What do the numbers add up to?

Not all sex has the same risk.

Vancouver campaign steps away from standard 'use a condom' message:
Do the math. Calculate your risk.

via xtra!, by Natasha Barsotti

That’s the catchy title of a new ad campaign the Health Initiative for Men (HIM) is rolling out for gay men seeking more information than the standard “use a condom every time you have sex” refrain.

Initially, it was going to be a condom campaign, HIM project coordinator Jody Jollimore says, but that approach quickly morphed into a more nuanced campaign about risk.

Among the campaign’s key messages: “Not all sex has the same risk. Your risk of picking up or passing on HIV depends on the kind of sex you’re having and who you’re having it with.”

Read the rest.

Study: Gay couples need prevention too

via Bay Area Reporter, by Matthew S. Bajko 

HIV prevention needs to take a more holistic approach 

that goes beyond messages about safe sex.

Excerpt:

Gay couples' top reasons for establishing "sexual agreements," defined by the researchers as rules about whether sex with outside partners is allowed, had more to do with positively impacting their relationships than as an HIV prevention strategy, the study found. The main reasons couples established sexual agreements ranged from building trust in the relationship and promoting honesty between partners to protecting the relationship.

 "We found that gay couples are interested in building healthy, satisfying, and loving relationships," stated Hoff, who is attending the International AIDS Conference kicking off this weekend in Vienna, Austria. "These desires, when nurtured, can lead to strong relationships. Yet the reality is that a broken sexual agreement, or one that isn't clear to either partner, can make both partners vulnerable to HIV."

Read the rest. 

And for another view, from Box Turtle Bulletin...
The bogus “couples study” is back… and this time doing more harm than ever

Sex and the POZ Gay Man

Via POZ - If being HIV positive raises a million questions, being poz and sexually active raises a million more. In his article "Law & Disclosure" in The Positive Side, Glenn Betteridge wrote about one such question for people living with HIV/AIDS (PHAs): When are you required by law to inform your sexual partner of your HIV status?

Even if you've managed to keep the courtroom out of your bedroom, plenty of other uncertainties remain. Does having an undetectable viral load mean you're no longer infectious? How do sexually transmitted infections (STIs) affect people with HIV? How do you initiate sex if you think your prospective partner may be poz-phobic?

HIV-positive gay men may find these questions especially pressing. Gay culture can put a lot of value (and pressure) on having sex. How can a poz gay man feel healthy and horny when sex seems so fraught with potential landmines? Here are some issues that you might consider as you chart your course.


Read the rest...

Daniel Reeders on "Risky Business"

The little forum that could...

via Trevor's blog, by Daniel Reeders


Check out pics from the event here.



I'm enjoying the free wifi and replica designer furniture at the Centre on Halsted, marvelling at this amazing space, and the contradictions of American culture.

On my way here, I passed a huge billboard on N Halsted, warning that hotdogs kill. Cancer, you see. The message: not eating in moderation, but total hotdog abstinence.

I'd just had breakfast, which like almost every other meal I've had here, came with a huge, unbidden helping of fried potato. The enormity of the normal serving size here is deadly -- through diabetes and heart disease -- but exception was being made of a single food.

Instead of saying "eat less, mostly vegetables", there's a billboard for a single illness targeting a single food. Somewhere else, a diabetes agency has no doubt done a billboard about corn syrup (rather than declining bottomless refills).

I've been here five days and I'm already feeling swamped by a myriad of health messages. Almost invariably they are phrased as Don't Do X. None have sought to communicate skills and ideas for managing the complexities of your own health.

On Monday night I came to the Centre on Halsted for a forum about barebacking, called Risky Business, moderated by Fausto Fernos and Mark Felion from Feast of Fun - the top gay podcast on iTunes! - featuring Tony Valenzuela, Rev Musafa Ali and Dr Braden Berkey.

And something similar was happening. Rather than talk about pleasure, unsafe sex without the label, or the complexities of sexual negotiation in a mixed poz/neg sexual world, co-presenters Fausto and Mark sought a consensus: Don't Do Bareback.

The audience rebelled. Keith Green, someone I've long admired for his contributions to Lifelube and the Gay Men's Health Summit online community, challenged the panel: the subtitle for the event is "reclaiming pleasure" - why can't we talk about that?

