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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!

Tricks Of The Trade — Part 3

Today I return to a series I started back in October. (You can Find the first two parts of this series HERE and HERE!) As you may recall from back then, a friend of mine, who is writing a book about male sexuality for women, asked me if I could be her go-to-guy for a bunch of questions she had about pleasuring a man which she wants to include in her book. I think it is only fair that you, my loyal audience, should get this information before anyone else does.

COCK & BALLS

Does the concept of blue balls really exist? (With all of the tantric activity that goes on, I assume it’s more of a myth than anything else, but we would love to hear otherwise if I’m wrong!)BlueBalls

Yep, it’s slang for an actual condition — congested prostate or vasocongestion caused by prolonged sexual arousal. A dude’s balls and prostate will ache if an ejaculation/orgasm doesn’t dissipate the trapped blood that fills the vessels in his cock and surrounding genital area during sexual arousal.

During sexual arousal, a guys balls can increase in size 25-50 percent. This is particularly true for younger men; wouldn’t you just know it.

Are there any “secret spots” on the male body that we should know about, that aren’t on the penis or in the butt?

You know those two things on a guy’s chest? I think they’re called nipples. Some men’s nipples are hot wired to their dick. I know several men who are orgasmic through nipple play alone. Any man can learn to sensitize and find pleasure in their nipples or other parts of their body as well.

Are there any magical/mystical techniques that gay men have mastered that straight women should know about?

floppy critterThere sure are, but us gay men are sworn to secrecy about this. And I’m not about to break this sacred code of silence. However, every straight woman should have a good gay male friend that she can ask about things like this. Most gay men are not as discreet about this as I am. They will gladly tell you what they do to pleasure their men if you ask them. Get a gay friend, if you don’t already have one, and have the talk. You will be amazed.

What exactly is the Frenulum? Is there any biological purpose to it? Why is it so sensitive? And what should a girl do with it?

Actually a frenulum is a small fold of skin tissue that prevents an organ in the body from moving to far from a particular location. There are frenula at several points of the body, including several in the mouth, some in the digestive tract, a couple in the vagina, and, my favorite, the one on a guy’s cock.

This is an elastic band of tissue under the dickhead that connects to the foreskin, and helps cover the dickhead when not aroused. Sadly, the frenulum can be partially or even totally removed during circumcision.

Think of the frenulum as a guy’s feeble excuse for a clit. It’s loaded with nerve endings. If a chick wants to know what to do with a frenulum, all she has to do is ask herself what she likes having done to her clit.

Any tricks of the trade on what a gal should do with a man’s testicles? Anything that will really drive him wild?by the balls

Loads of guys like having their balls stretched. Guys have been stretching their balls for just about as long as us men folk have had balls to stretch…and that’s a mighty long time. The only thing that screams male virility and potency as much as a big dick is a pair of big low hangin’ nuts. In fact in many societies throughout history a man’s cajones were considered sacred. They were revered as objects of religious, social, cultural, and even magical power. In fact in ancient Rome, when a man would take an oath he would grab his balls, just like we put our hand on a bible today. In fact, some etymologists believe that’s where we got the word, “testify,” from the Latin: testis.

Men discovered early on that ball stretching was both erotic fun and relatively easy to do. Just to clarify…when I say ball stretching, what I really mean is sack (scrotum) stretching. One cannot really increase the size of his balls (testicles). Soon men in many societies were stretching their junk to call attention to their manliness. With the help of a stretching device of one sort or another, and there are several, men were able to lengthen their balls with very little effort.

A gal can help a guy do this. The simplest method, and you don’t even need no stinkin’ equipment for this, is called the manual method. All ya do is give your man’s huevos a nice sustained tug. Alternate your tugging with some nice ball massage. Over time this will help to lengthen his ball sack because you’re manually forcing it downward. The more you pull and the longer you pull, the more you will affect the hang of your guy’s balls. It’s also pretty sexually stimulating too.

This method is particularly effective after a hot bath or shower. His skin will be at its most pliable then. This method is safe and effective and even a rank amateur can pull it off, so to speak. This’ll be fun and pleasurable all on its one. Your guy will love that you are paying his balls some attention while you’re jerkin or suckin him off. And that will make him and his nuts much happier.

What are your thoughts on circumcision? We’ve read that it actually can cut off important nerve endings — is there any truth behind this?

Foreskin HugI am completely opposed to infant circumcision. It is genital mutilation. And yes, it can and often does remove important nerve endings. (See question 4 above and read below.)

