Your Honest-to-God Guide to STDs
Chances are, if you’re reading this, you’re scared by the idea of catching some sort of STD. Or at least you have been in the past. That night you got drunk and didn’t have a condom but went for it anyway. Or the girl you took home who had a reputation for sleeping with every third guy in the phone book. Perhaps you freaked out and rushed to get tested the next morning. Maybe you started Googling around frantically to convince yourself that you’re OK, only to find horrifying images and statistics about how people lost internal organs, limbs and never, ever had sex again because they were so hideously deformed by some pesky infection… Your mind begins racing, your liver DOES hurt you think to yourself. It must be an early onset of AIDS. Obviously…
The unfortunate thing about STD “education” is that it focuses on very specific information: symptoms, treatments, and every worst-case scenario. Any real world experiences or likelihood is absent. Down-to-earth guidance on how this information should affect your behavior is usually glossed over — telling you to abstain from having sex (yeah right) and to use a condom (even though it doesn’t prevent everything).
As a result, people start getting paranoid and some serious social stigmas develop.
What’s never discussed is the actual prevalence of STD’s, the realistic chance of catching these STD’s or what the experience of catching them would be like.
I still remember the night a girl I was dating told me that she had HPV. I felt like I was going to vomit. I immediately imagined that my cock had morphed into a giant tumor, shooting pellets of cancer into girl’s cervixes. Or the time one of my best friends told me over the phone that he had what appeared to be a herpes breakout. I nearly cried for the guy. Holy shit. What was he going to do? No girl would ever want to have sex with him again.
But as I learned more, got tested more, spoke to more doctors and did more research, I realized that the truth STD’s are more complicated than previously assumed, and that getting them is a far more benign experience than I ever imagined. For instance, there are over 100 strains of HPV, and only four of them lead to most cervical cancers in women… assuming it’s left untreated for a period of years… and assuming she hasn’t already been vaccinated… and even if she does get cervical cancer it’s very unlikely to be fatal. So what I assumed was my cancer-laden pee-shooter in my pants, actually had something like a 1/100 x 1/100 x 1/2 x 1/100 chance of actually causing serious health problems in a girl.
The more I learned about STD’s, the more I encouraged men to relax a little bit about them. Wear a condom. Get tested periodically. Stay away from the crackwhores and dirty needles. Do that, and you’re going to be fine. Seriously.
For instance, the chance that any particular woman has syphilis in the United States is about 1 out of 10,000. The chance of being struck by lightning in your lifetime is 1 out of 8,434… just to give you some perspective. And the difference is syphilis can be cured with a little penicillin, lightning can’t.
Over the years I’ve been inundated with emails from paranoid guys, telling me that a condom broke, or that they slept with four girls in two months and now they’re convinced they caught something. Or that there’s a girl who’s slept with 15 guys before, and they think she probably has something.
This is all ridiculous and borne out of being poorly informed. Yes, for all of our talk of sexual education in our culture, we really do a horrible job of imparting the important information about sexual health to young men and women. In fact, I’ve come to believe that a lot of sexual health information has an agenda of fear-mongering and promoting abstinence rather than giving people specific information that they can use to make good decisions.
What guys don’t even realize is that as men, we have it pretty damn good. Most STD’s don’t harm us as much as they do women. Many STD’s aren’t as contagious through vaginal sex for men as they are for women. Hell, a lot of STD’s don’t even do anything to us.
What I aim to do with this article is to break down the most common STD’s in the most realistic way possible. Statistics, symptoms and treatments are listed. Sources are include. But I’m also going to list a couple of other things that you won’t find anywhere else: 1) what the experience of actually contracting that STD would be like; and 2) how likely you are to catch each STD if you had rampant unprotected sex.
In fact, I’ve put together a statistic of my own for each STD: the RAW Score. The RAW Score is a rough estimation of the average amount of single American women you would have to have unprotected sex with to contract that particular STD. For STD’s which are cured, I did this by taking the amount of reported cases per year, dividing it by two, and then factoring it into the amount of single women in the US (approx. 49 million) to get a percentage of single women who contract said STD each year. For STD’s which are incurable, I simply take the percentage of the American population with that STD and divide it by two. Not a perfect method by any means, but the numbers are so stark that it gets the point across nicely: you’re not likely to catch anything serious any time soon.
And finally, I will say this again and again: use a fucking condom. Don’t be an idiot. Use a condom, get tested regularly. I personally get tested every 10 partners or so. I’ve never had anything come up positive (although apparently I had some sort of strain of HPV at some point), but I still get tested.
But the other reason that I’m going to keep saying use a fucking condom is for the part at the very end of the article: yes, once we cover the most common STD’s, we’ll take a minute to look at what you SHOULD be worrying about as an unmarried, independent man.
Living With It: Uncomfortable… especially when they stick a cotton swab up your peehole. Then you take some pills and it’s gone.
