The End of Safe Gay Sex?

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By Patrick William Kelly

June is Pride Month, a ripe time to reflect on one of the most startling facts about our sexual culture today: Condom use is all but disappearing among large numbers of gay men.

Many rightly attribute the condom’s decline to the rise of PrEP — an acronym for pre-exposure prophylaxis, a two-drug cocktail that inoculates a person from contracting H.I.V. But another crucial component is the fading memory of the AIDS crisis that once defined what it meant to be gay.

After tracking the sexual practices of 17,000 gay and bisexual Australian men from 2014 to 2017, a team of researchers this month unveiled the most convincing evidence to date. While the number of H.I.V.-negative men who are on PrEP increased to 24 percent from 2 percent, the rate of condom use decreased to 31 percent from 46 percent. More troubling, condom use among non-gay men is also down significantly</a

Although public health advocates have been sounding the alarm on condom use for the last decade, their calls have gone largely unheeded. Part of that is because of a shift in how we talk about risky sex: The Centers for Disease Control and Prevention has replaced “unprotected” with “condomless” sex.

The dangerous implication is that PrEP alone may ward off all sexually transmitted infections. Indeed, studies have shown a strong correlation between PrEP use and the contraction of S.T.I.s. PrEP enthusiasts counter that PrEP mandates testing for S.T.I.s every three months, a practice that promotes rather than discourages a culture of sexual health.

But a 2016 study by the University of California, Los Angeles illustrated that PrEP users were 25.3 times more likely to acquire gonorrhea and a shocking 44.6 times more likely to develop a syphilis infection (other studies have found no significant uptick in S.T.I. rates, however).

More than the specific public-health risks of declining condom use among gay men is the shocking speed with which a sort of historical amnesia has set in.

The very idea of “safe sex” emerged from the gay community in the early 1980s, in response to the AIDS crisis. Drag queens once ended performances with catchy one-liners like, “If you’re going to tap it, wrap it.”

AIDS indelibly shaped what it meant to be gay in the 1980s and 1990s. When I came out at the tender age of 14 in 1998, I recall my mother’s reaction. As tears welled up in her eyes, she buried her face in her hands and said, “I just don’t want you to get H.I.V.” No stranger to controversial allusions, the AIDS activist and author Larry Kramer famously called it a homosexual “holocaust.” Condom use, therefore, was never a negotiating chip.

Until it was. PrEP, which the Food and Drug Administration approved in 2012, replaces the condom’s comforting shield. Liberated from the stigma of AIDS, gay men, many people think, are now free to revert to their carnivorous sexual selves. In this rendering, the condom is kryptonite, a relic that saps the virile homosexual of his primordial sexual power.

AIDS is no longer a crisis, at least in the United States, and that is a phenomenal public-health success story. But it also means that an entire generation of gay men has no memory or interest in the devastation it wrought. AIDS catalyzed a culture of sexual health that has begun to disintegrate before our eyes. What is there to be done to bring it back?

One answer is to recall the gay culture of the 1970s that gave rise to the AIDS crisis in the first place. The myth of a world of sex without harm is not new. The 1970s were a time of unprecedented sexual freedom for gay men, during which diseases were traded rampantly, fueled by a libertine culture that saw penicillin as the panacea for all ills.

The nonchalant dismissal of the condom today flies in the face of the very culture of sexual health that gay men and lesbians constructed in the 1980s. If a hyper-resistant strand of another life-threatening S.T.I. develops, we will rue the day that we forgot the searing legacies of our past. We might also recognize that PrEP has not proved nearly as effective a prevention strategy for women as it has for men, and that some strains of H.I.V. have developed resistance to the drug.

While we debate the utility of latex, what are we to think about the millions of sex workers, injecting-drug users and marginalized populations (in particular, black men who have sex with men) without adequate access to costly and coveted drugs like PrEP? If they develop AIDS, they also struggle to acquire the triple drug therapies that have since 1996 turned AIDS into a manageable if chronic condition. Millions have died from lack of access while pharmaceutical companies rake in billions every year.

We might also pivot away from the individualistic and privileged approach of our dominant L.G.B.T. organizations — what one scholar called the “price of gay marriage.” We might, then, regain a radical sense of queer community that we lost in the wake of AIDS.

Complete Article HERE!

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Can You Get An STI From Anal Sex?

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That itch in your butt? It may not just be a harmless rash.

By Isadora Baum

[W]hen you think of sexually transmitted infections, symptoms like vaginal itching and pelvic pain probably come to mind. But the same STIs that threaten your health down below can infect other body areas. They’re typically transmitted through oral sex or anal sex, but some can be picked up after direct skin contact.

The scary thing about getting an STI in another part of your body is that you’re less likely to recognize signs, so you don’t seek the right treatment—and the infection potentially gets worse. Here are four body areas that can play host to an STI, plus the symptoms to look for.

On your face

You already know that genital herpes can spread to your lips if you have oral sex with someone who has this STI. What you may not know is that the same type of herpes that shows up below the belt can infect other parts of your face, such as around your mouth, Amesh Adalja, MD, an infectious disease physician and senior scholar at Johns Hopkins Center for Health Security, tells Health. Herpes can also appear on your tongue or nose.

How do you know if a sore on your face is herpes? Early signs are the same as genital herpes: tingling and itching, and then as the sore develops, it blisters and scabs over. If you’re unsure, check in with a dermatologist. You can treat herpes with over-the-counter cold sore remedies; your doctor can also prescribe antiviral meds that cut the duration of an outbreak.

In your butt

Yep, we have to go there. Chlamydia, gonorrhea, and syphilis can be transmitted to the rectum if you have anal sex with an infected partner, Karen Brodman, MD, a gynecologist in New York City, tells Health. Your risk of one of these backdoor STIs increases if you develop small tears or nicks in the thin skin of the anus, through which the bacteria can get into your system.

STIs transmitted through skin contact, such as genital herpes or HPV, can develop in or outside the anus and rectum, says Dr. Brodman. Herpes may also show up as sores on the skin of the buttocks. And of course, HIV is spread via anal sex, as are blood-borne viruses such as hepatitis B and C.

Signs of an STI in your behind include rectal burning, unusual discharge, bleeding, pain, or a fissure, says Dr. Brodman. You might also notice blisters or achiness in the groin, she adds. If any of these develop, let your doctor know. And don’t be embarrassed—she’s seen it all before.

In your eyes

STIs that trigger eye infections include herpes, gonorrhea, chlamydia, and syphilis, says Dr. Adalja. The signs of many of these conditions mimic pink eye: think pain, swelling, redness, and discharge.

An eye herpes infection, however, can present differently. If the herpes virus is in your eye, it may result in an outbreak of one or more lesions on the eyelids or even the cornea, triggering pain and sensitivity that could jeopardize your vision by causing scarring. If you have any symptoms, see your ophthalmologist promptly, says Dr. Adalja.

In your throat

STI infections in the soft, moist tissues of the back of the mouth and throat are more prevalent than you might think. Chlamydia and gonorrhea (including the drug-resistant strain known as “super gonorrhea”) can set up shop here if a person contracts either of these infections during oral sex. Scarily, you may not even know it; sometimes the only symptom is a sore throat, according to the Centers for Disease Control.

HPV is another infection that invades the throat—and it’s thought to be behind the recent rise in cases of head and neck cancers, especially among men. While there are more than 100 types of HPV, the type that causes many cases of cervical cancer, HPV 16, is also responsible for most head and neck cancers. Though HPV of the throat is becoming more common, a 2017 study emphasizes that the overall lifetime odds of cancer is low. Still, if you think you might be at risk, talk to your doctor.

