Preventing sexually transmitted infections (STIs)

How do I know what my sexual health status is?

Routine testing will tell you if you have a sexually transmitted infection (STI) like gonorrhea, chlamydia, syphilis or HIV. Some STIs do not have symptoms, so you can have them without knowing. Finding and treating an STI early has benefits:

• It reduces the chances of passing the STI on to your partner(s)
• You are less likely to develop complications like pelvic inflammatory disease and infertility from STIs, or immune system failure from advanced HIV disease
• Treating STIs and HIV lessens the chance of HIV being transmitted

Exposure to an STI can happen any time you have sexual contact with another person that involves the genitals, the mouth (oral) or the rectum (anal). The more sexual partners you have, the more likely you are to be exposed to an STI.

Talk to your health care provider about getting tested for STIs or go to your local sexual health clinic. In some areas, you can go online to request a test for some STIs at https://getcheckedonline.com/Pages/default.aspx.

Can vaccines provide protection?

Some STIs, such as hepatitis A and B, and human papillomavirus (HPV), can be prevented with vaccines. Talk to your health care provider about how to get these vaccinations.

Can medications provide protection?

HIV Pre-Exposure Prophylaxis (PrEP) is the use of daily HIV medication by people who are HIV-negative to prevent HIV infection. HIV PrEP is different from PEP (post-exposure prophylaxis), as HIV PrEP is taken before exposure to HIV and may be taken on a long-term basis.

Doxycycline post-exposure prophylaxis or doxyPEP, an antibiotic which can be taken after sex without a condom, can help prevent some STIs in certain groups. These include gay, bisexual, and other men who have sex with men (gbMSM) and transgender women.

To determine if HIV PrEP or doxyPEP are right for you, talk to your health care provider.

How do I talk about prevention?

Talk to your partner(s) about preventing STIs before having genital, oral or anal sex.

• Make sure your partner(s) has been tested and treated for STIs
• Avoid sexual contact if you or your partner(s) have symptoms of an STI, have been exposed to an STI or are being treated for an STI
• Discuss using protection, such as condoms, dental dam barriers and lubricant
• Alcohol and some prescription and illegal drugs can interfere with your ability to have a conversation and make decisions to have safer sex

If you have difficulty discussing safer sex with your partner(s), talk about it with your health care provider or counsellor.

For tips on how to talk to your partner(s), visit the BC Centre for Disease Control (BCCDC) Smart Sex Resource: https://smartsexresource.com/sexual-health/partners-communication/talking-to-your-partners.

Practice safer sex by using a condom

When used correctly, external (“male”) and internal (“female”) condoms help prevent the spread of many STIs during vaginal, anal and oral sex. Condoms are less effective at protecting against STIs transmitted by skin-to-skin contact, such as herpes simplex virus, genital warts (human papillomavirus (HPV)), and syphilis (when sores are present).

Important things to remember when using condoms:

• Check the condom package for damage. Do not use a condom that has been damaged
• Check the expiry date. Do not use a condom that has passed its expiry date
• Carefully open the package so that the condom does not tear. Do not use a condom that has been torn
• Keep condoms away from sharp objects such as rings, studs or piercings
• Store condoms at room temperature
• Use a new condom every time you have sex. Do not reuse condoms
• Do not use 2 condoms at once. Using 2 condoms together may result in a condom breaking
• Use only water-based lubricants with external (“male”) latex condoms. Oil-based lubricants, such as petroleum jelly, lotion or baby oil, can weaken and destroy latex
• Water or oil-based lubricant may be used with polyurethane/nitrile condoms
• Use only condoms made of latex or polyurethane/nitrile/polyisoprene rubbers. Latex and polyurethane condoms are the best types of condoms to use to help prevent pregnancy and STIs. (Lambskin and sheepskin condoms can help prevent pregnancy but don’t work as well as latex or polyurethane condoms to prevent STIs)
• Avoid using condoms with spermicides containing nonoxynol-9 (N-9) as it can irritate tissue and may increase the chance of getting an STI

Practice safer sex by using dental dams or other barriers

A dental dam is a piece of thin latex that is placed over the vagina/internal genitals or anus during oral sex. It can also be called a latex barrier/sheet, latex dam, oral dam or sheet. Dental dams are a good way to lower the chance of getting or passing sexually transmitted infections (STIs).

Important things to remember when using dental dams:

• Before you use the dam, hold it up to light and check for holes
• Rinse it gently with warm water to remove powder 
• Hold the dam over the vagina/internal genitals or anus
• Be sure that only one side of the dam touches the vagina/internal genitals or anus
• Use a new dam each time you have oral sex
• Use a different dam for the anal area and the vagina/internal genital area
• Use lubricant on the vagina/internal genitals or anus to improve sensation
• Dispose of the dam in the garbage