Health Check-Ups Are Important

Regular Check-Ups are Important

It's time to take charge of your health! Schedule an appointment with your health care provider to discuss what screenings and exams you need and when you need them.

Below are resources to help you and your health care provider determine what health services and screenings are best for you.

Why are Check-Ups Important?

Regular health exams and tests can help find problems before they start. They also can help find problems early, when your chances for treatment and cure are better. By getting the right health services, screenings, and treatments, you are taking steps that help your chances for living a longer, healthier life. Your age, health and family history, lifestyle choices (i.e. what you eat, how active you are, whether you smoke), and other important factors impact what and how often you need healthcare.

Where Can I Go for Health Services?

The best place to go for health services is your regular health care provider. However, if you do not have one, the links below provide other options.

CDC's National Breast and Cervical Cancer Early Detection Program (NBCCEDP) offers free or low-cost mammograms and Pap tests. Find out if you qualify.

HIV Testing Resources

Find Affordable Health Care in Your Community (HRSA)

What Health Services are Recommended?

The links below provide information about important exams, screenings, and vaccinations.

Breast and Cervical Cancer Early Detection

Cholesterol

Colorectal Cancer Screening

Diabetes and Me

High Blood Pressure

Immunization Schedules

Oral Health for Adults

Prostate Cancer Screening

Skin Cancer: Basic Information

Pocket Guide to Good Health for Adults (AHRQ)

HIV/AIDS

Viral Hepatitis

How Can I Prepare for My Appointment?

The links below provide tools to help you prepare for your next appointment.

Check-Up Checklist: Things to Do Before Your Next Check-Up

Family History: Tools and Resources

Women's Preventive Services: Required Health Plan Coverage Guidelines (AHRQ)

Be Prepared for Medical Appointments: Build Your Question List(AHRQ)

Men: Stay Healthy at Any Age- Checklist for Your Next Checkup (AHRQ)

Women: Stay Healthy at Any Age- Checklist for Your Next Checkup(AHRQ)

Encouraging Others

You may also want to start a campaign in your community (i.e. a faith-based setting, workplace, school, or civic group) to encourage others to make an appointment for a check-up or health screening on National Women's Check-Up Day (the day after Mother's Day each year) or National Men's Health Week (the week before Father's Day each year).

Dental Check-Ups

How often should I go to the dentist?

The standard recommendation is to visit your dentist twice a year for check-ups and cleanings. This frequency level works well for most people, although some people with gum disease, a genetic predisposition for plaque build-up or cavities, or a weakened immune system might need to visit the dentist more frequently for optimal care.

Also, keep in mind that certain life events — particularly those that cause stress or illness — might cause changes in the mouth or the development of an infection, and might make more frequent visits to the dentist necessary. At the other extreme, people who have taken great care of their teeth and gums, and have gone years without any problems whatsoever might choose to lengthen the time between visits. Ask your dentist what visitation schedule works best for your state of dental health.

The three biggest reasons that most strongly support the twice-yearly visitation schedule are:

• So that your dentist can check for problems that you might not see or feel
• To allow your dentist to find early signs of decay (decay doesn’t become visible or cause pain until it reaches more advanced stages.)
• To treat any other oral health problems found (generally, the earlier a problem is found, the more manageable it is.)

What happens at the typical check-up appointment?

The following oral health care activities usually take place at the typical dental check-up visit:

