STD/STI: Bacterial Vaginosis

Vaginal cells with ‘bad’ bacteria on them. Called ‘Clue cells’.

Bacteria love warm, wet places. Which means at any given time there are millions of them in every vagina on the planet. The good news is that the vast majority of these bacteria are ‘good’ bacteria – that is they help us stay healthy and eat the bacteria and viruses that would make us sick. Sometimes, things go wrong, and we end up with fewer good bacteria. Then the ‘bad’ bacteria start having a field day, and things get icky. This is bacterial vaginosis.

Not all medical authorities consider bacterial vaginosis an STD/STI – but that is largely because we don’t actually know how people get it. What we do know is that it is more common among people with multiple sex partners, and right after the first encounter with a new sex partner. So if it isn’t directly transmitted by sex, sex is definitely involved.

Prevention: Don’t douche. Don’t have lots of sex partners. (That’s pretty much all medical science can tell us.)
Treatment: Usually clears up on its own in a few days, otherwise antibiotics.
Symptoms: Sometimes, there aren’t any. When there are they include itching, smelly discharge, burning urination.

So if the symptoms are mild, and it usually clears up on its own anyway, why do we care?

There is one major complication of BV that is actually a little scary: it puts you are greater risk for getting other STD/STIs, like HIV, Hep, Chlamydia and all the other stuff we actually worry about. It also increases the likelihood of your partners being infected with an STD/STI if you are infected.

If you have any symptoms of BV, and they don’t clear up on their own in a day or two, see your doctor about getting an antibiotic. To protect yourself against other STD/STIs, don’t have sex if you or your partner have any of the symptoms of BV.

Back to the Long List of STD/STIs

The Long List of STD/STIs

How many STD/STIs are there? I’ll bet more than most of you were aware of. The following list was compiled through a combination of health related sites, including Planned Parenthood, the CDC and the American Social Health Organization. No one site contained all the STD/STIs in this list.

Links current as of March 9, 2015

If you want to keep up with all the STD/STI posts, your best bet will be to bookmark this page, so you can come back and check for new links.

Normally I try to keep this blog safe to read at work and around the kids. Fair warning: I will be adding pictures where appropriate, some of this stuff will be NSFC, NSFW and not something you want to look at while eating.

STD/STIs: How often should I get tested?

So far we’ve looked at, why STD/STI tests are important, where you can get them and how much they cost, and what testing involves. The one important question about STD/STI testing we haven’t looked at yet is how often we should get tested. So that’s what were going to do today.

No matter what your relationship status, it’s probably a good idea to get tested at least once a year. Partly because there are some STD/STIs that you can get from kissing a family member or friend or sharing a glass of water. Partly because getting in the habit of being tested is an important part of protecting yourself and your partners.

For any parents who may be reading this, I highly recommend that you make it a routine to take your teenage children to get tested once a year whether or not you are aware of them being sexually active. It is very likely that your children will become sexually active without you being aware of it. It is likely that they will not discuss their sexual practices with you. Making it a yearly routine to get STD testing and telling them: “I am not asking, and you do not need to tell me, but I am going to make sure that if you are active you are safe;” can be an important step in helping your children establish healthy and safer sex practices.

Okay, so that covers the bare minimum, at the very least get tested once a year, just in case. Let’s look past the bare minimum. A fairly standard medical recommendation is that you should get tested about three months after getting involved with a new sexual partner. This recommendation assumes that you and your new partner are exclusive. So if you both get tested once, and you both test negative, then as far as conventional wisdom is concerned there is no reason to get tested again until and unless you get a new sexual partner.

Closed Poly Relationships
This advice can work well for closed poly relationships or poly-fidelitous relationships. If you are not getting new sexual partners, and your partners are not getting new sexual partners, then in theory there is no way for STD/STIs to enter your polycule. If you bring a new partner into your polycule, you can all go out and get tested after three months, and if everyone’s clear just go with the minimal once a year testing.

Okay, I hear you, I hear you, open, closed or sauerkraut, what happened to getting tested before getting involved with a new partner and exchanging test results? Why am I saying get tested after a new partner is involved rather than having a check before hand?

You are right, the standard advice and a lot of poly communities is to exchange STD/STI tests before getting sexually involved. And it’s advice that I repeated earlier in this series when I was going over the basics of safer sex. Yes, it is a good idea to exchange STD/STI testing results with a new partner before becoming sexually active with them. It just may not be enough.

