“I prefer to do it without a condom”
Before he could object, she added that it was the fourth day of her cycle so it would not be very messy and there was no chance of getting pregnant. She thought her declaration would take care of any concern on his part and was stunned when he flatly refused to do it without protection.
“Don’t you have enough self control to pull out in time?” she retorted in a huff!
Dr Prakash Tawde, 35, was not surprised by her preference or her reaction because he had been through the drill many times. “A lot of people believe that if you don’t use a condom, it is going to be okay because they trust this person and know that they don’t have HIV (human immunodeficiency virus).”
So whenever this conversation happens, he tells them that he will use protection no matter how safe they are or how few sexual partners they have had.
“Multiple women have done that and sometimes it has been with women I have been in a relationship with, but even then you need to test and you need to trust.”
Considering the risks involved in any sexual activity, even those who are open to discussing protection for birth control are often edgy when it comes to talking about safe sex. All the people, who spoke to THE MAN on STDs, revealed the gaps in the conversations and of course during their interaction which lead to high exposure.
One does wonder whether the taboo around discussing Sexually Transmitted Infections (STIs) is so strong that people prefer to live in denial and are willing to take extreme risks. Dr Prakash agrees, “It’s not just about pregnancy. I have seen healthcare workers who either are not aware of STIs or they are high risk takers. Or, they believe it can’t happen to them.”
Having said that, he does admit to being careful while selecting such partners and watches out for red flags like cold sores or discharges or itching. People who have not used protection in the past are a big No-No according to him.
He also admits that he has had multiple partners, so any potential partner can choose to back out if they are concerned about safety.
How open is an open conversation?
While Dr Prakash and his partners are open about asking each other’s body count (number of people they have been sexually active with in the past) or test status, not everybody is equally comfortable.
In some cases it is almost impossible to discuss protection without implying that the other person has a disease. They are offended by a harmless question like, “Are you safe?”
Chennai-based Suresh Iyer, 46, experienced a situation where the woman was offended to such an extent that she lashed out, “Are you asking because you have an STD?”
Obviously, it didn’t go anywhere because Suresh is very clear about his priorities. According to him, it should be a normal question, but it is not that normal. Having said that, he has been asked whether he is safe.
“It is imperative that you ask, you know and you tell. It does not matter whether the relationship that you are entering into is for the long term or short term. In fact, in one situation, a woman called up after three years to say that she tested positive for some disease and I should test too!” Thankfully, it wasn’t for something like HIV and he wasn’t too worried because he has been testing post exposure when needed or during his annual health check-up based on the recommendation of a doctor.
In his case, he has been asked if he is safe while discussing protection. But, that question usually comes up in an intimate situation when the issue of whether to use a condom or not arises.
For many men, using a condom continues to be for birth control rather than safety as Bengaluru-based dentist Dr Meghna Sharma, 45, discovered. “Initially I was hesitant to ask but then I started asking after I went through a health scare.”
Mostly, she has received defensive responses like, “Of course I am clean.” But, many guys do get it when she asks, “Have you been tested?”, even though she doesn't mention STDs. “I have also been upfront too. If we are going to that level of discussion to ensure safety, then I also throw in the fact that I prefer to use protection and I don’t use any pills. If the conversation reaches a point where we decide to get intimate then I have discussed it openly.”
How safe is so-called safe sex?
Mumbai's Ramya Krishnan, 44, tells all her potential partners that she does not enjoy oral sex. “They are usually shocked and keep asking repeatedly whether I have tried receiving oral sex and how all their previous girlfriends enjoy way more than penetrative sex. My response is a standard ‘not interested’ because I know that nobody uses protection during oral sex.”
Dr Meghna has also discovered that there aren’t many takers for using protection during oral sex. In fact, when it comes to safe sex, in her experience even doctors are not aware of what to ask or when to test. She had a nasty incident where her gynaecologist, who could not answer all her doubts, referred her to an infectious diseases expert at a renowned hospital. This doctor bombarded her with questions to describe the positions they indulged
in and the anatomy of her partner, which she felt was unnecessary and probably an attempt to rattle her for some perverse pleasure!
After that experience, she has taken to reading and educating herself about the risks and tests to stay safe.
But, even if your policy is no condom, no sex, there is a risk of contracting certain infections like HPV (human papillomavirus) if you are merely sexually active. While women can get a pap smear to check for HPV, there is no way that men can test for HPV.
Certain strains of HPV can cause different types of cancer, such as cervical cancer, throat cancer or anal cancer, depending on which part of the body is carrying the virus.
In Dr Prakash’s case, even though he is aware of HPV, it is a risk he is willing to take because HPV can even be transmitted through kissing (exchange of saliva). “I probably have HPV because I have had multiple sexual partners,” he admits.
How does one stay safe?
Dr Duru Shah, Director Gynaec World, answered all our questions related to prevention, safety and testing. Are there any signs of infection to watch out for in your partner?
If there are blisters around the genital area or around the mouth, usually referred to as cold sores, then it may be due to an active herpes infection.
Apart from herpes, there are other infections like HPV that can be contracted. One of the signs of HPV is genital warts. Unprotected oral sex can lead to the transmission of these diseases.
If the genital area has any warts or sores or foul smelling discharge, it could be due to an infection.
But, HIV may not have any of these apparent signs, so practice safe sex.
How soon after exposure can one get tested?
It all depends on the kind of test. If it is a specific test for a certain disease, which is usually more expensive, then you can get tested right away or you may need to wait for 3-4 days before testing. Most of the viral infections appear in the blood only 3-4 days after getting infected.
How frequently do you need to test?
Unless you had unprotected sex or there is a tear in the condom or a leak, you don’t need to test every time you have had intercourse. If you suspect your partner has a disease or you develop an infection or if there is a discharge, then of course, you need to test immediately. Else, as a routine, you can get an STI profile with your annual health check-up.
Frankly, it is better to use protection than take a risk.
Also read: Why women ghost? It's not them, it's you
Is it ok to not use a condom during periods?
During periods, the woman is more susceptible to pick up infections. So that is the time that you need to use protection for sure to keep you and your partner safe!
Some claim that they take a course of medication, especially to prevent AIDs, before going for sex tourism!
Is there any medication that you can take beforehand to prevent STDs?
PrEP (pre-exposure prophylaxis) is a medicine that is given to women who want to conceive with their HIV positive partner. Normally, it is not used as a preventive because the partner is checked for the viral load. Only when the viral load is under control, then the woman is given the medicine on the days she is ovulating.
In short, it is okay when there is a need for it and not a general prophylaxis. Again, using a condom is a safer choice.
What kind of questions can you expect, when you go to doctor after any exposure
All the doctor needs to know is whether you had unprotected intercourse.
What to do if you contract an infection?
It is important to treat not only the infected person but also their partners. And if they have been sexually active with multiple people, then it is important to treat the partner’s partners! It is like contact tracing during Covid.
Bottomline: Thanks to the pandemic, people are openly discussing their vaccination status on dating apps or even how they have been covid free. Don’t you think it is high time we discuss our STD free status or test reports?
* Carry and use condoms
* Get tested, if symptoms appear
* Inform all partners so they can get treated
Asking for STD status and using a condom during penetrative intercourse alone is not enough to prevent an infection. You need to use protection for all kinds of sexual activity, including oral sex