FS #155 Generation Bareback

THE GAY HEALTH AND LIFE MAG ISSUE #155 AUG/SEP 2016

ARE WE

GENERATION

BARBACK? Cover © Les Sterling www.lessterling.com

IS CONDOM USE ON THE DECLINE? DO WE NEED TO RETHINK HIV PREVENTION? SHOULD WE BE WORRIED? IS PrEP THE ANSWER? FSMAG FSMAGAZINEUK WWW.FSMAG.ORG.UK

ALSO SIX MYTHS ABOUT PREP HIV PREVENTION IN 2016

THE SEX LIFE OF A GAY TRANS MAN THE EX-FACTOR

Editor’s letter @IanHowley

Why we need to rethink HIV prevention I was born in 1984. I know, I know, if you’re older than me you’ve already rolled your eyes so far back in your head you’ve just won gold at the ‘Eye Rolling Olympics’, hear me out. I was born in 1984. I obviously don’t remember much of that whole decade. It wasn’t until the mid 1990s that I learned about AIDS and HIV. I had no idea what it was, how you ‘got it’ or just how serious it was around the time I was born. So it’s difficult for me to think of HIV in the same way that a lot of older gay men do. I remember once asking my mother what HIV and AIDS were. She told me ‘It’s something that happens in other countries, you don’t need to worry about’. In fairness to her I was growing up in a small little town in the middle of Ireland. I said OK and continued to eat my packet of cheese. Enough said.

Fast forward to 2016 and so much has changed, not just for me - now leading a gay men’s health charity. We’ve come so far in the terms of where we are in HIV prevention. Gone are the days of the tombstone adverts. Now we live in an age where the majority of gay and bisexual men living with HIV in the UK have the condition under control - 95% of people on treatment are undetectable.

Recent data from the PARTNER study showed that there were no transmissions of HIV by anyone living with the virus who was on medication and undetectable. So if that’s the case, why are we still seeing high number of HIV infections?

When I started working in LGBT health I was shown an HIV prevention campaign, which was produced by another organisation. I was asked what I thought about it. I said there’s no ‘why’. I got some puzzled looks. “Why? Can you explain?”. My reason was that we just assume men know why they have to wear a condom or why they should go and get tested. I said there was no explanation to tell anyone why they should want to remain HIV-negative. And thus I opened a door to a question that stumped a few people. Ask yourself, why would you want to remain HIV-negative? We’re told all the time to try and avoid HIV but when men do become HIV-positive they are told not to worry, that it’ll be fine, that they will lead a near to normal life. So I go back to my original question, why?

If we are living in a world where HIV can have little impact on your overall health once managed, why do we put so much effort into keeping gay men HIV-negative? Personally, I feel that we have got stuck in a bubble of telling men to ‘just wear a condom’, or ‘get tested’, and even ‘take PrEP’.

There’s a lot of statements and not a lot of reason. Assuming that men know why they should remain HIV-negative is part of the problem.

HIV prevention is about so much more than telling someone to wear a condom, to test, to take PrEP. It’s also about self-esteem, self worth, mental health and empowerment. If you don’t care about yourself, why would you care about remaining HIV-negative? And this is where HIV prevention has to change. We need to step back and think about how do we approach this. We can shout at you about PrEP as much as we like and we may even convince you to go on it. But will you take it as prescribed if you don’t care about yourself? Will you care about condom use after you’ve had six beers, two vodkas and a shitty day at work? Life as a gay man is so much more than HIV. Sometimes we forget that.

How many men wake up in the morning and think about HIV or STIs? How many, when horny, are thinking about the consequences of not using a condom. How many are thinking ‘it could happen to me?’ The majority of us are thinking about work, paying bills, going on dates, getting hammered at the weekend, dealing with a needy partner or a break-up. Life is full of different challenges and we need to address that there’s more to gay men’s health than HIV. The game has changed and we need to change tactics. If we are to finally win the fight against HIV it’s not going to be down to just PrEP or condoms or testing. It’s going to be when we, as a community, start to value our own lives and see our self worth. It will be when we work on our selfesteem and make sure we look after the issues we face in our day-to-day lives. Remaining HIVnegative is just one part of the battle to be healthy. Matthew Hodson formally of GMFA once said in the pages of this magazine, “We are not equal until we have full health equality.” And it’s true.

Ian Howley, Editor, FS @IanHowley Published by GMFA 11 Ebenezer Street London, N1 7NP Tel: 020 7738 6872 Email: gmfa@gmfa.org.uk Website: www.gmfa.org.uk Charity number 1076854 ISSN 1750-7162

The FS team for issue 155 was Ian Howley (Editor), Saif A, Hadley, Stuart Haggas, Matthew Hodson, Michael Lee, Professor Rusi Jaspal, Liam Murphy, Ruaidhri O’Baoill, Mark Reed, Gavin Smith, and Aedan Woltan. Design and layout by Ian Howley.

Appearance in FS is not an indication of an individual’s sexual orientation or HIV status. The views of our writers are not necessarily the views of FS, of the organisations mentioned, GMFA, or of the editor. Volunteers contribute to the planning, writing, editing and production of FS.

Cover and feature shots by © Lee Sterling | www.lessterling.com under a Creative Common licence via flickr.com.

ARE WE

GENERATION

BAREBACK? Words by Stuart Haggas | @GetStuart Photos © Les Sterling www.lessterling.com | www.flickr.com/lessterling

COVER STORY

It’s been 35 years since the New York Times reported on a ‘rare cancer seen in 41 homosexuals’ – an article from the summer of 1981 that’s considered the first major news story about HIV/ AIDS. A generation of gay men have since grown up with condoms and safer sex campaigns a familiar part of everyday life.

Recent studies show an increase in unprotected sex amongst HIV-negative gay men. Why are some of us ditching condoms? And in a world of treatment, undetectability and PrEP, is this the start of generation bareback?

SINGLE GAYS This summer, GMFA surveyed over 1,500 gay and bisexual men about their general sexual health.

One question asked ‘How much sex in the past year was unprotected anal sex?’

14% said that they have not had any any anal sex in the last year.

22% said that they have not had any unprotected anal sex in the last year.

18% said that about one-quarter of the sex they are having is unprotected 7% said about half 4% said about three quarters 19% said nearly all of the sex they had was unprotected.

16% said they only have unprotected anal sex.

To round all the above off, about 36% of gay men did not have unprotected anal sex in the last year. About 25% said they only had unprotected anal sex some of the time. And 39% said that all or nearly all of it was unprotected. So who is not using condoms?

Gay men who are married/civil partnered or dating a regular partner can reach a stage in their relationship when they agree to condom-free sex with each other – indeed 51% of the men who responded to our survey say they’ve had sex with just one partner in the past year.

41% said they were in a monogamous relationship.

But gay men in long-term and monogamous relationships aren’t the only ones choosing not to use condoms.

Almost a quarter (24%) those are single men. Being single gay men, they may be having bareback sex with any number of partners. GMFA’s survey asked these single men how many sexual partners they had unprotected anal sex with in the past year. Their answers are: 14%: 1 partner 26%: 2-4 partners 25%: 5-12 partners

15%: 13-29 partners 16%: 30-99 partners 4%: 100+ partners Ian Howley of GMFA told us his thoughts on these stats: “We know that the majority of gay and bisexual men use condoms some of the time.

There is an idea out there that everyone doesn’t use condoms, and for a lot of people who responded to this survey this is the case. But many of these men are in long term relationships, or are married/civil partnered or said they were in a monogamous relationship. When you look at these stats, it’s only a small percentage of gay men, who are having lots of unprotected anal sex, who are at a high level of risk. So to say everyone barebacks all of the time is untrue” The survey also asked everyone who took the survey about their HIV status.

Of the single men who completed the survey: 38% are definitely HIV-negative 16% are probably HIV-negative 34% are definitely HIV-positive 2% are probably HIV-positive 10% don’t know Altogether, 54% of single men who are having bareback sex describe themselves as HIV-negative. We decided to ask these men why they choose not to use condoms.

treatment so are safe.”

Lorne is 24 from Cardiff. He’s single, only has bareback sex, and has had condomless anal sex with over 30 guys in the past year. He’s not worried about becoming HIV-positive either.

“It’s far from a death sentence,” he says, “I’d prefer to have HIV than diabetes.”

He’s also not concerned about having bareback sex with someone who is HIV-positive. “I endeavour not to decline someone based on their HIV status.”

Mike is 30 from Manchester. He’s single, and nearly all of the sex he’s had in the past year was bareback. He doesn’t worry about HIV or other STIs. “I know it can happen but I just don’t think about it. I get tested regularly.”

Joe is 25 from the Isle of Wight. He’s single, nearly all of the sex he has is unprotected, and he has been fucked bareback by over 30 guys in the last year. “As much as I have no desire to catch HIV, I’ve already adjusted to the fact that it may just happen,” he says.

“The reality is, I’m in a high risk group, and even without having bareback sex, I could still be at risk. I don’t want it, but I realise that it could happen, safer or not.”

Mike is 32 from London. He’s single and has had unprotected anal sex with over 30 guys in the past year. He doesn’t worry about picking up STIs or becoming HIV-positive, nor does he ask the status of his casual sex partners. “I don’t ask as I don’t care,” he says. “I’m a bareback cumdump. I understand the risks.”

SINGLE, NEGATIVE AND GAY SEX BAREBACK SURVEY STATS Sam is 35 from Brighton. He’s single. He doesn’t worry about picking up STIs or becoming HIVpositive, nor does he ask the status of his casual sex partners.

“I’m not concerned,” he says. “I know I should be, but I don’t use a condom.

I presume most who have HIV are on

This echoes a pattern identified in the most recent Gay Men’s Sex Survey.

“The data from the Gay Men’s Sex Survey 2014 indicates that condom use among HIV-positive men hasn’t changed much since 2010,” says Cary James of THT, “but it does appear that condom

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Photo Lee Alessandro Sterling www.lessterling.com Photos©© Cala www.alessandrocalza.com

Photo by Chris Jepson © www.chrisjepson.com

use amongst HIV-negative men has declined and so has the overall statistic for gay men.”

“In the 2010 survey, 35.9% said they had condomless anal sex with a non-steady partner in the last year,” elaborates Ford Hickson of Sigma, who carried out the research. “In the 2014 survey, 39.2% had.”

Breaking this down by HIV status, these figures were: 32.7% in 2010 and 36.6% in 2014 for men without diagnosed HIV (moderate increase).

64.3% in 2010 and 63.5% in 2014 for men with diagnosed HIV (no significant change).

TREATABLE, BUT STILL TRAUMATIC “I don’t feel nostalgic for the days when there was no effective treatment for HIV. I lost far too many friends at a young age as a result of HIV, and the effective treatment we now have seems to me little short of miraculous,” says GMFA’s Matthew Hodson.

“But I don’t feel surprised that the motivation to protect yourself against HIV has become less pressing when we have seen a shift from it being a death sentence to a virus that is now very treatable.

“I do know some men who have been diagnosed with HIV and have largely shrugged and taken it in their stride,” Matthew adds. “Far more often I encounter men who have really struggled to come to terms with their diagnosis, at least in the short term.

For most, hearing equivalent words to: ‘Your result has come back and you’ve tested positive for HIV’ is still a powerful and traumatic moment.”

WORRIES Sam, Lorne, Mike, Joe and Mike aren’t unusual in not worrying about STIs including HIV. Of the single HIV-negative men who mostly or only have bareback sex, 42% said in our survey they’re not worried about HIV, and 43% said they’re not worried about other STIs. However, 47% admit they do worry about becoming HIV-positive, and 48% worry about picking up an STI – but despite

these worries, they continue having unprotected sex.

Some accept that becoming HIVpositive is an inevitable consequence of this choice. “I enjoy anonymous unprotected sex,” says David, 27 from Manchester. “It’s bound to happen.”

Others have concerns about the level of honesty and clarity around a HIV diagnosis. “I don’t sleep around and just sleep with guys I’m dating,” says Daniel, 35 from Essex. “The last guy was someone in an open relationship and he said he was negative and free from STIs, but there’s always a slight worry in the back of my mind that they may have something that wasn’t detected in a test, or they may have been dishonest. I prefer to sleep with someone unprotected who has been tested, but I get concerned not everyone is as honest as me.”

