• HIV stands for human immunodeficiency virus.
• It is a virus that weakens the immune system by destroying important cells (T-Cells) that fight off disease and infection.
• Untreated HIV may develop into AIDS (Acquired Immunodeficiency Syndrome).

HIV is passed by certain bodily fluids, including blood, pre-seminal fluid (pre-cum), semen (cum), rectal fluids, vaginal fluids, and breastmilk from a person who has HIV. The most common ways that HIV is passed from one person to another is:

• Unprotected anal, vaginal, or oral sex with a person who has HIV.
• Sharing unclean needles with a person who has HIV.
• HIV can be passed from a pregnant person to their unborn child during pregnancy, birth, or breastfeeding.

• Symptoms may appear within 2 to 4 weeks after exposure and they typically last a few weeks.
• Some people may not get any symptoms for many months or even years after infection. Because of this it is important to get tested for HIV, even if you have no symptoms.

• The most common signs and symptoms of early HIV infection are flu-like (fever, muscle aches, swollen glands, loss of appetite, etc.). Once these go away, a person may not experience other symptoms for many years.
• Signs of an untreated HIV infection may include: night sweats, fevers, fatigue, diarrhea.
• If HIV continues to go untreated, AIDS may develop. When a person has AIDS, their immune system is so weak that bacteria, viruses, or other germs that wouldn’t normally cause illness can cause them to become very sick which can lead to being put in the hospital or death.

• There is no cure for HIV.
• Treatment may include a variety of medications that stop or limit the virus’ ability to make copies of itself in the body.

Learn more about the medications:

• HIV PrEP
• HIV PEP

The Centers for Disease Control and Prevention (CDC) recommend the following testing schedule for HIV:

• Everyone between the ages of 13 and 64 get tested for HIV at least once in their lifetime.
• Pregnant women: at first prenatal visit.
• Men who have sex with men (MSM): every year.
  • For MSM with multiple sex partner(s) or those who use drugs, especially meth and any drugs that are injected: every 3-6 months.

There are many options for testing in Los Angeles County.

• If you are looking for an HIV testing location near you, please visit: cdc.gov.
• HIV testing can also be done at home. For more information about home testing and to order an HIV test that you can take at home, please visit: TakeMehome.org.

There are many different options for preventing HIV, depending on what you feel your risk may be and what type of behavior you engage in. Some of these options include:

• Pre-Exposure Prophylaxis (PrEP)- medications an HIV-negative person can take to prevent HIV before exposure. This can prevent HIV in someone who may be exposed during sex, or through using injection drugs.
• Post-Exposure Prophylaxis (PEP)- medications an HIV-negative person can take to prevent HIV after exposure. This can prevent HIV in someone who may be exposed during sex, or through using injection drugs.
• Using barriers during sex can reduce your risk of getting HIV or passing it to a partner. These barriers include:
  • Condoms (external, latex, used on a penis).
  • Internal condoms (used in a vagina or anus).
  • A dental dam for oral sex.
  • Latex gloves for rimming and fingering.
• Reducing the number of people you have sex with.
• Abstaining from any kind of sex eliminates the risk of getting HIV.
• If you use injection drugs, using clean needles and not sharing needles can reduce your risk of getting HIV or passing it to others. For more information on where to access a syringe exchange program in Los Angeles, please click here.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/hiv/basics/index.html.

• Syphilis is a sexually transmitted disease (STD).
• Syphilis is a skin and blood infection caused by a bacteria (Treponema pallidum).
• It can spread to other parts of the body after it enters the blood, including organs.

• Syphilis can be easily transmitted through skin-to-skin contact with a syphilis sore during vaginal, anal, or oral sex.
• Sores are usually found on or around the penis, vagina, or anus, or in the rectum, on the lips, or in the mouth.
• Because syphilis is passed through skin-to-skin contact, it can also be passed through foreplay, rubbing, masturbation (self or with partner) or touching.
• Syphilis can be transmitted even without penetration.
• Syphilis can spread from an infected mother to her unborn baby. This is known as “congenital syphilis”.

