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SEX SEX staying in control of your sex life, relationships and health


casual seX, fuck Buddies, Boyfriends… Whether you’re after a loving relationship or a night of passion, having sex can be liberating and fun. However, deciding your boundaries and staying safe is not always easy. When choosing sexual partners, some men select men with the same HIV status as themselves. This is sometimes called ‘sero-sorting’. Most gay men use condoms for fucking most of the time. However, when having sex with men they believe to have the same HIV status, some men don’t. This is not a reliable way to prevent the transmission of HIV. There is still no cure for HIV. It you catch the virus, it will have a signifi cant impact on your health and your life. Regardless of your HIV status, using condoms or not fucking are the most reliable ways to protect you and your partners from HIV and other sexually transmitted infections. You may have thought about not using condoms, perhaps because you believe that your partner has the same HIV status as you. This booklet will help you assess the risks. It will give you information on: ➤ Avoiding risks with casual partners and fuck buddies ➤ Coming up with a plan to stay safe in relationships ➤ Staying HIV-negative ➤ Looking after your health and the health of your partners if you are HIV-positive ➤ Talking openly about safer sex with your partners 2 let’s talk sex

contents

hiV-negatiVe?

Love and sex Tips for HIV-negative men in relationships

4-11

Casual sex Tips for HIV-negative men with casual partners

12-19

HIV-negative? Information on testing and knowing your HIV status

20-25

hiV-positiVe?

Being positive Information to help you stay healthy

26-33

Love and sex Tips for HIV-positive men in relationships

34-37

Casual sex Tips for HIV-positive men with casual partners

38-43

further information:

Needs discussion Meeting places for sex

44-49

Staying in control Coping with high risk situations

50-53

Help and support Where can I get more information?

54-56 let’s talk sex 3


casual seX, fuck Buddies, Boyfriends… Whether you’re after a loving relationship or a night of passion, having sex can be liberating and fun. However, deciding your boundaries and staying safe is not always easy. When choosing sexual partners, some men select men with the same HIV status as themselves. This is sometimes called ‘sero-sorting’. Most gay men use condoms for fucking most of the time. However, when having sex with men they believe to have the same HIV status, some men don’t. This is not a reliable way to prevent the transmission of HIV. There is still no cure for HIV. It you catch the virus, it will have a signifi cant impact on your health and your life. Regardless of your HIV status, using condoms or not fucking are the most reliable ways to protect you and your partners from HIV and other sexually transmitted infections. You may have thought about not using condoms, perhaps because you believe that your partner has the same HIV status as you. This booklet will help you assess the risks. It will give you information on: ➤ Avoiding risks with casual partners and fuck buddies ➤ Coming up with a plan to stay safe in relationships ➤ Staying HIV-negative ➤ Looking after your health and the health of your partners if you are HIV-positive ➤ Talking openly about safer sex with your partners 2 let’s talk sex

contents

hiV-negatiVe?

Love and sex Tips for HIV-negative men in relationships

4-11

Casual sex Tips for HIV-negative men with casual partners

12-19

HIV-negative? Information on testing and knowing your HIV status

20-25

hiV-positiVe?

Being positive Information to help you stay healthy

26-33

Love and sex Tips for HIV-positive men in relationships

34-37

Casual sex Tips for HIV-positive men with casual partners

38-43

further information:

Needs discussion Meeting places for sex

44-49

Staying in control Coping with high risk situations

50-53

Help and support Where can I get more information?

54-56 let’s talk sex 3


loVe and seX

tips for hiV-negatiVe men in relationships Some men in a long-term relationship choose not to use condoms when they have sex with their boyfriend. If you’ve chosen not to use condoms, be warned, there are lots of risks involved with this. There are ways of reducing the risk of passing on HIV but they won’t necessarily be as reliable as using condoms.

roughly a third of gay men infected with HiV thought that it happened while having sex with a regular partner.1 this is often due to couples abandoning condoms without being certain that both partners are HiV-negative.

HaVinG a plan It will help you to stay safe if you come up with a plan fi rst. This could include how to cope with slip-ups and what your boundaries are for having 4 let’s talk sex

sex with other guys. The fi rst step is to have the right facts. So before you

go ahead, you need to be sure that you are both HIVnegative. If either of you has never tested, or if you have taken any sexual risks (such as fucking without condoms) since your last test, you should go for an HIV test to avoid any

doubt about your HIV status.

MakinG an aGreeMent The decision to abandon condoms in a relationship can be tricky. There are lots of things to think about and you both need to be happy with the decision, without either let’s talk sex 5


loVe and seX

tips for hiV-negatiVe men in relationships Some men in a long-term relationship choose not to use condoms when they have sex with their boyfriend. If you’ve chosen not to use condoms, be warned, there are lots of risks involved with this. There are ways of reducing the risk of passing on HIV but they won’t necessarily be as reliable as using condoms.

roughly a third of gay men infected with HiV thought that it happened while having sex with a regular partner.1 this is often due to couples abandoning condoms without being certain that both partners are HiV-negative.

HaVinG a plan It will help you to stay safe if you come up with a plan fi rst. This could include how to cope with slip-ups and what your boundaries are for having 4 let’s talk sex

sex with other guys. The fi rst step is to have the right facts. So before you

go ahead, you need to be sure that you are both HIVnegative. If either of you has never tested, or if you have taken any sexual risks (such as fucking without condoms) since your last test, you should go for an HIV test to avoid any

doubt about your HIV status.

MakinG an aGreeMent The decision to abandon condoms in a relationship can be tricky. There are lots of things to think about and you both need to be happy with the decision, without either let’s talk sex 5


of you feeling under pressure. A healthy relationship is based on mutual trust and respect. We’re all responsible for our own health and the health of our partners. So as part of the plan, you should agree whether you are both going to be monogamous or have sex with other guys. Either way, you need to be able to trust each other so neither of you has unprotected sex with other partners. Talking openly with each other can help build and strengthen this trust. Many men stick to their agreement with their boyfriend. Some men don’t. It can take just one slip-up in the heat of the moment to put you both at risk.

if you don’t use condoms in your relationship, you could still get infected with HiV if there is any chance of either of you catching the virus from other guys.

Think about how you might cope if you or your boyfriend made a mistake. It is not easy to own up to this. But if you have an honest discussion with each other about how you

taking an HiV test with your partner shows a level of commitment and care towards each other. For more information on testing, go to page 20.

6 let’s talk sex

will both address it before you ditch the condoms, it will make it a lot easier to get back on track if it ever happens.

tHe risk OF stis If you and your boyfriend have agreed to have an open relationship, there is an increased risk of you catching other sexually transmitted

infections (STIs). Many STIs are more infectious than HIV. You can catch STIs such as chlamydia, gonorrhoea and syphilis through cock sucking or rimming, as well from fucking without condoms. You might then pass these on to your partner. It is a good idea to go for regular check-ups to test for STIs as part of your plan.

HOW did tHat Happen? Maybe you have had sex without condoms with your boyfriend on the spur of the moment. Maybe you’ve done this several times, yet you haven’t had a chance to talk to each other about it properly. If this has happened to let’s talk sex 7


of you feeling under pressure. A healthy relationship is based on mutual trust and respect. We’re all responsible for our own health and the health of our partners. So as part of the plan, you should agree whether you are both going to be monogamous or have sex with other guys. Either way, you need to be able to trust each other so neither of you has unprotected sex with other partners. Talking openly with each other can help build and strengthen this trust. Many men stick to their agreement with their boyfriend. Some men don’t. It can take just one slip-up in the heat of the moment to put you both at risk.

if you don’t use condoms in your relationship, you could still get infected with HiV if there is any chance of either of you catching the virus from other guys.

Think about how you might cope if you or your boyfriend made a mistake. It is not easy to own up to this. But if you have an honest discussion with each other about how you

taking an HiV test with your partner shows a level of commitment and care towards each other. For more information on testing, go to page 20.

6 let’s talk sex

will both address it before you ditch the condoms, it will make it a lot easier to get back on track if it ever happens.

tHe risk OF stis If you and your boyfriend have agreed to have an open relationship, there is an increased risk of you catching other sexually transmitted

infections (STIs). Many STIs are more infectious than HIV. You can catch STIs such as chlamydia, gonorrhoea and syphilis through cock sucking or rimming, as well from fucking without condoms. You might then pass these on to your partner. It is a good idea to go for regular check-ups to test for STIs as part of your plan.

HOW did tHat Happen? Maybe you have had sex without condoms with your boyfriend on the spur of the moment. Maybe you’ve done this several times, yet you haven’t had a chance to talk to each other about it properly. If this has happened to let’s talk sex 7


you, now is a good time to discuss how to protect each other. By agreeing a plan, going back to using condoms, or getting tested for HIV and deciding boundaries, you can be more confi dent about keeping each other safe.

reVieWinG YOur deCisiOn If you’re uncertain that you have made the correct decision, remember that you have a right to change your mind and start using condoms again.

Condoms or not fucking are the most effective ways of preventing the transmission of HiV. if you fuck without condoms with your boyfriend, there are ways of reducing the risk of HiV being passed on – such as going for an HiV test to be certain you are both negative – but these ways are not as reliable as using condoms. it’s best to return to using condoms if you ever doubt whether the sex you have is safe.

planninG tO be saFe. think it through – is ditching condoms something you both want to do and have you thought about the risks involved? Have a plan – if you’ve got into the habit of not using condoms, or you’re thinking about it, come up with some rules to stay safe. know your facts – it’s possible to make the wrong assumptions about your HiV status. Get tested – the only way to be sure of your status if you’ve taken risks since your last HiV-negative test result is to get another HiV test. 8 let’s talk sex

I’m in an open relationship. We tested together and now we don’t use condoms, but we’ve agreed that if one of us makes a mistake outside the relationship, we’ll be honest, ‘fess up and go back to using condoms.

Make an agreement – make a joint decision about whether you’re in an open or monogamous relationship and support each other in sticking to it. know the risks – even if you are both HiV-negative, sex without condoms leaves you more vulnerable to stis. review your decision – you can always change your mind so keep talking openly with each other to make sure you’re both happy with your decision. Have a back-up plan – if you doubt your decision, your HiV status, or the HiV status of your boyfriend, using condoms is the safest option. let’s talk sex 9


you, now is a good time to discuss how to protect each other. By agreeing a plan, going back to using condoms, or getting tested for HIV and deciding boundaries, you can be more confi dent about keeping each other safe.

reVieWinG YOur deCisiOn If you’re uncertain that you have made the correct decision, remember that you have a right to change your mind and start using condoms again.

