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HIV STI info

Here is a good map showing who is more likely to be immune to HIV

Author: July 11, 2014 0 Comments

Are  you Immune to HIV?

 

 

Where are you parents/ancestors from?

 

 

 

 

 

 

 

 

This map came from:   http://evolution.berkeley.edu/evosite/relevance/IA2HIV2.shtml

This map shows the percentage of people from each country who are immune to HIV.   13.7% of the population have the gene for immunity to HIV in Sweden, while 5.5 % have this gene in Italy.

 

If one parent has this CCR5 allele then a person is resistant to HIV, if both parents have the CCR5 gene then the offspring is “immune” to HIV.

 

Some people would like to know if they are “immune” or partially immune to HIV.

You can get tested to find out if you are immune to HIV at  http://www.delta-32.com/

 

 

People with two copies of the CCR5 delta32 gene (inherited from both parents) are virtually immune to HIV infection. This occurs in about 1% of Caucasian people. 

One copy of CCR5-delta32 seems to give some protection against infection, and makes the disease less severe if infection occurs. This is more common, it is found in up to 20% of Caucasians. 

Should everyone be tested for this mutation? Not necessarily. It would be dangerous to assume you are completely safe from infection if you have the CCR5-delta32 mutation.

It’s not an airtight guarantee of never getting AIDS. Some unusual types of HIV can use other proteins for entering cells. Rarely, there have been people who have two mutant CCR5 genes who have died from AIDS. 

Also, CCR5 is not the whole story of immunity to HIV infection. Some resistant people have been found who have two perfectly normal copies of CCR5. So other genes also contribute to slowing down HIV infection, and scientists are busy trying to identify them.

The above is from   http://brothersgrimmandgorey.blogspot.ca/2010/12/possible-hiv-cure.html

HIV STI info

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Some interesting information on risk of HIV transmission

Author: May 30, 2014 0 Comments

From: HIV Update <bulletins@bulletins.aidsmap.com>
Date: Thu, May 29, 2014 at 9:04 AM
Subject: Long-term HIV transmission risks – HIV update, 29 May 2014

Long-term HIV transmission risks

A group of American researchers have published an analysis which attempts to estimate the long-term risks of HIV being passed on within a couple.

This was a mathematical modelling study – in other words, it does not report new findings from a study of couples in the real world. Instead, modelling studies use previous research findings, assumptions and mathematical techniques to simulate a sequence of likely future events.

Their findings show that even if the risk of HIV being passed on during one sexual act is relatively small, the risk can accumulate over time for a couple who have sex regularly for a number of years.

The researchers wanted to get a rough idea of the long-term benefits and risks of using different methods to reduce the likelihood of HIV transmission. They were interested in couples where one person is HIV-positive and the other person HIV-negative, who were assumed to have penetrative sex six times a month.

For example, for an HIV-positive woman and HIV-negative man, who only have vaginal sex:

  • If no protective measures are taken, 6% risk of transmission after one year, which adds up to 44% after ten years.
  • If the negative partner takes pre-exposure prophylaxis (PrEP), 2% risk after one year, 15% after ten years.
  • If condoms are used, 1% risk after one year, 11% after ten years.
  • If the positive partner takes HIV treatment, 0.2% after one year, 2% after ten years.
  • If condoms and PrEP are used, 0.3% after one year, 3% after ten years.
  • If condoms and HIV treatment are used, 0.05% after one year, 0.5% after ten years.
  • If condoms and PrEP and HIV treatment are used, 0.01% after one year, 0.1% after ten years.

The risks are much greater for couples who practise anal sex, whether they are heterosexual or gay. (The risk of HIV transmission during receptive anal sex is 18 times greaterthan that during vaginal sex).

For a gay male couple:

  • If no protective measures are taken, 52% risk after one year, which adds up to 99.9% after ten years.
  • If the negative man takes PrEP, 34% risk after one year, 98% after ten years.
  • If condoms are used, 13% risk after one year, 76% after ten years.
  • If the positive man takes HIV treatment, 3% after one year, 25% after ten years.
  • If condoms and PrEP are used, 8% after one year, 59% after ten years.
  • If condoms and HIV treatment are used, 1% after one year, 6% after ten years.
  • If condoms and PrEP and HIV treatment are used, 0.3% after one year, 3% after ten years.

Some mathematical models that we have reported on in the past could be criticised for being based on unrealistically optimistic assumptions. This one can be criticised for including some rather pessimistic assumptions.

In particular, the estimates for pre-exposure prophylaxis (PrEP) and condoms assume that people who plan to use them don’t always manage to. Both PrEP and condoms are likely to be much more effective when they genuinely are used consistently.