Complete Article HERE!

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Queen Mother of the South: My Life as a Transgender Parent

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[T]he Southern part of the U.S. has to be one of the more conservative regions in the nation. Rooted in traditional, religious, and conventional values, it is often referred to as the “Bible Belt.” Southern traditionalists marvel at their old-fashioned ways and high moral standards. These standards are applied to every aspect of Southern culture, regardless of race, color, ethnicity, religion, or gender.

Evonne Kaho

This is most evident in the Southern family. As experienced by many in the South, I was taught that the family should consist of a father, a mother, and children. As in my family, these roles are defined and dominated by principles engrained in “Southern tradition.”

Although I embraced this experience, deep down I knew that my life would take a turn that would clash with the very things I had been taught to respect and uphold. In 2000, I became a transgender woman. My transformation was a long-awaited accomplishment that symbolized my freedom, but not an end to my struggle as a member of the transgender community. I so desperately wanted to be a parent, but I shivered at thought of becoming one in Mississippi. As a transgender woman, I hoped, but I thought that I had no chance of having my own child. After all, as a child, I was taught that only traditional families that consisted of heterosexual couples should have children.

In 2002, I met the mate of my dreams, and we were married. In 2003, we were blessed with a beautiful baby girl. Watching the women in my family, I knew how to be a mother, but society was not ready for it. Even my parents criticized me and told me that my household was an abomination to God and was not the right environment in which to raise a child. With less and less support, I became stronger and more determined to be the parent that my child needed. I was taught that support, love, understanding, patience, and empathy were needed to successfully raise a child, and I possessed them all. My transgender identity did not prevent me from loving my daughter, nor did it take away from the positive contributions that I made in her life.

My daughter is 15 now and more beautiful than ever. She is one of my more, if not my most, important accomplishments. She is loving, caring, empathetic, and most of all open-minded. I taught her not to judge or to be critical of those who differ from her. My mate and I both reinforced choice. We would often explain to her that her choice to be whatever she wanted should not be dictated by who we were.

When I contracted HIV, the hardest thing was not accepting that I had it, but deciding how I would explain it to my daughter. I didn’t want the ignorance and stereotypes of society to determine her view of me or those like me.

I remember the morning that I told her. I asked myself, “Am I really prepared her this?” Sure, she knew about HIV/AIDS. My mate and I had both talked to her about it. However, other people had the disease, not one of her parents. It was one of the hardest things that I had ever done. She looked at me and said, “Mama, they have medicine for that, and you will be OK; I will help you.” I had not failed. That was one of my defining moments as a successful parent. The loving, caring, and empathetic spirit that I had worked so hard to impart to my daughter had revealed its beautiful head.

That day, as well as my experiences since, has equipped me with the skills I need to care for others like me. The number of transgender families has increased since 2003. As the CEO of Love Me Unlimited for Life, a non-profit transgender organization in the state of Mississippi, I have the resources to help transgender families and those living with HIV/AIDS. My organization serves as a support system for individuals who lead alternative lifestyles.

Becoming transgender after forming a family can be hard. We provide support for the whole family. In addition, we provide a repertoire of resources for families whose parents are living with HIV/AIDS. It’s very hard to explain to your child what HIV/AIDS is and what it means to live a long healthy life with it. It’s neither a death sentence nor a punishment for being homosexual or transgender; it’s a life change like having any other chronic disease.

Over the years, I have become a mother to many in the LGBTQ community. I have utilized the same parenting skills that I began using with my own child in 2003. Regardless of their ages, they appreciate the love and support that they receive. I am thankful that I have been able to serve as a beacon of hope for so many.

After all, I am known as “Queen Mother of the South.”

Complete Article HERE!

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Here’s what happens when you get an STI test — and if it comes back positive

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By Erin Van Der Meer

[I]f you’ve never had an STI test, you’re probably imagining it’s a horrendously awkward experience where a mean, judgmental doctor pokes around your nether regions.

But like getting a needle or going to your first workout in a while, it’s one of those things that seems much worse in your mind than it is in reality.

For starters, often you don’t even have to pull down your pants.

“If someone comes in for a routine test for sexually transmissible infections (STIs) and they don’t have any symptoms, they usually don’t need a genital examination,” Dr Vincent Cornelisse, a spokesperson for the Royal Australian College of General Practitioners, told Coach.

“The tests that are ordered will depend on that person’s risk of STIs – some people only need a urine test, some need a self-collected anal or vaginal swab, and some people need a blood test.

“We aim to make this process as hassle-free as possible, in order to encourage people to have ongoing regular testing for STIs.”

Cornelisse says the embarrassment and stigma that some of us still feel about getting an STI test is unnecessary.

“STIs have been around for as long as people have been having sex, so getting an STI is nothing to be ashamed about, it’s a normal part of being human.

“Getting an STI test is an important part of maintaining good health for anyone who is sexually active.”

If you’re yet to have an STI test or it’s been a long time, here’s what you need to know.

How often do you need an STI test?

On average it’s good to get an STI test once a year, but some people should go more often.

“Some people are more affectionate than others, so some need to test every three months – obviously, if someone has symptoms that suggest that they may have an STI, then a physical examination is an important part of their assessment.”

As a general rule, people under 30, men who have sex with men, and people who frequently have new sexual partners should go more often.

To get an STI test ask your GP, or find a sexual health clinic in your area – the Family Planning Alliance Australia website can help you locate one.

What happens at the test?

As Cornelisse mentioned, the doctor will ask you some questions to determine which tests you need, whether it’s a urine test, blood test or genital inspection.

You’ll be asked questions about your sexual orientation, the number of sexual partners you’ve had, your sexual practices (like whether you’ve had unprotected sex), whether you have any symptoms, whether you have injected drugs, and whether you have any tattoos or body piercings.

Your results will be sent away and returned in about one week.

What if you test positive?

There’s no reason to panic if your results show you have an STI – if anything, you should feel relieved, Cornelisse says.

“If you hadn’t had the test, you wouldn’t have realised you had an STI and you wouldn’t have had the opportunity to treat it.

“Most STIs are easily treatable, and the other ones can be managed very well with modern medicine. So don’t feel shame, feel proud – you’re adulting!”

You’ll need to tell your recent sexual partners. While it might be a little awkward, they’ll ultimately appreciate you showing that you care about them.

“People often stress about this, but in my experience people appreciate it if their sexual partner has bothered to tell them about an STI – it shows them that you respect them,” Cornelisse says.

“Also, if this is a sexual partner who you’re likely to have sex with again, not telling them means that you’re likely to get the same STI again.”

The risks of leaving an STI untreated

You can probably think of 400 things you’d rather do than go for an STI test, but the earlier a sexually transmitted infection is caught, the better.

A recent spate of “super-gonorrhea” – a strain of the disease resistant to normal antibiotics –can result in fertility problems, but people who contract it show no symptoms, meaning getting tested is the only way to know you have it, and treat it.

“Untreated STIs can cause many serious problems,” Cornelisse warns.

“For women, untreated chlamydia can cause pelvic scarring, resulting in infertility and chronic pelvic pain.

“Syphilis is making a comeback, and if left untreated can cause many different problems, including damage to the brain, eyes and heart.

“If HIV is left untreated it will result in damage to the immune system — resulting in life-threatening infections and cancers — which is called AIDS.”

There is a long-term treatment for AIDS, but this depends on it being caught early.

“People living with HIV now can live a healthy life and live about as long as people without HIV, but the chance of living a healthy life with HIV depends on having the HIV diagnosed early and starting treatment early.

