SEX, Safely

Safe Sex

What is safe sex to you? Do you use a condom every single time that you engage in sex? What does the word “sex” even mean to you?

Sorry to be the bearer of bad news, but if you think that you have been having 100% safe sex and you are not using a condom when you engage in oral sex, you are indeed putting yourself at risk for STI’s (sexually transmitted infections). This includes cunnilingus (ie eating out a female), and analingus (licking another persons anus or ‘rimming’). Any and ALL sexual activity, EVEN with a condom or dental dam is inherently risky. The point of this post is to not make you a celibate nun, but have some facts spelled out for you in plain English.

More importantly, every single sexually transmitted infection can be transmitted through oral sex. Yes, that means HIV, Hepatitis A, B, C, Syphilis, Gonorrhea, Chlamydia, and Herpes Simplex, and HPV. While you can rest slightly easier that the rate of transmission via oral sex is much lower, you need to understand that your risk is not zero.

It has been reported that the rate of persons under 30 with positive STI screenings is now 50%. Yes, ONE out of every TWO people will have an STI before the age of 30. Many people are attributing the rise in syphilis, chlamydia, and gonorrhea to the widespread use and adoption of PrEP (Truvada, or Pre-Exposure Prophylaxis), because it has increased the overall percentage of reported “condomless” sex acts. However, it must be noted that we are seeing a rise in diagnosed STI’s is because younger persons are in fact going to see their health care providers for more frequent testing as well. Also, studies have shown that most people lie about using condoms anyway.

I will talk about PrEP in another post, but the incidence of HIV has actually dropped almost 20 percent over the past 2 years even though other STI’s have increased. In short, PrEP works so stop being a sexual Nazi.

Any time that you engage in a sexual act (any act involving another persons genitals and yourself) that you need to do your due diligence and get yourself tested. It is your responsibility to get tested at least annually (yearly), if not more frequently when you are having sex with multiple partners. In particular, for men who have sex with men, the rates of gonorrhea and chlamydia are missed 30-40% of the time unless your provider neglects to perform an oral and rectal swab. This is also irrespective of the fact if you are a strict “top” and also if you are not performing any penetrative sex acts. In short, if you put a dick in it or near it, you bettah swab that shit.

And while I will never encourage anyone to have condomless sex based on scientific facts, life is about choices and making choices based on these facts. It has been statistically proven that people who use condoms more often than those who do not, have reportedly less instances of STI’s across the board. That being said, even when condoms are used correctly 100% of the time, they do not eliminate the wearers risk of contracting and STI. The only way to avoid getting an STI is to not have sex at all, and this is not living. Would you judge someone for walking around outside buying groceries and contracting a community acquired pneumonia? Doubtful. So we need to work on de-stigmatizing STI’s and encouraging everyone to get tested.

That being said, you should most often times not run out and get tested the next day immediately after engaging in a new sexual act as oftentimes even if you have contracted a new STI, the test will likely come back negative since it has had no time to incubate.

Chlamydia

  24 hours to 5 days after new sexual act

Gonorrhea

  2-6 days after a new sexual act

Syphilis

    3-6 weeks after a new sexual act

HPV

  Can take months

HIV

   At least 9 days with most modern testing

STD CHECK offers a full list of when to get tested if you are worried about certain STI’s.

The point of this post is not meant to scare you, but to empower you to take charge of your sexual life. Get tested. Most of these infections are treatable, and are definitely no longer death sentences. People with HIV are living long, productive and healthy lives on ART; also fun fact no one that has reached undetectable viral loads has ever passed HIV on to another sexual partner even when they did not use condoms or PrEP. People with Hepatitis C now have a cure thanks to new antiretroviral treatments as well . So go out there, HAVE SEX, get tested, and be vocal about your status with all of your partners and make it a normal part of the conversation. Silence equals death, and we are so over that.

I am also happy to announce that I have set up an alliance between the Hudson Pride LGBT Center in Jersey City NJ to have them send their clients to our clinic for HIV Testing/Treatment/Prevention, STI testing/treatment, as well as all necessary preventative health screenings. I am extremely excited for this partnership, and I hope that it helps to educate ourselves as doctors as well as the community.