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Cum makes us happy

A study at the University of New York has discovered that semen has anti-depressant qualities. The study, conducted in June, assessed 293 female students and concluded that mood-altering hormones in semen, such as oestrogen, testosterone, and prolactin, are absorbed into the bloodstream through the vagina. But what about gay lads? Study leader Gordon Gallup states that gay men often retain semen for extended periods of time following anal intercourse, suggesting some kind of psychological benefit. But further research is needed to determine if exposure to semen through oral or anal sex has the same mood-lightening effects. Of course, semen can carry the HIV virus so going on a spunk gulping binge isnt a good idea for mood enhancement if you end up becoming infected. Kinda defeats the purpose dont it?

A shag, no ice, but a slice please...

Aussie researcher Prof Roger Short reckons lemon juice could be used to kill HIV and sperm. In the lab, Short says he has found that a lemon juice solution killed the HIV virus. He suggests that either a sponged soaked in lemon juice or a thin slice of lemon could be inserted before sex to act as barrier against HIV. He also suggests that men could use lemon-juice as an after-sex wash. Now if you are holding your willy just imagining the stinging pain that might cause, Prof Short says fear not: "Lemon juice is not in any way painful to the user if no lesions are present." We're still unsure. But before you all start popping lemons up your jacksies, there are still loads of questions that need to be answered and research that needs to be done. We dont know if it actually works or that it doesn't cause more harm than good. So until then, leave that slice in your Gin and Tonic where it belongs.

12 TIPS ON HOW TO GIVE A BETTER BLOW JOB PROBLEMS GETTING IT UP? LOOKING AFTER YOUR ARSE ASK THE DOCTOR N9 THE LUBE YOU SHOULDNT USE

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ISSUE #69 DECEMBER 2002

FROM THE EDITOR

G-A-Why dont you?

Because sometimes you wanna do something different

elcome to the new and improved F***sheet or FS (as its now known). Along with a new name, comes a new design, and a new attitude. Every issue, FS will bring you the most up-todate gay mens health news, views and features. We will keep you informed on the latest issues and research regarding HIV in a simple, accessible way. Youll find out about the courses and services available to you in London and loads of great projects that you can get involved with. And we havent forgotten the stuff that really matters to you, like how to give a better blowjob. And speaking of... Since this is issue 69, we have dedicated it to one of our favourite pastimes - oral sex. But whenever you bring up the subject, one question inevitably comes up just how safe is it? Well, the answer isermwe dont really know. Almost daily there is a new report on some research that has come-up with slightly different results than the one before some say there is a small risk, others say there is no risk at all. So I guess the best answer is that there is probably a small but real risk, but thats not much help is it? Its really up to you to make your own choices about how you want to handle it. Check out Peter Harts feature on page 8 for more. Well we hope you enjoy FS. We welcome your letters, questions and comments. You can email them to: caryj@gmfa.demon.co.uk or send them by post to the address below.

Name: Tennis London

What is it? The club provides a safe, comfortable environment for gays and lesbians to meet and play tennis. It also promotes the sport among the gay community and raises funds for charity through its annual international tournament in Battersea Park. Where and when do you meet? The club meets weekly at Westway Tennis, Crowthorne Road, London W10 on Sunday evenings from 5pm until 9pm. The nearest tube is Latimer Road. How many members do you have? 120 What about social activities? The Club also arranges social events such as coaching weekends and an annual Christmas party among other things. Did any of your members compete in the Gay Games? Yes. Club members won two bronze medals at the Sydney Gay Games in the men's doubles divisions. How can people find out more? Look at our website at www.tennislondon.com
G-A-Why dont you? is a new project at GMFA that helps promote the scene beyond clubs and bars and helps new groups to get off the ground. For more information or to be part of it, ring Dnal on 020-7738 6872 or email donalh@gmfa.demon.co.uk

Cary James

This issue of F***sheet (FS) was edited by Cary James. The FS team for issue 69 was Peter Hart, Matthew Hodson, Andrew McDonald, Matt Newbury, Steve Perkins, Matt Rhoades and James Stafford. Jeremy Cohen approved. FS is the part of London Gay Mens HIV Prevention Partnership. We encourage responses to articles and relish argument and debate. We reserve the right to edit contributions. The views of the author are not necessarily the views of FS, of the organisations mentioned or of the editor. If you would like to receive FS, cancel your subscription, or notify a change of address call Hayley or Cary on: 020 7738 6872. FS is commissioned, written, edited and subbed by volunteers. To volunteer for GMFA, write, phone or e-mail the office details below. Published by Gay Men Fighting AIDS, Unit 43, Eurolink Centre, 49 Effra Road, LONDON, SW2 1BZ. Tel: 020 7738 6872. Fax: 020 7738 7140. Charity number 1076854. ISSN 1469-2228 e-mail: gmfa@gmfa.demon.co.uk Website: www.gmfa.org.uk
Design and layout by Departure Identities Ltd www.departure.uk.net.

To get your very own copy of delivered to your door every issue, email your details to: caryj@gmfa.demon.co.uk or ring 020-7738 6872

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All you have to do is ask

Assertiveness Training is about change, choice and communication. Its techniques enable you to ask for what you want in a way that really works. Heres how
How often do you ask for what you want? All the time? Sometimes? Only when you are sure youll get it? Only with people and in situations when you know you wont lose? In considering the act of making a request, remember the following: specific, as you may need to repeat it until the other person hears it and acknowledges your request. This technique of repetition and "fielding" helps you not to get hooked into the other persons issues and unwillingness to hear your request. For example: "I appreciate that you have better things to do than re-organise the rota, and I would like to take the next two weeks off." Or "This is nothing to do with not enjoying your company, I do enjoy it and Id like to postpone dinner next week."

