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Where can I get a test? Persons who would like to get tested for HIV may utilize the services of Voluntary Counseling and Testing (VCT) sites at the public hospitals, health centres and NGOs nationwide.

You can also call the AIDS hotline on 223-7138 or 223-7139 for assistance.

Human Sexual Practice is Diverse A GUIDE FOR SAFER LIVING

A blood test for HIV looks for these antibodies. If you have them in your blood, it means that you have HIV infection. As the HIV antibodies test HIV-Positive. Being HIV-positive, or having HIV disease, is not the same as having AIDS. Many people are HIV-positive but don't get sick for many years. As HIV disease progresses, it slowly wears down the immune system. Viruses, parasites, fungi and bacteria that usually don't cause any problems can make you very sick if your immune system is damaged. These are called "opportunistic infections.� If you are tested positive you will be referred to a Health Centre for free Anti RetroViral treatment.

Supported by the Ministry of Health, with funding from the GOG/ World Bank HIV/ AIDS Prevention & Control Project

Society Against Sexual Orientation Discrimination (SASOD) SPECTRUM HEALTH NET PROJECT


Spectrum Health Net Project | Human Sexual Practice

AIDS Stops with me! SPECTRUM HEALTH NET

What Does "AIDS" Mean?

The Spectrum Health Net is a project designed to provide holistic Information, Education and Communication health promotion materials primarily through web-based formats which include special pages for Lesbian, Gay, Bisexual and Transgender people. This project is supported by the Government/World Bank Guyana AIDS Prevention and Control

AIDS stands for Acquired Immune Deficiency Syndrome: • •

Acquired means you can get infected with it. Immune Deficiency means a weakness in the body's system that fights diseases.

Syndrome means a group of health problems that make up a disease.

AIDS is caused by a virus called HIV, the Human Immunodeficiency Virus. If you

Project, administered by the Health Sector Development

get infected with HIV, your body will try to fight the infection. It will make

Unit of the Ministry of Health, and has resulted in the devel-

"antibodies" -- special molecules to fight HIV.

opment of the website at http://www.sasod.org.gy and these and other supporting materials.

You should know your HIV status (condition) by taking a test for HIV.

"No matter where you are on the spectrum Protect yourself at all times"

Website: www.sasod.org.gy Email: sasod_guyana@yahoo.com Phone: 686-0835 / 617-6107

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Society Against Sexual Orientation Discrimination

Disease and Sex

Spectrum Health Net Project | Human Sexual Practice

Table of Contents Am I Gay?

Any person engaged in sexual activity is at risk of contacting a sexually transmitted infection (STI). There are other STIs but we will focus on Hepatitis.

Hepatitis

Hepatitis A,B.C are three common viral infections that affect your liver. Persons

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Safer Sex - Masturbation

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- Oral Sex

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- Protecting yourself

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Anal Sex -(‘Buggery’)

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Provisional guidelines for anal sex with female condoms

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Where to Get Condoms?

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Circumcision

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Disease and Sex

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‘AIDS’ Stops with me!

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Where Can I get Tested?

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who engage in anal sex (buggery) are at risk for certain types of hepatitis, most notably hepatitis A and B. Hepatitis viruses cause most cases of liver damage around the world. Hepatitis can also be due to toxins (notably alcohol), other infections or from a compromised immune system, common in people infected with HIV. It may be dormant where the affected person may not feel ill. A person starts to feel sick and begins to show signs of being infected when the disease causes the liver to not work as it should.

There are now vaccines available for hepatitis A and B and all persons who engage in anal intercourse (buggery), oral-anal sex (rimming) or other sexual or casual contact involving the anus (fisting, fingering, sharing anal-sex toys, etc) are urged to get vaccinated. Vaccines are available at the following locations:

Ministry of Health- Brickdam, Georgetown

The Dorothy Bailey Health Centre on South Road and Bourda Street, Georgetown.

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Society Against Sexual Orientation Discrimination

H

uman Sexual Practice is Diverse

Am I Gay? This maybe one of the most common questions young men/women ask themselves. The truth is, very few of us are 100% heterosexual (or 100% Gay). It can be said that heterosexual men/women may have fantasies about people of the same gender, sometimes at the peak of orgasm, and this leaves them feeling a sense of insecurity. This in fact is one of the most carefully kept secrets in society . However, you are really only Gay when you have concluded without a doubt, that you as a male prefer other males sexually over females, or as a female prefer females sexually over males. Random fantasies and even sexual encounters don't make you Gay. In response to the need to better understand differences as regards gender in the face of the HIV/AIDS epidemic, a fact became widely known, that few had previously understood . It was recognized that it is important to describe behaviour, rather than social identity. The term “men who have sex with men” came about with a shortened form known as ‘MSM’. It is rare for medical journals to include sexuality and sexual behavior as important components of men’s health and wellbeing. It is even more unusual to acknowledge Gay outside the context of HIV/AIDS; The use of this term in a men’s health context, both shed light and challenges. Gay is a behavioural definition; it does not imply an identity, and it does not consider sexual attraction.

