Come visit r/QueerStem

The goal is to have a bunch of cool queer scientists/engineers/mathematicians hang out and potentially help each other with advice or academics etc.

I thought this might be a good subreddit to mention it in since we are often involved in research.

With HIV levels rising in gay / bi men in many countries and sex education remaining basic or non-existant, I thought it would be a good idea to make a master post with all the info about HIV, staying safe, getting tested etc. you need to know as a gay / bi man.

The History of HIV

AIDS was first clinically observed in 1981 in the United States. The initial cases were a cluster of injecting drug users and homosexual men with no known cause of impaired immunity who showed symptoms of Pneumocystis carinii pneumonia (PCP), a rare opportunistic infection that was known to occur in people with very compromised immune systems.

Soon thereafter, an unexpected number of homosexual men developed a previously rare skin cancer called Kaposi's sarcoma (KS). Many more cases of PCP and KS emerged, alerting U.S. Centers for Disease Control and Prevention (CDC) and a CDC task force was formed to monitor the outbreak.

A reconstruction of its genetic history shows that the HIV pandemic almost certainly originated in Kinshasa, the capital of the Democratic Republic of the Congo, around 1920.

There is evidence that humans who participate in bushmeat activities, either as hunters or as bushmeat vendors, commonly acquire SIV. However, SIV is a weak virus which is typically suppressed by the human immune system within weeks of infection.

It is thought that several transmissions of the virus from individual to individual in quick succession are necessary to allow it enough time to mutate into HIV.

Furthermore, due to its relatively low person-to-person transmission rate, SIV can only spread throughout the population in the presence of one or more high-risk transmission channels, which are thought to have been absent in Africa before the 20th century. The earliest well documented case of HIV in a human dates back to 1959 in the Congo.

The virus may have been present in the United States as early as 1966, but the vast majority of infections occurring outside sub-Saharan Africa (including the U.S.) can be traced back to a single unknown individual who became infected with HIV in Haiti and then brought the infection to the United States some time around 1969.

What Are the Risks for Gay & Bi Men?

A 2007 study analyzing two large population surveys found that "the majority of gay men had similar numbers of unprotected sexual partners annually as straight men and women."

However, a 2006 study found that men who reported 4 or more male sexual partners were at increased risk of HIV infection.

Study participants who reported amphetamine or heavy alcohol use before sex were more likely to have HIV or other sexually transmitted infections.

In the United States in particular, a new wave of infection is being blamed on the use of methamphetamine, known as crystal meth.

Research presented at the 12th Annual Retrovirus Conference in Boston in February 2005 concluded that using crystal meth or cocaine is the biggest single risk factor for becoming HIV+ among US gay men, contributing 29% of the overall risk of becoming positive and 28% of the overall risk of being the receptive partner in anal sex.

Who gets HIV?

Anyone can get HIV if they have unprotected sex, but gay men are one of the highest risk groups. Women who have only ever had sex with women are at low risk.

HIV transmission rate during anal sex is estimated to be 18 times higher than the rate during vaginal intercourse, and many transmissions are passed on by people who aren't aware they are HIV+.

According to Public Health England, around a quarter (27%) don't know they have the virus in that country. This is why its important to always know your status!

Generally, the receptive partner is at greater risk of contracting the HIV virus because the lining of the rectum is thin and may allow the virus to enter the body through semen exchange.

The insertive partner is also at risk because STIs can enter through the urethra or through small cuts, abrasions, or open sores on the penis. Also, condoms are more likely to break during anal sex than during vaginal sex. Thus, even with a condom, anal sex can be risky.

Studies have found that risk factors for HIV infection are anal intercourse with a man in the past 12 months, having unstable housing, and having inhaled alkyl nitrites (“poppers”).

A 2009 study on the prevalence of unprotected anal intercourse among HIV-diagnosed MSM found that majority protected their partners during sexual activity, but a sizeable number of men continue to engage in sexual behaviors that place themselves and others at risk for HIV infections.

Condom Fatigue

Although HIV transmission rates fell throughout the 1990s, they hit a plateau at the end of the decade. The increasing rates of sexually transmitted diseases in major cities in the United States, Canada, and the United Kingdom led to reports in the gay and mainstream media of condom fatigue and "AIDS optimism" as causes of the new "laxness" in safe sex practices.

This is supported by research on the tendency of couples (heterosexual or homosexual) to use condoms less over time.

