STI Disclosure Protocols

What Disclosure Is For

Two things: legal protection (yours) and informed consent (theirs). The provider has a right to make their own decision. The client has a right to make theirs. Disclosure is the mechanism that lets both happen — and it cuts the legal risk of "knowing transmission" prosecutions to near-zero on the disclosing side.

Timing

Disclose during the initial booking exchange — before deposit, before names, before meeting time. The reasoning: this is the moment when both parties can opt out cleanly without anyone having invested anything. A provider who declines after booking-stage disclosure has done both of you a favour. A provider who declines after a deposit, or in person, has been failed by the booking process.

For ongoing partners (sugar arrangements, repeat bookings), re-disclose meaningful changes: new partners, new exposures, new positive tests, changes to ART or PrEP regimen, a recent vaccination.

What to Disclose

The brief should cover four things and stop there:

1. The infection in functional terms. "HIV-positive on ART, undetectable" / "HSV-2, no current outbreak" / "HPV, vaccinated partner only" / "Hepatitis B chronic, vaccinated partners safe."
2. Treatment status. Active ART; on PrEP; recently completed antibiotics for syphilis/gonorrhea/chlamydia; vaccination status.
3. Most recent test date and result. "Tested 32 days ago, clean apart from HSV-2."
4. Any active outbreak or recent high-risk exposure. Don\'t book around an active outbreak; don\'t book within the window period of a recent unprotected exposure.

What Not to Disclose

You don\'t owe the provider your sexual history, the partner who transmitted to you, or your medical-system relationship. The provider needs operating instructions for the next two hours, not a history.

HIV-Specific: U=U

"Undetectable equals untransmittable" is the consensus across the WHO, CDC, BHIVA, and every other major public-health body. A person on consistent ART with sustained undetectable viral load does not transmit HIV sexually. The PARTNER and Opposites Attract studies covered tens of thousands of condomless acts with zero transmissions.

In practice: HIV+ undetectable disclosure is increasingly met with informed acceptance, especially among providers who work with HIV-status-aware health programmes. Some providers will still decline; that\'s their right, and it\'s rare and getting rarer.

HSV (Herpes)

HSV-1 (typically oral) and HSV-2 (typically genital) are extraordinarily common — adult prevalence varies 30–80% depending on country and demographic. Most carriers are asymptomatic most of the time. Practical rules:

• Active outbreak: don\'t engage in the activity that uses the affected area.
• Antiviral suppression (valacyclovir/Valtrex daily) reduces transmission to a partner by ~50%.
• Condom use during shedding (which can occur without symptoms) further reduces.
• Disclosure is ethical baseline; legal consequences for non-disclosure of HSV vary widely.

HPV

The most common STI. Most carriers clear it within 2 years. The Gardasil-9 vaccine prevents the highest-risk strains (6, 11, 16, 18, 31, 33, 45, 52, 58). Adults up to age 45 can still be vaccinated and benefit. Disclosure of HPV is practically meaningless in most cases — you don\'t know which strain, the partner is statistically already exposed, and asymptomatic infection is the rule. Vaccination is the right tool.

What to Bring

• Screenshot or PDF of your most recent (≤90 day) test panel.
• Prescription bottle photo or clinic letter for ART or PrEP if you\'re on either.
• Vaccination record for HPV / Hepatitis B if relevant.
• Your prescriber\'s name and contact in case of medical emergency.

Frequently Asked Questions