And others have deep concerns about the consequences of their preference for bareback. Carlos is 23 and lives in Ireland. He’s bisexual, single, mostly passive, and nearly all of the anal sex he’s had in the past year was unprotected. He worries about picking up STIs and becoming HIVpositive. “Due to my last few instances of engaging in high risk behaviour, against my better judgement,” he explains, “becoming positive is still very much a real danger and it’s a lifelong disease to be stuck with.”

Darius is 26 from Glasgow. He’s single, versatile, and all the anal sex he’s had in the last year has been bareback. He worries about picking up STIs and becoming HIV-positive.

“I’m petrified,” he admits. “I think it is the fear of the unknown and fear of the stigma associated with it. I am currently waiting for the results of my latest tests.

I’m scared in case I do pick something up – and it could have been easily prevented.”

REASONS TO WORRY “HIV remains distinct from most other STIs because there is no cure. If left untreated it will kill you, and it is one of the most stigmatised of all medical conditions,” says GMFA’s Matthew Hodson.

“I often hear people condemning others for their sexual choices. It’s easy to judge but it usually isn’t helpful.

Somehow because it involves sex (and, what’s more, it involves gay sex) people feel free to get moralistic in a way

COVER STORY

that they wouldn’t about smoking or drinking alcohol to excess.

“I would want to say to anyone who believes that HIV is inevitable for them, that it’s not,” Matthew adds.

OPEN RELATIONSHIP AND BB It’s not only single guys, or guys in monogamous relationships, who are having bareback sex.

Some guys in open relationships told us they have bareback sex with casual partners outside their relationship Kevin is 34 from Ireland. He’s versatile, in an open relationship, and much of the sex he’s had in the last year was unprotected. He asks casual partners their HIV status before having sex: “So I could make an informed decision on the risks.” Kevin worries about becoming HIV-positive. “I’d prefer not to have to take a pill for the rest of my life, but it happens sometimes.”

Bruce is 42 from Leeds. He’s in an open relationship, he’s passive, and nearly all of the sex he has is unprotected. He doesn’t ask partners their status. “Although I am HIVnegative I don’t serosort,” he says.

“This is partly because I’m on PrEP, partly because most HIV-positive guys are likely to be undetectable (and negative guys who don’t get tested are probably higher risk), and partly because I think sorting guys by HIV status is kinda dehumanising. If a guy tells me he’s positive it doesn’t deter me from letting him fuck me bareback.

Most positive guys are undetectable these days.”

Bruce adds that he doesn’t worry about becoming HIV-positive: “I’m on PrEP but also I have several HIVpositive friends who live full healthy lives. I don’t expect to get it, but if I do I don’t think I’ll be too worried about it.” He does however worry about some other STIs. “Many other STIs are treatable, but super gonorrhoea and hep C do worry me.”

PrEP TALK If condom-free porn is becoming the standard industry practice, does the normality of bareback porn affect gay men’s attitudes towards sex? www.fsmag.org.uk

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Photo by Chris Jepson © www.chrisjepson.com

Photo © Lee Sterling www.lessterling.com Photo by© DanAlessandro Hall © GMFA Cala www.alessandrocalza.com Photos

they can personally avoid any harms, that they don’t care or that they know and care but find themselves unable to take control – or a combination of these.”

“Any decrease in condom use is something which we take very seriously,” says Cary from THT, “but it’s important to remember that gay men use condoms more than any other highly affected group, so although gay men’s condom use is not perfect, Some men will only have bareback sex with negative guys, while others that fact should be recognised and feel it’s better to bareback with men supported.

“That said, most gay men at some who are positive, on treatment, and point in their lives have chosen not with an undetectable viral load. to use a condom. The moment that Darius explains that he wouldn’t have we decide to use a condom or not unprotected sex with someone who told is a very intimate, often emotional, him they were HIV-positive. “I would be and irrational moment. In the heat of too scared to put myself at risk,” he says, “and I understand this is silly as it is safer the moment, rationality and logic are often not the first things in our minds. to have unprotected sex with someone who knows they have HIV and is receiving It’s important that HIV prevention recognises that reality. For some treatment, rather than someone who men, knowing the facts about HIV doesn’t know their status.”

“If you have unprotected sex with prevention will be enough to motivate Max is 41 from London. He’s top lots of sexual partners, the chances them to use a condom. But for others only, and nearly all of the sex he’s had are that you will pick up STIs – and a different approach might be needed. in the past year was bareback. He’s not unless you are taking PrEP, that It’s important that we work to drive includes HIV,” says GMFA’s Matthew worried about picking up STIs including behaviour change on rational, social HIV. “I don’t shag anonymous randoms,” Hodson. and emotional levels. In this way we he says. He would consider having “Some people go through periods of will have the best chance of reaching their lives when they feel that they are not sex with someone who is HIV-positive. those who may not have responded to “Possibly, I suppose. It would depend on able to stop having unprotected sex. For messages in past.” their health, viral load, medication, and many this will just be a phase, for some “We are complex beings and our whether they were undetectable – but I it’s a long-term choice. For these people think the sensible option would be to use needs, desires and concerns are PrEP could make a real difference, and complex too,” adds Matthew. “Easy a condom.” the cost of providing PrEP for a period answers tend not to work and what is much cheaper than the cost of HIV works for some people will not work for treatment and care for life.” others. Which is why HIV prevention And what of HIV-positive single guys and sexual health will be most effective when it can address a variety of needs, who only or mostly have bareback relating to an individual’s knowledge, sex? will and power to take control of their “I am HIV-positive and undetectable,” health, recognising that there will still says Harrie, 50 from London. “I only play “Gay men who struggle with their be some who will choose not to do so.” bareback, and usually with other positive use of chems for sex often say that guys, or negative on PrEP.” it’s as a result of wanting to live up “I’m HIV-positive and only have sex to the porn fantasy of sex,” Matthew with other positive guys,” agrees Chris, 36 adds. from Manchester.

“It’s a part of the struggle of modern “I never do ask,” admits Ben, 31 from life that our expectations are often raised Middlesbrough, “and very rarely get asked far beyond what we are likely to achieve.” myself either.”

Steven from Eurocreme disagrees, “Condom use among gay men adding: “Gay porn, I believe, doesn’t set went from virtually zero in the the standard for sex. It acts as an access early 80s, pre-AIDS, to very high point to find what you’re into. Some numbers in the late 80s and early people may be disappointed in sex at 90s’’, says Matthew. times – even porn stars get that from time ‘‘Condom use has slipped back a to time – but that’s life. Not every day will little since then, partly because HIV be a blast, so why should we expect the is no longer a death sentence, and “Asking why someone has same to happen in sex? partly because we’re not seeing the unprotected sex is like asking why “If you feel down in the dumps regularly someone drinks too much,” says same investment in sexual health that in life, you should talk about it with we saw a decade ago. With resources GMFA’s Matthew Hodson. someone and inevitably try changing your deployed to promote condoms and “There are going to be a vast array perception or find what’s bringing you sexual health, encourage testing, of reasons why someone might do that. down and change it. The same goes for challenge stigma, ensure that all gay It might be that they’re unaware of the sex. men are well educated about HIV health consequences, that they believe

“Is really a pragmatic response to my sexual habits as I bareback rather a lot,” Bruce explains. “I do frankly think it should be available on the NHS because the protection it provides should be accessible for all those in high risk groups.

I am HIV-negative and on PrEP. I have met poz guys who don’t like barebacking with neg guys, but have changed their mind on hearing I’m on PrEP.” “I am on PrEP daily,” says Tom, 37 from London. “I always make sure I have bareback sex with other PrEP users or undetectable positive people.”

Mike, 30 from Manchester, would use PrEP if it were available on the NHS. “Better safe than sorry,” he says, “especially when my dick takes over my brain and I do things I know are risky, but I’m too horny to think clearly.”

“If you watch god-like hardcore action and find yourself unable to orgasm with your husband, boyfriend or latest hookup from Grindr, perhaps it’s not porn that’s the problem. Porn may act as a focus, but it shouldn’t be regarded as an all-out cause.”

NEG OR POZ?

PrEP WORK

PORN EXPECTATIONS

POSITIVELY BB

INFORMED CHOICE

HEAT OF THE MOMENT

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For more information on sex, sexual health, STIs and HIV, visit www.gmfa. org.uk/sex.

HOW RISKY IS FUCKING WITHOUT CONDOMS? Most gay men who have HIV caught it from getting fucked without a condom.

As far as gay sex goes, getting fucked without a condom, and having your partner cum inside you, is the riskiest thing you can do. This is because the lining of the arse can absorb liquids directly into your bloodstream. If there’s HIV in his cum, and it goes up your arse, that will be absorbed too. Getting fucked without him cumming inside you is lower risk but, as there is HIV in pre-cum too, there is still a risk of HIV transmission.

In group sex it’s theoretically possible to catch HIV from getting fucked even if your partner is HIV-negative, if he has fucked someone who is HIV-positive and then fucks you immediately afterwards. This is because there could be traces of HIVinfected anal mucus or blood on his cock.

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Getting fucked is also high risk for most other STIs, including chlamydia, gonorrhoea, herpes, syphilis, warts, hepatitis B and it is now thought that you can catch hepatitis C as well.

Condoms provide an effective barrier against most STIs, including HIV, although some STIs, such as syphilis and warts, can still be transmitted if the condom does not cover the entire infected area, such as the base of the cock. If you are infected with an STI in your arse, it will increase the chances of you being infected with HIV if you are HIV-negative. If you are HIV-positive and have an STI, it is likely that there will be higher concentrations of HIV in all of your body fluids, including blood and anal mucus, and so you will be more infectious.

doing the fucking to become infected.

Other infections in or around his arse, such as chlamydia, gonorrhoea, herpes, syphilis, warts and hepatitis B can be passed to the guy fucking through his urethra (the tube you piss through). Condoms can prevent most of the infections that you can get from fucking, although it’s worth remembering that some STIs can be transmitted even if you use condoms.

If the guy getting fucked is HIVpositive and has an undetectable viral load the risk of transmission is greatly reduced.

How risky are fucking and getting fucked with condoms?

If the person doing the fucking is HIVpositive and has an undetectable viral load the risk of transmission will be greatly reduced. A recent study found no cases where HIV was passed on by someone who was undetectable.

While it is rare, condoms can break during fucking and this could make it possible for HIV or other STIs to be transmitted. Condom breaks usually occur because condoms are used incorrectly or are used for long sessions without changing them.

What if I fuck without a condom?

If you use condoms correctly with plenty of water-based lube, it will Fucking someone without a condom is greatly reduce the chances of them less risky than getting fucked without breaking. If you are having group sex, a condom, but it is still one of the it’s also important to change condoms riskiest sexual practices that gay men for each partner. This is because it’s do. If you are HIV-negative, fucking theoretically possible that traces of someone bareback is more likely to HIV-infected anal mucus or blood lead to infection than sucking cock. This could remain on a condom after a is because the anal mucus that lines guy with HIV gets fucked. This is also the arse (we all have it) can contain true for other STIs, including hepatitis a very high concentration of HIV. The C. While condoms offer protection mucous membrane just inside the tip of against HIV and most STIs, they the penis and the foreskin can absorb cannot prevent them all. Even if you liquids, like anal mucus, directly into always use condoms for fucking we the bloodstream. HIV experts used to recommend that you get regular sexual think that infection from the receptive health screens at a GUM clinic and partner (bottom) to the insertive partner continue to test for HIV on an annual (top) was as a result of bleeding in the basis. arse. Although it’s possible that blood is responsible for transmission in some For more information on sex, cases, we now think that anal mucus sexual health, STIs and HIV, visit is the body fluid that enables the man www.gmfa.org.uk/sex.

Photo © Lee Sterling www.lessterling.com

prevention and PrEP provided, we could end HIV within a generation.”

“The field of HIV prevention has changed enormously in recent years,” agrees Cary from THT. “The recent results of the PARTNERS study have shown that HIV-positive people with undetectable viral load can’t pass on the virus. And PrEP has given us another powerful tool in stopping more men from becoming infected. All of these things will change the way people view HIV. That is not something to be feared but an opportunity for us to evolve towards our goal of eliminating HIV.” “GMFA wants all gay men to have a choice,” Matthew adds. “We want the choices that men make to be informed ones, so that they know how to avoid HIV and other STIs, and they know the consequences of having HIV. And we want men to have the will and the power to make choices for themselves.”

What will the next generation be? Will more of us choose generation bareback?

And if we do, does that risk derailing the possibility of ending HIV?