Workable compromise
This is a skill that we all need when there is a genuine conflict of interest. One person does not need to win or lose if you negotiate from an equal position taking into consideration each others needs. Each person gets enough of what they need without the need for feeling resentful. For example:"I appreciate that changing the rota will cause problems with staff cover, would it help if I went a week later?" Or "I need to postpone dinner next week, how would meeting for a drink the following week suit you?"

You dont require anyones approval if you are asking for something you have the right to. You have the right to communicate your own wants and needs. Asking for what you want doesnt guarantee that you will get it, however you are more likely to get it than if you dont ask. You are more likely to get what you want if you ask clearly and directly. If you dress up your request, you may be misunderstood or not heard.
Theres a technique that will help you make requests, Here are a few of them with examples of how you can make them work for you.

Round it off well

Bring closure to the interaction in an affirmative way. It shows that you respect the other person and their willingness to compromise. For example: "Thanks for that, I will enjoy my time off and I appreciate your flexibility." Or "Thats a relief, I am pleased that you are OK with this and I look forward to meeting you for a drink the week after next" Take this method and try it out. It may take a few attempts to work. However, when you give yourself permission to ask and experience doing it, you will see that by taking action you are saying "I like myself enough to ask." Remember, you may not always get what you want, yet thats better than not asking and feeling like you failed. Its a much better place to be.
To find out more about your rights and to learn how to communicate clearly and directly, book onto a GMFA Assertiveness Course. GMFA and PACE offer many free workshops and courses for gay men in London. For a full listing of whats on offer, visit www.metromate.org.uk or contact James at GMFA on 020 7738 3712 or PACE on 020 7281 3121.

Self-disclosure
There are times when our own feelings can hijack our attempts at being clear. This technique can help if you are feeling anxious or unsure. Start with a statement of your feelings. No one can deny you your feelings. They are valid. For example: "I am feeling quite anxious about asking you for this " or "Im really anxious not to spoil our friendship however"

Be specific
This means deciding what it is you want to ask and how to communicate it clearly and directly. For example: "and Id like to take the next two weeks off work." Or "...Id like to ask if we can postpone going out for dinner next week."

Acknowledge the response

In order to avoid sounding robotic and to show the other person that you have heard what they are saying, it is important to acknowledge their response. All you need to do is repeat their response back to them with

your request. This technique is known as fielding. For example: "I know it means re-organising the staff rota and I would like to take the next two weeks off as annual leave." Or "I know you were looking forward to it and I really would like to postpone dinner next week."

Repetition
You need to ensure your request is clear and

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Sucking fantastic
Wanna give a better blowjob? Here are twelve things you should try
Alcohol tightens the throat muscles so its best to avoid it (especially spirits) if you wanna to relax your throat. Drinking orange juice suppresses the gag reflex. If you feel like youre going to gag when youve got a cock in your mouth - swallow. Dont worry, it wont go down. Breathe through your nose. Exhale before taking cock in your mouth. It will increase your oral capacity by 33 percent. Flatten your tongue. Say mmm or aaah to relax your mouth beforehand (you may want to do this quietly or hell probably think youre a bit weird). Take the cock into your mouth slowly and allow your throat to relax around it. If he tries to force it in youll gag for sure. Youll find it easier if you have plenty of saliva. If your mouth feels dry have a glass of water handy. You can alternate hot and cold sensations by rinsing your mouth with a hot drink and iced water in turn. Dont just use your mouth, use your hand as well. You can use it: as a stopper to ensure that you control the amount of cock you take; as an improvised cock ring to keep him hard; to wank him as you work him; or to play with his balls, arsehole, nipples or perineum (the bit between his arse and balls). Different men like different things - and more men than you may think arent keen on receiving blowjobs at all. Some like lots of activity around the head, others find the head too sensitive and prefer work along the shaft of the penis. Some men dont enjoy deep-throating, so even if youre really good youre not guaranteed a round of applause afterwards. Ask your partner what he likes and go for it.

Arse Facts
Here are a few things everyone should know about sex involving your arse

Tears Get too rough and you can get tiny rips or tears
in your arse hole or the lining of your arse. In fact, sticking anything up your bum can cause a little bleeding and minute tears. These arent dangerous in themselves, but do offer a way into your bloodstream for germs like HIV and other sexually transmitted infections. Thats why lube is a must - less friction equals less tearing. Silicon-based and waterbased lubes dont weaken latex condoms. Oil-based lubes (like Vaseline, hand cream and food products) do. (If the bleeding carries on, go to your local hospitals A&E department.)

Spongy Your arse lining absorbs liquid like a sponge

does. Thats why some medicines are put up the arse. Its a quick way to get something into the bloodstream. Its also why getting HIV infected cum in someones arse is so risky. The HIV in the spunk soaks into the arse lining then goes straight into the bloodstream.