• Professionals who will treat you — Two oral health care professionals - your dentist and the dental hygienist – will likely see you. The hygienist will conduct an initial oral exam of your gums and teeth, document any changes in your overall health and medicine use, clean and polish your teeth, talk to you about caring for your teeth and gums, and answer any questions you might have about home care products. Your dentist will also conduct an oral exam of your mouth (for signs of oral cancer or other diseases), gums, and teeth; ask about changes in your overall health or medicine use; review the cleaning done by the hygienist; diagnose any oral health problems; and make treatment recommendations.
• Cleaning — Although home-based tooth brushing and flossing help remove plaque, only a professional cleaning – provided by your dentist or dental hygienist – can thoroughly clean your teeth and remove the hardened plaque (called calculus or tartar) that builds up on teeth. Most hygienists use a series of metal hand instruments to clean your teeth. Some are using ultrasonic scalers, which provide deep cleaning above and below the gum line.
• Polishing — After your teeth have been cleaned, they are polished to remove plaque and stains on the tooth surface. The polish contains an abrasive substance and fluoride, and is applied using a small rotating rubber cup or brush attached to the dental hand piece.
• Prevention — Your hygienist might offer additional instructions for you to follow at home, based on the results of your exam. Don’t hesitate to ask your hygienist for instructions about brushing or flossing, or general care questions about your teeth and gums.
• X-rays — X-rays might or might not be taken during your check up. Your dentist will consider your clinical examination, dental history, and risk for developing cavities in determining the frequency for X-rays.
• Treatment recommendations — If any oral health problems are identified during your examination, your dentist will make recommendations for the best next steps. These might include referral to another oral health care specialist, additional diagnostic tests, or advice to return for restoration work or additional oral health care.

If I am visiting a new dentist for the first time, what essential information do I need to share with the dentist?

Your new dentist will want to become familiar with your oral health so that he or she can notice changes or problems more easily during future visits. First, however, even before assessing your oral health, your dentist will want to know more about your general health. Areas that he or she will address with you include:

• Medical history/current medicines — Your dentist will want to know if you have been diagnosed with any diseases. It is important to tell your dentist all of your health issues, not just those you think relate to your mouth. Several diseases, diabetes for example, can increase the risk of periodontal disease or might require that your dentist use a different anesthesia or take a different approach to treatments or prevention. Bring a list of all medicines you are currently taking and their dosages. Some medicines can cause dry mouth, which can increase your risk of cavities. Other important reasons why your dentist needs to know your medicines are so that he or she doesn’t prescribe a medicine that could interact with one you are already taking and to change the type of anesthesia given, if necessary.
• Current dental health — Don’t hesitate to tell your dentist if you think you have a new cavity, sensitive teeth, feel any lumps or bumps, or have any oral health concerns. By informing your dentist of any symptoms you might be experiencing, you might help him or her make an early diagnosis.
• Dental fears — Let your dentist know if you have any fears about going to the dentist or receiving dental care. Dental treatments have changes drastically from years ago and so have pain management options. Your dentist will discuss ways to ease your fears, minimize pain, and make you feel more comfortable.

My dentist’s office called to inform me that my next appointment would be a comprehensive exam. What does this involve?

Comprehensive dental exams not only check for tooth decay and gum health but also examine your entire mouth, head, and neck area. This type of exam is generally given if you are a first-time patient to a new dentist, but should also be given periodically by any dentist you’ve been visiting for years. The comprehensive exam will likely include these evaluations:

• Head and neck — Your dentist will look for any problems on the exterior surface of your head and neck, as well as feel for any swelling or tenderness (which are signs of an infection or disease) in your lymph nodes and salivary glands in your neck area. Your dentist will also examine your temporomandibular joint to determine if it is working properly.
• Soft tissue — The soft tissues of your mouth include the tongue, inside of the lips and cheeks, and the floor and roof of the mouth. Your dentist will examine these areas for spots, lesions, cuts, swellings, or growths that could indicate an oral health problem. Your dentist will also inspect the back of your throat and tonsil area.
• Gum tissue—. Your dentist will examine your gums and supporting structures of the teeth. Your dentist will look for signs of gum disease, which include red or puffy gum tissue and tissue that easily bleeds when gently poked. If your dentist determines you have gum disease, he or she might send you to a periodontist.
• Occlusion —Your dentist will check how well your upper and lower teeth come together. Your dentist might simply look at how your teeth meet, or he or she might take wax impressions of your teeth if a more careful exam of "your bite" is necessary.
• Clinical examination of teeth — Your dentist will check for signs of tooth decay by examining the surface of every tooth. He or she will likely poke your teeth with a dental instrument, called an explorer, to look for cavities. (Decayed enamel feels softer when poked compared to healthy enamel.) Your dentist will also check for any problems with fillings, braces, bridges, dentures, crowns, or other restorations.
• X-rays — Your dentist will take X-rays to look for signs of tooth decay, as well as for gum disease and other oral health problems.

