“Guys On Top Don’t Get HIV… Right?”

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We’ve all heard that ‘tops’ are less likely to get HIV than ‘bottoms’. Sometimes guys will be on top during anal sex (or frontal sex with trans guys) in order to reduce their risk of getting HIV. When guys with different HIV statuses have unprotected anal or frontal sex, sometimes the negative guy will top the poz guy to reduce the risk of transmission.

 

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This is called ‘strategic positioning’, and is based on the fact that it’s easier for HIV to get into the body through the ass than through the cock.

However, some factors could make strategic positioning not so strategic for reducing HIV transmission risk.

  • If a poz guy is ‘strategically positioning’ himself on the bottom, but he isn’t used to it, he could be more likely to injure himself and increase the risk of HIV transmission.
  • If a negative guy is ‘strategically positioning’ himself on top, but he isn’t used to it, he could be more likely to injure his partner and increase the risk of HIV transmission. If he is uncircumcised, he may injure his foreskin, which can also increase the risk of transmission.

It’s technically less likely to be infected as the top than the bottom, although the risk isn’t eliminated. According to a study in Australia, around 1 in 5 men who recently contracted HIV were tops. In a research study published in 2007, among a sample size of 102 gay and bi men who were recently diagnosed HIV-positive, 10 of them were infected despite ‘strategic positioning’.

Giving and receiving unprotected anal sex are both considered high-risk for HIV. That means a lot of guys have become HIV-positive this way. When a condom is used, it’s low-risk for both partners.

Don’t assume another guy will bottom or top just because he is trans, masculine/feminine, or because of his ethnicity, race, age or cock size. Also, don’t make assumptions about your partner’s HIV status.

 

From the Sexual Health survey 2014 conducted at AFA Anonymous Testing Site and online, a total of 91 MSM responded. 27% of the participants have an inconsistent condom use with casual partner(s).

Figure 1. In the past 6 months, with your casual male partner(s), would you say that condoms during anal sex (whether insertive or receptive, top/bottom) were used?

Never used condoms 5 5%
Sometimes 9 9%
Most of the time 12 13%
All the time 43 45%
No casual male partner(s) 22 23%

 

With practice, most guys can have pleasurable anal sex without any pain whatsoever. Here are some tips for trying out a new position:

  • Try it on your own first. Use your finger or a sex toy.
  • Go slow. Foreplay can help. Spend some time getting turned on, lubing up your or his ass, and getting mentally prepared. If it hurts, stop.
  • If you’re on top, pay attention to his body language: tensing up, breathing, etc. This will give you cues as to whether you’re going too hard or too fast.
  • Alcohol and other drugs (like cocaine) can numb pain, so you should avoid using them when trying a new position for the first time. You might hurt yourself or your partner and not know it.
  • If you’re bottoming for the first time, try a position that’s comfortable for you. Some guys prefer to bottom from on top, lowering themselves onto him while he lies on his back, so they can have more control. Some guys prefer to lie back with their legs in the air, so they can relax more. It varies from guy to guy, and can depend on factors such as his or your body size, weight, cock size, flexibility, and sheer will.
  • When he’s entering you, try relaxing your ass just after a short tight clench. Clench, relax, repeat. It will get easier with practice!
  • If you have questions about improving your anal sex experience, you can talk to a local service organization, visit some sex shops, and do some research online at sites like MySiliconelovedoll.com.
  • Remember: not all gay men have anal sex. If it isn’t doing it for you, there are plenty of other ways to get off.

Your risk reduction strategy is up to you. But it’s important that you know the facts before you decide what kind of sex you want to have. No risk reduction strategy is as effective as consistently using condoms with lots of lube.

Remember that unprotected sex puts you at greater risk for HIV and other sexually transmitted infections. An STI can harm your health, and also put you at greater risk of getting or passing on HIV. They often don’t show symptoms, so you should get tested regularly.

Source: Thesexyouwant

What The Heck is Syphilis?

