Get Real! Can People With No Sexual Experience Have STIs?

Heather Corinna

Maybe they don't. But it still makes sense to start a life-long commitment to safer sex practices now.

Laura E asks:

If both
the people involved in having sex have had no previous partners of any
sexual nature, is it safe to presume they don’t have any STDs?

Heather replies:

that’s truly the case — if any two people have had NO sexual contact
of any kind with other partners — then, for the most part, either of
them having a sexually transmitted infection is highly unlikely. It’s
never safe to just presume someone has no STIs without having had any
testing, but in this situation, you can know that it’s not a likely
scenario with most STIs.

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But there are some important caveats.

For starters, when we call an infection "sexually transmitted," we do so because that is how it is most often transmitted or contracted: not because that is only
how it is transmitted or contracted. While many STIs are highly
unlikely to be transmitted any other way than with oral, vaginal or
anal sex — like Chlamydia, Gonorrhea, Syphilis, genital Herpes or HPV
— some STIs can be and are transmitted or contracted nonsexually, such
as by sharing sheets or towels, intravenous drug use, at birth or
through breastfeeding.

HSV-I — oral herpes — is most commonly transmitted non-sexually,
and most people who have it contract it in childhood. Oral herpes can
be transmitted between those two people, orally or genitally. Given how
many people have oral herpes, that is a considerable risk. But most
people with oral herpes have had cold sores (the most common symptom of
HSV-I) at some point, and if they don’t know if they have, could
certainly ask a parent if they remember them ever having one. As well,
even if Herpes is transmitted, while it certainly is an inconvenience
and no one wants it, in most people, it also is not likely to cause any
serious health problems.

Some other sexually transmitted infections can be transmitted
nonsexually. For example, while in many areas, most women are now being
screened for HIV with their pregnancies, and many children getting
regular health care will be tested for infections they could have
acquired through their mothers well before their teen years, HIV can be
transmitted through breast milk, so some people get HIV that way. HIV
can also be transmitted through intravenous drug use or the use of a
dirty needle (like with tattooing or piercing), as is also the case
with Hepatitis. Pubic lice — often colloquially called "crabs" — and
trichomoniasis are STIs that are often also transmitted through casual
contact, like by sharing damp towels with someone who has one of those,
rather than just through sexual contact.

The other big caveat is whether or not any two people really
have or have not had any sexual partnership before. Two big issues with
what we can know that are that a) many people are not truthful about
their sexual history, even to people close to them and b) people often
tend to define what is and isn’t sex differently.

Let’s face it: plenty of us know that sexual history can be hella
loaded. Often when we’re talking to someone about it, it feels like, or
is clear that, there is a kind of answer they want and a kind they
don’t. In some situations, it feels precarious to say we’ve had any
previous sexual experience, while in others, saying you’ve none is
loaded: it depends on who’s asking and what they think is ideal. People
tend to make judgments about us based on sexual history — whatever it
is. And some partners clearly would like their partners to never have
had others, particularly if they have not themselves. Plus, when we’re
talking about sex, it’s usually because we want sex, and when any of us
has an agenda, it can tend to be more likely to be dishonest if we
think doing so might get us what we want.

For those reasons and more, many people find it very hard to be
honest about sex and their sexual history, and many just plain won’t
be. Young people, in particular, also tend to have a pattern of being
more likely to be dishonest about sexual history than older people do,
which isn’t all that surprising when you consider how much more loaded
an issue sex often is for teens and young adults.

I also know that when we love and trust someone — especially if
we’ve known each other for some time or been dating for some time — or
even when we just really like someone, it’s no fun to consider that
that person may not be truthful about sexual history, but it is common.
So, to be realistic, we have to acknowledge that’s entirely possible.
As people who work in sexuality research know, we have to be very
careful about how much stock we put in sexual self-reporting, because
it has a long history of being notoriously unreliable.

