WELCOME

About this section

Three short films about this section, navigating the website, and the story behind MENRUS.CO.UK. Enjoy!

ABOUT SEXUALLY TRANSMITTED INFECTIONS (STIs) | MEN R US | 1m
NAVIGATING THE WEBSITE | MEN R US | 1m
BUILDING MENRUS.CO.UK | MEN R US | 3m

Click below to show to the icons used

  • MEN R US is comprised of six SECTIONS: YOU, MEN, BODY, SEX, STIs, and DRUGS.
  • Under each SECTION, content is listed in the INDEX or tap the book icon if you are using a smartphone or tablet. Use the arrows to expand or collapse the chapter headings.
  • Quick links are listed under MORE STUFF or tap the info icon if you are using a smartphone or tablet.
  • IF YOU GET LOST there are Back to top links under every subject.
  • All LINKS open in a new window or tab and the key to the link icons are as follows:

Film or film clip
Sound clip
Photograph
Further information; eg: another website
Books
Groups or street services
Telephone; eg: support helpline
Internal link to another MEN R US section

  • A SEARCH function is located top screen right (next to DRUGS). It’s handy and we encourage you to try it!
  • There is a CONTACT US link the top right of the screen or tap the info icon if you are using a smartphone or tablet.
  • The ‘7th’ section ABOUT US contains MEN R US project info, contact details and Q&A.
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ABOUT STI

If you think you have a STI

If you think you have a STI…

  • Don’t have sex
  • Read this very helpful section
  • And get to a clinic

And yes, you can Google your symptoms until the cows come home to try and find out what you have but, frankly, this is bloody useless.

So, at the risk of repeating ourselves, get yourself to a clinic!

SXT | SXT
Find a sexual health service | NHS Choices
London sexual health services | MEN R US

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You're not the first

YOU'RE NOT THE FIRSTIf you ever thought that you were the first or only person to have had a sexually transmitted infection (STI) – think again; they have been around for thousands of years. Gonorrhoea was first mentioned in the Bible and the name of the disease was given by the second century Greek physician Galen. The origin of syphilis is less clear but by the 16th Century it was making its way across Europe.

Anybody can get a STI from someone who already has one. The trouble is that STIs are usually passed on by someone who doesn’t know that they have an infection and so just asking your partner won’t protect you. The majority of STIs enter the body through tiny abrasions, sores or cuts in the body, many of which can be invisible to the eye. A few STIs only itch, some are painful, some are permanent and many can be serious if left untreated.

Effective prevention, protection and treatment will significantly reduce the likelihood of getting STIs or, if you do get them, will reduce or eliminate the harm they can cause.

Over recent decades, HIV has affected the lives of gay men everywhere and has changed the way we think about sexual health. Not only do we have a better understanding of our health needs, but many sexual health services have responded to the need for improvement. None of us really want to dwell on STIs, but being aware on what’s going on leaves you free to concentrate on having a good time.

Celebrating a century of sexual health care in the UK | British Association for Sexual Health and HIV | 8 Jun 2017 | 2m 43s

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Reducing risks

Be proactive

Being sexually healthy is not only about dealing with sexual problems as they arise, it’s also about avoiding problems in the first place. Most sexual activity carries some kind of risk of getting a STI and, while never pleasant, many gay men see them as an occupational hazard.

You significantly reduce the risk of getting or passing on STIs by:

  • Prompt visit to a sexual health clinic if you think you have a STI
  • Vaccination against hepatitis A and B
  • Routine clinic check-ups every 3-6 months. If you have unprotected sex, use drugs or have had a recent STI, we suggest you have check ups every 3 months
  • Using condoms when fucking
  • Not sharing injecting equipment
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Signs and symptoms

Sexually transmitted infections are caused by:

  • Bacteria which generally live and multiply in the warm and moist parts of your body like your throat, inside your penis and in your anus and rectum.
  • Viruses which generally need to get into the blood stream before they can do harm.
  • Parasites which live on your body in areas like your groin and armpits.

While some STIs have no symptoms, most do and can include:

  • Itching in or around the cock, balls and arsehole.
  • Burning or itching when you piss or poo.
  • Needing to piss or poo and then not being able to go, or only going a little.
  • Spots, scabs, or rashes on the cock, balls, or entrance to the arsehole or body rash,
  • Pus from the end of the cock or from the arsehole itself.
  • Unusual lumps or bumps.
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STATISTICS

SEXUAL HEALTH SERVICE CUTS

Sexual health service cuts

LSHTP.pubSomething which may have passed you by is the roll-out of the London Sexual Health Transformation Programme “…a partnership of 29 London boroughs with the aim of drawing together a new collaborative commissioning model for sexual health services” say London Councils. “From April 2017, when the Programme is due to be implemented, patients will be able to access services through the internet rather than having to attend a clinic.”

Six clinic closures to date

As the Programme is being rolled out, 6 sexual health services have closed, to date:

  • The Lloyd Clinic
  • Clare Simpson Sexual Health Clinic
  • Marlborough Clinic
  • The Courtyard Clinic
  • Artesian Health Centre Sexual Health Clinic
  • Vauxhall Riverside Sexual Health Clinic

MEN R US has asked about other clinics which we believe may be at risk, but we are (still) waiting for responses to our enquiries. However, we suspect more closures are on the way.

Online system not online until 2018

Worryingly, we understand that the web portal system where we (the patients) will access services is not online as planned. It appears we will have wait until 2018 at a time when there are already reports of sexual health services becoming further stretched, and turning away patients.

Poor communication

Communication regarding the closures seems to have been poor, the public often confused about what is open and closed. Ultimately, one gets the impression this Programme is more about the ‘transformation’ of sexual health services by stealth.

Read on

So, we encourage you to read these articles from the Guardian which explain the state of affairs rather well:

What to do if you’re a Londoner worried about gonorrhoea? Test yourself, apparently | The Guardian | 17 Oct 2017
Sexual health shake-up in south-west London unsafe, experts say | The Guardian | 16 Aug 2017

“This new analysis from the King’s Fund paints an extremely worrying picture for sexual health services across the country. With the dust having barely settled from the news that the first cases of gonorrhoea resistant to all known antibiotics have now been identified in three countries, the prospect of sexual health services facing further significant cuts to funding could not come at a more dangerous time.

With an unprecedented demand for services, coupled with record levels of new STI diagnoses and treatment-resistant infection, we are truly facing the prospect of a ‘perfect storm’ in sexual health. It is essential that the new Government ensures sexual health services are appropriately funded so that vital sexual health promotion, prevention, testing and treatment can be delivered. Failing to do so is the falsest of false economies and the consequences will be felt for years to come.”

Dr Elizabeth Carlin, BASHH President, commenting on the King’s Fund findings showing that local councils are planning on making large cuts to funding for sexual health services | Jul 2017

Industry award for the London Sexual Health Transformation Programme

There is some good news however: earlier this year the London Sexual Health Transformation Programme won an industry award from the Municipal Journal for ‘Reinventing Public Services.’

So, a reduced likelihood of an omnishambles then. Thank goodness for that.

Read more

London Sexual Health Transformation Programme | London Councils
Award for London Sexual Health Transformation Programme | ADPH | 15 Aug 2017

What to do if you’re a Londoner worried about gonorrhoea? Test yourself, apparently | The Guardian | 17 Oct 2017
Sexual health shake-up in south-west London unsafe, experts say | The Guardian | 16 Aug 2017
Government cuts ‘leave sexual health services at tipping point’ | The Guardian | 3 Aug 2017
Sexual health clinics ‘at tipping point’ after Government cuts and huge rise in demand, councils warn | The Independent | 2 Aug | 2017
Further cuts to services increase risk of ‘perfect storm’ for sexual health | British Association for Sexual Health and HIV (BASHH) | 12 Jul 2017
Government cuts are brewing a sexual health crisis | The Guardian | 27 Jun 2016
What do cuts in sexual health services mean for patients? | The Kings Fund | 3 Apr 2017
Cuts to sexual health services are putting patients at risk, says King’s Fund | British Medical Journal | 14 Mar 2017
Cuts to sexual health services will lead to STI ‘explosion’, warn experts | The Guardian | 3 Jan 2016

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DO IT LONDON

Do It London

DO IT LONDONDo It London is an on-going campaign delivered and coordinated by the London HIV Prevention Programme (LHPP) is a London-wide sexual health promotion initiative. It aims to increase HIV testing and promote prevention choices to Londoners. The programme is funded by 31 London boroughs and managed on their behalf by Lambeth Council. As well as our city-wide Do It London campaigns, the LHPP also provides a free condom distribution, outreach and rapid HIV testing service for men who have sex with men (MSM). This service is delivered by GMI Partnership and Freedoms. It also commissions online sexual health outreach and advice via websites and apps.

Useful links include: finding an HIV testing centre near you, finding a sexual health clinic near you, HIV self-sampling kits, HIV self-testing kits, HIV testing, condoms, information about PrEP, and achieving undetectable status.

Do It London | London HIV Prevention Programme (LHPP)
 Gay men need more HIV campaigns like Do It London | Attitude | 23 Sep 2017

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PREP

PrEP (pre-exposure prophylaxis)

PrEPPrEP means Pre-Exposure Prophylaxis, and it’s the use of anti-HIV medication – taken regularly – to keep HIV negative people from becoming infected. It is not available through the NHS (as yet), though you can get it on private prescription.