The figures produced are rough estimates and there is much that scientists can debate. Nonetheless, the study brings to light four key points:

  • A small risk of transmission in a single act of sex translates into a much larger risk during a sexual relationship that lasts several years.
  • The risks of transmission through anal sex, especially in the long term, are much greater than through vaginal sex.
  • Current research shows that effective HIV treatment provides more protection than other strategies, including condoms.
  • The safest strategy is to use several prevention methods in combination, such as HIV treatment, PrEP and condoms.

HIV STI info

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Why would you want to know if you are immune to HIV?

Author: March 15, 2014 0 Comments

Why would you want to know if you are immune or partially immune to HIV?

Most gay men will know someone who has lots of unsafe sex but they are still negative it is likely because they are immune to HIV.   There are also lots of people who have been HIV positive for along time but are relatively healthy, these people are likely partially immune.

IF both your parents have the gene (CCR5) to make one immune to HIV then you will be immune.  IF one of your parents has the gene (CCR5) then you  will be partially immune to HIV.

 

IF YOU ARE HIV NEGATIVE – you may want to know you are immune because:

You can find out if you are immune to HIV or partially immune to HIV but getting a simple swab of your mouth.  The results will tell you if you are unlikely to become HIV + (partially immune), or if you will almost certainly will not become HIV+.  This knowledge may help you to have less anxiety about sex or some people may decide to have risker sex.

If one is partially immune then you will be a slow progresser, then the HIV virus will not have the same effect on you as someone who is not partially immune.

 

The immunity comes from not having receptors that allow the virus to enter the body.  One who is partially immune has fewer receptors so becoming infected is lessened and if one does get infected the disease will progress more slowly.

 

IF YOU ARE HIV POSITIVE – you may want to know you are immune because:

You will know if you are a slow progresser.   You may want to take less HIV medication to keep your viral load suppressed.  You may have peace of mind that you are not so likely to get sick from HIV.

A company called delta-32 will sell you the test to find out if you are immune to HIV.   Their website gives a lot of interesting information on HIV immunity.

Their website is:     http://www.delta-32.com/

HIV STI info

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Where to get tested for immunity to HIV/Who is immune to HIV?

Author: March 13, 2014 0 Comments

http://www.delta-32.com/  This website will now give  you the test for HIV immunity.

The map below show where people are most likely to be immune to HIV.

Picture

The delta 32 mutation is more prevalent in some racial backgrounds than in others. Population studies of the Caucasian population of western European ancestry revealed that approximately 1% of people were homozygous (2 copies) for the delta 32 mutation and up to 20% of people were heterozygous (1 copy). Within the United States, Canada and Australia, the frequency is 8% to 10% within the Caucasian background individuals, but less than 1% in the Afro-American populations. There is also a very low frequency of the mutation among the population in eastern Asia but much higher towards western Asia.

HIV STI info

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Gay men and Sex(uality) and Drug Use

Author: February 19, 2014 3 Comments

Gay men and Sex(uality) and drug use
Drugs are people substitutes – People are drug substitutes 1