OUR NATION'S BLOOD SUPPLY

In the early years of the HIV epidemic, blood transfusions were at increased risk for transmitting HIV infection.  In 1985, however, an HIV test became available, and screening of all blood donations rapidly became universal.  The U.S. blood supply is now among the safest in the world:

• All blood donors are prescreened for HIV risk factors.
• Blood donations are required to be tested both for presence of antibodies to HIV and of nucleic acids of HIV (RNA).  RNA testing detects HIV at an earlier stage than HIV antibody testing.
• Blood and blood products that test positive for HIV are safely discarded and are not used for transfusions. Donors whose blood tests positive for HIV are notified by the collecting agency and are deferred from further donations.

It is important to know that you cannot get HIV from donating blood.  Blood collection procedures are highly regulated and safe.

DO NOT DONATE BLOOD TO LEARN YOUR HIV STATUS

Some people think that donating blood is a better way to learn their HIV status than asking their doctor for an HIV test or visiting a clinic. This is not true. You should not donate blood to find out if you are HIV-positive.

Why?  Because the HIV tests used to screen donor blood are highly accurate—but they aren't perfect.  If you have been infected with HIV recently, even the most sensitive test may not show it, and you can infect others if your blood is transfused to them.

If you have engaged in high-risk sexual or drug taking behaviors, you should not donate blood.  It is important, though, to learn your HIV status. You can get an HIV test at a number of places, including your local health department, public health clinic, or doctor’s office or at many local AIDS service organizations, community-based organizations, and even in mobile vans. Visit AIDS.gov’s HIV Testing Locations page to learn more and search for locations near you. By getting an HIV test, you can protect your own health, as well as the health of people who need blood!  It is also possible to purchase a kit over the counter that lets you send a finger stick blood sample to a laboratory that will provide you anonymously with your HIV test result by phone.

TESTING DONATED BLOOD

The U.S. Food and Drug Administration (FDA), Health Resources and Services Administration (HRSA), National Institutes of Health (NIH), and Centers for Disease Control and Prevention (CDC) have responsibilities related to maintaining the safety of blood, as well as tissues, blood stem cells, and organs. In the U.S. regulations require that each unit of donated blood is tested for the following infectious agents to ensure its safety:

• Hepatitis B and C viruses (HBV and HCV), which cause inflammation of the liver.
• Human Immunodeficiency viruses  (HIV-1 and HIV-2), the viruses that cause AIDS.
• Human T-Lymphotropic Virus (HTLV-1 and HTLV-2), which causes infections that can lead to leukemia or neurologic disease.
• Treponema pallidum. the bacterium that causes syphilis
• West Nile Virus, a virus spread through the bite of a mosquito that can cause neurologic disease.
• Chagas Disease, a disease that can lead to intestinal dysfunction or cardiac disease. 

For more information, see FDA's Keeping Blood Transfusions Safe and CDC's “How safe is the blood supply in the United States?”

ORGAN/TISSUE TRANSPLANTS

The risks of transplant-related HIV infection are low. All organ and tissue donors are screened for risk factors, and tested for HIV and other diseases that potentially could be transmitted through transplantation. However, although HIV tests are highly accurate, the tests do not always detect the virus in people with very recent infection. In 2007, there were four documented cases of HIV spread through organ transplants. These were the first cases in 20 years, and they were linked to a single donor, who tested negative for HIV in pre-transplant testing.

The Health Resources and Services Administration provides oversight of Organ Procurement and Transplantation Network (OPTN), the national system to coordinate organ donor screening, procurement, donor-recipient matching, and transplantation.  OPTN policies require specific screening tests that must be performed in potential organ donors before the organs can be used for transplantation.

The U.S. Food and Drug Administration regulates human tissues for transplantation. In general, people with risk factors or who test positive for infectious diseases cannot donate tissues. All tissue donors are screened and tested for Human Immunodeficiency Virus, types I and II, and hepatitis B and C viruses. Depending on the type of tissue being donated, some tissue donors are also screened and tested for: Human T-cell Lymphotropic Viruses, types I and II; Syphilis; Chlamydia; and Gonorrhea. In addition, all donors are also screened for risk factors for West Nile Virus and human transmissible spongiform encephalopathy, including Creuztfeldt-Jakob disease.

WHAT IS POST-EXPOSURE PROPHYLAXIS?

