Strange Bedfellows by Ina Park

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We need to talk openly about STDs/STIs and we should be grateful to Ina for this highly readable exploration of them.

The moralistic policing of sex results in STIs being inherently stigmatised, it assumes that if you end up with an STIs it is your “fault” for having too much sex with too many people – and pointing out that you don’t have ‘much’ sex with ‘many’ people to get an STIs doesn’t really help challenge that stigma.

We can focus so much on the STIs that we fall into the trap of seeing the mere absence of STDs/STIs as “health” - but it is not that simple. Ina notes that the World Health Organization “has been discussing and defining the idea [of sexual health] since 1975. They describe sexual health as ‘a state of physical, mental and social well-being in relation to sexuality. It requires a positive and respectful approach to sexuality and sexual relationships, as well as the possibility of having pleasurable and safe sexual experiences, free of coercion, discrimination and violence.’” (p298)

How do we create and support a culture of sexual health, which needs to embrace a diverse range of sexual expression and allow room people to make choices that lead to good sex.

And a part of that is perhaps sharing more openly our own sex lives, and our own encounters with STIs – the more we all talk about it the less power society’s shaming will have over people.

For too long I went without getting a sexual health check up – the reasons for this were complex, but had a lot to do with the fear of HIV – despite knowing it was treatable I was trapped in a mindset that couldn’t face finding out. When I did start to getting tested on a regular basis the emotional roller-coaster between the day of the test and the results was intense. This wasn’t helped by the time during the follow up chat with the Sexual Health Advisor he said given the pattern of STIs I had picked up over the previous couple of years it would seem to be a case of when not if I got HIV. Only with access to PREP have I finally been released from that burden of worry.

The way the HIV changed the landscape and attitudes to other STIs is so complex, Ina notes that for many “other STIs didn’t seem to be as big a deal compared to HIV. What was a little syphilis in the grand scheme of things?” (p294) and therefore once HIV is managed, by treatment or treatment as prevention, then the regime of regular testing and occasional treatment for other STIs can become a part of normal life. But this leaves health professionals like Ina nervous about the rise of antibiotic resistant infections and other complications so there is a strong advocacy for condom use within the book which I understand but it does not connect with me personally.

So maybe I don’t agree with everything that Ina Parks says or suggests – but I agree with most of it, and that is not really the point – the real value is opening the conversation, that is the thing that will make the positive change.