Sexually Transmitted Diseases/gay sex

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Question
QUESTION: I've heard that you cannot get HIV from gay oral sex  even if the seamen load is swallowed provided that the recieving guy doen'st have any open mouth sores......True?

Durex & trojan condoms are strong enough for gay anal sex?

I've seen pictures of gay porn actors with a reddness around the lower neck/upper chest region.....Is that a sign of the disease?

ANSWER: Hello Jeff,
Anytime "exchanges" blood or bodily fluids with anyone, there is risk of transmission of infectious diseases.  This includes certain types of hepatitis, herpes, gonorrhea, chlamydia, strep throat, HIV, infectious mononucleosis, syphilis, the common cold, influenza, human papilloma virus, and a bunch of other ones, some exclusively through sex, others not necessarily so. It is incorrect to characterize "gay oral sex" as different from "heterosexual oral sex" because germs can be transmitted irrespective of the sexual orientation or sex practices of the participants. That being said, it is important to say that HIV transmission from just oral sex is a very low risk activity, whether you swallow or spit out the semen.

All condoms, if put on correctly and remaining intact during sexual activities with proper and sufficient  lubrication are good enough for anal sex.  Again, it doesn't matter whether it is "gay" anal sex or "straight" anal sex!

Redness around the upper chest or lower neck is usually a sign of either sun exposure and/or flushing and blood vessel dilation, totally unrelated to having any specific diseases.  Recall that most of such flicks are done in warm sun shiny areas, which increases the likelihood of sun induced redness and tanning, which may enhance their "buffness" which is a marketing ploy to attract business.

Good luck!
--mark


---------- FOLLOW-UP ----------

QUESTION: So sorry for all the questions

So basically oral sex between 2 men is OK?
Are those other diseases you talked about deadly too?
Do people die suddenly if they have the disease?
Until when or if there is ever a vaccine/cure, Do gays have to use a condom every time they have sex....even if they are in a commited relationship?
Is anal & vaginal tissue made up differently....how can some rapes or one-night stands like on the 'Maury' talk show don't result in HIV while others do...(or aren't they telling)...

Can HIV/AIDS meds be crushed into powder to be taken easier or does that lose their potency?
Would medicine like theraflu, etc help or would those be pointless?

Again, sorry for all the questions

Answer
Hi Again, Jeff,
Your questions are really more complex than meets the eye.  

Oral sex between 2 PEOPLE (not just men!) of any sex may or may not be "okay" because it depends on whether the participants may be infected with an STD but without symptoms, and whether such an infection can be transmitted during oral sex.  It is NOT just about HIV. Syphilis, herpes, gonorrhea, chlamydia, HPV/warts, etc. can all be spread from mouth to genital contact.

Other diseases mentioned can cause acute, chronic disease with terrible sequella including death in some cases. However, this is not common.

People rarely die suddenly if they develop such a disease, however meningococcal meningitis is something that can be spread through oral sex and kissing, is not considered an STD, and can cause death, although it too is not very common.  Chicago's gay community is experiencing an outbreak right now, but I am unaware of any other details.

If two people are absolutely free of infectious diseases, then they need not be concerned about passing something bad to their partners. However, some germs not commonly thought of as STDs may be transmitted and cause disease. Remember, that it takes all participants to make a decision, and that all means everyone shares the responsibility.  Most people negotiate to use or not use condoms, and although there may be some risk as there is with crossing the street in heavy traffic, most find satisfactory options.  There will probably not be a vaccine or cure for every possible STD in our lifetimes.  

Anal & vaginal tissues are different and have different susceptibility for abrasions, bleeding, and susceptibility to different germs. Rape is a crime of violence and not all people who commit unconsensual sex have infections that can be transmitted, even during rough sex.

There are many HIV medications, and some mixtures of medications ("cocktails") can be mixed with certain foods. However most should not be taken in ways they are not designed because they may not be effective.

Medications like theraflu, whether over-the-counter or prescribed, may cause bad side effects, and should not be done without consulting with a knowledgeable health care provider.

Good luck!
--mark  

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Mark P. Behar

Expertise

Almost any question or concern about gay men's health issues, sexually transmitted infections, abnormal Pap smears, anal cytology (anal "Pap smears"), etc. There is no such thing as “d/d free” or “clean” (free of infection), so why do so many of us deceive ourselves into thinking that some people are indeed totally free from a potentially infectious disease, like HIV, herpes, hepatitis, syphilis, chlamydia, warts, gonorrhea, etc., just because they say so? Clinical laboratory tests are not perfect, and having a “negative” or “nonreactive” test does not mean that a person is free from infection. Perhaps at the moment the test was taken, the person was uninfected; or, perhaps, the test wasn’t sensitive enough to detect presence of the infection. There is really no way that anyone can determine that they are truly “disease free,” and there are over a hundred of infectious conditions that can be spread without your knowing anything. Rather than trying to “pre-screen” or “serosort” a potential sex-mate with deceptive questions that are impossible to know by today’s technologies, a wiser option may be to consider everyone infected with something, and either use appropriate protective measures (“safer sex”), or accept the responsibility and consequences of possibly “catching” something from someone who’s hotter than expected (pun intended!). There is much research that supports the contention that an HIV positive person reliably taking HIV medications, and having an undetectable viral load, presents a lower risk for transmission of HIV than people who may think or say they are HIV negative, but are not. Food for thought!

Experience

Family Practice PA since 1981; Volunteer Clinician for Brady East STD (BESTD) Clinic, Milwaukee, since 1977; answered STD questions submitted to their web site. Professionally lectured at national and regional Physician Assistant and Nurse Practitioner conferences, and at national gay & lesbian health conferences on topics including HIV/AIDS, herpes, hepatitis, STDs, human papilloma virus (the cause of venereal warts), abnormal Pap smears, gay and lesbian health issues, among others.

Organizations
Co-Founder, Lesbian, Bisexual, & Gay Physician Assistant Caucus of the American Academy of Physician Assistants, Inc.; American Academy of Physician Assistants; Wisconsin Academy of Physician Assistants; National Co-Chair (2012-16), National Association of Black and White Men Together: A Gay, Multiracial Organization for All People (NABWMT)

Publications
Journal of the American Academy of Physician Assistants (JAPA) Q Visions, Quarterly Newsletter of the NABWMT

Education/Credentials
Bachelor's of Arts, 1972 (University of Wisconsin, Milwaukee, WI) Graduate Credits Experimental Psychology, 1972-75 (Tulane University, New Orleans, LA) Physician Assistant, Bachelor's of Science, 1981 (George Washington University, Washington, DC); Masters in Physician Assistant Studies, 2000 (University of Nebraska Medical Center, Omaha, NE)

Awards and Honors
Colposcopy Recognition Award (CRA), the American Association of Colposcopy and Cervical Pathology; Distinguished Fellow, Clinical Preceptor, American Academy of Physician Assistants; Fellow, Wisconsin Academy of Physician Assistants

Past/Present Clients
Brady East STD Clinic, Milwaukee, WI Milwaukee Health Services, Inc. (Martin Luther King Heritage Health Center), Dept. of Family Medicine and Early Intervention Program for HIV Infected Persons

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