Read the rest.

Lost generation: Are modern HIV campaigns failing younger gays?

via Pink News, by Ramsey Dehani

As someone reminded me recently, people born in the early nineties are now reaching adulthood. It is safe to say that these younger gays will not remember the images of the AIDS scare in the 1980s and 1990s.

With modern HIV advertising focusing less on condom use, are the younger generation being ill-advised on the dangers of unsafe sex?

The Terrence Higgins Trust (THT), Britain's largest sexual health charity, has recently launched a campaign called 'THIVK' aimed at knowing your HIV status and getting tested. It is the first 'testing' campaign in ten years.

Advertising advocating condom use has become harder to find, with many gay magazines containing none at all.

THT itself has come under scrutiny over its refusal to use hard-hitting campaigns because it does not want to "demonise" HIV sufferers.

The modern promotions are a world apart from the infamous 'tombstone' and 'iceberg' ads of the 1980s.

But it appears many people still "die of ignorance". With infection rates among gay men climbing 110 per cent between 1999-2007 (1,450 cases to 3,050), there is an argument for more hard-hitting campaigns.

I spoke to a 20-year-old gay student about his views on safe sex. He said: "Condoms are really important. I always try to use them." But he added: "Sometimes I forget though, especially when I'm drunk."

Read the rest.

***Interested in how porn, and bareback porn, affects our sexual desires and practices? Are videos depicitng edgy sex a hot but safe way to get off, or does condomless porn signal a dangerous normalizing of risk? Join us for "Risky Business - Reclaiming Pleasure" - a live podcast forum at the Center on Halsted this coming Monday, August 17. Click here for more info, and to RSVP for this free event. We will talk about the kind of sex, intimacy, fantasies and pleasure we crave, and how we can get there.

Barebacking tax: Should people who don’t use condoms pay higher healthcare premiums?

via The Daily Loaf, by Shawn Alff

Congressman Steve Buyer (R-Ind) knows how to fund healthcare reform: charge those who engage in sex without condoms higher insurance premiums. Before we dismiss Buyer as another nut who is just trying to slow down healthcare reform, let’s consider the consequences of this proposition.

The first question is how insurance companies would regulate risky sex acts. Would there be a barebacking police who raids your room after a one-night-stand, searching for a used condom? More than likely barebacking would become incorporated into the health-history/pre-existing-conditions questionnaire that establishes the appropriate insurance premium for your lifestyle. Like me, you’ve undoubtedly been less than sure about how to answer a few of these questions, like “Do you use tobacco?” and “How heavy of a drinker are you?” I puff on a cigar about twice a year, often times vomiting afterward, but does this put me in the same ranks as chain smokers? I don’t think drinking three Busch Lights a night qualifies me as a heavy drinker, because to me Busch Light is basically water, but I doubt my insurance provider would agree. Many of us feel a sense of accomplishment when we get away with lying to our providers until we develop a health problem related to our risky behavior and our insurance refuses coverage.

Read the rest.

RESEARCH: The Non-sexual Needs of Men that Motivate them to Engage in High-Risk Sexual Practices with Other Men

"If I'm in chat and I put that I am looking for my knight in shining armor, they tell me to fuck off, haha. So it's best to say I'm looking for sex and then see what happens. I know that normally guys use the Internet to find sex, first you get them into bed, and then you find out their name. What I ask for and what I offer is sex, then if I like the person, maybe something else will happen, whether it be friendship or even better a stable relationship, but as the situation is, the only way is to go for sex first and see what happens."

by Percy Fernández-Dávila

Abstract: Currently there is a growing trend toward high-risk sexual practices with casual partners in the group of men who have sex with men (MSM) in many industrialized countries. This study offers some understanding of why a group of men had unprotected anal intercourse (UAI). A grounded approach was used to analyze 20 interviews with MSM from Barcelona between 18 and 40 years of age who had at least one episode of UAI in the past three months. The results reveal that many respondents had UAI practices with casual sexual partners because they were in search of experiences that were not directly related to sexual relations: reaffirmation of a sense of personal worth and of their own physical attractiveness, offset shortcomings and feelings of emotional loneliness, the search for connection and intimacy, being in love, conversion of the risk intopleasure for the forbidden and a desire to rebel against established rules. In these cases, concernsabout sexual and health care seemed to overwhelm and were not taken into account when havingUAI. It is important that HIV prevention programs include in their messages the power of these motivations that lead to practices of UAI.

