This page is general education. It does not replace advice from a doctor, therapist, counseling service or lawyer who knows your situation.
STI basics
Sexually transmitted infections (STIs) are common. The World Health Organization estimates that more than one million curable STIs are acquired every day worldwide, and most of them cause no symptoms. Having an STI says nothing about your worth. It is a health matter, and most are easy to test for and treat.
Bacterial and curable
Chlamydia, gonorrhoea and syphilis are treated with antibiotics. Trichomoniasis, caused by a parasite, is also curable. Untreated, some can cause pain, infertility or serious long-term harm.
Viral and treatable
HIV, hepatitis B, herpes and HPV are caused by viruses. Medicines can control HIV, herpes and hepatitis B very well, but do not remove them. Most HPV infections clear on their own.
Through blood
HIV, hepatitis B and hepatitis C can pass through blood. This matters for blade play, needles, piercing and impact play that breaks the skin.
Through skin and other contact
Herpes, HPV, syphilis and mpox can pass through skin-to-skin contact, so condoms lower the risk but do not remove it. Hepatitis A passes through traces of faeces, for example in rimming, fisting or scat play.
STIs spread mainly through vaginal, anal and oral sex, and also through shared toys, fingers and hands, and contact with blood. Infections can sit in the throat or rectum without symptoms, which is why where you test matters.
No symptoms does not mean no infection
Many STIs go unnoticed for weeks or years. The only way to know your status is to get tested. Unusual discharge, sores, itching, pain when peeing or bleeding after sex are reasons to see a doctor soon.
Testing
How often
- At the start of a new relationship, before you stop using barriers with each other.
- At least once a year if you have several partners.
- Every three to six months if you have many partners, take PrEP, or play in group settings.
- Whenever you have symptoms, after a condom broke or slipped, or after a partner tells you they have an STI.
What to ask for
- HIV, syphilis, chlamydia and gonorrhoea as a basic set.
- Swabs from the throat and rectum if you have oral or anal sex, because a urine test only covers the genitals.
- Hepatitis C if you do blood play, share needles or snort substances, and hepatitis B if you are not vaccinated.
- Say what you actually do. Testing staff hear everything, and a clear picture gets you the right tests.
Health offices
Many public health offices in Germany (Gesundheitsamt) offer anonymous HIV and STI testing and counseling, often free or at low cost.
AIDS service organizations
Local Aids-Hilfe organizations in Germany, Austria and Switzerland offer counseling and, in many cities, anonymous tests.
Checkpoints
Community testing centers called Checkpoints exist in several German and Swiss cities. They are especially used by queer people, but open to many others.
Doctors and clinics
Your GP, a gynecologist, a urologist, a dermatology and venereology practice or an HIV practice can test you. Health insurance usually pays when there are symptoms or a known risk.
Some infections only show up in tests after a while. A laboratory HIV test can reliably rule out an infection six weeks after a risk, a rapid test or self-test after twelve weeks. If you were tested soon after a risk, the testing service will tell you when to repeat it. A positive rapid or self-test always needs confirming in a laboratory.
Barriers and toys
Barriers that work
- External condoms for penises and toys, used from start to finish and in the right size.
- Internal condoms for the vagina or anus, which can be put in before play begins.
- Dental dams (or a condom cut open) for oral sex on the vulva or anus.
- Nitrile or latex gloves for fingering, fisting and any contact with blood or broken skin.
- Plenty of water- or silicone-based lubricant. Oil damages latex condoms.
Toys
- Choose non-porous materials such as medical-grade silicone, glass or stainless steel: they can be cleaned thoroughly.
- Clean toys after every use as the maker recommends. Porous toys (jelly, rubber, some TPE) cannot be fully cleaned, so cover them with a condom.
- Put a fresh condom on a toy when it moves to another person, and when it moves from anus to vagina.
- Keep a toy that has been in contact with blood for one person only, or use a new condom each time.
Barriers reduce risk a lot but do not cover everything: infections spread by skin contact, such as herpes, HPV and syphilis, can pass where the barrier does not reach. That is one reason why vaccinations and regular tests complement them.