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Syphilis is a sexual transmitted infection and one of the many sexual transmitted infections (STIs) you will learn from Gayhealth.sg. We will make it simple for you so that you can be equipped with this “silent ” infections which can cause brain damage, nerves, heart, eyes and even blood vessels. Okay, go grab a refreshing drink, sit down on a comfortable chair and read this, or book mark this page, so in an emergency, you know where to get up-to-date, lay men information.

What is Syphilis?

Syphilis is caused by bacterial and is (easily) curable if detected early. However, late infections may leave permanent organ damage. Infection can be asymptomatic for a long time, only to surface later. As a result, many infected persons are unaware and continue to spread the infection to others.

How do I get it?

As with most sexually transmitted infections, one becomes infected through unprotected sexual intercourse. Unlike other STIs like HIV, Syphilis can be contracted through intimate skin to skin contact. You can get infected when any of your body parts including mouth or genitals, come into direct contact with someone who has an affected sore (Chancre), even with condom use.

What can it do to me? 

If you don’t seek treatments, syphilis can show up many years later and will cause severe damages to your organs as mentioned above.

Who should get tested for Syphilis? 

Anyone who is sexually active and if you think you came in contact with a painless sore (chancre) that is usually found in the genitals area and in the mouth. Makes you think twice about play Spin the Bottle huh. 

If it is a “silent” infection, how would I know? 

Ok relax. You can test for Syphilis by going for a blood test. Usually it will take 21 days to 3 months for the infection to show up after exposure.

Wait! Blood test?

Yes, of course! How else will they test for it? It’s a simple, quick and painless rapid (finger prick) test. Only a couple drops of blood is taken. It canbe done anonymously too.

Can you tell me the signs and symptoms? 

So you have stages of infection when left untreated. Ready?

Primary Stage: 

  • First signs usually occurs between 9 to 90 days following following infection.
  • It shows up as a painless sore (chancre) on the penis, in the mouth or anal canal.

Secondary Stage: 

  • After the chancre disappears, there is a period with no symptoms lasting three to six weeks.
  • Non-itchy rash, especially on palm and soles.
  • Wart-like growths on the genitals and anus.
  • Fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscles aches, and fatigue.

Wah! Why so many stages huh? 

It’s actually just one stage. Only when left untreated, it will progress. Now train yourself to include Syphilis testing with your HIV test so you can fix it before it becomes stage 2.

There is a cure for this, right? 

Yes there is. If detected within one year of infection, syphilis is easily treated with penicillin injections.  If you are allergic to penicillin you will get a different injection of  doxycycline or erythromycin. If syphilis is detected later than one year, you will require longer courses of treatment. It is currently felt that persons living with HIV may need a longer course of treatment to successfully cure a syphilis infection.

We have Syphilis testing at our Anonymous Testing Service (ATS) at 31 Kelantan Lane. See operating hour HERE.

You can contact us for more information.

MAILING ADDRESS:

9 Kelantan Lane #03-01
Singapore 208628
or
c/o DSC Clinic:
31 Kelantan Lane #02-16
Singapore 200031

TALK TO US

Tel : (65) 6254 0212
Fax :(65) 6256 5903
Email : info@afa.org.sg

Feeling Down and Sex

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Ever noticed that your sexual appetite and behavior change when you’re stressed? When you’re depressed? When you’re happy? Your state of mind affects how horny you get, how often you want sex, and what kind of sex you might have. It’s why some people make use of male pheromones to help get them into the right mood for what they want to do.

We live in a society where gay and bi guys are told from a young age that we are sick, immoral and even criminal. Some gay and bi guys are rejected by their family or friends. Discrimination against us is commonplace, especially those of us who are HIV-positive. It only makes sense that this would have a negative impact on our mental health.

Often, gay and bi men live with depression, anxiety and feelings of low self worth. For many guys it’s just the reality of surviving homophobia, racism, transphobia, and many other forms of discrimination. Some of us have also survived traumatic events in our lifetime, such as childhood abuse, sexual assault, or we are living with post-traumatic stress.

photo 2 (17)

Being in this state of mental health, whether temporary or more long-lasting, can make us devalue ourselves and take more risks with our health. We might also take risks in an attempt to satisfy some other need, such as:

  • self-worth and affirmation
  • having meaningful connections with others
  • feeling desired sexually and comfortable with ourselves
  • self-confidence
  • feeling at ease
  • reducing anxiety

Maybe you notice these issues when you are hooking up? Maybe you notice them after a pattern of behaviour. Maybe you don’t notice them at all. These are bigger issues that can put us at greater risk, but require more than just knowledge about HIV transmission to overcome.