Read the whole paper here.

Barebacking, Facebook, and HIV Prevention in 2009

Ultimately, asserts Davis, the problem is not going to be solved by "making people feel bad because they don’t use a condom. Very few people will change their behavior just because they’ve been made to feel bad about something. That’s a very short path to failure."

What’s in a word?

Can a little loaded term like "barebacking"-used as a thinly veiled, homophobic demonization of unsafe sex practices-so effect an at-risk population that the resulting stigma becomes a significant contributing factor to an increase in HIV infection within that population? And if so, what’s to be done?

Read the whole thing, via EDGE, by Scott Stiffler.

Truth

[click to enlarge]

smartsex courtesy of tpan

Stay Negative

Just found out you’re HIV-negative?


Where you go from here
is up to you.

LifeLube recommended!
via GMFA the gay men’s health charity
Part of the Pan London HIV Prevention Partnership


Your next HIV test could also be negative, or it could be positive.

But you can be in control of that. You can stay negative.

Even though you have a negative test result now, this might not be the case in the future if you put yourself at risk.

That’s why it’s important to develop strategies to help keep you HIV-negative. We’ve written this book to help you.

The information in this booklet was accurate on 1 April 2009
Click here to download the booklet.

Fresh off the Meat Rack --- SM Safely

And just in time for IML

Your partner hints at a little rope bondage to “spice things up.” In a bar, a man dressed head-to-toe in leather asks ifyou enjoy nipple clamps. You keep hearing about erotic, sexy, sweaty sex that involves kink and you wonder… “what if ?”

If any of this rings true, then this is a good booklet for you. Think of this as a “starter kit” for perverts (said lovingly) that translates lingo, speaks frankly about erotic play and gives tips on how you can play safer even when you feel like being a little piggy.

Most of the topics presented here have entire books written about them. This is simply an intro. No book can replace hands-on training or in-person mentoring, so if you discover a new personal fetish in these pages and want to learn more, check out the resources in the back.


So, enjoy. Play safe. Play hot. But most of all, PLAY!

[click ^ to access the document in PDF format]

[click ^ to enlarge table of contents]

[enjoy]

Click here to download the document.

Alternatives to condom use can help reduce HIV transmission among gay men

via Fridae - empowering gay Asia - by Jan Wijngaarden

The HIV epidemic among gay men in Asia is continuing to grow. 30.7 percent of Thai men who have sex with men are now infected with HIV in Bangkok; in Cambodia, Vietnam and Indonesia between 5-10 percent of men who have sex with men have HIV. In a cross-sectional study among MSM in Taipei in 2004, the HIV prevalence was 8.5 percent; in Singapore in 2007, 4.2 percent; and in Hong Kong in 2006-7, 4.1 percent. In most places our transgender sisters are even harder hit.

And that while transmission of HIV is quite hard, with a relatively low per-contact-transmission chance – HIV is much less efficient than other viruses, such as the ones causing flu or measles. Preventing HIV is relatively simple – covering our favorite organ with a 0.06 mm thick coating whenever we have anal sex...

Yes indeed, I am talking about condoms. So why are – even in places were significant numbers of men are infected with HIV – significant numbers of men still not using condoms? Are they not thinking clearly or what?

Well – perhaps so. A recent study from Sydney, Australia that appeared in the AIDS journal earlier this year (Jin F, Crawford J, Prestage GP et al, 2009) found that even when men do not use condoms, they still employ certain strategies to reduce their risk for HIV infection (or for transmitting HIV to their partners, if they are already HIV positive). Three of these strategies were found to reduce the chance of getting HIV significantly, compared to men who did not use any strategy (and no condoms).

These strategies are not as effective and not as safe as always using condoms, but nevertheless, they are protective.

What were these strategies?

Read the rest.

