Getting What It Takes

^{Risk... and me
Drugs, alcohol and their effects
Beyond the condom}

Risk... and Me

Risks may seem inevitable in life. Some are unpredictable, others are chosen. When it comes to evaluating sexually transmitted infections (STIs), it is not always easy to evaluate the risk of transmission. Can I get HIV/AIDS by performing fellatio? Can I get gonorrhea if I don’t swallow any semen? What is low- or high-risk sexual behaviour? Many questions come to mind.

One thing is certain, anal sex without a condom exposes you to greater risk of contracting HIV and all other STIs. For this reason, using condoms for this practice is strongly recommended. Nevertheless, the decision to take a risk or to not take one is far more complex than knowing that you have to use a condom.

Behaviours that can promote the transmission of HIV

No risk
•    kissing, including giving tongue and exchanging saliva.
•    mutual masturbation without contact with pre-ejaculatory fluid or semen
•    body rubbing, massages, caresses, etc.
•    using unshared sex toys, used with a condom or cleaned after use

Low risk
•    oral sex (fellatio, cunnilingus)
•    anal or vaginal penetration with a condom
•    rubbing genital organs if there is contact with pre-ejaculatory fluid or semen

High risk
•    anal or vaginal penetration without a condom
•    shared use of dildos or sex toys
•    sharing needles or injection equipment (drugs, steroids, etc.)
•    tattooing and body piercing using unsterilized equipment

What factors lead me to take risks?

When there is anal penetration, decisions are made quickly and you don’t have the time or you don’t feel like thinking about using a condom. Even if at the beginning of the sexual encounter you intended to use a condom, passion sometimes wins out over reason. This is deeply human but unfortunately places us in a position of vulnerability in which emotions and body pleasure can win out over our knowledge about using condoms and our concern for sexual safety.

Some triggers can ignite this passion and promote risk taking. Such events can blur our internal frame of reference—our values, beliefs, our knowledge—to the point that we suddenly do what only seconds before would have been unthinkable:
•    Desire. The desire we feel for the other person, but ESPECIALLY, the other person’s desire for us. It seems to intensify and justify the desire to have anal sex. When we feel that the other person desires us and when he communicates this with his body heat, the initial intention to use a condom may change.
•    Trust. When we trust the other person, we feel closer to him. This feeling can strongly motivate us not to use a condom. After all, we know each other! The decision to trust someone or not to trust someone is usually based on criteria we set for ourselves, consciously or not.
•    Intuition is also a factor mentioned when the time has come to place your trust in someone. There are people with whom the connection is instantaneous, inexplicable. It’s a question of feeling, chemistry, an impression of familiarity. And familiarity motivates trust.

Some men have no criteria for trust but can nevertheless have criteria for mistrust. Generally speaking, when you mistrust a sexual partner, you tend to use a condom for anal sex, to choose other sexual practices, or to avoid contact with semen and other body fluids.

Sexual preferences

While anal penetration is the preferred sexual practice, the risk of not using a condom is higher. According to a Montreal study of 1,800 men who have sex with men (the Omega Cohort Study), anal penetration can have a different meaning for each individual:
•    Aspect of fusion/total communion with your partner
•    Favour/privilege, for example, with your boyfriend only
•    Playing games of domination and submission
•    Sexual maturity, the impression of having reached sexual maturity if you practise anal sex
•    Ultimate pleasure, enjoyment•    Sadomasochistic violence

The meaning given to anal sex also represents a factor that will influence the decision to use or not to use a condom.

I failed just once…

Putting on a condom is a simple action that saves us a great deal of stress because it prevents our exposure to risk. The condom is still the best method for protecting our sexual health.

In reality, however, at least once in our lives we probably think “to hell with the condom!” Sometimes, under the effect of drugs or alcohol, our perception of risk changes. People who fail to use the condom may feel ashamed, guilty, angry, panicked, judgmental of themselves, and isolated. In this case, we must remember that once is not a habit. Talking about our experiences and our emotions with a friend or resource person can help us get through a somewhat uncomfortable situation and help us to reinforce our personal strategies with regard to this failure.

Drugs, Alcohol and Their Effects

Drugs and alcohol may make you feel more self-confident and less shy. In the gay community, drug and alcohol use and their impact are often trivialized. Recreational drugs are perceived as being “in” and quite harmless.

While these substances can bring pleasure, they are not without consequences. The important thing is to make informed choices and to set limits. For example, do you tend to accept anal penetration without a condom (given or received, top or bottom) under the effect of drugs or alcohol? If yes, what strategies could you use to reduce your risks in terms of the transmission of HIV or STIs?