• A syphilis sore usually shows up around 3 weeks after infection, but it can take anywhere from 10 and 90 days to appear.
• Many people may not notice the initial sign, and many have no signs or symptoms at all.
• It is still possible to pass syphilis to a sex partner, even if you have no symptoms.

The type of symptom you see depends on how long you have been infected with syphilis. Symptoms are grouped into 4 stages:

• Primary Syphilis:
  • A painless sore called a “chancre” (SHANG-kr) appears at the place where the bacteria entered the body.
  • The chancre usually appears on the penis, testicles, vagina, vulva, mouth, throat, rectum or in the butt.
  • A chancre is highly contagious if touched by another person.
  • This sore will go away on its own (even without treatment) after several weeks.
  • This does not mean the infection is gone. Syphilis will still be present in the body and it is still possible to pass syphilis to others.
• Secondary Syphilis:
  • A rash on the body, palms of the hands and soles of the feet.
  • Hair loss.
  • Sore throat.
  • Wart-like growths on the genitals.
  • Lesions in the mouth or in other areas with a mucous membrane.
  • Swollen lymph glands.
  • Weight loss.
  • Fatigue or feeling tired.
  • Muscle and joint aches.
  • Similar to the initial symptoms, these symptoms will go away on their own without treatment. It will still be possible to pass syphilis to others and the infection will still progress.
• Latent Syphilis:
  • This stage is also known as the hidden stage, because there are usually no signs or symptoms during this stage.
  • Symptoms will go away without treatment, but the infection will still progress.
• Tertiary Syphilis:
  • Without treatment, syphilis infection will begin to damage internal organs and other parts of your body such as the brain, nerves, eyes, heart, blood vessels, liver, bones and joints.
  • This occurs many years after signs of secondary syphilis.
  • Symptoms include difficulty coordinating muscle movements, paralysis, numbness, blindness, deafness, dementia and death.

Complications of syphilis can occur at any stage and they may include:

• • Neurosyphilis: when syphilis infects the brain.
  • Ocular syphilis: when syphilis infects the eyes causing trouble seeing or blindness.

For people who are pregnant or may become pregnant, it is also possible to pass syphilis to an unborn baby. When a baby is born with syphilis, it is called “congenital syphilis”. Complications of congenital syphilis for the baby include:

• • Stillbirth (baby born dead).
  • Nasal discharge from baby’s nose (“snuffles”). This mucus contains the bacteria itself and it is very contagious.
  • Rashes and skin sores.
  • Permanent brain and nerve damage.
  • Permanent bone deformities.

• Syphilis is treated with antibiotics.

• When and how often you get tested is up to you and it can be based on how often you are having sex. You may want to get tested every 3, 6 or 12 months.
• Centers for Disease Control and Prevention (CDC), the California Department of Public Health (CDPH) and Los Angeles County recommend the following testing schedule for syphilis:
  • Pregnant women: at first prenatal visit, during their third trimester (28-32 weeks), and at delivery.
  • Men who have sex with men (MSM): Once every year.
    • For those who have sex with anonymous partners, or who have multiple sex partners, or those who use drugs, syphilis testing is recommended every 3 – 6 months.

• To find a place where you can get tested, visit: gettested.cdc.gov.

The best way to avoid syphilis is to avoid touching another person’s syphilis sores or lesions. This can be done a number of different ways:

• Using barriers during sex can reduce the risk of getting syphilis. This includes:
  • Condoms (external, latex, used on a penis)
  • Internal condom (used in a vagina or anus)
  • Dental dams when having oral sex
  • Gloves that prevent fingers/hands touching sores or rashes will also help prevent infection
  • Barriers don’t always cover all infected areas. It is still possible to get or pass syphilis, even when condoms are used correctly.
• Reducing the number of people you have sex with can also reduce the risk of getting syphilis
• Abstaining from any kind of sex is the only way to completely eliminate the risk of getting syphilis.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/std/syphilis/stdfact-syphilis.htm.

• Chlamydia is a sexually transmitted disease (STD) caused by a bacteria (Chlamydia trachomatis).
• The most common bacterial STD in the U.S.
• Most common among youth ages 20-40 years across the United States.
• It has been on the rise in Los Angeles County for the past decade.

