SAFER-SEXUAL PRACTICES MAKES "IT" PERFECT

• » Negotiating Safer-Sex: What's For Dessert?
• » Speaking of Rubbers
• » Moving on to Lubes, Lubes, and more Lubes
• » No Penalties for Early Withdrawal
• » Un-Safe Sex Rationing
• » Douching... Before and After-Care
• » HIV Immunity, I Don't Think So.
• » HIV/AIDS and other STD/STI's: Sexually Transmitted Diseases/Infections
• » HIV Testing and the Window Period
• » Street Drugs ... and Alcohol
• » Vaccinations
• » A Word to the Wise on Poppers... and Viagara/Cialis, etc.
• » Internet Resources

NEGOTIATING SAFER-SEX: WHAT'S FOR DESSERT?

Open communication allows you and your partner(s) to negotiate some safer-sexual practices. What's good for you may not necessarily be good for the other person(s). Just because you like it "raw" (sans condom, without a condom, "bare-backing") doesn't mean they do, or are able to effectively say "No" to condom-less sex. And, just because you think he or she is "safe", or physically looks like their safe doesn't make it so. HIV doesn't discriminate; however, we all should be more discriminating when it comes to negotiating safer-sexual practices, namely when and how to use condoms.

Asking your partner four simple words, "What's your HIV status?" goes a long way in stopping the spread of HIV—not to mention opens lines for other avenues on questions about previous partner history, HIV testing, what's "safer" to you, STD/STI's and pregnancy issues. Be aware that just because they may look great doesn't mean they aren't infected with HIV. Talk with your partner openly and honestly... it's all about trust. If you both decide to go "sans condom" (without a condom), then it should be mutually decided - but only after careful considerations. But on my advice, always use a rubber!

SPEAKING OF RUBBERS

Condoms are 99.99% effective in stopping the spread of HIV when used correctly. They're also the great equalizer, if negotiating safer-sexual practices is beyond your scope. Use ‘em, each and every time you have penetrative sex. But use them correctly. "And how exactly?" you might ask.

Well first, off you gotta keep them handy. Around the house, in your front pocket (without other stuff in there that that might puncture them), at your mother's (but please negotiate with her first). Never store them in your wallet. Why? Well, you sit on your wallet a lot and that can cause the protective air in the condom to deflate or pop open, rendering it potentially ineffective later on. Always store condoms in a cool and dry place, and away from direct sunlight.

Check the expiration date on them. Using an outdated condom can cause "breakage" during sex, leaving you wide open for HIV and other STD/STI's... or Pregnancy.

Open the condom package. Just because you carry around a condom doesn't make you a safer-sex person, you actually have to use it!

Open it carefully, avoiding your teeth or sharp objects when doing so.

Lube the tip of your penis. It makes the condom go on easier and potentially more pleasurable during sex. Don't use too much lube too, or it could cause the rubber to come off during intercourse. Never use oil-based lubricants, such as petroleum jelly (Vaseline), hand lotion, cooking oil, or baby oil, because that actually weakens the condom.

Rolling, rolling... rolling, not rawhide! Sorry, I'm getting carried away. Roll the condom correctly over the tip of your penis. There is a right and wrong way to do that. First check with your finger to figure out which way the condom rolls. Taking that 50/50 chance and just slapping it on your dick and finding out it's rolled on the wrong way, and then re-rolling it on the right way, may actually leave pre-cum on the outside of the condom. Pre-cum does have HIV in it.

Lube up your partner and the outside of the condom. Friction without the right latex- friendly lube can cause the condom to break during sex.

