The Ins and Outs of Gay Sex (37 page)

And gay men deal with issues that our heterosexual counterparts never face.
We would never tell an HIV-negative straight couple to continue having safe sex (except for purposes of birth control) once they enter a monogamous relationship.
And yet gay men are advised to do this all the time.
Why?
Because HIV is far more prevalent among men who have sex with men, and men are promiscuous creatures.
Monogamy takes a concerted effort.
No decision to abandon safe sex between gay partners can be made lightly.
The cost of a mistake can be lethal.

Medical research has documented that gay men in relationships are more likely to have unprotected anal sex than men who are not in relationships, whether they are monogamous or not.
Obviously, this is a potentially very dangerous situation.
We also know that almost half of all gay men in relationships who engage in unprotected sex do not know either their or their partner’s HIV status.
Again, this is high-risk behavior.
Gay men in relationships may be lulled into a false sense of security that has no basis in reality.
They wrongly assume that by virtue of their couplehood they are protected from HIV.
Knowledge about partners’
HIV status, sexual behavior, and commitment is our only defense.

For many gay men the issue of monogamy is a moot point because they are unattached and actively dating.
Sure, the idea of a long-term relationship sounds appealing, but so far they haven’t found the guy.
Dating by its very nature is not monogamous, and few of us date one man at a time.
Each date you go on brings with it questions regarding whether you will have sex with the guy and if you do how far you’ll go.
And lurking in the back of your mind is that old fear:
Will this be the one who gives you an STD?
There are ways for us to protect ourselves from HIV and STDs as long as we’re willing to make the effort.

Whether you’re monogamous or not, the only way absolutely to prevent catching an STD is to not have sex at all—including kissing.
Even that guy you’re seeing could give you something like herpes months into your relationship because he had a flare-up.
For most of us, giving up sex is an unacceptable notion.
We see someone hot, someone we’re attracted to, and desire kicks in, sometimes clouding judgment to the point where it can’t be trusted.
(Especially if we’re under the influence of some drug or alcohol.
) (See
Chapter 11
.
) In previous chapters I have tried to lay the framework for you to make a sound decision about whom you have sex with.
If you know the risks and what to look for, I can’t guarantee that you will never catch an STD—they are just too prevalent in this day and age—but at least you’ll be armed with the knowledge to make the best possible choice.
Many of us carry the hope of one day living that storybook life with our own Prince Charming.
But we forget that we have to kiss a lot of frogs before
we find our prince.
Kissing frogs is not a problem as long as we know our own limitations and those of the frogs!

When AIDS first happened upon the gay world, numerous studies analyzed the sexual practices of gays.
Staggering numbers of sexual encounters coupled with orgiastic group sex seemed the rule, not the exception.
Even under the shadow of AIDS, many of us still have sexual histories numbering in the hundreds or even thousands, but we remain free of HIV.
Clearly, safe sex has made the biggest difference, but so too has our growing understanding of various STDs.
The guidelines issued by the Centers for Disease Control on how to avoid contracting HIV include the warning against having sex with an infected partner.
For many gay men, this is unacceptable.
It is fine to have sex, to experiment and to love—just do it safely and with the strength of knowledge.

Where you find “love” has a lot to do with how great your risk is for catching an STD.
The more sexual encounters your partner has had, the more likely he is to bring an STD into your relationship.
Now, I certainly don’t expect you to demand a list of his previous conquests, but there are clues.
If your dream boy is lying naked on a bed in some bathhouse begging you to enter, or hanging out in a steam room flashing his erection, chances are he’s not a virgin and you’re not his first.
Although it should go without saying that prostitutes expose themselves to numerous partners and as such are the most likely to give you more than an orgasm, I am amazed by the number of patients I see who are shocked to learn they caught something from a call boy.

As one patient told me, “I’m too busy to waste time on idle chitchat.
I work twelve-hour days, then spend another two at the gym.
When I’m horny I call someone from the ads.
They’re always hot, and I know I’ll get what I want.
They have to be clean.
It’s their business.”

Sure, he got what he wanted from his last experience, but he also got herpes as his lasting reminder.

I know you can find true love in a bathhouse, and I’m not telling you that all men there carry STDs, just understand what you’re getting into.
The kind of sex your partner usually has and the type of sex you have with him helps predict your risk for catching a new STD.
Even if the guy is just “servicing” you, don’t be shocked if you catch something from his mouth.
Faced with an unknown partner in a high-risk situation, mutual masturbation is safe and can be hot.