• Chlamydia can be spread whether you have symptoms or not.
• Chlamydia is transmitted from one person to another through sexual fluids –this includes pre-cum, semen, vaginal fluid, and from mother to baby through birth fluids.

• Many people never experience symptoms.
• For those who show symptoms, they usually appear about 7 – 21 days after exposure.

• For those who do experience symptoms, these may be some symptoms:
  • A white, yellow, green, or clear drip/discharge from the penis, vagina or butt.
  • Burning or pain when you pee.
  • Pain in the lower belly or back, sometimes with a fever.
  • Pain during sex.
  • Vaginal bleeding after sex or between periods.

• When and how often you get tested is up to you and it can be based on how often you are having sex. You may want to get tested every 3, 6 or 12 months.
• For people with anonymous sex partners, multiple sex partners, involved in sex work, or who have had a sexually transmitted infection in the past, testing is recommended every 3 – 6 months.
• Testing is done by collecting a pee sample, and/or swabbing the vagina, butt and throat.

• To find a place where you can get tested, visit: gettested.cdc.gov.
• To find a local youth friendly clinic for an in-person test, visit pocketguideLA.org.

• Chlamydia is treated with antibiotics.
• It is important for all partners to be treated at the same time and to abstain from having sex until they have finished the antibiotics.
• Even after someone has been treated, it is still possible to get chlamydia again.

• Using barriers during sex can reduce the risk of getting chlamydia. This includes:
  • Condoms (external, latex, used on a penis).
  • Internal condoms (used in a vagina or anus).
  • A dental dam for oral sex.
  • Barriers don’t always cover all infected areas. It is still possible to get or pass chlamydia, even when condoms are used correctly.
• Reducing the number of people you have sex with can also reduce the risk of getting chlamydia.
• Abstaining from any kind of sex is the only way to completely eliminate the risk of getting chlamydia.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/chlamydia/about/.

• Gonorrhea is a sexually transmitted disease (STD) caused by a bacteria (Neisseria Gonorrhea).
• Gonorrhea can happen in your genitals, butt, throat, or eyes.
• Most common among young adults aged 20-24 years across the United States.
• It has been on the rise in Los Angeles County for the past decade.

• Gonorrhea can be spread whether you have symptoms or not.
• Gonorrhea is transmitted through sexual fluids – infected yellowish green discharge from penis or vagina, pre-cum, semen, vaginal fluid, and from mother to baby through birth fluids.
• Gonorrhea can also be spread through close genital contact. This means you can get gonorrhea from someone if your genitals touch, even if you don’t have sex or ejaculate (cum).

• Many people may not experience any symptoms.
• For those who will show symptoms, they can show up right away or as long as 30 days after.

• Many people may not experience any symptoms.
• For those who do experience symptoms, the most common ones are:
  • Burning or pain when peeing.
  • A white, yellow, or green discharge (pus) from the penis.
  • Increased vaginal discharge.
  • Painful or swollen testicles.
  • Vaginal bleeding between periods.
  • Anal discharge, itching and/or soreness.
  • Anal bleeding.
  • Pain when pooping.
  • Dry or sore throat.
  • Discharge in your throat.

• Gonorrhea is treated with antibiotics.
• It is important for all partners to be treated at the same time and to abstain from having sex until they have finished the antibiotics. This prevents people from re-infecting each other.
• Even after someone has been treated, it is possible to get gonorrhea again.

• When and how often you get tested is up to you and it can be based on how often you are having sex. You may want to get tested every 3, 6 or 12 months.
• For people with anonymous sex partners, multiple sex partners, involved in sex work, or who have had a sexually transmitted infection in the past, testing is recommended every 3 – 6 months.
• Testing is done by collecting pee or pus samples, and by swabbing the vagina, butt and throat.

• To find a place where you can get tested, visit: http://gettested.cdc.gov/.
• To find a local youth friendly clinic for an in-person test, visit pocketguideLA.org.

