If you are sexually active, or thinking of becoming sexually active, it is important that you Talk. Test. Treat. to protect your health. These three small actions can have a big impact on your sexual health!

TALK

Talk openly and honestly to your partner(s) and your healthcare provider about sexual health and sexually transmitted infections, or STIs.

Talk with your partner(s) BEFORE having sex. Not sure how? We have tips to help you start the conversation. Make sure your discussion covers several important ways to make sex safer:

• Talk about when you were last tested and suggest getting tested together.
• If you have an STI (like herpes or HIV), tell your partner.
• Agree to only have sex with each other.
• Use condoms the right way for every act of vaginal, anal, and oral sex throughout the entire sex act (from start to finish).

Talk with your healthcare provider about your sex life as it relates to your health. This helps your healthcare provider understand what STI tests you should be getting and how often.

Here are a few questions you should expect and be prepared to answer honestly:

• Have you been sexually active in the last year?
• Do you have sex with men, women, or both?
• In the past 12 months, how many sexual partners have you had?
• Do you have anal, oral, or vaginal sex?
• What are you doing to protect yourself from infection?

Not all medical checkups include STI testing, so don’t assume that you’ve been tested unless you discuss it with your provider. If your provider does not discuss sex or STI testing with you, bring it up.

Ask your healthcare provider whether certain vaccines, like the hepatitis B vaccine or the HPV vaccine are right for you.

TEST

Get tested. It’s the only way to know for sure if you have an STI.

Many STIs don’t cause any symptoms, so you could have one and not know. If you’re having sex, getting tested is one of the most important things you can do to protect your health.

Learn which tests CDC recommends for you. Even if you’re pregnant, you can still get an STI. If you’re having sex, you’re still at risk.

Find out what STI care options are available near you. In addition to traditional, in-person visits, other options that may be available include:

• Video or phone appointments with your healthcare provider.
• Express visits allow walk-in STI testing and treatment appointments without a full clinical exam.
• Pharmacies and retail clinics, such as at a grocery store or big-box store, for on-site testing and treatment.
• At-home collection where you collect your own sample and take or mail it to a lab for testing.

If you’re not comfortable talking with your regular healthcare provider about STIs, find a clinic near you that provides confidential testing that’s free or low cost.

TREAT

If you test positive for an STI, work with your healthcare provider to get the correct treatment.

Some STIs can be cured with the right medicine, and all STIs are treatable. Make sure your treatment works by doing these things:

• Take all of the medication your healthcare provider prescribes, even if you start feeling better or your symptoms go away.
• Don’t share your medicine with anyone.
• Avoid having sex again until you and your sex partner(s) have all completed treatment.

Your healthcare provider can talk with you about which medications are right for you.

Chlamydia is an infection caused by bacteria. Chlamydia is the most common sexually transmitted disease (STD) in the U.S.

How is it spread?

Men get chlamydia through vaginal, oral, or anal sex (or sexual contact) with an infected partner.

What are signs of chlamydia in men?

There may be no signs or symptoms of infection. Symptoms may not appear until several weeks after exposure and can include:

• Pain/burning with urination.
• Watery/mucus discharge from penis.
• Redness, swelling or itching at the tip of the penis
• Hard to start urination.
• Blood in semen or urine.
• Discomfort during sex.
• Rectal pain, bleeding, or discharge.
• Testicular pain, tenderness and swelling (less common).

See your health care provider to be tested if you have signs of chlamydia.

How do you know if you have chlamydia?

The only way to know if you have chlamydia is by a medical exam. Many men with chlamydia do not have any signs of infection and routine testing is not recommended. Get tested if you:

• Have an oral, anal or vaginal sex partner who has been recently diagnosed with an STD.
• Are sexually active and have signs as listed above.
• Are having sex with someone who might be having sex with others.

How is it treated?

Chlamydia can be treated and cured with antibiotics. Always finish antibiotic treatment, even if signs of chlamydia go away. Do not have sex until after treatment and signs of it are gone. See your health care provider if your signs do not go away after treatment.

People who have had chlamydia and have been treated may get infected again if they have sexual contact with a person infected with chlamydia.

