STDs Expert Forum
Safe Practices?
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The STD Forum is intended only for questions and support pertaining to sexually transmitted diseases other than HIV/AIDS, including chlamydia, gonorrhea, syphilis, human papillomavirus, genital warts, trichomonas, other vaginal infections, nongonoccal urethritis (NGU), cervicitis, molluscum contagiosum, chancroid, and pelvic inflammatory disease (PID). All questions will be answered by H. Hunter Handsfield, M.D. or Edward W Hook, MD.

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Safe Practices?

Hi there! I hope you and your family had a happy holiday! (As do I wish the same for the rest of the forum users!)

I wrote to you in the February 2005 regarding my risk of a potential exposure (I'm a 22 year old gay male; in Jan, was the receptive partner in a breif ejaculation-less unprotected anal intercourse). Your encouragement and knowledge was greatly appreciated. I saw a urologist, GP, ER Doctor and HIV screening service after my unprotected incident in Feb 2005, was given an HIV test (neg) and was told that I need not be concerned with anything STD-related.

I've never really been that risky in my behavior except fot that isolated instance. In 22 years, and to this day, the majority of my sexual experiences involve mutual masturbation, frottage and mutual oral sex, often without any swallowing.

I know that as a gay man, I'm part of a riskier demographic and thus extra caution is necessary. However, I'm atypical in the sense that I only engage in sexual behavior with people that I'm "dating," and that it involves less risk in terms of the activities in which we participate. I've only engaged in anal sex (as the receptive partner) three times; twice with protection and with a person I've known and spent time with non-sexually and once during my unprotected "incident" at a club where there was a 10 second penetration without ejaculation.) Aside from that, I've engaged in less-risky behaviour (see previous paragraph) with 10 people over the past 5 years of my being sexually active.

My questions involve responsible STD screening:

1. Am I less at risk given my sexual activities/number and "relationship" with partners? I don't want to waste money and time getting unnecessary tests.  From the point of my club "incident" on, I've made sure to only engage in protected intercourse (if we get that far), and to stick with less-risky activities (such as avoiding anal sex), and avoid doing them with people with whom I've had a short relationship.

2. Given my comparative lack of promiscuity and more responsible sexual behaviors/activity preferences, is it wise to just get yearly HIV tests and to avoid more intensive and costly testing unless there is a specific cause for concern regarding HIV or other STDs (ie, failure/omission of protection) in the future?

3. Are the activities that I mentioned before (mutual masturbation, frottage and mutual oral sex, without any swallowing) less risky enough to the point that I should only get full STD tests in the event there's symptomatic or event-based cause for concern (with the exception of yearly "just in case" HIV tests?)


Thanks again for your help; your work is supported through all of your forum users who "pay forward" your knowledge; I know I have!

I just want to find a happy medium between responsible screening/safter sex and still enjoying sexual contact without a hazmat suit, all without wasting state funding getting unnecessary tests.

Thanks again,
Happy Holidays!

F
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As you realize, not all gay men are at equal risk for HIV; some are at zero risk and of course some heterosexuals are at very high risk. You describe a sexual lifestyle that should keep you pretty safe.

The main advice I have for sexually active gay men is 1) know your partner; 2) know your HIV status, expect your partner to know his, and always share it with each other before having sex (even if low-risk exposure or condom-protection is planned, because both condoms and intentions often fail in the heat of the moment); and 3) always use condoms for anal sex, except in committed, ongoing relationships.  A fourth good idea is to avoid tempting situations (drugs, alcohol, bars, bathhouses, especially in combination with each other.)  It sounds like you intend to follow those guidelines, and more.

As to your specific questions:

1 and 2) I agree it is silly for people to seek HIV testing after every exposure that frightens them (the issue on the minds of most people on this forum who ask questions about HIV exposure).  If you follow the practices you outline, getting tested once a year will be plenty.

3) Those are pretty much completely safe activities.

Congratulations on your responsible approach and attitude.  Keep your guard up, though; as I said above, the best intentions sometimes fail.

Happy holidays--  HHH, MD
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