Search Results: Longer

You are browsing the search results for longer

Sit and Stay…Longer

Share

Podcasting will resume next week Monday with a swell Q&A Show. Today, however, I want to pay tribute to my long-time companion, Ginger The Dog, who died last Friday, one month shy of her 14th birthday. She was so much a part of my life that she often appeared in my posting and provided sound effects in numerous podcasts. Here’s one such posting, re-posted from January 2005. This particular column remains one of my most popular postings ever.

 

 

Anyone the least bit familiar with Dr Dick’s wacky household will know all about Ginger. For the uninitiated, Ginger is a 5 year old German Shorthair Pointer, who believes she’s the center of the universe and who daily runs the good doctor into the ground.24604.jpg Ginger is special. She’s no one’s pet — least of all mine.

She doesn’t even think of herself as a dog — except when she forgets herself and takes off after a squirrel or a rabbit. And she makes a point of reminding me, several times a day, that she doesn’t “belong” to me. Rather, it is I who have the great privilege to share a domicile with her. I tell you all of this by way of introducing today’s topic. No, it’s not bestiality, ferchrisake! It’s behavior modification and sexual response. Ya know — learning how to last longer.

Here we’ll discuss the remedy for that pesky premature ejaculation problem everyone is talking about. Ginger was a year and a half old when she moved in and took over the joint. She had been abandoned and was, for all intents and purposes, completely feral when she arrived. Once here, Dr Dick tried to imprint a more civilized behavior pattern on his new housemate using several tried and true dog-training methods. Which, for all intents and purposes, are simply behavior modification techniques for doggies.

Successful behavior modification is dependent on the consistency of the stimulus. Consistent stimuli — a command and a treat — are supposed to create the desired response —sitting and staying. Sadly, this approach wasn’t overly successful for Ginger and me. In fact, about the only one who got trained/modified was Dr Dick. Ginger remains blissfully resistant to all efforts to civilize her.

The following correspondents, we hope, will succeed in modifying their sexual response with greater ease than my attempts to train Ginger The Dog. What differentiates them from the dog is that each of my correspondents has the motivation to change. Ginger, on the other hand, has no such motivation. She thinks she’s perfect just the way she is.

Hey Doc,I have a major problem that I hope I could get some advice from you. It’s about my sexual issue. Whenever I’m having sex, I can’t control my nerves. It means I can’t relax. And I come too fast and rapidly. I can’t have foreplay or enjoy sex. Do you know any medications or anything that would help me to prevent this? I guess my problem is what people called “premature ejaculation”. I can ejaculate rapidly, at first I thought it was really good. But later I figured out that wasn’t good. And that it’s a sickness. Please help me. Hope to hear from you soon.Thanks Dylan

Hey Dylan,Your premature ejaculation concern is not a sickness. In fact, it’s a very common complaint. Learning to last longer is a relatively easy thing to accomplish if that’s really what you want. Motivation is key.Let’s start with how you jack-off. If I had to guess these little sessions are speedy affairs, right? Quick jack-off sessions, just to relieve sexual tension can be a good thing, but they are also modifying your sexual response and interfering with your partnered pleasure.

Premature_Ejaculation_ManIf your body is being sensitized to cuming quickly, like while jerkin’-off, then that’s how it will respond later, when you are at play with a partner.I suggest that you take a different approach to your self-pleasuring activity. Some, if not all, of your masturbation should be dedicated to full body masturbation. That is, while you’re diddlin’ yourself with the one hand, your other hand is busy exploring the rest of your body. The object is to play with the sex tension and move it around. Some people call this edge play or edging.

The object here is to avoid an ejaculation. Move the sexual energy all over your body, touch and pleasure your whole body while stroking you cock. A nice massage lotion will add to the enjoyment. Make this time last as long as you can. As you approach the point of ejaculation, stop stroking your dick and continue to play with another part of your body, your tits, ass hole, prostate, feet, etc. When the urge to cum subsides, you can start to stroke your dick again. Practice this method over and over until you can last 30 minutes.

Successful behavior modification is dependent on the consistency of the stimulus.5431362.jpg Consistent stimuli — full body masturbation — will create the desired response — lasting longer.You are teaching your body a new way to respond to sexual stimulation. This will no doubt also increase your stamina when you’re with a partner. When you’re having sex with a partner do the same thing as when you are masturbating. Encourage your partner to spread the sexual energy around. Discourage her/him from concentrating on your dick. Work at stalling your orgasm. If you’re getting close to cuming, have him/her turn his/her attention to another pleasurable activity.