Condoms or not fucking are the most effective ways of preventing the transmission of HiV. if you fuck without condoms with your boyfriend, there are ways of reducing the risk of HiV being passed on – such as going for an HiV test to be certain you are both negative – but these ways are not as reliable as using condoms. it’s best to return to using condoms if you ever doubt whether the sex you have is safe.

planninG tO be saFe. think it through – is ditching condoms something you both want to do and have you thought about the risks involved? Have a plan – if you’ve got into the habit of not using condoms, or you’re thinking about it, come up with some rules to stay safe. know your facts – it’s possible to make the wrong assumptions about your HiV status. Get tested – the only way to be sure of your status if you’ve taken risks since your last HiV-negative test result is to get another HiV test. 8 let’s talk sex

I’m in an open relationship. We tested together and now we don’t use condoms, but we’ve agreed that if one of us makes a mistake outside the relationship, we’ll be honest, ‘fess up and go back to using condoms.

Make an agreement – make a joint decision about whether you’re in an open or monogamous relationship and support each other in sticking to it. know the risks – even if you are both HiV-negative, sex without condoms leaves you more vulnerable to stis. review your decision – you can always change your mind so keep talking openly with each other to make sure you’re both happy with your decision. Have a back-up plan – if you doubt your decision, your HiV status, or the HiV status of your boyfriend, using condoms is the safest option. let’s talk sex 9


My boyfriend and I tested negative together. We waited three months and retested, just to be absolutely sure. Now we fuck each other without condoms. We’re monogamous so it’s great not to have to worry about HIV any more.

With my ex-boyfriend, we were both keen to be monogamous. After a few months we did the ‘going for HIV tests together’ thing and stopped using condoms. Then I had a few too many drinks and went home with another guy. We used a condom but I couldn’t tell my boyfriend I’d slept with someone else because he might not’ve trusted me again. That only happened once in the three years we were together but it made me realise how hard it is to be 100% monogamous – and how diffi cult it can be to talk about it when something goes wrong.

10 let’s talk sex

I’m really not sure about this idea of my boyfriend’s to stop using condoms. I know we are a couple and I trust him, but we aren’t exactly monogamous.

Falling in love isn’t enough. I’d have to know for certain that my boyfriend and I are both negative by taking an HIV test together and I’d have to be able to discuss with him if I screw up. And I have to know that he is able to do the same.

let’s talk sex 11


My boyfriend and I tested negative together. We waited three months and retested, just to be absolutely sure. Now we fuck each other without condoms. We’re monogamous so it’s great not to have to worry about HIV any more.

With my ex-boyfriend, we were both keen to be monogamous. After a few months we did the ‘going for HIV tests together’ thing and stopped using condoms. Then I had a few too many drinks and went home with another guy. We used a condom but I couldn’t tell my boyfriend I’d slept with someone else because he might not’ve trusted me again. That only happened once in the three years we were together but it made me realise how hard it is to be 100% monogamous – and how diffi cult it can be to talk about it when something goes wrong.

10 let’s talk sex

I’m really not sure about this idea of my boyfriend’s to stop using condoms. I know we are a couple and I trust him, but we aren’t exactly monogamous.

Falling in love isn’t enough. I’d have to know for certain that my boyfriend and I are both negative by taking an HIV test together and I’d have to be able to discuss with him if I screw up. And I have to know that he is able to do the same.

let’s talk sex 11


casual seX tips for hiV-negatiVe men with casual partners In most cases, when we have sex with someone new, we don’t know their HIV status. However, some HIVnegative men think they are being safe by having sex without condoms with guys they think are also HIV-negative. For HIV to be transmitted sexually, one of the partners must be HIV-positive. If everyone only had sex with people who had the same HIV status as them, then there would be no increase in the number of people with sexually transmitted HIV. However, if you have sex without condoms with a casual partner, even if you think he 12 let’s talk sex

is HIV-negative, you could be putting yourself at risk. Around 40% of HIV-negative men who say they ‘know’ their partner’s HIV status are in fact guessing.2

let’s talk sex 13


casual seX tips for hiV-negatiVe men with casual partners In most cases, when we have sex with someone new, we don’t know their HIV status. However, some HIVnegative men think they are being safe by having sex without condoms with guys they think are also HIV-negative. For HIV to be transmitted sexually, one of the partners must be HIV-positive. If everyone only had sex with people who had the same HIV status as them, then there would be no increase in the number of people with sexually transmitted HIV. However, if you have sex without condoms with a casual partner, even if you think he 12 let’s talk sex

is HIV-negative, you could be putting yourself at risk. Around 40% of HIV-negative men who say they ‘know’ their partner’s HIV status are in fact guessing.2

let’s talk sex 13


assuMptiOns

Sex with my buddy is fantastic. I know he wants to fuck me bare but I’m really not sure I can trust him enough to keep me safe.

Many HIV-negative men believe that if someone is willing to have unprotected sex with them, they will also be HIV-negative. But many HIV-positive men believe that if someone is willing to have unprotected sex with them,

it’s because they are also HIV-positive. If a guy you have sex with doesn’t mention HIV, it doesn’t mean that he has the same HIV status as you. It just means he’s chosen not to talk about it. Even if he says he is HIV-

about three quarters of gay men expect HiV-positive men to disclose their status before sex.3 However, only one in five HiV-positive gay men always tell their casual partners that they have HiV.4 14 let’s talk sex

negative, remember that some men have HIV but don’t realise it. There are about 32,000 gay men with HIV in the Uk, with at least one in four of them unaware of their infection.5

or HIV-negative because you met them in a certain bar, or a sauna or backroom. However, because of advances in treatment, it is becoming increasingly rare that someone shows visible signs of HIV infection, such as facial wasting or the skin cancer kaposi’s Sarcoma. The majority of men in the Uk with HIV will probably not have any visible symptoms and so you will not be able to tell by looking at them.

HOW Can YOu tell? It’s easy to make assumptions about someone’s HIV status based on where you meet them. You might think a guy is more likely to be HIV-positive

FuCk buddies If you meet a guy regularly for sex, you may have a different view on how safe your sex is. The rules that work for sex let’s talk sex 15


assuMptiOns

Sex with my buddy is fantastic. I know he wants to fuck me bare but I’m really not sure I can trust him enough to keep me safe.

Many HIV-negative men believe that if someone is willing to have unprotected sex with them, they will also be HIV-negative. But many HIV-positive men believe that if someone is willing to have unprotected sex with them,

it’s because they are also HIV-positive. If a guy you have sex with doesn’t mention HIV, it doesn’t mean that he has the same HIV status as you. It just means he’s chosen not to talk about it. Even if he says he is HIV-

about three quarters of gay men expect HiV-positive men to disclose their status before sex.3 However, only one in five HiV-positive gay men always tell their casual partners that they have HiV.4 14 let’s talk sex

negative, remember that some men have HIV but don’t realise it. There are about 32,000 gay men with HIV in the Uk, with at least one in four of them unaware of their infection.5

or HIV-negative because you met them in a certain bar, or a sauna or backroom. However, because of advances in treatment, it is becoming increasingly rare that someone shows visible signs of HIV infection, such as facial wasting or the skin cancer kaposi’s Sarcoma. The majority of men in the Uk with HIV will probably not have any visible symptoms and so you will not be able to tell by looking at them.

HOW Can YOu tell? It’s easy to make assumptions about someone’s HIV status based on where you meet them. You might think a guy is more likely to be HIV-positive

FuCk buddies If you meet a guy regularly for sex, you may have a different view on how safe your sex is. The rules that work for sex let’s talk sex 15


Condoms or not fucking are the most effective ways of preventing the transmission of HiV. if you fuck without condoms, there are things you can do to reduce the risk of HiV being passed on, but they will not be as reliable as using condoms. the more often that someone is exposed to HiV, the more likely it is that they will become infected with HiV. with a complete stranger or for a relationship might not be right for this situation. If you have or are thinking of having sex without condoms with a guy you regularly meet for sex, can you really be sure that he is HIV-negative? He may not be aware that he is HIVpositive, or he may have chosen to keep his positive status from you. Maybe the arrangement is

turning into something more. This can be great – many relationships start out this way. However, staying safe while not using condoms with an HIV-negative partner requires trust. You can build trust by being honest and talking openly with each other about the sex you have. Be honest with yourself – does this trust exist between you and a guy who you meet for sex?

tHinGs tO tHink abOut. if someone you’re going to have sex with doesn’t mention HiV, it doesn’t mean that he has the same HiV status as you. How a guy looks or acts, or where he hangs out, is no indication of his HiV status. ditching condoms and still staying HiV-negative requires trust, which may not exist between fuck buddies. 16 let’s talk sex

WHO’s respOnsible? Both HIV-positive and HIVnegative men are equally responsible for the sex they have together. Men who know they are HIV-positive have responsibility because they are aware they can pass on the virus and have the power to stop this happening. Negative men have a responsibility to look after their own health. Men who are not sure of their HIV status have a responsibility to ensure that their behaviour does not endanger themselves or their partner. Just because your partner does not disclose his status, it does not mean the responsibility to stay safe belongs solely to

him. It also does not mean the responsibility lies solely with you. Everyone, regardless of their HIV status, should take responsibility for safer sex.

some guys don’t realise they are HiV-positive. Most guys don’t disclose their HiV status. using condoms if you fuck is the most reliable way to protect you and your partners from HiV. You don’t have to fuck. sticking to sucking cock, wanking each other, or having less sex are all ways to reduce the risk of HiV transmission.

let’s talk sex 17


Condoms or not fucking are the most effective ways of preventing the transmission of HiV. if you fuck without condoms, there are things you can do to reduce the risk of HiV being passed on, but they will not be as reliable as using condoms. the more often that someone is exposed to HiV, the more likely it is that they will become infected with HiV. with a complete stranger or for a relationship might not be right for this situation. If you have or are thinking of having sex without condoms with a guy you regularly meet for sex, can you really be sure that he is HIV-negative? He may not be aware that he is HIVpositive, or he may have chosen to keep his positive status from you. Maybe the arrangement is

turning into something more. This can be great – many relationships start out this way. However, staying safe while not using condoms with an HIV-negative partner requires trust. You can build trust by being honest and talking openly with each other about the sex you have. Be honest with yourself – does this trust exist between you and a guy who you meet for sex?

tHinGs tO tHink abOut. if someone you’re going to have sex with doesn’t mention HiV, it doesn’t mean that he has the same HiV status as you. How a guy looks or acts, or where he hangs out, is no indication of his HiV status. ditching condoms and still staying HiV-negative requires trust, which may not exist between fuck buddies. 16 let’s talk sex

WHO’s respOnsible? Both HIV-positive and HIVnegative men are equally responsible for the sex they have together. Men who know they are HIV-positive have responsibility because they are aware they can pass on the virus and have the power to stop this happening. Negative men have a responsibility to look after their own health. Men who are not sure of their HIV status have a responsibility to ensure that their behaviour does not endanger themselves or their partner. Just because your partner does not disclose his status, it does not mean the responsibility to stay safe belongs solely to

him. It also does not mean the responsibility lies solely with you. Everyone, regardless of their HIV status, should take responsibility for safer sex.

some guys don’t realise they are HiV-positive. Most guys don’t disclose their HiV status. using condoms if you fuck is the most reliable way to protect you and your partners from HiV. You don’t have to fuck. sticking to sucking cock, wanking each other, or having less sex are all ways to reduce the risk of HiV transmission.

let’s talk sex 17


Using a condom when I have casual sex and not getting HIV means that I can have unprotected sex with the person that I fall in love with and can trust, if he’s also negative.