For the best lubes that money can buy, go to: http://www.idlube.com (The Primo site for all your personal lubricant needs) Have sex, yes go for it. Complete sexual intercourse. Negotiate with your partners when it's right to stop. Make sure the condom doesn't slip off after you've "popped" off and are ready to withdraw. Hold the condom at the base of the penis to avoid the condom from falling off and into your partner and causing semen or body fluids to escape out of the condom and into your partner. Withdraw while still erect, your penis that is. (Note: "Erect" might also mean standing. For more info on the types of sexual positions out there, buy the book: Complete Kama Sutra Unabridged Translation ) Tie off the condom. Make a loop and tie it so no semen leaks out Toss it. Don't flush it. Why? No one wants it in their water supply! Repeat if necessary, sex that is. There is also something called the "Female Reality Condom", a soft, polyurethane condom that covers a wider area for the "receptive" partner. Essentially, it looks like an elongated bag and protects against STI/STD's and HIV. It also transmits "heat" better, for a potentially more "enjoyable" experience. For more info on condoms and the Female Reality Condom, go here: http://www.friendtofriend.org/condom/usage.html

MOVING on to LUBES, LUBES, and more LUBES

Like my mechanic and president always says, "Oil is the lifeblood of your car and of this great nation". And like your car, clunky bodies during sex require adequate amounts of lubrication to keep the gears from grinding. Lube, obviously, helps to reduce friction, irritation and tears to your sexual organs that occur as a result of sex. A tear in the rectal/vaginal wall during un-lubricated sex just opens you up for nasty infections, like HIV. Don't depend on spit to get you through the evening either. Always use a latex-friendly lube, like ID-Millennium, ID-Glide, or ID-Velvet (duly registered trademarks our favorite lubrication center).

For a fantastic list of sensually approved condom-friendly lubes, go here: http://www.idlube.com

While lubes are "a good thing", they don't provide protection against infection. Don't get into the Nonoxynol-9 mentality either, believing that it provides protection against HIV (It does however provide you with some protection against pregnancy, by acting as a spermicidal agent... but not much). One study actually found that it aided in causing those tears I spoke of earlier. And what do tears do? They can open you up for HIV.

NO PENALTIES FOR EARLY WITHDRAWAL, sans condom ("barebacking")

A word on "bare-backing". To bareback literally means, "to ride it raw"... in sexual lingo, it means having sex without a condom. This is the number one transmission avenue for acquiring HIV. Do it and you're exposing yourself to a plethora of sexual problems. Always negotiate the use of condoms to protect yourself against HIV and other STD/STI's. On the "Risk Continuum" of sexual escapades, bare-backing is the highest risk transmission category out there; and if you already are HIV-infected and bareback, you can re-infect yourself and you're partner with a drug-resistant strain of HIV. We call it "Super-Infected", and it ain't super. To read about "Super-Infection" and "Re-Infection" of HIV go here: http://www.thebody.com/index/treat/superinfection.html

Early withdrawal before ejaculation or "Cumming" (without a condom) outside your partner, poses fewer risks to the receptive partner, but you still risk acquiring HIV. It's an option to use. We call it "Harm Reduction". But, since HIV and other infectious germs (like Gonorrhea, Chlamydia and other STI/STDs) can be in pre-cum, this method still poses a significant risk. "Pull-out before you pop-off", in other words.

Recently, the CDC (Septermber 2009) stated that if you are HIV + and adherent to your meds; have no other co-occuring STD/Is; are undecteable in your viral load; and have CD4 counts are above 350, you VASTLY reduce your chances of infecting others. Keep in mind, though, when answering the call to saddle-up bareback or unmount your rider, even though someone can answer "Yes" to everything above, people still lie or are unaware of these important vectors of transmissions.

Risk Continuum means the level of safer-sexual activities out there:

No Risk are things like:
» Hugging
» Massage
» Self-masturbation
» Phone sex
» Fantasy
» "Dry humping"

Very Low Risk are things like:
» Stimulating someone else's genitals using only your hands
» Oral sex without directly putting the genital into mouth
» Oral sex with a condom
» Receiving oral Sex without a condom or barrier method
» Sharing sex toys that have been cleaned and/or "wrapped" up, meaning using a condom on the toy
» Tongue Kissing without the presence of open sores or bleeding gums, etc.

