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The Stuff Between your legs

I have a weak erection and a low sex drive. Is there anything I can use to be able to go on for hours?

Its normal to have a low sex drive sometimes and to struggle with getting an erection. There are many things that affect men’s sex drive and erections like their mental health, nutrition, and overall physical health.  Illness like depression, diabetes, and Hypertension can all affect your sex drive. Your best option is to ask a healthcare professional and get their opinion.

You can also see a doctor to see if you have erectile dysfunction and there are some medications that you may be able to take as well. If you are suffering from some form of erectile dysfunction unrelated to another issue, there are some medications you may be able to take.

I’m thinking about getting circumcised but I am HIV-positive, is that a problem?

You can definitely get circumcised even though you are HIV positive! Some men think that circumcision is only for HIV-negative guys to reduce their risk of getting infected but there are plenty of reasons (traditional and medical) that circumcision may be right for you too. If you get circumcised, it would be a good idea to be on ARVs first to improve your immune system and ensure the healing process runs smoothly.

Whenever I have sex with my partner I end up cumming really quickly. It's really embarrassing. What can I do?

This is a common condition and is known as premature ejaculation. It is especially common in younger guys and mostly goes away without any treatment. There are a few things that can help slow down your ejaculation. First, start things of slow. Take a break if you feel like you are getting excited too quickly. Some men use condoms to decrease the stimulation to their penis to prevent premature ejaculation but remember to never use more than one condom at a time because they could break. If you are still concerned, speak to a healthcare professional who may be able to provide additional support.

Sometimes I have receptive anal sex and it's really painful. Is there anything I can do to make it more comfortable and pleasurable?

Anal sex does not have to be painful. Your anus is surrounded by muscles that are naturally very tight and unlike a vagina, the anus does not naturally lubricate itself so it is very dry. In order to make anal sex more pleasurable, you first need to make sure your anus is well lubricated with water-based lube. Apply lube before sex and during in case, it gets dry. Next, make sure your muscles around your anus are relaxed. You can use your fingers to slowly stretch these muscles until you feel comfortable. You should also control how quickly and deep you are penetrated so that you can slowly let your muscles relax. Its easier to do this if you are sitting on top so you can control how things go.  

STIs

I found out that someone I have sex with has an STI. What should I do?  

Its easy for many STIs to be transmitted between sex partners even when condoms and lube are used. So if someone you have had sex with has an STI you should go to the clinic and let your healthcare worker know. Remember, STIs sometimes don’t make symptoms even if you are infected. So its good to get check out and treated.

How do I get tested for STIs?

How you get tested for STIs will depend on what health care services you have available to you. You can find friendly clinical services by contacting your local organizations. Many healthcare facilities will be able to use a small drop of your blood to test for HIV and Syphilis. Some clinics may not be able to test for some STIs easily like Hepatitis A, B, and C, but you should still speak to a healthcare worker about them. Finally, other STIs like Herpes, Chlamydia and Gonorrhea can be checked visually or you may receive treatment even if you have no symptoms if your partner has been infected.

What kind of infections can I get if I have sex with another man without a condom?

You can be exposed to the same STIs whether you have condomless sex with another man or a woman. These include Chlamydia and/or Gonorrhoea, Syphilis, Hepatitis A, B, C, Warts (HPV), Herpes (HSV), and HIV. Find out more about these STIs here.

There is something wrong with my anus, I think maybe I have anal warts. What do I do now?

Anal warts are caused by a sexually transmitted virus called HPV (human papilloma virus). Health providers are able to treat these warts in a number of different ways depending on the facility (freezing them (called cryotherapy), using creams or lotions or sometimes surgical removal. Some men feel uncomfortable discussing this with a health care provider or letting them know that they have had receptive anal sex. If that is the case, you should speak to your local organizations to find a health care provider that provides competent and friendly service to men who have sex with men.

HIV

I think I’ve just been exposed to HIV. What do I do now?

If you believe you are HIV negative and that you were exposed more then three days ago then you should let your healthcare worker know and get tested after your window period. If you are HIV-positive then you should start ARV treatment.

If you think you have been exposed less than 72 hours ago (3 days) then you may be able to get P.E.P. If taken correctly, P.E.P will significantly reduce your chances of getting HIV. Find out more here.

After you have received PEP you will be reminded to come to the clinic after one month, and again after three months, to make sure that the PEP worked and that you are still HIV negative.

A guy came on me. Am I at risk?

Its normal to be worried if you are unsure how HIV is transmitted or if you don’t know if you have been exposed. For HIV to transmit each of the following has to happen:

1. Your sex partner has to be HIV positive
2. There has to be enough HIV in their to be transmitted. HIV-positive people on ARV medications who are virally suppressed do not pass on the virus to others.
3. Their HIV-infected bodily flood (semen or blood) needs to enter your body through the inside of your anus, under your foreskin, the head of your penis, the pee tube at the end of your penis, your eyes, or an open cut or sore on your body.

If you are not sure if his cum actually went into your body or unsure of his HIV status or viral suppression then the risk is still there. The best thing would be to go for an HIV test and then again after 4-6 weeks to exclude the window period.