Even if your new partner got their test results back the day you became sexually involved, they could have been infected with an STD/STI that did not show up in the test. HIV is notorious for the fact that tests will not return an accurate result for at least a month after you’ve been infected. There are several other STD/STIs that can take several weeks to show up in testing. So even if you are in a closed relationship, and even if you exchange test results before getting sexually involved, getting tested again after you get sexually involved with a new partner is a good idea.

Open Relationships
If you are in an open relationship, or are in a situation where you and/or your partners are getting involved with new sexual partners on a frequent basis, it is a good idea to get tested regularly once month or once every three months. Even if neither you nor your partners are entering new sexual relationships, if your metamours frequently have new sexual partners or really if anyone in your poly network frequently gets involved in new sexual relationships, you are best off getting tested at least every three months.

Again, it is still a good idea to exchange STD/STI tests before becoming sexually active with the new partner. Also again, exchanging STD/STI tests does not protect you hundred percent from the possibility that to your new partner may have STD/STIs that just didn’t show up in the test. It also (and I hope obviously) does not protect you from the possibility in an open relationship that your partner may get an STD/STI in the future from one of his or her new partners. Which is why regular testing is still important.

Condoms, Fluid Bonding and STD/STI Testing
I want to take a minute to address the idea that if you use condoms you don’t need to worry about getting test. This idea is prevalent enough that a few years ago when I took part in a research study on polyamory, I told the interviewer that my triad had an agreement to get regular STD/STI testing and she automatically assumed we were fluid bonded. The assumption, of course, being that if we were using condoms there would be no reason for us to be tested regularly.

If you’ve been following along in this series on STD/STIs, you may remember the post on barrier methods and the list of specific STD/STIs that condoms do provide some protection from. It’s important to remember though, that condoms do not protect against all STD/STIs and do not provide 100% protection against any STD/STI’s.any STD/STI’s.

Using a barrier method to protect yourself against STD/STIs is a very good idea. Barrier methods are not failproof. They are also not foolproof. If you use barrier methods, it is still a very good idea to get tested regularly.

And that wraps up our section on STD/STI testing. Next week, I’ll start going over the various STD/STI’s: how they infect you, but their symptoms are, long-term medical effects, available treatments and ways to protect yourself against each one.

What Does STD/STI Testing Involve?

Like anything medical, if you’ve never had an STI test before, it can be a bit nervous making. Especially since no one ever bothers to explain anything. STI tests can actually take several forms depending on exactly which STI is being tested for. So if you are being tested for multiple STIs, there may be a couple of different tests.

There are four ways STIs are tested for:

  • Blood testing – includes HIV and Hep, so is part of just about every STI test on the planet
  • Physical Exam – looks for crabs, herpes sores and other obvious signs of STIs
  • Swabs – checks for bacteria such as gonorrhea and chlamydia, and used to test possible herpes sores
  • Urine testing – alternate method for testing for gonorrhea and chlamydia, and a few others.

Every clinic and lab will handle their testing a bit differently, but in general (and depending on what STIs you are being tested for) you can expect something like this:

When you first arrive you fill out any necessary paperwork. The desk may give you a cup to get a urine sample while you wait. When it is your turn, you get called back to see a nurse or med-tech. They’ll have you take off your clothes so they can do a physical exam. They may swab any sores you have or swab the inside of your genitals. After you get your clothes back on they’ll draw blood. Then you head home and you’ll get the results of your tests in a few weeks.

Polyamory and STD/STIs: Getting Tested


The two big questions everyone asks are where to get tested and how much will it cost. Unfortunately, there is a common idea that STD/STI testing is horribly expensive. This keeps many people from getting tested, even though there are many inexpensive options for STD/STI testing. Obviously your options depend a bit on where you live, so I’ll try to break it down a bit. However the default here is US info.

Where to get tested? And what does each cost?

The easy answer here is ‘ask your doctor’. If you have health insurance (or live in a place with universal health care – you lucky bastards) you can get ask your doctor about how and where to get tested for STD/STIs.

If going to your doctor is not an option – for reasons of cost or privacy – there are several other options.