The evidence

In February 2015, the PROUD study reported that PrEP reduced the risk of HIV infection by 86% for gay men and other men who have sex with men. It measured the effectiveness of daily PrEP for those recruited during the 2 year study. In the UK there is still some concern that widespread use of PrEP could reduce the number of people who are using condoms and therefore increase the number of exposures with people who are not aware of their HIV infection, and who are potentially very infectious.

The campaign to get PrEP on the NHS (in a nut shell)

  • Gay men (and many HIV agencies) are campaigning vigorously for PrEP on the NHS
  • The NHS won’t pay for it, though you can buy it online for approx. £45/ month
  • The National AIDS Trust launched a judicial review challenging the NHS’ decision
  • On 2 August 2016 the High Court ruled the NHS can fund PrEP
  • The NHS appeals and loses (November 2016)
  • Scotland makes PrEP available on the NHS (April 2017)
  • NHS allocates 10,000 people PrEP in a £10m trial lasting 3 years (August 2017)
  • PrEP Impact Trial begins (October 2017)

PrEP Impact Trial from October 2017

A number of clinics in England have agreed to participate in the trial (see link below) which will be updated as sites begin opening to recruitment across the country. Clinics participating in the trial will open to recruitment in a phased approach over a few months. It is not possible to open all sites at exactly the same time and that means that some clinics will open a few months before others. If your local clinic opens slightly later, you will still have the opportunity to join the trial. Different clinics will be ready to start at different times and the rate at which trial sites will open will be dependent on the speed at which clinics can get local approval and put systems in place to train staff and capture trial data.

PrEP Impact Trial | Public Health England/ NHS England
Where you can get PrEP | Map | Forum Link

Further information

PrEP (Pre-exposure prophylaxis) | Prepster
PrEP (Pre-exposure prophylaxis) | I Want PrEP Now
PrEP (Pre-exposure prophylaxis) | iBase
PrEP (Pre-exposure prophylaxis) | Gay Men Fighting AIDS (GMFA)
PrEP (Pre-exposure prophylaxis) | Terrence Higgins Trust (THT)
PrEP (Pre-exposure prophylaxis) | National AIDS Trust (NAT)
PrEP (Pre-exposure prophylaxis) | Wikipedia

More…

Buying PrEP online: safer use and NHS monitoring | i-Base and others | June 2016
HIV drug row: A very modern dilemma for the NHS | Nick Triggle, BBC | 2 Aug 2016

PrEP: HIV ‘game-changer’ to reach NHS in England from September | BBC | 3 Aug 2017
Fall in HIV among gay men could spell end for Britain’s epidemic, say experts | The Guardian | 22 Jun 2017
Sex without fear – my experiment with… PrEP | The Guardian | 22 Jun 2017
Massive drop in London HIV rates may be due to internet drugs | New Scientist | 9 Jan 2017
NHS England has power to fund Prep HIV drug, court decides | BBC 10 Nov 2016
NHS loses court appeal over ‘game-changing’ HIV drugs | The Guardian | 10 Nov 2016

More about PrEP

PrEP, condoms, STIs and antibiotics

Studies show a significant rise in bacterial STIs in men who are using PrEP that appears to be related to their sexual networks and the level of condom use. Even if PrEP is the game-changer many are hoping it to be, PrEP offers zero protection against other STIs which are on the rise at a time when antibiotics are failing. Just in case it has slipped our collective minds – PrEP is as effective as condoms at reducing the spread of HIV, however fucked up and boring this may sound.

Antibiotics ‘may be lost’ through overuse, says chief medical officer | BBC | 13 Oct 2017 | 59s

 

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PEP

PEP (post-exposure prophylaxis)

PEPPost Exposure Prophylaxis (PEP) is a course of medication after a potential exposure, designed to reduce the risk of HIV infection. It is the same meds that are used to treat HIV.

The course of medication lasts 28 days and may be able to prevent you becoming infected with HIV if you start taking it within 72 hours of being at risk of HIV exposure; eg: a condom break during fucking.

If you think you may need PEP don’t spend the next 72 hours wondering, or searching the Internet for the right advice. The right advice is right here and you should go to a sexual health clinic now as time is of the essence. You can also obtain PEP at A&E (Accident and Emergency) departments of some hospitals. A&Es are especially important at weekends because most sexual health clinics are closed.

Sexual health clinics (London) | MEN R US
A&E London | MEN R US
Find a sexual health service | NHS Choices

GMFA
NAM Aidsmap
i-base
Wikipedia

Use of PEP: UK Guidelines | NICE | BASHH | 2015

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SXT

SXT search for sexual health services

SXTSXT is a free on-line service (also available as an app) that helps find the right type of sexual health service at a convenient time near you including screening, HIV testing, chlamydia testing, PEP and sexual assault. Run by professionals, SXT has a database of more than 2,500 clinics across the UK and is open for everyone: all genders, ethnic groups and sexualities.

SXT | SXT

Three Flying Piglets (one of our other projects) has just completed a series of short animated films “TOM MEETS SXT” to promote the service.

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NATIONAL AIDS TRUST

National AIDS Trust

NATIONAL AIDS TRUSTThe National AIDS Trust (NAT) was founded in 1987 as a non-government organisation (NGO) by the Department of Health, in order to deal with the escalating concern with HIV and AIDS nationally. Today NAT’s funding comes from public donations, corporate supporters, grant-making trusts and foundations and its own fundraising work – it doesn’t receive funding from the UK Government. NAT is a policy and campaigning charity, working to improve the national response to HIV through policy development, expertise, and the provision of practical resources rather than through offering direct support services to people living with HIV.

Alarming trend for cutting or completely decommissioning HIV support services

Freedom of Information requests have exposed an alarming trend for cutting or completely decommissioning HIV support services across England and Wales. In England there was an average cut of 28% in expenditure for HIV support services between 2015/16 and 2016/17. The regional variation in cuts is enormous, with some areas entirely losing support for people living with HIV.

NAT also has a comprehensive range of resources available including: HIV in the future NHS, why PrEP is needed, your rights: a guide to human rights and HIV, your voice: a guide to disclosure and HIV, using the global evidence base to reduce the impact of HIV stigma, how NHS overseas visitors charges apply to migrants and asylum seekers in England, preparing for Personal Independence Payment (PIP), and tackling HIV discrimination at work.

HIV support services: The state of the nations | National AIDS Trust | Mar 2017
Why we need HIV support services: A review of the evidence | National AIDS Trust | Mar 2017

National AIDS Trust | National AIDS Trust

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Check ups

Sexual health clinics

Sexual health clinics or services provide treatment for Sexually Transmitted Infections (STIs) and practical help to reduce the risk of getting them in the future. Some services are referred to as Genito Urinary Medicine (GUM) clinics which is the medical term for this field of medicine.

For many years, ‘GUM’ or ‘clap’ clinics were hidden away in hospital basements but many improved from the 1990s, with changes driven largely by gay men, developing a more positive and comprehensive understanding of gay men’s health. And for those who want them, there are clinics specifically for gay men, and evening opening times.

Having said that, improvements are not universal and the quality of service can vary between clinics. In some cases, thankfully more rarely today, we can still be patronised and mistreated by homophobic and judgemental staff, although they do seem to be on the way out.

If you are sexually active, finding a GUM clinic you like is essential, particularly if you can build up a good relationship, if required.

What services do sexual health clinics (GUM clinics) provide? | NHS Choices

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Finding a clinic

Unless a clinic has been recommended to you by a friend, it can difficult to know where to go, whether you’re looking for your first clinic or moving to a different one. 

To find a clinic near you, click on the map at the top right of this page, or info icon or use these links:

Find a sexual health service | NHS Choices
London sexual health services | MEN R US

With few exceptions, most of us use clinics run by the National Health Service – they’re free (including treatment prescriptions) and generally very good. Alternatively, you can go to a private clinic and pay for it. Depending on where you live and work, it can be worth thinking about the clinic location, although this should be a secondary consideration after the quality of the service you receive. Even if there’s just the one locally, some gay men do go elsewhere to reduce the likelihood of recognition or because the service is crap. So shop around to find a clinic which best suits your needs.

Go online or phone up the clinic and find out if you need an appointment, or whether it is a ‘walk-in’ service. ‘Walk-in’ clinics can be very busy and it’s almost impossible to gauge how long you’ll be there. It is advisable to put aside a morning or afternoon until you have a clearer idea of how the clinic works. You might want to ask if they have a special clinic for gay men if that’s what you’re after.

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Confidentiality

Sexual health clinics (STI clinics) are bound by law to ensure the confidentiality of your records, so it’s OK to give your real name and address. All information about you and your sexual health is protected by law under the NHS Trusts and Primary Care Trusts (Sexually Transmitted Diseases) Directions 2000 and The NHS (Venereal Diseases) Regulations 1974.

Confidentiality and the venereal diseases regulations | NAM Aidsmap

In September 2015 a breach occurred where the 56 Dean Street clinic sent out the names and email addresses of 780 people when a newsletter was issued to clinic patients. Although this was appalling it was an exceptionally very rare occurrence in the sexual health field. Patients were supposed to be blind-copied into the email but instead details were sent as a group email.

