Wednesday, April 7, 2010
I am regularly asked how to have the difficult discussion with a potential partner regarding being seropositive for herpes ( meaning bloodwork shows you have had an infection in the past, but no outward appearance of disease) or clinically proven or suspected herpes.
This is always tough, but can be managed in a tactful manner. OK, my patients are mostly postmenopausal women,and sex is not an emergency for most of them. In discussions I always ask a potential partner about how are we going to address the topic of STDs. Since nobody knows for sure at any given moment what is what, I recommend that we both get tested and look at the results together. At that point, you can see who has what. Most people are so upset by a diagnosis of herpes they assume the rest of the world is clean, and that they are the only ones with a history of std's. NOT SO! So the scenario goes like this
She: " What do you think we should do to address STDs?"
He: 1.What? 2. I always use condoms. 3.Why?
She: Should we use condoms or both get tested?
He: Oh, what do you think?
She: Well, I read that getting tested is a good way to figure out a strategy unique to us.
He: OK how do we go about getting that done?
One week later after results are obtained:
She:OK here are my results.
He: 1. Here are mine 2.I was too ashamed to get mine done 3.Ok, I'll do it next week.
She: Looks like I am positive for herpes. How about you?
He: 1. Me too, what does that mean? 2. I'm clean, how do we manage this? 3. I have xyz, what do we do?
This is where you add that 1. Transmission is reduced with use of medication, and through condom use. Pick one.
OR: we both have the same thing, Whoopee and jump under the sheets!
Now getting STD testing is as easy as approaching your physician. Pretty much any doctor worth his or her salt should order STD testing without putting you through the third degree. I understand if they want to find out about high risk behaviors, but for the majority of us, it is just to be safe.
Many independent labs will offer STD testing upon patient request. Public health departments have STD clinics that offer free/ low cost/ or ability to pay testing.
Nobody should ever make you feel dirty for asking. That is simply not allowed, so don't feel that way. As a physician and surgeon, I test about every six months.
More to come