Tag: HIV

Anal sex myths post header featuring three butt plugs: silicone, glass, and stainless steel.

4 Anal Sex Myths You Should Stop Believing

Published on by Amy

Anal sex is probably one of the most misunderstood sex acts of all. It carries an allure for a lot of people, whether they want to be on the giving end or the receiving end or both. However, it also scares a lot of people. This is, in part, due to incorrect assumptions and beliefs. Anal sex myths can scare people off who might otherwise be interested in trying this type of play. They can also lead people to engage in dangerous behaviours or take unnecessary risks due to a lack of knowledge.

Here at C&K, we’re all about fact-based and non-stigmatising information. So let’s bust some anal sex myths, shall we?

Anal sex always hurts

This is perhaps one of the most harmful anal sex myths, and actually likely leads to more avoidable pain and injuries. After all, if you think anal is supposed to hurt you’ll be more likely to push through pain, which can be dangerous. In fact, though anal can be intense and some mild discomfort can be normal, pain is your body’s way of telling you that something is wrong.

With proper lubrication, warm-up, enthusiastic consent, and communication with your partner, anal sex does not need to be – and should not be – painful. If something hurts it’s time to adjust, add more lube, or stop for now.

And by the way: those “numbing” or “desensitizing” lubes designed for anal sex? Avoid them at all costs. The ingredients in them can be harmful, they increase your risk of injury, and (frankly) if you have to numb your body to engage in a particular sex act, then you probably shouldn’t be doing that thing at all.

Anal sex isn’t pleasurable for the bottom

This particular myth always strikes me as really sad, particularly when I see questions from people who are trying to grit their teeth and force themselves into anal sex they don’t want to please their partner.

Anal sex isn’t pleasurable for everyone and, if you don’t enjoy it, then you shouldn’t do it! However, if you do want to, it can be just as pleasurable for the bottom (the person being penetrated) as for the top (the person doing the penetrating.) Think about it: if anal sex wasn’t pleasurable for the receptive partner, why would anal sex toys such as butt plugs and prostate massagers be so popular?

One of the reasons that anal sex can feel so pleasurable for cis men and other people assigned male at birth is due to the prostate. Approximately the size and shape of a walnut, this gland is located just below the bladder and in front of the rectum. It is responsible for producing some of the fluid in semen and, when stimulated, it is incredibly sensitive.

However, anal sex isn’t all about the prostate, and can be just as pleasurable for receptive partners who do not have one. There are still tonnes of highly sensitive nerve endings in and around the butt, which can feel incredible. And, of course, it is located close to the genitals. According to a 2022 study on (cis) women’s experiences of anal pleasure: “[the anus] contains a dense network of sensory nerves that participate with the genitals in the engorgement, muscular tension and contractions of sexual arousal and orgasm.”

Yes, it’s even possible for some people to have an orgasm from anal sex without any direct stimulation of the genitals! Aren’t bodies awesome?

Anal sex is only for gay men (or: all gay men have anal sex)

Wrong on both counts! Many of the most common anal sex myths centre on sexual orientation, from who engages in it to what it means about your sexuality if you do.

Firstly, anal sex is for anyone who wants to have it. We all have a butt, after all! Liking or not liking anal sex doesn’t imply a single thing about your sexuality. Your sexual orientation is about who you’re attracted to, not which acts you want to do.

Also, not all men who have sex with men (MSM) have anal sex. One 2011 survey of almost 25,000 gay and bisexual men in the US found that only 35% of respondents had had anal sex during their last sexual encounter. Some queer men do it regularly, some do it occasionally, and some never do it at all. All of this is completely normal and awesome.

You can’t get pregnant, so anal sex is safe sex

It’s true, of course, that a person cannot become pregnant from anal sex. This doesn’t mean, though, that anal is a risk-free form of sex.

In fact, when it comes to the transmission of STIs, unprotected anal sex is actually riskier than most other kinds of sexual activity including unprotected vaginal sex. However, it’s easy to mitigate this risk with a few basic precautions.