When most people talk about drug use and sex, they think of addiction. So I should preface my comments on this subject with my take on “addiction”. First of all “addiction” is not a word I use. I believe that when people use the word addiction they are only describing what they see as “bad behaviour”. We have many repetitive behaviours that we do daily and perhaps compulsively but the word addiction would not be used to describe these behaviours. Some examples of such behaviours may be: I may wish to kiss my partner every day or a few times a day and have a negative feeling if it does not happen, I may like to cuddled daily, I may enjoy a few glasses of cold water daily etc. Often when the term “addiction” is used it seems to only provide a way of describing behaviour one is critical of, the label of addiction is not helpful and does not add to understanding.
Beginning a counselling relationship without acceptance and disempowering (http://www.pearsoned.ca/highered/showcase/shebib/pdf/samplechapter_ch07.pdf) an individual is a poor way to begin a counselling relationship. (http://www.ccpa-accp.ca/blog/?p=2996 ) One of the main characteristics of counselling is acceptance without judgment. (http://infed.org/mobi/helping-relationships-principles-theory-and-practice/) Starting counselling with a label describing the person as engaging in bad behaviour can be counterproductive. This is especially true when it is implied that “the person has no control over their behaviour.
People use drugs for a reason. There is an emotional need that is being met by the drug that is being used. Given this, the best way to begin to help an individual is to explore what they get out of using the drug. The next step is to help them to find other ways of meeting those emotional needs that more fully rewarding.
One drug that is popular with many gay men is Chrystal Meth. (http://www.wehoville.com/2013/12/02/crystal-meth-gay-men-start-load-road-addiction/ ) For some of those gay men crystal meth use can be problematic. Therefore without judgment I begin to explore with gay men what emotional needs does crystal meth allow him to satisfy. It often becomes apparent that most gay guys will use crystal meth to allow them to be the “sex pig” (http://cbrc.net/resources/2013/desire-and-defiance-pig-sex-project) that they would like to be, but do not allow themselves to explore without drugs. I was once asked to do a workshop on “Pig Sex” (http://www.realjock.com/gayforums/16537 ) . (Pig sex, is like pigging out at a Christmas dinner – that is eating too much, and a bit of everything.) The main point that came out of this workshop was: “We may not have the same kinks, but I know I will not be judged”. This lack of judgment allowed for a freedom in “pigging out”. Many gay guys have sexual needs/fantasies that they cannot fulfill without crystal meth. The use of that drug allows a person to explore many aspects of sexuality that may not be explored without some drug use, due to of internal and/or external inhibitions. It follows then that part of the motivation for crystal meth use may be because of sexual inhibition, and fear of judgment. If this true, than the goal is to help him to become less sexually inhibited, and be free to explore his sexual desires, without the problems caused by drug use. (I would suggest the therapist also must NOT be sexually inhibited.)
In addition many gay guys who use crystal meth are often looking for a feeling of being emotionally connected (at least for the moment) with the other guy(s). Many gay men grow up denying their sexual and emotional feelings. This denial of sexual and emotional feelings often happens because as the gay guy is growing up he will often have feeling of being different than other boys, of “not belonging”, and also questioning if they are lovable if parents and others knew they were gay. This sense of separation, being different, and questioning if they are lovable has a profound on most gay men.
Given that crystal meth allows a gay man to achieve feelings of connectedness, sexual openness and a feeling of freedom from judgment, it is not surprising that many gay men would be attracted to use crystal meth. Many gay men find great pleasure in what crystal meth can bring them. It is only because crystal meth is meeting these deep personal needs of a gay man that he uses this drug again and again and again. Often crystal meth users do not know of another way to feel sexually free and emotionally connected. Therefore, the goal is not, to stop crystal meth use, but to find ways to be sexually uninhibited and emotionally connected with other gay men. Stopping or reducing crystal meth use may be a byproduct of a happier more fulfilled life.
Craig Sloane reports that “By using gay affirmative treatment,” and “Promote self-acceptance, create safe and non-judgmental environments. We have to set up treatments that don’t pathologize gay sex.” (http://www.addictionpro.com/article/crystal-meth-and-its-use-among-gay-men )
Counsellors need to begin laying the foundations of a nurturing therapeutic relationship that refrains from labels and judgments that disempower a person. The therapist must recognize that drug use is meeting a person needs. Explore those needs and seek alternative ways of meeting those needs if drug use if problematic.

1. (Blachly, 1970) Seduction: A Conceptual Model in the Drug Dependencies and Other Contagious Ills, Paul H. Blachly, M.D., 1970, Charles C. Thomas, Springfield, Illinois

 

Most of my career has been working with criminals, and much of that with sexual criminals, I also work in the area of sexual health.  Much of my work has been with gay men at BC Centre for Disease Control, and in private practice.  I wrote a column in the local gay newspaper, Xtra, on gay men and health.  I tend to see the “problem behaviour that is presented” as the symptom,  (for example:  Sex, drug use, violence etc.) the goal is to discover what are the many facets that are pushing that behaviour.  Gay men have generally grown up emotionally alone, afraid of discovery, being taunted-bullied or teased with a constant fear of rejection from parents, family, friends, and classmates, this provides a unique obstacles later in life. (For more info: www.bcoleman.ca)

HIV STI info, Interesting stuff for gay guys

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PEP Coming to BC Finally

Author: April 12, 2012 0 Comments

 

 

Accessing HIV post-exposure drugs
GAY MEN’S HEALTH / BC launches nPEP pilot project
Nathaniel Christopher / Vancouver / Wednesday, April 11, 2012
Gay men in Vancouver will soon have expanded access to a drug therapy that can prevent them from becoming HIV-positive after exposure to the virus.

Next month the Ministry of Health and the BC Centre for Excellence in HIV/AIDS (BC-CfE) will implement an 18-month pilot project called non-occupational post-exposure prophylaxis (nPEP).

Right now PEP treatments, which are initiated within 72 hours of exposure to HIV and cost between $1,000 and $1,500, are publicly funded only for victims of sexual assault or people exposed to the virus in the workplace. Under nPEP the government will cover the costs for treatments following other high-risk exposures to HIV, such as unprotected sex and intravenous drug use.

