The most important thing to know about STDs: get tested. Get tested every three months. Get a blood test and pee in a cup. And if you’re giving blow-jobs, or bottoming, ask your doctor to swab your mouth and butt as well! To find a free or low-cost test near you, go to gettested.cdc.gov.
Some of us call them STDs, some STIs (sexually transmitted infections). Whichever you prefer is fine.
The Centers for Disease Control and Prevention estimate that every year, nearly 20 million new sexually transmitted infections occur, with young people age 15 to 24 disproportionately affected. In 2015, the total number of chlamydia, gonorrhea and syphilis infections reached an all-time high.
Gay men and other men who have sex with men are also heavily affected by STDs, and trends show that rates of STDs are increasing quickly. Between 2014 and 2015, the rate of syphilis increased 12.8% among gay and bi men. In 2015, gay and bi men accounted for 82% of syphilis cases among all men. We’re also at an increased risk for gonorrhea and chlamydia, when compared to women and men who do not have sex with other men.
Here’s the good news: most STDs can be treated, and many are curable. But delaying treatment not only makes it more likely that other people will be infected, but also may cause health problems for you and your partner. People with STDs that cause genital ulcers can face increased risk of getting HIV if they’re exposed. And some STDs can cause long-lasting health problems. They’re so easily detected, and most of them are so easily treatable, that it’s well worth getting tested to find out if you need treatment, and to make sure you don’t pass one on inadvertently to someone else.
Since STDs often show no symptoms, many people who get an STD don’t know they’re infected. The only way to know if you or a partner has an STD is to get tested. Every three months.
If you notice that you have burning or discharge from your penis, throat or butt, or if you have pain or discomfort when you pee, go in right away to get an STD test. Also, if you’ve got a rash and/or ulcers in your mouth or on your genitals – don’t wait for your three month check-up; go get that test!
The number of gay and bi men who are getting syphilis is increasing. Syphilis is easily transmitted between sex partners since symptoms are not always visible and symptoms go away even when not treated. If you’re having sex, get tested for syphilis every three months.
What is syphilis?
Syphilis is a blood infection caused by the bacteria Treponema pallidum.
How do you get syphilis?
You can get syphilis by touching a sore caused by syphilis—called a lesion or chancre—on another person. People who have syphilis usually get lesions on their genitals or butt or inside their rectum. People can also get lesions on their lips or in their mouth which may be infectious.
What are the symptoms of syphilis infection?
Many times, people with syphilis don’t know they have it because they don’t get any symptoms. When people do experience symptoms, they usually appear in three stages.
Within a few weeks after you’ve been infected on the part of your body where you were infected (usually on your penis, balls, mouth, throat, rectum or in your butt), you’ll get a sore. It might be painful, but not always. It’s also often hard to see. It will scab over, then heal. Even without treatment, it will go away on its own but the infection will progress to the next stage.
Two to six months after you were infected, you might get a rash. This rash could be on your chest, back, palms of your hands, the soles of your feet, scrotum, or other parts of your body. You also might get a fever, have a sore throat, lose your hair in patches, have headaches, have swollen lymph glands, lose weight, be tired or have muscle and joint aches. This can go on for six months or more, and without treatment, the infection will progress to the next stage.
Without treatment, a syphilis infection will begin to damage your internal organs and other parts of your body–such as your brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. This kind of damage might not be noticeable for years, and in very rare cases might be serious enough to cause death.
Even when a person with syphilis doesn’t show any symptoms, they are still able to transmit syphilis to others.
Syphilis is diagnosed with a blood test. If you’re having sex, get tested for syphilis, HIV, gonorrhea and chlamydia every three months. For more testing information, you can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
Can syphilis be treated?
Syphiis can be treated with penicillin, and cured if diagnosed early on. Other drugs are used if a person with syphilis is allergic to penicillin.
How can it be prevented?
Don’t touch another person’s syphilis sores or lesions. Condoms, dams or gloves that cover sores will help prevent infection.
If you’re on treatment for syphilis, wait to have sex with other people until your sores are completely healed.
Gonorrhea can be spread during anal, oral and vaginal sex.
What are the symptoms of gonorrhea infection?
