By Dr. Thanes Vanig

Q. In the past I haven’t been responsible when it comes to sex. How do I discuss this with my doctor?

Matt, Phoenix, Arizona. 

A. You have to find a physician that you feel comfortable discussing this with. It is very important to be honest to your provider. A physician has to be open-minded, familiar with MSM sexual activities, and has knowledge about sexually transmitted disease diagnosis, treatment, and prevention. There are many sexually transmitted infections that you can have without any symptoms such as syphilis, rectal gonorrhea and chlamydia, HIV, etc. so it is important to get appropriate testing even if you do not have any signs or symptoms.

Q. I’ve heard good things about using PrEP to prevent HIV transmission. If I’m on PrEP do I still need to use a condom?

Kelvin, Tustin, California.

A. We recommend all patients on PrEP (Pre-Exposure Prophylaxis) continue using condoms. PrEP is a way to prevent HIV infection by taking a pill called Truvada daily. In all the clinical trials that showed benefits of PrEP, subjects in the trial were instructed to continue using condoms and practicing safe sex. They also had intensive counseling on safe sex behavior regularly. If used properly with safe sex, it can reduce the risk of HIV infection by 86-92 percent.

As always please discuss your individual needs with your personal doctor.