It's more than just condoms

Prevention for HIV serodiscordant couples: it's more than just condoms

via Aidsmap, by Michael Carter

Promoting 100% condom use may not be the most appropriate HIV prevention strategy for serodiscordant couples, according to research presented to the Fifteenth Conference of the British HIV Association. However, researchers found that there was little awareness or use of other methods of HIV prevention, such as post-exposure prophylaxis (PEP) or the impact of viral load on infectiousness.

Investigators recruited 38 serodiscordant couples (where one partner is HIV-positive, the other HIV-negative) to a prospective study lasting three years. Most (30) of the couples were gay men. To be included in the study the couples had to have been in their relationship for at least two years and to have engaged in at least 20 separate episodes of unprotected anal or vaginal sex in the previous twelve months.

The couples were interviewed about their understanding of issues such as PEP, viral load and infectiousness, and the reasons why they engaged in unprotected sex. The investigators hypothesised that there were likely to be three factors underlying unprotected sex in relationships: failure to understand the mechanisms of HIV transmission; emotional reasons; and a low concern about the consequences of HIV transmission.

Read the rest.

Don't Assume - Make your Relationship Agreements Explicit and Specific

via our aussie friends, acon

Relationship Agreements are the agreements that people make in regards to the sex they have inside and outside of a relationship. All relationships have agreements about how we live and operate in the relationship including things like whether you separately or together, how much time you spend together and what you do with that time, how you operate financially, who cooks, who cleans and what you watch on TV. The agreements below are specifically about the sex people choose to have. This includes sex with each other and or sex with other people.

There is no one relationship agreement that fits all people or types of relationships.

All relationships are different and there fore so are the agreements we need to make. The relationship agreements you had in your last relationship may not be a good one for your current relationship. Indeed your relationship agreement may change throughout your relationship. Your relationship agreements must be based on what you and your partner want and feel, not what other people are saying or doing All relationships have a relationship agreements, not just open relationships. Exclusive relationships have a relationship agreements, that is, they agree to only have sex with each other It may sound trite, but assuming you are monogamous is not an agreement; it is an assumption, and those assumptions may be incorrect. So talking about your agreement is the best way to avoid misunderstandings.

Basically, Agreements need to be clear and spoken between both of you.

They must be agreed to by both of you. One partner suggesting an arrangement and the other not agreeing is not an agreement. Don’t feel harassed or coerced into agreeing to something that you are not comfortable with as you will often only regret the decision. If you are unsure about something you can continue to consider it, read up on the issue, or trial it to see if it is want you both want or if it will work for your relationship.

Relationship agreement’s need to be specific and detailed. They should outline the type of sex that is allowed, with whom, where, when, safety considerations like safe sex, and alcohol and drug consumption, and other conditions that suit your relationship.

Read the rest for other things to consider.

How many people will you infect with HIV in 2009?

via Ickaprick and Ironpussy (our new fav blog)

Of all the people living with HIV in North America (1.1 million in the US and 58,000 in Canada), how many of them will transmit the virus to somebody new in 2009? Or, put another way: what percentage of poz people will hit New Year's Eve 2009 and say with confidence, "HIV ends with me. I did not infect any sexual partners this year"?

The answer is important for lots of reasons (like measuring the efficacy of prevention efforts), but one stands out more than others. Tracking transmission rates holds the key to proving or debunking the wide-spread belief that HIV+ people are reckless, selfish assholes who don't care very much if they infect other people or not.

Read the rest.

"Most men don’t use condoms at one time or another..."

You don't need to be a hot, speedo-clad Aussie to take advantage of these sexual risk reduction strategies - via Australia's very cool "Cruising" site - which offer clear, non-judgmental info for sexually active gay men beyond "use a condom every time." The site also features good, practical stuff about saunas (bathhouses), backrooms, sex clubs and crusing online, netiquette, cyber sex - and more.

Check it out.

What I do makes a difference

Most men have heard a lot, even from a young age, about HIV and how condoms are the most effective way to stop HIV being passed on. In Australia, HIV remains heavily concentrated amongst men who have sex with men with more than 85% of current HIV infections occurring amongst them. Almost every HIV infection amongst men who have sex with men in Australia has taken place during times when men have had anal sex without condoms.

