Introduction
If you’ve ever thought that you were the first or only person to have had a sexually transmitted infection (STI) - think again; they have been around for thousands of years. Gonorrhoea was first mentioned in the Bible and the name of the disease was given by the second century Greek physician Galen. The origin of syphilis is less clear but by the 16th Century it was making its way across Europe. More recently, HIV has affected the lives of gay and bisexual men everywhere and has changed the way we think about sexual health. Not only do we have a better understanding of our health needs but many genito-urinary medicine (GUM) and sexual health services have responded to the need for improvement. None of us really want to dwell on STIs, but being aware on what’s going on leaves you free to concentrate on having a good time. Anybody can get a STI from someone who already has one. The trouble is that STIs are usually passed on by someone who doesn’t know that they have an infection and so just asking your partner won’t protect you.The majority of STIs enter the body through tiny abrasions, sores or cuts in the body, many of which can be invisible to the eye. A few STIs only itch, some are painful, some are permanent and many can be serious if left untreated. Effective prevention, protection and treatment will significantly reduce the likelihood of getting STIs or if you do get them, will reduce or eliminate the harm they can cause.
Reducing the risks of infection
Being sexually healthy is not only about dealing with sexual problems as they arise, it’s also about avoiding problems in the first place. Most sexual activity carries some kind of risk of getting an STI and, while never pleasant, many gay men see them as an occupational hazard. You can significantly reduce the risk of getting or passing on STIs by:- Vaccination against hepatitis A and B.
- Using condoms when fucking
- Routine clinic check-ups every four to six months.
- A prompt visit to a sexual health clinic if you think you have an STI.
Causes and common symptoms
Sexually transmitted infections are caused by:- Bacteria which generally live and multiply in the warm and moist parts of your body like your throat, inside your penis and in your anus and rectum.
- Viruses which generally need to get into the blood stream before they can do harm.
- Parasites which live on your body in areas like your groin and armpits.
- Itching in or around the penis, testicles or anus.
- Burning or itching when you urinate or shit.
- Needing to urinate or shit and then not being able to go, or only going a little.
- Spots, scabs or rashes on the penis, testicles, or anus.
- Pus from the end of the penis or from the anus.
- Unusual lumps or bumps.
HIV and STIs
Having HIV already and getting an STI can put extra strain on the immune system and increase your viral load (the amount of virus present in the blood). This, in turn, can make you more infectious (in terms of HIV) to others. If you get infected with another strain of HIV, this could do more harm than the one you already have and increase the likelihood of disease progression. If you get infected with a drug-resistant strain of HIV, drug treatment will be less effective.It’s therefore essential that you have regular sexual health check-ups to make sure that you haven’t picked anything up, particularly STIs which show few or no symptoms. Since most men find out that they have HIV at a clinic, you may already have a doctor who manages your sexual health. If you have any concerns or problems - don’t hesitate to pick up the phone or visit.
Sexually Transmitted Infection - Chlamydia, Lice and Gonorrhoea
Sorting out symptoms and what they may mean
If you think you have an STI, you might wonder what kind of STI it is. The symptom chart opposite matches a range of symptoms commonly associated with sexually transmitted infections. By relating your symptoms with the chart, you should get an indication which STI you could have. Some symptoms can indicate other illnesses or medical problems. All the more reason to see someone as soon as possible. The chart is for guidance only and you should not attempt to diagnose or treat yourself. Always consult a doctor. Almost all STIs require a test at a sexual health clinic to determine whether or not you have a STI.
