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Wednesday, July 11, 2012

Issue: Gay Men - Unsafe and Safe Sex Practices

The Philippines is now recording seven new HIV infections a day, versus one a day before 2007, making it one of only seven countries worldwide where HIV infection rates continue to rise rapidly Government epidemiologists have warned that by 2015, the total number of HIV cases in the Philippines could reach 45,000 from the reported 7,000 cases in 2011.

Most-at-risk groups include men who have sex with men (MSM) / gay sex with 395 new human immunodeficiency virus (HIV) infections among within this group from January to September 2008 alone, 96% up from 2005’s 210 reported infections. A spokesperson of the National Epidemiology Center (NEC) of the Department of Health says that the sudden and steep increase in the number of new cases within the MSM /Gay community, particularly in the last three years (309 cases in 2006, and 342 in 2007), is “tremendously in excess of what usually expected,” allowing classification of the situation as an “epidemic". Of the cumulative total of 1,097 infected MSMs from 1984 to 2008, 49% were reported in the last three years (72% asymptomatic); 108 have died when reported, and slightly more MSMs were reportedly already with AIDS (28%).

Factor that put the Philippines in danger of a broader HIV/AIDS epidemic is increasing exposure to unsafe sexual activities include unprotected anal sex and any sexual activity that draws blood is . It is important to remember that the virus is transmitted by bodily fluids – for men this includes, blood, ejaculate and pre-ejaculate – entering the bloodstream. Remember that the risk goes both ways. For example, it is commonly believed that only the partner who is penetrated (the ‘bottom’) is at risk, but HIV can be transmitted to the partner who penetrates (the ‘top’) via small cuts and abrasions on his penis or via the urethra (the tube that carries urine out from the bladder through the penis.

Unsafe Sexual Activities
  • Unprotected anal sex, since the virus can enter the bloodstream through mucus membranes or small cuts or abrasions
  • Withdrawing before ejaculation, since pre-ejaculate fluid can contain the virus
  • Using pre-ejaculate as a lubricant prior to anal intercourse
  • Sucking ejaculate from the anus (felching)
  • Activities involving razors or shaving, as blood can be drawn from small nicks and cuts
  • Any sexual activity that draws blood.

Safe Sexual Activities

  • Sexual activities that are considered safe include:
  • Kissing
  • Cuddling
  • Stroking and massage
  • Masturbation
  • Mutual masturbation
  • Ejaculating on unbroken skin
  • Urinating on unbroken skin
  • Oral sex (with a condom or no ejaculate in the mouth)
  • Protected anal intercourse (using condoms).

Safer Sex Suggestions
Some suggestions for safer sex, including when to avoid some practices:

Anal sex – use condoms and plenty of water-based lubricant.

Oral sex – there are a small number of recorded cases of people getting HIV from performing oral sex and taking ejaculate into their mouth. In almost all of these cases, the person had herpes sores, wounds, cuts or infections in their mouth. It isn’t easy for HIV to enter the bloodstream through the mouth or throat when sucking. However, to be sure of being safe, the HIV-positive partner shouldn’t ejaculate into their partner’s mouth. To further reduce the risk, a condom can be worn. The HIV-negative partner should avoid performing oral sex if they have cuts or sores in their mouth, a throat infection, have recently undergone dental work or have just brushed or flossed their teeth.

Penetration of the anus with finger – avoid if there are cuts or abrasions on the fingers, hand or arm. To be absolutely sure, wear a latex gloves

Licking and kissing the anus (oral–anal contact or ‘rimming’) – HIV can’t be transmitted via oral–anal contact, but other diseases can. These include hepatitis A and intestinal parasites and bacteria (for example, shigella). Use a barrier such as a dental dam or clear plastic wrap (but not the ‘microwave-safe’ variety – it has tiny holes in it).

Urinating on skin – avoid this practice if there are cuts or abrasions on the skin. Don’t allow urine to come in contact with the eyes or mouth, in case there is blood in the urine.

Feces – HIV can be transmitted if there is blood in the faeces. Don’t allow faeces to come in contact with the eyes, mouth or cuts on the skin. Other illnesses, such as hepatitis and intestinal parasites, can also be transmitted by faeces.

Sex toys – always put a condom on any sex toy (such as a dildo) before use. Wash all sex toys after use with warm water and soap. Consider having a separate collection of sex toys for each partner.

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