ADVICE

Photo © Lee Sterling www.lessterling.com

How to stop HIV

In 2014, over 3,300 gay men were diagnosed HIV-positive in the UK. About 84% of new HIV infections come from having sex with men who don’t know they have HIV. About 14% of gay men who are HIV-positive don’t know they have it.

Condoms Using condoms while having sex is still one of the best ways to avoid picking up any STIs, becoming HIV-positive or passing on HIV. Make sure you use plenty of water-based lube too. Stay away from Vaseline, baby oil and spit – they will make the condom rip.

For more information about condoms and lube, visit www.gmfa.org.uk/ condoms-and-lube.

Testing All sexually active gay men should test for STIs at least once a year. If you are having sex with new partners then you should test more frequently. Test for HIV too when you’re there. It takes about two weeks for most STIs and four weeks for HIV to show up in a test.

To find your nearest GUM clinic, visit www.gmfa.org.uk/clinics.

Treatment If you are diagnosed with HIV you will be put on treatment that will contain the virus in the body. Within a few short months the virus should become undetectable, meaning that it’s very

unlikely that the virus will be passed on to sexual partners. However using condoms will further reduce the risk of passing on HIV and STIs.

For more information on HIV, being diagnosed and support services for men living with HIV, visit www.gmfa.org. uk/living-with-hiv.

medication that can stop you becoming HIV-positive if started within 72 hours after sex (the sooner you start taking it the better). If you think you’ve been exposed to HIV, contact your local GUM clinic or go to an A&E. For more info on PEP, visit www.gmfa. org.uk/pep.

PrEP

Education

PrEP means Pre-Exposure Prophylaxis, and it’s the use of anti-HIV medication to keep HIV-negative people from becoming infected.

PrEP has been shown to be safe and effective. A single pill taken once daily, it is highly effective against HIV. The medication interferes with HIV’s ability to copy itself in your body after you’ve been exposed. This prevents it from establishing an infection and stops you becoming HIV-positive.

Knowing how HIV and STIs are transmitted is important. One way to stop HIV and STIs is to keep up to date with the latest news and information about HIV, STIs and safer sex.

PrEP is currently not available on the NHS to everyone, but you can find information about where to buy generic PrEP by visiting www.iwantprepnow. co.uk.

PEP PEP is a month-long course of HIV

For more information, visit www.gmfa. org.uk/sex.

Mental health No matter what advice we give you about how to stop HIV and STIs, if your emotional health is not good you may find it harder to care about protecting your sexual health. So if you are feeling down, experiencing low self-esteem or have symptoms of depression then it’s best to talk to a professional who can help you get back on track.

For more information on how to look after your mental health, or to find support

www.fsmag.org.uk

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THINK AGAIN 1 in 3 gay guys diagnosed with HIV are in their teens or 20s. *

*HIV in the United Kingdom: 2013 Report, Public Health England.

Know the Facts. Use Condoms. Test for HIV. www.gmfa.org.uk/thinkagainHIV

Disclaimer: No assumptions should be made about the HIV status or views of the model featured in this ad. GMFA projects are developed by HIV-positive and HIV-negative volunteers. Support GMFA by making a donation at: www.gmfa.org.uk/donate Photo © ChrisJepson.com. Design: no.star. © 2014 GMFA. Charity no: 1076854. Company limited by guarantee: 2702133.

So if a guy tells you he is HIV negative, he could be wrong.

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HIV PREVENTION AND THE GAY COMMUNITY

@startswith_me

It’s been 35 years since the first cases of AIDS were reported. In that time we have seen millions die from the virus. In the late 1980s the UK government rolled out the ‘Tombstone’ adverts – a campaign to drive fear about just how deadly the virus was. In the mid 1990s a breakthrough in medication meant that HIV changed from being a ‘death sentence’ to becoming manageable. Today, HIV treatment means that HIV need no longer be a death sentence and someone with the virus, who has access to medication, has a normal life expectancy. What’s more, we are increasingly confident that someone who has responded well to HIV treatment cannot pass the virus on to their partners.

Despite all of this, the numbers of gay men who are infected with HIV in the UK each year is not going down. Do we need to rethink HIV prevention? And is PrEP the answer? We surveyed over 1,500 gay men about the current state of HIV prevention and asked them what they really think about current campaigns, PrEP and what needs to be done. Here’s what they had to say...

Jason is 27 and from Peterborough. He thinks the current state of HIV prevention is poor and more needs to be done.

He told us: “It doesn’t have the impact it used to, due to the attitude that medication is getting better and people seem to think that you’ll take a few pills and it will be OK! The added craziness that PrEP is not available is ridiculous, especially with the rising number of diagnoses in the UK among gay men.”

David, who is 40 and from Birmingham, agrees: “It’s lacking.

Especially younger guys who don’t remember AIDS from the 1980s and many seem happy to bareback.”

Joshua, 30 from Leeds, told us he thinks the current funding cuts are not helping. “We need to get on top of HIV infection rates. Sexual services and the great prevention work they do are under threat due to cuts.”

Tim, 51 from Doncaster, had a lot to say. He told us: “It’s abysmal!

Coming out in the early 80s caused me so much extra stress due to the Gay=AIDS mentality at the time. I can remember my flatmate asking if I could use my own cutlery in case he ‘caught something’. Even now I still don’t mention my HIV status (even to very close friends) because people still make assumptions or ask questions you really don’t want to answer or make you feel uncomfortable. Anything that can prevent someone experiencing those feelings HAS to be given freely.”

Ali, 29 from Birmingham, told us: “There needs to be more work and awareness about gay sex in schools and colleges. There need to be stands at Gay Pride. Gay bars and saunas should have someone on hand to offer advice or testing. There is not much being done on social media or gay apps. So many negative men are

uneducated about what undetectable means, and the difference between HIV and AIDS.” And Alex, 22 from London, said: “I feel that it’s unrealistic to expect young gay men to only have protected sex – it simply won’t happen all the time. Often gay men are demonised for having unprotected sex, yet heterosexual unprotected sex happens just as frequently – as evidenced by high rates of teenage pregnancy. We need a more effective intervention, which in my opinion is PrEP, to tackle HIV prevention. That’s not to say that the use of condoms should not continue to be a huge area of health promotion, because we need to offer gay men a range of options to empower them to make decisions about their sexual health.”

Ian Howley, Interim CEO of GMFA responded to the comments. He told us: “The theme running through these comments is that not enough is being done, that funding cuts are impacting HIV prevention and that younger gay men are less aware about HIV and STIs. The fact that the majority of gay and bisexual men who responded to this survey feel like this should not be ignored.”

HIV CAMPAIGNS So what about current HIV prevention campaigns? Are they effective? Do gay men see them, react to them?

We asked: How many of theses HIV prevention campaign you remember seeing? (tick all that apply)

It Starts with Me HIV Testing Week HIV Aware Stop AIDS More to Safer Sex Think Again Do it London HIV Laid Bare Just Carry One

60% 53% 33% 23% 23% 20% 10% 5% 4%

We asked: Do you think current HIV prevention campaigns are intended for people like you?

Yes No I don’t know

49% 26% 25%

What about the guys who feel these campaigns are for them? Harry, 22 from Birmingham, said: “I’m a young gay man, and most awareness campaigns seem to feature men like me. I’m not sure I’d feel this way if I was older.”

Dave, 24 from London, told us: “A lot of the campaigns seem directed at people who have no knowledge or have uncertainties around HIV and either the facts or the stigma. In my case I’m fully aware of the information but it’s about managing myself. Part of why I have unprotected sex is that I sometimes have a huge lack of self-esteem and turn to substances, so that when someone comes along I lose any self-control, and go with what they want.”

Kristian, 25 from Swansea, said: ‘‘People have this idea that ‘it won’t happen to me’ (which I used to believe) and I think these campaigns in particular refer to me.”

And of those who didn’t feel like they were for them, Jack, 26 from Newcastle, said: “I’m living with HIV and I feel these campaigns generally are targeted at HIV-negative men, even though I think people living with HIV have a huge role in HIV prevention. I would like to see www.fsmag.org.uk

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more campaigns aimed at me that give me the tools to help stop HIV.” Simon, 33 from London, told us: “I think a lot of the current campaigns are soft and don’t really say anything. I look at happy smiley people saying ‘I’m testing’ and I think to myself... Really?

Are you really testing? Probably not.

You’re a model who turned up to a shoot and got paid to smile into a camera. It’s just not real and lacks motivation.”

Raz, 21 from Bradford, agrees: “I just don’t connect with any of the images I see. Being Asian I rarely see people like me in campaigns and when I do it’s normally aimed at straight couples. I would like to see more diversity.”

And Philip, 42 from Surrey, said: “A lot of the current campaigns are aimed at younger generations, which is fine, but I feel our generation is left out.”

in HIV prevention, but others feel it will lead to an explosion of bareback sex and higher rates in STIs. We decided to ask everyone who responded to our survey about their thoughts on PrEP. We asked: Do you know what PrEP is?

Yes No I’ve heard of it but not sure how it works

79% 10% 11%

When then explained what PrEP is and asked: Would you use PrEP if it was available on the NHS? Yes No Don’t know

68% 15% 17%

When asked why/why not:

Adam, 38 from London, said: “It would provide an extra measure of prevention, in addition to condom use.”

Jason, 27 from Peterborough, told us: “It would be a great precautionary measure. No matter how careful you are there’s always the chance you may Yes 47% get a bit too drunk or want to please No 11% someone so much that you give in and Sometimes 33% go unprotected. Why would the NHS not I don’t know 9% want to fund this!!!”

David, 40 from Birmingham, isn’t too When we asked why/why not: keen on it. He said: “I would want more especially Fastest, which allow me to reassurance than that before I stick drugs Jamie, 49 from London, told us: “I find actually check my status conveniently a lot of the information a bit vague and without time off work visiting inaccessible in my body, just so I can have a fuck with a nicer ending.” clinics. Actually knowing my status with contradictory. For example, reducing John, 28 from Surrey, doesn’t think certainty helps me manage and avoid your number of sexual partners is unnecessary anxiety, which in turn helps the NHS should pay for it. “If it can help contradicted by information that most reduce risk and the spread of HIV, then me focus on living a healthier life and HIV infections come from regular it’s worth taking as long as there are no managing my depression.” partners. We get repeatedly told that side effects. I wouldn’t mind paying for it And Michael, 37 from London, told condoms are the best way to avoid HIV because it’s my choice to use it. I don’t transmission when studies show PrEP us: “Not enough detail is given to make expect the NHS to pay. They can pay for an informed choice. They focus on one and treatment as prevention (TAP) PEP instead.” simple message, but the one size fits all are much more effective. Generally, JJ, 40 from London, said: “Condoms approach is failing lots of people who information on TAP is a complete are cheaper to the NHS and more simply opt out.” muddle. I realise this is because the effective. Don’t waste public money.” science is fast-changing, but you end And Przemek, 29 from London, told up having to guess what’s the best us: “I think it’s irresponsible to take drugs thing to do.” with unknown long-term side effects just Bob, 40 from London, said: “I’m to have unprotected sex, especially when still confused about oral sex and HIV. using condoms is cheap and easy, and Is it safe to swallow or not? I’ve had protects you from HIV.” conflicting information about this, even We asked Ian Howley of GMFA for his from sexual health clinics.”

You would have to be living under thoughts. He said: “I can understand why Rufus, 52 from London, told us: a rock not to have noticed all the lots of gay and bisexual men have mixed “Sometimes more specific detail is fuss over PrEP. For those still don’t feelings about PrEP. The current studies needed – which I realise can’t be know what PrEP does, it’s a tablet that show that PrEP is more effective than done with the majority of sexual health works to stop HIV transmission. If taken condoms at preventing HIV transmission. campaigns.” daily it can stop you from becoming Adrian, 41 from Solihull, said that HIV-positive. At the moment PrEP is not Anyone on the medication should be monitored on a frequent basis and tests having fast services has given him available on the NHS, but this hasn’t carried out to keep an eye on their health control. “I know all there is to know stopped gay and bisexual men from about transmission risks and behaviour. using PrEP. Many buy generic PrEP from and ensure that any STIs are diagnosed and treated. We should also note that The most helpful development recently online chemists. not all gay and bisexual men will use has been the advent of self test kits, For many, PrEP is the game changer We asked: Do you feel the information provided to you from HIV and sexual health campaigns help you to make informed decisions?

PREP AND THE GAY COMMUNITY

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PrEP and of those who do, most won’t take PrEP for long periods of their lives. PrEP is a breakthrough in HIV prevention and we need to utilise it.”