Low Risk are things like:
» Insertive vaginal or anal sex with a condom, being the "Top"

Medium Risk are things like:
» Receptive Vaginal or anal sex with a condom, being the "Bottom"
» Giving Oral Sex without a condom. Oral sex is a sticky situation, pardon the pun. Why? Because if the receiving partner has an open sore in his/her mouth or bleeding gums, etc. and the insertive partner has an open sore on their genital, HIV can be transmitted. Also, pre-cum has HIV in it. Remember to negotiate what's safer-sex for you, meaning talk with you partner first.
» Sharing sex toys without a condom

High Risk are things like:
» Insertive vaginal or anal sex without a condom

Very High Risk are things like:
» Receptive vaginal or anal sex without a condom

To view the "Risk Continuum" of sexual encounters, read here: http://www.engenderhealth.org/res/onc/hiv/preventing/miw/hiv6miw9.html

UN-SAFE SEXUAL RATIONING

Rationing out your "barebacking" (raw sex, sans condoms) over time reduces the number of HIV exposures you have (again "Harm Reduction"); better, but not best safer-sexual practices. The less partners you have in a given period over the course of a night/evening/day is just good sense and it allows the minute tears that occurs during sex (to your rectal/vaginal lining/urethra and skin around your penis) to heal properly. As a result, this can reduce - but remember, not eliminate, the risk you wager over an unsafe sexual performance.

Best practice: Condoms or Abstinence!

DOUCHING... BEFORE AND AFTER-CARE

Again, like my mechanic always says, "Douche out your tranny once in a while." What he means to say is that just like my car, douching can be a good thing, but only after so many miles and hours prior to needing that high-performance "fresh feeling". Using the warm sudsy waters of soap to clean yourself out helps prevent unnecessary, uhm... embarrassment during sex, but may not be a best safer-sexual practice if occurring immediately before a sexual encounter. Harsh detergents like soap and vinegar can strip your body of protective agents (certain germ fighting cells) and cause tears in sensitive areas of your "undercarriage". Again, those nasty little tears can open you up for infection. Try using just warm water versus the "suds and duds" method of harsh enema chemicals in certain over-the-counter products. If you are having sex with multiple partners over a short period of time, douche yourself out only after the last encounter. And for your "transmission's" sake, pee right after sex. The acidity in those fluids can help clean out your urethra.

HIV IMMUNITY? PARTIALLY TRUE.

No one is absolutely 100% immune from HIV. You may have heard certain reports about having absolute immunity, but the jury's still out to what certainty that HIV uses the CCR5 co-receptor (on the surface of the T-Cell) to gain access to its host during most initial infections. HIV does, indeed, like to use this co-receptor first, but there's also another co-receptor (called a CXCR4) that HIV utilizes (sometimes in an initial infection, often times during advanced infection) involved. Now if you inherit a CCR5-delta 32 gene mutation from both parents, your chances of becoming HIV infected are dramatically reduced. This occurs in about 1-3% of Caucasians. If you inherit one CCR5-delta 32 mutation (from just one parent), it will offer some protection against acquiring HIV and may even make HIV disease less symptomatic or severe if you get infected. Current estimates are that 10-25% of people from a Northern Europen descent may have a single CCR5-delta 32 mutation. This mutation changes the configuration of the CCR5 protein, so that HIV finds it hard to bind to it's surface.

If you really want the skinny on HIV, immunity and the CCR5-Delta 32 co-receptor cell theory, you can read about it here: http://www.physorg.com/news3333.html

HIV/AIDS and other STD/STI's: Sexually Transmitted Diseases/Infections

We all "came" into being through sex, pardon the pun. While most of us want to have sex, we don't want it to rule our lives or wreck havoc on our future health. Sex, unfortunately, can if you aren't using safer-sex practices or know your partner's intrinsic sexual health status. Getting tested for HIV and then getting your results is an easy way to protect yourself and your partners. (Every 3-6 months if you have unprotected sex or with multiple partners; or if you've never been tested before and you've been penetrated without a condom)

**Get tested at your local AIDS Service Organization. We proudly suggest Evergreen AIDS Foundation. Call them at 360.671.0703 ext. 3302 for a free Confidential or Anonymous HIV screening**

HIV: Human immunodeficiency virus (HIV) is a retrovirus that can lead to acquired immunodeficiency syndrome (AIDS). It's spread through:

