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Bewitched, Bothered and Bewildered!

Name: Jean
Gender: female
Age: 36
Location: New Haven, CT
I’ve been with the same man for 14 years. We both decided to become Christians about a year ago. Now he’s not interested in sharing the same bed and not interested in having sex with me. It tried to overlook this hoping it was some kind of phase, but it goes on and on and he still doesn’t want sex. He’s the only man that could ever satisfy me sexually. I dated a few guys, four to be exact, before we met. I still love this guy but he won’t acknowledge my feelings. I feel like I’m losing everything, my best friend, my partner, my lover …and my sanity. I’m happy we’re still together, but I’m frustrated to the point of exhaustion without my sex life. Any ideas what I could do to turn this around?

What an unhappy tale of woe you have you have to tell, Jean. The Christian conversion thing didn’t quite work out like ya thought, huh? Well maybe it has less to do with Christianity per se, and more to do with the Joe you converted with.

I’ve heard similar complaints from other people whose partners have unilaterally decided to make a radical life-change for themselves. Often these new zealots fail to appreciate how their life altering decisions impact on the wellbeing of their mate. And because they are so damn single-minded about their new passion — as every zealot is, there is rarely any talking to them.

Two former clients come to mind. First, there was George, a gay man in a 10-year relationship with this other really sweet guy, Robert. Eight years into the relationship Robert had a heart attack. Despite a full recovery and living a much healthier lifestyle after the hear attack, Robert got it in his head that if he were to have sex again, it would kill him. There was no reasoning with him. No sex ever again, period. This otherwise blessed relationship ended painfully. Pity that!

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Another client, Melissa, discovered long-distance running two years into her marriage to Allen. She became like a woman possessed. Running consumed her. Her career, her friends and family, her social life all suffered. But no one took the brunt of her newfound craze more than her husband. At first sex was out of the question because there was no time. Then all that body-punishing running radically changed her metabolism. She even stopped menstruating. Her libido virtually expired. Even the imminent demise of her relationship didn’t alter her running routine. So basically old Melissa just ran away from her marriage. Simple as all that!

In your case, Jean, your partner appears to have bought into the some of the worst sex-negative messages of Christianity. I suspect that there’s no turning this around and, unless you wish to continue to sacrifice your sexuality on this unworthy altar, I’d suggest you make peace with the fact that life will never return to how it once was.And what’s all this about he being the only man who could satisfy you? You’ve had only 4 other partners, for christ sake! And most, if not all, were crummy lovers. Am I right? You’re not the kind of gal that quits shopping for shoes after trying on only 5 pair, are you?There is a whole world of men out there that would be happily give you what you aren’t getting at home and some of them may even be good lovers. If no accommodation can be made with your husband about fulfilling your needs, than I suggest you beat a hasty exit.The longer you stay in this unhealthy environment the greater the chance will be that you will become more and more embittered. God gave us the gift of sexuality for a purpose. It was meant to give us pleasure and enhance life. Your sexuality is in danger of becoming just the opposite of what nature intended. Do yourself a favor and choose life and happiness. You’ll be glad you did…so will God.

Name: Pete
Gender: Male
Age: 22
Location: Ohio
dr dick: I am gay and i have no idea how to break it to my family. and they say all the time when they see a gay guy look at that fag glad he’s not my kid. i would disown him. just wondering if u could help me.

Ain’t it a bitch being surrounded by a bunch of yahoos! Coming out is rarely easy, but doing so to ignorant, fearful, bigoted people is the worst.

Pete, you should know that all bigotry is deeply rooted in the bigot’s own fear about him or herself. It stands to reason, all irrational fears and hatred, like homophobia, are more indicative of the troubled psychological make-up of the one with the prejudice, rather than the people he or she abhors.

Often people will use religion to back up their prejudice. It’s particularly galling when non-religious people do this. But it’s safe to say that authentically religious people don’t need to persecute or ostracize those who do not believe as they do. Any more than authentically heterosexual people need to persecute or ostracize people of other sexual persuasions. Let that be the standard by which you judge the worth of any message coming from a religious dogmatist or a moralizing heterosexual.9e.jpg

Before you start in on the self-disclosure thing with your family, Pete, I suggest you first try to clear a path for that discussion. Begin by challenging those around you who shame or denigrate those who are different. Ask them why they make such ridiculously uninformed and hurtful statements. Ask them if degrading other people makes them feel superior. And if it does, what does that say about their inadequacies. You could suggest that their intolerance of gay and lesbian people proves they have some hidden, unresolved sexual issues that they need to address. I mean — “me thinks you doth protest too much” — and all that, right?