Don’t get frustrated if you can’tt regain control over your sexual response right away. This is gonna take some practice, but I think it’s worth the effort. Once you mastered this technique, there are other more advanced methods that I can tell you about later.Good luck.

Hi Richard,

My question is in two parts. 1. How can I orgasm more quickly? 2. How can I orgasm easily when someone else is doing the stimulation?I know this question might sounds strange because many guys are trying to not cum too quickly.Here’s some background; over the years, I have gotten very in-touch with my physical sexual side. I have learned control the build up to orgasm and my orgasm. Having this control is amazing for the most part — it allows long periods of edge play, which I really enjoy.

However, the disadvantage is that I can’t easily orgasm quickly and usually can’t orgasm at all when someone else is doing the stimulation. These two limitations haven’t been a big concern until recently. My orgasm isn’t necessarily the most important part of sex for me. Unfortunately, many times my limitations are disappointing to a sex partner. He wants to see me cum and/or wants to make me cum. Both of these desires are totally understandable — I really enjoy doing the same for him.Is it possible for me to “learn” to cum more quickly and is it possible to “learn” how to cum from the stimulation of someone other than myself? Any suggestions or advice would be greatly appreciated!!

Jim

Hey Jim,

What an interesting predicament you present. As you suggest, I’m forever hearing from guys who have the opposite problem as you. They what to prolong their sex play before 180402.jpgcoming. Your message to me proves my point to them; our sexual response is altered, for good or for worse, by how we stimulate ourselves.Curious enough, the answer to your query resides in the detail you present about your particular sexual practices. Clearly, you have conditioned your body, and thus your sexual response cycle, to last a very long time, perhaps too long. I guess that’s the downside of long periods of edge play.

How does one remedy this? Gosh, you’ve conditioned yourself so successfully; there may be little you can do to reverse this.

Orgasms, as you know, are not things we can will to happen or not to happen. However, you could try to find a stroke or a type of stimulation that you could use to successfully bring yourself to climax. Concentrate on that stroke with the intention of getting yourself off ASAP. You would then have to show your partner(s) this technique if you wanted them to get you off. Just a thought, does ass play and prostate massage speed up your orgasm? It does for lots of other men. So if you’re not already doing so, perhaps you could incorporate some…or more of this.

What you’re gonna want to do here is reverse some of the conditioning you’ve done and relearn a new sexual practice or response. It can be done. Will it take determination? You betcha!

Good luck

Share

6 things a sex therapist wishes you knew

Share

It’s not always just about sex

By

Communication is essential in almost every aspect of our lives. But these days it can seem as though we’re more interested in social media than connecting with those we’re most intimate with. The 2014 British Sex Survey showed a shocking 61% of respondents said that it’s possible to maintain a happy relationship or marriage without sex. Whether you believe this or not, new research has emerged that shows just how important sex is for a relationship. According to lead author, Lindsey L. Hicks, more sex is associated with a happier marriage, regardless of what people say:

“We found that the frequency with which couples have sex has no influence on whether or not they report being happy with their relationship, but their sexual frequency does influence their more spontaneous, automatic, gut-level feelings about their partners,”

We spoke to Stefan Walters, Psychological Therapist at Harley Therapy London, to find out the role sex can play within a relationship and the attitude we should all be taking towards it. Here’s what he wishes we all knew:

1. It’s good to talk about sex!

Lots of clients still feel like opening up about their sex lives is a real taboo, and that sexual thoughts should be kept private and hidden away. But the truth is that sex is a huge part of who we are – it plays a vital role in determining our identities, and in shaping the relationships we choose throughout our lives – so it’s good to talk about it, and there’s nothing shameful or degrading about doing so. You might not think that your sexual thoughts are relevant to certain other issues in your life, but sometimes sharing these inner desires can really shine a light on something else that’s seemingly unconnected.

2. …but don’t JUST talk about sex

Sex is often the symptom, not the cause. Lots of people come to therapy looking to resolve a sexual issue, and often there’s a temptation to focus on that issue and not talk about anything else. But as you explore around the problem, you tend to find that what’s being played out in the bedroom is often related to other thoughts and feelings. Even something as innocuous as moving house or changing job can have an unexpected impact on libido, as attention and energy levels are focused elsewhere. So it’s really important to get the full picture of what’s going on.

3. There’s nothing you could say that would surprise your therapist

People go to therapy for all kinds of sexual issues. This might be a question of their own orientation, making sense of a certain fetish, or exploring some kind of dysfunction which they feel is preventing them from having the sex life they truly desire. No matter how embarrassed you might feel about a certain sex-related issue, your therapist won’t judge you for it, and will remain calm and impartial as you explore the problem. Sexual issues are very common reasons for people to seek therapy, so your therapist has most likely heard it all before; and however filthy or unusual you might think your kink is, someone else has probably already shared it.

