If you are having sex with other guys it's important to familiarize yourself with the various types of sexually transmitted infections (STI's) out there.
There are three categories of STI's: PARASITES, BACTERIA, and VIRUSES.
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PARASITES |
Crabs and Scabies are little critters, or mites, that infest your hair and skin and love warm "moist" areas, especially your crotch. Luckily they are quite treatable. |
CRABS
A VERY COMMON STI, Pubic Lice are tiny insects called mites that live on the skin, and lay eggs which attach to hair. Every year, millions of people treat themselves for pubic lice.
Symptoms |
Crabs usually show up 3 to 5 days after exposure. They love hanging out in your pubic hair but can also live on underarm hair, eyebrows, and eyelashes. Some guys don't know they are infected, but pubic lice can cause intense itching. |
Diagnosis |
A close look should show tiny pale grey or brown lice and/or small clumps of white eggs (nits) attached near the hair roots. |
Protection |
Highly Contagious! Crabs are transmitted by close physical contact including sex (even when wearing condoms), and sharing bedding, clothes, towels, or toilet seats. |
Treatment |
No need to see a doctor unless its a particularly stubborn infection. You can get over-the-counter genital lice shampoos from the drugstore. Some of the brands available are A200, RID, and InnoGel Plus. About a week after initial treatment, eggs may hatch, and a follow up treatment may be needed. Everyone who may have been exposed to pubic lice should be treated at the same time. To prevent recurrences, wash all fabrics that may have come into contact with the lice in hot, soapy water, and wash everything again after 7 days. For crabs on eyelashes or eyebrows, coat them with petroleum jelly and they should die from lack of oxygen. |
SCABIES |
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Frequently confused with Pubic Lice. Scabies burrow whereas lice hang out on the surface of the skin.
Symptoms |
Scabies are hard to see and often cause a rash or itching when they burrow under the skin to lay their eggs. They prefer warm areas of the body so it is common to see small curling lines on your penis or buttocks, or even around your navel. |
Diagnosis |
Sometimes self-diagnosis is possible but may require microscopic investigation by a clinician. |
Protection |
Scabies is passed on by skin to skin contact, or from shared towels sexual or otherwise. It's difficult to prevent initial infection. To prevent recurrences, wash all fabrics that may have come into contact with the mites in hot soapy water. All contacts including partners and roommates need to have treatment and it is advisable to repeat it after 7 days. |
Treatment |
Scabies is treated with a prescription cream, such as Kwell. Itching may persist after treatment. Everyone who might have been exposed should get treated at the same time. Repeated applications may be necessary, and it is important to thoroughly clean your house and wash all bedding and towels that might have been exposed. |
BACTERIA |
Bacterial STI's can be fairly easy to transmit, but are curable with antibiotics. Often there are no symptoms, so it is important for sexually active guys to get tested every 6 months. Having bacterial STI's makes it easier to transmit or get HIV. |
CHLAMYDIA |
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The MOST frequently reported bacterial STI, Chlamydia can infect your cock, throat, and eyes and if untreated, can inflame your urethral canal and make you infertile.
Symptoms |
About 50% of infected men have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure. Signs or symptoms include itching and a discharge from your penis or a burning sensation when urinating. Pain and swelling in the testicles are possible. Oral infections are increasingly common, resulting in what feels like a sore throat. |
Diagnosis |
You can get Chlamydia in your dick, mouth, or ass and while a urine test might catch the majority of infections, you may want to ask your clinician to do an oral and rectal swab as well. |
Protection |
Using condoms when having anal sex can be effective at preventing it, although it is important to remember that you can get Chlamydia from oral sex and finger-fucking. It can be transmitted by touching an infected area and then your own genitals or ass. You usually can't tell if someone |
Treatment |
It's easily cured with antibiotics. Your sexual partners should also get treated to avoid re-infecting each other. |
GONORRHEA |
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A bacterium that infects your cock, ass, throat or eyes. It often occurs at the same time as Chlamydia.