PEP involves taking anti-HIV drugs as soon as possible after you may have been exposed to HIV to try to reduce the chance of becoming HIV positive. There are two types of PEP: (1) occupational PEP, (sometimes called "oPEP"), and (2) non-occupational PEP, (sometimes called “nPEP”).  Workplace exposure (oPEP) is when someone working in a health-care setting is potentially exposed to material infected with HIV.  nPEP is when someone is potentially exposed to HIV outside the workplace (e.g., condom breakage, sexual assault, etc.)

To be effective, PEP must begin within 72 hours of exposure, before the virus has time to rapidly replicate in your body. PEP consists of 2-3 antiretroviral medications and should be taken for 28 days. Your doctor will determine what treatment is right for you based on how you were exposed to HIV. The medications have serious side effects that can make it difficult to finish the program. PEP is not 100% effective; it does not guarantee that someone exposed to HIV will not become infected with HIV.

WHO NEEDS PEP?

PEP is usually used for anyone who may have been exposed to HIV.

Healthcare workers have the greatest risk. They can be exposed to HIV by:

• Needle sticks or cuts
• Getting blood or other body fluids in their eyes or mouth
• Getting blood or other body fluids on their skin when it is chapped, scraped, or affected by dermatitis

The risk of HIV transmission in these ways is extremely low—less than 1% for all exposures.

PEP can also be used to treat people who may have been exposed to HIV by accident (e.g., condom breakage) or sexual assault.

WHEN SHOULD I TAKE PEP IF I’VE BEEN EXPOSED?

PEP is most effective if you take it within 72 hours of possible HIV exposure. The longer you wait to start PEP, the greater the risk of becoming HIV-positive.

Your healthcare provider will consider whether PEP is right for you based on how you might have been exposed and whether you know for sure that the individual who might have exposed you is HIV-positive. You may be asked to return for more HIV testing at 4 to 6 weeks, 3 months, and 6 months to determine your HIV status.

For more information, see the National Institutes of Health’s Health-Care Worker Exposure Guidelines orNonoccupational Exposure Considerations.

HOW ARE DRUG USE AND HIV RELATED?

Drug use plays a big role in the spread of HIV.  

• Injection drug use is a leading cause of HIV in the United States. If you inject drugs, you can get HIV from sharing used needles or other equipment (“works”) with an infected person. You can also then pass HIV to your sex and drug-using partners.
• Drinking alcohol or taking other drugs can also increase your risk for HIV. Being drunk or high affects your ability to make safe choices and lowers your inhibitions, leading you to take risks you are less likely to take when sober, such as having sex without a condom.
• Any kind of drug use can lead to HIV transmission when sex is traded for drugs or other high-risk behaviors take place while under the influence of drugs.

WHAT ARE THE HIV RISKS OF USING DIFFERENT TYPES OF DRUGS?

It’s important to know how different types of drugs can increase your risk of getting HIV or passing it to others.

INJECTION DRUG USE

DRUG USE AND HIV INFECTION

According to the most recent CDC data (2008):

• Injection drug users represent 12% of annual new HIV infections in the United States.
• Injection drug users represent 19% of those living with HIV in the United States.
• Among males, 9% of diagnosed HIV infections were attributed to injection drug use and another 4% were attributed to male-to-male sexual contact and injection drug use.
• Among females, 15% of diagnosed HIV infections were attributed to injection drug use.

For more details, including analysis by race/ethnicity, gender and region of the country, see CDC’s HIV Surveillance in Injection Drug Users (through 2008).

In 2008 alone an estimated 4,444 Americans were infected with HIV by injecting drugs.

Sharing drug equipment (or "works") can expose you to HIV-infected blood. If you share works with someone who is HIV-positive, that person’s blood can stay on needles or spread to the drug solution. In that case, you can inject HIV directly into your body.

You can get HIV-infected blood into drug solutions by preparing drugs with:

• A used syringe
• Used bottle caps, spoons, or other containers ("cookers")
• Used pieces of filtering cotton or cigarette filters ("cottons")
• Water that was already used to dissolve drugs or clean syringes

If you are an injection drug user (IDU), you can also pass HIV to your sex partners.

For more information, see CDC’s Why Is Injecting Drugs a Risk for HIV?