What can happen if you have chlamydia for a long time?

• Swelling in the anus.
• Eye and joint redness and pain.
• Inflammation of the liver capsule resulting in right sided abdominal pain.
• More likely to get HIV from a partner who is infected with HIV.

If you have chlamydia:

• Always finish all antibiotic treatment.
• Do not have sex with someone who has chlamydia or has not finished treatment (to prevent re-infection).
• Tell current and recent sex partners of the infection so they can get checked.
• Know that it can increase the risk of getting and spreading HIV.

How can you avoid chlamydia?

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting chlamydia. Each time you have sex use a condom:
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have chlamydia.

Genital herpes is a chronic, life-long, sexually transmitted disease caused by two herpes simplex viruses (HSV-1 and HSV-2).

• HSV-2 causes most genital herpes.
• HSV-1 can also cause genital herpes. More often it causes blisters of the mouth and lips (e.g., cold sores or fever blisters)

The U.S. Centers for Disease Control and Prevention (CDC) estimates that over 50 million persons, or about 1 out of 6 people ages 14 to 49 in the U.S. have genital herpes. It occurs in about 1 in 8 men. Many people with herpes have no signs of infection and do not know they have it. They can still pass it to others.

Herpes is more easily spread from men to women than from women to men.

How is it spread?

The herpes virus is spread by skin-to-skin contact with a person who has it:

• Most often, from herpes sores or blisters.
• Less often, from normal looking skin where the virus first entered the body.
• During vaginal, anal, or oral sexual contact, or skin-to-skin contact. This may happen even without visible sores.
• The herpes virus gets into the body from:
  • The lining of the mouth.
  • Regular skin that has small cracks or cuts.

Those who don’t know they have herpes can still spread the virus to others.

Those with a weak immune system can get herpes infection more easily. A weak immune system is caused by some diseases (e.g., cancer, HIV/AIDS) and by some medicines used to treat serious diseases.

See your health care provider (HCP) to be tested if you have signs of herpes.

What are signs of genital herpes in men?

Men who have the herpes virus may have no outbreaks or signs of infection. Many do not know they have the virus. Once you are infected, the virus stays in your nerve cells for life. When the virus is not active, there is no sign of infection. When the virus becomes active, a herpes outbreak occurs. Some men may:

• Not have any outbreaks.
• Have only one outbreak.
• Have multiple outbreaks.

First Outbreak

The first herpes outbreak often occurs within two weeks after sexual contact with an infected person. Sometimes the first outbreak will not occur until months or years after the first infection. The first signs may include:

• Itching, tingling, or burning feeling in the genital area.
• Flu-like symptoms, including fever.
• Swollen glands.
• Pain or tingling in the legs, buttocks, or anal area.
• Headache.
• A feeling of pressure in the area below the stomach.

After a few days, painful sores, blisters, or ulcers may appear where the virus entered the body. These areas include:

• Genital or anal area.
• The mouth.
• In the urinary tract.
• On the buttocks or thighs.
• On other parts of your body where the virus has entered.

Other Outbreaks

After the first outbreak, you may have more outbreaks. For most, these occur less often over time. The signs of herpes infection are mostly milder than during the first outbreak, and they go away faster.

For those with a weak immune system, outbreaks can be severe and long-lasting.

How do you know if you have genital herpes?

The only way to know if you have genital herpes is by a medical exam. Your HCP can examine you and test for it. Lab samples are taken from a sore, blister, or blood. Your HCP may ask to test you for other infections at the same time.

Tell past and current sex partners of your herpes infection.

How is it treated?

Genital herpes can be treated, but it cannot be cured. Antiviral drugs may be used during an outbreak to help to make it:

• Shorter.
• Less severe.
• Less frequent.

Antivirals can also be taken daily to reduce outbreaks. Living with genital herpes causes some to:

• Feel embarrassed or ashamed.
• Worry about infecting a sexual partner.
• Worry that having herpes will affect relationships with sexual partners.
• Avoid dating or sexual relationships.

Most people with herpes are able to live with the virus and manage outbreaks. Talking to trusted HCPs and friends can help. Discuss treatment options with your HCP. Also talk about ways to reduce passing the virus to others.

