FAQs

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What is mpox? Is that the same as monkeypox?

Yes! In late 2022, the World Health Organization changed the name of the disease to mpox because of concerns about racist and stigmatizing language.

You may also have seen it referred to as MPX. Globally, the disease is now called mpox.

Visit SF.gov/mpox for more mpox information or visit us online at www.SFCityClinic.org or call 628-217-6600 to schedule an appointment for the mpox vaccination at San Francisco City Clinic.

I recently met a woman who said she had tested positive for HPV after an abnormal pap smear. She said she has never had warts, and that it had been diagnosed as the more high-risk kind. Since that pap smear she has had several subsequent ones that came back normal. Could she transmit HPV to me? Is there anything I can do to protect myself?

Over 70% of sexually active adults will show evidence of a past HPV infection. Most HPV infections are asymptomatic - that is, people are infected and do not know it. It's possible you've already been exposed to the strain that this woman was diagnosed with. Many HPV infections go away on their own. When HPV infection goes away the immune system will remember that HPV type and keep a new infection of the same HPV type from occurring again. However, because there are many different types of HPV, becoming immune to one HPV type may not protect you from getting HPV again if exposed to another HPV type.

Some HPV infections persist and stay in the body. Some strains cause warts. The strains referred to as ""high-risk"" can cause changes to cells that eventually can lead to cervical cancer, anal cancer and rarely, oropharyngeal cancer. It is not possible to know if she has cleared the virus completely and at this time there are no tests to detect HPV in men.

As for ways to protect yourself, condoms can decrease the risk of HPV transmission. There is also an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine.

I am HIV-negative and just started dating a guy who is HIV positive. He says he's "undetectable" and that we don't need to use condoms. Is that true? What should I do?

An HIV-positive person who takes HIV medications correctly and achieves and maintains an undetectable viral load (meaning, the amount of HIV in their blood is so low that it can’t be detected with tests) for at least six months has no risk of sexually transmitting the virus to an HIV-negative partner. This is known as U=U (Undetectable = Untransmittable).

However, in any relationship, particularly a new relationship, it takes time to get to know and trust your partner. How long have you been dating this person? How well do you know them? Are you having sex with other people or do you have an agreement to be just with each other? PrEP is a great way to take your health into your own hands and protect yourself from HIV, regardless of your partner’s status.

Does the mpox vaccine work for clade II mpox, the type of mpox that caused a large outbreak starting in the summer of 2022?

The Jynneos vaccine is effective at preventing mpox! Less than 1% of people who have been fully vaccinated with the Jynneos vaccine have been diagnosed with mpox.

Getting vaccinated is one of the best ways to protect yourself, and we also want to remind people that while no vaccine is 100% effective, vaccination decreases the likelihood of illness.

And, if someone who has been vaccinated does get mpox, their symptoms are less severe and they are less likely to be hospitalized.

Other strategies people could use to decrease the risk of mpox infection include reducing their number of sex partners and using condoms.

Visit SF.gov/mpox for more mpox information or visit us online at www.SFCityClinic.org or call 628-217-6600 to schedule an appointment for the mpox vaccination at San Francisco City Clinic.

I'm hearing about a new “mpox”.

The CDC is monitoring an outbreak of a different strain of the mpox virus in the Democratic Republic of the Congo that causes more severe disease, called mpox Clade 1. The JYNNEOS vaccine is expected to be effective against Clade I.

We are closely monitoring the developments and will continue to update the community.

For more information, please visit CDC Website.

Visit SF.gov/mpox for more mpox information or visit us online at www.SFCityClinic.org or call 628-217-6600 to schedule an appointment for the mpox vaccination at San Francisco City Clinic.