TIPS

Before you go to have sex, think about how you’re feeling. Notice patterns of behaviour, or triggers that make you take risks. Acknowledge realities in your life that you might need to change, or you might need to accept.
Decide on some boundaries about what you will be comfortable with before you go ahead, and make a contract with yourself to stick to them.

Sometimes, your mood or low sexual desire may just be a one-off thing, or it may be something that happens regularly. Try and evaluate why it’s happening to you, and whether the problem lies elsewhere. You might be facing problems getting an erection when you are feeling stressed or down, and if this happens often, you might have to consult a doctor and buy vardenafil online to ensure that you can combat this issue.

If you find that your state of mind is making it difficult for you to make decisions you’re comfortable with, in the moment or later on, you can try one of these or other options that have worked for other guys:

  • Talk to someone like a trusted friend or family member about it. Just expressing our reality can help.
  • Increase your activity level through exercise, taking a class, connecting with others through a social group, or volunteering. Physical activity releases chemicals in the brain that elevate our mood. Connecting with others reduces feelings of isolation.
  • Get proper food and rest. This helps balance our mood.
  • Seek professional help from a counsellor, AIDS service organization, psychologist, etc. Sometimes it’s good to talk with a nonjudgmental and objective person who can also help connect us to other supports.

AFA MSM Programme

Daniel Le

Address: 9 Kelantan Lane #03-01
Singapore 208628

Tel: (65) 6254 0212

Fax: (65) 6256 5903

Email: daniel.le@afa.org.sg

1. If you need to talk to someone, please visit:

Oogachaga

Hotline 6226 2002

Tuesdays – Thursdays: 7pm – 10pm and,
Saturdays: 2pm – 5pm

WhatsApp 8592 0609

If you prefer to chat, you can get in touch through WhatsApp during our hotline operating hours. Please note that this is NOT an SMS service.

Click here for more info or to access e-mail counselling.

2. If you need to find community social groups please click our Supportive Networks for all the listings.

3. For anonymous testing, please visit:

  • ANONYMOUS TESTING SERVICE (ATS)

31 Kelantan Lane #1-16 S200031

Tuesdays & Wednesdays 6.30pm to 8.15pm
Saturday 1.30pm to 3.15pm

  • MOBILE TESTING SERVICE (MTS)

For operation detail, please visit our site to see where the testing van will be: http://afa.org.sg/whatwedo/support/mts/

No condom In Relationship – Will I Be OK?

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Many of us have accepted condoms as part of our sex life when we’re having casual sex outside of relationships, but it’s not unusual for guys who usually use condoms to stop using them when they get serious in a relationship.

Whether the relationship is monogamous or not, some guys feel that they’re willing to accept the risk of not using condoms with the person they’re in a relationship with, especially if they have an agreement about what kind of sex happens outside of the relationship. This is sometimes called ‘negotiated safety’.

When you agree to give up condoms, you’re also giving up some control over managing your own risk. That requires having a lot of trust in your partner.

Here are some things to keep in mind if you’re considering negotiated safety.

