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"Sex Acts and Facts: The Risks"

(An excerpt from Men Like Us, pages 66-68)


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Riskier Business

HIV is a lot less easily transmitted than viruses such as hepatitis B. As a consequence, getting a positive man's cum inside you doesn't always mean turning HIV-positive. Though the science is weak, guesstimates about the risk of getting HIV from unprotected sex with someone who is HIV-positive range wildly, from 3 in 10 to 1 in 1,600.

Whether or not you get infected depends on three things:

  1. The amount of HIV that gets in (it's not just how much someone comes -- people have more virus in their cum or blood at different times).

  2. How strong the HIV is and what fluid it's in. Some strains of HIV seem to be more infectious, and unless you have an STD in your penis, blood usually carries higher concentrations of HIV than semen.

  3. The ease with which that fluid can get to the bloodstream. The membranes of the rectum, say, pass the virus into the bloodstream more easily than the membranes of the mouth.

Researchers call this "Q, Q, R" -- quantity, quality, and route of entry. Unless you're having sex in a lab, or with a lot of broken skin, only the last -- the route of entry -- is easy to control. But researchers do suspect that having oral or anal intercourse without condoms is more likely to transmit HIV if:

  • One of you has recently turned positive. HIV production is highest in the early stages, leaving newly infected people more likely to infect others.

  • One of you has an open sore or other broken skin on the parts of the body you use for sex. Getting semen on an open sore will let HIV into your bloodstream. If you have HIV and an STD, virus is often found in the liquid that comes from such sores.

  • One of you has a sexually transmitted disease in your penis, rectum, or throat. If you're HIV-positive, having an STD that irritates the urethra makes you shed more HIV into your cum, pre-cum, or the discharge caused by the STD. If you're HIV-negative, having an STD in your penis, throat, or rectum weakens your defenses and draws cells to that location that can in turn be infected with HIV more easily.

Last, a word for positive men: A number of men who are on anti-HIV medications and tracking their virus load are getting word that their virus is "undetectable." This does not mean that they have no virus in their bodies, but rather that their blood tests aren't showing HIV. Active HIV has been found in the semen of more than one man with "undetectable" virus in his blood. And remember, warns Ken Mayer, M.D., director of Brown University's AIDS program, that virus levels can change from the time someone got their last test results. "We simply don't know enough to say that very low viral loads mean no danger of transmission," says Mayer. Finally, the fact that you're positive does not mean you no longer have to worry about whether you get more HIV in your body.

Safer Fisting

If you are going to practice something as risky as fisting, experienced handballers offer the following advice:

  • Use latex gloves, or even double gloves if you need to. Even a callus on your hand can be uncomfortable for the bottom. Keep spare gloves handy in case you need to change.

  • Use Crisco or oil-based lube. Even though oil-based lube is usually not the best choice for anal play, in this case you need more lube, and wetter lube, than most water-based products can provide. The thicker latex of gloves is less easily worn away than condoms, so they are not likely to break during fisting.

  • Don't let yourself be fisted by someone inexperienced.

  • Clean out beforehand. Many men who get fisted go on special diets for several days before, and douche.

  • Bring a series of dildos of graduated sizes, and make sure he uses them. It's not about getting there all at once.

  • Reserve the right to stop.

  • Be careful about being too high or drunk to know or say when you're in pain.

  • If you have any follow-up pain, fever, or bleeding, seek medical attention immediately.

Excerpted from Men Like Us: The GMHC Complete Guide to Gay Men's Sexual, Physical, and Emotional Well-Being by Daniel Wolfe. Copyright © 2000 by Daniel Wolfe. Excerpted by permission of Del Rey, a division of Random House, Inc. All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.

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This article was provided by Random House, Inc.. It is a part of the publication Men Like Us: The GMHC Complete Guide to Gay Men's Sexual, Physical, and Emotional Well-Being.
See Also
More Safer Sex Guides and Information
Safer Sex for the HIV Positive
Quiz: Are You at Risk for HIV?
10 Common Fears About HIV Transmission


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