In light of a coldsore and recent condom break I thought it might be useful to put down my STI policy for when things go wrong.
I practice safer sex, always. I say safer sex because there is no thing as 100% safe sex. Condoms, prophylactics and contraceptives all have failure rates. Condoms have been reported to have breakage rates of 0.4-0.8% by experienced users, here and here for example. I estimate that I’d use about 400 condoms/year (not all for vaginal, anal or oral sex, granted, but most would be) and using those statistics that should equal about 2-3 breaks per year. In 2014 I had one so I’m doing well. Yay me!
I also choose to have (based on advice from my GP and my Sexual Health clinic nurse) STI screening every 3 months. This is also a legal requirement for working in Victoria. I am also vaccinated against Hepatitis B and HPV.
I do suffer from coldsores (HSV 1) and if I feel one coming on, or have an active blister I do not take full service bookings and let non sexual booking clients know. If I have had something go wrong, such as a condom failure I get some additional testing done besides my normal 3 monthly tests. I have one test done fairly quickly to let the affected client know my status at that time (although this time I had the testing done for chlamydia and gonorrhoea at 1.5 weeks). I then have a follow up test at 6 weeks to get the all clear and then resume 3 monthly testing. Why get tested again at 6 weeks you say? STI window periods people! Most testing is looking at your bodies levels of antibodies against infection and your body can take time to produce these. Chlamydia and gonorrhoea might take up to 1-2 weeks before reliably showing, syphilis and HIV can take up to 6 weeks. So I let all clients know my situation when booking before this 6 week test has been done (which frankly is a huge pain in the ass but I respect that you put your trust in me) and it is their choice to see me or wait until test results, and treatment if necessary, is complete.
The window period is really important. If you think you have been exposed to an STI by all means get tested the next day if that helps you feel better but please, please have a follow up test. The first one might have missed something.