The best way to protect yourself and your partner(s) is to use a condom every time you have anal sex. If you choose to go barrier-free for anal – which I only recommend in the context of an ongoing relationship with someone you trust – make sure that both you and your partner(s) are having regular sexual health screenings.

You might also want to ask your healthcare provider if pre-exposure prophylaxis, or PrEP, is suitable for you. PrEP is a daily medication for people at risk of exposure to HIV, whether through sex or through drug use. According to the CDC, it reduces the risk of contracting HIV through sex by about 99% when used as directed.

Have questions about anal sex? Not sure if something you’ve heard is accurate? Let me know and I’ll try to answer them in a future post.

FYI: this post was sponsored. All writing and views are, as always, entirely my own.

STI test blood sample tubes

What Happens When You Go for an STI Test

Published on by Amy

Yesterday I went for my quarterly sexual health check-up, also known as an STI test. This is an important part of my life as a non-monogamous person and it’s now a really normal, routine, “no-big-deal” thing. But that wasn’t always the case! When I went for my first STI check-up at age 19, I was incredibly nervous mostly because I had no idea what to expect.

So let’s answer some common questions, shall we? Please bear in mind that my experiences are entirely based in the UK, so if you live in a different country your experience may vary somewhat.

Where do I even go for a test?

There are sexual health clinics or “GUM” (genito-urinary medicine) clinics at most major hospitals and at some smaller practices too. Just Google “sexual health test + [your town]”.

Some clinics have “walk in” times where you just turn up and wait to be seen. Bear in mind these tend to be VERY busy – I arrived 15 minutes before the clinic time officially started for my test, and still waited about an hour. Get there early, bring a book, and don’t expect to be seen in five minutes. Alternatively, some clinics have bookable appointments, where you ring up and book like any other medical appointment. Again, these services are very busy and in-demand so you might need to wait a couple of weeks to be seen. If you have symptoms, explain this at the clinic or on the phone and you may be seen sooner.

Do I have to pay?

Nope! In the UK, all sexual health services including testing and contraception are free of charge. Praise the NHS.

If I’m under 16, will they tell my parents?

No! As long as you’re over 13, you’re entitled to the same medical confidentiality as anyone. If your provider feels that there is a serious risk to your safety going on, such as sexual abuse, they may need to tell someone in order to keep you safe, but according to NHS guidelines “the risk would need to be serious and this would usually be discussed with you first”.

Also, if you’re under 18, get off my blog. This is not the space for you. Get yourself to Scarleteen.

Do I have to answer questions about my sex life?

Your provider will ask questions about your sexual practices so they can make sure they’re giving you all the tests and advice you need. You don’t HAVE to answer anything you don’t want to, of course, but it’s important to be as honest and thorough as you possibly can to make sure you get the best care. Everything you say is in strict confidence. Questions may include:

  • When was your most recent sexual encounter?
  • What is the sex of that partner? (They may assume opposite binary sex unless you tell them otherwise. It’s bad practice but heteronormativity is strong).
  • Is that partner your regular/only partner?
  • Have you ever injected drugs or knowingly had sex with someone who injects drugs?
  • Do you have reason to believe you might have come into contact with HIV?
  • Have you been raped or sexually assaulted? (If you indicate yes, they’ll ask if you need any support or resources).
  • Have you ever paid for, or been paid for, sex?
  • Have you had sex with someone born outside of the UK?
  • When was your last sexual health screening?
  • Are you pregnant or do you think you might be pregnant?

Once you’ve gone through these preliminary questions, it’s time for your test.

How is a test carried out?

There are slight variations depending on the clinic but here’s how it normally goes:

For folks with a vulva, you’ll swab the inside of your vagina and possibly provide a urine sample.

For folks with a penis, you’ll provide a urine sample and may also swab just inside your urethra.

If you engage in receptive anal sex, you will swab just inside your anus.

If you engage in oral sex, the health care provider will swab the back of your throat.

Unfortunately, anal and oral swabs are not always offered as a matter of course. You may need to prompt your provider for these. I strongly advise you do so, as infections can grow in these areas of the body without being present in the genitals.