Lots of people define what sex is and isn’t differently, too. We can
ask twenty different people who have all had oral or anal sex, for
instance, if they have had sex, and some will say they have while
others will say they have not. Even for those who have had intercourse,
some people won’t "count" that as sex sometimes if, for instance, a
penis was only in a vagina for a minute or two (despite that being
typical for many first-times), not in a certain depth, if vaginal
bleeding didn’t happen, or even just if that person would have
preferred that experience was not one they had.

Personally, I’m of the mind that the best way to deal with all of
this when you are starting to become sexually active is just to start
with safer sex right at the gate, just like you’d wear a seatbelt the
first time you were driving in a car. Since most people will not have
only one sexual partner for the whole of their lives, you and/or your
partner are likely to have to learn to use safer sex in time anyway, so
there’s little sense not learning right from the start.

I also think that when you come to sex together as safely and
responsibly as you can, that it not only protects your health as best
as possible, but it strengthens your relationship and is one thing that
can tend to enable the kind of environment where partners actually feel
more able to be honest about their sexual history. If your partner
happens to feel like asking for safer sex means you don’t trust them,
you can inform them of some of the issues I’ve filled you in on, and
also let them know that people develop trust over time, not instantly.
No one should be expected to trust blindly or right off the bat. We
earn trust from people, gradually, based on behaviors like, for
instance, two people showing each other that they care enough about
both of their health to play things as safe as they can if they’re
going to be sexually active and to be sexually responsible. Trust, all
by itself, just doesn’t keep us physically safe or healthy.

Negotiating safer sex also makes negotiating birth control, if and
when that is a factor easier, as well as negotiating sexual limits and
boundaries or sexual desires much easier. In the case that talking
about any of this or insisting on safer sex seems too daunting right
now, it’s probably a good idea to have another think on if you’re
really yet at a place — in your life or your relationship — where
it’s the right time for sex.

What I suggest anyone does is what is suggested by sound health
organizations like the CDC and WHO when it comes to protecting
yourselves as best you can if you’re going to be sexually active. You
should use latex barriers (like condoms) for all oral, vaginal and/or
anal sex for the first six months of any relationship. You and your
partner should each get tested during that time: if neither of you has had any sexual partnership at all before now (and none besides each
other during that time), one full screening for both of you at the end
of that six months will do just fine. You both also will need to be
sexually exclusive during that period of time to assure no new risks
are being introduced to the equation. In the meantime, you can know
that using safer sex practices and it being possible neither of you
likely has any STIs means you have very little risk, which lets the two
of you actually enjoy the sex you’re having more, physically and
emotionally. Less stress = better sex.

If those tests come out negative, and if you both have stayed
sexually exclusive and intend to remain so, then at that point, if you
like, you can go without latex barriers as your STI risks will be very
low — and known to be, not presumed or guessed — at that point. And
then, too, you two will have had a substantial period of time together
to build trust, and to be able to extend it when it comes to
something like trusting that both of you are staying monogamous if you
say that you are.

Okay? I know that sometimes safer sex and taking precautions can
seem less ideal (even though the idea of sex with no precautions being
more romantic is a bit of a strange ideal, since it often puts people
at risks of some very unromantic things) or like a drag, but it really,
truly only is as much of a drag as anyone makes it. When it is a
regular habit for everyone involved, it’s just no big deal — no more
so than other common aspects of sex like having to shift positions now
and then because our legs hurt, taking a second to go pee, or asking a
partner to change up what they’re doing because something else feels
better — nor is it something that gets in the way of trust, intimacy
or enjoyable sex. Rather, it tends to nurture those things a lot better
than gambling with presumptions does.

Here are some more links for you to inform yourself with:

Roundups Sexual Health

This Week in Sex: The Sexually Transmitted Infections Edition

Martha Kempner

A new Zika case suggests the virus can be transmitted from an infected woman to a male partner. And, in other news, HPV-related cancers are on the rise, and an experimental chlamydia vaccine shows signs of promise.

