Acted Rash-ly: STDs can increase your chances of "passing on" or "getting" HIV - Dr. Dick

Acted Rash-ly: STDs can increase your chances of "passing on" or "getting" HIV

Dear Dr. Dick,
I've been HIV positive for 8 years. My T-cells are in the toilet because I can't seem to tolerate the "miracle" drugs that everybody is celebrating. A couple months ago, I let another HIV positive guy ride me bareback. It was hot sex but I got a raging case of syphilis. I didn't even know it. I went to see my doctor after I got this rash on my hands and the bottom of my feet. He thought it was a reaction to one of my meds, so he switched me to something new, but the rash didn't go away. Finally, he tested me for syphilis and discovered I had it. And here's the kicker -- I was already in the second stage! I hate to think I could have passed this on to somebody else. My doc gave me a shot of antibiotics and now I'm OK. But the whole thing gave me quite a scare. Just a warning to others: Watch out! "The truth" ain't all that's "out there." Sign me...
Acted Rash-ly


Dear Acted Rash-ly,
Thanks for the letter. Your case is a good warning for a lot of us -- docs and patients.

For sexually active gay and bisexual men in Seattle, regular and thorough STD checkups are the order of the day. Syphilis cases are skyrocketing among local gay men. And sometimes docs miss the symptoms, especially if you have other health concerns. Syphilis was eliminated in King County in 1995 and 1996. But now it's back with a vengeance. And gay men are at highest risk, especially gay men who have HIV. Syphilis and other STDs appear to progress faster in men who have HIV. Also, STDs, including syphilis, make it easier to get and to spread HIV. As you found out there are many links between HIV and other STD infections. Here's some important info:

Having another STD increases your risk of getting or transmitting HIV.
Why? Because some STDs cause breaks in the skin or mucosal linings of the anus, mouth and vagina. STDs can infect the genitals and anus but they don't always show symptoms. Whether you see them or not, STD infections cause millions of white blood cells to gather around infected areas. These white blood cells are the body's first line of defense. They fight off invading bacteria and viruses. Sadly, white blood cells are also HIV's favorite target for infection. When HIV comes into contact with a syphilis sore or drippy discharge caused by chlamydia or gonorrhea, it's as if the body is rolling out a red carpet welcome. In short, we can say that pus (a visible collection of white blood cells) is a welcome wagon for HIV.


Here's an example. Say you don't have HIV, but you do have an active case of syphilis, chlamydia or gonorrhea. If you have unprotected sex with someone who is HIV positive, your chances of getting HIV can increase by as much as 400 percent. On the other hand, if you already have HIV and get another STD infection of top of it, the level of HIV virus in your semen or blood stream can go up to 10 times higher. This will make it much easier to infect your sex partners with HIV.


The higher the level of HIV in your body, the harder it is on your immune system. And if you have higher amounts of HIV in your genital tract, it is easier to give it to a sex partner. HIV positive people with seriously weak ened immune systems tend to have more frequent and serious STD-related symptoms. This is es ly true in late stages of HIV infection. For example, people with both HIV and herpes will often report more frequent and severe herpes out breaks.

Here are some tips that will keep you healthier:

  • Learn to know STD signs and symptoms. Pick up pamphlets from the STD Clinic or from NEON peer educators.
  • Reduce the number of new sexual partners and avoid sex with partners you do not know well. Many studies have shown that "anon" partners are especially risky.
  • Use condoms consistently and correctly with all new sex partners
  • If you are very sexually active, get a free check up at the Harberview STD Clinic. You can also get tested at Seattle Gay Clinic. Get a regular check up even if you don't have symptoms.
  • For women, douching (either vaginal or anal) may increase the risk of STDs. Douching is not an effective treatment for any STD infection.
Thanks for writing. Your letter is a good warning to all of us. Remember, most STDs are easy to treat. But they can have severe health consequences if they go unchecked.
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