Information from the San Francisco Department of Public Health. Excerpted here (at Buddies request) with permission. Updated June 2003, June 2004 & June 2005.
Your health is important. We have put together this brief guide to help you stay healthy, stay safe and have fun. We urge you to read, use and share this information and to take care of yourselves and each other.
San Francisco values your choices, your health and the health of the community.
Play hard, play smart, you're worth it!
San Francisco Department of Public Health
Table of Contents
Have you been tested lately? It is recommended that you get an HIV antibody test every SIX months if you are HIV negative and engaging in ANY risk behavior. If you need information, call (415) 502-TEST or log on to the website www.aidshotline.org. And, if you are sexually active with other guys, you should also get tested for Sexually Transmitted Diseases (STDs) every 3 - 6 months, whether or not you have symptoms, to detect "silent" infections. Blow Buddies members can get tested at Blow Buddies, AHP, The Stop AIDS Project or Magnet and get a free pass to the club.
If you think you might have just been exposed to HIV, there is a treatment that might help reduce your chances of getting infected. It's called post-exposure prophylaxis (PEP). Call 415-487-5538 for info.
One of the great things about being alive is having sex. But like many things in life, there are other aspects to consider. At City Clinic we often see conditions that could have been avoided with a little preparation. If you are sexually active, get tested for Sexually Transmitted Diseases (STDs) every 3 - 6 months, whether or not you have symptoms, to detect "silent" infections.
Fucking without a condom is the easiest way to spread HIV. Play it smart. Hopefully the people you have sex with will be honest and will know their HIV status...but they might not know or they might not want to tell you. Aside from HIV, you can also get gonorrhea, chlamydia, syphilis, hepatitis B, warts, herpes and shigella.
There has been a lot of confusion about how safe sucking dick is. It's really difficult to say exactly how safe it is for HIV, but research data shows it's a very, very low risk. We can't say it is 100% safe, but we know the risk is very low. While sucking may be safe for HIV prevention, it is not safe for STD prevention.
Spit or swallow? Not getting cum in your mouth should reduce your risk getting an infection. If you do take a load, it probably doesn't matter if you spit or swallow. Though not high risk for HIV, you can get gonorrhea, chlamydia, syphilis, hepatitis B and herpes.
The risk for transmitting HIV from rimming is very low. But risk for hepatitis A, herpes, shigella and intestinal parasites is high. Getting shots against hepatitis A can help reduce your risk.
There is little risk of STD infection and no risk of HIV infection from playing with pee. It is possible that hepatitis A can be spread by getting pee in your mouth. Get the hep A vaccination to reduce that risk.
What makes fisting risky, when it comes to diseases, is that the blood vessels in the rectum are close to the surface, which means damage can occur easily and can go unnoticed. Avoid too much alcohol or drugs when you fist or get fisted. Trauma can increase the HIV risk when you get fucked, so you might want to fuck before fisting. And use lots of lube!
Sharing toys can be fun, and fortunately they are easy to keep clean. A good idea is to put condoms on your toys, replace the condom between users, and use lots of lube. There is some risk of hepatitis, herpes, warts, and parasites.
Mutual Jerking Off
Not much risk here. Getting cum on you won't transmit STDs -- that can happen only if the cum gets inside your mouth or butthole.
When you need someone to talk to, sometimes it's helpful to talk with someone other than our friends or family. Consider finding a counselor or mental health professional. In private sessions, you can have a chance to discuss how healthy sex fits into your life, how to have fulfilling relationships, or how to feel good about your body. Also, these professionals can work with you on emotional challenges and developmental issues, such as coming out, depression, grief, anger, stress, and relationship issues.
Useful Mental Health numbers: (Don't be discouraged if there's a waiting list. Some of these programs are very popular.)
If you party, party in moderation. It is easier to do things outside of your comfort zone when you've had too much to drink or you're high on drugs. You are also doing some potential damage to your immune system and your health in general. If your routine becomes unmanageable, you might want to consider discussing your usage with your health care providers, or contact one of the agencies below.
