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Q&A with Dr. Laura Kogelman.

It's a different dating world than it was 30 years ago. It's important to get up to speed on how to protect yourself from contracting an STD. In this Q&A, Dr. Laura Kogelman, a leading expert in HIV treatment and Associate Professor at Tufts University School of Medicine, talks about how to ensure a clean bill of health for yourself and your new partner, including therapies that can treat STDs, what type of lubricants to use with your condoms and more. If you have some tips of your own, feel free to share them in our discussion pages.  ​

Are there any physical signs I need to look for before having sex? 

Look to see if there are any sores or lesions on your partner’s genitals. Even if the lesions do not seem to bother your partner, they may represent a sexually transmitted disease (STD) and should be treated to avoid possibly transmitting an infection to you.

I just had sex and didn't use a condom, what should I do? 

You can go to your local emergency room for evaluation and treatment.  They can give you therapy to prevent certain STDs like chlamydia or gonorrhea and can give you HIV post-exposure prophylaxis, or PEP.  PEP meds are medications used to treat HIV. You take them as soon as possible after a possible exposure to HIV and take them for 28 days.  Taking these meds promptly after a risky sexual encounter is very effective in reducing the risk of getting HIV.  It is critical that you follow up closely with an ID physician or your PCP to get follow up HIV testing while you are on PEP and for about 2 months after completing PEP.

My partner tells me not to worry about using condoms because I can't get pregnant, is it safe? 

No. Condoms are very effective for preventing HIV as well as many other STDs. But, unless you know you are  in a monogamous relationship and your partner has been recently screened for HIV or STDs, condoms are still recommended.

I have an STD. Do I have to tell my partner if I have sex with a condom? 

Yes. Though condoms are very effective at preventing transmission of HIV and other STDs, they cannot prevent all transmission.  STDs may be passed on through oral sex, vaginal sex and anal sex, as well as just from genital contact.  Particularly infections such as herpes and syphilis may affect parts of the genitals not completely covered by condoms.  You should get treated promptly for any STDs and avoid sexual contact for at least a week after treatment.  You should disclose the information to your partner so they can get tested and treated as well. 

I've tested negative for HIV and STDs for the last 3 years. I always ask my partners to use condoms. Do I need to keep getting tested? 

Unless you are in a strictly monogamous relationship, it is always a good idea to get tested before engaging in sexual activity with a new partner.  This is also a good way to open up the dialogue with your partner to make sure he gets tested as well, eg “I got tested and have a clean bill of health, why don’t you show me yours.”
 

I need to use a vaginal lubricant for sex. Can I use with a condom? 

Yes.  But make sure you only use water-based (eg K-Y or Astroglide) or silicone-based (eg Pjur Woman Bodyglide and Uberlube) lubricants.  NEVER use an oil-based lubricant with latex condoms (baby oil, coconut oil, Vaseline etc).  These can weaken the latex and increase the risk of condom breakage.

When I was younger, I used spermicide with a condom. Now that I'm post-menopause, do I still need spermicide? 

Spermicides are generally not recommended.  They do not significantly increase the effectiveness of condoms and the can lead to urinary tract infections in women as well as genital irritation.

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