Recently in STDs Category
Dear Dr. Dick, his profile says he's negative...
Dear Dr Dick,
Like so many other gay and bisexual men in Seattle I spend a great deal of time online looking for hookups. It seems that is where all the HOT guys hang out. When I hookup with guys from websites I practice safe sex. However recently I met two guys online that I am considering barebacking with. That's cool if all parties involved are HIV negative right? Both of guys have posted the following statement in their online profiles: "HIV NEG as of November 20, 2008." [I'm guessing that you meant 2008??]
So here my question: is it safe to bareback with them?
Hooked on the Man Hunt
Dear Hooked on the Man Hunt,
Thank you for your question!
The short answer is, no, barebacking (intentional unprotected anal sex) is a very risky sexual practice. Barebacking can easily transmit HIV, along with several other sexually transmitted infections. These potential partners say they are HIV-negative but they were negative as of a year ago, so consider these facts:
In a recent large study of gay/bi men, on average about 2% became infected each year; but among those guys who engaged in the highest risk behavior the rates of new infection reach levels as high as 8% yearly. Other studies have shown that recently HIV-infected guys are the most infectious, because they have very high levels of virus in their blood and semen in the first few months after being infected, before their bodies have brought the infection under some control. So, if you happen to encounter a guy who enjoys high risk behaviors, there could be an 8% chance that he's acquired HIV in the past year, and he may be not just pretty but also pretty infectious.
Knowing your own and your partner's HIV status is an important part of maintaining one's overall health. However, because one advertises their year-old HIV status in an online profile or in person does not necessarily mean it is accurate and frankly it's a big risk to take for HIV, the worst of all sexually transmitted diseases.
Additionally, someone is HIV negative can have another sexually transmitted infection (STI) present. Anal and/or oral sex without condoms can still spread infections such as syphilis and gonorrhea.
Be sure to talk more about this with your partners and even your doctor to settle on a decision that works best for all parties.
Best,
Dr. Dick
Anal Fissure
Pride & My Ass
Dear Dr. Dick,
If this Pride season is anything like the last one - my ass is going to be very busy housing bursting buldges - literally! Last year, amidst all my safety tactics I still managed to get an anal fissure! While it has healed considerably since then, I am worried I might not be doing enough to have an exciting, safer and healthy pride season!
Thanks,
Robbie Rumpsworth!
Dear Robbie Rumpsworth,
I am glad to hear your anal fissure has healed considerably! For those readers who have not heard that term before, an anal fissure is a tear in the skin of anal canal. Most anal fissures are caused by severe stretching of the anal lining. Symptoms of an anal fissure include bright red bleeding from the anus, most noticeable on the toilet tissue or on the toilet.
Striking pain and/or consistent discomfort during anal sex should be a strong indication to inspect your ass hole. Or better yet, since someone has to be very flexible to really examine their own ass, go visit a doctor or knowledgeable health care provider and let them examine you carefully. If you plan on taking multiple dicks with lots of girth or even getting fisted -it is recommended that you do some anal prepping on your own. Get a butt plug or even use your own fingers and water-based lube to safely stretch your hole before the main event!
Given that a fissure is a tear in the anal skin, and that that provides ready access to your blood, you are at increased risk of acquiring infection by bacteria and/or virus' such as HIV, Syphilis, or Gonorrhea -if one of your partners is so infected, of course. And any partners who have direct access to your blood may more easily acquire a blood-borne infection, like HIV or hepatitis B or C, from you if you've already become infected.
Remember the old adage: Healthy pink parts contribute to a healthy sex life! So, stock up on water-based lube and condoms of all sizes, colors and feels for those bursting buldges! And, don't have too much fun, unless you're being very careful with yourself and with your partner(s).
Dr. Dick
***
Do I have a girl's disease?
Dear Dr. Dick,
I recently came out and have been enjoying a lot of gay sex! I've been told to get tested, and now I have this weird discharge on my penis & pain when peeing. My friends say it's chlamydia and that I need to run to the STD Clinic. But I thought chlamydia's only for girls?
--Young and Naive
Dear Y & N,
It's good you are enjoying gay sex. But it's best that you enjoy SAFE gay sex!
Your friends are definitely right that you need to get tested and you could have chlamydia; but you could also have something else, like gonorrhea. Let's start by clarifying that: CHLAMYDIA is NOT just a girl's problem, and I'll write a bit more about that. Call your nearest STD Clinic and set up an appointment ASAP.
What is chlamydia?
Chlamydia is a sexually transmitted disease (STD) caused by a bacteria called Chlamydia trachomatis. It can spread from person to person during sexual intercourse when a person's mucous membranes come into contact with an infected person. It can be transmitted without complete insertion of a penis into the anus. It is less likely, although possible, to be transmitted to the throat during oral sex.
Should you worry about chlamydia?
If left untreated, infections can lead to prostatitis (inflammation of the prostate gland), urethral scarring, infertility, or epididymitis (inflammation of the epididymis, a structure on each testis). Chlamydia makes it easier for an HIV negative person to acquire HIV if your partner is carrying the virus, and rectal chlamydia may increase chances of getting HIV ten to twenty-fold. If you already have HIV and have chlamydia, you could be 8-10 times more likely to shed HIV in your semen and increase your risk of infecting others with HIV.
What does chlamydia look like?
Symptoms of chlamydia usually appear from 1-3 weeks after infection, but then usually go away, even if left untreated. Many people infected with chlamydia never have any symptoms at all. Men may experience discharge from the head of the penis or the anus; pain or itching at the head of the penis; and/or pain with urination. 50% of infected men have no symptoms. Sometimes chlamydia is like gonorrhea (GC), another bacterial infection, which also causes discharge from the penis and pain or burning on urination. These infections can be distinguished by culturing the discharge. GC also makes it easier to acquire and transmit HIV.
Now what?
Get tested right away. If you are infected, chlamydia is cured with antibiotics. Your partner(s) should be tested as well. Continue to get tested every 3 months for HIV & STD. Start this regimen and use condoms with all partners. There are plenty of options to choose from.
For more information, call the HIV/STD Hotline at 206-205-7837 or Toll-free: 800-678-1595
--Dr. Dick
WTF? Is it herpes on my back?
Dear Dr. Dick,
I've got some kinda rash thing on my back way above my asshole. It looks like when I got herpes, but it's on my back. What the fuck?
