STIs are undoubtedly a sensitive subject. When you test positive for an infection, the prospect of notifying your recent sexual partners can seem insurmountably daunting.
Nevertheless, ‘the conversation’ is one you need to have. When left untreated, STIs such as chlamydia and gonorrhoea can cause serious complications. In the case of HIV, viral hepatitis and syphilis, these infections can become life-threatening if left to develop.
So getting tested for STIs, and treated where necessary, is of paramount importance; and this may not happen without prompt partner notification.
We spoke to GP Clinical Lead Dr Daniel Atkinson to get his insight on how to (and how not to) tell a partner that you’ve tested positive for an STI.
What’s the best way to tell your partner you have an STI?
‘What will be at the forefront of most people’s minds when broaching the conversation is that it isn’t going to be pleasant, and we might be apprehensive because we don’t know how the other person is going to react, whether we’ll hurt their feelings or whether they’ll get upset.
The best way to think about it really is to treat the importance of the conversation - the fact that you absolutely need to have it - as the priority, but keep in mind the fact that it’s going to be difficult news for the other person to hear.
Don’t drop the news on the other person in an offhand manner or try to crowbar it in between other things. And don’t treat it as something you’ll just tell someone when you next happen to see them. Let the other person know beforehand that you need to have a chat about something sensitive, and that this something sensitive is the reason for the conversation.
If you’re having the conversation in person, make sure you’re somewhere quiet and fairly neutral, where you aren’t going to be disturbed. If you’re talking in a public place, don’t choose anywhere overtly busy. Talking about such a sensitive subject with a lot of people around can increase the feeling of pressure on the other person, and make them feel more self conscious.
If you’re going to be having the chat over the phone (and yes, a voice call is always going to down better than a text message) arrange a mutually convenient time where you can both be somewhere quiet and private.
Think through what you’re going to say beforehand, and how you need to say it. When you’re having the conversation, try to be as clear and as measured as possible. Although the temptation may be to rush through and get the news out, talk slowly and steadily. If you rush it or jump and back and forth, that can create confusion or mean you’ll have to explain everything again.
When you’ve delivered the news, although it will be awkward, don’t rush for the nearest escape route. Stay with the person, or stay on the phone; it might take a little time for the news to register, and they may have other questions to ask you. It’s better to let them end the conversation when they’re ready, and ask them if there’s anything else they need to know before parting.’
How much info you need to give when informing a partner about an STI?
‘You definitely need to tell them what infections you’ve tested positive for. They’ll likely be advised to have a full STI screen, but they’ll be asked when getting tested if they’ve had any recent partners with an infection and what these infections were; so giving them this information is a standard courtesy. It’ll also be useful for them to know what the doctor has recommended (be it treatment, abstaining from sexual relations for a certain period or getting tested again in a few weeks), so they know what to expect if they test positive too.
Ask them if they know where they can get tested. If they don’t, it might be helpful to them to let them know where you got your test result, and if you’re aware of any, what local services are nearby.’
What information do you need to have ready?
‘The names of the infections you’ve tested positive for, certainly, and when you tested positive for them. It can help to have some info on these infections, just in case the other person asks. Offer to send the other person a link to a helpful web page with more info on the condition, what testing involves, and how it’s treated (you can find plenty of examples on sites like Treated.com or NHS Choices). Again, giving them info on where you got tested and what the doctor suggested is likely to be useful. It will probably also be reassuring for them if you know which infections you’ve tested negative for.
Discussing the ins and outs of personal circumstances surrounding how you contracted the infection depends on your relationship. If the other person is a long term partner, it’s very probably a chat you need to have (and have in person). If the other person is a casual sexual partner, you might both feel that this information is not essential for you to discuss.
Where a relationship is more established and telling someone about a positive test result is likely raise questions of trust, it is probably also worth doing some reading about how long you might have had the infection for. In most cases, Chlamydia can be present for months or even years without any symptoms so a positive test today doesn’t necessarily indicate you’ve caught it recently. Having said that if you’ve had previous negative tests and you know how you’ve caught this infection, most people would tell you that honesty is the best policy, however difficult that may seem at the time.
If you are going to go into the more personal details and circumstances, again, it can be helpful to think about what you’re going to say beforehand - but don’t let this get in the way of telling them about the infection you’ve contracted and what they need to do. This should be the first and most important thing you tell them.’
What to do if your partner reacts angrily
‘Do your best to stay calm, and don’t bolt out of there. Listen to the other person and let them say what they have to say. Trying to interrupt or talk over them is likely to make the situation more tense and hostile. If you can, wait for them to finish talking, before adding anything else.
Giving them as much info about what to do from here - such as where to get tested and what your doctor told you to do - will help to address feelings of uncertainty and apprehension the other person might feel. If you can tell them what they have to do next, even though it’s not something they’ll want to do, it will save them the hassle of doing their own research (and show them that you’ve taken their wellbeing into consideration).’
When is the right moment to inform a partner?
‘Really, there’s never going to be a ‘right moment’. STIs can cause long term health issues, so the right moment is as soon as you can practically have the conversation. The sooner you have the chat, the sooner the other person can get tested themselves, and get treatment if necessary.
Once more, don’t rush the conversation. Just make a concerted effort to arrange to have it somewhere private and feasible for both of you as soon as possible.
In the exceptional case of HIV, you need to tell the other person right away. If the other person has contracted the infection, treatment is available that can stop the virus from developing, but only if it’s taken within 72 hours of exposure. Telling a partner right away can help improve their chances of getting this treatment in time and not having the virus for the rest of their life. Even if this window has passed, the other person will need to see a doctor and get tested for HIV as soon as possible, so that they can recommend treatment in the case of a positive result.’
Is there different advice for different STIs?
‘Yes. As we’ve discussed, notifying partners if you’ve tested positive for HIV should be treated sensitively, but with urgency. Syphilis is another condition which manifests in stages, and sometimes requires hospitalisation if it isn’t caught in time. But in any case, it’s better to tell your partner about an infection you’ve tested positive for as soon as is feasible, so they can get the testing and advice they need.’
Are there any services that can inform a partner on your behalf?
‘Yes. All sexual health services will tell you that you should inform all of your recent sexual partners about any STIs you have and some will offer to contact those sexual partners if you feel you can’t do it yourself. They won’t disclose your identity and will usually tell your partner(s) that they may have come into contact with an STI, and that testing is recommended. (Although if you’re the only person they’ve had sex with recently, then obviously it won’t take much working out!)
If you don’t have much information about a recent sexual partner (for example, if you haven’t kept their number or don’t know where they live) it’s worth offering any information you do have, such as a username on a dating app as even this can be useful.
Some sexual health services will use app-based partner notification services, such as SXT. you can find out more about them here. These are services where you can add the mobile number(s) of recent sexual partners and SXT will contact them anonymously to let them know they may have come into contact with an STI. This allows sexual health clinics to track whether they’ve been tested and treated, even if they go to a clinic somewhere else in the UK.
Specific questions you should ask during the conversation
‘If you’re the one with the positive test result breaking the news, always ask the other person if there’s anything else related to the infection or getting tested that they want to know before the conversation is over. It might be tricky to approach and, again, it depends on your relationship, but if your partner is having or has had sex with other people besides you, they’ll need to be notified too if your partner tests positive.
If you’re the one being told the news, you need to ask what infection the other person has tested positive for (if they haven’t told you already) and when they tested positive for it. If they’re willing to tell you, ask them what the doctor suggested they do. When you see a doctor they’ll tell you this anyway, but it can help to prepare you if you know what to expect.’