Are At-Home STI Tests the Future of Sexual Health?
As someone whose partner has several other partners (some of whom also have other partners), it’s essential for my health — and peace of mind — to get regular sexually transmitted infection screenings. I actually have a running task on my calendar that reminds me to ask my doctor for one every three months.
But not everyone is lucky enough to have an affordable, available GP or OB-GYN to run these tests several times a year. This has real consequences for both people’s sexual health and public health in general. With the rise of incurable gonorrhoea and increasing rates of other STIs in America, it’s more important than ever not only to practice safer sex, but also to get tested regularly.
I recently spoke with Ursula Hessenflow, co-founder of MyLabBox, about some of the trends she has seen when it comes to STI testing, shame and trust between partners. MyLabBox is an online STI testing service operating in the U.S. and other countries around the world.
“When I entered back in the dating scene,” Hessenflow tells me, “I realized that this is a conversation that people are not having. I tried to bring it up with friends, and when it did come up, it was awkward. People are very put off by talking about STIs.”
And when it actually comes up with new sexual partners? “People just getting to know each other rely a lot on that trust factor and don’t get tested together, or even ask if they’ve been tested.”
Especially between new partners, sex is already an awkward topic. But bringing STIs and safer sex concerns into the mix is often considered a mood-killer, a turn-off. Thanks to romantic comedies and romance novels, we expect first sexual encounters with new partners to be magical, romantic and mind-blowing. And even though the reality rarely meets the expectations of the myth, we still, somehow, are afraid to talk about desires, needs and concerns (including health concerns) until we are way more involved with someone.
One of the reasons that might be is because sex in general still has lots of stigma attached to it; STIs even more. Registered nurse Nicole Pasquino, professional practice leader at Options for Sexual Health in British Columbia, Canada, and sexual health nursing professor at the University of British Columbia, explains that “if testing were more common and accessible, for example through online STI testing, and more people had the experience of STI testing being part of their normal health care routine, it absolutely could lessen the shame and stigma of having that initial conversation with a new partner.”
Simplifying and normalizing STI testing is one of the main goals of MyLabBox. “We want to make it as acceptable and simple as brushing your teeth,” Hessenflow says. “We even have a partner kit; we encourage people to test together.” The benefits are obvious: no awkward conversation with an unknown clinician, no having to visit another location to undergo testing and no need to see a clinician again to discuss the results.
But one of the things that struck me as most positive about online testing is how it removes potential barriers for members of the LGBTQ communities. I’m lucky in that I have an absolutely professional, sex-positive doctor who knows about my polyamorous relationships, my bisexuality and my kink activities.
Not everyone has that chance, and many LGBTQ friends and acquaintances speak of traumatic experiences with clinicians who judged them, made assumptions about them and even refused them services.
Something similar happened to Hessenflow. “I had an interaction with an OB-GYN who told me I wasn’t particularly at risk when I asked to be tested. There are misperceptions that you may not be at risk based on your age, marital status, etc.”
Pasquino explains that LGBTQ individuals can face unique barriers when accessing health care services, and STI testing has unfortunately been no different.
"There are assumptions about who they are having sex with, the types of sex they are having, that they are having unsafe sex, trying to access services with a name different than what is on their medical insurance plan, and assumptions about the types of services they need, just to mention a few," she says. "There are also many LGBTQI+ people who don’t seek services due to the barriers such as judgment, negative past experiences, shame and fear.”
An option like MyLabBox or the one we have here in British Columbia, GetCheckedOnline, “will hopefully not only allow care providers to connect with more people in underserved communities, but will also allow those patients who have experienced barriers to have a new way to access sexual health services,” Pasquino adds.
However, despite its enormous benefits, online STI testing is not a panacea. It does fulfill a need — mostly that of bringing sexual health on par with other routine health care and of reducing stigma. But it is not a replacement for talking to a doctor when symptoms appear.
Pasquino notes that from a clinical standpoint, online testing is most suitable for patients who are not experiencing any symptoms.
"Anytime a patient is experiencing symptoms, they need to see a care provider for assessment,” she adds.
Shame notwithstanding, if you notice symptoms and suspect an STI, you should always make an appointment with your GP or visit a walk-in clinic to get prompt treatment.
As online STI testing becomes more common and more affordable, it will become easier to discuss sexual health with our friends, partners and health care providers. Hopefully, soon we will mention STI testing as openly as mammograms or Pap tests and encourage each other to look after our sexual health as much as we do heart, breast or mental health.