4. The biggest sexual organ is the brain

People spend so much time focusing on genitals, but often forget about the brain. Sex is a deeply psychological process, and one person’s turn ons can be another’s turn offs. This is because we all get aroused by different sensory stimuli, and have a different set of positive and negative associations for all kinds of situations and events; often relating back to previous experiences. You can have a lot of fun with your body, but truly great sex needs to involve the brain as well. After all, it’s the brain that gets flooded with a magical cocktail of chemicals – dopamine, serotonin, oxytocin and endorphins – at the point of orgasm, to produce an almost trance-like experience

There’s no single definition of a good sex life

5. Sex means different things to different people, at different times

There’s no single definition of a good sex life. Sexuality is fluid, and needs and desires can change drastically from person to person, and even day to day. For example, at the start of a relationship sex is usually about pleasure and passion, but over time it can become more about intimacy and connection, and then if a couple decide to have children it can suddenly become quite outcome-focused. Sometimes people struggle to cope with these transitions, or may find that their own needs don’t match with their partners’, and this is why talking about sex is so important in relationships.

6. Don’t put it off

If you do have a sex-related worry or concern, it’s best to talk about it as soon as possible. If you don’t feel comfortable discussing it with a family member or a friend or partner, then seek out a good therapist to explore the issue with you. The longer you wait, the more it becomes likely that you build the issue up in your head, or start to complicate it even further. It’s always best to tackle issues, rather than to let them fester or be ignored. More than ever, people are talking openly about their sexual orientations and desires, so there’s no need to deal with your worries alone. Everyone deserves to feel sexually fulfilled, and that includes you.

Complete Article HERE!

Share

The nitty-gritty of middle-age sex

Share

‘It’s good to experiment’

By Alana Kirk

If you are drinking your morning coffee while reading this, then perhaps this article should come with a warning. There are going to be phrases that we tend not to discuss much in public such as vaginal dryness, loss of libido and erectile dysfunction. However, they are a natural part of life, and if we want to continue to be active sexual people well into middle age and beyond, then we have to acknowledge and then address them, because turning the trials and tribulations of middle-age sex into the joy of sex is not difficult.

Sex is important to all of us, regardless of age. Not only is it excellent for getting the blood pumping and putting a youthful spring in your step, it has a number of other benefits too, such as reducing stress, strengthening your immune system, boosting self-esteem, and relieving depression.

The famous manual, The Joy of Sex, still has some salient advice for middle- aged and older people even though it was written nearly 50 years ago. It’s author Alex Comfort wrote: “The things that stop you enjoying sex in an old age are the same things that stop you from riding a bicycle – bad health, thinking it’s silly and no bicycle”.

Well, we can pump up a flat tyre, add some lubricating oil, and still be having sexual enjoyment with no partner. As recent research has shown, and despite an ageist societal view on the topic, our sexuality doesn’t die with middle and growing age. Our sexual needs and levels evolve and change over the years, and the particular issues that might arise from menopause, for example, do not mean we should give up on it. We just need to learn to adapt.

Emily Power Smith may be Ireland’s only clinical sexologist, and talks to large numbers of middle-aged women in her clinics and at talks around the country. “I’ve spoken and written more on this topic than any other related to sex, and the main driver for women coming to me with an issue is poor education. Generally women are very misinformed about what they should be expecting and are very quick to blame themselves.”

If we look at sexual activity as a life-long issue, there can be plenty of interruptions to the normal flow, including illness, childbirth and child rearing, loss of confidence, menopause, and hormonal fluctuations. Low libido, erectile dysfunction, and vaginal dryness are all just normal challenges that can affect our sexual lives, but importantly, ones that can be easily addressed.

“We do specific menopause consultations and counselling for women who start experiencing changes and want to know that they are a normal part of the ageing process,” says Dr Shirley McQuade, medical director of the Dublin Well Woman Centre. “Many women come in with a specific symptom thinking it’s all over, but in fact nearly all issues can be addressed. You just need to realise that your, and your partner’s body changes.”

So what are the main issues and what can be done about them?

Peri-menopausal symptoms

Menopause can effect every aspect of your being, and symptoms including hot flushes, not sleeping, and poor concentration levels, can affect how you feel about yourself.

“Hormonal changes can mean your libido and sex drive go, as well and the emotional havoc they can play,” explains Dr McQuaid. Mood swings, empty nest syndrome, trying teenagers, or work/life balance can weigh in to make us feel less than energetic about sex.