--WTF
Dear WTF,
It's hard to tell from that little bit of information what the rash might be, but herpes (whether it's Herpes Simplex or Herpes Zoster) usually starts with a tingling or burning or even aching in the area involved.
Then almost simultaneously small blisters (fluid-filled) form that are hypersensitive, that usually break, leaving ulcers that may weep a few days then scab over.
It's possible that herpes simplex could occur there, but unusual. Herpes simplex usually involves a mucosal surface (like the penis, testicles--balls, or around the anus or mouth).
Herpes zoster is more likely up on the back, and is a re-occurrence of chicken pox--which is the same virus only localized, and is usually in a band-like distribution. Zoster is often more painful and more prolonged.
But there are a myriad of other rashes which might be what's going on...so be advised to see a dermatologist or a good doctor for starters!
And DON'T SCRATCH!
--Dr. Dick
DO COLDSORES TURN INTO GENITAL HERPES?
Dear Dr. Dick,
Every winter, I find myself irritated with a cold sore. And every winter, when it gets cold, I find myself cuddling up with someone...and getting really warm, and eventually hot under the sheets. If I have a cold sore, will it turn to genital herpes? I want to be safe and not give an STD to my partners.
--Cold & Cuddly Cub
Dear CCC,
That's really great to hear that you are concerned with your partners as much as you are with your sexual health! It's definitely a good way to enjoy the holidays.
Let's start with the basics and make sure we are on the same page with cold sores.
Cold sores (aka fever blisters) are small red blisters that usually appear on the lips and outer edges of the mouth. They often weep a clear liquid and form scabs after a few days.
Cold sores are usually caused by the herpes-1 virus (not
the herpes-2 virus, which causes genital herpes, an STD). Herpes-1 virus can lay dormant in the body and becomes active later when something triggers it.
There is no cure for cold sores, but there are remedies you can use that will reduce the severity and frequency of them. Cold sores may appear after colds, fevers, exposure to the sun, stress, during or for no apparent reason. Generally it is felt that anything that compromises the immune system may trigger the cold sores, such as infection, cancer or any illness.
If you have a cold sore already, pop the sore so it will drain and be able to dry out and heal faster.
Before-Care
- Prevention of cold sores is advisable. Herpes simplex is highly contagious!
- Avoid kissing someone with cold sores or having sex with someone who has genital
- herpes. Exposure to sun triggers sores. Use a sunscreen of at least 15 SPF on your lips and other susceptible areas.
- If stress triggers them, practice relaxation techniques.
- Don't use the same towels, razors or utensils as someone with cold sores.
- Vitamin C: Take 200-500 mg. of vitamin C three times a day. This greatly reduces the duration of the sores.
- Vitamin E: Applied topically, will provide pain relief.
- Yogurt: Eating plain yogurt (with acidophilus) is a good preventive measure. Yogurt seems to stimulate the immune system.
Both herpes-1 and herpes-2 can cause cold sores and genital herpes, but cold sores are usually caused by HSV-1 and genital herpes usually by HSV-2.
However, it does compromise anyone with a cold sore for exposure to genital herpes, especially with oral sex or any type of skin contact. Condoms and dental dams maybe used, but can not guarantee protection.
If you believe you have been exposed to HSV-2 (Herpes-2), get tested! Call 205.STD (7837) or the Link Study, a research herpes trial at the UW (206) 251-5821.
--Dr. Dick
BUMPS ON MY BUTT?
Dear Dr. Dick,
I've been in a semi-monogamous relationship. My boyfriend and I have been playing with a third guy for the past year. It's been a different guy several times. We try to play safe, wear condoms, but sometimes we slip. We get tested every 6 months for HIV & STD's. But I've noticed these bumps on my butt. I think they're just skin tags. My boyfriend says they're nothing and to not worry and be so paranoid. Well, I am worried and paranoid! What am I to do?
--Nervous As Hell
Dear NAH,
It sounds like there are few things going on with you, your boyfriend and your sexual life. I'm not a therapist, but COMMUNICATION IS KEY. Always keep an open communication with your partners. So everyone knows what's going on, sexually and otherwise, especially with PLAYING SAFE.
In a better world, it would be nice to have a consistent third sex partner, who is both HIV/STD Negative and has SAFE SEX with you and your partner.
- So, ALWAYS USE PROTECTION: Oral Sex, Vaginal Sex & Anal Sex.
- If there's unprotected anal sex, you and your partner(s) should get tested more frequently. Every 3 months would be best.
- Try to go to the same place, especially if they are COOL with your sexual history & lifestyle.
Now to the BUMPS on your BUTT. It's not possible to tell just from what you describe. They could be skin tags, fissures or just plain unusual folds. BUT (pun intended), they could also be anal warts. The BEST way is to see a doctor, a provider at the local STD clinic or a specialist like a proctologist, who can BEST ASSess your symptoms. At the very least, get tested for STDs.
Warts, caused by Human Papilloma Virus (HPV) can sometimes creep behind you without warning and could be what you're noticing! Sometimes, you may have been infected a while, but symptoms might not show up until weeks or even months afterwards. And warts are easily transmissible through genital contact, especially without condom protection.
Other than feeling these around your butt, generally warts are painless. Guys (& girls) often ignore symptoms without annoying pain or overt physical signs.
Typical signs are wart-like growths in the butthole, and sometimes inside the anus. They appear white at the tips or flesh colored, raised or flat. If in bundles, they appear cauliflower-like. They may bleed with irritation with bowel movement or just wiping yourself. Don't wait for bleeding! As soon as physical signs show, SEE a DOCTOR! Only a doctor can diagnose you, and of course it's hard to see your own butt.
Treatment can be as easy as cryo-laser (freezing with laser), surgically removing the warts or using anti-viral ointment treatment. There is no treatment to remove the virus in your system. Once you're infected, you're infected for life. But symptoms can be managed. So, try always to condoms consistently and correctly, communicate clearly, and play safe.
To manage your worry & paranoia, see a doctor!
--Dr. Dick
Sex Clubs and STDs
Dear Dr. Dick,
Since it's going to be cold out this season, I've decided to keep myself warm in the sex club. My friends said not to go because I'll catch STDs there. Is that true?
Klub Kidd
Dear KK,
Well, it depends... are you there to have sex (oral or anal) or to exchange Christmas gifts? The bottom line is NOT WHERE you are, but WHAT you DO. It's the behavior. NOT the location.
