A: Studies have demonstrated a lowered risk for HIV transmission among circumcised men. For information, you can read about these studies at the Centers for Disease Control.

Studies about sexual pleasure among circumcised and non-circumsised men are rather variable, incidentally. Some studies find that men report a difference, and some do not.

[ Cross posted from Yahoo! Answers, where this SFSI Answer was chosen best answer to this question. ]

A: Studies have demonstrated a lowered risk for HIV transmission among circumcised men. For information, you can read about these studies at the Centers for Disease Control.

Studies about sexual pleasure among circumcised and non-circumcised men are rather variable, incidentally. Some studies find that men report a difference, and some do not.

[ Cross posted from Yahoo! Answers, where this SFSI Answer was chosen best answer to this question. ]

A: Amoxicillin is not one of the recommended treatments for gonorrhea according to CDC guidelines. The preferred treatment for gonorrhea depends on where you live, as different strains of gonorrhea that are resistant to different antibiotics are more or less common in different areas. Often treatment for chlamydia is given at the same time because these infections frequently occur together.

It is extremely common for females to show no symptoms of gonorrhea, and occasionally for males as well. Gonorrhea can cause serious complications when untreated or only partially treated, so we recommend you see a medical provider to get an accurate diagnosis and appropriate treatment.

Here is some more information at Planned Parenthood.

My husband and I are polyamorous. My other partner kissed a woman who did not disclose to him until later the same evening that she had a three-day-old cold sore. The cold sore did have a scab, and did not bleed or leak fluid onto his lips or mouth. She has told him that she has tested positive for oral herpes.

My questions are:

1. Should we all now fore go oral sex without a dental dam or condom? If so, for how long?
2. How soon can we be tested for oral herpes? The incident occurred approximately 48 hours ago.
3. Neither my husband, my partner, nor myself have ever had a cold sore/fever blister, but we have never been tested for oral herpes. Is it possible that we are all asymptomatic carriers? If so, what will a positive test result now tell us?
4. Should we all refrain from social kissing, the sharing of drinks, etc. with others? If we have been infected through the recent kiss, can we pass the virus to others before any of us develop sores?

A: It sounds like you are concerned about one of your partners kissing a woman who has tested positive for oral herpes, and (correct us if we are wrong) you have presumably been in contact with this partner who was exposed to the woman’s cold sore, in which case you and your husband are concerned about contracting oral herpes. If anything is inaccurate about this description, please let us know!

1. If you want to be on the safe side it might be good to use condoms and dental dams until you can consult with a medical provider. We have not been able to find reliable information about the possibility of transmission during the incubation period of oral herpes (from exposure to showing of a blister) which is about 2 – 12 days. You are correct that it is possible to transmit herpes from the mouth to the genitals through oral sex.

2. If a sore appears, the fluid from the sore can be swabbed and tested. Keep an eye out for symptoms of blisters that look to be in clusters or alone. There’s more information on symptoms at the American Social Health Association. If you do not develop symptoms, you could get a blood test. These tests detect antibodies to herpes, and it could take up to 3 months for antibodies to develop. Blood tests can give you information as to whether or not you have antibodies to herpes in your bloodstream, however this test will not tell you where the herpes is located on your body.

3. It is possible that you could be asymptomatic carriers despite never having shown any symptoms. HSV-1 is extremely common, some stats showing that between 50% and 80% of people have it. It’s also possible that you are in the minority of the population who do not have it. Again a positive blood test (the test you would have to take in the absence of a sore that can be swabbed) would only tell you if the virus is in your body, not where the infection is located.

A: STD risk is based on a lot of factors including the sex act, contact with body fluid, and part of the body receiving the act or fluid. Because of the sex acts and anatomy involved, yes, lesbians are at a lower risk for contracting STDs. However, there are still risks.

The best way to protect yourself from STDs is to use a barrier. Specifically, condoms and dental dams. Condoms can be used on toys and can cut down on fluid transmission. Dental dams are thin sheets of latex that can be placed over any genital area, either the vagina or anus. You can also use gloves as a barrier against body fluids.

A: The short answer is that it is very unlikely you would experience another outbreak of warts, or infect a partner, fifteen years after your symptoms disappeared.

To explain a bit more fully: Scientists have detected more than 100 different strains of HPV. Approximately 30 types can affect the skin in the genital area, producing cell changes that sometimes lead to warts or pre-cancerous lesions. Your outbreak was caused by one of these strains. At some point after your symptoms were treated, your immune system kicked in and successfully suppressed the virus so that your symptoms did not recur. By that time, you were already significantly less likely to be contagious to a partner than while you were symptomatic; after fifteen years with no symptoms, passing on the virus is even less likely. Experts are not 100% certain whether the body is actually able to completely eradicate the virus, or whether you do in fact carry your strain forever. Practically speaking, though, this doesn’t matter much, because the effect is the same: you remain symptom free, and highly unlikely to infect a partner.