I hate condoms so I’ve often been tempted to get one of my casual buddies to fuck me without a condom but I have to be honest with myself. Do I really know about what he gets up to with other men? I guess not, so I’ve decided I’d really rather not take the risk.

18 let’s talk sex

At the moment, I’m having a lot of casual sex with guys I meet online. I use condoms every time so I don’t have to worry about HIV and other STIs, and can just enjoy all the sex I’m getting.

let’s talk sex 19


Using a condom when I have casual sex and not getting HIV means that I can have unprotected sex with the person that I fall in love with and can trust, if he’s also negative.

I hate condoms so I’ve often been tempted to get one of my casual buddies to fuck me without a condom but I have to be honest with myself. Do I really know about what he gets up to with other men? I guess not, so I’ve decided I’d really rather not take the risk.

18 let’s talk sex

At the moment, I’m having a lot of casual sex with guys I meet online. I use condoms every time so I don’t have to worry about HIV and other STIs, and can just enjoy all the sex I’m getting.

let’s talk sex 19


hiVnegatiVe? If you have received an HIVnegative test result, you’ll know how reassuring it can be to be certain of your HIV status. You can make more informed decisions about your future, your relationships and the sex you have.

However, even if you tested recently, there’s no guarantee the next result will be negative if you put yourself at risk. If you have sex without condoms – even if you think the guy you have sex with is HIV-negative – you could be exposing yourself to HIV. It’s important to know how to keep yourself negative.

there’s a booklet from GMFa called tested negative? which can help you with this. it is available for free from Gu clinics in london or can be downloaded at www.gmfa.org.uk/ staynegative.

If you have never tested specifi cally for HIV, or have taken any sexual risks (such as fucking without condoms) since your last HIV-negative test result, you should go for a test to be sure of your HIV status. Going for an HIV test can be stressful for many of us. But

in tHe knOW

20 let’s talk sex

By the time I went for the test, I was convinced I was positive. Getting a negative test result gave me the kick up the backside that I needed to keep using condoms.

I tested positive over a year ago. I realise now that if I hadn’t gone, I’d still be positive. I’d just be in a worse situation, not knowing and so not being able to deal with it. let’s talk sex 21


hiVnegatiVe? If you have received an HIVnegative test result, you’ll know how reassuring it can be to be certain of your HIV status. You can make more informed decisions about your future, your relationships and the sex you have.

However, even if you tested recently, there’s no guarantee the next result will be negative if you put yourself at risk. If you have sex without condoms – even if you think the guy you have sex with is HIV-negative – you could be exposing yourself to HIV. It’s important to know how to keep yourself negative.

there’s a booklet from GMFa called tested negative? which can help you with this. it is available for free from Gu clinics in london or can be downloaded at www.gmfa.org.uk/ staynegative.

If you have never tested specifi cally for HIV, or have taken any sexual risks (such as fucking without condoms) since your last HIV-negative test result, you should go for a test to be sure of your HIV status. Going for an HIV test can be stressful for many of us. But

in tHe knOW

20 let’s talk sex

By the time I went for the test, I was convinced I was positive. Getting a negative test result gave me the kick up the backside that I needed to keep using condoms.

I tested positive over a year ago. I realise now that if I hadn’t gone, I’d still be positive. I’d just be in a worse situation, not knowing and so not being able to deal with it. let’s talk sex 21


it’s worth remembering that not going won’t change your HIV status – it just means you won’t know what it is.

tHe beneFits OF CertaintY There are lots of benefi ts to knowing your HIV status. For many of us, the biggest benefi t is peace of mind. If you test negative, you can stop worrying about the unknown. You might also fi nd it easier to commit to protecting yourself in the future. For some men, the greatest benefi t is being able to have sex without condoms with their boyfriend and being confi dent that they won’t infect them. If you have sex without condoms with your boyfriend and you’re both HIV-negative, there is no chance of either of you contracting HIV from each other. However, there are lots of other things you need to think about to stay safe – such as whether there is any risk of 22 let’s talk sex

either of you getting HIV from outside of the relationship. Turn to page 4 for information to help you to protect you and your partner. Over a quarter of gay men with HIV don’t know they have it.6 If you are HIV-positive but don’t test, you will have to deal with it eventually - probably when you become ill. It will be more diffi cult to deal with learning you have HIV if you are ill already.

HOW OFten tO test It is recommended that you take an HIV test at least once a year if you’re sexually active. This may vary depending on the type of sex you have. If you only have one partner who you know is HIV-negative, then testing regularly may be less important to you. If you are having sex with lots of different partners, you may want to test more frequently. If you’ve tested negative in

around 90% of gay men in london who are unsure of their HiV status are actually HiV-negative.7 the only way you can know for sure is to get tested. the past, it doesn’t mean you can never get HIV. If you have risky sex, you will need to test again to know if you have been infected.

tHe diFFerent HiV tests aVailable If you go for a sexual health check-up, most clinics now include an HIV test on an ‘opt out’ basis – they tell you they’re doing an HIV test and you have an option to decline – rather than you asking for one yourself. Some clinics have more than one type of test available, but not

all clinics offer all types of test. To use the right test, the clinic needs to know how long it’s been since you were last at risk of getting HIV (the last time you took a sexual risk, such as fucking without condoms). It doesn’t necessarily take three months to get an accurate test so it is worth getting tested if your risk was more recent. Some tests can detect if someone has HIV two to four weeks after being infected. Ask your clinic if you are unclear or want to know more about the test you are being let’s talk sex 23


it’s worth remembering that not going won’t change your HIV status – it just means you won’t know what it is.

tHe beneFits OF CertaintY There are lots of benefi ts to knowing your HIV status. For many of us, the biggest benefi t is peace of mind. If you test negative, you can stop worrying about the unknown. You might also fi nd it easier to commit to protecting yourself in the future. For some men, the greatest benefi t is being able to have sex without condoms with their boyfriend and being confi dent that they won’t infect them. If you have sex without condoms with your boyfriend and you’re both HIV-negative, there is no chance of either of you contracting HIV from each other. However, there are lots of other things you need to think about to stay safe – such as whether there is any risk of 22 let’s talk sex

either of you getting HIV from outside of the relationship. Turn to page 4 for information to help you to protect you and your partner. Over a quarter of gay men with HIV don’t know they have it.6 If you are HIV-positive but don’t test, you will have to deal with it eventually - probably when you become ill. It will be more diffi cult to deal with learning you have HIV if you are ill already.

HOW OFten tO test It is recommended that you take an HIV test at least once a year if you’re sexually active. This may vary depending on the type of sex you have. If you only have one partner who you know is HIV-negative, then testing regularly may be less important to you. If you are having sex with lots of different partners, you may want to test more frequently. If you’ve tested negative in

around 90% of gay men in london who are unsure of their HiV status are actually HiV-negative.7 the only way you can know for sure is to get tested. the past, it doesn’t mean you can never get HIV. If you have risky sex, you will need to test again to know if you have been infected.

tHe diFFerent HiV tests aVailable If you go for a sexual health check-up, most clinics now include an HIV test on an ‘opt out’ basis – they tell you they’re doing an HIV test and you have an option to decline – rather than you asking for one yourself. Some clinics have more than one type of test available, but not

all clinics offer all types of test. To use the right test, the clinic needs to know how long it’s been since you were last at risk of getting HIV (the last time you took a sexual risk, such as fucking without condoms). It doesn’t necessarily take three months to get an accurate test so it is worth getting tested if your risk was more recent. Some tests can detect if someone has HIV two to four weeks after being infected. Ask your clinic if you are unclear or want to know more about the test you are being let’s talk sex 23


given or the window period. For more information on testing, visit www.gmfa.org. uk/testing. Even if you use condoms things can go wrong, such as a condom breaking. If this happens to you, or you make a mistake and take a risk, you need to know about PEP (Post Exposure Prophylaxis). This is a course of HIV medication which you can take if you have been at risk of infection. The course lasts about 28 days and, if taken within 72 hours of the risk taking place, may be able to

I hadn’t tested for seven years as I’d always used condoms. Then I started thinking about all the little things, like when a condom broke or I was too out of it to know what I’d done. Now I’ve tested negative, it’s a huge relief. prevent you from becoming infected with HIV. However, PEP is not a substitute for condoms and there is no guarantee it will work. For more information, visit, www.gmfa. org.uk/pep.

tHinGs tO tHink abOut.

Over a quarter of gay men with HiV are not aware of their infection. knowing your HiV status puts you in control.

Most men who aren’t sure of their status are HiV-negative. if you don’t use condoms with your boyfriend, taking an HiV test is the only way to be sure you are HiV-negative. using condoms or not fucking remain the most reliable ways to avoid getting HiV. 24 let’s talk sex

I tested positive over a year ago. Testing negative made I realise now that if I me realise I could stay hadn’t gone, I’d still be negative and that positive. I’d just be in I was able to keep myself a worse situation, not being able HIV-negative. to deal with it.

let’s talk sex 25


given or the window period. For more information on testing, visit www.gmfa.org. uk/testing. Even if you use condoms things can go wrong, such as a condom breaking. If this happens to you, or you make a mistake and take a risk, you need to know about PEP (Post Exposure Prophylaxis). This is a course of HIV medication which you can take if you have been at risk of infection. The course lasts about 28 days and, if taken within 72 hours of the risk taking place, may be able to

I hadn’t tested for seven years as I’d always used condoms. Then I started thinking about all the little things, like when a condom broke or I was too out of it to know what I’d done. Now I’ve tested negative, it’s a huge relief. prevent you from becoming infected with HIV. However, PEP is not a substitute for condoms and there is no guarantee it will work. For more information, visit, www.gmfa. org.uk/pep.

tHinGs tO tHink abOut.

Over a quarter of gay men with HiV are not aware of their infection. knowing your HiV status puts you in control.