For obvious reasons, sex clubs or bath houses are traditionally where men find other men for sex, be it oral, anal or mutual jack-off. Whether you're at home, in the bushes or in the office, WEAR A CONDOM! Especially, if it's someone you don't know or have only met for the first time. Talking about sexual history and safety before sex is good. BUT, how do you really know?
I know it does sound preachy. But, the truth of the matter is that the only sure way to protect yourself from STDs, especially HIV is to NOT have sex or wear a CONDOM consistently and correctly if you do have sex. So, wear a condom if you have sex & have fun.
Here are some quickie factoids about the more common STDs [Sexually Transmitted Diseases] whether at a bath house, the bushes, or by the fireplace:
CHLAMYDIA
Chlamydia is caused by bacteria. These bugs can infect the penis or rectum. It is one of the most common of all STDs. If symptoms occur, and often there are no symptoms they usually appear 1-3 weeks after infection.
The most common symptoms are:
- Discharge from the penis; the discharge may be clear, cloudy, or yellowish
- An itchy feeling inside the penis
- Pain or burning feeling while urinating
- A swollen or tender testicle
GONORRHEA
Gonorrhea is caused by bacteria. This infection is sometimes called "GC" or "the clap". Infections mostly involve the penis, the rectum or sometimes the throat, but occasionaly GC can dissiminate through the blood and involve other organs. It is easily treated with a single dose of antibiotic. If symptoms occur, and they generally do, they usually develop 2 to 10 days after catching the infection.
These are the main symptoms:
- Discharge from the penis, usually yellowish
- Pain or burning feeling while urinating
- Discharge from the anus
- Anal itching
- Painful bowel movements
- Blood or mucus on the feces
SYPHILIS
Syphilis is caused by bacteria. The initial infection usually causes an open, painless sore ("chancre") at the infection site, but up in the anus or in the back of the throat, this sore may not be noticed. Syphilis has several stages. Symptoms vary with each stage, but often there are no symptoms, even though serious damage may be happening.
Symptoms may include:
- painless open sore on the penis, rectum, or anus, even the mouth or lips - the so-called primary stage of infection
- spotty skin rash on the palms or soles, often with a low-grade fever, swollen lymph glands, and feeling punk - the "secondary" stage of syphilis.
There are definitely many more STD's... but let's focus on these for now. Chlamydia, gonorrhea and syphilis are all curable. Don't wait for a symptom to pop! Get tested regularly every 3 to 6 months, more often if you are highly sexually active and having unprotected sex. Find a doctor, tester or counselor that you are comfortable with being honest about your sexual history. You can start at Rest Stop...
Jason is our resident tester/counselor who has the street smarts & compassion with guys who use. He can even talk to you about vein care and proper needle use, if you've gone that far Rest Stop is every Wednesday from 6 to 8pm at Seattle Counseling Service at 1216 Pine, 3rd Floor. Or call the HIV/STD Hotline at 205.STDS for the nearest location.
HAPPY HOLIDAYS,
Dr. Dick
Before anyone slides down your chimney make sure they have the right gear!
Genital Herpes and HIV
Dear Dr. Dick,
What's the deal with genital herpes and HIV? I had a herpes outbreak. Does this mean I'll get HIV next?
-Confused & Curious Chris
Dear CCC,
Not necessarily. Although studies show that if you have genital herpes, you could be 2X more likely to catch HIV (Especially when you have herpes sores). BUT, it doesn't have to be. And if you are HIV positive and have genital herpes you are more likely to pass on HIV to your partners.
First of all, WHAT is GENITAL HERPES?
Genital herpes is a very common sexually transmitted disease (STD) practically always caused by HSV-2 (herpes simplex virus-2). Although 25% of adults in the US have genital herpes, the rates are HIGHER among gay men. And 80% don't know they have it. But oral herpes (HSV-1), which commonly just causes cold sores on the lips or mouth can also be on the genitals. Blisters and sores on the penis, vagina, anus, buttocks and elsewhere are common signs. Itching, burning, pain and discomfort are likely to happen.
HOW does it get passed around?
Herpes 2 can easily be passed through skin-to-skin contact. So, you don't need to have sex to get this! But it is most often passed through unprotected oral (blowjob), vaginal and anal sex.
NOW WHAT?
Don't panic!
Get tested for sexually transmitted diseases regularly and make sure you are getting the blood test for herpes. Every 3-6 months is very good, especially if you are sexually active. Know your status! You can find out at NEON's Rest Stop, where anonymous and confidential testing is always available and FREE! Every Wednesday at 6pm to 8pm.
- If you test positive, a good place to explore treatment options is the STD Clinic @ 731.3590 for treatment options OR the Link Study @ 520.3800 where you can get expert advice and great benefits like FREE herpes treatment for a year and get paid for it!
- Minimize spreading it to your sexual partners, by properly and consistently using CONDOMS for oral, vaginal and anal sex, if abstinence is not a realistic option.
- Try to avoid sex when sores and blisters are obvious and visible. HIV is more easily transmitted when sores are present!
- It's not the end of the world, don't delay getting checked regularly. It's good to know.
Simply,
Dr. Dick
Factoids:
1. Genital herpes is treatable, but not curable (just like HIV).
2. Herpes makes HIV so much easier to catch and to spread.
3. With or without symptoms, people can pass viruses around.
1 out of 4 has genital herpes.
Whoa, Nelly! Gonorrhea has gone haywire!
Dear Dr. Dick:
What's up with all this talk about gonorrhea lately? I hear there's a lot of it going around. Is that true? What does it look like and how do I know if I have it?
Nervous Nelly
In 2001 there were 166 cases among Seattle gay/bi men. In 2002 there were 289! That's an increase of 74% in one year! Yikes!
So what's going on here? Well, lots of anal sex without condoms mostly. It doesn't take a rocket scientist or a brilliant handsome doctor like myself to figure that one out. Some guys are fucking like bunnies and not wrapping their carrots! And it only takes one bad carrot to turn the whole bunch bad!
It's easy to have gonorrhea and not know it. If gonorrhea is up your butt (which is very common in guys who butt fuck without condoms) it may be painless. Or the discharge may be hard to notice. It it's in your throat, you may have redness or pain when you swallow. So you might think you just have a sore throat or strep. And about 10% of guys never even develop symptoms- anywhere! See how easy it can be to spread gonorrhea?