  • Talk about it first. A decision to drop condom use in your relationship requires open and honest talk about what kind of relationship each partner truly wants, and discussion about each other’s HIV status, now and in the future.
  • Condomless sex is not an expectation in any relationship, regardless of length, seriousness or commitment. Don’t feel pressured into giving up condoms if you don’t want to. This is important to remember especially when you use online sex dating apps (information about which you can find on this Sex Blog). If you feel forced by your partner, make sure that you let them know how you feel about not using condoms.
  • Don’t feel pressured into a type of relationship you don’t want either. Don’t pressure your partner into a relationship he doesn’t want, whether it’s monogamous or non-monogamous. Be aware what an abusive relationship looks like, and that most people in abusive relationships deny it. Click Here for more information.
  • Make your agreement with your partner clear and practical in terms of what kind of sex is allowed and with whom, and what consequences there will be that are realistic for both partners.
  • Get tested for HIV and other STIs. Be sure you’re making this decision based on the most up-to-date information. Keep getting tested on a regular basis.
  • Know all the risks. Maybe your agreement includes condom use with others only when you’re fucking. That reduces your risk for HIV, but you’re still at risk for other STIs that can be transmitted through oral sex.
  • Be prepared to start using condoms again. You might break your agreement with your partner. You might do something risky. You might have sex with others even though you agreed not to. In this situation, you’ll need to find a way to tell him so you can both re-negotiate your safety. So talk to your partner about what you’ll do if either one of you slips up, or suspects that he has an STI.
  • Breaking an agreement doesn’t mean the relationship is over. Be willing to extend the same understanding to your partner that you would expect extended to yourself. If your partner tells you that he has broken your agreement, it could be because he cares about you and doesn’t want to put you at risk.
  • You might not know what your partner is actually doing. Sometimes we make assumptions that our partners are monogamous or non-monogamous. Sometimes we break agreements. Sometimes he won’t tell you. Are you willing to accept the risk?

Gay and bi guys have pioneered new ways of thinking about sexual and romantic relationships. Whether a guy wants to be monogamous or non-monogamous, neither is a reflection of his commitment to his relationship. Some guys find it difficult to sustain monogamous relationships over the long-term, so opening up the relationship to other sexual partners can be a way for them to preserve the relationship.

Source: Thesexyouwant

Action for AIDS – MSM Programme

Address: 9 Kelantan Lane #03-01
Singapore 208628Tel : (65) 6254 0212Fax :(65) 6256 5903
Email : daniel.le@afa.org.sg

Condom Use and Risk Reduction

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Most gay men who don’t use condoms are mindful of HIV and attempt to reduce their risk

By Roger Pebody

Three-quarters of Australian gay and bisexual men who report unprotected anal intercourse with casual male partners say that they “often” or “always” employ some sort of risk reduction strategy with those partners. Many attempt to select partners who they believe have the same HIV status as themselves (serosorting); a significant proportion use condoms most but not all of the time; and smaller numbers practice ‘strategic positioning’ or withdrawal before ejaculation.

The study shows that a simple, black and white division of gay men into low risk ‘condom users’ and high risk ‘men who don’t use condoms’ is misleading. However that is sometimes the impression given by behavioural surveys.

Martin Holt of the University of New South Wales presented the data to the 20th International AIDS Conference in Melbourne yesterday. It is derived from an analysis of the responses to two large-scale, cross-sectional community surveys of Australian gay and bisexual men in 2011 and 2012. A total of 15,615 completed the surveys.

Overall, 38% had no casual partners (and are not included in this analysis, even if they did not use condoms with their partner), 28% always used condoms with casual partners and 13% had no anal sex.

That leaves 21% who reported anal sex without a condom with at least one casual partner in the previous year – this group was the focus of the study.

Moreover as risk reduction strategies differ according to HIV status, the analysis made comparisons between the 2339 men who had tested HIV negative and the 603 men who were diagnosed with HIV. The small number of men who had never tested for HIV were excluded from the analysis.

Holt was interested in risk-reduction strategies the men used “often” or “always” with casual partners, including:

  • Condom use.
  • Serosorting (having a partner perceived to have the same HIV status) when having anal sex without condoms.
  • Strategic positioning when having anal sex without condoms – in other words, the HIV-positive partner taking the receptive position (bottom).
  • Withdrawal before ejaculation during anal sex without condoms.

HIV-positive men who didn’t consistently used condoms with casual partners reported serosorting (60%), condoms (22%), strategic positioning (17%) and withdrawal (15%).

HIV-negative men were more likely to report using condoms most of the time, but serosorting was still the most widely reported tactic (44%), followed by condoms (41%), strategic positioning (24%) and withdrawal (22%).

Three-quarters of men reported using more than one strategy; the strategies most commonly combined were serosorting and condom use.

There was a very strong association between using these strategies and disclosing HIV status to sexual partners. This was the case both for HIV-positive and HIV-negative men.