INJECTING DRUG USERS ARE ALSO AT-RISK OF HEPATITIS INFECTION

HIV infection isn’t the only risk: Injecting drugs is also the main way of becoming infected with the Hepatitis C virus(HCV). In fact, 50%-90% of HIV-infected injection drug users are also infected with Hepatitis C, a liver disease caused by HCV.

HCV infection sometimes results in an acute illness, but most often becomes a chronic condition that can lead to cirrhosis of the liver and liver cancer. HCV infection is more serious in HIV-infected persons. It leads to liver damage more quickly. Co-infection with HCV may also affect the treatment of HIV infection. Therefore, it’s important for people who inject drugs to know whether they are also infected with HCV and, if they aren’t, to take steps to prevent infection.  To find out if you are infected, your doctor or other health care provider will have to test your blood to check for the virus. Hepatitis C can be treated successfully, even in HIV-infected persons.

METHAMPHETAMINE

Methamphetamine ("meth") is a very addictive stimulant that can be snorted, smoked, or injected. It has many street names including: crystal, tina, black beauties and more.  View a list of more street names.

Meth can reduce your inhibitions and interfere with sound judgment regarding your behavior, which may make you less likely to protect yourself or others. This increases your risk of getting or transmitting HIV infection, both through sex and injection drug use.

Even though using meth is an HIV risk factor for anyone who does it, there is a strong link between meth use and HIV transmission for men who have sex with men (MSM). Studies show that MSM who use meth may increase their sexual AND drug-use risk factors. They may:

• Use condoms less often
• Have more sex partners
• Engage in unprotected anal sex—especially as the receptive partner (“instant bottom”)
• Inject meth instead of smoking or snorting it

Meth use can make the effects of HIV worse for people who already have HIV disease. Studies on animals suggest that meth makes HIV reproduce faster. Other studies show that when HIV-positive people used meth, they suffered more damage to their brain cells. Their ability to think was also more damaged than meth users who were HIV-negative.

ALCOHOL AND OTHER DRUGS

Using alcohol and “club drugs” like Ecstasy can alter your judgment and impair your decisions about sex or other drug use. You may be more likely to have unplanned and unprotected sex or use other drugs, including injection drugs or meth. Those behaviors can increase your risk of exposure to HIV. If you have HIV, this can also increase your risk of transmitting HIV to others.

IF I USE DRUGS, HOW CAN I REDUCE MY RISK OF HIV INFECTION?

If you are using drugs—injecting drugs, meth, alcohol or other drugs—the best way to reduce your risk of HIV is to stop using drugs. To find a drug treatment program near you, enter your ZIP code in the “Find HIV/AIDS Prevention & Service Providers” widget. You’ll then see a list of nearby substance abuse treatment providers who can assist and support you in your decision to take control. (If you have a web site to which you’d like to add this widget, visit this pagefor instructions on how to add the widget to your site.)

If you are injecting drugs and believe you cannot stop using yet, here are some other things that will reduce your riskof getting HIV or transmitting it to others:

• Never use or "share” syringes (needles), water, or drug preparation equipment that has already been used by someone else.
• Use a new, sterile syringe each time you prepare and inject drugs. You can get clean needles from pharmacies or syringe services programs (often also called needle-exchange programs).
• Only use syringes that come from a reliable source (e.g., pharmacies or syringe services programs).
• Use sterile water to prepare drugs, such as water that has been boiled for 5 minutes or clean water from a reliable source (such as fresh tap water).

• Use a new or disinfected container ("cooker") and a new filter ("cotton") each time you prepare drugs.
• Before you inject, clean the injection site with a new alcohol swab.
• Safely dispose of syringes after one use.

Also, if you engage in sexual activity, reduce your sexual risk factors for HIV infection.

Finally, the CDC also recommends that people who inject drugs get screened for HIV at least once every year.

In recent years, new cases of HIV infection resulting from injection drug use have decreased thanks to prevention programs for substance users.

For more information, see CDC’s How Can Injection Drug Users Reduce Their Risk for HIV Infection?

REDUCING YOUR SEXUAL RISK

HIV can be spread by having unprotected sexual contact with an HIV-positive person. "Unprotected" means sex (anal, oral, or vaginal) without barrier protection, like a condom.