Slimey The inside of your arse is lined with mucus; a

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Beam me up Sammy!
Gay boys who invite men up their back passage are all too aware of how much fun the prostate can be. That little gland is a virtual fountain of pleasure for the fuckee, leading many to call it the male Gspot. Now the Prostate Cancer Charity wants everyone to know with their new website: www.planetprostate.com. The site aims to reduce cancer deaths through the promotion of the prostates role as the male G-spot. The website invites us to join Sammy Sperm on his journey to Planet Prostate on the SS Ejaculation via five levels of interactive and challenging gaming, which explains the function of the prostate gland along the way. And its bloody good fun. The charity campaign will raise their awareness of the location and function of the prostate gland, which ultimately serves as the first step in prevention of prostate cancer. They also want to challenge the myth that prostate cancer is a old mans disease. Prostate cancer affects 20,000 and kills 10,000 men each year, yet has a lower profile than testicular cancer, which affects far fewer men. thin layer of slime that lubricates the passage of shit on its way out of the body. It also protects against infection. But it easily rubs off if things are stuck up your arse another reason to use plenty of water-based lube for arse play. And remember- once into the rectum, there are fewer and fewer nerves that feel pain, so you could be causing damage without feeling it if you dont take care.
This article originally appeared in Exposed 4, which also contains loads more great info. For your free copy, ring THT direct on: 0845 12 21 200 The Arse Class is a one-day workshop about your arse, how to keep it healthy and how to get the most pleasure possible from getting fucked. The Arse Class will be on a national tour of 10 UK cities, and premieres in London on 14 December. If youre a boy who wants to know your butt better, ring 020-7738 6872 for more informa-

FUCKING POSITION OF THE MONTH

This month: Piggy Front
FUCKER: Standing legs apart, supporting his partners weight. FUCKEE: Facing partner, sitting on their hips. Legs wrapped around partners waist. Arms around his neck. Unless partner is particularly strong, probably leaning against a wall. ADVANTAGES: You can kiss, and its very impressive especially when done without a wall to lean against. DISADVANTAGES: Receptive partner has very little control. Very strenuous for the insertive partner. Not easy to get a major thrusting motion going.

SCORES
STRENGTH: TECHNICAL DIFFICULTY: STYLE: PLEASURE: OVERALL RATING:

Dont wanna catch em at all!

Name: Syphilis Class: Bacterial infection.
Transmission: Through fucking without a condom, and less often through cock sucking or rimming Powers: During the first stage, small painless sore or hardened lump will appear 1 to 10 weeks after infection, near the point where the bacteria entered your body. This could be your arse, cock, or mouth. Up to 26 months later, during the second stage, you experience a rash on the body and a flu-like illness involving fever, headache, and sore throat. Strengths: If left untreated for many years, the infection can cause blindness, brain damage, heart attacks, paralysis, and strokes. Weaknesses: Syphilis is detectable by a blood test and is completely curable with antibiotics, causing no permanent damage, if treated early enough.

Nastiness rating: 9 (if not treated early)

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G
Any man can have problems getting a hard-on. But if you are HIV positive, you are even more likely to experience sexual dysfunction. Cary James finds out more

ay men are meant to be non-stop sex machines always up-for-it and able to get a rock-hard erection at the drop of a trouser. But like other gay myths such as all gay men can dance and gay men have good fashion sense, this one isnt always true. Sexual dysfunction (having problems getting a hard-on) is something every man experiences at some time in his life, but that doesnt make it any easier. "When I came out on the gay scene, I thought you were meant to be having wild sex all the time. I would pick-up just for the sake of it, but when we got home, I often couldnt cum or even get a proper hard-on. I really felt like something was wrong with me, but I was terrified to mention it to anyone," remembers Jack, a 25 year-old from London.

Nightmare
Not being able to get or maintain a hardon is many mens worst fear and one that most really dont want to talk about. "I didnt know what to do. I couldnt bring myself to talk to my friends about it, and my family was out of the question. So, I just suffered and avoided sex at all costs. It wasnt until I was in counselling for an unrelated problem that I found out I was normal. I kick myself for all the time I wasted," Jack says. The causes of sexual dysfunction can be psychological, physical or a combination of the two. It can also be caused by HIV, HIV medications and diabetes. Not talking about it can often make the problem worse, especially if the cause is psychological. And as your sexual problems get worse, your self-esteem and relationships can also suffer. Jim from Manchester says his sexual problems and his inability to talk about them cost him his relationship. "It became a huge issue. It was all either of us thought about, when we did try to have sex. But we could never talk about it rationally. I would get too embarrassed and he was the type that thought if you ignored a problem it would go away. When we got into fights, he would use my sexual problems as a weapon. It destroyed us."

The drugs dont work

Recreational drugs like cocaine, ecstasy

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and alcohol often play the cruel joke of making you horny as hell, but then not able to get an erection. Despite this, health professionals report many gay men play down the link between drugs and poor sexual performance, because despite not being able to get an erection, they remain horny. This leaves them with the impression that the drugs are increasing rather than damaging their sexual performance. This can have a profound effect on a mans confidence. If someone is expecting drugs to help their sexual performance and they do the opposite, then you could believe that the problem is yours rather than a result of the drugs. " I go out and cane it most weekends. I would normally pick-up a shag, but when we got home, I couldnt get a hard-on to save my life," says 23 year old Tom. " I would blame it on the drugs, but then I began to doubt myself and started having problems when I wasnt on drugs. I eventually made a rule never to pickup when I was on drugs. Then things got back to normal for me sexually."

What can be done?

Here are some possible treatments for sexual dysfunction.

