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Safe ***/HIV positive discussion


Submitted by t3ddy Location: All India (All India, India)

Like to share any safe *** tips ?

wanna discuss about your recent unsafe encounter??

Any thing related to HIV /STDs

Are you positive already wanna share any good or bad experience .. Stigmas people have.?

Can you have *** with a poz person?

Reply/Post a comment


Displaying 151 to 198 of 198 comments.
Previous comments: 1  2  3  4  

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DrGoogle
Posted On Feb 2, 2022 - 05:00 AM

Prevention, Early Detection , Mitigation of Sexually Transmitted Infections ( STIs)

Structure of this write up 
1. What constitutes High Risk Behaviour ? 
2. What are common STIs  ? 
3.  What are the various Preventive methods available ( ABCDE...)  ? 
4. What to do if STIs suspected /occurs ?
5. What tests to do , how frequent ?
6. Reliable , Authoritative online resources 


1. What constitutes High Risk Behaviour ? 
Low risk *** 
1. Abstinence ( no *** - zero risk ) 
2. Self *** ( masturbation)
3. Non penetrative *** ( Body ***, mutual masturbation ) 
4. Oral *** ( with condom)
5. Oral *** without condom/condom slippage/tear , swallowing , rimming
6.Penetrative *** with consistent , correct condom use


High risk *** ( with gradually increasing risk ) 
1. Penetrative *** without condom ( insertive role / i.e. being Top ) 
2. Penetraive *** without condom  ( receptive role / being bottom ) 
3. Penetrative *** without condom involving multiple partners ( orgies , group *** )
4. Penetrative *** without condom , under influence of alcohol / drugs
5. Penetrative *** without condoms with  instrumentation ( toys ) / truama ( fisting ) / violence 
6. Penetrative *** without condoms in presence of active untreated STIs ( visible lesions on *** / rectum / ***/skin ) 
7. Penetrative *** with condom but with Commercial *** Workers ( CSWs ) 
8. Penetrative *** without condom with Commercial *** Workers ( CSWs) 
9. Penetrative *** with or without condom with Person living with HIV/AIDS who is not on treatment

Incidence of HIV ( and other STIs ) are very high in CSWs . Prevalence of HIV is almost 30 % in CSWs in cities like Mumbai , Chennai.  1 out of every 3rd CSW is likely to have HIV and other STIs.

High risk *** consists when one( or both )  of the either / other partners has history of  either one or more of following 

multiple partners , active untreated STIs , *** abuse , engagement in commercial *** , use of violence , HIV infection .

Many of the risk factors can't be truly verified as other partner may not reveal personal history. Hence when in doubt assume worst ( Err on side of caution).  Risk factors add up.

Casual *** i.e. *** with unknown partner also carries similar high risk feature as partner history can't be reliable. 

Risk to receptive partner ( bottom ) is several times higher than insertive ( Top ) partner(s).


2. What are common STIs ?
Bacterial - Gonorrhoea ( Gonococcus ) , Syphilis  ( Treponema pallidum ) , Chancroid ( Hemophilus ducrei )  , Chlamydia ( Chlamydia trachomatis) 

Viral - Herpes ( HSV2 , HSV1 ) ,  Kaposi's sarcoma virus 
warts , skin cancers ( Human Pappiloma Viruses ) , Hepatitis viruses  ( Hepatitis A, Hepatitis B , Hepatitis C , Hepatitis D , Hepetitis E  ) . Of these Hepatitis B is most important. 

HIV -AIDS ( HIV 1 , HIV 2 ) 


3. What are Preventive measures available ? 
A. Abstinence 
Complete Abstinence ( Avoid *** when possible )
Near complete Abstinence ( self *** , masturbation )
Partial abstinence ( non penetrative *** )

B. Be faithful , Behaviour modification
*** with ( mutually faithful ) single partner ( Long Term Relationship ) 

Minimise number of *** partners ( lower the number , lower the risk and vice a versa. Number of partners can vary 0 to several thousand over lifetime)

C. Condom - Consistent , correct use. 
Circumcision - reduces risk of HIV
( self explanatory )


D. Drugs 
Vaccinations , PreP , PEP 

Hepatitis B vaccination - as explained in previous separate post in detail. 

Human Papilloma Virus ( HPV ) vaccine - Prevents *** , penile , oral , throat warts and *** cancer , penile cancer , cervical cancer.
HPV can be transmitted from skin not covered by cobdom. 
Vaccine indicated at adolescent stage but can be taken upto age of 45 years. 
Also 3 dose vaccine schedule. 


PreP - Pre Exposure Prophylaxis for HIV. 
Indicated for couples where one partner is HIV positive ( There are couples like that who decide to keep relationship even when one partner has HIV ) 
Or those with Very high risk life style.

Need to take HIV medication for prevention ( by uninfected , HIV negative person ) on long term basis. Needs regular follow up , testing. Cost of drugs and monitoring, adverse effects of long term medication need to be understood 

PreP is not indicated or feasible for everyone. Evidence is limited to specific setting ! 
Focus on condoms rather than PreP and other measures. Discuss with experienced physician.