“It is really important to take the time for yourself when you are peri-menopausal, to take stock and adjust to the changes that are happening. I see lots of women who have reached senior career level or have lots of people depend on them and it can be difficult because they feel overwhelmed and aren’t giving enough time to themselves to deal with how they feel.”

The advice is to take pressure off yourself, and try and cull some of the responsibilities. Exercise, eat and sleep well and acknowledge that you can seek help if you need it. “I’ve seen women go to cardiologists because they think they have heart problems when they wake up sweating in the night, or go to rheumatologists with joint pain, when in fact they are just the symptoms of hormonal change.”

Hormone Replacement Therapy

HRT is a common treatment for women who are suffering from continued and difficult symptoms, and it only takes two or three weeks to find out if it will work for you. According to the National Institute for Health and Care Excellence (NicE) in their 2015 recommendations, the benefits of HRT, available in tablet form, gels, and patches far outweigh any risks.

According to Dr McQuaid, it is a positive option to take. “About 15 years ago there were scares about risks relating to heart disease and cancer, but the studies were seriously flawed. For women who take it through their 50s, the benefits are significant.”

HRT is available for as long as your symptoms last, with the average duration being eight years. Despite scaremongering to the contrary, there are no withdrawal symptoms or problems when you stop taking the drug, as long as you leave it long enough for your natural menopause to conclude. HRT masks the symptoms, so if you stop before they have fully receded, they will return.

Not all women experience menopausal symptoms, and for women who do, they do eventually pass.

Vaginal dryness

It is completely normal for most women in menopause to experience dryness. The drop in your body’s oestrogen levels means the vaginal membranes become thinner and drier which can makes for uncomfortable dryness. As a result, thrush and Urinary Tract Infections (UTI) are also more common. Lubrication is widely available and will transform your sexual experience if dryness is a problem. Dr McQuaid also recommends treating the underlying issue rather than just the symptom. A prescription product, licensed in Ireland as Vagifem, provides low levels of oestrogen to the local area, and if taken over the longer term can alleviate all symptoms of dryness. Regular sexual activity or stimulation from masturbation also promotes vaginal health and blood flow.

Erectile dysfunction

For men who may identify their every maleness with work and sexual ability, a lowering of libido or erectile dysfunction can be catastrophic. However, accepting that this will happen occasionally, and seeing it a normal part of the ageing process and hormonal changes may encourage them to seek help. The advice is to go to your GP to get checked out to make sure erectile dysfunction is not related to vascular changes and bold pressure / diabetes, and then again there is a simple medication solution.

Painful intercourse

Again this can be a common change in sexual experience, usually due to vaginal dryness. However, other reasons could be a prolapse of the uterus or front wall of vagina which can cause discomfort, so the first port of call for any pain is to get examined by your GP or at the Well Women clinics. All issues can be addressed with medication or procedures.

Heavy periods

A common complaint for women entering peri-menopause is very heavy periods, which are caused by the womb being uncomfortable and bulky. Some women from the age of 40 develop fibroids which make the womb heavier and along with hormonal fluctuations, combine to make structural and hormonal changes that affect the flow of periods. Some women have low iron levels, because heavy periods are the main reason for low iron which makes you tired, so it’s important to keep a medical check on your body while going through the menopause.

Traditionally this was often treated by a hysterectomy, whereas today women can access the pill or coil. All countries where the coil has been introduced have seen a significant reduction in hysterectomy operations.

Change of mind

Addressing specific symptoms is only one way of evolving our sexual lives. Changing the way we have sex is another. “I meet women who have only ever used one position, and now that that proves painful they are at a loss,” explains Dr McQuaid. “It’s useful to experiment and change. It’s more interesting too!”

What we need to remember is that sex is not just about intercourse. There is a variety of sensual, loving, exciting activities that can bring joy and satisfaction. For women experiencing menopause especially, they might need and want more touching and foreplay than before, but after years of marriage, it can be more difficult to change. Asking for what you need is important. Tantric sex – slightly ridiculed in the press after Sting and Trudie Styler admitted to it – is encouraged by many counsellors as it focuses on the sensual intimacy rather than an orgasmic goal.

Whatever the issue with sex may be, Dr McQuaid advises you start with a medical to check to make sure everything is okay. Once that is done, it’s just about dealing with specific issues. “I’ve had a 78-year-old woman come to me recently having a little bit of trouble because her partner has been given Viagra. So she went on Vagifem and has no more problems,” says McQuaid. “I have lots of women come to us for help and they’re happy and healthy and they certainly don’t stop having a sex life. Nor should they.”

