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There are many myths about STIs and STDs in LGBTQ + individuals, that discriminate, and also prevent their easy access to sex education, prevention, and treatment.
While ‘queer’ is often used as an umbrella term to refer to the LGBTQ+ community, and while the acronym LGBTQ itself is said in a single breath, the individuals that comprise this community possess a variety of distinct identities.
LGBTQ expands to Lesbian/Gay/Bisexual/Transgender/Queer, and the + indicates other sexual and gender identities within the spectrum, including Intersex Variations, Asexual, Pansexual, and Genderqueer/Genderfluid/Agender identities, and any number of self-defined identities. This diversity of identities and intersectionalities within the queer community often goes unacknowledged, with many identities within the spectrum invisibilized.
This, along with a lack of awareness and conversation, compounds the myths surrounding the queer community and sexually transmitted diseases and infections (STDs and STIs).
With the topic of STDs and STIs also largely lacking in open discourse, this article will dismantle some of the prevailing myths about STDs, STIs, safe sex practices, and the queer community.
STIs differ from STDs in that STIs are a broader category of infections that can spread through sexual contact, many of which may not have any symptoms. It is only when the infection changes or alters how the body typically functions that it is called a disease. STDs are always preceded by STIs, but STIs do not always lead to the development of an STD.
Simply testing positive for HIV does not necessarily mean that the individual has AIDS or has a “disease.” HIV can be categorized as an STI. Therefore, while HIV is the simply the virus, AIDS is the disease/illness that may or may not develop as a result of being infected by HIV, i.e., being HIV-positive.
HIV, or Human Immunodeficiency Virus, is overwhelmingly associated with gay men, but the virus is by no means a concern restricted to a single demographic. While it is true that rates of testing HIV-positive is higher in gay and bisexual men and Men who have Sex with Men (MSM), HIV is a virus that can be transmitted to any individual through sexual contact or through exchange of infected bodily fluids.
Labelling HIV a “gay disease” or only associating it with the gay/bisexual men community is harmful, because it perpetuates harmful stereotypes by building a false cause-and-effect narrative about being gay and testing positive for HIV. It is important, therefore, to understand the implications of testing HIV-positive to understand HIV and AIDS outside the context of an individual’s sexual orientation.
Many people can be infected with HIV for a long time and may not display any symptoms without developing AIDS. This is why it is important for all individuals, not just gay men, to use protection during sex and to get tested regularly.
While AIDS used to be considered a fatal or terminal disease, it is now considered simply a chronic illness that can be medically managed.
One of the most common courses of treatment is Anti-Retroviral Therapy (ART), which aims to suppress the replication of the virus and halt/slow the onset or progression of AIDS in HIV-positive individuals. ART also reduces the potential for transmission of HIV infection, and it is recommended that HIV-positive individuals begin an ART regimen as soon as possible and adhere strictly to the prescribed schedule.
The National AIDS Control Organization (NACO) published a list of ART centers across India that can be accessed here. Orinam, an LGBTQA+ collective, maintains a crowdsourced list on their website of doctors, clinics, and pharmacies that provide ART as well as other preventive treatments such as Post-Exposure Prophylaxis (PEP; a combinations of medications that may be taken to reduce the chance of HIV infection if you believe you may have been exposed to it).
Gay/bisexual/queer men, MSM, and individuals assigned male at birth are susceptible to STIs other than HIV, just like anyone else who is sexually active. Some of these STIs include herpes, genital warts, syphilis, and chlamydia. Genital and oral herpes in particular are highly contagious and, like many other STIs, can infect people of all genders and sexual orientations, regardless of the gender(s) of their sexual partner.
It is not true that individuals assigned female at birth do not need to use protection while having sex. Any form of unprotected genital contact carries some risk, so using protection while having sex is important for individuals regardless of gender identity and sexual orientation. This myth that queer women and AFAB individuals are an entirely low risk population is dangerous because it perpetuates the idea that they do not have to consider any forms of protection while having sex; furthermore, queer women are less likely to routinely seek sexual healthcare or get preventative tests under this assumption.
Queer women and AFAB individuals are at a reduced risk for the HIV virus in general, but the risk is higher for bisexual women and AFAB people, than women and AFAB who have exclusively have sex with other women and AFAB people.
Other STIs that queer women and AFAB individuals are at a risk for are herpes, Human Papillomavirus Infection (HPV) or genital warts as well as chlamydia and gonorrhea. It is therefore important to get tested regularly, especially if you or your partner have had (or also have) sex with men.
It is also important to keep in mind safe sexual practices and protection to reduce risks of contracting STIs. In addition to thoroughly cleaning sex toys before and after use, it is recommended to put a condom over penetrative sex toys before using them. You can buy dental dams or make them out of condoms to use while engaging in oral sex.
Any type of protected genital contact, whether or not it is penetrative, carries some risk of exposure to STIs regardless of the individuals’ gender identities and sexual orientations. As such, there is no form of “sex” that is entirely risk free or “safe,” so people with all sexual orientations will do well to use protection while engaging in oral sex either in the form of condoms or dental dams.
While having multiple sexual partners, especially without protection, does increase the chances of contracting an STI, the way in which you have sex has a great bearing on the risks, not the number of times you have sex. It is recommended that you use protection every time you have sex, regardless of your and your partner’s gender identities and sexual orientations.
This myth is particularly harmful because not all STIs or STDs have visible symptoms or an external manifestation and often gives people a false sense of security which prevents them from getting preventative checks or from getting regularly tested. Even once visible symptoms such as rashes or bumps may appear, they may often be conflated with other conditions and in general, accurate diagnosis and treatment will be delayed. This also greatly increases the chances of the infected individual infecting others.
It is recommended that you get screened for STIs once a year if you are sexually active or once every 6 months if you have multiple sexual partners. This is true for all individuals, not just for those in the queer community.
Many of the myths surrounding STIs and the queer community, and the conflation of risks for STIs with sexual orientation has led to the widely held belief, that it is unsafe to receive blood from a member of the queer community, particularly gay and bisexual men.
Adding to this belief are reports of blood banks in New Delhi and other cities refusing blood for gay and bisexual male donors, with doctors and hospital chairmen saying that gay and bisexual men “come under a high risk category” particularly because of the “probability of multiple partners.”
This myth and ban, especially coming from the medical community, unnecessarily and falsely stereotypes the queer community.
Individuals who have unprotected anal sex, including straight individuals, are a high risk category. Assuming that gay and bisexual men have unprotected sex with multiple partners simply by virtue of their sexual orientation is harmful stereotyping. Gay and bisexual men and other members of the queer community are no more or less likely to have unprotected sex or have multiple sexual partners than straight individuals.
Therefore, STIs and STDs are a concern for any individual who is sexually active, with gender identity and sexual orientation having far less bearing on the risks than you might think. It is important to understand sexual health in a comprehensive manner outside of the myths and stereotypes that conflate STIs and STDs with sexual orientation so as not to perpetuate harmful and false stereotypes about the queer community as well as sexual health in general.
Be safe, regardless of who you are and who you’re having sex with!
Header image is a still from the movie Kapoor & Sons
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