What is gonorrhea? It's a bacteria that can infect your mouth, throat, urethra (pee tube) and butt. Symptoms appear 2-10 days after infection:
- Burning when you pee
- Green/yellow discharge from your dick or ass. Pre-cum looks clear. Gonorrhea doesn't.
- Blood or mucus in your feces
- Painful bowel movements or rectal pain
Having gonorrhea also makes it easier to get and give HIV. So for these reasons, every gay/bi man who has unprotected sex should get a STD test every 3-6 months. Make it a regular part of your health routine.
Gonorrhea is easy to treat. A simple swab or urine test, a single dose of antibiotics and you're done. You can go to your regular doctor or to the STD clinic. Once you've been treated, you should stay away from sex for at least a week and tell your recent sex partners to get checked too. So, fuck bunnies, please use those condoms! And if you haven't been to the STD clinic in a while-- best to hop on down and get checked out.
Until next time, Dick
What you can't see: Dr. Dick on symptomless STDs
Dear Dr. Dick,
Before sex I always check out a guy's dick for any sores, bumps, or rashes. If I don't see anything weird, I assume he's OK. But in your last article, you said you can still get an STD from a guy even if he doesn't have any symptoms. How does this happen? Do I need a magnifying glass to tell if a guy is really safe?
Signed, Sherlock
Dear Sherlock,
While I applaud your commitment to safer sex play, holding a magnifying glass up to a guy's penis might be misinterpreted, if you know what I mean. But the answer is yes, it is possible to get an STD -and infect others - even when you don't see any symptoms. This is true for HIV too.
STDs are caused by bacteria and viruses that get inside your body through sexual contact. Those lovely sores, bumps, oozes, and rashes you see are just outside signs of the infection inside your body. With many STDS, outside symptoms are often not present and can change over time. However, the bacteria or virus is still living on the surfaces of genital skin or mouth and throat tissue. Or in the fluids there too. This is their launch pad for infection!
Gonorrhea and herpes can be tricky like that. For example, many guys with gonorrhea never get the pus-like discharge. Herpes lesions can come and go, but most infection occurs before or after an outbreak. You might even have an STD right now and not even know it!
That's why all sexually active gay/bi men should get tested for STDs every 3-6 months! Routine STD check-ups are important if you're a bottom, have lots of sex partners, are HIV-positive, or if you've had an STD in the past. STDs don't go away on their own. Tests and treatments are easy and low-cost (often free) at Harborview's STD Clinic.
Until next time!!
Dick
Careful out there - a lot of symptoms hide in places you can't see! Like in the back of the mouth or throat and inside the anal cavity. There may be something lurking inside so put away that miner's hat and put on a condom!!
Dr. Dick on Syphillis: How can I avoid getting it again?
Holy syphilis Dick Doc,
Sure I like to have fun with the boys - but getting syphilis twice in one year is too much! Damnit, how come other guys can't figure out they've got syphilis? I noticed a sore just inside my tunnel-o-love, so I went straight to my doc. Believe me, it wasn't fun... I couldn't have sex for weeks. It's seems that every time I go to the baths or hook up with a guy off the Internet, I've got to get a dose of penicillin. Is there any way to make sure that I don't get it again? Twice bitten, thrice shy.
Dear Twice Bitten,
Two times in one year... I can see how you might be a bit upset. It may not make you feel any better but you're not the only one to be so unlucky. As you've discovered, syphilis has been making a come back among gay and bisexual men. In 1996, there were no cases of "locally acquired" syphilis in King County. But in 1997, this changed and for the last couple years, we've seen over 60 cases of syphilis each year. The majority of these cases have been among gay and bisexual men. Of these, 70% also have HIV. This worries me. Syphilis, like most other STDs, makes it easier for HIV to spread. Unlike syphilis, HIV can't be cured with a shot of penicillin.
Rates of syphilis among gay and bisexual men have been increasing in major cities of the United States, Canada, Europe, and even Australia. And since syphilis hasn't been around for a while, it's no surprise that many gay and bisexual men lack basic knowledge about this STD. To make matters worse, the symptoms of syphilis often go unnoticed or show up in places on your body that are difficult to see... unless you're a contortionist.
Most cases of syphilis in Seattle have been linked with places guys use when they want to find a partner for a quick hook up. So if you go to Seattle's baths, sex clubs, parks, or hook up over the Internet, you greatly increase your chances of meeting a guy who has syphilis. This appears to be what happened to you, Twice Bitten.
You can always talk with your sex partners before you have sex with them about STDs. You might still get an STD but at least you'll be more informed about the risk you are taking. Using condoms for anal sex - and oral sex - will reduce your risk as well. Avoiding bath house sex is another option.
I've pulled together a Little Quiz and some info that I hope may help inform others. And, if you think that you might have syphilis, please go to your doctor or an STD clinic for a sex check-up. If you have any questions, call the HIV/STD Information Hotline (206) 205 7837 or check out www.crystalneon.org or http://www.metrokc.gov/health/apu.
Wishing you good sex and good health,
Dr. Dick
How is syphilis spread?
- Direct contact with a syphilis sore on the genitals, penis, vagina, anus, or in the rectum.
- Direct contact with infected blood-- such as sharing used syringes.
- Transmission can occur during vaginal, anal, or oral sex.
- Dark field microscopy can be used to examine material from infectious sores.
- An accurate, safe and inexpensive blood test.
- Yes! A single high dose of injectable penicillin will cure most cases.
- Taking leftover antibiotics won't cure syphilis.
- Having had syphilis does not protect you from getting it again.
- Follow-up syphilis testing is recommended.
- Talk with partners about HIV and STDs before you have sex.
- Using condoms for fucking and sucking.
- Get tested for STDs every 3 to 6 months.
Nervous Nelly: Getting an STD screening
Dear Dr. Dick
I have some weird bumps on my dick that aren't going away, but I'm a little nervous about getting tested. I've heard all kinds of horror stories about what they do to you -- do they really stick a big Q-tip up your dick? Aren't these STD tests painful? What am I getting myself into?
Nervous Nelly
Dear Nervous,
Everyone has heard horror stories about STD testing -- of giant Q-tips that doctors and nurses wield with glee in their eyes. However, over my last 12 years as Dr. Dick, the STD Sexpert, huge strides have been made in patient comfort.
