The problem with these pictures of herpes is that they are the most extreme cases, and do not give an accurate representation of a herpes lesion. Looking at these images won’t give you any more information, but will give you so much more anxiety.

So what does a herpes lesion look like? A herpes lesion generally looks like a small blister or group of blisters that forms, then breaks open. The resulting sore takes one to two weeks to heal. This sore may sting and is generally uncomfortable. A herpes lesion in the genital region can form anywhere on the genitals, including on butt cheeks, near the anus, on vaginal lips, in the vaginal canal, on the penis, scrotum or on the inner thighs. However, herpes symptoms vary widely from person to person. Some people have symptoms so mild that they don’t notice them, or mistake them for another condition, like an insect bite, an ingrown hair, “jock itch,” or a yeast infection. Some people have very severe symptoms which are extremely painful and include itching, burning, stinging and tingling. Some symptoms which might occur in conjunction with the “classic” symptoms of blisters are flu-like symptoms such as fever and swollen glands. Some people will have painful urination or tingling or soreness in the area before a blister appears. How can you know if you have a herpes lesion? The only way to know for sure is to get tested.

Most people experience their first herpes symptoms between 2 and 14 days after their first exposure. Subsequent outbreaks can then happen at regular intervals or randomly. Many people who have had herpes for a while notice patterns or triggers for their herpes symptoms, and can even come to predict when an outbreak is going to occur. Some believe that stress, certain foods or certain activities increase the likelihood of a herpes outbreak.

The unfortunate news is that herpes symptoms and outbreaks will vary widely for each person. The less unfortunate news is that, for those who are infected, herpes does not affect the immune system. It is rare that adults will have any health problems due to herpes, beyond the discomfort of occasional outbreaks. However, it is important to note that having genital herpes makes it easier to acquire and/or transmit HIV.

The herpes symptom “life cycle” consists of a prodrome period, when the herpes virus (which lies dormant in a bundle of nerves at the base of the spine), wakes up and travels to the surface of the skin. This can cause the tingling or tenderness in an area where a herpes blister might form. If a blister forms, it will break open and form a lesion which will scab, then heal. The number of herpes outbreaks average 4-5 per year for most people. Repressive therapies, which will be discussed in the next blog post, can help lessen the number of outbreaks.

Herpes can be transmitted at any point that the virus is not dormant. During the prodrome period, and during an active outbreak the virus can be spread by skin to skin contact. It is possible for the virus to spread from the affected area to any skin, but it is most common that the virus is spread from genital to genital or mouth to genital contact. Additionally, even if no lesions or other symptoms are present, the virus could be shedding without symptoms (asymptomatic shedding) and transmission can occur. Because the herpes virus can be shed with no visible symptoms, and because it is spread by skin to skin contact, it is very common. In fact, the American Social Health Administration estimates that 1 in 5 adults has genital herpes and that 90 percent of those who have the virus are unaware that they have it.

However, like we noted above, herpes is uncomfortable and inconvenient, but it doesn’t cause any damage to the immune system and, for the most part, adults will not have any adverse health effects from a herpes infection. It is important, though, to pay attention to any symptoms that might be herpes and have any suspected lesions or areas swabbed and tested for herpes. Knowing whether or not you have herpes allows you to make sensible and informed decisions about sexual activity and allows you to tell your partners so they can make sensible and informed decisions as well.

Although condoms aren’t 100 percent effective at stopping herpes transmission, condoms do reduce transmission between outbreaks. When an outbreak occurs or when an outbreak is suspected, couples should abstain from having genital-to-genital or mouth-to-genital contact during these times to reduce the risk of transmission. Other forms of sex that don’t include skin-to-skin contact can be enjoyed during this time, such as dry humping with clothing on or mutual masturbation.

If you think you might have a herpes lesion, go to your doctor or a testing clinic as soon as you can for the most accurate results. If you have questions about where to find herpes testing, give us a call at 800-777-2437.

For additional information on herpes, see these resources below:
Comprehensive and credible information on herpes can be found on the American Social Health Administration website at http://www.ashastd.org/herpes/.