“Which it’s why it’s so important to be tested regularly, particularly as many STIs often don’t cause symptoms, so you won’t know you have one.”

Looking at the big picture, if you have an undiagnosed and untreated STI, you could give it to your sexual partners, who pass it onto theirs, which is how you got it.

“Getting a regular STI test is not only important for your own health, it also makes you a responsible sexual partner,” Cornelisse says.

“I encourage people to discuss STI testing with their sexual partners. If your sexual partners are also getting tested regularly, it reduces your risk of getting an STI.”

Complete Article HERE!

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6 sexually transmitted infections you should know about and how to treat them

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“Sex is great, but safe sex is better

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[S]exual Health Week upon us, which means it’s time to have that awkward STI chat.

You might be in a loving relationship or think you’re a few decades past your sexual prime, but the STI talk isn’t just for teenagers. According to research last year there has been a surge in sexually transmitted infections in the over 45s (with a dramatic 25% increase in STI diagnosis in women over 65s).

Meanwhile, back in December, it was reported that a third of Brits with an STI caught it while in a relationship – the survey also revealed 39% of people didn’t tell their partner they had an infection.

STIs have been with us for centuries. In the past mercury, arsenic and sulphur were used to treat venereal disease – which had serious side-effects, including death due to mercury poising. The introduction of Penicillin and modern medicine in the 20th century meant, thankfully, the big difference now is that greater awareness and modern medicine means they can be treated much more effectively.

Prevention and education is best practice, so here are what you need to know about six of the more commonly-known STIs…

1. Chlamydia

Chlamydia is the most common STI in the UK mainly due to many people not knowing that they have it. Symptoms can vary between men and women and most have no symptoms at all.

Men can experience pain or burning whilst urinating, cloudy discharge from the tip of their penis, and discomfort in their testes.

Women can sometimes experience a similar discomfort when urinating and discharge from their vagina, pain and/or bleeding during or after sex, and heavier or irregular periods. Usually though, they have no symptoms at all.

If chlamydia is untreated it can lead to serious pelvic infections and infertility so it is very much worth getting checked regularly.

How to treat it

Chlamydia can be diagnosed through a simple urine test, and fortunately can be treated with a single dose of antibiotics.

2. Genital Warts

Genital warts are the second most common STI and can be identified as small fleshy growths around the genitals or anal area. The warts are generally not painful, however may be itchy and irritable. While condoms are the best preventative method for genital warts because they are spread by skin-to-skin contact the area around the genitals my still become infected.

Treatment

Creams and freezing can get rid of them.

3. Genital Herpes

Genital herpes is a common infection and is caused by the same virus that causes cold sores (HPV).

Symptoms can occur a few days after infection and can generally be identified by small uncomfortable blisters which can really hurt – making urinating or just moving around very uncomfortable. The blisters go away by themselves after about 10 days but very often come back again whenever your immunes system gets a bit low or distracted.

Treatment

Unfortunately, there is currently no definitive cure for genital herpes, however each attack can be very effectively managed by using anti-viral medications which you can get from your doctor. Try to have the medications on hand because the sooner you use them in each attack the better they will work.

4. Gonorrhoea

Gonorrhoea is caused by bacteria called Neisseria gonorrhoeae or gonococcus. It can spread easily through intercourse, the symptoms are similar to those of chlamydia except usually more pronounced. If the person experiences discharge from their penis or vagina it can either be yellow or green in colour and there can be quite a lot of it.

Like Chlamydia though, the symptoms are not always present.

Treatment

The infection can be identified through a swab or urine test, and can be treated with antibiotics. Unfortunately, bacteria is getting resistant to more and more antibiotics and treatment is getting more difficult. Right now, though it is still well treated with an antibiotic injection.

5. Pubic lice or ‘crabs’

Crabs have commonly been seen as the funny STI and are often the punch line to many a joke. But as with all STIs, the reality really isn’t very funny.

Also known as pubic lice, crabs can be easily spread through bodily contact. They are usually found in pubic, underarm and body hair, as well as in beards and sometimes in eyebrows and eyelashes. The lice crawl from person to person, and can take weeks to become visible. They are usually spotted due to itchiness and in some cases people can find eggs in their hair.

Treatment

Pubic Lice can usually be treated using creams or shampoos which can be purchased readily from pharmacies.

6. HIV

Of all the STIs mentioned HIV probably is the most famous and feared. In the 1980s having HIV was effectively a death sentence and, tragically, it brought with it huge stigma. Thankfully, today modern drugs have had a huge impact on the HIV community, enabling them to live happy and healthy lives. But what is it?

HIV is a virus which attacks the immune system and is most commonly spread through unprotected sex. Many people with HIV appear healthy and do not display any symptoms, but they may experience a flu-like illness with a fever when they first become infected.

The final stage of HIV is AIDS, this is where the immune system is no longer able to fight against infections and diseases.

Treatment

There is currently no cure for HIV – however, modern medicine has come a long way enabling people to live long and otherwise normal lives.

Sex is great, but safe sex is better. If you’re concerned about STI’s visit your local sexual health clinic for a screening.

Complete Article HERE!

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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

[T]he 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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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

[W]hile 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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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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Women with HIV, after years of isolation, coming out of shadows

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Patti Radigan kisses daughter Angelica after a memorial in San Francisco’s Castro to remember those who died of AIDS.

By Erin Allday

Anita Schools wakes at dawn most days, though she usually lazes in bed, watching videos on her phone, until she has to get up to take the HIV meds that keep her alive. The morning solitude ends abruptly when her granddaughter bursts in and they curl up, bonding over graham crackers.

Schools, 59, lives in Emeryville near the foot of the Bay Bridge, walking distance from a Nordstrom Rack and other big chain stores she can’t afford. Off and on since April, her granddaughter has lived there too, sleeping on a blow-up mattress with Schools’ daughter and son-in-law and another grandchild.

Five is too many for the one-bedroom apartment. But they’re family. They kept her going during the worst times, and that she can help them now is a blessing.

Nearly 20 years ago, when Schools was diagnosed with HIV, it was her daughter Bonnie — then 12 and living in foster care — who gave her hope, saying, “Mama, you don’t have to worry. You’re not going to die, you’re going to be able to live a long, long time.”

“It was her that gave me the push and the courage to keep on,” Schools said.

She had contracted HIV from a man who’d been in jail, who beat her repeatedly until she fled. By then she’d already left another abusive relationship and lost all four of her daughters to child protective services. HIV was just one more burden.

At the time, the disease was a death sentence. That Schools is still here — helping her family, getting to know her grandchildren — is wonderful, she said. But for her, as with tens of thousands of others who have lived two decades or more with HIV, survival comes with its own hardships.

Gay men made up the bulk of the casualties of the early AIDS epidemic, and as the male survivors grow older, they’re dealing with profound complications, including physical and mental health problems. But the women have their own loads to bear.

Whereas gay men were at risk simply by being gay, women often were infected through intravenous drug use or sex work, or by male partners who lied about having unsafe sex with other men. The same issues that put them at risk for HIV made their very survival a challenge.

Today, many women like Schools who are long-term survivors cope with challenges caused or compounded by HIV: financial and housing insecurity, depression and anxiety, physical disability and emotional isolation.

“We’re talking about mostly women of color, living in poverty,” said Naina Khanna, executive director of Oakland’s Positive Women’s Network, a national advocacy group for women with HIV. “And there’s not really a social safety net for them. Gay men diagnosed with HIV already historically had a built-in community to lean on. Women tend to be more isolated around their diagnosis.”

