Twitter Facebook Instagram Google+ Tumblr YouTube E-Mail WhatsApp Sign In Check Close snapchat
Search
Exit Clear
Just The Tips Just The Tips

Just The Tips: I Want to Have Unsafe Sex

Just The Tips: I Want to Have Unsafe Sex: © Andrew Brookes / Corbis

© Andrew Brookes / Corbis

Dear Just The Tips,

It’s becoming increasingly hard for me to not have sex without a condom. I’m a gay man, and I’m interested in certain kinds of sexual subcultures: daddies, sex parties, glory holes, dark rooms, etc. I have friends who participate in those things, and I’m intrigued. I’ve been on Truvada, a preventative for HIV infection, for a year. I do all the things to maximize its effectiveness. I take it at the right time and get my prescription refilled regularly. Part of me feels like I should go off of it so I really make sure that I don’t have sex without a condom!

I don’t want to be the odd man out in certain situations, especially because I am a man of color, and being that guy who says, “Hold on, let me get my condom,” at a sex party feels lame. What should I do?

Feeling Unsafe

My Dearest,

The party line on this particular question is and probably always will be: Have safe sex. Take the birth control, take the Truvada and put the sock on the foot before you put it in the shoe.

If you are having sex with a penis using a condom, it gives you a lot less to worry about: pregnancies, STIs, awkward conversations and, my personal nightmare, thousands of dollars in medical bills.

So, as your consigliere in this matter, I am obligated to tell you to have protected sex. Period. It is the best option.

HOWEVER I am also human and I am aware that intercourse without a condom can feel really good. What. Are. We. To. Do. About. THAT.

“A how-to guide for unsafe sex” is murky territory, and I wade into it with trepidation because, as I said, it’s NOT the best option. However, as consiglieres before me have done, I’ll go there. I’ve employed the help of a professional—Dr. William Dewitt is an HIV specialist and primary care doctor who works the Callen-Lorde Community Health Center, one of the premiere medical facilities for LGBT health issues.


STAY ON TRUVADA
It’s easy to think that if we expose ourselves to risk and make ourselves more vulnerable (i.e. go off our HIV preventative meds) we will make better decisions in the moment. Uh-uh. That’s kind of like not giving a bunch of horny teens condoms and expecting they won’t have sex. Newsflash: Abstinence-only education states have the highest rates of teen pregnancy. Stay on your meds.

A WORD FROM THE DOCTOR
Dr. Dewitt says that the question of condom vs. no condom is interesting and “one that no longer has a simple answer.” Here he lays it out for us:

“Safer sex” used to mean a latex or polyurethane barrier. Period. But there have been studies that show HIV preventative medication (“PrEP” such as Truvada) is at least 85 percent effective in reducing relative risk as compared to a placebo group, which is at least as effective as condoms as reported in “real world” studies done by the CDC.

Although a latex or polyurethane barrier blocks HIV viral particles almost 100% in the lab, the CDC’s “real world” analysis shows the effectiveness to be somewhere closer to 80%. This is seen because of human error; improper storage (hot, cold or shearing), imperfect placement, improper removal, and any bit of oil can compromise the barrier and can cause small or large tears. Also people often don’t use condoms from START to FINISH.

Obviously, condoms are all we have against the much more common buggers (gonorrhea, chlamydia, herpes, syphilis, etc). However, all of them are easily transferred by oral sex of the fellating or cunni/analingus varieties. I’d venture to say that almost no one thinks twice about unprotected oral sex.

So what does all of this mean? Condomless sex is now different from unprotected sex. PrEP alone does provide a large degree of protection when taken as prescribed. Having condoms AND Prep is like seatbelts with airbags. Together they can drop your individual risk to a number that is vanishingly small. I think bottom line. As an HIV doctor, I can’t call a perfectly adherent patient choosing not using condoms 100% irrational, but they are accepting a higher degree of risk. But I also wouldn’t put out a PSA saying that the era of the condom is over just yet.

GET TESTED
If you are having unprotected sex make sure you’re getting tested. Dr. Dewitt says you should do this every three months, and sooner if you have symptoms or were told by a partner that you’ve between exposed. Make sure your provider tests everything you use. Tongues and toys count! So does “dipping” (when you insert just the tip of the penis into an orifice). Gonorrhea and chlamydia are rather “sticky.” They jump bodies much easier than blood borne HIV. You should swab your throat and anus if they are even MARGINALLY involved. Testing just using urine won’t catch asymptomatic infections elsewhere. If you’re under 27 you should jump at the chance to get the HPV vaccine (to help prevent genital warts as well as cervical and anal cancer) through your insurance.

RACE AND SAFE SEX
I do not want to downplay what you’ve mentioned at the end of your question. The fact that you are a man of color in these sexual situations makes you feel like you stand out. The history of the sexual health of black men in this country is fraught with atrocities such as the Tuskegee syphilis experiment in which men in rural Alabama were told by the U.S. Public Health Service that they were receiving free health care when in fact they were being used to study the natural progression of untreated syphilis. That experiment only ended in 1972.

Even today black male sexual health is woefully under-addressed, and men of color are often fetishized for their perceived sexual prowess or virility. Your feelings of “lameness” are operating on an interpersonal level and yet, as you probably know better than me, carry with them a deeper cultural history.

May I be so bold as to quote the illustrious James Baldwin in this matter? In an interview, when asked whether being “black, impoverished and homosexual” made him feel disadvantaged, he responded by saying, “No, I thought I’d hit the jackpot. It was so outrageous you could not go any further…so you had to find a way to use it.”

There is a deep irony in the levity of Baldwin’s response. “Using” a position that has been historically oppressed socially (and sexually) is no small task and not one that can always be achieved. It’s not on your back to stop feeling self-conscious about your color at sex parties; it’s on your community to find ways to make space for difference.

Whether or not you choose to have sex with a condom, race will continue to be a factor in yours (and all of our) sexual lives. Condoms will not prevent that. Neither will a lack of condoms. I would venture to say that that is a good thing. These are conversations need to be had, even (and especially) at a sex party.

xK


Just the Tips is Playboy.com’s weekly advice column, with professional matchmaker Katherine Cooper. Have a question for Katherine about sex, love or dating? Shoot her a note at justthetips@playboy.com.


More From Just The Tips See all Just The Tips