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.

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).

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.

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.

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 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.

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.

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.

I'm a gay guy and have been together with my boyfriend for over a year. We don’t use condoms. Recently I've become worried that he's having sex with other people. It has me wondering if I should ask him to start using condoms again? How can I do that without a fight?

You describe a difficult situation - that is, what to do when agreements about condom use and sex may feel broken. The best thing to do is to discuss the situation and acknowledge that you are concerned about your own health, as well as your partner's health. If you focus on the health aspects and not the relationship issues, you may be successful when bringing up the subject with him. It will be a tough discussion and you have to decide if your love is worth it.
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