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<h3><!--mstheme--><font color="#003366"><b><font face="Verdana" size="3"><a name="THE">THE</a> A - Z OF GAY MEN’S SEXUAL
HEALTH</font></b><!--mstheme--></font></h3>
<p align="center"><font face="Verdana" size="2"><b>(by Dennis Gray, Senior Health Adviser,
Victoria Clinic, London)</b></font></p>
<p align="justify"><font face="Verdana"> </font><b><font face="Verdana" size="6">A</font></b><font face="Verdana">bstinence ? Yes, abstinence ? If you catch a sexually transmitted infection
such as <a href="sti/gc">gonorrhoea</a> or <a href="sti/chlamydia">chlamydia</a>,
abstinence is required until the final check-up confirms that the treatment has worked.
Otherwise you may pass the <a href="glossary#Infection">infection</a> on to your
partner.</font><b><font size="6"></p>
<p align="justify"></font><font face="Verdana" size="6">B</font></b><font face="Verdana">alls
! Testicular cancer particularly affects men aged between 15 and 40 and can be cured if
it’s treated in time. Try this ; stand when you are relaxed after a bath. Using one
hand hold each ball, in turn, with your thumb on top and middle and index fingers
underneath. Roll gently looking for swelling, tenderness, hardness, lumps or any change in
its weight.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">C</font></b><font face="Verdana">um,
you know about. But what about pre-cum ? Pre-cum is the fluid that comes as anything from
a drop to a flood during sexual excitement. Pre-cum helps with sexual lubrication but
contains sperm and HIV if you are HIV positive. Any penetration without a condom is risky.
</font><b><font size="6"></p>
<p align="justify"></font><font face="Verdana" size="6">D</font></b><font face="Verdana">imensions,
Penis, schlong, willy and stranger names besides have been used to describe the humble
organ. Out with your rulers ! Several different studies have shown that the average
flaccid length is 4 inches and erect length 6.25 inches. Half of all men have erect
lengths between 5.5 and 7 inches. If worries about your penis dimensions interfere with
sex or relationships you might need to consult a professional (no, we don’t mean
rent-boy). <i>See Erectile dysfunction.</i></font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">E</font></b><font face="Verdana">rectile
dysfunction, premature ejaculation or difficulty with sex and relationships affect almost
everyone at some time - often at times of emotional stress. Your penis is really just
trying to tell you it needs a rest. Most problems will sort themselves out. But for
long-term difficulties, psychosexual therapy or counselling can usually help.</font></p>
<b><font size="6">
<p align="justify"></font><a href="glossary#Foreskin"><font face="Verdana" size="6">F</font></b><font face="Verdana">oreskin</a>. Research shows that cut (circumcised) men are a bit less
likely to get genital infections, including HIV, than uncut men. These days most men wash
frequently and avoid a build-up of that thick, white smelly stuff called smegma. Sometimes
men need circumcision if the foreskin won’t go back comfortably during sex or
masturbation.</font></p>
<p align="justify"><a href="sti/gc"><b><font face="Verdana" size="6">G</font></b><font face="Verdana">onorrhoea</a> can cause a greenish-yellow discharge and pain when peeing.
Most men notice the symptoms 3 - 4 days after infection. But there aren’t always
symptoms, especially if the infection is in the rectum or throat. It is easily treated
with penicillin though there are a few types from South East Asia that have become
penicillin-resistant and are treated with another <a href="glossary#Antibiotics">antibiotic</a>.</font></p>
<p align="justify"><font face="Verdana"><a href="sti/hsv"><font size="6"><b>H</b></font>erpes</a>
is a common viral infection which produces little blisters or ulcers on the genitals,
including the bum, and <a href="glossary#Cold Sore">cold sores</a> on the lips. Herpes
can feel quite nasty when you catch it, and, for about half of those infected, it
reappears every so often. The person with herpes is most infectious when the actual ulcers
are present and the day or so before (you might notice a tingly feeling). GPs and <a href="clinics/whatisa">GUM clinics</a> may prescribe helpful treatments if it is caught early
enough.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">I</font></b><font face="Verdana">ntercourse.