HIV can make it worse

Men with HIV are more likely to experience sexual dysfunction, for various reasons. HIV itself can damage the nerves in the cock, causing impotence. Men with HIV often have low testosterone levels, resulting in loss of libido. HIV drugs can cause loss of feeling in the groin and contribute to lowered sex drive. Although research about whether certain HIV drugs actually cause impotence, or other sexual problems, has been inconclusive, it is obvious to anyone who has been on the HIV drugs for any amount of time that they do upset the apple cart in more ways than one. According to several recent studies up to 70 percent of positive gay men on combination therapy have experienced some form of sexual dysfunction. Psychologically, anxiety and fear of transmitting the virus or telling someone you're positive can make it difficult to get a hard-on. Loss of sex drive can also lead to anxiety and depression, creating a vicious cycle.

Counselling if the cause of your problem is psychological, then seeing a psychologist or counsellor could help. THT (020-7835 1495), PACE (020-7697 0014) and HGLC (020-7407 3550) all offer free, confidential sexual health counselling. Ring to book an initial consultation. Testosterone replacement This can be very effective for loss of sex drive. Although there are over the counter options, see your GP first. Herbal Alternatives - Several herbs have been studied for their ability to increase hormonal levels in both men and women. Tribulus has been shown in recent studies to increase levels of sex hormones in both men and women without any side effects. However, finding tribulus in local health food stores may still be difficult. Viagra - Sildenafil (Viagra) is the most likely method of treatment youll be offered. Viagra is taken about an hour before having sex and will last for up to 5 hours. Viagra helps to increase the blood flow to the penis, and it works wonders. Vacuum Pumping - This is a tried and tested method of getting more blood into the penis, and can be very effective for treating erection problems without medication.

John felt frustrated, dysfunctional, useless and demoralised. "It also made me retreat from trying to establish relationships as I felt it was difficult, and burdening enough discussing my HIV status to a sexual partner, before having to introduce this element." Sex had always been one area of Johns life that he felt he had some control over, now he felt that control was gone. "It made me seek out more illicit casual

scribed Viagra and was able to address the problem head-on. Today, John still admits to feeling frustrated about having to rely on another drug to 'perform' this most basic of function. It has taken the element of spontaneity out of sex, particularly with my long term partner." Emotionally, the experience has had a lasting effect: "I know more about myself, have more knowledge about how to deal with sexual

"I couldnt cum or even get a proper hard-on. I really felt like something was wrong with me."
sex as this reduced the risk of embarrassment to myself and ease in being able to literally walk away from a situation that I could not perform in. It also made me seek out more and more other HIV positive gay men to have sex with as I reasoned that there at least one element of my status would not be so much of an issue." Eventually it was confirmed that Johns problem was caused by a combination of the peripheral neuropathy and HIV. He was predysfunction and be more open about it." His best advice to someone going through the situation is to: "seek out help through clinics and even GP's. Accept the reality and deal with it - it makes the issues more acceptable. It has to me. And remember, the most important member to be proud of is not in your pants."
Several GUMs offer sexual dysfunction clinics. For more information and advice on sexual dysfunction, visit www.metromate.org.uk/erection

Johns story
John is a positive gay man whos experienced sexual dysfunction first hand. After my second bout of peripheral neuropathy (loss sensation in your extremities) in 2 years, I found erections more and more difficult to sustain, or even obtain," John remembers. "This coincided with a period of depression resulting from other aspects of surviving with HIV, and both compounded each other."

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Theres one question that HIV counsellors are asked by nearly everyone who visits them "Can I get HIV from oral sex?" Peter Hart attempts to find an answer.

ts Friday night in a busy London gay bar. Plenty of guys are on the pull, and the vast majority know that if they end up shagging tonight, theyll use a condom. But its a different story when it comes to blowjobs. In the UK, its a simple fact that most men just dont use condoms for oral sex. Why? Well, most of us reckon that the risk of catching HIV from giving or receiving a blowjob is so low, we dont need to bother with any protection. Some studies reveal the risk could be greater than previously thought, while others report no risk at all. Back in 2000, a study of 102 gay and bisexual men in America found that nearly eight percent of infections came from oral sex, concluding that it "contributes significantly" to the spread of HIV. A different study, also from the USA, found it to blame for nearly one in ten infections. Another revealed a seven percent transmission rate over several years. And the lastest reported no risk at all. So whats

Only oral "I got HIV from oral sex," says one gay
American, Bill, who publishes a yearly account of his treatment on the internet. "So how did this happen? I thought oral sex was safe. There have been reports of people getting it from sucking, but I always dismissed these as people who really did fuck without a rubber, or shoot drugs, or engage in other high-risk behaviour, but just didnt want to admit it." Bill explains hes never done drugs, hes always used a condom when fucking, and partners always withdrawn before cumming. Yet he found himself sero-converting (the process where someone goes from being HIV-negative to HIV-positive, as HIV antibodies first start to appear in the bloodstream), despite not having had anal sex for over a year. However, Bills story appears to be contradicted by another recent study, which suggested that the chances of HIV transmission from oral are, in fact, zero. This time, 198

HIV-negative people were chosen all were gay or bisexual, and almost all were male. They had no anal or vaginal sex, and did not inject drugs in the six months prior to the study beginning. Almost all the men reported giving blowjobs without condoms, yet only one HIV infection was reported. Even this infection was found to have occurred outside of the six month study period, meaning it was impossible to conclude it had resulted from a blowjob alone. But Kimberly Page Shafer, who headed the study at the University of California in San Francisco, urges caution in interpreting these results, saying they were based on a relatively small sample. This need for caution is emphasised by Dr Susan Ball, an HIV specialist and associate medical director of GayHealth.com. "You cant draw global conclusions about the safety of oral sex from a six-month study," she says. "In the face of other studies, no clinician is going to say this study proves that oral sex is safe."