Psychologically however, it is also important to rise above the social conditioning that we lose our sexiness as we get older. “There is just no scientific evidence to back this up,” explains Power Smith. “Irish women are very quick to blame themselves and feel guilty for not being better, not feeling enough or good enough. In part we are brought up to feel this way with magazines and media, and then when middle age hits, physical things happen to compound that.” She has three golden rules for women in their middle age with regards to keeping their sex lives healthy and functioning: masturbation, lubrication and communication.

So while the number of potential causes of sexual changes and challenges during menopause and middle ageing can seem overwhelming, there are just as many strategies and treatments for overcoming them.

You can go back to drinking your coffee now.

Complete Article HERE!

Share

Why millennial sex sucks

Share

By Naomi Schaefer Riley

Could sex for millennials get any worse? Late last month, researchers at Columbia uncovered a trend called “stealthing,” in which a man discreetly removes his condom during intercourse because he believes it’s a man’s right to “spread one’s seed.” According to the study women are calling rape crisis hotlines with stories of this practice and there are, of course, Internet chat rooms devoted to it.

We can now add stealthing to the growing list of trends that make sex seem anything but enjoyable for young adults today, and which seem to explain why millennials are having less sex than any generation in 60 years, according to a study published last year. Some believe young, ambitious adults are letting their careers get in the way of their sexual pursuits. But if you think about the sexual experiences available to most millennials, it’s a surprise more of them aren’t taking lifetime vows of celibacy.

Take the ubiquity of online porn. According to a Barna Group study from last year, 57 percent of young adults (ages 18 to 24) report “seeking out” porn regularly, compared to only 41 percent of Gen-X adults. For many young men, porn seems to be supplanting relationships as a way to, well, get their jollies.

In their 2011 book, “Premarital Sex in America,” Mark Regnerus and Jeremy Uecker interview a young man who explains, “I think I like my own ‘personal time’ as much as I like having intercourse.” Regnerus and Uecker write that “if porn-and-masturbation satisfies some of the male demand for intercourse — and it clearly does — it reduces the value of real intercourse.” With the supply of sexual outlets rising, the “cost of real sex can only go down, taking men’s interest in making steep relationship commitments with it.”

But the effects of porn go even further than that. In a study in the Journal of Family Theory and Review, Kyler Rasmussen of the University of Calgary reviewed 600 pornography studies from the 1960s through 2014, and found that viewing porn “can reduce satisfaction with partners and relationships through contrast effects [i.e., where male viewers find their partners less attractive compared to the women they see in porn]; reduce commitment by increasing the appeal of relationship alternatives; and increase acceptance of infidelity.”

And if men aren’t enjoying sex because the women don’t look like porn stars, imagine how little women enjoy having to compete with porn stars. The number of women undergoing labiaplasty jumped 39 percent in the US from 2015 to 2016.

Meanwhile, there are plenty of ways to get sex outside of relationships now, thanks to technology. Apps like Tinder allow men and women to hook up with multiple partners within hours of each other if they like. And the technology allows people to keep such liaisons secret from their partners in ways that they never could have before.

It seems like paradise for some, but this much casual sex with strangers seems to be having discernible health consequences. The Centers for Disease Control reported a 19 percent increase in reported cases of syphilis, a 12.8 percent increase in gonorrhea cases and a 5.9 percent increase in chlamydia cases from 2014 to 2015. In New York alone reports of syphilis grew by 29 percent from 2015 to 2016, mostly among young adults.

Even college campuses, which were supposed to be fun places for young people to party before they had to get real jobs and wake up at a reasonable hour, are failing to bring much sexual satisfaction. One of the women in Lisa Wade’s book, “American Hookup: The New Culture of Sex on Campus,” describes the atmosphere at college parties as “a bestial rubbing of genitals reminiscent of mating zebras.” After the initial excitement of finding out that sex was readily available, even the men Wade interviews seem kind of annoyed by the whole atmosphere.

Wade, a professor at Occidental College, finds that sexual encounters with women mean there is no possibility that a friendship can continue. After any hookup, there is a kind of contest to see who can care about it less. And in order for any sexual encounter to happen in the first place, everyone has to be rip-roaring drunk.

And let’s not forget all the other problems that come when young people purposefully lose control of their senses and then hop into bed. Did anyone consent? Will someone be mad in the morning? Didn’t the dean tell us to ask before unbuttoning someone’s shirt? Couples married for decades can experience more fun and spontaneity than these kids who practically need a contract before getting undressed. When it comes to sex, at least, it seems youth is no longer wasted on the young.

Complete Article HERE!

Share

The New Gay Sexual Revolution

Share

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!

Share