I don't have insurance but I really need an STI and HIV check-up. What should I do?
If you're in San Francisco, we offer STI and HIV testing at SF City Clinic whether or not you have insurance.  If you're not in San Francisco, you can click here to find a clinic near you: https://gettested.cdc.gov/. HIV tests are available over the counter at pharmacies, if you are able to pay. Visit our About You page to find out which STI tests you might need.
My doctor told me I have Chlamydia, but I don't feel sick or have any symptoms. What's up with that?
Chlamydia infections are often asymptomatic, which means the infection is present but you feel fine. This is especially common for Chlamydia infection involving the rectum (butt), pharynx (throat) and cervix. Chlamydia can still cause problems, even when you feel ok. In women, it can cause inflammation in the reproductive tract that can lead to infertility and increase the risk for an ectopic (tubal) pregnancy. Chlamydia infections can increase the risk of getting or transmitting HIV, especially when additional HIV prevention strategies (like PrEP for people who are HIV negative and treatment for people who are HIV positive) are not used.
My doctor said that I tested positive for hepatitis C but that the virus is undetectable. What does this mean?

This means that you were infected with hepatitis C at some point but your body was able to clear (get rid of) the infection, and so you no longer have the virus. Unfortunately, if you are exposed to hepatitis C in the future, you can be re-infected.

Some people never clear hepatitis C and so the virus is still detectable in their blood. This means they are at risk for the complications of having hepatitis C, for instance iver damage, and that they can transmit it to others. Luckily there are well tolerated medications that can treat hepatitis C in as little as 8-12 weeks.

Can you get HIV from giving a rim job?
No. While it may be theoretically possible to get HIV from a rim job (i.e. oral-anal sex or eating ass), most health experts believe this is safe sex in terms of HIV transmission.  There have been no cases reported of HIV transmission through oral-anal sex. Oral-anal sex can, however, transmit shigella, amoeba, giardia, hepatitis A and maybe even syphilis and gonorrhea. There are vaccinations available to prevent you from being infected with hepatitis A and B. Regular STI check-ups are also recommended as a good way to stay healthy.
Can I get COVID-19 through sexual activity?

YES! Exposure to the virus can occur during sexual activities.

  • COVID-19 has not yet been found in semen or vaginal fluid.

  • COVID-19 has been found in feces of people who are infected with the virus.

We still have a lot to learn about COVID-19 and sex.

The San Francisco Department of Public Health recommends avoiding close contact - including sex - with anyone outside your household. If you do have sex with others, have as few partners as possible and avoid group sex. If you usually meet your sex partners online or make a living by having sex, consider taking a break from in-person dates. Video dates, sexting, or chat rooms may be options for you.

My boyfriend has a history of genital warts (on his penis) but he doesn't have any now. If I give him a blow job, could I get HPV in my throat, and if so, what symptoms would it cause?

It is possible to spread HPV from the penis to the throat during oral sex, but it is rare.

As for ways to protect yourself, condoms can decrease the risk of HPV transmission. 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.

