Q: How are herpes and warts transmitted? What are the risks?

A: The risks are low, but both HPV (genital warts) and herpes are transmittable even without a visible outbreak. Some people carry and transmit the virus without any symptoms at all, although transmitting the virus is very much more likely during visible outbreaks.

Using a condom can help protect you from any outbreak on his penis or her vagina or his/her anus, but if the HPV or herpes outbreak area is elsewhere in the genital region (for instance, the base of the penis or the outer vaginal lips), you are not protected.

If you are a woman, you can augment your safe sex practices with the use of the female condom (the brand name is “Reality”), which covers more of your vulva region.

You can use condoms on penises, and you can also use latex sheets as a dental dam (a barrier for oral-vaginal or oral-anal sex), or the use of plastic wrap (like Glad Wrap) as a dental dam.

Using the latex sheets or plastic wrap can augment any condom use to cover more area from skin to skin contact, etc.

The two virus-based STDs that you mention are skin to skin transferred. That could mean genital as well as oral. As for risk percentages, any outbreak that is visible is the highest risk for Herpes. HPV can be transferred with OR without a wart outbreak.

Oral sex is possible if you use an oral dam (or plastic wrap) or a condom. I know it may not sound sexy, but it can be if you give it a try. Note that there are dry, flavored condom for oral sex, like the brand “Kiss of Mint”.

Q: Can you tell me about visible sores on genitalia or other body parts?

A: It’s tempting to ask us these sorts of medical questions, for many different reasons. Some doctors can be very judgmental about sexually transmitted diseases (STDs). Or, you might be too embarrassed to go to your family doctor about this sort of problem. And, some doctors just aren’t as knowledgeable as they could be about STDs.

Unfortunately, though, this isn’t something we can help you with directly. First, most of us aren’t doctors, and thus aren’t qualified to give medical advice. But more importantly, even if we were doctors, we wouldn’t be able to give you an accurate diagnosis over the phone or email or web site.

Often the best place for help is an STD or birth control clinic operated by your city or county’s Department of Public Health. Not only is the staff less likely to be judgmental about STDs, they are more likely to have experience treating a wide variety of STDs. You can call us for clinic referrals in the San Francisco Bay Area, or look in your phone book if you live outside our area.

For more information…

  • American Social Health Association (ASHA)
    Detailed information about STDs and a hotline. They can’t diagnose you over the phone, but they can give you information about STDs.

Q: What are AIDS and HIV?

A: Acquired Immune Deficiency Syndrome (AIDS) is an immune system disease caused by a virus called the Human Immunodeficiency Virus (HIV). The virus infects certain cells (called T-cells) in the immune system which help the body fight off infections.

When the immune system is sufficiently damaged, the body is unable to fight off even minor infections, and the infected person becomes sick and may eventually die from such infections.

People who have been infected with HIV are called “HIV-positive”, because antibodies to the HIV virus were detected in their blood.

How you become infected

HIV is spread through the exchange of body fluids. Blood and semen are the most infectious fluids. In order to become infected, you need to get an infected person’s body fuids onto a mucous membrane or directly into your bloodstream (unbroken skin is an effective barrier against infection, so getting body fluids on your skin is generally not considered a significant risk). Almost all infections can be traced to sexual contact, sharing needles, or blood transfusions.

HIV cannot be spread through casual contact — you can’t get it from a toilet seat, you can’t get it from touching an infected person, you can’t get it from sharing food with or drinking from the same glass as an infected person.

High-risk versus low-risk activities

The activities that put you at the highest risk for HIV infection are unprotected intercourse (having anal or vaginal intercourse without a condom) and sharing needles.

Oral sex is considered a much lower-risk activity, although there is some debate over exactly how low-risk it is. Most clinicians agree that very few cases of HIV infection can be traced to oral sex.

Sexual activity that does not involve any contact between another person’s body fluids and your mucous membranes are considered to be basically risk-free. Examples are mutual masturbation (assuming you don’t have any cuts on your hands), massage, touching, stroking, and phone sex.

It’s important to remember that HIV is a virus, and that the virus doesn’t just appear in people’s bodies spontaneously. It has to come from somewhere. If you have sex with a partner who is not infected, you are at no risk at all of HIV transmission, no matter what kind of sex it is.

How can I tell if I am infected with HIV?

If you have had a high-risk encounter with someone you think might be infected, you can get a simple test from your doctor or a local health clinic. The clinician will take a sample of your blood or your saliva, and you will get your results within a few days to a week.

If you go to a local clinic, you may be able to get HIV tests that are free and anonymous/confidential. Anonymous means they don’t know who you really are. Confidential means they know who you are and they agree not to tell anyone.

If you are looking for referrals for HIV tests in your area, feel free to call us toll-free.

Is there a cure?

There is no cure at this time, in the sense that once you are infected, you will always have the virus in your body. On the other hand, there are extremely effective treatments available, which can lower the amount of virus in your system and stop the damage to your immune system.

How to avoid becoming HIV-positive

The best way to avoid becoming infected is never to exchange any body fluids with an infected person.

If you are not absolutely sure that your partner is uninfected, use a latex or polyurethane condom for intercourse.

For more information…

  • AVERT’s AIDS & HIV Education and Research Trust
    This UK-based web site offers some of the best, most up-to-date, most comprehensible and most non-judgmental information about HIV/AIDS for non-specialists and laypersons.
  • The Body
    Comprehensive HIV/AIDS information resource. Click on their “site map” for a long list of available pages on AIDS and HIV topics and frequently asked questions.
  • UCSF HIV InSite
    UCSF Medical School site on HIV current events in treatment, policy, and prevention
  • UCSF Center for AIDS Prevention Studies
    Research and prevention site based at UCSF in San Francisco.