Poo, the log in timed out and I lost the first version of this - this might be a little more terse

I just wanted to put an additional notice out about the Herpevac vaccine.  It protects against HPV!  I know that it is available at Planned Parenthood and most STD clinics in the US.  I'm not sure about it's availability in the UK,  maybe someone could add it to this post.

There are a couple of vaccines available here, I think. They're no use if you've already got the few (but significant) strains of HPV they help protect against. They're expensive. Probably because of that, there's been a pile of publicity around the benefits - the producers want to make as much money as possible before their patents run out - and not much about the drawbacks.

I can certainly see the argument for (freely) vaccinating all girls prior to the start of their partner sex lives - it will doubtless save lives.

I'm personally less convinced about adults paying for it, especially if they're already getting regular checks / cervical smears etc. If you've had plenty of partners in your condomless private life, you may well already have most or all of the strains. If you have used condoms with every boyfriend, you quite possibly don't have any... but if you're going to continue that, why have the vaccine?

Different people will make different personal choices, and hooray for that.

Any advice on what to do when you encounter a client with symptoms of STD's?  I'm in nursing so my reaction to a recent client was very clinical and I know I made him uncomfortable.  For girls that do oral wihout condoms,  do you ask all clients if they have an STD or when they were last tested?

If someone says they don't have anything, there are three possibilities:

a) they don't have anything,

b) they know they do, but they think that you wouldn't have sex with them if they said so, so they've lied,

c) they do have something, but they don't know it.

The second one is particularly common amongst people with HIV or herpes, but doubtless happens with other things too. The third applies to somewhere between a third and a quarter of people with HIV.

In any case, 'No I don't have anything' is not particularly useful, and I certainly wouldn't base any safer sex decision on it outside a committed relationship (and even then, I'd want joint, same room test results).

Instead, I check for sores and if a squeeze of their penis produces pain or pus, it doesn't go in me, and they get details of sexual health clinics, plus tips on how to be fast tracked. It's only happened once, and I was happy to give a discount on another booking (I don't think they realised they had anything).

do you ask a guy to shower first?  Do you include this in their time or give them additional time to shower?

Depens on their attitude. If they've moaned a lot about it, it comes out of their time.