For example, for HIV-negative men, those who disclosed to some sexual partners were almost twice as likely to practice a strategy as those who did not (odds ratio 1.76, 95% confidence interval 1.39 – 2.21) and those who disclosed to all partners were three times as likely to have a strategy (odds ratio 3.43, 95% confidence interval 2.66 – 4.42).

HIV-positive men who always disclosed were seven times more likely to use these strategies (7.11, 95% CI 3.70 – 13.67).

HIV-negative men who had a regular partner were less likely to practice any risk reduction strategy if their partner was untested or HIV negative.

Martin Holt concluded that interventions should aim to improve the consistency with which gay and bisexual men employ risk reduction strategies. Men should be encouraged to disclose their HIV status, to make effective agreements with their regular partners about casual sex and to choose the best strategy in different scenarios. Alternative approaches such as PrEP are likely to be appropriate for those men unable or unwilling to use existing strategies.

References
Holt M et al. Consistent and inconsistent use of HIV risk reduction strategies by Australian gay and bisexual men who report unprotected anal intercourse with casual male partners. 20th International AIDS Conference, Melbourne, 2014, abstract THAD0101.

First Published By: aidsmap.com on 25 July 2014

New Technical Support Hub Launched

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CLAC Launches Global Technical Support Hub to Advance the Health and Rights of Key Populations and People Living with HIV

New Coalition to Provide Community-Led Technical Support in Novel Approach to Addressing HIV among Key Populations Globally

The Community Leadership and Action Collaborative (CLAC) has launched a new global technical support hub, helping communities of men who have sex with men (MSM), injection drug users, sex workers, transgender people and people living with HIV (PLHIV) to engage successfully with the Global Fund to Fight AIDS, Tuberculosis and Malaria.

Launched at the 20th International AIDS Conference (IAC) in Melbourne, Australia, the new hub provides access to tools and resources for building and strengthening community systems and a database for technical support concerning the HIV response. The hub also serves as a portal for communities to access direct technical support provided by the CLAC’s seven member organizations: the Global Forum on MSM & HIV (MSMGF), the AIDS and Rights Alliance for Southern Africa (ARASA), Global Action for Trans* Equality (GATE), the Global Network of People Living with HIV (GNP+), the Global Network of Sex Work Projects (NSWP), the International Network of People who Use Drugs (INPUD), and the International Treatment Preparedness Coalition (ITPC).

“We are excited to announce the launch of the CLAC’s new technical support hub at this year’s IAC, following the conclusion of the MSMGF Pre-conference,” said Dr. George Ayala, Executive Director of the MSMGF.

“The CLAC offers an important opportunity to ensure the meaningful engagement and empowerment of all key populations in the HIV response. We know that we cannot successfully respond to HIV without the full meaningful participation of communities, and that is what the CLAC strives to do.”

The CLAC is committed to the provision of technical support that is hands-on, interactive and occurs in an environment of mutual trust, respect and sharing. Rather than conducting one-off trainings, the CLAC reinforces ideas and actions by linking them with technical assistance and ongoing mentoring. This includes facilitating opportunities for formal and informal knowledge sharing and joint actions, which promote recognition and appreciation of the unique experiences and expertise of community stakeholders. This is particularly important for PLHIV, MSM, people who inject drugs, sex workers and transgender people, for whom human rights are routinely contested.

The new technical support hub can be accessed at http://www.clac.cab.

Read : 10 things to know about Truvada

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10 things you need to know about the pill to prevent HIV

It’s been called, simultaneously, a medicine to “end the HIV epidemic” and a “party drug:” Pre-exposure prophylaxis, or PrEP for short, refers to a daily antiviral treatment that prevents HIV.

That’s right: People who don’t have the virus can take a pill a day to save themselves from getting infected.

Haven’t heard about PrEP? You’re probably not alone. The drug-maker, Gilead, doesn’t advertise Truvada (its brand name) for prevention, and the Centers for Disease Control and Prevention only endorsed it this past May—two years after it hit the market.