Most men who aren’t sure of their status are HiV-negative. if you don’t use condoms with your boyfriend, taking an HiV test is the only way to be sure you are HiV-negative. using condoms or not fucking remain the most reliable ways to avoid getting HiV. 24 let’s talk sex

I tested positive over a year ago. Testing negative made I realise now that if I me realise I could stay hadn’t gone, I’d still be negative and that positive. I’d just be in I was able to keep myself a worse situation, not being able HIV-negative. to deal with it.

let’s talk sex 25


Being positiVe information to help you stay healthy If you know that you are HIVpositive, you can make informed decisions about protecting yourself and your sexual partners. Being HIV-positive, you may think there is no need to protect yourself during sex as you’re already infected. You may also think that as long as you have sex with other men who are also HIV-positive, then you don’t need to use condoms when you fuck or get fucked. Some HIV-positive men choose to do this so 26 let’s talk sex

if you have unprotected sex you could be at risk of co-infection with another sti and possibly re-infection with a different strain of HiV. they can get the intimacy associated with sex without condoms and not have to worry about infecting their partners. It can also remove the worry of being rejected based on HIV status. If men with HIV have unprotected sex only with

When I was fi rst diagnosed, I used to disclose to all my sex partners. After having one guy too many freak out and leave, I’m sticking to other positive guys from now on.

let’s talk sex 27


Being positiVe information to help you stay healthy If you know that you are HIVpositive, you can make informed decisions about protecting yourself and your sexual partners. Being HIV-positive, you may think there is no need to protect yourself during sex as you’re already infected. You may also think that as long as you have sex with other men who are also HIV-positive, then you don’t need to use condoms when you fuck or get fucked. Some HIV-positive men choose to do this so 26 let’s talk sex

if you have unprotected sex you could be at risk of co-infection with another sti and possibly re-infection with a different strain of HiV. they can get the intimacy associated with sex without condoms and not have to worry about infecting their partners. It can also remove the worry of being rejected based on HIV status. If men with HIV have unprotected sex only with

When I was fi rst diagnosed, I used to disclose to all my sex partners. After having one guy too many freak out and leave, I’m sticking to other positive guys from now on.

let’s talk sex 27


ERGO is a health research organisation that would like to fi nd out more about readers of this booklet. The information gathered from this survey will help establish the types and levels of need gay men have in London in order to help plan the best and most useful HIV prevention services. The survey asks questions that highlight any needs that individuals personally might have for a range of information, advice, individual and group support services presently available. Please take a few minutes to complete the questionnaire, providing as much information as possible, and return it by post.

other positive men, it will not lead to new HIV infections. However, if you are HIVpositive and have had or are thinking of having sex without condoms, you should be aware that there are other risks involved for both you and your partners.

CO-inFeCtiOn Co-infection is having another infection as well as HIV. If you don’t use condoms, you have a greater risk of getting hepatitis and other STIs such as: syphilis gonorrhoea herpes HIV-positive men with a low CD4 count are more vulnerable to STIs.

CO-inFeCtiOn WitH Hepatitis Hepatitis is a general term referring to infl ammation of the liver. The most important types to be aware of are Hepatitis B (Hep B) and Hepatitis C (Hep C). Both can have a signifi cant impact on the

there has been a lot of debate about whether Hep C can be passed on through fucking without condoms with a man who has Hep C. some studies suggest that it can.8 also, HiV-positive men are more likely to catch Hep C during sex than men who are HiV-negative. 28 let’s talk sex

1. Please tell us how you got this copy of the booklet: Picked up in a GU clinic Picked up in a gay pub, club or bar Picked up in a sauna Downloaded from a GMFA website From a GMI Partnership health trainer From another HIV or sexual health service (please specify):

2. Please tell us briefly in your own words what specifically you have

learnt from this booklet:

3. How many times have you had the result of an HIV test in the last 12 months? None Once Twice 3 times 4 times 5 or more times 4. What do you believe your HIV status is? Defi nitely HIV-negative (I don’t have HIV) Continues over the page


ERGO is a health research organisation that would like to fi nd out more about readers of this booklet. The information gathered from this survey will help establish the types and levels of need gay men have in London in order to help plan the best and most useful HIV prevention services. The survey asks questions that highlight any needs that individuals personally might have for a range of information, advice, individual and group support services presently available. Please take a few minutes to complete the questionnaire, providing as much information as possible, and return it by post.

other positive men, it will not lead to new HIV infections. However, if you are HIVpositive and have had or are thinking of having sex without condoms, you should be aware that there are other risks involved for both you and your partners.

CO-inFeCtiOn Co-infection is having another infection as well as HIV. If you don’t use condoms, you have a greater risk of getting hepatitis and other STIs such as: syphilis gonorrhoea herpes HIV-positive men with a low CD4 count are more vulnerable to STIs.

CO-inFeCtiOn WitH Hepatitis Hepatitis is a general term referring to infl ammation of the liver. The most important types to be aware of are Hepatitis B (Hep B) and Hepatitis C (Hep C). Both can have a signifi cant impact on the

there has been a lot of debate about whether Hep C can be passed on through fucking without condoms with a man who has Hep C. some studies suggest that it can.8 also, HiV-positive men are more likely to catch Hep C during sex than men who are HiV-negative. 28 let’s talk sex

1. Please tell us how you got this copy of the booklet: Picked up in a GU clinic Picked up in a gay pub, club or bar Picked up in a sauna Downloaded from a GMFA website From a GMI Partnership health trainer From another HIV or sexual health service (please specify):

2. Please tell us briefly in your own words what specifically you have

learnt from this booklet:

3. How many times have you had the result of an HIV test in the last 12 months? None Once Twice 3 times 4 times 5 or more times 4. What do you believe your HIV status is? Defi nitely HIV-negative (I don’t have HIV) Continues over the page


Probably HIV-negative Not sure/don’t know Probably HIV-positive Definitely HIV-positive (I have HIV) I don’t want to say 5. And what is this belief based on? Please choose the option that most closely applies. I have tested HIV-positive I think I am HIV-positive although I have NOT had a positive test result I have tested HIV-negative and have NOT fucked or been fucked by ANYONE since my last negative test I have tested HIV-negative and have NOT fucked or been fucked EXCEPT WITH A REGULAR PARTNER since my last negative test I have tested HIV-negative but HAVE fucked or been fucked since my last negative test

I have never had an HIV test and I think I am HIV-negative because I have NEVER fucked or been fucked without condoms I have never had an HIV test and I think I am HIV-negative because I have ONLY RARELY fucked or been fucked without condoms I have never had an HIV test and I think I am HIV-negative because I have ONLY fucked or been fucked without condoms WITH A REGULAR PARTNER Other (please specify):

6. In the last 12 months, how many men have you fucked or been fucked by without using a condom?

None 1 2 3 or 4 5-29 30+ 7. Have you had a sexually transmitted infection (STI) in the last year? Yes No If yes, which of the following STIs have you had? (tick all that apply) Gonorrhoea Syphilis Chlamydia Other (please specify):

8. Some of the following statements are true and SOME ARE FALSE. For each of the following

please tick whether you think it is true (T) or false (F) or don’t know (?).

T F?

Most gay men with HIV get it through anal sex A properly used condom will normally protect you against HIV transmission A gay man who is HIV-positive would always tell me they have HIV before having sex without condoms You can’t get HIV if you are the active/ insertive partner in anal sex HIV can be passed on through anal sex even when no one cums Oil-based lubricant is safe to use with condoms for anal sex Continues over the page


Probably HIV-negative Not sure/don’t know Probably HIV-positive Definitely HIV-positive (I have HIV) I don’t want to say 5. And what is this belief based on? Please choose the option that most closely applies. I have tested HIV-positive I think I am HIV-positive although I have NOT had a positive test result I have tested HIV-negative and have NOT fucked or been fucked by ANYONE since my last negative test I have tested HIV-negative and have NOT fucked or been fucked EXCEPT WITH A REGULAR PARTNER since my last negative test I have tested HIV-negative but HAVE fucked or been fucked since my last negative test

I have never had an HIV test and I think I am HIV-negative because I have NEVER fucked or been fucked without condoms I have never had an HIV test and I think I am HIV-negative because I have ONLY RARELY fucked or been fucked without condoms I have never had an HIV test and I think I am HIV-negative because I have ONLY fucked or been fucked without condoms WITH A REGULAR PARTNER Other (please specify):

6. In the last 12 months, how many men have you fucked or been fucked by without using a condom?

None 1 2 3 or 4 5-29 30+ 7. Have you had a sexually transmitted infection (STI) in the last year? Yes No If yes, which of the following STIs have you had? (tick all that apply) Gonorrhoea Syphilis Chlamydia Other (please specify):

8. Some of the following statements are true and SOME ARE FALSE. For each of the following

please tick whether you think it is true (T) or false (F) or don’t know (?).

T F?

Most gay men with HIV get it through anal sex A properly used condom will normally protect you against HIV transmission A gay man who is HIV-positive would always tell me they have HIV before having sex without condoms You can’t get HIV if you are the active/ insertive partner in anal sex HIV can be passed on through anal sex even when no one cums Oil-based lubricant is safe to use with condoms for anal sex Continues over the page


You can always work out someone’s HIV status by how they look or what they say There is a course of medicine you can take immediately after exposure to HIV to lessen the chances of HIV infection

9. How do you feel about becoming/being HIV positive? For each statement below please say whether you agree (A) or disagree (D) or are not sure (?).

AD ?

I don’t think about it I don’t really care about what happens to me It’s just a matter of luck It’s too late for me to change anything

It’s not such a big deal any more I worry about it but it doesn’t stop me taking risks Other (please specify):

10. How do you feel about using condoms? For each statement below please say whether you agree (A) or disagree (D) or are not sure (?).

AD ?

I choose my partners carefully so I don’t need to use condoms each time Condoms don’t work for me Using condoms takes all the fun out of sex It’s not my job to look after other

people, it’s their look out Sometimes I don’t use them – I can’t help myself After sex (or the next day) I often experience guilt, shame or anxiety about the level of risk I took Other (please specify):

11. How often do you end up having anal sex without a condom after you have said to yourself you were not going to? I have not had anal sex without a condom since deciding not to [go to question 13] Once or twice ever Once or twice a year Every 2-3 months

Once a month or more I used to have sex without a condom but don’t any more I have never said to myself that I will not have anal sex without a condom

12. Thinking about when you have fucked without a condom in the last 12 months, which of the following factors played a part in your having anal sex without a condom? Please tick all that apply. I had been drinking I was using drugs I was very upset I was going through a bad time in my life I got carried away in the heat of the moment It felt better without a condom He didn’t want to use a condom and I went along with it I knew he had HIV Continues over the page


You can always work out someone’s HIV status by how they look or what they say There is a course of medicine you can take immediately after exposure to HIV to lessen the chances of HIV infection

9. How do you feel about becoming/being HIV positive? For each statement below please say whether you agree (A) or disagree (D) or are not sure (?).

AD ?

I don’t think about it I don’t really care about what happens to me It’s just a matter of luck It’s too late for me to change anything

It’s not such a big deal any more I worry about it but it doesn’t stop me taking risks Other (please specify):

10. How do you feel about using condoms? For each statement below please say whether you agree (A) or disagree (D) or are not sure (?).

AD ?