Symptoms |
It's common to have no symptoms, so it's important to be tested regularly. If they do occur, it will be in 2-10 days, but can take as long as 30 days. Symptoms include a dry, sore throat, itchiness and pain during bowel movements, a clear, yellow or green discharge from your cock or ass, pain or burning when urinating and testicular pain or tenderness. Oral infections are usually asymptomatic but may cause a sore throat. In men, gonorrhea can cause epididymitis, a painful condition of the testicles that can lead to infertility if left untreated. Even if the symptoms clear up, the infection may remain. |
Diagnosis |
The clinician will typically request a urine sample or may administer a rectal or oral swab. |
Protection |
Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Ejaculation does not have to occur for gonorrhea to be transmitted or acquired. Touching infected genitals or ass and then your own genitals, ass or eyes can also transmit it. Using condoms and latex gloves can help prevent transmission, as can washing your hands right after sex. |
Treatment |
Completely curable with antibiotics. Gay men are at increased risk for a drug-resistant strain so your doctor may prescribe a more potent antibiotic. |
Important Facts |
Having gonorrhea makes it easier to transmit or get HIV. Untreated, it can result in throat or ass ulcers, serious infections of the balls and urethra. |
GUT INFECTIONS |
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Gut infections are caused by bacteria, such as amoebiasis, shigella, giardia, cryptosporidium, and salmonella.
Symptoms |
Symptoms can include diarrhea, stomach cramps, excessive farting, nausea and fever. These can show up within several hours of exposure. Gut infections can be particularly severe for HIV positive people. |
Diagnosis |
If you think you've got a gut infection from sex, your doctor will only know which tests to carry out if you say you think you got it from sex. Not telling the doctor this means you will not be test for the right things, leaving the infection to cause you serious damage possibly. A stool sample will be tested. Anti-diarrheal treatments may make some gut infections worse. Antibiotics will need to be used for some infections. Partners should be checked or treated to prevent you from being re-infected. |
Protection |
Gut infections can be passed on sexually or through food or water. You can pick them up when small amounts of infected shit get into your mouth from your fingers, rimming, fucking, or handling used dildos. To avoid gut infections, use gloves for butt play and use a dental dam for rimming. Don't share insertive sex toys unless new condoms are used each time and clean toys between uses. Wash your hands after handling used condoms or toys and after sex involving butt play. |
Treatment |
Exact treatment varies depending on the specific infection. Antibiotics may be used, although the infection may go away without treatment. Antidiarrheal treatments can make the infection worse, so only take them on recommendation of a healthcare provider. Drink more fluids than normal to avoid dehydration. Can be particularly serious for HIV+ people and lead to longer term opportunistic infections. Threadworms are treated by taking tablets or powders sold in chemists (no prescription needed). |
Important Facts |
Having gonorrhea makes it easier to transmit or get HIV. Untreated, it can result in throat or ass ulcers, serious infections of the balls and urethra. Gut infections can cause serious problems if HIV has weakened your immune system. Sometimes the infections can be very difficult to get rid of or impossible to cure. |
SYPHILIS
Syphilis is a bacterial infection that infects the dick, throat or arse and then spreads to different parts of the body through the bloodstream. If left untreated syphilis can cause irreversible damage to the nerves, bones, skin, eyes, and brain.
Symptoms |
Stage 1: Infection may show up 10-90 days after infection. A painless red sore on your cock, balls, mouth, throat, ass or vagina which turns into a scab and then heals. It's common for the symptoms of syphilis to go unnoticed.Stage 2: You may develop a rash on your torso, palms, or soles of your feet. Symptoms may also include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches and tiredness. These symptoms usually occur 7-10 weeks after exposure and may last up to a couple of months before disappearing.Stage 3: Syphilis stops being infectious to sexual partners after about 2 years, but remains in your body and begins to damage internal organs including your brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Damage to internal organs can be fatal. |
Diagnosis |
The usual test for syphilis is a blood test. However, if a sore (called a chancre) is present a swab can be taken of it. Syphilis can take up to three months after exposure for the infection to show up in the blood test. Once someone has been infected with syphilis most future blood tests will show up as positive - even if they have been successfully treated. A particular test is used to identify a new infection - as well as to see if treatment has worked. |
Protection |
Syphilis is passed on by touching the sores and rashes of someone with the infection including foreplay, mutual masturbation, giving or receiving anal or oral sex, or ass play. Only areas physically covered by condoms, gloves or dams are protected from infection. Even when there are no symptoms, the infection can be passed on through contact with infected body fluids, like cum and blood. |
Treatment |
If caught early, Syphilis is easily cured with antibiotics. The duration of treatment depends on the stage of infection and ranges from between 1 and 30 days. Partners should also be treated. |
Co-infection with HIV |
Having syphilis increases the risks of HIV transmission and Syphilis is harder to detect and harder to treat in people with HIV. It is a serious infection that can be mistaken for other infections found in people with HIV. While the symptoms of syphilis infection are usually similar, some HIV positive men develop severe organ and nerve damage much more rapidly than HIV negative men. For some, syphilis can decrease the CD4 count (therefore causing damage to the immune system) as well as increasing the their viral load. |
VIRUSES |
Viruses are the most troubling STI's for many guys because they are incurable and may leave you with chronic symptoms. |
GENITAL
AND ANAL WARTS (HPV) |
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One of the most common viral STI's, Human Papilloma Virus (HPV) may cause warts in or on your cock, ass, or surrounding areas. There are more than 60 types of HPV that can cause different problems. Many people can be infected with HPV and not know it. Some types can lead to cancer.
