STD how do you protect yourself

[adventurous old guy]

There's a lot of discussion lately about relative risks and people's response to them. Think terrorist attack vs fridge falling on you. The latter is the higher risk. I think people are more likely to accept a risk if they understand it and think they have a good chance of avoiding it. I think I am safe from falling fridges. With driving, you think you are in control. Occasionally some idiot will cross the centre line and head-on you, but that's not the foremost risk in our minds when we are on the road. And flying, where we don't have any personal control has a far lower risk than driving but people are far more anxious about it. There was a spike in road fatalities in the US after 9/11 (as I recall) when nothing was in the air. With sexual health, no matter what you do, it all depends on the other person to some extent and people are frightened by that element that they can't control.

Hmmm, I think the distinction here is that we are talking about risks we CAN control, e.g. by not having sex at all, taking the various precautions discussed here, etc. So the comparisons with plane crashes, terrorist acts, and drivers crossing the center line are distinguishable. Deciding if and how to have sex are matters of personal choice and -- as pointed out by Benjamin here and in other threads -- personal responsibility to our fellow human beings. For me, the fear of an STD is a kind of psychological/ethical/maybe even spiritual gift. It challenges me to think through what I'm going to do, why, who it affects and the amount of risk I'll take to enjoy the thrill of sex, one the experiences I have that makes me feel most connected and alive. Weighing everything, my personal calculation is to choose to wear condoms and to kiss. Even though kissing involves risk I could reduce, I just don't enjoy sex without it, and hence wouldn't really enjoy life without it.

 

I just read How to Survive a Plague, excellent insider account from a New York journalist (David France) who covered early HIV activism. I became sexually active with men in 1977, just as HIV in the U.S. and everyone's response to it was starting. I had many friends who just shut down sexually during that time and became super contained. France captures some similar stories that took me back. I just couldn't do that, then or now. Gotta kiss to feel connected and alive!

[rossthebosssf]

To date, I have never caught a STI and I'm negative. Even when I was younger I just simply used common sense and shied away from any sort of high risk behavior. In my younger days before HIV, I was a top only, so that spared me from the epidemic and I was quick to adopt condom usage before others. I always clean up right afterwards and also urinate. Not sure if there's scientific correlation, but it's kept me clean despite well over 1000 partners. In my older years, I have taken a few more risks, but I'm careful of my partners knowing their status and I use PrEP.

[marylander1940]

I would go as far as to say that some people's fear of every form of sexual contact borders on being some kind of anxiety disorder.

 

I often wonder if the same people (not trying to single out the OP because we get a lot of these kind of threads) drive cars and accept the inherent risk involved there without anxiety. Risk versus reward. You wear your seatbelt and go about your daily business.

 

I'm going to continue to be very oral in my life because the rewards far outweigh the risks. Especially when you're talking about kissing.

 

I'll keep you in mind next time someone is shocked about me NOT giving head with a condom.

[SuenosAmor]

Most sexually active guys have all of them already, so you just have to assume that risk. Younger guys hopefully have had their HPV vaccine (too late for us older dudes), so the likelihood of getting warts from young guys is lower these days. The best advice is to get tested every three months, or every month if you're super active.

[+ MasssageGuy]