I choose my partners carefully so I don’t need to use condoms each time Condoms don’t work for me Using condoms takes all the fun out of sex It’s not my job to look after other

people, it’s their look out Sometimes I don’t use them – I can’t help myself After sex (or the next day) I often experience guilt, shame or anxiety about the level of risk I took Other (please specify):

11. How often do you end up having anal sex without a condom after you have said to yourself you were not going to? I have not had anal sex without a condom since deciding not to [go to question 13] Once or twice ever Once or twice a year Every 2-3 months

Once a month or more I used to have sex without a condom but don’t any more I have never said to myself that I will not have anal sex without a condom

12. Thinking about when you have fucked without a condom in the last 12 months, which of the following factors played a part in your having anal sex without a condom? Please tick all that apply. I had been drinking I was using drugs I was very upset I was going through a bad time in my life I got carried away in the heat of the moment It felt better without a condom He didn’t want to use a condom and I went along with it I knew he had HIV Continues over the page


We’ve both been tested for HIV and were negative I thought it would be Ok with this person He was worth it It was with a regular partner I never use condoms with A condom wasn’t available I was at a sauna, sex party or similar place In other circumstances (please specify):

13. In an average month, how many times do you have anal sex using a condom? None [go to question 15] Once Twice 3-10 times 11-20 times 21-30 times More than 30 times 14. In THE LAST 12 MONTHS how many times

have you had a condom break, slip or otherwise fail while you were using it for anal sex? Never Once Twice 3-5 times More than 5 times 15. Do you now feel that you need more information about any of the following? Please tick as many as apply. How HIV is transmitted Safer sex What to do after a possible exposure to HIV Advice on how to use condoms effectively Advice on how to use condoms consistently How to improve sexual choices Strategies for preventing HIV transmission How to cope with situations where you get carried away

How to get more control over the sex that you have None of the above Other [please specify]:

16. To what extent would you be interested in using any of the following HIV prevention or sexual health resources or services? Say whether you are not interested (N), possibly interested (P), or very interested (V).

NP V

Reading booklets

Reading leaflets

Website

Newsletter

Calling a helpline

Talking with another gay man who understands your situation

Talking with a trained professional

Having counselling

Talking with a group of gay men in the same situation as yourself

Having an HIV or other STI test Other (please specify):

17. After reading this booklet, do you feel you know more about any of the following? Answer a) Much more, b) A little more, c) No more.

AB C

How you can be sure of someone’ s HIV status The likelihood of a sexual partner disclosing his HIV status The risks of HIV transmission from having unprotected sex Continues over the page


We’ve both been tested for HIV and were negative I thought it would be Ok with this person He was worth it It was with a regular partner I never use condoms with A condom wasn’t available I was at a sauna, sex party or similar place In other circumstances (please specify):

13. In an average month, how many times do you have anal sex using a condom? None [go to question 15] Once Twice 3-10 times 11-20 times 21-30 times More than 30 times 14. In THE LAST 12 MONTHS how many times

have you had a condom break, slip or otherwise fail while you were using it for anal sex? Never Once Twice 3-5 times More than 5 times 15. Do you now feel that you need more information about any of the following? Please tick as many as apply. How HIV is transmitted Safer sex What to do after a possible exposure to HIV Advice on how to use condoms effectively Advice on how to use condoms consistently How to improve sexual choices Strategies for preventing HIV transmission How to cope with situations where you get carried away

How to get more control over the sex that you have None of the above Other [please specify]:

16. To what extent would you be interested in using any of the following HIV prevention or sexual health resources or services? Say whether you are not interested (N), possibly interested (P), or very interested (V).

NP V

Reading booklets

Reading leaflets

Website

Newsletter

Calling a helpline

Talking with another gay man who understands your situation

Talking with a trained professional

Having counselling

Talking with a group of gay men in the same situation as yourself

Having an HIV or other STI test Other (please specify):

17. After reading this booklet, do you feel you know more about any of the following? Answer a) Much more, b) A little more, c) No more.

AB C

How you can be sure of someone’ s HIV status The likelihood of a sexual partner disclosing his HIV status The risks of HIV transmission from having unprotected sex Continues over the page


The difference between undiagnosed and diagnosed HIV infection How STIs are transmitted HIV testing The meaning of a ‘window period’ prior to an HIV test

18. After reading this booklet, are you more likely to do any of the following? Answer a) Much more, b) A little more, c) No more.

ABC

Use condoms for sex Have an HIV test Go to a GUM clinic Discuss HIV status with sexual partners Use a GMFA website Go on a groupwork event

19. We also want to work out how many gay men are using HIV prevention

services and resources across London. Because you are likely to be invited to fill in more than one instance of this survey, we need to make sure that we don’t double count you when estimating levels of need and service use. To help us do this please give us the following information which we hope will create a unique code that you can remember but which can NOT be traced back to you. First two letters of your mother’s fi rst name The number of the day of the month you were born on First two letters of your own fi rst name When you have completed the questionnaire please post it to:

ERGO, Freepost ERGO Consulting No postcode or stamp is required. Many thanks.

you against Hep C.

health of HIV-positive men. Previously, Hep C was mainly seen in intravenous drug users who had been sharing needles and in people given blood transfusions with blood products infected with Hep C. However, there have been

a growing number of cases of Hep C infection in HIVpositive gay men. Hep C is a serious illness caused by a virus passed on through infected blood that attacks the liver. There is no vaccine available to protect

There are a number of ways that it is believed that Hep C can be transmitted through sex. These include: Being fi sted by a man with Hep C who has cuts or sores on his hand and isn’t wearing a glove or who has just fi sted another man who has Hep C. Being fucked without a condom by a man with Hep C or a man who has just fucked another man who has Hep C. Using a dildo or another sex toy that has just been used on a man with Hep C and which hasn’t been thoroughly cleaned, or had a new condom put on it. Sharing a pot of lube with a man with Hep C, as lube can be contaminated with blood. Most people who get Hep C will not be able to get rid of it without treatment. The standard treatment for Hep let’s talk sex 29


The difference between undiagnosed and diagnosed HIV infection How STIs are transmitted HIV testing The meaning of a ‘window period’ prior to an HIV test

18. After reading this booklet, are you more likely to do any of the following? Answer a) Much more, b) A little more, c) No more.

ABC

Use condoms for sex Have an HIV test Go to a GUM clinic Discuss HIV status with sexual partners Use a GMFA website Go on a groupwork event

19. We also want to work out how many gay men are using HIV prevention

services and resources across London. Because you are likely to be invited to fill in more than one instance of this survey, we need to make sure that we don’t double count you when estimating levels of need and service use. To help us do this please give us the following information which we hope will create a unique code that you can remember but which can NOT be traced back to you. First two letters of your mother’s fi rst name The number of the day of the month you were born on First two letters of your own fi rst name When you have completed the questionnaire please post it to:

ERGO, Freepost ERGO Consulting No postcode or stamp is required. Many thanks.

you against Hep C.

health of HIV-positive men. Previously, Hep C was mainly seen in intravenous drug users who had been sharing needles and in people given blood transfusions with blood products infected with Hep C. However, there have been

a growing number of cases of Hep C infection in HIVpositive gay men. Hep C is a serious illness caused by a virus passed on through infected blood that attacks the liver. There is no vaccine available to protect

There are a number of ways that it is believed that Hep C can be transmitted through sex. These include: Being fi sted by a man with Hep C who has cuts or sores on his hand and isn’t wearing a glove or who has just fi sted another man who has Hep C. Being fucked without a condom by a man with Hep C or a man who has just fucked another man who has Hep C. Using a dildo or another sex toy that has just been used on a man with Hep C and which hasn’t been thoroughly cleaned, or had a new condom put on it. Sharing a pot of lube with a man with Hep C, as lube can be contaminated with blood. Most people who get Hep C will not be able to get rid of it without treatment. The standard treatment for Hep let’s talk sex 29


C can cause side effects such as high temperature, joint pain, weight loss, nausea and depression. Some treatments can also cause a low white blood cell count and a low platelet count. Hep C treatment can reduce your HIV treatment options. Ribavirin, a treatment for Hep C, should not be taken taken with the anti-HIV drugs ddI, d4T or Tenofovir, as this can cause potentially fatal side effects. Ribavirin can also cause anaemia and so should not be taken with the anti-HIV drug AZT. Only about 30-50% of men who have HIV and the most common form of Hep C will respond to Hep C treatment.9 The rest will go on to develop chronic long-term Hep C infection, putting them at a high risk of developing liver disease and liver failure. People with HIV can progress to this 30 let’s talk sex

if you are in an open relationship where you don’t use condoms with your main partner, there is a higher risk of passing on an sti that you caught outside the relationship to your partner. stage much faster than people without HIV. Having Hep C can also mean that your HIV treatment may not be as effective as it otherwise would be. People with HIV and Hep C who start HIV treatment may see a smaller rise in their CD4 counts than people with HIV alone. The damage Hep C does to your liver could also mean that you have a greater risk of side effects from your anti-HIV drugs, and metabolic disorders such as insulin resistance – the body’s inability to respond to and use the insulin it produces – and diabetes.

You can reduce the risk of getting re-infected, or re-infecting partners, by using a condom when you fuck or by not fucking – whether you are in a monogamous or open relationship, or have sex with casual partners.

re-inFeCtiOn Re-infection, also known as super-infection, is being infected with another strain of HIV in addition to the one

you already have. While research has shown that this is probably not very common, it can happen. Re-infection happens in let’s talk sex 31


C can cause side effects such as high temperature, joint pain, weight loss, nausea and depression. Some treatments can also cause a low white blood cell count and a low platelet count. Hep C treatment can reduce your HIV treatment options. Ribavirin, a treatment for Hep C, should not be taken taken with the anti-HIV drugs ddI, d4T or Tenofovir, as this can cause potentially fatal side effects. Ribavirin can also cause anaemia and so should not be taken with the anti-HIV drug AZT. Only about 30-50% of men who have HIV and the most common form of Hep C will respond to Hep C treatment.9 The rest will go on to develop chronic long-term Hep C infection, putting them at a high risk of developing liver disease and liver failure. People with HIV can progress to this 30 let’s talk sex

if you are in an open relationship where you don’t use condoms with your main partner, there is a higher risk of passing on an sti that you caught outside the relationship to your partner. stage much faster than people without HIV. Having Hep C can also mean that your HIV treatment may not be as effective as it otherwise would be. People with HIV and Hep C who start HIV treatment may see a smaller rise in their CD4 counts than people with HIV alone. The damage Hep C does to your liver could also mean that you have a greater risk of side effects from your anti-HIV drugs, and metabolic disorders such as insulin resistance – the body’s inability to respond to and use the insulin it produces – and diabetes.

