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STDs (Expert Forum)
Gay Man Trying to Be Safe - Your thoughts?
Answered by
University of Washington
Seattle - WA
This forum does not cover AIDS/HIV issues. This forum is for questions and support regarding STD issues such as: Chlamydia, Crabs (pubic lice scabies), Gonorrhea, Hepatitis (viral), Herpes, HPV, Molluscum Contagiosum, PID, Rectal Infections, Syphilis, Trichomonas, Warts, Yeast Infection.
IMPORTANT
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
This forum is limited to questions about STDs other than HIV/AIDS. For questions about HIV prevention, or if you have general questions about safe sex (e.g., condoms, how to protect yourself from HIV and STDs), please visit the HIV Prevention and Safe Sex Forum
Some of the most common types of questions concern the risk of HIV or STD after a particular sexual exposure, and about symptoms that might or might not be due to HIV. If your question is along these lines, please visit the HIV Prevention and Safe Sex Forum.
Gay Man Trying to Be Safe - Your thoughts?
by massguy, Mar 19, 2006 12:00AM
I am 32 year old gay man living in the Boston area. I have always had anxiety about HIV and try to always play safe. I know I am in a HIV risk category and while I have accepted the fact that I am gay, I still get anxious about sex. Here is what I do:
1. I think I follow your advice to a T, I always ask my sexual parters their HIV status, if they have ever been treated for an STD and when they last tested (some of them look at me like I am crazy - but I don't care). If they don't know, or say yes to what I ask. I don't have sex with them, I walk. But then again, some people lie or say they are hiv neg when they truly don't know - but I treat them like they have every STD known when I am intimate with them. I rarely have have anal sex and if I do it is mostly in a dating relationship after I know them. I ALWAYS use a condom (I am a top), use lots of water-based lube and thankfully, I have never had a condom rip, break or come off, never!
2. I do, on occassion have oral sex with men. My previous doctor (who recently retired from the Fenway Community Center) told me that if I do this without a condom the risk is extremely low for HIV, as long as I don't allow ejaculation in my mouth. And the risk is off the charts if allow someone to have oral on me. I know pre-*** can contain HIV virus particles, so I try to avoid it but sometimes it's hard. Is my risk, really low?
3. I do, on occassion rim. however, I examine the area first and only do it lightly (no bitting). I have been vaccinated for heps (of course not C since there isn't a vaccine). I hear that rimming is not an act in which HIV is known to be passed - is that true?
I have never had an STD - I do get tested yearly at the Fenway. Most of the time, the people taking the test after hearing what sexual activities I participate in say I am at extremely low risk - but I still get nervous. Giving up sex is an option to help with my HIV anxiety, but I think sex is important so I just stick with my safe sexual boundaries. I just don't want to ever put myself at risk. Just so you know, I don't go to bath houses, don't go to bars, have never had sex while drunk or even heavy drinking and I never do drugs. And I always (sometimes it turns them off - but thats their problem) "quiz" my sexual partners on their history, HIV status, risks, etc. I guess I am doing everything right, with the exception of not having sex, but that is not an option.
What do you think about my risks, my practices and if you have any suggestions as to lower my risks further - I would love to know.
You run a great service here Doctor, I not only admire you're work, but I greatly respect your honestly and forthright.
Take care, and thanks for taking the time to read my post!
Bruce
1. I think I follow your advice to a T, I always ask my sexual parters their HIV status, if they have ever been treated for an STD and when they last tested (some of them look at me like I am crazy - but I don't care). If they don't know, or say yes to what I ask. I don't have sex with them, I walk. But then again, some people lie or say they are hiv neg when they truly don't know - but I treat them like they have every STD known when I am intimate with them. I rarely have have anal sex and if I do it is mostly in a dating relationship after I know them. I ALWAYS use a condom (I am a top), use lots of water-based lube and thankfully, I have never had a condom rip, break or come off, never!