SEEKING INFO In a previous FS survey we asked over 1,000 gay and bisexual men about where do they find sexual health information. 75% told us they go online. For this issue we asked the 1,500 men who responded to this survey which sexual health websites they have visited in the past year: We asked: Have you ever visited any of these HIV/sexual health websites in the last year? Tick all that apply. www.nhs.uk www.tht.org.uk www.gmfa.org.uk www.fsmag.org.uk www.startswithme.org.uk www.nat.org.uk www.hivaware.org.uk www.avert.org.uk www.man2man.ie Other

59% 55% 43% 24% 19% 14% 12% 6% 5% 4%

It’s all well and good asking

people what they have or haven’t seen, or what they think needs to be done, but what do gay men think they need more information about?

We asked: Which of the following topics would you like more information about? Tick all that apply.

Info on PrEP 64% Info on PEP 50% Info on bareback sex 48% Info on HIV testing 37% What to do after having 36% unprotected sex How to discuss safer sex 34% with someone who has a different HIV status How to prevent HIV 34% Sex with multiple partners 33% Information on hep C 32% STI testing 31% Chemsex 25% Condoms and lube 21% How to discuss safer sex 20% with someone who has the same HIV status as me What does this tell us? Ian Howley, Interim CEO of GMFA told us: “HIV prevention has changed a lot over the past 35 years. We are now at a stage where studies have shown that someone living with HIV and on

medication cannot pass on HIV. We are also at a stage where we have a wonderful new tool called PrEP and the fact 64% of the gay and bisexual men who responded to this survey want more information about it shows they need more than a one size fits all approach to HIV prevention.

“The need for information on PrEP, PEP, how to make bareback sex safer, and the general discussion around talking about safer sex shows what gay and bisexual men are looking for.

“Everyone is different and we need to meet gay men where they are at and not where we think they should be. At GMFA we have over one million visitors to our website each year.

Those coming to the site are looking for information on how to have the best sex with the least possible risk. We also provide up-to-date information on PrEP, PEP, being HIV-undetectable, what to do if you’ve put yourself at risk, as well as practical info on condoms and lube.

“We’re in a new era when it comes to HIV and we all need to work together to make sure that we supply the information gay and bisexual men are looking for. But unfortunately we are in a time where spending on HIV prevention has been cut year-on-year, donations in the sector as a whole are down and we are seeing charities close. Something needs to be done.” www.fsmag.org.uk

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6 myths about PrEP Words by Liam Murphy @liamwaterloo

For a drug that’s proven to prevent the transmission of HIV, the topic of PrEP is a divisive one for the gay community. Some think it will ruin us and we should all just wear condoms, others think it’s not the responsibility of the NHS to provide it and then there are those who are morally against it as it “makes us look promiscuous and gives gays a bad name”.

I think a large part of the reason some gay men are against PrEP is a miscommunication about what it is, what it’s for and who it’s for. Which I will attempt to address here in a simple, easy to read format with no long words. Because I don’t know any.

Myth 1: PrEP is for everyone The way some critics talk you’d think PrEP is going to be a compulsory government sanctioned medication, forced down the gullets of unsuspecting gays by armed PrEPstapo as they queue to get into G-A-Y Late. This, of course, is not the case. PrEP isn’t and shouldn’t be for everyone. It should be made available to those most at risk, who can’t afford to pay for it themselves and whose condom adherence is perhaps not always 100% (for whatever reasons).

A gay man who always uses condoms, goes for regular sexual health check-ups and whose only association with bareback sex is watching porn, is unlikely to need PrEP. An assessment will be made by a sexual health professional before PrEP is recommended. Not forced upon them. Recommended.

Myth 2: PrEP is a licence to bareback Now we have PrEP, why bother with condoms? Burn them. Incinerate them.

Gather them all up and throw them on a bonfire. Save a couple for a waterballoon fight. Obviously I’m only kidding, that would be idiotic. Condoms are still vital as they can protect against a myriad of other STIs and should still be used as part of a wider safer sex armoury.

Organisations like GMFA always advise using condoms along with other safer sexual health strategies, which include condoms, regular testing, education about HIV and viral load, condoms, communication, condoms, what to do in an emergency (PEP) and condoms.

no evidence to suggest that PrEP users are any more promiscuous than anyone else – what they do have is the security of knowing they can’t get HIV or pass it on.

It’s a mistake to make sex a moral issue where people who bareback are the bad guys; it’s about getting gay men to engage with sexual health services, providing them information and empowering them to take control of their sex lives with the different HIV prevention methods available.

Myth 4: PrEP is too expensive to be made available on the NHS The cost of PrEP as a HIV prevention method is actually cheaper than the lifetime healthcare costs of someone living with HIV. In the long term, every case of HIV that’s prevented will save the NHS money. Not forgetting the fact that PrEP won’t be compulsory – all gay men won’t be forced to take it. It will only be made available for those at risk. And quite honestly, can we really put a price on preventing someone from having to cope with a lifelong illness? The answer to that question should be no. Also it was rhetorical.

Myth 6: All you need to do is take PrEP, other safer sex methods be damned

I hear this bandied around a lot. “Sexual health organisations just want gay men to go on PrEP and use nothing else” or “They only care about HIV. What about other STIs?”. To quote Whitney: SHOW ME THE RECEIPTS. Show me where GMFA or any other sexual health organisation, or anyone other than PrEP-detractors has ever said that. PrEP is and will always be promoted as part of a wider safer sex armoury, which includes condoms.

Condoms are still important. Condoms will protect you from a whole host of other STIs. However, occasionally condoms can fail. But imagine a world where you’re using both condoms and PrEP – it’s double protection, like a car with seatbelts and airbags or…deodorant. I’m having an analogy mind-blank. I do acknowledge that organisations and charities like GMFA have focused on campaigning to make it available on the NHS and less about the virtues of PrEP and how it will actually be applied (although check our blogs and FS – we have been talking about it). But here I am doing it now… so there.

PrEP quick facts:

Myth 5: PrEP is a magic pill that solves everything

PrEP stands for Pre-Exposure Prophylaxis.

PrEP is a pill an HIV-negative person takes (developed to treat people with HIV) regularly to reduce their risk of HIV infection.

Nope. No. It’s not. It does prevent HIV PrEP does not protect you from other infection, which is pretty wondrous in itself, STIs. but it’s not that simple. You’ll need to go PrEP is currently not available on the for routine check-ups and blood tests NHS. every three to four months, as well as liver National AIDS Trust is currently seeking and kidney function checks. But that’s only legal action after NHS England refused to mandatory if it’s available on the NHS. You fund it. can buy PrEP unmanaged now online, You can buy PrEP in the UK through when really the NHS should get people sites such as www.iwantprepnow.co.uk. to engage with sexual health services and For more information about PrEP, visit monitoring PrEP adherence (you can’t miss a dose!) and its impact on the body. www.gmfa.org.uk/prep.

Myth 3: PrEP users are sluts First of all, don’t slut shame, it makes you a piece of shit. Second of all, there’s www.fsmag.org.uk

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Photo © www.flickr.com/johnhopephotography

HOW TO PUT ON A CONDOM...

Step 1

Step 3

When your cock is hard, take the condom out of the wrapper carefully using your fingers. Using your teeth to tear the packet could damage the condom. Squeeze the air out of the teat on the tip of the condom (if there is one) and put it over the end of your cock.

Don’t stretch it and then pull it over your cock as this will make it more likely to break.

Check the condom occasionally while fucking to ensure it hasn’t come off or split. If you fuck for a long time you will need to keep adding more lube. When you pull out, hold on to the condom and your cock at the base, so that you don’t leave it behind. Pull out before your cock goes soft.

They can however be used with non-latex condoms, like Durex Avanti, Mates Skyn or Pasante Unique. Don’t use spit as it dries up quickly and increases the chance of your condom tearing.

Lube

Erection problems: www.gmfa.org. uk/erection-problems.

Step 2 Roll it down the length of your cock – the further down it goes the less likely it is to slip off. Put some water-based or silicone-based lubricant over your condom-covered cock. Put plenty of lube around his arse too. Don’t put any lube on your cock before you put the condom on, as this can make it slip off.

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When you don’t use enough lube, or use the wrong kind, the likelihood of condom failure is increased, making transmission of HIV and other STIs possible.

Water-based lubes (e.g. Liquid Silk, Wet Stuff and ID Glide) and silicone-based lubes (Eros Bodyglide) work well with condoms. Oil-based lubricants like cooking oil, moisturisers, sun lotions,

baby oil, butter, Crisco, Elbow Grease, etc, can also cause latex condoms to break.

Useful links

Condoms and lube: www.gmfa.org. uk/condoms-and-lube.

Cumming too quickly: www.gmfa. org.uk/cumming-too-quickly.

To buy cheap condoms and lube, visit the Freedoms shop at: www.freedoms-shop.com.

No matter what sexual act you are doing, there’s a risk of getting an STI. HIV is considered the ‘big one’ because it’s incurable. Once you have it, you have it for life (the same for herpes). But there are many more STIs out there, some of which you can get from oral and anal sex. And none of them are easy to have to deal with. Here’s what you need to know about:

Chlamydia Chlamydia is a bacterial infection. It is most commonly passed on by fucking or getting fucked without a condom, but it can also be passed on by sucking cock or rimming.

Crabs Crabs are usually transferred during naked body contact (yes, we mean sex).

Less often, they can be caught from infested bedding, clothes and towels.

Gonorrhoea Gonorrhoea, or ‘the clap’, is a bacterial infection of the urethra (the tube you piss out of), arse, throat or eyes. It can be passed on by rimming, sucking cock, fucking or getting fucked without a condom.

virus can be spread by sharing needles, sharing snorting straws, unprotected sex, or by getting blood or infected cum in your mouth, eyes, or on to broken skin.

Hepatitis C The hepatitis C virus is present primarily in blood (including dried blood) and can also be present in cum. Traditionally injecting drug use was the most common way to catch hepatitis C but it is now known that unprotected sex, particularly high risk sex and group sex, is associated with hep C infection. In particular HIV-positive gay men are getting hepatitis C sexually. However, this does not mean HIV-negative guys are not at risk from unprotected sex or sharing sex toys.

Hepatitis A

Herpes

Hepatitis A is found in shit and is acquired by getting shit in your mouth.

This can happen through sex acts such as rimming or sucking someone’s cock after unprotected sex.

Herpes is a virus that is spread by skin to skin contact. There are two forms of herpes: HSV-1 causes cold sores around the mouth, and HSV-2, or genital herpes, which leads to sores around the cock and arse. You can get herpes by kissing, sucking cock, rimming, fucking without condoms and even frottage! You can also get it by sharing sex toys. Cold sores on

Hepatitis B The hepatitis B virus is in blood, cum, piss, spit and shit, as well as other body fluids of a person who’s infected. The

your mouth can be spread to another person’s cock or arse, and genital herpes can be spread to the mouth.

Shigella Shigella is a bacterial infection which you can get by coming into contact with poo. You can get it from having sex with someone who has it, especially from rimming, but also from fisting, fingering or sharing of sex toys and douches, as it’s easy to get tiny bits of poo on your hands. Recently, Shigella has become more common amongst men who have sex with men. You only need to get a tiny amount of the bacteria in your mouth to start feeling sick.

Syphilis Syphilis is a bacterial infection which is most usually transmitted through fucking without a condom and cocksucking, but which can also be caught through rimming, fisting and even through skin to skin contact (although this is rare).

For more information on sex, sexual health and STIs, visit www.gmfa.org.uk/sex.

www.fsmag.org.uk

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THE SEX

EDUCATION YOU DIDN’T GET IN SCHOOL. www.gmfa.org.uk

Thanks to all those who flashed their pants for #Pants2HIV Support GMFA – text GMFA14 £5 or £10 to 70070 © 2014 GMFA | Charity Number: 1076854 Company limited by guarantee: 2702133

OPINION What is sex really like for a gay trans man?

By Aedan Wolton

@aedan_james

Despite the wonderful diversity within our LGBTQ communities, it can sometimes feel like the ‘T’ is silent. Trans people are often left off the sexual health agenda, and even within community spaces, transphobia is rife.

On the often hyper-masculine, phallocentric gay scene, queer trans men (guys assigned female at birth) can experience unique forms of invisibility and discrimination, making even a simple hook-up feel really complex!

I spoke to Jamie, a 50-year-old trans man about his experience of navigating the cruising scene, and his strategies of maintaining good sexual health in a system that was not set up for trans people.