To hear Dr. Anna Kaminski from Planned Parenthood and Dan Savage talk about herpes on one of his podcasts, visit http://www.thestranger.com/SavageLovePodcast/archives/2010/07/13/savage-love-episode-195 to listen.

How do you talk to your sexual partners about STDs? How about STIs? And…. what is the difference between a sexually transmitted disease (STD) and a sexually transmitted infection (STI)? The American Social Health Association describes the distinction: the term disease “implies a clear medical problem, usually [with] some obvious signs or symptoms. But in truth several of the most common STDs have no signs or symptoms in the majority of persons infected. Or they have mild signs and symptoms that can be easily overlooked” and, so they should now be described as an infection.

One STI that is cloaked in mystery is herpes, but it doesn’t need to be. If you don’t have herpes, learning about it helps you avoid contracting it. If you do have herpes, understanding it helps you avoid transmitting it and helps you talk to your sexual partners about risk reduction. And sometimes, people can have herpes and not know it, so in the interest of safety, let’s talk herpes.

Herpes is a virus. It’s a virus that has two types. Herpes Simplex 1 (HSV-1)  and Herpes Simplex 2 (HSV-2). Both can cause blisters, sores, bumps or a rash to form. The difference between Herpes Simplex 1 and Herpes Simplex 2 is where the sores are generally located on the body. In the case of HSV-1, the sores are found on and around the mouth, and are called cold sores or fever blisters. HSV-2 generally causes sores on and around the genitals (penis, vagina and vulva), the anus, thigh, or buttocks. The genital infection is what people generally think of when they hear the word “herpes.” But both types of virus are technically “herpes.” There are also cases of HSV-2 infecting the mouth and  HSV-1 causing genital breakouts, but there is no way of knowing, without testing, which type is causing the breakout. However, generally, the two types prefer to infect their customary areas.

So, what is a virus? A virus, when contracted, invades a body’s cells and takes over those cells in order to replicate. Our bodies fight viruses with antibodies and can often suppress them so that the infected cells don’t replicate, but viruses don’t die off, and viruses can resurface. Also, viruses are often contagious without any symptoms and some spread very easily. Some viruses, like colds and plantar warts, don’t cause much alarm, as our bodies can generally suppress them in a reasonable amount of time. Other viruses, like HIV, can cause major health complications and may eventually cause death. Although people don’t die from herpes, and although herpes can be a manageable infection, it is important to understand how herpes is transmitted, herpes symptoms, and how doctors test for herpes in order to reduce the chance of transmission.

Herpes is the most common sexually transmitted disease. Over 60 million adults in the United States have herpes and a million new cases are diagnosed every year. An estimated 70 percent of people who have herpes don’t know when they contracted it and don’t know that they had an initial outbreak—or didn’t even have an initial outbreak.

like 70% of americans, michael scott gets cold sores (which are caused by the herpes virus)

Herpes is spread by skin to skin contact and can be spread even without signs of an outbreak. Generally, herpes is a manageable, non lethal virus, but it does come with increased risk of other sexually transmitted infections. A person with genital herpes has a much higher risk of acquiring HIV. And a person who has both HIV and herpes is more likely to transmit both infections.

Since herpes is so common, and generally misunderstood, we are going to dedicate three blog posts to it. This first one has given a general overview of what herpes is. It’s a virus that causes nonlethal outbreaks. It’s the most common STD and it’s spread by skin to skin contact. In the next couple of posts, we are going to go into more detail about the symptoms and transmission of herpes and the testing for and treatment of herpes.

In the meantime, if you have questions give us a call 800.777.2437 or chat with us online at oregonaidshotline.com

The Reality Behind the Female Condom:

The Female Condom (also called the Reality Condom, Bottom Condom, or Insertive Condom) is a condom that can be inserted into the vagina or the anus.  It’s made out of a non-latex rubber (either polyurethane or nitrile) and is safe to use if you have a latex allergy.

