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 PROOF-POSITIVE PROTECTION
I’m HIV positive and I have had unprotected sex with other infected men. Can I get reinfected with an HIV strain different than my own?
Brandon
Broken Arrow, OK
HIV-positive men having unprotected anal sex with other HIV-positives are “serosorting.” They’re sorting out sex partners by HIV status so they don’t infect HIV-negative guys. The L.A. Times reported serosorting may be responsible for San Francisco’s new infections declining. But you seem to be asking about dual infection, or superinfection, among positive people having unprotected sex. Urban legend says once HIV positive, you’re free of risks from unprotected sex with other positive guys. Au contraire, homo. Doctors caution that reinfection with new, possibly drug-resistant HIV strains may occur further weakening your immune system, which can hasten disease progression and limit treatment options. Look at it this way: Studly dude has HIV Strain A resistant to Drug 1. He gets infected with Strain B, which could be resistant to Drugs 2 and 3. Researchers believe that a Strain C can then emerge and prove to be resistant to all three drugs. Unprotected sex also exposes you to other sexually transmitted infections—gonorrhea, syphilis and others. —FP
SAY IT AIN'T SO
I heard that some STDs are now becoming resistant to many medications that have been on the market. Does that mean gonorrhea is now incurable? And what’s the difference between an STD and VD?
Dexter
via Internet
The term “venereal disease” (VD) is taken from the name Venus, goddess of love from Roman mythology and has been replaced by the more contemporary “sexually transmitted disease” (STD). Both terms describe infections that are passed on by means sexual and otherwise. There is mounting evidence that increasing STD rates are fueled by a variety of factors, including relaxed safe sex practices, substance abuse—especially of crystal methamphetamine—and the availability of the Internet for meeting sex partners. This claim is supported by parallel increases in syphilis and HIV. In the U.S. each year, about 700,000 people are infected with gonorrhea, and about 75% of all reported gonorrhea is found in younger persons aged 15 to 29. In the 1980s, gonorrhea became resistant to penicillin and tetracycline. As a result, the Centers for Disease Control (CDC) recommended fluoroquinolone antibiotics as the treatment for gonorrhea. The oral medication ciprofloxacin revolutionized the treatment of gonorrhea. However, the number of cases of fluoroquinolone-resistant gonorrhea more than doubled between 2002 and 2003. The drug-resistant strains are a major health care concern for gay men especially because the rates of drug resistant gonorrhea in gay and bisexual men are 12 times higher than in straight men. The CDC recommends that doctors not use a fluoroquinolone antibiotic in gay and bisexual cases but recommends using an injectable antibiotic like ceftriaxone. The drug-resistant strain appears to still be sensitive to this form of injectable medication. In routine cases, treating patients with the oral medication azithromycin is also acceptable. —FS
OLD DOG, NEW TRICKS
My boyfriend just turned 34 and I am swiftly approaching 39. My desire for sex has lessened from five times a week to three. I don’t stay erect throughout sex but rather start strong, deflate, then strong to the finish, taking me longer to climax than it used to. I’m limited to one orgasm a night, and in the past two months, I sometimes give up while my boyfriend still finishes. He has told me that it makes him wonder if I still find him as sexually attractive (I do!), and I’m beginning to worry that there may be a looming health problem. Are these conditions normal for a man approaching 40 or signs of a serious problem?
Dean
Fort Lauderdale, FL
Your situation is not uncommon in a relationship that is approaching five years. Since you still find your partner attractive, you might look at other factors that may be involved, such as alcohol use, drug use or cigarette smoking. If these factors exist, they do work against your libido. If none of these factors are involved, you might begin to address the psychological aspect of your relationship, such as anger, fear, guilt, depression and anxiety. Stressful life events (if present) must be addressed. Some ways to address these events may include sex therapy, behavioral therapy and vitamin and herbal therapies. Some sexually enhancing herbs include ginkgo biloba, damiana and saw palmetto may also help. The amino acid, arginine, acts as a penile vasodilator by releasing nitric oxide. It is a natural Viagra or Levitra. High doses of L-arginine (3 to 6 grams) have been used with much success. However, the best way to start the recovery process is to talk to your partner. Communication is the key to the success of any relationship. —PF
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