Category Archives: Health Concerns

The New Gay Sexual Revolution

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PrEP, TasP, and fearless sex remind us we can’t advance social justice without including sex in the equation.

By Jacob Anderson-Minshall

The sexual revolution of the 1960s and ’70s came to an abrupt and brutal end for many gay and bi men the moment AIDS was traced to sexual contact. In the early days of the epidemic, sex between men was equated with AIDS, not just in the mainstream media, but also in prevention efforts by other gay men. Since AIDS in those days was seen as a death sentence, for men who had sex with men, every sexual interaction carried the risk of death. Indeed, tens of thousands died of AIDS-related conditions.

“I was alive when homosexuality was [still] considered to be a psychological illness,” David Russell, pop star Sia’s manager, recently told Plus magazine. “The two generations ahead of mine, and a good portion of my generation, were completely decimated by AIDS. They’re gone.”

While some men with HIV outlasted all predictions and became long-term survivors, the widespread adoption of condoms is credited with dramatically reducing HIV transmissions among gay and bi men in subsequent years. Yet reliance on nothing but that layer of silicone — a barrier some complain prevents true intimacy and pleasure — couldn’t erase the gnawing dread gay men felt that every sexual encounter could be the one where HIV caught up to them.

There have been, of course, moments when nearly every gay or bi man has allowed their passions to override their fears and enjoyed the skin-on-skin contact that opposite-sex couples often take for granted. Thinking back on those unbridled and unprotected moments of passion filled many of these men with terror, regret, and guilt.

“Shame and gay sex have a very long history,” acknowledges Alex Garner, senior health and innovation strategist with the gay dating app Hornet. “And it takes much self-reflection — and often therapy — to feel proud and unashamed of our sex when everything around us tells us that it’s dirty, immoral, or illegitimate.”

Since the late 1990s and the advent of lifesaving antiretroviral drugs, some of the angst around sex between men faded — and with that came changes in behavior. Condom use, once reliably high among gay and bisexual men, has dropped off in the past two decades. According to a recent study published in the journal AIDS, over 40 percent of HIV-negative and 45 percent of HIV-positive gay and bi men admitted to having condomless sex in 2014. Researchers found the decrease in condom use wasn’t explained by serosorting (choosing only partners believed to have the same HIV status) or antiretroviral drug use. And despite what alarmists say, condom use had been declining long before the introduction of PrEP.

Garner, who has been HIV-positive for over two decades, says he’s almost relieved he acquired the virus at 23, because “My entire adult life I have never had to worry about getting HIV.”

The Rise of PrEP

Now there’s hope the younger generation may also experience worry-free sex lives — without the side effects of living with HIV.

The use of the antiretroviral drug Truvada as pre-exposure prophylaxis, or PrEP (it’s the only medication approved for HIV prevention), has been shown to reduce the chance of HIV transmission to near zero. Since the medication was first approved as PrEP in 2012, only two verified cases of transmission have been documented among those who adhere to the daily schedule (a third, according to HIV expert Howard Grossman, could not be confirmed). New, longer-lasting PrEP injectables should reach market in the next few years. Studies suggest that on-demand PrEP (such as taking it before and after sexual activity) may also be effective.

“This is a revolution!” Gary Cohan, MD, who prescribes PrEP, told us in 2016. “This should be above the fold in The New York Times and on the cover of Time magazine. A pill to prevent HIV?”

Undetectable Equals Untransmittable

Those who are already HIV-positive also have a sure-fire option for preventing the transmission of HIV that doesn’t rely on condoms. It’s called treatment as prevention, or TasP. Those who are poz, take antiretroviral medication, and get their viral load down to an undetectable level, can’t transmit HIV to sexual partners. Last year, The New England Journal of Medicine published the final results of HPTN 052, a study that proved antiretroviral medication alone is enough to prevent HIV transmission among serodiscordant couples. In a Facebook Live interview for AIDS.gov, Dr. Carl Dieffenbach, director of the Division of AIDS at the National Institute of Allergy and Infectious Diseases, noted, “The chance of transmitting [HIV] if you are virally durably suppressed is zero.

Since Dieffenbach’s statement, a number of HIV organizations and medical groups have joined the “Undetectable Equals Untransmittable” bandwagon, including GMHC, APLA Health, and the Latino Commission on AIDS.

The Centers for Disease Control and Prevention recommends the use of condoms in addition to PrEP or TasP, primarily because neither biomedical approach prevents other sexually transmitted infections like gonorrhea or syphilis. Still, PrEP and TasP make it safer to have condomless sex — and that could jump-start the new sexual revolution. “When the threat of HIV is removed from sex there is a profound sense of liberation,” Garner says. “Sex can just be about sex.”

One hurdle is PrEP stigma, furthered by the myth of “Truvada whores,” and AIDS Healthcare Foundation’s Michael Weinstein’s deliberate efforts to portray the HIV prevention pill as “a party drug.”