PEP - Post Exposure Prophylaxis 
 HIV medications course for 28 days after suspected exposure or *** with HIV infected individual 

2 or 3 HIV drugs given.
Efficacy in prevention of HIV above 90%

Must be taken as soon as possible after exposure . Best to start within 48 hours . Efficacy drops after 72 hours delay but still advisable after 72 hours ( of said exposure event / unsafe  high risk *** ) 

Should be offered to anyone presenting with Acute STIs e.g. Gonorrhoea , Chancroid  ( Discuss PEP with your doctor if you have been detected to have acute STI like Gonorrhoea , Chancroid ) 

Need for repeated PEP is a trigger to discuss , consider PreP ! 

E. Early treatment of STIs
STIs increase risk of HIV transmission / acquision. Early recognition and treatment reduces complications as well as 
Suspect  if penile , rectal , oral lesion related to recent sexual act. 

4. What to do if STIs suspected /occurs ?
See Skin specialist / Infectious Diseases Specialist / Urologist / Internal Medicine specialist. This is the best recourse. Experienced physician will know what questions to ask , what tests to do and next plan of action besides reassuring you.

Avoid ***  during active STIs.
Start treatment as soon as possible.
Inform all of your recent partners so they can test and treat. 


5. What tests to do , how frequent ?

When to Test
A. Baseline 
1. Premarital 
2. Preconception ( planning pregnancy , child )
3. Pre employment , travel 

B. Periodic
1. Annual testing - once a year 
2. Event driven - after specific suspected high risk encounter or STI fear /symptoms 

More frequent testing for specific individuals with Very High Risk behaviour. 

Where to test ?
Visit STI clinic , Skin clinic at Public Hospital
Or visit experienced Skin specialist , Infectious Diseases Specialist
Teleconsultation may help if you feel shy. 

How to test ?
A. Guided by Doctor
B. Self testing 

What to test ?
Tests - Individual tests or  STI panel 

Individual tests for onsly specific STI
E.g. VDRL for Syphilis 


STI panel 
Blood - tests for antibodies against HIV ( 1,2) , Syphilis , Hepatitis B , Hepatitis C , Chalmydia , Herpes 
Swab from lesion - for PCR or culture for Gonorrhoea , Chancroid , Syphilis 

Self testing
Self testing possible for HIV. Urine pregnancy like kits using saliva , urine , blood available ( if positive , needs confirmation ). 

Additional tests
*** pap smear for those with *** warts or with persistent *** complains
 ( risk of *** cancer ) 

Who should know your test result ?
Yourself , your doctor , your partner 

How to recognise STIs ?
Unusual urethral , penile , rectal , oral , vaginal lesion , pain , discharge in sexually active individuals

Syphilis 
Primary syphilis - painless swelling 
Secondary syphilis - either one of following skin rashes ,  *** wart like lesions , *** ulcers

Treatment - Inj penicillin or Tab Doxycyline 100 mgbBD x14 days 
Followed by treatment for Latent syphilis 

Gonorrhoea - intense urethral pain with milky white penile discharge
Inj Ceftriaxone 250 mg or Tab Azithromycin 1 gram ( single dose ) 

Chancroid - painful ulcer over *** , rectum . Swelling in groins

Herpes - painful blisters ( fluid filled lesions ) 
Acyclovir 

HIV 
Acute HIV - may resemble any viral infection
Chronic HIV - weight loss , recurrent infections , chronic diarrhoea 

Lifelong Anti HIV medications - available free at ART centre under National programme.


6. Reliable , Authoritative Online Resource

There are many . But to keep things simple and uncluttered I suggest only followimg CDC site

Since CDC is a US agency . Local Data , socio cultural context has to be understood while reading their resources.

https://www.cdc.gov/std/default.htm

This is very well explained exhaustive resource. CDC uses very plain english for lay people. 


All STIs are preventible , treatable. Most are easily curable.
HIV is treatable , Free treatment is available and theoretically curable ( cure attained in few patients though current strategy not practicable ).


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DrGoogle
Posted On Feb 2, 2022 - 06:30 AM

Correction
The highest incidence of HIV in Commercial *** Workers ( CSWs) in Mumbai was 13% and not 30 % as written in post above.

These numbers are estimates and not absolute and likely underestimated. However the fact that incidence of HIV is very high in CSWs doesn't change irresoective of figues like 13% or 30%.

*** with or without condom with Commercial *** Workers therefore constitutes as a High Risk Behaviour.

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SPARSH1999VERS
Posted On Feb 2, 2022 - 01:58 PM

1.) WHERE TEENAGERS SHOULD DO HIV , HEP - B&C TEST?
2.) DO THESE LABORATORIES KEEP RESULT DISCREET?
3.) DO THEY ASK IDs?

3.) WHERE WE GET HEP - B&C VACCINES? (IN NAVI MUMBAI)
4.) HOW MUCH DOES IT COST ?







