurt you more than they help.
It's not really helping the situation, because you know he didn't hide it from you and that's kind of what’s the important thing here you don't want someone who hides things from you. So really kind of look at that. And then the last bit is in terms of this metamour, or person, I think that it's understandable to have the feelings you have. Like, obviously this person was introduced to you in a not so great situation.
So obviously you're going to still have some feelings about that and you may need to have a little bit of time and space away from this person for a little bit until you kind of rebuild that bond of trust with your partner and that's totally legit and that's fine, but also remember like you don't necessarily know how much this person knew, and you don't necessarily know if— I mean, I hope that he at least told this person that he was polyamorous.
But like, unless he specifically said to this new person like, “Hey, my partner says that I can't use condoms for— or that I’m supposed to use condoms for oral but fuck it,” like… Unless that specifically happened I don't think that it's necessarily this other person's fault and I think you know that, but it is okay for you feel a little bit of a way about it and you probably will until you kind of rebuild that trust with your partner, but, you know, try to remember that she can't necessarily— she only goes by the information she knows.
Unfortunately, and, you know, she's not going to know that that was a violation of your boundary. You know, and that's not really her fault, in a way. I think sometimes when people that we care about and that we love do things that violate our boundaries or hurt us, and that involves another person that's sometimes easier for our brain to say “okay we don't want to be mad at the person that we love, so we’re going to redirect all of our anger at this person because it's easier because we don't know them”.
So you might want to be aware that like some of your feelings are kind of bleeding out of it, because you feel understandably frustrated, but you're also kind of sympathetic to what your partner is saying to you and you don't want to be mad at him but you're still upset. So it's a bit of a redirection in this case, but I do think you'll feel better later on.
And it's okay to be emotional is last thing that I want to say to you. Emotions are logical. I really hate— I can't remember… there's some philosopher, some terrible person who came up with the idea that emotions are one thing and logic is another and that they are two separate oil and water concepts and ne’er the twain shall meet. It's not true. Emotions can be a very very logical and rational response to a situation. You had an expectation that something would happen. It didn't happen the way you expected it to happen.
And now you're feeling confused and upset and that is rational. That is logical. It is logical and rational to feel things. So give yourself a little bit of a break here. Allow yourself to be emotional, maybe see a therapist. If you have access to therapy, you can get all that emotion out in a safer place. And not kind of use your partner to vent the situation. Talk about it with your friends if you have friends you can talk to us about, But don't stop yourself from feeling emotional. It's okay to feel emotional, it doesn't make you a bad person doesn't make you unable to do polyamory.
It doesn't make you… you know. It doesn't mean anything. It's not a character flaw. It's just you being a human being. You have emotions. You're not a Vulcan. It's okay. Sorry for the siren in the background. So to sum up, first and foremost, learn a bit more about a STIs because it's really really really hard to reduce your risk, completely. It just is. Like it's just a hazard of the trade. There are lots, there’s— if you're in America, there's something called. I think it's. Jesus. No, it's not Jesus.
It's San Francisco Sex Information. That's what it is. And there's a lot of information there. There's Planned Parenthood. There's a website for teenagers which is called Scarleteen, but it's still quite good. And they'll actually tell you kind of like what risks of what STIs you have with different sexual acts depending on what the genitalia configuration is. So you can learn more about like which acts are inherently more risky for which STIs, and there’s skin to skin contact sex with you, even with a condom doing penetrative sex, you're still somewhat at risk for.
So understanding that might help you— I mean— it's gonna freak you out. And it freaked me out, but it will help you realise just like that it's just part of the risk. It’s just part of it. But we have overhype STI so just kind of remember that you're working in an environment where you were likely terrified about this kind of stuff. And that doesn't really help you especially when you're immunocompromised.
Also, maybe work on itself trying to control everything that your partner does with other people, control what you do with your partner in terms of boundaries. Maybe don't be fluid bonded. That's okay. It doesn't have to be a big thing. Like, I think actually being fluid bonded stressed me out more because I put too much emphasis on it. It had this meaning and then once the meaning was removed it honestly felt made me feel so much better.