What is the risk of HIV from fisting, fingering, mutual masturbation, oral-anal sex, cum in the eye, cum on a cut, sharing a glass, sweat, etc…?
There is zero risk of getting HIV from mutual masturbation, oral-anal sex (aka rimming, eating ass, etc), sharing a glass, sweat, or other types of casual contact. Likewise, there is zero risk of HIV from getting cum on a cut, unless it is a fresh, open cut where HIV could gain entry. Fingering also has no risk unless there is an open cut or wound on the skin, although fingernails could damage the rectum or vagina and make it more susceptible to infection through subsequent sexual activities like intercourse/fucking. You can talk to your provider or call the City Clinic PEP line if you have questions about whether you need PEP. Fisting (inserting part or all of the hand in the rectum or vagina) in and of itself is not considered high risk for transmission of HIV. However there is a much higher risk of damaging rectal or vaginal tissue, which would be much more vulnerable to infection through any intercourse/fucking that happens after fisting. Washing up before and after ass play like fisting, and using latex gloves, and/or making sure there are no open cuts or wounds is a good idea to prevent transmission of infections.
When does the protection start once I get vaccinated?

Once you get your first dose of the vaccine, it takes about 2 weeks for your body to create some protection.

But you won’t get the strongest protection until 2 weeks after the second dose which comes a month after the 1st dose.

So, if you get your first dose today and your second dose in 4 weeks, you've got maximal protection starting in 6 weeks.

If you've already gotten both doses of the vaccine, you're set! There is no recommendation for booster doses at this time.

Visit SF.gov/mpox for more mpox information or visit us online at www.SFCityClinic.org or call 628-217-6600 to schedule an appointment for the mpox vaccination at San Francisco City Clinic.

I went to a bachelor party and went down on a stripper.  Can I get an STI from performing oral sex on a woman?
It is extremely unlikely that you would get a sexually transmitted infection from putting your mouth on a vulva (external genitals of someone that does not have a penis). By the way, this sexual activity is called ‘cunnilingus’. We do not believe that gonorrhea or chlamydia are transmitted that way and you cannot get HIV from performing oral sex on a vulva. It is theoretically possible to get syphilis from performing oral sex on a vulva but that is very rare. If you wish to protect yourself, you can use a barrier (a ‘dental dam’, a thin square of latex) between your mouth and your partner’s vulva.
Can I get COVID-19 through sexual activity?

YES! Exposure to the virus can occur during sexual activities.

  • COVID-19 has not yet been found in semen or vaginal fluid.

  • COVID-19 has been found in feces of people who are infected with the virus.

We still have a lot to learn about COVID-19 and sex.

The San Francisco Department of Public Health recommends avoiding close contact - including sex - with anyone outside your household. If you do have sex with others, have as few partners as possible and avoid group sex. If you usually meet your sex partners online or make a living by having sex, consider taking a break from in-person dates. Video dates, sexting, or chat rooms may be options for you.

While I'm getting mpox vaccinated, are there other things I should ask my provider about?

Yes! Taking active control of your sexual health starts with open communication with your provider.

There are many other steps you can take to protect your sexual health this summer, such as routine testing for STIs, including HIV, seeking HIV PrEP, and doxy-PEP.

Visit SFCityClinic.org for more information or call to schedule an appointment.

You can also schedule an appointment with your medical provider to discuss how you can stay active in your sexual health routine.

You can also get tested for STI's and HIV at home by ordering a test kit from take-me-home.org.

Cases of mpox are still occurring. If you have not been vaccinated, get vaccinated, which includes making time for both shots. If you only got the first one, you can still get the second.

Having both shots offers you the strongest protection.

Speak to your medical provider about getting yours today.

Visit SF.gov/mpox for more mpox information or visit us online at www.SFCityClinic.org or call 628-217-6600 to schedule an appointment for the mpox vaccination at San Francisco City Clinic.

I just tested positive for an STI and had 3 partners in the past month. Do I need to tell them? How do I tell them?

To protect the health of your partners and prevent you from getting an STI again, we encourage you to tell all your partners.

Self-disclosure is the act of sharing with sex partners about a recent diagnosis with an STI or HIV, and how they might have been exposed. Self-disclosing may feel personal or vulnerable. But self-disclosing can be empowering, honest, and helps your sex partners get the care that they might need as well.

There are two ways self-disclose:

  1. Talking with your sex partners directly
  2. Sending your sex partners an anonymous text message with TellYourPartner.org

The best method is the method that is most comfortable for you. Each one shows that you care about protecting your partners’ health and want to stop the spread of STIs or HIV in your community.