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DrGoogle
Posted On Feb 2, 2022 - 04:03 PM

Thanks for very important and practical questions

1. HIV test is best done at Voluntary Testing Councelling Cente ( VCTC) / Integrated Counselling Testing Centre ( ICTC ) at numerous public hospitals / district hospitals.
These tests are free.
Tests are reliable as routine Quality Control is done.
HIV test are done using 3 different methodologies ( Only if all 3 are positive then it is reported as positive ).
This may not be done in private where only 1 test is done.

Most importantly Pre Test and Post Test counselling is done.

2. Tests are anonymous and absolutely confidential.
3. No ID , adress proof is sought.
Test report doesn't have name of the person.
Even teenage can go for testing.

Counsellors are social workers , well trained in counselling. They understand importance of secrecy , confidentiality.

In unfortunate circumstances of test coming positive , counselors provide important link for further care , support and refer accordingly.

Some ICTC also do concomitany Hepatitis B ( HbsAg) , Hepatitis C ( Anti HCV antibody ) tests but this depends on availability of kits.
If not done , you can do these tests in any private laboratory. Most labs don't ask for doctor's referral letter.

ICTC centres available at Terna Medical college as well as Airoli , Nerul , Turbhe as per MSACS site ..
http://www.mahasacs.org/ictccentre.htm


4. You can get Hepatitis B vaccine at any pharmacy.
Price ranges from 90 rs to 300 rs per dose ( 1 ml / 20 ug of antigen ) based on company.
Purchase vaccine just before injection.
Any private GP can administer it for some charge or you can see if nurse in public hospital can administer it for you. Doctor will not ask why you are getting this vaccine. This vaccine is recommended for everyone and is part of National Immunisation Programme.

There is no vaccine for Hepatitis C.

There is vaccine for Hepatitis A but most of us in India get natural infection early on and usually Hepatitis A is mild and recovers naturally.

HPV vaccine ( Gardasil ) costs about 2500 -3000 rupees per dose ( No generic available ). These vaccines provide life long protection. Cost is not much keeping this in mind.


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SPARSH1999VERS
Posted On Feb 2, 2022 - 04:32 PM

Any suggestions on oral fun.... ? Like what measures to be taken while having oral fun. Can exchange of saliva cause any problem? Or if you ejected Spe*m in someone *** / vice versa?

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DrGoogle
Posted On Feb 2, 2022 - 04:40 PM

1. Preferable to use flavored condoms for oral *** ( risk of HIV transmission is very low but not zero. There are other infections that can be transmitted via oral ***. Like Human Pailloma Virus which can cause warts in throat , wind pipe. Also syphilis , gonorrhoea etc can be trandmitted

2. Better to avoid ejaculation in ***. Swallowing not advisable due to risk of infections. Spit out immediately and gargle.

3. Exchange of Saliva is less risky. Can be done with regular stable partner with whom you are in mutually faithful relationship.
Saliva transmits infections like CMV , EBV which by the way most of get by first or second decade of life. These viruses only cause asymptomatic life long infection in 90-95% of population. They became significant only under special circumstances ( HIV infection , transplantation etc )
Salivary transmission of HIV is extremly extremly rare but reported.

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ram2001
Posted On Feb 2, 2022 - 05:33 PM

As per my knowledge HPV vaccine not for male the vaccince cost 3500 is only for girl's for cirvical cancer. 1 godzilla vaccine rs 10000 is introduced in india but it efficacy not tested in india. All doctors not prescribinng it for males.

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DrGoogle
Posted On Feb 2, 2022 - 05:47 PM

HPV vaccine is also indicated for men.
Of course it's primary approval was for prevention of cervical cancer in women.

HPV can cause ugly looking warts over *** , anus , *** , pharynx.
It can also cause penile , *** , oropharyngeal cancer in men.

It can and should be administered to men.

Please see this CDC link for details


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ram2001
Posted On Feb 2, 2022 - 07:02 PM

I know but in india icmr and medical bodies not yet aporoved HPV vaccine use on male. I personally go to various hospitals and vacvination centre but they dont allow me. Hrnce morw clarity and confirmation needed

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ram2001
Posted On Feb 2, 2022 - 07:04 PM

Please give suggestions in india context and ground realities

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gaylove2013
Posted On Feb 2, 2022 - 07:25 PM

latest HPV vaccine (Gardasil9) is recommended for men ,the cost is high about 10.8k,launched recently in India

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DrGoogle
Posted On Feb 2, 2022 - 08:15 PM

Gardasil 9 ( covers 9 most important HPV strains ) is just an extended version of Gardasil ( covers 4 most important strains ) which itself was an extended version of Cervarix ( covers 2 most important HPV strains).
Gardasil 9 is thus not a new vaccine. Just extended version of Gardasil.

( Same was done with Pneumococcal vaccine Prevenar 7 was followed by Prevenar 13 )

Of course Gardasil 9 is better
But if not affordable or available Gardasil can also be taken.
Some physicians are refusing to administer Gardasil to men by playing by the rule that in India it was not approved explicitly for men. But ample of data exists for safety and efficacy from US.

I personally would have no reservation to prescribe even Gardasil to men given the data and efficacy.

To reduce the cost even 2 dose ( instead of 3 dose schedule ) is acceotable.


Just find a friendly understanding physician and get vaccinated.