Chlamydia
Chlamydia is a bacterial infection which you get from unprotected fucking, fingering, rimming, deep kissing and oral sex. Symptoms show themselves one to three weeks after infection. It affects the penis, anus and the throat but can also spread to the bladder and the prostate gland. The body develops an allergic reaction to untreated chalamydia causing an acute form of athrirtis in the joints where it cause permanent damage. It is easily treated with antibiotics although you should go back to the clinic to check that it has cleared up.Crabs Pubic lice
Pubic lice are small insects no more than 3mm across and under the microscope look very much like crabs, hence the nickname. They can be seen with the naked eye particularly when they’ve eaten your blood and are bloated. Crabs have a long sharp hollow nose which they use to pierce the skin and draw up a tasty meal . They live in hair anywhere on the body but you will usually find them first in the groin and chest areas. They move around like Tarzan, holding tightly onto a hair with their claws and swinging to the next. They can easily be passed on though close physical contact including shared bedding, towels and clothing. You don’t only get crabs through sex, so be careful before you point that finger! They are sometimes passed on through day-to-day social contact with friends, flatmates or anyone with whom you share your home. Crabs are easily treated with a special lotion, available from any chemist, or free, from a clinic. Even after effective treatment you can still feel itchy for a few days and - believing the crabs still there - some people re-treat themselves which can cause skin irritation. All bedding and clothes that have come into contact with you should be washed at no less than a 600 c wash.Gonorrhoea
Gonorrhoea is a highly infectious bacterial infection which you get from unprotected fucking, fingering, rimming, deep kissing, and oral sex. Left untreated the infection can spread to the prostate gland, bladder, the balls and joints and cause permanent damage. Blindness has be known and in some cases, death. A course of antibiotics is usually prescribed.Sexually Transmitted Infection - Hepatitis
Hepatitis is caused by a family of viruses - such as A, B and C - that affect the liver and reduce its ability to function. One of the largest and most important body organs, the liver makes and regulates many of the body’s chemicals and helps break down and eliminate drugs, toxins and others poisonous substances from the blood. When it’s infected, it becomes swollen, painful and doesn’t work properly which means that poisons - which would otherwise be processed by the liver - build up in the bloodstream. Recovery can take many months and the consequences of hepatitis can be serious, cause long-term damage and in some cases liver failure. (Hepatitis can also be caused by the side-effects of some medical drugs, overdosing on some drugs eg paracetamol, and long-term alcohol abuse - which put the liver under great strain).Vaccination
Unlike the majority of STIs, Hepatitis A and B are preventable through vaccination. So with few exceptions you can virtually eliminate getting it in the first place, and it’s difficult to understand why so many gay men who know about it don’t bother. If you’re gay and sexually active, it’s essential!How you get it and symptoms
Hepatitis A
Hepatitis A is most commonly associated with poor toilet hygiene and contaminated food and water although you get it from rimming, scat, and kissing. While some people don’t get any symptoms at all, they usually occur two to eight weeks after infection and include diarrhoea, loss of appetite, aches and pains, pale slimy shits, dark coloured piss and a yellowing or jaundice of the skin and eyes. Although very unpleasant, hepatitis A is rarely serious and the body usually fights off the infection within a few weeks, though some symptoms may persist for up to six months.
Hepatitis B
Hepatitis B is much more serious than hepatitis A and can cause long-term liver damage. In a minority of cases, this can cause chronic liver damage leading to death. You can get hepatitis B from unprotected fucking and shared dildos, oral sex, watersports (if the piss gets into the eyes and mouth) and rimming. In fact, it’s a bit of an all rounder which is why vaccination is essential! Most people experience no symptoms but have a period of illness up to six months after infection. These include tiredness, jaundice, dark coloured piss, pale slimy shits, stomach pains and itching. The majority of people recover fully although a small percentage remain carriers of the virus and can …peperonity.com/porn/sites/gaysexguide/11581672
HIV and AIDS
What it does
HIV stands for Human Immunodeficiency Virus. Isolated in 1983, it belongs to a family of viruses known as retroviruses. Although the syndrome of illnesses associated with HIV infection was only recognised in the early 80s, analysis of stored blood samples reveals it was present as long ago as 1959. A virus is a very simple organism, consisting of an outer coating enclosing genetic material. When a person becomes infected with HIV, the virus enters the cell and the viral genetic material is copied into the gene of the infected cell. These cells will remain infected for the rest of their lives, as HIV uses them as factories to produce more copies, which can then go on to infect more cells. Although many different cells within the body are infected with HIV, it particularly damages cells which are part of the body’s defences against infection (the immune system). This is why people with advanced HIV infection are much more susceptible to certain infections (and types of cancer) since the function of the immune system is progressively weakened by the damage done by HIV. AIDS (Acquired Immune Deficiency Syndrome) is the name given to the collection of illnesses (or syndrome) which someone can get if their immune system has been severely damaged by HIV.How you get it
Fucking without condoms and sharing needles to inject drugs are the two main ways HIV is transmitted. While there is some risk with other sexual practices such as cocksucking, rimming, finger fucking and fisting, the risks are negligible compared to unprotected fucking, which accounts for a significant number of HIV transmission cases between men. The most effective way to prevent HIV transmission - and protect yourself against many other STIs - is to fuck with condoms or not to fuck at all. That said, it you are determined to fuck without condoms and you aren’t sure if you might get HIV or pass it on, there are things you could do that would make it less likely.Treatment
While there is no cure or vaccine, there is a range of treatments which have improved significantly in recent years. Treatments to fight HIV work in different ways but many aim to make it more difficult for HIV to copy itself, so reducing the amount of virus in the blood. This in turn means that HIV does less damage and reduces the likelihood of an AIDS-related illness. While there have been major advancements in the way we combat HIV, there is neither a cure nor a vaccine and both are unlikely in the near future.Sexually Transmitted Infection - Testing for HIV
Once someone is infected, the body will produce antibodies or markers in the blood and these can be detected, usually, after 8-12 weeks of infection, with a blood test. Symptoms associated with HIV are also common to many other medical conditions. A proper check-up and an HIV antibody test will only determine whether you have HIV, the common ‘flu or something else. If you are concerned, go to clinic.