Talking with your partners

Talking to your partners about a recent diagnosis, or self-disclosing, will help them access STI testing and treatment as soon as possible.

Here are some tips on talking with your partners/self-disclosing:

  • Share when you’re ready, comfortable, and in a safe space.
  • Practice what you will say in front of a mirror or with a trusted friend.
  • Learn more about your diagnosis to feel confident sharing information about it to your partner: STI Basics
  • Direct partners to testing sites such as the SF City Clinic or another location that is more convenient.
    • The SF City Clinic offers free testing and treatment with drop-ins and appointments.
    • Follow this link to a list of other locations that can be more convenient: GetTested
  • Share other resources available to them such as PEP, PrEP, and doxy-PEP.

Here is a video with an example of what it can be like to talk with your partner

Using TellYourPartner.org

TellYourPartner.org is a FREE, ANONYMOUS online service that can send a text message to your partners notifying them of a recent contact to an STI or HIV.

Learn more on how this service works.

How to use TellYourPartner.org (available in English and Spanish)

  1. Click the link to open the website
  2. Click the rectangle box “Send a Text”
  3. Move through the 5 steps to get started. This is where you will provide your partner’s cell phone number, select the STI you were diagnosed with, and then send the anonymous message.

 

Should I be concerned about mpox?

San Francisco Department of Public Health is working with state and federal agencies to monitor for mpox, and to help control the spread of the virus.

One of my sex partners just found out that he has syphilis. The last time we had sex was about 3 weeks ago. I was tested for syphilis at my PrEP follow-up visit last week and was negative. My doctor says I still should get the shot. Is that true? Why do I need it if I'm negative?
The syphilis test can take up to 12 weeks to turn positive after someone is infected. Syphilis is really easy to transmit. It’s very possible that you got syphilis from him when you had sex 3 weeks ago. By getting the shot, you will get rid of any incubating syphilis. This will prevent you from developing symptoms and also prevent you from transmitting syphilis to any of your other sex partners. It’s great that your partner told you and that you're both getting checked out and taking care of your health.
I'm a gay man. I'm not on PrEP because I basically never have anal sex, and when I do, I always use condoms. When I hook up, its usually oral sex or mutual masturbation and I never let anyone cum in my mouth. Last night I was drunk and gave a blow job to a guy who came in my mouth. Should I take PEP?
PEP, or Post-Exposure Prophylaxis (prevention) is the use of combination anti-HIV medications after an exposure to HIV. Giving head is extemely low risk in terms of HIV transmission, and we do not generally recommend PEP for people who perform oral sex on someone else, unless in very specific situations - for instance the person giving head has bleeding gums, recent dental work or open sores in the mouth. Receiving oral sex (i.e. having someone blow you) is an even lower risk activity.
I started using meth a few years ago. At first, I was only using it about once a month when I would go out to party and hook up. Now I use it daily and can't hook up without it. My friends have no idea how much I'm using. The nicotine patch was a lifesaver when I quit smoking cigarettes. Are there any medications I can take that might help me stop meth?

Although many have been studied, at this time no medications have been approved by the FDA for treating methamphetamine addiction. There is ongoing research into the pharmacologic treatment of methamphetamine addiction, and so there is hope that a medication that helps with meth use will be found. In a small study looking at a medication called mirtazapine, men who have sex with men actively using meth who were in the counseling plus mirtazapine group had fewer positive urine tests for meth than those in the counseling-only arm.

Check out Tweaker.org for more information on methamphetamine and sex or call The Stonewall Project at 415.487.3100.

I am a gay man and just got diagnosed with anal warts. They were treated with liquid nitrogen and went away. Is it possible that they will recur? Is there anything I can do to prevent a recurrence? Is it possible for me to spread HPV to my partner even if all the warts are gone?

Anal warts, which are caused by HPV, can be removed by a doctor or with treatments applied at home. Depending on which treatment is used, there is a 10-30% chance of the warts coming back. Some people have only one outbreak of warts, others have recurrences over time.

Genital warts are most likely to be transmitted to your sex partners when the warts are actually present but sometimes warts are too small to easily see. Very little is known about passing HPV to sex partners if the virus is present but no warts can be seen. It is possible that your partner has already been exposed to this strain of HPV but didn't get any warts.

