Q: Should you permanently abstain from performing oral sex if you have herpes simplex-1 (cold sores), as the virus can become genital herpes if contracted through mouth-to-genital contact?
A: Herpes of the mouth, more commonly known as cold sores, is incredibly common. Studies show about 50 - 80% of adults in the U.S. test positive for this virus. So, if people with oral herpes couldn't perform oral sex, then virtually no one would be able to.
It's actually perfectly safe to perform oral sex if you have oral herpes, as long as you're not in the middle of an outbreak. If you have open sores (cold sores) on the mouth, then you should abstain from performing oral sex or touching people with your mouth in general, because this could spread the virus. However, if sores aren't present, then there is no way you could transmit the virus to anyone else. So, as long as you don't have open sores on your mouth, it's totally fine to perform oral sex.
Q: How often should one check for STDs? Does UCM offer a service for checking?
A: How often one should get checked for sexually transmitted infections (STIs) depends on a person's lifestyle. If a person is regularly engaging in risky sex (e.g., sex with multiple partners, sex with relative strangers, sex without the use of condoms), then you would want to get checked regularly; about once a month. However, if someone is using protection and is having sex in serially monogamous relationships (relationships with one person at a time), then you can space out checks to be less frequent; perhaps twice a year. Although, it doesn't hurt to get checked more often than you need to, so if you ever feel like you just want to "make sure," go ahead and get checked.
Thankfully, the UC Merced health center does offer STI testing, which is free to students. This service is confidential and cannot be viewed by anyone but you. A typical screening will involve giving a small amount of blood so that the doctors can check for herpes, HIV, and a few other STIs. If you feel that you need a fuller check-up, they can also take a penis/vagina sample and test that for gonorrhea and chlamydia (although, this usually isn't necessary unless you are showing symptoms of these STIs). You can also visit Planned Parenthood (there is one in Merced) and they can also provide you with free and confidential STI screenings. There are now even at-home STI screening kits that you can submit through the mail. These can be purchased at most drug stores (CVS, Rite Aid), but they cost anywhere from $30 to $150, depending on what kind of test you get. One popular STI test kit that tests for 10 different infections costs over $350. Given these costs, you would likely be better off using the free resources at your disposal.
Q: If my partner is on birth control, is there really a need for a condom as well? Is there much difference in the chance of getting pregnant when the two methods are combined versus only using birth control?
A: Condoms are a great method of preventing birth. If they are used correctly, they can be 98% effective (meaning if 100 couples had sex regularly for a year and they used condoms, only 2 of the 100 would get pregnant by the end of the year. Birth control (oral pills, implants, IUDs, etc.) work even better. If they're used correctly, they are 99.3 - 99.5% effective (only 1 in 200 couples would get pregnant using it in a year).
If your only goal is to prevent pregnancy, there really is no reason you would need more protection than birth control alone. However, condoms are the only form of contraception that can prevent sexually transmitted infections (e.g., herpes, gonorrhea, HIV). If you're absolutely certain that you and your partner do not have STIs, then it's relatively safe to not wear condoms during sex. The other thing to consider, though, is that oral birth control is only effective if a person remembers to take it every single day. Even missing the pill for just two days can greatly reduce its effectiveness in preventing pregnancy. So, in this case, condoms can be a great backup plan.
If your partner is on an oral (pill) form of birth control, she may benefit from getting a more long-lasting form of birth control, such as an implant or IUD. You can find more information on these here. These forms of birth control don't need to be administered every day, so there's no chance of forgetting to take it and becoming unprotected. Studies show these "long acting, reversible contraceptives" (LARCs) tend to be much more effective in reducing pregnancy, even when compared to traditional birth control. In other words, if you're using a LARC and neither of you have an STI, then there really isn't a need to use condoms.
Q: I am a male who plans to have sex with another male for experimental reasons and I was wondering what can I do to have safe and protected sex since this person that I plan to have sex with is new to me.
A: it's always a good idea to consider ways of protecting yourself before you have sex, so I'm glad you're already thinking about this! Using protection is pretty much the same whether you're having sex with a man or a woman: Use condoms. Condoms are the only way to prevent the spread of STIs during sex and should always be used with new partners. I would hope that you could also talk with this person about their past sexual history and whether or not they have an STI before having sex with them. Although, people aren't always honest about this, so it's always a good idea to use condoms regardless.