You can reduce the risk of getting re-infected, or re-infecting partners, by using a condom when you fuck or by not fucking – whether you are in a monogamous or open relationship, or have sex with casual partners.

re-inFeCtiOn Re-infection, also known as super-infection, is being infected with another strain of HIV in addition to the one

you already have. While research has shown that this is probably not very common, it can happen. Re-infection happens in let’s talk sex 31


exactly the same way as the original (primary) HIV infection – mainly by fucking without condoms, but also by sucking cock. However, oral sex carries a low risk of HIV transmission and therefore carries a low risk for re-infection. If you have recently been infected, or you’re not on HIV treatment, you might be at a higher risk of re-infection.

In very rare occasions, reinfection could reduce your treatment options. However, there is very little research to prove this. It is also possible that if you are re-infected with a more aggressive strain of HIV, this could cause a sudden rise in your viral load and a drop in your CD4 count, putting you at more risk of an HIV-related illness.

YOu Can reduCe tHe risk OF GettinG Hep C bY:

My boyfriend is HIVpositive and shags around without condoms. He knows I don’t want him to as I care for him and his health. But we’ve decided to wear condoms with each other as he doesn’t want to pass anything on to me.

using a condom when you fuck or get fucked. using a new condom for each partner if you have group sex. using a new condom on your dildo if it’s been used on someone else. if you get fisted, making sure the man fisting you is wearing an unused latex glove. if you don’t have any latex gloves, make sure he doesn’t have cuts or sores on his hands, and has washed his hands thoroughly if he has just fisted someone else. if you inject steroids or recreational drugs, using a new sterile syringe each time. if you snort recreational drugs, using your own drug snorting straw, banknote or bullet. 32 let’s talk sex

I don’t want to get Hep C – it’s just not worth it.

let’s talk sex 33


exactly the same way as the original (primary) HIV infection – mainly by fucking without condoms, but also by sucking cock. However, oral sex carries a low risk of HIV transmission and therefore carries a low risk for re-infection. If you have recently been infected, or you’re not on HIV treatment, you might be at a higher risk of re-infection.

In very rare occasions, reinfection could reduce your treatment options. However, there is very little research to prove this. It is also possible that if you are re-infected with a more aggressive strain of HIV, this could cause a sudden rise in your viral load and a drop in your CD4 count, putting you at more risk of an HIV-related illness.

YOu Can reduCe tHe risk OF GettinG Hep C bY:

My boyfriend is HIVpositive and shags around without condoms. He knows I don’t want him to as I care for him and his health. But we’ve decided to wear condoms with each other as he doesn’t want to pass anything on to me.

using a condom when you fuck or get fucked. using a new condom for each partner if you have group sex. using a new condom on your dildo if it’s been used on someone else. if you get fisted, making sure the man fisting you is wearing an unused latex glove. if you don’t have any latex gloves, make sure he doesn’t have cuts or sores on his hands, and has washed his hands thoroughly if he has just fisted someone else. if you inject steroids or recreational drugs, using a new sterile syringe each time. if you snort recreational drugs, using your own drug snorting straw, banknote or bullet. 32 let’s talk sex

I don’t want to get Hep C – it’s just not worth it.

let’s talk sex 33


loVe and seX tips for hiV-positiVe men in relationships Some HIV-positive men in a longterm relationship with another HIV-positive man prefer not to use condoms when they have sex with each other. There are health risks involved with this that you should be aware of. The decision is a personal one and you should not feel pressurised to stop using condoms.

MOnOGaMY If you are in a monogamous

relationship with another HIVpositive man and don’t want to use condoms, you should both go for a sexual health check-up fi rst. This way you can be sure that neither of you has another STI such as Hepatitis C or syphilis which you could pass on through unprotected sex. Relationships can change over time so it’s worth thinking about, and discussing with each other, what would happen if one of you did have sex with

if you are HiV-positive, the impact of some infections, such as Hep C, on your health is significantly higher. using condoms will help protect you and your partners against these infections. 34 let’s talk sex

someone else. Would you be able to talk about it with each other? If you can’t, then there is the risk that an STI could be passed on within the relationship.

Open relatiOnsHips If you have sex with men outside your main

I fi nd it really diffi cult to trust other people. I’ve always had it in my mind that I look after myself better than anyone else can. Whenever I’m in a relationship, I always insist on condoms.

let’s talk sex 35


loVe and seX tips for hiV-positiVe men in relationships Some HIV-positive men in a longterm relationship with another HIV-positive man prefer not to use condoms when they have sex with each other. There are health risks involved with this that you should be aware of. The decision is a personal one and you should not feel pressurised to stop using condoms.

MOnOGaMY If you are in a monogamous

relationship with another HIVpositive man and don’t want to use condoms, you should both go for a sexual health check-up fi rst. This way you can be sure that neither of you has another STI such as Hepatitis C or syphilis which you could pass on through unprotected sex. Relationships can change over time so it’s worth thinking about, and discussing with each other, what would happen if one of you did have sex with

if you are HiV-positive, the impact of some infections, such as Hep C, on your health is significantly higher. using condoms will help protect you and your partners against these infections. 34 let’s talk sex

someone else. Would you be able to talk about it with each other? If you can’t, then there is the risk that an STI could be passed on within the relationship.

Open relatiOnsHips If you have sex with men outside your main

I fi nd it really diffi cult to trust other people. I’ve always had it in my mind that I look after myself better than anyone else can. Whenever I’m in a relationship, I always insist on condoms.

let’s talk sex 35


relationship then there’s the chance that one of you could pick up an STI from another man and then pass it on to your partner. It’s a good idea for you both to have regular sexual health check-ups as this will help you look after each other’s health. For more information on re-infection and co-infection with another STI, turn to page 26.

We tried having an open relationship but I could tell he wasn’t happy with it. Now we’re totally monogamous and actually it works out better for us both. We prefer not to use condoms and we know about the risks – but this way we can look after each other’s health and not worry about other people.

FiVe tHinGs tO reMeMber.

if you don’t use condoms, there is a risk of co-infection or re-infection. if you are in a monogamous relationship and plan to ditch the condoms, you should both get a sexual health check-up first. if you are in an open relationship, you could pick up an sti from another man and then pass it on to your primary partner. if you are HiV-positive, the impact of some stis (such as Hep C) on your health can be greater. if you are worried about re-infection or co-infection, use a condom when you fuck.

36 let’s talk sex

I was in an open relationship with another positive guy and we weren’t using condoms with each other for a while. I’d heard about reinfection and I got a bit edgy as I wasn’t sure how safe he was being with other people.

We always make sure we’ve got some condoms in the fl at for when we have a threesome because we don’t want to have to discuss our HIV status with casual shags – you can’t tell how they might react. Using condoms lessens the risk of us infecting someone and we don’t have to have that awkward conversation that could kill the mood.

let’s talk sex 37


relationship then there’s the chance that one of you could pick up an STI from another man and then pass it on to your partner. It’s a good idea for you both to have regular sexual health check-ups as this will help you look after each other’s health. For more information on re-infection and co-infection with another STI, turn to page 26.

We tried having an open relationship but I could tell he wasn’t happy with it. Now we’re totally monogamous and actually it works out better for us both. We prefer not to use condoms and we know about the risks – but this way we can look after each other’s health and not worry about other people.

FiVe tHinGs tO reMeMber.

if you don’t use condoms, there is a risk of co-infection or re-infection. if you are in a monogamous relationship and plan to ditch the condoms, you should both get a sexual health check-up first. if you are in an open relationship, you could pick up an sti from another man and then pass it on to your primary partner. if you are HiV-positive, the impact of some stis (such as Hep C) on your health can be greater. if you are worried about re-infection or co-infection, use a condom when you fuck.

36 let’s talk sex

I was in an open relationship with another positive guy and we weren’t using condoms with each other for a while. I’d heard about reinfection and I got a bit edgy as I wasn’t sure how safe he was being with other people.

We always make sure we’ve got some condoms in the fl at for when we have a threesome because we don’t want to have to discuss our HIV status with casual shags – you can’t tell how they might react. Using condoms lessens the risk of us infecting someone and we don’t have to have that awkward conversation that could kill the mood.

let���s talk sex 37


casual seX tips for hiV-positiVe men with casual partners

In most cases, when we have sex with someone new, we don’t know their HIV status. However, some positive men think they are being safe by having sex without condoms with guys they think are also HIV-positive.

assuMptiOns Many HIV-positive men believe that if someone is willing to have unprotected sex with them, it’s because they are also HIV-positive. However, many HIV-negative men believe that if someone 38 let’s talk sex

is willing to have unprotected sex with them, they will also be HIV-negative. If a guy you have sex with doesn’t mention HIV, it doesn’t mean that he has the same HIV status as you. It just means he’s chosen not to talk about it. If there is any doubt about the HIV status of your sexual partner, using a condom when you fuck is the most reliable way to avoid passing on HIV.

WHO’s respOnsible? Both HIV-positive and HIVnegative men are equally responsible for the sex they

about three quarters of HiV-negative gay men expect HiV-positive men to disclose their status before sex.10 if someone you are having sex with doesn’t ask to use condoms it may be because they assume that you are HiV-negative. let’s talk sex 39


casual seX tips for hiV-positiVe men with casual partners

In most cases, when we have sex with someone new, we don’t know their HIV status. However, some positive men think they are being safe by having sex without condoms with guys they think are also HIV-positive.

assuMptiOns Many HIV-positive men believe that if someone is willing to have unprotected sex with them, it’s because they are also HIV-positive. However, many HIV-negative men believe that if someone 38 let’s talk sex

is willing to have unprotected sex with them, they will also be HIV-negative. If a guy you have sex with doesn’t mention HIV, it doesn’t mean that he has the same HIV status as you. It just means he’s chosen not to talk about it. If there is any doubt about the HIV status of your sexual partner, using a condom when you fuck is the most reliable way to avoid passing on HIV.

WHO’s respOnsible? Both HIV-positive and HIVnegative men are equally responsible for the sex they

about three quarters of HiV-negative gay men expect HiV-positive men to disclose their status before sex.10 if someone you are having sex with doesn’t ask to use condoms it may be because they assume that you are HiV-negative. let’s talk sex 39


have together. Men who know they are HIV-positive have responsibility because they are aware they can pass on the virus and have the power to stop this happening. Negative men have a responsibility to look after their own health. Men who are not sure of their HIV status have a responsibility to ensure that their behaviour does not endanger themselves or their partner. There is also the legal side to consider. If someone with HIV infects their partner through unprotected sex and did not disclose their status, they could be vulnerable to prosecution.

disClOsure How open you want to be about your HIV status

if either of you is making assumptions without knowing the facts, it could be that your partner is HiV-negative and that you are placing him at risk of contracting the virus.

with casual partners – and anybody else – is up to you. You may feel there are good reasons for telling them, possibly for your own benefi t, not just theirs. However, be sure that it’s the right thing for you before you do. Once you have disclosed your status to somebody you will not able to

some men like to be very open about their HiV status. that way they never really have to worry if people know or not. this strategy doesn’t suit everyone. Other men fear rejection or being stigmatised for having HiV. 40 let’s talk sex

take that information back. However, if you have decided to have sex without condoms with other positive guys, disclosure is important. To be sure that you are both HIV-positive, you need to have made your HIV status

clear to each other. Some HIV-negative men will not pick up on ‘clues’ about your HIV status – such as anti-HIV drugs lying around – so, to avoid doubt, you should state clearly that you have been diagnosed with HIV. There are other risks to your health, such as reinfection with another strain of HIV and co-infection with other STIs, if you don’t use condoms. For more information on these, turn to page 26.

