Ethical Responsibility: STI Edition

Last year I published a post called “Ethical Responsibility,” and it has been one of the top viewed posts since. In that post, I pose an ethical question surrounding infidelity.

Today, we’re going talk talk about the ethical responsibility around Sexually Transmitted Infections (STI), formally known as STDs.

First, let me make this abundantly clear:

There is no shame in having an STI. None whatsoever. Far too many people who have any STI, especially an incurable one like Herpes (HSV), HPV, or HIV, feel a lot of shame around the infection. They feel like a leper, like their sex life is over.

You’re not a leper.

Your sex life is not over.

STIs are hugely stigmatized in our culture, which is unfortunate as it causes an increase in the shame and thereby and increase in people hiding their STIs from partners, which, of course, increases chance of transmission. Most STIs are curable these days. A round of antibiotics or a shot will kill most STIs, so the only thing that makes these different than any other virus (like the common cold or the flu) is that they are transmitted sexually and concern the genitals. In our prudish society, I suppose this makes all the difference in the world.

For me, that’s balderdash.

That isn’t to say that one does not have the ethical responsibility to not only be tested regularly and share your results with your potential and current sexual partners. Even if it’s curable, you have a responsibility to tell everyone. Just as you don’t want to transmit a cold or the flu or strep throat, out of respect and common curtesy, the same goes for STIs. And even moreso because we are talking about an intimate act that requires trust. As I’ve written about before, Sex is a Gift — respect yourself and respect your partners. Get tested. Share results.

Now, for nondurable STIs, it’s even more essential that you know what you have, what you’ve been exposed to, and inform your potential/current partners of those results.

Let’s take Herpes, one of the most stigmatized STIs out there.

Herpes Simplex Virus One (HSV1): Oral Herpes/Cold Sores – there are those who don’t even consider this an STI because, although it can be transmitted sexually, so can just about any virus, including the flu. This virus is normally transmitted through casual affection between family members, normally during childhood. So you can get it from a parent, aunt or uncle, grandmother, friend, friend of a friend, etc. Just like a cold or the flu or strep throat, among other viruses.

Up to 80% of the population carry HSV1, and 60% of those acquire it before age 6.

I carry HSV1. When I was tested last year, my test came back positive for HSV1, and I was mortified. I asked the doctor, the lab technician, my psychiatrist, and loads of friends if I needed to contact past lovers and tell new lovers that I carried HSV1. Every one of them said no, that it wasn’t a proper STI. They said that if a person is sexually active at all, that means even kisses other people, then they’ve already been exposed to it if they hadn’t been throughout the rest of their lives through casual affection.

I’ve never had an outbreak on or around my lips. No cold sores. No nothing. But the blood test came back positive. There are other ways it can manifest, though, as I’ve been learning. I’ve had sore throats and canker sores on and off throughout my life. These may be caused by the HSV1 virus, and they might not be…but at least I know.

I didn’t call my former lovers to tell them I had it, for everyone said “no big deal.” I do, however, tell any new lover as soon as possible. I start that STD/STI talk up front now, even though HSV1 isn’t considered an STI by most of society. I still tell them now…if for no other reason than to open up that conversation because I no longer trust people to tell me if they have something on their own.

Plus, HSV1 can be transmitted via oral sex, so it can be transferred from oral or genital. Although that is so rare it almost never happens, that’s not my concern. My concern is that my partner has the choice. It’s their body, their health. Not mine.

So I tell everyone now.

Up until this year, I figured that if someone had an STI, they would divulge that before we got sexually active. After all, I would. When I was 20, I contracted chlamydia through unprotected sex. It was caught during a normal checkup, thankfully, and I was treated. Even while on the antibiotics, when I would no longer be contagious, I told a new lover that I was being treated for it.

I let him decide whether or not he wanted to take the risk.

That’s respect.

Herpes Simplex Virus Two (HSV2): Genital Herpes – It is estimated that 20% of the population carries HSV2, that’s one in five people. 80% of them don’t even know they have it. This is not something that is transmitted through casual affectionate contact via family members and friends. Unlike HSV1, HSV2 is transmitted sexually. It is your responsibility to get tested if you are sexually active. It is your responsibility to share those results with your partner.