Drugs can help lower the chance that you will pass the virus to others.

During outbreaks of genital herpes, you should:

• Keep the infected area clean and dry.
• Avoid touching the sores or blisters.
• Clean hands after contact with the infected area.
• Avoid skin-to-skin contact from the time you first notice signs of herpes until the sores have healed.
• Avoid sexual activity.

How can you avoid genital herpes?

Most men get genital herpes from sexual contact with a person who has herpes. You can get the virus without having sex. To avoid it:

• Do not have vaginal, oral, or anal sex.
• Avoid skin-to-skin and sexual contact.
• If you do have sex, practice safe sex:
  • Reduce the number of sexual partners.
  • Use condoms correctly. Condoms can reduce the risk of getting genital herpes. But, condoms may not cover all infected areas. Each time you have sex use a condom (male or female type):
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have herpes.

Genital warts appear as a small bump or groups of bumps in the genital area. They can be small or large, raised or flat, or shaped like a cauliflower. They are caused by some types of human papilloma virus (HPV). These viruses may not cause warts in everyone.

How are they spread?

Men can get genital warts from sexual contact with someone who has HPV. Genital warts are spread by skin-to-skin contact, usually from contact with the warts. It can be spread by vaginal, anal, oral, or handgenital sexual contact. Genital warts will spread HPV while visible and after recent treatment. Long-term sexual partners usually have the same type of wart-causing HPV.

What are signs of genital warts in men?

Genital warts can grow anywhere in the genital area:

• On the groin.
• Under the foreskin of the uncircumcised penis.
• On the shaft of the circumcised penis.
• In or around the anus.
• In the mouth or throat (rare).

Genital warts:

• Can be any size – from so small they can’t be seen, to big clusters and lumps.
• Can be smooth with a “mosaic” pattern or bumpy like a cauliflower.
• Are soft, moist and flesh-colored.
• Can cause itching, burning or pain.

Not all HPV infections cause genital warts. HPV infections often do not have any signs that you can see or feel. Some HPV infections can be more serious.

Even if you see no visible genital warts, you could still have HPV infection.

How is it treated?

See your health care provider (HCP) to discuss treatment. Even when genital warts are treated, the HPV infection may remain. Warts may also return after treatment. Over-the-counter treatments for other types of warts should not be used. Treatments include:

• Medicines (creams, ointments, solutions or gels) applied directly to the warts.
• Burning off the warts.
• Freezing off the warts.
• Cutting the warts out.
• Using special lights or lasers to destroy the warts.

Condoms may not fully protect against HPV since HPV can infect areas not covered by a condom.

What can happen if you have genital warts for a long time?

The immune system fights HPV infection. The types of HPV that cause genital warts do not cause cancer. Without any treatment, genital warts may:

• Go away.
• Remain unchanged.
• Increase in size or number.

If you have genital warts:

• Talk with your HCP about treatment.
• Know that you may never know when you got HPV or who you got it from.
• Know that partners who have been together for a while can have the same HPV types, even if both have no signs.

How can you avoid genital warts?

• Get the HPV vaccine.
  • Certain types of HPV vaccines protect against the low-risk HPV that causes 90% of genital warts.
  • HPV vaccine can be given to males aged 9 to 21 years old.
  • The Centers for Disease Control and Prevention (CDC) recommends all 11-12 year old males get the HPV vaccine (in 3 doses).
  • Young men can get vaccinated through age 21.
  • Men who have sex with men and men with compromised immune systems (including HIV) can be vaccinated through age 26.
• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting HPV. But, condoms may not cover all infected areas. Each time you have sex use a condom:
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have HPV.

Gonorrhea is an infection spread by bacteria. Also known as “the clap” or “the drip”, it affects both women and men. Men can get it in moist, warm areas such as the urethra, anus, mouth, throat, and eyes.

How is it spread?

Men get gonorrhea from sexual contact with someone who is infected. Anyone who has gonorrhea can spread it to others. Gonorrhea can be spread through oral, vaginal, and anal contact between:

• Men and women.
• Men and men.

Men can get or spread HIV more easily if they have gonorrhea.