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Spectrum Health Net Project | Human Sexual Practice

Circumcision Circumcision is the surgical removal of all or part of the foreskin, the skin that covers the head of the penis. The procedure is usually performed for religious, cosmetic, and/or hygienic reasons. Circumcision as a medical procedure for an adult has the following disadvantages:

• • • •

temporary pain after the operation (this is true for any surgery) temporary irritation of the glands (the head of the penis) different and/or decreased sensation during sex risk of complications and/or surgical errors (again, as with any surgery)

On the other hand some of the advantages are:

• •

cleanliness or ease of maintaining hygiene. slightly reduced risk of getting sexually transmitted infections (STIs), such as human immunodeficiency virus (HIV — the virus that causes AIDS) and Human Papilloma Virus (HPV — the virus that causes genital warts and is linked to cervical cancer risk in women who have sex with "uncut" men).

Health care providers also recommend that after circumcision a man abstains from any kind of sexual activity for four to six weeks to allow for a full recovery. In fact, even having an erection in this period of time after the procedure can cause complications, such as discomfort, pain, and disruption of the stitches. It should be noted that if you are having insertive penetrative sex nothing is more effective in preventing the transmission of HIV than using a condom. However regular cleaning of the foreskin and the glands, usually alleviates most potential hygienic problems. Additionally, safer sex techniques are much more effective in preventing STIs than circumcision. But as always, with any kind of medical condition, your best bet is to check with a doctor and get a personal opinion. If you are uncircumcised but want to be circumcised what are your options? You can consult a doctor (urologist) at the Georgetown Public Hospital Corporation surgical clinic.

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Society Against Sexual Orientation Discrimination

Where to get condoms? Male condoms: Available from the National AIDS Programme Secretariat of the Ministry of Health, and all health centres and government hospitals. Flavoured condoms – for oral use only - are sold at drug stores.

The choice of diverse “practices” signals that male-to-male sex may incorporate a range of sexual behaviours, which may or may not, include oral and anal sex . The international medical literature on Gay men paints a picture of individual risk-taking and at-risk groups. This is particularly if not exclusively, considered in the context of the HIV risk, and to a much greater extent, at risk of other sexually transmitted infections (STIs). Gay men are at greater risk of getting (contracting) gonorrhoea or syphilis than are other men. Many consultations with Gay men are to probe issues other than STIs and reflect the profile of health conditions experienced by men, generally. Therefore, it is not surprising that publications on Gay men almost never offer a definition, or if they do, proceed to bundle MSM with Gay, bisexual and other homosexual active men into a single analysis. Gay men and their health needs are most likely to evade recognition because of the nature of most clinical practices.

Female condoms: Available at public hospitals and health centres.

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Society Against Sexual Orientation Discrimination

Safer Sex: MASTURBATION Masturbation is (touching yourself) giving yourself or someone else sexual pleasure by touching your own or others genital organs, until orgasm/climax (ejaculation ) is reached. Masturbation can be done by hand or with other parts of the body (this usually excludes the mouth). FEMALE MASTURBATION Women can learn how to explore themselves sexually, how to masturbate and reach better orgasms. So masturbation can be rubbing your vulva (clitoris and the two lips) with your fingers so as to have an orgasm/climax, or it can just be stroking your nipples, squeezing your thighs together, riding a bicycle ; or sitting on top of a working washing machine. What it comes down to is more what is in your mind than what you are physically doing. In fact the range of activities that are really masturbation vary widely indeed. Enough to say that, if you deliberately do anything that involves pampering or stimulating your body's erogenous zones, directly or indirectly that is said to be masturbation. Masturbation is usually thought of as an “alone” activity, but is more common as a form of HIV risk reduction behaviour. Two or more people who wish to enjoy and satisfy themselves sexually can safely masturbate each other to organism with virtually no HIV or other STI risk. Masturbation with a partner is commonly called mutual masturbation or ‘outercourse’.

Spectrum Health Net Project | Human Sexual Practice 8.

Check every now and again during sex that the outer ring of the female condom hasn't slipped inside your anus, or that his penis hasn't slipped between the female condom and your anus. If it has, stop, remove the female condom, and use a new one before starting again.

9.

Don't re–use the female condom. Some Gay men are reported to have used a female condom as a semi–permanent barrier to HIV, having sex with multiple partners. The female condom is designed for vaginal sex and for single use. If you use it more than once for anal sex, we don't know the strains that it could put on the sides of the sheath, which might easily tear. And if you get a lot of semen in the female condom, we don't know how effective it is in holding it in, or whether any seepage into your rectum could take place. It is likely that sex in somebody else's cum would also be dangerous for your partners.

10. Removing the female condom. Because the female condom lines the inside of the rectum, your partner doesn't have to withdraw immediately after coming. You can remove the sheath when it suits you, making sure that no semen is spilt. Twist the outer ring to keep the semen inside, then pull gently. Throw away the used female condom.

11. DO NOT USE BOTH FEMALE AND MALE CONDOMS AT THE SAME TIME!

Outercourse entails the rubbing up or sliming up or non-penetrative sex . It is sexual activity without vaginal, anal, and possibly oral penetration, as opposed to Intercourse which is basically inserting the penis, whether into mouth, vagina or anus. In outercourse no bodily fluids are exchanged and it is therefore considered relatively safe; as such outercourse can also be used in as foreplay, in preparation for sexual intercourse.

