FAQs

Element Not Found.
I'm a gay guy and have been together with my boyfriend for over a year. We don’t use condoms. Recently I've become worried that he's having sex with other people. It has me wondering if I should ask him to start using condoms again? How can I do that without a fight?
You describe a difficult situation - that is, what to do when agreements about condom use and sex may feel broken. The best thing to do is to discuss the situation and acknowledge that you are concerned about your own health, as well as your partner's health. If you focus on the health aspects and not the relationship issues, you may be successful when bringing up the subject with him. It will be a tough discussion and you have to decide if your love is worth it. With all that said, you both may want to consider getting on PrEP, and at the minimum making sure to have your provider do routine STI testing recommended for gay and bisexual men.
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
I'm on PrEP and I just bottomed with a guy who came inside me. Do I need to start PEP?
The medication regimens for PEP and PrEP are similar, but usually a PEP regimen contains 3 medications active against HIV while PrEP is 2 medications (combined into one pill). If you've been taking your PrEP regularly, there is no need to add a 3rd medication. PrEP alone is extremely effective at preventing HIV. If you've been missing PrEP doses, you should talk to a provider about whether it makes sense for you to add a 3rd drug for PEP.
I just bottomed with a guy who came inside me. He says he is HIV negative and has no STIs. I can't be sure of how honest he is being, and now I am panicking. What should I do?
It would be a good idea to see a medical provider and get a complete HIV and STI checkup. If its been < 72 hours since the sexual encounter, you should seek care right away as PEP can prevent HIV if started soon after a possible exposure to HIV. If its been more than 72 hours, its still a good idea to talk to a medical provider. You can get tested for HIV and STIs, and talk to your provider about whether PrEP is right for you.
My girlfriend suggested that we have anal sex without a condom. It would be our first time. I thought you were always supposed to use one because of the risk of infection. If you and your partner don't have any STIs or HIV, is it safe to not use a condom for anal sex? All of the information I've found out there assumes you don't know your partner's status in regards to STIs and HIV.
You're right -- in order for you to be exposed to HIV or STIs, your sex partner(s) has to be infected. So, if you're in a relationship and you've both tested negative for STIs recently, and neither of you are having sex with anyone else, you're not at risk for getting or giving an STI.  A person can have an STI and spread it to others without knowing it. You can't tell whether or not a person has an STI just by looking at them which is why its important to get tested for STIs, even if you're feeling ok.
I’m a woman and I only ever have sex with other women. I never inject drugs. What is my HIV risk?
HIV transmission between two cis women (that is women who were female at birth and who identify as female) is very rare. There is one documented case of HIV being transmitted this way [https://www.cdc.gov/mmwr/preview/mmwrhTml/mm6310a1.htm]. In this case, one partner was HIV+ and not on medications. The couple engaged in oral sex, vulva-to-vulva contact, and sharing of sex toys. They had sex during menstruation and sometimes had “rough sex” where blood was present. It is difficult to tell exactly which sex act transmitted HIV. So the risk of two cis women transmitting HIV is very low but not zero. The most important intervention you could take would be if you have a female partner who is known to have HIV, she should be on treatment.
How long after being exposed to syphilis can you be accurately tested? Also, how long after being exposed will symptoms start? What symptoms should I look for?
The symptoms of syphilis can appear as soon as two weeks after you are infected, but it can take up to 12 weeks. The syphilis blood test can turn positive two weeks after you are infected, but it can take longer. Sometimes the syphilis blood test does not turn positive until 12 weeks after you are infected. That is one reason why we recommend you get treated for syphilis if their partner was positive, even if your test result is negative. The initial symptom is a painless sore at the site of infection - sometimes people don't see the sore, especially if it’s inside the vagina, rectum (butt), or throat.  A few weeks after the sore goes away, most people will develop a rash. The rash can be on the chest, back, arms, legs, hands, feet and/or genitals.
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.
What is a pelvic exam? What is a pap smear and what's the difference between them?
A pelvic exam is a check-up of the vulva, vagina, and cervix (opening of the uterus, inside the vagina). It may or may not include a pap smear, which is a test looking for abnormal cells on the cervix that are usually caused by an infection of human papillomavirus (HPV). For more information, please visit our pelvic exam and pap smear info page.
Whenever my boyfriend and I have unprotected sex, I develop a bladder infection and need to go on antibiotics. Is there anything I can do to prevent this?
Many women get urinary tract infections (i.e. UTI or bladder infection) from any physical contact with their genitals -- penile intercourse, oral intercourse, digital intercourse, sex toy use, masturbation, etc. To prevent this, some women drink lots of fluids before sex, and empty their bladders both before and after sexual activity (the acidity of the urine can help to kill some bacteria). Your partner washing before sex, especially under the hood of his penis if he's uncircumcised, couldn't hurt either to reduce the frequency of your infections. 
Do I need to douche before or after sex?
It’s never necessary to douche. Vaginas are designed to be self-cleaning and douching can throw off the healthy environment, which can lead to increased risk for STIs or other vaginal infections. For this reason, vaginal douching is discouraged. Some people who have receptive anal sex (i.e "bottom" or have someone else's penis in their butt) douche before anal sex so that sex is not messy. Douching is a personal choice. It is most important to avoid injury to the anal/rectal tissue to reduce the risk of STIs.
Why do some guys have crooked penises? Is there a cure or a way to straighten a penis?
It is normal for some men to have a shape to their penis. The way the muscles, fascia and skin develop from birth to puberty shape the final result. No two penises are exactly the same, and that is part of the miracle of human diversity. Some partners report greater pleasure with different shaped and sized penises. I am sure that there is some surgeon out there who could convince someone with a very differently shaped penis to undergo cosmetic reconstructive surgery, but medically the treatment would be unnecessary and potentially very harmful.
If I have herpes, can I still have children?
Absolutely. Many people with herpes have healthy pregnancies and healthy deliveries. If you have herpes and you want to get pregnant with your partner, you can protect your partner by taking medication that will suppress your herpes while you are trying to get pregnant. If you have herpes and you are pregnant or want to become pregnant and not pass anything on to your baby, talk to your doctor, nurse practitioner or midwife about how to protect your baby.
I got a Depo shot 3 months ago but now I want to try to have a baby. How soon can I get pregnant?
It can take a long time after your last Depo shot for your fertility to return. The average amount of time it takes someone to get pregnant after stopping Depo is 9 to 10 months – this means about half of people who stop Depo will get pregnant within 10 months. By 18 months after the last shot, about 90% of people will get pregnant [https://managingcontraception.com/after-taking-only-two-depo-provera-shots-how-long-will-it-take-for-me-to-become-pregnant-30315/ and https://www.accessdata.fda.gov/drugsatfda_docs/label/2010/020246s036lbl.pdf ]. If someone wants to use Depo and knows she would like to be pregnant within a year or so, Depo may not be the best method (especially for people over age 35). If you are planning to conceive in the near future and have used Depo, we encourage you to talk to your provider about other methods of birth control, or when to stop using Depo.
I have read online that HPV can go away after 1-2 years, is this true?

