Gay and Lesbian Well-Being

Covering issues vital to the psychological health and happiness of gays, lesbians, and their families.

Condomless Sex and Gay Men

It is somewhat difficult to get a read on how widespread or successful the prophylactic use of HIV treatment medications is, but the movement of HIV prevention in this direction as well as the hostile reaction by some, is revealing in what is says about gay men and our general attitudes about sexuality. Read More

This post should be required reading

Especially for gullible, well-meaning liberals who think gay marriage should be legalized because gay men are "just like us" and want nothing more than to settle down in happy, blissfully monogamy and fidelity.

Most heterosexual marriages

Most heterosexual marriages are neither monogamous nor faithful. You just don't admit it.

Really, talk about denial.

Really, talk about denial. There are hundreds a millions of females prostitutes in the world. Who are their customers? Overwhelmingly, married men.
Conversely, lesbians are well known to rarely be promiscuous, to be "nesters", and serially monogamous.
Promiscuity is a "male" thing, not a gay thing. It makes complete sex, evolutionarily speaking -- if the goal is to spread your genes. A lot of gay men who get married were already monogamous and will remain so. Some who have had "agreements" keep the same "agreements" Marriage is about social status -- not fidelity.
And we have nothing to dothe 50% divorce rate about heterosexuals. If we end up having the same one it'll just prove we're all human beings first.


So, gay men are getting diseases caused by promiscuity and refusal to use condoms, but you're blaming it on puritanism?

Qualify claims

Please shed light on the particular papers detailing the prophylactic effect of truvada.

it goes against nature

My friend once said that the reason why the "safe-sex" message has failed was because it goes against millions of years of evolution. We are hard-wired for connection and procreation. It's about the need to have our legacy go on long after our bodies decay. A condom just gets in the way of this. His notion caused a seismic shift in my thinking regarding intimacy during sex. The years and years of feeling guilty suddenly evaporated and realized that the only thing required of me is to be responsible, the best way I can.

Condomless Sex and Gay Men

A great piece, making the point that we have to ally our HIV and STI prevention methods alongside pleasure, not against it. If I have one criticism it's the strange remark that being a bottom is about submission - I suspect the writer is not a bottom or he'd never say such a thing!
As for PrEP references, see!prep-right-for-me/c1n64
The original scientific paper:
New York Times piece:
UK Independent piece:
Will that do?

Chemical Latex, Monogamy & Trust

I despair when I read such articles...
Firstly, using drugs prophylactically to keep 'me!' safe is selfish and drives home(pun intended!)the concept of unconnected sex for my own satisfaction. Would you trust a horny guy who told you he was on the pill, or had a negligible count?
Secondly, monogamy is a viable alternative to promiscuity and is a very effective protection against infection - for some people. My partner and I were very sexually active for 14 years (without fear or guilt)and had a grand old time together. We met in the bad old days when nobody knew what AIDS was and we made a pact 'not to bring death home'. Not everyone has been has fortunate as me to have had such a bonded relationship.
Thirdly, condom fatigue would be true if it were the older sets that had abandoned them. Instead, the highest rates of infection are in the youngest generation, who have not lived through the ' bad old days'. HIV is seen as a survivable condition so the 'death' incentive has diminished and they never got into the condom habit to begin with.
Fourthly, there are more STIs than HIV. Condoms make sense for lots of prophylactic reasons.
Finally, esthetic and sensual reasons. Really? Get over it. Ultra fine and lubed and you won't know you've got one on. And as for impeding 'spontaneity? That's what shag bunnies say about foreplay in general.
So I regret to say that the tried and tested messages of TRUST and MUTUAL RESPONSIBILITY remain the best defense against infection.

It's funny that you say that

It's funny that you say that the highest rates of infection is the younger population, because this statistic is actually shifting. One of the fastest growing age demographics for new positives is the 45 and up group. This group would be late teens and early 20s at the height of the HIV/AIDS Pandemic. I'm sorry I can't offer citations for the actual statistic, but it's kinda late at night while I'm typing this. I'm sure you can look it up to verify this though.