HIV prevention: PrEP, PEP and U=U
PrEP: before
Pre-exposure prophylaxis is an HIV medicine taken by HIV-negative people to prevent infection. It is highly effective when taken as prescribed. It needs a prescription, an HIV test before starting and regular tests for HIV, other STIs and kidney function, usually every three months. In Germany, statutory health insurance covers PrEP for people with a higher risk. PrEP does not protect against other STIs.
PEP: after
Post-exposure prophylaxis is an emergency treatment after a possible HIV exposure, for example a broken condom with a partner of unknown status or a needle-stick injury. It is taken for about four weeks. It works best the earlier it starts.
U=U: undetectable = untransmittable
People with HIV whose treatment keeps the virus below the detection limit, usually confirmed over at least six months, do not pass HIV on through sex. This is one of the clearest results in HIV research and is supported by the WHO and national health bodies.
PEP is urgent: go now, not tomorrow
Start PEP as soon as possible, ideally within a few hours. Austrian guidance and many international bodies give 72 hours as the latest point; Swiss guidance says 48 hours. Go to a hospital emergency department or an HIV clinic straight away and say that you need PEP. If you are unsure whether your situation counts, ask there: the staff will assess it with you.
U=U applies to sex. For contact with blood, effective treatment also lowers the risk greatly, but this has been studied less. Talk with a doctor if blood play is part of your relationship.
Vaccinations
Vaccines protect you against some infections where barriers fall short. Ask your GP to check your vaccination record and whether the following make sense for you. Recommendations and cost coverage differ by country, age and situation.
- HPV: protects against the virus types behind most HPV-related cancers (cervix, anus, throat and others) and against genital warts. It is routine for young people; adults can ask whether it is still useful for them.
- Hepatitis B: spread through blood and sex, so especially relevant for blood play, piercing and multiple partners.
- Hepatitis A: spread through traces of faeces, relevant for rimming, fisting and scat play.
- Mpox: in some countries recommended for people with a higher risk, for example men who have sex with men and have changing partners.
Contraception basics
If one partner can get pregnant and the other produces sperm, contraception belongs in the negotiation as much as safewords do. Only condoms protect against both pregnancy and many STIs, so many people combine a condom with another method.
Common methods
- Barrier methods: external and internal condoms, diaphragm.
- Hormonal methods: pill, patch, vaginal ring, injection, implant, hormonal IUD.
- Copper IUD or copper chain, without hormones.
- Fertility awareness methods, which need training and a lot of discipline.
- Sterilisation, which is meant to be permanent.
Emergency contraception
The morning-after pill is available without a prescription in pharmacies in Germany, Austria and Switzerland, usually with a short consultation. Levonorgestrel is taken within 72 hours, ulipristal acetate within 120 hours, and both work better the sooner you take them. A copper IUD fitted within five days is the most effective option. Emergency contraception does not protect against STIs.
Blood and body fluids in impact and blade play
Canes, whips and some floggers can break the skin, sometimes without anyone noticing at first. Blade play, needles and play piercing involve blood on purpose. Treat every drop of blood as potentially infectious, whatever anyone says about their status.
- Wear gloves whenever blood or broken skin may be involved, and change them between people.
- Use sterile, single-use needles and blades, and dispose of them in a puncture-proof sharps container.
- Keep implements that touched blood for one person only. Leather, wood and rope cannot be reliably disinfected.
- Clean and disinfect non-porous implements and surfaces according to the product instructions.
- Cover fresh wounds, keep them clean and watch for signs of infection such as spreading redness, heat, pus or fever.
- Get vaccinated against hepatitis B and include hepatitis C in your regular tests.
Talking with partners about status
Talking about tests and status is part of negotiation, not an accusation. It works best when it is routine: before play, sober, and with the same questions for everyone.
Questions that help
- When were you last tested, and for what?
- Do you use PrEP, or are you on HIV treatment with an undetectable viral load?
- Which barriers do we use for what, and is there anything you never do without one?
- Do we share toys or implements, and how do we clean them?
- What do we do if a condom breaks or someone bleeds unexpectedly?
If you get a positive result, many testing services help you tell partners, and some can notify them anonymously. Living with HIV, herpes or another infection does not end your sex life or your kink life. With treatment, honesty and good practice, it rarely limits what is possible.
Sources and further reading
We link to independent public health bodies, counseling services and official legal texts. They are not responsible for our content.