Jamie is currently not in a relationship. He spent 22 years in the military and, when not going to concerts or the football, he enjoys an active sex life with guys who he meets in cruise bars, darkrooms and saunas.

He occasionally uses apps, but says they can be a bit time-consuming. For a lot of trans guys, another downside of apps is that they can provide an anonymous space for men who are not clued-up on trans issues to ask some pretty invasive or inappropriate questions.

Jamie spoke to me about his experience of cruising in saunas where “your body shape is more exposed, as are the scars.” In these steamy environments, he tends to opt for backless pants as he’s still undergoing lower surgery and avoiding lengthy discussions about his genital configuration makes life a little easier!

“Darkrooms are better, in that clothes can hide things more easily.

You just need to stop wandering hands if you don’t want to be touched.” He tells me the downside of hooking up

like this comes when someone wants to see him again, or spend the night together. “I can’t, because I didn’t explain who I was first.” For a lot of guys, knowing if or when it might be safe to tell a hook-up that you’re trans can be an incredibly difficult and anxiety-provoking experience.

On top of worries about disclosure or transphobia, sexual health can be a tough field to navigate for a lot of trans people too. There’s a lack of accurate information that’s relevant to trans bodies, and a lack of sexual health clinics able to offer transappropriate services. Despite this, Jamie is conscientious about his sexual health and is buying PrEP (medication to prevent HIV) online in order to stay HIV-negative.

“I was wary in case it wasn’t the genuine product. The turning point was accessing websites like iwantprepnow. co.uk.” Jamie had some concerns about whether PrEP is as effective for him as it is for other gay men, as no trans guys have been included in any of the PrEP studies so far, but he feels it’s a useful addition to his sexual health toolkit.

Jamie buys generic PrEP without prescription from AllDayChemist, and currently has all of his follow-up testing and care at 56 Dean Street in Soho, where I am a health advisor, helping to run cliniQ – the only weekly, trans-led sexual health clinic in the UK. “Although I don’t need them, I understand why some people would appreciate the dedicated trans clinics. Finding a place where having a non-standard body is expected and needs less of an explanation is important for lots of trans people. Anything that reduces barriers to accessing sexual health services and advice should be applauded.”

When Jamie first started to transition, he felt like all the other trans guys he met or read about were

attracted to women, but after some exploration he found other gay and queer trans men who were also into the darkroom and sauna scenes.

Jamie feels that although there are a number of places for people to find information on the medical aspects of transition, there is a very real lack of information to help navigate the sexual elements. “PrEP is really helping with that aspect. I don’t believe it has changed my outlook on HIV, but I feel free to embrace the sexually charged environments that I visit, and it’s great to think that someone else’s status is not an issue.”

There’s a need in the UK, and globally, for a more open discussion about trans people’s sexual wellbeing, not just limited to HIV prevention, but also sexuality, relationships, and sexual pleasure. “I can’t speak for others but I need to explore, and I need to know what I want in bed now. I have a different body, I have a different outlook, and I’m having sex in different environments from those I am used to.

PrEP is important to me for that reason.

I can relax and just enjoy this element of my life.”

With the advent of PrEP guys like myself, Jamie, and our patients in cliniQ can focus on finding the sex we want without fears for our sexual health.

There’s still a huge amount of transphobia on the queer scene, but hopefully with education and increasing inclusion gay trans men can have a happy sex life without fear.

Aedan Wolton is a social worker and specialist Trans Health Advisor at cliniQ and 56 Dean Street in Soho. He is also a campaigner, avid gardener and cat enthusiast.

For more information about trans sexual health, visit www.cliniq.org.uk. www.fsmag.org.uk

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LIFE

HIV ME With Ruaidhri O’Baoill

@RuaidhriOB

Telling my family I’m living with HIV is the best thing I’ve done I had flown home especially for the weekend. I had spent the previous three months obsessing over the exact choice of words and how, when and even where in the house I said it.

By the time I arrived at home I was an emotional and exhausted wreck.

We had not long finished our dinner when I saw my younger brother who, sitting on the opposite side of the table, gave me a look as to say ‘go on, tell them’. It was then I proceeded to break down in tears as I told my parents I was HIV-positive.

At the start, I decided that I was only going to disclose my status to a close group of friends and that telling my family was going to be put on hold. There were a few reasons for this but there were two that were more important than any of the others.

Firstly, I had moved away from home and at that time I was only managing to get back twice a year. I felt that if I told them so soon after being diagnosed everything would have been far more

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reassure them that everything was dramatic and they would have either going to work out in the end. made me fly back home or would have Mum and Dad joined my brother come to London themselves. At that moment in time I was not ready to face at the kitchen table and after months them. I needed my own time to process of planning my speech, everything crumbled to pieces and what I this. I needed my own space to work actually said was a blubbering mess. out how I felt about myself, being HIVSilence was met with crying which positive and my future. Secondly and was followed by many, many hugs. probably the deciding factor was that I had told my brother a few weeks I felt that I needed to tell them I was beforehand as I felt I wouldn’t be able positive with a positive! I thought that to completely do this on my own. He the best way for me to do this was to reacted with a level of maturity and take control of my health, honesty that pretty much floored which I knew would me. This responce and also have been their being there with me especially number one Mum that weekend, has been far concern. took the news more important to me than As a result the hardest, as he will ever know.

I decided unbeknownst to me Mum took the news the that I was she admitted that ever hardest, as unbeknownst to only going since I came out me she admitted that ever to tell them this was her was since I came out this was her when I was biggest fear. was biggest fear. Dad remained undetectable. quite calm and asked a lot of This way I could questions which I was prepared for. somehow soften I made sure I brought every piece of the blow and hopefully

literature I had home with me. That was my strategy. The more I could educate and dispel any myths the better chance they had of understanding and accepting the situation I now found myself in. The chat, which felt like it went on for hours, was brought to a surprising end when we all had a much needed, albeit slightly awkward, giggle.

Dad happened to comment on how positive I was being with everything.

I replied, jokingly, asking if we could all not use the word positive just yet.

Looking back I definitely feel this was our family breakthrough moment which my Dad and his innocent choice of words should take full credit for!

Over the past two years I have always been very mindful that although it is me who is living with HIV it is also my family and friends who are going through it with me at the same time. I’ve always ensured that I have made myself available to them for any questions, concerns or fears they may have. Since I came out, again, my family have not only continued their incredible level of support and love but have continuously taken me by surprise with how they have handled it.

Only recently my Mum, who has been enjoying the social media aspect of life ‘i.e. Facebook’, took it upon herself to respond to the somewhat harsher critics of one of my previous articles. Initially I was concerned because I am very aware of the soulless maliciousness that can come with social media and didn’t especially want my Mum involved in that. However I was wrong as she made very sure that her voice was heard, and I cannot thank her enough.

We all come from different families and I know that some will be more supportive than others. There is no law to say you need to disclose your status to your family. I did because I wanted to. I did because I knew that they would have been completely heartbroken if I took away the opportunity for them to help me. If I didn’t have them right there lifting my head up when it fell, encouraging me to be honest with how I felt and simply just loving me, I wouldn’t be the happy boy I am today.

You’ve done me very proud

Ruaidhri was diagnosed HIVpositive in August 2014. He’s an HIV activist with a keen interest around stopping stigma within the gay community. In his spare time he likes to stalk Victoria Beckham and run after plastic bags on a windy day.

HIV LIFE Family and friends Whether or not you tell your family may depend on how close you are to them and how much support you can expect from them. If you feel their concern will become a burden for you, possibly because of an extreme emotional response or even the possibility that they may reject you, then it may be better not to tell them.

If there is a family member that you are particularly close to, you might want to talk to them first and find out whether they think it would be useful to tell the rest of your family. They may even be able to help you disclose your status to other family members. You could think about who in your family you first told that you were gay, or who was most supportive. It may seem daunting, but disclosing to a family member can actually lead to a stronger relationship. By showing someone that you can turn to them for support and trust them with personal information, they may feel closer to you. These discussions could also help them to feel more able to share any difficulties that they are having in their life.

How your family reacts at first may be very different from the way they behave after they have had time to better understand what living with HIV means. An emotional response could be followed by help and support, or vice versa. It very much depends on the individual you are disclosing to and how well informed they are. By being clear about your reason for telling them (whether it’s for support, because you want someone to listen or just because you want them to know) they may be able to respond in a more positive way.

There are many misconceptions and myths about HIV, so those close to you may become very scared for you when you tell them you have HIV. Where possible, be prepared to provide information; they may have questions and concerns that you could answer which would reassure them and help them to understand what your diagnosis means.

Some people find talking to close friends easier than telling their families, especially if their friends are more informed about HIV. Friends can also provide a different point of view from family members. While it is important to think carefully about who you tell, it’s also important to remember that everyone needs someone to talk to from time to time.

It’s possible that you may already know some gay friends who have HIV. It’s also possible that in telling one of your friends, you find out that they also have HIV. Telling a friend who has HIV may mean that you get some useful support and advice from someone who has been through the same emotions and feelings as you.

Having a close circle of friends who you can confide in will help to relieve some of the pressure you may feel in dealing with HIV on your own. As with your family, be prepared to answer any questions they may have. Your friends may well need reassurance about what having HIV means as much as you need support from them.

Remember though that since your friends may be worried after hearing that you have HIV, they may feel the need to talk to other friends who may not already know. If you don’t want this to happen, be clear with them that you want them to keep the news to themselves.

Support More details about the risks of different sexual acts, both for HIV and for other STIs, can be found in the section How risky is...? on GMFA’s website. Visit www. gmfa.org.uk/sex.

GMFA has a section of its website dedicated to gay men living with HIV. Visit www.gmfa.org.uk/living-with-hiv.

www.fsmag.org.uk

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OPINION

Grindr, chemsex and self-esteem

By Professor Rusi Jaspal @ProfRJaspal www.sites.google.com/site/rusijaspal

Recently, I was invited to contribute as a featured speaker to the Let’s Talk About Gay Sex and Drugs open-mic event at Ku Bar in Soho. The theme of the event was ‘control’, which was defined broadly to include all forms of control that we may or may not have over ourselves, others and the events that surround our lives. I decided to focus on self-control and approach this from the perspective of self-esteem and selfefficacy.

By self-esteem I mean your sense of self-worth, that is, feeling good about yourself and feeling that other people value you. Homophobic prejudice, which can lead to internalised homophobia, can severely undermine our sense of self-esteem.

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By self-efficacy, I am referring to the feeling that you can do things that matter to you and that you can stop doing the things that you think are bad for you. There are events that can cause you to question your selfefficacy, such as the desire but inability to leave the ‘chemsex’ scene.

Addiction and sexual risk-taking We can become addicted to many things – some seemingly trivial, others discernibly more serious.

I’d like to focus on just two sources of addiction that some gay men experience: Grindr and ‘chemsex’.

There are of course some clear advantages associated with using Grindr. The geospatial element of

Grindr means that gay men can meet other gay men in their geographical vicinity. This way of meeting may be perceived as ‘safer’ than others, such as cruising. However, in small-scale research that I’ve conducted on gay men’s experiences of using Grindr, I have found that some feel that they are unable to limit their use of Grindr and that their ‘excessive’ use of the app can induce a poor self-image: ‘‘Sometimes I end up falling asleep with it [Grindr] open on my phone and I wake up thinking I should really get a life. I feel like an idiot.’’ (Mike, 28) “I do think it’s [Grindr] taking over my life a bit... You’re watching a film on Netflix and you go ‘I’ll just check my messages’ and then you’re on until like 4 in the morning, just chatting

and chatting and trying to hook up. dimensions of one’s life, including work It feels like a massive waste of time responsibilities, relations with other sometimes, but I’m hooked.” (Peter, 22) people, and physical and psychological Many individuals outline how their health, as has been described in a Grindr use has taken over their social previous article in FS. lives. One interviewee described Of course, many gay men use a holiday abroad during which he Grindr and engage in chemsex without reported spending an entire day in his showing any signs of addiction. In other hotel room connected to the hotel’s words, they have the ability to control Wi-Fi so that he could use Grindr: their behaviours and do not view them “I’ve spent the whole day in my as encroaching on other dimensions of holiday room just looking for a hook-up their lives, but this is not the case for when I could have been actually talking everyone. in a human way and exploring the place and what have you.’’ (Kumar, 30) Sexual risk-taking and HIV Grindr use can encroach on prevention valuable face-to-face social time with friends and family, as some individuals HIV disproportionately affects the feel that they are constantly glued gay community – according to to their mobile devices in pursuit Public Health England’s HIV data, of a sexual encounter that, in many gay and bisexual men made up cases, they never even find. Some 43% of people living with HIV and individuals reported feeling bad about 57% of new diagnoses in 2014. themselves because they spent so Both self-esteem and self-efficacy much time on the app, and simply seem to be key factors in sexual riskfelt unable to limit their use taking. We know that most of it despite wanting gay men use condoms to. Their self-esteem some of the time, but Their and self-efficacy many do not use them self-esteem were constantly consistently. The threatened by their ability to negotiate and self-efficacy excessive use of condom use were constantly Grindr. with one’s sexual threatened by their partners is key to Chemsex is another addiction HIV prevention. excessive use of for some gay men However, some Grindr. living in London gay men lack (and indeed in other self-efficacy, that is UK and European the sense of control cities). A recent chemsex and competence that documentary clearly is required to negotiate demonstrated the debilitating condom use, and they may feel effects that this practice can have on pressured into having condomless people’s lives. The Chemsex Study sex by their partner. In my research published in 2014 provides some into negotiating condom use, I’ve had valuable insights into the reasons gay men tell me that they often feel why some gay men are so drawn to disempowered in sexual situations. the practice of chemsex. Some gay Why? I would argue that a lack of selfmen felt that the substances used efficacy is a key explanation. in chemsex sessions could enhance “Sometimes I’m just there waiting sexual self-confidence and reduce for him to pull out a condom and if he inhibitions, enabling them to engage in doesn’t, I can’t bring myself to sort of practices they may not feel comfortable say ‘no, we’ve got to do this’.” (Mark, with in sober settings.