How long does it take to know if I am HIV positive or negative?

The time you are infected or exposed to the HIV virus depends on how your body responds to the virus by producing antibodies. You can generally test HIV positive between 4-6 weeks after exposure but a small percentage of people can take up to 3 months for this to happen. This time frame also depends on the HIV test being used so make sure to ask your healthcare provider.

I'm HIV-positive and feel so alone. What can I do?

There are many guys who are positive who feel exactly the same way as you do, you are not alone. The best thing for you to do is to find a support network of other people living with HIV or create your own support network by letting a close friend or family member you trust know about your status. Check with your local organizations to get a referral to these kinds of groups.

I'm negative and my partner is positive. What are my chances of being infected?

There are many ways now for people who have different HIV status to have sex safely.

• If the HIV positive partner has been on ARV medication for at least 6 months and has an undetectable viral load, then they will not transmit the virus to their sex partner.
• The HIV negative partner can start PrEP. Taking PrEP will provide 92-100% protection from getting HIV from their sex partner.
• Using condoms and water-based lube consistently will also prevent spreading HIV between partners.

Its important to open and honestly discuss your HIV status with each other so that you can find an easy and convenient option to prevent HIV.

I’m HIV-positive, where can I get ARVs?

You can get ARVS from a public health institution or through a funded NGO for free. Find a list of service providers here who can provide ART or a referral to best facility for you.

PrEP 

Where can I get PrEP?

Unfortunately, PrEP is not easily available in many places yet. This is because it is still relatively new and governments are working to find the best way to make it available. You may be able to access PrEP through special projects that are providing it or even through a local clinic if it is available in your community. You should contact one of your local organizations to find out more.

You can become HIV-positive if you are exposed to the blood, semen, or vaginal fluid from someone who is HIV-positive and who is not virally suppressed.  If someone who is HIV-positive is on treatment and are virally suppressed, then the risk of being infected by HIV is dramatically lower.

Being exposed to HIV can occur through unprotected sex and/or through sharing a needle. Anal sex without a condom is a very risky type of unprotected sexual behaviour and can easily lead to becoming infected with HIV or passing it on to somebody else. The risk of HIV transmission through anal sex without a condom and water­based lubricant is about 18 times higher than for vaginal sex.

The risk of getting infected with HIV is much higher for the bottom (receptive) partner than the top (penetrating) partner. This is because the bottom guy is more likely to get semen inside his anus, which is the easiest way to get HIV.

There are many simple steps we can all take to prevent HIV.

These steps work best when they are combined together. So if one fails or we forget to use it, then we can still rely on the others to help us stay HIV-negative.

Those of us who are HIV-positive can also take steps to make sure we don’t pass on HIV to others.

Using condom and condom-compatible lube when having sex

Using condoms is your best defence against HIV and other STIs because they prevent the exchange of body fluids that might contain HIV (semen and blood).

Those of us who are HIV-positive should also use condoms when we have sex to help prevent our spreading HIV to others and to stop us getting other STIs. Find out more information about how to use a condom here.

Did you know that there are correct ways and incorrect ways of using condoms?

• Never use more than one condom at the same time on your penis. You might think this makes you more protected. But it doesn’t. It actually means the condoms can break by rubbing up against each other
• If you are having sex with more than one person then use a fresh condom every time you penetrate a new partner to avoid spreading HIV and other STIs
• Find condoms that work best for you since they come in different shapes and sizes. Here are some places to find condoms
• Always use condom-compatible lubricant with a condom, especially for anal sex. Don’t use Vaseline or spit. Find out more below

Water-based Lubricant, or lube, is a slippery substance that makes having anal sex much more comfortable and fun. It also stops your anus or penis from being hurt or damaged from too much friction.

Water-based lube, like KY jelly, is the best lube to use with condoms because lube made with from liquids will damage the condom. When using water-based lube, we should remember:

• Cooking oil, baby oil, petroleum jelly (or ‘Vaseline’), and many hand lotions are all oil-based and shouldn’t be used because they will break your condom
• Using saliva is not slippery enough to be used as lube as it evaporates quickly and can spread other STIs (although HIV is not contained in saliva)
• Always put plenty of lube on the opening of the anus and on the condom after you’ve put it on before you start having sex. If the sex starts to feel dry or sticky, or carries on for a long time, use more lube to protect the condom and keep you and your partner happy

Changing your behaviour

The truth is, changing our behaviour is really hard, especially when it comes to sex. Even if you’re not perfect, like most of us, here are some things you can do to lower your risk of becoming HIV-positive:

1. Carry a condom and a small sachet of lube with you when you go out. You’ll be more likely to use them if you’ve got them with you.
2. If you’re not using condoms when having sex, try to reduce the number of guys you have condom-less sex with. This is not perfect but will reduce your exposure if you and your partners test frequently. Find out more about testing here!
3. Keep a lookout for STI symptoms. You should be aware of STI symptoms no matter how many partners you have. You can avoid having sex with someone if you notice a visible STI symptom. If you notice one on yourself, you should stop having sex until you get it tested and treated. Having an STI will increase your risk of getting HIV and other STIs. Remember some STIs don’t produce symptoms, so get tested regularly anyway.
4. Drinking less alcohol may help you reduce your risk because drinking alcohol can make you make bad decisions about yourself, who you have sex with, and how you have sex.
5. If you are using injection drugs with needles make sure to use clean needles and kits. Find out everything you need to know here.  