London clinic leaks HIV status of patients | BBC News | 2 Sep 2015

If you’re going to have an HIV antibody test you may decide to give a false name, and this is not against the law. However, don’t forget it… and any other false information you provide. Unfortunately, the same standard of confidentiality cannot be assured outside your clinic if you’re referred to another hospital department or service.

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When you arrive

When you arrive you should report to reception, where you will be booked in and given a numbered ticket (depending on the system). You then wait until your ticket number or name is called. If it’s your first time, you may need to answer a few questions or complete a short questionnaire.

Some guys feel the need to give a different name which is OK as long as you remember it… and respond when it’s called out! At some point you will be given a reference number. Don’t lose it as it links you with your clinic file which sits amongst tens of thousands of other records. Although they can be found by your name and/ or date of birth, looking for records in this way causes delays and extra waiting time for you.

Visits may take up to 2 hours, sometimes longer, so don’t be afraid to ask how long it is expected to take. Longer waits usually occur in clinics that provide a ‘walk-in’ service where it can be difficult to match demand with staff. If the waiting room is packed and the clinic is short staffed, you could be there for several hours – it’s unavoidable. Pre-arranged appointments are more likely to keep to time, but are prone to delays like any health service.

Everyone is there for the same reasons and nobody is likely to feel any less awkward than you. Just get on with it; take a book or watch a movie on your phone to pass away the time. Some clinics even have free wifi.

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The consultation

Practice varies between clinics but you can usually expect the following during a clinic visit:

Routine check ups

If you are going for a regular check-up with no concerns or symptoms (that you know of) you will be asked for some or all of the following:

  • Complete a short questionnaire
  • Pee in a pot
  • Swabs from bum and/ or throat depending on the sex you’ve had (for gonorrhoea, chlamydia)
  • Bloods tests for syphilis, HIV and viral Hepatitis

Check ups with concerns or symptom

You will be seen by a clinician (a nurse or doctor) who will find out about your reason for attending the clinic

  • You will be called by name or number and shown to a consulting room and while the consultation is taking place the door should be closed
  • Clinicians should introduce themselves (sometimes there is a student present and you should be asked whether this is OK. If you’d rather see the clinician alone – say so, particularly if it’s your first time at the clinic or if you are feeling in any way nervous)
  • You will be asked about any problems or concerns you might have. Explain in your own words what seems to be the matter and describe any symptoms

You may also be asked these sorts of questions…

  • How many people you’ve had sex with recently and their sex
  • Whether your partners were casual, known to you or regular
  • The kind of sex you’ve had and whether you used condoms (or not)
  • Whether you’ve had STIs before
  • If you have been vaccinated for hepatitis in the past (as you may need a booster)
  • Your alcohol intake and recreational drug use
  • General health problems, are taking medication or have allergies

Difficult and embarrassing though they might be, be truthful, and be as specific as possible. If you hide anything (eg: say you always use condoms when in fact you don’t) or are economical with truth, you may be not be tested for something you have.

The examination

Depending on why you are attending you will be examined, this is likely to include:

  • the cock and balls
  • the throat and the glands in your throat
  • arsehole
  • the skin.

You will need to provide samples to find out whether you have a sexually transmitted infection.

Swabs

Using swabs, samples are taken from:

  • your pee hole
  • your throat
  • your arsehole
  • you may also be asked for a urine sample

These are used to test for gonorrhoea, chlamydia, pus in the rectum, or penis (proctitis or NSU).

Blood tests

You will then be asked to give a blood sample for syphilis, HIV and Hepatitis

Initial test results

Some of the test results will be available during your visit so after you have been examined and provided the necessary samples, you are likely to be returned to the waiting area for a short time before seeing the nurse or doctor again.

Treatment

Depending on the diagnosis you may be given a course of treatment (usually antibiotics)

Other test results

The rest of your results will take a week or so and you will have to go back to get them and most clinics communicate your results by text or telephone, however you may be asked to attend for your results or review.

At the end

Thoughtful clinicians will close your session by checking that everything is OK and give you an opportunity to ask any other questions.

Clinics and support | GMFA
Visiting a STI clinic | NHS Choices

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Surveys, studies and trials

Sometimes there may be a member of staff ‘hovering’ in the waiting area with a survey. Feel fee to say no, but it’s a way to pass the time and support the clinic in its work.

If you are receiving HIV treatments/ therapies, you may be asked to take part in a clinical trial or survey (especially if you are newly diagnosed).

Before you make any decision you need to understand the purpose of the survey/ trial etc; what is involved; your rights; and whether there are any dangers or risks. If you have difficulty in understanding what is being asked of you, ask that the questions or information are rephrased or re-explained. You should also be given time to think about what has been said before you make any decision.

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Treatment

If you have a STI then you’ll be prescribed a course of treatment. If you’re given antibiotics then it is very important that you complete the whole course even if you think the symptoms have gone away.

The infection may not have been fully cured and if it comes back then it can be more difficult to treat second time round. You will be asked to come back to check the infection has gone away.

If you don’t understand what the treatment is and you want to know, don’t be afraid to ask. If you are unhappy with what you’ve been given then ask if there’s an alternative. All treatment and prescriptions are free.

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Telling partners

If you have or have had a recent infection you should tell all your partners (if you can) so that they can also go for check-ups. This may not be easy – but think about it if the roles were reversed.

Clinics will want to make sure that all your recent partners are traced so that they can be warned that they need a check-up too. Just assure the clinic that you will personally tell all your partners. Then do it!

Alternatively, there is ‘provider referral’ where a clinic will contact partners on your behalf anonymously. All you have to do is give the clinic his first name and mobile number. They will do the rest and will not identify you at all.

Remember, you can have most STIs without there being any external or recognisable symptoms. The situation is more complex if you test HIV antibody positive but the health adviser should help you tackle the issues.

Notifying my partners | GMFA

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The service you can expect

Generally clinics provide an excellent and consistent service and, you should be to

  • Understand and be kept fully informed about what’s going on
  • Have questions asked with sensitivity and in plain language
  • Have time and attention to express concerns and ask questions
  • Have your questions answered honestly and in plain language
  • Be given time to understand the answers
  • Be asked for your consent to any tests or treatments

Communication works both ways

Occasionally staff assume you are straight (heterosexual) and/ or may only have a limited understanding of gay sex. If you feel the line of questioning is insensitive or offensive so say: firmly but politely. Clarifying something can be awkward and embarrassing but trends in gay sex can be complicated and fast moving (the language and apps we use, for example). Providing your knowledge can also help staff and clinics in the work they do.

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Saying thank you and making complaints

Acknowledging when and where clinics get it right is just as important as complaining. Many dedicated staff work very hard to ensure that clinic services meet our needs with the least discomfort and embarrassment. Quite simply, if you’re pleased with the service say so and spread the word.

Making a complaint can be difficult and embarrassing, particularly if it involves coming face to face (again) with the member of staff about whom you’re complaining. Think carefully about

  • why you are complaining
  • what you want to say
  • what you want to get out of the situation.

Maybe it’s an apology you want, or an improvement in the service you’ve received?

Being clear and calm will not just help you but also the clinic in understanding why you’ve made the complaint in the first place. You may want to deal with the situation then and there. Alternatively, when you get home make a note of the incident before contacting the clinic again. An irate call to the clinic may make you feel better but unless you provide your name, who was involved, and what happened, it’s unlikely that the clinic can carry the complaint further).

It may be useful to talk it through with a friend – preferably one who’ll be supportive but objective. If you don’t wish to contact the member of staff concerned directly, try the clinic’s business manager or senior clinician. Some clinics have a system for complaints and suggestions and this may be a useful place to start.

Patient Advice and Liaison Service (PALS)

Alternatively, clinics are usually part of a hospital or NHS type Trust with a Patient Advice and Liaison Service where you can raise your concern or make your complaint through them.

What is Patient Advice and Liaison Service (PALS)? | NHS Choices
Find a PALS near you | NHS Choices

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HIV

HIV testing

Getting an HIV test is the only way to know if you have HIV. The immune system usually takes 3 to 8 weeks to make antibodies against HIV, but tests differ in how early they are able to detect antibodies. Although most HIV tests look for these antibodies, some look for the virus itself. The period after infection but before the test becomes positive is called the window period.

HIV testing | GMFA
HIV testing | NAM Aidsmap
HIV testing | NHS Choices

 Diagnosis and testing of HIV infection | Animated HIV Science | 6 Nov 2013 5m37s

There is big push in the UK to get people to take an HIV test, with most recent developments being a 3 minute finger prick test (sexual health clinic) and home self-test kits which went on sale from April 2015 in the UK for £30 approx.

HIV Self Test Kit | National AIDS Trust
HIV self-testing kit goes on sale in UK | The Guardian | 27 Apr 2015

HIV testing is free at an NHS sexual health clinic with support on hand if it’s not the result you are expecting, or even if it is the result you are expecting for that matter.

Find a sexual health service | NHS Choices
London sexual health services | MEN R US (STI).

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HIV treatment

HIV is treated with a combination of drugs called ‘antiretrovirals’, also known as antiretroviral therapy (ART). These drugs work to stop the virus making copies of itself (multiplying) and so reducing the amount of HIV in the body. Reducing the HIV in your body enables your immune system to recover, giving it a greater chance of fighting off, and recovering from, infections and other illnesses.