What are signs of gonorrhea in men?

Some women and men can have gonorrhea without any signs. For men, signs include:

• Painful or burning urination.
• White, yellow or green discharge from penis.
• Testicular/scrotal pain.
• Anal discharge, pain/itching, bleeding or painful bowel movements.
• Fever, abdominal pain, rashes, and swelling or pain in joints over time.
• Sore throat.
• Red or itchy eyes.
• Eye discharge.

See your HCP to be tested if you have signs of gonorrhea.

How do you know if you have gonorrhea?

The only way to know if you have gonorrhea is by a medical exam. Your health care provider (HCP) can examine you and test for it. Lab samples may be taken from the bladder, bowels, throat, urine, or eyes. Your HCP may ask to test you for other infections at the same time. See your HCP to be tested for gonorrhea if you:

• Have any sign of gonorrhea.
• Have new or multiple sex partners.
• Do not practice safe sex.
• Are having sex with someone who might be having sex with others.
• Are having sex with a partner who has a sexually transmitted disease (STD).
• Are exchanging sex for money or drugs.

How is it treated?

Gonorrhea can be treated and cured with antibiotics. Always finish antibiotic treatment, even if signs of gonorrhea go away. Do not have sex until after treatment and signs of it are gone. See your HCP if your signs do not go away after treatment.

What can happen if you have it for a long time?

Gonorrhea can lead to swelling in the testes but rarely results in infertility.

If you have gonorrhea:

• Always finish all antibiotic treatment.
• Wait seven days after finishing treatment before having sex.
• Do not have sex with someone who has gonorrhea or has not finished treatment (to prevent re-infection).
• Tell current and recent sex partners of the infection so they can get checked.
• Know that it can raise the risk of getting and spreading HIV.
• People with gonorrhea should be tested for other STDs.

Tell current and recent sex partners of the infection.

How can you avoid gonorrhea?

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting gonorrhea. Each time you have sex use a condom (male or female type):
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have gonorrhea.

HIV stands for human immunodeficiency virus. HIV is a virus that attacks and weakens the immune system. The immune system is the body’s defense against infections.

If you are infected with HIV, you are said to be “HIVpositive.” Over time as HIV weakens your immune system, you are more likely to get other infections. The late stage of HIV infection is known as Acquired Immune Deficiency Syndrome (AIDS). With medicines, the virus can be controlled so AIDS may not occur.

How is it spread?

Each year in the U.S. about 50,000 people get infected with HIV. More than 1.2 million people in the U.S. are living with HIV infection and approximately 13% are not aware they are infected. Men account for 76% of all adults and adolescents living with HIV. The HIV virus is found only in certain body fluids:

• Blood.
• Vaginal fluid.
• Semen.
• Breast milk.

HIV is NOT spread by:

• Tears
• Sweat
• Feces
• Urine
• Saliva

Contact with infected body fluids can spread HIV by:

• Sexual contact.
  • Vaginal and anal sex.
  • Sharing unclean sex toys.
  • Oral sex, very rarely.
  • Body fluids with HIV can enter tiny breaks or rips in the linings of the rectum or mouth. Rips and tears may not be seen or felt.
• Needle sharing:
  • Used or unclean needles.
  • During illegal drug use.
• Breastfeeding:
  • HIV can be spread to babies and others who drink breast milk from a woman who is HIV positive.
• Pregnancy and birth:
  • HIV-positive women can spread the virus to their babies during pregnancy and birth.

HIV is rarely spread from a blood transfusion because:

• All donated blood is tested for HIV.
• There is no risk of getting HIV when donating blood.

What are signs of HIV?

Most people with HIV will not show signs of HIV until years after getting the virus. Those who have been infected with HIV may have:

• Fever.
• Chills.
• Night sweats.
• Headache.
• Sore throat.
• Swollen lymph nodes, mainly on the neck.
• Tiredness.
• Rash.
• Sores or infections in the mouth.
• Body aches.

You can’t tell if a person is HIV infected by looking at them.

How do you know if you have HIV?