FiVe tHinGs tO reMeMber.

if someone you’re going to have sex with doesn’t mention HiV, it doesn’t mean that he is also HiV-positive. if you don’t use condoms with an HiV-positive partner there is a risk of co-infection or re-infection. Whether you want to disclose your HiV status is your decision. You and the guy you have sex with are equally responsible for the sex you have together. using condoms can help protect against HiV and other stis. let’s talk sex 41


have together. Men who know they are HIV-positive have responsibility because they are aware they can pass on the virus and have the power to stop this happening. Negative men have a responsibility to look after their own health. Men who are not sure of their HIV status have a responsibility to ensure that their behaviour does not endanger themselves or their partner. There is also the legal side to consider. If someone with HIV infects their partner through unprotected sex and did not disclose their status, they could be vulnerable to prosecution.

disClOsure How open you want to be about your HIV status

if either of you is making assumptions without knowing the facts, it could be that your partner is HiV-negative and that you are placing him at risk of contracting the virus.

with casual partners – and anybody else – is up to you. You may feel there are good reasons for telling them, possibly for your own benefi t, not just theirs. However, be sure that it’s the right thing for you before you do. Once you have disclosed your status to somebody you will not able to

some men like to be very open about their HiV status. that way they never really have to worry if people know or not. this strategy doesn’t suit everyone. Other men fear rejection or being stigmatised for having HiV. 40 let’s talk sex

take that information back. However, if you have decided to have sex without condoms with other positive guys, disclosure is important. To be sure that you are both HIV-positive, you need to have made your HIV status

clear to each other. Some HIV-negative men will not pick up on ‘clues’ about your HIV status – such as anti-HIV drugs lying around – so, to avoid doubt, you should state clearly that you have been diagnosed with HIV. There are other risks to your health, such as reinfection with another strain of HIV and co-infection with other STIs, if you don’t use condoms. For more information on these, turn to page 26.

FiVe tHinGs tO reMeMber.

if someone you’re going to have sex with doesn’t mention HiV, it doesn’t mean that he is also HiV-positive. if you don’t use condoms with an HiV-positive partner there is a risk of co-infection or re-infection. Whether you want to disclose your HiV status is your decision. You and the guy you have sex with are equally responsible for the sex you have together. using condoms can help protect against HiV and other stis. let’s talk sex 41


Being positive, it’s a lot less stressful for me to fuck other positive guys. I usually meet guys online – where it’s easier to discuss your HIV status. I still usually use condoms, but I don’t have to worry about HIV if I don’t.

I used to think ‘I already have the virus, why shouldn’t I fuck bare?’ Then I started using condoms because I’d heard about the risks of other infections. It wasn’t so much for me – it was more that I didn’t want to be responsible for someone else.

Being open about my positive status encourages other guys to be as well. That way if they tell me they are positive, we can decide if we’re going to use condoms or not.

42 let’s talk sex

I don’t tell casual shags that I’m positive. If I’m after sex, I just want it to be about sex. Using condoms means I can keep it that way.

let’s talk sex 43


Being positive, it’s a lot less stressful for me to fuck other positive guys. I usually meet guys online – where it’s easier to discuss your HIV status. I still usually use condoms, but I don’t have to worry about HIV if I don’t.

I used to think ‘I already have the virus, why shouldn’t I fuck bare?’ Then I started using condoms because I’d heard about the risks of other infections. It wasn’t so much for me – it was more that I didn’t want to be responsible for someone else.

Being open about my positive status encourages other guys to be as well. That way if they tell me they are positive, we can decide if we’re going to use condoms or not.

42 let’s talk sex

I don’t tell casual shags that I’m positive. If I’m after sex, I just want it to be about sex. Using condoms means I can keep it that way.

let’s talk sex 43


needs discussion Bars, cluBs, saunas, Backrooms, online… We can meet each other for sex in lots of different places. Some men assume they know the HIV status of other men because of where they meet. It’s easy to have these preconceptions. However, most men with HIV won’t have any visible symptoms, so you won’t be able to tell by looking at them.

CruisinG Online When meeting guys for sex online, it can be even easier to make assumptions, perhaps 44 let’s talk sex

without really realising it. On some gay websites where guys meet for sex, you can say whether or not you have safer sex by choosing options such as ‘always’, ‘never’ and ‘needs discussion’. How a guy acts or appears in a bar or a club is not an indication of his HIV status. Neither is his online profi le. One guy might assume that if someone says ‘needs discussion’ in the safer sex option on their profi le, then they are HIV-negative. Someone else might assume

I go to sex venues and I’ve had guys tell me they are negative so it’s Ok to not use a condom with them. Trouble is… I have to tell them I’m positive.

let’s talk sex 45


needs discussion Bars, cluBs, saunas, Backrooms, online… We can meet each other for sex in lots of different places. Some men assume they know the HIV status of other men because of where they meet. It’s easy to have these preconceptions. However, most men with HIV won’t have any visible symptoms, so you won’t be able to tell by looking at them.

CruisinG Online When meeting guys for sex online, it can be even easier to make assumptions, perhaps 44 let’s talk sex

without really realising it. On some gay websites where guys meet for sex, you can say whether or not you have safer sex by choosing options such as ‘always’, ‘never’ and ‘needs discussion’. How a guy acts or appears in a bar or a club is not an indication of his HIV status. Neither is his online profi le. One guy might assume that if someone says ‘needs discussion’ in the safer sex option on their profi le, then they are HIV-negative. Someone else might assume

I go to sex venues and I’ve had guys tell me they are negative so it’s Ok to not use a condom with them. Trouble is… I have to tell them I’m positive.

let’s talk sex 45


there are men at hard core sex clubs who are HiV-negative, just as there are HiV-positive young guys dancing to kylie at a bar on a saturday night. they are HIV-positive. And this can lead to confusion if it’s not backed up by honest discussion when you meet. If you fi nd it diffi cult to have this conversation, using a condom if you fuck is the best way to stay safe. If you are HIV-positive, there is no guarantee that the guy you meet is also positive based on clues in his online profi le. If you are HIV-negative, you might disclose your status to each other when you meet and decide to ditch the condoms. This is not safe. It might be that he’s HIV-positive but doesn’t realise it.

tHinGs tO reMeMber Clues in someone’s online profi le are not enough to be sure of his HIV status. Both HIV-positive men and HIV-negative men pick up 46 let’s talk sex

guys for sex in saunas, bars, backrooms and other meeting places. If you have HIV and don’t disclose your status, the guy you have sex with might assume you are HIV-negative. If you are HIV-negative, the guy you have sex with might assume you have HIV if you are willing to have unprotected sex. You can’t be sure of a guy’s HIV status from his looks, behaviour, the sex he likes or where you meet. You can protect yourself and your partners by using condoms if you fuck.

Recently I’ve had a couple of encounters at the sauna with guys who wanted me to fuck them without condoms. If someone asks you that when it’s a casual fuck, you have to wonder how many other guys they’ve had unsafe sex with.

I’m HIVnegative and I’ve always thought most of the guys at a sauna were also negative. But that’s where I met my boyfriend – and he’s been diagnosed positive for over three years.

let’s talk sex 47


there are men at hard core sex clubs who are HiV-negative, just as there are HiV-positive young guys dancing to kylie at a bar on a saturday night. they are HIV-positive. And this can lead to confusion if it’s not backed up by honest discussion when you meet. If you fi nd it diffi cult to have this conversation, using a condom if you fuck is the best way to stay safe. If you are HIV-positive, there is no guarantee that the guy you meet is also positive based on clues in his online profi le. If you are HIV-negative, you might disclose your status to each other when you meet and decide to ditch the condoms. This is not safe. It might be that he’s HIV-positive but doesn’t realise it.

tHinGs tO reMeMber Clues in someone’s online profi le are not enough to be sure of his HIV status. Both HIV-positive men and HIV-negative men pick up 46 let’s talk sex

guys for sex in saunas, bars, backrooms and other meeting places. If you have HIV and don’t disclose your status, the guy you have sex with might assume you are HIV-negative. If you are HIV-negative, the guy you have sex with might assume you have HIV if you are willing to have unprotected sex. You can’t be sure of a guy’s HIV status from his looks, behaviour, the sex he likes or where you meet. You can protect yourself and your partners by using condoms if you fuck.

Recently I’ve had a couple of encounters at the sauna with guys who wanted me to fuck them without condoms. If someone asks you that when it’s a casual fuck, you have to wonder how many other guys they’ve had unsafe sex with.

I’m HIVnegative and I’ve always thought most of the guys at a sauna were also negative. But that’s where I met my boyfriend – and he’s been diagnosed positive for over three years.

let’s talk sex 47


I know that if someone doesn’t say ‘always’ for safer sex on their online profi le, they are not for me. I always use condoms so I don’t want to be in a position where I have to argue my case.

My profi le says I’m positive, and if I’m not sure if the guy I’m hitting on is positive, I just ask him.

I only have sex with other positive guys. If I get approached by negative guys online, I tell them I only fuck positive guys. I get the odd bad reaction, but that’s their problem. I want to enjoy sex, not worry about HIV.

Whenever I see ‘needs discussion’ on a guy’s profi le, I just assume that means he’s positive. But I was proved wrong by this one bloke I met as he’d thought I was negative.

48 let’s talk sex

let’s talk sex 49


I know that if someone doesn’t say ‘always’ for safer sex on their online profi le, they are not for me. I always use condoms so I don’t want to be in a position where I have to argue my case.

My profi le says I’m positive, and if I’m not sure if the guy I’m hitting on is positive, I just ask him.

I only have sex with other positive guys. If I get approached by negative guys online, I tell them I only fuck positive guys. I get the odd bad reaction, but that’s their problem. I want to enjoy sex, not worry about HIV.

Whenever I see ‘needs discussion’ on a guy’s profi le, I just assume that means he’s positive. But I was proved wrong by this one bloke I met as he’d thought I was negative.

