Last week the Centers for Disease Control and Prevention released its annual report on sexually transmitted diseases in the United States. Although the data, which are for 2009, show some progress in lowering the rates of STDs, blacks are still bearing the brunt. African Americans accounted for approximately half of all chlamydia (48 percent) and syphilis (52 percent) — and nearly three-quarters of gonorrhea (71 percent) — cases in 2009.
Yes, this is bad news. But before we get down on ourselves and label African Americans promiscuous, we have to remember that just about everyone — black and white — has sex. And a lot of folks, regardless of race, are not using condoms. In actuality, many studies have shown that African Americans report fewer sexual risk factors than their white counterparts, meaning that we use condoms more often.
But the reality is that for a number of reasons — including little or no access to good health care and treatment, and women sharing male partners because high rates of incarceration and poverty have led to a lack of available men — too many African-American communities are already saturated with these STDs. We therefore find ourselves coming into contact with these diseases more often than do people in the mainstream community.
This is why we really need to be careful by being even more diligent about using condoms and getting tested regularly. Not to mention, having an undiagnosed STD can compromise your immune system, making you more vulnerable to seroconverting (acquiring HIV) if you come into contact with the virus.
So what can we do? The key is talking about these issues with the people we choose to sleep with. Yeah, I know, that can be extremely difficult for some of us. We may be embarrassed or ashamed, we may not feel empowered, or we may be too worried about what the other person will think — or afraid that he or she will leave us. Or we just don't have the facts about STDs and safer sex and don't think that we are at risk.
But in fact, all of us are.
We are not dating and having sex in our parents' or grandparents' day, when a shot of penicillin cured all, and getting pregnant was the most pressing consequence of unprotected sex. We are living in the era of AIDS. And none of us can afford to have a coy, timid or uninformed approach when it comes to our sexual health.
In the spirit of World AIDS Day today, The Root, instead of talking about how you need to start having these conversations, asked Chicago-based sex expert Rachael Ross, M.D., to help us provide you with invaluable tips on how to have these conversations with your partner or partners.
Here are six common scenarios:
"There isn't anything slutty or 'gay' about talking to your partner about condoms before you have sex," Ross confirms. "That is called being responsible, because everyone is at risk." She suggests asking your prospective partner about his condom use in previous relationships to ease into a conversation about your desire to use condoms.
You: So in your past relationships, how often did you use condoms?
Wait for his or her response.
Then your answer should be:
You: Well, in my past relationships, I always use condoms; I am pretty adamant about that. It's about safety.
"This approach helps set your expectations from the jump so this person understands how you roll. When it comes down to intimacy, then, there shouldn't be any issues," says Ross, who also notes, "Always bring your own condoms so that you can be prepared."
2. You have just tested positive for a curable STD. How do you talk to your partner about it and protect him or her?
This can be tricky. Ross suggests that the first step is coming to the table calm and not trying to place blame on each other. Remind your partner that both of you have had previous relationships, and since STDs are not always symptomatic, especially in men, one of you may have had this infection before getting together and just didn't know because you were not tested for it.
"Suggest that your partner get tested — you can even go with him or her — and then get treated," says Ross. It's important that both of you get treated, because if you have unprotected sex with each other, you'll just continue passing the infection back and forth.
This would also be a good time to talk about the need to use condoms regularly, because while both of you may be cured, this doesn't mean anything if one of you is having unprotected sex with other partners. Ross warns, "If you are walking around assuming that you are in something monogamous and you are not, you are going to end up in some serious trouble."
3. You're a man who worries about performance issues with condoms and wants to find the least embarrassing way possible to resolve it.
While some women believe that this is just an excuse that men create to get out of using condoms, the problem is real. "Men need to train themselves by masturbating with condoms on to help get the penis used to having and keeping an erection [with a condom on] when having actual intercourse with someone else," says Ross. "This is going to take some practice."
Which, if you think about it, doesn't have to be so bad, especially if someone can help you out.
This is never going to be a comfortable conversation, because issues of trust, infidelity and safety are difficult to discuss, but Ross stresses that you need to have this talk anyway. "It's important to be calm, rational and honest when expressing your lack of trust in your partner, and explaining why you feel this way," she says.
She suggests the following script:
You: I have been feeling really funny, and I want to talk to you about it. Something just doesn't feel right about our relationship. I am having serious doubts that we are in a monogamous relationship. Until we can work out these trust issues, I would feel more comfortable if we started using condoms, because I am feeling that my health is at risk. Are we in a monogamous relationship? Because I really need to know.
Bottom line: Listen to your gut and don't be afraid to speak up for yourself.
5. Your prospective partner tells you that he or she has been tested for HIV and/or other STDs, but you haven't seen proof. You want reassurance but don't want to come off as if you are conducting an interrogation.
Of course you don't want to make someone feel as if he or she is being grilled by Benson and Stabler from Law & Order: SVU, but if you need the proof to ease your mind, you need the proof. And you shouldn't have to apologize for it.
If the person admits that he or she needs to be tested or doesn't have up-to-date results to show you, Ross suggests getting tested together — even making a date out of it. "The two of you can go and get tested together, reaffirming World AIDS Day or whatever you want to commemorate, and then share your results with each other."
If you don't want to put in all that time or effort, make sure your prospective partner e-mails you or show you those test results. "For every day you don't see their results, send a friendly e-mail reminding them that you are waiting," Ross advises. "You can even include sexy rewards as an incentive."
And just as in scenario number two, a negative result does not mean ditching condoms. You still need to talk about the nature of your relationship and whether it is monogamous — and even if it is, there needs to be a conversation about safer sex. If you still want to use condoms, be open about your feelings. And remember that this isn't just about your partner — it's about your health.
6. Your partner (male or female) pressures you not to use a condom because not wearing a condom would demonstrate your love. He or she also tells you, "No one else makes me use a condom."
How many times have we all heard this? Ross recommends just flipping the logic on your partner.
You: Well, if we love each other so much, we should want to protect each other. Look, both of us have had previous relationships, and this is about our safety — that is what love is about.
As for the claim that no one else has made your partner use condoms in the past:
You: I completely understand if no one else made you use condoms, but I thought I was special. This is what I need in order to be in this relationship.
While these tips will prove helpful for some, they are not likely to work for everyone. Be prepared not to get the results you want every time. Some people are just not going to want to get tested, use condoms or have a dialogue with you about these issues. If that happens, remind yourself that some things are not negotiable, and someone who claims to love and care about you is going to want to protect you.
At a time when HIV/AIDS is ravaging our community, we have to remember what is at stake when we make a conscious decision not to have safer sex: our very lives.
Kellee Terrell is news editor for the Body, a website about HIV and AIDS. To learn more about World AIDS Day, go to the Body's World AIDS Day 2010 resource center.