Features > The Guidance Counselor

by Doug McClelland

(posted June, 2004)

From: Charles
Subject: Precum dangers
Question: I met a guy at a nude beach and he was sucking me while he fingered my ass. I saw him reach down and rub some precum off his cock and stick his finger up my ass. I quickly stopped him and jumped into the water to rinse out. My hemorrhoids were a bit sore that day. Now I’m worried he rubbed precum in my ass. There was no blood present but you know how hemorrhoids can bleed a bit. Now I am worried he may have infected me. I’m not sure if he is HIV+ but I suppose he could be. Is there anything that can be done after an experience like this?

Dear Charles: In HIV positive guys both precum and cum can contain the HIV virus. The more body fluids you are exposed to, the greater the risk of HIV infection. So you can become infected with HIV if you are exposed to precum.

In your case I’d say the chances are low that you need to worry. Although it sounds kind of sexy to me that the guy would use his precum to lube your ass, one would expect that a guy who was positive would know better than to do this. So let’s hope this behavior was an indication of his negative status. Secondly; the fact that this was a very small amount of fluid, and that you immediately washed yourself out reduces the chance of any infection. In addition, the cocktail of medications positive guys take can reduce the amount of virus in body fluids to very low levels, reducing transmission chances further. So chances are you are ok.

But as to your question about what can be done after such an experience; the answer is changing. Post-exposure prophylaxis, or PEP, which means taking anti-HIV drugs after a sexual exposure to prevent infection, does work if begun within 48 hours. Studies say this treatment works about 70% of the time. Until fairly recently this procedure has only been available to medical professionals exposed to blood products accidentally. I asked my own doctor what he would do if I came in telling him that the condom had broken while I was being fucked by someone who I didn’t know the status of last night. He said he would immediately put me on a drug cocktail for two months, and that he would expect this would prevent infection. The idea is that by hitting the virus hard right away the drugs prevent HIV from becoming established in your body. Unfortunately studies have also shown that even when men are aware of PEP they hesitate to use it because they underestimated their risk. In Brazil Dr Mauro Schechter and colleagues have provided ‘starter packs’ of four day’s worth of 3TC and AZT to HIV negative gay men, with instructions to start taking them no more than 48 hours after a risky sexual exposure. They are then required to report to their clinic within the four days. Perhaps this is a model for us to pursue.

Even more exciting are studies being done on the drug Viread which is one of the drugs used in PEP. The premise being studied is that you would take Viread everyday and it would prevent HIV from infecting you. Three separate studies are underway in various parts of the world right now, the largest being paid for by The Bill and Melinda Gates Foundation. It would be a bit like the birth control pill allowing sex without pregnancy taking hold for women. Some physicians who specialize in treating HIV have already begun to prescribe Viread in this way experimentally. While our ultimate goal is for science to give us a vaccine to prevent HIV, this may provide a safe half way point where we can wait safely.

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From: Ben
Subject: No more sex with my partner
Question: I have been with my lover for twenty-three years. I met him in a sleazy theater, and we had great sex. At first we were happy together. Now we have ups and downs but we still have managed to forgive and forget. We seem to just hang out, not having sex, and be more into problem solving and not being lovers at all. I even find him sneaking out and dating with other men, which at first I objected to, but as the years went by I got used to him having sex with a person other than me. I told him that he can move out and pursue whatever he wants to do with his life but he still wants me and cares about me. Now, I am in my late thirties and still very attractive, and lots of men want me, but for some reason I still care about him and cannot leave because I still love him.

I don’t know what’s wrong with me or him. Are we both insane? How can this be happening? We stopped having sex years ago, even though I bring the subject up. We are just two lost individuals in a crazy world not wanting to leave each other no matter what. We’re constantly hurting each other by seeing other people and not being honest with each other. A lot of times I’ve wanted to leave him but when I think about how we have been through thick and thin then my mind tells me to just hang around and love him the way he is.

Please tell me what to do. Should I leave him and go on with my life or do the foolish things that I am doing right now?

Dear Ben: Your letter includes a number of issues involving relationships. First off; if you are still in your late thirties, but have been in this relationship for twenty-three years that means you entered it in your teens. Personally, I think that is way too early to make lifetime commitments. People have not grown into themselves at that age and there is huge potential to grow divergently. Any relationship started at that age is unlikely to be permanent, so it is possible that it is just time for you to move on.

But maybe you guys are among those rare people who find Mr. Right very early and are right to go through life growing together. If that is the case then you’ll still have to deal with the normal evolution of a gay relationship. In my experience, most gay men who maintain long-term relationships successfully come to understand that sex and love are two separate things. Once you have been together for years you begin to understand that a bit of recreational sex on the side is not a threat to your long-term primary relationship. You can get past sexual jealousy and possessiveness to a point of trust. Recreational sex takes on a role similar to any other recreational activity your partner participates in separately from you. Just as you would wish him to enjoy a film he attended without you, you should accept a bit of outside recreational sex.

In your letter I note that only your lover is having outside sex despite the fact that lots of other men want you. This nails down the primary problem for me. You and your lover need to have an honest relationship understanding that which makes both of you happy. My prescription would be that you also start participating in a bit of recreational sex outside your relationship and that this be done in the context of both of you understanding that the relationship is now ‘open’. It is impossible for two people to satisfy each other’s every sexual need for a lifetime. If you still want to have sex with him, perhaps you could try it with the spice of an added third.

If you have been together for twenty-three years you must have many successful things in your partnership. If you need to go outside your relationship to fulfill just one aspect of your life (sex) you are not doing too bad. Consider what percentage of your life you expect to spend having sex compared to all the other things you do successfully in a day with this man.

Single life is not all it’s cracked up to be: ask your single friends. Personally I think that a long-term open relationship is the ideal gay arrangement.

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From: LuvAsian
Subject: Question on herpes
Question: I have read your column and other material on STDs but I am still a little confused. I have two questions: what STD is one at danger of contracting through oral sex? Is there a difference in giving and receiving? And if someone has herpes, is any physical contact enough to give someone else the virus? I do not have herpes, and have heard conflicting info. For example, if someone I want to give a hand job to has warts on their penis and I touch them will I get herpes?

Dear LuvAsian: It is possible to pick up various STDs from almost any sex act. This is why we use the terms ‘high risk’ and ‘low risk’, but rarely the term ‘no risk’.

With oral sex you have the possibility of contracting HIV, herpes, syphilis, gonorrhea, etc. Receiving oral sex is somewhat less risky that giving it. Herpes is most likely to be spread when the carrier has active blisters. It is possible for it to be spread at other times, but generally if there are no blisters there is minimal chance of infection. Warts are something entirely different than herpes. You might get warts from that exposure but not herpes.

Transmission of most of these things can be prevented by the use of condoms. As well, the liberal use of soap and water after exposure can help in some of these cases, such as exposure to warts. There are various medical treatments for these different conditions, and you should immediately see a doctor if you exhibit any symptoms.

 

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