Most men don’t use condoms at one time or another. Sometimes these decisions are made wisely with an informed sense of the risk being taken and efforts made to reduce the risk of getting or passing on HIV. Other times, these decisions are made in a less-than-informed way, with not a lot of effort being made to reduce risk. Sometimes we’re not really sure how risky or safe what we’re doing really is or we just don’t want to think about HIV at the time. So it’s not until later that we start thinking about the risks we may have exposed ourselves to.

What follows here is not an attempt to advise you to not use condoms. It is given in the knowledge that while condoms and lube are always the easiest and most effective way to stop HIV transmission in casual sex, sometimes men don’t use condoms. At these times, there are other things we can do to reduce the chances of HIV being passed on. Most of these strategies will reduce risk but not eliminate it altogether.


Want to top?

Some men of different HIV statuses fuck without condoms by having the negative guy “top” (that is, be in the dominant or insertive position in anal sex) and the positive guy “bottom” (that is, be in the submissive or receptive position). Sometimes this is called “strategic positioning”. This idea is based on the assumption that the chances of the negative man getting HIV are reduced if he is the one that cums inside the positive man, rather than the positive man cumming in him. It’s also based on the idea that “tops” (men who fuck, rather than get fucked) are less likely to get HIV. While this is true and the chances of getting or passing on HIV are generally greater if a positive man tops a negative man, tops can still get HIV.

Some men have still caught HIV even though they’ve used this strategy. Around 1 in 5 men who recently contracted HIV were tops. This strategy reduces the chances of HIV being passed on, but it does not eliminate the chances altogether. It also means that sometimes men have to take on positions in anal sex that they wouldn’t normally or that they don’t particularly want to do, simply because of the HIV statuses of the two men. It also means that it’s important that both men know what HIV status they are.

I’m pulling out!

Some men reduce the chances of HIV being passed on by pulling out before cumming when they fuck. While this might reduce the chances of HIV being passed on, it doesn’t eliminate the chances altogether. Pre-cum (the clear fluid that comes out of your dick prior to cumming) can contain HIV and little breaks and tears can occur in the lining of the arse when fucking, making HIV more likely to be passed on. HIV can also enter the head of the dick from another man’s arse.

Counting down…

Some men use the results of viral load tests to make decisions about anal sex. Viral load is a test taken by HIV positive men to measure the amount of HIV in their blood. These tests help HIV positive people and their doctors to make decisions about treatment. There van be other factors besides treatments that affect a viral load test result. Other sexually transmitted infections and other infections like the ’flu can increase a person’s viral load.

Commonly, people with HIV who are well check their viral load every three months. It is possible for a person’s viral load to go up and down quickly depending on what else is happening to their health. So, the results of a viral load test taken weeks or even days ago may be very different to what that person’s viral load is now. The lowest viral load results available are called “undetectable”. This doesn’t mean that there is no viral load (only HIV negative people have a zero viral load) – it only means that the viral load is below the level detectable by current tests. Also, viral load tests are measurements of the amount of virus in blood and no test is readily available to measure the viral load in cum. Lots of HIV positive men are interested in knowing whether a low or undetectable viral load result (for their blood) applies to their cum as well. Many experts say that generally, viral load results can be applied to levels in cum, however there is evidence that suggests there can be quite different levels of virus in blood and cum at the same time. Other sexually transmitted infections for example, can rapidly increase the amount of HIV in cum.

Some men make decisions about the chances of HIV being passed on, on the basis of viral load results thinking that an undetectable test means that there is no chance of passing on HIV. This is not true. HIV treatments cannot make an HIV positive man become HIV negative again. Once a man becomes HIV positive it will always be possible for him to pass HIV on to someone else, no matter how effective HIV treatment is for him or how low or undetectable his viral load is. Remember also that a viral load count only indicates what your viral load was at the time of your last test, not what it might be at the moment.


I don’t know anyone with HIV

Some HIV negative men don’t use condoms because they think there aren’t HIV positive men around the places they go to have sex, like beats or sex clubs and saunas. HIV positive people live in all areas of Victoria and Australia – inner city, suburban, regional and rural areas. A lot of people still think that HIV is an inner city problem and that no one in their suburb or town has HIV. Even if we’re travelling and are in a place we aren’t normally, it’s important not to think that there are no HIV positive men around. Wherever you are, it’s important to not guess that a guy you’re cruising or having sex with has the same HIV status as you.