If your family environment doesn’t improve with that tactic, you may find that, at least in the short run, discretion is the better part of valor. Sometimes coming out to one’s family is best done only after you’ve come out to friends and co-workers. This strategy will provide you a bank of support that you can fall back on if the family disclosure things turn out badly.

My counsel to those just starting the coming out process is to reserve the good news about you and your sexuality for the audience best situated for receiving it. Celebrate your queerness with open-minded people first. Nowadays there’s much more acceptance of alternative lifestyles in the popular culture then ever before. Particularly younger people seem to have more tolerance for diversity. But however you choose to handle this difficult but important developmental task, don’t sink to the lowest common denominator. Don’t cave into the bigotry that surrounds you. Don’t let it intimidate you into a life of shame, repression or self-loathing. Live authentically. Pete, and live proud! Because when you do, you are a shining example of a happy, healthy, integrated and well-adjusted human being.

Finally, just remember you are not alone. Sex positive and gay positive organizations abound. If you need help with any of your coming out, if you’re feeling isolated and alone — turn to one of them. They are there to help. And there are even support organizations for your family members too. Turn them on to: PFLAG (parents and friends of gays and lesbians).

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 cock ring and that helps I guess. Is there anything else I can do to increase my performance to match my libido?

Your concern is a familiar one, Bob. 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.p.jpg

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 experimenting 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.

This 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 himself or herself, 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 them. 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 interferers with or even shuts down the sexual arousal, then 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, ya’ll

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Know Thyself!

It’s 2006 people! The internet impacts on nearly every aspect of our lives. We have more immediate access to more specific information about every conceivable thing under the sun — an access and availability unparalleled in history. We have the collective knowledge of all humankind at our fingertips, both literally and figuratively. Despite this super-available wealth of information, many of us still live in the dark when it comes to our bodies and how they work. We are uninformed about our anatomy, unaware of the mechanics that make us tic, and oblivious to our own sexual response cycle. This sort of ignorance and estrangement leads to all sorts of troubles.

Hi Richard
I really only had my first male sexual encounter in September (which I enjoyed!). We tried oral. He was cut and I’m not. I didn’t enjoy receiving it though as the head my dick is sensitive to the point of being sore when the foreskin is pulled all the way back. I only do that in the shower when I’m cleaning down there. When I self-pleasure, I do it in a way that the foreskin never goes full back, just halfway. I’m not sure if this is a common problem with uncut men.
I do like the idea of anal sex and I’m looking for a patient top for my first time. But I’m just worried about the whole sensation and preparation, etc.
Wayne

Wow, Wayne, new to gay sex, huh? I’m glad to hear that you’re enjoying yourself. Yes,b4.jpg the prospects of fully enjoying your newfound sexual interests must hold great allure. Congratulations!

As to your issue of your hypersensitive dick head — let’s just say that’s part of the joy of having an uncut dick. Many uncut men report similar sensitivity, especially when they haven’t had a lot of partnered sex. Some of the discomfort will dissipate on its own with the more cock-play you have. However, you can also hasten the desensitization process by retracting your foreskin and leaving your unsheathed dick in your underwear for an hour or so at a time. You could also try masturbating with your foreskin completely retracted. This will, no doubt, feel a bit odd and perhaps even uncomfortable at first, but like I said, this will subside. The object of these exercises is to take the edge off, so to speak. You don’t need to concern yourself with thoughts of total desensitization — there’s no likelihood of that happening. But you do want to get to a point where you can enjoy some great head without worrying that you will be sore afterward. You might also want to encourage your cock sucking friends to be especially careful when they’re chowin’ down on your tender meat.

In anticipation of finding that patient top you seek; you can prepare yourself, and your asshole, for the enjoyment to come. During your own private sex play — masturbation — be sure to include your sphincter and prostate. Familiarize yourself with your whole hole-area. Use your fingers and/or a small dildo to test the waters, so to speak. Take your time and use lots of lube. Don’t be afraid to experiment and push the limits a bit. The more that you know about your own ass, the more you will be able to inform future partners on how best to pleasure you.