Beyond using condoms, another way to protect yourself against HIV/AIDS specifically is by taking the preventative medication, PrEP. This is a once-daily pill that can greatly reduce your chance of contracting HIV if you come in contact with the virus. It's often recommended to men who have sex with other men on a regular basis, especially if they're having sex with multiple partners. PrEP is a prescription medication and it does have some side-effects, so it's a good idea to talk about this with your doctor if you're interested.
Q: By boyfriend and I were talking about the possibility of having a threesome with another girl. If we do it, should my boyfriend change condoms as he goes between the other girl and me? I'm worried about getting a STD.
A: Yes, your boyfriend should definitely change condoms when switching between partners. If one person has an STD, than that virus/bacteria can stick to the outside of the condom, which would then be introduced to the second partner if he doesn't switch condoms in between.
Q: I just got diagnosed with genital herpes. I do not wish to tell ANYONE about it.. even future partners. Yet I know this is incredibly unfair and I will feel absolutely terrible if I don't tell them. How can I go about this?
A: You're right that it's always a good (and right) thing to tell your partners if you have an STI (sexually transmitted infection), such as herpes. The good news is that you now know that you have this STI, so you can actively manage it. You're already far better off than the thousands of people who have STIs, but don't even know it. Thankfully, herpes itself is very treatable and, if you follow the steps outlined below, it's unlikely you'll pass it on to anyone else.
The first thing you should do is contact your doctor about getting on medication to keep the herpes virus in remission. Most often when people get herpes, they will only have occasional outbreaks (and usually more often right after getting the virus). There are certain medications, such as Valtrex, that help to keep these outbreaks from happening. This lessens the pain and sores caused by herpes and also greatly prevents the virus from spreading.
Herpes typically spreads when a sore forms, which releases puss that contains the virus. If that puss comes into contact with someone else's genitals, then they can contract the virus. So, if you notice that you're having an outbreak, with visible sores, pain or itching on the genitals, don't have sex during that time. Outbreaks are most likely to occur right after contracting the virus or when the immune system is compromised, such as when someone has a flu or cold.
Lastly, you should try to contact the last person you had sex with, as this is likely the person you contracted the STI from. It wouldn't be helpful to accuse or chastise them, but you can let them know that you have the virus, which makes it likely that they do as well. Simply raising awareness of the disease, as well as how to manage it, can greatly help prevent its spread in the greater community.
What type protection is necessary for oral sex?
A: Most sex ed instructors tell people to use condoms or dental dams when having oral sex. For those who don't know, dental dams are thin squares of latex or polyurethane (the same materials that are used to make condoms) and can be used to drape over the penis or vulva while having oral sex. Condoms and dental dams can help prevent the spread of some sexually transmitted infections. However, the truth is that almost no one uses these when having sex. It's rare that dental dams can even be found at sex shops.
For the most part, oral sex is relatively safe. There is certainly no way to get pregnant from having oral sex and there aren't many STIs that can be transmitted through oral sex either. The biggest risk is contracting oral herpes (herpes simplex 1). However, a majority of people contract oral herpes during the lifetime and it's not dangerous. Oral herpes tends to results in only a few cold sore outbreaks during a person's life. Most people with oral herpes don't show any symptoms at all. One can get some other STIs through oral sex, such as gonorrhea or HPV, but these cases are fairly rare. Also, a very easy way to prevent getting HPV by any means is to get vaccinated for it.
In short, don't worry too much about contracting STIs when having oral sex. It's a good idea to get to know your sex partner beforehand, so that you can know if you're particularly at risk of contracting an STI from them. But, oral sex is generally a very safe way to have sex.
Q: If one guy and one girl have only slept with each other in their whole entire life. How can trichomoniasis pop up? I understand it is an STD but I don't believe either of us cheated.
A: It is very unlikely to get trichomoniasis without having sex with someone. This STI (sexualy transmitted infection) is caused by a parasite that lives in either the vagina or urethra. It needs a dark, moist area to survive, so it doesn't last long on dry surfaces (such as door knobs or toilet seats). In order for someone to contract it without having sex, an object would have to be placed into an infected vagina or urethra and then almost immediately placed into the vagina or urethra of someone else. If you can imagine a scenario where that happens that doesn't involve sex, then you're more imaginative than I am.