One of the theories behind the older generation having increasing rates is that so much focus is on the younger generation and people believing they are in the clear after a certain age because HIV is a "young people's" disease. Add this with the fact that this group are becoming newly divorced or widowed and entering into the dating scene without these messages being told to them.

We have to be very careful with these ideas that one age group, or one race, or one region is prone or responsible for getting HIV. While these statistics are important, it can also lead to other groups being blind to their risks. One of the reasons that the South has become "Ground Zero" for HIV and STIs is because much of the focus had historically been in New York and the West Coast. Now, we're seeing the same parallels with age and racial demographics. The highest rates of new infections are those that didn't appear to be at high risk 10 - 20 years ago.

I don't see how taking

I don't see how taking Truvada prophylactically is any different than a woman taking the pill. Women have always been punished for having sex by not being allowed to have control over their own bodies, and now it seems to be the same for gay men.

Many, many older men have

Many, many older men have abandoned condom use as well. The difference for them is that their "casual sex" tends more often to be with friends or acquaintances, who are either known to be HIV-negative or known to be HIV-positive with undetectable viral loads.

Condom use

We were told to start using condoms as a temporary adjustment until a cure was found, 30 years ago. We are here.

Many of us have been barebacking for decades, just now coming out of the closet about it.Bare is natural and obviously desired. All these judgmental couples are doing it bare. And straights do it bare and deal with the many other STDs. So many people are attached to their fear. They grew up with the shame and have to retain it in some way.

This article is brilliant. Needs to be in the Huffington Post and every gay magazine on the planet.

Thank-you Anonymous "Editor"

...For pointing out those typos. Best, ML

How people really work

I almost did a double-check for the date, because in my mind the "real" reasons gay men barebacked was out and spoken of decades ago. Increased sexual pleasure, and a sense of increased intimacy that results, all within the context of choices often made with some degree of intoxication, in which partners will choose to believe convenient histories ("I just broke up with my negative lover with whom I was monogamous") etc. There is no increase in low-self esteem, there is an increase to have a connection that feels more like a connection, physically and emotionally.
The increase in transmission has a lot to do with the coming-out time period, particularly in communities of color, where experimentation is done on the down-low, without much communication about the kind of sex because everyone is still thinking (but not talking) about the fact they are having sex with another man period.
The model that is not being looked at is right before us. Why do so many girls and women technically aware of how to avoid it, still get pregnant -- a live-changing decision comparable to becoming HIV-positive in its impact? We have to look at emotional calculations that operate the real world, not around a conference table.
In this instant-cure, silver-bullet, nownownow world, of course taking a pill that you don't have to reveal having taken to your partner while feeling you have stayed safe--while avoiding "the conversation"-- is appealing.
I have always disclosed my status. "Me too" is the usual reaction, but often enough, also "wow, no one ever said that to me right away before." That's the sad reality - a giant subsection of gay men are more afraid of rejection than getting AIDS. (I am not. I never take rejection over HIV personally -- I say "good for you.") They already feel massive marginalization form "Drug and Disease Free" demands on line,which they end up ignoring or assume are lies. The fix to that is so culturally deep, we need to surrender to whatever works in HIV prevention, not whatever "should" work.

An issue...

A couple issues to bring up here:

1) Wearing a condom does not necessarily mean the elimination transmission of HIV during anal intercourse. Similarly, "pulling out" doesn't eliminate it either. (Raises hand because it's how I am now living with HIV.)

2) The issue regarding condoms that we are ignoring: they are FDA-approved (and tested) as a device for vaginal intercourse. They've never been approved by the FDA (who holds the authority to approve a medical device in the US) or even tested by them... in 30 years. Never. Not once. It's also interesting to note that it is the only medical device that other arms of the government actively promote to a population that it is not medically approved to do. Case in point: Do you see national condom companies attempting to market their product towards gay men? Absolutely not. Why not? Because they could get big fines for advertising off label. Condoms are regulated. All this to say-- it doesn't take a rocket scientist to consider why a product that is being used off-label (off it's "approved" target) isn't working for another target. Most gay men don't even like the word vagina... let alone continually using a product designed for vaginal intercourse.