“Non-occupational post-exposure prophylaxis will be rolled out in the next few weeks,” confirms Dr Val Montessori, co-chair of the therapeutic guidelines committee at BC-CfE. “If the individual is assessed as having been in a high risk situation, nPEP, which includes three medications active against HIV, will be prescribed. A physician is the only one who can prescribe these HIV medications. The cost of the medications will be covered for this pilot by PharmaCare.”

Bill Coleman welcomes the nPEP pilot project, but he wonders why it took so long to launch and says it will leave gay men outside Vancouver at risk.
(Nathaniel Christopher photo)

NPEP will soon be available at St Paul’s Hospital’s emergency department, the John Ruedy Immunodeficiency Clinic at the BC Centre for Disease Control, the Bute St Clinic, Spectrum Health Clinic and the Vancouver Coastal Health Downtown Community Health Centre.

“We are in the process of carefully reviewing the necessary information for the pharmacy, the pilot sites and the individuals who may access nPEP,” Montessori says. “We anticipate that the pilot will be ready to roll out in May.”

NPEP is not the “morning-after pill” for unsafe sex, but it can be an effective tool to prevent infection, says Jody Jollimore, project manager for the Health Initiative for Men (HIM).

“PEP is not a silver bullet,” he notes. “It’s not going to prevent HIV infections in our community completely, but certainly in certain instances it can be an effective tool. Our key will be to promote it not as the end of condom use but something that can be used in addition to a condom.”

PEP can have mild to severe side effects for many people, he adds.

“This is not a walk in the park,” he says. “In fact, the research says that over 80 percent of guys who access PEP once never return for a second course. So guys aren’t using this as a morning-after pill. And they won’t.”

HIM has been pushing for PEP to be more accessible to gay men for years. In 2010, the organization released a position paper titled “Post-Exposure Prophylaxis for Consensual Sexual Activity in British Columbia” which argues that gay men are becoming HIV-positive because they can’t access PEP.

The paper describes three Vancouver-area men who attempted to access PEP after having unprotected receptive anal sex with other men. One of them was “able and eager” to pay for the PEP himself; the other two were not given the option of paying. All three were denied the treatment and subsequently seroconverted.

Bill Coleman, a Vancouver therapist who has worked with the HIV community for more than 25 years, says inaction from provincial HIV policymakers led to many needless HIV infections.

“They are slow and backward in their policy,” Coleman says “That is just really unforgivable. I still see people who, if they would have known about PEP, might not be infected and may not have infected other people. I just think it’s quite unforgivable that they didn’t take any action for years.”

Jollimore notes that some gay men are able to access PEP with the right health insurance, a doctor who will prescribe it and knowledge of the treatment itself. “Without that it’s a bit of a patchwork as to who can get it and who can not,” he says. “Certain third party health insurance companies already cover these medications. For instance, we had a flight attendant contact us about a year ago and we directed him to the appropriate health care providers, he got a prescription, submitted the prescription to his insurance company and they covered the medications for him.”

Coleman says some gay men in the community, unable to access PEP, have taken matters into their own hands by taking their HIV-positive friends’ medication. “But most people wouldn’t know enough about PEP to do it.”

Jollimore believes the nPEP pilot project was implemented in response to growing pressure from the gay community, as well as studies that show PEP is an integral component of HIV prevention, especially among people at higher risk of HIV infection such as gay men and intravenous drugs users.

“There are a number of factors I think that are influencing why it’s happening now,” Jollimore says. “One of them is the Stop HIV/AIDS pilot project which of course is touting a treatment-as-prevention model, which is saying that having people on medication can prevent transmission of HIV. So PEP fits within that model, of course, but also there’s been a growing pressure that comes from the community onto the various health authorities to make this prevention available.”

Montessori agrees that nPEP “dovetails nicely with the efforts currently underway in BC to expand HIV treatment as prevention, which is aimed to curb AIDS-related morbidity and mortality, as well as new HIV infections. BC is currently leading the country regarding the rate of decline of AIDS-related morbidity and mortality, as well as new infections, and this trend has remained apparent over the last decade.”

Coleman wonders why the project is limited to just Vancouver. He believes the action being taken is halfhearted and still leaves much of the population at risk.

“Why would it be a pilot project and why isn’t it available everywhere in the province?” he asks. “What if you live in Victoria or Prince George and need PEP? Many provinces  provide it so why is this place so backwards?”

