We've all (probably) heard the story of the birds and the bees—the centuries-, likely millennia-old oral tradition using analogy to explain intercourse by referencing what can be observed in nature. As times have changed, so have we, including how we receive information. In an era when social media puts everything at our fingertips, it's no surprise sex education is prevalent online.
An increasing number of TikTokers have taken to the platform to share their experiences about sexual health, from how they talk to their partners to how they handle contracting a sexually transmitted infection or disease (STI/STD). The comment sections of these viral videos are often riddled with myths, misinformation, stigmas and generally unaware teens and adults.
We rounded up some of the most frequently recurring questions about STIs/STDs and sought answers from Tajuana Blackman, a sex health educator and HIV prevention coordinator based in Kansas City, Missouri, and Taylor Akers, a sexologist and sexual bioanthropologist based in Indianapolis. Think of it as the birds and the bees 2.0.
I've been with my partner for two-plus years. Should we still be getting tested for STIs/STDs?
Blackman: The CDC [Centers for Disease Control and Prevention] recommends getting tested every three to six months if you're sexually active. Always ask for a full panel screening to ensure no STIs fall through the cracks.
Akers: Yes, the CDC does recommend every three to six months, but there are more specific testing recommendations for certain populations, such as heterosexual women, gay, bisexual, men who have sex with men, and pregnant women, as they are disproportionately affected by STIs at high rates. I also personally recommend testing before new partners and after old ones. It's always best to #knowyourstatus.
What is the testing process like?
Blackman: Culture collection can look different and range from urine tests and blood tests to swabbing of the genitalia.
Akers: When going to get tested, you'll start by answering a detailed questionnaire about your sexual history. These questions are vital in case of a reactive test so that your partners can be contacted in order to be tested and treated. Site-specific STI testing is incredibly important. This is when the areas you use for sex (anal, oral or vaginal) get swabbed for testing.
I've been seeing the same doctor since I was a kid. How do I talk to her about sex?
Blackman: Bring it up. The more your doctor knows, the better. If you're having any abnormal symptoms, such as itching, bleeding, bad odor or discharge, don't hesitate to share that with your physician so they're better equipped to provide the care you need.
Akers: If you're anxious about mentioning sexual health concerns to your provider, write down what issues you are having first. When you see your provider, just be honest and begin the conversation by saying, "I'm having personal issues with 'XYZ' and [am] unsure of how to navigate it. Do you have any recommendations? How can we fix this?"
How do I know if what's happening down below is because of sex? Are STIs common?
Akers: Human papillomavirus, or HPV, is the most common viral STI in the United States, with an estimated 43 million infections in 2018. Chlamydia is the most common bacterial STD reported in the United States and is often asymptomatic. In 2019, a total of 1,808,703 cases of chlamydia trachomatis infections were reported to the CDC.
When symptoms are present, they usually consist of an unusual vaginal discharge, pain when urinating, bleeding after sex or in between periods, and pelvic pain and discomfort for vagina owners. For penis owners, the symptoms could be burning during urination, watery "drip" discharge from the tip of the penis and swollen testicles. If you have rectal chlamydia, the symptoms include bleeding, rectal pain and discharge.
Gonorrhea has become progressively resistant to antibiotics and is another common bacterial STD, especially for people ages 15 to 24 years old. When symptoms are present, vagina owners can experience vaginal discharge and painful urination, which could be mistaken as a UTI [urinary tract infection] or vaginitis. For penis owners, the symptoms are unusual white, yellow or green penile discharge and painful urination.
I'm dating someone who has herpes (HSV). Can we have sex?
Akers: The decision to have sex with a person living with an STI or STD comes down to your own personal choice. For penetrative sexual contact, use barrier methods like condoms or dental dams. If your partner is having an active outbreak [or] has lesions or ulcers, it's best to avoid sexual contact with those areas to prevent transmission.
HSV [herpes simplex virus] is treatable and can be managed by consistently taking antiviral medication, which helps lessen or prevent outbreaks and can assist in reducing the chance of transmitting it to partners.
My partner doesn't want to be tested because he says we should trust each other. I want us to get tested but don't want to risk my relationship. Advice?
Akers: The decision to have sex with a person who refuses to get tested comes down to your own personal judgment. If you decide to have any type of sexual activity with a person who won't get tested, know the risk you're putting yourself and your body in, and own it.
Use barrier methods and #knowyourstatus before going into the situation. There are resources available to help you ask your partner(s) to get tested.
We don't have insurance. Can the ER test for STDs?
Blackman: An emergency room or urgent care would not be the most ideal location for something like this. There are a lot of healthcare facilities that offer routine testing, like your local health department or on-campus clinics for college students.
Akers: Visit the Get Tested website by the CDC to find a nearby STI testing site. There are also local community health centers or nonprofit organizations, such as Planned Parenthood, that specialize in sexual and reproductive health care at a low-cost, sliding scale or even for free if you live in a metropolitan area. You can also order STI tests online from places like nurx.com or other at-home STD test kits.
Sex is a fun way to express attraction between partners, but it's important to do so safely and when all parties are comfortable engaging in sexual activity, even nonintercourse acts such as cuddling, mutual masturbation and outercourse.