Tag Archives: HIV/AIDS

Straight, No Chaser: Your HIV and STD Risks From Sexual Activities Other Than Intercourse

November 3, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Today, your sexual IQ goes up, and hopefully your risk for sexually transmitted infections (STIs), including HIV, goes down.
This is the fifth and last post in a series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS, click here.
For an explanation of the risk of contracting HIV from specific acts of sexual intercourse, click here.

Here are some terms you should understand.
Rimming: oral-anal contact
Fingering: digital sexual stimulation
Now let’s review.

Performing Oral Sex On A Man

You can get HIV by performing oral sex on your male partner. The risk is not as pronounced as it is with unprotected vaginal or anal sex, but oral sex clearly is a mode of transmitting HIV.
You are also at risk for getting other sexually transmitted infections (STIs), including herpes, syphilis, chlamydia and gonorrhea.
Using condoms during oral sex reduces the risk of contracting HIV and other STIs.
Your risk of contracting HIV from oral sex is reduced if your male partner does not ejaculate in your mouth.
Your risk of contracting HIV from oral sex is reduced if you do not have open sores or cuts in your mouth.

Receiving Oral Sex If You Are A Man

The risk of contracting HIV is less with receiving oral sex than many other sexual activities, but it is still present.
Your risk of contracting HIV from receiving oral sex is reduced if you do not have open sores or cuts on your penis.
Oral sex also presents a risk of contracting other STIs, most notably herpes.

Performing Oral Sex On A Woman

Significant levels of HIV have been found in vaginal secretions, so there is a risk of contracting HIV from this activity, although the risk is not a great with other sexual activities.
It is also possible to contract other STIs from performing oral sex on a woman.
There are effective barriers you can use to protect yourself from contact with your partner’s vaginal fluids. You can use dental dams or non-microwaveable plastic wrap to protect against HIV and other STIs. (According to the Centers for Disease Control and Prevention, plastic wrap that can be microwaved will not protect you—viruses are small enough to pass through that type of wrap.)

Receiving Oral Sex If You Are A Woman

The risk for contracting HIV while receiving oral sex is significantly lower than for unprotected vaginal sex, but it is still present.
It is also possible to contract other STIs while receiving oral sex.
There are effective barriers you can use (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over your vulva to protect yourself from STIs.

Oral-Anal Contact (Rimming)

The risk of contracting HIV by rimming is very low but comes with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.
You should use a barrier method (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over the anus to protect against infection.

Digital Stimulation (Fingering)

There is a very small risk of getting HIV from fingering your partner if you have cuts or sores on your fingers and your partner has cuts or sores in the rectum or vagina.
The use medical-grade gloves and water-based lubricants can during fingering eliminates this risk.

If you have any additional questions, please feel free to ask questions or provide comments. I cannot more highly endorse the websites at cdc.gov and the US Department of Health and Human Services.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Your HIV and STD Risks From Specific Acts of Sexual Intercourse

November 2, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

Let’s be clear that we’re explicitly discussing the types of sexual behaviors that will lead to transmitting HIV and other sexually transmitted infections (STIs). Over the next two days, we will run the gamut of sexual behavior and its implications.
This is the fourth in an ongoing series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS, click here.

What I hope to accomplish here is to identify those activities that place you at significant risk for contracting HIV and other sexually transmitted infections (STIs). The take-home message is you really should identify your partner’s health status before you begin sexual activity.
Today we will focus on four types of sexual activity and discuss the risks of each. Let’s start with some terminology.

Receptive sex risks speak to risks to the receiver.
Insertive sex risks speak to risks to the giver.
Bottoming is a way of describing receptive anal sex.
Topping is a way of describing insertive anal sex.

Now, let’s review.

Receptive Vaginal Sex

Vaginal sex without a condom is a high-risk behavior for HIV infection.
HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
If you currently have an STI or vaginal infection, your risk for contracting/transmitting HIV is increased because your tissue will be inflamed. This has nothing to do with the presence or absence of symptoms.
Female condoms protect HIV infection if used correctly. However, the risk still exists for any area exposed and infected (in the presence of an open sore or bleeding, for example).
Barrier birth control methods (such as diaphragms, IUDs and cervical caps) DO NOT protect against STIs or HIV infection. If infected semen or sperm contracts inflamed or otherwise injured vaginal tissue, the risk of transmission/contraction is present.
Birth control pills do not protect against HIV or other STIs.