Access to nPEP varies by province and territory. It is covered only in Quebec, Prince Edward Island, Newfoundland and Labrador and on a case-by-case basis in Alberta, according to Jim Pollock, communications director at the Canadian AIDS Treatment Information Exchange.

NPEP has been available to Quebec residents since 1999 and is funded there by the provincial drug plan regardless of how the patient was exposed to HIV.

It’s also available at every hospital and health centre in Newfoundland and Labrador.

“It’s all covered here,” says Gerard Yetman, executive director of the AIDS Committee of Newfoundland and Labrador. “We’re also in discussion to have PEP available with our needle exchange van that actually operates in two centres in the province. PEP is available basically for anybody who requires it.”

Montessori says the BC-CfE will share the results of the pilot project with the BC government, which will ultimately decide how readily available nPEP will be in the future.

HIV STI info, Xtra newspaper columns

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Don’t stigmatize the poz guys

Author: March 13, 2012 1 Comment

 

 

 

This one tends to continuation on from my last article in Xtra on 15 Dec 2011, but from a new angle.

 

I recently talked to an MD who works for the government in the field of HIV and s/he said that we need a nuanced message to deal with the new information out there about undetectable viral load reduces the risk of transmitting HIV.  S/he feels we need new messaging because s/he see people every day coping with viral load questions.  My response was that the CDC does not know the meaning of nuance they only know short messages with an all or nothing message, Later I talked with one of those bureaucrats that is part of developing those all or nothing messages. (S/he does not see patients in real life, and I wonder if s/he only knows about sex from journals and books.)  S/he confirmed s/he likes the all or nothing short simple messages.  Short and simple seems to be more important than how accurate the message is.

 

 

 

What if you wanted to go skiing and wanted to make sure you would not get injured in an accident on the dangerous highway 99.  You could decide to drive only between 2AM and 3AM, when there are fewer cars, you can get the best snow/ice tired there are, you can get the safest car with the most air bags, you could decide to only drive on days when there is no snow or rain.  But likely this would not be practical or fun – but safer.  Likely you will just drive to the ski hill when you want to ski and tell yourself to be careful.  After all you did it for two years and had no problems so just tell yourself to be careful.  Well it is a lot like fucking.  There are things you can do to make it safer but they may not all be fun or practical.

 

The Journal Science has declared that the scientific breakthrough of 2011 was a study (HPTN 052), this study found that a person with an undetectable viral load reduces transmission of HIV by 96%.  One article said “Having an undetectable viral was as effective as condoms.

 

That is like going to buy a pair of jeans for $100.00 but finding out they are reduced by 96% so they now cost $4.00.  That is a huge difference.

 

So lets look and what this means for fucking without condoms.  If you are getting fucked raw by a HIV poz guy with and undetectable viral load the chance of getting infected goes from 1 in 200 (no HIV treatment) to 1 in 5,000.  If you are fucking a poz guy raw with undetectable viral load the chances of getting HIV goes from 1 in 1,538 (no treatment) to 1 in 38,461.

 

So if you have sex with a poz guy with an undetectable viral load and if you use a condom that reduces it a further 96%.  So it is like those $100 pair of jeans go to $4.00, and then are deduced again by 96% and now they cost 16 cents.

 

We are told that BC government is spending $50,000,000 to get as many positive persons as possible to have an undetectable viral load.  They call it “Treatment as Prevention”, but that is just the marketing to the government.  It is not preventing HIV transmission but it is reducing the risk of getting HIV by 96%.

 

The risk of fucking without condoms changes dramatically – yea it is reduced by 96%!.  What do us as gay guys do?  Do we take more risks?  Do we decide that maybe we play more in the sandbox with the poz guys with undetectable viral load because they are not so scary now?

 

Do negative guys become scarier to play with because 2.5% of them may be poz and not know it and therefore may be 20 -25 time more likely to pass on HIV. For the guys who think they are negative but are newly positive then getting fucked by them changes the risk from 1 in 200 for a (poz guy with detectable viral load) to 1 in 10 for newly poz guy.

 

You may ask a negative partner if he get tested on a regular basis.  If he does it likely is because he is concerned he is maybe positive.  So why would you think he is negative if he thinks he may be poz and gets tested regularly to find out.

 

So if you decide to have sex only with guys who believe they are negative what is the chance of getting HIV?  We know 2.5% of those guys who think they are negative are really positive.  If we assume that those 2.5% are newly infected and that is why they do not know they are poz then the chance of becoming poz is about 1 in 200 if you choose only guys who think they are negative.   An interesting number – it is the same number as getting fucked by a poz guy with detectable viral load.

