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Tips for for a a fi fitter, sexier, Tips for fitter, Tips tter, sexier, sexier, more confident more confident you more confident you you 1

GETTING STARTED Looking after our health is important. But it doesn’t have to involve running a marathon or spending half your life in a gym. The reality is, having a healthy mind and body can involve lots of different areas of our lives. If you’ve thought about making some changes, whether to your diet, the amount you drink, your friendships or relationships, this booklet is for you. Looking after our bodies is part of it. Not only does it keep us fit but also it gives us more confidence, makes us more relaxed and means we are better equipped to tackle any difficulties in our lives. As gay men, sexual health and particularly preventing the transmission of HIV is important to us. We’ve included information on how to make looking after yourself and your partners a part of your overall health plan. Start by thinking about which chapters relate to areas of your life that you want to change. You may want to read these first.

We’ve included lots of practical advice for making improvements – big and small. And you don’t have to commit to changing everything. Taking time to think about any issues and making one or two small steps can make a big difference.

CONTENTS Keeping fit

Eating well

Drugs and alcohol

Smoking

Sexual health

Relationships

Friendships

Making a plan

Help and support

54 3

CONTENTS Keeping fit

Eating well

Drugs and alcohol

Smoking

Sexual health

Relationships

Friendships

Making a plan

Help and support

54 3

KEEPING FIT OK, so we all know we should exercise regularly. Perhaps you’ve paid for a gym membership only to find you’ve gone once or twice before the novelty wore off. The gym is a great way to keep fit but it’s by no means the only option. The Department of Health recommends that adults do at least 30 minutes of moderate-intensity physical activity a day on at least five days a week. According to the British

Heart Foundation, moderate-intensity activity means working hard enough to make you breathe more heavily than normal and become slightly warmer, but not so hard that you are unable to talk and exercise at the same time or that you become exhausted.

There are lots of ways to build this into your regular routine. Here are some ideas to help you get started: Find something that you enjoy doing so that you’re more likely to stick at it. An hour or so of hard graft in the garden or around the house can work wonders. If you are moving and working your heart and lungs sufficiently, it’s good exercise. 4

Take up yoga. It’s a great workout for the body, mind and soul. Find a good teacher though and don’t be tempted to learn from a book or DVD – you could risk injury. There are lots of different styles to choose from so it’s worth shopping around for classes. Some are quite physically demanding so you can really go for it. Make simple changes. Take the stairs instead of the lift, walk up the tube escalators, or get off the tube or bus one stop early and walk. These things seem obvious but if we do them every day it can make a big difference. Dance more when you are out and at home. Dancing is great exercise, provided you’re not under the influence of drugs or alcohol. Try sticking on your favourite CD at home for a half-hour boogie, or you could join a gay dance group to make it more sociable. Walk more. Using a pedometer can really help motivate you and increase the amount of walking that you do. London is a great city to see by day or night, in the winter or summer. So make the most of it and ditch the tube or bus in favour of a brisk stroll that gets the heart pumping faster. If you have a dog, you will need to walk it daily. Make this your exercise too – it’s not all about the dog.

KEEPING FIT If you don’t like going to the gym, you could always do some exercises at home. Installing a chin-up bar in the hallway is a good idea. They’re cheap, easy to install, and don’t take up much space. You can do a range of arm, shoulder and abdominal exercises with them in the privacy of your own home – just don’t be tempted to hang your coats on them instead.

Choose up to five changes you know you can make to get more exercise. It can even be just one. Any more than five and you might be setting unrealistic goals. Now set your own timeframe in which to start these. Remember, you don’t have to make all the changes at once.

Press ups and sit ups are simple to do at home and require no equipment. Between them, they exercise all of the core muscles. They’re also good for general maintenance if you are a gym-goer. Skipping is a really cheap way to keep fit - it’s great for the heart.

