GETTIN’ SHOT I had a hepatitis B vaccination many years ago (around 1985). I was under the impression that if I had a hep B vaccination, it would last my whole life, but a co-worker has told me differently. Do I need to get another hep B vaccination?
Michael Rockville, MD
This topic is so important for gay men because hepatitis B is transmitted like HIV: through blood and other bodily fluids. The only way to prevent yourself from contracting hep B is by wearing condoms during sex and getting the hep B vaccine. Given in three separate shots over a six-month period, your body will then develop antibodies against the virus so that you are immune to the disease. Typically the vaccine protects you for about 10 years. You mentioned that you received the vaccine in 1985, so that is over 20 years ago. Currently, there is one vaccine called the Twinrix, which is a combination hep A and B vaccine also given in three shots over a six-month period. I highly recommend this vaccine, especially to all my gay male patients. Hepatitis A is contracted through fecal-oral contamination, a common problem with infected food and some forms of sex.
MAKING THE CUT My brother says a recent published study claims that uncircumcised men are at significantly higher risk for contracting HIV than snipped men. Is that true? Why?
Jonathan Newport Beach, CA
According to more than 40 studies, male circumcision provides significant protection against HIV infection. Circumcised males are two to eight times less likely to become infected with HIV, says The British Medical Journal. Circumcision also protects against other sexually transmitted infections, such as syphilis and gonorrhea. Since guys with an STD are more likely to become HIV-infected, circumcision may be even more protective. The most dramatic study on circumcision studied straight Ugandan couples, one partner HIV-positive, the other negative. No new infections occurred among any of the 50 circumcised men over 30 months, whereas 40 of 137 uncircumcised men became infected during this time. Eighty-nine percent of the men did not use available condoms. Uncircumcised men are at greater risk of infection because a foreskin’s inner surface contains cells with HIV receptors. These cells are likely the primary point of HIV’s entry into the penis of an uncircumcised man.
COUPLES WHO TANGO TOGETHER TEST TOGETHER I recently asked my boyfriend to get tested for HIV with me…again. We’ve been together for almost a year and when we first started dating we both got the whole STD checkup— together, at the same time. He says that I’m being overly worrisome and that he hasn’t been with anyone but me. According to him if I also have not cheated, there is no point in getting another test. What do you think? Can HIV show up a year later? Is there any reason to either get or not get tested?
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Angel via Internet
My recommendation for any sexually active gay male is to undergo a routine STD screening to include tests for gonorrhea, chlamydia, syphilis and especially HIV. For couples who are monogamous and intend on not practicing safe sex, I would recommend HIV testing once every three months for one year. After this time you could safely assume that you are both HIV negative. We know that HIV is a virus that is contracted through blood and bodily fluids and that it is transmitted during unsafe sex—especially receptive anal sex. HIV seroconversion usually occurs after six weeks, but there are cases of conversion occurring after three months and, yes, even up to a year, although it is rare. My feeling is not to become overly paranoid. However, since you and your boyfriend have not even been together for a full year, then it is not a foolish request to get tested one more time. There is no sense in fighting about it. Simply present the facts and see if you can persuade him.
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