There are far fewer women aging with HIV than men. In San Francisco, nearly 10,000 people age 50 or older are living with HIV; about 500 are women. Not all women survivors have histories of trauma and abuse, of course, and many have done well in spite of their diagnosis.

But studies have found that women with HIV are more than twice as likely as the average American woman to have suffered domestic violence. They have higher rates of mental illness and substance abuse.

What keeps them going now, decades after their diagnoses, varies widely. For some, connections with their families, especially their now-adult children, are critical. For others, HIV advocacy work keeps them motivated and hopeful.

Patti Radigan (righ) instructs daughter Angelica and Angelica’s boyfriend, Jayson Cabanas, on preparing green beans for Thanksgiving while Roman Tom Pierce, 8, watches.

Patti Radigan was living in a cardboard box on South Van Ness Avenue in San Francisco when she tested positive in 1992. By then, she’d lost her husband to a heart attack while a young mother, and not long after that she lost her daughter, too, when her drug use got out of control and her sister-in-law took in the child.

She turned to prostitution in the late 1980s to support a heroin addiction. She’d heard of HIV by then and knew it was deadly. She’d seen people on the streets in the Mission where she worked, wasting away and then disappearing altogether. But she still thought of it as something that affected gay men, not women, even those living on the margins.

Women then, and now, were much more likely than men to contract HIV from intravenous drug use rather than sex — though in Radigan’s case, it could have been either. IV drug use is the cause of transmission for nearly half of all women, according to San Francisco public health reports. It’s the cause for less than 20 percent for men.

Still, when Radigan finally got tested, it wasn’t because she was worried she might be positive, but because the clinic was offering subjects $20. She needed the cash for drugs.

She was scared enough after the diagnosis — and then she got pregnant. It was the early 1990s, and HIV experts at UCSF were just starting to believe they could finesse women through pregnancy and help them deliver healthy babies. Today, it’s widely understood that women with HIV can safely have children; San Francisco hasn’t seen a baby born with HIV since 2004.

But in the 1990s, getting pregnant was considered selfish — even if the baby survived, its mother most certainly wouldn’t live long enough to raise her. For women infected at the time, having children was something else they had to give up.

And so Radigan had an abortion. But she got pregnant again in 1995, and she was desperate to have this child. She was living by then with 10 gay men in a boarding house for recovering addicts. Bracing herself for an onslaught of criticism, she told her housemates. First they were quiet, then someone yelled, “Oh my God, we’re having a baby!”

“It was like having 10 big brothers,” Radigan said, smiling at the memory. Buoyed by their support, she kept the pregnancy and had a healthy girl.

Radigan is 59 now; her daughter, Angelica Tom, is 20. They both live in San Francisco after moving to the East Coast for a while. It was because of her daughter that Radigan stayed sober, that she consistently took her meds, and that she went back to school to tend to her future.

For a long time she told people she just wanted to live long enough to see her daughter graduate high school. Now her daughter is in art school and Radigan is healthy enough to hold a part-time job, to lead yoga classes on weekends, to go out with friends for a Friday night concert.

“Because of HIV, I thought I was never going to do a lot of things,” Radigan said. “The universe is aligning for me. And now I feel like I deserve it. For a long time, I didn’t feel like I deserved anything.”

Anita Schools, who says she is most troubled by finances, listens to an HIV-positive woman speak about her experiences and fears at an Oakland support group that Schools organized.

Anita Schools got tested for HIV because her ex-boyfriend kept telling her she should. That should have been a warning sign, she knows now.

She was first diagnosed in 1998 at a neighborhood clinic in Oakland, but it took two more tests at San Francisco General Hospital for her to accept she was positive. People told her that HIV wasn’t necessarily fatal, but she had trouble believing she was going to live. All she could think was, “Why me? What did I do?”

It was only after her daughter Bonnie reassured her that Schools started to think beyond the immediate anxiety and anger. She joined a support group for HIV-positive women, finding comfort in their stories and shared experiences. Ten years later, she was leading her own group.

She’s never had problems with drugs or alcohol, and she has a network of friends and family for emotional support, she said. Even the HIV hasn’t hit her too hard, physically, though the drugs to treat it have attacked her kidneys, leaving her ill and fatigued.

Like so many of the women she advises in her support group, Schools is most troubled by her finances. She gets by on Social Security and has bounced among Section 8 housing all over the Bay Area for most of her adult life.

Schools’ current apartment is supposed to be permanent, but she worries she could lose it if her daughter’s family stays with her too long. So earlier this month they moved out and are now sleeping in homeless shelters or, some nights, in their car. She hates letting them leave but doesn’t feel she has any other choice.

Reports show that women with HIV are far more likely to live in poverty than men. Khanna, with the Positive Women’s Network, said surveys of her members found that 85 percent make less than $25,000 a year, and roughly half take home less than $10,000.

Schools can’t always afford the bus or BART tickets she needs to get to doctor appointments and support group meetings, relying instead on rides from friends — or sometimes skipping events altogether. She gets her food primarily from food banks. Her wardrobe is dominated by T-shirts she gets from the HIV organizations with which she volunteers.

“With Social Security, $889 a month, that ain’t enough,” Schools said. “You got to pay your rent, and then PG&E, and then you got to pay your cell phone, buy clothes — it’s all hard.”

At a time when other women her age might be thinking about retirement or at least slowing down, advocacy work has taken over Schools’ life. She speaks out for women with HIV and their needs, demanding financial and health resources for them. In her support group and at AIDS conferences, she offers her story of survival as a sort of jagged road map for other women struggling to navigate the complex warren of services they’ll need to get by.

The work gives her confidence and purpose. She feels she can directly influence women’s lives in a way that seemed beyond her when she was young, unemployed and directionless.

“As long as I’m getting help and support,” Schools said, “I want to help other women — help them get somewhere.”

Billie Cooper is tall and striking, loud and brash. Her makeup is polished, her nails flawless. She is, she says with a booming laugh that makes heads turn, “the ultimate senior woman.”

For Cooper, 58, HIV was transformative. Like Radigan, she had to find her way out from under addiction and prostitution to get healthy, and stay healthy. Like Schools, she came to understand the importance of role-modeling and advocacy.

Cooper arrived in San Francisco in the summer of 1980 — almost a year to the day before the first reports of HIV surfaced in the United States. She was fresh out of the Navy and eager to explore her gender identity and sexuality in San Francisco’s burgeoning gay and transgender communities.

Growing up in Philadelphia, she’d known she was different from the boys around her, though it was decades before she found the language to express it and identified as a transgender woman. But seeing the “divas on Post Street, the ladies in the Tenderloin, the transsexual women prostituting on Eddy” — Cooper was awestruck.

She slipped quickly into prostitution and drug use. When she tested positive in 1985, she wasn’t surprised and barely wasted a thought worrying about what it meant for her future — or whether she’d have any future at all.

“I felt as though I still had to keep it moving,” Cooper said. “I didn’t slow down and cry or nothing.”

Transgender women have always been at heightened risk of HIV. Some studies have found that more than 1 in 5 transgender women is infected, and today about 340 HIV-positive trans women live in San Francisco.

What makes them more vulnerable is complicated. Trans women often have less access to health care and less stable housing than others, and they face higher rates of drug addiction and sexual violence, all of which are associated with risk of HIV infection.

Cooper was homeless off and on through the 1980s and ’90s, trapped in a world of drugs and sex work that felt glamorous at the time but in hindsight was crippling. “I was doing things out of loneliness,” she said, “and I was doing things to feel love. That’s why I prostituted, why I did drugs.”