Another web journal tells the story of Ray, a 32-year-old Asian man who, for two years, "gave blowjobs to everyone and anyone in sight," at gay saunas. "The first guy I blew after an eight year absence from oral because I was afraid of contracting something was HIV positive," he continues. Yet Ray remains uninfected by the virus. "Lets be honest," he says, "if it were a real high risk, thousands of men would be infected." A study from Spain, of 135 HIV-negative heterosexuals in a sexual relationship with someone with HIV, apparently supports the San Francisco studys results. It found that more than 19,000 instances of unprotected oral sex, over a ten year period, failed to lead to a single case of HIV transmission. Ejaculation into the mouth of HIV-negative women occurred on around 3,000 occasions. But Dr Barry Evans, a public health consultant with the UKs Public Health Laboratory Service (PHLS), is also swift to advise caution in drawing any strong conclusions. He believes that analysing people in a relationship, where one partner already has HIV, may not provide the best evidence. "Some people seem more prone to transmission of the virus in just a few incidences of oral sex," he points out, explaining that if the HIV-negative people in the study hadnt already caught the virus, then there could be some bias, as they would possibly have reduced vulnerability. In addition, he explains that people who are sero-converting present a higher-thannormal risk to an unprotected partner, as a result of an increased viral load. Yet in the Spanish study, the HIV-positive people had previously sero-converted, so were possibly less infectious during the study.

Spanish study

Although the evidence from various studies appears to be quite conflicting, most health officials have agreed over one point. "Oral sex is not risk free," says Dr Barry Evans. "Instead of a handful of cases a year in the UK of HIV being transmitted through oral sex, we are seeing 30 to 50." Certain activities are understood to increase vulnerability. A Statement of Risk, published by the Government in June 2000, points out that the most risky oral sex is when someone cums in your mouth. "This would involve exposure to the greatest amount of HIV in the infected partners semen," it states. This is something that HIV-positive Bill agrees with. "Im a deep throat specialist. I

Still a risk

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Risky Business You stand a greater

risk of getting HIV from blowjobs when:
You are the person doing the sucking The other person cums in your mouth You have cuts, sores, infections or ulcers in your mouth You have poor oral hygiene, or youve just been to the dentist Othersucking situations are lower risk - but remember, low risk doesnt mean no risk. For further help and advice, contact check-out www.metromate.org.uk, or visit your local STI clinic (listing available on Metromate). However, he adds: "One new case of infection each week, compared with the number of episodes of unprotected oral sex going on, is pretty small. But for that one person a week whos sero-converting, it can still have pretty devastating consequences."
*Names have been changed to protect identities. Bills account of how he got HIV from oral sex can be found at www.geocities.com/fdjk3. Rays Bathhouse Diaries are at www.bathhouseblues.diary-x.com.

love to have a guy fuck my face and blast a load down my throat. I think this is how I got infected. I had several guys banging pretty hard on my tonsils. I would advise against it." GayHealth.coms Dr Susan Ball explains that the risk of transmission is also increased by other factors. "Whenever there is a break in the normal skin or mucous membrane if you have a sore in your mouth or recent dental work was done it puts you at increased risk for HIV." Various other sexually transmitted infections, such as gonorrhoea, chlamydia and syphillis, can also be transmitted orally and far more easily than HIV - so experts suggest that people might still want to use a condom during blowjobs.

Although unprotected fucking is clearly the highest risk activity, accounting for over 90 percent of HIV transmissions in gay men in the UK, a report by the PHLS concludes its important for people to be more aware of the dangers of blowjobs, too. Then, say the experts, we have to decide for ourselves on the level of risk we consider acceptable in sex. "Some people want hardly any risk," says Dr Evans, "so they might want to use a condom for all oral sex, especially if its with an anonymous partner, or they dont know that persons HIV status. But other people say the risk is small, and that theyre prepared to take that risk."

You decide

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example, even if the risk of spitting or swallowing is roughly the same, how big a risk is it? How much does a sore throat or bleeding gums increase this risk? What about if your throat gets sore from sucking cock for a long period of time? How long after brushing your teeth before your mouth returns to normal and the increased risk of infection is

Matt Rhoades goes in search of the answer to the ever illusive question "What is the real risk of getting HIV from a blow job."
ow safe is sucking dick? It has been widely accepted that it poses almost no risk at all for the guy getting sucked, but what about for the sucker? I turned to the web for some answers. I started off at the Terrence Higgins Trust site and the advertising campaign they ran on sucking last year, www.tht.org.uk/gaymen.htm One ad explains how the risk of infection from HIV as the sucker is pretty similar whether you spit or swallow. Its getting cum in the mouth that puts you most at risk. Another ad highlights the risks a throat infection could have in making more likely that the sucker could catch HIV. A third explains how having gum disease, mouth ulcers or having recently brushed your teeth increases the risk of infection. The fourth advertisement cautions

no longer present? A quick google search took me to www.howardbrown.org/services/ wellness/pr9.htm where I learned a few things. According to the information on this site, its best to wait two hours after brushing your teeth or flossing before sucking cock. Minor throat injuries caused by sucking for long periods (say with a number of partners in a backroom) could also increase the risk. Consumption of alcohol can increase the risk of transmission because it reduces the ability of the mouth and throat to fight off infections. Again, this site stressed that not getting cum in your mouth at all was probably the safest option, but that the risk of infection was pretty small either way. So there is some useful information about sucking cock for gay men on the web; it just takes some finding. What would be great is a website with all of this information and a more detailed discussion of just how small a small risk is. Gay men could use this to help make decisions about the sucking they do. Anybody know one?
For more info on awesome oral check out: www.gaylifeuk.com/sexguide/suck.shtml for "How to Give a Blowjob www.metromate.org.uk Or if youre not old fashioned and like to read books: "Going Down: The Instinct Guide to Oral Sex" by Ben R Rodgers and Joel Perry (Alyson Books). This book gives you no less than 135 pages of mind blowing techniques and tips on how to play the man flute like a maestro.