How to use the Insertive Condom:

1.) Check the expiration date.  Open the condom by tearing it at the top right corner.

2a.) For vaginal sex:  make sure the inner ring is at the bottom of the pouch, squeeze the flexible inner ring between your thumb and finger so that the ring becomes long and narrow, and use your finger to insert it into your vagina.  It may be easier to insert it if you squat or put one leg up.  Push it up as far as it will go while keeping the outer ring on the outside of the vagina.  The inner ring will fit behind the pubic bone and over the cervix.  The outer ring should lie over the lips of the vagina.

2b.) For anal sex: make sure the inner ring is at the bottom of the pouch, squeeze the flexible inner ring between your thumb and finger so that the ring becomes long and narrow.  Gently insert the inner ring into your anus.  Use your index finger inside the condom to push the ring past the sphincter muscle.   You can also remove the internal ring (some people find that more comfortable) and either use your partner’s erect penis, your fingers, or a sex toy (such as a dildo) to insert it.  After it’s inserted make sure the outer ring is outside of and covering the anal opening.

3.) After the condom is in place, make sure it’s not twisted by feeling the inside of the condom.  Add more lube to the penis and the  inside of the condom and then guide your partner’s penis into the condom.   Make sure that your partner’s penis is inside the condom and not on the outside of it.

4.) To remove the condom twist the outer ring and gently pull out.  Wrap the condom in the package or a tissue and throw it away (don’t flush it).

Have more questions about condoms?  Call the Oregon HIV/STD Hotline at 800.777.2437 or chat with us online at www.oregonaidshotline.com

Apoyo Latino: 1.800.499.6940

Apoyo Latino is the Oregon Spanish speaking HIV/STD Hotline provided by Cascade AIDS Project.  Apoyo Latino provides culturally relevant HIV/AIDS information, support, and referrals to the Latino and/or Spanish speaking community.  It is a confidential and free service open Monday through Friday from 9:00 a.m. – 5:00 p.m.

Hotline Counselors have quick access to thousands of up-to-date local and national resources and can make appropriate referrals as needed.  Many calls include referrals to HIV/STD testing sites, AIDS services organizations, legal, financial, substance abuse, domestic violence, physical or mental health care, support groups, and GLBTQ services.

Counselors are also able to help HIV+ callers get connected to the support services they need including case management, legal, housing, prescription coverage support, financial, housing, and transportation assistance.

If you or someone you know is infected or affected by HIV/AIDS or STDS and need assistance you can call anytime during our hours to speak with a compassionate and knowledgeable individual.

Servicios de Intervención Temprana, Apoyo Latino

(antiguamente conocido como Care Link y Apoyo Latino)

Cascade AIDS Project

Descripción:

Es un programa de Cascade AIDS Project que ayuda a la gente con VIH/SIDA a conectarse con servicios relacionados con el VIH/SIDA.

Servicios:

• Ayudarle a encontrar servicios médicos y un trabajador de casos personales
• Ayudarle a encontrar un seguro médico
• Hacer sus citas médicas y/o llevarle al médico
• Ayudarle a llenar las formas necesarias
• Abogar por usted con los proveedores de servicios
• Ayudarle a encontrar recursos de transporte
• Ofrecerle información y referirle a servicios
• Hablar sobre las barreras que existen por la diferencia del idioma y la cultura

Requisitos:

Todos los servicios son gratuitos y están disponibles para todos, posean o no documentos.

Horario: Se atiende de lunes a viernes de 9am a 5pm.

Contactos:

503-223-5907 Hay personal bilingüe.

1-800-499-6940 Línea en español.

Using your head when giving head:

Let’s talk blow jobs.  This is the mouth on penis action.  If you want to eliminate any possible risk of STDs then use a polyurethane, polyisoprene, or latex condom.  Don’t like the taste of condoms?  Fear not, there are condoms that come in different flavors!

OK, OK… I can actually hear you sighing from here.  I know, using condoms for oral sex isn’t realistic for everyone.  The good news is that if barriers aren’t your thing there are still ways to lower your risk.