You might want to experiment with douches too. Over the counter stuff is ok, but a simple solution of warm water and a bit of vinegar or lemon juice works even better. It’s cheaper too. When it comes to fucking, a clean ass is a happy ass. Remember when you bottom, your anal hygiene is your responsibility. The more you know about anal health and hygiene, before you give up your ass for the first time, the more likely both you and your top will enjoy yourselves.

Good luck

Hi again Richard
I appreciate you taking time to answer my questions and for the advice you’ve given me. I still think an uncut cock is a curse though! LOL Each time I read your suggestion about rolling back my foreskin, I have to cross my legs. So I just need to get over that. 🙂
I will try a dildo and some lube for exploration. The nearest I have come so far is to try a finger wrapped in tissue paper. The reason this worried me was because even after a BM, sometimes it caused gas to be released and once or twice even “forced” another movement.
When being topped, does the cock go past the “squishy” muscle that I can feel with my finger? And how would one apply a water and lemon juice solution?
Wayne

Hello again, Wayne,

l1.jpgYou’ll never convince me that an uncut dick is a liability. I firmly believe that, in most circumstances, body parts are best left in their natural state.

Learning to care for an uncut dick is something else indeed. There are plenty of resources on the internet for uncut men like you. I suggest doing a search with word strings like: Sex Information or Health Information and Uncircumcised. You’ll be pleasantly surprised with the wealth of information available.

One word of caution, have your wits about you when reading through the information you find on the net. For example, you will probably notice that the American medical industry has a very strong bias toward circumcision. For some reason, our culture would prefer to mutilate a cock instead of teaching the cock’s owner, be it boy-child or grown-up man, how to care for and clean his pecker in its natural state.

Wait a minute; you’re wrapping your finger in toilet paper before sticking it in you ass? That can’t be fun or comfortable. Listen, partner, your ass is your friend, it’s the source of loads of pleasure. Shit also comes out of your ass, but it’s not the end of the world if you get a bit of it on your finger during exploration. It’s soap-and-water soluble, ya know. Rootin’ around in your bum or someone else’s bum can and often does produce some interesting byproduct. No surprise there, it’s an asshole after all.

Washing your hands after butt play, as well as keeping them away from your mouth until they are washed, will help keep things sanitary. May I suggest you get a copy of: Anal Pleasure and Health: A Guide for Men and Women by Jack Morin, Ph.D. It’s an excellent primer for the anal novice. You can find it online.

My, you are uninformed about your own anatomy. The squishy muscle you speak of is your sphincter muscle. And yes, one would hope that a top’s dick would go past that muscle to at least the depth where his cock can stimulate your prostate. Unclear on where your prostate is? You’ll find plenty of information online about that too. Do a search with word strings like: Prostate and Health Information and Anatomy.

Here’s some more homework for you. Do and internet search using the words: Anal Douche. You will find all the information you need about the care and cleaning of your asshole. You’ll also find a vast array of implements designed for just this purpose. Have a ball!

Good luck

Dr. Dick,
Please help me. I am an attractive 21-year-old guy. I have no problems with meeting women nor do I have a low libido, the problem is that I suffer from hemorrhoids. This is really embarrassing as I don’t even let a girl touch my ass. And you know how girls like to play with a guy’s ass these days. I know there are cures for hemorrhoids, but none have worked and my doctor said it is useless to cure them because anal sex will cause their return. Please, please help…I am dying of frustration and fear.
Regards,
Jay

Dear Jay,

You are not alone. Many men and women suffer from hemorrhoids and, as you say, itfingerfuck02.jpg can be frustrating, even embarrassing. But there is hope.

The first thing you ought do is look for another physician. If you are accurately reporting your doctor’s comments about butt fucking and hemorrhoids then he’s got a problem. What he told you is simply not true. You needn’t live a life of frustration and fear just because you have an ass-phobic doctor.

Do an internet search with word strings like: Hemorrhoids and Health Information and Anal Sex.

It’s hard for me to imagine a case of hemorrhoids so bad that it couldn’t be helped or cured by one of the many new and sophisticated therapies and interventions currently available. And with regard to butt fucking, there are many people who would believe that light anal stimulation can actually help relieve and even prevent hemorrhoids from reoccurring.