positive guys who are getting sucked that a high-viral load increases the risk of transmission, although there is a difference between the amount of virus present in the blood and the amount in semen. Overall, I was left a little confused. For

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anyway. You may find this brings you even closer. Steve, Southwark

Every issue our readers try to help someone with their problem and a counsellor gives his expert opinion.
Im 32 and have been out for ages but Ive always been a top. I met this guy just over a month ago and we have started seeing each other quite regularly. Up until two weeks ago, I always fucked him but last week he fucked me for the first time. I was a bit surprised by how much I enjoyed it but the biggest surprise for me was that I suddenly realised I was worried about HIV. Id never really thought about it before. Then he tells me yesterday that he is HIV+ and Im really freaked out. I really like him but I dont know what to do. Dale from Deptford
YOUR ADVICE:
Dear Dale,
a) You like him. b) Hes told you one of the most difficult things there is to tell someone, so he must like you. c) Youre enjoying the sex. Apart from that, you didn't say whether you used a condom, so I'm presuming you did. It's still the best way to protect yourself from HIV. Use any condom that you feel comfortable with as long as it has the KiteMark on the packet. Remember to use plenty of water based lube. Carry on using them when you're having sex - it's a pain, and it's a better option than becoming HIV positive. Is he on combination therapy? The drugs bring the viral load in his semen down so that lessens the chance of transmission of the virus taking place. Ultimately - if you like him, he likes you and you're having good sex, there are more good things in the equation than bad. I'm more than a little jealous... Barrie, East London one way for you to enjoy sex, which is bound to be helpful in the future. The most important thing as I see it, however, is to support your partner. Hes opened up to you, which was probably really hard for him. The fact that he clearly trusts and respects you suggests that youve got a very strong relationship together. Be proud that he feels this way about you. Talk your worries through with him rather than bottling up chances are hell probably be able to put your mind at rest about a few things

A COUNSELLORS OPINION:
Counsellor Anthony from HGLC says:
Hey great that you are enjoying this new relationship, but lets talk about dealing with your anxiety. You do not say if you have been using condoms or not. Put simply, condoms stop HIV. All us gay guys have to make ourselves aware of the risks involved in contracting HIV and make decisions on the type of sex we then have. You can only do this if you are well informed. You could talk to a counsellor who can advise you on whats risky behaviour, help you with your own safe sex strategy and explore communication and negotiation issues within your relationship. PACE, HGLC and THT all offer free counselling services. You could also make an appointment to visit a sexual health GUM clinic. They are confidential, offer sexual health advice and information, and also carry out tests for HIV and STIs. Think of them as a kind of regular sexual MOT. THT do a range of really useful free leaflets and guides and I would recommend: Need Help?, The Manual, and Condoms. To get a copy, ring THT direct line a call on 0845 1221 200. Visit www.metromate.org.uk where youll find loads of helpful information on sex, HIV, locations of GUM clinics, and counselling services available to you.

Next months problem:

I recently started going out with this guy and things are going great between us, apart from one small problem. Hes always horny in the mornings, and while getting an erection at that time is not a problem for me, I find it almost impossible to climax. Ive always preferred sex at night, and in the mornings I just dont feel as aroused. Ive tried lots of things, including going to the toilet beforehand, but nothing seems to work. Im worried that he thinks hes not satisfying me. Please help! Sleepless in Shepherds Bush
If you have some advice for Sleepless or you have a problem that needs sorting, email it to: sortitout@gmfa.demon.co.uk

Dear Dale,
The feelings youre experiencing sound perfectly natural for someone whos just undergone a new experience. On the plus side, youve discovered theres more than

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Unsafe sex is a great risk

Unsafe sex has been listed as the worlds second-greatest health risk in a report released by the World Health Organisation last month. The report concluded that 2.9 million deaths each year could be ascribed to unsafe sex. HIV/AIDS is the fourth highest cause of death, overall. Being underweight is top of the list of health risks. The report found both underweight and unsafe sex to be far more prevalent in developing countries than developed countries.

Dirty needles
Reports of HIV and Hepatitis infections from needles and medical equipment are coming in from around the world. A hospital in Oklahoma has recalled an extra 500 patients to be tested for hepatitis C, following revelations that a nurse reused needles among patients. The appeal, made in early October, brings the suspected risk group to 1,220. Officials at the hospital are offering free treatment to anyone diagnosed with hepatitis C following the recalls. 52 patients have tested positive for hepatitis C so far, 17 of whom have also tested positive for hepatitis B. In Africa, evidence has been uncovered of HIV infection in adults with no sexual exposure to the virus and in children with negative mothers. Some studies suggest that as many as 40% of HIV infections in African adults are linked to injections. HIV can survive in syringes at room temperature for more than four weeks. 29 employees of an Egyptian hospital have been sentenced to one year in prison after 17 dialysis patients in their care contracted HIV.