Here are a couple tricks of the trade:

• use the “harmonica method”.  By focusing on the shaft of the penis and not the head you’ll avoid any cum or pre-cum.
• watch out for deep throating (especially vigorously).  It may irritate the lining of your throat making it easier for those pesky STDs to infect you.
• if you have the head of the penis in your mouth then try not to take any ejaculate/semen into your mouth.
• partner not so great about telling you when they’re going to cum?  When you think they’re getting close you can try finishing them off with your hand to avoid the unexpected ejaculation.
• got ejaculate in your mouth?  spit it out quickly instead of swallowing it and it will help reduce your risk.

The low down on going down:

When you’re performing oral sex on a vagina it’s a similar deal.  Using a barrier like a dental dam (thin sheet made out of latex), condom (cutting it down the side), or saran wrap will do the trick.  Stay away from microwavable saran wrap because it’s more porous (has bigger holes in it) and HIV may be able to get through the holes.  For added pleasure slap some water or silicone based lube on the side of the barrier that will come into contact with the vagina.   If you don’t want to use a barrier then try to minimize how much fluid you swallow.   You should know: there is an increased risk for getting HIV is she is menstruating (having her period) because blood has more virus in it than vaginal secretions (aka the fluid in the vagina).

The art of rimming: 

Ah, yes, the licking of the bum.  HIV is not typically transmitted through pooh, BUT there are other things like hepatitis A (there’s a vaccine you can get to prevent this!), parasites, and other STDs that can be.  You can use a barrier such as a dental dam (thin sheet made out of latex), condom (cutting it down the side), or saran wrap (preferably non microwavable) to protect yourself.  Pleasure tip:  put some water or silicone based lube on the side of the barrier that will be facing the butt.  One thing to know is that if you’re going to be rimming someone who just received anal sex (bottomed) then there’s the possibility of blood being present that can transmit different viruses, including HIV.

When it’s all said and done:

Get checked out.  Most STDs don’t have symptoms so get checked regularly.  Have them look in your mouth and swab your throat as well as your goodies.  I hear this a lot: “So what if I get a little gonorrhea in the throat?  I can clear that up with antibiotics!”  Well, yes, you can BUT some STDs aren’t curable (i.e. herpes) and if you have a STD in your mouth then it’s easier to get HIV from performing oral sex.

If you and your partner are monogamous you can both get checked out.  You can’t get something from someone who doesn’t have it.  And if they do have something that isn’t curable, then you’ll know what you’re looking for!

So there you have it.  Oral sex in a nutshell.  Have questions?  Need more info?  Call the Oregon HIV/STD Hotline 800.777.2437, we’re here to help!  You can also chat with us online at www.orgeonaidshotline.com

Text Book Definition: oral sex is sexual activity between partners in which someone’s genitals (penis, testicles, vulva, vagina, clitoris, labia) or anus are being stimulated by someone else’s mouth, lips, or tongue.  Examples:  mouth to vagina (aka: eating out, cunnilingus), mouth to penis (aliases: fellatio, blow job), or mouth to anus (affectionately referred to as analingus or rimming).  There’s lots of different slang, but it all means the same thing, mouth on genitals or bum action.

How to protect yo-self when heading south:

Generally speaking oral sex is low risk for HIV, but can be high risk for other sexually transmitted diseases (STDs).   If you get a STD in your mouth then it makes getting other STDs (like HIV) much easier.  Most STDs aren’t going to show symptoms so your partner(s) could have an infection and have no idea.  So let’s talk defense!

Say AH:

Check your mouth.  If you have open cuts or sores in there it’s going to make it a heck of a lot easier to get infected with STDs…including HIV.

Flossing & brushing is normally something I encourage; however, try not to do it a couple hours before or after performing oral sex.  It can cause little cuts/tears in your gums which make it easier for STDs to infect you.  This is also true for sharp foods like chips so put down the bag of Doritos!

Side Note:  If you need to do something to get a particular taste out of your mouth try keeping mints or gum around.  You can also incorporate food into your sex play to get different favors.  More on that here.