Anti-HIV drugs | NAM Aidsmap
Introduction to ART | i-base

Undectable=Untransmittable | Prevention Access
NAM endorses Undetectable equals Untransmittable (U=U) consensus statement | NAM aidsmap

Understanding CD4 counts and viral loads

Whether you have been recently diagnosed yourself, or if you know somebody living with HIV, understanding even a little bit about CD4 counts and viral loads is worth knowing. For example, you might hear someone say “I’m undetectable and my CD4 count is 781” but what does it mean?

A CD4 count is a blood test that measures CD4 T lymphocytes (CD4 cells) in 1 cubic millimetre of blood. It shows the ‘strength’ of your immune system function to fight off infections. Normal CD4 counts range from 500 to 1,500 cells. A CD4 count of less than 200 is one of the ways to determine if a person with HIV has progressed to AIDS. This doesn’t mean a person is near death, but rather that their immune system is so badly damaged that they would have great difficulty fighting off an infection if one were to come along.

A viral load blood test measures the number of active HIV virus copies (or particles) there are in 1 millilitre of blood. For example, a person not on HIV treatment may have a viral load of several million. A higher viral load means a person will be more infectious to others; eg: through unprotected fucking. The goal of HIV treatment is to bring your viral load down to undetectable levels which is usually regarded as less than 100.

We are oversimplifying but as crude example: A person with HIV infection and not on HIV medication might have (when tested) a viral load of 1,000,000+ and a CD4 of 370. Once on HIV treatment (eg: 3-6 months later) that person would be looking good if the viral load was less than 100, and the CD4 count was 500.

Effective HIV treatment is about keeping your CD4 count high and your viral load low or undetectable. We should also add that CD4 counts and viral loads can go up and down depending on how well your HIV medication is working, whether you’ve another STI, and your health generally. This is not unusual.

The clinic doctors specialising in HIV are very experienced in both telling you what you need to know, and answering your questions and concerns.

 CD4 and viral load | NAM Aidsmap
How CD4 and viral load are related | i-base
What is a CD count and viral load? | National AIDS Trust

Viral Load and Monitoring | Animated HIV Science | 7Nov 2013 | 4m37s

Take your meds!

Today’s HIV treatments are extremely effective, enabling in the majority of cases a normal life expectancy; particularly if you are diagnosed early (the point of infection). Being on ART also reduces the risk of transmitting HIV to others.

You will need to take your HIV tablets as prescribed, which in most cases is one daily dose, to ensure you have enough medication in your body to keep the HIV in check. So, no messing around and missing doses!

Some people do experience side-effects, which can vary between treatments and individuals, although after a few weeks most usually subside or if they don’t can be alleviated by medication. There is still no cure but for most people HIV is now a ‘chronic condition’, a serious but manageable illness that you will live with for the rest of your life.

Adherence and why it is so important | i-base
Why taking your HIV treatment properly is so important | NAM Aidsmap

Publication1HIV treatment interactions

HIV Drug Interactions from the University of Liverpool. provides a clinically useful, reliable, comprehensive, up-to-date, evidence-based drug-drug interaction resource, freely available to healthcare workers, patients and researchers. The HIV iChart app gives easy access to our drug interaction information on mobile devices.

HIV Drug Interaction Checker | University of Liverpool

Finding out more

NAM Aidsmap

NAMNAM works to change lives by sharing information about HIV and AIDS. It produces useful information that you can trust, and makes sure it is there for anyone who needs it. It believes that having independent, clear and accurate information is vital in the fight against HIV and AIDS. It enables individuals and communities affected by HIV to protect themselves, care for others, advocate for better services and challenge stigma and discrimination.

Acorn House, 314-320 Gray’s Inn Road, London WC1X 8DP
020 7837 6988 9.30am – 5.30pm, Mon-Friday

HIV i-base

Formed in 2000, HIV i-Base is a treatment activist group providing timely and up to date information about HIV treatment to HIV positive people and to health care professionals. All resources are produced by and with the involvement of HIV positive people and are reviewed by a medical advisory group.

4th Floor, 57 Great Suffolk Street, London SE1 0BB.
0808 800 6013 | Mon-Wed 12-4pm

UK Community Advisory Board (UKCAB)

Set up in 2002, The UK-CAB is a network for community HIV treatment advocates across the UK. Among its aims: to develop and strengthen a network of treatment advocates, provide expert training on current treatment issues and develop community representation in clinical trials, and setting the standard of care open to HIV positive people and community advocates.

c/o HIV i-Base, 4th Floor, 57 Great Suffolk Street, London SE1 0BB
020 7407 8488

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After a positive diagnosis

Everyone’s experience of being diagnosed with HIV is different. As the news sinks in and you start to come terms with what it means, you may go through a range of different feelings. You may feel like being by yourself, or being with just your partner, you may want to chat with a close friend, or you may want to speak to a professional counsellor, perhaps at the clinic where you received your diagnosis.

Once you’ve accepted your diagnosis you may want to chat with other people who have are HIV positive. A number of organisations run groups where you can share your experiences with other newly diagnosed people, including groups that are just for gay men. You may not necessarily all be going through the same feelings and emotions, or want to ask the same questions, but these groups can be a usefully way to find support and share experiences.

Coming out again

For some HIV positive gay men, telling others about their status can be as stressful or traumatic as coming out as gay. It is important to think carefully about who you want to tell and why. Once you have told someone about being HIV positive, you cannot take the information back. Coming out is a very personal process and should be your choice. Obviously, it can feel very natural to want to tell your partner and/ or your family immediately but the response may not be what you expect. It certainly doesn’t help to be dealing with other people’s crap while still sorting out your own. If, however, you have decided to come out, the following may be helpful:

  • Be aware that telling people may affect you more than you think and they may not react in the way you expect.
  • Don’t tell people if you don’t want them to tell others.
  • Try and prepare yourself for the questions they may ask or the issues they may bring up.
  • Try and choose the right time and place.

People have different reasons for coming out. For some it may be to get support or health care whilst others might want their sexual partner(s) to know. Not telling someone about your diagnosis might prevent you getting the support, advice and services that are appropriate to your needs. Whatever reaction you get to coming out, being positive is nothing to be ashamed of.

First steps at the clinic

After your HIV diagnosis, several things are likely to happen:

  • You will be subjected to a flurry of medical tests to establish your state of health and to what extent the virus is affecting your immune system.
  • If appropriate, you may be offered treatments to reduce or stabilise the level of HIV in your body or treatments to help prevent the development of opportunistic infections.
  • Depending on your needs, state of health and circumstances, you will be helped to apply for benefits or put in touch with a social worker or home care support team.

There is sometimes an assumption by professionals that because you are gay you know what to do and where to go. This is, of course, not likely to be true where your new HIV diagnosis is concerned. Of course it may be difficult to gauge whether you’re getting the information you need and want, but if you have any doubts ask – or get a second opinion from a helpline or other organisation.

This can be overwhelming, particularly at a time when there is likely to be a lot on your mind and you may be feeling very stressed and emotional. Spare some thought for how you are feeling. Being HIV positive can play havoc with your emotions. Whether you chat regularly with a mate, attend a group, phone a helpline or seek professional help – don’t ignore your feelings. Some find it difficult to ask for help or accept it, but there’s nothing wrong with getting it or asking for it.

We all need help once in a while – it doesn’t mean that we are weak or incapable. Equally, saying ‘no’ doesn’t necessarily mean you are being awkward – so don’t feel guilty or afraid about saying it. The following tips are designed to make getting help and support easier, and so you make decisions which suit you and meet your needs.

  • Try to deal with one thing at a time.
  • Find a doctor or clinic you like. If you don’t like them, change them.
  • Make decisions in your own time.
  • Take at least some time to learn more about HIV and how it could affect you. But you don’t have to become an expert or know everything at once. Knowing more will help you feel more in control.
  • Consider how you could make your lifestyle healthier. It may include, for example, changes to your diet, having more fun or doing relaxation exercises. Even if you think you’re a sceptic, give it a chance; you can always go back to clubs, drugs, and ready-made-meals – they ain’t going nowhere!
  • Listen to your body, it’s usually pretty good at telling you what it likes and doesn’t like. You may take it for granted but it is your friend, get to know and understand it better.
  • If there are changes to be made to your life, they are rarely drastic or wholesale and you don’t have to make them all at once. You have time.
  • If you’re attending an appointment, there’s nothing to stop you taking someone with you. A little moral support and another pair of ears can be very helpful.

When you are speaking about your HIV, particularly in relation to HIV services, you may come across people whom you don’t know, don’t like or who don’t seem to understand what your needs are. Here are some tips to get you through:

  • Be honest and direct – say what’s on your mind.
  • Consider taking notes and preparing some questions beforehand. This way you can take the information away and understand it better in your own time.
  • Listen to what is being said and think what you want to say next before opening your gob.
  • If you’re getting irritable or angry, say so… then take some deep breaths, take a break, or go to the toilet. If you really can’t handle it, leave. You can always go back when you’re ready.
  • If you’re told something which you don’t understand, repeat what’s been said in your own words and ask if you’ve understood correctly.
Just diagnosed | NAM Aidsmap
Just found out you are HIV positive… | i-map

Living with HIV | Positively UK
Recently Diagnosed | Positive East
Just found out you’re positive? | Metro Centre
Support group for HIV+ men | London Gay Men’s Group

Beyond positive online magazine | Beyond Positive
Positively Aging Forum (HIV) (PAF)
Living with HIV | Naz Project
Living with HIV | Cara Trust
Living with HIV | THT

Over 50s LIving with HIV Health, Wealth and Happiness Project | THT
This project  supports the financial, emotional and physical well-being of over 50s living with HIV in Brighton, Bristol, London, Manchester and the West Midlands. Whether you’ve been diagnosed recently or have been living with HIV for many years you may find one of its services may be able to help.