“Fear and shame have been ingrained in gay sex for decades,” Garner admits. “And it will take time and a great deal of work to extricate those elements.” But he remains optimistic that “together negative and poz men can shift the culture away from fear and toward liberation.”

He argues that what’s at stake is far more than just a better orgasm.

“Our sexuality is at the core of our humanity,” Garner says. “Our sexuality is as integral to us as our appetite. We can’t advance social justice without including sex. As queer people and as people of color, our bodies have been criminalized, our sexuality has been pathologized, and structures continue to dehumanize us. It’s a radical act of resistance when, as gay men, we choose to find pleasure and intimacy in our sex. Our sex has been, and will continue to be, intensely political. It can change our culture and our politics if we embrace it and run to it instead of away from it.”

Complete Article HERE!

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Oncologists need to discuss sexual issues with patients, says doctor

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Dr. Anne Katz was in Windsor on May 11, 2017, to address Windsor Regional Hospital staff about cancer, intimacy and sexuality.

By Chris Thompson

A Winnipeg doctor who specializes in treating sexual issues with cancer patients is hoping to spread the word about doctors being up front with their patients.

Dr. Anne Katz held an online forum for Windsor Regional Hospital workers about cancer, intimacy and sexuality.

Katz is the author of several books dealing with the issue.

“Really the message is that sexually it is really important for people, for all of us, and I really want to encourage oncology care providers to raise the topic of it with their patients, because when we don’t talk about it, the patients thinks it’s a taboo,” said Katz.

“And 80 per cent of cancer survivors experience sexual difficulty after cancer treatment.”

Katz said doctors should be more willing to bring up sex issues with their cancer patients.

“So it really is something where we have to expose people to having that conversation,” said Katz.

“All cancers, all people, men, women, gay, straight, people recognize things aren’t going right during treatment, but all more commonly sexual problems aren’t recognized until after treatment.”

Katz said many people undergoing cancer treatment don’t realize there is an issue until later.

“Usually people during treatment are really not feeling that well, so it’s kind of on the back burner but it really is a sentinel of survivorship,” Katz said.

“People come to see me and we know certainly that most men who experience prostate cancer are going to experience erectile difficulties, most women with breast cancer often experience body issues, early menopause, or exaggerated menopausal symptoms, people with colorectal cancer have problems.”

Katz said everyone who is experiencing cancer needs to address the issue.

“It really is all cancers,” Katz said. “We’re all sexual beings, literally, from cradle to grave, whether you act on it or not.

“Even if you’re not partnered. It’s so much a part of quality of life for cancer survivors. So it goes away, there are some couples that lose that connectedness, there are some couples that use sex to make up after fights. They are fighting a lot because there is no way to resolve the fights.

“Unless oncology workers can address it and talk about it, patients are very reluctant to bring up the topic.”

Complete Article HERE!

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What To Do If You Get A Panic Attack During Sex

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By Sophie Saint Thomas

A few years ago, while an ex-partner was going down on me, I realized I was having trouble breathing. Then a sense of dread filled my head, and I felt like I was being stabbed in the chest. So I quickly asked him to stop — not because he was doing anything wrong, but because I was having a panic attack during sex.

One of the (few) good things about panic attacks is that they usually only last for about 15 minutes, says Gail Saltz, MD, psychiatrist and author of The Power of Different: The Link Between Disorder And Genius. When I had my attack, I sat on the edge of the bed and did a series of breathing exercises. Gradually, I did begin to feel better.

But one of the most perplexing aspects of panic attacks is that they’re intensely fearful physical reactions that occur in the absence of any real danger or identifiable cause, as the Mayo Clinic explains. In my case, I was in a safe space with someone I trusted when my ex was going down on me. However, I had very real and terrifying feelings of detachment, the aforementioned shortness of breath, and chest pains.

Of course, I’m speaking about panic attacks during consensual sex. Fear that happens during an assault or dangerous sexual experience is completely different than having a panic attack during healthy sexual intimacy. (Reach out to RAINN if that’s the case.)

Although there are many causes for panic attacks, post-traumatic stress disorder (PTSD) is often to blame, says Barbara Greenberg, PhD, clinical psychologist and relationship expert. That was true for me: I’m a survivor of multiple sexual assaults and have been diagnosed with PTSD by a psychiatrist. As a result, sometimes during sex, I’ll have a flashback of an incident and experience a panic attack. Although the attacks subsided thanks to therapy and medication, it’s an ongoing process.

That said, panic attacks during sex can also happen to people who haven’t been sexually assaulted or diagnosed with PTSD. Dr. Greenberg says that generalized anxiety disorder and panic disorder can also trigger panic attacks during intimacy, but anyone can have one during their life — with or without a diagnosed disorder. Sometimes these things just happen.

