Important abbreviations:

HIV = human immunodeficiency virus

AIDS = acquired immune deficiency syndrome

STI = sexually transmitted infection(s)

ART = antiretroviral therapy

PrEP = preexposure prophylaxis

PEP = postexposure prophylaxis

Can I get HIV from oral sex?

The chance of contracting HIV through oral sex with an HIV-positive person who has not started antiretroviral therapy is extremely small. It is difficult to calculate the risk because many people who practice oral sex, also have vaginal and / or anal sex. Mouth-to-penis is considered as the riskiest oral sex. The risk of contracting HIV through oral sex is extremely small compared to anal and vaginal sex.

Can I get HIV from kissing?

It is impossible to get infected with HIV through mouth or social kissing. You cannot get infected with HIV through saliva. In some extremely rare scenarios, people have contracted HIV due to deep tongue kisses because both partners have had blood in the oral cavity resulting from bleeding gums or wounds.

HIV / AIDS

 

  • What is HIV / AIDS?

HIV (Human Immunodeficiency Virus) is a rapidly mutating virus that attacks the immune system. When the HIV virus is not treated with antiretroviral therapy (ART), it will eventually lead to AIDS (acquired immune deficiency syndrome). If a person with AIDS is not initiated on antiretroviral therapy (ART), AIDS leads to death.

  • How is HIV transmitted?

HIV is transmitted through blood (including menstrual), semen (including precum), vaginal and rectal fluids, and breast milk. Sexually, HIV is transmitted through unprotected anal, vaginal, and oral sex. HIV is not transmitted by kissing, touching, or sharing utensils.

  • How is HIV treated?

There is no cure for HIV, however, there’s antiretroviral therapy (ART). ART needs to be taken every day and is extremely successful at keeping the virus in the human body at an “undetectable” level. An HIV-positive person who adheres to their ART and has “undetectable” HIV cannot infect their sexual partners, even if the sex they practice is unprotected. Hence, the term Undetectable = Untransmittable, or U=U, has been coined.

  • What should I do?

Get tested for HIV every 6 months, if you practice sex with different partners – every 3 months. Use condoms regularly. There are also new methods to prevent HIV. One of these is PrEP (pre-exposure prophylaxis). PrEP is taken once a day or on demand, and protects you against HIV during sex. Another method is PEP (post-exposure prophylaxis), which should be taken within 72 hours after a risky sexual encounter. Unfortunately, neither PrEP nor PEP are available in Bulgaria at affordable costs, but this is something we are trying to change.

  • Problems

Lack of a cure for HIV. Currently, an HIV-positive person has to take ART every day to keep his virus at an “undetectable” level. Stigma. Strong public disinformation. Discrimination against people living with HIV. Discriminatory medical practices towards people living with HIV. Lack of affordable PrEP and PEP in Bulgaria.

Hepatitis A

 

  • What is hepatitis A?

Hepatitis A is a viral infection which affects the liver.

  • How is hepatitis A transmitted?

Many people, including medical practitioners, continue to forget the fact that hepatitis A can be transmitted sexually. Hepatitis A can be transmitted via any sexual activity with an infected person, it is not limited to fecal-oral transmission. Condoms are not an effective way to prevent the spread of hepatitis A.

  • How is hepatitis A treated?

As a viral infection, hepatitis A is not treated with antibiotics. In addition, there is no particular cure. The patient should be well taken care of, and generally within 14-28 days, the immune system overcomes the virus. There have been cases where hepatitis A has remained in the body for more than a month.

  • What should I do?

The world has the very successful universal hepatitis A vaccine at its disposal. Please get vaccinated! That way you not only save yourself weeks or months of pain, but also protect everyone you communicate with.

  • Problems

An insufficient number of people are being vaccinated against hepatitis A. The pseudoscientific anti-vaccine movement over the past few decades has done a great disservice to humanity. Diseases like hepatitis A, for which science has created a vaccine, should be completely eradicated.

Hepatitis B

 

  • What is hepatitis B?

Hepatitis B is a viral infection which affects the liver. Hepatitis B (together with Hepatitis C) is the major cause of liver cirrhosis / cancer worldwide. Acute hepatitis B is, in most cases, cleared by the body’s defenses, and in a few months or less, the infected person acquires immunity. Unfortunately, there is also chronic hepatitis B, which, like HIV, is a chronic disease that requires a regular intake of medication.

  • How is hepatitis B transmitted?

Sexually, hepatitis B is transmitted through anal, vaginal and oral sex. There is evidence that hepatitis B can also be transmitted through deep kissing.

  • How is hepatitis B treated?

As a viral infection, hepatitis B is not treated with antibiotics.  The treatment is complex and requires counselling with a doctor.

  • What should I do?

The world has the very successful hepatitis B vaccine at its disposal. Please get vaccinated! That way you not only save yourself weeks or months of pain (if it’s acute hepatitis B) or a chronic disease which forces you to take meds for the rest of your life (if the hepatitis B becomes chronic) but also protect everyone you communicate with.

  • Problems

An insufficient number of people are being vaccinated against hepatitis B. The pseudoscientific anti-vaccine movement over the past few decades has done a great disservice to humanity. Diseases like hepatitis B, for which science has created a vaccine, should be completely eradicated.

Hepatitis C

 

  • What is hepatitis C?