Here's some thoughts from someone who is in the medical field. There's always a risk and it is hard to ascertain the risk in numbers for STIs etc. Theres a really good article for understanding relative risk, absolute risk and why numbers do not always fit which I'll put below in this message. VET the escort. If he says he does not ever bareback but there is an amuteur video of him barebacking in his profile think twice about it... If there is PNP in his profile I'd think twice about the person (under the influence he might do something he usually doesn't do. I always ask an escort if he barebacks while messaging even if it says safe only in his profile (usually there might be reverse psychology implied b/c the escort thinks I'm wanting to BB), I've had ppl tell me they BB with clients even though their profile says safe only. If he says yes I say thank you for your time we're not a match. I'll also ask an escort if he is on prep and if so if he is willing to show me the bottle/prescription- it is the only for me to know someone is truly on PREP. I look to see the fill date, make sure it says truvada/emtricitabine and tenofovir disoproxil fumarate etc. for him to have the prescription he must have had a negative test within the last 3 months which gives me some assurance. GET THE GUARDASIL VACCINE. half of nonsmoking throat cancers are related to those hpv strains 6, 11, 18 etc. Get the hep B, hep C vaccine (hep A if you really want it) if your going to give rimming etc. I'd just get it for extra precautions tbh. herpes is a weird infection b/c it has a wide spectrum of severity. Most of the time when you see herpes online etc its the most aggressive form of it not what most of the population has. for example ive watch porn vids and could tell someone has HSV 2 even though it was quite benign. After any encounter always shower and clean up after. HPV majority of the population has it, just in different locations. I have it on my hands and fingers, you can always get them frozen off. PREP + Condoms gives good protection from HIV. however PREP has shown to have some side effects for the liver which is why docs have to check up on Liver enzymes (AST, ALT) to see how liver function is going for someones health. Personally I'm not on PREP constantly only in periods where I'm meeting with a lot of people. For bacterial STIs I don't worry about too much there's always doxycline, azytrhromycin/clavulanate, and 3rd generation cephalosporins/Vancomycin for the bad ones.

GUARDASIL is not recommended for "older" folks, correct?

[MikeyGMin]

I'll keep you in mind next time someone is shocked about me NOT giving head with a condom.

Who, pray tell, is shocked by that? Every time it's ever come up the vast majority of people here say they have no interest in sucking on latex. This, along with your constant references to being "pack attacked" anytime a couple people disagree with you, makes me wonder if you have a bit of a persecution complex.

[marylander1940]

Who, pray tell, is shocked by that? Every time it's ever come up the vast majority of people here say they have no interest in sucking on latex. This, along with your constant references to being "pack attacked" anytime a couple people disagree with you, makes me wonder if you have a bit of a persecution complex.

 

I'll let you know next time the subject comes up.

[mike carey]

GUARDASIL is not recommended for "older" folks, correct?

My understanding is that no recommendation has been made for older people, not that it has been recommended against. 'Not recommended' can have either meaning, and the difference is not trivial. I quickly read the CDC link above and didn't see a reference to age, but may have missed it.

[LoganHungTop]

I've done it raw a few times and luckily I've never catched anything. But I do take prep and I'm a top so maybe it all depends on how risky you want to be. I personally get more turned on when its bareback and preferably when i breed the bottom

[+ saminseattle]

GUARDASIL is not recommended for "older" folks, correct?

 

While it might be correct, it's also very misleading. From a public health perspective, you get less bang for the buck when you vaccinate older people. But from an individual perspective you can still reduce your risk of HPV-related cancer by getting the vaccine. https://www.companyofmen.org/threads/oral-using-a-condom.116256/page-2#post-1130744 (posts 35 and 36).

 

I got vaccinated last year, and it has given me the peace of mind to indulge in oral sex without condoms more than I did before. Of course, I had to pay for it myself rather than using insurance. It cost me $618 total for the 3 shots, over a 6 month period. Well worth it in my opinion.

[mike carey]

Thanks, @john777. The AAFP advice covers who to give the vaccination to, but does not contraindicate for people over 26. Antibiotics for viral infections is a different case as they have no effect. HPV vaccination for people over 26 still confers some immunity for those people. People should ask their doctor.

[+ BenjaminNicholas]

While it might be correct, it's also very misleading. From a public health perspective, you get less bang for the buck when you vaccinate older people. But from an individual perspective you can still reduce your risk of HPV-related cancer by getting the vaccine. https://www.companyofmen.org/threads/oral-using-a-condom.116256/page-2#post-1130744 (posts 35 and 36).

 

I got vaccinated last year, and it has given me the peace of mind to indulge in oral sex without condoms more than I did before. Of course, I had to pay for it myself rather than using insurance. It cost me $618 total for the 3 shots, over a 6 month period. Well worth it in my opinion.