Gardasil 9 has been around in US since 2014. Since then it has been approved in more than 80 countries.
In India also it recieved approval in 2018. Launched just few months back. Indian regulatory authorities are unlikely to approve vaccine in India without local data.

Vaccines are generally safe.


Any allergic response is contraindication ; subsequent doses must be avoided.

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Nu-Man
Posted On Feb 3, 2022 - 09:10 AM

Is syphillis treatable.
Can we have *** with someone who has been treated for syphillis or does it reside in the body always.

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DrGoogle
Posted On Feb 3, 2022 - 09:46 AM

Syphilis is easily treatable and curable !
However Syphilis test TPHA may remain positive for very long time. VDRL may also remain positive for long time after completing full course of Syphilis treatment but usually shows significant decrease in titre of antibodies.
After treatment of Syphilis ( Primary , Secondary Syphilis ) ( 14 day course with Crystalline Penicillin or Tab Doxycycline 100 mg twice daily x 14 days ) however some trepnoma may still survive in body giving rise to what we call Latent Syphilis. This can later on cause Tertiary , Quaternary syphilis affecting heart and brain respectively.


Person who has completed full 14 days course of Primary , Secondary Syphilis but has not recieved treatment for Latent Syphilis may still be able to pass infection to his partner. Hence treatment for Latent Syphilis is strongly recommended.

Since TPHA may remain positive for life long and latent syphilis can reactivate - future repeat testing may be required to see the evolution.

Partner also must be tested and if positive should be treated.

Syphilis reinfection can occur ( prior infection doesn't provide immunity . Reinfection is difficult to diagnose as previous infection modifies clinical presentation second time and high degree of suspicion is required in treating physician or else Syphilis reinfection can be easily missed.

Due to persistent TPHA positivity diagnosis of syphilis reinfection is challenging.


Syphilis is a highly communicable infectionand hence Syphilis infection as well as reinfection is not uncommon among Commercial *** Workers as well as MSM ( Men Having *** with Men - gay , bisexual ).

Since Syphilis serology , treatment is complex , so consultation with experienced physician like Skin Specialist or Infectious Diseases Specialist is required.

For Syphilis treatment , management , counselling do not go to any other doctor besides Skin Specialist in public hospital or Infectious Diseases specialist.

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chap123
Posted On Feb 3, 2022 - 05:14 PM

So I tried penetrative *** 3 times. It was not even complete ***, it was more like just inserting and removing immediately. I did have oral *** with some people I met on apps. They are very discreet people, so I am pretty sure they are safe. Am I still safe from hiv?

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ram2001
Posted On Feb 3, 2022 - 05:51 PM

Any form of *** is unsafe in present context as we dont know std status of others either all partners tested before *** or intercourse or monthly std test needed as such things cant predicted now

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ram2001
Posted On Feb 3, 2022 - 05:57 PM

For syphlis monitoring VDRL RPR is better as compared to VDRL as it gives quantitative ups and down of titer of syphlis antibody for better management and long term monitoring. Syphlis total anty body TPAB is also good option as compared to TPHA.

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DrGoogle
Posted On Feb 3, 2022 - 06:10 PM

@ram2001

Agree totally
Decent looking or discreet looking is hardly any way related to safety from STDs.


Casual *** carries perhaps same risk as having *** with Commercial *** Workers ( who tend to have very high risk of STIs due to nature of profession and sheer number of clients they are exposed to )

Best option is to enter in long term mutually faithful relationship and /or always practise safe *** .

While most STIs are treatable and curable , HIV still carries enormous stigma despite being a Chronic manageable illness.

Prevention is better than treatment.

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DrGoogle
Posted On Feb 3, 2022 - 06:35 PM

As far as Syphilis serology is concerned.

There are lot of variations from lab to lab , physician to physician in what tests are done and how they are done.

Let me share a case of one of the member from Ohmojo as an example.

Clinical diagnosis of Syphilis was confirmed with VDRL and TPHA. 14 day doxycycline course was given about 1 year back.


No baseline VDRL titre was available as only qualitative VDRL was done.
No latent syphilis treatment was advised.
No follow up and repeat VDRL titres have been done for 1 year since treatment.

If VDRL titre doesn't come down within 1 year . Reassessment and even Cerebrospinal Fluid exam may be required to rule out Neurological involvement based on clinical condition and serology reports.

Syphilis is an old disease and General Physicians ( MBBS doctors ) hardly see it or know how to manage it.
Even in any academic centre most cases directly go to Skin department. Other departments seldom see or manage Syphilis cases.

For serology since VDRL is cheap and wideky available . It is always done. But VDRL is non specific , false positive tests are not uncommon.
Hence second test like TPHA or TPAB are mandatory but availability is variable from place to place. So often for diagnosis purpose TPHA is done.

For follow up purpose titres are helpful. 4 fold decrease in titre confirms successful treatment.
Rise in titre after intial fall may mean reactivation or reinfection.
Failure of titre to decrease may mean treatment failure or seroresistance.

All these need clinical expertise.

Best is that one follows up with experienced skin specialist or Infectious Diseases specialist.
Other doctors who are not used to manage Syphilis may leave patient after primary course without necessary tests , follow up , counselling . Which may result in possible complications.