This Week in Sex is a weekly summary of news and research related to sexual behavior, sexuality education, contraception, STIs, and more.

Zika May Have Been Sexually Transmitted From a Woman to Her Male Partner

A new case suggests that males may be infected with the Zika virus through unprotected sex with female partners. Researchers have known for a while that men can infect their partners through penetrative sexual intercourse, but this is the first suspected case of sexual transmission from a woman.

The case involves a New York City woman who is in her early 20s and traveled to a country with high rates of the mosquito-borne virus (her name and the specific country where she traveled have not been released). The woman, who experienced stomach cramps and a headache while waiting for her flight back to New York, reported one act of sexual intercourse without a condom the day she returned from her trip. The following day, her symptoms became worse and included fever, fatigue, a rash, and tingling in her hands and feet. Two days later, she visited her primary-care provider and tests confirmed she had the Zika virus.

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A few days after that (seven days after intercourse), her male partner, also in his 20s, began feeling similar symptoms. He had a rash, a fever, and also conjunctivitis (pink eye). He, too, was diagnosed with Zika. After meeting with him, public health officials in the New York City confirmed that he had not traveled out of the country nor had he been recently bit by a mosquito. This leaves sexual transmission from his partner as the most likely cause of his infection, though further tests are being done.

The Centers for Disease Control and Prevention (CDC)’s recommendations for preventing Zika have been based on the assumption that virus was spread from a male to a receptive partner. Therefore the recommendations had been that pregnant women whose male partners had traveled or lived in a place where Zika virus is spreading use condoms or abstain from sex during the pregnancy. For those couples for whom pregnancy is not an issue, the CDC recommended that men who had traveled to countries with Zika outbreaks and had symptoms of the virus, use condoms or abstain from sex for six months after their trip. It also suggested that men who traveled but don’t have symptoms use condoms for at least eight weeks.

Based on this case—the first to suggest female-to-male transmission—the CDC may extend these recommendations to couples in which a female traveled to a country with an outbreak.

More Signs of Gonorrhea’s Growing Antibiotic Resistance

Last week, the CDC released new data on gonorrhea and warned once again that the bacteria that causes this common sexually transmitted infection (STI) is becoming resistant to the antibiotics used to treat it.

There are about 350,000 cases of gonorrhea reported each year, but it is estimated that 800,000 cases really occur with many going undiagnosed and untreated. Once easily treatable with antibiotics, the bacteria Neisseria gonorrhoeae has steadily gained resistance to whole classes of antibiotics over the decades. By the 1980s, penicillin no longer worked to treat it, and in 2007 the CDC stopped recommending the use of fluoroquinolones. Now, cephalosporins are the only class of drugs that work. The recommended treatment involves a combination of ceftriaxone (an injectable cephalosporin) and azithromycin (an oral antibiotic).

Unfortunately, the data released last week—which comes from analysis of more than 5,000 samples of gonorrhea (called isolates) collected from STI clinics across the country—shows that the bacteria is developing resistance to these drugs as well. In fact, the percentage of gonorrhea isolates with decreased susceptibility to azithromycin increased more than 300 percent between 2013 and 2014 (from 0.6 percent to 2.5 percent).

Though no cases of treatment failure has been reported in the United States, this is a troubling sign of what may be coming. Dr. Gail Bolan, director of CDC’s Division of STD Prevention, said in a press release: “It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persists. We need to push forward on multiple fronts to ensure we can continue offering successful treatment to those who need it.”

HPV-Related Cancers Up Despite Vaccine 

The CDC also released new data this month showing an increase in HPV-associated cancers between 2008 and 2012 compared with the previous five-year period. HPV or human papillomavirus is an extremely common sexually transmitted infection. In fact, HPV is so common that the CDC believes most sexually active adults will get it at some point in their lives. Many cases of HPV clear spontaneously with no medical intervention, but certain types of the virus cause cancer of the cervix, vulva, penis, anus, mouth, and neck.