It’s a matter of respect for your fellow human being, especially because they are your lover.

I didn’t get that respect, and countless other women he’s been with haven’t either. I was exposed to HSV2 recently, and I wasn’t given a choice for six weeks. Once I found out, and I only found out because I brought up the topic and told him about the HSV1, despite the advice of all those friends and professionals mentioned above, I was already falling in love. I took the risk, after all, I had already been exposed multiple times over those six weeks, and I could understand his embarrassment. Of course, I would’ve taken the risk anyway, especially because he’s on the suppressant drugs that, according to him, gives less than a 1% chance of transmission, especially with protected intercourse.

That was his excuse for not divulging the information. The risk was so low, that he had made the decision for all his partners. He did the research, he said. He knew best, he said. He made the decision for everyone.

Not okay.

First of all, the risk of transmission isn’t less than 1%, it’s more like 12-15% chance, even on the suppressant drugs with protection. These drugs actually only reduce the risk of transmission by 48%.

Secondly, transmission is through asymptomatic shedding, even on the suppressant drugs. A new study shows that even high doses of the antiviral suppressant drugs doesn’t stop asymptomatic shedding.

Thirdly, it’s been seven years since he’s had an outbreak, and he still hasn’t had the blood test done to find out if it’s HSV1 or HSV2. It is, of course, likely HSV2, since it manifested genitally, but the point is his lack of responsibility around the entire issue. Something, by the way, he became very angry, accusatory, withdrawn, callous, and condescending about. That was the first time I saw the monster beneath the mask, but I explained it away, telling myself he was feeling ashamed and allowing my love for him to take a nurturing stance, an accepting one. This is an example of how my compassion becomes dangerous to me.

Regardless, the chance of transmission or type is irrelevant. He knows he has some form of herpes. He know he’s had several outbreaks. He knows he has to take suppressant drugs to reduce the risk of transmission. And he knows that it’s his choice to lie to his partners by omission, which speaks to a serious lack of honesty and integrity.

That is a problem in any relationship, especially a polyamorous one where there are multiple partners at risk if one person is dishonest. His other girlfriend, by the way, didn’t find out for five months, and he didn’t tell her. She found out through a mutual friend of ours. She has a husband and children. Her husband has other lovers.

Dishonesty in polyamorous circles is dangerous.

Be responsible for your body and be respectful to your partner(s). Get tested. Be honest. Have integrity.

Find the courage.

There is no shame in having an STI. There is only shame in deception.

(When you get tested, you must ask to be tested for herpes. Get the blood test done.)

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Varicella Zoster Virus (HSV3), AKA Chicken Pox 

Enough said to illustrate the absurdity of the stigma around HSV2. It’s virtually the same virus that causes cold sores and chicken pox. Not fun, either of them. Nothing you want to have or to transmit, but also nothing to be ashamed of. Nothing to hide.

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Bottom line: There is no shame in having an STI.

The shame is in lying about it or deceiving your partners around it.

The shame is not having the integrity to be honest about it, to have the respect for your partners to make their own choice around the risk, no matter how small that risk might be.

It’s their body. It’s their choice.

Show some respect.

Now…for the ethical questions…

Do you start that conversation or do you trust your partner to tell you if s/he is positive for something?

Do you require documentation? I’ve met people in the poly community who require documentation and still use not only condoms but latex gloves and dental dams. How far do you go in protecting yourself?

If you know someone who has an STI, especially an incurable one, who does not tell his partners about it before sexual activity (if ever), would you warn that potential partner about not only the STI but also on the lack of trustworthiness and integrity of that person?

Why or why not?

What if that person is in your polyamorous community and was fairly promiscuous?

What if that person was chatting up a good friend? The wife of a good friend?

What if they had a habit not only of lying about their STI status but also of exploiting partners before cruelly devaluing and discarding them? Of manipulation?

When does silence become complicity?

Next week, We’re going to discuss how silence is the abuser’s greatest weapon.
Do you want to help arm them by using the excuse “it’s none of my business”?

~ by omgrey on May 2, 2012.