STD Prevention for Gay, Bisexual and MSM

• STDs are spread through sexual contact (without a condom) with someone who has an STD. Sexual contact includes oral, anal, and vaginal sex, as well as genital skin-to-skin contact. While condoms are effective, HPV and HSV can be spread by contact with the area around the genitals not protected by the condom.
• Some STDs—like HIV, chlamydia and gonorrhea—are spread through body fluids, such as semen (cum). Other STDs, including HIV and Hepatitis B, are also spread through blood. Genital herpes, syphilis, and HPV are most often spread through genital skin-to-skin contact.

• Most STDs have no signs or symptoms, so you (or your partner) could be infected and not know it.
• The only way to know your STD status is to get tested.
• Having an STD such as herpes makes it easier to get HIV.

All sexually active gay, bisexual, and other men who have sex with men should be tested regularly for STDs. The only way to know your STD status is to get tested. Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner. CDC recommends sexually active gay and bisexual men test for

• HIV (at least once a year);
• Syphilis;
• Hepatitis B;
• Hepatitis C if you were born between 1945 to 1965 or with risk behaviors (see “how is hepatitis C spread“);
• Chlamydia and gonorrhea of the rectum if you’ve had receptive anal sex or been a “bottom” in the past year;
• Chlamydia and gonorrhea of the penis (urethra) if you have had insertive anal sex (been on the “top”) or received oral sex in the past year; and
• Gonorrhea of the throat if you’ve given oral sex (your mouth on your partner’s penis, vagina, or anus) in the past year.

For anyone, being sexually active means you are at risk for STDs. However, you can do many things to protect your health. You can learn about how STDs are spread and how you can lower your chances of getting them.

Get Vaccinated: Gay, bisexual, and other men who have sex with men have a greater chance of getting Hepatitis A, Hepatitis B, and HPV. For this reason, CDC recommends that you be vaccinated against Hepatitis A and Hepatitis B. The HPV vaccine is also recommended for men up to age 26.

Be Safer: Getting tested regularly and getting vaccinated are both important, but there are other things you can do to reduce your risk for STDs.

• Talk honestly with your partner about STDs and getting tested—before you have sex.
• Use condoms correctly every time you have sex.
• Think twice about mixing alcohol and/or drugs with sex. They can lower your ability to make good decisions and can lead to risky behavior—like having sex without a condom.
• Limit your number of sexual partners. You can lower your chances of getting STDs if you only have sex with one person who only has sex with you.

Know Your Status: If you know your STD status, you can take steps to protect yourself and your partners.

If you do have sex, always protect yourself with a condom or dental dam. For condoms to help protect you and your partner(s), you must use them consistently and correctly every time you have sex. Condoms aren't 100% effective. Some STDs can be spread by contact with infected areas not covered by a condom.

• Read and follow package directions.
• Make sure the label says the condom helps protect against HIV and other STDs.
• Check the expiration date.
• Put the condom on before any anal, oral, or vaginal contact.
• Use a new condom for each act of anal, oral, or vaginal sex.
• Use a water-based lubricant for anal and vaginal sex. Never use latex condoms with oil-based products, such as petroleum jelly, lotions or vaginal products that have oil.

Things to know:

• Pre-exposure prophylaxis or PrEP, is a daily medication taken by HIV negative people to reduce the likelihood of getting HIV.
• PrEP was approved in 2012 by the US Food and Drug Administration.
• PrEP is taken before coming into contact with HIV.
• PrEP is used with other prevention methods, such as condoms.
• PrEP must be prescribed by a health care provider.
• If taken consistently, PrEP reduces the risk of getting HIV by more than 90%.
• PrEP differs from post-exposure prophylaxis or PEP. PEP is taken after exposure. In relation to HIV, PEP is taken for about month after high-risk exposure.

You should not use PrEP if you:

• Don’t know your HIV status.
• Are HIV positive.
• Have symptoms of acute HIV infection (symptoms similar to the flu).
• Don’t know whether you have hepatitis B or have been successfully vaccinated.
• Can’t find a health care professional or clinic to provide regular HIV and STD testing and prevention counseling along with Truvada.
• Don’t think you can take it every day.
• Just plan to take it from time to time, such as over a weekend of partying.
• Have kidney disease or reduced kidney health.

Resources:

• PrEP Resources in Georgia