Curable: Yes (2-4 Weeks)
RAW Score: 37 Women
Condom Protects: Yes
Chlamydia is a minor bacterial infection mostly transferred through intercourse. In men it’s uncomfortable and generally harmless. In women, there’s a slight chance that if untreated, it can cause some damage to her reproductive system.
Symptoms include it hurting to piss and your balls aching. Although 25% of men don’t experience symptoms. 70% of women will also not experience any symptoms, which actually makes it more dangerous for them (most doctors recommend women screen for chlamydia at least once a year).
Living With It: Painful. Hope for no pus. Then you take some pills and it’s gone.
Curable: Yes (within a month)
RAW Score 141 Women
Condom Protects: Yes
Gonorrhea is Chlamydia’s big brother. In fact, the two often occur together. The difference is that gonorrhea can be transferred via any orifice: penis, vagina, anus, mouth. It often takes a few weeks for symptoms to show up, and it’s even more unpleasant to deal with.
The symptoms for gonorrhea include it hurting to piss, aching balls, swollen urethra, sore throat, and pus coming out of your dick. Yes, that was pus coming out of your dick.
Living With It: Itchy. Then 15 years later you go insane and kill yourself… (no, seriously.)
RAW Score About 10,000 Women (no, that’s not a typo)
Condom Protects: No
The famous philosopher Nietzsche was a bit of a lush and had a fondness for prostitutes. Somewhere along the way, he contracted syphilis and his body began to wither from the inside out. Over the course of this torturous process, he famously proclaimed “God is dead” and slowly slipped into dementia and died.
Syphilis was the 19th century’s version of the AIDS epidemic. It was famously cured by Alexander Fleming in 1928 and it hasn’t been much of an issue since. Pretty much nobody gets syphilis anymore. In fact, in 2006, every reported case of syphilis in the United States came from only two cities (no, I don’t know which cities).
Syphilis plays itself out in stages. The first stage is you get bumps or breakouts, not dissimilar to herpes I imagine (forgive me for not looking up images). This happens a few weeks after contracting the virus. From there, after a few months, you break out into rashes. These rashes go on for weeks or months and eventually subside. From there, the you have no symptoms. Until 15-20 years later your internal organs start bleeding, you lose control of your motor functions, and you start losing your mind.
So the moral of the story? Get tested sometime in the next 15 years. Oh, and don’t live in one of those two mystery cities.
HPV (High-Risk Strains)
Living With It: A nuisance. A few years of awkward conversations.
Curable: No, but it typically leaves on its own after a few years. There is also a vaccine.
RAW Score: 50 Women
Condom Protects: No
HPV is where things begin to get interesting. HPV is the latest STD freak-out of our generation. If all you’ve heard is the few tidbits that get passed around, it sounds horrifying. Over 50% of the population gets it at some point, that it causes cancer, condoms don’t protect it, etc., etc.
This is true. But again, what’s more important is the information you DON’T hear. And here it is: there are over 100 strains of HPV. All except for about six of them are basically harmless. And all of them but two have no symptoms in men. Feeling a little better? Good, let’s keep going…
Those two that cause symptoms in men cause genital warts. Warts sound terrible, but they’re completely harmless and can be removed within the matter of days with basic surgery (a few weeks to few months with a self-applicated chemical treatment). The other four high-risk strains can, if left untreated, lead to cervical cancer in women. New studies are also showing that oral sex with someone who has these strains can possibly lead to throat cancer down the road. But HPV throat cancer rates are still insanely low and the other rare type of cancers caused by HPV are rare and almost never fatal.
The good news is that women are getting checked more and more for lesions on their cervix these days. Also, women who do get lesions can have a minor procedure that prevents them from getting cervical cancer, so it’s nothing to freak out about. The HPV vaccine is being given to just about every girl under 26 (and many men too) in most states these days. And when you factor in that HPV usually leaves your body naturally after a few years (assuming you’re healthy), and chances are this is going to be almost a non-issue 5-10 years from now.
If you’re sexually active, chances are you’ve already got at least one strain of HPV. But again, only six out of over 100 are considered high-risk, and you’re far less likely to have those. Unfortunately, many places still do not test men for HPV. So the only way you can know if you have it is if a girl you’re dating tells you, or if you happen to find a wart. Either way, it sucks, kind of ruins your day, causes a lot of awkward conversations… but you move on and everything ends up being fine.
Living With It: There’s a good chance you already have it.
Curable: No, but who cares?
RAW Score: 5 Women
Condoms Protect: No
So I got good news and bad news. The bad news is that a shitload of people have Herpes (including probably myself). The good news is that the vast majority of people never show symptoms and don’t have enough for it to show up in their blood levels.
I have to admit, Herpes was the last STD I was actually worried about (reason I’m not worried about HIV below). Then I started researching it for this article and realized I probably already have it. In fact, if you’ve been with as many women as I have, it’s almost statistically impossible to NOT have it. And chances are you have it too!
