Conversations between lovers about STIs are important in theory but difficult in bed

Having sex can be fun; and talking about sex can be fun. Talking about sexually transmitted infections with a sexual interest, however, is a totally different matter, according to new research from Indiana University's Center for Sexual Health Promotion.

The study, to be discussed Nov. 6. during the American Public Health Association's annual meeting, found a disconnect between the public messages that promote STI testing as a way to prevent STIs such as HIV and chlamydia and the conversations—or lack of them—occurring in bedrooms.

"Talking to partners about STIs is an important conversation to have," said Margo Mullinax, lead researcher for "Talk about testing: What sexual partners discuss in relation to STI status and why." "However, findings from this study suggest campaigns need to promote specific messages, concrete tips and tools around sexual health conversations stratified by relationship status. Campaigns should also address STI stigma and promote messages of normalcy with regard to talking about STIs."

STIs, if untreated, can lead to a range of health problems including infertility, so a growing public health emphasis has been on preventing STIs through testing. Mullinax said little was known, however, about how STI testing figured into actual conversations between lovers, particularly among the college-age crowd that accounts for a disproportionate number of new STI cases nationwide.

She recruited 181 sexually active men and women, average age 26, to take an anonymous online questionnaire that probed the issue, looking for insights into how conversations about STIs might influence behavior and decision-making.

She described the sample as highly educated, with many participants who commented on their own work in education. More than half were in monogamous relationships. Most of the participants were white and identified themselves as heterosexual or straight.

Mullinax said she was surprised to learn that about the same percentage of study participants engaged in sex without a condom regardless of whether they talked about STIs with their partners.

"Participants who reported talking to their partners about STIs say it affected their decision to engage in certain behaviors in that it made them feel more comfortable and led them to stop using condoms," she said. "But this finding concerns me given that many participants did not also report routinely getting tested nor having detailed conversations with partners about STIs."

Here are some of the other findings:

  • Many participants reported that they occasionally, rarely or never got tested before having sex with partners who were casual (50.3 percent) or long-term (38.7 percent).
  • Of the people who did discuss STI testing, very few discussed concurrent sexual partners or when partners' testing occurred in relation to their last sex act, and only half clarified what types of STIs their partner had been tested for. These issues are important components of assessing STI risk.
  • About a third of participants said they told a partner they didn't have an STI even though they hadn't been tested since their last sexual partner.

Mullinax said just a little more than half of study reported feeling "very comfortable" talking to partners about how to prevent STIs. Less than half felt "very comfortable" talking with a partner about sexual histories. Comfort levels improved—and conversations became easier—when people felt better informed about STIs and had practice talking about STIs with

"Take time to get informed," she said. "It will only make your more comfortable and ensure that you are really protecting your health."

More information: Mullinax will discuss her study at 1:15 p.m. Nov. 6. The co-author is Michael Reece, co-director of the Center for Sexual Health Promotion at IU Bloomington and associate dean of the IU School of Public Health-Bloomington.

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