 

Where do all these numbers leave us.   Well poz guys with undetectable viral load are a lot less likely to infect someone then if they did not have an undetectable viral load.   Negative guys who will take risks with you will take risks with others also, – did you think you were special – so he may be poz.

 

A number of negative guys have told me that often poz guys are just more fun to have sex with than negative guys.

 

So where does the leave us?  Are poz guys (with undetectable viral load) sought after now, and are the “negative” guys shunned as having the potential for infecting others?  The science may say there is a good case for this.  But after all it is fear and prejudges that made many negative guys shun poz guys in the first place, – it was not science!  Our prejudges against poz guys as sex partners will not change easily.

 

What we do not need is the institutional marginalization of poz guys.  Many organizations will tell us we are at higher risk if we have sex with a poz guy.  Surveys ask “do you have sex with poz guys?”, they then tell you are at more risk if you do have sex with poz guys, this is not true if the viral load is undetectable. The institutional response should be: “ know your partners viral load” not his HIV status!

 

Well this is my last regular column in Xtra,   I plan on doing a retrospective piece next month outlining what I have learned while writing these pieces and bring up a few points to consider.  I may be back with the occasional writing on gay men’s health.

HIV STI info, Stuff that did not make it in the newspaper

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More on genetic immunity to HIV

Author: March 7, 2012 0 Comments

 

UPDATE!!!

http://www.delta-32.com/  This website will now give  you the test for HIV immunity.

The map below show where people are most likely to be immune to HIV.

Picture

 

Some people are immune to HIV (well, almost totally immune).  There are thousands of organizations giving public messages about HIV, but very few will talk about genetic immunity to HIV.  The general understanding of immunity to HIV is that some 1% to 3 % of the population is immune to HIV because of the genes they carry. People fromSwedenorNorthern Europeseem to be more likely to have this genetic immunity.

However, there are a few people who have become HIV+ even though they were supposed to be immune. This is an extremely small number, but the immunity is not 100%.  When I talk about immunity in this article,  I, am therefore referring to almost total immunity.

I first heard about HIV immunity back in the mid/late 90s.  At that time, a gay guy who I knew socially told me he was a researcher who was doing research into genetic immunity to HIV.  He told me that he felt that the only way someone who had the CCR5 gene (the name of the gene linked to immunity) from both parents was for them to have the virus in the anus from someone who had fairly advanced stage of HIV.  I have lost track of this guy, but the last I heard he was still working on this research in theUSon the East Coast.

To be immune to HIV both of your parents must have the CCR5 gene.  IF only one of your parents have this gene, then you will be less likely to become HIV+, and if you do become HIV+ then you are more likely to be a non-progresser, which means that HIV will not have as severe effect on your body.   About 10%-15% of the population fall in this group of being less likely to become infected.   One study from 2001 in Science Daily reported that persons with the CCR5 gene from one parent “had a 70% reduced risk of HIV infection”. I have talked to lots of guys who say: “I have had lots of unsafe sex and I am still negative so I must be immune”.  Well it may be, or it may also be that instead of 50 time of unsafe sex it may take 400 times before this person becomes infected.

I found a story by the Australian Federation of AIDS Organisations Inc. (2007) describing an Australian company, delta32.com.au, who advertised on Gaydar.com.au to offer CCR5 gene testing.  Two organizations complained that the company should not test gay guys for the CCR5 gene, and the website was soon closed.  Many other websites I found were closed down, or did not reply to my emails.  There appears to have been pressure to make sure people (gay men) are not allowed or encouraged to find out if they are immune from getting HIV.

Despite this, it is possible to get tested for the gene that causes HIV immunity (CCR5).  But before we go there, there are a few important questions to consider.  These questions are:  Would you want to know if you were immune to HIV?   What would you do with that knowledge?  Would you stop using condoms?  Would you believe someone who told you they were immune to HIV so they do not have to use a condom to fuck you? What about STIs?  How much would it be worth for you to find out if you were immune to HIV?  These are all interesting and difficult questions to sort through.  But the real question, I believe is: should you have the right to know that you might be immune to HIV?  Is it better that we do not know that HIV immunity exists?  Does this make a better and safer society?  I have no clear answers to these thought provoking questions.  But I tend to believe that honesty and transparency makes for a better society.  I do not think there are many times that hiding information from the public is a good idea.

So, I did a great deal of searching online to find someplace  you might find out if you had the CCR5 gene and if from one parent (partial immunity) or both parents (almost complete immunity).

IF you are an HIV+ guy, would you want to know if you had one of the genes meaning that you are less likely to have complications from HIV?  I am sure there are some people that think that people should not be allowed to know if they have the CCR5 gene.  But if you are not one of those and are interested, here is how you can find out if you have the CCR5 gene from one or both parents.

