Take control – get the sex you want
Ultimately, it's down to you to take control of your own sex. Information resources, such as this website, can give you all the knowledge that you will need to prevent transmission of HIV, but it's up to each individual to choose whether or not to follow this advice.
However, there are reasons why you may not always have control in sexual situations. These may be:
- drugs and alcohol affecting your ability to stay in control
- someone taking control from you by using force or intimidation
- problems that you have coming to terms with your sexuality or sexual behaviour.
Drugs and alcohol
The gay scene is largely based around pubs and clubs, and so it's not surprising that alcohol and drugs play a large part in many gay men's lives. In fact over 90% of us drink alcohol.1 It can make you feel more relaxed, more sociable and loosen your inhibitions. Drug use can do the same and can help you to forget the working week, or alter the way you're feeling. Nearly 20% of us have used drugs such as ecstasy and cocaine in the last year, and about 40% have used poppers. A lot of us use more than one type of drug.1In fact, we're around ten times more likely to use some recreational drugs than the general population.2
There's no doubt that drugs and alcohol change the way you think and feel. With some drugs the effect is dramatic – like the high you get from E – and with others it can be less so. Lots of people use drugs and alcohol without losing control, while others find that they can neither control their drug and alcohol use, nor what they do when they use them. However, even subtle effects from drugs or alcohol can alter your judgement, perceptions and the decisions you make. You may find that when you are drunk or off your face, you do things you would not do when you are sober. This could include things like telling yourself that it's OK to have unprotected sex with someone 'just this once'. That's why it's important to plan for safer sex.
If you intend to drink alcohol or take drugs when you go out, take condoms and lube with you, or know where to get them. This should help to increase your chances of using condoms when you need them. Condoms are the most effective way you can plan for safer sex, but there are other ways of reducing the risks if you don't use condoms.
Thinking about the kinds of sex you want and don't want can help too. If you know your sexual boundaries when you're sober it will make you more likely to make the same choices when you're not. If you're informed about the kinds of sexual risks you're happy with, you can make the right choices for you, even if you've taken drugs or had a drink.
Limiting the amount of drugs and alcohol you take can be easier said than done. The effects of drugs and alcohol depend on many things, like the amount of food you've eaten or the general mood you are in before taking them. However, if you know your limits and try to stick to them you are less likely to regret your actions or any decisions that you make whilst under the influence.
You could also have an agreement with your mates to look out for each other. If you're out in groups it's easier to spot if someone's had a bit – or a lot – too much.
It's important to be informed about the drugs you take. Some drugs not only affect the way you think, they can also increase the risk of HIV transmission.
Poppers (amyl nitrite) has been linked with an increased risk of HIV transmission when used by a negative guy whilst being fucked by a positive guy without a condom.3 This may be because poppers can cause the blood vessels in your arse to dilate, which gives the virus a better chance of entering the bloodstream. It may also be linked to the fact that poppers can relax the arse muscles making it easier for some men to get fucked, and for longer.
Some researchers also think that Viagra could have a similar effect by allowing fucking to continue for longer than if the drug isn't used, especially if mixed with other drugs.3
Drugs such as coke, crystal or ecstasy may make you more vulnerable to infections, including HIV.4 Crystal meth has also led to an increase in the level of viral load in HIV-positive men, which means that they will be more infectious.5
While some drugs may facilitate transmission, drugs are not the cause of HIV. Whether you take drugs or not, using condoms is the best way to protect yourself and your partner.
Many people manage their drink and drug use without problems. However, over 30% of gay men in London worry about their alcohol consumption and over 20% worry about their recreational drug use.1 If your drinking or drug use is causing you concern, or you want some information about drink, drugs or safer sex, the links below may help.
Antidote offers information and support exclusively to the LGBT community around drugs and alcohol. Whether you want to cut down or stop using or drinking, or want information about keeping safe, try www.antidote-lgbt.com.
You can also find out how counselling could help by visiting the counselling section of our website.
If it's basic drug info you're after, you could also try www.dancesafe.org, www.talktofrank.com or drugfucked.tht.org.uk. You might think the information on some drug websites is a bit patronising at first, but they are a good place to learn the basics so you can keep yourself safe.