3) Great piece! Remember when girls are always joked at for wanting the "bad" guys... The risk takers and those that do things that they should do. Don't you think that happens in the gay world as well? Hooking up and not using condoms is "risky" and "bad." It crosses the acceptable line for some-- and thus, it's the perfect invitation for others.

PrEP is finally a tool that relaxes some, although it's not for everybody. But it is approved for men who have sex with men-- and in my opinion, the first real prevention tool that is intended for more than vaginal intercourse.

Sex and the medico/health profession

One of my friends began living in a monogamist relationship. He had always been a top but he wanted to bottom for his lover. He found it difficult to relax during anal sex and suffered great pain. He held a prominent position in a health organisation so he sought out expert advice. The organisation for which he worked had a well known Coli rectal specialist. My friend saw this specialist and asked for help. The specialist's first response was to make some snide remarks about gays and what they get up to. Next he made some gratuitous observations about the rectum being like a valve - designed to let things out and to not let things in. My friend held his ground and finally the specialist suggested my friend use a cream which contained lignocaine that was usually prescribed for haemorrhoids. If the cream was applied before anal sex it desensitized the rectal muscles and lining and would help my friend to relax and enjoy penetration.

The author of the current article makes the point that the medico/health profession rarely, if ever, address the issue of sexual pleasure in HIV prevention campaigns.

But as the story of my friend and his Coli rectal specialist shows, this failure does not extend just to HIV campaigns but to all forms of gay sex (and probably hetro-sexual sex as well).

People who are handicapped or elderly have also suffered from the failure of the medico/health profession to recognise that sex is about having pleasure. It has only been in the last 20 years that the health profession has come to accept, grudgingly, that the handicapped and the elderly are also entitled to a sex life.This is surprizing because good sex is recognised to be part of maintaining good health.

As a gay man, I have always been up front with my treating physicians about my own sexual activities.But I find the reactions of my doctors to be instructive. They are often smug-I presume because they are in marriages where they feel they can have all the sex they want without the risks I have to navigate on a daily basis, or they become overly clinical-warning about the dangers of unprotected sex-as if I did not know about condoms etc.

When I was a young man, attempting to understand gay sex, an old Queen took me aside and said: "Gays and Straights have sex the same way...they both do it the best way they can!"

If the medico/health profession would just accept the truth of this statement then I am sure that they would be able to formulate more sensible strategies about sex education, AIDS and STD prevention programs. But the real problem is that behind the current strategies there is an insidious presumption (or prejudice) that somehow the only safe (read superior) sex is vaginal heterosexual intercourse and if you gays must fuck one another you are consigned to use condoms.

The irony is that the greatest cohort of people having anal intercourse are heterosexuals. The sex surveys indicate that 20% of heterosexual couples regularly enjoy anal sex. There is also the belief, held by many Doctors, that HIV/AIDS is difficult to transmit via vaginal sex. So many of the Doctors I deal with, express their surprize when I point out to them that Clade E (one of the sub groups of the AIDS virus) prefers heterosexual transmission.

If I have one criticism of the article it is this: the author is too lenient on the medico/health profession about their failures in solving HIV/AIDS.

Back in 1985 we were told a vaccine would be available by the end of the decade. Thirty five years later were are still waiting for an effective cure. I understand the difficulties that the scientists have confronted in dealing with a retro-virus. But back in 1985 our scientists crowed about their achievements, about how they had unlocked the genome etc. All that we have witnessed since, shows that having spent billions of dollars, our scientific community is still flummoxed by this virus and that all they can offer, is that we wear a piece of latex when having sex - a device which was invented in the 18th century. So much for the progress of modern science.

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Michael C. LaSala, Ph.D., is Director of the MSW program and associate professor at Rutgers University and author of Coming Out, Coming Home: Helping Families Adjust to a Gay or Lesbian Child. more...

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