23) Many of the interviewees felt that “I haven’t got the confidence to chemsex could facilitate sexual desire/ even take a condom out, let alone tell libido, intimacy, sexual connection him put it on. It’s a confidence thing.” and sense of sexual adventure. When (Simon, 26) such needs are perceived as being Self-esteem is also important. met in the chemsex context, some For instance, compulsive sexual individuals may essentially ‘forget’ behaviours (or ‘sex addiction’) can what it is like to have sex outside of stem from decreased self-esteem. A this context. This, coupled with the sexual encounter (even with ‘no strings use of addictive substances, can lead attached’) can make some people feel to both a physical and psychological attractive, valued or loved, even if for a reliance on the practice of chemsex. short period of time: Clearly, this can encroach upon other “Having sex was more than just

having sex for me. I finally felt like guys actually wanted me so I gave in. I felt ugly before that and now guys wanted me.” (Richard, 27) “It sounds stupid but each time I got fucked, I thought this was the start of a love story. How wrong was I?’’ (Alex, 25) The transient boosts to self-esteem that casual sexual encounters can sometimes provide could lead some gay men to seek such encounters more frequently and to neglect safer sex practices in the process. Some people may simply go along with their sexual partner’s desire not to use condoms. In other words, the priority is to have sex and to derive self-esteem, rather than to think about HIV or to negotiate condom use.

Possible ways forward Not everyone who uses Grindr or who engages in chemsex is necessarily addicted.

But many gay men are, and for some, this addiction is having a profoundly negative impact on their lives. Similarly, not everyone engages in sexual risk-taking but some gay men do and are therefore at high risk of HIV exposure. Addiction and sexual risk-taking are important issues and ones that I believe we as a community should try to engage with.

We need to build our self-esteem and self-efficacy to ensure that we lead fulfilling lives. We need to discuss these issues in a frank and candid manner. When people acknowledge problems, they are more likely to begin the process of dealing with them.

We need to bring groups and individuals together, which incidentally is one of the reasons that I find events like the Let’s Talk About Gay Sex And Drugs so beneficial for the gay community. When people come together and talk, silence and stigma disappear.

Finally, we need to support one another by developing a more cohesive LGBT community that speaks out in favour of the issues that affect us.

For more information about chemsex, visit www.gmfa.org.uk/ saferchems.

For more information about mental health, visit www.nhs.uk/ mentalhealth.

www.fsmag.org.uk

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OPINION

THE EX-FACTOR

By Mark Reed

@mark_reed88

In a phenomenon that seems to be particular to the gay community, a lot of guys end up with a friend or two who they used to go out with.

Some still go on holiday together.

But how close a friend can your ex really be?

It seems only natural that at some point after a break-up, you might want to form a friendship. If it was a good relationship then there was something that drew you both together. Even though it broke down, you still want to have that person in your life. It seems a shame to remove them completely. You woke up together. You had breakfast together. You walked in the park together. You laughed together. You made love together. Then all of a sudden, you turned the tap off.

You saw this person all the time. And now you don’t see them at all.

It’s hard to renegotiate your relationship with an ex. Of course you might need to have that time apart before you can even contemplate a friendship.

When you’re ready to get back in touch, these are some good things to consider.

Why do you want to be friends?

You want to be clear about why you want to be friends with your ex. Is it because you’re hoping that maybe you can get back together? That sounds like something we should already know, but sometimes we don’t want to delve too deep and admit to ourselves that we want that person back. If that’s the case, then establishing a friendship is not a good idea. You either tell them how you feel or give yourself time for those leftover feelings to subside. You don’t want to end up in a situation where you’re trying to act the friend, but wishing for something more. You’ll end up an emotional basket case, rocking from side to side while watching Bridget Jones’s Diary on repeat. That’s not a good look on anyone. So make sure you want to be friends because you genuinely want them to be a significant part of your life, and not because you’re still secretly in love with them.

Readjust your expectations What are you expecting from your ex?

They’re not going to talk to you every day, reassure you, support you and do all those things that a boyfriend does. Equally, you aren’t going to be obliged to provide those same things for your ex. So, it might take some time to renegotiate a friendship and not get stuck in your old ways. That can be hard,

realising that you can’t treat them the way you used to.

Losing that physical ease with someone can be particularly difficult. You loved to hug him around the waist whilst he did the dishes because he couldn’t get away. You liked when he rested his hand on your lower back while you were watching TV together. You played with his beard and he’d get annoyed because it tickled. You miss all these things and you can’t do them any more, that feels strange.

You get used to it and over time, you establish a new dynamic. A new dynamic where you don’t do the shopping together, or ask each other how their day was all the time, or spoon on the sofa after a long day. It’s sad but of course it’s a necessary step.

Friends with benefits It’s not unusual for you and your former beau, once you’ve established a friendship, to fall into old habits, mostly habits involving poking and holes. Of course, it’s an easy option. You know each other, how you both operate, your little do’s and dont’s, etc. And it’s not only easy, it can feel safe having sex with someone you used to be emotionally intimate with. For those reasons, it seems possible – even likely – that it will happen.

However, if you’re going to open that door, prepare yourself for what may be lurking there. You might see it as just some friendly fun, but what if it starts to reawaken your feelings for your ex, or vice versa? Then you’re back to square one, the place you’ve been trying to escape.

If only things could be as straightforward as that movie with Mila Kunis and Justin Timberlake, right? Maybe it wasn’t actually so straightforward. I don’t know, I never watched the movie, it looked terrible.

Know when to abort Some relationships just aren’t worth saving. They’re destructive, or they bring out the worst in you: your insecurities, your fears, and just about everything that you didn’t like about yourself. You think you need to hold on to this person, but in actual fact, you need to get far away from them. This isn’t Baywatch, and you’re not David Hasselhoff. You can’t save everyone.

They may be a great person, a person that you loved dearly but that doesn’t mean that together you make a great couple, let alone good friends. Some

break-ups may not even be that dramatic, but they still hurt like hell. I would urge caution if you’re forming a new friendship whilst your old wounds are still healing.

Your ex’s new romance So, your friendship is going swimmingly and you’re becoming the best of chums.

But, your new bff/former ex drops the fact they’ve started seeing someone new. Now you have to decide just how you’re going to deal with that piece of information. If you’re lucky, you’ll be in a place where you can be happy for them and not feel like you’ve been punched in the stomach. If you’re not so lucky, it may feel like someone has ripped your stomach out and replaced it with a card that says ‘Haha! I told you this would happen’. You need to be very secure in yourself to be able to handle this well.

Even if you are happy, well adjusted, and have effectively ‘moved on’, you still might not want to hear about his new boyfriend. You don’t want to get back together, but it’s painful to imagine them with someone else. That’s OK. That’s who you are. You decide how deep this friendship can be. Will you be best buddies or Christmas card pals or something in between? Everyone’s different. Some people will be able to talk with their ex about new romances and have a great, honest and open friendship, whereas some people will have to have their ex at arm’s reach. You choose what’s right for you.

It’s not you, it’s me It seems that everything I’ve said so far highlights the precautions to take when establishing a friendship with an ex rather than the positives. Personally, I feel that we shouldn’t automatically become friends with our exes, just because lots of other gay men do. Friendships can be fraught and complicated enough at times, even if you weren’t a couple. I want to be damn sure that this isn’t going to bite me in the ass when I realise that I can’t – or worse – don’t want to be friends with this person any more.

So, yes, I am cautious when it comes to making friends with an ex and so should everyone. That doesn’t mean you can’t. I count one or two exes as very good friends, I’m very happy they’re still in my life.

I just made sure they were there for the right reasons, and not the messy, complicated ones that made us break up in the first place.

www.fsmag.org.uk

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Call Galop

for hate crime advice, support or reporting

T: 020 7704 2040 www.galop.org.uk 28 | | 26

Photo © www.flickr.com/seeminglee

8 WAYS TO MAKE AN OPEN RELATIONSHIP WORK

ADVICE

HOW TO SURVIVE A HATE CRIME

by Mark Reed

@mark_reed88

taking them home, mention that you have a flat mate who is probably in (or a friend sleeping on your sofa) – even if you don’t. Someone who intends robbing or harming you may be deterred if they think you have company.

AVOID CONFLICT

If a situation looks like it might turn violent, try not to engage. Try to calm the situation down or look instead for ways of getting out of the situation.

There is no shame in refusing to fight or trying to get away, especially if the odds are against you.

IF YOU ARE ATTACKED

The 11th of June, 2016, was a Saturday night like any other at gay nightclub Pulse in Orlando.

Last orders had been called at the bar as the crowd danced on to the final few songs. At the same time, Omar Mateen walked into the club with an assault rifle and opened fire. He killed 49 people and wounded 53 others in one of the most horrific LGBT hate crimes in history. You might want to think differently but violence towards the LGBT community is alive and well.

Last year, forces in England and Wales released figures showing that homophobic attacks had increased by almost a quarter since the previous year. In 2014-15, 5,597 hate crimes were recorded against gays and lesbians – an unprecedented rise of 22 percent on the previous year – which could be down to the increase of people reporting incidents.

So with hate crime looking like it’s on the rise, we all need to be extra vigilant and and look out for ourselves, and each other. But what can we do to stay out of harm’s way? LGBT hate crime prevention charity GALOP shares their advice on how to avoid conflict, and deal with it if necessary.

BE AWARE

Take note of your surroundings, and of the people around you. If there are choices about where to walk, always choose well-lit, populated areas and stay near to main roads. Avoid lonely short-cuts at night. Move away from groups of people behaving in an

erratic or provocative manner. Cross the street, change direction or grab a cab if you think there is danger. Try not to draw attention to yourself.

Hopefully this will never happen to you, but if you are attacked, you may decide to fight back, but try to get help and attention. Shout to bring others to your assistance. Sometimes shouting ‘Fire!’ will bring people more quickly. If your attacker has a weapon, try to run.

Get help as soon as you can.

THE POLICE CAN HELP

The police take homophobic crimes very seriously, so if you are a victim do report it as soon as possible. This When travelling at night, try to travel includes verbal abuse, name calling, with friends as much as possible. If you find yourself alone on top of a bus, harassment, vandalism or actual physical attack. The police can’t do or in an empty tube or train carriage, anything to improve the situation move as soon as you can to where there are other people, or get off if you unless they know it’s happening. If you do report it to the police, make feel it might be safer to do so. If you sure they give you a crime reference can afford it, get cabs for journeys by number and always ask for a copy of yourself. the crime report to be sent to you.

SAFETY IN GROUPS

BE CONFIDENT

Whether you feel confident or not, walk with your head up and in a determined manner. Look like you know where you are going, even if you don’t. If you feel nervous, or alone, remind yourself that you have as much right to be walking the streets as anyone else.

DRINK AND DRUGS

If you are out of it, you are more vulnerable. If you know you will be drinking or taking drugs, arrange to travel with friends. Try to stay with them when you’re out and don’t take off by yourself.