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Undetectable = Untransmittable

U=UU=U means Undetectable = Untransmittable which essentially means if someone with HIV has an undetectable viral load then they cannot pass on the virus through sex. Over the last year, HIV organisations across the world  have joined the U=U campaign to endorse the statement that HIV sexual transmission does not occur when viral load is undetectable on HIV medication or antiretroviral therapy (ART). While the impact of HIV medication on reducing HIV transmission has been known for a long time,  it’s new to say ART stops sexual transmission completely. This change is especially important given that prejudice and discrimination against HIV positive people is still widespread.

In 2016, we saw data from the PARTNER study which followed 888 sero-different couples, where one partner was HIV positive and had an undetectable viral load and the other partner was HIV negative. After six years and over 60,000 condom-less sex acts later the study has reported ZERO linked partner-to-partner infections. At the International AIDS Society 2017 conference, there was even more evidence from the Opposites Attract study which followed 343 gay couples, where again one partner was undetectable and the other was HIV negative. The data showed once again that there were ZERO linked partner-to-partner infections.

The Partner Study | Alison J. Rodger, Valentina Cambiano, Tina Bruun, et al | 12 Jun 2016
Opposites Attract Study | Bavinton et al,  and the Opposites Attract Study Group

CDC acknowledges U=U | European AIDS Treatment Group | 29 Sep 2017
The evidence for U=U: why negligible risk is zero risk | i-base | 9 Aug 2017
Consensus Statement | Prevention Access Campaign | 21 Jul 2017
 Effective HIV treatment means ‘zero’ risk of transmitting virus | THT | 21 Jul 2017
BHIVA endorses ‘Undetectable equals Untransmittable’ (U=U) consensus statement | BHIVA | 12 Jul 2017
NAM endorses Undetectable equals Untransmittable (U=U) | NAM aidsmap | 9 Feb 2017

Zero Risk | Dr Carl Dieffenbach | Prevention Access Campaign | 14 Nov 2016

Living With HIV: What you need to know about HIV-undetectable and viral load | GMFA | 7 Sep 2016 | 00m51s
HIV: Stopping the Virus Starts With You | Stop the Virus | 27 Apr 2015 | 1m49s
HIV: What’s Going on Inside Your Body | Stop the Virus | 25 Jul 2014 | 2m37s
HIV: The Goal of Undetectable | Stop the Virus | 25 Jul 2014 | 3m18s

Undetectable Viral Load & The Sex You Want | Gay Men’s Sexual Health Alliance | 24 Jul 2017 | 2m30s

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CIHRRC

CIHRRCThe Canadian-International HIV and Rehabilitation Research Collaborative (CIHRRC) is an international research collaborative addressing research priorities in HIV and rehabilitation for people living with HIV in the UK and Canada. The areas of research are:

  • Episodic health and disability
  • Ageing with HIV across the lifespan
  • Concurrent health conditions
  • Access to rehabilitation and models of rehabilitation service provision
  • Effectiveness of rehabilitation interventions
  • Enhancing outcome measurement in HIV and rehabilitation research

The Collaborative is comprised of 40+ researchers, clinicians, people living with HIV, and representatives from community organisations in Canada and around the world.

What is episodic disability and rehabilitation?

As people live longer with HIV they may experience the health-related challenges of HIV, concurrent health conditions, and ageing. These health-related challenges may be termed ‘disability’, and may sometimes fluctuate resulting in ‘good days’ and ‘bad days’ living with HIV. The term ‘episodic disability’ is used to describe physical, cognitive, mental and emotional symptoms and impairments, difficulties carrying out day-to-day activities, challenges to social inclusion, and uncertainty or worrying about the future. It may sometimes fluctuate on a daily basis or over the longer term living with HIV. ‘Rehabilitation’ is defined as “any services or activities that address or prevent impairments, activity limitations, and social participation restrictions for people living with HIV.”

Finding out more

If you are living with HIV and/ or getting older you may find CIHRRC’s research both interesting and of value. In addition to the written research, its website includes over 40 films.

Canadian-International HIV and Rehabilitation Research Collaborative
Uncertainty, ageing and HIV | Patty Solomon, McMaster University | 13 June 2013 | 10m50s

3rd International Forum on HIV and Rehabilitation Research (May 2016)
Winnipeg, Canada
Day 1

2nd International Forum on HIV and Rehabilitation Research (October 2014)
Chelsea and Westminster Hospital, London
Day 1

1st International Forum on HIV and Rehabilitation Research (June 2013)
Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto
Day 1 / Day 2

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HIV stigma

HIV stigma

stigma ˈstɪɡmə/ noun
Mark of shame and humiliation often driven by views, beliefs and assumptions we make about people. Makes it more likely that people will be singled out, ostracised, or marked out as strange, different (not in a nice way) and, in some cases, thought of as dangerous. Stigma is crippling, bringing on feelings of isolation, shame, hopelessness, blame, self-hatred, which often prevents people from seeking help and support.

Over the past 30 years of the HIV/ AIDS epidemic, many advances have been made in treatment and care, and HIV is now considered to be a chronic medical condition rather than the fatal illness it once was. Unfortunately, people living with HIV have been stigmatised and discriminated against since the virus was first discovered in the 1980s, and it continues…

Today, the stigma and discrimination faced by people living with HIV remains a major issue. It appears in many forms and ranges from rejection by friends, family or partners to being physically assaulted. It’s also a distinctly unattractive trait among some gay men using hook-up web apps.

As well as leading to feelings of isolation, depression and fear, stigma can also contribute to the spread of HIV. If someone is scared to go for a test, they may not know that they are HIV positive, and that could lead to them unknowingly infecting someone else. Fear of testing is often what leads to people being diagnosed late, which means they are in poorer health when diagnosed and in turn may not respond as quickly or as well to treatment, which ultimately means they reduced their opportunities for returning to good health.

Stop HIV stigma | GMFA
HIV, stigma and discrimination | NAM Aidsmap
Law, stigma and discrimination | NAT
HIV stigma and discrimination | Avert
Stigma and HIV | Terrence Higgins Trust

HIV isn’t dirty, stigma is | GMFA
The stigma of HIV still remains | The Guardian | 15 Aug 2013
People Living with HIV: UK Stigma Index | FPA | 2015-17
People living with HIV stigma index (worldwide) | Stigma Index

HIV: living with the stigma | Channel 4 News | 17 Dec 2015 | 5m 12s
Living with the stigma of HIV | Michael Rizzi | 24 Nov 2015 | 6m 48s
Luke on HIV stigma | Saving Lives @ Heart of England NHS Foundation Trust | 21 Nov 2014 | 1m 6s
HIV stigma: I have judged.. other people are going to judge me | HIV Foundation Queensland | 16 Jun 2014 | 9m 12s
The stigma of HIV/AIDS: connecting the dots | RYOT | 21 Apr 2015 | 2m 58s
The day I found out I was HIV positive | ImFromDriftwood | 8 Jun 2012 | 3m 2s

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HIV AND AIDS HISTORY

HIV and AIDS History

HIV/ AIDS in the United Kingdom | Wikipedia
History of HIV and AIDS overview | Avert
Our History: Terrence Higgins Trust | Terrence Higgins Trust

AIDS: The first 20 years | Simon Garfield

AIDS: The first 20 years (part one) | The Guardian | 3 June 2001
AIDS: The first 20 years (part two) | The Guardian | 3 June 2001

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"Killer in the village" BBC Horizon (1983)

A rise in the demand for Pentamidine to treat pneumocystis pneumonia alerted health authorities to HIV/AIDS. First transmitted in 1983, Horizon traces the spread of AIDS across America. AIDS – Acquired Immune Deficiency Syndrome – was only named in 1982, and was still largely unknown. This programme follows the search for a cause and cure, and asks whether the seeds of a spreading epidemic had already reached London.

Horizon: Killer in the Village, 1982-1983 | BBC | 55m 45s

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"And the band played on" (1987)

“Upon it’s first publication twenty years ago, “And the band played on” was quickly recognised as a masterpiece of investigative reporting. An international bestseller, a nominee for the National Book Critics Circle Award, and made into a critically acclaimed film, Shilts’ expose revealed why AIDS was allowed to spread unchecked during the early 80’s while the most trusted institutions ignored or denied the threat. One of the few true modern classics, it changed and framed how AIDS was discussed in the following years. Now republished in a special 20th Anniversary edition, “And the band played on” remains one of the essential books of our time.” Macmillan (US).

And the band played on | Randy Shilts | Macmillan (US)
And the band played on | Wikipedia

“And the band played on” is also a 1993 American television film docudrama directed by Roger Spottiswoode. The teleplay by Arnold Schulman is based on the best-selling 1987 non-fiction book by Randy Shilts. The film premiered at the Montreal World Film Festival before being broadcast by HBO on September 11, 1993.