Fortunately Internet resources in today's era enable patients to educate themselves.

That is 'Democritisation' of Medicine ...thanks to Internet.

But please use information from Google responsibly.

Information and knowledge and Wisdom are not the same things !

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Raajiv
Posted On Feb 4, 2022 - 08:37 AM

@drGoogle..
Thanks for insight.. you r doing really a great job..

Can u please let me know wat all tests required for STI..
I heard STI panel is there.. will it detect all types of STI or any other tests also required..

STI panel is very expensive.. any alternative or do u suggest some specific tests for a sexually active person..

Also whether they are done on doctor's advice only or labs do them.. are they discreet..

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DrGoogle
Posted On Feb 4, 2022 - 09:13 AM

You don't need STI panel every time !

You need to do screen for HIV and Syphilis because they can be asymptomatic for severa yea
Annual screening must.
More frequent testing may be done based on your sexual life intensity and your own threshold.

Other STI tests can be done if and when required. I.e. you have actual suspicion , sympyoms.

STI panel is required when you have penile , rectal lesion like painful ulcer . Differentiating individual STis are not easy. Under such circunstances STI panel saves time and efforts.
So STI panel should be done only if you have penile , scrotal , vaginal , rectal lesion suspicious of STIs.
Routine STI panel testing is not recommended. It is waste of money.

If you have heoatitis b vacccination then reoeated tesing for Hepatitis b is not required.
Many labs offer screeing tests without referral from doctor. Discretion is maintained and rather it is obligatory and legally punishable if not maintained.

But having a physician to guide specific testing and assure you is better than self testing.




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ram2001
Posted On Feb 4, 2022 - 05:59 PM

STI panel is good as orher std such as HPV herpes gonorrhea also asyptomatic. So it is better to do all std tests along with HIV every year. They are now quite cheaper in gay friendly labs.

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Raon3
Posted On Feb 4, 2022 - 06:03 PM

Can u advise if taking massage with happy ending has any STD risk?

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ram2001
Posted On Feb 4, 2022 - 06:10 PM

I think STD risk is always there in massage as it is skin to skin contact . Kissing ; body play hand job oral *** everything individually or combination is always high risk.it is better to be tested as no other choices to avoid asymptomatic infections.

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Agatsya
Posted On Feb 4, 2022 - 06:23 PM

Getting tested for STI screening just costs 500 INR on healthians app. Check it out. Free home collection and report delivered to your email the next day.

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DrGoogle
Posted On Feb 4, 2022 - 06:29 PM

Frankly speaking most of the tests in STI panel are pretty useless. They are added just to increase the cost.

For example HSV 1 , 2 IgG tells you past infections. It doesn't change management substantially once it comes positive.
Same is true about Hepatitis A . Many of us are exposed , naturally infected . Positive IgG doesn't help us.
Similarly you don't need hepatitis b testing if you are vaccinated ( which everyone from LGBTQIA community ought to )
Hepatitis C sexual transmission is pretty rare.
It is important for those who are into IV *** abuse.
But since it can cause cjronic infection which is now curable. I have no objection eventhough the risk is low for sexual transmission.

Most STI panels in India don't include HPV and given the hundreds of strains antibody tests are useless.

STI panels based on PCR are better but again they are better utilised in diagnosis rather than routine screeing.

Doing STI panel annually is a waste of money and resources. But if you don't mind the cost then it is alright.

HIV , Syphilis and in additional risk factors then HCV are optimal for annual screening.

Better to vaccinate for Hepatitis B and HPV to protect as both are highly transmissible and can cause cancers. If vaccinated annual screening for these two are redundant.





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DrGoogle
Posted On Feb 4, 2022 - 06:35 PM

Massage with happy ending ( handjob ) has main risk factor for HPV transmission. Very low risk for HIV

If blowjob is included in so called happy ending then risk for Gonorrhoea , Syphilis atc are there . Risk for HIV is still low.

But how many times do the massage with happy endings do / don't involve penetrative ***.

Ultimately everyone need to risk stratify themselves.

Good practical rule is ' Err on side of precaution '

Early diagnosis of asymptomatic infections play very important role in breaking chain of transmission in community.

It is also known that periodical regular testing does make one conscious of risk and it may have restraining effect on high risk behaviour.
From that perspective I do support periodical testing

However one has to have some balance. Testing yoursekf every month or 3 months can also take toll on your mind ( even if one doesn't mind toll on pocket .

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DrGoogle
Posted On Feb 4, 2022 - 06:55 PM

Correction
Massage with happy ending ( handjob ) will be risk factor for HSV , HBV , HPV as well as Syphilis and Gonorrhoea though risk is lower.
Most of these organisms with the exception of HPV need atleast microabrasions on skin to penetrate and cause infections.

*** *** ( without condom ) carries significantly higher risk because *** mucosa is thin and liable to rupture. Hence risk to reciever ( bottom ) is much higher.

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DrGoogle
Posted On Feb 4, 2022 - 07:30 PM

There are hundreds of possible tests.

They are not advisable as they are not consequential.

