What's the risk
Trans guys are tops, bottoms, versatile, pigs, sweet lovers, power bottoms, doms, subs, switches and so much more. It’s never cool to assume that all trans guys are bottoms. Plenty of us aren’t into penetration at all and prefer to let our fingers, fists and cocks do the talking while some of us who bottom are up for anal sex only, others like it in every hole we’ve got.
We all deserve hot sex and a little bit of knowledge goes a long way.
The Human Immunodeficiency Virus (HIV) breaks down a person’s immune system—the thing we have that fights infections and illnesses. Untreated and over time, HIV damages the immune system so much that a person will eventually develop Acquired Immune Deficiency Syndrome (AIDS).
HIV can affect anyone, and while it certainly doesn’t discriminate, in Australia, gay, bi and queer guys are most at risk, with around 750 of the 1000 new HIV diagnoses each year occurring among these populations. As trans guys who like fucking cis men, we need to be aware of HIV.
So how is HIV transmitted?
This stuff is important to know, particularly for trans guys who might be starting to explore and act on a new sexual attraction for guys. Plenty of trans men are connected to lesbian communities or in relationships with women when they start to medically affirm their male gender and are surprised to start getting the hots for cis men. This can be a very vulnerable and scary time for trans guys who haven’t needed to really think about the risks associated with sex before, so let’s lay it all out now.
HIV can only be transmitted via blood, cum, pre-cum, breast milk, rectal mucus or front-hole fluid getting into the blood stream of someone who is HIV negative. So this means that for sex between guys, unprotected sexual intercourse and sharing needles are the predominant routes for transmission.
For HIV infection to happen, a whole lot of things need to line up first, so it’s pretty easy to prevent the virus from entering the blood stream.
The four E's
First of all, HIV needs to exist in the person you’re fucking. So if he isn’t HIV positive then you can’t get HIV. Kinda obvious right? Keep going.
There also needs to be enough HIV in his bodily fluids for transmission to take place. So if he is HIV positive and takes anti-HIV meds, it’s likely that he will have an undetectable viral load, which makes it virtually impossible for him to transmit HIV. These days, it is probably safer to fuck a dude who has an undetectable viral load without protection (condoms or PrEP) than it is to fuck a dude who just tells you he’s negative.
Some guys use the symbol [+u] on hook-up apps to let potential partners know they are undetectable. It is recommended that HIV-positive people get their viral load tested every three to twelve months, depending how long they have been taking HIV treatment.
An exit point out of his body and entry point into your body also need to be a thing. Jerking off and cumming all over your face or elsewhere onto your skin is not an HIV risk; even oral sex is considered a very low risk of transmission.
If you are fucking with condoms then the entry point barrier is pretty easy to see and feel. If you are taking PrEP daily it means HIV cannot get a grip on your body and won’t survive. Find out more about PrEP. Using condoms or PrEP is considered safe sex in HIV prevention. PrEP does not protect from other STIs or pregnancy though.
STIs (sexually transmissible infections) are essentially ‘sex souvenirs’. They can be passed through sucking, fucking, eating, licking, fingering, touching or kissing, and can even be passed on by sharing toys. You can get an STI in your arse, your front hole, or your throat.
Using condoms provides a high level of protection against STIs but just be aware that if you are touching his cock with your hand before popping on a condom or fingering his arse, and then touching your own junk, it is possible to catch an STI. If you are blowing him without a condom and he has an STI in his cock, you are likely to get it in your throat.
The most common STIs are chlamydia, gonorrhoea, genital and anal warts (HPV), syphilis and herpes (HSV), and it’s easy to spread an STI from hole to hole. If you’re into getting it in all your holes, make sure he only goes from front to back too. Going from anal to front hole can result in a very painful infection (such as a urinary tract infection).
Other STIs include Mycoplasma Genitalium – an atypical bacterial infection of the front hole and/or urethra, Trichomonas Vaginalis (Trich) – a protozoan infection of the front hole and/or urethra, scabies and public lice (crabs) – parasites.
While not typically considered an STI, Bacterial Vaginosis can develop after penetrative sex and is essentially an imbalance in naturally occurring bacterial flora. If you have multiple partners it might be worth adding it to the list of tests. Smoking also increases risk on this one too, just sayin’.
You might have seen graphic STI imagery of oozing cocks and dripping holes, but seriously, STIs may not have any symptoms whatsoever, so the only way to tell is to get a sexual health check every three to six months, depending how much action you’re getting. If you do have symptoms you’ll definitely know, but don’t rely having symptoms as a testing reminder – use this one instead.
Generally, STIs are easily treated but it’s important to have them diagnosed and treated as soon as possible after infection. Some STIs can make you more susceptible to HIV infection, and they can also increase the HIV viral load (the amount of virus) in cum, pre-cum and other body fluids. Chlamydia can also really impact fertility if left untreated so if there are baby making plans in your future, keep this in mind and test regularly.
If you have been diagnosed with an STI, it’s really important—not to mention a nice thing to do—to let your sexual partners know that they should be tested. It doesn’t have to be a big deal. Many gay guys have been through this scenario countless times and will appreciate your honesty, but if they freak out just know that you’ve done the right thing by telling them. A simple text or app message might be:
“Just thought I’d let you know that my recent sexual health test came back and I’m now the proud owner of chlamydia. Not for long though! Maybe get a test as soon as you can.”
If that’s too hard or too confronting, you can also notify him, anonymously if you wish, here.
Hepatitis cause inflammation of the liver. You can be vaccinated for hepatitis A and B and there are now very effective treatments for hepatitis C. It is a really good to know about the different hepatitis infections you might come into contact with, particularly if you are injecting hormones and/or any recreational or other drugs, or getting into heavier action around fisting or blood play.
Hepatitis C (hep C) is transmitted primarily through sharing injecting equipment so using new, clean injecting equipment, not only prevents hep C and HIV transmission, but it also protects your veins from damage caused by blunt or barbed needles.
Hep C can also be transmitted through unsterile tattooing or body piercing equipment, through medical procedures where surgical equipment has not been sterilised between patients, and through needle-stick injuries or any other direct blood to blood contact.
There is also a risk of hep C transmission through condomless sex, particularly among those guys that are living with HIV. Things like long, hard fucking sessions, fisting and toys can also increase this risk because of tears that may occur.
It is a hardy virus and lives much longer outside of the body than HIV does as well. It will hang out in a lube tub as well, so if you are fisting or getting fisted be mindful of this and use tubes or pump-packs of lube instead.
For information about hep C and sex, check out The New Deal website.
Effective and affordable Hep C treatments are now available in Australia, but so far, there is no vaccine for hepatitis C.
Hepatitis A is transmitted by getting hep A contaminated faeces (shit) into your mouth. This can happen through contact with contaminated food, but it can also be transmitted through rimming. Symptoms can be terrible but most people with hep A will fully recover, and once you’ve had it, you can’t get it again. If you’ve never had Hep A, it’s a good idea to get vaccinated. Your sexual health clinic or GP can help with this.
Hepatitis B is the most common variety of hepatitis and is transmitted in body fluids including blood, cum and front hole fluid. About 90% of adults infected with hep B will clear the virus themselves and won’t need treatment at all. Hepatitis Australia has plenty of information about all of the hepatitis viruses here.