The most-asked question concerns the fearsome "swab."
First, it is not the size of a Q-tip!
It is actually very small (about the size of a kite string -- 1/16th of an inch), and only needs to be inserted about 1/8 of an inch into the urethra (pee hole). If you still have a phobia of anything that's not human going near your penis, then you can do another type of test that is done on a urine (piss) sample. You will need to ask for it though. It is a little more expensive to run, and so not offered as the standard form of penile STD screening.
While penile swabbing can be avoided, this is not true for the throat and butt.
While many people have symptoms like burning or discharge, many folks will not have symptoms or have very mild symptoms that they don't really notice (a herpes outbreak can some times feel like a pulled or ingrown hair). So, if you have oral sex and/or anal sex you should get your throat and butt swabbed.
Also, you should think about whether you want to get tested for HIV. Swabbing works for gonorrhea and chlamydia.
But the presence of herpes, syphilis, hepatitis A, B, and C, and HIV are all blood-based. However, only about 2 teaspoons of blood are needed.
If you are concerned about the clinician finding a vein, you can ask if they would be willing to let you help them. You can also go to a clinic that has a staff of more experienced clinicians like Spring Street Clinic on Capitol Hill. Also, your clinician should conduct a visual exam looking for rashes, sores, warts, or any other unusual symptoms that may lurk in hard to see places. A good clinician will be friendly and respectful, and respond to your needs.
You can just walk in between the hours of 7:30 am to 4:30pm, or call for an appointment at 731-3590.
Safely yours,
Dr.Dick
P.S. You should get vaccinated for Hepatitis A and B if you haven't had them. Why not make a day of it and get this done too!
Acted Rash-ly: STDs can increase your chances of "passing on" or "getting" HIV
Dear Dr. Dick,
I've been HIV positive for 8 years. My T-cells are in the toilet because I can't seem to tolerate the "miracle" drugs that everybody is celebrating. A couple months ago, I let another HIV positive guy ride me bareback. It was hot sex but I got a raging case of syphilis. I didn't even know it. I went to see my doctor after I got this rash on my hands and the bottom of my feet. He thought it was a reaction to one of my meds, so he switched me to something new, but the rash didn't go away. Finally, he tested me for syphilis and discovered I had it. And here's the kicker -- I was already in the second stage! I hate to think I could have passed this on to somebody else. My doc gave me a shot of antibiotics and now I'm OK. But the whole thing gave me quite a scare. Just a warning to others: Watch out! "The truth" ain't all that's "out there." Sign me...
Acted Rash-ly
Dear Acted Rash-ly,
Thanks for the letter. Your case is a good warning for a lot of us -- docs and patients.
For sexually active gay and bisexual men in Seattle, regular and thorough STD checkups are the order of the day. Syphilis cases are skyrocketing among local gay men. And sometimes docs miss the symptoms, especially if you have other health concerns. Syphilis was eliminated in King County in 1995 and 1996. But now it's back with a vengeance. And gay men are at highest risk, especially gay men who have HIV. Syphilis and other STDs appear to progress faster in men who have HIV. Also, STDs, including syphilis, make it easier to get and to spread HIV. As you found out there are many links between HIV and other STD infections. Here's some important info:
Having another STD increases your risk of getting or transmitting HIV.
Why? Because some STDs cause breaks in the skin or mucosal linings of the anus, mouth and vagina. STDs can infect the genitals and anus but they don't always show symptoms. Whether you see them or not, STD infections cause millions of white blood cells to gather around infected areas. These white blood cells are the body's first line of defense. They fight off invading bacteria and viruses. Sadly, white blood cells are also HIV's favorite target for infection. When HIV comes into contact with a syphilis sore or drippy discharge caused by chlamydia or gonorrhea, it's as if the body is rolling out a red carpet welcome. In short, we can say that pus (a visible collection of white blood cells) is a welcome wagon for HIV.
Here's an example. Say you don't have HIV, but you do have an active case of syphilis, chlamydia or gonorrhea. If you have unprotected sex with someone who is HIV positive, your chances of getting HIV can increase by as much as 400 percent. On the other hand, if you already have HIV and get another STD infection of top of it, the level of HIV virus in your semen or blood stream can go up to 10 times higher. This will make it much easier to infect your sex partners with HIV.
The higher the level of HIV in your body, the harder it is on your immune system. And if you have higher amounts of HIV in your genital tract, it is easier to give it to a sex partner. HIV positive people with seriously weak ened immune systems tend to have more frequent and serious STD-related symptoms. This is es ly true in late stages of HIV infection. For example, people with both HIV and herpes will often report more frequent and severe herpes out breaks.
Here are some tips that will keep you healthier:
- Learn to know STD signs and symptoms. Pick up pamphlets from the STD Clinic or from NEON peer educators.
- Reduce the number of new sexual partners and avoid sex with partners you do not know well. Many studies have shown that "anon" partners are especially risky.
- Use condoms consistently and correctly with all new sex partners
- If you are very sexually active, get a free check up at the Harberview STD Clinic. You can also get tested at Seattle Gay Clinic. Get a regular check up even if you don't have symptoms.
- For women, douching (either vaginal or anal) may increase the risk of STDs. Douching is not an effective treatment for any STD infection.
Syph-less in Seattle: Many guys with syphilis don't know they have it.
Dear Dr. Dick
A friend of mine is getting treated for syphilis. He didn't know he had it until some guy started to go down on him at the baths. The guy jerked back and bolted for the door when he saw an oozy red-hot crater on my friend's dick. (He showed it to me and I don't see how he could have missed it. It was so red it looked like a stoplight). I say the idiot didn't feel it cause he was using too much speed. He says he didn't notice it because syph sores don't cause pain. Who's right? Also can you get syphilis in your mouth or butt? What's the deal?
PS. Who's the famous person that went crazy from syphilis? I can't remember. Do you know? I figure since my friend is already loony at least he'll have some company.
Syph-less in Seattle
Dear Syph-less,
Hope you didn't bet your shoes because you'd be dancing barefoot in Volunteer Park. He's right. His sore was painless because syphilis kills the nerve endings in the infected area. This is a true case of where no pain really means no gain.
Syphilis is caused by a corkscrew-shaped germ that drills its way into mucous mem brane tissue. This is the soft, thin skin on penises, in vaginas, butt-holes and in our mouths. Once you catch syphilis, it can take from 10 days to 3 months before you see the first sign. Some times, you won't see anything at all. If it is not treated syphilis can go on into three stages.