The Stickman cometh

GMFAs new campaign tells men that they can safely use any kite-marked condom, whether or not it is extra strong. Since the early days of HIV, extra strong condoms have been recommended for anal sex. The reasons for promoting extra strong condoms seem to have been lost in time. Recent research by City University found no difference in failure rates between standard and extra strong condoms when used for anal sex. "The arguments about condom thickness have distracted attention away from the more likely reasons for condom failure, such as inappropriate lubricant or the wrong size of condom," says GMFA mass media project worker Matthew Hodson. "Men should be able to find a condom thats appropriate for them. Standard condoms are available in a much larger range of shapes and sizes and are easy to find at your local shop, or late night garage."
GMFAs condom campaign, starring the marvellously endowed Stickman, will hit the press in December.

Dying of ignorance
The biggest challenge facing HIV health promotion organisations is tracking down those who are infected, according to a US study. It reports that 35 percent of US HIV-related deaths in 2000 occurred in late testers - patients who were diagnosed within 6 months of their death - most of whom could have benefited from testing earlier.

No sex says the Vatican

The Vatican has reiterated its support of sexual abstinence and its opposition to condoms as a means to prevent the spread of HIV worldwide. Monsignor Javier Barragan, president of the Pontificial Council for Health Workers said abstinence is the only way to prevent HIV/AIDS. The Catholic Church maintains that condoms are not 100 percent effective in preventing HIV and contribute to a pan-sexual society, in which sex is a means of pleasure as well as procreation. And... whats wrong with that?

We are family
The Big Up group at GMFA, celebrated Black history month with the launch of their new booklet In the Family 2. The booklet celebrates the builders of the black gay community in the UK and featured a foreward by author and broadcaster Bonnie Greer. The Right Honourable Paul Boateng MP, addressed the capacity event at Waterstones Piccadilly. Antendees also enjoyed a programme of music, poetry and song.

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Positive muppet
The South African version of Sesame Street is introducing a HIV-positive character. Kami, a five-year-old AIDS orphan, will help educate the kiddies, and many adults, about HIV/AIDS. However, conservative campaigners in the USA have already begun work to stop Kami from appearing in the American version.

Gay and Irish? Wanna make 20?

Sigma Research is looking for gay or bisexual men who were born in the Republic of Ireland and have moved to the UK, to take part in a research project. The one-off interview is completely confidential, can take place during the day or evening and interviewees will be paid 20. For more info or to sign-up, call Cathy, Gary or Laurie on 020-7737 6223 or email: cathy@sigmaresearch. co.uk.

PACE team grows

PACE's Sexual Health Counselling Service has now been expanded. Two new counsellors have joined the team and can see people at PACE's centre in Holloway or at the Turning Point centre in Brixton. Anthony Johnson has joined Dennis Carney in developing and co-facilitating workshops aimed at black men who have sex with men including: Tongues Untied, Black, Gay n Proud, and Brother 2 Brother. For more information ring: 020-7281 3121

Older gay men wanted

Gay and bisexual men are wanted to take part in a research project at the Institute of Education at the University of London. Participants should be 60 years old or over and live in London. The informal interviews will be part of research to explore how gay and bisexual men adapt to growing older and explore both positive and negative experiences. For more information or to take part, contact David on 07812 592 293 or email davidgayhealth@yahoo.co.uk.

Beauty before age, say positive men.

A survey of HIV-positive patients in California suggests that many would be willing to sacrifice years of life to avoid the potentially disfiguring lipodystophy syndrome. Lipodystrophy syndrome causes fat to be displaced throughout the body resulting in disfiguring lumps or a protruding belly. On a scale with death on one end and perfect health at the other, patients rated HIV causing a 26 percent decrease in quality of life. That leapt to 46 percent when combined with lipodystrophy. In an imaginary scenario, three-quarters of patients said they were willing to increase their risk of dying to avoid the effects of lipodystrophy.

Addicted to sex?
THTs Gay Mens Sexual Addiction Recovery Group at Lighthouse West London is recruiting now for January 2003. Its a 12-week evening support group aimed at addressing the addictive or compulsive use of sex. Participants learn about sex and love addiction and have an opportunity to understand the origins, patterns and triggers of their sexual behaviour. For more information or to arrange an initial consultation, contact Alex on 020-7835 1495.

Fighting homophobia

THTs new campaign targets homophobia inside the UKs Afro-Caribbean community. The campaign challenges the idea that homosexuality is something that isnt part of everyday black family life and highlights the positive choices that friends and family of gay black men can make instead of ostracising them. The campaign has already attracted the attention of the national press and its hoped the campaign will be a point of reflection for the black community.