Insertive Vaginal Sex

HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
Condom use is a critical means of protection against STIs that are present without obvious symptoms. Use condoms with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Receptive Anal Sex (Bottoming)

Bottoming without a condom provides the highest risk for contracting HIV, more so than any other sexual behavior.
HIV has been identified in pre-ejaculatory semen. “Pulling out” prior to ejaculation may not decrease your risk.
Rectal douching before anal sex can increase your HIV risk. Douching irritates the rectal tissue and can make you more receptive to contracting HIV. Soap and water in a non-abrasive manner are adequate means of cleanliness.
If bottoming, you will best minimize the risk of transmitting HIV and other STIs by always using a water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize irritation to the rectum during sex and subsequent transmission.

Insertive Anal Sex (Topping)

Topping without a condom is a high-risk behavior for transmission of HIV and other STIs. An infection may be present. If small sores, scratches or tears are also present, they would provide a ready path of entry and transmission of HIV.
Similarly, those same lesions in your partners rectum could harbor infected cells in blood, feces or other fluid, which, when contacted, could infect you through your penis.

Check back for the next post in this series on HIV/AIDS. It will focus on HIV and STD risks from sexual activities other than intercourse.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: How Do You Contract HIV/AIDS?

October 28, 2016Genital/Urinary, Infectious DiseaseAIDS, Blood, Blood transfusion, Body fluid, HIV, HIV-AIDS, HIV/AIDS, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This isn’t 1983. The mystery of how HIV infection is contracted has come and gone. Yet HIV and AIDS awareness are still critical. You need to be knowledgable to be empowered.

This is the first blog in an ongoing series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of the signs and symptoms of HIV/AIDS is, click here.

First, let’s address a simple principle. The HIV virus can live and reproduce in high levels in blood other body fluids, including breast milk, rectal mucus, semen (and pre-semen) and vaginal fluids. If any of those fluids are infected and are transmitted to another’s body, that individual can become infected with HIV. In special circumstances (such as healthcare workers), individuals may become exposed to other areas that may contain high levels of HIV, including amniotic fluid (in pregnancy women), cerebrospinal fluid (from the brain and spinal cord) and synovial fluid (from various joints).
Now please take a moment and look at the lead picture. In addition to those circumstances listed, you should know that fluids such as feces, nasal fluid, saliva, sweat, tears, urine or vomit don’t by themselves contain high enough levels to transmit HIV. However, if those fluids are mixed with blood and you have contact with both fluids, you may become infected via these routes.
HIV is transmitted through body fluids in very specific ways:

During anal, oral or vaginal sex: When you have anal, oral, or vaginal sex with a partner, you will have contact with your partner’s body fluids in areas very likely to be high in HIV viral load if your partner is infected. HIV gets transmitted in these instances through small breaks in the surfaces of the mouth, penis, rectum, vagina or vulva. One of the reasons HIV infection rates are higher in individuals with herpes and syphilis is because those diseases cause open sores, creating additional opportunities for HIV-infected body fluids to enter the body.
During pregnancy, childbirth or breastfeeding: Babies have constant contact with their mother’s potentially infected body fluids. Means of transmitting HIV from mother to child include through amniotic fluid, blood and infected breast milk.
As a result of injection drug use: Injecting drugs puts you in contact with blood. If those needles and their contents are contaminated, you can be directly delivering HIV into your bloodstream.
As a result of occupational exposure: Healthcare workers must be constantly diligent against this method of transmission. Risks of HIV transmission to healthcare workers occur through blood transferred from needlesticks and cuts, and less commonly through contact of infected body fluids splashed into the eyes, mouth or into an open sore or cut.
As a result of a blood transfusion or organ transplant: Fortunately, these days, this is very rare given the stringency of screening requirements in the United States, but it is possible to transmit HIV through blood transfusions or organ transplants from infected donors.

