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Sex Health Information

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

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Table of Contents

bulletDo you have a health care provider?
bulletPublic health clinics in SF
bulletWhat do you like to do sexually?
bulletCounseling and mental health
bulletDrinking and drugging
bulletSex is about pleasure...making your dick work for you
bulletWhat to know about STDs

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.

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Do you have a health care provider?    (Back to top)

It's a good idea to see your regular health care provider at least once every two years. If you're over 40, you should go once a year. If you're HIV+, you should see your provider on a regular schedule. Talk about diet, exercise, smoking and cancer prevention. In addition to HIV/AIDS, heart disease and cancer are the number one and two concerns in men over 40.

If you are sexually active, it's good to get tested for STDs regularly. If you have new partners, getting an STD check every three months and an HIV test every six months is important.

Avoid lube with nonoxynol-9 (N-9). N-9 has been shown to increase risk for HIV. Remember any lube is better than no lube.

Good provider checklist:

bulletIs your health care provider open to questions?
bulletDoes your provider take a medical history, including a sexual history?
bulletDo you trust your provider?
bulletDoes your provider seem comfortable discussing sensitive issues like sex and drug use?
bulletDoes your provider explain his/her choices for treatment or non-treatment?

Coming out to your provider...

bulletThere are benefits to being open about your sexuality with your provider. S/he can give you better advice and support you in your health care choices. Think about the pros and cons.
bulletYou may also decide that you want a provider who is gay (or gay friendly). The Gay and Lesbian Medical Association (GLMA) has a list of gay providers in the Bay area, and can be reached at 415-255-4547, or at www.glma.org.

STD Test Checklist

bulletThroat swab for gonorrhea and chlamydia
bulletUrine test for gonorrhea and chlamydia
bulletRectal swab for gonorrhea and chlamydia
bulletBlood test for syphilis
bulletOral or blood test for HIV
bulletGenital, oral and skin examination by a care provider


Image courtesy of Magnet. Used with permission.

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Public health clinics in San Francisco     (Back to top)

bulletSF City Clinic (STD Clinic); 356 7th Street; 415-487-5500; Online testing at www.stdtest.org 
bulletMagnet; 4122 18th Street; 415-581-1600; www.magnetsf.org 
Magnet is a center for gay men's health and can provide valuable information as well as STD and HIV testing.
bulletCole Street Youth Clinic; 555 Cole Street; 415-751-8181
bulletHaight Ashbury Free Medical Clinic; 558 Clayton Street; 415-487-5632
bulletMission Neighborhood Health Center; 240 Shotwell Street; 415-552-3870
bulletTom Waddell Clinic; 50 Ivy Street; 554-2950.

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What do you like to do sexually?     (Back to top)

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

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.

Sucking

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.

Rimming

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.

Watersports

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.

Fisting

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

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.

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Counseling and Mental Health    (Back to top)

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.)

bulletReach/AIDS Health Project; 415-476-3902
bulletSan Francisco Sex Info Line; 415-989-7374

In a crisis:

bulletHIV/AIDS Nightline; 415-434-2437
bulletSF Suicide Prevention; 415-781-0500
bulletLYRIC Talkline (youth); 415-863-3636

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Drinking and Drugging    (Back to top)

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:

bulletDrug Line (24/7 Drug Crisis Line); 415-362-3400
bulletNew Leaf; 415-626-7000
bulletPROP; 415-355-2000
bulletStonewall Project; 415-502-1999

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Image courtesy of Magnet. Used with permission.

Sex is about pleasure...making your dick work for you   (Back to top)

Let's face it: sex is about pleasure. Think about ways of maintaining pleasure (or even increasing it!) while decreasing the risks.

Starting out

Before you go out, decide what's OK and what's not OK for you sexually. And pack your gear. Have some key phrases that you can use to communicate to your partner what you are willing and not willing to do. Communicate with your partner about what you both can do to lower any risk. Make decisions on what risks are acceptable and what risks are not, then STICK TO YOUR GUNS!!

Gear

You might want to try different types of condoms and lube, to find the best fit for you. There are many kinds of condoms out there, so experiment a little to find the ones that you think feel best. Then, make sure you keep condoms around...pull them out and have them ready before the action starts. It's easier to talk about when they are in view.

Checking your gear

You might have to slow things down for a few seconds to check your gear, but check from time to time during sex to make sure the condom didn't break. And remember, LUBE, LUBE, LUBE.

Remember, you're half of the party. Don't depend on your partner to provide protection or good judgment in all sexual situations. You must be responsible for your own protection, and use your own good judgment.

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What to know about STDs    (Back to top)

HIV

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.

Herpes

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.

Warts

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

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

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/NGU

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

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

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

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."

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Special thanks to the staff of SF City Clinic, Stefan Rowniak, Sister Kitty Catalyst and SafeGuards Project.

Photos: Toby Jantzen  
James Scott Geras 

Design: Sam Laser Graphics 415-864-2588

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San Francisco City Clinic
356 Seventh Street
San Francisco (between Folsom and Harrison)
www.sfcityclinic.org

for more information on this booklet, call 415-355-2003.

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This booklet is available in the club as long as supplies last.  (Back to top)

Sex Health links

Safer Dicksuckin' 12 Step Meetings in SF Butt it feels better (safer-sex info for tops)
Using your HEAD (safer-sex info on oral sex) Health Information from San Francisco Department of Public Health (comprehensive) About STDs
Syphilis - Get Tested Every Six Months! Not everything you wanted to know about sex and your mouth ... Hepatitis and other bugs Use a fuckin' rubber
SM Sex...Safely   Master link list

Click to go to Sex Health Info page

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