Free The Ins and Outs of Gay Sex by Stephen E. Goldstone

scabiei
burrows into your skin, builds a nest, and raises a family. Not a pretty picture. Your hands, particularly the web spaces between your fingers, are common sites, and so are your genitals, arms, and abdomen. Intense itching that worsens at night is characteristic, and transmission occurs through direct contact or sharing a bed with an infected partner. The diagnosis is made either by seeing the burrows the parasite makes into your skin or by skin biopsy. Prescription creams such as lindane (Kwell) as well as a thorough washing of all linens and clothes kills the mite. Remember to notify any of your partners at risk for infection and get tested for other STDs.

Summary
     
    Unfortunately, as our attention focuses on HIV, doctors and patients alike are less aware of the other highly prevalent yet curable infections. Men go untreated because their problem is not diagnosed.
     
If you have one STD, get checked for others.
Notify all partners at risk so they can be tested and, if necessary, treated.
Even though a chancre will go away without treatment, you still have syphilis.
Gonorrhea in your anus and mouth is much harder to diagnose than in your penis.
Penetration or ejaculation is not required for the transmission of these infections—close sexual contact is enough.
Don’t forget to wash all clothes and linens in hot water after a case of crabs or scabies.
     

CHAPTER 4
     

Non-HIV Viral Sexually Transmitted Diseases—
     

OR HIV ISN’T THE ONLY
VIRUS OUT THERE!
     
    I
washed my hands and turned to face my patient.
    “They’re hemorrhoids, right, Doc?” he asked.
    “No,” I said. “They’re definitely not hemorrhoids. You’ve got venereal warts.”
    He pointed to his index finger. “Could they be from my hands? I had a wart burned off there several months ago.”
    “No, you got these warts from sex.”
    “Impossible. I only have safe sex. Always a condom. You can’t get it with a condom, can you?”
    In the AIDS era, most guys are so worried about HIV that they forget about all the other viral sexually transmitted diseases. Although the list is long, the most common viral STDs include herpes, condyloma, and molluscum. (No, it’s not something you’d order at a raw bar. ) I have included hepatitis in this chapter because within the gay community, this disease is often spread through sexual contact. As we saw in Chapter 3 , most STDs are far more prevalent than AIDS and don’t require ejaculation or even penetration to spread. Viral STDs are no exception, but it gets worse; the condom you so faithfully wear for penetration may not protect you. If your partner has been rubbing his penis against your butt or groin, he can easily pass a virus. You say it couldn’t happen because you make him wear a condom even during foreplay. Don’t forget about his scrotum, pubic hair, and base of his shaft, areas not covered by the condom. He can carry viruses there and give them to you. And once you catch one of these nasty viruses, you can have it for life.
    This doesn’t mean you are doomed to a life of pain and unsightly blisters. On the contrary, viral STDs are typified by recurring outbreaks between quiet periods. These viruses hide within your cells, safe from marauding antibodies, white blood cells, and medications.
    A virus is the simplest biological form—a segment of genetic material tightly wrapped inside a protein coat. Unable to reproduce on its own, a virus must invade a living cell to multiply. Once safe inside, the virus commandeers the cell’s reproductive machinery and new viruses are made. When a virus is dormant in a cell, its genetic material is still present but idle until it receives some unknown biological stimulus to reproduce again. Then the cells are turned into factories making copies of the virus. New viruses break out of the cells (sometimes but not always destroying the cell in the process) and move to infect other cells—in your body or in an unsuspecting partner!
    Each viral