In the first stage a single, painless sore or ulcer grows wherever the bacteria first drilled into you. If you're a bottom this sore is going to grow in your butt. If you give head it will grow in your mouth. Since it doesn't hurt, you may not even know it's there. All you have to do to spread syphilis is bring the right type of mucous membrane into contact with this sore which teems with these bugs. No body fluids required - just tag, you're it. This sore can last for several weeks and then will just go away on its own. But the bugs are still in you.
After that you may not see anything else for a couple of weeks to a couple of months. Then, in the second stage, you may notice a rash on your face, chest, back, the palms of your hands or the bottoms of your feet. It can be very faint and it won't itch. You might also get fevers, what look like large warts in your genital area, white patches in your mouth or you may just feel tired all the time. If these symptoms show up some place that's moist (where the corkscrew germs can swim around), all you have to do to spread it is expose a partner's soft mucous membrane tissue. Sometimes the rash is so faint that people don't notice it or they think it's something else--like an allergy. All of these symptoms will go away by themselves within a month and a half. But again, the bugs are still there.
After this, you can enter the third stage. Syphilis can lie around in your body for years before it does anything else. If you carry it long enough, it can cause sores in your brain or eat away at other internal organs. Untreated, it can lead to insanity, a ruptured aorta (the main blood vessel from your heart) or death. (Remember Al Capone?) The other worry with syphilis is that all those open sores make it easier to catch HIV.
Now, here's the good news. Syphilis is easy to detect and very curable.
Recently there have been several cases of infectious syphilis among gay or bisexual men in King County. Most of these men report anonymous park or bathhouse sex.
So . . . if you or your partner have indulged, this is a very good time to visit your local STD clinic or doctor for a checkup. (Look for the free coupon in AmphetaZINE). If a partner or public health person tells you that you've been exposed to syphilis, see your doctor immediately. If the medicine is given before the first sore appears you won't get any symptoms at all.
As for famous people who have had syphilis, the list is long.
Here's a short sample: Henry VIII, Paul Gaugin, Friedrich Nietzsche, Ivan the Terrible, Ramses V, Peter the Great, Pope Leo X, Benito Mussolini, and the more than 400 Black Alabama sharecroppers who were not treated in the infamous Tuskegee experiment.
Dr. Dick
Itching to have sex again: How to get rid of crabs (pubic lice)
Dear Dr. Dick,
Help! I'm at my wit's end, and so I'm calling in a professional (that's you, doc). My problem is crabs. About six weeks ago I tricked with this really hot guy. He fucked me for 4 hours (using condoms and plenty of lube, you'll be happy to know), and left me his phone number so we could get together again.
Unfortunately, he also left me with a bad case of crab lice. Needless to say, I haven't used the phone number. But I didn't let it get me down. After all, crabs are easy to get rid of, right? "So no problem," I thought, "I'll just hop on down to the pharmacy and pick up some Rid."
Well, to make a long story short, I used the Rid 4 times, but those pesky crabs JUST KEEP COMING BACK! I've showered and scrubbed so many times, I'm afraid of rubbing my skin raw. It's driving me crazy! I can't have sex without passing them on. I can't seem to get rid of them. Not to mention the itching!! Please help me, doc. Do I have some sort of super mutant crabs, or am I doing something wrong? Sign me...
Itching to have sex again
Dear Itching,
Good news. Pediculis Pubis, also known as "crabs," haven't mutated into drug resistant super-crabs. It's more likely that you're missing a few of the little buggers, and all it takes is one fertile female, (and they are fertile practically from birth), and you are re-infected.
As you found out or knew, they prefer pubic hair, but as they multiply, they will spread to any hairy area. The upper legs, butt cheeks, and navel are favorite places. So make sure that you treat all hairy or fuzzy areas.
But killing the crabs on your body is only the first step. You also have to kill the ones that may have dropped off onto bedding, furniture, rugs and other surfaces. The beast can live up to 48 hours away from the host (that's you).
To take care of that, just regular washing of bedding in hot water and soap will suffice. On chairs, couches and mattresses, use a vacuum to go around all seams and buttons. It wouldn't hurt to spray a household cleaner (Formula 409, Pine Sol, etc.) before vacuuming. It will make you feel better and will smell good and clean.
If you've done all of this and you're still finding LIVE crabs, bring yourself and any intimate friends to your local STD clinic. We will help you get rid of the critters once and for all.
Have a Happy and itch-free Valentines Day...
Dr. Dick
Info from Dr. Dick about Chlamydia
Dear readers, Dr. Dick is back, but we didn't get any letters last month. We did get a lot of phone calls from tweakers worried about chlamydia. We sent your questions to the good doctor for his sage advice. Here's what he had to say:
What is chlamydia?
(clah MID ee uh) It is a very small, very slow-growing bacteria that is only passed during sex.
It grows really well in the cock, the butthole and the pussy.
You can have chlamydia for a long time (some times one or two years) and not have any symptoms.
The only way to know if you have it is to have a culture or urine test done at your doctor, or at the local STD clinic.
Can I get chlamydia from giving or getting a blowjob?
If blowjobs were all there was to sex (and for some people they are) chlamydia wouldn't be the growing problem it is. This particular bacteria prefers not to live in the throat. You don't have the right kind of cells in there for it to attach itself and grow.
If I get symptoms, what should I look for?
In the cock, a feeling like a tickle or an itch on the inside. It can come and go, or it can be there all the time.
In the butt, maybe blood or mucous coating on the turd, or a dis charge from the butthole. The discharge can be clear or it can look like pus. It might feel slimy. If your drawers get wet, have your butt checked!
Another note on chlamydia symptoms: A lot of times, chlamydia doesn't have any symptoms. But the most common signs in men are:
- a burning feeling when you pee and/or
- a slight discharge from the penis. The discharge is usually clear or whitish in color. It might crust or harden around your pee hole (urethra), or leave spots on your underwear or jeans. Sometimes chlamydia will make your testicles swell and hurt, also.
Tweaker sexcapades often last many hours. Are we more likely to give or get chlamydia than our non-using peers?
What does ice-skating have to do with chlamydia!? Oh, you said sex-capades, not ice-capades. Never mind.
