Okay, so I was recently talking to a friend, and something she said left me with a bit of an ethical dilemma. This friend, let’s call her Aisha, told me she had some juicy juicy info to share. It was highly classified. I told her “Girl, I got you. Vault!” so she proceeded to give me the 411. Sometime last year, she visited a close friend of ours at her house. Let’s call her Serena. Aisha spent the evening chatting and hanging out with Serena and her boyfriend. Sometime around midnight Aisha decided it was time to leave. Serena and her boyfriend said, “Hey, it’s late, you shouldn’t be out in town at this time. Spend the night here and leave in the morning.” Aisha said, “This is a one-bedroom apartment, there’s nowhere for me to sleep. Serena and her boyfriend gave Aisha a coy glance and said “Why don’t you sleep in our bed with us?” Aisha’s Spidey-senses started to tingle. “Sleep in your bed?” she asked. “Why?” “It’ll be so crowded with the three of us in there.” Serena said, “I’m sure we’ll manage if we snuggle.” Aisha was like “Aaaah.” The subtext was clear. They were going to have a threesome.
So they did. By all accounts it was pleasurable for all three parties. As Aisha gave me the nitty-gritty I was amused and intrigued. I was also shocked. Not at the news of the threesome but at the fact that Aisha had had it with such a close friend of ours, when I knew for a fact that that friend did not know that Aisha had HPV. So I asked Aisha, “What is your policy on divulging your STD to people you sleep with?” I expected her to say that she disclosed it all the time and then let people make the decision about whether they wanted to have sex with her or not. Her answer surprised me. She said she divulged it sometimes and at other times she decided it was better to keep the news to herself.
Now, there are many types of HPV and most of them are harmless. But about 30 strains of HPV affect the genitals and cause warts. HPV isn’t uncommon. According to the Cleveland Clinic, about 80% of sexually active people are infected with HPV at some point in their lives. In most cases, it’s a pretty benign strain of the virus – it doesn’t present any symptoms, it clears up on its own and doesn’t leave any lasting effects. For other people however, they have a more serious strain of HPV and it stays and becomes a condition they manage for the rest of their lives. They treat the warts that form in one of the following ways:
- Cryosurgery — freezing the warts off with liquid nitrogen.
- Loop electrosurgical excision procedure (LEEP) — using a special wire loop to remove the abnormal cells.
- Electrocautery — burning the warts off with an electrical current.
- Laser therapy — using an intense light to destroy the warts and any abnormal cells.
- Prescription cream — applying medicated cream directly to the warts.
HPV is transmitted through skin-to-skin contact so even though condom use decreases the risk factor, you can still get it from a sexual partner. A lot of medical professionals believe that once your warts have been treated through one of the methods above and they are no longer visible, passing the virus on to someone else is a remote possibility. But almost all the literature I’ve seen concedes that this is not 100% foolproof. The virus can be dormant even if there are no external warts, and as such, in very rare cases, you can get it from skin-to-skin contact with someone who has it, even if it is dormant. Aisha had her warts frozen off with cryosurgery and she doesn’t have any external warts. Her stance – she told me – is to decide on a case-by-case basis whether to divulge her diagnosis or not. Telling people comes with a social cost, she said, and if this is a casual relationship with very little long-term potential then why would you expose yourself in that manner to someone who won’t be around for long? She said with a long-term partner it would come up when they were sharing intimate details about their life journeys. With a one-night stand there would be very little talking in the first place and it wasn’t something worth bringing up. The cryosurgery left her with scars and so if someone noticed the scars and asked her about them she would tell the person they were from genital warts. But if no one noticed and no one asked, then she figured it was no one’s business but her own.
I won’t lie. I kinda judged her. For a minute I thought about going to Serena and telling on her. My stance on STD disclosure has always been an extension of my views on sexual agency. I think everyone is entitled to the highest amount of agency possible when it comes to sex. People need to engage in sexual activity without any hint of subterfuge or coercion. People need to be able to advocate for their pleasure and their health. In order to be a successful advocate for themselves people need to have all the facts of the situation, so they are not making decisions in a vacuum. In withholding details about your health status you are robbing your prospective sexual partner of the choice to make an informed decision about whether they want to sleep with you. Post blank and the period.
However, as I tossed this thing around in my head, I started becoming a little sympathetic to Aisha’s situation. I started thinking about a cousin of mine who caught chlamydia a few years back. He underwent treatment and is totally cured. He’s married now, but I would bet my last dollar that were he single he would not begin every sexual encounter with “Hey, one time in grad school I caught chlamydia from this girl….” He would consider it something that was no longer relevant. People don’t usually disclose their STD history, just their STD status. I realized the problem with Aisha was that because she subscribed to the school of thought that it was incredibly rare to transmit HPV when you have treated your external warts and gone over a year without a relapse, she thought of her HPV more as her STD history than her STD status. She believed access to information like that was something only people who meant something to her should get.
STD’s unfortunately carry such a social stigma, particularly when women have them. This is of course because of the very worst of oppressive sexual norms. Women are shamed for sex. People who contract STD’s are, erroneously, viewed as people who are having a lot of sex. People who contract STD’s are erroneously, viewed as people who make irresponsible decisions about their sexual partners. So a woman with an STD automatically becomes a dirty, irresponsible slut who should be avoided. It’s sad. And ludicrous. Navigating the world of sex with an STD can be a complicated thing. Not to say that it’s the end of the world and people with STD’s should be pitied and condescended to. No. STD’s which cannot be cured can be managed, and a lot of people with them can have fulfilling sexual lives. People with STD’s aren’t damaged. What is damaging is how society treats them.
So I have sympathy for Aisha. But my stance hasn’t changed very much. I still think that with things like HPV and herpes, which are for all intents and purposes permanent, you should share your status every time, regardless of the presence of external symptoms. With things that are yet to be treated or are only currently being treated, and as such, are active infections, it is a moral obligation to divulge their existence. But another moral obligation is for the rest of us to react with sensitivity and kindness when someone shares something so personal. We have the right to weigh the risks and then agree or refuse to have sex with them but we do not have the right to judge or to be unkind. The more understanding people are of STD’s, the more likely people with them will be to tell the truth about them. It will make all of us safer. Whether flying solo, having one-on-one action or broadening the party to include more people, sex will be more honest and more fulfilling.
F.N. is a thirty something Ghanaian free-lance writer who alternates between living in Accra and Washington, DC