The only way to know you have HIV is by getting an HIV test. Routine HIV testing is recommended for all adults. HIV tests are offered by health care providers (HCP) in doctor’s offices, hospitals, local public health departments, and in local clinics. Most HIV tests use either blood or saliva. HIV tests are very accurate but may not show HIV from a recent infection. Always discuss your test result and retesting with your test provider.

The sooner you know if you have HIV, the sooner your HCP can know when you will need treatment.

How is it treated?

There is no cure for HIV. But there are medicines to help your body fight HIV. Your HCP can help you choose which to take and when to start. Treatment is lifelong. It can:

• Reduce the amount of virus in your body.
• Reduce the spread of HIV to others.
• Help most people with HIV live longer and healthier lives.

What can happen if you have HIV for a long time?

If HIV is not diagnosed and treated, it can progress into AIDS. AIDS stands for acquired immunodeficiency syndrome. AIDS is the late stage of HIV infection. When you have AIDS, the virus has greatly weakened your immune system. If HIV is not treated, other infections can occur that can be life threatening. The only way to know if you have AIDS is through a medical exam and testing by your HCP. Signs of AIDS are:

• Rapid weight loss.
• Fevers.
• Night sweats.
• Extreme tiredness.
• Swelling of the lymph nodes in the armpits, groin, or neck which doesn’t go away.
• Diarrhea that lasts for more than a week.
• Sores of the mouth, anus, or genitals.
• Infections such as pneumonia, tuberculosis, and certain cancers.
• Red, brown, pink, or purplish blotches on or under the skin or inside the mouth, nose, or eyelids.
• Depression.
• Memory loss and other brain or nerve problems.

If you have HIV:

• See a HCP regularly.
• Take medicines as prescribed.
• Tell current and recent sex partners that you have HIV.
• Avoid spreading HIV to others by:
  • Using condoms during all sexual contact.
  • Not sharing used or unclean needles and sex toys.

How can you avoid HIV?

The best ways to avoid HIV are:

• Not having sexual contact.
• Using condoms during all sexual contact.
• Not using or injecting illegal drugs. If you do, use a new sterile needle and drug equipment each time to prep and inject drugs.

Other ways to avoid HIV are:

• Having less sex partners.
• Have sex with only one partner:
  • Who does not have HIV.
  • Who does not have sex with others.
• Not reusing or sharing needles or drug equipment (works).
• If unused (new) needles and sterile works are not used:
  • Boil in water, or
  • Clean with bleach water and rinse with water before each use.

Ask your sex partners to test for HIV and other STDs.

Pre-Exposure Prophylaxis (PrEP)

• PrEP is medicine taken daily. When used with safer sex practices it prevents HIV infection.
• Truvada® is the pill that is used for PrEP. It is more than 90% effective if taken as prescribed.
• Discuss PrEP with your health care provider if you:
  • Are sexually active.
  • Are an injection drug user.
  • Have one or more of these risk factors for HIV:
    • Inconsistent condom use.
    • High number of sex partners.
    • HIV-positive sex partner.
    • A recent STD, such as gonorrhea, chlamydia, or syphilis.
    • An HIV-positive injecting partner.
    • Sharing of injection equipment.
    • Commercial sex work.

Human papilloma virus or HPV is the most common sexually transmitted disease (STD) in the United States. About 79 million Americans have HPV. The Centers for Disease Control and Prevention (CDC) says one in two sexually active people will have HPV at some point in their life.

There are over 100 known types of HPV. About 40 types can infect female and male genital areas.

Genital HPV is grouped into two types:

• Low-risk types can cause genital warts or may be harmless.
• High-risk types can raise the chances for cancer of the penis and anus.

Most sexually active men and women get genital HPV at some time in their lives.

How is it spread?

HPV is spread by skin-to-skin contact. Men get HPV from sexual contact with someone who has it. HPV can be spread by vaginal, anal, oral or hand-genital sexual contact. Some may have no signs of HPV but can still spread it to others. People can have more than one type of HPV. Long-term sex partners with HPV often have the same HPV types.

Risk of having HPV rise if you:

• Have been sexually active at an earlier age.
• Have multiple sex partners.
• Smoke.
• Have a weak immune system due to:
  • A medical condition (cancer or HIV).
  • Medicines.