48 let’s talk sex

let’s talk sex 49


staying in control coping with high risk situations The gay scene is largely based around pubs and clubs and so it’s not surprising that alcohol and drugs play a large part in many gay men’s lives. Most of us drink alcohol. It can make us feel more relaxed, more sociable and loosen our inhibitions. Drug use can do the same. Around 40% of gay men use drugs – such as cannabis, ecstasy, poppers and speed – and for most men it’s more than one type of drug.11 That 50 let’s talk sex

means gay men are over three times more likely to use drugs than the general population. Both drugs and alcohol change the way we think and feel. With some drugs the effect is dramatic – like the high you get from ecstasy – and with others it can be less so. Lots of people use drugs and alcohol without losing control. However, even subtle effects from drugs or alcohol can alter your judgment, perceptions and the decisions you make. You may find that when you are drunk or off your face,

you do things you would not do when you are sober. This could include things like telling yourself that it’s Ok to have unprotected sex with someone ‘just this once’. Also, you could be more likely to make assumptions about things such as whether the guy you have sex with has HIV. That’s why it’s important to plan for safer sex. If you intend to drink alcohol or take drugs when you go out, take condoms with you,

or know where to get them. This should help to increase your chances of using condoms when you need them. Carrying condoms isn’t the only way you can plan for safer sex. Think about the kinds of sex you want and don’t want. If you know your sexual boundaries when you’re sober it will make you more likely to make the same choices when you’re not. If you know your limits and try to stick to them, you are less likely to regret your actions or any decisions that you make whilst under the influence. Have an agreement with your mates to look out for each other. If you’re out in a group, it’s easier to spot if someone’s had a bit – or a lot – too much. Stay informed about the drugs you take. Some drugs not only affect the way you think, they can also increase the risk of HIV transmission. Some research has found this to be the case with let’s talk sex 51


staying in control coping with high risk situations The gay scene is largely based around pubs and clubs and so it’s not surprising that alcohol and drugs play a large part in many gay men’s lives. Most of us drink alcohol. It can make us feel more relaxed, more sociable and loosen our inhibitions. Drug use can do the same. Around 40% of gay men use drugs – such as cannabis, ecstasy, poppers and speed – and for most men it’s more than one type of drug.11 That 50 let’s talk sex

means gay men are over three times more likely to use drugs than the general population. Both drugs and alcohol change the way we think and feel. With some drugs the effect is dramatic – like the high you get from ecstasy – and with others it can be less so. Lots of people use drugs and alcohol without losing control. However, even subtle effects from drugs or alcohol can alter your judgment, perceptions and the decisions you make. You may find that when you are drunk or off your face,

you do things you would not do when you are sober. This could include things like telling yourself that it’s Ok to have unprotected sex with someone ‘just this once’. Also, you could be more likely to make assumptions about things such as whether the guy you have sex with has HIV. That’s why it’s important to plan for safer sex. If you intend to drink alcohol or take drugs when you go out, take condoms with you,

or know where to get them. This should help to increase your chances of using condoms when you need them. Carrying condoms isn’t the only way you can plan for safer sex. Think about the kinds of sex you want and don’t want. If you know your sexual boundaries when you’re sober it will make you more likely to make the same choices when you’re not. If you know your limits and try to stick to them, you are less likely to regret your actions or any decisions that you make whilst under the influence. Have an agreement with your mates to look out for each other. If you’re out in a group, it’s easier to spot if someone’s had a bit – or a lot – too much. Stay informed about the drugs you take. Some drugs not only affect the way you think, they can also increase the risk of HIV transmission. Some research has found this to be the case with let’s talk sex 51


poppers (amyl nitrite) and Viagra. Drugs such as coke, crystal meth or ecstasy may make you more vulnerable to infections, including HIV. Crystal meth has also led to an increase in the level of viral load in HIV-positive men, 52 let’s talk sex

which means that they will be more infectious. While some drugs may facilitate HIV transmission, drugs are not the cause of HIV. Whether you take drugs or not, safer sex is the best way to reduce the risks. If you are concerned about

your drinking or drug use, or you want some information about drink, drugs or safer sex, here are some places you can go for advice: Antidote offers information and support exclusively to the LGBT community around drugs and alcohol. Visit www.

thehungerford.org/antidote. asp or email antidote@ turning-point.co.uk. For basic drug information, you could also try www.dancesafe.org, www.talktofrank.com or http:// drugfucked.tht.org.uk.

let’s talk sex 53


poppers (amyl nitrite) and Viagra. Drugs such as coke, crystal meth or ecstasy may make you more vulnerable to infections, including HIV. Crystal meth has also led to an increase in the level of viral load in HIV-positive men, 52 let’s talk sex

which means that they will be more infectious. While some drugs may facilitate HIV transmission, drugs are not the cause of HIV. Whether you take drugs or not, safer sex is the best way to reduce the risks. If you are concerned about

your drinking or drug use, or you want some information about drink, drugs or safer sex, here are some places you can go for advice: Antidote offers information and support exclusively to the LGBT community around drugs and alcohol. Visit www.

thehungerford.org/antidote. asp or email antidote@ turning-point.co.uk. For basic drug information, you could also try www.dancesafe.org, www.talktofrank.com or http:// drugfucked.tht.org.uk.

let’s talk sex 53


help and support where can i get

more information? There are many services in London that offer support to help you have safer sex. A full guide to services in London is available at: www.gmfa.org.uk/ londonservices.

Web Information about HIV and safer sex can be found at: www.gmfa.org.uk/sex.

Helplines THT Direct: 0845 12 21 200 London Lesbian and Gay Switchboard: 020 7837 7324 54 let’s talk sex

bOOklets Booklets offering sexual health information and advice can be picked up free from racks in gay venues around London. They can also be downloaded at: www.gmfa.org.uk/booklets.

MaGazine FS (the fit and sexy gay man’s health magazine) is full of information and advice about

sex, relationships, drugs and HIV. It is available free in gay venues every other month.

COndOMs You can get free condoms and lube in London from many gay bars, clubs and saunas. You can buy very good value condoms and lube online from: www.freedoms-shop.nhs.uk.

One–tO–One

Free counseling, mentoring and health trainer services are provided by the GMI Partnership. For further information or to book appointments, call 020 8305 5002, email info@ gmipartnership.org.uk or visit: www.gmipartnership.org.uk.

GrOupWOrk There are lots of different groups and courses in London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit: www. gmfa.org.uk/gwk.

Footnotes 1. Macdonald N et al. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Sex Transm Infect. Online edition, 2007. 2. Zablotska Manos I et al. Practice of serosorting: will it minimise HIV transmission risk? Eighth AIDS Impact Conference, Marseille, abstract 282, 2007 3. Sigma Research. Multiple Chances: findings of the United Kingdom Gay Men’s Sex Survey 2006 4. Sigma Research. Testing Targets: findings of the

United Kingdom Gay Men’s Sex Survey 2007: 2009 5. Health Protection Agency. Testing Times: HIV and other sexually transmitted infections in the United Kingdom, 2007 6. Health Protection Agency. sexually transmitted infections and men who have sex with men in the UK, 2008 7. UCL, Julie Dodds, Danielle Mercey. Sexual health survey of gay men, London 2005, annual summary report. 8. HIV and Acute HCV (HAAC) group. Recent epidemic of acute Hepatitis

C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours, 2007 9. NAM. Weight-based ribavirin dosing achieves high success rates in Hepatitis C/HIV co-infected patients, Aidsmap news: 21 November 2006 10. Sigma Research. Testing Targets: findings of the United Kingdom Gay Men’s Sex Survey 2007 11. Sigma Research. Consuming Passions: findings of the United Kingdom Gay Men’s Sex Survey 2005

© 2009 GMFA – the gay men’s health charity Charity number: 1076854. Company limited by guarantee: 2702133. The information in this booklet was correct on 1 December 2009. Design: Vortex Creative Ltd Photography: James Stafford All photographs are posed by models. No inference can or should be made about their HIV status. Our thanks to all who took part. Dakota Strong appears courtesy of www.maleorderagency.com.

let’s talk sex 55


help and support where can i get

more information? There are many services in London that offer support to help you have safer sex. A full guide to services in London is available at: www.gmfa.org.uk/ londonservices.

Web Information about HIV and safer sex can be found at: www.gmfa.org.uk/sex.

Helplines THT Direct: 0845 12 21 200 London Lesbian and Gay Switchboard: 020 7837 7324 54 let’s talk sex

bOOklets Booklets offering sexual health information and advice can be picked up free from racks in gay venues around London. They can also be downloaded at: www.gmfa.org.uk/booklets.

MaGazine FS (the fit and sexy gay man’s health magazine) is full of information and advice about

sex, relationships, drugs and HIV. It is available free in gay venues every other month.

COndOMs You can get free condoms and lube in London from many gay bars, clubs and saunas. You can buy very good value condoms and lube online from: www.freedoms-shop.nhs.uk.

One–tO–One

Free counseling, mentoring and health trainer services are provided by the GMI Partnership. For further information or to book appointments, call 020 8305 5002, email info@ gmipartnership.org.uk or visit: www.gmipartnership.org.uk.

GrOupWOrk There are lots of different groups and courses in London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit: www. gmfa.org.uk/gwk.

Footnotes 1. Macdonald N et al. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Sex Transm Infect. Online edition, 2007. 2. Zablotska Manos I et al. Practice of serosorting: will it minimise HIV transmission risk? Eighth AIDS Impact Conference, Marseille, abstract 282, 2007 3. Sigma Research. Multiple Chances: findings of the United Kingdom Gay Men’s Sex Survey 2006 4. Sigma Research. Testing Targets: findings of the

United Kingdom Gay Men’s Sex Survey 2007: 2009 5. Health Protection Agency. Testing Times: HIV and other sexually transmitted infections in the United Kingdom, 2007 6. Health Protection Agency. sexually transmitted infections and men who have sex with men in the UK, 2008 7. UCL, Julie Dodds, Danielle Mercey. Sexual health survey of gay men, London 2005, annual summary report. 8. HIV and Acute HCV (HAAC) group. Recent epidemic of acute Hepatitis

C virus in HIV-positive men who have sex with men linked to high-risk sexual behaviours, 2007 9. NAM. Weight-based ribavirin dosing achieves high success rates in Hepatitis C/HIV co-infected patients, Aidsmap news: 21 November 2006 10. Sigma Research. Testing Targets: findings of the United Kingdom Gay Men’s Sex Survey 2007 11. Sigma Research. Consuming Passions: findings of the United Kingdom Gay Men’s Sex Survey 2005

© 2009 GMFA – the gay men’s health charity Charity number: 1076854. Company limited by guarantee: 2702133. The information in this booklet was correct on 1 December 2009. Design: Vortex Creative Ltd Photography: James Stafford All photographs are posed by models. No inference can or should be made about their HIV status. Our thanks to all who took part. Dakota Strong appears courtesy of www.maleorderagency.com.

let’s talk sex 55


GMFa projects are developed by positive and negative volunteers. to volunteer or donate call 020 7738 6872 or go to: www.gmfa.org.uk/aboutgmfa


Let's Talk Sex