• Using barriers during sex can reduce your risk of getting gonorrhea. These include:
  • Condoms (external, latex, used on a penis).
  • Internal condoms (used in a vagina or anus).
  • A dental dam for oral sex.
  • Barriers don’t always cover all infected areas. It is still possible to get or pass gonorrhea, even when condoms are used correctly.
• Reducing the number of people you have sex with.
• Abstaining from any kind of sex is the only way to completely eliminate the risk of getting gonorrhea.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/gonorrhea/about/.

• Trich (short for Trichomoniasis) is a sexually transmitted disease (STD) caused by a protozoan parasite (Trichomonas vaginalis).
• Most common, curable STD.
• Most common among women in the United States.

• Trich can be spread whether you have symptoms or not.
• Trich is spread from one person to another through vaginal sex without a condom with
  someone who has Trich.
• During sex, the parasite usually spreads from a penis to a vagina or from a vagina to a penis. It
  can also spread from a vagina to another vagina.

• Trich can be spread whether you have symptoms or not.
• Trich is spread from one person to another through vaginal sex without a condom with
  someone who has Trich.
• During sex, the parasite usually spreads from a penis to a vagina or from a vagina to a penis. It
  can also spread from a vagina to another vagina.

• These may be some symptoms among women and people with a vagina:
  • Itching, burning, redness, or soreness of the vagina.
  • Discomfort when peeing.
  • A clear, white, yellowish, or greenish, thin vaginal discharge with a fishy smell.
  • Pain during sex.
• These may be some symptoms among men and people with a penis:
  • Itching or irritation inside the penis.
  • Burning after peeing or ejaculating.
  • Discharge from the penis.
  • Pain during sex.

• Get tested if you have signs or symptoms or have had contact with a person with
  trichomoniasis.

• Please contact your healthcare provider if you think you have Trichomoniasis.
• Call 2-1-1 if you do not have health insurance or a medical provider.
• You can also visit any Public Health Sexual Health Clinic.

• Trich is treated with antibiotics.
• It is important for all partners to be treated at the same time and to abstain from having sex.
  until they have finished the antibiotics, usually for 7 days.
• Even after someone has been treated, it is still possible to get Trich again.
• Without treatment, the infection can last for months or even years.

• Using barriers during sex can reduce the risk of getting Trich. This includes:
  • Condoms (external, latex, used on a penis).
  • Internal condoms (used in a vagina or anus).
  • A dental dam for oral sex.
• Reducing the number of people you have sex with can also reduce the risk of getting Trich.
• Abstaining from any kind of sex is the only way to eliminate the risk of getting Trich completely.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/trichomoniasis/about/.

• Herpes is a sexually transmitted disease (STD) caused by a virus (Herpes Simplex Virus or HSV) which causes ulcers on the body.
• There are 2 viruses that can cause herpes:
  • Type 1 (HSV-1): it commonly infects the mouth and lips (“fever blisters”, “cold sores”).
  • Type 2 (HSV-2): it commonly infects the anus, vagina, and surrounding areas.

• Herpes can be spread through “skin-to-skin” contact from sores/ulcers or infected skin that looks normal.
• Herpes can also be transmitted by vaginal, anal or oral sex through direct contact with an ulcer or infected skin.
• You or your partner don’t have to see ulcers to spread it to each other. The virus may be present and it can spread whether you have symptoms or not.
• 70% of people are infected with herpes when the other partner does not have symptoms or ulcers on the skin.

• About 80% to 90% of infected people have no symptoms, or have extremely mild symptoms that they do not notice.
• If symptoms occur, they may appear between 2-12 days after exposure.

• For those who do experience symptoms, the most common ones are:
  • Blisters or ulcers on the mouth, genitals or rectum.
  • Flu-like symptoms including aches, pains and feeling generally unwell.
  • Tingling or burning around the genitals.
  • Trouble peeing and/or pain when peeing.
  • Unusual vaginal discharge.

The blisters will typically heal and go away within one to two weeks. Even though the blisters are gone, the virus is still in the person’s body. Additional outbreaks will occur, and herpes can still be passed to others.