» Unprotected Vaginal or Anal sex
» Blood
» Mother-to-child, Breast Milk

The "Initial Infection" (incubation period) generally occurs 1-4 weeks after an unprotected sexual exposure and can occur with or without symptoms. This is the point at which you are most likely to spread HIV to other partners and never know it! (So, if you've had a precarious sexual fling without a condom, get tested)

"Acute Infection", is where you begin to get the symptoms, about 4 week's worth after the initial infection. Symptoms can (but not always) include: Flu-like feelings, fever, swollen lymph glands/nodes, sore throat, rash, muscle pain, general malaise/fatigue and mouth and oral manifestations, like yeast infections, or "thrush", headache, nausea, vomiting and/or all of these.

Untreated, HIV goes into an "Asymptomatic" (latency) period where you may not feel like you're infected, but you are. This lasts anywhere from 4 weeks to 5-10+years.

The last stage, called "Advanced HIV" begins to clinically manifests itself as some pretty bad symptoms, called "Opportunistic Infections" Opportunistic infections (OI's), like oral candidiasis (thrush, or a yeast infection), Kaposi's Sarcoma (a form of cancer), Pneumocystis Jirovecii Pneumonia (PCP, a nasty yeast-like fungus, causing pneumonia), reactivation of herpes viruses (like cytomegalovirus, or CMT, Shingles, etc.) are just some common infections that take advantage of our weakened immune system. For a thorough list, click on: http://www.aids.org/factSheets/500-Opportunistic-Infections.html.

"AIDS" is merely the end stage of HIV. It's where those opportunistic infections really begin to ravage your system and take hold and if untreated cause death. There is no cure for HIV/AIDS. However, most individuals treated with Highly Active Antiretroviral Therapy (HAART, the drug "cocktail"), or Anti-retroviral drugs (ARVs), you can go on living your life; but you will always be infected.

AIDS basically means that your CD4 T-cell count (Helper T- cells) drops below 200 and you have clinically manifested at least one OI. The number 200 corresponds to the counted number of T-cell copies in a micro-liter drop of blood. An average person has about 600-1200 T-cells in the same micro-liter drop of blood.

CD4- cells are an important part of our white blood cells and play a vital role in keeping our immune system in check by activating responses in our bodies to help eliminate "pathogens" (viruses, bacteria, etc.). They can influence a variety of other immune cells by sending out signals called "cytokines". To be completely effective, there have to be lots of ‘em - CD4-cells that is. And the thing about HIV is that it expressly targets our CD4-cells.

Towards the end stage of HIV infection, when you are diagnosed as having AIDS, your T-cell count is just too low to effective fight off those nasty OIs and without ARVs, your body just simply can fight those infections any longer.

There are other nasty STD/STI's out there like:

» Syphilis
» Gonorrhea
» Chlamydia
» Trichomoniasis
» Pelvic Inflammatory Disease

Condoms when used properly as illustrated above protect you against these infections. There are also treatments and cures for each and every infection listed above.

Other STD/STI's include:

» Genital Warts
» Herpes
» Hepatitis-A,B & C viruses

For more info on each STD/STI mentioned above, go to: http://www.cdc.gov/STD/

HIV TESTING and the WINDOW PERIOD

HIV testing consists of either a blood draw (either veni-puncture, or finger-prick methods) or an oral swab.

ORAL TESTS: Yes, we can check to see if you are infected with HIV orally. How? Well, by swabbing the inside of your mouth with an apparatus that collects oral bodily fluids. Oral fluids contain antibodies to HIV and are effective mechanism in determining if a person is HIV-positive. They are then either sent off to a laboratory to produce the results, or they can be "rapidly" (usually within 20-40 minutes after specimen collection) collected using flat pad, cotton-like apparatus and then placed into a buffered developer solution on the spot. After the "developer solution" is used, the test can then be interpreted by a professional.

BLOOD TESTS: There are also rapid "finger-prick" tests using a droplet of blood collected on a specimen loop and developed in a similar solution. It can then be interpreted in 20-40 minutes by a professional.

