| Sexually transmitted
diseases (STDs) include chlamydia, gonorrhea, herpes simplex virus
(HSV), hepatitis B, HIV, syphilis, trichomonas and HPV. Hepatitis
C is not efficiently transmitted sexually, but is often screened for
along with those listed above, especially in patients with high risk
behaviors such as intravenous drug use.
Screening for chlamydia and gonorrhea can be done
with a urine test or by swabbing the cervix. Herpes can be detected
through antibodies in the blood or by testing an active lesion. Hepatitis
B and C, HIV and syphilis are tested for through blood tests. Trichomonas
is diagnosed by testing vaginal discharge. Finally, HPV testing for
high risk strains is done at the time of a pap smear.
Also, screening for herpes is now becoming more
routine, even in monogamous patients. The herpes virus can be spread
even in the absence of an active lesion. This is referred to as asymptomatic
shedding and requires only contact of the genital area to pass on
the virus. There is benefit in knowing whether you or your partner
has herpes. You can take a medication such as Acyclovir to decrease
asymptomatic shedding and, in turn, decrease the chances of infecting
your partner.
If you have never been screened for STDs, you should
be tested. If you are under the age of 26 and sexually active, it
is suggested that you be screened for Chlamydia routinely. Further
screening, then, is up to you. As much as we’d all like to believe
our partner is being faithful, that, unfortunately, is not always
the case. Just be sure to take care of yourself and your health, first
and foremost.
QUESTION
I've been dating this guy for a little over two years, and we’ve
been talking about marriage for a while now. The problem is that I
don’t think he is ready even though he’s 32. He has a
job that’s not really going anywhere—he doesn’t
like it and can barely support himself. He’s not very driven
and is pretty lazy with most aspects of his life, but he keeps assuring
me that he will step it up when we are married. He is a really good
guy, and I’m not sure I want to lose him. Should I keep waiting?
ANSWER by Anju Mulchandani
A lot can happen in two years. It is understandable that you would
be confused about whether to continue dating your boyfriend if you
really care about him. However, having been with your boyfriend for
this long should also give you enough insight to be able to answer
important questions that can shed some light.
- Do you think your boyfriend’s long term
goals are compatible with yours? Think about his career, family, etc.
- What is he doing to meet these goals?
- Has his level of maturity and responsibility increased
since you first met him?
If you hesitated when trying to answer these questions,
then you might have a problem. It is never a good idea to marry someone
in the hopes that he will change. You have no reason to believe that
this will ever happen. In fact, your boyfriend has more incentive
to try to change now so that he can win you over, incentive that he
won’t have after marriage.
Additionally, as much as you want your boyfriend
to become a responsible, mature person, these qualities are probably
more important to you than they are to him. If getting a new job and
becoming financially stable were as important to him, he would be
doing something to improve the situation.
If you do decide to get married and have a family,
would you be happy with the current situation? It sounds as though
you would have to be the primary bread winner and take on the role
of the “adult” in the relationship.
It is important to have realistic expectations going
into marriage, otherwise you are only setting yourself up for failure.
So now is the time to really ask yourself if you have the compatible
goals and values that are important for a successful marriage.
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