Rape and sexual assault
It's important to remember that you have the right to agree to, or refuse, any type of sex with any adult. You also have the right to change your mind at any point if you have agreed to something but then choose not to do it. If you get into a situation where you feel that your partner is not respecting your rights to refuse any type of sex, or is trying to get you to do something after you've told him that you don't want to do it, get out of that situation immediately – even if it happens in your own home or with your regular partner.
Male sexual assault is not rare. In any one year, around 7% of gay men have been forced into having sex which they didn't want.6 Having control taken away from you not only puts you at risk of HIV transmission when you are raped, but it can also have an impact on your ability to take control of sexual situations in the future.
If you get raped, there are some things you may want to do. Both male rape and sexual assault are illegal. Whether or not you report your attack to the police is a personal decision that only you can make. The police have made considerable progress in recent years in responding to reports of male sexual assault and if you decide to report the attack it is their duty to listen and respond appropriately. You will get access to counsellors and advisers as part of the police process and, as the crime is reported, the person who raped you may be prosecuted. However you also need to be aware that helping the police build a case against your attacker may mean long hours going over the attack and reliving it. There is also a medical examination. It will help the police to build a case against your attacker if you report it immediately and do not wash prior to the examination.
If you are HIV-negative and you are put at risk of HIV transmission during the attack, you may want to consider accessing PEP. You will need to do this within 72 hours of the attack, but the earlier you access PEP, the more likely it is to be successful.
There are other agencies that provide help and support to men who have been raped or assaulted.
Survivors is an agency that provides face to face counselling and support groups to victims of male rape and childhood abuse. Their website is www.survivorsuk.org. They have a helpline on Mondays, Tuesdays and Thursdays from 7pm to 9.30pm on 0845 122 1201, or you can contact them at email@example.com.
The Ambrose King Centre is a GUM clinic that has a specialist service for men who have been sexually assaulted. They can be contacted on 020 7377 7306.
There are also three specialist centres in London with experienced professionals who offer medical help, counselling and practical and emotional support. You can contact these centres directly on the numbers below.
Haven Camberwell: 020 3299 1599
Haven Paddington: 020 3312 1101
Haven Whitechapel: 020 7247 4787
You can also access counselling, or if you need someone to talk to immediately you can call the Samaritans on 08457 90 90 90.
Being confident about your sexuality and sex life
When we were young, most of the messages that we received about gay people, from our family, teachers and other children, were negative. We absorbed these messages before we knew we were gay. When we realise that we are gay it is easy for these negative messages to influence how we feel about ourselves and other gay men – particularly as some of the negative messages about being gay are given to us by people that we love and respect.
Likewise, some of the messages we receive from the media can negatively impact on how we feel about ourselves. It is impossible for most of us to live up to the image of gay men that requires us to be young, fit, devastatingly attractive and ready for sex at all times.
Most gay men overcome their conflicting views about being gay, but some can't. This can lead to people not valuing themselves, which may undermine the control they have in sexual situations.
For some gay men, the sex, drugs and disco lifestyle may become too much. It can be great to have the freedom to have sex with who you want, when you want, but some people can get trapped by this and getting sex turns into an obsession.
Sometimes, just recognising why you may not be comfortable with your sexuality will help you deal with it better. Most gay men find that they become more confident in their sexuality as they get older, but changing your behaviour may take more than information websites such as this can provide. If you have difficulty in coming to terms with your sexuality, or you feel that you don't have control over the sex you're having, you might want to consider talking to a professional about it. The GMI Partnership offers free counselling that can help you deal with your problems.
People often say 'it just happened' if asked why they had sex that wasn't as safe as they wanted it to be. This is just an excuse. Sex of any type never 'just happens'. Even if there is no verbal communication, you know when you are going to have sex, you know when you are about to fuck or get fucked without a condom, and you have an opportunity to take responsibility for your actions and communicate whether or not you are agreeing to the sex.
Interviews conducted by GMFA suggested that many HIV-negative men believe that it's up to HIV-positive men to take responsibility for stopping the transmission of HIV, as they are armed with the knowledge of their own infection. However many HIV-positive men felt that it was up to the HIV-negative man to make the effort to prevent himself from becoming infected, and that anyone who was willing to have unprotected sex was probably positive already.
The truth is that if we want to halt the spread of HIV it's up to every individual to take responsibility.
