• Warning: Explicit content
I get an STI check-up every six months.
It's not as often as is recommended for single, sexually-active people (who are advised to go three-monthly), but it's more often than many people I know – some of whom have never been tested.
I was a vocal advocate for the government funding of pre-exposure prophylaxis (PrEP) in New Zealand to prevent new HIV infections; something that finally came into effect earlier this year.
I'm not on it personally, but support those who are: they deserve kudos for contributing to the nationwide goal of eliminating new HIV transmissions in our country by 2025.
PrEP is not an HIV cure but has been scientifically proven to be safer than condom use. However, it doesn't protect against the myriad of other STIs out there in New Zealand, which continue to thrive.
Across the North Island, gonorrhoea, chlamydia, and syphilis infections are rampant. According to New Zealand Doctor, they are spreading rapidly through small, tightly-connected communities in the regions with poor access to sexual health information and facilities.
Such STIs are also going gangbusters in the big cities: Auckland and Wellington are both recording year-on-year highs; particularly of syphilis, an infection that keeps multiplying every year in these parts of the country.
For gay men, for example, there's been a 500 per cent rise in cases in Auckland since 2013, and it's increasingly common in the heterosexual community, including straight women.
Here in these metropolitan areas, sexual health clinics are free, fast, and easily-accessible. We have no reason not to use them, and no reason to see new STI infections continue to trend upwards.
How do you actually contract an STI?
Few people actually understand how STIs transmission happens. We know "unprotected sex" is the cause, but what does that actually mean in practice?
In a general sense, any kind of oral, vaginal, or anal sex without a prophylactic puts you at risk. I'm very strict with condoms for penetrative sex but I'll be honest with you, I've never used protection for oral sex. Despite professional advice that it's the best way to keep myself and my partners safe.
Exposure of another person's sexual fluids or blood to your mucous membranes (the soft, porous skin that covers the openings in your body) is how STIs are commonly transferred.
Some STIs, e.g. syphilis and herpes, can even be transmitted from person-to-person simply by direct contact with external genital sores. It's also important to dispel the myth that ejaculation must occur for STIs to transmit – it doesn't.
Even if you have protected sex every time, getting regularly tested remains important. Particularly if you have more than one sexual partners, but I also advise monogamous couples to get tested every now and again – if for no other reason than it's responsible practice for anybody who's sexually active (no matter their age, relationship status, or sexual orientation).
Even though I don't need to be, I still get a little nervous waiting for my STI test results. It's a natural feeling I think everybody experiences, although it is certainly diminished with regular testing. We are very fortunate in New Zealand to have rapid testing for HIV and syphilis readily available – giving you results in minutes. Lab results for other STIs tend to take a few days.
The logistics of testing are daunting – blood will be taken for HIV and sometimes other STIs, while the rest are tested through swabs of mouth, vagina, penis, and anus. None of it is pleasant, but it's not painful (nor shameful) either. Everybody must experience that same discomfort and you are not alone in feeling weird about the testing process.
Self-testing at home is available at home, but I don't recommend it. The reason for this is that if you test positive (which may be a false positive), you do not have the external support in front of you to deal with it. I believe testing is best left for a clinical setting where immediate medical advice and counselling will be given.
All STIs can be dealt with to ensure you have a safe and healthy sex life in the future, and many are curable through antibiotics or antivirals. There are some strains (e.g. 'superbug gonorrhea' and mycoplasma genitalium) that are antibiotic resistant, and must be treated accordingly.
A handful of cases of these STIs have been recorded in Australia and will almost certainly be present in New Zealand cities soon, if not already. It therefore pays to have them on your sexual health radar.