Note to reader: “STBBI” is an acronym for Sexually Transmissible and Blood-Borne Infection whereas “STI” is an acronym for Sexually Transmitted Infection. The terms “STI” and “STBBI” both refer to various conditions that can be transmitted between individuals through unprotected sexual contact. Throughout this article we will use these two terms interchangeably.

Your partner doesn’t want to get tested? While this issue isn’t always easy to address, it’s far from insurmountable. 

Knowing the symptoms of STIs can help identify a potential problem early on, but the absence of symptoms does not mean the absence of infection. That’s why screening for STIs plays a vital role in prevention: it can detect an infection before complications arise, and before it is passed on to others. 

It’s still important to communicate your concerns and boundaries because, to properly prevent STBBI transmission, it’s always best to know your respective sexual health status and jointly negotiate the prevention strategies that you will use. By discussing prevention openly, you can decide together on the most appropriate methods of protection, such as the use of condoms or regular check-ups with a health professional. By making STI screening and prevention a priority in your relationship, you create a space of trust and shared responsibility that strengthens not only your health, but also your complicity.

Here are some tips for approaching this issue with kindness and taking charge of your sexual health as a team.

Step 1: Listen to better understand

There are several reasons why someone may not want to get tested. For example, some people avoid screening services because they are afraid of testing positive or because they have had a negative screening experience in the past. Other people don’t believe they are at risk of contracting an STI, or consider discussing sexually transmitted infections or mentioning a need or desire to get tested as signs of distrust or infidelity.

In addition, given many people’s lack of education about STBBIs and screening, some may not know that these infections often don’t show any symptoms and that getting tested is the BEST preventive strategy for early detection and treatment.

For instance, chlamydia, one of the most common STIs, can go undetected for months, with few or no symptoms. A person can therefore be a carrier and unknowingly pass it on to his or her partners. If left undetected and untreated, chlamydia can lead to more serious health complications, such as infertility. Screening is therefore the most effective way of detecting the presence of this STI, even in the absence of symptoms.

The important thing is to ask questions and try to understand your partner’s reluctance without judgment.

Step 2: Share your knowledge

After listening and better understanding your partner’s reluctance, you can share some facts about sexually transmitted infections and screening to better explain the importance of screening as part of routine healthcare. Here are a few facts that can gently nudge the conversation forward:

• STIs often don’t show any symptoms, so you can have an infection and transmit it without knowing it. Hence the importance of getting tested to detect them, get treatment, and reduce the risk of transmission.
• Testing positive for an STI is common and it’s nothing to be ashamed of: having an STI does not make you dirty and doesn’t mean that you have poor hygiene. According to the Ministry of Health and Social Services, 40,000 STI diagnoses are made every year in Québec. 
• STI screening is a shared responsibility that limits the risk of transmission and protects our sexual health. Since you can have an infection for a while without knowing it, it’s not automatically a sign of infidelity.
• Routine STI screening is for everyone… even people in monogamous relationships. Infidelity does happen and it can affect our sexual health without our knowledge. These infections can also be transmitted through nonsexual means, such as through getting piercings or tattoos.
• STBBIs have window periods and are not all detectable by the same tests. There may be a delay between the time of infection and the ability of a laboratory test to detect it. You may therefore need to return at a later time to confirm earlier tests.

Step 3: Offer reassurance about the screening process

If your partner has concerns about the screening process, you can remind them that as medical services and practices have evolved, the processes, equipment, and services are much better than they used to be.

For example, at Prelib, several practices are put in place to make screening easy and simple:

• Appointments are made online and last approximately 20 minutes. No more drawn-out, uncomfortable moments in a crowded waiting room!
• Our screening process works on a self-sampling basis to make it as nonintrusive as possible. Our patients’ sexual health is in their own hands.
• The types of tests required are determined through a confidential, online medical questionnaire based on your lived experiences and practices.
• Screening appointments are always followed up by a doctor’s phone call to communicate your results, whether positive or negative, for your peace of mind.

So, there’s no reason to worry about safety or wellbeing. With Prelib, screening is quick, effective, and nonjudgmental.

To help you even more, we have put together a few examples of how to word things to ensure that the conversation gets off to a good start:

• “I learned that STIs often don’t show any symptoms and that you can have one without knowing it. So, screening is the only way to know for sure.”
• “STIs are really common, even when people are careful, and there’s nothing wrong with that. That’s why I’d like us to take even better care of ourselves and get tested. :)”
• “The idea of testing positive stresses me out too, but at least it would enable me to get the right treatment. If it happens, I’ll make sure you’re treated with care, I promise ;)”
• “If you’ve had a bad experience, it makes lots of sense to not want to go back. I can understand that. But today, there are clinics like Prelib where you can take the samples yourself. It’s way less intrusive that way!”
• “Would you like us to go together? We could make a date out of it and go out for coffee afterwards. :)”

Conclusion

It’s not always easy to deal with someone’s resistance to getting tested, especially when that someone is your sexual partner, but it’s not impossible to change their mind. The important thing is to avoid making judgments about their screening habits. Taking care of one’s sexual health should always be done without pressure.

That said, if the person remains reluctant even after hearing your factual arguments, it’s completely okay to enforce boundaries and take the appropriate measures to protect your health and limit the risk of transmission. For example, you can:

• Continue to get tested regularly to keep track of your sexual health.
• Continue to use protective methods such as condoms and PrEP.
• Stop all sexual activity. If you are uncomfortable with the idea of being sexually active without STBBI testing, that is also very legitimate.

And if you happen to test positive, we have a short reassuring guide on what to do when that happens.