The CDC’s new data suggests that an average of 38,793 HPV-associated cancers were diagnosed each year between 2008 and 2012. This is a 17 percent increase from about 33,000 each year between 2004 and 2008. This is a particularly unfortunate trend given that the newest available vaccine—Gardasil 9—can prevent the types of HPV most often linked to cancer. In fact, researchers estimated that the majority of cancers found in the recent data (about 28,000 each year) were caused by types of the virus that could be prevented by the vaccine.

Unfortunately, as Rewire has reported, the vaccine is often mired in controversy and far fewer young people have received it than get most other recommended vaccines. In 2014, only 40 percent of girls and 22 percent of boys ages 13 to 17 had received all three recommended doses of the vaccine. In comparison, nearly 80 percent of young people in this age group had received the vaccine that protects against meningitis.

In response to the newest data, Dr. Electra Paskett, co-director of the Cancer Control Research Program at the Ohio State University Comprehensive Cancer Center, told HealthDay:

In order to increase HPV vaccination rates, we must change the perception of the HPV vaccine from something that prevents a sexually transmitted disease to a vaccine that prevents cancer. Every parent should ask the question: If there was a vaccine I could give my child that would prevent them from developing six different cancers, would I give it to them? The answer would be a resounding yes—and we would have a dramatic decrease in HPV-related cancers across the globe.

Making Inroads Toward a Chlamydia Vaccine

An article published in the journal Vaccine shows that researchers have made progress with a new vaccine to prevent chlamydia. According to lead researcher David Bulir of the M. G. DeGroote Institute for Infectious Disease Research at Canada’s McMaster University, efforts to create a vaccine have been underway for decades, but this is the first formulation to show success.

In 2014, there were 1.4 million reported cases of chlamydia in the United States. While this bacterial infection can be easily treated with antibiotics, it often goes undiagnosed because many people show no symptoms. Untreated chlamydia can lead to pelvic inflammatory disease, which can leave scar tissue in the fallopian tubes or uterus and ultimately result in infertility.

The experimental vaccine was created by Canadian researchers who used pieces of the bacteria that causes chlamydia to form an antigen they called BD584. The hope was that the antigen could prompt the body’s immune system to fight the chlamydia bacteria if exposed to it.

Researchers gave BD584 to mice using a nasal spray, and then exposed them to chlamydia. The results were very promising. The mice who received the spray cleared the infection faster than the mice who did not. Moreover, the mice given the nasal spray were less likely to show symptoms of infection, such as bacterial shedding from the vagina or fluid blockages of the fallopian tubes.

There are many steps to go before this vaccine could become available. The researchers need to test it on other strains of the bacteria and in other animals before testing it in humans. And, of course, experience with the HPV vaccine shows that there’s work to be done to make sure people get vaccines that prevent STIs even after they’re invented. Nonetheless, a vaccine to prevent chlamydia would be a great victory in our ongoing fight against STIs and their health consequences, and we here at This Week in Sex are happy to end on a bit of a positive note.

Roundups Politics

Campaign Week in Review: Republican National Convention Edition

Ally Boguhn

The Trump family's RNC claims about crime and the presidential candidate's record on gender equality have kept fact-checkers busy.

Republicans came together in Cleveland this week to nominate Donald Trump at the Republican National Convention (RNC), generating days of cringe-inducing falsehoods and misleading statements on crime, the nominee’s positions on gender equality, and LGBTQ people.

Trump’s Acceptance Speech Blasted for Making False Claims on Crime

Trump accepted the Republican nomination in a Thursday night speech at the RNC that drew harsh criticism for many of its misleading and outright false talking points.

Numerous fact-checkers took Trump to task, calling out many of his claims for being “wrong,” and “inflated or misleading.”

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 Among the most hotly contested of Trump’s claims was the assertion that crime has exploded across the country.