As to adult circumcision, I need to say one thing from the outset. It’s a particularly thorny issue for me. I firmly believe in the right of an adult to augment, adorn and embellish, or in any other way customize his or her body. Just as long as that person has taken enough time to think it through. At the same time I am a furious proponent of genital integrity. So you see my conflict.

There are, of course, medical reasons for adult circumcision.

Take a really close look at a foreskin. I mean a really close look. What do you see? Veins, right? If you pinch a foreskin between your thumb and forefinger as hard as you can; what happens? OUCH! Ya know why that is? A foreskin is just chock-full of nerve endings, darlin’. A foreskin contains about 240 feet of nerve fibers and tens of thousands of specialized nerve endings, which can feel the slightest pressure, the lightest touch, the smallest motion, the subtlest changes in temperature, and the finest gradations in texture.

In many ways, a foreskin is just like one’s eyelid. It covers, cleans, and protects a guy’s dickhead just like one’s eyelid covers, cleans, and protects one’s eye. A foreskin keeps the surface of a guy’s dickhead healthy, clean, shiny, warm, soft, moist, and sensitive. And there are a whole lot of us who think a foreskin is totally hot.

A foreskin is a specialized, sensitive, and functional organ of touch. No other part of the body serves the same purpose. Besides, if it’s cut off, it’ll remove 50% of the skin of the cock.

Finally, I’m of the mind that millions of years of evolution has provided men a covering for our dickhead for a purpose. And to remove it is simply unnatural.

The Erotic Mind of Stella Harris — Podcast #406 — 02/10/14


Hey sex fans, welcome back.

The delightful literary artist, Stella Harris, is back with us again today for Part 2 of her turn on this The Erotic Mind show.bookstore-2-BW

Besides the great conversation we had last week, Stella read from her work and she like totally steamed up the joint, don’t cha know. With a little luck I think I’ll be able to prevail upon her to cast another smutty spell today. So stick around, it’s gonna be quite the ride.

But wait, you didn’t miss Part 1 of our chat, did you? Well not to worry if ya did, because you can find it and all my podcasts in the Podcast Archive right here on my site. All ya gotta do is use the search function in the header; type in Podcast #405 and PRESTO! But don’t forget the #sign when you do your search.

Stella and I discuss:

  • Her nom de perversion;
  • Becoming Stella;
  • Writing dirty letters to a lover good practice for writing erotica;
  • Strangers on the internet and local dungeons;
  • Fellow Portland resident, Tonya Jone Miller;
  • Fetishes and turn-ons;
  • Erotica/sex writing/romance/porn;
  • Her inspiration, Shanna Germain;
  • Advice for the novice writer.

 

Stella reads from her work in The Big Book of Orgasms.

Stella invites you to visit her on her beautiful site HERE! Her Facebook page is HERE! And her Twitter feed is HERE!

(Click on the cover art below to discover volumes featuring Stella’s work.)

BigBookofBondageCover kinky sex cover-small Shameless cover Strummed - cover-med SuddenSexCover love burns bright cover OrgasmsCover Calendar cover

BE THERE OR BE SQUARE!

Look for all my podcasts on iTunes. You’ll find me in the podcast section, obviously. Just search for Dr Dick Sex Advice. And don’t forget to subscribe. I wouldn’t want you to miss even one episode.

Today’s Podcast is bought to you by: DR DICK’S — HOW TO VIDEO LIBRARY.

drdickvod.jpg

Too pooped to pop

Name: Djon
Gender: Male
Age: 54
Location:
I’m a 54-year-old man, who 3 years ago managed to finally come out and live the life I so desperately longed for all my life. My question — is there a biological clock in men like the issues women have to deal with in menopause. During the last years of my marriage there was no sex life other than with myself. Now I’m living a fantastic life, with a great man who I love very much. I know there is more to life than sex but now that I’m finally able to express myself physically with a man my ability to perform is just not working.

I’ve tried Viagra and such years ago. They used to work in maintaining an erection, it was just by myself, but I always had fun. The headache’s and discomforts from the meds bring up the question — do I really want to take this?

But now the med’s don’t even help, and as for my libido it suffers with my lack of ability. I’ve been tested for testosterone levels and they say I’m right where I should be at for my age. I’ve seen two doctors about the issue and when they find out my partner’s sex they don’t want to deal with it and seem to just pass it off as an age thing.

I’m in fairly decent good shape, I exercise 3 – 4 days a week at the gym, can you send me any advice on a path to take.

