An HIV-positive person who takes HIV medications correctly and achieves and maintains an undetectable viral load (meaning, the amount of HIV in their blood is so low that it can’t be detected with tests) for at least six months has no risk of sexually transmitting the virus to an HIV-negative partner. This is known as U=U (Undetectable = Untransmittable).
However, in any relationship, particularly a new relationship, it takes time to get to know and trust your partner. How long have you been dating this person? How well do you know them? Are you having sex with other people or do you have an agreement to be just with each other? PrEP is a great way to take your health into your own hands and protect yourself from HIV, regardless of your partner’s status.
Human papilloma virus (HPV) is a family of over 100 different types of viruses. They are very common and spread very easily, and over 70% of sexually active adults will show evidence of a past HPV infection. Most HPV infections are asymptomatic - that is, people are infected and do not know it.
To answer your question, many HPV infections do go away on their own. However, some HPV infections persist and stay in the body. Some strains can cause warts and others abnormal PAP smears. The strains referred to as "high-risk" can cause changes to cells that eventually can lead to cervical cancer, anal cancer and rarely, oropharyngeal cancer.
Hepatitis B virus is found in blood, semen, and vaginal fluid. The virus can be passed from person to person when one of these fluids has contact with cuts or punctures in the skin or with the moist skin (mucosa) around the genitals or anus. Although hepatitis B virus can be found in saliva, it is not believed to be transmitted through kissing. Giving and receiving oral sex does put your partner at risk, particularly if you receive.
Condoms will protect both partners during anal sex. Remember to use lots of lube so the condom doesn't break. However, the best way for your partner to protect himself from hepatitis B is to get vaccinated right away. He should reach out to his medical provider, or to his local public health department, as soon as possible to figure out where he can get the vaccine. If you have anal or oral sex without a condom before he gets the vaccine, he should talk to his provider about PEP (post-exposure prevention) for hepatitis B right away.
Transmission of hepatitis B can also occur through sharing toothbrushes, razors, sex toys or injection drug equipment.
While anal warts themselves are unlikely to develop into anal cancer, people who have had anal warts are more likely to get anal cancer. This is because people who are infected with HPV subtypes that cause anal and genital warts are also more likely to be infected with HPV subtypes that cause anal cancer.
Infection with HPV is common, and in most cases the body can clear the infection on its own, but in some people the infection doesn't go away and becomes chronic. Chronic infection, especially with high-risk HPV types, can cause certain cancers over time, including anal cancer.
There are currently no national recommendations to screen for anal cancer. If you are living with HIV, then there is a higher risk of anal cancer and an anal pap smear could be considered. You should talk with your healthcare provider to determine whether an anal pap or other screening test might be useful for you.
There is also an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine. Since you may not have been infected with all 9 strains, the vaccine could still provide some benefit to you. If you have not already been vaccinated, you should talk to your provider about getting vaccinated.
Anal warts, which are caused by HPV, can be removed by a doctor or with treatments applied at home. Depending on which treatment is used, there is a 10-30% chance of the warts coming back. Some people have only one outbreak of warts, others have recurrences over time.
Genital warts are most likely to be transmitted to your sex partners when the warts are actually present but sometimes warts are too small to easily see. Very little is known about passing HPV to sex partners if the virus is present but no warts can be seen. It is possible that your partner has already been exposed to this strain of HPV but didn't get any warts.
There is no way to know for sure though because there are currently no HPV tests for men. There is an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine. If you or your boyfriend have not already been vaccinated, you should talk to your providers about getting vaccinated.
What a great question! PrEP is just one of several HIV prevention tools; deciding to take PrEP is a personal choice. As you say, people who only top statistically have a lower chance of acquiring HIV- according to the CDC, 0.1% as the top compared to 1% as the bottom (receptive anal sex). Some things to consider in deciding if PrEP is right for you: -Is your sex partner truly HIV negative, are they taking PrEP correctly, do you want control over HIV prevention by taking PrEP, are you ok with the small risk associated with getting HIV as a top if not on PrEP and not using condoms?
Overall PrEP is very safe and highly effective and is recommended for people at risk for acquiring HIV. Feel free to talk to staff at City Clinic or your health care provider about how to take PrEP. If you don't think you're high enough risk to take PrEP everyday, you can talk to your provider about just taking PrEP before and after you have sex. This is called 2-1-1 PrEP and is a good option for some men. Talk to your provider to learn more about it and to make sure you understand how to use 2-1-1 PrEP correctly.