In Sexual Health, Knowledge is Power

There is a lot of misinformation circulating about HIV and when a person is at risk for getting HIV. Unfortunately, this misinformation is leading many people to keep putting themselves or others at risk. When it comes to your sexual health, it is critical that you are informed … with the right information.

Some of the things I often hear from patients are: I am always safe, I always know my partners, or I always check my partner(s)’s HIV status when I meet them on Web sites, such as manhunt or gay.com. The problem is, you cannot tell if a person has an STD — including HIV — simply by looking at them or knowing them. While knowing someone more than 24 – 48 hours can understandably bring you some sense of comfort — particularly if you are going to be sexually intimate with that person — knowing a person does not help you identify a clean bill of health. Up to 75 percent of people infected with chlamydia and gonorrhea have no symptoms, and it usually takes seven to ten years before any symptoms of an HIV infection appear. In all three of these cases, people are exposing their sexual partners to infection even though symptoms are not present. Also, the sores, lesions or skin disorders that characterize other STDs often appear in places that are not visible, such as inside the rectum or the shaft of the penis.

Another problem is that, quite frankly, people lie! Rather, some people lie and others simply don’t know or understand that they became infected after their last negative test. Current research shows that attitudes have shifted toward a sense of “it’s not my problem” where sexual activity is concerned. For example, a survey conducted by the Utah Department of Health in 2008 asked a number of HIV positive individuals if they inform their partners of the HIV positive status. Several respondents stated, “No, it is not my responsibility to protect them.” Anecdotally speaking, I find the same attitude in my discussion with HIV positive individuals: “It’s just not my problem.” There is also a real fear amongst HIV positive men that if they even bring up the issue of condom use, sexual partners will begin to suspect that they are HIV positive and they will be ostracized in the community.

I also encounter many men whose plan to protect their sexual health is to get an HIV test every six months. With each negative test they tout their HIV status as negative, and they feel confident that they are negative. But this plan is flawed because you can get a negative test this morning, but if you go out and have unprotected sex an hour later, then that negative test is null and void. This plan also does not consider the fact that there is a three to six month window period for rapid HIV testing. This means that some people may take up to that long to get a positive test after they have become infected with HIV. I can say that the majority of people who receive a positive HIV diagnosis in my office are truly shocked and had no idea they were positive. Their reactions show that many people are misinformed about being at risk or don’t know they’re at risk, and they have likely been telling partners that they are not HIV positive.

So, what can you do to be informed and to maintain good sexual health?

1.    Abstinence. But abstinence only works if it is realistic for you. You are the only one who can make that decision.

2.    Monogamy. Monogamy is the next safest plan, but only if certain guidelines are followed. Make sure that you both communicate and both agree to monogamy. Start with condoms and do not stop using condoms until both you and your partner have been tested and are negative for all STDs including HIV and both of you are out of your six month window period for HIV. If there is any chance that either you or your partner is not completely compliant with the monogamy plan, then … Condoms, condoms, condoms!

3.    Having multiple sexual partners. It is possible to have multiple sexual partners and still remain disease-free. Again, condoms, condoms, condoms! Protection is really the only way to remain sexually healthy outside of abstinence and monogamy, even if you think you know your partner’s status. If you have multiple partners, each of them also likely has multiple partners. This creates an entire network of partners, and means you are being exposed to any diseases that any person in this network has. Condoms, when used appropriately, will provide protection from diseases that exist within this network.

Knowing your disease status is critical, as is not falling into a false sense of security by getting tested every six months. The simple fact is, if you have ever engaged in unprotected sex and you are a man who has sex with other men, your risk for getting HIV is significant. You should be tested immediately and then you should repeat that test at three and six months to ensure that you truly not infected. If you have any other unprotected encounters, the three to six month period starts over, and does so with each encounter you have.

The Salt Lake Valley offers low cost STD and HIV testing Monday through Friday. For more information, call (801) 534-4601.