The Testing Diaries: Joey
Do you feel anxious about the idea of getting tested for sexually transmitted infections and diseases? Some of our readers certainly do.
Some never had adequate sex-education and did not realize that sexual activity with a partner -- and not just anal or vaginal intercourse -- can pose STI risks in the first place. Some are not sure where to go for testing or how to ask for it. Others feel uncomfortable discussing STIs with a partner or potential partner. We get it: this stuff can be hard, and it is usually not the kind of thing where someone just takes us by the hand and leads us through.
This is why we're starting this new series at Scarleteen's blog. In it, some of Scarleteen's volunteers will share their own stories of how they deal with different aspects of STI testing and reproductive healthcare.
I was tested for the first time seven years ago, shortly after I had my first sexual experiences. Things did not go according to plan: though I'd insisted on condom use, the person I was with at the time had not honored my request. I wound up on Scarleteen to ask about pregnancy risks, and was advised to test for STIs.
An STI risk had not been on my mind at all. I was not in a very good space at that time, and already worried about the pregnancy risk, so when I heard about STIs, I immediately became convinced that I was going to die of AIDS. In a panic, I made an appointment to see my gynecologist, where I received the next blow.
In the German health care system, insurance coverage is required, so those who cannot afford private insurance are covered by government health insurance. And unfortunately, this health insurance does not cover STI testing. So when I asked my gynecologist for a full screening, she handed me the price listing. The cheapest test was the chlamydia test at 30 Euro ($37 US), the others were more expensive and cost up to 80 Euro ($98). I was floored. How was I supposed to afford even one of those tests, let alone all of them? If I was going to get only one test, which one should it be? I left without getting any tests at all.
Unwilling to give up, and still haunted by the fear of being HIV positive, I turned to Google. After some searching, I discovered that the health department offers HIV tests for sex workers, anonymous and free of charge. Deciding that this was better than nothing, I went to the health department to try and get tested there.
I was pretty scared. I hadn't told any of my friends in town about what I was going through, so I had no one to accompany me and support me. I wondered what the testing would be like, what the nurses would think of me, what kind of questions they would ask. But, I realized pretty quickly that I need not have been afraid.
I was the only person there to get tested that afternoon, and the nurse was friendly and cheerful. For statistical purposes, they had to ask me which activities I had engaged in that I thought might have put me at risk, but I did not feel at all judged. They took my blood, then gave me a slip of paper with a number on it and asked me to come back to pick up my results in a week. Since the test was anonymous, they would need that number to match it up with my test results.
I returned a week later to pick up my results, and they were negative.
Over the years as I continued to be sexually active, and especially as I became move involved at Scarleteen, I did some more research on STI testing in Germany, and I kept being amazed at how cavalierly STIs are treated here. Though we receive fairly unbiased, age-appropriate sex education at several points in school here (for me, it was in 2nd and 7th grade), I do not remember any mention of any STIs beyond HIV and though I do not remember specifically what we were taught. I, like many of my friends, came away with the impression that only gay men are at risk for HIV. This lack of information and awareness is coupled with a lack of resources: even those who are informed and want to get tested have a hard time getting tests. Not only are they expensive, but even in the medical community there is a very lax attitude around this topic. I have had a gynecologist tell me that "no one gets syphilis anymore," when I asked why the tests were so difficult to access.
The result is that very few people are able to properly take care of their reproductive health. I'm a geek about this, so I bring it up a lot, and the vast majority of the people I have spoken to about it here in Germany have never been tested, or even considered doing so. Of all the sex partners I have had here, only two have brought up STI testing, and of those only one (my current primary partner) had ever been tested previously.
There are ways to get tested, however.
Most private insurances, I am told, cover testing. Government insurance is required to pay for a full panel if you state that you are planning on trying to conceive. You can get free, anonymous HIV (and sometimes also syphilis) testing at any branch of the health department, and also at some branches of Pro Familia (which is a bit like Planned Parenthood in the US, save that most of their offices do not provide any medical services beyond pregnancy testing). Some gynecologists are staring to push chlamydia testing, and as a result it has become more affordable.
None of this is ideal, of course, but it's smart to take advantage of what's there regardless.
After that disastrous conversation with my first gynecologist about getting tested, I switched practices and a sympathetic doctor there treated me to a chlamydia test free of charge when she realized how distressed I was. She could not justify giving me a more expensive test for free, but she told me chlamydia was also what I was at the highest risk for, and thankfully the result was negative. After that, I insisted on condoms with new partners, and also always brought up STIs and safer sex.
Four years after my first adventures in testing, I was in the US for an exchange semester, where I took advantage of the awesome services of the campus health center and received my first ever full screening. This was by far my best testing experience. For the first time, I did not feel like I had to justify myself or like I was asking for something out of the ordinary.
Finally about a year ago, I went for my most recent test together with my then brand-new partner. This was important to both of us, especially because we both by that point had a fairly colorful sexual history. With almost all of my previous partners, I had been the one to bring up testing, and though all of them reacted with curiosity, it was nice, for a change, to be with someone who already got it. Going to get tested together made me feel very respected, and it made me feel like we were taking a giant step in ensuring that our relationship would be a safe and healthy one, both emotionally and physically.
Overall, I wish testing was easier, but I'm glad for the opportunities I have. By now, this is not a big deal anymore. Getting checked for STIs is just another part of my regular healthcare, like getting my flu shot or having a check-up at the dentist. It's not the most comfortable thing ever, but I actually really enjoy the feeling of taking charge of my sexual health.