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Sex Paraphernalia and STD Safety

Dildos and toys (plastic, metal, rubber instruments inserted in rectum)
STD risks include:

• Chlamydia
• Gonorrhea
• Hepatitis A, B, and C
• HIV
• Parasitic infections
• Syphilis

Shared dildos can spread disease to the mouth and anus. When body fluids like blood or pus are shared, the risk is increased. Washing the hands and the dildo after one partner has used it can greatly reduce the spread of disease.

Enema (introduction of fluid into the rectum)
STD risks include:

• Chlamydia
• Gonorrhea
• Hepatitis A, B, and C
• HIV
• Parasitic infections
• Syphilis

Sharing an enema involves the same risks as sharing a dildo. An enema insert should be washed thoroughly before a partner uses it. Enema is not recommended for cleaning the anus and rectum. The water can force bacteria and flora from the rectum and lower intestine into the upper intestine. Enemas deplete the normal flora of the rectum and can lead to infection.

Partners who receive the fluid as it is expelled from the anus risk contracting STDs associated with oral-anal sex, especially if the fluid enters the mouth, open skin, anus, or meatus.

Drug Use
The use of party drugs, like amyl nitrate (poppers, rush, snappers) is dangerous during sex because they lower blood pressure, raise pulse rate, and increase circulation. Amyl nitrate is an inhalant used for muscle relaxation and the immediate rush that it causes. Its effects on the cardiovascular system increase the risk for heart attack and loss of consciousness. It is used during or before sex because it causes disinhibition and a general feeling of well-being, but it can lead to incaution and poor judgment of sexual risks. Mixing poppers and alcohol can be deadly.

Nonoccupational Postexposure Prophylaxis (NPEP)
NPEP, or PEP, is an antiviral treatment regimen that can prevent HIV infection after exposure to the HIV virus. Health care workers have been using PEP since 1986 whenever they have been exposed to a large amount of blood, gotten blood in an open wound, or been stuck with a contaminated needle.

Occupational PEP (used for exposure on the job) prevents HIV infection in about 80% of people who seek medical care immediately after exposure. Full patient compliance is necessary for successful treatment, which lasts for several months and requires three daily doses. It costs $600 - $1000 and can cause serious side effects including nausea, fatigue, headache, and general malaise. There is no scientific evidence that shows its effectiveness after sexual exposure.

Information and advice can be obtained by calling the toll-free 24-hour PEPLine at 1.888.HIV.4911 (1.888.448.4911), or by calling Fenway Community Health at 617.927.6100.

General STD Information and Prevention Suggestions

• It is safe and smart to ask a partner about STD history, HIV, and STD prevention before having sex.
• HIV reinfection is possible. People infected with one strain of the virus can contract and spread different strains during unprotected sex. Compounded infection affects treatment.
• Many new HIV infections are resistant to medication.
• Hepatitis A and B vaccinations are highly recommended for men who have sex with men. Vaccination can be obtained from a primary care provider.
• HIV-negative people can maintain their status by avoiding contact with semen and blood.
• It may be helpful to keep condoms around if the chance exists for spontaneous or unplanned sex.
• Use a water-based lubricant (e.g., KY Jelly) that does NOT contain nonoxonyl-9 (N9).

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