So do yourself a favor. Get a second opinion, a third if necessary. Find a sex-positive doctor. You can even do an internet search for Sex Positive Doctors. Or you can get a referral from a local gay hotline. Or look for a proctologist at a local university hospital. You’re more likely to find an open-minded practitioner there.

Your current physician has given you very poor advice indeed. He has done you a great disservice. Don’t let him have the last word.

Good Luck,
dr. dick

New study finds girls feel unprepared for puberty

Girls from low-income families in the U.S. are unprepared for puberty and have largely negative experiences of this transition, according to researchers at Columbia University’s Mailman School of Public Health and the Johns Hopkins Bloomberg School of Public Health. Their latest paper on the puberty experiences of African-American, Caucasian, and Hispanic girls living mostly in urban areas of the Northeastern U.S. shows that the majority of low-income girls feel they lack the information and readiness to cope with the onset of menstruation. The research is one of the first comprehensive systematic reviews of the literature on puberty experiences of low-income girls in the U.S.

The findings are published online in the Journal of Adolescent Health.

“Puberty is the cornerstone of reproductive development,” said Marni Sommer, DrPH, MSN, RN, associate professor of Sociomedical Sciences at the Mailman School of Public Health. “Therefore, the transition through puberty is a critical period of development that provides an important opportunity to build a healthy foundation for sexual and reproductive health. Given the importance of this transition, the research is striking in its lack of quantity and quality to date.”

The investigators used Qualitative Research guidelines to review the data from peer-reviewed articles with a qualitative study design published between 2000 and 2014. They used a quality assessment form as a further check of the data.

The age of breast development and menarche has declined steadily in the U.S. during the last 25 years, with 48 percent of African-American girls experiencing signs of physical development by age 8. “This trend may mean that increasing numbers of African-American girls are not receiving adequately timed puberty education¬, leaving them uninformed and ill-prepared for this transition,” said Ann Herbert, doctoral candidate at the Bloomberg School of Public Health.

Although many of the girls reported being exposed to puberty topics from at least one source—mothers, sisters, or teachers—most felt that the information was inaccurate, insufficient, or provided too late. Girls also reported being disappointed in the information they received from mothers; meanwhile many mothers said they were unable to fully address their daughters’ needs. Mothers were uncertain about the right time to initiate conversations, uncomfortable with the topic, and uninformed about the physiology of menstruation. The timing of puberty also influenced girls’ puberty experiences.

The researchers noted that despite a strong focus on adolescent sexual health outcomes, such as sexually transmitted infections and teen pregnancy, clinicians and practitioners in the U.S. have yet to capitalize on the issues of puberty onset and menstruation as a window of opportunity to improve adolescent sexual and reproductive health. In addition, the current body of research leaves out many topics entirely. “For example, missing are the voices of adolescents with non-conforming gender role and sexual orientation,” Herbert said.

Earlier research showed that irrespective of race, higher-income girls had more knowledge about puberty, were more prepared for menarche, and had more positive attitudes about menstruation, strongly suggesting socioeconomic disparities related to preparation for puberty.

“Findings from the current review suggest that low-income girls today expressed a sentiment similar to girls studied in the 1980s and 1990s—a feeling that they were largely unprepared for puberty and menarche,” noted Herbert.

“Our review makes it clear that there is a need for new more robust interventions to support and provide information about for low-income , something we are considering for the coming years,” said Sommer.

Complete Article HERE!

Why Generation Tinder won’t go back to dating ‘the old-fashioned way’

By Jenny Noyes

“My most memorable Tinder date?” Kate Iselin gestures as if to say get ready. “It was a gentleman who invited me to lunch, took me to the food court at Martin Place and showed me a photo of his penis. Soft.”

It’s not the fondest memory Iselin – a writer and former sex worker – has of her experiences on the app. But the negative and the bizarre do have a tendency to stick with you.

Horror stories aside, Iselin, 28, is overwhelmingly positive about the impact apps like Tinder have had on the contemporary dating experience. And she’s not alone.

Despite a steady stream of articles about Tinder “killing romance”, making people depressed, or putting them in danger, the app and others like it are as popular as ever (even if some users are loathe to admit it).

Iselin herself has recently returned to 30 Dates of Tinder, a blogging project she’d abandoned a year ago due to “personal stuff” including a relationship. The concept is fairly self-explanatory: she goes on 30 random dates, and writes about them. Now halfway through, she’s accepted every date request received – “provided the date location was safe and they didn’t seem like a closet serial killer,” she says.