How does one get AIDS?
AIDS is a progression of HIV into its later stages and occurs after one’s immune system is severely damaged. You don’t “get AIDS” as much as HIV progresses to AIDS in certain circumstances. Many of us recall that HIV could progress in this way to AIDS in a matter of a few years a few decades ago. Fortunately, with the development of specialized medications in the 1990s, people with HIV are living much longer with HIV before they develop AIDS.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

May 9, 2016Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Behind the Curtain, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be learn to be responsible in managing it once it’s known that you have an incurable STD such as HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

A really reasonable way to think about having sex with an incurable STD is to think about kissing someone with a cold or the flu. You could still do it, but you’re likely to be at risk. When the symptoms aren’t there, your partner could still be a carrier of the disease and could still give you the disease. Your better course of action is to wait until all symptoms are gone and then still be careful.

You have to simultaneously appreciate that your life will be approximately normal, even as you’ve had a significant change. Even as you get about living the rest of your life, you should be aware of risks that can cause an outbreak.

Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

April 26, 2016General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Behind the Curtain, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

As an emergency physician, my first consideration is to eliminate life threats. Along the way, I cure disease and provide a ton of information. With all of these efforts, I provide a heavy dose of tough love and straight talk meant to empower (and hopefully never belittle). This is heavy on my mind because this week we’ll be discussing sex – not the pleasant aspects, but those instances when something has gone wrong as a result of sex.

I’ve been on the receiving end of hundreds (more likely thousands) of couples coming in, usually one dragging the other by the ear, attempting to determine if “something’s going on”, and yes, more than a few relationships have left the emergency room dissolved after such conversations. I would like to have the beginning of such a conversation with you much in the way that I might have with one of these couples. This is a very appropriate prelude to a conversation about sexuality transmitted infections (aka STIs aka STDs).
Patient: I have a foul smell coming from my vagina. I know he’s doing something!
Doctor: Can you tell me what it smells like? Is there any vaginal discharge, rash or other lesions that you’re seeing?
Male partner (who would have been better off saying nothing): It smells like fish!
Patient (after shooting eye lasers at her partner): I am not having sex with anyone but him, so I know he did something!
Male partner: Doc, I’m not doing anything. She’s the only one I’m with, and I don’t have any symptoms.
Doctor: So each of you only has each other as a partner?
Couple: <nods yes>
Doctor: Would you bet your lives on it?
Couple: <Stunned silence>
Doctor: Well that’s exactly what you’re doing every time you’re having unprotected sex. Now about that discharge…
This upcoming week we are going to address several of most common and/or most important STIs out there for you to know about.

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss. In this case, what you don’t know can kill you. No matter what you think about how ‘good’ it is, it’s not worth risking your life over. Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
If you’re sexually active, you really should follow this series. There’s going to be a lot covered. Might I suggest you cover it as well?
Feel free to ask your SMA expert consultant any questions you may have on this topic.
Order your copy of Dr. Sterling’s new book Behind The Curtain: A Peek at Life from within the ER at jeffreysterlingbooks.com, iTunes, Amazon, Barnes and Nobles and wherever books are sold.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook @ SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.
Copyright © 2016 · Sterling Initiatives, LLC · Powered by WordPress

Straight, No Chaser: Living With An Incurable Sexually Transmitted Infection

December 9, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, Herpes, HIV, Hiv And Aids, HIV/AIDS, HPV, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

You’ve requested it, and it’s only fair. We’ve spent a lot of time discussing sexually transmitted diseases and infections (STDs, STIs). It’s reasonable to discuss living with an STD. The first point to appreciate is most STDs can be treated; that’s been discussed at length in several previous posts. Next you should understand that those that can’t be treated don’t represent a death sentence. STDs are simply diseases. To be clear you will need to make adjustments to you life, and this Straight, No Chaser will discuss those.
Even if you were irresponsible in acquiring an STD, you must be learn to be responsible in managing it once it’s known that you have an incurable STD such as herpes, HPV or HIV/AIDS. Refer back to the Straight, No Chaser Comprehensive Safe Sex Guide for details.