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.

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 am a gay man and just got diagnosed with anal warts, does this mean I'm at risk for anal cancer? Should I get an anal pap smear?

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. 

I received a HPV vaccine shot a few years ago but never went back for the 2nd and 3rd shots. Should I start all over?
One of the most common questions we get asked is, “If I missed a dose of HPV vaccine, do I need to start all over again from the beginning of the series?”  No, with the HPV vaccine, you can just pick up right where you left off. You get credit for the first or second dose that you’ve already gotten.  If you're < 15, you only need 2 doses of the HPV vaccine.
I was recently diagnosed with non-gonococcal urethritis and I'm unclear about what causes it. Help!
Urethritis means inflammation of the urethra (the tube that carries urine from the bladder through the penis out of the body).  Symptoms of urethritis include discharge from the penis and pain or discomfort with urination.  The most common sexually transmitted infections to cause urethritis in men are gonorrhea and chlamydia.  When a man has symptoms of urethritis but has negative tests for gonorrhea and chlamydia, it is called NGU (non-gonoccocal urethritis) or NSU (non-specific urethritis).  NGU can be caused by infections such as chlaymdia, mycoplasma genitalium, herpes, adenovirus or trichomoniasis. You can get NGU from insertive anal, vaginal or oral sex (that is, putting your penis in someone else's butt, vagina, or mouth). It can be caused by an infection, and is sometimes non-infectious (that is, not caused by an organism like a bacteria, virus or parasite). 
I was recently diagnosed with non-gonococcal urethritis (NGU). I took some antibiotics and my symptoms went away, but they came back about 2 weeks later. What should I do?
Most people who get repeat infections get them from untreated partners so it's really important to make sure your partners are also treated. That said, NGU can be challenging because sometimes the medical provider is unable to determine exactly what bug (i.e bacteria, virus or parasite) is causing it.  If you have not yet been tested for mycoplasma genitalium, you could ask your provider if they could order this test for you. When NGU recurs soon after treatment or never gets better, it's sometimes necessary to try a different type of antibiotic.  You could ask your provider to check the latest CDC treatment guidelines, or seek consultation from an expert in sexual health.