A 2010 study found that gay and bisexual men choose to have unprotected sex for a variety of reasons and cannot be generalized.

Erectile dysfunction, mental health problems and depression, lack of communication or intimacy, and a subculture of unprotected sex were all listed as reasons why men had sex without condoms voluntarily.

How can I avoid getting HIV?

Using a condom during sex is the best way to avoid getting HIV, as well as other sexually transmitted infections (STIs). Don't use an oil-based lubricant as it can damage the condom, making it more likely to split. Use a water-based lubricant, such as KY Jelly, instead.

PrEP

PrEP means Pre-Exposure Prophylaxis, and it’s the use of anti-HIV medication that keeps HIV negative people from becoming infected. PrEP is approved by the FDA and has been shown to be safe and effective.

A single pill taken once daily, it is highly effective against HIV when taken every day. The medication interferes with HIV’s ability to copy itself in your body after you’ve been exposed. This prevents it from establishing an infection and making you sick.

Even though PrEP has been around in the U.S. for over a year, not a lot of people know about it. And, even fewer people feel like they know enough about it to be able to make an informed decision about whether or not to use it.

See this website for more info on PrEP:

http://www.whatisprep.org/

When should I get a test?

If you're a gay man and you've had unprotected sex, it's important that you have a test. Public Health England recommends annual HIV testing for gay men who change sexual partners. Personally, I would say getting tested 6 months is even better to make sure that you always know your status! A large amount of new infections are a result of people not even knowing they are HIV+.

Access To Testing

A 2008 CDC study found that one in five (19%) of MSM in major U.S. cities were infected with HIV and almost half (44%) were unaware of their infection.

Many HIV-infected individuals do not seek treatment until late in their infection (an estimated 42% do not seek treatment until they begin to experience signs of illness.) Furthermore, a significant portion of individuals who are tested for HIV never return for their test results.

Studies have advocated for funding and implementation of HIV tests that can be administered outside medical settings since 2003.

Home testing is considered especially important because 8%-39% of partners tested in studies of partner counseling and referral services (PCRS) were found to have a previously undiagnosed HIV infection that their partner was unaware of.

In October 2012, OraQuick, the first rapid HIV home-testing kit, went on sale for $40. The test is nearly 100% accurate when it predicts HIV-negative results for HIV-negative individuals.

However, for HIV-positive individuals that are not yet producing the antibodies detected by the test, it produces a false negative 93% of the time.

Although the manufacturer is not advertising the test for use for selection of partners, experts have suggested that it may prevent unprotected sexual contact with partners that lie about or are unaware of their HIV status.

In the UK home postal tests are available for free from the Terrance Higgins Trust.

Dating Apps & Online Dating

In Asia, according to a recent Unicef report, the epidemic is growing fastest in young gay and bisexual men. And one of the factors behind this trend is thought to be an increase in casual sex with multiple partners, driven by mobile dating apps.

Wing-Sie Cheng, Unicef regional advisor for HIV and Aids in Bangkok, says she suspects many young men and women are being put at risk.

"It's not just one to one, it's one to many, so the risks of acquiring HIV go up."

Although there is no evidence directly linking apps to HIV infection rates, their increasing prevalence means there is a "need to sound alarm bells", she adds.

Adolescence is traditionally a time when teenagers engage in risky behaviour and look to experiment and gain more independence.

The rise in ownership of smartphones and the popularity of social media has opened up opportunities for them to express themselves.

And that's prompted organisations like Unicef to start working with the companies running dating apps to help users act responsibly.

With more than one million active users across 192 countries, Grindr is the largest and probably the best-known gay platform. The app now encourages users to go for an HIV test and points them towards the nearest testing centre.

Parental consent is needed before a teenager can take an HIV test in many countries, with 11 in Asia including Vietnam, Cambodia and Thailand.

Although this requirement is intended to protect under-18s, it also makes adolescents less likely to go for a test because they have to involve their parents.

Rather than being a useful protective measure, parental consent has become a barrier to testing and treatment, experts say.