Just a little prick:

Vaccinate yourself.  There are vaccines for hepatitis A, hepatitis B, and human papillomavirus (HPV) which can all be transmitted sexually.  If you need help finding a place to get vaccinated call the Oregon HIV/STD Hotline 800.777.2437

Getting hot n’ heavy:

Okay, so you decided you’re going to give the gift of oral sex to your partner, but now what?!  Well, first, it’s a good idea to survey the land.  The general rule of thumb is that if you see any blisters or sores on the goods then watch out… that could be a STD.  If you want to be a little more stealth than switching on the lights and giving them a visual exam try inspecting the area while kissing their stomach, thighs, lower back, etc.  It’s good foreplay and they’ll be none the wiser while you’re having a little looksey around for funky colored discharges, lesions, or bumps.  Can’t see through the forest of pubes?  Maybe you can talk to your partner about trimming or waxing.  Some people bring this into their sex play, but to each their own.

Warning: if someone is about to go down on you and they have blisters or sores on their lips or mouth then be careful because they can easily transmit that infection to your privates.

Check back soon for Part 2 of ABC (A: Analingus, B: Blow jobs, C: Cunnilingus) Risk Reduction Techniques where I talk about saran wrap, spittin’ vs swallowing, and other fun things!

As always, give us a holler if you have questions or wanna chat.   Oregon HIV/STD Hotline 800.777.2437 or chat online at www.oregonaidshotline.com

We’re here for YOU!

Condoms are GRRREAT! When used correctly they help protect you from a whole host of bacterial and viral infections (they’ll also keep you from getting preggers if that’s one of your concerns).

But I’m not going to talk about statistics or the basics of how to use a condom (here’s some videos on the basics if you wanna brush up). For right now, I’m going to talk more about how condoms can increase your pleasure during sex – yeah, that’s right, I said INCREASE your pleasure.

First, there are tons of different types of condoms. Big ones, snugger ones, ones with spirals, bumps, ridges, pleasure pockets, and bends. Ones that make you tingle, ones that are thinner and some that are thicker. Plus, all sorts of flavors (fyi, flavored condoms should only be used for oral sex because they can cause problems for the va-jay-jay and the bum). All those condom “extras” aren’t just there for show; they can increase different sensations and make sex feel better (and last longer!). But, hey, don’t take my word for it; conduct your own research experiment to figure out what you like. And for extra fun you can learn how to put on a condom with your mouth. It helps incorporate condoms into sex play and is also a pretty neat party trick. It’s a good idea to practice this beforehand so that you don’t damage the condom with your teeth. I’m sure your partner will have no problem letting you practice, but if so, then revert to the old banana standby. Different folks like different strokes so this might not be for you. Half the fun is finding out what you like!

Now, let’s talk lube! Lube ain’t just for anal sex. Lube and condoms are like peas and carrots; they complement each other very nicely no matter where you’re sticking your dingy.

Is lube a new venture for you?  No worries, I’ll walk you through it. Put a drop of water based or silicone based lube on the erect penis before putting on the latex or polyurethane condom (trust me on this) and then as much as you like on the outside of the condom or directly on the vagina or rumpus. Reapply lube as needed while you’re doing the deed (dry sex causes too much friction which can cause the condom to break). People always ask me what the best lube is, and while I hear lots of great things about silicone based (my favorite being, “you can slip n’ slide on gravel with that stuff!”) the fact is that it’s really a personal choice. So depending on what you’re into it may vary.  Here’s a list of different lube pros and cons to help get you started.

That’s all for now, but check back soon for our next installment of Hotflash!

In the meantime, if you have questions or wanna talk about more fun ways to reduce your risk then give the Oregon AIDS/STD Hotline a call at 800.777.2437 or chat with us live online at www.oregonaidshotline.com. Our Hotline Volunteers are super nice, nonjudgmental, and ready to answer all your burning questions! We’re here Monday-Friday 9am-6pm and Saturday 12pm-6pm (pacific).