Category Archives: Health Risks

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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Men who have sex with men account for over 80% of syphilis infection rates in the US

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MSM are 106 times more likely to get syphilis than men who exclusively have sex with women

Doctors advise waiting for the skin to heal after shaving before having sex

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A new study of syphilis transmission rates reveals men who have sex with men account for 81.7% of cases in the United States.

This study found gay, bisexual or men who have sex with men are 106 times more likely to get the sexually transmitted disease.

Researchers analyzed data collected in 2015 and compiled the first of its kind state-by-state report on syphilis rates.

The study found gay and bisexual men living in the South had the highest rates of the disease, such as North Carolina, Mississippi and Louisiana.

North Carolina, for example, had 748 cases per 100,000 gay and bisexual men.

Alaska had the fewest cases, with only 73 cases per 100,000 gay and bisexual men.

HIV infects healthy immune cells in the human body by inserting its DNA into the cell’s genome

Fred Wyand, spokesman for the American Sexual Health Association urged people to look at the broader picture.

Wyand said: ‘Better access to healthcare, more welcoming attitudes, better support systems are all important, of course,’ WebMD reports.

‘We need to understand there are challenges faced by many gay and bisexual men greater than what most folks endure,’ Wyand concluded.

For a full list of State-specific cases of syphilis, check out the Morbidity and Mortality Weekly Report.

Why do men who have sex with men report higher numbers of syphilis?

A further breakdown highlights men who have sex with men accounts for 309 cases per 100,000.

This is in contrast to men who only have sex with women accounting for 2.9 cases per 100,000.

And women with 1.8 cases per 100,000.

Dr Robert Grant, chief medical officer of the San Francisco AIDS Foundation explains why this might be the case.

Grant told CBS News: ‘Now that we have effective therapies for HIV, people who were previously untested and tested infrequently are now getting tested.

‘Sexually transmitted infections tend to go together.

If they come in and ask for HIV testing, we test for syphilis, chlamydia and gonorrhea as well.

‘People have everything to gain and nothing to lose by getting an HIV and syphilis test.

‘This report will help reinvigorate people’s awareness and hopefully send the message that by getting a test and following through with treatment, we can decrease or even eliminate syphilis as a problem,’ Grant said.

Complete Article HERE!

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Undoing the STIgma: Normalizing the discourse surrounding STIs

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April is STD/STI Awareness Month.

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Let’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

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10 Things You Always Wanted to Ask an HIV-Positive Guy

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I’m a gym homo. I love Neapolitan pizza. I hate scary movies. I have six tattoos. I take cock like a champ. And, I’m HIV-positive.

After living with HIV for four years, I’ve heard the same questions over and over. Sometimes I wish I could present quick, pre-packaged answers — a list of “saved phrases” on my phone — but then I remind myself how desperately I asked questions during that first impossible week after getting my test results.

So today, I’m answering the questions that everyone secretly wants to ask an HIV-positive guy. What would you like to know?

1. Do you know who infected you?

I don’t. Most HIV-positive guys I’ve talked to do not know who infected them.

Few people intend to give someone HIV. There are random crazies, but most guys are just doing what I was doing — fucking around, having fun, and assuming everything is fine. You can give someone HIV without knowing you’re positive.

The virus has to “build up” to a certain point in your body to trigger an HIV test, which means you can test negative and still have transmittable HIV.

There’s an ugly myth that HIV-positive folks recreationally go around infecting others. That’s a lie regurgitated by fearmongering, anti-fact, sex-negative, poz-phobic people. It’s likely that the man who gave it to me did not know he had it. I feel for him, whoever he is, because at some point after playing with me, he got news that no one is ready to hear.

I do not, but don’t take that as an indicator of what most HIV-positive guys do. Many HIV-positive men become more diligent about condom use after seroconverting.

In the age of PrEP, condoms are no longer the only way to protect yourself (or others) from HIV — or the most effective. PrEP — a once-a-day, single-pill regimen that has been proven more effective than regular condom use at preventing HIV transmission — is something I urge all HIV-negative guys to learn about.

I play bare. I accept the risks of catching other STIs and STDs as an unavoidable part of the sex I enjoy. I get a full-range STD check every three months, and sometimes more frequently.

3. How did sex change for you after becoming positive?

Since seroconverting, I have more — and better — sex. Forced to see my body and my sex in a new light, I started exploring fetishes and interests I had never tried. In my early days of being positive, I played every week with a dominant. Today, I’m a skilled, kinky motherfucker.

4. Has anyone ever turned you down because of your status?

Many times. When I was newly positive, those refusals really hurt.

I remember one occasion that was especially painful. I was eating Chinese food with a friend and started crying at the table because several guys that week had turned me down on Grindr.

He let me cry for a few minutes, then said, “HIV is something in your blood. That’s all it is. If they can’t see how sexy you are because of something in your blood, they’re boring, uneducated, and undeserving, and you can do better.” He was right.

5. How old were you when you tested positive?

I was 21. I didn’t eat for a few days. I slept on friends’ sofas and watched movies instead of doing homework. Somehow I continued acing my college classes.

I walked down to the Savannah River every night to watch cargo ships roll through, imagining their exotic ports — Beijing, Mumbai, Singapore, New York — and their cold passage across the Atlantic. I wanted to jump in the black water every night but I knew some drunk tourist would start screaming and someone would save me.

I made it through those months, and I’m glad I did. The best of my life came after becoming positive.

6. What does “undetectable” mean?

“Undetectable” is a term used to describe an HIV-positive person who is diligently taking their meds. In doing so, they suppressed the virus in their body to the point that their viral load is under 200 copies/m — unable to be detected on a standard HIV test (hence, “undetectable”). Put simply: the virus is so low in your body that it’s hard to transmit.

