QUESTIONS
When does HIV to show up in a blood test?
Oral Sex, Anal Sex and HIV
Two condoms better then one?
Is Rimming Safe?
Boyfriend has Bumps on Penis
Mild Burning and Discharge
Silicone Based Lubricants
Gay Teens and Examinations
Kissing = Risky?
Girlfriend wants Anal Sex
Fertile time for Women
Lube and Anal Sex
ANSWERS
When does HIV to show up in a blood test?
How long does it take for HIV
to show up in a blood test?
The HIV test is
an antibody test that measures the body's reaction to the HIV virus. It
takes up to three months after infection for the antibody to become present.
That's why we call the period after exposure before an HIV-positive test the "window period" -- when people can actually be infected but have a negative or normal antibody test.
Doctors recommend a repeat test six months after the first to make sure
the "window period" was truly negative. Most sexually active people at risk for HIV have interpreted this as the need to get an HIV test every six months. This is a not a bad idea and should be accompanied by STD tests at the same time.
To your health,
Dr. B
Oral Sex, Anal Sex and HIV
I would say I'm bisexual. Recently, I've had a guy experience where a
man sucked me off. I understand the risk for the person giving the blow
job, but how much risk is there to the receiver of contracting an STD?
Okay, let's answer your questions one by one. Oral sex and semen swallowing
carry a very, very low risk of HIV infection. While some recent studies
have suggested it may be zero, there are definitely case reports and
individual experiences that support that HIV can be transmitted through
oral sex, although it seems to be rare. It may be possible to take this
concept further and reduce an already low risk activity to a lower risk
one, the thinking would be that no semen would be safer than some, but
truthfully there is no scientific proof in this area yet. There seems
to be even a lower risk of transmission in people who receive oral sex
and I am not aware of any case reports that document getting oral sex
as a way to get HIV.
On to your next question. Receptive anal sex is the riskiest form of sex.
HIV is in pre-cum -- the fluid before ejaculation, so even if the inserter
pulls out, infection is possible. Men do get infected from both anal receptive
and anal insertive sex but anal receptive sex is about 10 times more risky.
Some numbers that some folks quote is 1 in 50 vs. 1 in 500 chance of infection
from receptive vs. insertive anal intercourse.
Condoms work very well to reduce the risk of transmission from an infected
partner to an uninfected one. Of course if both partners have recently
tested negative and had not had any new partners since their tests, then
the risk of transmission is very, very low.
And lastly, if you are treated once for an STD like gonorrhea, syphilis
or chlamydia, it does NOT protect you from future infections. We see patients
every day with new STDs that they have had before. Each germ is a little
different and your immune system does not protect you from future infections.
To your health,
Dr. B
Two condoms better then one?
Would wearing two condoms during sex decrease my chances of getting HIV?
There
is no evidence that wearing two condoms is more effective than wearing
one, and in fact, there is some hearsay evidence that the friction of the
two condoms rubbing together can cause them to break, making you more susceptible
to HIV and other STDs.
To your health,
Dr. B
Is Rimming Safe?
I was wondering how safe oral sex is -- both giving and receiving.
Questions
about oral sex are probably the most common ones we get. In terms of HIV,
oral sex both ways is very safe. The University of California San Francisco
and the San Francisco Dept. of Public Health just completed a study of
men in San Francisco who have only had oral sex and found zero new HIV
infections. A very recent study from Spain confirmed earlier studies that
oral sex is safe sex in terms of HIV. However, there are case reports and
individual experiences that support that HIV can be transmitted through
oral sex, although rarely. As far as whether oral sex is riskier if you
swallow, truthfully no one really knows.
What's important is that other STDs like syphilis, gonorrhea, chlamydia
and herpes are definitely transmitted through oral sex, and oral sex
has likely contributed to San Francisco's current syphilis outbreak.
Many of these infections are easily diagnosed with simple tests and can
be treated with available medications.
