I have herpes. Do I have to tell every single partner about it?

“The hard-and-fast ethical rules we come up with in conversation often don’t feel as compelling in real life”

Ask Kai: Advice for the Apocalypse” is a column by Kai Cheng Thom to help you survive and thrive in a challenging world. Have a question? Email askkai@xtramagazine.com.

Dear Kai, 

I’m curious to know your thoughts about disclosing STIs to new sexual partners. Is it something we always have to do, or does it depend on the context, the type of STI, the type of sex we’re having, etc.? The personal aspect of this is that I recently was diagnosed with herpes (Type 2, if that makes a difference), and I was surprised by how embarrassed and ashamed I felt.

I had decent access to queer sex-positive spaces and reading when I was younger, and I know that it’s not “immoral” or “dirty” to have an STI—not to mention tons of people have the herpes virus (HSV). I was raised with the idea that we should talk about STIs with potential and current sex partners, that we shouldn’t shame ourselves or anyone else about them and that it’s always a good idea to practise safer sex. So it was a shock to realize that I seriously struggled to tell new hookups and dates (I have a lot of partners—I’m a slut okay?). And it was shittier still, though less surprising, to see that some people were actually kind of jerks about it, suddenly acting awkward, making mean jokes or treating me like I was dirty. It made me sort of feel like, “Do I have to tell folks at all?” Except of course I should, because I believe in informed consent to sex. But then again, the vast majority of people don’t disclose STIs, especially not one as common as herpes, and a lot of people don’t even know they have it. 

A part of me thinks it’s really shitty to even consider not disclosing. But another part of me thinks that it’s honestly not that big a deal. Yet another part really doesn’t want to give up having a lot of sex with a lot of different people, and I’m afraid of what might happen if I wave my herpes flag high. What if this means I can’t be a slut anymore? 

Surprisingly Ashamed Sinful Slut 

Dear SASS, 

Let me begin by saying that I salute and celebrate your inner slut. Cheers to them and cheers to you, cheers to all the weirdo queer sluts who sashay about on this wretched mortal vale, bringing naughty pleasure and adventure to an all-too-frequently mundane and repressed existence under the boring norms of the Hetero-Patriarch’s World. Never forget, SASS: blessed are the sluts, for we shall inherit the earth. 

 

In the meantime, of course, many of us have also inherited STIs and the accompanying stigma, and this is what you must contend with now. I am sorry that you have been treated badly by some of the people you’ve disclosed to, SASS. You do not deserve it, particularly as you were doing the right—and courageous—thing by disclosing in the first place. 

Yet the topic of STIs (like sex itself) has a way of bringing out the very worst in some people, not least because of the hypocrisy that tends to spill forth when individuals project their own fears and insecurities on to those who are brave enough to be honest. How many people engage in sexual activity without ever knowing they have, or getting tested for, STIs? How many of those people are the very ones who shame and scold others? 

In the queer community, this is particularly disappointing, since so much of our history and culture is supposedly built around sexual liberation and enlightenment, borne of centuries of oppression and the collective trauma of the AIDS crisis. Perhaps it is because of these same traumas that some segments of our community can be so judgmental or stigmatizing of STIs. Maybe it’s the desire to distance oneself from those shared experiences, to achieve some kind of safety from a queerphobic society by acting sexually “respectable” that gives life to continued slut-shaming and STI-shaming among us. 

Enough beating around the proverbial bush, SASS. Let me answer your question directly. Do you always “have” to disclose your HSV 2-positive status to each and every sex partner and potential sex partner in your life? In short, my (decidedly non-medical, non-authoritative) opinion is: it is always better to disclose if it is possible and safe for you to do so. Yet it is not always possible or safe, and there are many who would argue that the symptoms of genital herpes are so relatively minor (and widespread) compared to the stigma attached to the virus that it makes more sense not to disclose. 

Let’s back up a bit here for those who may not have the skinny on genital herpes: genital herpes can be caused by either of two viruses, known as herpes simplex 1 (HSV-1) and herpes simplex virus (HSV-2). These viruses cause periodic outbreaks of cold sores or blisters. HSV-1 often causes cold sores in the mouth, but can also be spread to the genitals by acts such as oral sex. HSV-2 often causes cold sores on the genitals, and is often spread through genital-to-genital contact, or via contact with genital fluids. 

Herpes is an extremely common infection—both the Public Health Agency of Canada and the U.S. Centers for Disease Control report that more than one in 10 people between the ages of 14 and 59 are already positive for HSV-2, and an even greater number are positive for HSV-1. Genital herpes cannot be cured, but it can be treated with medications that can prevent or shorten cold sore outbreaks and reduce (but not eliminate) the likelihood of passing the virus on to a partner. 