It’s pretty common for a guy with gonorrhea not to have any symptoms, and even more so if the infection is in his butt or throat. If you have gonorrhea you might get symptoms like a dry or sore throat, itchiness and pain when you have a bowel movement, a discharge from your penis, and/or pain or burning when you pee. An infection in your throat might cause discharge, but this is less common. Symptoms can take between two and ten days to show up. Rarely, if left untreated, gonorrhea can get into your blood and cause joint pain, rashes, or other symptoms.
You’ll probably know if you have an infection in your penis. But just in case, make sure to tell your healthcare provider if you are experiencing any of the symptoms above or if one of your partners was recently diagnosed with an STD. For more testing information, you can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
Can gonorrhea be treated?
We can cure a gonorrhea infection with antibiotics. But you shouldn’t have any sex for seven days after you start your antibiotics to make sure the infection goes away. Gonorrhea is also a smart bacterium, and has developed resistance to several kinds of antibiotics. CDC right now recommends using both a shot of ceftriaxone and taking oral azithromycin. If your symptoms continue for more than a few days after you get treated, you should go back to your healthcare provider and get checked.
How can it be prevented?
Using a condom when you have sex can help prevent you from getting gonorrhea, if the area that’s infected (e.g., your partner’s penis or butt) is covered.
Chlamydia is one of the most common STDs in the U.S., with over a million new cases reported every year.
What is chlamydia?
Chlamydia is a bacterial infection that can happen in your urethra (the tube in your penis), rectum (butt), or throat. It’s caused by the bacteria Chlamydia trachomatis.
How do you get chlamydia?
Chlamydia can be spread during anal, oral and vaginal sex.
What are the symptoms of chlamydia infection?
Only about 10% of men with chlamydia will show symptoms, especially if the site of infection is the butt or throat. Symptoms can include a dry or sore throat, itchiness and pain when you poop, or discharge from your penis and pain when you pee. Chlamydia symptoms usually take about a week to show up.
A medical practitioner can diagnose chlamydia by swabbing your throat or butt. Urine tests are usually used to test for chlamydia infection in the urethra. For more testing information, you can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
How is chlamydia treated?
We can cure a chlamydia infection with antibiotics. If you had sex while you were infected with chlamydia, your sexual partners should also get tested for chlamydia and treated if they are infected. But you shouldn’t have any sex for seven days after you start your antibiotics to make sure the infection goes away.
How can it be prevented?
You can lower the risk of getting chlamydia by using condoms.
Hepatitis A is a very contagious liver infection caused by the hepatitis A virus.
How do you get it?
Most often, people get hepatitis A when they come into contact with fecal matter from someone with hepatitis A. This might happen during activities like ass play and rimming, or by touching an infected person’s butt during sex and then not washing your hands before eating or drinking.
The virus can also be transmitted in water (e.g., by eating shellfish from contaminated water sources) or orally (e.g., by sharing eating utensils, sharing a joint, or by kissing an infected person).
What are the symptoms?
People with hepatitis A might get mild flu-like symptoms, nausea and vomiting, abdominal pain, joint and muscle pain, and jaundice (yellowing of the skin, eyes or urine). Symptoms may take between two and seven weeks to show up but the infection usually clears the body within a month. Rarely, people can be sick for several months.
A blood test is used to diagnose hepatitis A. Once you have had hepatitis A, you’ll have antibodies in your blood and will probably become immune to it. That means once you’ve had it, you probably won’t get it again. For more testing information, you can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
Can it be treated?
Hepatitis A can be treated within two weeks of getting it—but most people don’t find out they have hepatitis A until it’s too late for treatment. Then, all you can do is get plenty of rest and drink lots of fluids. In some severe cases, people with hepatitis A need to go to the hospital.
How can it be prevented?
The CDC recommends that all gay and bisexual men get a hepatitis A vaccine. The vaccination comes in two required doses—the second dose is given six months after the first. There is also a hepatitis A and B combined vaccination that’s available, which comes in three doses. The second dose is given one month after the first; the third six months after the initial dose.
To prevent hepatitis A transmission, wash your hands after using the bathroom and before and after sex (especially ass play), and use dams for rimming.