And the band played on | Closing scene | HBO Films | 1997 | 4m 27s

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"How to survive a plague" David France (2012)

How to Survive a Plague is a 2012 American documentary film about the early years of the AIDS epidemic, and the efforts of ACT UP and TAG. It was directed by David France, a journalist who covered AIDS from its beginnings. “A riveting, powerful telling of the story of the grassroots movement of activists, many of them in a life-or-death struggle, who seized upon scientific research to help develop the drugs that turned HIV from a mostly fatal infection to a manageable disease. Ignored by public officials, religious leaders, and the nation at large, and confronted with shame and hatred, this small group of men and women chose to fight for their right to live by educating themselves and demanding to become full partners in the race for effective treatments. Around the globe, 16 million people are alive today thanks to their efforts.”

How to survive a plague | Wikipedia

How to survive a plague | Trailer | 2013
How to survive a plague | Film review | The Guardian | 10 Nov 2013
How to survive a plague | David France | Pan Macmillan Books | 2017

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"Don't die of ignorance" AIDS campaign (1986-7)

AIDS Monolith: Don’t Die of Ignorance Campaign, 1987 | BFI | 20 May 2016 | 51s

“Don’t Die of Ignorance” AIDS campaign | Witness, Radio 4 | 9m
In 1986 the British government launched the world’s first ever public health campaign on HiV and AIDS. It was highly controversial and faced considerable opposition from Prime Minister Margaret Thatcher. Mike Lanchin speaks to former Health Minister, Norman Fowler, whose insistence made the campaign a reality.
Past campaigns: AIDS don’t die of ignorance | Ethical Marketing News | 30 Apr 2017
The AIDS health campaign | The National Archives | 26 Jan 2016
Thatcher tried to block ‘bad taste’ public health warnings about AIDS | The Guardian | 30 Dec 2015

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HIV STORY PROJECT

HIV Story Project

HIV STORY PROJECTFounded in 2009, The HIV Story Project is a San Francisco based non-profit organisation focused on bridging HIV/AIDS with film, media and storytelling to fight the pandemic and the global stigma associated with it.

Generations HIV is a digital media experiment recording video questions, answers and stories by people from all walks of life about HIV/AIDS. Whether HIV+ or HIV-, a loved one or a caregiver, we have all been impacted and affected by this global health pandemic, and we all have a story to tell.

Generations HIV | HIV Story Project

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Hepatitis C

STI A-Z

STI A-Z

Chlamydia (chlamydia trachomatis)
GMFA
NHS Choices
Wikipedia

Gonorrhoeae (neisseria gonorrhoeae)
GMFA
NHS Choices
Wikipedia

Crabs (pthirus pubis)
GMFA
NHS Choices
Wikipedia

Crabs Away! | Three Flying PIglets | 2011 | 9m 2s

Hepatitis A (HAV/ picornavirus)
Get Hepatitis A vaccinated
GMFA
NHS Choices
British Liver Trust
Wikipedia

Hepatitis B (HBV/ hepadnavirus)
Get Hepatitis B vaccinated
GMFA
NHS Choices
British Liver Trust
Wikipedia

Hepatitis C (HCV/ flavisirus)
GMFA
NAM Aidsmap
NHS Choices
Wikipedia
Chemsex | MEN R US

Herpes (herpes simplex HSV-1, HSV-2, and there are others)
GMFA
NHS Choices
Wikipedia
For cold sores around the mouth and nose see:
Cold sore (herpes simplex virus) | NHS Choices
Herpes simplex | Wikipedia

HIV (human immunodeficiency virus)
GMFA
NAM Aidsmap
NHS Choices
Wikipedia

HPV (human papillomavirus)
GMFA
Wikipedia

LGV (lymphogranuloma venereum)
GMFA
Wikipedia

MCV (molluscum contagiosum).
GMFA
NHS Choices
Wikipedia

NSU (non-specific urethritis) and NGU (non-gonococcal urethritis)
GMFA (NSU)
NHS Choices (NGU)
Wikipedia

Non-specific proctitis (NSP)
GMFA
Wikipedia

Scabies (scarcoptes scabiei)
GMFA
NHS Choices
Wikipedia

Shigella
GMFA
NHS Choices
Wikipedia
PHE Leaflet
Gay and bisexual men in UK warned of shigella outbreak | nam aidsmap | 30 Jan 2014

Syphilis (treponema pallidum)
GMFA
NHS Choices
Wikipedia

HPV (papillomavirus)
GMFA
NHS Choices
Wikipedia

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London clinics

Central

EUSTON/ BLOOMSBURY (C)

Mortimer Market Centre
Capper Street (off Tottenham Court Road), London WC1E 6JB
Map | Clinic website

CITY (C)

Bart’s Sexual Health Centre
Kenton and Lucas Wing, St Bartholomew’s Hospital, West Smithfield, London EC1A 7BE
Map | Clinic website

FULHAM (C)

John Hunter Clinic
St Stephen’s Centre (next to Chelsea & Westminster Hospital), 369 Fulham Road, London SW10 9NH
Map | Clinic website

HACKNEY (C)

Homerton Sexual Health Services
Homerton University Hospital, Homerton Row, London E9 6SR
Map | Clinic website

LONDON BRIDGE (C)

The Lloyd Clinic CLOSED 2017 Read more here
Guy’s Hospital, Southwark Wing, 2nd Floor, Great Maze Pond, London SE1 9RT

PADDINGTON (C)

Guys @ St Mary’s Hospital
Jefferiss Wing (1st Floor), St Mary’s Hospital, Praed Street, London W2 1NY
Map | Clinic website

The Working Men’s Project
Winsland Clinic, Jefferiss Wing (1st Floor), St Mary’s Hospital, Praed Street, London W2 1NY
Map | Website

Jefferiss Wing Centre for Sexual Health
St Mary’s Hospital, Jefferiss Wing, Winsland Street (off Praed Street), London W2 1NY
  Map | Clinic website

SOHO (C)

56 Dean Street
56 Dean Street, Soho, London W1D 6AQ
Map | Clinic website

Dean Street Express
34 Dean Street, Soho, London W1D 4PR
Map | Clinic website

SOUTHWARK (C)

Burrell Street Centre Sexual Health Clinic
4-6 Burrell Street, London SE1 0UN
Map | Clinic website

CHELSEA (C)

John Hunter Clinic
St Stephen’s Centre (next to Chelsea & Westminster Hospital), 369 Fulham Road, London SW10 9NH
Map | Clinic website

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North

ARCHWAY (N)

The Archway Centre
681-689 Holloway Road, London N19 5SE
Map | Clinic website

BARNET (N)

Clare Simpson Sexual Health Clinic CLOSED 2017 Read more here
Barnet Hospital, Wellhouse Lane, Barnet, London EN5 3DJ

HAMPSTEAD (N)

Marlborough Clinic CLOSED 2017 Read more here
The Royal Free Hospital, Pond Street, London, NW3 2QG

HARRINGAY (NE)

St Ann’s Sexual Health Clinic CLOSED 2017 Read more here
St Ann’s Hospital, St Ann’s Road, London N15 3TH

BRENT (NW)

Patrick Clements GUM Centre
Central Middlesex Hospital, 2nd Floor, Acton Lane, London NW10 7NS
Map | Clinic website

HARROW (NW)

Northwick Park Hospital GUM Department
Northwick Park Hospital, GUM Department, Watford Road, Harrow, Middlesex HA1 3UJ
Map | Clinic website

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South

SOUTHWARK (C)

Burrell Street Centre Sexual Health Clinic
4-6 Burrell Street, London SE1 0UN
Map | Clinic website

NEW CROSS (SE)

Waldron Health Centre
Contraception and Sexual Health Dept., Suite 8, 2nd floor, New Cross, London SE14 6LD
Map | Clinic website

BECKENHAM (SE)

Beckenham Beacon Sexual Health Clinic
Beckenham Hospital, 379 Croydon Road, Beckenham, BR3 3QL
Map | Website

CAMBERWELL (SE)

Camberwell Sexual Health Centre
Camberwell Building (Ground Floor), 94-104 Denmark Hill, London SE5 9RS
Map | Clinic website

CROYDON/ THORNTON HEATH (SE)

Croydon University Hospital GUM Department
Croydon University Hospital, 530 London Road, Thornton Heath, Croydon CR7 7YE
Map | Clinic website

GREENWICH (SE)

Trafalgar Clinic for Sexual Health
Trafalgar Centre, Queen Elizabeth Hospital, Stadium Road, London, SE18 4QH
Map | Clinic website

CARSHALTON (SW)

St Helier Medical GU Department
St Helier Hospital, Wrythe Lane, Carshalton SM5 1AA
Map | Clinic website

RICHMOND (SW)

GUM Clinic Roehampton
Queen Mary’s University Hospital, 2nd Floor, Roehampton Lane, Richmond SW15 5PN
Map | Clinic website

SUTTON (SW)

St Helier Medical GU Department
St Helier Hospital, Wrythe Lane, Carshalton SM5 1AA
Map | Clinic website

TOOTING (SW)

The Courtyard Clinic CLOSED Read more here
St George’s Hospital, Blackshaw Road, London SW17 0QT

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East

BARKING (E)

SH Clinic Outpatients East
Barking Hospital, Upney Lane, Barking, London IG11 9LX
Map | Clinic website

HOMERTON (E)

Homerton Sexual Health Services (The Clifden Centre)
Department of Sexual Health, Homerton Hospital, Clifton House, Homerton Row, London E9 6SR
Map | Clinic website