Things I can do

When I will start this

1. Find your nearest swimming pool and do 30 minutes of lengths regularly. Try learning a new stroke or, if you can’t swim, find a class to learn how. Make it a social occasion. There are lots of gay sports groups around that you could join. This can make exercise more fun and you can also meet new friends. For listings, visit www.gmfa.org.uk/theguide.

2. 3. 4. 5. Make a commitment to yourself to stick to your plan and to reward yourself regularly for all your hard work.

Things I can do

When I will start this

2. 3. 4. 5. Make a commitment to yourself to stick to your plan and to reward yourself regularly for all your hard work.

EATING WELL A healthy diet doesn’t have to be about eating organic porridge and raw vegetables. It’s better to make long-term improvements that you’ll stick to rather than force-feeding yourself stuff you won’t enjoy. Eating healthily gives us the energy and nutrition we need and offers lots of other benefits, such as reducing the risk of heart

disease, diabetes, strokes and high blood pressure. If you have HIV, you may be more at risk of heart disease and strokes, so a good diet is particularly important.

You can make small changes that will have a big impact. Here are some ideas you could try: Don’t skip breakfast. Coffee on the go may seem like a good idea if you’re running late but you’re missing an important meal. A good breakfast sets us up for the day and gives us important energy and nutrients. People who eat breakfast are more likely to lose weight, and keep it off, than those who skip breakfast. Watch out for too much sugar. Try replacing foods that have lots of added sugar, such as sweets, cakes and biscuits, with healthier snacks, such as fruit and nuts. 8

Avoid too much salt. According to the Food Standards Agency, 85% of men eat too much salt and about 75% of the salt we eat is already in the food we buy, such as breakfast cereals, soups, sauces and ready meals. Check the food labels and avoid adding extra salt to dishes. Try using spices such as coriander, fennel or cumin instead of salt to add flavour to your meals. Swap white potatoes for sweet potatoes. Sweet potatoes release energy into your body more slowly, so it’s longer before you feel hungry again. Plus, sweet potatoes are high in beta-carotene, which is a powerful anti-oxidant that helps ease post-workout soreness and stiffness, according to a study at Japan’s Osaka Gakuin University. Swap red meat for fish. We should be eating at least two portions of fish a week, including one of oily fish. Fish is a good source of a vitamins and minerals and oily fish has lots of omega-3 fatty acids, which help prevent heart disease. Eat your 5-a-day. Most of us probably know that we should eat five portions of fruit or veg a day, but how many of us really do? It’s not as difficult as it might sound. Fresh juices and smoothies, side salads and dried fruits can all add up. Frozen veggies are also a good option as you can store them longer and simply add to a stir fry. 9

disease, diabetes, strokes and high blood pressure. If you have HIV, you may be more at risk of heart disease and strokes, so a good diet is particularly important.

EATING WELL Cut down on fatty foods. Check the labels – more than 20g of fat per 100g, or more than 5g of saturates per 100g, is too high so steer clear. Look out for foods that are low in fat and try to avoid those that are high. If a product is branded as ‘low fat’, check the label to make sure that it really is. Drink plenty of water. According to the Food Standards Agency, we should be drinking about 6 to 8 glasses (1.2 litres/2.1 pints) of water, or other fluids, every day to stop us dehydrating – more if the weather is warm or we exercise. Alcohol doesn’t count though and it’s best to avoid soft and fizzy drinks that are high in added sugar. Take a packed lunch to work. It could be that left over pasta from last night or a homemade soup. It’s a great way to keep your lunch healthy and you can also save some pennies. Learn some simple recipes. It can be easier to eat healthily if you cook your own food. There are lots of recipes to choose from so spend some time browsing the internet to find your favourites. Remember, don’t set yourself unobtainable goals. Avoid fad diets and trendy detox plans as these can quickly go out of the window. Instead, think of some simple ways that you can make healthy changes that you’re more likely to stick to. 10

Think of up to five ways you can make changes to your diet and write them below. It can even be just one. Now set your own timeframe in which to start these. Remember, you don’t have to make all the changes at once.