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Society Against Sexual Orientation Discrimination

Guidelines for anal sex with a female condom

Spectrum Health Net Project | Human Sexual Practice

Safer Sex: ORAL SEX Female on Female: This is probably considered the safest type of sex. It can

1.

The easiest way to use the female condom for anal sex is to wear it like a ‘male' (penile) condom. Put lubricant in the female condom and then place it over the penis (or a dildo). Use plenty of lubricant on the outside of the female condom or around your partner's anus before starting penetration.

be noted that in so far, research conducted in the preparation of this article has not found one reference to HIV transmission from performing oral sex on a woman. Of course that is not to say there are no risks. Genital herpes, systemic yeast infection or a urinary track infection (UTC) are possible. Washing one’s

2.

Alternatively, you could try to insert the female condom in the anus first, as for vaginal sex. Use plenty of lubricant around the anus, and loosen it with a finger in readiness for the female condom. Make sure your fingernails are cut short.

hands before touching a women’s vagina will help reduce the chances of a UTC. Only the use of a barrier such as a dental dam will stop the transmission of herpes. Further exciting foreplay such as pouring honey or other foods onto the vagina may be fun, but be careful not to be excessive, as too much sugar in the vagina can induce a yeast infection.

3.

After removing the female condom from its wrapper, hold the inner ring between your thumb, index and forefinger, and squeeze it so that it forms an oval. Don't remove the inner ring, as this will lead the female condom to become tangled, and could lead to breakage

Male on Male: The risk of becoming infected with HIV through unprotected sex (without a condom) is common. Hence, oral sex is lower than that of unprotected (anal or vaginal) sex. Moreover, a lower risk activity can become a

4.

Push the female condom up into your rectum as far as you can, using the inner ring as a guide, whilst spreading your anus with your other hand. You may find this easier if you raise one leg onto the side of the bath, or a stool.

significant way people get infected if it is done often enough. Oral transmission of HIV is very difficult to single out, because few people engage exclusively in oral sex . The transmission of HIV also varies by the level of virus found in the body. People are actually most infectious in the immediate weeks after they

5.

Then put your index finger inside the female condom, until you feel the bottom of the inner ring. Push up as far as you can, but do not insert the outer ring.

become infected, and before their body has started to manufacture enough antibodies to resist the replication of the virus. The HIV tests done in Guyana will detect whether you are infected or not; So if you know your sexual partner has more than one partner (is a player or sweet boy/girl) you should take even

6.

7.

You will find that the outer ring, and perhaps a small part of the female condom, are on the outside of your anus. That's meant to happen, and should stop the female condom from slipping inside

more precautions . Although oral sex is considered a low risk activity with some risk of transmission – it is better to use a condom.

Use more lubricant inside the female condom, to keep it moist, and add it whenever you need it during sex.

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Society Against Sexual Orientation Discrimination

Spectrum Health Net Project | Human Sexual Practice

Protecting Yourself

Anal Sex (‘Buggery’)

During oral sex, you can also protect yourself:-

Unless you are in a monogamous relationship (one faithful partner) and both of you have been tested twice for HIV (second test 3 months after the first in case one of you became infected with HIV in the three-month window period when it may not show up in the test) you should not be having / engaging in insertive anal intercourse without a condom. FULL STOP - no ifs/ ands/ or /buts! You know the drill already – use the condom correctly, use water-based lubricant to avoid the condom from breaking, when you cum/ejaculate, hold the condom at the base of your penis and pull out to keep the semen from getting into your partner’s anus.

Do NOT brush your teeth or floss before you have oral sex. Bleeding gums (as any open wound / break in the skin) create a place where the virus can enter your body. Use mouthwash, mint or chew gum to if you want to freshen your breath.

You should not deep throat without a condom and do not lick the pre-cum/ejaculation; (yes, even pre-cum contains the virus).

If you ‘deep throat’ (oral sex) without a condom, try not to swallow semen and definitely don’t let semen remain in your mouth.

Use a condom when performing oral sex. If you use a condom you will be pretty safe unless you tear it with your teeth. Flavoured condoms are made for oral sex only.

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Who is at risk? The ‘bottom’ receptive man (or receptive women) is 10 times more at risk of contracting HIV than the ‘top’ guy( or insertive man) . If you like being penetrated make sure your partner uses a condom correctly and uses lube. You should carry strong fresh condoms and lube because if you are ‘giving it up’ you need to make sure you protect yourself. If you like it ‘bareback’ and have multiple partners then know that you have a high chance of becoming infected. The anus tears easily (ever have a bit of blood in your pants after a heavy go at it?) making it easier for the virus to enter your body.

Anal sex with a female condom: Like condoms, it appears that, although not designed for the purpose, female condoms (often called femidoms) do work as an effective barrier during anal sex. A study in the United States of 14 male couples using the equivalent of the female condoms found that, although no leaks or tears were found in any of the sheaths used, all of the men found design and usage difficulties, 'which were primarily due to lack of experience and knowledge' of the product.

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