She began to clean up around 2000, though it would take five or six years to fully quit using. She found a permanent place to live. She collected Social Security. She started working in support services for other transgender women battling HIV. In 2013, she founded TransLife, a support group at the San Francisco AIDS Foundation.

“I was coming out as the activist, the warrior, the determined woman I was always meant to be,” she said.

Cooper never developed any of the common, often fatal complications of HIV — including opportunistic infections like pneumonia — that killed millions in the 1980s and 1990s. But she does have neuropathy, an HIV-related nerve condition that causes a constant pins-and-needles sensation in her feet and legs and sometimes makes it hard to walk.

Far more traumatic for her was her cancer diagnosis in 2006. The cancer, which may have been related to HIV, was isolated to her left eye, but after traditional therapies failed, the eye was surgically removed on Thanksgiving Day in 2009.

The cancer and the loss of her eye was a devastating setback for a woman who had always focused on her appearance, on looking as gorgeous as the transgender women she so admired in the Tenderloin, on being loved and wanted for her beauty.

Rising from that loss has been difficult, she said. And she’s continued to suffer new health problems, including blood clots in one of her legs. Recently, she’s fallen several times, in frightening episodes that may be related to the clots, the HIV or something else entirely.

Since Thanksgiving she’s been in and out of the hospital, and though she tries to stay upbeat, it’s clearly trying her patience.

But if HIV and cancer and everything else have tested Cooper’s survival in ways she never anticipated, these trials also have strengthened her resolve. She’s becoming the person she always wanted to be.

“A week before they took my eye, I got my breasts,” she said coyly one recent afternoon, thrusting out her chest. Behind the sunglasses she wears almost constantly now, she was smiling and crying, all at once.

Aging with HIV has been strangely calming, in some ways, giving her a confidence that in her wild youth was elusive.

Now she exults in being a respected elder in the HIV and transgender communities. She loves it when people open doors for her or help her cross the street, offer to carry her bags or give up a seat on a bus.

Simply, she said, “I love being Ms. Billie Cooper.”

Complete Article HERE!

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10 Topics Gay Guys Never Discuss With Their Parents

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When you’re gay, it’s hard to talk to your parents about certain things. No matter how accepting or open-minded they may be, gay relationships, gay culture, and the mechanics of gay sex will stay a mystery to them — unless, of course, one of your parents is gay — or both.

Anyone who has been out of the closet for any amount of time knows that “gay” is more than a label to define your sexuality. It is a core part of your identity, and words like “queer,” “bi,” and “LGBTQ” constitute a significant part of your life — your people, your language, and your interests, both politically and socially. These words define a culture that our straight parents will never fully know. They may watch softened depictions of it on Modern Family, but they have never sung drunk karaoke at your favorite gay watering hole or queened out to Britney. They’ve never danced in a sea of sweaty men till 6 a.m. and they have no idea what Nasty Pig is.

Much of our culture can be hard to explain. Poppers and anal plugs will probably never warrant a conversation with mom, but other conversations — about PrEP and nonmonogamy, for example — can lead to greater understandings. Here’s a list of all those things gay men don’t talk about with their parents, with a small smattering of advice on how to do so!

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1. Douching

The thought of you having sex with another man crossed your parents’ minds from the moment they found out you were gay. Though they would never admit it, they still wonder about it from time to time. The image flashes when they’re trying to go to sleep, when they’re taking the dog out for a walk. Like many straight people, they may be clueless as to how it all works and may mistakenly believe it to be a very messy business. But douching — the process of cleaning out the anal cavity before sex — is one of those off-limits topics, one I would never bring with to them.

One way to hint at it without having to say anything is to have your parents over to your place for a night where there is, regrettably, only one shower. You must conveniently forget to unscrew the metal douching hose from its attachment at the side of your shower head. I’m not saying you should picture your mother naked, but envision her standing in your shower, looking through your assortment of overpriced sugar scrubs, charcoal-infused body bars, and organic, woodsy-smelling shampoos, and frowning over that dangling hose with the phallic-shaped metal attachment at the end. Then, hopefully, it will click, and she’ll deduce that your sex is not quite as messy as she thought.

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2. Poppers

When I’m talking to guys on Scruff whose profiles read “No PnP,” I usually ask, “Do you use poppers?” Most frequently, the answer is, “Sure. Love poppers.”

Poppers, while still a drug, are so mild that many gay men do not consider them in the same “sex drug” category that Tina (crystal meth) and G fall into. They’ve become staples of gay sex, gay culture, and gay history. We’ve been using them since the ’70s for their particular power of relaxing the anal sphincter for a few minutes, just long enough to get sex revved up. But if you try to explain the process of inhaling alkyl nitrites — video head cleaner — to your parents, they will likely conjure the imagine of junkies snorting glue in the school supplies aisle.

As with many items on this list, you could make the reasonable argument that poppers — like most facets of gay sex — never need to be brought up to your parents, since your sex life is not any of their business. But if they ever wonder why you have a few small amber bottles of some chemical that smells like nail polish in the freezer, poppers may inadvertently become a discussion topic in the kitchen.

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3. Fisting

Even if you don’t do it, you know someone who does. Fisting has long lost its shock value in gay circles, and has crossed over from dark sex dungeons into the arena of mainstream gay life. Many guys who aren’t regularly seen in leather harnesses now enjoy fisting. But imagine explaining to Dad how some guys take hands (and more) up the anus — especially when the idea of taking an erect penis up there is already outside the realm of his imagination. Many people, gay and straight, do not believe — or have not accepted — that fisting, when done safely and correctly, does not create long-term damage and can be an incredibly passionate and enjoyable sexual experience.

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4. Drag

Even though words like “slay” and “werq” have broken into the straight lexicon — primarily thanks to RuPaul’s Drag Race — the art and culture of drag is still a queer creation and belongs to us. Straight people are welcome to enjoy drag shows at their local gay bar, so long as they tip, but theirs is not a history of disenfranchisement and oppression, abuse and homelessness, poverty and sex work — a queer history in which drag emerged as an act of self-empowerment.

Drag can be hard to explain to your parents. It was hard to explain to mine. My parents assumed that all gay men dress up in women’s clothes and sing diva power ballads, so the concept of drag was indistinguishable from the rest of gay life to them. They could not appreciate drag’s cultural importance because it’s not their culture, and they did not understand its complicated history with the transgender movement because they do not understand, and refuse to understand, the concept of transgender identity.

To them, as well as to many others, drag artists and trans people are the same thing — a deeply incorrect assumption that has led to something of a modern cultural rift between trans activists and the drag world. The two camps have an overlapped history, since many trans folks first discovered their true identities through drag. In the ’60s, ’70s, and ’80s, when the concept of “transgender” was not as developed as it is today, many transgender people could only express themselves through drag art. As our cultural understandings both of drag and transgender identity have evolved, the two have split, and the burden has fallen on many transgender folks and trans activists to highlight and explain the significant difference between the two. Many people, my parents included, consider a trans woman to be “a man in a dress” — essentially a drag performer — and the phrase has become a terribly offensive slur against transgender women.

Take your parents to a drag show. Give them bills to tip the queens. (This assumes that your parents, unlike mine, are wiling to set foot in a gay bar.) Let them see drag in all its ferocity and kitschy wonder, then afterward, walking home, highlight the fact that what they saw was performance art, a toss-up between cabaret and camp. Explain to them that even if a transgender person does drag, the drag is the performance, but their trans identity is not. Regardless of what someone does onstage, transgender identity is a person’s authentic identity. “While drag is done for an audience, coming out as transgender is done solely for oneself,” a trans friend once told me. “And it is just as healthy and important to do as any coming-out, any form of self-acceptance that your mental health depends on.”

