Recently in HIV Category
Dear Dr. Dick, his profile says he's negative...
Dear Dr Dick,
Like so many other gay and bisexual men in Seattle I spend a great deal of time online looking for hookups. It seems that is where all the HOT guys hang out. When I hookup with guys from websites I practice safe sex. However recently I met two guys online that I am considering barebacking with. That's cool if all parties involved are HIV negative right? Both of guys have posted the following statement in their online profiles: "HIV NEG as of November 20, 2008." [I'm guessing that you meant 2008??]
So here my question: is it safe to bareback with them?
Hooked on the Man Hunt
Dear Hooked on the Man Hunt,
Thank you for your question!
The short answer is, no, barebacking (intentional unprotected anal sex) is a very risky sexual practice. Barebacking can easily transmit HIV, along with several other sexually transmitted infections. These potential partners say they are HIV-negative but they were negative as of a year ago, so consider these facts:
In a recent large study of gay/bi men, on average about 2% became infected each year; but among those guys who engaged in the highest risk behavior the rates of new infection reach levels as high as 8% yearly. Other studies have shown that recently HIV-infected guys are the most infectious, because they have very high levels of virus in their blood and semen in the first few months after being infected, before their bodies have brought the infection under some control. So, if you happen to encounter a guy who enjoys high risk behaviors, there could be an 8% chance that he's acquired HIV in the past year, and he may be not just pretty but also pretty infectious.
Knowing your own and your partner's HIV status is an important part of maintaining one's overall health. However, because one advertises their year-old HIV status in an online profile or in person does not necessarily mean it is accurate and frankly it's a big risk to take for HIV, the worst of all sexually transmitted diseases.
Additionally, someone is HIV negative can have another sexually transmitted infection (STI) present. Anal and/or oral sex without condoms can still spread infections such as syphilis and gonorrhea.
Be sure to talk more about this with your partners and even your doctor to settle on a decision that works best for all parties.
Best,
Dr. Dick
HIV+: is my health that important?
Dear Dr. Dick,
I'm already HIV-positive and pushing 50. Do I really need to be concerned with safe sex and my overall health?
--Daddy POZ
Dear Daddy POZ,
Great question! The answer is YES!
No matter what your age, it's good to be health-conscious, especially with your sexual health and that of the local gay/bi community. If we're ever going to get HIV/AIDS under control we must care about ourselves and our communities.
In a recent study, MEN have DETECTABLE HIV in their SEMEN more often than women do in their vaginal secretions, thus making them more likely to INFECT sex partners. Also, in the same study, 70% of the men taking antiretroviral drugs had detectable HIV in their semen, compared to 82% of men NOT taking anti-HIV drugs. So, antiretroviral drugs may reduce but do not eliminate your chances of infecting others.
So, the researchers of this study conclude, "on or off antiretroviral therapy, men may be more infectious than women." (Source: POZ February 2005)
In addition, the following general health recommendations for gay and bisexual men (and really, all men) help promote health and prevent disease:
- Not smoking and avoiding smoky places. Save the money you would have spent on smoking or buy more important things, as FOOD & CLOTHING.
- Eating a healthy and varied diet that is low in fat and high in fiber. Fresh fruits and vegetables... can't keep still? Snack on a carrot or celery.
- Drinking only in moderation. Two drinks a day is in moderation. But, DO drink plenty of water: 8 glasses per day is great!
- Regular health exams and screening for STDs.
- Regular prostate and colon cancer screening after age 50. Schedule one with your doctor, or find one in the Resource List
- Tetanus immunization booster every 10 years. Schedule one with your doctor, or find one in the Resource List
- 30 minutes of aerobic activity 3-4 times per week. Walking is good... watching porn is NOT aerobic exercise! (masturbation is not aerobic; for exercise to be aerobic one must do it for at least 20 min, getting the pulse up to 130-140/min. levels)
T-Cells and Crystal
Dear Dr. Dick:
I'm HIV+ and my doctor says crystal is bad for my HIV. But when I'm getting high, my T-cells stay up. Then when I stop using, my T-cells drop. Does this mean that crystal somehow revs up my immune system?
- Sam on Summit Avenue
Well, Sam, many guys notice the same thing. But a lot of guys see their T-cells drop when they're using speed. Some guys see no change at all.