Health Clinics

Your local health department has an interest in keeping STD/STIs under control and treated. In the US, municipal health departments offer STD/STI testing either at special once a month clinics or at special offices set up specifically for STD/STI testing (which depends on how many people they expect to need testing and what they can afford). Their tests are either free or at a nominal fee (usually around $10, though I have seen as high as $30).

Outside of the US, I know that Great Britain, Australia and Canada all offer STD/STI testing centers in addition to the ability to get tested by your doctor. I do not know about the rest of the world, but it is (at least theoretically) easy enough to call your local health department and ask or look them up online.

In the US, these clinics rarely cover all STD/STIs, but they will always cover HIV, Hep B, syphilis and these days gonorrhea. They will rarely test for herpes unless you have a sore of some sort – testing for herpes is unreliable at the best of times and is unlikely to be worthwhile unless you have an active outbreak.


There are also places such as Planned Parenthood where you can get tested (some charge for STD/STI testing, some do not).

Mail Order and Medical Labs

You can also pay out-of-pocket for STD/STI testing. ‘Anonymous’ testing where you send samples by mail order, or you can go down to a local medical lab. The advantage of this is you can get tested for any STD/STI you can afford. However, they will typically charge you over $300 for what you can get for less than $30 from your health department. While it is true that health departments don’t test for all STD/STIs, if you really want to be tested for ‘all’ STD/STIs (I have never seen any lab or for pay program that actually covers all STD/STIs, hell there is no HPV test for men) you are probably best off getting tested by the local clinic for whatever they cover and only paying out-of-pocket for what they don’t cover.

So there you go – finding where to get tested, and affording to pay for it, isn’t nearly as bad as you may have thought.

STD/STI Testing: Introduction

For the past month or so, I’ve covered the various ways poly-folk can reduce their risk of getting infected with STD/STIs. One of those ways which deserves a much closer look is regular STD/STI testing.

Getting tested is fairly standard in the poly community. It’s part of the advice in practically every forum, website and book on polyamory: use protection and get tested. However, STD/STI testing isn’t much talked about. Everyone agrees that getting tested is good, but:

  • What does testing involve?
  • What does it cost?
  • Where can you be tested?
  • What STD/STIs are tested for?
  • How often should you get tested?
  • How often should you ask your partners to get tested?

are questions that rarely come up. So for the next few weeks, I’ll be delving into the nitty gritty of STD/STI testing. Starting with:

What is STD/STI Testing?

The ‘duh’ answer is that STD/STI testing is exactly what it sounds like: medical testing to determine whether or not a person has STD/STIs. And the way we say it makes it sound like there is one straightforward test that you go in and get and when it comes back you know if you have an STD/STI or not.

If only.

‘STD/STI testing’ is really something of a misnomer. There is actually a different test for every STD/STI – well every STD/STI that can be tested for. Some of them have no test in the usual sense. Doctors test for pubic lice with a physical exam, and either they see something or they don’t.

So when you go for an STD/STI test, you are actually going in for a series of tests that may include blood tests, urine tests, cell samples and physical exams. may because it is actually extremely rare for every STD/STI to be tested for. Hep B and HIV are, of course, the big ones. I have never heard of an STD/STI test anytime in the past ten years that didn’t test for Hep B and HIV. Herpes is almost never tested for (and when they do, the tests aren’t very reliable). The only way to know for sure what is being tested for is to ask when you are tested.

Results from an STD/STI test usually take around 2 weeks. A month isn’t unheard of, a week is a pleasant surprise. So don’t go in to get tested expecting to have a print out to show your partners the next day. And speaking of print outs, many STD/STI testing centers don’t give you one. They just call you with your results. By law in the US (and I believe many other countries), you are entitled to a copy of you medical records, so even if they don’t routinely give out printed results it is possible to them, but you may need to jump through some hoops for it.

On a more philosophical level, ‘what’ STD/STI testing is, is the bet way to stop the spread of sexual transmitted infections. Please note, not ‘keep from being infected’ but ‘stop the spread’. When we get tested, we really aren’t doing it for us – if the test comes back positive, we’re already infected. We are doing it for our partners, and their partners, so that if we are infected, we can get treated and take precautions so that our partners (and their partners) don’t get infected. Asking your partners to get tested is for you. Getting tested is for them.

Which leads right into my last thought on ‘what is STD/STI testing’: A damned good way to say ‘I love you.’