So my advice is: Enjoy oral sex and get regular check-ups. A good
check-up includes throat testing for gonorrhea, rectal testing for
gonorrhea and chlamydia, urine testing for gonorrhea and chlamydia
and blood tests for herpes, syphilis and HIV. We call that the grand
slam!
To your health,
Dr. B
Boyfriend has Bumps on Penis
I've been going out with this guy for awhile now. Every time I go down on him I see something on his penis that alarms me. On the underside of the shaft, he has these little bumps similar to pimples. They aren't warts, I don't think. He told me once it was okay - that they had something to do with puberty. He won't go to see a doctor about them. So far, I haven't gotten any sexually transmitted diseases from it. Do you know what he has?
The only way to get a proper diagnosis is for this guy to see a doctor or healthcare provider. All sexually active people should get regular check-ups. Perhaps in light of the fact that you're recently sexually active together, you might be able to suggest a doctor's visit rather than focusing on the little bumps which he's reluctant to have checked.
Just so you know, there are a several kinds of bumps that persist on the
penis and are part of normal anatomy, as your partner suggests. One type
is sebaceous (epidermoid) cysts. These are basically swollen follicles
under the skin that are whitish-pink-yellow in color, smooth, and are single
or in groups. Another cause of bumps that are normal are called pearly
penile papules -- shiny bumps along the coronal sulcus -- the ring around
the head of the penis. Abnormal bumps like warts are usually rougher and
more cauliflower -like. They can be the same color as the skin or somewhat
lighter or darker. Other bumps that are infectious include syphilis, herpes
or scabies. This is why now would be a good time for you and your partner
to get complete sexual health check-ups.
To your health,
Dr. B
Mild Burning and Discharge
I'm a gay man, and although I'm mostly celibate, as part of my annual physical,
I get tested for all the main STDs: HIV, syphilis, chlamydia, and gonorrhea,
just for my own peace of mind. I always test clean, however every so often
I experience discharge after urination. If I'm disease free, what could
cause this? I've also experienced an occasional discomfort like a mild
burning during urination, but it's nothing severe or constant. Any thoughts?
What
you describe could be an STD called urethritis. About 40% of cases are
caused by bacteria like chlamydia or gonorrhea. Other cases may be caused
by other bacteria like mycoplasma, viruses like herpes or even yeast. Receiving
oral sex can cause urethritis from bacteria in the mouth. Other causes
can include reactions to chemicals or lubricants like N-9. Rarely urinary
tract infections and kidney stones can cause urethritis. Only a doctor
can make a diagnosis after an examination. For more information on non-gonoccochal
urethritis (NGU), click here.
To your health,
Dr. B
Silicone Based Lubricants
How safe are silicone-based lubricants for use with condoms? Do they cause
any damage to latex?
While water-based lubricants are the most commonly
recommended type of lubrication, silicone-based lubricants should be fine.
They last longer, are still effective in water and you need less of them.
Many people prefer silicone-based lubricants for anal sex.
You can always do your own check by inflating condoms and rubbing them
with water-based, silicon-based and oil-based lubricants. You'll see that
after a minute or so, the latex condom with the oil-based lube will break.
To your health,
Dr. B
Gay Teens and Examinations
I am a teen who has recently been receiving anal sex -- with condoms of
course. My question is that I know teen girls need internal exams when
they first have sex, but if I'm a guy having anal sex, does that mean I
need a check-up, too? If yes, how often?
Yes, sexually
active men, including young men, should get regular checkups at least once
a year and ideally after every two new partners. Some doctors recommend
twice a year to keep things simple.
Men who have receptive anal sex (bottoms), regardless of condom use, should
get rectal tests for chlamydia, gonorrhea and blood tests for syphilis
and HIV at their checkups.
Men who have insertive sex (tops) should get urine tests for gonorrhea
and chlamydia at the same frequency and also blood tests for HIV and syphilis.
