HIV & STD Education
Sexually Transmitted Diseases (STD)
What are STDs?
Sexually transmitted diseases (STDs) are passed from one person to another through intimate physical contact – such as heavy petting – and from sexual activity including vaginal, oral, and anal sex. STDs are very common. In fact, CDC estimates 20 million new infections occur every year in the United States. STDs can mostly be prevented by not having sex. If you do have sex, you can lower your risk by using condoms and being in a sexual relationship with a partner who does not have an STD. STDs do not always cause symptoms, so it is possible to have an infection and not know it. That is why it is important to get tested if you are having sex. If you are diagnosed with an STD, know that all can be treated with medicine and some can be cured entirely.
There are dozens of STDs. Some STDs, such as syphilis, gonorrhea, and chlamydia, including HIV, are spread mainly by sexual contact. Other diseases, including Zika and Ebola, can be spread sexually but are more often spread through ways other than sex.
What is HIV (Human Immunodeficiency Virus)?
HIV stands for human immunodeficiency virus. It is the virus that can lead to acquired immunodeficiency syndrome or AIDS if not treated. Unlike some other viruses, the human body can’t get rid of HIV completely, even with treatment. So once you get HIV, you have it for life.
HIV attacks the body’s immune system, specifically the CD4 cells (T cells), which help the immune system fight off infections. Untreated, HIV reduces the number of CD4 cells (T cells) in the body, making the person more likely to get other infections or infection-related cancers. Over time, HIV can destroy so many of these cells that the body can’t fight off infections and disease. These opportunistic infections or cancers take advantage of a very weak immune system and signal that the person has AIDS, the last stage of HIV infection.
No effective cure currently exists, but with proper medical care, HIV can be controlled. The medicine used to treat HIV is called antiretroviral therapy or ART. If people with HIV take ART as prescribed, their viral load (amount of HIV in their blood) can become undetectable. If it stays undetectable, they can live long, healthy lives and have effectively no risk of transmitting HIV to an HIV-negative partner through sex. Before the introduction of ART in the mid-1990s, people with HIV could progress to AIDS in just a few years. Today, someone diagnosed with HIV and treated before the disease is far advanced can live nearly as long as someone who does not have HIV.
Should I Get Tested for HIV?
CDC recommends that everyone between the ages of 13 and 64 get tested for HIV at least once as part of routine health care. About 1 in 7 people in the United States who have HIV don’t know they have it.
People at higher risk should get tested more often. If you were HIV-negative the last time you were tested, and that test was more than one year ago, and you answer yes to any of the following questions, you should get an HIV test as soon as possible because these things increase your chances of getting the virus:
- Are you a man who has had sex with another man?
- Have you had sex—anal or vaginal—with an HIV-positive partner?
- Have you had more than one sex partner since your last HIV test?
- Have you injected drugs and shared needles or works (for example, water or cotton) with others?
- Have you exchanged sex for drugs or money?
- Have you been diagnosed with or sought treatment for another sexually transmitted disease?
- Have you been diagnosed with or treated for hepatitis or tuberculosis (TB)?
- Have you had sex with someone who could answer yes to any of the above questions or someone whose sexual history you don’t know?
You should be tested at least once a year if you keep doing any of these things. Sexually active gay and bisexual men may benefit from more frequent testing (for example, every 3 to 6 months).
If you’re pregnant, talk to your health care provider about getting tested for HIV and other ways to protect you and your child from getting HIV.
Before having sex for the first time with a new partner, you and your partner should talk about your sexual and drug-use history, disclose your HIV status, and consider getting tested for HIV and learning the results.
What is Hepatitis C (HCV)?
Hepatitis C Testing Recommendations
Testing Recommendations for Hepatitis C Virus Infection
CDC’s Testing Recommendations for hepatitis C virus infection (HCV) are outlined below. Testing should be initiated with anti-HCV. For those with reactive test results, the anti-HCV test should be followed with an HCV RNA.
Persons for Whom HCV Testing Is Recommended
- Adults born from 1945 through 1965 should be tested once (without prior ascertainment of HCV risk factors)
- HCV testing is recommended for those who:
- Currently injecting drugs
- Ever injected drugs, including those who injected once or a few times many years ago
- Have certain medical conditions, including persons:
- who received clotting factor concentrates produced before 1987
- who were ever on long-term hemodialysis
- with persistently abnormal alanine aminotransferase levels (ALT)
- who have HIV infection
- Were prior recipients of transfusions or organ transplants, including persons who:
- were notified that they received blood from a donor who later tested positive for HCV infection
- received a transfusion of blood, blood components, or an organ transplant before July 1992
- HCV- testing based on a recognized exposure is recommended for:
- Healthcare, emergency medical, and public safety workers after needle sticks, sharps, or mucosal exposures to HCV-positive blood
- Children born to HCV-positive women
Note: For persons who might have been exposed to HCV within the past 6 months, testing for HCV RNA or follow-up testing for HCV antibody is recommended.