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5. Bears, Otters, and Pups, Oh My!

The labels will be the bane and the delight of your gay life. Gay men have long established the bizarre practice of defining and stereotyping ourselves into labels based on body type and sex practices. In the gay lexicon, burly, hairy men over a certain age are “bears.” Young bears are “cubs.” Skinnier, scruffier guys are “otters.” Young, lean, hairless guys are “twinks.” Guys into puppy play (a kink scene that was listed on my list of 30 kinky terms every gay man should know) who enjoy the “pup” role are “pups,” both in and out of the scene. Guys who prefer condomless sex are “pigs.” Tall, skinny gay guys are “giraffes” (a lesser-known label).

How did we come up with these? Regardless of where they came from, and in spite of their much-debated value, the labels are likely here to stay. While they are common parts of our speak, your parents would probably be confused to learn that you think bears are sexy or that your boyfriend is a puppy.

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6. Nonmonogamy

Nonmonogamy works out for gay men. In fact, this writer believes that nonmonogamous pairings, open and semi-open relationships, and relationships with relaxed sexual parameters are ideal for us — much more so than the monogamous alternative. The concept of nonmonogamy may seem foreign to our parents. Having a frank conversation about the parameters of your particular gay relationship with your parents may be awkward, but it can lead to something good. Explaining the distinction between sex and love may not leave everyone in agreement, especially if your parents are religious, conservative, or both. But at the very least, it will be an illuminating window into your life.

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7. HIV

Gay men are still disproportionately affected by HIV compared to our straight counterparts. While no one needs to come out as HIV-positive, least of all to their parents, many poz gay men choose to do so at some point, for various reasons. Coming out to my parents about my status was hard; I did it the same morning an op-ed I wrote about coming out as poz was published in The Advocate last December.

Many of our parents remember the early days of the AIDS epidemic, so the news can be hard for them. They may mistakenly believe that the outlook for an HIV-positive person in 2016 is the same as it was 30 years ago. Most well-informed gay men, particularly those who live in urban areas, are up to speed on modern HIV care and know that with antiretroviral treatment, HIV has become a livable chronic illness that is more preventable today than ever before. Our parents aren’t accustomed to seeing testing trucks outside of gay clubs or HIV pamphlets disseminated in chic gayborhoods, so they will probably need some information to alleviate the initial fear. Give them resources and time.

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8. PrEP

There may never be a need to talk about your once-daily Truvada pill to your parents, but if they see the medicine bottle by the sink one day when the family is sharing a beach condo, you need to have answers ready.

PrEP is the once-a-day pill regimen for HIV-negative people that has proven extremely effective at preventing HIV transmission. Statistically, it’s more reliable than regular condom use. Upon initial explanation, your parents will likely respond the way many have responded to PrEP and see it as an excuse to have raucous unprotected sex. Even if you are having raucous condomless sex, you will have to explain to them that you are still protected from HIV.

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9. Top/Bottom

Just as your parents have been envisioning your sex from the moment they first learned you were gay, they have been wondering “what you do.” When/if they meet your boyfriend, they will wonder “what he does.” They won’t say it aloud, but they wonder, late at night, after the dinner dishes have been put away, whether you’re the top or the bottom. (I always find it remarkable how straight people assume every gay man is one or the other — versatile guys don’t exist in straight visions of gay sex.)

Like douching, this is one I will never talk about to my parents, no matter how chummy we get.

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10. Kink

My parents know I am gay. They know I am having sex. They know I date and have sex with other men. But they do not know and will not be told how much I love having used underwear stuffed in my mouth and my wrists tied together with duct tape. The only time I ever came close to explaining my kink practices was at the beach a few years ago when I realized there were still red caning lines on my butt and legs. I lay in the tanning bed to darken the skin around the marks and opted for a pair of baggier, less flattering board shorts.

While kink is not restricted to gay men, we have certainly been longtime practitioners of the rougher arts. Like drag, leather was originally our thing and has by and large remained so. Kink and fetish play are things that gay men of all stripes can at least be familiar with, and have probably dabbled in at one time or another. But it is one area of gay life that our parents may have a hard time distinguishing from rape and abuse, perversion and degeneracy. Explaining it can be tough.

Its accouterments can be hard to hide — all those ass toys and leather gear require storage, and that sling in the bedroom cannot reasonably be disguised as a place to hang laundry. Have a regimen prepared for surprise visits and dinners, and if you enjoy getting backlashes or caning down your legs, try not to do so before a family beach trip.

Complete Article HERE!

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The Pill That Prevents HIV Is As Safe As Daily Aspirin

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Taking Truvada every day to prevent HIV isn’t any more dangerous than taking a daily aspirin to prevent heart attacks, a new study finds.

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Truvada

People who take Truvada, the once-a-day pill that prevents HIV, are no more at risk for dangerous side effects than those who take an aspirin a day to prevent heart attacks, according to a new study.

Researchers compared Truvada and aspirin by looking at the drugs’ risk profiles in large, published studies. Although the two drugs come with distinct side effects — Truvada most commonly causes dizziness, vomiting, and weight loss, whereas aspirin is most commonly associated with bleeding problems — the frequency of side effects is roughly equivalent.

But the drugs have very different reputations, among both doctors and the general public. Century-old aspirin, when taken as a preventative tool against heart attacks, is viewed as an everyday medication, no big deal. But Truvada, also known as pre-exposure prophylaxis (or PrEP), is a new pill, intertwined with the loaded issues of HIV and sex habits, and mired in uncertainty.

“Everyone’s got aspirin in their medicine cabinet,” Jeffrey Klausner, professor of medicine and public health at the University of California, Los Angeles, and lead author of the study, told BuzzFeed News. “But as a physician I’ve seen people come into the hospital and die from aspirin overdoses — people can be allergic.”

The side effects of each drug are markedly different, Klausner noted, and affect different organs. But after crunching the numbers, he said, “it really looked like I could say Truvada compared favorably, in terms of its safety profile, to aspirin.”

An estimated 52% of American adults aged 45 to 75 are prescribed a daily aspirin to prevent cardiovascular and gastrointestinal diseases, including heart attacks and cancer.

Truvada, which was approved by the FDA in 2012, has been shown to have roughly 92% efficacy in preventing transmission of HIV. The CDC estimates that about 1.2 million Americans are at high enough risk for contracting HIV that they should be prescribed the drug. But only about 21,000 currently get it.

According to Klausner, who trains doctors around the country on how to treat and prevent HIV, much of this has to do with ambivalence about prescribing otherwise healthy individuals a daily pill.

“A lot of the concerns I hear from providers are about safety,” Klausner said. “There have been continued voices saying, ‘Wouldn’t it just be better if people used condoms, or reduced their number of partners?’ Those are important strategies, but they don’t work for everyone.”

The issue of doctor awareness about PrEP is one of the biggest barriers to its wider use.

The new study “is an interesting thought experiment,” Dawn Smith of the CDC’s Division of HIV/AIDS Prevention, told BuzzFeed News. But, she added, “I’m not sure it addresses the safety concerns that some clinicians have.”

Smith noted a CDC study showing that in 2015, about one-third of primary care doctors and nurses had never heard of Truvada. Beyond the lack of awareness, she said, doctors don’t want to cause any side effects, no matter how minor, in otherwise healthy patients.

