Q&A: Gay/Bisexual Men

  1. How can I find a doctor that is gay-friendly in Rhode Island?
  2. If I only have oral sex, am I at risk for HIV?
  3. If I only have oral sex, am I at risk for STDs?
  4. If I am strictly a top, am I at risk for HIV with partners who are HIV+ or don’t know their status?
  5. When can I have sex again after I get treated for an STD?
  6. If I have an STD and have sex, do my chances of being infected with HIV increase?
  7. Could I have an STD or HIV and not even know it?
  8. I had anal sex with a guy recently without using a condom. What should I do?
  9. Is it safe to have anal sex without a condom as long as a guy doesn’t ejaculate while inside?
  10. Is HIV a big deal now that there are drugs to treat it?
How can I find a doctor that is gay-friendly in Rhode Island?

First suggestion is to check out the Men2MenRI.org website for doctors recommended by other gay men in Rhode Island.

Otherwise, although there is no official list of “gay friendly” primary care doctors in Rhode Island, here are a few ways to go about your search:

1.       Ask some friends for referrals.

2.        Directly contact doctors’ offices and ask if they have doctors that specialize in gay men’s health.

3.       Check out OPTIONS magazine, which often has information about gay-friendly health services and announcements from doctors who are accepting new patients.

4.       Fenway Community Health , located in Boston, MA, is dedicated to the health needs of gay/bisexual men and is the closest provider of its kind.

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If I only have oral sex, am I at risk for HIV?

Yes. It is possible for either partner to become infected with HIV or a STD through performing or receiving oral sex, although this is extremely rare.  There are some things that can increase the risk of HIV transmission during oral sex including:

 1.        If there is gum disease.

2.       There are cuts or sores around the mouth, throat or penis.

3.       If ejaculation occurs during oral sex.

4.       If other STDs are present.

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If I only have oral sex, am I at risk for STDs?

Yes.  You can become infected with an STD when performing or receiving oral sex.  Nearly every STD can be spread via oral sex, including herpes, viral hepatitis, chlamydia, gonorrhea, and syphilis.  Oral-anal (rimming) has also been implicated in transmission of hepatitis A and B and some other diseases.

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If I am strictly a top, am I at risk for HIV with partners who are HIV+ or don’t know their status?

Yes.  If you are a top, there are a number of factors that influence the chances of acquiring HIV from a HIV positive sex partner.   A lot depends on whether you have other STDs and whether your penis was exposed to any blood from his rectum.

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When can I have sex again after I get treated for an STD?

It is recommended that people treated by their doctor for non-viral STDs (such as syphilis, chlamydia, gonorrhea, and trichomonas) wait at least seven days after ending their treatment to have sex again.

It’s a different story for viral STDs (i.e., herpes, viral hepatitis) that there is no cure for.  Once infected with a viral STD, it is recommended that you not have sex when you have visible symptoms or don’t feel well, and that you always use condoms to reduce risk of transmission.

 

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If I have an STD and have sex, do my chances of being infected with HIV increase?

Yes.  Individuals can be up to five times more likely to become infected with HIV when other STDs are present.  STDs can cause sores and other breaks in the skin or mucous membranes, making it easier for HIV to enter the body.  STDs also cause inflammation, thus increasing the number of white blood cells in the genital area – the very cells that HIV targets most.

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Could I have an STD or HIV and not even know it?

Yes.  Many STDs and HIV do not have symptoms men can see or feel. The only way to know for sure if you have HIV or an STD is to have regular STD and HIV testing.  

It’s also important to learn what is normal for your body.  Get things checked out when something changes. Like a new or unusual discharge (yellow or white fluid) coming out of your penis.  Other things that may not be normal in men include: 

  • Pain when you have sex or urinate
  • Burning when you urinate
  • Bumps or sores around your penis, anus, or mouth
  • Pain in your testicles
  • Rashes on your body

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I had anal sex with a guy recently without using a condom. What should I do?

If you have unprotected anal sex with a guy whose HIV status you do not know, it is important to act quickly.  There are medications you can take, but you have to start them within 72 hours of having sex for them to work.

Depending on the day of the week and time of day that you may have been exposed, two options for getting care include contacting your primary care doctor for an immediate “urgent care” appointment, or contacting The Miriam Hospital Immunology Clinic by calling 401-793-2928 during regular business hours, Monday-Friday.

 

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Is it safe to have anal sex without a condom as long as a guy doesn’t ejaculate while inside?

No.  HIV can be transmitted through pre-cum during sex.  Men cannot control the release of pre-cum, so wearing a condom during anal sex is recommended.

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Is HIV a big deal now that there are drugs to treat it?

It is still a big deal.  Although there have been many medical advances to help people live with HIV,  here is a list of issues that people with HIV have to consider:

Most people with HIV will have to take medications for the rest of their lives. If they ever stop these medications, they will be at risk of dying from HIV/AIDS related diseases. These medications can include three or more drugs taken multiple times a day.

The medications used for HIV are relatively safe, but can have effects on brain function, metabolism, fat distribution, cholesterol, and kidneys. Long-term effects of many of these medications are unknown.

Even when compliant with medications, individuals with HIV are still at risk for a number of illnesses and conditions, including fungal and bacterial infections and cancers.

There are still many unknowns about how aging will impact the lives of people with HIV; however, as a person ages having HIV may increase the risk of kidney, brain, and heart disease.

The estimated health care costs over a lifetime for a person newly infected with HIV is estimated at $618,900.

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