There are important differences between managing different diseases. Putting HIV/AIDS aside momentarily, consider the following general considerations regarding herpes or HPV.

You can live a mostly normal life with these conditions. Unless you’re in the midst of a herpes outbreak or are showing the warts of HPV, you will appear normal. Every other positive attribute you possess will still be intact. Use that positivity to help you through.
It’s only fair and reasonable to have a conversation with existing and/or new sexual partners about your condition. You and your partner should meet with your physician to discuss risks and possibilities. You will want this information to make informed decisions about what you choose to do moving forward.
If you are showing symptoms or in the midst of an outbreak, you should avoid any sexual activity.
Unless you’re in the midst of an outbreak, you can have sex. Remember that these STDs can be transmitted even in the absence of symptoms, so please protect yourself and your partner.

Of course intercourse is a very risky activity. Couples who have been exposed to one STD are likely to have been exposed to multiple. You don’t want to “ping-pong” diseases between you and your partner. Follow the recommended guidelines for having and avoiding sex based on your symptoms.
Surgery, trauma or any cause of a reduced immune system can produce an outbreak. If you’re diabetic, on steroids, have lupus or other conditions that affect the immune system, have a conversation with your physician.

At some point, you’ll get over the guilt and shame associated with having an untreatable STD and start focusing on the rest of your life. Be sure to live that life so it’s not causing more damage along the way; out of sight can’t be out of mind with an incurable STD. Be especially mindful of your risks of giving your partner your disease, both from specific acts of intercourse and from other sexual activities besides intercourse. Remember, these diseases all affect more than sex; managing these diseases is managing your health.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Your HIV and STD Risks From Sexual Activities Other Than Intercourse

December 5, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

Today, your sexual IQ goes up, and hopefully your risk for sexually transmitted infections (STIs), including HIV, goes down.
This is the fifth and last post in a series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS, click here.
For an explanation of the risk of contracting HIV from specific acts of sexual intercourse, click here.

Here are some terms you should understand.
Rimming: oral-anal contact
Fingering: digital sexual stimulation
Now let’s review.
Performing Oral Sex On A Man

You can get HIV by performing oral sex on your male partner. The risk is not as pronounced as it is with unprotected vaginal or anal sex, but oral sex clearly is a mode of transmitting HIV.
You are also at risk for getting other sexually transmitted infections (STIs), including herpes, syphilis, chlamydia and gonorrhea.
Using condoms during oral sex reduces the risk of contracting HIV and other STIs.
Your risk of contracting HIV from oral sex is reduced if your male partner does not ejaculate in your mouth.
Your risk of contracting HIV from oral sex is reduced if you do not have open sores or cuts in your mouth.

Receiving Oral Sex If You Are A Man

The risk of contracting HIV is less with receiving oral sex than many other sexual activities, but it is still present.
Your risk of contracting HIV from receiving oral sex is reduced if you do not have open sores or cuts on your penis.
Oral sex also presents a risk of contracting other STIs, most notably herpes.

Performing Oral Sex On A Woman

Significant levels of HIV have been found in vaginal secretions, so there is a risk of contracting HIV from this activity, although the risk is not a great with other sexual activities.
It is also possible to contract other STIs from performing oral sex on a woman.
There are effective barriers you can use to protect yourself from contact with your partner’s vaginal fluids. You can use dental dams or non-microwaveable plastic wrap to protect against HIV and other STIs. (According to the Centers for Disease Control and Prevention, plastic wrap that can be microwaved will not protect you—viruses are small enough to pass through that type of wrap.)

Receiving Oral Sex If You Are A Woman

The risk for contracting HIV while receiving oral sex is significantly lower than for unprotected vaginal sex, but it is still present.
It is also possible to contract other STIs while receiving oral sex.
There are effective barriers you can use (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over your vulva to protect yourself from STIs.

Oral-Anal Contact (Rimming)

The risk of contracting HIV by rimming is very low but comes with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.
You should use a barrier method (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over the anus to protect against infection.