NEWHAM (E)

Greenway Centre
Newham General Hospital, Glen Road, London E13 8SL
Map | Clinic website

LEYTONSTONE (E)

Whipps Cross Hospital Department of Sexual Health
Whipps Cross Hospital, Whipps Cross Road, Leytonstone, London E11 1NR
Map | Clinic website

ROMFORD (E)

SH Clinic
Queens Hospital, GUM Department, Rom Valley Way, Romford, Essex RM7 0AG
Map | Clinic website

WHITECHAPEL (E)

Ambrose King Centre
Royal London Hospital, Whitechapel Road, London E1 1BB
Map | Clinic website

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West

SOUTHALL (W)

Ealing Hospital GUM Department
Uxbridge Road, Southall UB1 3HW
  Map | Clinic website

HILLINGDON (W)

Tudor Centre
Hillingdon Hospital, Pield Heath Road, Uxbridge UB8 3NN
Map | Clinic website

HAMMERSMITH (W)

West London Centre for Sexual Health
Charing Cross Hospital, Fulham Palace Road, London W6 8RF
  Map | Clinic website

HOUNSLOW (W)

Sexual Health Hounslow
Level 2, Heart of Hounslow Centre for Health, 92 Bath Road, Hounslow TW3 3EL
  Map | Clinic website

ISLEWORTH (W)

West Middlesex Hospital Sexual Health Clinic
West Middlesex Hospital, Twickenham Road, Isleworth, London TW7 6AF
  Map | Clinic website

KINGSTON UPON THAMES (W)

The Wolverton Centre
Kingston Hospital, Galsworthy Road, Kingston upon Thames, London KT2 7QB
  Map | Clinic website

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London A&E

London A&E

King’s College Hospital | Denmark Hill, London SE5 9RS | MAP
020 3299 9000 (Switchboard)

Lewisham Hospital | Lewisham High Street, Lewisham, London SE13 6LH | MAP
020 8333 3000 (Switchboard)

The Royal London Hospital | Whitechapel Road, Whitechapel, London E1 1BB | MAP
020 7377 7000 (Switchboard)

St Thomas’ Hospital | Lambeth Palace Road, London SE1 7EH | MAP
020 7188 7188 (Switchboard)

St Mary’s Hospital | Praed Street, London W2 1NY | MAP
020 3312 6666 (Switchboard)

Hammersmith Hospital | Du Cane Road, London W12 0HS | MAP
020 3313 1000 (Switchboard)

Charing Cross Hospital | Fulham Palace Road, London, W6 8RF | MAP
020 3311 1234 (Switchboard)

Chelsea & Westminster Hospital | 369 Fulham Road, London SW10 9NH | MAP
020 3315 8000 (Switchboard)

Royal Free Hospital | Pond Street, Hampstead, London NW3 2GQ | MAP
020 7794 0500 (Switchboard)

University College London Hospital | 235 Euston Road, Euston, London NW1 2BU | MAP
020 3456 7890 (Switchboard)

Whittington Hospital | Magdala Avenue, Highgate Hill, Archway, London N19 5NF | MAP
020 7272 3070 (Switchboard)

Homerton University Hospital | Homerton Row, Homerton, London E9 6SR MAP
020 8510 5555 (Switchboard)

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Condoms

From tortoise shell to latex

TortoiseThe most effective way to protect yourself and your partner(s) from the risk of infection from STIs is the use of condoms and water-based lubricant – every time when you get fucked or fuck.

In the past, condoms have been made out of all sorts of materials: horn or tortoise shell for that extra sensitive gentle touch, oiled paper, linen or animal gut. Up until the 1930s rubber condoms were thick, washable and re-usable.

However, the development of latex in the late 1930s meant that thinner, disposable condoms could be produced. More recently we have seen the arrival of a polyurethane condom which is said to be stronger than latex, although more expensive. However, being thinner, sensitivity should be greater and it is the only condom which can be used with oil-based lubricants.

Condom History | Wikipedia

The Humble Little Condom: A History | Anne Collier | Prometheus Books

How a condom is made | BillyBoyUSA* | 13 Sep 2011 | 8m38s
Get it on | Durex | posted by robertrugan.com | 0m30s
Loop de Loop – Condoms | posted by Daniel Luke | 0m44s
AIDES Smutley | posted by AIDES | 2m20s

A little tedious perhaps but we feel we should clarify that MEN R US has no relationship with any of the condom manufacturers featured in this section, and acknowledges there are many many other brands available to purchase online, from chemists, shops and supermarkets, etc… but some are also FREE from many sexual health clinics.

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Stronger condoms

For many years, stronger condoms have been the bedrock of HIV prevention, though the landscape is changing. Today, there’s a shift to choosing the right condom which may not necessarily need be thicker with good technique and lashings of lubricant.

In 2001, an evaluation concluded “…there is no evidence from the present investigation to support the use of stronger (thicker) condoms over standard strength condoms among gay men. The appropriate use of additional lubricant should be encouraged.”

Obviously thicker condoms will lessen dick sensitivity and, although they offer better protection under ideal circumstances, the benefits may be outweighed if your dick is so de-sensitised that you have to ferret around for hours before you can cum. On the other hand, guys often love a good ferret! It’s your choice: if you feel safer and more secure using a stronger and/ or thicker condom then use them!

An evaluation of a thicker versus a standard condom with gay men | Golombok S, Harding R, Sheldon J. AIDS, 2001;15(2):245-250.
Condom efficacy in gay men | NAM Aidsmap

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Nonoxnol-9

Nonoxynol-9 is widely used in contraceptives for its spermicidal properties (it kills sperm on contact). It has been promoted as a backup method for avoiding pregnancy and to protect against STIs in the event of condom failure.

In the late 1990s, studies have found that condoms with nonoxynol-9 can irritate the lining of the rectum/ arse leading to increased risk of STI transmission, including HIV. Most condom manufacturers in the UK have stopped using N-9, but avoid condoms described as spermicidally lubricated.

Lubricants containing N-9 may enhance rectal transmission of HIV and other STIs | Contraception, 2004 | 70(2):107-110
David M Phillips, Kristin M Sudol, Clark L Taylor, Laura Guichard, Robert Elsen, Robin A Maguire
Confusion over use of nonoxynol-9 among gay men in San Francisco despite public warnings | 2003 | NAM Aidsmap
Nonoxynol 9 | Wikipedia

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Condom standards

CE + ISO + BSIYou may find several standards stamped on condom wrappers but, in our opinion, our order of preference is:

  1. ISO Standard is managed by the International Organization for Standardisation; give world-class specifications for products, services and systems, to ensure quality, safety and efficiency; and are instrumental in facilitating international trade.
  2. CE Mark is a European Economic Area symbol of licence approval. It therefore means that it meets all the requirements of European Legislation.
  3. BSI Kitemark is the registered trademark owned by the British Standard Institution, an accepted sign of reliability and a significant assurance that a product meets rigorous standards of production and testing.
ISO Standard | International Organisation for Standardisation | Wikipedia
CE Marking | GOV.UK | Wikipedia
BSI Kitemark | British Standards Institute | Wikipedia

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Latex and non-latex

The majority of condoms are made from two types of latex:

Natural rubber latex

Latex condoms weaken and damage easily when they come into contact with oil-based lubricants and other substances such as baby oil, mineral oil, suntan lotion, cooking oil, baby oil, petroleum jelly, cold creams, skin lotions and, bringing up the rear so to speak, butter or margarine.

Synthetic latex

A type of plastic (eg: polyisprene and polyurethane) which doesn’t irritate people with latex allergies. Though less stretchy than natural rubber latex, synthetic latex condoms can be very thin and be used with oil based lubricants.

Lambskin condoms

An alternative to latex and non-latex condoms made from a thin layer of sheep cecum, a part of the intestine. We mention them because you may come across them but they DO NOT prevent the transmission of viral STIs including HIV and herpes. On the upside the lambskin condoms are effective against pregnancy, they don’t trigger latex allergies, are biodegradable and can be used with oil-based lubricants.

Lambskin condoms | lambskincondoms.org

Vegan friendly condoms

New to the market, Glyde condoms come in several sizes, are made of natural rubber latex (with only natural and vegan colours and flavours) and are suitable for use with water based or silicone based lubricants.

Condoms suitable for vegans | Glyde Condoms

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Condom considerations and jargon

Condom Measurements

Condom Measurements

Whether clubbing, dining, or attending an interview, most of us think about what we’re going to wear. The cut of the clothes, the colour combo, and the impact bring it all together. But when it comes to sex, we can be so fixated on the fuck we forget that the right condom can give you and your partner(s) more pleasure, more security, and more fun.

You shouldn’t really feel a perfectly fitting condom. Too large and it can slip off (and yes: up the arse). If it’s too small it can be a bugger to put on (as your dick is choked to death) and it’s more likely to break while fucking. So while condom length is important its girth (or width) should also be a consideration. More of this later.

