If you caught Covid-19, the flu or gastro, you would probably notify the people you have kissed in recent days. But if you contracted chlamydia, gonorrhea or even a papillomavirus (HPV) infection, would you do the same to your partners?
In theory, the answer is simple: yes. The only thing to do in this case is to warn the people with whom you have had sexual relations. But in practice, it seems a little more complicated than that, according to a recent study published by American researchers in The Journal of Sex Researchwhich reports that in practice, only half of people tell their partner before sex that they have contracted a sexually transmitted infection (STI).
Screenings on the rise but…
Going to the dentist or getting tested for an STI is not the most pleasant thing, but when you have to go, you have to go! In France, after a low point during the Covid-19 pandemic, screenings for the most common STIs have started to rise again. “In 2022, 2.6 million people will have benefited at least once from reimbursed screening for Chlamydia trachomatis infection, 3 million from screening for gonococcal infection and 3.1 million from screening of syphilis, indicates Public Health France. The screening rate for these three STIs continues to increase in 2022 as it has for several years, apart from a one-off drop in 2020.”
Problem: the contamination figures for these three STIs are also on the rise. Fortunately, these three STIs benefit from effective treatments. Provided you get tested, if you have symptoms, have had risky sex, or if your partner indicates having tested positive for an STI. It is on this last point that in practice things go wrong. According to work published by researchers at the University of Tennessee, who sifted through data from around thirty studies carried out in the United States and linked to the announcement of an STI to sexual partners, only half of people interviewed warned – or thought they should warn – their partner that they had an STI before having sex with him or her.
Screenings on the rise
There are some for whom the question does not arise. Like Dylan Witter, hero of the brilliant Netflix series “Lovesick” who, when he learned that he had tested positive for chlamydia, undertook to contact all his former sexual partners to warn them and allow them, if necessary, to receive the appropriate treatment. That’s for fiction.
In fact, fortunately, this also happens. While he sees a lot of people coming alone, “we also see people coming in pairs to get tested, which, obviously, helps make the diagnosis for the partner of an infected person,” explains Dr. Nicolas Dupin. , dermatologist responsible for the Sexual Health Center at Hôtel-Dieu (AP-HP) in Paris. And it is also not uncommon to see men and women in consultation who come because their partner told them they had contracted an STI and that they needed to be tested.”
Speaking out of love or moral obligation, remaining silent out of shame
According to the conclusions of the authors of the study, announcing – or not – that one has contracted an STI from one or more sexual partners, whether one is in a relationship with or whether they are regular or occasional, gives rise to the person concerned has different feelings, depending on their profile and concerns. There are those who do it out of love for their partner, to avoid health problems linked to an absence or delay in diagnosis. While most of the most common STIs can be treated quickly, delaying treatment can worsen the condition and cause various harmful effects, including infertility. Those who speak do so out of “moral obligation or even out of love for their partner,” describe Kayley D. McMahan and Spencer B. Olmstead, co-authors of this work. Results indicated that relationship factors such as higher levels of commitment, relationship quality, length of time together, and feeling of closeness were important factors in disclosure.
That’s for the half who choose to speak. The other half chooses to remain silent out of “fear of the partner’s reaction and response, out of fear of being rejected, out of fear of a breakup or even due to the lack of connection.” “obligation” to inform its partners, observe the authors of the study. A figure which “does not surprise at all” Dr Dupin. “Particularly for couples who are supposed to be monogamous: the announcement of an STI, which then constitutes an admission of infidelity, remains a very complicated subject to address. I see it in consultation, with people who have had unprotected extramarital affairs. There, guilt and fear of being left take precedence over health issues.”
“Demystifying the dialogue around STIs”
So, at the sexual health center where he receives all those who come to be tested, Dr Dupin ensures that he provides the necessary information. “When we have patients diagnosed with gonorrhea, chlamydia or syphilis, we must inform them of the need to warn their partners. In practice, there is no mandatory notification system or systematic tracking of STIs, he specifies. And we are not able to check whether the person has informed their partner(s): it is up to the patients’ discretion.”
Although every year, tens of thousands of people test positive for the most common STIs, to date, contracting an STI still remains very serious. Which pushes many people to remain silent. “What I systematically tell patients who test positive for an STI is that you need to warn your partners,” insists Dr. Dupin. Especially since if we don’t say anything, we recontaminate ourselves. For example, in the case of chlamydia, which in 80% of cases is asymptomatic in women, if we say nothing, the woman can eventually develop inflammation of the uterus and fertility problems, and the man can contract it. again. Talking is decisive for the health of your partner and your own. Just like wearing a condom.”
For the head of the sexual health center at Hôtel-Dieu, “we must demystify the dialogue around STIs, break the taboo of shame and put the issue of health and the need to receive treatment quickly at the forefront. In certain populations at risk who are likely to contract several STIs and who are used to very regular monitoring of their sexual health, there will be a tendency to warn their partners directly. Some tools make it very easy.” This is also the purpose of the project led by Olivia Son, an infectious disease specialist from Martinique, who launched the KYSS association a few months ago (for Know Your Status, or know your status in French). An app project intended to allow everyone to anonymously warn their partners in the event of an STI, without disclosing their telephone number or email address.