Hepatitis C is a viral infection which affects the liver. Hepatitis C (together with Hepatitis B) is the major cause of liver cirrhosis / cancer worldwide.

  • How is hepatitis C transmitted?

Hepatitis C is transmitted by blood. Therefore, unprotected sexual encounters, when the anus, vagina, or penis are bleeding, make hepatitis C transmission possible during sex.

  • How is hepatitis C treated?

As a viral infection, hepatitis C is not treated with antibiotics. Unlike hepatitis A and B, science has discovered wonderful cures for hepatitis C. The treatment lasts for about 80 to 120 days and is extremely successful. Curing hepatitis C is easiest during the earliest stages of infection, hence regular testing for hepatitis C is recommended.

  • What should I do?

Get tested for hepatitis C every 6 months. If you think you are part of a high-risk group (fisting, bareback sex or injectable drug use), get tested every 3 months. Use condoms. Use sterile needles and syringes while injecting drugs.

  • Problems

There is no hepatitis C vaccine yet. An already infected person may have no symptoms for years, which leads many carriers of the virus to believe that they do not have hepatitis C in the system. Lack of regular testing awareness as well as the need to catch the infection at the earliest possible stage continue to be major problems.

HPV

 

  • What is HPV?

HPV (human papilloma virus) is a viral infection with at least 170 different types. Most of them are completely harmless, but others are carcinogenic and can cause cervical, penis, anus, throat, and mouth cancer.

  • How is HPV transmitted?

HPV is the most easily and commonly transmitted STI in the world. HPV is transmitted through unprotected anal, vaginal, oral sex, but there are types that are transmitted even through skin-to-skin contact between people. HPV is transmitted very easily, and is not bound to semen or blood.

  • How is HPV treated?

There is no cure available for any of the HPV types. The upside is that the immune system successfully combats most HPV types. Do not take antibiotics because HPV is a viral (not a bacterial) infection.

  • What should I do?

Science has discovered a highly successful HPV vaccine. Please get vaccinated! This not only protects you from the carcinogenic HPV types, but also protects everyone you communicate with. HPV tests are extremely expensive, so the most reasonable way to protect yourself is to get vaccinated against HPV.

  • Problems

An insufficient number of people are being vaccinated against HPV. The pseudoscientific anti-vaccine movement over the past few decades has done a great disservice to humanity. Diseases like HPV, for which science has created a vaccine, should be completely eradicated.

Syphilis

 

  • What is syphilis?

Bacterial infection. When the bacteria have been in the body for too long, they become extremely difficult to treat and can lead to blindness, brain damage, heart disease and death.

  • How is syphilis transmitted?

Syphilis is transmitted through unprotected anal, vaginal, and oral sex. Syphilis is also transmitted through deep “French” kisses. Syphilis is transmitted very easily, and is not bound to semen or blood.

  • How is syphilis treated?

The most recommended (and quick) treatment option is penicillin.

  • What should I do?

Use condoms. Get tested regularly for syphilis.

  • Problems

In the early stages, syphilis is an infection which is very easy to treat. Unfortunately, there is no penicillin in Bulgaria, and doctors are often forced to treat people with Ceftriaxone or other antibiotics that are injected much more frequently compared to the one or two shots of penicillin.

Gonorrhea

 

  • What is gonorrhea?

Bacterial infection. It can lead to arthritis and infertility. In relation to sexual transmission, gonorrhea can be found in the urethra, cervix, anus, throat.

  • How is gonorrhea transmitted?

Gonorrhea is transmitted through unprotected anal, vaginal and oral sex. There is evidence that it can also be transmitted through deep “French” kisses. Gonorrhea is transmitted very easily, and is not bound to semen or blood.

  • How is gonorrhea treated?

With antibiotics. If you test positive for gonorrhea, the consultation with a doctor/nurse is a must because the choice of the antibiotic and the dosage depend on where the gonorrhea is found.

  • What should I do?

Use condoms. Get tested regularly for gonorrhea with a rectal, throat, urine / urethral swab.

  • Problems

Unfortunately, the bacterium has already highly mutated and in some countries around the world there is a phenomenon called “super” gonorrhea. Super gonorrhea cannot be cured, making it a chronic illness such as HIV and chronic hepatitis B.

Many clinics in Bulgaria often only test for gonorrhea with a urethral swab / urine, omitting the fact that the patient may have had both oral and / or anal sex. This is a problem because the patient may test negative for gonorrhea in the urethra but have it in the throat, for example.

Chlamydia

 

  • What is chlamydia?

Bacterial infection. It can lead to infertility and irreversible damage to reproductive organs. In relation to sexual transmission, chlamydia can be found in the urethra, cervix, anus, throat.

  • How is chlamydia transmitted?

Chlamydia is transmitted through unprotected anal, vaginal and oral sex. Chlamydia is transmitted very easily, and is not bound to semen or blood.

  • How is chlamydia treated?

With antibiotics. If you test positive for chlamydia, the consultation with a doctor/nurse is a must because the choice of the antibiotic and the dosage depend on where the chlamydia is found.

  • What should I do?

Use condoms. Get tested regularly for chlamydia with a rectal, throat, urine / urethral swab.

  • Problems

Many clinics in Bulgaria often only test for chlamydia with a urethral swab / urine, omitting the fact that the patient may have had both oral and / or anal sex. This is a problem because the patient may test negative for chlamydia in the urethra but have it in the throat, for example.

 

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