“Decades of progress made in bringing down crime are now being reversed by this administration’s rollback of criminal enforcement,” Trump claimed, according to his prepared remarks, which were leaked ahead of his address. “Homicides last year increased by 17 percent in America’s 50 largest cities. That’s the largest increase in 25 years. In our nation’s capital, killings have risen by 50 percent. They are up nearly 60 percent in nearby Baltimore.”

Crime rates overall have been steadily declining for years.

“In 2015, there was an uptick in homicides in 36 of the 50 largest cities compared to the previous years. The rate did, indeed, increase nearly 17 percent, and it was the worst annual change since 1990. The homicide rate was up 54.3 percent in Washington, and 58.5 percent in Baltimore,” explained Washington Post fact checkers Glenn Kessler and Michelle Ye Hee Lee. “But in the first months of 2016, homicide trends were about evenly split in the major cities. Out of 63 agencies reporting to the Major Cities Chiefs Association, 32 cities saw a decrease in homicides in first quarter 2016 and 31 saw an increase.”

Ames Grawert, a counsel in the Brennan Center’s Justice Program, said in a statement posted to the organization’s website that 2016 statistics aren’t sufficient in declaring crime rate trends. 

“Overall, crime rates remain at historic lows. Fear-inducing soundbites are counterproductive, and distract from nuanced, data-driven, and solution-oriented conversations on how to build a smarter criminal justice system in America,” Grawert said. “It’s true that some cities saw an increase in murder rates last year, and that can’t be ignored, but it’s too early to say if that’s part of a national trend.” 

When Paul Manafort, Trump’s campaign chairman, was confronted with the common Republican falsehoods on crime during a Thursday interview with CNN’s Jake Tapper, he claimed that the FBI’s statistics were not to be trusted given that the organization recently advised against charges in connection with Hillary Clinton’s use of a private email server during her tenure as secretary of state.

“According to FBI statistics, crime rates have been going down for decades,” Tapper told Manafort. “How can Republicans make the argument that it’s somehow more dangerous today when the facts don’t back that up?”

“People don’t feel safe in their neighborhoods,” said Manafort, going on to claim that “the FBI is certainly suspect these days after what they did with Hillary Clinton.”

There was at least one notable figure who wholeheartedly embraced Trump’s fearmongering: former KKK Grand Wizard David Duke. “Great Trump Speech,” tweeted Duke on Thursday evening. “Couldn’t have said it better!”

Ben Carson Claims Transgender People Are Proof of “How Absurd We Have Become”

Former Republican presidential candidate Ben Carson criticized the existence of transgender people while speaking at the Florida delegation breakfast on Tuesday in Cleveland.  

“You know, we look at this whole transgender thing, I’ve got to tell you: For thousands of years, mankind has known what a man is and what a woman is. And now, all of a sudden we don’t know anymore,” said Carson, a retired neurosurgeon. “Now, is that the height of absurdity? Because today you feel like a woman, even though everything about you genetically says that you’re a man or vice versa?”

“Wouldn’t that be the same as if you woke up tomorrow morning after seeing a movie about Afghanistan or reading some books and said, ‘You know what? I’m Afghanistan. Look, I know I don’t look that way. My ancestors came from Sweden, or something, I don’t know. But I really am. And if you say I’m not, you’re a racist,’” Carson said. “This is how absurd we have become.”

When confronted with his comments during an interview with Yahoo News’ Katie Couric, Carson doubled down on his claims.“There are biological markers that tell us whether we are a male or a female,” said Carson. “And just because you wake up one day and you say, ‘I think I’m the other one,’ that doesn’t change it. Just, a leopard can’t change its spots.”

“It’s not as if they woke up one day and decided, ‘I’m going to be a male or I’m going to be a female,’” Couric countered, pointing out that transgender people do not suddenly choose to change their gender identities on a whim.

Carson made several similar comments last year while on the campaign trail.