PrEP – Pre-Exposure Treatment for HIV
Pre-exposure prophylaxis (or PrEP) is when people at very high risk for HIV take HIV medicines daily to lower their chances of getting infected. PrEP can stop HIV from taking hold and spreading throughout your body. It is highly effective for preventing HIV if used as prescribed, but it is much less effective when not taken consistently.
Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods.
PEP – Post-Exposure Treatment for HIV and Hep C
PEP (post-exposure prophylaxis) means taking antiretroviral medicines (ART) after being potentially exposed to HIV to prevent becoming infected.
PEP should be used only in emergency situations and must be started within 72 hours after a recent possible exposure to HIV. If you think you’ve recently been exposed to HIV during sex or through sharing needles and works to prepare drugs or if you’ve been sexually assaulted, talk to your health care provider or an emergency room doctor about PEP right away.
Consistent and correct use of the male latex condom reduces the risk of sexually transmitted disease (STD) and human immunodeficiency virus (HIV) transmission. However, condom use cannot provide absolute protection against any STD. The most reliable ways to avoid transmission of STDs are to abstain from sexual activity, or to be in a long-term mutually monogamous relationship with an uninfected partner. However, many infected persons may be unaware of their infection because STDs often are asymptomatic and unrecognized.
Whatever choices you make about sex it is important that you feel that they are the right choices for you.
Making choices about sex is not always an easy or straight forward process. People have sex for all sorts of different reasons including because they:
- are ‘horny’ (aroused)
- are ‘in love’
- want to lose their virginity
- want to experiment
- feel lonely
- want to feel physical intimacy
- fancy someone
- want to feel emotional intimacy
- were drunk or ‘out of it’
- enjoy sex
- like the person
- feel pressure to have sex.
Sex should be a positive and enjoyable experience, yet sometimes sex can end up having a negative impact on your life and health. Be honest with yourself about what you want and the choices you make.
Sometimes sex and the choices we make aren’t always rational decisions. Lots of people say, ‘sex just happened’. Often people talk about making choices in the ‘heat of the moment’. While we all learn from our experiences, thinking ahead may enable you to be more in control.
When you think about sex and making decisions about sex there are many things to consider.
- How do you feel about having sex?
- How does your partner feel about sex?
- What do your friends and parents think?
- Are you having sex with someone you feel safe with?
- How will you feel after sex?
- What contraception will you use?
- How will you prevent STIs?
- Do you need to talk to your partner about sex?
- What sort of sex are you prepared to have (oral, vaginal, anal, etc.)?
- Why do you want sex?
You need to do what feels right for you. To feel better about the choices, you make you can:
- Communicate with your partner. In any relationship between two people, communication is important. Communication can allow us to clarify our needs, feelings and wants and to also hear about those of our sexual partner. You can check if you are wanting the same things, and if your wants are different whether that is acceptable to you.
- Talk to friends and family. Friends and family may be able to provide good advice and support. Sometimes talking can help clarify how you are feeling. Make sure you talk to people who will respect your confidentiality and privacy.
- Be clear and honest about your own wants and desires.
- Seek out information. Have the facts about sex, STIs, condoms and contraception at hand so you can make well informed choices.
- Talk to a health care worker. There are many services specifically set up to help with sexual health issues.
- Be prepared. If you are planning to have sex make sure you have condoms and water based lubricant available.
Having sex for the first time
If you are just starting to become sexually active, remember staying in control can be tough but keep in mind that:
- kissing or groping does not mean that you must have sex;
- just because you have a boyfriend/girlfriend does not mean you have to have sex with them;
- at any time during sex you can choose to stop if you no longer wish to continue
- Sex without your permission is a crime, even if it is with somebody you know; and
- sex must be your choice – don’t let yourself be pressured or bullied.
Are you ready for sex? Your first sexual experience should be positive and safe, but how can you know if you’re ready for sex? Here’s a checklist from the World Health Organization of life skills that you need to keep yourself safe. Can you honestly say yes to each one?
- Can you make good decisions about relationships and sex and stand up for those decisions?
- Can you deal with the pressures for unwanted sex?
- Can you recognize a situation that might turn risky or violent?
- Do you know how and where to ask for help and support?
- Do you know what safe sex is and could you insist on condoms?
If you don’t feel sure about these things, you might not be ready to have sex. Delaying sex until you feel confident and comfortable will help you to make sure your first sexual experiences are safe and positive.
Alcohol and other drugs
Alcohol and other drugs can affect the decisions you make about sex and practicing safer sex.
People like using alcohol and other drugs when out socializing. The reasons for this are varied but can include:
- a socially acceptable practice;
- makes you more social and friendlier;
- more likely to chat to people you find sexually attractive;
- your friends are all doing it;
- feel more in control;
- removes your inhibitions; and
- frequently socialize in pubs, clubs or other places where alcohol is served.