Symptoms |
Symptoms, if they occur, show up in 2-3 months or longer. Symptoms include small bumpy warts on, in or around your cock, balls, ass or vagina, discomfort when going to the bathroom if the ass is infected, and anal or vaginal itching. Warts are often painless. HPV can increase the risk for anal cancer. HIV and HPV co-infection can increase the size and frequency of warts. |
Diagnosis |
A doctor usually can diagnose genital warts by direct visual examination. The doctor may be able to identify some otherwise invisible changes in the tissue by applying vinegar (acetic acid) to areas of suspected infection. This solution causes infected areas to whiten. |
Protection |
HPV is a virus that is spread through sex or close skin-to-skin, genital area contact with someone who is infected. Warts may not always appear in the place where skin contact occurred. Condoms can reduce the risk of transmission but do not always cover the infected area. Bi-annual anal pap smears are recommended for sexually active gay men. |
Treatment |
There's no cure for HPV, although outbreaks often decrease over time. Doctors can remove the warts by freezing, burning, laser or by applying wart paints or creams. Treatment can require several visits. Don't use over the counter wart medications on genital or anal warts. |
Hepatitis A |
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The word "Hepatitis" simply means inflammation of the liver.
Symptoms |
Symptoms may appear 2-4 weeks after exposure, and resemble a mild flu like illness, accompanied by vomiting, abdominal pain, and jaundice (yellow skin and eyes). Although the Hepatitis A virus can cause prolonged illness up to 6 months, it typically only causes short-lived illnesses and it does not cause chronic liver disease. |
Diagnosis |
Your doctor will examine you for signs of jaundice, and abdominal tenderness, take a blood sample, and ask you about other conditions that could explain liver inflammation (i.e. alcoholic liver disease). |
Protection |
Get vaccinated! There's an effective Hepatitis A vaccine, and a Hepatitis A and B combo vaccine. Hepatitis A is transmitted by small particles of infected fecal matter entering your mouth through assplay and rimming. Using dams, and washing your hands after sex with an infected person, can help reduce the risk. It can also be passed on through using eating and drinking utensils handled by an infected person, or by infected food. |
Treatment |
There's no effective medication for Hepatitis A. Getting proper rest and nutrition, reducing alcohol consumption, and avoiding medications toxic to the liver such as acetaminophen are important. Most people who get Hepatitis A will recover and develop an immunity to the virus. |
Hepatitis B
A virus which causes inflammation of your liver.
Symptoms |
Symptoms may occur 1-6 months after exposure, and include loss of appetite, tiredness, nausea, dark urine, and jaundice (yellow skin and eyes). Some people have no symptoms. |
Diagnosis |
Diagnosis is obtained through a blood test. Prognosis is assessed by liver biopsy. |
Protection |
Again, get vaccinated! There's an effective Hepatitis B vaccine, and a Hepatitis A and B combo vaccine. Hepatitis B is transmitted by infected blood or semen entering your bloodstream through activities like unprotected anal sex, sharing infected injecting equipment, toothbrushes or razors, oral sex, and tattooing and body piercing with unsterilized equipment. |
Treatment |
With proper rest, nutrition and monitoring, many people recover from Hepatitis B. Some retain the virus in their body. There are treatments available for those who become chronic carriers. These treatments are often difficult. A compromised immune system, due to HIV for example, increases the likelihood of becoming a chronic carrier. Chronic Hepatitis B can increase the risk of cirrhosis of the liver and liver cancer. |
Hepatitis C
A virus that can cause serious damage to your liver.