Crystal Methamphetamine. Crystal use and abuse is on the increase in our community. Its use is directly tied to increases in STD and HIV infections. It is hard to make good decisions about personal risk while tweaking. For more info, visit www.tweaking.org. If you need encouragement to stop using cyrstal meth, call to find out about the Positive Reinforcement Opportunity Project (PROP). For other treatment options, contact one of the agencies listed below:
The virus that causes AIDS. Most commonly gotten by getting fucked, but both tops and bottoms can get it. Using a regular or rectal condom and lots of lubrication is the best defense. There is no cure, but there are a number of treatments which have improved the health of people living with HIV/AIDS - although they do not work for everyone, nor can everyone tolerate the side effects.
STDs such as gonorrhea, chlamydia, herpes and syphilis increase the spread of HIV. Getting frequently screened and treated for STDs can reduce the risk of HIV.
A very common viral infection, causing itching, tingling, redness, pain, blisters and ulcers, usually around the dick, butt and mouth. Herpes is transmitted by skin-to-skin contact, so avoid the area of an outbreak if you know someone who has herpes. It often becomes chronic, and most people experience a few outbreaks a year. Condoms can reduce but not eliminate risk. There is no cure, but medications can help speed healing time and reduce outbreaks.
Viruses cause warts so small you can't see them; others are visible and painless, and appear on the dick or butt. They are transmitted through skin-to-skin contact and are very common. Using condoms reduces but does not eliminate the risk. Treated by freezing with liquid nitrogen, using chemicals, or surgery.
Hepatitis A and B are liver infections caused by different viruses. Symptoms may include fatigue, poor appetite, fever, nausea, vomiting, and jaundice (yellowing of the skin and eyeballs), and is potentially very serious. A and B are transmitted sexually. There are effective vaccines for hep A and B. To reduce risk, get vaccinated against hep A and B.
Gonorrhea is a bacterial infection that may or may not cause symptoms: a sore throat, pain during bowel movements, burning when peeing, or thick discharge (pus) from the dick or butt. Or, you may carry it and not know it. The bacteria can be passed by oral sex. Condoms can help reduce the risk. It is easily curable with antibiotics. Frequent screening by your doctor can detect "silent" infections.
Chlamydia is caused by a bacterial infection in the dick, butt, or throat. It may or may not have symptoms, which include burning when peeing, a clear or white drip from the dick, or pain. It is curable with antibiotics. Condoms and frequent screening can reduce the risk.
Syphilis has been sharply on the rise in the gay and bi community. It can cause a painless sore on the dick or in the mouth or butt, which goes away and later becomes a rash, often on the palms and soles. Syphilis is transmitted through direct sexual contact with the sore or rash. Condoms can help reduce but not eliminate risk. It is very treatable with antibiotics. An easy blood test can tell if you are infected. Getting frequent check-ups by a doctor will reduce the risk of developing the complications of syphilis: paralysis, damage to blood vessels and death.
Parasites, such as giardia and amoeba, can cause upset stomach and diarrhea with bleeding, which is easily diagnosed and treated with antibiotics. Exposure to shit through rimming and drinking contaminated water are the most common ways they're transmitted.
Shigella is caused by a bacterial infection. Its symptoms include stomach cramps, bloody diarrhea and fever. Shigella is found in shit, and you can get it even if he looks clean so wash with soap and water before, after and during all sex and "ass play."
Special thanks to the staff of SF City Clinic, Stefan Rowniak, Sister Kitty Catalyst and SafeGuards Project.
Photos: Toby Jantzen
Design: Sam Laser Graphics 415-864-2588
San Francisco City Clinic
for more information on this booklet, call 415-355-2003.
This booklet is available in the club as long as supplies last. (Back to top)
Sex Health links
Buddies Head Hotline: (415)