In his analysis, Klausner looked at the “NNH” — or “number needed to harm” — meaning the number of people who take the drug before one person experiences a harmful side effect. The NNH for Truvada in gay men or transgender women was 114 for nausea and 96 for unintentional weight loss. In women, side effects appeared more frequently, with 1 in 56 women experiencing nausea, 1 in 41 vomiting, and 1 in 36 mildly elevated liver enzymes.

Rarer adverse events for Truvada include kidney problems and a small decrease in bone mineral density, but Klausner notes that both of those effects have been shown to be reversible once the medication is discontinued.

In contrast, aspirin had an NNH of 15 for bleeding problems and 20 for easy bruising. Rarer problems included ulcers and other gastrointestinal problems.

Because it’s so much older, aspirin has been tested in many more people with many more years of follow-up, Klausner noted. Because Truvada is a relatively new drug, it will take awhile to accrue the data needed to make its long-term safety bulletproof.

In the meantime, however, Klausner hopes more doctors will educate themselves about the HIV prevention drug. And after that, he said, “we should work to make it the same price as aspirin.”

Complete Article HERE!

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Survivors of 1980s AIDS crisis reveal what happened to them

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In Honor of World AIDS Day

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From the role of lesbians to the vanishing of whole neighborhoods, real LGBTI people share their experiences

by Joe Morgan

Survivors of the 1980s AIDS crisis have shared accounts of their experiences.

As the UK celebrates LGBT History Month, users of Reddit revealed what it was like to be living in what felt like a constant state of tragedy.

Real LGBTI people remember the confusion, the lack of information, the lack of support from the government because of the suffering from the virus known only at the time as GRID (gay-related immune deficiency).

‘I’m a 62-year-old gay man. I thankfully made it through the epidemic that started in the early 80s and went right through the mid-90’s. You ask what it was like? I don’t know if I can even begin to tell you how many ways AIDS has affected my life, even though I never caught the virus,’ one user said.

‘By the early 80s, I had what I would consider a really large circle of friends and acquaintances and once the epidemic really started to hit, it was not uncommon to find out three, four or more people you knew had died each month. We set up informal and formal support groups to look after our friends who took sick. Feeding them when they would eat. Changing them. Washing them. Acting as go-between with families who “were concerned” about their sons, nephews, brothers, etc., but wouldn’t lend a hand to help because AIDS was, you know, icky.

‘After they passed, there were memorial services to plan with no real time to grieve because when one passed, you were needed somewhere else to begin the process all over again.

‘I kept a memory book/photo album of everyone I knew that died of AIDS. It’s quite large to say the least. Who were these guys? These were the people I had planned to grow old with. They were the family I had created and wanted to spend the rest of my life with as long as humanly possible but by the time I was in my late 40s, every one of them was gone except for two dear friends of mine.

‘All we have left of those days are each other, our memories and pictures. I hope that statement doesn’t come off as pitiful though. I am fit, active, healthy and you know what? I enjoy every single day of my life. I enjoy it because most of my friends can’t. In my own personal way, I want to honor their lives by living and enjoying mine.’

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Another user said: ‘It was flat out scary. every guy you met was like a possible time bomb. especially the early period when we knew very little about it – didn’t know if you could get it by kissing, by holding hands…

‘Then lots of your friends or friends of friends get sick and sicker and then die. And you never ever quit being really really fucking pissed off about the whole thing. I’m alive today due to sheer randomness.’

And another said: ‘If you were living in the Castro in San Francisco, everyone in the neighborhood was gay… So it wasn’t just your friends that were dying, it was your whole neighborhood. One day your mailman would be replaced, the next day that flower shop was gone… You wouldn’t be invited to the funeral, so it was just like people were disappearing.’

‘It was madness. It was terribly cruel,’ another Redditor said. ‘It was inexplicable and unexplained, for a very long time. Research was underfunded, and in many cases large institutions and public figures rooted for it to be happening. People died suddenly of unexplainable things. Toe fungus! Tongue thrush! Rashes. Eyes welling up with blood. Horrible shit.

‘Everyone knew it was hitting gay men, nobody knew what it was. They called it the gay cancer. People were very superstitious. I had handfuls of groceries and man lectured me on not pressing the elevator buttons with my nose because I could catch AIDS from it. Yes. That happened.’

A lesbian of the era said: ‘While I was not ‘at risk’ (per se, we know more these days), we all lost many good friends. It is true that there is a somewhat mystifying (to me) separatist attitude between some gay men and lesbians, especially back then, this tragic time really brought us together.

‘Sitting at the bedside of a terminally ill friend, and just holding their hand when everyone else was just terrified, was a gift I was one of those willing to give.

‘No one should die alone, and no one should be in the hospital on their death beds with family calling to say “this was gods punishment”. My friends and I, men and women, acted as a protective layer for ill friends, and companion to mutual friends juggling the same, difficult reality of trying to be there, and be strong when we were losing our family right and left. Difficult times, that should never be forgotten.’

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Another Redditor paid tribute to the role of lesbians, calling them ‘every bit as heroic as soldiers on the front lines of any war’.

‘These women walked directly into the fire and through it, and they did not have to. And that they did it even as some of the gay men they took care of treated them with bitchiness, scorn, and contempt.

‘It was, at the time, not at all unusual for gay men to snicker as the bull dyke walked into the bar with her overalls and flannels and fades. Much of the time, it was casual ribbing which they took in stride. But it could also be laced with acid, especially when lesbians began gravitating toward a bar that had until then catered largely to men.

‘When the AIDS crisis struck, it would be many of these same women who would go straight from their jobs during the day to acting as caregivers at night. Because most of them lacked medical degrees, they were generally relegated to the most unpleasant tasks: wiping up puke and shit, cleaning up houses and apartments neglected for weeks and months. But not being directly responsible for medical care also made them the most convenient targets for the devastating anger and rage these men felt – many who’d been abandoned by their own family and friends.

‘These women walked directly into the fire. They came to the aid of gay men even when it was unclear how easily the virus could be transmitted. Transmission via needlestick was still a concern, so they often wore two or three layers of latex gloves to protect themselves, but more than once I saw them, in their haste and frustration, dispense with the gloves so that they could check for fevers, or hold a hand that hung listlessly from the edge of a bed whose sheets they had just laundered.

‘They provided aid, comfort, and medical care to men withering away in hospices, men who’d already lost their lovers and friends to the disease and spent their last months in agony. They’d been abandoned by their own families, and were it not for lesbians – many if not most of them volunteers – they would have suffered alone. And when there was nothing more medicine could do for them and their lungs began to fill with fluid, it was often these same women who’d be left to administer enough morphine to release them, given to them by the doctor who had left the room and would return 15 minutes later to sign the certificate (a common practice at the time).

‘I knew a woman around that time who’d had at one point been making bank in construction. But at the outset of the AIDS crisis she had abandoned her career to pursue nursing instead, and was close to her degree when we were hanging out. She was a big, hearty drinker, and fortunately so was I. We’d been utterly thrashed at a bar once when someone whispered a fairly benign but nonetheless unwelcoming comment about her. Middle fingers were exchanged, and afterwards, furious and indignant, I asked her, Why do you do it? Why did you abandon a career to take care of these assholes who still won’t pay you any respect?

‘She cut me a surprisingly severe look, held it and said, “Honey, because no one else is going to do it.” I remember feeling ashamed after that, because my fury and indignation weren’t going to clean blood and puke off the floor; it wasn’t going to do the shit that needed to get done.