Symptoms |
Symptoms are similar to those of Hepatitis A and Hepatitis B, and may take between 6 weeks to 6 months to show up. Many people with Hepatitis C never have symptoms until decades later. |
Diagnosis |
Many clinics in Utah (including the Utah AIDS Foundation) offer a low cost Hep C blood test. If the initial screening test is positive, your doctor will recommend more intensive testing, including a liver biopsy. |
Protection |
There's no Hepatitis C vaccine. The virus is spread by Hepatitis C positive blood entering your bloodstream. Means of transmission include sharing injecting equipment and works, including needles, spoons and tourniquets. Hepatitis C is rarely transmitted during sexual activity, as transmission through sexual body fluids is thought to be very rare. |
Treatment |
Regular injections which last for several months or pills are common treatments, but they don't work for everybody. Becoming a chronic carrier of Hepatitis C is more likely than with Hepatitis B. Being HIV+, or otherwise immune compromised, can increase the likelihood further. Chronic Hepatitis C can increase the risk of cirrhosis of the liver and liver cancer. |
HERPES |
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The herpes simplex virus comes in several types. Type I (cold sores) is estimated to be present in 50 to 80 percent of the American adult population. Over 50 million people, are infected with type II (genital herpes), and the majority of these cases may be unaware they are infected.
Symptoms |
Symptoms, if they are going to occur, often appear 2-30 days after exposure, but can take months to years. Symptoms include itching or tingling around the infected area(s), an outbreak of painful blisters or sores which later form scabs, and a mild flu like illness. |
Diagnosis |
Herpes can be difficult to diagnose unless you are experiencing a current outbreak, so do not wait until symptoms subside to visit your doctor. If you are manifesting signs of an outbreak, your doctor will take a culture of the lesion for testing. A blood test is available if you have had an outbreak previously but symptoms are in remission. |
Protection |
Condoms can reduce the risk of transmission but do not always cover the infected area. HSV can be passed on both sexually and non-sexually during skin to skin contact by: direct contact with a sore, mouth to genitals, genitals to mouth, genitals to genitals, and mouth to ass. It can be transmitted when there are no symptoms present. |
Treatment |
There's no cure but there is treatment that can reduce symptoms and speed up recovery. The possibility of repeated outbreaks varies from person to person. In time, outbreaks may become less frequent or stop altogether. |
HIV/AIDS
HIV (Human Immunodeficiency Virus) is a virus that attacks your body's immune system. HIV infects and destroys key cells in the body which fight off invading organisms, germs or cancers. AIDS (Acquired Immune Deficiency Syndrome) refers to the range of specific illnesses that a person with HIV may get when their immune system is badly damaged.
Symptoms |
Initial Infection: The point of infection is when the virus enters the body and takes hold. A person newly infected with HIV may show no symptoms at all but a person is infectious to others the moment he becomes infected. Most healthy people have between 800 and 1200 T-cells at this time. Some people experience flu like symptoms which may include fever, swollen glands, sore throat and a rash in the weeks following infection.Window Period: A person can be infected with HIV and still test negative during the window period since it often takes 3-6 months after becoming infected with HIV to receive a positive test result. It can take 3-6 months for a person's antibodies to be in sufficient numbers to detect (hence the name HIV antibody test). T-cells remain at normal levels during this period.Asymptomatic HIV: This is the period of time when a person is infected with HIV but shows no obvious signs or symptoms. A person with HIV infection is often completely healthy throughout this period with a T-cell count of over 500. This period is variable in length, but can often last from 8 - 15 years.Symptomatic HIV: During this period a person develops clear symptoms of immune deficiency that are not severe enough for an AIDS diagnosis. These symptoms don't appear in everyone and begin to occur when a person's T-cell count drops below 500. This period is extremely variable in length. Some common symptoms include swollen lymph nodes, fever, fatigue, rashes, and weight loss.AIDS: AIDS is the end stage of HIV disease and is characterized by major defects in the immune system and/or the presence of opportunistic infections. An AIDS diagnosis occurs when a person's T-cell levels drop below 200 or one or more opportunistic infections occur. Some opportunistic infections include: Karposi's Sarcoma, Tuberculosis, cancers, CMV, and PCP (pneumocystis carinii pneumonia). These infections often lead to death in a person with AIDS. |
Diagnosis |
The most common test for HIV is an HIV antibody test. Most Utah clinics offer a rapid antibody test, which offers same day results. The antibodies can take up to 3-6 months to develop. HIV can be transmitted during the window period before HIV antibodies appear so it is important to get retested outside of the window period to be confident of your results. |
Protection |
HIV can be transmitted by blood, semen (and pre-cum), vaginal fluids or breast milk entering the bloodstream. Traces of HIV can be present in other body fluids like saliva and mucous, but not in sufficient concentration to transmit the virus. The most common ways HIV can be transmitted are:Anal or vaginal sex if you are fucking or being fucked without using condoms.Sharing drug injecting equipment, including needles and works.Sharing body piercing or tattooing needles.For sexually active people, HIV infection is best prevented by using condoms and plenty of lube when giving or receiving anal or vaginal sex. If you have cuts or sores in your mouth or if you've had recent dental work, using a condom when giving oral sex or avoiding oral sex altogether is helpful in prevention. |
Treatment |
Although we know more about HIV than ever before, there's still no cure and no effective vaccine. HIV treatments are complex, have numerous side effects, and don't always work for everyone. There are several treatment options available, and several different classes of anti-HIV drugs. A common treatment is combination therapy which usually uses three or more anti-HIV drugs simultaneously. |
MOLLUSCUM |
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A viral infection of your skin caused by a pox virus.