Try talking to a potential partner before bedding him.
Straightforward questions like “Am I your first tonight?”
or “What STDs have you had?”
certainly work but will probably scare him off.
And even if he sticks around to answer your questions, there is no guarantee that he’ll tell you the truth.
Less direct questions often will provide the same information within the framework of a normal conversation and not make you sound so much like the sex police.
Ask what he likes sexually to get a clue as to how high risk his behavior is.
(Does he like to get fucked, even without condoms?
Does he routinely let men come in his mouth?
) A person’s drug history also has bearing on his chance of carrying an STD.
Men who have sex while under the influence are prone to sexual carelessness.
The number of previous partners a man has had also impacts on his risk for carrying an STD.
Has he ever been in a relationship?
Have his relationships been measured in weeks, months, or years?
While not a guarantee, a man who dates or has had lengthy relationships is probably lower risk than someone who
just
frequents bathhouses or other high-risk environments.

If you find taking this sort of sexual history before you remove your clothes embarrassing, remember that your prospective partner is probably just as nervous as you.
No
one wants to catch an STD, and it is in the back of every dating guy’s mind.
Ask a question and chances are he won’t be offended, and it might just open up a dialogue you both find interesting.

I know some men who, in lieu of asking sexual history-type questions, try to estimate their risk by checking a prospective partner’s home for various telltale medications.
One patient said that on going home with a new guy, he would immediately ask to use the bathroom.
Once safely behind the locked door he ran water to camouflage the noise of the opening medicine cabinet door.
If the medicine cabinet was clean he’d ask for a drink of ice water.
That necessitated a trip to the kitchen, where countertops, windowsills, and usually the refrigerator could be perused for those little pharmacy bottles.

Sure, you’ll probably find out if your prospective partner is HIV positive, provided he’s on medication, but you certainly won’t know if he just had a shot for gonorrhea or if he hasn’t seen a doctor for that nasty discharge.
You won’t be able to detect most STDs by a quick search for medicine bottles.
Many times even an infected partner is unaware of his condition because he is symptom free or has delayed seeing a doctor hoping his problem will just go away.

Besides analyzing your risk of catching something from a new sexual partner, you must know your own limitations as well.
Are you the kind of guy who can go to a “jerk-off” club and just jerk off?
Or will you be down on your knees in a flash or bent over in a dark corner while some guy whose name you don’t even know plows away?
Can you call a talk line and just talk?
Are you drunk or drugged out of your mind before you find yourself in some guy’s bed?
Your own behavior probably has as much to do with your relative risk of catching an STD as the guy you sleep with.

So you’ve asked some questions and you’ve decided that you want to have sex with the guy—well, not so fast.
Any good doctor will tell you that a history is only half of an evaluation; don’t forget the physical exam.
Surprised by this notion?
Why shouldn’t you examine any prospective partner before performing the most intimate of acts?
When in some exotic new restaurant, you smell your food, look at it closely before tasting that first bite, don’t you?
So why shouldn’t you do the same with a new partner before he winds up in your mouth?

I don’t expect you to don a white coat and rubber gloves, but at least give him the once-over
with the lights on!
Don’t make it a clinical examination, make it a hot sexual experience, and
keep your eyes open.
(See
Figure 10.
1
.
) Be aware of any sores on his penis, and if you see one, ask about it.
Don’t be embarrassed; you have a right to know what you’re exposing yourself to.
And don’t forget to look in his pubic hair and scrotum, other harbingers of STDs that aren’t covered even if he wears a condom.
Tiny clustered open sores or blisters can mean herpes, and you might catch it just from jerking off.
A larger open wound certainly can be from an overzealous previous conquest, but it may be from syphilis, not teeth.
When a partner has penile sores, it’s best to limit contact (hands without cuts are usually okay) until you know for sure.
Be careful that you don’t touch your penis when touching his.
Small bumps especially on the undersurface of his penis can be hair follicles.
Warts tend to be flatter and have broader bases, while follicles look like the goose bumps you get when you’re cold.
Hair follicles are usually the same color as surrounding skin, whereas warts may be either lighter or darker.

If your date seems to have an inordinate amount of pre-cum or if his testicles are tender when you gently rub them, think about the possibility of urethritis, prostatitis, or epididymitis.
These are also contagious, but you’ll probably be okay if you limit the session to masturbation.
Again, don’t forget to wash your hands before touching your own body.

Figure 10.
1:
Examine your partner before sex.
It can be erotic.

I’ve talked about masturbation quite a bit as being relatively low risk.
It is, especially if the masturbation involves two naked guys touching only their own dicks.
Even if you do him and he does you, and you both wash your hands after it’s all over, you’re probably pretty safe and it can be very hot.
The minute it goes beyond that with your penis rubbing against his, docking, or rubbing between butt cheeks, your risk rises significantly.
And once body cavities are entered, risks climb further.
Now, I’m not telling you “Don’t suck his cock” or “Don’t let him suck yours.”
Just use your brain.
If he’s got a lot of pre-cum and you’re worried, or if he’s got some sore that
might
be from his zipper, put a condom over it and you’ll probably be fine.