A little frustrated: Djon

A little frustrated? Holy cow, darlin’, you sound a lot frustrated. I don’t blame ya. You finally find what’s been missing throughout your whole life only to discover that your plumbing is now givin’ out on you. Ain’t that a bitch! And before I continue I want to tell you and all the other alternative lifestyle people in my audience, don’t settle for a sex-negative physician no matter what. Dion, find yourself a sex-positive doctor that will look beyond your choice of partner and give you the respect you deserve! Damn, I hate shit like that.

andropause2258You raise an interesting question about the aging process when you ask if men experience something similar to menopause in women. The short answer is — yeah, you betcha! In fact, it even has a name; andropause.  I’ve written and spoken extensively about this very subject. Here’s what I want you to do. Look for the CATEGORIES section in the sidebar, look for the category — AGING. There you will find everything I’ve written and said about Andropause, and Sex and Aging.

You’ll find a whole lot more information there than I can put together for you in this posting. However, I can offer you an overview. It’s only been recently that the medical industry has started to pay attention to the impact changing hormonal levels have on the male mind and body. Most often andropause is misdiagnosed as depression and treated with an antidepressant. WRONG!

Every man will experience a decrease testosterone, the “male” hormone, as he ages. This decline is gradual, often spanning ten to fifteen years on average. While the gradual decrease of testosterone does not display the profound effects that menopause does, the end results are similar.

And listen, when a physician says that your testosterone level falls within an acceptable range, he/she isn’t telling you much. Let’s just say you had an elevated level of testosterone all your life, till now. Let’s say that you now register on the lower end of “acceptable”. That would mean that you’ve had a significant loss in testosterone. But your doctor wouldn’t know that, because he has no baseline for your normal testosterone level to begin with.andropause

There is no doubt that a man’s sexual response changes with advancing age and the decrease of testosterone. Sexual urges diminish, erections are harder to come by, they’re not as rigid, there’s less jizz shot with less oomph. And our refractory period (or interval) between erections is more pronounced too.

Andropausal men might want to consider Testosterone Replacement Therapy (TRT). Just know that most medical professionals, like yours, Dion, resist testosterone therapy. Some mistakenly link Testosterone Replacement Therapy with prostate cancer. Even though recent evidence shows prostatic disease is estrogen-dependent rather than testosterone-dependent. I encourage you to be fully informed about TRT before you approach your doctor, your new sex positive doctor, because the best medicine is practiced collaboratively — by you and your doctor.

Finally, getting the lead back in your pencil, so to speak, may simply be an issue of taking more time with arousal play. Don’t expect to go from zero to 60 in a matter of seconds like you once did. Also, use a cockring.  But most of all, fuckin’ relax, why don’t cha already. Your anxiety is short-circuiting your wood, my friend. And only you can stop that.

Good luck

It’s a small world after all

Name: ali
Gender:
Age: 25
Location: canada
my girlfriend dont waana get maried to me beacuse she is afraid of sex , she hates sex because she think its a disguesting thing like sucking fingering n etc what am i suppose to do i love her how i satisfy her dat we have to marry???

Why would you want to marry a chick that doesn’t like sex as much as you do? That just seems crazy to me. If you think you’re gonna win her over and change her mind about sex by marrying her, that’s even crazier. Loving someone is not enough to overcome this kind of sex aversion. If she’s unwilling to see a therapist to help her through her distaste of sex, then I’d say it was time for you to find another potential bride.

misunderstanding

 

Name: Randy
Gender:
Age: 24
Location: Florida
Is it possible that anal sex can result in increased flatulence?

Ahhh yeah! Think of your ass as a cylinder and your partner’s cock as a piston. All this slamming in and out forces air up your bum. And what happens to that trapped air after (and sometimes even during) the fuck fest? You got it…farts for days. It’s no big thing, all bottoms get fuck-farts. The same is true for women — her pussy is the cylinder and her partner’s cock is the piston. All this slamming in and out forces air into her cooch, producing the very familiar pussy-fart.

Name: Jonathan
Gender: Male
Age:
Location: UK
Hello, please could you tell me if there is a way to increase the size of my testicles permanently, I do shoot a good amount of cum but they are small in the hand and look small in underwear and swim trunks, have you any advice on what I could try,

Hold on there, big fella. What are you tellin’ me? Do you want to increase the size of your balls (testicles), or the size of your sack (scrotum)? You can do the later, but not the former. If you are past puberty, your balls are the size they are gonna be, there’s no increasing them. Your sack, on the other hand can be stretched to increase its size. Will that satisfy you? If so, read this: …don’t let me get too deep. If not, you’re out of luck, darlin’!

Oh, and by the way, the “good amount of cum” you mention, most of that, 70% of it, is not sperm, the reproductive cells produced in your balls. Most of your semen is a mixture of fluids produced in your seminal vesicles, prostate, and bulbourethral glands.

Good luck.

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