Here it is – the dreaded S-word.

Sexually transmitted diseases (STDs) have been defined as “infections transmitted through sexual contact (oral, vaginal and anal), caused by bacteria, viruses or parasites.”

While most STDs caused by bacteria and parasites – for instance, gonorrhoea, syphilis, and chlamydia – can be cured by antibiotics; there is no antidote for STDs caused by viruses, namely: HIV, HPV (genital warts), herpes, and hepatitis.

But all hope isn’t lost, for timely medical intervention and treatment can help to alleviate symptoms of the four H’s in most infected individuals, albeit not curing them. In addition, hepatitis can be prevented with the help of a vaccine – thence, eliminating chances of contraction.

While most cis-het individuals encounter their fair share of STDs during the course of their lifetime, it’s not surprising that LGBTQ youth are far more likely to succumb to an assortment of diseases and health conditions, than their cis-het counterparts. An increased exposure to health inequities, the cherry on top of a poor immune system – often results in a greater predisposition to sexually transmitted diseases, amongst the average queer individual.

There are a number of reasons for this correlation- including, but not restricted to: a) sociocultural barriers to medical care, b) greater risk of sexual assault, c) sexual promiscuity, e) poor mental health and d) higher biological susceptibility, amongst others.

Whilst certain risk factors are unpredictable, and largely unavoidable, there are a number of precautions which queer people can take – in order to remain sexually healthy. However, in the event of contracting an STD, there are also numerous methods which could be employed in order to alleviate symptoms, and in most cases, cure the infection.

Here is a guide to sexual health, in terms of sexually transmitted diseases:

Unlearning is the way

As queer individuals, we’re often fed stale bread crumbs of cis-het sex-education in secondary school – which is often unhelpful, and almost always results in feelings of isolation, dysphoria and unnecessary stress. Since a majority of us grow up with little to no understanding of queer sex, pleasure and safety – we often end up cultivating unsafe sex habits.

In order to develop safe sex habits, it’s essential to educate ourselves, and gain awareness about the same. Researching, speaking to professionals – who’re knowledgeable about the queer community, learning from other queer people’s experiences (although these aren’t always reliable, so ensure that the information you receive is fact-checked), and attending seminars/ workshops about queer sex, are all excellent ways of acquiring new information, and educating yourself about stigmatized topics.

Resources:

• Books – The Pride Guide: A Guide to Sexual and Social Health for LGBTQ Youth is a guide written exclusively for queer youth by long-time therapist and sex educator, Jo Langford. Accessible, easy to understand, empathetic and often hilarious – the content of this book perfectly encapsulates what it means to be a queer person in today’s day and age, whilst seamlessly navigating the less-trodden path of queer sexual activity – in all its awkward glory.
  
• Websites – Trevor Support Center: Sexual Health is an organization, which provides crisis intervention and suicide prevention services for queer youth. As part of their initiative, they’ve included some helpful resources for LGBTQ individuals – on the topic of sexual health.

• Seminars / Workshops – Several LGBTQ organizations in India – regularly hold seminars, workshops, open mic events and other fantastic campaigns to unite the desi queer community. Examples of these organizations are – The Humsafar Trust (Mumbai), The Naz Foundation Trust (Delhi), Gay Bombay (Mumbai), Udaan Trust (Maharashtra), Lakshya Trust (Gujarat), Orinam (Chennai), and of course, Gaysi Family (Mumbai) – amongst others. Meeting other queer people, sharing experiences and exchanging stories can prove to be excellent ways of gaining first-hand information about sex, pleasure and what it means to be a part of the community. Needless to say, be wary of false information and unsavoury/ predatory individuals.
  Some of the aforementioned organizations also occasionally conduct seminars, workshops and discussions on sexual health – be sure to check those out!

Use protection (duh!)