Going forward, however, you’ll be hearing a lot more. This month, both the International Antiviral Society-USA and the World Health Organization—opinion leaders in medicine—backed the antiviral, recommending all HIV-negative at-risk individuals consider taking it as part of a strategy to reduce the global incidence of the disease. But there’s a lot more to the story. Here’s what you need to know:

  1. Public health officials aren’t recommending this pill for “all gay men,” despite what the headlines say
  2. Truvada is not a condom replacement
  3. We don’t yet know exactly how the drug will be used in real life
  4. We do know Truvada only works effectively when taken every day
  5. Truvada can cause drug-resistant HIV infection
  6. Besides that, it’s pretty safe
  7. “Truvada whores” are a thing
  8. Uptake has been slow—but that’s not the full story
  9. The drug is expensive
  10. HIV remains a socioeconomic crisis in America and around the world

Click to read more about the above 10 points

First published on vox.com – 21 July 2014

Telling Him I Want a Condom

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Sure, we know that condoms significantly reduce the risk of HIV transmission, but it isn’t always as easy as it sounds to have safer sex, even if you want to! Sometimes we don’t ask or insist on what we want because we’re afraid of rejection, or we might have other reasons.

Every relationship has power imbalances, which can change from time to time. Maybe one partner feels less attractive or smart than the other, or one has less money or education. One partner might experience more privilege in society as a result of his race, ethnic background, age or gender identity. One partner might have more power in one area and less in another.

These imbalances can make it more difficult for you or your partner to express what both of you want, including condom use and other risk reduction strategies. If the imbalance is preventing you from saying what kind of sex you want, consider talking to a professional about it.

Tips for communicating what you want:

  • Find a way to communicate what you want that feels comfortable for you.Keep in mind that few men are going to react negatively if you tell them what kind of sex you like, or that you want to use condoms. If he does react negatively, do you want to have sex with him anyway?
  • If you’re in a situation where verbal communication isn’t as feasible, such as a bathhouse sauna or dark room, or you just don’t feel comfortable communicating verbally, use visual cues. Reach for a condom. Display it prominently on the bed. Tuck it into your waist with your towel.
  • Saying that you want to use a condom doesn’t imply that you are HIV-negative or HIV-positive. The majority of gay and bi guys use condoms most of the time, regardless of HIV status.
  • Alcohol and other drugs can affect your judgment and ability to communicate what you want. If you’re planning on drinking or doing drugs, plan ahead of time what kind of sex you are comfortable with, so you don’t have to make that decision when you’re under the influence.
  • Pay attention to what your partner wants, too. Communication barriers and power imbalances aren’t always one-sided. Sometimes you’ll feel uncomfortable communicating, and sometimes he will. Make sure this doesn’t prevent him from bringing up what he wants.
  • If you’re finding it difficult to express what you want, talk to a friend, supportive family member, or a community organisation.

You deserve the kind of sex you want, and there are ways for you to get it.

Source: The Sex You Want

HIV Transmission Today

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We have learned a lot about how HIV is transmitted. When AIDS first hit our community, no one knew why gay and bisexual men were becoming sick, or how it could be prevented. In the absence of knowledge, people came up with their own theories and prevention methods. Some of them turned out to be useless, and some of them ended up working.

Now that we have much more scientific evidence about HIV/AIDS, we can make decisions about our sex lives that are based on the real risk of HIV transmission, not fear or misinformation.

Here’s what we know today…

You can be infected with HIV if you do something that allows enough of the virus to get into your bloodstream from the body fluids of a person who is HIV-positive.

There are only five everyday body fluids that have enough HIV in them to infect someone:

  • blood
  • semen (cum and pre-cum
  • vaginal fluids (including menstrual fluids
  • breast milk
  • rectal fluids*

In order for transmission to occur, one of these fluids must come into contact with an entry point into the bloodstream in the HIV-negative person: a cut or abrasion on the skin, or the mucous membranes (internal lining) inside the body.

* What are rectal fluids and why have I never seen this before?
Rectal fluids are the fluids that cover the inside of the ass, and are the body’s natural form of anal lubrication. You may not have seen this listed before, because it’s only recently that research has demonstrated how HIV infection happens inside the ass.