Things I can do

When I will start this

1. 2. 3. 4. 5. Make a commitment to yourself to stick to your plan and to reward yourself regularly for all your hard work.

Things I can do

When I will start this

1. 2. 3. 4. 5. Make a commitment to yourself to stick to your plan and to reward yourself regularly for all your hard work.

DRUGS & ALCOHOL The gay scene is largely based around pubs and clubs, so it’s not surprising that alcohol and drugs play a large part in many gay men’s lives. Most of us drink alcohol. It can make us feel more relaxed, more sociable and loosen our inhibitions. Drug use can do the same. To help you think about your alcohol and drug use, read the following statements and think about whether they apply to you: ➤ “I can’t imagine having a good time without drink

or drugs.” ➤ “When drinking with friends, I’m usually the first to

be ready for another.” ➤ “I quite often phone in sick on Mondays.” ➤ “I drink more than I like to admit, either to myself

➤ “I only feel relaxed enough to have the sex I want

when I’m high or drunk.” ➤ “I’m usually too shy to approach men unless I’ve had

a drink or taken drugs.” ➤ “I sometimes worry about sexual risks I might have

taken while drunk or high on drugs.” If any of these statements ring true for you, you might want to look at how you can make changes and try to cut down. CUTTING DOWN ON ALCOHOL The Department of Health recommends that adult men should not regularly drink more than 3-4 units of alcohol a day – that’s about 1.5-2 pints of ordinary strength lager or 1.5-2 small (175ml) glasses of wine. If you drink more than this, it’s well worth trying a few ways to cut down. Here are some ideas:

or others.” ➤ “I sometimes take drugs just because my friends are

taking them.” 12

Know your intake. Keep a diary of how much you drink for one week. This will give you a starting point and help you decide if you want to cut down. You may be surprised at the results. 13

or drugs.” ➤ “When drinking with friends, I’m usually the first to

be ready for another.” ➤ “I quite often phone in sick on Mondays.” ➤ “I drink more than I like to admit, either to myself

➤ “I only feel relaxed enough to have the sex I want

when I’m high or drunk.” ➤ “I’m usually too shy to approach men unless I’ve had

a drink or taken drugs.” ➤ “I sometimes worry about sexual risks I might have

or others.” ➤ “I sometimes take drugs just because my friends are

taking them.” 12

Know your intake. Keep a diary of how much you drink for one week. This will give you a starting point and help you decide if you want to cut down. You may be surprised at the results. 13

DRUGS & ALCOHOL Set yourself a limit. Before you go for a night out, decide how much you are going to drink and try to stick to it. Try to keep track of how much you drink but don’t fret if it doesn’t go to plan first time. Keep trying each time you go out. Don’t forget to eat. Lining your stomach with food before drinking can make you drink less and can help stop you getting drunk too quickly. Skip rounds. Avoid getting caught up in rounds with a group of friends. Try skipping a round or two, or have a non-alcohol drink instead. Go for a weaker option. If you drink spirits, stick to single measures rather than doubles. If you drink lager, go for a weaker option such as Fosters or Carling rather than strong lager such as Stella Artois or Kronenbourg, or go for a shandy. Start drinking later in the evening and avoid happy hours. There are lots of tempting offers in bars, such as a double spirit for an extra pound. If you were planning to have a single, stick to your plan. Try alternating between alcohol and non-alcoholic drinks. Having a water is a good idea as it will help keep you hydrated.

If you are sharing a bottle of wine, wait until your glass is empty before topping up. It’s easier to keep track of how much you’ve had.

CUTTING DOWN ON DRUGS Taking drugs can damage our health, make us feel depressed or unwell, and get in the way of our work, family and social lives. Most recreational drugs are illegal, so you need to be prepared for the consequences if you use them. For information on drugs and the law, along with lots of other advice, visit http://drugfucked.tht.org.uk. If you are going to take drugs, try thinking of ways you can cut down. Here are some ideas: Decide in advance how much you are going to take. Tell your friends and stick to it.