The provider will then do a blood test to check for blood-borne STIs such as HIV, Syphilis and Hepatitis. (You can get a vaccination against Hepatitis B and if you haven’t had the vaccine, I recommend you ask your provider for it. This is most commonly offered to men who have sex with men, or women who have sex with bisexual men, but I really believe everyone should get it if possible).

You do the vaginal and rectal swabs yourself in private, either behind a curtain in the consulting room or in the bathroom. Your provider will give clear instructions on correct insertion of the swabs. There is not usually a need for a genital examination unless you have any symptoms such as genital warts, a rash or pain.

Does the test hurt?

Not really. Throat, anal and vaginal swabs aren’t exactly comfortable but shouldn’t be painful either, and they only take a couple of seconds. Some men do find the urethral swab slightly painful but, again, you only need to go very slightly inside and it only takes a few seconds.

Some people (hi, I’m one of them) find blood tests make them feel a bit sick and lightheaded. If this is you, tell your provider and they’ll let you lie down and should check on you at every stage. The actual test feels like a brief quick scratch, nothing more.

Will my provider judge me for the things I tell them?

They really shouldn’t. I’ve been getting STI tests regularly for 10 years and only a couple of times encountered a judgemental provider. And yes, I always tell them I’m non-monogamous and exactly how many partners I’ve had since my last test.

Your provider’s job is to help ensure your health and safety, not to judge you. If you feel that they are overly judgemental or they make inappropriate comments about the things you tell them, you should report this to the hospital or practice.

Again: this is really rare. Most sexual health professionals are absolutely lovely. Comments I’ve had on explaining my lifestyle range from “sounds like you have lots of fun!” to “it’s great to see you’re being responsible and taking care of everyone’s sexual health”.

Even the judgy comments were hardly “you’re a filthy slut and you’re going to hell”. They were more along the lines of, “you need to be aware that you’re at high risk for STIs and unwanted pregnancy” (“no I’m not, because I take precautions and know the facts”, I did not say but wanted to).

How and when will I get my results?

Many clinics operate a “no news is good news” policy, meaning that if you don’t hear from them within two weeks you can assume everything is fine. But they should also give you a card or phone number with details on how to check your results if you want to be sure. I always recommend you phone, as it is rare but possible for a clinic to lose your samples. This happened to my partner once, and they didn’t call to let him know he needed to be re-screened until after the two week window had passed.

Other clinics may text or email you (usually something simple like “your tests or all fine”) or, less commonly, ring you to let you know you’re in the clear.

What if I do have something?

If you do have an infection, they will ring you to let you know. Then you’ll make an appointment to go back to the clinic and make a plan for treatment. For most of the common STIs, such as gonorrhea and chlamydia, treatment is a simple course of antibiotics.

For more serious STIs it’s more complicated (if you have HIV, for example, you’ll be on medication for the rest of your life – but you can still live a totally normal, long and fulfilling life). STIs are not a death sentence. They are not a source of shame. They’re things that humans sometimes contract in the course of doing normal human activities like having sex – and it’s much better to know so that you can get the most effective treatment quickly.

Bear in mind that HSV (herpes) and HPV (human papillomavirus) are EXTREMELY common – most of us are carrying one, the other or both and may never even know it! – and are not picked up on standard screenings unless you have symptoms such as warts. HPV can also be picked up on cervical screenings, so if you have a vagina make sure you go for your smear tests.

But STI testing is just for sluts!

Nope! Everyone, and I mean everyone, should be getting tests. Stigma like this, that people who go for tests are inherently slutty (and that being slutty is bad) contribute to the misinformation and fear-mongering that are already far too ubiquitous in our culture.

How often should I get a screening? 

That really depends.

My partner and I go every three months because we are non-monogamous and quite promiscuous. Three months is also about the longest incubation period for any of the known STIs, so this schedule means that if we do contract something we are unlikely to have it for long without finding out.

If you’re a swinger, polyamorous or have a lot of casual sex, I really recommend the three-monthly schedule. At an absolute, absolute minimum, please try to go every six months.