Digital Stimulation (Fingering)

There is a very small risk of getting HIV from fingering your partner if you have cuts or sores on your fingers and your partner has cuts or sores in the rectum or vagina.
The use medical-grade gloves and water-based lubricants can during fingering eliminates this risk.

If you have any additional questions, please feel free to ask questions or provide comments. I cannot more highly endorse the websites at cdc.gov and the US Department of Health and Human Services.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: Your HIV and STD Risks From Specific Acts of Sexual Intercourse

December 4, 2014Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS, click here.

Receptive sex risks speak to risks to the receiver.
Insertive sex risks speak to risks to the giver.
Bottoming is a way of describing receptive anal sex.
Topping is a way of describing insertive anal sex.

Now, let’s review.

Receptive Vaginal Sex

Vaginal sex without a condom is a high-risk behavior for HIV infection.
HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
If you currently have an STI or vaginal infection, your risk for contracting/transmitting HIV is increased because your tissue will be inflamed. This has nothing to do with the presence or absence of symptoms.
Female condoms protect HIV infection if used correctly. However, the risk still exists for any area exposed and infected (in the presence of an open sore or bleeding, for example).
Barrier birth control methods (such as diaphragms, IUDs and cervical caps) DO NOT protect against STIs or HIV infection. If infected semen or sperm contracts inflamed or otherwise injured vaginal tissue, the risk of transmission/contraction is present.
Birth control pills do not protect against HIV or other STIs.

Insertive Vaginal Sex

HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
Condom use is a critical means of protection against STIs that are present without obvious symptoms. Use condoms with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Receptive Anal Sex (Bottoming)

Bottoming without a condom provides the highest risk for contracting HIV, more so than any other sexual behavior.
HIV has been identified in pre-ejaculatory semen. “Pulling out” prior to ejaculation may not decrease your risk.
Rectal douching before anal sex can increase your HIV risk. Douching irritates the rectal tissue and can make you more receptive to contracting HIV. Soap and water in a non-abrasive manner are adequate means of cleanliness.
If bottoming, you will best minimize the risk of transmitting HIV and other STIs by always using a water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize irritation to the rectum during sex and subsequent transmission.

Insertive Anal Sex (Topping)

Topping without a condom is a high-risk behavior for transmission of HIV and other STIs. An infection may be present. If small sores, scratches or tears are also present, they would provide a ready path of entry and transmission of HIV.
Similarly, those same lesions in your partners rectum could harbor infected cells in blood, feces or other fluid, which, when contacted, could infect you through your penis.

Check back for the next post in this series on HIV/AIDS. It will focus on HIV and STD risks from sexual activities other than intercourse.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: The Doctor/Patient Sexually Transmitted Disease (STD) Talk

November 8, 2014General Health and Wellness844-SMA-TALK, Bacterial vaginosis, Chlamydia infection, Gonorrhea, Herpes, HIV/AIDS, HPV, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, SyphilisJeffrey Sterling, MD

Chlamydia

Gonorrhea

Syphilis

Herpes

Not talking about them, not protecting yourself from them, and not testing yourself for them is truly believing that ignorance is bliss. In this case, what you don’t know can kill you. No matter what you think about how ‘good’ it is, it’s not worth risking your life over. Also, as an additional conversation, I’ll discuss Bacterial Vaginosis.
While you’re waiting for the next post, go back and reread another of the most common sexually transmitted diseases: this post on ‘The Sexually Transmitted Cancer”. It definitely should be considered required reading for everyone who is sexually active or about to become active, and I would have addressed it first had I not already covered it. Might I suggest you cover it as well?
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what 844-SMA-TALK and http://www.SterlingMedicalAdvice.com(SMA) offers. Please share our page with your friends on WordPress, Facebook @ SterlingMedicalAdvice.com and Twitter at @asksterlingmd.
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Straight, No Chaser: Your HIV and STD Risks From Specific Acts of Sexual Intercourse

December 3, 2013Genital/Urinary, Infectious Disease, Obstetrics and GynecologyAIDS, Anal sex, Female condom, HIV, Hiv And Aids, HIV/AIDS, Safe sex, Sexual intercourse, Sexually transmitted disease, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS, click here.

