Ten Common Questions

Two of the most common reportable infections are Chlamydia and Gonorrhea. In Allegheny County in 2018, 58% of all new Chlamydia and Gonorrhea infections happened in people under the age of 25. When left untreated, they can make it make it difficult to have children or get pregnant, as well as other long term health problems.

The other reportable infections include HIV and Syphilis.

Even though there have been great strides within the field of HIV, there continues to be around 40,000 new infections nationally per year. It is estimated that 1 in 7 people with HIV do not know their status. The good news is that due to the effectiveness of HIV medications, a person with a consistent undetectable viral load (low level of virus in the blood) has a zero chance of transmitting the virus. Syphilis, on the other hand, has been rising steadily since 2001, and while infections are highest among gay and bisexual men, we have seen a new trend of cases rising in heterosexual females.

Regarding HIV, individuals between 20-29 are especially affected by HIV. As with national statistics, young black/African American gay and bisexual men are disproportionately affected. Syphilis has been rising steadily since 2001 and infections are highest among gay and bisexual men. Symptoms of syphilis, like chancre sores (painless round sores during primary syphilis) and rash (which forms on the palms of hands, bottoms of feet, and torso during secondary syphilis), disappear over time. However, even once symptoms clear up, the infection remains and cause long term serious health consequences, including still birth, miscarriage, brain/heart problems, and even death. Find more information about HIV/STDs (see "Educational Materials" tab).

If you are sexually active: Yes. But remember, risk can vary depending on several different factors: where you live, what age you are, the type of sex you are having, how many STDs you have already had, and so on.

If you have ever been or currently are sexually active there is always some risk. That’s not to say that if you have sex you will for sure get an STD, we just mean that there is no way to make sex 100% risk-free but here are things you can consider doing to help reduce risk:

• Water-based lubricants help prevent the breaking of condoms and/or help reduce the chances of small tears forming in the anus or vagina.
• Condoms and barriers during anal, oral, and vaginal sex
• PrEP (Pre-exposure prophylaxis)
• Frequent STD and HIV testing
• If HIV positive, take medication as directed by your doctor. Find more information about how being unable to detect HIV in the blood can make it hard to pass or transmit HIV - this is called "Undetectable equals Untransmittable" also known as U=U.
• If possible, reduce the number of new or frequent partners.

No. While some people might have symptoms, most people will not have any visible symptoms. About 80% of people with an STD will not notice any visible symptoms – this is why it is important to get tested frequently, wear condoms, and consider taking PrEP.

The answer to this is no.

Here are a few things that are important for you to know:

Anal Sex

When it comes to anal sex, a good rule of thumb is that if you can get infection on your genitals (penis/vagina), you can also get it in your rectum. This includes HPV, Syphilis, Gonorrhea, Chlamydia, Herpes, etc. There are several reasons people have anal sex: pleasure, fear of pregnancy, a partner wants to try it, body dysphoria, avoiding vaginal sex because of menstruation/period, to keep vaginal “virginity,” and many others. Whatever the reason, it is important to know what the risks are to help you make more informed choices.

Anal sex, especially receptive anal sex, is riskier for transmitting HIV. What is meant by receptive anal sex is, during anal sex, the partner inserting the penis is called the insertive partner (or top), and the partner receiving the penis is called the receptive partner (or bottom). Only certain body fluids – blood, semen (cum), pre-seminal fluid (pre-cum), rectal fluids, vaginal fluids, and breast milk – from a person who has HIV can transmit HIV.

When having anal sex, micro-tears can happen in the rectum. Unlike the vagina, which is typically more elastic and stretches more easily, the anus is not as flexible. Even if you don’t see blood, those tears are likely still there, which can leave one more vulnerable to getting HIV if their partner has HIV.

Oral Sex

When it comes to oral sex, you can get STDs when you don’t use barriers like external condoms or dental dams. HPV, Chlamydia, Gonorrhea, Herpes, and Syphilis can all be transmitted during oral sex.

Actually, what you get tested for can depend on a lot of different things, such as: where you go, your doctor, your insurance, or what your doctor thinks you’re at risk for. It is always important to ask for what specific tests you might want or need.

The Allegheny County Health Departments Public Health Clinic offers free walk-in testing. Our standard testing includes testing for Chlamydia, Gonorrhea, Syphilis, and HIV. Find information on additional testing done at our Public Health Clinic (HIV/STD).

No, it does not. However, as a harm reduction method, if pulling out is the only form of birth control and STD prevention you have access to, it is better than nothing. If you are unable to use condoms, consider using PrEP to reduce your chances of getting HIV. PrEP doesn’t protect you from other sexually transmitted infections but is better than no protection.

No. If you wear more than one condom you are more likely to experience a tear. Wear only one condom the correct way every time you have sex. Do not reuse condoms. Do not flip them inside out. If you or your partner lose an erection while wearing a condom, you should take it off and replace it with a new one even if it is during the same session.

Here is a video talking about important things to know about using a condom correctly:

• How to Put On A Condom - Planned Parenthood

Pre-Exposure Prophylaxis (PrEP) is a medication that is taken daily to lower the chances of getting HIV. It is designed for individuals who are at high risk for getting HIV. Taking PrEP before you are exposed to HIV can reduce your risk of contracting the virus. PrEP is recommended for people who:

• Have had more than one STD
• Are a man who has sex with other men
• Are a transwoman who has sex with men
• Have a partner who is HIV positive (or if you think they might be HIV positive)
• Have anal sex without a condom
• Have multiple sex partners and don’t always use condoms
• Have a partner who has multiple sex partners
• Use needles to inject drugs

This answer is not one size fits all, so here are some recommendations from our health educators and nurses (some of these differ from CDC recommendations which are linked below if you are curious about the differences):

• At least once a year, even if you are in a committed monogamous relationship.
• When you have a new sexual partner.

If this isn’t realistic:

• If you have new or multiple partners, consider getting tested every 3 months.
• If you had a condom break.
• If you or a partner are pregnant.

More information on the CDC recommendations.

The Allegheny County Health Department’s Public Health Clinic offers free and confidential walk-in HIV/STD screening at our NEW location in the Hill District at:

Public Health Clinic
1908 Wylie Avenue
Pittsburgh, PA 15219

Open Monday, Tuesday, Thursday and Friday from 8 am – 3:30 pm, and Wednesday from Noon – 7:30 pm.

Call 412-578-8081 for more information.

Find more testing options for you: HIV Care Options in Allegheny County(PDF, 380KB)