What are signs of HPV in men?

If you have HPV, you may not be able to see or feel it. You can have HPV even if years since your last sexual contact with an infected person. You may never know which sex partner gave you HPV. HPV infection may cause:

• Genital warts (low-risk HPV).
• Cancer (high-risk HPV).
  • Cancer of the penis (more common).
  • Cancers of the anus, throat, tongue or tonsils (less common)

How do you know if you have HPV?

Most men with HPV have no signs or signs go away on their own. Right now, there is no approved test for HPV in men. Testing before having signs is not recommended. Some providers may offer anal Papanicolaou or “PAP” tests to men who are at high risk for anal cancer (men with HIV or those who receive anal sex).

How is it treated?

Genital HPV infections are very common but:

• Most show no signs.
• Most go away with no treatment within a few years.

If HPV does not go away, treatments are not the same for low risk HPV and high-risk HPV:

• Low-Risk HPV (Genital warts) – Even when treated, virus may remain. Warts can also come back after treatment. Over-the-counter medicines for other types of warts should not be used. Treatments include:
  • Watch and wait to see if the warts stay the same, get bigger, or go away.
  • Medicines put on the warts.
  • Burning off the warts.
  • Freezing off the warts.
  • Cutting the warts out.
  • Using special lights or lasers to destroy the warts.
• High-Risk HPV – cancers from HPV are more treatable if found and treated promptly.

What can happen if you have HPV for a long time?

Some types of low-risk HPV can cause genital warts. If not treated, genital warts may:

• Go away.
• Remain unchanged.
• Increase in size or number.

High-risk HPV can cause cancer. See your provider if you have strange growths, lumps or sores on your penis, scrotum, anus, mouth, or throat.

If you have HPV:

• Talk to your health care provider (HCP).
• Know that long time sex partners often share the same HPV types, even if both have no signs.

How can you avoid HPV?

• Get the vaccine for HPV.
  • One type of HPV vaccine can protect against the low-risk HPV that causes 90% of genital warts.
  • It is for all males 11 or 12 years old – up to 26 years of age for men with weak immune systems and men who have sex with men.
  • The Centers for Disease Control and Prevention (CDC) recommends all 11-12 year old girls and boys get the HPV vaccine.
• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting HPV. But, condoms may not cover all infected areas. Each time you have sex use a condom (male or female type):
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
• Have sex with only one partner who does not have sex with others and does not have HPV.

Condoms may not fully protect against HPV since HPV can infect areas not covered by a condom.

Syphilis is a sexually transmitted disease (STD) caused by bacteria.

How is it spread?

Men get syphilis from sexual contact with someone who has it. Anyone with syphilis can spread it to others. Those who have it may not show signs or know they have it. Syphilis can be spread by contact with a syphilis sore which occurs on external genitals, vagina, anus, or in the rectum. Syphilis can be spread between:

• Men and women.
• Men and men.

What are signs of syphilis in men?

There are four stages of syphilis. Each is defined by how long the person has had it. Signs vary in each stage.

1. Primary Stage: The first sign of syphilis is often a small, round, firm sore. These appear at the place where it entered the body such as the penis, tongue, or lips. Most do not cause pain. There can also be more than one sore. Signs often go away in about 3 to 6 weeks even without treatment. If not treated in this stage, it will progress into the other stages.

2. Secondary Stage: This stage can start with a rash over one or more areas of the body. These appear mostly on the palms of the hands and the bottoms of the feet. Other signs may be:

• Sores in the mouth or anus.
• Sore throat.
• Swollen glands.
• Large, raised gray/white lesions in mouth, underarm, or groin area.
• Fever.
• Hair loss in patches.
• Head and muscle aches.
• Weight loss.
• Tiredness.

If not treated in this stage, signs will still go away. However, the syphilis bacteria are still in the body. The infection will progress into the latent stage.

3. Latent Stage: This stage is also called the hidden stage. It can last many years. Syphilis remains in the body with no signs of infection. Without treatment, syphilis can pass to the Late Stage. This can take 10 to 20 years.