 

I got the vaccination as well, paid out of pocket, but for peace of mind (for what that's worth). I got it when I was 27, which is considered a year later than recommended for sexually active gay men. Those are odds I'm willing to take.

 

As long as there continues to be no standard test for verifying HPV, it will be tough to get control of this issue.

[SuenosAmor]

Unfortunately, you can't rely on your sexual partner's word when it comes to STDs. Sometimes they don't even know they have one, especially when it comes to HPV, HSV, and, of course, HIV (in the early stages). The best thing you can do is protect yourself by getting tested regularly and use your meds appropriately if you have treatable ones.

[JetBlack]

People who contact me ask all the time if I have any STD's, and I don't mind, since I want to know as well.

 

After every appointment I gargle a few times immediately, and wash up with soap and water at my first opportunity.

 

So far I've been lucky to not have had an STD, but it just takes 1 guy lying 1 time and you can end up with one.

 

Just make sure you are tested regularly and ask questions of all your partners, whether you're hiring or hooking up.

[mike carey]

This popped up in my twitter feed (well, I follow @Huffpostqueer so it would):

http://www.huffingtonpost.com/entry/i-made-an-hiv-prevention-video-for-guys-who-hate-condoms_us_596538b6e4b0911162fc2f84?section=us_queer-voices&ncid=tweetlnkushpmg00000054

I think the video is worth watching.

[+ Funguy]

As a physician I would strongly recommend getting the HPV vaccine. One major reason it is "un"recommended (as opposed to NOT recommended which implies there might be a problem) after age 26 is that the initial studies of the vaccine were only up to age 26. It was incorrectly assumed that by that age if you were sexually active you would already have been exposed and the vaccine would not be effective. This avenue of thought did not take into account M-M sex and the usage of condoms as well as those people who were in a monogamous relationship from early on and whose partner is no longer in the picture. They are now out in the "dating" pool and need protection.

 

At the other end of the spectrum are older people who might want to get a blood test for HPV and see if their titers of antibodies show whether or not they have been exposed or if they are immune. If titers are positive, the vaccine will do them no good.

[LADoug1]

Has anyone heard of a top getting HIV from bareback?

[escortrod]

Has anyone heard of a top getting HIV from bareback?

I have. He had gonorrhoea at the time, which increases the risk of infection, but even without this it is entirely possible. Many heterosexual men have contracted HIV from PIV (penis in vagina) intercourse.

[LADoug1]

I have. He had gonorrhoea at the time, which increases the risk of infection, but even without this it is entirely possible. Many heterosexual men have contracted HIV from PIV (penis in vagina) intercourse.

I know a top who never got tested for HIV because he thought he was safe. I thought he was irresponsible.

[boiledeggz]

Of course "tops" (or insertive partner) have gotten HIV. It is the number #1 mode of transmission in the entire world, through penis and vaginal / heterosexual sex. The tissues lining the vagina are MUCH tougher than the tissues lining the rectum. That means it can withstand the trauma that comes with sex, and yet the men are still being infected. Now imagine the lining of the rectum, which let's face it, is not meant for receptive sex. It would bleed easily from penetrative sex and transmit the virus if the insertive partner has any abrasions on his penis or through the urethra. The problem is that few people are just one thing, they top and bottom. So how can you accurately isolate the incidence of transmission through topping when people engage in both acts?

[+ saminseattle]

Now imagine the lining of the rectum, which let's face it, is not meant for receptive sex.