Whilst indulging in vaginal or anal sex, it is absolutely imperative to use a latex condom during the act. A few precautions to take before using a condom:

• Check the expiry date
• Use a suitable lubricant – for instance, oil-based lube doesn’t go well with latex, so it would be advisable to look for some alternatives
• Check for lacerations
• Make sure the package has an air bubble, which ensures that it hasn’t been tampered with
• Unroll the condom onto the penis, not before
• Leave space at the tip for semen, preventing tears during ejaculation or withdrawal

Engaging in oral sex, on the other hand, would require the use of a dental dam – a thin, flexible piece of latex which prevents the exchange of bodily fluids during mouth-to-genital or mouth-to-anal contact. A few precautions to take before using a dental dam, in addition to the list of precautions already mentioned above:

• Use water-based dental dams to prevent breakage
• Store them in a cool, dry place
• Don’t stretch a dental dam

Resources:

• Buy dental dams

• Buy condoms

Avoid exchange of bodily fluids with an infected person

Of course, this doesn’t mean that one must subject infected people to isolation, mistreatment or harassment – it merely signifies that there are certain things we need to be careful about.

In case you’re living in close quarters with an infected person, especially an HIV-infected individual, please take the following precautions to ensure your health and safety:

• Avoid sharing toothbrushes, underclothes, syringes, or any other material – through which, blood or semen could be transmitted
• Only have sexual contact upon your doctor’s approval
• Seek treatment for the infected person
• After treatment or approval from your doctor, only engage in low-risk activities (for instance: kissing) initially – before gradually moving to high-risk activities (for instance: genital-to-genital contact), to ensure that the treatment has been successful.

Responsible consumption of alcohol and substance abuse

STDs can often spread as a result of excessive consumption of alcohol and drugs. Alcohol might increase the likelihood of promiscuity in queer individuals, which could increase the chances of contracting an STD. In addition, it might make it easier to lapse into unsafe sex habits, for instance, forgetting to use a condom. Moreover, consuming alcohol around untrustworthy people could result in a higher possibility of being coerced into sexual activity.

In relation to the positive correlation between STDs and substance abuse, certain STDs like HIV can be transmitted by sharing needles used to inject drugs . Substance abuse might make it easier to contract STDs, especially if the source of the drug is not hygienic or safe.

Resources:

• iCall is another excellent psychosocial helpline, which aims to offer counselling services by telephone, email and chat. “The helpline caters to people across age groups, gender identities, sexual orientations, languages and most importantly, across issues.” (iCall, 2019)

Contact a therapist or a helpline

In case you’re in a situation where you require advice, information or comfort, contacting a therapist or an LGBTQ helpline would be a good idea.

Resources:

• MSM and transgender individuals can avail Sahaay Helpline, an NGO aided by The Humsafar Trust. Their toll-free number 1800-2000-113 is available 24×7, and promises full anonymity and confidentiality to their users. Currently, the helpline is available in Hindi in three Indian states- Chhattisgarh, Delhi and Maharashtra.

• SAATHII is an organization which aims to provide “universal access to rights, health, legal and social services for communities marginalised on account of HIV status, gender and/or sexuality.” (SAATHII, 2018) Do not hesitate to contact them if you’ve contracted an STD, and would like to undergo treatment or medical care

Medical care – seek treatment

The single most important thing to do before engaging in sexual activity with another individual, is to test yourself for STDs, and request the other person to do so as well. Don’t feel shy or apologetic about initiating a conversation about their sexual habits. Be straightforward and matter-of-fact about it.

As far as possible, limit your sexual partners to reduce risk of exposure. If you pursue sex work or practise promiscuity, ensure that you get tested at least once every three to six months – and that your partners/clients have also been tested negatively in the same time span.

In addition, one can immunize themselves against Hepatitis B and Human Papillomavirus (HPV) with the help of a vaccine – thence, eliminating chances of contraction.

In the case of contraction of an STD, seek treatment immediately. Educate yourself on the symptoms of each infection, and how it manifests in individuals with your gender identity.

Resources:

• The Humsafar Trust (Mumbai) recently set up India’s first healthcare centre for the desi LGBTQ community. The clinic aims to spread awareness about Human Immunodeficiency Virus (HIV), as well as provide treatment for the same. They provide the following services for a nominal fee of Rs. 1000/- for a period of one year: HIV and Syphilis testing, mental health counselling, regular medical check-ups, nutrition counselling and legal aid. In order to ensure the safety and comfort of patients, the employees at the clinic are also members of the queer community.