WHAT’S A HATE CRIME?

A hate crime is a crime that is carried out against a person that is believed to be motivated by hostility or prejudice towards any aspect of that person’s identity.

This includes: disability; gender identity; race; ethnicity or nationality; religion; faith or belief, and sexual orientation.

Most hate crimes are acts of physical and verbal abuse, but they can also include harassment.

For more info or to report a homophobic attack in London visit www.galop.org.uk, ring 020 7704 BE MINDFUL IN THE BAR Take care of your drink at all times, and 2040 or email info@galop.org.uk. don’t accept alcohol or drugs from strangers if you don’t know where they Outside London, contact local police as most constabularies now have came from. When you meet someone dedicated LGBT liaison officers and you want to leave a club or bar with, try to introduce them to a friend before hate crime units. you leave. If you live alone and are www.fsmag.org.uk

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www.gmfa.org.uk/pep PEP is a course of HIV medication which you can take if you have been at risk of HIV infection.

The course of medication lasts 28 days and, if you start taking it within 72 hours of putting yourself at risk, it may be able to prevent you from becoming infected with HIV. PEP can be accessed through your local GUM clinic or A&E department.

To find your nearest GUM clinic, visit www.gmfa.org.uk/clinics.

GMFA . 11 Ebenezer Street, London N1 7NP. Charity No: 1076854.

48 |

Part of

OPINION

By Hadley

@wordsbyhadley

How are you?

How are you? It’s a question you’ll often hear as you go about your day.

The easy answer is “I’m fine.”

Maybe you are just ‘fine’, but maybe you’re a little less than fine. But how can you say that to somebody first thing in the morning? The truth is, we’re pretty rubbish when it comes to talking about how we’re feeling. A few years ago, the “I’m (not) fine” reply came to me as naturally as breathing. And it turns out I’m not the only gay guy who’s felt anything but gay.

In mid-June Matthew Todd released his long awaited book Straight Jacket.

Like many gay men, I bagged myself a copy as soon as I could and started flicking my way through the pages. The book accompanied me on a weekend away from London and on the train journey somebody asked me about the book. “This book is going to change the world!” I exclaimed. And I meant it. The very idea for this book is both brave and genius. It’s never easy talking about your own experiences of mental health, addiction or relationships. Yet, here was a book which discussed these very issues. It’s even arranged into three sections, taking the reader on a journey: from Shame, to Escape and finally on to Recovery.

It isn’t just the voice of Matthew Todd that we experience, but we also get to hear the experiences of other

LGBT people. As I read these various accounts, I could identify friends of mine, people I’ve worked with and I could recall hearing about some of the stories in the news. This allowed me to relate to these issues, showing me that it was happening to real people. It’s all very well and good showing me a pie chart of statistics which illustrates that LGBT people are more likely to suffer from depression, but how does that relate to me and my friends?

Although I’m not the biggest fan of statistics, they do provide us with some context. The RaRE Report, published

by PACE, states that 34% of young LGB people had made at least one suicide attempt in their lives, compared with 18% of young heterosexual people. The study also found that many people who took part in the study were deeply impacted by bullying aimed at their sexual orientation and physical appearance. Speaking as somebody who was bullied for being gay, before I even knew what ‘gay’ meant, that it led me to the false conclusion that being gay was something to be ashamed of.

It would be wrong to assume that all gay men are either depressed, selfharming or suicidal; the book makes this very clear. But something that the book does highlight are the potential consequences of homophobia on a person’s mental health. Furthermore,

the book brings so-called ‘gay issues’ into mainstream discussion. Our straight friends may empathise with our experiences of homophobia, but can they fully understand it? I’d argue this book goes some way to bridging that gap in understanding.

I think it’s about time we started talking to one another about these issues. Just because we use a word which means ‘happy’ to describe our sexual orientation, doesn’t mean we need to be happy all the time. It’s OK to feel something other than gay.

Perhaps this is why the idea of breaking down this false sense of security and admitting we’re not feeling great is such a challenge? We have all sorts of feelings: happy, sad, elated, scared, confident, and self-conscious. So the next time a friend asks you how you’re feeling, just know that you don’t always need to say ‘fine’.

SUPPORT: If you need someone to talk to, you can call Samaritans on 116 123 or LGBT Switchboard on 0300 330 0630.

www.fsmag.org.uk

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TRUE LIFE

By Michael Lee

I’m still in love with him – how getting over your ex is a journey Getting over someone is hard. Trying to forgot about his mannerisms, the way he called you ‘babe’ or the way he spoke your name is easier said than done.

How can you just forget about his existence and go about your day when you look at your phone and realise his name will never pop up and give you butterflies. The road to getting over him is a long and well-trodden path. It is a journey, a journey that will test your willpower and mental strength.

Is there ever such a thing as loving someone too much? Loving someone so much they utterly consume your entire existence, from the moment you wake from restless slumber, beneath sweat-soaked sheets, riddled with paranoia, heart racing with anxiety, to the very second those weary, sleepy eyes reluctantly close and drift back into fretful sleep. He was my very obsession and my everything, and I’m still in love with him.

It’s that moment stuck in between consciousness and being barely able to function that is most intriguing yet frightening, that quietened part where my over analysing brain cannot stop functioning under the flickering of stars etched in the darkened skies above my rooftop window. As the light of the full moon beams through the stained window and lights up the banished corners of my bedroom.

It’s this moment when the thoughts return, the thoughts that are hushed when I am busy, when the night falls quiet, when the war in my mind begins.

I fall asleep and sink into a never ending reimagining of the relationship that truly never was, the boyfriend who I never got, and the chiselled heart I utterly miss.

We argued, we bickered but ultimately we loved, even though we lived under circumstances that made it unsustainable. Sometimes just having love is not good enough. I wished I was

the centre of his world, his everything, but I just couldn’t be, and now I retreat back to my own world, the world that exists inside my head.

The hardest part of losing someone is not necessarily having to say goodbye, but rather having to learn to live without them, and this is what pains me the most, that I’ll never be able to see his cheeky and adorable smile ever again. I miss his voice; I miss our late night conversions that would go into the early hours. I miss hearing his opinions on politics and social commentary and how he was very stubborn and set in his ways. I miss his awkwardness and unwillingness to conform to his surroundings but most of all, I just miss him being him, because that’s what made me fall for him in the first place.

Now I find myself trying to fill the sudden void that his absence has left.

It hurts, it hurts really badly. The pain is palpable. He mattered to me, and now he has abandoned me. We abandoned each other when having one another became too much to bear. It was true love, I know it, that’s why it’s so hard for me to just forget about him and walk away.

You talk to someone every day and can’t imagine your life without them, then suddenly you don’t see them any more and all you have left is your memories of yesterday. He’s still on my whatsapp through we haven’t spoken for months. It’s such a far cry from when he was my boyfriend, when his name would constantly pop up on my screen and the butterflies in my stomach would flutter around. Now those once beautifully coloured butterflies are dead and decayed, laying lifeless in the pit of my stomach.

My mind is cluttered with memories of him and everywhere I go he is still there, but one thing is for certain, no

matter how much I desperately try to move on, I know that I’m still in love with him. Maybe one day I’ll forget about him and move on, maybe I won’t, all I know is nothing is for certain, except the love I still have for him right here, right now, even though he is no longer by my side. The journey is a long and hard concrete road; I’ll just try to not let my heart turn to stone along the way.

FS SAYS: IT GETS BETTER Anyone who has gone through a break up will tell you that being dumped is hard to deal with. When someone that you have very strong feeling for tells you they don’t want you, it can be difficult to hear. But... as the famous campaign says... It gets better!

It’s generally accepted that there are several stages of a break up. 1) Looking for answers, 2) Denial 3) Bargaining 4) Relapse 5) Anger 6) Acceptance and 7) Hope.

The stages of grief that follow any trauma, breakups included, can happen over the course of minutes or even seconds, across days, months, or years, and then switch around without warning, leaving you feeling without foundation, especially in the beginning. You feel alien to yourself or cut off from the world. However, like any emotional situation, continuing on in life means learning to live without that part of yourself, and finding ways to compensate for its loss.

Try to recognise that there is a method, and a structure of sorts to a grieving process. Knowing that you are not alone can help you ride it out. Your grieving is normal — without it, we would not be wired the way we are to handle the many pains and losses that occur in our lives. As the grieving process progresses you will begin to see your way through to a point at which you can let go in a more proactive and self-protective way—a way that you may eventually come to understand as a new beginning.

If you would like to talk to someone about your relationship struggles, call LGBT Switchboard on 0300 330 0630.

Would you like to write a true life story for FS? Email fsmag@gmfa. org.uk.

www.fsmag.org.uk

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The rise of the gay super geek

by Saif A.

@Mrseras

Gays, geeks and superpowers.

Well, that’s what this particular breed of gays wish they had.

Following the sweeping phenomenon that has taken the world by storm with the release of Pokemon Go, I have taken it upon myself to find out what the fuss is all about with the help of an awesome LGBT gaming group called LDNGaymers.

For those who don’t know, LDNGaymers is a group of LGBTQI+ individuals who have banded together to offer a safe space with a zero tolerance for any form of attitude for fellow gay gamers (gaymers for

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short). They meet often and their events have been a resounding success!

They currently have a residency at the Old School Yard where they deck out an especially geeky (think everything Marvel) pub with a variety of vintage and current generation consoles and projectors for the purpose of spending an entire evening gaming with other fellow gays. There is something for everyone and the joys of meeting new gaymers is one the most popular reasons to check them out!

Saif: So, LDNGaymers, could you tell us a bit more about what you would define as a gay geek and

what makes them super?

LDNGaymers: Well, anybody can be a geek and there are a wide variety of geeks from gaming to anime or board game geeks. What makes you super is how invested you are into your geek genre. To infinity the gay super geek will go.

Saif: Do you define yourselves as gay super geeks?

(All get up and perform the various Power Ranger poses and accompanying battle cries)

Saif: (stunned) I will take that as a resounding yes. A lot of people hate labels and stereotypes. Why do you choose to label yourself as ‘gay super geeks?’

We like the label. It’s self deprecating and ironic. If you would want to label yourself, why call yourself a geek, who is usually the outcast on the social popularity scale? We also think giving yourself an identity which others can immediately understand or relate to also helps two parties open up to one another, if that makes sense.

Saif: That’s a great way of looking at it. Do you think there has been a rise in the gay super geek then?

We can say, with certainty, that the number of gay super geeks has risen steadily over the last two years. We think our numbers are going up like this because it’s become almost commonplace to just be into the fantasy world, thanks to comic book movies. Everything is a lot more accessible and mainstream, so it’s easier to invest into whatever your craft is.

Saif: If I asked you to visualise who you think the gay super geek was and who you think they are now, what would you see?

Before? We can only imagine a person who will have one set group of friends.

These friends will, if that person is lucky, share the same interests but most of the time this will not be the case. London is especially bad for finding people who like what you do despite the healthy gay population we have. It can still be extremely difficult bonding over anything that does not involve drinking and partying.

Now? They’re everywhere, anyone, any age and any gender, if they do identify with one. From who we’ve met, we find it’s especially the gays in their twenties and early thirties who grew up with the Ataris and Segas but that may just be a birds of a feather thing.

Saif: Do you think that we will see more people come out as gay super geeks?

We think so. We think it’s becoming more acceptable to be into superheroes and escape into the realm of fantasy for a while, if you consider the constant reports of violence throughout the world.

This is especially true for LGBTQI+ people. It can be a rough ride if you’re one of us, and don’t we all know it. It’s not all doom and gloom though, we’ve spoken to a few of our members about why they love what they love and some just find it a wonderful creative outlet to let the imagination go wild.

We constantly get feedback from our members about how lovely the people are at our events.

Many have formed friendships they would never have made and credit us with giving them a place to make it happen, very much in line with what we hoped to achieve.

Saif: So about the group, how did that happen?

Saif: What type of person comes to this group?

It started off as a casual monthly meetup between friends that we took turns hosting at our own homes. We just had so many people asking to come that we decided to find a space and do it there. This has since grown into a 50-person strong event with people from all sorts of backgrounds joining in on the fun.

There is also the aim of tackling homophobia in the gaming and general geek world by giving people a platform to speak from, if that makes sense.

Regular and super gay geeks are both very welcome by the way!

We have every kind of person coming to our events. At any one event we have a wide variety of ages (18+) present.