Here's why:
There's nothing about speed that causes your body to make more T-cells. Or keep them around longer. But the stress of a high does seem to cause more T-cells to move into your blood away from other tissues in your body. And since your T-cell count comes from a blood test, it might look like you have more T-cells. But you probably don't. They may have just moved around a little.
Crystal may "rev up" other body systems, but it does NOT make your immune system work harder. In fact, speed actually makes your T-cells weaker! Crystal makes it harder for T-cells to fight off viruses, bacteria, etc and to grow new T-cells. A double whammy! And the more you use speed, the worse the damage gets.
Also, T-cells go up and down all the time. Stress easily lowers T-cells. And there's a lot of stress in not eating, sleeping, drinking enough water... or even picking up a nice case of syphilis. Sound familiar? So your T-cells may drop. But they also might bounce back again.
HIV meds are another problem. Your T-cells can also drop if you don't stick to your meds schedule. Every day, on time, exactly the way the doctor told you. Drug resistance can develop easily.
And finally, one T-cells count isn't enough. You need to look at several counts over time. And T-cells are just one small piece of your immune puzzle. You can't tell how "healthy" you are just by T-cells. You and your doctor will use many different tests to do that.
So your doctor is right- crystal really not great for HIV. But it is good to tell your doctor about your drug use so you can make the best decisions about your HIV.
DOCTOR'S ORDERS!
Until next time, Dick
Scared sick: Get the scoop on HIV testing and special HIV+ services.
Dear Dr. Dick
I just tested HIV+. I was a little shocked but I've taken some major sexual risks lately. I wish I could go back and change things but I can't. The guy that tested me at the baths assured me the test was anonymous. But I've heard that people who test positive get their name reported to the health department. Is this true? I'm not ready to be "labeled" HIV+ but I want to make sure my health is okay. What can I do?
Scared Sick.
Dear Scared Sick,
It deeply saddens me each time that I have to tell someone that they're HIV+. It does no good to try and make people feel bad about the "risky" sex they've had. Most everyone knows they can become infected from having unprotected sex. Anal sex without a condom is the most risky, but people can get infected just from getting or giving a blow job, too. If you're still having a hard time staying safer, you may want to get some support. It's of great concern that more gay and bisexual men, including many with HIV, are getting (& giving) STDs than in the past few years.
I commend you on having the courage to get tested. This can be a really hard thing to do if you think the result may come back HIV+. Please, rest assured that the test you got at the baths was indeed anonymous. Your test was linked to the fake name you gave the tester. There is no way to track it back to the real you.
Anonymous HIV and STD testing is always available from the HIV/AIDS & STD Programs of the public health department (which provide testing in the baths), and the Seattle Gay Clinic. With an anonymous test, you will never be asked to use your real name or have to show any kind of ID. If you get tested at other places, like your doctor's office or a local clinic, you will probably get a confidential test. However, some docs do anonymous testing, too. This kind of test keeps your name private. By law, doctors and clinics must report new HIV+ cases to the local public health department when they have the patients' names. But reporting is really no big deal and is used only to keep count of case numbers and where the epidemic is headed. With "named" HIV reporting, the reported names are converted to a special unique code. Once this happens, all names are erased.
How can you check out your health without being reported as HIV+? Well, I have some good news for you - maybe the best you've heard of late. The HIV/AIDS Program, the same one that provides free & anonymous HIV/STD testing, has a program called One on One.
In One on One, you can get health services that are anonymous and free. One on One is a great way for people to check up on their health and still protect their privacy. With One on One you can get a complete medical evaluation, CD4 count, viral load, STD screening and treatment, in-depth info about HIV, emotional support, and referral to a good doctor who can follow you and advise you on your medical needs.
One on One is really helpful, especially for people who are nervous or confused about their HIV+ test result. One on One will never use your real name or ask for any kind of ID. Being told you are HIV+ can be really scary and may freak you out. You might not be ready for anyone - no matter who it is - to know about it. You can still check up on your health while you decide what you want to do next.
To make an appointment, call the HIV/STD Hotline at 205-7837 or 1-800-678-1595. Ask about the One on One program.
I wish you good luck and good health. And please, be safe.
Dr. Dick