Don’t get drunk before you start taking drugs. You’ll be less able to think clearly about the drugs you’re taking. Also, there are dangers with mixing alcohol with recreational drugs. For example, alcohol combined with cocaine increases the risk of a heart attack. Don’t buy lots of drugs at once. If you have them in your pockets, it’s easy to take them before you’ve even thought about it. 15

If you are sharing a bottle of wine, wait until your glass is empty before topping up. It’s easier to keep track of how much you’ve had.

DRUGS & ALCOHOL Cut down on how much you take. For example, if using ecstasy, take just half a dose rather than a whole one.

If your friends suggest taking more drugs, remind them that you are cutting down and have set yourself a limit.

PLANNING FOR SAFER SEX Both drugs and alcohol change the way we think and feel. With some drugs the effect is dramatic – like the high you get from ecstasy – and with others it can be less so. Even subtle effects from drugs or alcohol can alter your judgement, perceptions and the decisions you make. You may find that when you are drunk or off your face you do things you would not do when you are sober. This could include things like telling yourself that it’s OK to have unprotected sex with someone ‘just this once’. Also, you could be more likely to make assumptions about things such as whether the guy you have sex with has HIV. That’s why it’s important to plan for safer sex.

If you intend to drink alcohol or take drugs when you go out, take condoms and lube with you, or know where to get them. This should help to increase your chances of using condoms when you need them. Carrying condoms and lube isn’t the only way you can plan for safer sex. Think about the kinds of sex you want and don’t want. If you know your sexual boundaries when you’re sober it will make you more likely to make the same choices when you’re not. Talk to your sexual partners about your limits. If you plan for this, it will make it easier to discuss things like using condoms if you are under the influence. Have an agreement with your mates to look out for each other. If you’re out in a group, you can spot if someone’s had a bit – or a lot – too much and you can then look after them. Stay informed about the drugs you take. Some drugs not only affect the way you think, they can also increase the risk of HIV transmission. Some research has found this to be the case with poppers (amyl nitrite) and Viagra. Plus, if taken together, poppers and Viagra can be fatal. 17

DRUGS & ALCOHOL Cut down on how much you take. For example, if using ecstasy, take just half a dose rather than a whole one.

If your friends suggest taking more drugs, remind them that you are cutting down and have set yourself a limit.

DRUGS & ALCOHOL Drugs such as coke, crystal meth or ecstasy may make you more vulnerable to infections, including HIV.

Crystal meth can also lead to an increase in the level of viral load in HIV-positive men, which means that they will be more infectious. While some drugs may facilitate HIV transmission, drugs are not the cause of HIV. Whether you take drugs or not, using condoms if you fuck is the most reliable way to prevent the spread of HIV. If you find you are losing control of some areas of your life because of drinking or drug use, or if you have some concerns or just want more information, here are some places you can go for advice: Antidote offers information and support exclusively to the LGBT community around drugs and alcohol. Visit www.thehungerford.org/antidote.asp or email antidote@turning-point.co.uk. For basic drug information, you could also try www.dancesafe.org, www.talktofrank.com or http://drugfucked.tht.org.uk. For information and advice on the impact of alcohol, try www.alcoholconcern.org.uk or call Drinkline, the national alcohol helpline, on 0800 917 8282.

DRUGS & ALCOHOL Drugs such as coke, crystal meth or ecstasy may make you more vulnerable to infections, including HIV.

SMOKING If you smoke, quitting is possibly the single biggest improvement you can make to your health. So it’s well worth the effort! You probably already know the bad effects it has on your health. It puts you at risk of heart disease, cancer and strokes, to name a few. If you are HIV-positive, it can have even greater

risks. HIV-positive smokers are more likely to develop smokingrelated illnesses such as lung cancer, emphysema, heart disease and strokes, than HIV-negative smokers. If you have HIV, smoking can also increase the risk of getting an HIVrelated illness.