See, there are two types of Herpes: HSV-1 and HSV-2. HSV-1 usually causes breakouts around the mouth — we just call them canker sores or fever blisters. Over 80% of the population has HSV-1 although at any given time almost none of us have a break out. HSV-2 causes breakouts around the genitals. Except the majority of people never get breakouts or get such minor breakouts that they don’t even realize that it’s herpes. My friend who has had a breakout said that he originally thought his was just a bug bite. It wasn’t until a second one showed up that he decided to get it checked out. It’s been over three years and he hasn’t had another breakout since. He’s also in a monogamous relationship and his girlfriend has never had a break out.
Herpes never goes away, but it’s harmless. In fact, even if you do get breakouts, most people stop getting them after a couple years. And if you’re one of the unlucky few who actually does get a bad break out, you can take medication to suppress them. So there. Not worried about herpes anymore… After all, I probably already have it, and so do many of you.
Living With It: You may become decrepit and bankrupt. But you’ll probably live.
RAW Score: 3,000 Women
Condoms Protect: Yes
HIV is no longer the death warrant it once was. Don’t get me wrong, contracting it would be awful and surely life-altering, but you’d live. I just hope you have good health insurance. As of 2011 the life expectancy of someone who contracts HIV is 40 years from the day they contract it. When in doubt, just look at Magic Johnson.
But here’s some other good news about HIV and why I don’t ever worry about it. 80% of men who get HIV get it from gay sex or drug usage. Recent studies show that men are very unlikely to contract HIV through vaginal sex by itself. What this means is that even if you somehow had unprotected vaginal sex with an HIV-positive girl, you’re still quite unlikely to be infected.
Also, I hate to say it, but HIV positive cases are predominantly lower income and/or African-American. African-Americans account disproportionately for 42% of all HIV cases. So if you’re having vaginal sex with middle-class or upper-middle class girls, then you’re extremely unlikely to be at risk.
The symptoms of HIV are flu-like symptoms a couple weeks after contracting it. From there your immune system slowly shuts down over the period of years. There are a lot of therapies and treatments available, and there are a some promising leads towards a cure. So the news on the HIV front over the past few decades has actually been mostly good.
But still, wear a damn condom.
Living With It: Completely and irreversibly life-changing
Curable: Uhh… err…
RAW Score 26 times with any woman
Condom 85% effective
Over the years I’ve had dozens of men ask me about STD’s, many of them looking for information, but many of them simply looking for reassurance that they were not going to shrivel up and die. I always tell them that 1) they’re going to be fine; and 2) they should be far more worried about babies. Notice the 1 in 26 times. That’s not 26 women, that’s 26 occurrences of unprotected intercourse. That’s MUCH more likely than anything else listed here with the exception of Herpes.
I can tell you, in all of my years working as a dating coach, with all of my sexual partners, with all of the crazy hedonistic people I partied with, I’ve only known one person who had a herpes break out, a few people with HPV, and one person who had Chlamydia. I’ve never met or even heard of anyone who got HIV. I’ve never met or heard of anyone who got cervical cancer. I’ve never met or heard of anyone who contracted gonorrhea or syphilis. But I can think of at least a dozen people who have dealt with unwanted pregnancy or had a major pregnancy scare.
Do NOT fuck around with this.
And as a man, let’s be clear. If you get a girl pregnant, especially a girl you don’t know very well, you’re completely powerless. She has the legal choice of what to do with it. And if she decides to keep it, she’s got you by the balls for 18+ years. Half of every paycheck you make for the next 20 years is going to some kid that she may not even let you see depending on where you live. And if you don’t cough it up, or if you run into money problems and can’t pay, you go to jail. She marries some other guy? Doesn’t matter. You want to fight for custody or hell, even more visitation rights? Better hire a lawyer.
Now, obviously most women are going to be empathetic and cool about the situation. But the point is that paternity rights in the US are a joke. And let’s say you do put in the effort and try to make it work, try to raise your kid and be an available father and all that jazz — say goodbye to late-night parties with your buddies, say goodbye to spending all your extra cash on awesome vacations or Vegas trips, forget those season tickets you were saving up for. Say hello to finding babysitters, changing diapers, working overtime and explaining to every girl you date that you’ve got a kid. If you’re older and more established, this may not be as big of a problem, but if you’re some 22-year-old guy just hitting his stride and not even done with school yet, forget it…
And even if the girl decides to not keep it, welcome to the most gut-wrenching experience of your life. I’m lucky in that I’ve never had to deal with a legitimate pregnancy, but I know people who have — staunch, hardcore, liberal, don’t-give-a-fuck party-goers — and shit gets real… real fast. It’s easy to walk around and say, “I would do this or that,” but when it comes time to walk the walk, many people can’t stomach it, or live with some serious guilt or regrets until the grave.
Wrap it up. Get tested regularly. Have open conversations with your sexual partners: “Have you been tested? Are you on birth control?” The five seconds it takes is always worth it.
Stay smart and stay safe.