Avoiding infection

If you are having sex with men, particularly on or around the London scene, it is important that you take especially good care of your sexual health.
Diagnosis of sexually transmitted infections has been rising in the UK since the mid 1990’s with most of this increase evident in the London area. For these reasons, everyone needs to be aware of the risks of Sexually Transmitted Diseases (STIs), not just for their own sake but also for that of their partners.

If you are concerned about any aspect of your sexual health we can offer you appropriate advice on what your risks are likely to be and what tests you will require on the basis of your sexual history.

How can I protect myself?
Sexual abstinence is the only way to guarantee that you will remain free from sexually transmitted infections. However, for most people, this is not a viable option, as an active sex life is important for many men's overall sense of well-being. However, in addition to the obvious requirement to use a condom for anal sex, there are a number of ways in which you can intelligently reduce your risk of acquiring an infection:

Use a condom for oral sex
Up to 40% of new cases of syphilis last year were thought to be caught through unprotected oral sex! Make sure you are wearing a condom if you are receiving oral sex from a new partner.

Use a dental dam for rimming
If you like to rim, you may be at risk from bowel infections such as Shigella, and other infections such as Hepatitis A and syphilis. Correct use of a Dental Dam will minimise this risk. This is a small, square sheet of latex or polyurethane which you place between your mouth and your partner's anus. You can make one yourself from a condom as shown here: http://www.emmagoldman.com/services/STI/oralsex.htm or you can buy them in a sex shop or through the internet.

Don't dip without a condom
Dipping is the name given to the practice of penetrating the anus with the penis and withdrawing before ejaculation occurs. This reduces but by no means obliterates the risk of acquiring HIV if your partner is infected. Your risk of catching any of the other sexual infections if your partner has an infection is not significantly reduced.

Try non-penetrative forms of sex
Mutual Masturbation, massage and kissing are generally considered to be very safe forms of sex with a very low risk of acquiring any form of sexual infections, provided there are no open sores in the genital area.

Wash with soap and water....
...when sharing sex toys or having brachio-proctic sex (fisting). This reduces the risk of acquiring a bowel infection in this way. You should also ensure you have been vaccinated against Hepatitis A.

What tests should I have as a sexually active gay man?
The tests that you require depend in part on the type of sex you have had. The British Association for Sexual Health and HIV strongly recommend the following tests for gay men who are sexually active. If you have multiple partners it is further recommended that you have these tests performed at least every six months:

• Throat swab for gonorrhoea,
• Penile swab for Non-specific urethritis (NSU)
• Urine test for gonorrhoea and chlamydia
• Rectal swab for gonorrhoea and chlamydia
• Blood test for HIV, Syphilis and Hepatitis B

What else can I do?
It is wise to get yourself and your partner immunised against Hepatitis A and B. We can provide this service for you or it can be arranged free of charge through the NHS or your GP.

Recreational Drug Use
It's a good policy to avoid sex while under the influence of alcohol or drugs, particularly ketamine, methamphetamine (Crystal Meth), ecstasy and gamma-hydroxybutyrate (GHB). These will lower your sexual inhibitions and may increase your likelihood of having unsafe sex, perhaps involving roughness which may break the skin, increasing the risk of infection.