Alcohol or other drugs can have negative effects on your sex life, and health more generally. Research shows alcohol and other drugs do affect the decisions people make about safe sex. Research also shows that people often state that they had unsafe sex because they were ‘drunk’ or ‘out of it’.
Alcohol and other drugs can lead to you making decisions you wouldn’t otherwise make. For example, you may choose to have sex with someone you wouldn’t have otherwise chosen, you might not use a condom whereas you normally would, you may regret having sex at all. During sex it’s not uncommon for men to lose their erection after heavy drinking or taking other drugs.
If you are having a night out and think you might have sex with someone, it is important you decide beforehand about what you want to do. Once you have made that decision you need to stick to it.
If you think you might have unsafe sex once you have been drinking or taking drugs, then you need to consider not drinking or taking drugs or reducing your intake so that you can stay more in control.
If you choose to inject drugs, don’t share any injecting equipment including needles, syringes, swabs, filters, spoons, tourniquets, the mix, etc. Sterile syringes are available from pharmacies and Needle and Syringe Program outlets. The program is an anonymous and confidential service. See safe injecting for more information.
How do I know if my partner has an STI?
If there are no obvious symptoms then it is not possible to tell if someone has an STI, unless that person decides to tell you. People can have an STI and not even know they do. This is one of the reasons why practicing safer sex and seeing a doctor for a regular sexual health check-up is important.
Some people believe you can tell if someone has an STI based on the number of sexual partners they have, who they have sex with, if they dress well, or if they look ‘clean’ and ‘healthy’. These beliefs are incorrect and often reflect the values and biases of the person making the statement.
Unless there are obvious symptoms, there is no way you can tell if somebody has an STI by judging the way they look, their sexual behavior or hygiene.
There is no one type of person who catches STIs. Anyone who is sexually active can be at risk of catching an STI.
How should I negotiate safer sex?
If you want to practice safe sex, then there is a range of things you can do to make sure you stick to that decision.
- Make sure that you have a supply of condoms always available.
- Ensure you know how to use a condom correctly
- Be clear about the reasons why you want to use a condom – your partner may have all sorts of arguments about why they don’t want to use them.
- Talk to your partner about safe sex – so they are clear about your expectations.
- Put the condom on.
- Hand the condom to your partner and ask them to put it on.
- Avoid alcohol or drugs if it is likely to weaken your resolve.
- Make it clear to your partner that you won’t have sex if a condom is not used.
- Make sure you choose a brand of condom that fits comfortably.
- If your partner won’t use a condom, then engage in sexual acts other than intercourse.
- Don’t let putting a condom on disrupt the flow, make sure they are nearby and easily within reach.
Your partner needs to respect your decision regarding safe sex – if they don’t then you need to consider how much they value you and your beliefs.
Engaging in sexual acts other than intercourse that oral sex without a condom can still be a risk
to contract oral warts, chlamydia or gonorrhea. Any mucous membrane contact can be a risk for STIs.
Insurance and Costs
Project Response Testing and Treatment Center accepts most major insurance coverage. You will need to bring your insurance and photo ID with you to the Center. HIV Treatment can be provided through your insurance coverage. However, if you do NOT have insurance, HIV treatment will be covered under the Ryan White Program or the AIDS Drug Assistance Program and Hepatitis C treatment may be covered through a Patient Assistance Program offered by the Pharmaceutical Manufacturer. In most cases there is little to no cost for patients with HIV and/or Hepatitis C that do not have insurance coverage.
If you do not have insurance
If you do NOT have insurance, please contact our clinic at 321-372-5003. Our staff will provide you with information regarding other support options available to you. Project Response, Inc. strives to provide quality HIV, STD and Hepatitis testing and treatment to everyone in the Brevard county area and will work with patients to seek out all non-insured resources that are available to them based upon income or risk.
Project Response does offer free HIV and Hepatitis C testing. We welcome walk-ins at our office located at 745 South Apollo Boulevard for both tests. For a broader range of testing including HIV, Hep C, Chlamydia, Gonorrhea and syphilis, the fee is $50. Please be aware that tests for Herpes, Hep A & B, Trichomoniasis, and others can cost up to $200 for each test. That may be cost prohibitive for those who do NOT have insurance, however, please inquire to see if you have other options.
Patient Assistance Programs
Some treatments can be costly, especially for those with a low- or no-income status. In these cases, if you cannot afford the prescription drug, you may be eligible for assistance programs offered by the pharmaceutical companies known as Patient Assistance Programs or PAP.
To qualify, you will need to complete an application for the drug company with information about your financial situation. Project Response Testing and Treatment Center can assist you with that process or you can often download the form from the company’s website. Your treatment team or Doctor will submit to the pharmaceutical company the application, information about your prescription and other supporting documentation, as required.
The drug company will review the application and determine whether you qualify for assistance. For example, they may pay all costs, or if you have insurance and your co-pay is too expensive, they may choose to cover all or part of your co-pay.
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