Even if you’re in a monogamous relationship, it’s wise to test every now and then if there’s ANY possibility that either of you has had sex outside of your relationship at any point. Unfortunately, cheating is rife and many people have caught STIs this way and not known they had them for months or years.

Whatever your relationship style, I recommend a test before every new sexual partner where possible.

Anything else I need to know?

Many clinics offer free condoms and, less commonly, dams (for oral sex on vulvas). Don’t be afraid to ask for supplies or take them if they’re offered to you. Using barriers is the best way to protect yourself and your partners from STIs.

When did you last get tested? If it’s been a while, go and book one in!

Header image for a post about meaningful things to do for World AIDS Day

Five Meaningful Things To Do for World AIDS Day

Published on by Amy

December 1st is World AIDS Day. The AIDS epidemic, at its height in the 1980s and early 1990s, is still in many ways ongoing and has claimed over 35 million lives in the last ~40 years. Check out this fact sheet to learn more.

From the World AIDS Day website:

[World AIDS Day is] an opportunity for people worldwide to unite in the fight against HIV, to show support for people living with HIV, and to commemorate those who have died from an AIDS-related illness. Founded in 1988, World AIDS Day was the first ever global health day.

Many of us, especially LGBTQ+ people, feel helpless in the face of something this huge. It scares the shit out of lots of us – and it should. AIDS was and is one of the most destructive pandemics in human history. But there is hope, too. UNAIDS have a hugely ambitious treatment plan which, if it works, will see 90% of HIV-positive people knowing their status, 90% of these on antiretroviral therapy, and 90% of these with a viral load declared “undetectable” – all by 2020.

So today I wanted to share some small but meaningful things you can do to make a difference this World AIDS Day.

1. Donate if you can

Donate to a charity that’s doing important work in the areas of HIV and AIDS. I suggest amfAR who are pioneering research into a cure, Terrence Higgins Trust who campaign and provide services connected to HIV and sexual health, or the National AIDs Trust who fight for change and champion the rights of people living with HIV/AIDS.

2. Get a test and know your status

When was your last full sexual health screening? Go book one in now! If you’re sexually active, you really should be getting a test every six months at a minimum – and more often if you have multiple partners, practice unprotected sex, or regularly have anal sex. I’m fairly slutty and I have a full screening every 3 months. Knowing your status is the best way to protect yourself and your partners.

3. Smash the stigma and share factual information

See people talking shit about people with HIV, AIDS or STIs? Tired of false information? Engage in some stigma-smashing by challenging them to rethink their views and sharing some facts. People living with HIV are not dirty, sluts, immoral or stupid. HIV cannot be transmitted except via infected blood or sexual fluids (or to infants via breast milk). It cannot be passed on through kissing, skin-to-skin contact, sharing food or drinks, water fountains, toilet seats, mosquitoes, saliva, sweat, or modern blood transfusions. This handy guide is useful to share.

4. Stock up on sexual health supplies

As many people as possible practicing safer sex is one of our greatest weapons against HIV/AIDS. Make sure you’re well-stocked with condoms, dams and gloves, as appropriate to the types of sex you have. If you can’t afford to buy supplies, ask your doctor or sexual health provider where you can access them for free. Remember to check your condoms and dams before using to make sure they’re still in date!

Pro tip: Gay bars/clubs and sexuality-focused events often give out safer sex supplies as freebies. If you go to any of these, don’t be scared to claim some for yourself! I used to go out to gay bars so often I don’t think I paid for condoms until I was 24.

5. Wear your red ribbon

The red ribbon is the internationally-recognised symbol of HIV/AIDS awareness and advocacy.

What are you doing to support World AIDS Day and show solidarity with people affected by HIV all over the world?

This post contains affiliate links.

Gloved hand holding a vial of blood for a post about when to start getting STI tests

When Should You Start Getting STI Tests?

Published on by Amy

A reader writes:

“Hi Amy! I have a possibly-stupid question about sexual health testing: I’m quite new to having any kind of sex, and have never had penis-in-vagina (PIV) sex. What point should you start getting tested? I obviously want to practice safer sex, but should I get tested now or does it not matter so much until I start having penetrative sex?”