‘HIV killed my friends, took my lover from me, and tore up my life. During that time, I did what I could. But nothing I did then or have ever been called to do in my life puts me anywhere near the example set by the lesbians I knew in the 80s and 90s. I’ve felt obligated to remember what they did, and to make sure other people remember it too.’

Complete Article HERE!

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2.5 Years Later, Zero Cases Of HIV In Large San Francisco PrEP Group

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A new study reveals that after 2.5 years, a group of more than 600 San Francisco men who have sex with men (MSM) taking Truvada as pre-exposure prophylaxis (PrEP) have had zero cases of HIV contraction.

The study also finds that many of these individuals are using condoms less and more than half of those in the group study had contracted at least one sexually transmitted infection (STI) within a year.

From POZ.com:

Researchers at Kaiser Permanente published their findings in Clinical Infectious Diseases. The paper represents a powerful endorsement of PrEP’s ability, in a real-world setting, to prevent HIV infection among those at very high risk of contracting the virus. The lack of new HIV infections among these men challenges the stance of AIDS Healthcare Foundation president Michael Weinstein, who has vigorously campaigned that PrEPshould not be used as a widescale public health intervention.

On the flip side, the Kaiser findings challenge the received wisdom from PrEP clinical trials that those taking Truvada as HIV prevention do not increase sexual risk-taking while on the medication.

“Our study is the first to extend the understanding of the use of PrEP in a real-world setting and suggests that the treatment may prevent new HIV infections even in a high-risk setting,” reports lead author Jonathan Volk, MD, MPH, a physician and epidemiologist at Kaiser Permanente San Francisco Medical Center. “Until now, evidence supporting the efficacy of PrEP to prevent HIV infection had come from clinical trials and a demonstration project.”

It’s important to reiterate that according to Kaiser, though no one using PrEP contracted HIV, there was a very high rate of other sexually transmitted infections (STIs).

POZ.com breaks it down:

After six months, the clinicians at Kaiser surveyed 143 of the cohort about their sexual risk-taking. At that time, 74 percent reported that their number of recent sexual partners had not changed since starting PrEP, while 15 percent said they had fewer sexual partners and 11 percent said they had more. Regarding condom use, 56 percent said they used them at the same rate after starting Truvada, 41 percent used them less and 3 percent used them more.

Because these individuals were not engaged in a clinical trial, there is no control group to measure the change in these men’s sexual risk-taking against. So there is no way to tell if the group would have changed their risk-taking in a similar pattern if they had not been taking PrEP.

One thing is clear, however: These men would have been at very high risk of contracting HIV had they not been taking PrEP while engaging in the same level of sexual risk-taking. The evidence is in their very high rate of STIs. Six months into taking PrEP, 30 percent of the PrEP users had been diagnosed with at least one STI. After a year, half of them had contracted one or more STIs, with 33 percent diagnosed with a rectal STI, 33 percent with chlamydia, 28 percent with gonorrhea, and 5.5 percent with syphilis. As noted, two of them contracted hep C.

“Without a control group, we don’t know if these STI rates were higher than what we would have seen without PrEP,” stressed the paper’s co-author Julia Marcus, PhD, MPH, postdoctoral fellow at the Kaiser Permanente Division of Research. “Ongoing screening and treatments for STIs, including hepatitis C, are an essential component of a PrEP treatment program.”

No one in the group has been diagnosed with HIV.

Our takeaway, PrEP is clearly doing its job in HIV prevention, however we need to remain vigilant in testing and treatment for STIs. The choice to use or not use condoms is up to the individual, but be aware of the risks and ensure that you’re regularly being tested to protect your health and potentially that of your sexual partners.
Complete Article HERE!

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Mellow With Age

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Name: Bob
Gender: Male
Age: 54
Location: Laguna Beach
As an older man, I’ve started having performance problems. Unfortunately there’s no decrease in my libido. I think some of my problem is psychological. I’m also HIV+. And I find myself worrying about transmission even with condoms. But some of the problem is physical. I do wear a cockring and that helps I guess. Is there anything else I can do to increase my performance to match my libido?

Thanks for your comment and question. Your concern is a familiar one. Men regularly present this problem in my private practice and I also have a personal familiarity with the issue in my own life.

Diminished performance, at least in terms of a perpetually stiff dick, is a natural occurrence as we age. There was a time when I thought this was a major problem. I don’t think like that now. These days I’m helping my older clients (and myself) appreciate the full range of sensuality that is the unique purview of us more seasoned lovers. I’ve always felt that as gay men we are too genitally focused, especially when it comes at the expense of all the other pleasure zones our bodies have been gifted with.Kedori - Eileen Gray Bibendum Armchair

The rushed, hormonally driven sex of my youth has matured into a slower, more relaxed and sensual sexuality that I am thoroughly enjoying. This has been one of the very best gifts of the aging process. It’s even having an effect on my younger partners and they are appreciative.

So I no longer equate performance with a stiff dick. For those times when I absolutely need a rock-hard hardon a cock ring does just fine. I’m aware that I may need more time to achieve this kind of erection, but I’m not just twiddling my thumbs while I’m waiting, if ya know what I mean. I am no longer frustrated by this natural phenomenon, because I no longer have unrealistic expectations.

I realize that many men are using with an erection-enhancing medication such as Viagra, but I suggest that this be reserved for those who are truly experiencing erection dysfunction.

I’m also concerned with the alarming rise of younger men, men in their 20’s and 30’s who are using Viagra or another similar drugs recreationally. This is very troubling. If your young body is having difficulty producing an erection, then you need medical attention ASAP, or maybe you just need some sleep. However, if you’re abusing Viagra just so you can have an erection that lasts for hours that’s a real bad idea for several reasons. Not least of which is your body will habituate itself to that stuff and you will find that, in time, you won’t be able to get it up at all without ever increasing doses of Viagra.

viagra cartoonThis is gonna fuck up your cardiovascular system big time. In fact, you may very well be inducing the very sexual dysfunction the drug is supposed to help. Consider the person who overuses eye drops or lip balm or any number of otherwise innocuous health and beauty products. Their body will stop making the natural substances that these over the counter products are intended to assist. It’s counterproductive and it’s ill advised. If this is a problem with relatively harmless over the counter products, you know you are playing with fire when you’re abusing powerful prescription meds.

Whoops, sorry Bob, I went off topic there for a minute. It’s just that every opportunity I get to put out a message that will dissuade someone from hurting one’s self, I just launch into it.

So back to you. It is clear from what you tell me, your performance problems do, as you suggest, also have a psychological component to it. You have a fear that, despite being responsible in your sex play and even though you play safe, you could accidentally pass on HIV.

It’s true; one’s brain can indeed override almost every function of our body. For example, we draw each and every breath we take without even thinking about it. However, if a situation dictates our brain can and does override that essential pulmonary function and we can hold our breath. The same is true with our sexual response cycle. Sometimes we can become sexually aroused without really thinking about it. However, if for one reason or another our brain assisted by our conscience interferes with or even shuts down the sexual arousal, that’s pretty much, all she wrote.

Your scruples about the possibility that you could accidentally pass along HIV are interfering with your sexual response cycle. No cockring or an erection-enhancing medication is going to change that darlin’!

In other words, the problem is not in your cock, the problem is in your head. This is something you’re gonna have to wrestle with and finally resolve. This tension between your head and your dick is actually a good thing. Your body is providing you an opportunity to align your moral values with your sexual performance. How will this resolve itself? I couldn’t say. But I know for sure resolution is possible.

I do suggest, however, that you not try to do this in a vacuum. Reach out to a HIV support group or a sex-positive therapist for the help you need in making peace between your head and your cock.

Good luck

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