Active or passive ? Arthur or Martha ? <a href="glossary#Insertive">Insertive</a> and <a href="glossary#Receptive">receptive</a> ? Whichever way you like it, take a tip from
medical staff doing rectal examination in genitourinary (<a href="clinics/whatisa">GUM</a>)
clinics. If you lie on your left hand side in bed, he can enter you from behind following
the natural line of the bowel. This should be more comfortable. (About six in ten gay men
are as happy to be Arthur as Martha). <i>See Safer sex.</i></font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">J</font></b><font face="Verdana">erk
off. Yes, gay men are a community of wankers. A study of gay men’s sexual activities
found that we wank six times as much as we <a href="glossary#Oral">suck</a>. Over 90
per cent of gay men have wanked in any one month period.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">K</font></b><font face="Verdana">Y
is probably the best known water-based lubricating jelly. Oil-based lubes are unsafe
because the oil damages condoms. Lack of adequate <a href="glossary#Lubricant">lubrication</a>
is probably the main cause of torn or lost (inside your bum, not fallen off your bedside
table !) condoms.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">L</font></b><font face="Verdana">iver
damage can be caused by the hepatitis viruses A, B and C. Typical symptoms include severe
exhaustion, yellowing of skin and the whites of the eyes, very dark urine, whitish faeces
(shit). ‘A’ usually comes through faeces getting into the food cycle,
‘B’ from semen (spunk) and sometimes saliva, ‘C’ is more likely to be
caught from blood from shared injecting drug use. Although hepatitis A and B can come from
sex there appears to be a very small risk that hepatitis C can be caught this way. If you
haven’t had one, you should consider vaccination for hepatitis B. You can get the
jabs from your GUM clinic. Vaccination for hepatitis A is considered a good idea for
travellers to countries with poor hygiene. Hepatitis A usually only affects sufferers for
a couple of months but the other type are more dangerous. A few people with hepatitis B,
and rather more with hepatitis C, can get serious liver damage or liver cancer later in
life.</font></p>
<b><font size="6">
<p align="justify"></font><a href="sti/molluscu"><font face="Verdana" size="6">M</font></b><font face="Verdana">olluscum contagiosum</a> is a highly contagious but harmless infection
which can be transmitted both sexually and non-sexually. Molluscum have a waxy, pearly
appearance and are treated the same way as <a href="sti/hpv">warts</a> (<i>see Warts</i>).
In HIV disease (and sometimes without HIV disease) molluscum can be a problem on the face.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">N</font></b><font face="Verdana">SU
or <a href="sti/nsu">non-specific urethritis</a> is an inflammation in the urethra,
the tube inside your penis. It might hurt when you pee or a yellowish cloudy fluid may
ooze out. Sometimes NSU is caused by a bug called <a href="sti/chlamydia">chlamydia</a>
which is treated with antibiotics. But NSU can also arise spontaneously. Some men are
susceptible to it and too much alcohol can make it worse.</font></p>
<b><font size="6">
<p align="justify"></font><a href="glossary#Oral"><font face="Verdana" size="6">O</font></b><font face="Verdana">ral</a> sex can spread infections such as gonorrhoea, herpes and syphilis.
Although it’s not a major route of HIV infection, it’s probably best not to let
your partner cum in your mouth. Rimming is oral sex with your partner’s bum and can
transmit bugs, including hepatitis A, from the bowel to the mouth. Contrary to popular
belief rimming is unlikely to be significantly involved with the spread of hepatitis B,
unless blood is present.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">P</font></b><font face="Verdana">rostate
gland. Take your middle finger, add lube and put it in your bum. That big lump you can
feel just inside is your prostate gland. It makes part of the seminal fluid (which
together with the sperm makes up spunk), and is responsible for much of the pleasurable
feelings from anal sex. As men age the prostate can swell and restrict the flow of urine
and a check-up to rule out cancer is required. Men over 40, particularly those with a
family history of prostate cancer, should discuss check-ups with their <a href="clinics/whatisa">GUM</a> clinic doctor.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">Q</font></b><font face="Verdana">uellada.
<a href="sti/pubic">Crabs, or pubic lice</a>, are tiny dark blood-sucking creatures
which like our coarse body hair. You can see their black eggs attached to the pubic hairs.