Many people with genital herpes never experience symptoms or may first experience symptoms months or years after they were infected.

• There is no cure for herpes.
• Antiviral medications can shorten outbreaks, lessen discomfort, and prevent symptoms from getting worse.

• Testing for herpes is done by swabbing a blister/ulcer on the skin.
• A blood test can check for herpes antibodies, but these are not routinely available.
• Testing is only recommended for a person who has symptoms or has had skin-to-skin contact with a person with herpes.

To find a place where you can get tested, visit:  http://gettested.cdc.gov/

• • There are things you can do to reduce your risk of getting herpes. These include:
    • Reducing the number of people you have sex with.
    • Using barriers during sex such as:
      • Condoms (external, latex, used on a penis).
      • Internal condoms (used in a vagina or anus).
      • A dental dam for oral sex.
      • Latex gloves for rimming and fingering.
    • Abstaining from any kind of sex is the only way to completely eliminate the risk of getting herpes.

  If you or your partner are experiencing symptoms of a herpes outbreak, it’s best to wait to have sex until the outbreak has cleared.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/herpes/about/.

• Genital warts are a sexually transmitted disease (STD) caused by HPV (human papilloma virus).
• HPV causes warts (sores or growths) to appear on the skin.

• Genital warts are passed by direct skin-to-skin contact with the warts and/or infected skin that looks normal during oral, vaginal, or anal sex.
• Genital warts can also be passed through foreplay, rubbing, masturbation (self or with partner) or touching.
• Penetration is not necessary to transmit the virus that causes genital warts (HPV).

• Warts can appear anywhere from 3 weeks to 8 months to years after.
• Many people with HPV may never show symptoms of warts.

• Many people never experience symptoms.
• For those who do experience symptoms, the most common ones are fleshy bumps that can be flat, round or shaped like cauliflower around the genital areas (vagina, penis, or butt).

• There is no cure for HPV, although most people with HPV infections see them resolve on their own within 2 years.
• Treatments to remove visible warts and abnormal cell growths range from medication to surgery to freezing the warts off.
• Warts and abnormal Pap tests can come back even after treatment.

Because HPV can also cause certain types of cancer, testing is recommended for certain parts of the body.

• For people with a cervix, a Pap test can detect abnormal cell growth in the cervix.
  • Recommended for people with a cervix between 21 and 63 years of age.
  • People with cervixes should get regular tests at 21 or three (3) years after becoming sexually active, and every three years if the test comes back normal.
  • If abnormal tissue is found, yearly testing is recommended.
  • HPV co-testing is recommended for people with cervixes who are over 30 years of age.
• Currently, there is no approved HPV test for the penis.
• The Centers for Disease Control and Prevention (CDC) does not recommend routine testing for HPV or HPV-related diseases before there are signs or symptoms.
• People who have butt (anal) sex may consider anal pap smears. This is recommended for those who may be at increased risk for anal cancer, including men with HIV or men who receive butt (anal) sex.

• To find a place where you can get tested, visit: https://gettested.cdc.gov/.

There are several ways to prevent genital warts, and certain types of cancer caused by HPV.

• There is an HPV vaccine (Gardasil 9) for the following:
  • Recommended for 11-12 years old (can be given between 9 to 26 years old).
    • 9-14 years old: 2 dose series (6-12 months apart).
    • 15 and older: 3 dose series (1-2 months and 6 months apart).
  • Also recommended for:
    • Gay and bisexual men (or MSM) through age 26.
    • People with compromised immune systems (including people living with HIV/AIDS) through age 26.
• Using barriers during sex can reduce your risk of getting HPV or passing it to a partner. These barriers include:
  • Condoms (external, latex, used on a penis).
  • Internal condoms (used in a vagina or anus).
  • A dental dam for oral sex.
  • Latex gloves for rimming and fingering.
• Reducing the number of people you have sex with.
• Abstaining from any kind of sex is the only way to completely eliminate the risk of getting genital warts caused by HPV.

For more information, visit the Centers for Disease Control and Prevention (CDC) website:

https://www.cdc.gov/std/hpv/stdfact-hpv.htm.