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Weve always been told that condoms are good things, but if they are lubricated with Nonoxynol-9 they can be dangerous. Matt Newbury reports on the renewed calls for a ban on condoms lubricated with Nonoxynol-9 and why they should be avoided.

ay boys arent usually bothered whether or not the condom they use has a spermicide on it. We arent gonna get pregnant are we? But we should be bothered. Nonoxynol-9 (N9) has been commonly used as a spermicidal lubricant for many years, but according to recent research carried out in Africa the use of N-9 actually increases the chance of transmission of HIV and sexually transmitted infections. N-9 was developed as a way of reducing the risk of unwanted pregnancies during the 1950s. It was believed that if the condom broke, you would then have a back-up line of defense. In the 1980s, lab tests suggested that N-9 also killed HIV and other STDs. During that time, N9 products were specifically targeted at gay men. Christopher E Harris MD, President of the Gay and Lesbian Medical Association, released a statement recently saying:

"At one time it was thought that N9 might offer some protection against HIV. It does not. Recent research indicates that using N9 rectally might cause the thin layers of cells that line the rectum to become inflamed, possibly enhancing the risk of HIV transmission.

sexually transmitted diseases at a similar rate to women who used a lube that didnt contain the chemical. More alarmingly, the women who applied the gel several times a day were far more likely to become infected with HIV than those who didnt use N9. The World Health Organisation has said that N9 lubricated condoms "should no longer be promoted." Closer to home, The Terrence Higgins Trust is joining with other organisations including the National AIDS Trust and GMFA to call for N9 products to be removed from sale across the UK. Evidence shows that even low doses of N9 in the rectum can cause abrasions and stripping of the skin lining the rectum, says Will Nutland, head of the gay mens team at THT. We have joined with organisations around th world to inform gay men of the risks. THT have now withdrawn all condoms and lubricants containing N-9 from London and regional centers, and from condom distribution schemes operated by THT. "Theres no reason for its inclusion in condoms and sexual lubricants and every reason to remove it," said Mr Joseph OReilly, the Deputy Chief Executive and Director of Policy at the National Aids Trust. "This is a product which says it does one thing and does completely the opposite." Despite this, the Freedoms scheme, which is funded by the government to provide free and low cost condoms for gay men, continues to sell condoms with N-9 through their website. They do, however, state they are not suitable for gay sex. No one from Camden and Islingtons Gay Mens Team, who run the scheme, was available to comment at the time of going to press. There has been no indication on whether or not they are considering discontinuing the sale of N-9 lubricated condoms. "It's beyond time that UK and European

Using N9 might cause the thin layers of cells that line the rectum to become inflamed, enhancing the risk of HIV transmission
The findings of a team from the Institute Of Tropical Medicine show that N-9 failed to prevent infections when female prostitutes who used an N9 gel acquired HIV and other health regulators took the same action and worked with condom and sexual lubricant manufacturers to discontinue the use of N9. Were also calling on retail outlets to discon-

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Hey Doc, Ive got a problem

The doctors at Gayhealth.com answer the questions you may be too shy to ask in the flesh.
I am 32 years old. Though I've been "out" for almost 10 years, I have not been able to successfully combine intimacy with sex. It's either hot sex or cuddling with someone, but never both. I have broken up with so many good guys after becoming disinterested in them within a couple of days or weeks. Please help. I am not getting any younger. Not getting any younger could be a positive thing. With maturity, you may find yourself better able to combine intimacy with a loving relationship. Since this has been a recurrent problem for you, I suspect there is some psychological basis to what you experience. A lack of desire once you have had someone is typical for many men, but usually stops if you find someone you are really interested in. Part of the problem may be that your relationships may begin "in bed." It might help if you find someone whom you think is relationship material, then avoid having sex with him until you really get to know each other. With time, if the relationship seems like it truly has potential, you can begin to explore sex -but again, take it slow. That said, I think it might also be helpful for you to talk to a therapist to try to work out some of root causes of your feelings. I have difficulty masturbating using my hand. For the last few years now (I'm 22) I find the easiest way to masturbate is to grind my penis softly against a soft flat surface (like a bed). It sounds painful but I'm still wearing underwear and I cum quite fast. The only problem is it makes a mess in my underwear and sometimes I have to peel the tip of my penis from the underwear. For years it was not a problem but recently the tip of my penis has become very numb and it hurts when objects such as the underwear cloth brush against it (this usually occurs after I masturbate). I'm worried that maybe I've hurt the skin at the tip. Maybe I've peeled skin off. Is this permanent damage? Should I discontinue this method of masturbation and try a different method? I'm worried I may have caused permanent damage to my penis. Friction from masturbation can irritate the skin. If your semen dries then it can also cause the skin to stick to your underwear and tear when you remove the clothing. Ideally you should remove the underwear as soon as you ejaculate. Then nothing should stick. If you do rub the skin infection. Either way, you should urge him to see a doctor. As far as your red spots are concerned, it sounds like you are irritating your penis during sex. It could be from friction or an allergy to lubricant or latex condoms (if you use these). Be sure your lubricant is water soluble and free of additives like nonoxynol-9, flavours and perfumes. Be very gentle and don't rub your penis too hard. A one percent hydrocortisone cream sold in pharmacies might also help. If the problem persists, see a dermatologist. Take care.

It might help if you find someone whom you think is relationship material, then avoid having sex with him until you really get to know each other
or irritate it the nerves can become hypersensitive for a while. This should go away once the irritation heals. You might want to try and reduce friction by using silk underwear and even putting lubricant on your penis inside your underwear. You can also try different ways to masturbate. Good luck. My boyfriend suffers from a severe cough, which hasnt got any better even after medication. We often indulge in oral sex. Is this a sign of a sexually transmitted disease (STD)? I have red spots on my dick head. Normally it occurs after masturbation. At times it burns and is painful. Is this point to be noted? The cough does not sound like a STD, but more like a lingering cold or sinus To ask your own question or to read more questions and answers, go to www.gayhealth.com and click on Ask

This page comes to you courtesy of www.gayhealth .com.

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