Receptive sex risks speak to risks to the receiver.
Insertive sex risks speak to risks to the giver.
Bottoming is a way of describing receptive anal sex.
Topping is a way of describing insertive anal sex.

Now, let’s review.

Receptive Vaginal Sex

Vaginal sex without a condom is a high-risk behavior for HIV infection.
HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
If you currently have an STI or vaginal infection, your risk for contracting/transmitting HIV is increased because your tissue will be inflamed. This has nothing to do with the presence or absence of symptoms.
Female condoms protect HIV infection if used correctly. However, the risk still exists for any area exposed and infected (in the presence of an open sore or bleeding, for example).
Barrier birth control methods (such as diaphragms, IUDs and cervical caps) DO NOT protect against STIs or HIV infection. If infected semen or sperm contracts inflamed or otherwise injured vaginal tissue, the risk of transmission/contraction is present.
Birth control pills do not protect against HIV or other STIs.

Insertive Vaginal Sex

HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
Condom use is a critical means of protection against STIs that are present without obvious symptoms. Use condoms with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Receptive Anal Sex (Bottoming)

Bottoming without a condom provides the highest risk for contracting HIV, more so than any other sexual behavior.
HIV has been identified in pre-ejaculatory semen. “Pulling out” prior to ejaculation may not decrease your risk.
Rectal douching before anal sex can increase your HIV risk. Douching irritates the rectal tissue and can make you more receptive to contracting HIV. Soap and water in a non-abrasive manner are adequate means of cleanliness.
If bottoming, you will best minimize the risk of transmitting HIV and other STIs by always using a water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize irritation to the rectum during sex and subsequent transmission.

Insertive Anal Sex (Topping)

Topping without a condom is a high-risk behavior for transmission of HIV and other STIs. An infection may be present. If small sores, scratches or tears are also present, they would provide a ready path of entry and transmission of HIV.
Similarly, those same lesions in your partners rectum could harbor infected cells in blood, feces or other fluid, which, when contacted, could infect you through your penis.

Check back for the next post in this series on HIV/AIDS. It will focus on HIV and STD risks from sexual activities other than intercourse.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: What are the Symptoms of HIV and AIDS?

December 2, 2013Infectious DiseaseAIDS, Disease, HIV, Hiv And Aids, HIV-positive people, HIV/AIDS, National Institutes of Health, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, WordPressJeffrey Sterling, MD

This is the third in an ongoing series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of how HIV is contracted, click here.

The National Institutes of Health has a nice method of categorizing HIV signs and symptoms, which I’ll replicate here. There are several take home messages, and I’ll use the pictures to communicate them.

HIV Positive Without Symptoms
Many people who are HIV-positive do not have symptoms of HIV infection, and symptoms only evolve as their condition deteriorates toward AIDS (Acquired Immunodeficiency Syndrome). Sometimes people living with HIV go through periods of being sick and then feel fine.

Signs and Symptoms of Early HIV
As early as two–four weeks after exposure to HIV (but sometimes as far out as three months later), people can experience an acute illness, often described as “the worst flu ever.” This is called acute retrovirus syndrome (ARS) or primary HIV infection. This represents the body’s natural response to HIV infection. During primary HIV infection, there are higher levels of virus circulating in the blood, which means that people can more easily transmit the virus to others.
Symptoms resemble a flu-like syndrome, including fever, chills, nights sweats, muscle aches and fatigue. Other symptoms may include a rash, sore throat, swollen lymph nodes and ulcers in mouth. It is important to state that not everyone gets ARS when they become infected with HIV.

Signs and Symptoms of Chronic or Latent Phase HIV
After the initial infection and seroconversion, the virus becomes less active in the body, although it is still present. During this period, many people do not have any symptoms of HIV infection. This period is called the ‘chronic’ or ‘latency’ phase. This period can last up to 10 years—sometimes longer.

Signs and Symptoms of AIDS
While the virus itself can sometimes cause people to feel sick, most of the severe symptoms and illnesses of HIV disease come from the opportunistic infections that attack the infected individual’s compromised immune system.
When HIV infection progresses to AIDS, many people begin to suffer from fatigue, diarrhea, nausea, vomiting, fever, chills, night sweats, and even wasting syndrome at late stages.
Unless symptoms are discovered late, HIV/AIDS is much better being diagnosed early based on risk factors and exposures. That said, use the knowledge provided to prompt evaluation and testing.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.

