I just had unprotected sex... what do I do now?

Almost every week, I get a letter from someone who is panicking about the fact that they've had unprotected sex. The specifics of what they're worried about depend on the circumstances -- who they are and who they've slept with -- but most people have one or both of two basic concerns.

  1. Could this have gotten me pregnant?
  2. What is the risk of my having gotten an STD?

The first question is a lot easier to answer than the second. Fortunately, it's also a lot easier to deal with. However, determining STD risk is less straightforward.

STD risk depends on whether your partner is infected, of course. It also depends on how you had sex, and any of a number of other factors that are incredibly difficult to quantify.

On one hand, STDs aren't transmitted every time an infected person has sex. On the other hand, many people don't know they're carrying something. So what do you do after an episode of unprotected sex? Start thinking proactively.


Plan B
BOSTON - FEBRUARY 27: The Plan B pill, also known as the 'morning after' pill, is displayed on a pharmacy shelf February 27, 2006 in Boston, Massachusetts. Many states may have to deal with legislation that would expand or restrict access to the drug since the federal government has not made a decision to make the pill available without a prescription. Joe Raedle/Getty Images

If you are a woman who has just had unprotected vaginal intercourse with a man, consider investigating emergency contraception. Emergency contraception can be used within 72 hours of unprotected sex to prevent pregnancy. It is most effective when used as soon as possible.



AIDS treatment and man sleeping on bed
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If you have just had unprotected sex with someone who you know, or suspect, to be HIV positive, take a breath. It is still possible to reduce your risk of becoming infected with the virus. Call your doctor and ask about post-exposure prophylaxis, or PEP. She may be willing to prescribe you a short course of antiretroviral therapy. These therapies can reduce your risk even after a known exposure to HIV.

Post-exposure prophylaxis is different from pre-exposure prophylaxis, or PrEP. PEP is given after a risky encounter instead of being taken in advance of one. To remember the difference, it may help to think of PrEP as something you take in preparation, while PEP is something to pep you up after an event that has left you concerned. Neither is 100% effective, but they can each significantly reduce risk. 



Young Couple on a Date
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Want to know how risky your recent encounter was? The best thing you can do is talk to the person you slept with. If they've recently been tested for STDs, and not had any other risky encounters since then, you may be able to rule out some things to worry about. However, it's important to be aware that many doctors do not regularly test for STDs. In addition, even when testing is done, it may not always include screening for everything you're interested in knowing about.



female doctor taking blood sample
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If you've just had unprotected sex, it doesn't necessarily make sense to go to the doctor for STD testing right away. The benefit of doing so is that you would be able to reassure your sexual partner about anything you may have exposed them to. However, if you're concerned about whether you may have contracted an STD from having sex with them, you'll have to wait. It takes anywhere from a few days to a few months for STD tests to become accurate.



Various colors of condoms and contraceptive
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If you're stressing out about having had unprotected sex, that may be a sign that you should think about being more consistent about practicing safer sex in the future. The best way to do that? Be prepared. If you're carrying condoms, dental dams, and other forms of protection on your dates, you're much more likely to use them. One of the biggest barriers to using barrier methods is not having them on hand.


Make Casual Sex Less Casual

Most people who are worried about the possible side effects of unprotected sex are concerned about unprotected sex they've had casually. Often, this is sex they've had without spending much time thinking about whether it's something they want to do. That's why it's important to remember that sex can, and should, be an active choice. Ideally, sex is something you're doing because you both want to, not just because you can. That's true whether you're having a one night stand, or are in the middle of a ten year relationship.

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