A Clean Bill of Sexual Health (is a Dirty Phrase!)

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“A clean bill of sexual health” is a phrase used to mean that you are STD free. But (we have to address the problems) let’s talk about the trouble with this phrase. Because not all infections can lead to symptoms or diseases, particularly in the short-term, an STD (sexually transmitted illness) is a better term. What if you have an STI. Is your “bill of health” then dirty? What would that do to you, the bearer said bill and STI.  Presumably dirty by association, as is, it is implied, the activity that created the possibility for infection – sexual engagement (activity).

a clean bill of sexual health

However, STIs are not “dirty”. While they can be related to sexual involvement, they are not caused by poor personal hygiene or any other form of sexual activity (emotion). STIs can be described as infections caused by viruses, bacteria and other infectious organisms. They are no more “dirty” than common respiratory illnesses such as a cold or even COVID. These are also common, and may have serious repercussions. 

How can you make sure you stay infection-free? Like COVID, you need to know your health and risk factors. For a physical, visit your doctor, regardless of whether they are a general practitioner or a gynecologist or a urologist. Protect yourself before you engage in sexual activity. Barrier methods are safer than any other methods of sex. These methods are not like birth control which is for the prevention of pregnancy. The only method that reduces STI rates is to use barrier methods. They create a barrier that prevents infecting organisms from entering. These are similar to COVID masks, but for sexually-involved body parts. Barrier methods include the male condom but also the insertive condom and the female condom. They can also be used for medical grade gloves or cunnilingus (a piece that is designed to anal/oral play, or cunnilingus). It may also include a face mask in 2021. These masks greatly reduce the chance of infective agents being passed or given if they are used correctly and consistently. Consistently and correctly refers to using the products as directed.

However, a reduced risk is not necessarily a zero risk. You must be aware that any sexual contact can lead to infection. What can you do if you want your sexual contact to remain safe and healthy? Same thing you do if you want to make sure you don’t have COVID – you get tested! This brings us to the next question: for how long?

You should be aware of a variety of STIs and have them tested. These STIs can have serious consequences, including the potential for death, as well as social stigma and emotional distress. These are important facts, but not scare tactics. This information is just an additional tool to help you balance your risk-reducing and pleasure-supporting plans.


Table 1: STIs 
  • Chlamydia
  • Herpes (oral or genital)
  • Gonorrhea
  • Hepatitis A, B, and/or C
  • HIV
  • Human Papilloma Virus (HPV)
  • Syphilis
  • Trichomoniasis
  • *Bacterial Vaginosis 

        *(associated with increased risk of becoming infected or transmitting other STIs, may be 

         transmitted amongst women who have sex with women)


Table 2: Most Common Signs of STI
  • Bumps or sores (on the genitals, anal/rectal region, or mouth).
  • The penis is released
  • Vaginal discharges unusually
  • Bleeding from your penis
  • Unusual bleeding from your vagina
  • Pain during penetration, while peeing or in the abdomen or pelvic region
  • Rash
  • Fever
  • Swollen lymph nodes (in the groin or anywhere else in the body).
  • Or none 


Table 3: The Most Significant STI Consequences 
  • Pelvic Pain
  • Inflammatory disease of the pelvic floor
  • Infertility
  • Pregnancy complications
  • Eye inflammation
  • Arthritis
  • Heart disease
  • Neurologic damage
  • Cancers (including genital/rectal/liver, head and neck, and liver)
  • Social stigma
  • Emotional distress
  • Death 


How does testing fit in with this? While different health groups may have different recommendations, most recommend that sexually active adults test at least once a year for chlamydia, gonorrhea, and HIV. If you have sex with more than one partner or sex without barrier protection, it is recommended that testing be done every 3 to 6 months. This is similar to COVID safety testing. It is important to get to know your partner’s health and lifestyle before you engage. Then, keep an eye on the relationship throughout. It is important to discuss the results and conduct ongoing testing.

Additionally, testing sooner or again should be considered if you do enter start interacting without knowing the STI status of all parties involved, if you have a failure of barrier protection without knowing your partner’s status, if you experience any symptoms, or if you become pregnant. There is one caveat: testing may need to be done more than once due to the timing. 

This is because of the incubation period – the time for an infecting organism to take hold, multiply, and induce the body to create an antibody response. COVID’s incubation period is 3 days. This means that you won’t get accurate results if the test is performed less than 3 day after exposure. Different STIs have different incubation period, ranging from 1 to 20 years. Some STI tests do not measure the organism, but the antibodies. Discuss with your health care provider whether you need more than one test or if you want to continue testing yearly.  

Most doctors can perform testing and it is available at many, if not all, public health clinics. It is usually covered by insurance or offered free of charge at certain clinics. Although there may be a fee, it is usually less expensive than serious health consequences. Bottom line: Please make sure to protect yourself and understand your status. Because being STI free, just like being COVID free, while not appropriately described as “clean”, is certainly a fun and freeing starting point for better sexual, physical, and mental health. 

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