Even CMV , EBV , HHV 6 , HHV 7 , HHV8 , JC virus , BK virus , HTLV 1 , HTLV 2 etc are also sexually transmissible.

They cause life long asymptomatic infections which are not important for general population We don't test for them routinely. We do test many of these viruses before organ , bone marrow transplant ( setting in which they become very important ) .

Similarly HSV1 and HSV 2 antibody test doesn't help as by 20s almost 40 -50 % have already got exposed. Positive or negative test for these 2 doesn't help .

Some tests are left best for physician to decide based on clinical context.

Labs like to creat panel tests by adding unnecessary tests to extort extra money from patients. Patients feel better that they had 7 or 10 tests in one panel.

But the fact that some of these tests are inconsequential are often not known to patients ( a fact that laboratories exploit ! ) .

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Namasthe
Posted On Feb 5, 2022 - 02:49 AM

As a PRACTICING DOCTOR I really wanted to give my insight and knowledge here. I may have come across some 500 HIV positive patients already. The fact that hiv spreads through saliva is bullshit.

As a doc, no one gives u 100% assurity on any test not ***. I have not heard hiv transmitting through smooches at all. It is possible theoretically if there is sores with active bleeding, but that's theory.

There was a study that showed of 30000 times a bj with a positive patient, only two turned positive, in another study it showed with some 50k times not even a single person turned positive. You can assess the risk. Hypothetically to answer the reason they said maybe bleeding causes hiv transmission.

Of all the patients I saw who turned positive, they never used condoms. None. When I studied in mbbs it said the risk of sexual exposure to hiv is 2% compared to blood transfusion of around 95%. That 2% is because of microbleeding during intercourse. If the person is positive and too slim, it indicates the chances of transmission of virus is high since the person is at an advanced stage of HIV.

Hepatitis B is one that has high transmission rate. But a two dose vaccine is a cure.Of some 100 hepatitis b positive patients I came across, none were vaccinated and of course none used condoms.

Hepatitis c, extremely rarely is an std, and it is said without blood it can't be transmitted.

These are the dangerous STDs

Syphilis is one relatively dangerous but one shot of penicillin cures you permanently. I have seen some 10 cases. But of course all involved vaginal *** without condoms. Theoretically syphilis can cause oral ***, but I guess it's very uncommon. I had come across a women who had developed genital syphilis, but didn't have any oral manifestation even though she had given a bj. If u don't take *** in ur ***, ur practically safe for syphilis. And of course none had any oral manifestation of syphilis.

The other ones like gonorrhea, warts, herpes causes symptoms in ur genitals like pain, lesions, discharge, but they do not transmit if there is no external manifestation.

STDs are used to potentially scare the entire population here. Yes some are serious, but if u r using a condom and having *** with decent, educated, aware men who use condoms and practice safe ***, be assured you are healthy.

India has higher percentage of HIV that is 1-1.5% of population compared to UK 0.2% , even though the entire population of UK is highly sexually active than India where the majority of the population is conservative. It is because the percentage of population which is sexually active doesn't have knowledge of safe sexual practices nor use condoms.

If u r gonna have ***, practice safe *** measures . But dont have this anxiety and loose ur moment.

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DrGoogle
Posted On Feb 5, 2022 - 05:46 AM

@ DrNamasthe

Thanks for sharing your thoughts and continuing discussion on this very important topic.

While I agree with some of your points , some other points that you have raised are factually inaccurate and misleading.

I will counter them with published hard data from reliable authorities and I am providing links for same. You and anyone else can go through said links.

1. HIV transmission through saliva is bullshit.
Indeed HIV transmission through saliva is extremly rare. Few reported instance are questionable.
But look at subsequent points below.
Other STIs can be transmitted trough unprotected oral *** and hence bottomline and Expert advise that Condoms should be used for even oral *** remains unchanged.

2. Hepatitis B vaccine two dose are cure .

This statement is misleading . Vaccine prevents infection and doesn't cure.
Once chronic infection is established Hepatitis B infection is extremly hard to cure.

3. Theoretically Syphilis can be caused by Oral *** but I think it is very uncommon.

On the contrary oral *** is a significant and common mode of Syphilis transmission as per this CDC study.
This is specifically refers to MSM ( Men having *** with Men i.e. Gays and Bisexuals )

https://pubmed.ncbi.nlm.nih.gov/15496825/


4. Syphilis is one dangerous but one shot of penicillin cures you permanently.

Single dose of Benzathine penicilline ( because it is long acting ) treats Early syphilis.

....But treatment for Latent syphilis with 3 doses of long acting penicillin weekle for 3 weeks is recommended.

Cure is not permanent ! As relapse can occur.
Also it doesn't prevent future infection.

https://www.cdc.gov/std/syphilis/treatment.htm

5. Other ones like gonorrhoea , warts ....but they don't transmit if no external manifestations.

Asymptomatic infections are far common.
You don't need external maifestations. And lesions deep within rectum and *** are not visible even if present.