Hepatitis A & HIV
If you have HIV and get hepatitis A, you’ll have to stop your HIV medications and possibly drugs you might be taking to treat an opportunistic infection. This is because many antiretroviral medications are processed by the liver and can’t be tolerated during an acute hepatitis infection (which affects the liver). So it’s probably wise to get immunized if you have HIV.
Hepatitis B is a liver infection caused by the hepatitis B virus. The virus causes liver inflammation and can lead to liver disease.
How do you get hepatitis B?
You can get hepatitis B if the blood, semen, saliva or other body fluid from a person with hepatitis B enters your body. That means you can get hepatitis B from an infected person during condomless oral or anal sex, or by using an infected person’s toothbrush, razor or injection equipment.
What are the symptoms of hepatitis B infection?
People who have hepatitis B infection may experience mild flu-like symptoms, nausea and vomiting, abdominal pain, joint and muscle pain and jaundice (yellowing of the skin, eyes or urine). Symptoms may take between one and six months to appear. Some people do not get any symptoms.
Most adults will recover completely from hepatitis B without treatment. But some people may develop a chronic hepatitis B infection, which lasts for more than 6 months. People who develop a chronic hepatitis B infection may be at risk of developing cirrhosis and liver cancer.
A blood test is used to diagnose hepatitis B. People who have had hepatitis B once already probably won’t get it again. This is because they developed antibodies to it when they first were infected and now they are immune to the infection. For people who don’t naturally recover from hepatitis B on their own, the infection should be monitored with blood tests, called liver function tests, for the rest of their lives. For more testing information, you can find free and low-cost testing for both STDs and HIV at gettested.cdc.gov.
Can hepatitis B be treated?
There is no cure for hepatitis B, but most people who were infected as adults clear the infection from their body on their own. People who do develop chronic hepatitis B should speak to their regular doctor about treatment options. People with liver damage may need to be treated while people without liver damage may not need treatment.
The treatment options won’t cure hepatitis B, but they can decrease the severity of the infection and prevent liver damage as well as reduce the risk of transmitting it to someone else. Sometimes, people are prescribed antiviral medications, like Truvada, which can be used to treat hepatitis B.
How can hepatitis B be prevented?
The CDC recommends that all MSM should be tested for hepatitis B and if not infected or immune, vaccinated. The vaccinations is delivered in a series of three doses. The second dose is delivered 1 to 2 months after the first, and the third dose is delivered 2 to 5 months after the second. There’s also a combination hepatitis A and B vaccination (see hepatitis A page for details).
To reduce the risk of getting or giving hepatitis B:
Use condoms and water-based lube during sex (change between partners);
Use gloves and lube during fisting (change between partners);
Don’t share sex toys (or put condoms on insertive toys and change them between partners);
Wash your hands and sex toys after sex and between partners;
Don’t share injection equipment such as needles, syringes, swabs, spoons, filters, water and tourniquets. Use new equipment, and wash your hands before and after injecting;
Don’t share toothbrushes, razors, nail clippers, or nail scissors;
Make sure body artists use sterile equipment for tattoos, piercings, and other body art; and,
Wear disposable gloves if you give someone first aid or are cleaning up blood or other body fluids.
Hepatitis B & HIV
People with HIV that get hepatitis B might have to temporarily stop taking their antiretroviral HIV medications and medications they may take for opportunistic infections. This is because many HIV medications are processed by the liver, and can’t be tolerated during acute hepatitis B illness.
People with HIV who get hepatitis B may experience a more rapid progression of their HIV illness, although studies have not established this entirely.
Hepatitis C is a liver infection caused by the hepatitis C virus (HCV). Infection with the virus causes liver inflammation and can cause liver disease.
How do you get hepatitis C?
Hepatitis C is transmitted from contact with infected blood. You can get infected if even a small amount of infected blood gets into your blood stream. Sharing needles, syringes, or other equipment to inject drugs can transmit hepatitis C. People also get hepatitis C from needle sticks and sharps injuries in healthcare settings.
It’s also possible to transmit hepatitis C by sharing toothbrushes, razors, or tattoo and piercing equipment.