So like use barriers with your partners. Have oral sex with condoms with your partners. You can have like penis in vagina sex, you can have through like boxer shorts, to lower your risk of skin to skin contact, like there's other stuff. You can use, you know condoms with toys. Use as much barriers as possible with your partner. And then they can— he can do kind of whatever he wants to, assume his own risk with other people. And that way, you're protected a little bit more than you know and he's a little bit more freer to do what he wants in those situations and then you don't have to worry as much. I think that— that's honestly helped me loads and I'm in your position, and I feel so much better now.
Now that I— instead of trying to control what my partner does, I control what my risk with my partner is, and that is, it's so much better, at least from my experience. Another thing to think about is this inform informing rule, and whether or not this actually suiting you or it's creating more problems in your relationship than it needs to be. If your partner didn't hide anything from you. And you know his explanation checks out, then maybe you need to think about changing that role up, because it seems like he's willing to have conversations with you about stuff. It seems like he's willing to keep you involved. It seems like he's willing to— he's not hiding anything from you.
So, just think about whether or not that rules, actually helping you and and what it actually means is a text at 3am “Hey, I'm going to shag this person”… A phone call at 2am, like… is that something you really want to want to do? Is that really going to help you? I think having a better understanding of, yes, you need to disclose find a good time to disclose this to me, you know, and especially like now that I have that rule in terms of, you know, I decide what protection I use with my partner and then that they don't have to worry so much about what they do with other people, they can assume their own risk.
Now I'm not that worried about disclosure because it used to be that our rule was that if my STI risk changes because you slept with someone new, then you need to tell me right away. But now that we're using like a lot of barriers between us I'm like okay, it'd be nice to know if there's a change in STI risk in general but I'm good. I'm as protected as I can be and I still want them to get regular STI checkups and they do anyway.
But if they were the kind of person that didn't care about their sexual health, me forcing them to do it isn't going to change anything so like if your partner didn't care about talking to you about stuff, then this rule isn't gonna force them to. So, yeah, think about that rule. And then last but not least thing, again, like, oh yeah, there was two things. One thing. It's not the metamour’s fault that that she didn't know that that was your barrier and you're kind of misdirecting the anger. It's okay to be uncomfortable for a while.
Give yourself permission to be a little bit uncomfortable with her but again kind of realise that maybe you're misdirecting some of that anger. And then last but not least allow yourself to be emotional. It's not bad to be emotional, just know… try to understand how your emotions affect your actions, and sometimes when you feel really really anxious and really really scared, just like you know I've had obsessive compulsive disorder in the past. When I felt anxious I felt the desire to compiles, a desire to control the anxiety by acting in some way that I think will control it, but actually just feeds into the anxiety.
And I think a lot of times when people are in these kind of relationships, they get a compulsion when they feel all this anxiety to do something, to create a rule, create a boundary, to change things, to close things up or do whatever in order to try and stop all that emotion because they don't give themselves permission to feel it. They blame themselves where they think that they're bad or they're irrational or controlling… Let yourself feel things just realise when you're when your motivations for something or to stop those feelings or to get rid of them because that's not helpful and find a healthier way to express your emotions.
Like don't make your partner your therapist. Find a therapist, if it's affordable to you. And, yeah allow yourself to have it because you're not going to be able to get rid of anxiety. The biggest obstacle in my personal experience with anxiety was punishing myself for having it. And so the thing that I try hard in my relationships to do is to just give myself permission to have the feelings. Don't beat myself up for it, and experience it. Because sometimes you just have to go through it, come out the other end and “Okay, that was bad, but here I am, I survived 100% of my worst days, and I'm okay”.
Sometimes you just have to go through that, unfortunately. It sucks but it's kind of a thing that sometimes has to happen. So yeah, I hope that helps and good luck.