We had a bit of back-and-forth discussion and then they followed up with a second question:

“To complicate things a bit, I’ve also learned that I have vaginismus. I’m planning to go to the GP about this, but it made me realise that I have zero idea what would happen when getting a tested for STIs! I assume this would involves things going into my vagina?”

First: on when to test

My view is that anyone who is having any kind of sex with other people should be getting tested regularly, whether that sex is penetrative or not.

Different activities carry different transmission rates: very broadly speaking, anal sex is riskier than vaginal sex, which is riskier than oral sex, which is riskier than hand sex or toy sharing. However, any sexual activity with another person does carry a level of transmission risk, including (in the case of HSV/herpes and HPV) any skin-to-skin contact.

Please don’t take this as intended to scare you, dear reader. Forewarned is forearmed.  Knowing the facts means you can take steps to look after your own and your partners’ sexual health.

What barriers and safer sex methods you use is entirely up to you. Personally, I use condoms for PIV sex, anal sex, and shared toys (unless they’re pure silicone and without a motor, which can be boil-sterilised.) I don’t often use barriers for oral, though there have been exveptions. Your level of acceptable risk may be different, and that’s completely fine.

A good rule of thumb is to let the most risk-averse person set the level of precautions (e.g. “I don’t insist on barriers for oral but I’ll happily use one if a partner wants to”). And of course, whatever protective methods you ultimately decide to use or not use, it’s vital that this goes hand-in-hand with an open and honest conversation about testing practices and sexual history with your partner(s).

For more info on how to have this conversation, check out Reid Mihalko’s Safer Sex Elevator Speech.

Finally, this bears saying over and over again: Most STIs aren’t that scary, and the majority can be cured with a simple course of antibiotics if they’re caught early. A huge percentage of the population carries either HSV-1 or HSV-2, and the majority will never have an outbreak and may never know they’re carrying it. Even HIV, which many regard as the worst of the worst, is completely manageable these days and those diagnosed can live a full and normal life.

Knowing your status is your first and best weapon in protecting yourself, so please start getting tested as soon as you start having sex with other people.

Now, on to the second question: what actually happens when you go for a test?

It slightly depends on the clinic.

I’ve been going for STI testing regularly since 2009. Back then there tended to be a full, clothes-off-feet-up-in-stirrups examination by a nurse. But that hasn’t been the case for years. And as someone who has moved around a lot, I’ve been to quite a few different clinics.

Every clinic I’ve been to in the last 6+ years has asked for either a urine sample or a self-swab, the latter being more common. This is a tiny tiny thing that you put in your vagina for a few seconds, swirl around and then pop into a sterile container and give to the clinic nurse. You do this in private, either behind a curtain in the consulting room or in the bathroom.

If you’re having anal or oral sex, they should do rectal and throat swabs too, though I sometimes have to prompt the practitioner to do this.

They’ll also do a blood test, which is to screen for blood-borne infections such as syphilis and HIV.

The most important bit is to speak to the nurse/practitioner on the day about any concerns you have, including your vaginismus. The swab things are really tiny (much much smaller than even the smallest tampon), but if anything going into your vagina is a no-go for you, they should offer you another option such as a urine test wherever possible. STI testing shouldn’t have to be painful or uncomfortable.

At some point during the test, they’ll ask you some questions about your sexual history, especially your most recent partners. Some of the questions might seem weird or irrelevant, but it’s important to answer them honestly. A good healthcare practitioner shouldn’t make you feel judged for whatever you tell them, and if they do, you’re within your rights to gently push back or even ask to see somebody else.

After that, you usually wait around two weeks for your results. Some clinics will text you to tell you everything is okay, and others operate on a “no news is good news” policy. If there are any issues, they will call you and ask you to come in to discuss the issue and your treatment options.

And that’s it! Go forth, lovely reader, and have lots of responsible safer sex.

UPDATE: I wrote in more detail about what happens when you go for an STI test.

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