Dudley S. Danoff, MD, FACS
Men have good reason to be concerned about sexually transmitted diseases, whether a viral infection such as herpes; a bacterial infection like syphilis; or HIV/AIDS, as these diseases have been on the rise in recent years. The time to worry about sexually transmitted diseases is not at the moment of intercourse. You need a game plan long before you get into bed with someone.
To stay safe in today’s sexual environment, men must communicate with their partners about their sexual histories, know the basics about the most commonly transmitted diseases, and always take precautions to protect themselves.
Communicate about Sexual Histories
Know your potential sex partner as well as possible before having sex and have the patience and courage to ask probing questions about that partner’s past sexual practices and previous partners. You must make a sound judgment about the truthfulness of your potential partner’s answers.
When you are sexually intimate with any given partner, you are potentially linked to every previous sexual encounter in which your partner has ever indulged. Next time you consider having a one-night stand with a stranger or sleeping with a new partner on a whim, think of the risk. Delaying gratification could end up saving your life.
On the other hand, if you are the carrier of any kind of sexually transmitted disease, your absolute duty is to be open and honest with potential partners. If you take sound medical precautions, engage only in safe sexual practices, and exercise sensible sexual judgment, you can be free of fear when it is time to get in bed with someone.
Know the Basics
While significant progress has been made in preventing, diagnosing, and treating certain STDs, the Centers for Disease Control and Prevention (CDC) estimates that twenty million new infections occur each year in the United States alone. Here are some basic facts you should know about the most commonly transmitted STDs:
Chlamydia: This bacterial infection remains the most commonly reported infectious disease in the United States. In men, it can cause pain and swelling of the testicles, as well as nonspecific urethritis, an inflammation of the male urethra. Even without symptoms, the infection can still be transmitted. Symptoms usually include a watery discharge and burning when you urinate. A simple urine test can detect chlamydia, and the infection can then be effectively treated with antibiotics.
Gonorrhea: This is the second most reported genital infectious disease in the United States. An infected patient usually has a yellowish and pus-like discharge. While gonorrhea is easily cured, untreated cases can lead to serious health problems. Fortunately, gonorrhea can usually be cured with oral or injected antibiotics. Drug resistance, however, is becoming an increasingly important concern, especially among men who have sex with men, who are estimated to account for over 42 percent of all gonorrhea cases.
Syphilis: This genital ulcerative disease usually begins with a simple sore. If diagnosed early and treated, the sores will usually disappear. If missed, the infection can linger without symptoms and develop into secondary syphilis, characterized by a rash or multiple highly contagious sores. Untreated syphilis is rare today, though reported rates of primary and secondary syphilis in 2018 reached their highest point since 1991. Like many other STDs, syphilis also facilitates the spread of HIV.
Genital Herpes: More than one in six people in America ages fourteen to forty-nine are infected by this virus. Herpes can lie dormant for long periods of time, only to break out in blister-like lesions during periods of stress, exhaustion, or illness. Symptoms might also include fever, headache, a burning sensation while urinating, and an unexplained discharge from the penis. When the blisters appear, the infection is highly contagious. Although herpes is not curable, or easily preventable, in almost all instances it is no more than a transient annoyance in healthy men and women.
Genital Human Papillomavirus (HPV): This is the most common sexually transmitted virus in the United States. About seventy-nine million people in the country are currently infected, and about fourteen million more get infected each year. Most HPV infections do not cause any symptoms and will clear up on their own, but HPV can cause cervical cancer in women and penile or anal cancer in men. The most common solution is the HPV vaccine, which is an inactivated (not live) virus that protects against four major types of HPV. The HPV vaccine is routinely recommended for both females and males ages eleven or twelve through twenty-six.
AIDS: The virus that causes AIDS, human immunodeficiency virus (HIV), is found in bodily fluids and attacks the cells of the immune system, leaving the body so vulnerable to bacteria, viruses, and parasites that the outcome is almost invariably death. The CDC recommends that people protect themselves by limiting their number of sexual partners, never sharing needles, and using condoms consistently. Though the development of highly effective treatment regimens is prolonging the life of HIV-positive patients far beyond what we were capable of even fifteen years ago, we still don’t have a cure. Extreme caution in both your choice of sexual partners and your sexual menu is your only defense.
Take Precautions to Protect Yourself
When in doubt about a partner’s past sexual history, you should heed the usual advice about using condoms or avoiding intercourse. Condoms may cramp your style (some patients compare it to taking a shower with their socks on), but your life is at stake. You can love sex even with latex. If you play by the new ground rules, you can still exercise your sexual power to your heart’s content. You just have to do it with discernment, caution, and care.
Dudley Seth Danoff, MD, FACS, is president and founder of the Cedars-Sinai Medical Center Tower Urology Group in Los Angeles, a Diplomate of the American Board of Urology, a Fellow of the American College of Surgeons, and author of The Ultimate Guide to Male Sexual Health.