 

While I agree that anal sex is more likely to result in bleeding compared to vaginal sex, which explains the higher HIV transmission rates, that hardly means the rectum is not “meant” for sexual play. This is very close the suggestion that vaginal intercourse is “natural” and anal sex is not because it is a non-reproductive form of sex, which is the underlying “purpose” of sex in the first place. I don’t agree with this line of thinking or the implicit assumptions it adopts. You might as well say that the mouth is “meant” for eating and drinking, not giving blow jobs, so oral sex is deviant behavior. There is no intelligent designer operating the machinery of evolution, “intending” us to use certain body parts only in certain ways. IMHO, anal sex is a great and beautiful thing, so let’s not badmouth it

 

Of course, there are some additional risks associated with it and taking some extra precautions would be prudent, whether one is the “top” or the “bottom.” In terms of HIV transmission, I have read that the risk is about 10 times greater for the bottom, but both are riskier than vaginal intercourse. https://www.cdc.gov/hiv/risk/estimates/riskbehaviors.html

 

Getting back to non-HIV STIs, did anyone see the recent reports that meningitis vaccines may provide some protection against gonorrhea as well? http://www.nbcnews.com/health/health-news/meningitis-vaccine-protects-against-gonorrhea-too-n781831

 

A number of forum members seem to be knowledgeable on medical/vaccine issues, @LivingnLA, @purplekow, @gallahadesquire, @WolfRamNHard, @Funguy, @Unicorn, @john777, and I am curious about their thoughts on this recent development.

[+ Funguy]

The association between Meningitis vaccine and rates Gonorrhea infection is interesting but with such few studies done and in a relatively "closed" environment (i.e. New Zealand) it is difficult to evaluate. Why doesn't the Meningitis C vaccine do the same? Both vaccines, for Neisseria meningitidis "C" and "B" are closely related? Why not a vaccine for gonorrhea which is also a Neisseria bacterium. I don't have answers but it will be nice to see some work in the future.

 

BTW, the review makes note that many of these vaccines are lacking in the teenage population but one reason for this that it does not mention is that, in the US, most parents are only interested in the vaccines which are "required for school." That leaves out Meningitis C and B, HPV. Occasionally colleges will require Meningitis C and some now are requesting Meningitis B (seventeen and older). Once there are a few more years of Meningitis B under our belts in college, we should get the gonorrhea incidence to compare rates.

[escortrod]

While I agree that anal sex is more likely to result in bleeding compared to vaginal sex, which explains the higher HIV transmission rates, that hardly means the rectum is not “meant” for sexual play. This is very close the suggestion that vaginal intercourse is “natural” and anal sex is not because it is a non-reproductive form of sex, which is the underlying “purpose” of sex in the first place. I don’t agree with this line of thinking or the implicit assumptions it adopts. You might as well say that the mouth is “meant” for eating and drinking, not giving blow jobs, so oral sex is deviant behavior. There is no intelligent designer operating the machinery of evolution, “intending” us to use certain body parts only in certain ways. IMHO, anal sex is a great and beautiful thing, so let’s not badmouth it

"Meant for" could easily be interpreted as "evolved to serve this particular function". I think it's reasonable to assert that the vagina did evolve primarily for penetrative sex (along with giving birth), while the anus and mouth probably didn't. Unless you have evidence to the contrary?

[+ saminseattle]

"Meant for" could easily be interpreted as "evolved to serve this particular function"

 

Perhaps it’s all semantics, but I think that that kind of short hand is really a misinterpretation, which basically amounts to imputing human or divine characteristics to an impersonal phenomenon. Human anatomy has evolved to be more or less functional if various ways, but its features have not been “designed” for any particular “purpose.” Rather than looking at what things are supposedly “meant for,” I focus on their function. And personally, I find that the mouth and the ass to be perfectly functional for my sex life.

[escortrod]

Perhaps it’s all semantics, but I think that that kind of short hand is really a misinterpretation, which basically amounts to imputing human or divine characteristics to an impersonal phenomenon. Human anatomy has evolved to be more or less functional if various ways, but its features have not been “designed” for any particular “purpose.” Rather than looking at what things are supposedly “meant for,” I focus on their function. And personally, I find that the mouth and the ass to be perfectly functional for my sex life.

Well, no, I was very careful not to use the word "designed", or anything that implied it. I agree about focussing on function (for the same reason I don't really care about arguments as to whether homosexuality is 'natural', or to what extent it is genetic, etc). It is for that reason that I have no problem accepting that the rectum didn't particularly evolve for penetrative sex, since it does serve that function quite well, with some caveats.