However, if your panic attacks are, like mine, recurring and have an identifiable root cause, it’s an especially healthy idea to see a psychiatrist, Dr. Saltz says. “If you are having multiple panic attacks or PTSD flashbacks you should 100% get treatment,” Dr. Saltz says. Treatment will begin with an evaluation of the cause of the panic attacks with a mental health professional. Then, that person will suggest therapy, medication, or both.

But is there anything you can do when you’re in the midst of a panic attack during sex? The first thing to do, if you can, is explain to your partner what’s happening — and step back from sex to take care of yourself. You can always try having sex again later when you’re feeling better. Deep breathing exercises, mindfulness practice, and reassuring self-talk can all be helpful in calming a panic attack, says Michael Aaron, PhD, a sex therapist and author of Modern Sexuality: The Truth about Sex and Relationships. Changing your physical position or getting up to walk around can also help comfort you.

At that point, Dr. Aaron says it’s okay to take any anti-anxiety medication you’ve been prescribed, such as benzodiazepines (e.g. Xanax, Ativan, and Klonopin). Because you can become dependent on such medications over time, they’re meant to be used on an as-needed basis, Dr. Aaron says. But, depending on your individual needs, you may be taking them for a week or have a prescription at-the-ready for the rest of your life. While you’re taking these medications, though, you’re also (ideally) learning other self-soothing techniques in therapy that will come in handy when you stop taking the meds as frequently.

On top of managing what’s happening in your own mind and body, explaining it to your partner presents another challenge. In particular, when I had a panic attack, my partner had a hard time understanding that he did nothing wrong. But Dr. Saltz says that, in the moment, it’s enough to “tell your partner [your panic attack] will pass, take slow and deep breaths, and relax your muscles.” After the crisis has passed, you can get into a more detailed description of what you experienced — and how it wasn’t your partner’s fault.

If you’ve been a witness to someone else’s panic attack, know that they have likely experienced panic attacks before meeting you and probably will have them after you’ve parted ways, says Amanda Luterman, MA, OPQ, a psychotherapist who specializes in sexuality. “What you can do is be a soothing and stabilizing partner for that person, keep the focus on them, and reassure them that it’s going to pass,” she explains.

So, remember that panic attacks do go away. But if you continue to have them during sex as part of a larger mental health issue or due to unresolved trauma, you should seek treatment. Trust me, it can be a life- (and sex life-) saving experience.

Complete Article HERE!

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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

While HIV studies have extensively examined issues related to gay, bisexual, and queer men, one group missing from such research has been transgender men.

Consequently, Vancouver and Victoria researchers undertook one of the first such Western Canadian studies, with the findings published on April 3 in Culture, Health, and Sexuality. This study allowed researchers to take a look at HIV risk for this population, and within the Canadian context of publicly funded universal access to healthcare and gender-related public policies that differ from the U.S.

The study states that trans men have often been absent from HIV studies due to small sample sizes, eligibility criteria, limited research design, or the misconceptions that trans men are mostly heterosexual or are not at risk for HIV. What research that has been conducted in this area has been primarily U.S.–based.

The Ontario-based Trans PULSE Study found that up to two-thirds of trans men also identify as gay, bisexual, or queer.

The researchers conducted interviews with 11 gay, bisexual, and queer transgender men in Vancouver who were enrolled in B.C. Centre for Excellence in HIV/AIDS’ Momentum Health Study.

What they found were several aspects unique to gay, bisexual, and queer transgender men that differ from gay, bisexual, and queer cisgender men and illustrate the need for trans-specific healthcare.

None of the participants in the study were HIV–positive and only two of them knew of trans men who are HIV–positive.

Participants reported a variety of sexual behaviours, including inconsistent condom use, receptive and insertive anal and genital sex, trans and cisgender male partners, and regular, casual, and anonymous sex partners.

The gender identity of the participants’ partners did influence their decisions about sexual risk-reduction strategies, such as less barrier usage during genital or oral sex with trans partners.

While trans men shared concerns about HIV and sexually transmitted infections with gay cisgender men, bacterial vaginosis and unplanned pregnancy were additional concerns.

Almost all of the participants used online means to meet male partners. They explained that by doing so, they were able to control the disclosure of their trans status as well as experiences of rejection or misperception. Online interactions also gave them greater control over negotiating safer sex and physical safety (such as arranging to meet a person in public first or in a sex-positive space where others are around).

When it came to healthcare, participants reported that regular testosterone therapy monitoring and transition-related care provided opportunities to include regular HIV– and STI–testing.

Some participants, however, experienced challenges in finding LGBT–competent healthcare services, with issues arising such as clinic staff using birth names or incorrect pronouns, insistence on unwanted pap testing, and a lack of understanding of the sexual practices of trans men.

The researchers note that these findings indicate the need for trans-inclusive services and trans-specific education, particularly within services for gay men.

Complete Article HERE!

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The charity helping disabled people with sex

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A charity in Taiwan has volunteers who provide sexual “help” for a small number of disabled people.

Complete Article HERE!

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