Some of the ways to reduce your risk of getting HIV through sexual contact include:

• Don't have sex. Sex (anal, oral, or vaginal) is the main way that HIV is transmitted. If you aren't having sexual contact, you are 100% protected from getting HIV in that way.
  
• Be monogamous. Being monogamous means: 1) You are in a sexual relationship with only one person and 2) Both of you are having sex only with each other. Having only one sex partner reduces your risk of getting HIV—but monogamy won't protect you completely unless you know for sure that both you and your partner are not infected with HIV.
  
• Get tested and know your partner's status: Knowing your own status is important for both your health and the health of your partner. Talking about your HIV status can be difficult or uncomfortable—but it's important to start the discussion BEFORE you have sex.
  
  You need to ask your sexual partners:
  • Have you been tested for HIV?
  • When was the last time you had an HIV test?
  • What were the results of your HIV test?
  If you have more than one sex partner, the CDC recommends that you be tested for HIV and other sexually transmitted infections (STIs) every 3-6 months.

• Use condoms consistently and correctly. To reduce your risk of getting HIV or other STIs, you must use a new condom with every act of anal, oral, or vaginal sex. You also have to use condoms correctly, to keep them from slipping off or breaking.
  
  You have to use the right kind of condom too. Latex condoms are highly effective against HIV. (If you are allergic to latex, you can use polyurethane or polyisoprene condoms.) Lambskin condoms will NOT protect you from HIV, because the virus is small enough to slip through lambskin.
  
  You should always use a water-based lubricant when you use a condom for anal or vaginal sex. Lubricants reduce friction and help keep the condom from breaking. Do NOT use an oil-based lubricant (like petroleum jelly, hand lotion, or cooking oil). Oil-based lubricants can damage condoms and make them less effective.
  
  Both male condoms and female condoms will help protect you against HIV and other STIs. To learn more about how to use a condom correctly, see the U.S. Department of Veterans Affairs' Tips For Using Condoms And Dental Dams.
  
  Condoms do not provide 100% protection against all STIs—but you are ALWAYS safer using a condom! You can get certain STIs, like herpes or HPV, from contact with your partner's bare skin, even if one of you is wearing a condom. But condoms lessen the risk of infection even for those types of STIs.
  
  Condoms with the spermicide Nonoxynol-9 are NOT recommended for STI/HIV prevention. Nonoxynol-9 (N9) irritates rectal and vaginal walls, which increases the chance of HIV infection if infected body fluids do come in contact with them.

For more information, see CDC's How To Use A Condom Consistently And Correctly.

RISKY BUSINESS

All sexual practices can be made "safer"—meaning you can lower your risk of transmitting/contracting STIs and HIV—but some activities are much safer than others. Here's a list of sexual activities and the risks they pose for transmitting HIV or other STIs:

Receptive Anal Sex (Bottoming)

• The odds of getting HIV from "bottoming" without a condom are higher than any other sexual behavior.
• HIV has been found in pre-cum (pre-ejaculatory fluid), so having your partner pull out before he cums (ejaculates) may not decrease your risk.
• Do not douche before sex. Douching irritates the lining of your rectum and this can increase your risk for getting HIV. If you are concerned about cleanliness, clean the rectum gently, with a soapy finger and water.
• If you are bottoming, always use plenty of water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize damage to the rectum during sex and to prevent the transmission of STIs (including HIV).

Insertive Anal Sex (Topping)

• "Topping" without a condom is considered a high-risk behavior for transmission of HIV and other STIs.
• Your partner may have sores or other signs of infection in his/her rectum that you can't see. If you have tears or cuts on your penis, HIV can enter your body this way.
• It is possible for blood and other fluids containing HIV to infect the cells in the urethra of your penis.

Receptive Vaginal Sex (Risks For Women)

• Vaginal sex without a condom is considered a high-risk behavior for HIV infection.
• During vaginal sex, HIV is transmitted from men to women much more easily than from women to men.
• The risk for transmission is increased if you currently have another STI or vaginal infection. Many STIs and vaginal infections are "silent"—meaning you don't have any symptoms, so you may not be aware that you are infected.
• Many barrier methods that are used to prevent pregnancy (diaphragm, cervical cap, etc.) DO NOT protect against STIs or HIV infection because they still allow infected semen to come in contact with the lining of your vagina.
• Oral or hormonal contraceptives (i.e., birth control pills) DO NOT protect against STIs or HIV infection.
• Female condoms DO prevent against HIV infection, if you use them correctly and consistently.