In terms of your immunity or susceptibility to HPV in the future, you can consider yourself “immune” to the strain with which you were initially infected. However, it is still possible for you to contract a different strain. (In fact, you have probably been exposed to other strains already, simply because HPV infection of some type is VERY common.) Much of the time, your immune system will fight off the HPV strain so that you never see symptoms. Taking all these factors into consideration, it is technically possible, but not very probable, that you could contract a different strain of HPV and experience symptoms again.

Hopefully, this information will help you make an informed decision about whether or not to tell partners about your history with HPV. The following web resource has a great breakdown of how an HPV infection progresses and resolves (don’t be deterred by the fact that the source is the American Society for Colposcopy and Cervical Pathology; the general information on HPV applies to both men and women).

A: There are STDs one can contract from activities that some may not automatically classify as sex, such as oral sex or rubbing your genitals on someone elses. Though it is very possible that it is not an STD, it is not possible to diagnose over the internet. Whenever anything is causing recurring discomfort or pain, the best course of action is to see a doctor. While the possibility of being diagnosed with an STD can be intimidating, the long term effects of having an undiagnosed STD can be a much worse experience. Many STDs are easily treated if caught early. If gone untreated, some STDs can have long term and even permanent effects.

It is possible that it is something other than an STD. It could be a Urinary Tract Infections, or even an allergy to a soap. It is best to let a doctor diagnose this. If it is a UTI or another type of infection, the doctor can help you with prescription anti-biotics.

If it is not a subject you feel comfortable discussing with your current physician, or you do not have one, we will be happy to help you locate an appropriate clinic in your area.

A: HPV can be effectively passed through any genital-to-genital contact, or sometimes through oral-genital contact. So, yes, it can easily pass between females.

A couple other things to think about:

1. HPV is sneaky. It’s possible to have it for years, lying dormant, and have it flare up later. The pap doesn’t test for the presence of HPV directly, but rather for abnormal cells present on the cervix. It’s entirely possible that she had an HPV infection at the time of her earlier pap, but it just hadn’t yet affected her cervix.

2. HPV found on the cervix (where a pap smear would find it) isn’t generally treated by medicine. Did they specifically say that she’d tested positive for HPV, or just that she should take some medicine for it? I wonder if what she’s getting is actually Gardasil–which is an HPV vaccine rather than a treatment and would administered before someone actually caught the virus. If that’s what it was, it’d be a series of three shots spaced out over several months. You may want to follow up and find out what she is being treated with and for.

These classes do not necessarily fulfill Continuing Education requirements for professional societies. If a class counts as professional development hours for a particular profession (ie. nurses, therapists or teachers) it will be noted in the class description.

Check out the upcoming classes on our Continuing Education page.

Next Class: Annual STD Update, with Yvonne Piper
Presenter : Yvonne Piper
Date : Monday, February 15th
Time : Doors open at 6:30, class from 7:00 to 8:00
Venue : Women’s Building, 3543 18th St. San Francisco

Buy Tickets!

Is it a higher risk than the same kind of activity in a private setting because of contact with surfaces or towels (provided I’m not sharing a towel)? I’m very careful about always sitting on my towel, no kissing, and no genital contact without a barrier but one of my current partners believes that just my going to a sex club is putting him at risk for contracting MRSA.

I’m a gay ftm guy and just trying to get a realistic picture of what my risks are.

A: MRSA is not so much an STD as a bacteria that lives on surfaces (and people) and is very hard to kill. It lives anywhere there are a lot of people and a lot of moisture, such as hospitals, prisons and military barracks. It’s not just for bath houses! The other people could have MRSA places other than their genitals, and it could be spread through skin to skin contact. However, it sounds like you are taking a lot of the necessary precautions.

Some steps to reducing your chance of contact with MRSA are the following -

- wear shoes, even flip flops
- use a clean towel to sit on (check!)
- use condoms and other barriers (check!)
- wash your hands for 20 seconds or use Purell after touching people or surfaces. You can do this at the end of the night and each time you go to the toilet,
- sanitize surfaces and tools (dildo, clamps) with rubbing alcohol

Here is some more information on Wikipedia.
http://en.wikipedia.org/wiki/Methicillin-resistant_Staphylococcus_aureus