Treatment is simple - wash the bedding and the clothes you have been using and apply
Quellada or <a href="medications/derbac">Derbac</a> (available from chemists without
prescription) to your hairy bits. Scabies is caused by even smaller creatures which cause
itching by - wait for it - burrowing through your skin. Your chemist will have Derbac or
other topical treatments for this annoying little beastie, too.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">R</font></b><font face="Verdana">ape
and sexual assault. About ten per cent of all men, and a higher proportion of gay men,
have been forced into some form of unwanted sexual activity. Sexual assault often leads to
feelings of shame and guilt. The legal system and the police have become more sympathetic
than they used to be. ‘Survivors’ operates a helpline on Mondays and Wednesdays
from 7.00 pm - 10.00 pm on 0171-833 3737.</font></p>
<p align="justify"><b><font face="Verdana" size="6">S</font></b><font face="Verdana">afe
sex. Only blood and semen can transmit HIV between two men. In practice unprotected <a href="glossary#Anal">anal</a> intercourse (anal sex without condoms) is the main way
HIV is caught during sex. The risk from unprotected <a href="glossary#Receptive">passive</a>
anal sex is higher than from unprotected <a href="glossary#Insertive">active</a> anal
sex - but both activities are unsafe. Some people are thought to have caught HIV from <a href="glossary#Oral">sucking</a>, even though it’s much less risky than
unprotected anal sex, so avoid cumming in your partner’s mouth. Untreated genital
infections dramatically raise the chance of HIV infection through unprotected sex. The
risk of infection from a partner with HIV each time you have unprotected anal sex is in
the order of one in a hundred. But the risk can vary widely depending on many factors,
including the state of people’s health at the time of unprotected sex. We know that
people are much more likely to have unsafe sex when they are depressed or elated. <i>See
Xtra-Strong.</i></font></p>
<b><font size="6">
<p align="justify"></font><a href="sti/candida"><font face="Verdana" size="6">T</font></b><font face="Verdana">hrush</a> is a fungal infection that can cause itchiness, redness and
inflammation under the foreskin. An anti-fungal cream should eliminate it in most cases.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">U</font></b><font face="Verdana">rinary
Tract Infections are caused by bugs from the bowel entering the bladder. But urine is fun
for those who like their sex wet, and luckily it cannot transit HIV infection.</font></p>
<b><font size="6">
<p align="justify"></font><a href="glossary#Vagina"><font face="Verdana" size="6">V</font></b><font face="Verdana">agina</a>. 10 per cent of gay men have been here in the last year or so.
Unprotected sex with a woman can expose you to the same infections you can catch from a
man. If you are gay it is easy to forget about <i>your</i> risk of HIV infection if you
have unprotected sex with a woman, although for her you are a ‘high risk’
partner and she should take precautions, too.<a href="sti/chlamydia"> Chlamydia</a>,
in particular poses a threat to women’s sexual health ; left untreated it can cause
fertility problems. Because it is so much easier to become pregnant than to catch HIV,
watch those cummy fingers, too.</font></p>
<b><font size="6">
<p align="justify"></font><a href="sti/hpv"><font face="Verdana" size="6">W</font></b><font face="Verdana">arts</a> are the most common sexually transmitted infection. Genital warts
can appear on the penis, anus or surrounding area and are caught by direct touch from your
partner’s wart. Treated by painting on liquids that freeze or burn them, the warts
usually need repeat treatments over several weeks.</font></p>
<b><font size="6">
<p align="justify"></font><font face="Verdana" size="6">X</font></b><font face="Verdana">tra-strong
condoms are the essential item for safer intercourse. The three more widely available
stronger brands which are suitable for anal sex are Durex Ultra Strong, Mates Superstrong
and HT Specials. You should store condoms away from heat and always use a <a href="glossary#Lubricant">water-based lubricant</a>. If you place a condom in a
container of baby oil for just a few minutes, holes will start to appear.</font></p>
<p align="justify"><b><font face="Verdana" size="6">Y</font></b><font face="Verdana">aws
is a childhood infection in tropical countries which is indistinguishable in blood tests
from the sexually transmitted infection syphilis. <a href="sti/syphilis">Syphilis</a>
is not very common nowadays in Western countries but is routinely tested for at GUM
clinics. If syphilis is left untreated for years, the heart or brain can be impaired. The
treatment (usually ten days of <a href="glossary#Antibiotics">antibiotic</a>
injections in the bum) is the same for both infections.</font><b><font size="6"></p>
<p align="justify"></font><font face="Verdana" size="6">Z</font></b><font face="Verdana">zzzzz.
Get some sleep ! Your sexual health is intimately connected with your physical and
psychological health. Taking regular exercise, learning to recognise when you are
over-stressed, getting enough sleep, using alcohol and drugs sensibly, and developing good
social (and family) relationships will all contribute to a healthy lifestyle - and a happy
sex life.</font> </p>
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