More and more gay & bi men who have HIV are getting hepatitis C, even though historically, sexual activity was thought of as a low-risk activity for transmission. Some of these cases might be from sharing injection equipment, but it seems that most are due to sexual transmission.
Hepatitis C transmitted during sex usually happens during condomless anal sex. Risk of transmission goes up with any sexual activity that damages the lining of the anus—such as fisting, sex sessions that last a long time or rough sex. Group sex, party drug use before sex and using unwashed sex toys can also put you at risk of hepatitis C if you’re exposed to blood or you have breaks in your skin.
The hepatitis C virus also lives in semen, but whether or not this adds to the risk of transmitting hepatitis C during condomless anal sex is unknown.
What are the symptoms or signs of hepatitis C infection?
A lot of people with hepatitis C won’t experience any symptoms. Other people may get flu-like symptoms, nausea, or abdominal pain pretty soon after getting infected. During the first 2 to 6 months after getting infected, about one in four people clear the virus from their body on their own. Others go on to develop a chronic hepatitis C infection, which can result in cirrhosis and liver cancer after many years.
How do I get tested for hepatitis C?
A combination of blood tests is used to diagnose hepatitis C.. If you’re living with HIV, you should have a hepatitis C test at least once a year. Testing more frequently may be recommended for HIV-positive individuals who are sharing drug equipment, have sexual activity that might case trauma or breaks in tissue, or having sex without condoms.
If you have hepatitis C now or have had it in the past, you have hepatitis C antibodies in your blood. But even if your body clears the infection on its own, you could get re-infected if you come into contact with the virus again. You don’t develop immunity to the hepatitis C virus (unlike hepatitis A and hepatitis B).
For people who don’t clear the virus on their own, the infection will be monitored with liver function tests.
There are newer treatments now available for hepatitis C that can clear the virus from your body and prevent the virus from causing cirrhosis (scarring) of the liver, liver cancer or liver failure. These new treatments are highly effective, with limited side-effects, even for people who are infected with HIV. Most people can be cured in 8 to 12 weeks.
Some people find complementary therapies and lifestyle changes to be helpful in managing hepatitis C symptoms.
Treatment options for people who are coinfected with HIV and hepatitis C can be more complicated. Your doctor will be able to tell you more about your treatment options. Talk to your doctor about your treatment options.
How can hepatitis C be prevented?
There isn’t a vaccine you can get to prevent hepatitis C infection.
Here’s what you can do to reduce the likelihood that you’ll get hepatitis C:
Don’t share injection equipment like needles, syringes, swabs, spoons, filters, water or tourniquets. Always use new injection equipment;
Use condoms and water- or silicon-based lube during anal sex, especially if there is blood or other STIs;
Wear gloves and use water- or silicon-based lube during fisting;
Don’t share sex toys with sex partners. Or, put a condom over insertive sex toys and change them between different partners;
Don’t share personal items like toothbrushes, razors, nail clippers, or nail scissors;
Make sure body artists use new and sterile equipment if you get tattoos, body piercings or other body art; and,
Wear disposable gloves if you give someone first aid or are cleaning up blood or other body fluids.
Hepatitis C & HIV co-infection
People living with HIV are more likely to have hepatitis C than people who are HIV-negative. This might be because behaviors that expose a person to HIV might also expose them to hepatitis C.
A person co-infected with hepatitis C and HIV:
May have more difficulty getting an accurate hepatitis C test result (i.e., may be more likely to get a false-negative or indeterminate test reading);
May have a higher concentration of the hepatitis C virus in their body fluids;
May have higher HIV viral loads but probably won’t experience faster HIV disease progression;
Can safely treat both infections. Should have their liver enzymes monitored regularly since HIV medications can cause liver inflammation or damage.
Shigella is a bacteria that can be spread through oral-anal contact. Shigella causes an infection called shigellosis, which can cause diarrhea, fever, and stomach cramps,
Practicing good hygiene is a good way to prevent shigellosis. Washing hands and genitals thoroughly after using the bathroom, use a dental dam when rimming. Showering and douching can also decrease the chance of infection before rimming. If you have condomless anal sex, the top (or insertive partner) should wash their penis before being sucked.