I didn’t think he was positive

Some HIV positive men don’t use condoms in some sex clubs where other HIV positive men tend to gather. If condoms aren’t introduced into the scene it’s easy to think that the other guy is already HIV positive as well. You can never be sure whether another guy has the same HIV status as you.

A lot of the time we think that if a guy has a different HIV status to us, he’ll say so. But a lot of HIV negative men think it’s more important that HIV positive men tell their HIV status. A lot of HIV positive men get rejected by HIV negative men when they say they’re positive. And lots of HIV negative men won’t have sex with a guy they know is positive. You can’t rely on HIV positive men to say they’re positive when they know they’re likely to be rejected. So don’t assume that you’re going to be told when fucking a guy who has a different HIV status to you. Also some men don’t know their HIV status so they couldn’t tell you whether they were HIV positive or negative. A lot of guys who don’t know their own HIV status assume that they’re negative when they might not be.

A lot of men still think they can tell whether a man is HIV positive or negative by looking at him. Men of all ages and all walks of life are getting HIV. There is not one single “type” of man that is HIV positive. HIV positive men look as different from each other as HIV negative men do. And a lot of HIV positive men don’t look “sick”. Sometimes whether a guy introduces a condom or not is what we use the most to indicate his HIV status. But men interpret wanting to use condoms in different ways.

Some men think that wanting to use a condom means a man is HIV negative; others think it means he’s HIV positive. There is evidence that men read condom use in this way differently in different cities and towns across Australia. There’s no way to tell whether a man is HIV positive or negative from the way he looks, how old he is or whether he wants to use a condom or not.

I must be immune

Some HIV negative men have had sex without condoms with men whose HIV status they don’t know and not got HIV. Others have had sex without condoms with men who they’ve even known were HIV positive and still not been infected with HIV. Sometimes HIV negative men and HIV positive men have knowingly fucked together and the HIV negative man has stayed HIV negative. Some of these HIV negative men even think they are immune to HIV. No one is immune to HIV. HIV only needs one opportunity to pass from one person to another, so the more opportunities you give, the more likely it is to happen. In other words, the more chances you take with your HIV status the higher the chances of you getting HIV. Just because something has happened to you once or twice or even many times before, doesn’t mean the same thing will happen each time in the future. So the more you fuck without condoms and the more men you fuck with, the more likely it is you will get and/or pass on HIV.


Read more on the Cruising site.

Multiple partners and multiple risks: exploring sexual concurrency

[via the San Francisco AIDS Foundation series of podcasts - this one is really fantastic and definitely worth 8 minutes of your attention!]

In this episode, Professor Gary Dowsett, deputy director at the Australian Research Centre in Sex, Health and Society at La Trobe University in Victoria, Australia, talks about concurrency, a term used to describe sexual relationships with multiple partners, in HIV prevention. Research shows that this practice is a factor in many new HIV infections, but effective interventions may include embracing-not rejecting-some of the structures that surround cultures with multiple sexual partnerships including gay men.

Listen to SFAF.org Podcast #38 - Exploring sexual concurrency: multiple partners and multiple risks. (8 minutes)

Professor Gary Dowsett, PhD, is a part of the Gender, Sexuality, and HIV Research Network recently launched by the San Francisco AIDS Foundation and the International Center for Research on Women, with support from the International AIDS Society and the Ford Foundation. One of the goals of this network is to identify gaps and priorities in HIV research, such as that on concurrency, and then to be able to develop effective program and policy responses appropriate to different communities and settings. Professor Dowsett is also an associate professor of clinical sociomedical sciences at Columbia University in New York, where he taught in the Department of Sociomedical Sciences and working with the HIV Center for Clinical and Behavioral Studies. A sociologist by trade, he has long been interested in sexuality research, particularly in relation to the rise of modern gay communities. Since 1986, he has been researching the HIV epidemic particularly in Australia's gay communities and has worked on many international HIV/AIDS and sexual health projects since the late 1980s.

The SFAF.org podcast gives you concise biweekly updates on current HIV/AIDS topics from our experts in policy, treatment and prevention. If you need podcast help or would like to subscribe to the podcast through iTunes or another program, please visit the SFAF Podcast web site.