The more time your cock spends in an infected butt or pussy, the more likely the bacteria are to latch on to your pee-hole and start to grow.Once you cock gets infected, it's very easy to pass the chlamydia on to all the warm, wet places you put your cock into. Respect your partner. Use a latex condom. It will block the bacteria no matter how long your sexcapade lasts.
I'm HIV positive. How will I be affected by chlamydia?
Your immune system is busy dealing with HIV. This means the chlamydia will be left to grow nearly un checked in your body. Your system just doesn't need the stress. The bacteria will put more strain on a system that is already over-worked. It will keep grow ing until per nent damage is done to the balls, rectal lining, or the rest of your plumb ing. The best ways to help your system help itself are:
- Get regular STD check ups.
- Talk to your partners about what is safe and not safe to do.
- Decide together what you will and will not do.
- Use condoms, gloves and dams to keep yourself and your partners safe.
Desperate: Urethra discharge. Which sexually transmitted diseases could it be?
Dear Dr. Dick,
Help! I'm in trouble and I don't know what kind of trouble it is. I've been having some pain and bleeding in my ass. A couple of times I've even shit out some yellowish stuff that looks like pus! I'm usually a top but have been fucked a few times lately--but not hard enough to still be hurting! I'm scared to go to the doctor because it seems serious and I have enough stress in my life. What is it?? What can I do?? I want my old happy butt back!
Desperate
Dear Desperate:
OUCH!! Sorry about "old happy butt." I hope that your obvious sense of humor about this situation means that you aren't feeling as desperate as you claim.
So, what is it or what can you do? Well, from the symptoms you describe, I can't tell you exactly what's going on. However, I can suggest some possibilities.
The first thing that comes to mind is a new type of gonorrhea that is making the rounds in Seattle. Unfortunately, this new strain thrives in butts. So far it occurs mostly among gay and bisexual men who have recently had the good luck of getting butt-funked and the bad luck of getting an ass infection. Now, most gonorrhea does not like to live in rectal neighborhoods. (I used to live in a neighborhood described as an "armpit.") Anyway, this new form of gonorrhea not only likes buttholes, it thinks they're a great place to breed large families. The good news--this kind of gonorrhea is easily treated. It causes no long term problems if it is treated soon.
On the other hand, your butt misery might be caused by other viruses or bacteria. Germs like chlamydia (clah-MID-ee-ah), herpes (HER-peez) or syphillis (SIFF-lis). Or it might be some other kind of run-of-the-mill butt bacteria that grows out of control and causes rectal swelling known as proctitis (prock-TIE-tus). Herpes is the only one of these diseases that is not curable.
Yes, dear Desperate, I do understand about STRESS--especially stress about going to clinics and seeing doctors. When I feel something going on with my body, my first thought is, "Maybe the problem will take care of itself." But most of the time it's still there--nag, nag, nag. Then it gets worse--more pain. then it becomes more stressful. So for peace of mind, go have your less-than-happy butt checked out. Even if your symptoms seem to have gone away, your butt can still have some bad bacteria living there. Besides, if you think the problem is stressful now, think about the idea of adding panty-liners to your wardrobe. Butt infections are nothing to play around with.
I wouldn't be doing my job if I don't ask an obvious question: Where do condoms fit into your butt-play? Was your fuck buddy wearing one that broke? Was he wearing one at all? Remember, even if you are HIV+, it is not good to get new infections. If you are HIV-, a bad butt infection allows HIV even more chances to get into your bloodstream. If you're bored with the rubber selection, check out the great new flavored TRUSTEX (see page __) or the Reality Condom (the one that you stick up your butt--it's fabulous). These new condoms are available at the Capitol Hill and Stonewall needle exchanges and at NEON's Thursday night harm reduction meetings.
BEST PLACES TO GET CHECKED: The STD Clinic at Broadway and Madison (720-4333) or the STD Clinic at Harborview Hospital (731-3590). Take an AmphetaZINE coupon with you and get everything free. Another place to get excellent STD care is the Country Doctor Clinic on 19th and Republican (461-4503).
Marathon Man: Anal Warts (HPV), an unrecognized epideminc among gay and bisexual men
Dear Dr. Dick --
A man that I fuck (and get fucked by) for hours at a time just told me that he has genital warts in his butt. I didn't know you could get them there, and I'm not sure what the problem is if you do. What's up with warts?
Marathon Man
Dear Man,
This is such an important issue. I'm glad you asked about it. Again I was forced to go to the experts to get the best information on what are sometimes called "the other speed bumps."
Here are some of the main points:
You don't have to have anal sex to get anal warts, also known as HPV (Human PapillomaVirus).
The warts can be on your dick, butt, balls, upper thighs or on your lips and mouth.
HIV+ people are more likely to get pre-cancerous or cancerous skin changes or growths on their anus.
Once you are infected with warts you will have the virus in your system for the rest of your life. The warts, however, can and should be removed as soon as you see them.
The signs you should look for if you are afraid you have warts are:
- Bleeding and itching from your anus.
- Anything that is on your genitals that is new, like bumps or skin that looks "funny."
- As one local youth put it, "It's like when you look down at your dick and it looks like you dropped some rice krispies on it and they got stuck."
- Unfortunately, many people have warts and don't know it. Sometimes they are hard to see, especially if they are inside the body.
To best protect yourself from warts and the threat of cancer, the experts recommend:
- All men who have signs of anal or genital warts or have had unprotected anal sex should get what is called an anoscopy. An anoscopy is when you have a device put up your butt to look for anything that may be unhealthy. The device used is called an anoscope. The best way to look at Uranus is with a telescope, but the best way to look at your anus is with an anoscope.
- All HIV+ gay or bisexual men should get an anoscopy once a year or when they have symptoms.
REMEMBER: You won't always have warts that you can see, but you still can be infected and infectious. Condoms will protect you on the parts of the body that they cover, but that does not include everything. Doctors won't always volunteer to do the anoscope thing -- some Doctors are buttphobic. You must be a good consumer and ask for an anoscopy. And as the old story goes, the Doctor may feel more appreciated while doing the anoscopy if you have a bouquet of flowers and a nice note waiting up there for her/him. If you are HIV-, the best place to get treated is the Broadway Clinic at 720-4333. If you are HIV+ and have questions, please call the AIDS Prevention Project wart study at 205-6247.
