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March 7, 2016

Risks

I hear from guys concerned about the risks of sexually transmitted infections (sti’s.) Yes, sti’s are real and the risk can very from a minor nuisance to a chronic condition that affects you for the rest of your life. There’s so much wrapped up in any discussion of sti’s since the way we discuss these conditions is informed by the way we put value judgements on sex. Yet, there’s not a lot of information on how to balance sexual expression with responsibility.

I recently came across an article, written by a sex positive physician that is a great non-judgmental treatise on balancing this risk. This article is well worth your time and not only medically accurate but also informative. The article looks at the risks to help each of us make decisions that are right for us.

From this article, here are some things you can do right now that may help to protect you:

  1. Get tested more often and get treated right away.If you are sexually active, you should be tested for STIs on a regular basis. Those on PrEP are being tested every three months as part of many centers’ protocol, but that may not be often enough. PreP or not, HIV positive or negative — if you’re having sex with multiple partners on a frequent basis, you may want to consider getting tested monthly or every six weeks. Early testing and treatment may be the way we get this STI epidemic under control, and if you are choosing not to use condoms, then increased awareness of STIs, more frequent testing and earlier treatment may be your best harm-reduction tools.

  2. Talk to your partners.When your sex partner tells you he has been recently tested, and he’s “STI-free,” your next question should be “how were you tested?” If he says blood and urine tests, you may want to put off sex, have non-penetrative sex or pull out that condom you weren’t going to use.

  3. Keep condoms in your toolbox for risk reduction.The risk of transmission of STIs from oral sex will continue. Even if you feel comfortable forgoing condoms because you’re on PrEP and feel protected from HIV, condoms need to remain in your toolbox of harm-reduction methods for use in anal sex to prevent STIs. It’s your choice whether to use them or not, but I encourage those of you who have stopped using them completely to reconsider, depending on your sexual situation.

  4. Demand that all medical providers do appropriate testing.All providers must be educated to do appropriate testing that evaluates all sites of possible infection, and testing should be available in all primary care settings. If your provider is not testing for oral and anal infection, then they are not testing appropriately.

  5. Demand that the government step up it’s commitment.STI testing must be more widely and economically available. We must demand that city and state health departments step up efforts to make testing available to all.

  6. Demand point-of-care testing.Point-of-care testing will allow faster identification of people in need and more rapid deployment of treatment. We could be testing people in venues associated with sex, in nontraditional settings and even at home.

  7. Demand new treatments for STIs.We need a concerted effort spearheaded by the National Institutes of Health and pharmaceutical companies to develop new, effective treatments for STIs before drug resistance becomes widespread.

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