I bottomed without a condom about 3 weeks ago. I used to be on PrEP but have been off for about 6 months. Over the last few days, I've been having fevers and feel really tired, could this be HIV?
Your story is concerning for acute HIV. This is the earliest stage of HIV infection and occurs about 2-3 weeks after someone gets infected with the virus. Not everyone gets symptoms during acute HIV, but most people have some combination of fever, tiredness (fatigue), sore throat, rash, swollen glands, diarrhea, and general weakness. Some say it's like the worst flu of their life. We strongly recommend that you see a provider and be sure to let them know you're worried about acute/early HIV infection. Rapid finger-stick or oral-fluid HIV antibody tests, and even lab-based “4th generation” antibody/antigen tests, can be negative during acute HIV, so it would be a good idea for your provider to send an HIV viral load test. If you are positive, the good news is that HIV is treatable, the medications used to treat HIV have very few side effects, people who stay in care and on their medications live long healthy lives with HIV, and there are programs to help pay for HIV medications whether or not you have insurance. If you are positive, we recommend that you get into care and get started on meds right away. If you are negative, you may want to consider going back on PrEP.
I've been with my boyfriend for about 3 months. I've always had normal pap smears, but I just had a check-up and found that that my pap smear was abnormal, and the HPV test came back positive. Did I get it from my new boyfriend? Is there a way he can get tested to find out if he has it?
While most HPV infections clear on their own, some HPV infections can live in the body for a long time, and often do not cause any symptoms. It is very possible for someone to have HPV for years (10, 20, even more) and never know it, and so you may have gotten HPV from a past sexual partner. HPV is extremely common, and most people who have been with two or more sexual partners in a lifetime have been exposed to the virus. Currently there are no HPV tests for men, and so there is no way to know if your boyfriend has it. 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, and its approved by the FDA up to age 45. If you or your boyfriend have not already been vaccinated, you should talk to your providers about getting vaccinated.
If I've been treated for an STI once, can I get it again?
Having been treated once for a bacterial STI like gonorrhea, syphilis or chlamydia does NOT protect you from future infections. Treatment with antibiotics helps get rid of STIs but it doesn't keep you from getting them again. Every day at SF City Clinic, we see patients with a new STI that they have had before. Each germ is a little different and your immune system does not always protect you. Condoms are the most effective way to protect yourself against STIs.
I've been treated for Chlamydia but it keeps coming back. Why is this happening?
Chlamydia is usually curable with the correct treatment. Most persons who get repeat infections get them from untreated partners so its really important to make sure your partners are treated. Occasionally, the treatment for chlamydia is unsuccessful. If you test positive for chlamydia more than 21 days after you've been treated, and have not had sexual contact with anyone since treatment, talk to your provider about trying a different antibiotic treatment. Here's a great resource on how to talk to your partner about STIs: https://www.plannedparenthood.org/learn/stds-hiv-safer-sex/get-tested/how-do-i-talk-my-partner-about-std-testing 
Are there any vaccines I should get that could protect me from STIs?
Yes! There are several vaccines that can protect you from getting other STIs. All sexually active adults should be vaccinated against hepatitis B. All men and women < 26 yo should receive the vaccine against HPV (and anyone aged 26-45 should also consider it). The HPV vaccine can prevent genital warts, cervical cancer in women and anal cancer in men and women. In addition, gay men and other men who have sex with men, trans women, and trans men who have sex with men should talk to their provider about getting vaccinated against Neisseria meningititis (the meningococcal vaccine) and hepatitis A. At this time, there is no vaccine against HIV, though researchers are actively working trying to develop one.
Are polyurethane condoms any better than latex? Are they more effective in stopping the transmission of HIV? I would prefer to use polyurethane because I can use oil-based lubricants with them.
Both version of today's marketed condoms are extremely effective when used consistently and correctly. Fortunately, there are increasing condom choices including new sizes and textures. In addition to latex and polyurethane condoms, the FC2 condom is a great option for women whose partners don't want to or can't wear a condom, and for bottoms who want to protect themselves during receptive anal intercourse (that is having someone else's penis in your butt). Check out our condom page for information on how to use a condom correctly or speak to your medical provider about using them. If you're not using condoms 100% of the time, are having trouble finding a condom that's right for you or if you just want an extra layer of protection against HIV, talk with your provider about PrEP.
Any tips for how to use a condom?
Pinch the air out of the tip, unroll the condom to the base of the penis and use plenty of lube (reduced friction = less likely to break or tear the condom). Remove the condom after ejaculation while the penis is still erect. To ensure the condom does not come off too early, hold the condom at the base of your penis when pulling out of your partner. The addition of a good quality, water based lube will of course mean less risk of the condom breaking. Always be sure to check the expiration date on the condom. Don't use any that have worn or torn wrappers. The extreme heat or cold can affect the quality of the latex - so don't store them in the car, sun, or your pockets for long periods of time. You can find more detailed instructions and information about the FC2 (internal) condom here.
My BF and I recently got back together after a breakup. We had unprotected sex and oral sex. A few days after we had sex, I began to have STI symptoms, including lots of discharge from my penis. I went to an STI clinic and was told on the spot I was infected with gonorrhea and was treated with a shot and a pill. I confronted my BF and he confessed to kissing someone else. I don't want to sound naïve, but I believe him or at least I want to for the sake of our relationship. My question for you is: Could he have gotten gonorrhea in his throat from kissing someone, and then a few days later, passed it on to me when he gave me a blow job?
Although there are some data that its possible to get gonorrhea in the throat from deep kissing, this is not the easiest or most common way to get gonorrhea in the throat. Usually people get gonorrhea in the throat from giving a blow job (i.e. performing oral sex on a penis) to a person who has gonorrhea in their penis.  You could have gotten gonorrhea in your penis either by getting a blow job from him (if he had gonorrhea in his throat) OR from topping him without a condom (if he had gonorrhea in his butt).  Gonorrhea in the throat and butt are almost always asymptomatic, so your partner probably didn't know he had it, and it’s possible he had it for a while. That's why it’s so important to make sure you are getting checked for STIs in the throat and butt, not just with a urine (pee) test.  Gonorrhea is completely curable. Glad you took care of yourself by getting tested and treated. People with gonorrhea should make sure recent partners get treated and try to get a repeat check-up 3 months after diagnosis.  In addition, sexually active gay men should be screened for STIs and HIV every 3 months.
I always bareback (have unprotected anal sex) with my partner. We are monogamous, both HIV negative and got checked for STIs about 6 months ago. Since my boyfriend loves to ejaculate inside me, I am wondering whether there is any health risk from the cement left in my rectum?
No, there is no particular risk of semen (cement) left in your rectum. Most of it will spill out of its own accord with your next bowel movement, if not before. The trick in your situation is to be very sure both partners are truly monogamous. This means that neither you nor your partner are enjoying a quickie here or there on the side. It's a good idea to keep communication open so you can both continue to be assured of your sexual health. If you or your partner have other partners, you should continue to get checked for HIV and STIs every 3 months, and talk to your provider about whether PrEP is right for you