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 At this time of year thoughts turn to sun, surf – and sex! Alistair Sutton speaks with gay GPs David Orth and Wendell Rosevear about doing it safely.
As the song says, sex hasn’t gone out of style. It should be mutually fun and hassle free. So what are the issues facing our community? How should we balance our sexual needs with rates of HIV and other STDs on the rise?
Awareness of safe sex gives you a choice between practising it or not; “rubber or trust”, as Dr Wendell Rosevear puts it. A gay couple needs to have a frank discussion about how they approach sex. If you choose to remain monogamous, you’re both HIV negative and you wish to have unprotected sex, you have to trust that neither party will stray. Rosevear says it is often this wish for trust that leads to problems.
Dr David Orth concurs: “Problems occur when couples use unprotected sex as a guarantee of monogamy,” he says. “If one party does have sex outside the relationship, how do you tell your partner? You need to be totally upfront and honest in discussing these issues.”
So what can you do to ensure you stay safe?
Firstly, always using condoms for anal sex is vital. Check to see that the condom has not passed its expiry date and make sure it hasn’t been exposed to heat (i.e. that box of condoms you keep in the car glove box for emergencies). Use plenty of lube on the outside of the condom – and wherever you want to stick it.
Avoid oral sex if you have bleeding gums or ulcers.
Gay men who have multiple partners should have an annual sexual health examination. You should also get a check if you develop any symptoms of an STD – adopt an ‘if in doubt, find out’ approach.
A sexual health check is simple, involving blood tests for HIV, syphilis, and hepatitis A, B and C. A urine test will reveal any trace of chlamydia and gonorrhoea. A physical inspection is used to look for warts. Untreated warts may lead to greater susceptibility to anal cancer. Swab tests of the throat are also used to see if you have contracted any STDs from oral sex. A rectal swab is recommended if you are in any way receptive (fingers, toes, dicks, fists, the kitchen table, etc.)
Gay men should be vaccinated for Hepatitis A and B. Once you get the vaccines you won’t have to worry about them!
In the event that unsafe sex does occur, you should immediately seek PEP (post-exposure prophylaxis). PEP – which may stop you from getting HIV – is available from all hospital emergency departments, sexual health clinics and from gay-friendly medical centres. But it must be taken within 72 hours of the unsafe incident, and the sooner the better.
Sex hasn’t gone out of style. But let’s take the fear out of it. Don’t wake up the next day thinking, “Shit, what did I do?”
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