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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

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

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

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

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

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

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

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

The Rise of PrEP

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

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

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

Undetectable Equals Untransmittable

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

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

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

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

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

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

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

Complete Article HERE!

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British Columbian study reveals unique sexual healthcare needs of transgender men

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by Craig Takeuchi

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Complete Article HERE!

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Does Progesterone Influence Baby’s Later Sexuality?

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A new study addresses whether supplementing progesterone during pregnancy, a common practice to prevent miscarriage, could influence a baby’s sexual orientation in later life.

Dr. June Reinisch, director emerita of the Kinsey Institute in the U.S., led the study. She found that bisexuality is quite common among men and women whose mothers received additional doses of the sex hormone progesterone while pregnant.

As discussed in the journal Archives of Sexual Behavior, researchers tracked the sexual development of 34 Danes whose mothers were treated with the hormone to prevent miscarriage.

According to the investigators, progesterone appears to be an underappreciated factor influencing the normal development of variations in human sexuality and psychosexuality.

Researchers believe the findings warrant further investigation given that little is known about the effects on offspring of natural variations in levels of maternal progesterone and that progesterone is widely used to treat pregnancy complications.

Men and women all naturally produce the sex hormone progesterone. It is involved in women’s menstrual cycles, and helps to maintain pregnancies and development of the fetus.

Progesterone plays a role in neural development and the production of other sex hormones as well as steroid hormones that help to regulate stress responses, inflammation, and metabolism in the body.

Physicians often prescribe progesterone and its bio-versions to support the fertilization process, to prevent miscarriages or premature births, or to increase babies’ birth weights.

The 34 participants in the study were drawn from the Copenhagen Perinatal Cohort, which comprises information collected from virtually all children born between 1959 and 1961 at the university hospital in Copenhagen, Denmark.

The 17 men and 17 women were selected because their mothers exclusively received the progesterone lutocyclin to prevent a miscarriage.

These men and women were compared with a carefully selected control group who were not exposed prenatally to lutocyclin or any other hormone medication, but who otherwise matched the study participants based on 14 relevant physical, medical, and socioeconomic factors.

The participants were all in their mid-20s when asked about their sexual orientation, self-identification, attraction to each sex, and sexual history using questionnaires and a structured interview with a psychologist.

It was found that men and women whose mothers were treated with progesterone were significantly less likely to describe themselves as heterosexual. One in every five (20.6 percent) of the progesterone- exposed participants labeled themselves as other than heterosexual.

Compared to the untreated group, the chances were greater that by their mid-20s they had already engaged in some form of same-sex sexual behavior (in up to 24.2 percent of cases), and that they were attracted to the same (29.4 percent) or to both sexes (17.6 percent). Both exposed males and females also had higher scores related to attraction to men.

“Progesterone exposure was found to be related to increased non-heterosexual self-identification, attraction to the same or both sexes, and same-sex sexual behavior,” says Reinisch.

“The findings highlight the likelihood that prenatal exposure to progesterone may have a long-term influence on behavior related to sexuality in humans.”

The research team believes further studies on the offspring of women medically treated with progesterone and other progestogens during their pregnancies are necessary. Additionally, studies examining the effects of natural variation in prenatal progesterone levels are warranted to provide more insight into the role that this hormone plays in the development of human behavior.

Complete Article HERE!

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High-risk sex, girl-on-girl experimenting linked among NYC teens

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By Susan Edelman

Nearly half the Big Apple’s sexually active high-school girls have had female partners — and many engage in behavior that endangers their health, an alarming new study finds.

Researchers from New York University and the Albert Einstein College of Medicine based their findings on a 2013 survey of public high-school students citywide — but most heavily in “high-risk neighborhoods” in the Bronx, Brooklyn and Manhattan.

Of 4,600 girls surveyed, 1,101, or 27.5 percent, were sexually active. Of those, 513, or 46.6 percent, reported same-sex experiences, according to the study, published this month in the Journal of Pediatric and Adolescent Gynecology.

This “vulnerable population of girls” who engage in same-sex or bisexual activity are twice as likely as heterosexual teens to be sexually active. The researchers also found:

  • These girls start having sex sooner, have more sexual partners and suffer more “intimate partner violence.”
  • They are less likely to use contraceptive methods — putting them at higher risk of unplanned pregnancy if they also have sex with boys.
  • They use more alcohol, marijuana and other illicit drugs.
  • They report more suicidal thoughts or attempts. Girls “not sure” of their sexual orientation are at highest risk of trying to kill themselves.
  • Even though female-to female transmission of HIV is possible, many of these girls do not test for it or other sex-related diseases.

Dr. Chanelle Coble, an adolescent pediatrician and assistant professor at NYU Langone Medical Center, co-authored the study with Einstein assistant professors and psychologists Rosy Chhabra and Ellen Silver.

The researchers found the abundance of same-sex activity even though not all teens who indulged identified themselves as lesbian or bi-sexual.

“Just looking at how someone describes themselves doesn’t tell the whole story,” Coble said. “When they’re young, it’s harder for them to be specific about their identity — they’re still exploring and figuring it out.”

An advocate for lesbian and bisexual youth called the study’s results, “disheartening, but not surprising.”

Lesbian and bisexual girls are often stigmatized and treated with hostility, said Emily Greytak, research director for GLSEN, a Manhattan-based group that promotes safe schools for LGBT students.

“That can lead to more risky behavior, and takes a toll on their health,” she said.

The surveys were conducted by the city Department of Health for the US Centers for Disease Control and Prevention.