Because vast proportion of STI are asymptomatic that is why it is called as Hidden Epidemic.

https://pubmed.ncbi.nlm.nih.gov/12649059/


6. STIs are used potentially to scare population here ...


This statement of your is absoluteky regrettable both as a member of community as well as a doctor.

Your statement implies some sort of conspiracy to scare LGBT.

Despite advances in diagnostics , screening awareness , intense risk communication management there is rising incidence of HIV and other STIs in MSM ( Gay , Bisexual men )

This is not a conspiracy but a hard data.
This is in contrast to sharp decline in incidence of HIV in heterosexual population.


https://journals.lww.com/aidsonline/fulltext/2013/11130/the_increase_in_global_hiv_epidemics_in_msm.1.aspx#:~:text=New%20HIV%20infections%20among%20young,HIV-positive%20by%20age%2040.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4696713/


Recently HIV incidence in MSM community has started declining thanks to continued preventive measures.

7. Your statement that HIV prevalence in India is 1-2% is factually wrong
Estimated prevalence is actually 0.2 % !

National adult (15–49 years) HIV prevalence was estimated at 0.22% (0.17%–0.29%) in 2020

Check NACO site

The HIV prevalence in UK is 0.17%

8. Your statement that risk of HIV transmission is 2% is without context.
2% for vaginal *** but 20% for *** *** but only in setting of acute HIV infection ( which lasts for only few weeks )

For chronic HIV infection , risk of sexual ttansmission ( vaginal ) is 0.07 % but for *** *** may be 1.4 % .

I think while qupting numbers you have to contexualise them . Lay people will be left confused by random numbers with context and nunances.

Risk of HIV ttansmission is variable but much higher for *** *** that is the bottom line.



Last but not the least I will say it categoerically that unnecessary conspiratorial accusations are unwarranted.
Risk communication is a key principle in preventive educational efforts. Unless people understand their risk they may not be able to protect themselves adequately.

Lot of people will find resonance in your statement that there are efforts to 'scare' LGBT community. This is really unfortunate. This is because risk understanding creates anxiety. People prefer denial rather than facing the real risk.

Worldwide 40 million people are infected with HIV . About 500 million with Hepatitis B and 300 millions with Hepatitis C . These are real estimates. They are not propaganda numbers to scare citizens of this world ( whether heterosexual or homosexual )


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Namasthe
Posted On Feb 5, 2022 - 11:04 AM

@drgoogle it depends on ur perspective exactly I meant. Of all the points I meant I guess the only thing I was wrong is prevalence. I searched my book again. Yes it's 0.28% in India yet 0.17 in uk. But my point still remains valid.

You might publish theoretically every data from internet, but what I said was what I saw in my practice. I didn't say syphilis can't be transmitted through saliva, I meant that risk is far low. Because of all the cases I saw, none had oral lesions. Maybe yeah it's because I saw some 10 cases. Syphilis is always with symptoms. If u have discharge, lesions get tested early and get one dose of penicillin that will cure. Yes it doesn't prevent future infection, but it cures the early one u have. If latent then u require iv penicillin for 7-10 days. Trust me with advent of testing and pencillin, neither me nor any of my professor has ever saw latent syphilis like neuroinfection Or cvs.

What I meant is true regarding hepatitis b, yes if u get it's 5% chances you might have serious disease but if u take two doses vaccine before u got hep b, you will not catch it is what I meant. Of course there's no point taking vaccine after u r positive.

I wish ohmojo would allow me to put pics in replies but yeah, the 1-2% for sexual exposure is what a read in my microbiology text book and I said, it wasn't blatantly a random number I said. It is also mentioned the number 95% for blood transfusion. That's what my professor thought me and that's what I wrote in exam and answered in viva.

The rest of the disease is something that if the infection are asymptomatic then you don't have any issue here. Except for some disease which can lead to pid in women, but that's not significant here.

I really wanted to summarize the fact that ppl potentially scare with topic STDs and kinda destroy their moment. I read online that someone had *** with prostitute and kissed her, but the ones in online said " Although risk of transmission of hiv from saliva is rare, it's reported, hence I suggest you to get tested'. Man, do these ppl really think the actors who kiss on screen test everytime?
Once a patient visited to us saying he might have hiv. The reason is, he had white patch in his tongue and google said it can be AIDS. Anyway he got tested but all he had to do was floss his tongue for few days and it was gone.

I know that a lot of ppl get hiv, hepatitis. For the record it happens in my hospital all the time, at least one or two will be detected in every admission. I am not here saying hiv is insignificant, in fact I still see hiv related death almost every week, all I am saying is, if you are practising safe sexual practices, you don't have to worry. In fact if they had used condoms they would have never contacted hiv in first place.
It's traumatizing for someone to have *** and always thinking of whether I will catch hiv, even though he is practising safe *** practices during ***. Ideally to remain absolutely disease free would be to be in a monogamous relationship in love with someone. If that was the case, neither you, nor me nor anyone here would be here. Tbh I replied this comment because the intention of you was contradicting mine. I was once a scared guy reading online about the same, then I met my colleagues, got their point of view. I might have had met some 70-80 guys. I am a lil choosy. I have used condoms all the time, and the recent sexual panel was clean for me. So does the people I know of. Hence for whatever I said I stand for.

