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In communities where there is high social incentive to test regularly and maintain honesty and strict use of STI prevention mechanisms like condoms, outbreaks are pretty rare.
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It wasn't until this year (!) that I learned specific stis can take weeks/months to show up on a test. I feel bad for people who don't have time to wait in between clients. How can an asymptomatic negative tester know they've actually caught something?
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people having casual sex outside of a poly/SW/kink scene can be pretty unwilling to use condoms, even though they are obv at risk. i suspect most STD transmission is from normies
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