Shigella infections may resolve on their own in 5 to 7 days in people with healthy immune systems. Other people may need to be treated with antibiotics.
Herpes can be caused by two different herpes simplex viruses (HSV type I and type II). You can give or get herpes whenever there is direct skin-to-skin contact and during oral, anal, or vaginal sex. Transmission can occur from many forms of intimate contact. These can include kissing, blow jobs, rimming, and fisting. Condoms can help prevent herpes transmission, but they aren’t 100% effective.
Most oral herpes cases, with fever blisters and cold sores on the mouth, are caused by HSV type I. Most genital herpes cases, with sores on the vagina, penis or anus—or the skin around those areas—are caused by HSV type II. Since many people have oral sex, type I is increasingly causing genital herpes cases. Once you are infected with HSV, it will live in your body forever. It may cause symptoms occasionally or may not cause any symptoms at all.
To accurately diagnose herpes, laboratory tests are recommended.
Provides a comprehensive approach to caring for people with herpes and HPV infections
Addresses the stigma and shame that comes with a herpes diagnosis
Provides herpes disclosure fact sheets
Crabs & Scabies
Pubic lice – also known as crabs, since that’s what they look like – live on pubic and other body hair (but not head hair). They can be spread without sexual contact, for instance by sharing bath towels or clothing. You might have pubic lice if you have itching where your pubic hair is, your skin in that area is irritated, or if you see specks of blood on your skin there.
The treatment for pubic lice is a topical medicated lotion that can be bought without a prescription. Pubic lice lay eggs that hatch 7-10 days later, so you might need a second round of treatment. During treatment, wash all your clothes and linens thoroughly in hot water and dry for an hour in high heat.
Scabies are tiny mites – smaller than crabs – that can burrow into the skin. They can cause intense itching and a pimple-like skin rash, although the first time someone gets them, symptoms may not show up for two to six weeks. Usually they’re spread by direct, prolonged, skin-to-skin contact with a person who has them. They’re diagnosed often based on the rash and the presence of burrows, although when possible it’s good to get the diagnosis confirmed using a microscope.
Scabies lotions and creams aren’t available over the counter, and you’ll need a doctor’s prescription. Make sure to follow the instructions carefully, Bedding and clothing worn or used next to the skin anytime during the 3 days before treatment should be machine washed and dried using the hot water and hot dryer cycles or be dry-cleaned. Items that cannot be dry-cleaned or laundered can be disinfested by storing in a closed plastic bag for several days to a week.
Human papillomavirus (HPV) is a virus that can cause genital and anal warts. It can also lead to cervical and anal cancer. There is an effective vaccine, of three different shots, that protects against warts as well as the virus types that can cause cancer. The HPV vaccine is available in the U.S. and recommended for men under 26. You can talk to your doctor to see if the vaccine is right for you.
There are over 100 different types of HPV—some of which are more harmful than others. The virus can cause warts on the penis and/or around the rectum. Some types of HPV cause changes in the cells of the mouth, throat and anus that can lead to cancer. Both warts and many types of cancer caused by HPV can be treated.
HPV is transmitted by skin-to-skin contact during anal or vaginal sex. HPV can be transmitted regardless of whether warts are visible. Genital warts aren’t the same as those that commonly happen on hands and feet. One type of wart won’t be passed from one part of the body (e.g., hand or foot) to another (e.g., genital area).
HPV is the most common STD in the U.S. People who have had condomless sex with more than two partners in their lifetime have probably been exposed to HPV. Even if you have a type of HPV that causes warts, you might not get symptoms for months or years—if ever.
Bacterial Meningitis is a severe bacterial infection that causes inflammation of the membranes covering the brain and spinal cord. It can be serious and is sometimes fatal. People living with HIV are at a greater risk than the general population of getting meningitis. Approximately 20% of HIV positive people who develop the disease die as a result.
It’s spread through the exchange of respiratory and throat secretions such as saliva. You can get it from someone who is infected by kissing, oral or anal sex, or sharing cigarettes or smoking equipment such as cigarettes or bongs.
There is an effective vaccine that is recommended for all gay men. One shot is given for men who are HIV-negative and two shots for men who are HIV-positive. There are treatments for meningitis but it’s important to get treatment right away.