Substance + Individual + Context = Effects

The effect of a substance depends not only on the substance itself but also on the context and on the psychological and physical characteristics of the person taking the substance.
•    Substance: When you take a drug, you never know exactly what you are taking because nothing guarantees its composition. In 2003, an analysis of 100 ecstasy pills revealed that 44% contained only MDMA (the active substance in ecstasy). As well, 10% of the pills contained no drug, and 8% contained unknown substances. You should also remember that a drug’s effects depend on the dose you take and on the way you take it (sniffed, smoked, or injected, for example).
•    Individual: Your psychological state can have an impact on the substance you use. For example, you are at risk of having a bad trip if you drink a lot of alcohol when you are going through a hard time. The effect would not necessarily be the same when you are tired as when you are in great shape. It is therefore important for you to know your limits. See how you react—the feeling you get when you take the drug, the state you are in when the high is over—and then adjust your use if you need to.
•    Context: The context in which you take a substance also has an impact on its effect. For example, you are more likely to have a pleasant experience if you take the substance with a close friend or friends rather than alone.

 Beyond the Condom

Despite the omnipresence of sexuality in our society, it seems easier to talk about it in a magazine or on television than in the bedroom, facing another person. Especially when there is a question of safe sex. Why is it so difficult to bring up the question of using condoms? So difficult in fact that we prefer to take a risk in silence and even to compromise our health rather than to discuss the issue frankly.

The decision to use a condom is above all a question of individual responsibility. You decide for yourself the kind of sexual life you want to live. It is important to ask ourselves why we use condoms or why we don’t use them. What is our perception of the condom? Does this represent a burden, an obstacle to spontaneity; or rather is it an opportunity to explore sexuality with total abandon and without risk?

Practising alone

Learning about sexuality, the discovery of your body and the pleasure it gives begins with masturbation. You are your first sexual partner, so why would learning about a condom be different? All the more so because you can take your time. The middle of passionate sex is not the time to stop and see how a condom is made, to check out its texture, or the best way to put it on, etc.

Practising putting on a condom during masturbation is the ideal way, both for beginners and for the experienced. The fact that you already use it regularly does not necessarily mean that you put it on correctly or feel at ease when you are using it. The idea is not to always masturbate with a condom, but to try it a few times, to get used to this little piece of latex. The more you use a condom, the easier it will be to make it part of your sexual life, and the less you will have the impression that it puts a damper on spontaneity. For those of you who lose your erection when you put on a condom, masturbation is a good time to learn: “What makes me lose my erection?” By looking for the causes, you will find solutions. Nevertheless, if you have good reason for thinking that the cause is psychological or physical, it would be good to consult a physician. It’s up to you to explore!

Fear

Fear is a factor that can prevent us from talking about condoms with a sexual partner:
•    Fear of what the other person will think of me.
•    Fear that the other person thinks differently from me
•    Fear of rejection
•    Fear that he will get angry
•    Fear that he thinks I have HIV or an STI
•    Fear that he’ll say no

Fear is irrational and often the cause is just in our mind. It is important to know your fears and to check their foundation in reality. We may be surprised to find out that the other person also wants to use a condom without quite knowing how to bring up the subject. If the contrary is so, if the partner refuses to use a condom, it is your right to ask yourself whether this man is desirable to the point of taking a risk.

Myths

Myths are other factors that can keep us from talking about condoms. They are preconceived notions, not founded in reality, notions we hold by which we justify unprotected anal sex. For example:
•    He would tell me if he were HIV-positive or HIV-negative.
•    If he’s not putting on a condom, he must be HIV-negative.
•    I often have sex without a condom and I’ve never gotten HIV. I must be immunized.
•    “Tops” can’t get it.
•    If he is ejaculating in me, he must be HIV-negative.
•    I am HIV-negative. I assumed he was too.
•    I am HIV-positive. I assumed he was too.
•    Not using a condom is a way of showing trust.

How do we know that we know? What are these conclusions based on? Whatever justifications we give ourselves, it doesn’t change the reality that by having unprotected sex, we risk exposing ourselves to HIV and other sexually transmitted infections. We must get informed and verify our beliefs.

Barebacking

In the middle of the ’90s, a movement promoting the deliberate refusal to use condoms appeared in the United States. In Canada, there was also an interest in barebacking by some gay and bisexual men. Barebacking is intentional active or passive unprotected anal penetration between partners who are either both HIV positive or of unknown HIV status, knowingly taking risks. Barebacking is different from the occasional failure to use a condom because it involves the intention not to use a condom.

Barebacking can result in many reactions. The sexual risk taking connected to barebacking can have major impacts on our individual and collective health. We must also remember that each person’s sexuality is different, something that contributes to our diversity. It is a form of communication, of self-expression, of contact with the other person, of pursuit of pleasure and intimacy. It can also fill a void, be an outlet for stress, or a form of giving yourself value. The important thing is to be able to experience your sexuality while respecting your limits and those of your partners.