2. I do, on occassion have oral sex with men. My previous doctor (who recently retired from the Fenway Community Center) told me that if I do this without a condom the risk is extremely low for HIV, as long as I don't allow ejaculation in my mouth. And the risk is off the charts if allow someone to have oral on me. I know pre-*** can contain HIV virus particles, so I try to avoid it but sometimes it's hard. Is my risk, really low?
3. I do, on occassion rim. however, I examine the area first and only do it lightly (no bitting). I have been vaccinated for heps (of course not C since there isn't a vaccine). I hear that rimming is not an act in which HIV is known to be passed - is that true?
I have never had an STD - I do get tested yearly at the Fenway. Most of the time, the people taking the test after hearing what sexual activities I participate in say I am at extremely low risk - but I still get nervous. Giving up sex is an option to help with my HIV anxiety, but I think sex is important so I just stick with my safe sexual boundaries. I just don't want to ever put myself at risk. Just so you know, I don't go to bath houses, don't go to bars, have never had sex while drunk or even heavy drinking and I never do drugs. And I always (sometimes it turns them off - but thats their problem) "quiz" my sexual partners on their history, HIV status, risks, etc. I guess I am doing everything right, with the exception of not having sex, but that is not an option.
What do you think about my risks, my practices and if you have any suggestions as to lower my risks further - I would love to know.
You run a great service here Doctor, I not only admire you're work, but I greatly respect your honestly and forthright.
Take care, and thanks for taking the time to read my post!
Bruce
Doctor's Answer
by H. Hunter Handsfield, M.D., Mar 19, 2006 12:00AM
, Mar 19, 2006 12:00AM
1,2) My main response is congratulations! You are being just about as safe as a gay man can be, short of either being celibate or in a permanent, mutually exclusive relationship with another HIV negative man. That you have remained STD-free over the years is a testament to the effectiveness of what you are doing. (Remember that all STDs are much easier to transmit, by all sexual practices, than HIV.) Barring any change in your behaviors and practices, I expect you to remain HIV-free forever.
3) As far as rimming is concerned, you are right about no documented HIV transmissions. That doesn't prove it hasn't happened, but the practice undoubtedly is fairly low risk for HIV (although the highest of risk for enteric infections such as salmonella, campylobacter, amebiasis, and hepatitis A).
Finally, as you know--but for others who might not know it, particularly if they live in New England--Fenway Community Health Center, Boston, is one of the country's premier resources for excellent lifestyle-specific health care for gay men (http://www.fenwayhealth.org/site/PageServer). You can rely on their advice about sexual safety and related issues. Fenway also runs an online forum on sexual safety and related issues, "Ask Dr. Cox". I believe it is new and I cannot vouch for it, but considering the source, I'm sure it is an excellent resources.
Thanks for the thanks about this site. Best wishes. Stay safe--
HHH, MD
3) As far as rimming is concerned, you are right about no documented HIV transmissions. That doesn't prove it hasn't happened, but the practice undoubtedly is fairly low risk for HIV (although the highest of risk for enteric infections such as salmonella, campylobacter, amebiasis, and hepatitis A).
Finally, as you know--but for others who might not know it, particularly if they live in New England--Fenway Community Health Center, Boston, is one of the country's premier resources for excellent lifestyle-specific health care for gay men (http://www.fenwayhealth.org/site/PageServer). You can rely on their advice about sexual safety and related issues. Fenway also runs an online forum on sexual safety and related issues, "Ask Dr. Cox". I believe it is new and I cannot vouch for it, but considering the source, I'm sure it is an excellent resources.
Thanks for the thanks about this site. Best wishes. Stay safe--
HHH, MD
General Rules:
1. Giving oral is more risky than receiving oral.
2. Being a bottom is more risky than being a top.
3. Rimming is not without risk and doing an examination beforehand will not lessen the risk.
Asking questions might be a good thing if the truth was always told or even known. (A person could become + AFTER the last test and BEFORE the next one) Does this enhance your experience?
The rule here is to always treat partners as if they were positive and act accordingly, i.e. never have unprotected sex.
Good luck with your decisions.
Thanks again, thanks for your nice comments..and belive me doctor, I will stick with these practices and never go outside those "unsafe" limits.
Take care,
Bruce