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Raajiv
Posted On Feb 5, 2022 - 11:24 AM

The last para of Dr namasthe nailed it .
Much relieved..

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ram2001
Posted On Feb 6, 2022 - 04:20 AM

As per dr google comment in india std treatment quite complex . Such as HIV meducines quite costly as free in govt hospitals but identity issue. In maharashtra bezamin peniciline available only on govt hospital even pvt hospitals not allowed to give benzamin peniciline shot in case syphlus infection. Medicinea are equally dangerous as peniciline may allergic or lufe threatening. Herpes treatment is alsp complex. HPV vaccines not recommended for males in india. Hence overall treatment is quite difficult as compred to infection.
Another issue faced with harassment as all doctors more interested in cause of infection and sexual orientation as compared to treatment itself. Hence confidentiality recognition safety of medicines are another big issue in std infection treatment create more stigma and social family isolation

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mohan14
Posted On Apr 1, 2022 - 02:28 AM

Syphilllis bacteria spreading in gay community is resistant to doxycycline as well. Be carefull I had personal experience.
Gays who are married to a girl are spreading hpv to their wives and causing cancer to them.
Before getting married once check for STD's
Don't spoil girls life and their family prestiage.

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Abhijit Mehra
Posted On Apr 1, 2022 - 05:05 AM

Mr. Ram2001 you are causing unnecesssary fear with yout comments.
1. HIV Treatment- I agree to what you say but now a days there is greater acceptance and if one is suffering from HIV they may get free medicines from Govt. hospital or buy....value of life is greater than the disease.
2. Coming to penicillin injection, they are available in pvt. hospitals also...its not restricted to govt. hospital...If one is allergic to penicillin there are other medicines to be given...one may be allergic to any medicine...its not a speacial case in terms of penicillin.
3. Herpes the disease is a viral and non curable, but its easily managable just like common cold. It hardly comes once a year after 1st year infection and there are oral medicines for that...
Looks like your are more interested to spread half baked information which is misleading...Id appreciate if you collect more information on these before posting

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mohan14
Posted On Apr 1, 2022 - 05:37 AM

If a bottom had active oral infection in his throat then the top is at higher risk to get it through blow job & later his wife can get it into her *** unknowingly

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ram2001
Posted On Apr 1, 2022 - 05:56 AM

For syphlis bezamine penciline injections allowed in govt hospitals only in maharashtra.

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Bottom1993
Posted On Apr 1, 2022 - 05:56 AM

I Am diagnosis with *** Warts HPC. Though it got treated with one cream but there are chances that it will come again

I am not 100% sure but I know I got from body massage. I was very frequent to different body massage parlour last year.

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Raajiv
Posted On Apr 1, 2022 - 01:16 PM

@bottom1993. How massage is reason for *** warts

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godfather
Posted On Apr 1, 2022 - 01:33 PM

anybody on prep any form like tenvir EM or Tavin EM . is it effective as prophylactic for HIV. if prep is used with condom chances of HIV and std goes down. anybody use PREP in this moment and how was your experience.

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ram2001
Posted On Apr 1, 2022 - 03:53 PM

PREP and condomes works only for HIV protection but other STD can be transfer by skin conracts even condome cant protect.

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mohan14
Posted On Apr 1, 2022 - 05:13 PM

Gay *** itself is so risky that highly *** resistant strains of bacteria & viruses prevailing among gay population world wide.
Syphilllis is good example.
Everyone involved in *** *** is having HPV strains
Some people says STD's are not so risky.
But gays who are married to a girl will suffer with mental trauma & don't know how to open up & get her treated.

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Jaytop
Posted On Apr 1, 2022 - 09:08 PM

Not GAY *** risky.... *** is risky. Get your facts straight.

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ThroatAssFuker
Posted On May 11, 2022 - 11:06 AM

I had some session with one bottom guy last night . He *** me , I staretd *** him with condome . after some time i observed the condome was broken I doesnt ***, and i stopped *** and cleaned with water and soap , applied some antifungal cream on dik. Now i am worrying about HIV . Can some one help me in this and suggest me what to do . Please inbox me

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TheSecretDoctor
Posted On May 11, 2022 - 12:03 PM

Hi,

HIV won't haunt you like this!! If you had *** unprotected with someone who is a HIV positive (probability is still kow). I have completed my project from ICMR 6 years back and what I got to infer is that people having regular unprotected *** with confirmed HIV patient are probable and definite to catch the infection!..

HIV unlikely to cause by throat! Cause the virus specially contracts the epithelia of your *** or *** after the *** fluid is released! Use a reliable protection! Be scared if corona and omicron now a days!! HIV is far away!

Be safe..*** safe!

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TheSecretDoctor
Posted On May 11, 2022 - 12:04 PM

You may contract STD curable like fungal infection, Chlamydia and some which will be there to stay with life long like HSV but the concentration will be less or high depending on your co morbidities! Better to be safe !

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Ramon123
Posted On May 11, 2022 - 12:33 PM

Is anyone in this thread actually HIV positive? How did you get it? When/How did you get tested? How are you dealing with it?

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