The Ins and Outs of Gay Sex (46 page)

Unfortunately, STDs are so prevalent that total abstinence is your only sure way to prevent catching one.

Rectal bleeding is a potentially serious problem.
Most men notice it after a bowel movement, either on toilet paper or in the bowl.
Although rectal bleeding most often results from hemorrhoids, it also can be a sign of other more dangerous conditions, such as cancer or colitis.
Try treating slight bleeding that stops soon after your bowel movement with stool softeners (see
Chapter 2
) and soaks in a warm tub.
When bleeding persists for more than a day or two or continues long after your bowel movement is finished, see your doctor.
Dark-red or maroon rectal bleeding or associated symptoms such as pain, fever, or pressure in your rectum are far more serious and merit immediate evaluation by your doctor.

Herpes and warts are very common and nothing to be embarrassed about.
I always advise honesty with partners, especially during a genital wart or herpes outbreak when you are highly contagious.
When warts or herpes blisters are limited to your anus, your penis might be safe for masturbation or oral sex.
Unfortunately, even if your treated warts or herpes went away, you may still be infectious.
Condoms are fairly protective but must be worn from the start of close physical contact.
Always wash your hands and any areas where semen lands immediately after sex, and tell your partner to do the same.
Soap and water can go a long way toward eliminating many STDs before they take hold.

Although the Centers for Disease Control advises HIV-negative men
against
all sex with HIV-infected partners, many gay men have it safely.
Knowledge is key.
Know your risks and make your decision accordingly.
Masturbation is safe, but keep his semen away from any cuts or sores on
your body.
If your HIV-positive partner wants to penetrate you (mouth or anus), make him wear a condom.
Many physicians and HIV experts warn against “deep tongue kissing,” but there has never been a documented case of HIV transmission from it.
If you have HIV, you must protect your partner even if he doesn’t want it.

You probably can’t.
When erect, the average penis really is 6 inches long and 1.
3 inches in diameter.
(Get out those rulers.
) When soft, penis size has much greater variability.
And as we all know, you can never predict how big it’s going to get when it gets hard.
Cock rings and pumps help some men add a little length to their penis by drawing in more blood and keeping it there, but priapism (inability to lose your erection) is a danger.
(And imagine how thrilled your partner will be while he waits for you to “inflate” your dick!
) Penis-enlarging operations are dangerous with often disappointing and possibly disfiguring results.
Viagra and other medications designed to treat impotence may make your erection stiffer, but they won’t increase size over what you normally have.

It happens, and there is nothing you can do about it.
My advice is to ignore it, and your doctor probably will too.
I guarantee that you are not the first person who got hard in his exam room.
Some men find their doctor’s touch arousing (especially if he’s poking around your anus or penis), and some may even be attracted to their physicians.
Some apologize for their erections, but it isn’t necessary.
If you feel you must say something, try making light of it.
Humor will help relax you, and Mr.
Happy might just go back to sleep.
Please don’t ask your doctor for a date, because that
puts you both in an awkward and potentially unethical situation.

Big toys or fisting can be dangerous.
Any stiff, long object may not negotiate the natural bend in your colon and tear through the wall—an extremely dangerous situation that requires emergency surgery to repair.
Thick toys (especially fists) can damage your sphincter muscle and may eventually lead to an inability to control your bowels.
When choosing a toy, make sure it’s soft and pliable.
And always use common sense:
If it hurts, don’t force it in.

Anal stimulation has a strong psychological component, and some men find that large toys satisfy them both emotionally and physically.
If you find a partner who can’t compete with what you have stored in your closet, you may not find him fulfilling.
Even if you’re used to large toys, most penises will need to stretch you for penetration and this should still feel pleasurable.
You might, however, reach the point where you really need to feel opened to the limit for satisfaction, and most men can’t do it for you.

Usually not.
A penis stretches your sphincter during anal sex, but it usually regains its tone (strength) soon after your partner pulls out.
So unless you’re in the habit of going to the doctor right after sex, he or she probably won’t find anything other than a normal sphincter.
Fisting and large toys, however, can stretch your sphincter sufficiently so that your doctor senses a difference.

I always advise honesty with your physician when answering questions regarding your sexuality and anal sex—especially if you have a problem “back there.”
Anal intercourse exposes you to many STDs and potential medical
problems that your doctor might not think of unless he or she knows you’ve partaken in those delights.

That depends entirely on your definition of “safe.”
When most men talk about “safe,” they refer only to their risk of catching HIV.
But that isn’t enough.
Oral sex (even kissing) can pass most STDs, including herpes, syphilis, gonorrhea, genital warts, hepatitis, and urethritis, between partners
without
ejaculation.
Sure, you may not catch HIV, but you might take away something other than his phone number from the experience.

Fellatio is relatively low risk for HIV—especially if your partner doesn’t ejaculate into your mouth.
There have been suspected cases of HIV infection after oral sex, so to be truly safe, insist partners wear condoms.
Spitting out semen after a partner comes in your mouth probably doesn’t add protection, because your greatest risk occurs when his semen bathes your gums and oral tissues.
Some men also believe not brushing their teeth before oral sex protects them from HIV, but I have never seen research to support or refute this conclusion.
I believe that not brushing offers no added protection, because tiny sores are always present around your gums from chronic irritation and poor dental hygiene.

Rimming carries almost no risk of HIV transmission, but again you can catch other infections, including diarrhea and hepatitis, from it.

Don’t ask, because your doctor’s not going to tell.
It’s unethical for a doctor to discuss another patient’s condition with you—even if you want only his name.
If you plan to hit on someone you see in the waiting room, don’t expect your doctor to help.