The HIV test detects HIV antibodies, not the virus itself. Antibodies are produced after someone has been infected with the virus. HIV antibodies do not effectively remove the virus from your system and so do not make you immune. It can take up to three months after infection for the test to detect antibodies. This means that if you have become infected within the last three months, a test will not necessarily be positive. If you decide to have an HIV test you should think carefully about the possible results. Positive means antibodies are present, negative means they are not. Some people are convinced they are negative but test positive and vice versa. It’s natural to speculate but you could be wrong.
A negative test result will mean that you have not got HIV (provided you have not put yourself at risk within the last three months) and that you cannot pass HIV on to anyone else. Recently there have been reports about certain people being immune to HIV. These cases are extremely rare, there are estimated to be only a handful of people in this country. For the majority of gay men, a negative result does not mean they are immune. If you’ve fucked without a condom in the last 15 years with someone you could not be 100% sure was HIV negative, then you’re probably lucky, not immune. A positive test result means you are infected with HIV and can pass it on to someone else. It does not, on its own, necessarily mean that you have AIDS, nor does it tell you if or when you will develop an AIDS-related condition.
If you go for a test at a GUM/sexual health clinic you should be offered the opportunity to talk to a counsellor, a health adviser or a doctor beforehand. Staff are there to ensure that you fully understand what the test involves. They are not there to tell you whether you should have a test or to pressure you into making a decision either way. There may be advantages and disadvantages to taking an HIV test. These will depend on you as an individual and what you think your test result might be. There can be no overall recommendation about testing, it is up to you. If you decide to have an HIV test, think about who you tell that you are having one. If someone knows you are going for a test, they might want to know the result. Would you really want them to know? If you or your partner are thinking about testing, don’t put pressure on each other to make a quick decision. Respect each other’s choices.
Sexually Transmitted Infection - After an HIV positive diagnosis
Everyone’s experience of living with HIV is different. As the news sinks in and you start to come terms with what it means, you may feel like being by yourself or with your partner, chatting with a close friend or someone at the clinic where you received your diagnosis. There are also groups where you can share your experiences with other newly diagnosed gay men, although you won’t necessarily ask the same questions or all go through the same feelings and emotions. 'I feel so lonely…’, 'I’m so relieved…’, and 'there’s just so much to think about…’ are not unusual responses. And, ’…am I going to die?’… 'who gave me it to me?’… 'what am I going to do now?’ and ’…who should I tell?’ are commonly asked questions. The quick answers are 'yes’… 'why does it matter?’…'take your time’ and 'no one until you are ready.’ But you will also learn that the answers to these and other questions are not necessary black or white, right or wrong, or good or bad. Take things at your own pace. Don’t rush into taking decisions or allow yourself to be coerced or bullied into doing things you may later regret. Most things can wait for a while, this includes talking to you family or partner, seeking proper advice before telling your employer (though as a rule you’re encouraged not to) or leaving your job and becoming destitute. For some HIV positive gay men, telling others about their status can be as traumatic as coming out as gay. It is important to think carefully about who you want to tell and why. Once you have told someone about being HIV positive, you cannot take the information back. Coming out is a very personal process and should be your choice. Obviously, it can feel very natural to want to tell your partner and/or your family immediately but the response may not be what you expect. It certainly doesn’t help to be dealing with other people’s crap while still sorting out your own. If, however, you have decided to come out, the following may be helpful:
Be aware that telling people may affect you more than you think and they may not react in the way you expect.