“Hard” is an understatement. The PARTNER study monitored 767 serodiscordant (one positive, one negative) couples, gay and straight, over several years. In 2014, the results showed zero HIV transmissions from an HIV-positive partner with an undetectable viral load to an HIV-negative partner.

Being undetectable means the likelihood of you transmitting HIV is slim to none. It means you’re doing everything scientifically possible to be as healthy as you can be, and you are protecting your partners in the process.

7. Have you had any side effects from the meds?

Yes, but side effects today are mild in comparison to what they were in the past. AZT was hard on the body, but we’re past that. New HIV drugs come out every year. We’re in a medical age where new treatment options, such as body-safe injection regimens, are fastly approaching realities.

On my first medication, I had very vivid dreams and nightmares, an upset stomach for a week or two, and I developed weird fat deposits on my neck and shoulders. I switched meds a year in and couldn’t be happier.

There are options. Talk to your doctor if you have shitty side effects and ask about getting on a different medication.

8. What’s it like to date after becoming HIV-positive?

It’s just like dating for everyone else. There are losers and jerks, and there are excellent, top-quality guys I love. My HIV status has never impeded my dating life.

I’m non-monogamous, polyamorous, and kinky, and I think these characteristics drive away interested guys faster than anything else. My status never comes up. I put my status loud and clear on every profile, and I say it directly before the first date. If you don’t like it, don’t waste my time — I have other men to meet.

9. How do you respond to HIV stigma?

It’s an automatic turn-off. Disinterested. Discard pile.

I have active Grindr and Scruff profiles (and a few others). Each profile reads: “If you’re afraid of my HIV status, block me.”

I’m not interested in someone who, in 2017, walks around terrified of HIV. Learn your shit, guys. Learn about how HIV is prevented. Get on PrEP. Use condoms.

Educate yourself and learn how it’s treated, and what the reality of living with HIV is like today (it’s so mild and easy that I forget about it, TBH).

Yes, you should take necessary steps to prevent HIV. However, you don’t need to live your life in fear or abstain from having sex with people merely because they’re positive. I no longer believe HIV is the worst thing you can catch. Hep C is way worse. Scabies is pretty miserable. And bad strains of the flu kill people.

HIV? It’s one pill (or a couple of pills) a day. Yes, you will have it forever. Yes, you will face stigma for having it. But, the people who stigmatize you are ignorant and out-of-date. Dismiss them.

10. What would you tell someone who just tested positive?

Welcome! You inadvertently joined a club you didn’t ask for, but the membership includes some of the greatest minds in history, so you’re in good company. The virus felled many of the greatest campaigners for LGBTQ rights and freedoms that ever lived. They struggled so that you can get up in the morning, pop your pill, and live a long life.

Those who lived and died paid your initiation fees. They fought, protested, rallied and organized so that you can be here — so that you can stick around and enjoy your fabulous, queer life. Always respect their sacrifice and dedication.

You are loved. You will find love. You will find impossibly good-looking men who want to fuck you (or want you to fuck them) who don’t give a shit about your HIV status. And if it’s in the cards, someday you’ll marry one of those fellas.

You have brothers and sisters who share this quality with you. In the words of Sister Sledge, we are family.

Complete Article HERE!

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…warts and all.

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Name: BD
Gender: Male
Age: 50
Location: ??
Hey doc,
Ok. I’m a 50 year old male homosexualist and I have apparently contracted genital warts at this late stage in the game. I have had 4 burned off so far, and think I detect other small, new ones. My understanding is that after this initial outbreak my immune system will control the virus.
My question is, I know they’re extremely contagious to others, but am I going to be spreading them around every time I masturbate? Cause that’s a lot. Thanks

Before I answer your specific questions, BD, let’s talk about genital warts. They are also known as venereal warts, anal warts and anogenital warts, don’t cha know. They are a highly contagious sexually transmitted infection (STI) caused by some sub-types of human papillomavirus (HPV). genital warts spread through direct skin-to-skin contact during oral, genital, or anal sex with an infected partner. Warts are the most easily recognized symptom of genital HPV infection.

Genital warts often occur in clusters and can be very tiny or can spread into large masses in the genital/anal area. The often have a tiny cauliflower shape. In women they occur on the outside and inside of the vagina, and sometimes on the cervix. Both women and men can get them on, around, or even inside their ass. Men may also find them on the tip of their cock, the shaft of their dick and/or on their balls. Only rarely do genital warts develop in one’s mouth or throat from oral sex with an infected partner.

The viral particles are able to penetrate the skin and mucosal surfaces through microscopic abrasions in the genital area, which occur during sexual activity. Once these cells are invaded by HPV, a latency (or quiet) period of months to years (even decades) may occur. HPV can last for several years without a symptom. Having sex with a partner whose HPV infection is latent and demonstrates no outward symptoms still leaves one vulnerable to becoming infected. If an individual has unprotected sex with an infected partner, there is a 70% chance that he or she will also become infected.

Alrighty then, to your specific questions, BD. I believe you are correct in your assumption that your immune system will control the virus. As to your other question, will you be spreading them around every time I masturbate; I’d have to say that there is some slight chance that your could spread the virus if you cum on someone’s skin and there happens to be a cut or an abrasion on the skin where you shoot. You also wouldn’t want to get your spooge in anyone’s eye, mouth or ass for the same reasons. But if you jerk off and your spunk falls on some inanimate object, like the floor, a wad of Kleenex, or your Aunt Tillie’s favorite antique comforter, then I think you’re fine.

Good luck

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