Dear Dr. Eva,
A relative recently tested positive for HIV. He has been working on a farm which always has swarms of biting mosquitos. He told me he thinks that he was infected with HIV by the mosquitos. Could that be true?
If it is true, would he be entitled to Workmen’s Compensation to cover the cost of his HIV care?
Aunt B
Dear Auntie B,
Some myths never die. There are many human diseases which can be passed by mosquitos. Only two of these occur in the mainland US: West Nile Fever and Eastern Equine Encephalitis. Worldwide, malaria is by far the most common and most deadly disease transmitted by mosquitos.
HIV cannot be transmitted by mosquitos or any other insects. A mosquito can take in the HIV virus as part of the ‘blood meal’ it gets when it bites, but the virus cannot survive in the gut of a mosquito. The ONLY ways HIV can be transmitted are: sexual contact (by far the most common), injection of contaminated blood products, and sharing contaminated syringes (“needles”) or other medical equipment that has been in contact with blood.
HIV is called a Sexually Transmitted Disease because it is transmitted by sexual contact!
It is not transmitted by mosquitos. Because the infection is not work related,
Workman’s Compensation does not apply.
Dr. Eva
Dear Dr. Eva,
After having a sexual infection, do you become immune or can you be re-infected with the same kind of infection?
Had a Few
Dear Had a Few,
I am sorry to tell you that none of the sexually transmitted infections (STI’s) leaves you immune. In other words, you can get syphilis, gonorrhea, chlamydia, and trichomonas as many times as you are exposed to them.
Some viral STI’s, herpes, HIV and sometimes hepatitis C, become chronic infections. They do not resolve, but remain in the body for life. Reinfection with a different strain of the same virus  is unusual with these infections, but it does sometimes occur.
Other viral STI’S, Hepatitis C and HPV (genital warts), will often clear up on their own, but the person can be reinfected later with the same or a different strain of the same virus.
So, unfortunately, having an STI does not protect you from having the same STI in the future.
The only way to be successful in dealing with STI’s is to prevent them, with condoms, dental dams, and safer sex.
Dr. Eva
Dear Dr. Eva,
I am a woman in my 60’s, divorced, quite a few years past menopause.  I have had two boyfriends in the last year. My boyfriends usually are older than me. I know it is important to use condoms, but my partners usually say they can’t keep an erection with a condom. I know this is unsafe but I am not sure what else I could do. Can you give me some ideas?
Anxious
Dear Anxious,
You are smart to be thinking about this. People who grew up before HIV/AIDS often think of condoms as birth control, not as infection control.
After menopause, due to dryness and thinning of the vaginal tissues, women become more vulnerable to STI’s. That’s why it’s very dangerous for you to have unprotected sex.
Here are some ideas. Please consider all of them seriously.
1. Before your relationship becomes sexual, let your potential partner know that you do not  have unsafe sex. Ever.
2. If he cannot keep an erection with a condom, here are some options:
a. Try one of the erection-enhancing medicines, such as Viagra or Cialis. These require a prescription and a doctor visit. People with certain conditions should not use these medicines; he should discuss this with his doctor.
b. Try a cock ring, available online and in sex toy stores. This is put on at the base of the penis after erection. It holds the blood in the penis, maintaining the erection.
Safe cock rings can be cut off in case of too much swelling. They should be made of fabric, thin leather, elastic or Velcro, never metal, plastic or wood.
c. Try the female condom, sold under the brand name ‘Reality’. This is like a diaphragm ring attached to a bag which fits into the vagina. These are sold in drugstores. If you cannot find one in the condoms section, ask a pharmacist. You should practice with it a few times before using it with a partner, to get comfortable with it. The female condom should not be used together with the male condom.
d. Simplest of all, you could tell your prospective partner that you have safer sex only, and let him know that includes intercourse with a condom, oral sex, and hand sex (mutual masturbation.)
Dr. Eva
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Dr. Eva Hersh, MD
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