Don’t ell people if you don’t want them to tell others.
Try and prepare yourself for the questions they may ask or the issues they may bring up.
Try and choose the right time and place.
People have different reasons for coming out. For some it may be to get support or health care whilst others might want their sexual partner(s) to know. Not telling someone about your diagnosis might prevent you getting the support, advice and services that are appropriate to your needs. Whatever reaction you get to coming out, being positive is nothing to be ashamed of.
This online advice guide is an extract from the book TOGETHER, by kind permission of Patriic Gayle and Gay Times Books. The book itself is over 300 pages long and contains:
- several chapters more useful advice and information
- more in-depth information in some chapters
- more pictures and tables
- further contacts at the end of each chapter
- a comprehensive listing of gay and health organisations
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NSU, Scabies, Syphilis and Warts
Non-Specific Urethritis (NSU)
NSU is a bacterial infection that you get from unprotected fucking, fingering, rimming, deep kissing and oral sex. The pain and burning sensation when pissing is sometimes referred to as 'pissing razorblades’ or 'pissing glass’. Untreated, NSU can spread to the balls which can become inflamed and can be very painful during sex. Sometimes there are no symptoms and NSU will only be picked up by a routine test at a sexual health clinic. However, symptoms are very similar to gonorrhoea and only a test will tell them apart. A course of antibiotics will treat most NSU infections.Scabies
Scabies is caused by a common mite, invisible to the eye, that burrows into the surface of the skin to lay its eggs. This causes severe irritation and small rashes and/or reddish tracks. You can find them almost anywhere on the body but you will often find them in the groin area, between the fingers, chest and stomach and feet. Like crabs, they can easily be passed on though close physical contact and shared bedding, towels and clothing, but this is less likely. The treatment is the same as for crabs - get hold of the appropriate lotion from the chemist, and follow the instructions. You must also wash all used clothes and bedding at no less than 60oc wherever possible to kill the mites and their eggs.Syphilis
Syphilis is caused by a tiny corkscrew shaped bacterium which is invisible to the naked eye. You get it through fucking, oral sex, fisting and most other physical contact with the sores or rash which are highly infectious. A blood test through a sexual health clinic will tell you if you haves syphilis. Over a period of years, symptoms develop through three stages as it spreads through the body and, if left untreated, will cause madness, heart disease and death. During stage one, a small sore appears on the cock, around the arsehole or the throat, no more than 1cm across; this heals in a couple of months. During stage two, about three months later, there is a skin rash which can be severe and is accompanied by headaches, nausea, flu-like symptoms, and loss of appetite. In some instances people lose their hair in clumps. During stage three, which usually starts within ten years of infection several things happen: the nervous system breaks down, heart failure, large ulcerous sores, madness and death. Syphilis is one a range of STIs which are tested for routinely at sexual health clinics and is rare in the UK although it is becoming more common in gay men.Treatment
If detected early, syphilis is treated with penicillin or and antibiotics for those who are allergic. However, As you progress through the stages, it becomes increasingly difficult to treat effectively.Warts
Genital warts are caused by the papillomavirus which you get from fucking, oral sex and most skin contact with them including touching, rubbing and scratching. They appear as small fleshy whitish cauliflower-shaped lumps on the cock, balls or the anus. They can also appear in the mouth, on the face and inside the rectal passage. While they are not known to cause harm to men, they can be unsightly and can be itchy or uncomfortable. Warts can be single or group tightly together. If you already have warts, shaving them or scratching them and them touching other parts of the body will cause them to spread. Sometimes warts disappear by themselves although you will still have the virus and they may appear months or years later. They are usually treated with a wart-removing liquid that is painted onto the warts until they go. They can also be frozen off with liquid nitrogen, o, in some cases surgery or laser treatment is used. ‘peperonity.com/porn/sites/gaysexguide/11581675
Step by Step
After your HIV diagnosis, several things are likely to happen:
You will subjected to a flurry of medical tests to establish your state of health and to what extent virus is affecting your immune system.