Insertive Vaginal Sex (Risks For Men)

• Unprotected vaginal sex is less risky for the male partner than the female partner—but there is still a risk that the male partner can contract HIV and other STIs.
• Some STIs are "silent," meaning that a woman may have an STI but not have any symptoms. Your partner may not know she has an infection, so it is important to use a condom.
• Use a new condom with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Performing Oral Sex On A Man

• You can get HIV by performing oral sex on your male partner, although the risk is not as great as it is with unprotected anal or vaginal sex.
• You are also at risk for getting other STIs, like chlamydia and gonorrhea.
• Your risk of contracting HIV is reduced if your male partner does not ejaculate (cum) in your mouth.
• Your risk of HIV is reduced if you do not have open sores or cuts in your mouth.
• Using condoms for oral sex reduces your risk of getting HIV or other STIs.

Receiving Oral Sex If You Are A Man

• There is less associated risk for HIV infection with this sexual activity.
• Your risk of HIV is reduced if you do not have open sores or cuts on your penis.
• There is a risk of contracting other STIs, including herpes.

Performing Oral Sex On A Woman

• HIV has been found in vaginal secretions, so there is a risk of contracting HIV from this activity.
• It is possible to contract other STIs from this activity.
• There are effective barriers you can use to protect you from contact with your partner's vaginal fluids. You can cut open an unlubricated condom and lay it over your partner's vulva. You can also use dental dams or non-microwaveable plastic wrap to protect against HIV and other STIs. (Plastic wrap that can be microwaved will not protect you—viruses are small enough to pass through that type of wrap.)

For more information on dental dams, please see the U.S. Department of Veterans Affairs' Tips For Using Condoms And Dental Dams.

Receiving Oral Sex If You Are A Woman

• The risk for contracting HIV this way is significantly lower than for unprotected vaginal sex.
• There is still a risk of contracting other STIs, like herpes, and bacterial infections.
• You should use a barrier method (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over your vulva to protect yourself from STIs.

Oral-Anal Contact (Rimming)

• The risk of getting HIV by rimming is very low—but this kind of sexual contact comes with a high risk of transmitting hepatitis A and B, parasites, and other bacteria to the partner who is doing the rimming.
• You should use a barrier method (cut-open unlubricated condom, dental dam, or non-microwaveable plastic wrap) over the anus to protect against infection.

Digital Stimulation (Fingering)

• There is a very small risk of getting HIV from fingering your partner if you have cuts or sores on your fingers and your partner has cuts or sores in the rectum or vagina.
• Use medical-grade gloves and lots of water-based lubricant to eliminate this risk.

Sex Toys

• Using sex toys can be a safe practice, as long as you do not share your toys with your partner.
• If you share your toy with your partner, use a condom on the toy, if possible, and change the condom before your partner uses it.
• Clean your toys with soap and water, or a stronger disinfectant if indicated on the cleaning instructions. It is important to do this after each use!

SAFER-SEX ACTIVITIES

These activities carry no risk of HIV transmission:

• Non-sexual massage
• Casual or dry kissing
• Masturbation (without your partner's body fluids)
• Frottage—also known as "dry humping" or body-to-body rubbing

You can still contract other STIs, like herpes, HPV, or pubic lice ("crabs") if you have bare skin-to-skin contact with your partner.

CIRCUMCISION

There has been a lot of research over the past few years about the role male circumcision plays in preventing HIV infection. Many of these studies have indicated that male circumcision can decrease the male partner's risk of contracting HIV during heterosexual vaginal sex. In 2007, the World Health Organization  reported that male circumcision reduced by 60% the transmission of HIV from women to men in three randomized, controlled studies in Uganda, Kenya, and South Africa.

There is much less available data for men who have sex with men and how circumcision might affect HIV transmission through anal sex. In addition, recent studies show that circumcision does NOT protect women from contracting HIV from male partners.