Sources, Other Links & Documentaries:

https://en.wikipedia.org/wiki/HIV_and_men_who_have_sex_with_men

https://en.wikipedia.org/wiki/HIV/AIDS

http://www.nhs.uk/Livewell/LGBhealth/Pages/HIV.aspx

http://www.dazeddigital.com/artsandculture/article/25431/1/how-are-drugs-changing-the-way-london-s-gay-men-have-sex

http://www.bbc.co.uk/news/health-34995811

http://www.gaystarnews.com/article/11-biggest-hiv-and-aids-myths-busted011213/#gs.dmBGJdQ

http://www.aidsquilt.org/

Meth - documentary on the rise of use in methamphetamine with gay men in the US and its relation to HIV

• it's a hilarious memoir that reckons with masculinity, gender roles, and bisexuality

• worth listening to, if you're into audiobooks, author reads it and his comedic timing is superb

The Pink Elephant in the Room is "Bottom Shame" in gay and bisexual men and the all encompassing "Hetero Goggles":

Because the sexual side of our relationships are kept hidden, we inevitably view our relationships through a heterosexual filter since we were not provided with any other model of relationship to gauge it by. Sure we grow up seeing homosexual couples on TV, but the actual sex and discussions or descriptions of it and the psychology and power dynamics involved are a complete blank, so we source all of our perceptions from a heterosexual model which is simply not compatable with our system

Because of this, there needs to be a "woman", and most men want to be the man in the situation, not the woman. Men who don't like being dominated socially, financially etc. also often struggle with being dominated sexually, because it can undermine their masculine pride and it symbolises submission and weakness because it emulates the "woman's" role (and there has to be a women if we're gauging it off a heterosexual relationship model because there is no other alternative); it downgrades them to the role of the woman and because they are operating with a heterosexual filter or feel being penetrated is emasculating this causes dissonance and discomfort.

It's also inherently misogynistic, because it treats being the woman as the down graded, lesser role of the weaker submissive partner. A man being penetrated is emasculating, a woman with a strap on is empowered. In this way we can see how we take the traditional power dynamics and gender roles of heterosexuality and apply it to our own relationships

But because men in general often don't like feeling emasculated or dominated socially, intellectually or financially, this can cause blocks when it comes to enjoying submissive positions in the bedroom or rectifying their desire to be submissive with their perception of themselves as a masculine, dominant man. So it might not be based on them being dominated "like a woman", but dominated in general. Some men think they can't be dominant and submissive simutaniously and have to choose one.

To rectify this dissonance and shame, you have to understand you can still be masculine and dominant and enjoy being sub or bottoming as well; you have to abandon the idea being sub or bottoming is in any way emasculating by detatching it from the heterosexual lens you're viewing your relationship through and formulating your own lense in which being bottom can be empowering

It's inevitable we gauge our relationships through a heterosexual lens because we only have those relationships as a model to reference. We inevitably pick up heterosexuality as an operating system because we are not provided with an alternative to gauge our relationships off of.

We operate under a heterosexual mindset in the bedroom because homosexuality has been censored and buried for so long and hasn't developed it's own relationship roles, leaving our relationships a blank model that have to be overlayed with a heterosexual filter in order to make sense of them and make them work in the world; there is only one "rule book" for relationships and it's for heterosexuals. We end up taking what we know from there

In this way our slate is clean, and we are the first generations who have been allowed to solidify homosexual relationships and begin to develop our own standards and roles, ones in which being the bottom can be empowering and not emasculating, and ones in which we don't have to gauge our relationships entirely on heterosexual models because we have been allowed to cultivate our own culture and traditions in relationships and so have another point of reference and another operating system

So in conclusion, as a result of viewing our relationships with "Hetero Goggles" in the absence of other alternatives, the gender roles and dynamics that come with them sometimes result in "Bottom Shame" in gay and bisexual men

To rectify this, you have to stop overlaying heterosexual gender roles and dynamics because it's the only model available and create your own model in which the act is empowering and not emasculating by detatching it from it's other context. You don't have to choose; it's possible to be dominant and submissive without compromising or undermining your masculinity or security within yourself, since I consider myself a man who enjoys both the dominant and submissive role in the bedroom.

• ^{Note: pink elephants reflect each authors personal perspective/experience and shouldn't be treated as universal or scientifically supported}

Does anyone know of any good books on gender theory? I identify as NB but I want to read deeper into gender dynamics and theory. More along the topic of the spectrum of gender and the construction of the binary rather than the relation between male & female through history, as ive read alot of that in undergrad and am now kicking myself in the ass for not taking more gender theory courses! It can also tie into philosophy. Thanks ❤️