People who have oral sex (suck cock) should get regular throat tests for
chlamydia and gonorrhea and syphilis tests.
To your health,
Dr. B
Kissing = Risky?
Is kissing a risky behavior for STDs?
Kissing poses no significant risk
for STDs. Other activities like mutual masturbation and dry humping (sometimes
called frottage) are also considered safer sex activities with little to
no risk for sexually transmitted diseases. Kiss away!
To your health,
Dr. B
Girlfriend wants Anal Sex
My girlfriend suggested that we have anal sex without a condom. It would
be our first time. I thought you were always supposed to use one because
of the risk of infection. If you and your partner don't have any STDs or
HIV, is it safe to not use a condom for anal sex? All of the information
I've found out there assumes you don't know your partner's status in regards
to STDs and HIV.
You're right -- in order for you to be exposed to HIV or
STDs, your sex partner(s) has to be infected. So, if you're in a relationship
and you've both tested negative for STDs recently, and neither of you is
having sex with anyone else, you're not at risk for getting or giving an
STD.
That said, many STDs are asymptomatic, and a person can even be a carrier
of an STD and spread it to others without knowing it. You can't tell a
person is "clean" just by looking - a recent series of STD tests
or knowledge that your partner hasn't had any other sex partners is necessary
to be sure that they are free of STDs.
It's important to talk with your partner about what it means to have sex
without a condom, particularly anal sex, which is a more risky activity
for spreading STDs and HIV than vaginal intercourse. It won't be an easy
conversation, but it's better to have it now than to worry later. You can
cover subjects like being exclusive, trust, drawing the lines for safer
sex, STD testing and more. A few tips for the talk:
- Pick a time when you won't be interrupted.
- Pick a neutral place to chat (not the bedroom, or in the throes of passion).
- Be sober.
- Be open to the possibilities.
- Have a sense of humor and use it—remember sex is about having fun.
To your health,
Dr. B
Fertile time for Women
When is the safest time to have sex -- when a girl is starting her period,
ending her period, or what?
If you use a condom or another form of contraception,
you don't have to worry about which time of the month you might be fertile
(able to get pregnant). But just so you know, the fertile period in a woman's
menstrual cycle usually lasts for three days, but can be up to 10 days
due to the life of sperm. The fertile time begins about 14 days before
a girl has her period. Trying to time your sexual activity without using
any other contraception is called the rhythm method and has a high failure
rate (10-20%). Condoms and birth control pills are much more effective,
and condoms also protect you against HIV and STD transmission.
To your health,
Dr. B
Lube and Anal Sex
I had anal sex for the first time about a month
ago. My partner did not use enough lube or enter slowly enough and I
experienced a sharp pain. I have not had bloody stools, but have been
experiencing a general soreness in the anal area. Should I go see a proctologist?
I have insurance, but it’s under my parent's name and would like
to avoid billing them for an anal checkup at all costs. Please help.
It is not uncommon to experience
discomfort after anal sex, particularly for your first time and when inadequate
lubrication is used. If the symptoms persist > 7-10 days or if you start bleeding, then a check up may be
in order to rule out an anal tear or fissure. If there is not persistent
trauma discomfort will wane with time. Comfortable anal sex can be assured
with lots of lube, lubricated condoms and careful entry. Don’t be
shy to ask your partners to go slowly if you need to. If the anal partner
is on top or sits down on the penis of his or her partner, he or she can
better control entry and prevent pain.
To your health,
Dr. B
Ask your Question today
Dr. B gets so many questions that he can't answer them all. We encourage you to search the archives to see if your question has already been answered.
Or you can check Dr. B by topic and the recent
Q&As to see if you can find an answer to your query. If you want to talk
to someone personally, you can always call 202-698-9860 during business hours.
We ask for the following information to help with statistics. All personal information is completely confidential and optional. Thanks for your help!
To your health,
Dr. B