There is no way to know for sure though because there are currently no HPV tests for men. There is an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine. If you or your boyfriend have not already been vaccinated, you should talk to your providers about getting vaccinated.

I've been with my boyfriend for about 3 months. I've always had normal pap smears, but I just had a check-up and found that that my pap smear was abnormal, and the HPV test came back positive. Did I get it from my new boyfriend? Is there a way he can get tested to find out if he has it?
While most HPV infections clear on their own, some HPV infections can live in the body for a long time, and often do not cause any symptoms. It is very possible for someone to have HPV for years (10, 20, even more) and never know it, and so you may have gotten HPV from a past sexual partner. HPV is extremely common, and most people who have been with two or more sexual partners in a lifetime have been exposed to the virus. Currently there are no HPV tests for men, and so there is no way to know if your boyfriend has it. There is an excellent vaccine that protects against 9 of the most common strains of HPV -including 4 high-risk strains and 5 strains that can cause warts. Its recommended that all men and women <26 receive this vaccine, and its approved by the FDA up to age 45. If you or your boyfriend have not already been vaccinated, you should talk to your providers about getting vaccinated.
A guy who I hooked up with about a month ago just texted me and told me that he just found out he has Hepatitis C. I'm on PrEP and I topped and bottomed with him without a condom. We snorted some meth together before we hooked up but there were no needles involved. He said I should get tested for Hep C. Should I be worried? I thought Hep C was something that people who inject drugs get?
The majority of hepatitis C infections result from people sharing needles or other equipment used to inject drugs. However, some people do become infected with hep C through anal sex. This risk increases for people who have an STI and are exposed to hep C. Sharing equipment used to snort drugs can also pose a risk for hep C. For people on PrEP we recommend testing for hepatitis C once a year. It sounds like you are potentially at risk for hepatitis C and that you should get tested. If you do have Hep C, there are great treatments that can cure Hepatitis C in 8-12 weeks.
My BF and I recently got back together after a breakup. We had unprotected sex and oral sex. A few days after we had sex, I began to have STI symptoms, including lots of discharge from my penis. I went to an STI clinic and was told on the spot I was infected with gonorrhea and was treated with a shot and a pill. I confronted my BF and he confessed to kissing someone else. I don't want to sound naïve, but I believe him or at least I want to for the sake of our relationship. My question for you is: Could he have gotten gonorrhea in his throat from kissing someone, and then a few days later, passed it on to me when he gave me a blow job?
Although there are some data that its possible to get gonorrhea in the throat from deep kissing, this is not the easiest or most common way to get gonorrhea in the throat. Usually people get gonorrhea in the throat from giving a blow job (i.e. performing oral sex on a penis) to a person who has gonorrhea in their penis.  You could have gotten gonorrhea in your penis either by getting a blow job from him (if he had gonorrhea in his throat) OR from topping him without a condom (if he had gonorrhea in his butt).  Gonorrhea in the throat and butt are almost always asymptomatic, so your partner probably didn't know he had it, and it’s possible he had it for a while. That's why it’s so important to make sure you are getting checked for STIs in the throat and butt, not just with a urine (pee) test.  Gonorrhea is completely curable. Glad you took care of yourself by getting tested and treated. People with gonorrhea should make sure recent partners get treated and try to get a repeat check-up 3 months after diagnosis.  In addition, sexually active gay men should be screened for STIs and HIV every 3 months.
During penile-vaginal intercourse using a condom, does the man have to hold the condom in place over the penis during thrusting or is it the case that once the condom is on, the male is free to use his hands elsewhere or do other things until he is ready to withdraw?
Generally speaking, if the condom is placed on the penis, and inserted into the vagina, it will stay in place as long as the penis is erect, leaving the hands free to move on to other things. On some occasions if air was not removed before putting on the condom or the condom was not rolled down the entire length of the penis, it could roll and slip off. Another situation where it might come off is with too much lubricant being used or after ejaculation when he is losing his erection. It's recommended to hold the condom at the base of the penis when pulling out of the vagina while the penis is still hard so that the condom doesn't come off.