STDs and Testing

Disclaimer: The information provided in this supplemental lesson is not intended to replace actual medical supervision and/or treatment. It is intended only to assist you in opening the dialogue between you, your partner and your doctor.

STD Testing and Sexually Compulsive Behavior ( Recovery)

One of the most devastating consequences of having engaged in sexually compulsive behavior is the potential that you may have compromised your physical health and/or the health of your partner. What complicates this is the reality that most who engage in such behavior also tend to engage in 'magical thinking' in terms of contracting such diseases. That being, 'they likely won't; don't have an STD and so, there is no need to admit the possibility that they may'. The potential for having an STD is a reality that most in recovery choose not to acknowledge--especially if their addiction has yet to be discovered. And even when that addiction is discovered, there is often ongoing deception to protect the extent of the behaviors involved. This, even at the expense of their partner's (and their own) health. (There are addicts who are so emotionally immature that they would willingly jeopardize their partner's life to maintain their secrets. They will continue to say that they only had protected sex--when that is not the truth. They will continue to say that there was never any penetration--when that is not the truth.)

As a person in recovery, checking yourself out for STDs is not only responsible and indicative of a true commitment to health--it is essential. The testing itself may be embarrassing and potentially shameful--as you will need to be brutally honest about things like extra-marital affairs, anonymous homosexual encounters and other sexual potentially dangerous behavior. So what? It's confidential, so do this willingly. Empower yourself to let go of these behaviors in exchange for a clean bill of health.

But what if it is unlikely that I have an STD?


You may feel that you can skip over this awkward and frightening topic if you do not have any symptoms of a sexually transmitted disease (STD), but in fact, some of the most widespread sexually transmitted diseases can be asymptomatic. That means that you may be infected even if you are not experiencing itching, redness, a fever, blistering, discharge or any other symptoms. The only way to tell whether you have been infected is to be tested.

If you are in a relationship and you know that you have engaged in behavior that may have transmitted an infection, you must approach this openly. The goal is to ensure that no infections have spread--not to add guilt/shame to an already difficult situation.

You do not necessarily have to seek help all on your own. You may wish to enlist the support of your family doctor, a counselor or a member of the clergy. It's not usually a good idea to get a friend or family member involved, although it may be tempting. However, the intervention of a professional may be helpful in this situation.

Whether or not you choose to ask for help in having this conversation, fully disclose whatever facts your partner may need to take care of his or her health. You do not have to describe every sexual encounter in detail -- but you do have to be honest. Any withholding of information at this crucial juncture will only jeopardize your future efforts to rebuild trust and your own sense of self-worth.

This will likely be difficult for you both. A possible script of your initial disclosure conversation might run as follows:

“As you know, I am coming to terms with the consequences of my actions. One thing that I need to tell you is that I may have exposed you to a sexually transmitted disease. I don't feel that I can tell you all the details of my behavior right now, but I do know that we need to get tested and, if necessary, treated. I understand that you may be feeling very angry and scared right now.”


If you do not have a current partner, you should still be tested for STDs. You may feel that if the only person you've jeopardized is yourself, you may not want to know the truth, but many STDs can lead to long-term health problems. By getting tested and (if necessary) treated, you are demonstrating to yourself that you value your own well being.

Getting tested may seem daunting. You may be afraid of what your doctor says, or you may not be able to afford the doctor's visit in the first place. Break this task down into smaller steps. For example:

1) Find clinic phone number in phone book.
2) Make phone call for appointment
3) Look for clinic on map
4) Drive to clinic on day of test.

And note, most cities provide either free testing or testing for nominal fees. And, such testing is completely confidential.

What should you be tested for?

A community member (who happens to be an MD), offered the following:
 
"I can't stress enough the importance of std testing. Early and often. What is routine testing in the well patient exam situation is not routine in this situation. Here is my list of what you should be tested for:

Blood tests(serology):
HIV
Hepatitis B and C
Herpes simplex types 1 and 2 (type-specific antibodies)
Syphilis

Direct sampling:
Gonorrhea (GC)
Chlamydia (CT)
Trichomonas
HPV (Human papilloma virus, high risk type)
Pap test


Additional things to know:
GC, CT and HPV can be tested from ThinPrep or SurePath liquid-based Pap testing material. Most labs offer this, but check with your doctor. They can also be obtained by direct swab of the cervix.

GC and CT can also be performed on voided urine by certain methodologies.

Trichomonas can be detected directly in the office, or by lab testing from a vaginal swab.

Some of you may have had the HBV (Hepatitis B Virus) vaccine, and would not need this test. I highly recommend HBV vaccination to everyone.

For men, the only tests that do not apply are HPV, Trichomonas and the Pap test. For obvious reasons urine is the preferred specimen for GC and CT testing.

Most of these infections are clinically silent. Don't base your decision to be tested on the presence of symptoms."

Please note, this is not intended as medical advice but rather, information to take to your medical doctor for further discussion.

Conclusion

It may sound strange, but the ordeal of getting tested for STDs can turn out to be empowering. Take this step as a way of separating yourself from your addictive past. Once you have made the decision to get tested and have followed through, pause for a moment and experience whatever feelings come your way. You may feel deeply ashamed of yourself. Acknowledge that feeling, but try also to recognize that by taking responsibility for your health and for communicating with those who are close to you, you have acted not as an addict, but as someone who is moving towards a life beyond addiction.

For more information on STDs, you may wish to visit the Center for Disease Control's website at http://www.cdc.gov/std/

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