The HIV-positive man has responsibility because he has the potential to inflict harm and the means to avoid inflicting harm.
The HIV-negative man has responsibility because he has the motivation and the means to avoid personal harm.
If you don't know your HIV status then you have the responsibility to ensure that your behaviour does not endanger either yourself or your partner.
Unsafe sex between gay men, HIV-positive and HIV-negative, is behind the spread of HIV in the gay community. Both positive and negative gay men in the UK engage in high-risk sexual activity (specifically, fucking without condoms) with men whose status they do not know, or whose status they know to be different from their own. This means that whatever your own HIV status, you can't rely on your partner to take responsibility for preventing the spread of HIV. Whether you want to protect your partners or protect yourself, it's up to you to take responsibility.
The easiest and most reliable way of getting control of the sex you have is to ask for what you want. It's very common for people to make assumptions about what other people want. It's also very common to blame other people for not knowing what you want. But the simple truth is, none of us was born with the ability to read someone's mind. The same is true in sexual situations – you can't expect your partner to magically know what type of sex you want. If there is something specific that you want to do or don't want to do, tell your partner.
If the type of sex you want is bit unusual, or you are in a situation where it is difficult to talk (like saunas or backrooms) then communicating what you want may require a considerable amount of interpersonal skills and self confidence.
However, for most of us, letting someone know that we want to use condoms when we fuck isn't that hard – you just say it. You can communicate the same message by discussing what you want to do when you have sex or what you don't do. "I want to use condoms if we fuck" communicates the same message as "I don't fuck without condoms". If you really feel like you can't talk, just reach for a condom – he'll get the idea. Find a way of communicating about the type of sex you want that is comfortable for you. Few men are going to react in a negative way if you talk about condoms. And if they do, you should start questioning whether or not you want to have sex with them anyway.
It's also best to communicate whether or not you want to use condoms earlier rather than later. If you find out that you want different kinds of sex, it's better to know this before you have sex rather than while you're having it.
Communicating that you use condoms when you fuck implies nothing about your HIV status. The majority of negative men and men with HIV use condoms most of the time.
And just as you have the right to communicate what you want, so does your partner. If he asks you to do something that you don't want to do, just be clear with him that you don't want to do it. Don't take offence or feel pressurised into doing something that you don't want to. By asking you for something he is clearly giving you the opportunity to say no.
Even when there is no verbal communication about the sex you are going to have, there is always a point where you know what is going to happen. This is the point where you either communicate that you don't want to do something, or agreement may be assumed through your silence.
If you have difficulty saying no to sex that you don't want, you might want to consider going on an assertiveness course. Or if there are particular issues in your life that you feel you need to address, you might benefit from accessing the free counselling services offered by the GMI Partnership.
1 Hickson F, Weatherburn P, Reid D, Jessup K, Hammond G. Consuming passions: findings from the United Kingdom Gay Men's Sex Survey 2005. Sigma Research, 2007.
2 Home Office. Drug misuse declared: findings from the 2009/10 British Crime Survey. Home Office Statistical Bulletin, July 2010.
3 Macdonald N, Elam G, Hickson F, Imrie J, McGarrigle CA, Fenton KA, Baster K, Ward H, Gilbart VL, Power RM, Evans BG. Factors associated with HIV seroconversion in gay men in England at the start of the 21st century. Sexually Transmitted Infections, 2008;84(1):8-13.
4 Nair MPN, Chadha KC, Hewitt RG, Mahajan S, Sweet A, Schwartz, SA. Cocaine differentially modulates chemokine production by mononuclear cells from normal donors and human immunodeficiency virus type 1-infected patients. Clinical and Diagnostic Laboratory Immunology, 2000;7(1):96-100.
5 Ellis RJ, Childers ME, Cherner M, Lazzaretto D, Letendre S, Grant I and the HIV Neurobehavioral Research Center Group. Increased human immunodeficiency virus loads in active methamphetamine users are explained by reduced effectiveness of antiretroviral therapy. Journal of Infectious Diseases, 2003;188:1820-1826.
6 Reid D, Weatherburn P, Hickson F, Stephens M, Hammond G. On the move: findings from the United Kingdom Gay Men's Sex Survey 2003. Sigma Research, 2004.