In my time as a full-service worker, I have learned to readjust how I approach talking about sex and hygiene with people who often don't feel as comfortable with the topic as I do. These conversations will usually occur when I ask my clients to send me a full STI (Sexually Transmitted Infection) screening before every appointment. This can often lead to pushback due to fear of the results, regardless of whether they're clear, due to their own perceived stigmas around STIs.
When I think about STIs, what initially comes to mind is how people typically view infections such as herpes or HPV, two of the most commonly transmitted viral infections. Oftentimes, people with a positive herpes or HPV status are either victimized, or viewed as dirty by others or themselves. But with a little more open discussion and learning new information, we can lessen these stigmas over time.
The World Health Organization (WHO) estimates that 64% of people globally under the age of 50 have oral HSV1 (Herpes Simplex Virus 1) or 13% of people under the age of 50 having genital HSV2 (Herpes Simplex Virus 2). Most people with HSV1 or HSV2 are asymptomatic, meaning they live most of their daily lives without showing visible signs of the virus, making it hard to detect.
Many people are unaware of their HSV status. When getting your routine STI screening, you may have noticed that your results don’t include a test for HSV. The reason for this is that most doctors don't normally screen for HSV unless you have been exposed and are showing symptoms.
Many people are unaware of their HSV status.
People with herpes are often the object of so much scrutiny that the diagnosis has the potential to be significantly more damaging than the health outcomes of having the actual virus. The stigma and scrutiny associated with an HSV diagnosis can lead to an increase in depression and severely impact one’s quality of life.
When you remove the societal stigma, it becomes clear that HSV is a viral rash like any other viral rash on your body. It's the stigma associated with it being an STI that allows people to view it differently than they would view chickenpox, measles or mononucleosis. The idea that HSV is different from any other rash on your body because of how people relate it to sex is wrong.
Taking everything I have mentioned earlier into consideration, I want to shift the focus to STIs that people are a little more considerate towards. Let me be clear that all STIs come with stigma, it's just that there are infections that can cause significantly more damage than HSV that are far less stigmatised. People will view a virus like HSV as a death sentence despite how harmless it can be, as opposed to bacterial infections like gonorrhoea and chlamydia that can have severe consequences like infertility, ectopic pregnancy, arthritis, and meningitis if left untreated.
This can all sound pretty scary, but these extreme cases can be avoided or treated with the right precautions and care: using condoms, dental dams, antivirals, prescribed antibacterial medicine, PREP (HIV preventative), and getting tested every few months.
For a while I succumbed to the harmful stigma surrounding STIs that is perpetuated by western society. Being someone with Obsessive Compulsive Disorder (OCD), I often struggled with the idea of being "contaminated." This manifested in the form of me being scared of intimacy out of fear that getting an infection would be the end of the world.
For a while I succumbed to the harmful stigma surrounding STIs that is perpetuated by western society.
Over the course of my entire sex-working career I have slowly learned that STIs are usually not as big of a deal as they seem. A good chunk of everything I’ve learned in recent years has been due to the bravery of those humanizing themselves online and taking it upon themselves to teach others (subzub on TikTok does an amazing job of this). Plenty of us were brought up with a damaging culture compounded by a lack of proper education surrounding sex and consent and the rise of the puritanical mindset. These views are heavily pushed by conservative algorithms on the internet.
Internalized shame is a hard thing to break, but I believe it isn't an impossible thing to unlearn and grow from with the right education and practice. It's up to all of us to have these conversations with the people in our lives, clients or otherwise, to help normalise an occurrence that many people will run into at some point in their lives.
Sources and references:
https://stdcenterny.com/herpes/asymptomatic-herpes-shedding.html
https://herpalert.com/blog/2019/10/28/the-correlation-of-suicide-and-herpes/
https://www.medicalnewstoday.com/articles/what-happens-if-chlamydia-is-untreated
https://www.everlywell.com/blog/sti-testing/gonorrhea-long-term-effects/
Herpes simplex virus
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