When choosing a condom, principle considerations should be:

  • its thickness (usually given in microns)
  • its width (and width at the head of the condom if it’s not a straight condom).
  • its length

Condom choice

The choice of condoms is bewildering and you can start to wonder why you might need an extra thin, non- lubricated, banana-flavoured, slim-fit condom. What is doubly frustrating is that comparing brands is just about impossible. Here are the options:

  • Standard condoms have straight sides
  • Fitted or trim condoms are slightly narrower below the dick head
  • Thinner or sensitive condoms are so you feel more; conversely, some guys will avoid them because they cum too quickly
  • Large, XL, or magnum condoms are longer and wider, including over the head of the dick
  • Extra strong or stronger condoms are usually thicker, but not always. According to manufacturers, some thin condoms claim to be as strong as stronger condoms
  • Textured condoms with ribs and bumps can increase sensation, but not everyone likes speed bumps
  • Coloured condoms can make oral sex more fun. Also, they could be a perfect choice for St Valentine’s or St Patrick’s Day, with matching flavours such as strawberry or mint. If you are planning to use a liquorice flavoured condom to accompany that black tie event we would advise you to warn your partner(s) in advance!
  • Flavoured condoms are just that, and some of the flavours can be an acquired taste. Who can forget minty mouthful, blow me bubblegum, bangin’ banana, chocolate temptation, blueberry muffin, fizzy cola, blowdom cannabis and succulent strawberry. They are great for oral sex, particularly for guys who are not into fucking
  • Non lubricated condoms are a sensible choice if you don’t like the taste of lubricated condoms. Great for sucking or you can add the lube of your choice if you’re fucking. Trivia: they are also used as protective covers for microphones and ultra sound machines, and for keeping stuff dry on camping trips.
  • Glow in the dark condoms have rather stumped us, but supposedly handy in a dark room? If anyone has an interesting tale to tell we’d love to hear from you.
  • Desensitising, extended play and delay condoms are for guys want to last longer before cumming or for guys who cum too quickly. They use a lubricant that slightly desensitises your dick which makes it a little numb. No harm, of course, but you have been warned.

We have trawled the websites of many well known manufacturers and distributors. While some provide condom length, width and thickness; others seem to be more interested in a sales pitch (for their own brands) and/ or posting customer reviews which are subjective, and not necessarily that helpful.

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Measuring dick

Finding the best condom fit takes some measuring on your part. You will need:

  • Stimulation to make you hard and erect; eg: a vivid imagination, porn, a man
  • A place where you will not be disturbed
  • A flexible sewing tape or tailors measure OR a ruler and a piece of string
  • A pen and paper
  • A man (optional)
  1. Place the tape or ruler along the length of your erect throbbing dick from the base to the tip. Bear in mind rulers often have a few ml at the end which you need to take into account (i.e. discount). Write down the measurement.
  2. Measure the girth or circumference of your penis with the tape around the thickest part of your dick (or loop the string around then use the ruler to calculate). Write down the measurement.
  3. Don’t waste it, how about a wank or a fuck?
How To Measure Your Penis | Condomerie | 17 Jun 2015 | 1m00s

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Matching dick size to condom size

Once you have your dick size (most importantly its girth or circumference) you would think it would be easy-peasy matching this information to the correct condom. Nope. Herding cats would be easier!

By way of an example, let’s use Fred (one of our volunteers) who kindly volunteered his dick stats:

His length erect: 14.5cm
His girth or circumference: 12.6cm

Condom calculators and charts

Even if Fred applies his measurements to website condom calculators, more often than not results show only those brands that the site sells. And he’s wary about buying a brand he’s not heard of before, or he might already prefer a brand which they don’t sell.

Made to measure condoms | Condomerie
Condom size calculator | Penis Sizes
Measurement Fitting (Calculator) | They Fit

Many websites also have charts which show at a glance that if your dick is ‘X’ wide and ‘Y’ long your condom size is ‘Z’. The trouble is, when we compared 6 sites, we found 5 different condom width sizes for a dick with a 155mm girth: 52, 53-57, 50-51, 50-53, 49-51 with a range in difference of 8mm (that’s nearly a centimetre). That’s enough for a condom to easily slip off a smaller dick or choke a larger one!

Condom companies

Even when you work out your condom size, the information provided by some of the major condom manufacturers makes for grim reading (or rather lack of it) – though well done Skins and Pasante!

Durex only has condom width (under the ‘more information’ link, assuming you find the tab)
Lifetsyles has no condom spec info next to condoms
Mates has no condom spec info next to condoms
Pasante has clear condom spec info next to condoms (under ‘additional information’)
Skins has clear condom spec info next to its condoms
Skyn only has condom width next to its condoms
Trojan has no condom spec info (though a ton of subjective reviews, some real customers we presume)

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Using condoms

 We just couldn’t give it to you straight, so here is our take on using condoms.

  1. If you’re going to fuck make sure you have condoms and lube to hand and remove all pets and ex-boyfriends from the area!
  2. Checking the use-by date first, take the rubber out of its wrapper avoiding sharp/jagged finger nails, teeth and cheap jewellery.
  3. With a thumb and forefinger pinch the end of the condom as this will get rid of the air and make room for the cum.
  4. Make sure it’s not upside down or you won’t be going anywhere!
  5. Roll it all the way down your dick. A hard dick makes this easier to do but it may go soft at this point. Simply work up some steam and – using a new condom, try again later.
  6. Place some lube on a finger or two and gently work it up his arsehole. He’ll get more pleasure if he’s relaxed and the condom is less likely to tear.
  7. Smother your dick with lube and ask him if he’s ready before putting it up his arse.
  8. Enter slowly, checking he’s OK. If you go in quickly you could hurt him. Once inside, off you go…   checking occasionally to see that the condom is still in place and intact.
  9. When you’ve finished, hold the condom at the base of your dick before pulling out. You don’t want to lose it up his arse do you?
  • Condoms do make a difference: You can’t feel as much and they can be awkward to use, BUT using them with lube every time you get fucked or fuck greatly reduces the risk of HIV infection and other STIs.
  • Condoms help protect against other sexually transmitted infections including gonorrhoea, syphilis, herpes, hepatitis, and NSU.
  • Wanking with condoms can also improve your technique and get you used to the idea/feel of using them.
  • Don’t leave condoms lying around for children to find as there is a risk of suffocation! Knot it, wrap it in a tissue or loo roll and bin it. (Not down the toilet, it may well bob back up).
  • Take a break… put on the kettle… leave… start again… or fall asleep in his arms.
Condoms and lube | GMFA

How to have anal sex | loveyourcondom.co.nz
Tony Duque se lo pone para ti | stopsida | 5 Mar 2015 | 2m05s
How to put a condom on | get sex educated | 17 Jul 2015 | 2m11s
How to put a condom on | Izzy Larry | 17 Aug 2015 | 1m33s

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Lubricants

Wonder of slippiness

While we’re probably preaching to the converted, arseholes and rectums are not self-lubricating. Though we may feel ‘wet’ at times, this small amount of natural mucus and sweat present (when fucking) can lead to discomfort, irritation, and infection without lube. We use 3 different types for sex:

  • water based lube
  • silicone based lube
  • oil based lube

Behaving similarly, they reduce the friction between whatever is going up your arse and the arse lining. However, you need the right amount of lube to do the job. Too much and the practicalities of what you’re trying to do become comedic/ faintly ridiculous. Too little and there is discomfort and pain (to both partners) and a risk of damaging the condom, the arse, or both.

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Water based lubes (condom compatible)

Water based lubes are considered the safest all-purpose lubricant choice. They do not damage or weaken latex condoms and, generally, do not irritate the inside of the arse. Particularly since the introduction of glycerine, they have come a long way since KY-jelly.

Water-based lubricants dry up eventually because your rectum absorbs the lubricant’s water content back into the body, leaving a sticky residue. Insufficient lubricant (of any kind) increases friction and is a major factor in condoms tearing or damage to the lining of your arse.

As a general rule a cheap-and-cheerful lube will work though dicks and arseholes may need re-lubing. More expensive lubes (often with glycerine) and sporting the latest in lube science will have more slippiness, lubiness, silkiness and smoothness.

Personal lubricant | Wikipedia

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Silicone based lubes (condom compatible)

Many of us find the texture of silicone-based lubes more pleasurable than other lubes and they certainly last much longer than water based lubes.

Silicone based lubricants don’t dry up because your arsehole and rectum is not capable of absorbing any of its components back into your body. It therefore stays there, goes further and lasts longer, but this in itself can cause ‘problems’: your lower intestine down to your arsehole can become a bob sleigh run and shit can shoot out at a moment’s notice!

It can also stain and thus be difficult to wash out of bedding and clothing, and it can cause damage to sex toys made of silicone.

Silicone based lubes like Wet Platinum, Eros, ID Millennium (there are others) are safe to use with all condoms, latex and polyurethane.

Personal lubricant | Wikipedia

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Oil based lubes (not condom compatible)

Oil-based lubricants don’t dry up because your arsehole and rectum is not capable of absorbing any of their components back into your body. It therefore stays there, goes further and lasts longer but this in itself can cause problems: your lower intestine down to your arsehole can become a bob-sleigh run and shit can shoot out at a moment’s notice!

If you’re into dildos or fisting then oil-based lubes are generally a better option because they last longer. If you have a fist up a mate’s arse, a comment like “excuse me, I’ve just got to pop out for some more lube”, doesn’t tend to go down well.

Oil-based lubricants and related oil-based substances weaken and damage condoms and should not be used together. These include baby oil, mineral oil, suntan lotions, cooking oil, petroleum jelly, butter or margarine, cold creams and skin lotions.

Personal lubricant | Wikipedia

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