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Dr Dick's response: It is very difficult to tell you exactly what the problem could be if I haven’t examined you. I would suggest that you consult with another doctor to get a second opinion. There are numerous things that could be causing the pain you are experiencing. A full STI screening would have to be done and we have to rule out that you don’t have any urethral defect or most importantly a problem with your sperm duct. An infection could also cause you to have that sharp pain when you ejaculate. The best possible doctor for you to consult with regarding this matter would be an urologist.
You may want to contact OUT's gay-friendly clinic if you are in the Pretoria / Gauteng area (click here). Or you may want to have a look at other gay-friendly clinics around South Africa, which you can find here.
Dr Dick's response: I assume that you mean both you and your partner are HIV negative. As long as both of you remain HIV negative, and you both remain monogamous (neither one of you cheats and has sex with anyone else, except with each other), you cannot become HIV positive. However, the safest option will be for both of you to get tested every three to six months, as we do not have any guarantees that our partners will always be faithful.
Dr Dick’s response: HIV is spread through body fluids, mainly semen, vaginal secretions and blood. Your risk of contracting HIV from any of those fluids is a possibility if they are present during oral sex. Note that even though oral sex is low risk for HIV transmission (in the absence of semen, vaginal secretions and blood), other sexually transmitted infections (STIs) could be transmitted. Condoms remain a method of prevention.
Dr Dick’s response: If you choose not to use a condom, minimise your risk in the following ways:
• If you are concerned that you might have been exposed to HIV, PEP (Post Exposure Prophylaxis) is an option (PEP is a course of anti-retro-viral medication that is taken within 72 hours after you were potentially exposed to the HI virus to reduce your risk of HIV infection). PEP does have side-effects and is not fool proof form of HIV prevention.
• Remember to use lots of water-based lubrication.
• If the penetrative partner is positive pull out before ejaculating – this may help reduce the risk of infecting the receptive partner – and consider less rough sex to limit tearing inside the receptive partner. If the receptive partner is positive s/he could ensure s/he is well lubricated, asks the penetrative partner to go slowly at first to minimise tearing or breaks in skin, and limits the duration (time) and intensity (roughness) of the sex.
• A lower number of sex partners might reduce your risk.
• Try to limit your use of drugs and alcohol during sex so that you are more in control.
• If you engage in very high risk sexual activities and you are HIV negative, speak to your doctor about the appropriateness of PrEP (Pre-exposure prophylaxis in the form of an ARV).
Dr Dick’s response: The highest risk for transmission is penetrative anal sex without a condom with ejaculation. Even though he did not ejaculate, there might still be some risk as HIV is transmitted through bodily fluids such as blood and semen. You might have exposed yourself to other sexually transmitted infections. I would recommend you visit your nearest health facility for an HIV and STI screening.
Dr Dick’s response: There is some risk to masturbating your friend. Be aware of any open wounds on your hands, fingers and penis – HIV can be found in bodily fluids including semen (sperm) and can be transmitted through wounds, sores, and openings. An idea is for you and your friend to have a regular HIV test (every 3 to 6 months) and a STI screening to make sure that both of you are safe and enjoy masturbating together without being worried.