With this in mind, let’s return to your ethical question, SASS. Yes, it is better to disclose whenever you can. However, I want to acknowledge that the hard-and-fast ethical rules we come up with in conversation often don’t feel as compelling in real life. I think this is because those rules don’t take into account the social power dynamics at play in any given real-life situation: there are real consequences to disclosing an STI, and that may be especially true for someone with a marginalized sexual or gender identity. A wealthy white person with lots of access to medical care might not be so intensely affected by the stigma against STIs as, for example, a racialized sex worker who relies upon sexual activity to put food on the table. 

It’s also worth interrogating the power dynamic that is inherent to a society that puts the onus on individuals to disclose their STIs without creating a supportive (or even neutral) environment in which to do so. In the dominant culture, we are quick to assign ethical responsibility to an STI-positive person. We tell them they should or must disclose. I think it’s very interesting, SASS, that we do not assign the same level of ethical responsibility to people receiving those disclosures to be kind and compassionate.

“While I do believe in disclosure, I also believe in STI-positive people being entitled to dignity and respect.

This becomes an even more important discussion when we broaden the discussion to include potentially deadlier STIs such as HIV. Statistics show that disclosure of HIV-positive status can lead to discrimination in the areas of housing, healthcare and employment, as well as intimate partner violence. Yet in many jurisdictions, including Canada, many HIV-positive individuals are also criminalized for not disclosing their status to sexual partners, putting them in a terrible catch-22. 

All this to say, SASS, the issue of STI disclosure is not always cut and dried. While I do believe in disclosure, I also believe in STI-positive people being entitled to dignity and respect, and one should not be sacrificed for the other. 

Another issue is simple practicality: in researching this issue to write the column you are currently reading, I was happy to see a number of articles—including some on government websites—that acknowledge the complex nature of disclosure and provided good practical advice on navigating and talking about STIs and safer sex. Yet the vast majority focused on good communication and health protocols between monogamous pairs in long-term relationships. None that I found addressed the topic of STI disclosure in the context of queer sex culture, hookup culture or sex work. 

What is disclosure when one’s access to sexual activity is to be found in primarily anonymous, group or casual environments such as bathhouses, cruising areas or hookup apps? How can you navigate disclosure safely when the person you’re about to have sex with is a stranger or a paying client? Maybe also a person who literally doesn’t speak the same language as you?

It takes real ingenuity, skill and practice to do so, and even then, communication may falter and fail—simply because human beings do. Our bodies are imperfect vessels, we leak fluids and feelings and yes, viruses and bacteria. While the stakes may be high, I think that we all also deserve a little grace, SASS. Please give that to yourself. 

Outside of disclosure, common sense and safer sex practices can help reduce the spread of STIs. Using condoms and other fluid barriers, sticking to lower-risk activities such as sexting, kissing and mutual masturbation, and even good hand-washing practices can all be ways to protect oneself and sexual partners regardless of disclosure. All of these are part of the ethical practice of sex—as is the acknowledgement (without moral judgment) of higher STI risk in group, casual and anonymous sexual encounters. 

Do the best you can to be the best person you can, SASS. That’s all any of us can do. I don’t think you need to give up having an adventurous sex life in order to be ethical, but you will have to make complex decisions and take responsibility for them as you go along. Where you do choose to disclose, know that you have nothing to be ashamed of, and that there are many who will choose to play and partner with you regardless. You are moving toward a future in which sexual pleasure is celebrated and STIs aren’t stigmatized, a future we all deserve to live in. Let’s be the sluts we wish to see in the world, SASS: sluts and proud, sluts forever.


Kai Cheng Thom is no longer a registered or practicing mental health professional. The opinions expressed in this column are not intended or implied to be a substitute for professional medical advice, diagnosis or treatment. All content in this column, including, but not limited to, all text, graphics, videos and images, is for general information purposes only. This column, its author, Xtra (including its parent and affiliated companies, as well as their directors, officers, employees, successors and assigns) and any guest authors are not responsible for the accuracy of the information contained in this column or the outcome of following any information provided directly or indirectly from it.

Kai Cheng Thom is a writer, performer, and social worker who divides her heart between Montreal and Toronto, unceded Indigenous territories. She is the author of the Lambda Award-nominated novel Fierce Femmes and Notorious Liars: A Dangerous Trans Girl's Confabulous Memoir (Metonymy Press), as well as the poetry collection a place called No Homeland (Arsenal Pulp Press). Her latest book, Falling Back in Love with Being Human, a collection of letters and poetry, is out now from Penguin Random House Canada.

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