There is a company in the UScalled “32andme” that does a broad range of genetic tests, including testing for the CCR5 gene. To order the kit, and instructions on how to send a saliva sample to the company in the US, go to  https://www.23andme.com/store. The test costs $209 US (so that is about 50 cents Canadian LOL).  To see an example of the report you will receive, look at:  https://www.23andme.com/health/Resistance-to-HIV-AIDS/ .  I assume there are other places that test for HIV immunity, but I did not find them.  I hope that readers will post addresses of other places to get tested for CCR5 at xtra.ca as a comment to this column.

I wonder if the reason people do not hear much about HIV immunity is that some will worry that it will perhaps give people a licence to not practice safe sex.  If there is more condomless sex, then there is the chance of spread of STIs.  However, it is important to remember that we are only talking about a small number of guys who will be immune to HIV.  Although we should find in the gay community that older negative  guys who have frequent condomless sex are much more likely to have the CCR5 gene because many of those without it protection will have become positive or will have already died.

 

 

 

 

http://www.wired.com/medtech/health/news/2005/01/66198?currentPage=1

http://www.afao.org.au/library_docs/policy/Delta_32.pdf

 

 

HIV STI info, Interesting stuff for gay guys, Stuff that did not make it in the newspaper

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More on gay guys and drug use

Author: March 7, 2012 0 Comments

 

 

There are many things that gay guys may do to excess.  The excess causing the most problems I see in our community are:  alcohol, Crystal Meth, coke, body image concerns.  The things that we do not do enough of are: self love, support for each other, self acceptance as we are, pursuing things that make us really happy.  Here I will look at the excesses.

Is there anything wrong with occasionally using drugs?  While some gay guys do not use substances there are many who do.  A few of those who use substances sometimes have trouble because of their use.

Some of the main problems around substance use are: unsafe behaviour, using drugs so much that is causes problems for the user i.e., financial concerns, and disrupting relationships, hindering personal growth.

I have tried to experience most drugs during my life, but I have not achieved that yet.

I think that the typical way of approaching problem substance use is to focus on the drug and not on the reasons for using the drug(s).  There are reasons why we may use drugs.  Drugs do something for the user.  The most common benefit we look for in substance use is to feel free/uninhibited.  Crystal Meth is a good example of this.  Crystal Meth often allows guys feel sexually free; to be free to be the sex pig they would like to be but are too inhibited to freely enjoy such sex without the assistance of drugs.  Alcohol also helps guys to feel less inhibited; coke can help guys to feel less vulnerable/more in control.  Marijuana can help us to feel more mellow/relaxed.

So the common theme behind most of this substance use is to compensate for feeling inhibited.  We do not feel free enough to be ourselves.  We learned at an early age to not be the gay kid in school, to not be who we are, to hide who we are … to inhibit our natural feelings.   It is no surprise to see our community use drugs that helps us to feel less inhibited and freer to be ourselves.

Most of us spent years trying to survive childhood and early adulthood by hiding our feelings, because we felt that was the only way to survive and thrive.  We knew that there was a risk in being free to be ourselves, these risks are real and intense, the most common fears of being ourselves centred around: safety risks (gay bashing), risk to our career advancement, risks to being teased or bullied in school, risk of losing love of our family/friends.  This early trauma of threat and survival will have an effect all our lives.  Some of us can use these experiences to make us stronger, confident that we can handle what comes our way.  For others we feel afraid, scared to be; apprehensive about the world that seems unsafe and unfair.   For most of us it is a bit of both.  (For me I think part of the reason for getting a PhD is to prove I was ok I was acceptable.)

It is not surprising that some of us use substances.  I believe that drugs are not the problem.   Drug use is the symptom. Usually the symptom is our trying to cope with fears and inhibitions in our lives.

Some guys find the traditional drug abstinence programs work for them, but many do not.

So what is another way to approach drug use in our community?  There is no one answer for everyone but I believe that for most guys it is important to explore what we get out of our drug use.  How can we get that same result without problematic substance use?  An example of this might be, how do we be free enough to be the sex pig we enjoy being without Crystal Meth?  Again in this case Crystal Meth may not be the problem but the enabler to allow us to be free.  Crystal often provides the sense of being free/spontaneous/inhibited, but most guys find the actual sexual stimulation/organism is less important than the feeling of being free to be a sex pig.

