Be Smart When You Bareback

HELLO! I’M ALEXANDER CHEVES. MY NICKNAME IS “BEASTLY.” I AM A WRITER, AUTHOR, AND SEX EDUCATOR. I GIVE ADVICE — NO QUESTION IS OFF-LIMITS. TO ASK ME SOMETHING, EMAIL ASKBEASTLY@GMAIL.COM OR SEND ME A MESSAGE HERE.

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I enjoy your honesty and open discussion. I love barebacking! I know the risk of it and understand its consequences. How common are hep c and herpes and do cum dumps contract them? 

Hi pig,

If you’re a cum dump, you probably already have a strain of HPV and are likely to have genital herpes. Although I haven’t experienced an outbreak yet, I probably have herpes and certainly have some strains of HPV. If you’re a sexually active man who has sex with men, your likelihood of having one of these sexually transmitted infections is almost guaranteed. These are the two most common STIs in the world — so common, in fact, that there’s no real point in testing for them. In men, they’re often asymptomatic, meaning you’ll likely never experience any symptoms.

For HIV-positive men like me, some strains of HPV can increase one’s chances of anal cancer, and in women, HPV can cause cervical cancer, but for the most part you don’t have to worry about these. Get anal Pap tests and HRAs every six months to monitor any cells is your butt that might be precancerous. This is recommended for most sexually-active gay men and certainly all HIV-positive gay men.

You asked specifically about herpes, which is insanely, ridiculously common and nothing to lose sleep over. Having herpes (there are two kinds, oral and genital) is not a sign of irresponsibility or recklessness. It’s just a sign that you’re a sexually active adult.

According to the World Health Organization, two-thirds of the general population under 50 have herpes simplex virus type 1, or oral herpes. When WHO released this data a few years ago (I covered it in Plus), they also revealed that their data suggests herpes simplex type 1, or oral herpes, is a common cause of genital herpes (herpes simplex virus type 2).

Both types of herpes are often asymptomatic, which means most people will never know they have either and never experience symptoms. Some may experience mild symptoms that never go recognized as herpes at all. I may have had herpes for years, but I’ve never been tested for it and have never had an outbreak. And until someone tells me I should worry about herpes (no one has), I’m going to keep living life as a cum dump. There’s no cure for herpes, but being such a mild infection, I don’t worry about it.

I have HIV, another incurable STI that is no longer worth living in paralyzing fear over thanks to modern anti-HIV meds. I fear cancer and getting gunned down by a lunatic with a gun, but not HIV. Educate yourself about how HIV is spread and treated, and learn about PrEP, a pill you should talk to your doctor about taking if you are HIV-negative and sexually active. PrEP prevents HIV transmission for HIV-negative folks. If you’re routinely taking anonymous loads and are HIV-negative, PrEP is something you should look into immediately.

Now, on to Hepatitis C. Hep C is more common among HIV-positive guys, particularly those of us into fisting, which is why I get tested for Hep C every time I do a routine STI/STD screening, which happens every three months (if I’m having a lot of sex, I go more frequently). Hep C, or HCV, isn’t statistically higher among men who have sex with men, according to Positively Aware. The only population with a higher rate of HCV is those of us with HIV. Of all the people living with HCV in the United States (3.5 million), 25% of them have HIV.

The most common way Hep C is spread is through injection drugs and sharing needles, so don’t do that. A doctor once told me that Hep C is so commonly associated with drug use that when someone tests positive for it at his hospital, they assume the patient has been using injection drugs.

As someone with my own experience with drugs, I know saying “Just don’t do them!” is sometimes not an option, but at least try not to share needles, or try to always use a clean needle every time. There are needle exchange programs in cities across the United States worth looking into if you’re injecting.

If you test positive for Hep C, keep in mind that the testing process is two-part. First, take an HCV antibody test. If the antibody test is positive, you should take a second HCV viral load test to confirm that you are chronically infected with HCV. You need to both because one in four people clear the virus within six months of infection naturally. If you’re told, “You are positive for hepatitis C because you tested positive for the antibody test,” follow up with the question, “Are you sure? Did you confirm that antibody result with an HCV viral load?” If they didn’t do a viral load test, ask for one.

You didn’t ask me about HIV, but I’m going to touch on it again. If you’re HIV-positive, take your meds as prescribed (daily). This is how you can become undetectable and therefore unable to infect others.

If you’re being a cum dump or even just enjoying lots of bareback sex, all this is relevant and pertinent information — information you should do more research on before getting started in a lifestyle of high-risk sex. Taking anonymous loads, being a cum dump, or whatever you want to call it is an extremely high-risk sex practice. There is a 100% chance that you will get an STI. Over the course of a few years, you will probably get many. Have a place where you can routinely get thorough, full-range STI screening (at least once a month). Have a doctor you can be honest with and tell them you don’t like to use condoms. If they judge you or berate you, find a new doctor.

Have good health insurance. Better yet, have friends in healthcare. Accrue friends who also don’t like to use condoms who monitor their own health seriously. Talk to them about this stuff. Have a support network.

Without this knowledge, you’re making uninformed choices, and without this medical and social support, you’re jumping into high-risk sex without any safety measures. High-risk sex is perceived by many to be irresponsible, but that’s a slut-shaming value judgement that doesn’t matter to us. You’re not wrong or sick or ill for wanting bareback sex. You’re not irresponsible or reckless or dirty. You just like what you like. You’re allowed to enjoy what you want so long as you are informed of the risks and take necessary steps to keep yourself and your partners safer. The healthcare approach for someone enjoying high-risk sex is responsive rather that preventative, but this is what many gay men choose to do and enjoy — myself included.

Taking anonymous loads is so much fun. It’s one of my favorite ways to spend a night. And it’s rare that I spend that night 100% sober. But being sexually adventurous is irresponsible if you’re not informed, aware, and smart.

Love, Beastly

7 Comments

  1. If you’re going to mention hep C, you really should also mention that it’s easily cured, assuming that your insurance or some other organization will cover the rather steep cost. There’s a lot of help available in many areas if you can’t afford it… the Magnet sexual health clinic in San Francisco can help you get treated free of charge, for example, if you have no other access.

    Liked by 1 person

  2. Great article. Although it wasn’t part of the question, and only briefly mentioned in the answer, my biggest concern about condomless sex generally are the reports about drug resistent gonorrhea. I’d love to get your thoughts and maybe current data about that.

    Like

  3. While HIV positive individuals are at higher risk of HPV related cancers, this is still a risk for all MSM which can be reduced by the HPV vaccine. Another thing you should check with your doctor.

    I wouldn’t know about access to it in the US, but is currently available via the National Health system in Scotland and on a trial basis in England to all MSM under 45.

    (In males, HPV is associated with 80-85% of anal cancers, 6-71% of oropharyngeal cancers and 50% of penile cancers [4, 5]. Additionally, HPV types 6 and 11 cause approximately 90% of genital warts in both males and females [6]. HPV- associated cancers, particularly anal cancer, disproportionately affect and are more common in MSM compared to heterosexual males. )

    Click to access HPV_MSM_programme_report_2018.pdf

    Like

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