ELISA (Enzyme-linked immunosorbent assay): This is the first step of any HIV test. It checks for the antibodies in your system. If an ELISA test is performed and antibodies are present, it's important to do a "confirmatory" test to double-check if you've been infected.

WESTERN BLOT: This type of tests checks for specific protein bands that are present in HIV-positive individuals. Together with an ELISA test, the tests are considered to be 99.0% accurate.

HIV PCR: The HIV Polymerase Reactive test is one that has been developed lately. It checks for specific DNA (Deoxyribonucleic Acid) and RNA (Ribonucleic Acid) sequences in the genetic structure of someone infected with HIV. It can detect more quickly the presence of HIV in your system rather than the other two above; however it can be somewhat costly.

WINDOW PERIOD: When testing, there is something called the "window period". When people are exposed to HIV, it takes some time for the antibodies to develop in their body. Most people generally develop detectable HIV antibodies within 6 -12 weeks after the initial infection. However, it must be noted that in some instances, individuals can rarely take up to 6 months. So keep in mind, when you're getting tested, if you're unsafe sexual encounter was yesterday or last night, most HIV test won't pick that up. And just because you're HIV-negative on one test, to make sure, get tested 3 months after the "window period" (assuming you have only safer-sex in the meantime or are abstinent)

**Get tested at your local AIDS Service Organization. We proudly suggest Evergreen AIDS Foundation. Call them at 360.671.0703 ext. 3302 for a free Confidential or Anonymous HIV screening**

PEP: Post Exposure Prophylaxis is exactly what the name suggests. It is a preventative course of medications (prophylaxis, ARVs) given to you if you think you've been exposed to HIV. However, it MUST be prescribed by a doctor and be done QUICKLY. PEP regimens are prescribed depending on the type of exposure to HIV you've come into contact with. As with any medications to HIV, there are risks involved. IMMEDIATELY talk with your doctor or your nearest hospital's emergency room for a consultation on PEP. Immediately means within 24 hours.

STREET DRUGS ... and Alcohol

On a not so lighter note concerning foreign substances, namely recreational drugs, I won't preach: Not about how it impugns your ability to effectively negotiate safer-sexual practices in the heat of the moment; nor will I chastise you on the precautions to take when injecting certain chemical agents into your body via needles (like not sharing needles, bleaching them if you do, or using clean needles altogether, which may aid in protection against Hepatitis and HIV); nor will I advocate a stance on the legality of drugs. If you want info on: HIV meds and Street Drug interactions, go here: http://www.google.com/search?hl=en&q=street+drug+hiv+interactions Cleaning your "Works" (Needles) go here: http://www.thebody.com/index/treat/superinfection.html

VACCINATIONS

For Pete's Sake (which coincidentally may be also be the name of your partner), please get vaccinated for Hepatitis A and B. It's simple, quick and effective in warding off these nasty infections. Go to your local Health Department or doctor to get the shots. Bare-backing actually exposes you to fecal matter and increases your risks associated with Hepatitis-transmitting fluids. To read about Hepatitis vaccinations go here: http://digestive.niddk.nih.gov/ddiseases/pubs/vaccinationshepab/

A WORD TO THE WISE ON POPPERS... AND VIAGARA/CIALIS, etc.

"Sniffing" poppers makes it easier for viruses to enter your bloodstream, causing a dilation of blood vessels in the rectum/vagina to leave you wide open (so to speak) for certain infections, like HIV.

Don't ever mix the two, either. Viagra/Cialis (or other "Erectile Dysfunction" medications) works similarly on dilating blood vessels in the penis and increases blood flow to your pelvic area, facilitating an erection. Mixing the two can cause an increase risk for heart attacks during sexual encounter.

INTERNET RESOURCES

TheBody.com: Everything and anything you wanted to know on HIV/AIDS.

IDLube.com: The Premier website for all your personal lubricant needs. The greatest place to sensationalize your sex-life safely by adding just the right bit of lube to your favorite condom. Here you can buy ID Glide, ID Juicy Lube, ID Cream, Millennium, Pleasure, Sensation and Velvet. Remember: Always make sure the lube your purchase is latex-friendly to your condom prior to purchase!