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m4mHealthySex.org is a joint effort between the HIV Prevention and Care Project and the Pitt Men’s Study at the Graduate School of Public Health, University of Pittsburgh. Our goal is to provide up-to-date sexual health information for men who have sex with men. Click on the menu or the page links above to find testing and care resources, including information about PrEP. You can also scroll down for the latest blog posts as part of our archive of sexual health information.

Coming out to your doctor in rural America

From NPR online

Finding the perfect doctor can be a feat for anyone. And a poll conducted by NPR, the Robert Wood Johnson Foundation and the Harvard T.H. Chan School of Public Health finds that 18 percent of all LGBTQ Americans refrain from seeing a physician for fear of discrimination.

One of those people is 20-year-old Alex Galvan. The moment right before he told his doctor earlier this year that he is gay and sexually active felt like a nightmare. Galvan lives in rural Tulare County in California’s Central Valley. He wanted to start a regimen of medication that helps prevent HIV infection, an approach called “pre-exposure prophylaxis,” or PrEP.

Alex Galvan

“Sitting in the waiting room was kind of like, ‘you got this, you’re just asking for a medication to help you,’ ” Galvan says, remembering what was going through his head before he came out to the doctor. “He’s not going to flip out. And then the moment before was, ‘Oh gosh, here it goes.’ ”

His doctor didn’t know about PrEP, and Galvan thought he was going to be rejected. Instead, his physician educated himself.

“I was kind of scared that he didn’t know what it was, but I was also relieved because I let him do most of the research,” Galvan says. “Yeah, and then I cried a little bit in the car, because I didn’t know what just had happened and it all kind of blurred together.”

Pediatrician Kathryn Hall knows about these concerns all too well. She has been practicing medicine in Tulare County for over a decade, and time and time again, her patients tell her they’re afraid to come out to their other doctors. A few years ago, she got so fed up that she surveyed more than 500 nearby doctors asking them basic questions about being welcoming. “I made the bar very, very low because we just didn’t get much education on LGBT health in medical school,” says Hall. “That is starting to change.”

Around 120 doctors responded to Hall’s survey, and most of them said they would be happy to serve this group. Hall says there are lots of ways that doctors can make it clear they’re accepting — a little rainbow flag on the door or taking out ad in a local magazine.

“Many of the physicians that I know are LGBT-friendly, but patients don’t know that and are very afraid that they’re being judged,” Hall says.

Read the full article on NPR.

 

Gay men’s stories of monogamy and non-monogamy: change, flexibility and tensions

From aidsmap.com

Many men, particularly younger men, implicitly expected monogamy to be the basis for long-term relationships. They felt it created stability, security, intimacy and trust. It was seen representing a more moral way of life than non-monogamy and promiscuity.

“We never discussed being completely exclusive: it was just a given that we would only see each other.” (Single, 21 years).

“Even though I’m gay I still believe in the whole stable family thing. So, I do want a husband and kids.” (Coupled, 22 years).

Nonetheless, men did not necessarily think that monogamy would last. It might be thought of as most important at the beginning of a relationship:

“I think it’s important to have monogamy for at least the first three years of your relationship because it creates emotional connections and a spiritual connection. And because in the first three years of your relationship, that’s all new and you don’t want to rip that out and have that strain put on the relationship.” (Single, 29 years).

Many men expected relationships to transition to non-monogamy over time. While some men explained this by talking about the ready availability of sex on the gay scene, others gave biological explanations:

“When you’ve got two hormonally driven men sometimes they just need an outlet if they don’t want to self-destruct.” (Single, 24 years).

The same man also said that social contact with other gay couples had led him to expect a non-monogamous relationship, even if he struggled with this expectation.

“Most people in relationships I know that have lasted are open so even though I don’t like it, I am aware that if I want a lasting relationship, there’s a good chance that’s the key to success.”

In contrast, other men aspired to non-monogamy. They might idealise older couples whose relationships were secure, successful and open:

“They’re deeply in love and they’ve got a home together. And they’re in a completely open relationship… That’s something I would like as well. It’d be nice to get to that point in time where insecurities have gone and you don’t worry about who’s sleeping with who, so long as you love the person you’re going home to… If [partner] and I do stay together long-term, that’s where I see our relationship going.” (Coupled, 28 years).

Read the full article.