We all use substances to help us feel better it may be coffee, alcohol, chocolate, etc.  Do these substances we use bring us closer to being the person we feel good about, and do they make us a happier better person?  If these substances do not contribute to our ultimate happiness then we may want to make some changes.   We must understand our fears and inhibitions as well as work on ways to change our habits.  I think drug use is not a bad thing but if we feel it is not helping us to be the best we can be, then we may want to make some changes.  Some things that we can do is use less of the drug, try a different drug that does not cause us problems.  But addressing the underlying issues is important to grow to be who we want to be.  This may involve counselling, or self-examination, or just pushing ourselves to take some risks to be more our ultimate ourselves.

HIV STI info, Interesting stuff for gay guys, Stuff that did not make it in the newspaper

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Help for gay guys to decide when to have bareback sex

Author: March 7, 2012 0 Comments

 

 

Sex between guys can be very complex.  Often when guys begin a sexual encounter they do not know how it will unfold, will it include: sucking, ropes, handcuffs, fucking, rimming, piss, electricity, alcohol, drugs, lots of alcohol, sounds, scat, tit play, other guys, fisting and many others.  The creative play between two guys exploring where their sex will go it part of the fun.

 

Reducing safe sex messaging to a simple prescription of “use condoms” is not very helpful, because we already know that message but who helps us to make the decisions in a complex playful experience of having sex.  The medicalization of safe sex messaging has not served us well.  Almost all new HIV infections now have emotional and psychological reasons as a main cause for lack of condom use.  The medical professional is not trained to integrate the emotional and psychological causes of problems, they are trained to look for medical causes.  Where is the messaging that helps us make the decisions we are comfortable with?

 

Let me give an example of how a psychosocial messaging may be more helpful for guys

 

A while ago a guy asked me, if he as poz bottom with long standing undetectable viral load could be fucked without condoms by his boyfriend who was negative.

 

I, as a person trained in psychology, made a few suggestions as follows:

 

1.         Consider how upset would your boyfriend be if he became poz.

 

2.         Also consider how upset you would be if your boyfriend became poz.

 

3.         Some people think that if either you or he have an STI that HIV transmission is more likely, so you could decide to not have unprotected sex outside the relationship.

 

4.         Some people think that if he cums and/or pees after fucking it will clean out the urethra and reduce the chances of getting HIV.

 

5.         If you (the poz guy) get a cold or some other infection your viral load MAY go up; you may wish to be more careful at these times.

 

6.         The spectrum Health website (the largest group of doctors treating gay men and HIV poz guys in BC, suggests that without an undetectable viral load there is 1 in 1,666 chance of getting infected as a top for each fuck.  (6.5/10,000) We can assume that with an undetectable viral load these odds are much less.  The exact chance of getting infected is not known but it may be 1 in 10,000 or maybe 1 in 100,000.  (BC is spending $50 million to reduce HIV poz guys viral load in an effort to reduce transmission; so they must believe that this will have a big effect in reducing the number of new infections.)  (The cynic in me thinks that it is not $50 million being spent because they care about the welfare of poz gay guys, or other poz persons.)

 

So by using the complex information above they can make decisions about the kind of sex they choose to have.

 

Notice that none of the above are “shoulds” but only things to consider when making decisions.  Medicine is good at “shoulds” and “musts” – at prescribing – a behaviour.  He did not want a prescription, but he really wanted to know was “what do I need to consider if we proceed with not using condoms” (if that is our choice).  He knows the normal message of use a condom, that is not what he is looking for and if no one helps him to know what to consider and give him an understanding of what are the risks and  how to reduce those risks of transmission he/they will be “fucking in the dark” – so to speak

 

What is interesting about this question is why he did not go to a medically trained person to ask this question.  I believe that he would have gotten a medical response that is prescriptive and not really useful for their decision making.  The medical profession has done wonders at supporting, treating and educating all of us on HIV.   But, the medicalization of HIV safe sex messaging has run it course.

 

It is time for medicine to step aside with the less than useful messages.  We need a psychosocial approach that will help us makes decisions that fit in our complex lived sexual experiences. What is needed is to understand that only pushing condoms is not effective.  What we need instead is messages to help guys to make informed decisions around their complex sexual decisions.

 

If there was more space I would add the following:

 

We need help to understand when and how we find ourselves vulnerable to take risks that are outside our comfort level.  For some it may be when drinking, for others it may be when depressed, for others it may be when horny, or lonely, or he is hot, or any number of things that we all need to understand more about how we put ourselves in situations where we are not comfortable afterwards.  In my experience the general pattern is when a person feels their life is falling apart, (job loss, boyfriend break up, money problems etc.) then they may do things that later they wish they had not done.

HIV STI info, Interesting stuff for gay guys, Stuff that did not make it in the newspaper

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