Jerkoff: What every gay man should know about herpes
Dear Dr. Dick,
I get speed bumps from shooting meth. I was masturbating to videos the other night and I wondered, can the herpes from my dick get into my speed bumps?
Jerkoff
Dear Jerkoff,
Good question. Let me guess: you played with your dick, picked at your bumps, played with your dick, picked at your bumps.
You can relax. Yes, a person can infect other parts of their body besides their dick, BUT it is not likely if you have had herpes for a long time. The longer a person has herpes the harder it is to pass to other parts of their body. This was a big question for many years -- does herpes spread from one part of your body to another because you might have a cut, scrape or some other opening in your skin? Or, does it spread because some types of skin are easier to infect than others? Research tells us it is mainly the type of skin. For example, the skin around your crotch, mouth and eyes is easier to infect with herpes than the skin you have on your hands or arms. This is assuming that your immune system is strong. If your immune system is not strong the risk goes up.
Also, if you do have a herpes outbreak on your arm it is not likely to happen more than once. Genital and oral outbreaks are more likely to happen again. Remember that friction can cause an increase in herpes outbreaks, so use LOTS of lube when you jerk off.
How will crystal meth affect my herpes? Will I have more outbreaks?
Great question -- so great that even the very smart Dr. dick had no answer. I had to call two herpes experts. They also really liked this question. To my dismay, they told me that there are no specific studies about crystal meth and its effects on herpes. Bummer, but not too surprising. So, to address your question, we do the next best thing. In this case, like Dr. Doolittle, we "talk to the animals" -- mice and guinea pigs in par-ticular. There have been a couple of studies where mice and guinea pigs infected with herpes were given epinephrine (EPP-e-NEFF-rin). Epinephrine is the same thing as adrenaline (a-DREN-a-lin) -- the hormone that our bodies produce during our "fright, fight or flight" reactions to danger. Speed drugs make our bodies produce epinephrine, and also tend to make the user feel threatened. That's why, when you shoot crystal, your heart rate speeds up, your muscle strength increases, and your lungs open up for faster and deeper breathing.
The mice and guinea pigs had more herpes outbreaks because of getting the epinephrine. We do not know if this would be true with humans, but there are studies to show that the use of alcohol and pot increased herpes outbreaks in humans. The same studies showed that the number of outbreaks went down when the person stopped using the drugs. I don't know the details of the studies so I can't comment more on this right now.
So what's going on with your herpes outbreaks right now? Do you notice that they're worse when you're shooting crystal? (What about you other readers?) If your outbreaks are not too bad and you want to keep shooting crystal, then you will most likely do what we all do when an activity we like has some bad effects on our health. You weigh the good things against the bad things and then decide. Is the pain from the herpes outbreaks so bad that the pleasures you get from shooting crystal aren't worth it? Unless the outbreaks are really bad, you can treat them like the manageable nuisance that they are.
Willy J: Is there a type of gonorrhea that can't be cured?
Dear Dr. Dick,
What about that strain of gonorrhea that can't be cured? I've been hearing about it on the news. I'm HIV+ and this worries me a bit. What will it do to me? Can I get it in my butt or mouth?
Willy J.
Dear Willy,
Relax. The news was wrong. With the right medication, this strain of gonorrhea is easy to cure. The problem is, the best medication is not the one that a lot of clinics use. The news also failed to mention that there have been only 11 cases of this kind of gonorrhea in Seattle. If you have had gonorrhea in the last year and you are worried, go to the Harborview STD Clinic and get checked out.
(Take a yellow NEON Coupon from this issue of AmphetaZINE for a free check-up and treatment.)
By the way: Recently, the STD Clinic has seen more and more cases of gonorrhea in the throats and butts of gay and bisexual men. There are probably more guys out there who are infected but they might not know it. The symptoms (for instance, it burns when you pee or there's oozing, dripping yellow stuff coming out of your butt or dick) don't show up in about 20% of the guys who get gonorrhea.
On the other hand, some guys might see the symptoms but avoid going to the clinic because they're too embarrassed. Don't be.
What about HIV and gonorrhea? Here's the deal. Gonorrhea causes tissue damage in the rectum, throat, and inside the penis. (It also damages the vagina but most AmphetaZINE readers don't have one.)
When the tissue is damaged, white blood cells (also known as pus) rush to fight off the infection. So...
- For HIV negative guys, having gonorrhea makes it easier for HIV to enter your system once you get exposed. Why? Because HIV likes to infect white blood cells. Having gonorrhea is like rolling out the welcome mat as far as HIV is concerned.
- For HIV+ guys, a case of gonorrhea can really wear down your system. If you see symptoms or suspect you've been exposed, go to the clinic and get checked out.
My advice: Don't sweat the petty things -- just pet the sweaty things (safely).
Ben Dover: Sexually Transmitted Diseases and You
Dear Dr. Dick,
I'm HIV positive and I only sleep with HIV positive guys. Why should I use protection?
-Ben Dover
Dear Ben,
That's a very good question, and I'm glad you asked it. HIV is not the only STD (Sexually Transmitted Disease) to be worried about. You might be thinking that you already have the most serious STD, so why worry about protection? This seems to make sense, except, when you are HIV positive other STDs can still cause serious problems for you.
Common STDs that are viruses, like Herpes or Genital Warts cannot be cured, but can be treated. If you are HIV positive they can become much harder to treat and the symptoms can be very painful and unattractive.The common symptoms for Herpes are:
- Red, swollen, itching sores on your genitals (cock & balls) or in your mouth
- Headaches
- Backaches
- Swollen glands
If the Herpes virus is causing symptoms like these you can be sure that it's putting some major stress on your immune system. To add to that stress you may find that you're not too pretty when you have a Herpes outbreak.
Common STDs that are bacteria like Gonorrhea or Syphilis can cause very serious infections in your penis, mouth, or butt that can be harder to treat if you are HIV positive.
If you are HIV positive and your partner is not, or the other way around, these STDs can make it easier for you or your partner to become HIV infected. STDs may create breaks in the skin or sores. Around these sores lots of infected or infectable white blood cells collect to fight the STD. This makes it easy for the HIV to enter the uninfected white blood cells and the rest of the blood system.
Remember that we can manage our sexual health in many ways, by asking questions, talking to friends, protecting ourselves and our partners, and getting STD checkups. If you have more questions about STDs or HIV, you can call 731-4394, or use the coupon in this zine for a free checkup!