Straight, No Chaser: How Do You Contract HIV/AIDS?

December 1, 2013Genital/Urinary, Infectious DiseaseAIDS, Blood, Blood transfusion, Body fluid, HIV, HIV-AIDS, HIV/AIDS, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No Chaser, United States, WordPressJeffrey Sterling, MD

Today is World AIDS day. This isn’t 1983. The mystery of how HIV infection is contracted has come and gone. You need to be knowledgable to be empowered.
This is the first blog in an ongoing series on HIV and AIDS.

For an explanation of what AIDS is, click here.
For an explanation of the signs and symptoms of HIV/AIDS is, click here.

During anal, oral or vaginal sex: When you have anal, oral, or vaginal sex with a partner, you will have contact with your partner’s body fluids in areas very likely to be high in HIV viral load if your partner is infected. HIV gets transmitted in these instances through small breaks in the surfaces of the mouth, penis, rectum, vagina or vulva. One of the reasons HIV infection rates are higher in individuals with herpes and syphilis is because those diseases cause open sores, creating additional opportunities for HIV-infected body fluids to enter the body.
During pregnancy, childbirth or breastfeeding: Babies have constant contact with their mother’s potentially infected body fluids. Means of transmitting HIV from mother to child include through amniotic fluid, blood and infected breast milk.
As a result of injection drug use: Injecting drugs puts you in contact with blood. If those needles and their contents are contaminated, you can be directly delivering HIV into your bloodstream.
As a result of occupational exposure: Healthcare workers must be constantly diligent against this method of transmission. Risks of HIV transmission to healthcare workers occur through blood transferred from needlesticks and cuts, and less commonly through contact of infected body fluids splashed into the eyes, mouth or into an open sore or cut.
As a result of a blood transfusion or organ transplant: Fortunately, these days, this is very rare given the stringency of screening requirements in the United States, but it is possible to transmit HIV through blood transfusions or organ transplants from infected donors.

Straight, No Chaser: What is AIDS?

November 24, 2013General Health and Wellness, Infectious DiseaseAIDS, Disease, HIV, HIV/AIDS, Immune system, Infection, National Institutes of Health, Sarcoma Kaposi, Sterling Medical Advice, SterlingMedicalAdvice.com, Straight No ChaserJeffrey Sterling, MD

This is the first blog in an ongoing series on HIV and AIDS.

For an explanation of how HIV is contracted, click here.
For an explanation of the signs and symptoms of HIV/AIDS is, click here.

After all these years, it’s still an interesting and important enough question to ask and to know how to answer. Most know that AIDS is a devastating disease caused by the HIV virus. However, courtesy of the National Institutes of Health, consider the following:
A – Acquired – AIDS is not something you inherit from your parents. You acquire AIDS after birth.
I – Immuno – Your body’s immune system includes all the organs and cells that work to fight off infection or disease.
D – Deficiency – You get AIDS when your immune system is “deficient,” or isn’t working the way it should.
S – Syndrome – A syndrome is a collection of symptoms and signs of disease. AIDS is a syndrome, rather than a single disease, because it is a complex illness with a wide range of complications and symptoms.
Acquired Immunodeficiency Syndrome is the final stage of HIV infection. People at this stage of HIV disease have badly damaged immune systems, which put them at risk for opportunistic infections.
You will be diagnosed with AIDS if you have one or more specific opportunistic infections, certain cancers (such as Kaposi’s sarcoma) or a very low number of CD4 cells (a measure of the strength of your immune systems function). If you have AIDS, you will need medical intervention and treatment to prevent death.
Check back to Straight, No Chaser for additional posts on HIV/AIDS, including risk factors and symptoms, progression/complications and treatment.
Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) offers. Please share our page with your friends on WordPress. We are also on Facebook at SterlingMedicalAdvice.com and Twitter at @asksterlingmd.