Our mission is to make people feel they are welcome, and we have elected event hosts who are designated to help by welcoming people and get them interacting with each other.

Saif: Is this group just about gaming?

Saif: Oh you guys! I just have one final question. What’s your message to anyone who wants to join a group like yours but is a little nervous about joining a group?

Not at all! We include every aspect of fantasy or fiction in our group. We just find gaming the best medium to bring everyone together as it’s usually the common denominator between every type of geek. You will find all of us discussing a wide range of topics such as Buffy to the politics of the Marvel-verse and you will even find most of us freaking out over the latest death in Game of Thrones. We are very diverse to the point that we also have an active division who are keen on physical activities, like bouncy castles and Laser Tag.

Saif: If the guys are cute, then I’m so there!

Ha, they are, but we do operate a safe space policy. No heavy petting allowed, unless it’s nintendogs or in private.

DON’T BE NERVOUS. We want you to be with your people. You deserve that.

We are a team and we need each other to make it.

Saif: Well, that’s an incredible message. I wish you all the best.

I’m going to be polishing my Street Fighter play to take you guys on at your next event.

Bring it on!

Saif: Do you think it’s important to be a part of something, like your group, that helps people connect?

Has anyone’s life changed for the better since they joined your group? Have you any stories about current members who have said positive things about your group?

Well, there you have it, beloved readers.

We went out there and got you some answers straight from the experts.

It’s the rise of the gay super geek and who knows, I might just meet you at one of these events. I’ll probably be the annoyed one at the bar, vowing to take revenge and beat the veterans at their own games. Say hello!

We think it is important for LGBTQI+ people to bond over things they are passionate about, whatever that may be. We are trying to bring back the community vibe as that seems to only come together during a tragedy.

We see no reason why it needs to be this way, so we did something about it. People have responded well.

LDNGaymers meet-ups take place on the third Wednesday of every month at the Old School Yard, 111 Long Lane, London, SE1 4PH. For more information about LDNGaymers, visit www.ldngaymers.com.

www.gmfa.org.uk

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THE LAST, LAST WORD Changing times: How HIV prevention has evolved...

by Matthew Hodson

@Matthew_Hodson

Matthew when he first joined GMFA in 1999 A child who was born on the day I started at GMFA would now be old enough to join the army or get married – two rights that British gay men didn’t have back then. I’ve been with GMFA about half of my adult life. After 17 years with GMFA it’s time for me to move on.

It’s been at various times wonderful and gruelling and frustrating and inspiring – and sometimes all of these at the same time. If I didn’t walk now, to take up a wonderful opportunity to work for the NAM, providers of aidsmap, I would end up being carried out in

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a box… or dragged out kicking and screaming.

So, as a parting shot, here are a few observations about the changes I’ve witnessed over the last 17 years.

HIV treatment works When I joined GMFA I had been diagnosed with HIV for about eight months. At my interview I probably pretended to be cooler about that diagnosis than I actually was at the time. This was near the beginning of the

era of effective treatment but before we believed with confidence that someone who was diagnosed promptly, and who was able to access treatment, would have a similar life expectancy to someone who was uninfected.

Back then the knee-jerk response for health promoters was that HIV meds were ‘highly toxic’. Since that time dosing has got much better, so the side effects that used to be all too common are now mercifully rare. I think that some who were involved in HIV prevention, and iothers who cared passionately about it almost missed the days when death was

the price that may be paid for not using a condom – it made the messaging that much simpler. For myself, I’m hugely grateful for the drugs that keep me alive.

I have to go to fewer funerals now in my late 40s, than I did throughout my 20s and 30s. HIV is now very treatable and this needs to be trumpeted loudly.

Undetectable means uninfectious

PrEP doesn’t offer any protection from other STIs, and gonorrhoea is getting harder to treat. PrEP is expensive, which is the main reason it hasn’t already been rolled out. Studies show that those who are greatly motivated to use it take it often enough for it to be effective but that isn’t going to be everyone. I only want to add to our prevention armoury, I don’t want to take anything away.

Stop blaming OK, I just made a lame blame joke (sorry Taylor, love you) but really, the blame game doesn’t help. It’s all too easy to see HIV as something that happens to other people, whether that’s older people, younger people, sauna users, proud pervs or whatever other category you feel you don’t fit into but secretly enjoy judging. Truth is, those of us living with HIV have probably made some good choices and some bad ones in our lives. So has everyone else. That judgeyblamey thing? Not helping.

Not only does HIV treatment give you a realistic expectation of a long life, it also means that it’s very, very unlikely that you will pass on the virus to your sexual partners. New data has just been released from a major international study looking at mixed HIV-status couples and, after almost 60 thousand acts of unprotected sex, not a single person got HIV from a partner who had an undetectable viral load. For all those who routinely sexually reject people who are open about their HIV status – your strategy is dumb. You are more likely to get HIV from sex, even protected sex, with someone who thinks that they’re uninfected, but isn’t, than from unprotected sex with someone who’s been diagnosed with HIV and is As I said at the top, I’ve been in HIV courteous enough to tell you about it. prevention for a long time. Every couple of years there’s some new moral panic about something that is supposedly behind the number of new infections.

I’ve lived through bareback porn, bugThe number of gay and bisexual men chasing and now chemsex. The truth is, who acquire HIV each year in the we are complicated and so are our sex UK has remained fairly stable. This lives. Of course taking drugs that reduce isn’t good enough. The proportion your inhibitions and make you feel all of men who haven’t been diagnosed horned up may result in some people is dropping, due to successful work having unprotected sex who wouldn’t to increase testing rates, and the otherwise. And yes, if all the porn you vast majority of those diagnosed see is bareback, perhaps that’s going to are undetectable on treatment (and feel more natural to you than protected therefore uninfectious). By now we sex, etc, etc. But there is no one single should be seeing a drop in new infections – but we’re not. Blame Grindr, reason why men have sex which puts them or their partners at risk of HIV. blame chems, blame Taylor Swift if you want but it’s clear we need to have more in our prevention armoury if we’re going to end HIV. PrEP could make that difference. The time is now.

There is no one reason why people get HIV

PrEP works

…and there’s no magic bullet

…But we still need condoms PrEP is going to be great for those who, for whatever reason, are not able to maintain consistent condom use but, in addition to my advocacy for PrEP, I remain a big cheerleader for condoms.

And because there’s no single reason why gay men take risks, there is no single answer that’s going to end all new HIV infections. All we can do is chip away at the mountain of challenges by ensuring that gay men have access to condoms and that we are encouraged to test early and often, by fighting for access to PrEP, by making sure that

everyone knows how HIV is and isn’t transmitted, by giving support to gay men so that they don’t end up having sex that’s not safe enough for them because someone pressured them into it, or because they were drunk, high, lonely or sad. On their own, none of these will be enough to end HIV. Together they just might be.

Support GMFA I’ve probably spent more hours in GMFA’s offices or working on GMFA’s projects than I’ve spent with any single human being. I’m still passionate about the work that GMFA does. I believe it’s vital that gay men have access to the kind of frank, direct and reliable information that GMFA provides, through its website and FS, its campaigns and groupwork. I believe GMFA does this better than anyone else. Unfortunately much of this work isn’t funded. I’m English enough to feel embarrassed asking for money when it’s contributing to my own salary. Now that I am no longer on the payroll I can say without hesitation: this work is too valuable to be lost. So if anything that you have read on this site has been valuable to you, organise a bake sale, shake a tin, run a marathon or set up a standing order. These services will be lost without funding.

GMFA has taught me so much and I’m enormously proud of the work that I have achieved here, and grateful to all the supporters, volunteers and colleagues who have inspired me with their talent, passion and dedication. GMFA will always have my support. I hope that it has yours too. It’s been immense.

Goodbye for now.

Matthew Hodson

Matthew finishes his role as CEO of GMFA on 19 August 2016.

Current FS editor, Ian Howley, will be taking over as CEO. This article is Matthew’s own opinion and not necessarily the view of GMFA as an organisation.

To make a donation or set up a standing order to GMFA, visit www. gmfa.org.uk/donate.

www.fsmag.org.uk

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ADVICE

How to build your confidence

Who should attend this type of groupwork?

If you feel more is required of you than you are able to give when faced with a challenge, you are likely to feel less in control of your life. This can lead to feeling more anxious, more helpless and more stressed. If you’re worried about risks you take because you feel you can’t talk about them, then Building Your Confidence is for you. Many men have said that having confidence is key to them maintaining their safer sex strategy, but this is something they have had to learn over time.

Why is confidence building important for gay and bi men?

Low self-esteem has often been mentioned as a causal factor in gay men having unprotected sex, as is a belief that HIV exposure and possible infection is inevitable. The INSIGHT study found that men who repeatedly test for HIV and remained HIV-negative differered in self confidence levels from those who went on to become HIV-positive. These men all shared a similar number of sexual partners, but those with higher confidence believe that the threat of HIV exposure does not affect them having healthy and fulfilling sex lives. This is thanks to their communication skills, HIV knowledge and belief in their own futures, which encourage them to protect themselves.

Words by Ian Howley @ianhowley

Tell us five things that gay and bi men will learn from this groupwork.

1. Tips for better conversational skills, including how to start different types of conversation, understand body language and ask questions.

Words by Ian Howley Are you as socially and sexually confident as you’d like? Not many gay men would answer “yes’’ to that question, but confidence is something we all need.

Why? Because confidence is related to self-esteem, and what you think of yourself or how you feel about your life is very important when it comes to your health and happiness.

We sat down with Nick Baker, head of groupwork for GMFA, to talk about the upcoming new groupwork programme Building Your confidence.

Nick, tell us about ‘Building your confidence’.

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@IanHowley Building your confidence is a oneday course run by GMFA, designed to help you improve your confidence using easily learnt practical skills. A lack of confidence in social and sexual situations can leave many gay men feeling unable to ask for what they want, or to say no to other people.

Confidence isn’t something we are all born with, but it’s not a secret art either. Practical skills that are used on the course will enable you to start and maintain conversations, make and refuse requests, including talking about sex. All with confidence.

2. Being able to ask for the type of sex you want, by feeling good about yourself, knowing what sex you like and being open to new things.

3. Help with setting your sexual boundaries. What are your personal safer sex rules? Is it the same for regular and casual partners.

4. How to deal with rejection.

Learn to overcome fear based on past experiences and to embrace uncertainty.

5. Saying no to the sex you don’t want.

What went wrong when sex hasn’t been as safe as you wanted it to be?

What about the gay men who can’t attend this course? What advice could you give them about confidence building?

Confidence is feeling comfortable that you can withstand what life throws at you. It builds by taking daily actions on a consistent basis. Something that first seemed scary, like starting a new job soon becomes a normal part of your life.

Many people lack confidence because they struggle with uncertainty and resist it. As your confidence grows you are better equipped to see the opportunity it holds. When faced with a stressful situation that would normally have you running for the hills, think about what thoughts are stopping you and how it makes you feel, both emotionally and physically.

These can be either helpful or unhelpful to your confidence and the action you take.

You fancy a guy in a bar and he’s smiled at you. You might think he’s too good looking for you, so you already feel rejected and are unlikely to do anything. You might even avoid him altogether.

Instead if your first thought is helpful – he looks nice, and seems interested – you will feel hopeful and physically more comfortable. You smile back and start a conversation…

If you take the risk you open yourself up to the possibility. Give him a chance and you both might win.

Even if it goes nowhere with this guy, and after ten minutes of chatting you go your separate ways, at least you’ve broken the cycle of inaction, and that’s a success. Small success builds confidence.

Building Your Confidence is a one day course designed to help you improve your confidence using easily learnt practical skills.

Post Exposure Prophylaxis, or PEP, is a course of HIV medication which you can take if you have been at risk of HIV infection.

The course of medication lasts 28 days and, if you start taking it within 72 hours of putting yourself at risk, it may be able to prevent you from becoming infected with HIV. If you believe that you need PEP you must act fast! The sooner you start PEP, the more likely it is to be effective.

When: 20 August 2016 10am-5pm Where: Positive East, 159 Mile End Road, London, E1 4AQ Cost: It’s free of charge and open to gay and bisexual men. Priority for places on this course will be given to people who live or work in Tower Hamlets.

For more information, visit www. gmfa.org.uk/building-yourconfidence.

For more information, visit

www.gmfa.org.uk/pep GMFA . 11 Ebenezer street, London N1 7NP. Charity No: 1076854.

Part of To support GMFA’s work visit: www.gmfa.org.uk/donate.

www.fsmag.org.uk

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