If appropriate, you may be offered treatments to reduce or stabilise the level of HIV in your body or treatments to help prevent the development of opportunistic infections.
Depending on your needs, state of health and circumstances you will be helped to apply for benefits or put in touch with a social worker or home care support team.
There is sometimes an assumption by professionals that because you are gay you know what to do and where to go. This is, of course, not likely to be true where your new HIV diagnosis is concerned. Of course it may be difficult to gauge whether you’re getting the information you need and want, but if you have any doubts ask - or get a second opinion from a helpline or other organisation. This can be overwhelming particularly at a time when there is likely to be a lot on your mind and you may be feeling very stressed and emotional. Spare some thought for how you are feeling. Being HIV positive can play havoc with your emotions. Whether you chat regularly with a mate, attend a group, phone a helpline or seek professional help - don’t ignore your feelings. Some find it difficult to ask for help or accept it, but there’s nothing wrong with getting it or for asking for it. We all need help once in a while - it doesn’t mean that we are weak or incapable. Equally, saying 'no’ doesn’t necessarily mean you are being awkward - so don’t feel guilty or afraid about saying it. The following tips are designed to make getting help and support easier, and so you make decisions which suit you and meet your needs.
Try to deal with one thing at a time.
Find a doctor or clinic you like. If you don’t like them, change them.
Make decisions in your own time.
Take at least some time to learn more about HIV and how it could affect you. But you don’t have to become an expert or know everything at once. Knowing more will help you feel more in control.
Consider how you could make your lifestyle healthier. It may include, for example, changes to your diet, having more fun or doing relaxation exercises. Even if you think you’re a sceptic give it a chance; you can always go back to clubs, drugs, and ready-made-meals - they ain’t going nowhere!
Listen to your body, it’s usually pretty good at telling you what it likes and doesn’t like. You may take it for granted but it is your friend, get to know and understand it better.
If there are changes to be made to your life, they are rarely drastic or wholesale and you don’t have to make them all at once. You have time.
If you’re attending an appointment, there’s nothing to stop you taking someone with you. A little moral support and another pair of ears can be very helpful.
When you are speaking about your HIV, particularly in relation to HIV services, you may come across people whom you don’t know, don’t like or who don’t seem to understand what your needs are. Here are some tips to get you through:
Be honest and direct - say what’s on your mind.
Consider taking notes and preparing some questions beforehand. This way you can take the information away and understand it better in your own time.
Listen to what is being said and think what you want to say next before opening your gob.
If you’re getting irritable or angry say so, then take some deep breaths, take a break, or go to the toilet. If you really can’t handle it, leave. You can always go back when you’re ready.
If you’re told something which you don’t understand, repeat what’s been said in your own words and ask if you’ve understood correctly.
Sexually Transmitted Infection - HIV Treatment
Over the past 5 years, the development of HIV treatments has revolutionised the way HIV is managed. A new generation of drugs work principally by slowing down the rate at which HIV reproduces in the body. This allows the immune system to regroup and strengthen which means that the body can fight off infections more easily. Death rates have been significantly lowered and people with HIV are staying healthier for longer. Although there are many benefits from taking these drugs, there is still a lot which isn’t known about them - for example, doctors don’t know how long the drugs will be effective. Some people experience side effects with these drugs. Often these will be mild, or will only last for a few days or weeks after starting the drug, but in a small number of people these side effects may be more severe, causing them to change drugs.
It’s vital to take these drugs exactly as prescribed. This is called being 'compliant’ or 'adherent’. For some of the drugs this means taking a specific dose at specific times during the day, and changing diet in order to increase the effect which the drugs have on the body. This can have an impact on people’s lifestyles, for example getting up early or staying up late to take a drug. However, if these guidelines aren’t complied with, there is a significant risk that some of the drugs will not be effective and you could develop drug-resistant virus. Resistance means that the virus has changed so that the drug will no longer affect it. Resistance may happen even if drugs are taken exactly as prescribed. Reinfection with HIV from someone who already has a drug-resistant strain may also mean that you might quickly develop resistance to the drugs - a compelling reason for having safer sex. Anyone considering taking anti-HIV drugs needs to think carefully about the advantages and disadvantages. Before you decide to take the drugs, you should talk to your doctor, and contact one of the organisations listed at the end of this chapter. Ask questions and find stuff out for yourself.
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