4. Late Stage: Syphilis in this stage can cause:

• Numbness.
• Problems with blood vessels.
• Damage to bones and joints.
• Difficulty walking.
• Blindness.
• Paralysis.
• Brain damage.
• Dementia.
• Heart disease.
• Death.

How do you know if you have syphilis?

Your health care provider (HCP) can examine and test you for syphilis. Blood or fluid from a sore can be tested.

How is it treated?

Syphilis can be cured with antibiotics in all stages of the disease. Always finish treatment. Do not have sex until after treatment and signs of it are gone. See your HCP if your signs do not go away after treatment. Some damage to your body caused by the disease may remain.

If you have syphilis:

• Always finish all antibiotic treatment.
• Do not have sex with someone who has syphilis or has not finished treatment (to prevent re-infection).
• Tell current and recent sex partners of the infection so they can get checked.
• Know that it can raise the risk of getting and spreading HIV.
• Get tested again after 6 and 12 months. Only a HCP can tell you when you no longer have it.

How can you avoid syphilis?

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting syphilis. Each time you have sex use a condom (male or female type):
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have syphilis.
• Know that other forms of birth control do not protect against syphilis.

Trichomoniasis is an infection caused by a tiny parasite. It affects both men and women. It is also known as “trich”.

How is it spread?

Men get trichomoniasis from sexual contact. Anyone who has it can spread it to others. It can be spread between:

• Men and women.
• Men and men.

What are signs in men?

Most men show no signs of “trich”. Others have signs that include:

• Itching and irritation inside the penis.
• Burning after urination or ejaculation.
• Discharge from penis.
• Painful intercourse.

Most infected men have no signs of trichomoniasis. Even so, “trich” can still be spread.

How do you know if you have “trich”?

The only way to know if you have “trich” is by a medical exam. Your health care provider (HCP) can take a sample for testing. Your HCP may also ask to test for other infections at the same time.

How is it treated?

“Trich” can be treated and cured with prescribed medicines that kill the parasite. Always finish treatment. See your HCP if your signs do not go away after treatment.

If you have trichomoniasis:

• Always finish treatment.
• Do not have sex with someone who has “trich” or has not finished treatment (to prevent re-infection).
• Tell current and recent sex partners of the infection so they can get checked.

How can you avoid “trich”?

• Avoid sexual contact.
• Have safer sex:
  • Reduce the number of sexual partners.
  • Condoms, when used correctly, can reduce the risk of getting trichomoniasis. Each time you have sex use a condom (male or female type):
    • During vaginal sex.
    • During anal sex.
    • During oral sex.
  • Have sex with only one partner who does not have sex with others and does not have trichomoniasis.

It might be hard to talk to a partner about getting tested for sexually transmitted infections (STIs), also called sexually transmitted diseases (STDs) — but it’s important to have the conversation. Chances are your partner will be glad you brought it up.

Talk before you have sex.

You can say:

• “Let’s get tested before we have sex. That way we can look out for each other."
• “Many people who have an STI don't know it. Why take a chance when we can know for sure?”

There are other things you may want to talk to a sex partner about. For example:

• Sexual history — like what type of protection you usually use (for example, condoms or dental dams) or the last time you got tested for STIs (including HIV)
• Risk factors — like whether you’ve had sex without a condom or used drugs with needles

Share the facts.

You can say:

• “Most STIs are easy to treat. And when they’re treated early, STIs are less likely to cause long-term health problems.”
• “STI tests are quick, simple, and usually painless. For example, rapid HIV tests can provide results from just a swab inside the mouth in only 20 minutes."
• "If you want to get tested at home, you can get an HIV home test or self-testing kits for other STIs."
• "If you don't feel comfortable talking about STIs with your regular doctor, you can get tested at a clinic instead."

Show that you care.

You can say:

• “I really care about you. I want to make sure we're both healthy.”
• “I've been tested for STIs, including HIV. Are you willing to do that, too?”
• “Let’s get tested together.”

Agree to stay safe.

You can say:

• “If we’re going to have sex, using condoms is a good way to protect us both from STIs. Let’s use condoms every time we have sex.”
• “We can enjoy sex more if we know it’s safe.”