Whoring around responsibly

One of the risks of being sexually adventurous is STIs - Sexually Transmitted Infections. I'm constantly amazed at how many guys who are out and about and whoring around are under-informed about them, and the precautions we can take to keep ourselves safer. I've mentioned in a previous post [see: Testing in Room 200] some of the things I do personally to help keep myself and others safe, but I want to go into a little more detail and offer some additional resources. 

There's a particular reason behind this post - I got a positive swab for gonorrhea at a quarterly PrEP checkup. I'm on PrEP - Pre-Exposure Protocol - which is a two-drug anti-viral medication taken daily which reduces to almost zero the chance of me contracting HIV. Because it can cause issues with liver and kidney function and other body systems, and because of the fact that anybody taking PrEP is by definition in a high-risk population for STIs, part of the treatment regimen is quarterly checkups with blood testing for HIV, syphilis, and hepatitis, urinalysis testing for chlamydia and gonorrhea, and then swab tests for the throat (pharyngeal) and ass (rectal) areas. Some doctors skip one or the other of these swab tests, which I think is STUPID, if you suck dick or get fucked in the ass... if your doctor doesn't order these tests at every quarterly checkup, I recommend you ask for the swab tests for any area where you come into contact with somebody else's mucus membranes. A friend of mine's doctor doesn't routinely swab his throat at PrEP checkups, and if I went to his doctor - I would not have gonorrhea, according to his lab. 

Chlamydia and gonorrhea are local - you get them in a spot on your body and they stay in that spot; they don't travel around your bloodstream like syphilis or HIV, so testing for gonorrhea in the urine will not tell you if you have it in the back of your throat, and you can pass it on to the next guy whose dick you suck. I've never had symptoms of gonorrhea; I don't know whether this has to do with my personal biology, or if it's the particular strains I've gotten, or what. So I haven't gone to the doctor with "Doc, I have this thing, it burns when I pee...." - I just go when it's time, or when somebody messages me and says, "You ought to go get checked."

If you're sexually active, you really ought to have a good gay primary care provider. If you can find one, a sex-positive provider is awesome. If you're in Dallas, I can highly recommend mine; if you want to get in touch, I'm happy to pass along his information. He's a Nurse Practitioner, and he stays current with all the newest and best information on sexual medicine for gay men, as well as general health information. Feel free to email me: rubmybutch (at) gmail (dot) com. If you don't have insurance, you can get connected with gay healthcare through a clinic like the Resource Center; there are similar ones in many big cities. If you're not sure how to look one up, send me a message and I'll try to help, or I'll do my best to hook you up with someone with connections who can.

Because I try to be responsible with my sexual choices, I contacted the partners whose information I have for the past month, and told them about my results. Because my test was only positive for one site, I could rule out many of my contacts - someone who sucked MY dick, but whose dick I didn't suck, would not be at risk at all. To get this from me, you'd have to have your cockhead rubbing against my tonsils. Fortunately, with the blog, I have a list. Unfortunately, with playing around at the bath house, I don't have names for many of the guys, or only first names - so, hopefully this post reaches a guy or two who I don't have contact information for. Baxter, Brian... you guys, I don't have your contact info. 

Gonorrhea in particular is becoming more problematic. Because we have been treating it for decades with antibiotics, we are now seeing strains that are resistant to many antibiotics. Previously, fluoroquinolone antibiotics were the primary line of defense, and if the infection didn't go away, doctors would resort to cephalosporin antibiotics, an intramuscular injection (shot in the butt cheek) of ceftriaxone (aka Rocephin). Now, because of the resistant strains, the high dose intramuscular injection of ceftriaxone is the preferred regimen. For the first time, I've now been advised to return in one to two weeks to confirm that it's gone - meaning that they are watching out for ceftriaxone resistance. This is a little scary. EDITED TO ADD: Got my results from the re-test a week later; confirmed that the antibiotic was successful. No more infection. 

A few more things you can do to help keep you safer, STI-wise: 

Condoms are always a smart choice. I don't like them, and I don't usually use them, but I can't argue sensibly against them on a basis other than not liking them. It's a risk I'm choosing with my eyes open. Speaking of which - did you know you can get gonorrhea in your eyes? You can - along with several other STI's. The things you learn!

You can get vaccinated for several things. I'm currently vaccinated against Mpox, Hep A, Hep B, and Meningitis (which has some crossover protection against gonorrhea, but apparently not enough for this particular case). Of course, getting vaccinated against flu, COVID, shingles, measles, etc. is always smart. You're out there swapping spit and who-knows-what fluids with other people; you will get their germs. 

I take Doxycycline PEP after a night of wild play. It doesn't catch everything (obviously) but it does give a significant layer of defense against a lot of unfriendly microbes. 

I recognize that I'm taking risks. I know that this is a down side, and I've decided to accept it. I balance it in my mind against the amount of pleasure and enjoyment I receive, and the sense of adventure and expansion I get in my spirit from the sexual fun that I have. I think of it like any adventurous sport - if you climb rocks, jump out of airplanes, ski down mountains, or scuba dive, you're going to get cut fingers, twisted joints, bee stings, snake bites... it's a trade-off. To me, it's WORTH IT.