Check out the links below for more information on HIV.

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You can also download the contents of this section by clicking here.

You can become infected with an STI if you are exposed the bacteria or virus that causes it.

• Syphilis – is spread through direct contact with a syphilis sore on a penis or inside a mouth or anus or through an infected bodily fluid.
• Gonorrhoea and Chlamydia – are spread after exposure to their bacteria in the urethra of a penis, a mouth, or an anus.
• Herpes – is spread through direct contact with the blister or sore on a penis, mouth, or anus. The blister fluid is very infectious.
• Warts – require direct contact with the virus that causes warts, even if no warts are present on the skin.
• HEP A, B, C – after exposure to the virus through faeces (HEP A), blood (HEP B & C), or other fluids like saliva, urine, or semen (HEP B).

Remember

• Unlike HIV, other STIs do not always require you to be exposed to bodily fluids like semen or blood.
• You can't always see STIs because some do not produce symptoms and other produce sores in the mouth or anus where you can not see them.

You can get treatment for most STIs at your local clinic where antibiotics are available. Some clinics may not be equipped to treat STIs like warts and this may need referral to a larger facility.

Some men are concerned to seek treatment for certain STIs especially if it involves the anus. They are worried that health care workers will criticize them for having anal sex. Unfortunately, this is a valid concern because not all health care workers are trained to support men who receive anal sex.

Find out where you can get care from specialized people for guys like you here.

What Men Should Know‬‬

Men use substances for a lot of reasons. Sometimes those substances are legal, like alcohol. Other times, those substances may be illegal. Regardless of the type of substance you use, its important for you to understand how it affects your body so that you can use it more safely and protect your health. ‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬

Using Drugs with Sex‬

Some men use drugs to make sex better. Some drugs can intensify sexual pleasure but they can also decrease inhibitions and contribute to risky sex, leading to HIV infection and other sexually transmitted infections (STIs).‬‬‬‬‬‬‬‬‬‬‬‬‬‬‬

‬‬‬‬‬‬‬‬‬Using Drugs with Needles‬

Injecting drugs with needles can be one of the highest risk ways to get HIV if needles are shared between HIV-negative and HIV-positive people. ‬‬

Check out the links below for more information on substance use

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You can also download the contents of this section by clicking here.

You do not deserve to be victimized, for any reason. If you are experiencing violence or abuse, even if its from a loved one or your sexual partner, you should get help to protect yourself.

Your mental health refers to how well you are feeling emotional and well your mind is working. Your mental health is very important because it can affect your physical health and your overall well-being.

When someone has a mental health issue, it means their mental well-being is suffering just like your body suffers when it gets hurt. There are many reasons people experience mental health issues. Some men are born at greater risk and others are at risk after dealing with things like stress or trauma.

Sometimes mental health issues can be small and go away easily.  Other times they can be serious and make it hard for people to function normally.

Men who have sex with other men may experience mental health issues like depression and anxiety, not because of who they have sex with but because they may experience violence, stigma, and discrimination.

Being able to recognize a mental illness is important because sometimes they can increase your risk for getting HIV by increasing your use of substances or of high risk sex.

Find out more about two common mental health issues, Depression and Anxiety, and importantly, where you can get help.

There is nothing to be ashamed of if you are suffering from a mental health issue.  It is something that many men experience, even if they don’t talk about it.

You can start by speaking to your friends or loved ones to get support. Let them know that you aren’t feeling well.

If you don’t feel like you can talk to friends or even if you do, you should speak to a nurse or health care provider at your clinic. Some mental health issues need counselling or even medication.

You can also check out some of your local organizations who may be able to provide you with a referral for care.

The first step is to reach out and ask for help, acknowledge that you aren’t feeling well.

We all have basic human rights, no matter who we are, or who we have sex with. One of those rights, it’s the right to health. This means that we all have the right to get health care including getting treated for HIV and STIs.

Sometimes, your right to health can be violated by healthcare workers if they:

• Deny you access to health care
• Discriminate against you while providing health care
• Tell other people about your health status without your permission

It's important that you recognize your rights and know if they are being violated by a healthcare worker so that you can do something about it.

Check out the links below for more information on your rights to health

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You can also download the contents of this section by clicking here.

LGBT Voice Tanzania

National Lesbian, Gay, Bisexual and Transgender (LGBT) organization working to advance equality, diversity, education, and justice for LGBT people in Tanzania.  

How to contact:

You can reach LGBT Voices Tanzania on: +255 715 334 419

Community Health Education Services & Advocacy (CHESA)

Human Rights, Awareness, Prevention programmes and Treatment Literacy for MSM

How to Contact:

You can contact CHESA on +255 620 520 600  or email them at [email protected].

Find CHESA on Instagram and Facebook @ CHESATANZANIA or on Twitter@ Chesa2008