Symptoms |
Lesions usually occur between 2-12 weeks after exposure. They look like waxy pimples with a dimple in the middle, and can appear in the genital area and elsewhere. Sexually transmitted lesions are usually found on the lower abdomen, pubic area and thighs. |
Diagnosis |
Your doctor will give you a physical examination and examine tissue taken from the sore under a microscope. |
Protection |
Molluscum can be transmitted by sexual and non-sexual skin to skin contact. Only an area covered by latex is protected from the virus. The best way prevent infection is to follow good hygiene (cleanliness) habits. Examine your sex partner's skin and wash thoroughly after sex. Don't scratch or pick at molluscum bumps. People with molluscum should not take part in contact sports unless all growths can be covered by clothing or bandages. Swimming should also be avoided unless all growths can be covered by watertight bandages. |
Treatment |
Molluscum is treated by freezing or scraping the lesions off the body, or the core of the lump, which contains the virus, can be extracted with a fine needle. It can't be completely cured, but symptoms can be eliminated. |
What else you should know |
Early treatment is important, since molluscum lesions can grow and spread over time. Immune compromised individuals are at particular risk for larger lesions and greater spread. |
FUNGI |
There's a fungus among us and its called thrush. Jock itch could also be included here as it is often transmitted sexually. Thrush, candidiasis, is an infection caused by yeast called candida. |
Symptoms |
Thrush can appear in your mouth or your dick and sometimes in your ass. It is not an STI but is sometimes related to sex. Symptoms include redness, rash or itching on the part of the body infected. |
Diagnosis |
Thrush is diagnosed by a simple genital examination but can be confirmed by a swab collected from the infected area. |
Protection |
It is normal to have small amounts of this yeast in the genital area but a range of factors can cause the yeast to overgrow. These can include taking antibiotics or steroids, using soaps and detergents and wearing tight clothing that makes you sweat a lot. Thrush is also more likely to occur if you are HIV positive. |
Treatment |
Thrush is treated with anti-fungal creams or tablets. HIV positive men will need longer courses of treatments. |
Prevention |
To avoid the infection coming back, uncircumcised men should wash (with water only) and dry under their foreskin daily. It may also help to wear light cotton underwear and to avoid tight restrictive clothing |
PACKAGE CHECK
You've only got one penis, so treat it well! Check out your package with this one minute self-exam that will help you find out whether you have STI’s that are showing symptoms. It is not a replacement for an STI checkup. Many people with an STI have no symptoms so the only way to really know whether you have STI’s or not is to have an STI checkup.
Grab a small hand mirror. Find a private place, get naked and look for sores, blisters, rashes, itching, redness, swollen bits, unusual odor or fluid, discharge on or around your dick, ass and balls.
Some helpful hints include:
Lift and look under the balls
If uncircumcised, pull back the foreskin
Look at the area between your asshole and your balls. (This is where the hand mirror becomes useful!) Check your pubic hair for small mites, eggs or lumps.
Gently squeeze the dick along the shaft to check for any unusual discharge. It is common to find some fluid when doing this. This does not necessarily mean that you have an STI. Check for discharge that is smelly or creamy in color.
If you experience any signs of what you think may be a sexually transmissible infection or would like an STI checkup, your doctor can test and treat STI’s. You can also get free and confidential services in Salt Lake City at the Utah AIDS Foundation. Call (801) 487-2323 or visit www.utahaids.org for more info.
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