Historically, any discussion of sexually transmitted infections was avoided due to the associated stigma. In older more conservative romance stories, the subject of sexual health was avoided so as not to disturb the escapist aspect of the writing and avoid controversy. If included, STIs were used as melodramatic plot devices associated with shame, moral judgement or villainy.
A secret diagnosis or past infection was a source of tension, often resolved by revelation followed by forgiveness. Misdiagnosis or fear of infection was used to create and obstacle and was not handled well. Pregnancy scares or infertility linked to past STIs was used strategically as a plot complication.
Redemption arcs where an infected character is shamed then forgiven risked stigmatizing real people.
Contemporary portrayals increasingly emphasize testing, disclosure, treatment and medical facts, especially in contemporary and medical romance. Authors portray STI screening, antiviral treatments and long-term management to demystify conditions.
Consent, boundary-respecting conversations, and safer-sex practices are more common. Some books entre characters living well with chronic STIs including HIV, HPV and herpes, to inform, reduce stigma and humanize the experience.
New adult and contemporary romance are more likely to address sexual health directly. Historical and some erotic romance may avoid or fictionalize medical realities for plot or setting reasons. To their credit, LGBTQ+ romance increasingly includes HIV/PrEP, undetectable = untransmittable (U=U) discussions, and/or the impact of diagnosis.
Occasional misinformation, stereotype reinforcement, or sensationalizing disease problems persist. Plot convenience, like characters who are miraculously cured, or details which are glossed over can misinform. The lack of nuance about asymptomatic infections, testing windows, or partner notification should be presented.
Many authors, now research, consult medical sources to present STIs accurately and sensitively. Some publishers and authors include content warnings and afterwords with resources or factual notes.
Increased reader demand for realistic, compassionate portrayals has encourage more informed treatment of the subject matter.
Here are a few recommendations to help authors portray STIs more responsibly, research current medical facts. Show informed consent and include honest disclosure and testing conversations. Avoid using STIs as a moral punishment, shocking plot twist or complication. Consider using trigger/content warnings with resource link in the author notes. Use sensitivity readers when depicting specific communities or lived experiences. Work to reduce stigma around STIs in your storylines.
Escape and enjoy.
