How to take control of your sex life and your health

If you’ve updated your Squirt.org profile recently, you might have noticed that there have been some changes.

One of the changes that we’ve made is to better reflect the changing landscape of HIV and other Sexually Transmitted Infections – STIs – and the options available to us all in terms of managing and maintaining our health.

It’s not so long ago that wearing a condom or abstinence were the only choices you had when it came to trying to protect yourself against HIV and other STIs, but things have changed. We now have a lot more tools available to us all.

What’s changed?

Your Squirt.org profile now gives you the option to indicate your prevention choices from the following menu:

• – Condoms
• – PrEP
• – PrEP and Condoms
• – TasP
• – TasP and Condoms
• – Let’s Talk
• – Rather Not Say

What does this all mean?

To help my understanding of what these different options mean, I sat down with Jason Domino. Jason is a porn actor who has founded Porn4PrEP and also The Good Porn Project. He’s particularly clued up about sexual health.

“These options are listed under Sex Preferences, but it’s not really a preference – it’s about knowledge, it’s about choosing what’s right for you…” explained Jason.

Jason is a passionate advocate for ensuring that everyone has access to information about sexual health and access to the sexual health tools that are right from them.

“I’m always educating Uber drivers…” laughs Jason. “It started after a couple of friends of mine were diagnosed with HIV. I knew that if they’d had access to PrEP that they wouldn’t have contracted the virus. I felt an obligation to share what I knew with other people. We all have a right to this kind of information.”

“When I start a conversation with an Uber driver, or anyone really, I always assume that they’re straight and that they only know about condoms…” explains Jason. “I always start by saying something like – Have you heard about PrEP? It’s a pill that can prevent you from acquiring HIV. I follow that up by saying that a lot of people don’t know that if you’ve got HIV you can lead a long and healthy life, and effective medication means that you can’t transmit the virus to anyone else.”

“It’s a non-confrontational way of educating…” smiles Jason. “By talking in the third-person, by talking about what other people don’t know about HIV and the prevention tools, it’s a safe space for the Uber driver to ask questions and gain information.”

“There’s a low awareness about PrEP, but even less people know about TasP…” explains Jason. “TasP stands for Treatment-as-Prevention. It’s also commonly referred to as U=U, or Undetectable = Untransmittable. What it means is that if you have HIV and you are on effective medication, your viral load will be so low that it will be undetectable and there is no risk that you could pass it on to someone that you have sex with.”

“I was explaining TasP to one Uber driver, and it totally blew his mind…” remembers Jason. “One of his aunts had contracted HIV, and she had been totally excluded from the family – he hadn’t spoken to her in over five years. They told her that she needed to pray to God to take the virus away. Once I’d explained U=U to him, that her treatment meant that she couldn’t pass the virus on to anyone else, he stopped the car and called her to start to build those bridges back to the family. There were a lot of happy tears while he was on the phone. It made my trip home a little longer than expected, but it was worth it. I feel fortunate to be in the position where I can simply pass on a small amount of information about the hard work others have done – especially when it can reunite families and inspire hope.”

“What everyone needs to know is that there are a number of different STI prevention tools…” adds Jason. “You have a right to be able to find out what’s best for you and what you can reliably use so that you can enjoy an active sex life.”

A quick guide to the terminology:

• – Condoms – a sheath worn over the penis to provide a physical barrier to infection.
• – PrEP – pills taken to prevent HIV.
• – PrEP and Condoms – taking pills and using condoms to prevent HIV and other STIs.
• – TasP – you have HIV but are undetectable and can’t transmit the virus to anyone else.
• – TasP and Condoms – HIV untransmittable and using condoms to prevent other STIs.
• – Let’s Talk – Encourages a conversation about sexual health.
• – Rather Not Say – Not keen to discuss sexual health.

How do I put this into practice?

I spoke with health specialist Matthew Hodson of NAM Aidsmap for his insights on these different options.

“The idea that safer sex begins and ends with using condoms is out of date…” explains Matthew. “Someone who is HIV+ and undetectable on treatment doesn’t pose any transmission risk to sexual partners. PrEP, when used correctly, is almost 100 percent effective, and certainly offers greater protection against HIV than condom use alone. Condoms still play a role in safer-sex. Condoms also prevent the transmission of other STIs, and for some men they’re preferable to the prospect of taking drugs to prevent acquiring HIV.”

“Condoms are a good strategy…” confirms Jason. “But, they’re not right for everyone. Maybe you’ve got piercings. Maybe you have erection issues when trying to put on a condom. Maybe it’s not always possible to negotiate condom use. It’s great that there’s now other options also available.”

For those of us who are a bit older, it can be hard to shake those early safe-sex messages that condoms were the only way to prevent HIV and save lives.

“For many gay and bisexual men, condom use has become intertwined with morality and notions of being a good gay man…” agrees Matthew. “That notion has caused harm. Telling someone that they’re wrong or disordered because they prefer to have sex without condoms, only serves to alienate them from sexual health messaging. Condoms are good for gay and bi men because they prevent transmission of infections  –  but that doesn’t make condom use morally superior to other methods of preventing HIV acquisition.”

“Testing is fundamental…” adds Jason. “The more information you have, the better equipped you are. You can make active and informed choices. It’s also important to remember that these conversations are continuing to evolve. Don’t feel embarrassed if you feel like you don’t know something or would like more information. We all have to stay up-to-date with the latest developments.”

“If you’re sexually active, you should get a full sexual health screen at least once a year, more often if you have had several sexual partners…” confirms Matthew.

“Using condoms when you fuck will prevent transmission of many STIs, but you can also acquire and transmit STIs – such as gonorrhoea – through oral sex. The more regularly people are screened for STIs, the earlier that they’re diagnosed and cured, and the less opportunity there is to pass on the infection.”

All photos feature Jason Domino and Hans Berlin | Photo: Matt Spike