Complete Article HERE!

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How Straight Men Who Have Sex With Men Explain Their Encounters

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The subject of straight-identifying men who have sex with other men is a fascinating one, in that it shines a light on some extremely potent, personal concepts pertaining to identity and sexuality and one’s place in society. That’s why some sociologists and other researchers have been very eager to seek out such men and hear them explain how they fit same-sex sexual activity into their conception of heterosexuality.

The latest such research comes in the journal Sexualities, from Héctor Carrillo and Amanda Hoffman of Northwestern University. They conducted 100 interviews, with men who identified as straight but sought out casual sex with men online, hoping to better understand this population. A big chunk of the article consists of snippets from those interviews, which were primarily conducted online by three female researchers, and at the end Carillo and Hoffman sum up what they found:

They interpret that they are exclusively or primarily attracted to women, and many also conclude that they have no sexual attraction to men in spite of their desire to have sex with men. They define sexual attraction as a combination of physical and emotional attraction, and they assess that their interest in women includes both, while their interest in men is purely or mainly sexual, not romantic or emotional. Moreover, some perceive that they are not drawn toward male bodies in the same way as they are drawn to female bodies, and some observe that the only physical part of a man that interests them is his penis. Men in the latter group do not find men handsome or attractive, but they do find penises attractive, and they thus see penises as ‘living dildos’ or, in other words, disembodied objects of desire that provide a source of sexual pleasure. Finally, as a management strategy for judging that their sexual interest in women is greater and more intense than their interest in men, they sometimes limit their repertoires of same-sex sexual practices or interpret them as less important than their sexual practices with women. That way, they can tell themselves that their sexual interest in women is unbounded, while their sexual interest in men is not.

All this contributes to their sense that they qualify as being called straight or heterosexual, even when some also recognize that their sexualities do indeed differ from exclusive heterosexuality, which in turn leads them to adopt secondary descriptors of their sexual identities. As indicated by the variety of terms that they used, those descriptors often reinforce a perception that, as a sexual orientation category, heterosexuality is elastic instead of rigid — that some degree of samesex desire and behaviour need not automatically push an individual out of the heterosexual category. And while some men are willing to recognize that their sexual behaviours might qualify their being called bisexual — and they may privately identify with that label — they feel that there is no contradiction between holding a private awareness of being bisexual and a public persona as straight or heterosexual. Again, this conclusion is strengthened by a lack of social incentives to adopt bisexual identities.

It’s interesting to keep that interpretation in mind as you read the interview snippets. Take, for example, the men who sought to make it very clear that while they sometimes got with men, they really liked women:

I know what I like. I like pussy. I like women … the more the merrier … I would kiss a woman. ANYWHERE. I can barely hug a man … I do have a healthy sexual imagination and wonder about other things in the sexual realm I’ve never done … Sometimes I get naughty and explore … That’s how I see it. [Reggie, 28]

Women are hot … I can see a beautiful woman walk down the street and I instantly can become hard and get horny. I don’t think I’ve ever seen a guy walking by and got a boner. Also, I would not want to kiss or make out with them or love them. They would be more like a sexual experience. [Charlie, 32]

Some of the men did think that their behavior possibly qualified them as bisexual, but didn’t quite want to take the step of identifying as such:

I think everybody is a little bi. Isn’t that what this research is about? There’s the Kinsey scale … It’s not like Bush saying you’re either with us or with the terrorists. I think I’m probably bi but what I present to the world is a heterosexual man. Internally I’m bi, but that’s not something most people know. I’m not ashamed, but the majority of people are ignorant and close-minded. [Simon, 27]

I am not openly bisexual to society except in sexual situations … I don’t have relationships with men; I am in a relationship with my wife and only love her. [I’m bisexual] only with men behind closed doors. [Dustin, 28]

In addition to being perhaps the first instance in recorded history of someone comparing their sexual orientation to George W. Bush’s counterterrorism doctrine, Simon’s statement contains an important point: Carrillo and Hoffman note that many of their respondents simply “see no real personal or social advantages that would stem from publicly adopting an identity as bisexual or gay.” In many cases, it may not be in their interests to do so — hence the compartmentalization of their same-sex encounters.

Another reason for such compartmentalization is that it allows some men the opportunity to explore parts of their identities they feel they couldn’t safely in heterosexual settings:

For most of my sex life I’m in control of things. I’m not a boss at work anymore but I’ve been in situations where I’ve managed a hundred people at a time. I take care of my family. I take care of my kids. I’m a good father. I’m a good husband in providing material things for my wife … I’m in charge in a lot of places … There’s times when I don’t want to be in charge and I want someone to be in charge of me … that’s what brings me over [to] the bisexuals … it’s kind of submitting to another guy or being used by another guy. [Russell, 54]

“Interestingly,” write Carrillo and Hoffman, “being dominated by a man seemed to them less threatening than being dominated by a steady female partner, perhaps because it could be construed as a temporary fantasy, instead of meaning a permanent change in the gender balance.”

This same dynamic popped up the last study on this subject I covered — the idea that men “get” something about sex that women don’t, and that because there’s a fully mutual understanding that what’s going on is just sex, same-sex experiences can be set off safely away from the rest of one’s (heterosexual) identity. You can be a “good father,” which many men imply to mean being a strong, straight man, while still messing around with men on the side. From these men’s perspective, they can have it both ways — the privileges of identifying as straight and the pleasure and excitement of same-sex relationships on the side — without their identity being threatened.

Complete Article HERE!

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