Clearly, there’s an appetite for reading stories about Tinder – and part of that is a fascination with what can happen when virtual strangers attempt to light a flame.

But as dating via Tinder increasingly becomes the norm, it’s less about the novelty of using a phone app to date people off the internet. Four years since Tinder launched, Iselin says she’s returning to her project with “a slightly more serious goal”. It’s now more about answering an age-old question than exploring a curious new technology: “To prove that love exists.”

Of course, the proof is already out there among the growing number of successful, lasting relationships launched via Tinder or its myriad competitors. These apps aren’t just facilitating one-night stands. People are finding lasting love in such significant numbers it is no longer considered “weird” to have a partner found online.

Fairfax Media columnist Giselle Au-Nhien Nguyen has met almost all of the people she’s dated, in her 28 years, online. Whereas five to 10 years ago there was a stigma attached to meeting people via the internet, it is now “completely normalised” among Gen-Y.

“Most people I know in relationships that have started in the last few years have met their significant others on Tinder,” she says.

Eliza Berlage, 26, met her boyfriend of 10 months on Tinder. She says it’s really a numbers game. “You could go to so many bars, libraries, music festivals, house parties, and still have as much luck … just swiping it lucky and giving it a chance and seeing how it goes.”

With numbers comes choice. And according to Iselin, it’s the choice these apps offer that makes them truly revolutionary – especially for women, minorities, and people whose preferences lie outside the norm.

Although there are some who feel nostalgic for the pre-Tinder dating scene, Iselin reckons women have never had it better; and she doesn’t see us ever going back.

“I know a lot of people say, ‘I would never use Tinder because I want to meet the love of my life the old-fashioned way’. But when we talk about old-fashioned times, we’re talking about a time when women in particular did not have a lot of choice in meeting partners.”

The same goes for people who may be otherwise constrained from exploring their sexuality ‘the old-fashioned way’, says Senthorun Raj, Grindr enthusiast and academic in law and gender studies.

“For people who are busy, those who have social, mental, or physical mobility issues, or individuals who are worried about ‘outing’ their sexual or gender identity in public spaces, dating apps can be a more comfortable way to chat, socialise, and become intimate than meeting people at clubs or bars,” he says. “For same-sex-attracted and gender-non-conforming people especially, these apps can be lifelines to connect with others dealing with similar experiences.”

What’s more, they have the ability to make connections “with people who we would never encounter in the places or circles we normally frequent,” he adds.

Of course, it’s not all rainbows, love-hearts and wink emojis for women, racial minorities or LGBT people. Prejudice and harassment is a real issue – but Raj says it would be a mistake to suggest apps like Grindr and Tinder have unleashed it.

“While Grindr does not cause these stereotypes, apps do make it easier in some ways to express harmful racial, age, and other ‘preferences’ because of anonymity or because the lack of ‘in-person’ interaction makes you feel like what you say or do online is … subject to less critical scrutiny.”

Nguyen says rape threats and racist, sexist comments are things she’s personally had to deal with just as much offline as on dating apps and social media.

“There’s such a big moral panic when it comes to online dating and safety, and it’s valid but we also need to remember that women face this everywhere. It really comes down to better education in schools about consent and respectful connections, and also the apps ensuring that they take reports of violence seriously.”

Sex and relationships expert Cyndi Darnell agrees that while mobile dating apps have revolutionised the sexual choices available and the ease with which users can access them, ultimately better education is needed to improve the human interaction side of things.

“We’re still operating on a very, very, very limited consent framework in terms of discussions around sex and pleasure … and yet our technology is far more advanced than that,” she says.

“There’s no app for getting over awkwardness. There’s no app for managing sexual anxiety. That’s the thing we need to remember: just because there is more access to sex, it doesn’t mean the quality of the sex has improved. We mustn’t confuse quantity with quality.”

Then again, there’s quality to be found – especially if you’re willing to put in the effort. “I’ve been on excellent dates and I have friends who’ve ended up in the most magical relationships,” says Iselin, who’s confident she’ll achieve her goal in one way or another by the end of her 30 dates.

“We are the generation now going to Tinder weddings. There are Tinder babies. I think that’s really exciting, and that gives me faith.”

Complete Article HERE!

Women with HIV, after years of isolation, coming out of shadows

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.”

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