About 70% of people with trichomoniasis never show symptoms of the STI, so they carry it with them without knowing it. This is why it's one of the most common STIs in the U.S., with an estimated 3% of the U.S. carrying the infection. Others contract the STI and only show symptoms years later. So, it could be that one of you has had it for a very long time and it's just now creating symptoms. Thankfully, trichomoniasis is very easy to treat, usually with just a single dose of an antibiotic.
For more information on trichomoniasis, check out:
Q: If you have a one night stand, what should you check for the following days?
A: One-night stands, hookups and casual sex in general can be a relatively safe experience as long as you prepare a bit in advance. Obviously, it's always best to have condoms on you, in case something like this happens. If you're a woman, I also suggest being on a long-acting reversible form of birth control, such as birth control implants, which are very safe and effective can be attained at Planned Parenthood. Also, it's not a good idea to be really intoxicated if you're going to hook up with someone, because then it's likely you'll be far more reckless, such as not using condoms or having sex in a way that you're not comfortable with.
Let's assume that you didn't totally prepare and perhaps you didn't use any safe-sex practices. In that case, if you're a woman and you don't want to get pregnant, I would strongly urge you to take "Plan B" or some other type of post-sex birth control. Plan B can be purchased at regular drug stores, such as CVS or Rite Aid. It's a bit expensive (around $50), but it's well worth it if you didn't use any form of birth control. This medication basically causes you to quickly begin menstruation, flushing away a potentially fertilized egg. This can cause you to experience some pretty bad cramping and a heavy flow, but that's to be expected.
If you're worried about STIs, I suggest going to Planned Parenthood to get a full STI screening. You can visit the Planned Parenthood in Merced at 3166 Collins Dr, Merced, CA 95348. You can get an STI screening for free and, even if you're on your parent's insurance, you can let Planned Parenthood know not to bill your insurance, so that your parents won't find out. There are some STIs that take a while after being infected to show up in a screening test, particularly HIV. Sometimes, HIV won't show up in a screening until 6 months after someone has been infected. So I suggest getting screening a week after a one-night stand and then scheduling another appointment for 6-months later to do a follow-up.
As you can see, having a one-night stand can cause a lot of issues and require a lot of work afterward if you don't properly prepare beforehand. So, in the future, make sure you're using some type of long-acting birth-control and condoms to protect yourself from pregnancy and STIs.
Can two people without STDs get them by being exposed to body fluids, like blood or feces, during sex?
Q: Can two sexually engaged partners who doesn't have AIDS or STDs get it by having unprotected sex where blood or fluids have mixed? For example, a male and a female having unprotected sex during her menstrual period.
A: If two people don’t have any STDs, then they cannot infect each other. STDs or STIs (sexually transmitted infections) are viruses or bacteria, so if neither person is infected with these, they cannot pass them along to anyone else. Also, having sex while a woman is on her period is perfectly safe and healthy.
However, many people with STIs are unaware that they’re carrying them. For example, scientists estimate that 70 – 80% of people carry Herpes Simplex-I (oral herpes or herpes of the mouth) by the time they are in their mid-20s. This is an extremely common virus that tends to get passed on by kissing, sharing food, or simply having hand-to-mouth contact with the virus. For most people, this never causes any symptoms, so they don’t realize they have it. For others, they may get cold-sores or rashes around their mouth, but only once in a while (often when they’re sick with something else). And yet, for others, they can have persistent sores on their mouth. Since STIs affect everyone differently, it’s impossible to absolutely know if someone has an STI without getting checked out by a doctor.
One of the most common STIs that often goes unnoticed is HPV (human papillomavirus). This virus usually has no impact on men who carry it, but can cause cervical cancer in women who contract it. So, it’s best to always use a condom when having sex if there’s any uncertainty in what STIs your partner (or you) have. It’s always a good idea to get a virus screening (which you can get for free at Planned Parenthood in Merced (209-723-7751), especially when you get a new sex partner. It would be great if you could have your partner do the same.
Answers provided by Dr. Ross Avilla
Dr. Ross Avilla has been teaching Human Sexuality since 2013 and has a PhD in psychology from UC Davis. Dr. Avilla is not a clinician and all information and advice offered on this website is for educational purposes only.