In December, Carson criticized the suggested that allowing transgender people into the military amounted to using the armed services “as a laboratory for social experimentation.”

Carson once suggested that allowing transgender people to use the restroom that aligned with their gender identity amounted to granting them “extra rights.”

Ivanka Trump Claims Her Father Supports Equal Pay, Access to Child Care

Ivanka Trump, the nominee’s daughter, made a pitch during her speech Thursday night at the RNC for why women voters should support her father.

“There have always been men of all background and ethnicities on my father’s job sites. And long before it was commonplace, you also saw women,” Ivanka Trump said. “At my father’s company, there are more female than male executives. Women are paid equally for the work that we do and when a woman becomes a mother, she is supported, not shut out.” 

“As president, my father will change the labor laws that were put into place at a time when women were not a significant portion of the workforce. And he will focus on making quality child care affordable and accessible for all,” she continued before pivoting to address the gender wage gap. 

“Policies that allow women with children to thrive should not be novelties; they should be the norm. Politicians talk about wage equality, but my father has made it a practice at his company throughout his entire career.”

However, Trump’s stated positions on the gender wage gap, pregnancy and mothers in the workplace, and child care don’t quite add up to the picture the Trumps tried to paint at the RNC.

In 2004, Trump called pregnancy an “inconvenience” for employers. When a lawyer asked for a break during a deposition in 2011 to pump breast milk, Trump reportedly called her “disgusting.”

According to a June analysis conducted by the Boston Globe, the Trump campaign found that men who worked on Trump’s campaign “made nearly $6,100, or about 35 percent more [than women during the April payroll]. The disparity is slightly greater than the gender pay gap nationally.”

A former organizer for Trump also filed a discrimination complaint in January, alleging that she was paid less than her male counterparts.

When Trump was questioned about equal pay during a campaign stop last October, he did not outline his support for policies to address the issue. Instead, Trump suggested that, “You’re gonna make the same if you do as good a job.” Though he had previously stated that men and women who do the same job should be paid the same during an August 2015 interview on MSNBC, he also cautioned that determining whether people were doing the same jobs was “tricky.”

Trump has been all but completely silent on child care so far on the campaign trail. In contrast, Clinton released an agenda in May to address the soaring costs of child care in the United States.

Ivanka’s claims were not the only attempt that night by Trump’s inner circle to explain why women voters should turn to the Republican ticket. During an interview with MSNBC’s Chris Matthews, Manafort said that women would vote for the Republican nominee because they “can’t afford their lives anymore.”

“Many women in this country feel they can’t afford their lives, their husbands can’t afford to be paying for the family bills,” claimed Manafort. “Hillary Clinton is guilty of being part of the establishment that created that problem. They’re going to hear the message. And as they hear the message, that’s how we are going to appeal to them.”

What Else We’re Reading

Vox’s Dara Lind explained how “Trump’s RNC speech turned his white supporters’ fear into a weapon.”

Now that Mike Pence is the Republican nominee for vice president, Indiana Republicans have faced “an intense, chaotic, awkward week of brazen lobbying at the breakfast buffet, in the hallways and on the elevators” at the convention as they grapple with who will run to replace the state’s governor, according to the New York Times.

“This is a party and a power structure that feels threatened with extinction, willing to do anything for survival,” wrote Rebecca Traister on Trump and the RNC for New York Magazine. “They may not love Trump, but he is leading them precisely because he embodies their grotesque dreams of the restoration of white, patriarchal power.”

Though Trump spent much of the primary season denouncing big money in politics, while at the RNC, he courted billionaires in hopes of having them donate to supporting super PACs.

Michael Kranish reported for the Washington Post that of the 2,472 delegates at the RNC, it is estimated that only 18 were Black.

Cosmopolitan highlighted nine of the most sexist things that could be found at the convention.

Rep. Steve King (R-IA) asked, “Where are these contributions that have been made” by people of color to civilization?