Most people who smoke want to stop, but quitting can be tough, so here are some tips to help: Think about your reasons for quitting. There are lots of good reasons for stopping smoking: your health, your finances, the state of your teeth, the smell etc. Focus on what motivates you to quit. Set a quit date. Make it a day when you don’t have any parties to go to, or work or family related stress to deal with. Give yourself the opportunity to seek support and prepare for a positive change. 20

Avoid smoking situations. If you know that you always smoke when you drink, or when you hang out with certain friends, avoid those situations, at least until you’ve got over the cravings. Join a GMFA quit-smoking group. GMFA’s course is rated ‘excellent’ by the NHS, and has a higher than average success rate. Plus you get to quit in the company of other gay men, which can make it that much more interesting… If that doesn’t appeal, there are plenty of mixed sexuality groups too. Your GP will be able to tell you where to find one. Replace the nicotine. It’s nicotine that makes smoking so addictive, but nicotine itself isn’t harmful. Using patches, gum or one of the other nicotine replacement solutions can help you get through the withdrawal. Try drugs. No, not that kind, that won’t help. You can get Champix or Zyban on prescription and both of these have high success rates in helping people to quit. Read a book. Allen Carr’s “Easy Way to Stop Smoking” has sold millions of copies worldwide. The method removes the fears smokers have around quitting so, by the end of the book, you should be a happy nonsmoker.

SMOKING Get support. Tell people that you’ve stopped and ask them to support you. It can make all the difference – and they’ll understand when you’re cranky. Think of yourself as a non-smoker. So long as you think of yourself as a smoker, you’re likely to fail. Rid your house of all your smoking junk – ashtrays, lighters etc. And imagine yourself in 20 years time as a happier and healthier non-smoker. Keep at it. If you’ve fallen right back into your old habit, take time to think and, when you’re sure you’re committed to giving up again, choose a new quit date. Consider using a different method – if you didn’t look for any support, go on a course; if you tried patches, try Champix. The more you try, the more likely you are to succeed. Don’t quit on quitting.

To book on a GMFA stop smoking group call 020 7738 3712 or visit www.gmfa.org.uk/ quit. For more information and advice about quitting visit www.gmfa.org.uk/ quitsmoking.

SEXUAL HEALTH Looking after your body means more than going to the gym or eating the right food. It also means keeping your cock and arse free from infections. Using condoms will protect you from many STIs and many of them are easily cured or can be vaccinated against. However, the transmission of some STIs can be difficult to prevent even if you have safer sex.

If you are sexually active, you should go for a check up about every six months to see if you’ve picked up any of these infections. You may have an STI without knowing it, so sexual health check-ups are an important part of staying healthy. Having an STI can also make it easier to catch or pass on HIV.

Here are some common STIs to be aware of: Gonorrhoea, or ‘the clap’, is a bacterial infection of the urethra (the tube you piss out of), arse, throat, or eyes. It can be passed on by rimming, sucking cock, fucking or getting fucked without a condom. Using condoms for fucking will prevent many cases of gonorrhoea. Sucking cock carries a risk even if he doesn’t cum in your mouth – so to reduce the risks further, you would have to use condoms for oral sex. Gonorrhoea is treatable by antibiotics and is completely curable. In some cases, untreated gonorrhoea can spread to the prostate gland and balls, which may lead to infertility. In the worst case scenario, it could also spread throughout your body causing inflammation of the joints and septicaemia. NSU (non-specific urethritis) is an infection of the urethra (the tube you piss out of). NSU is ‘non-specific’ because it is often impossible to identify exactly what is causing it. Some cases occur spontaneously without any sexual contact, like after a heavy wanking session when your urethra can become irritated. Mostly, you get it from fucking without a condom or, occasionally, you can get it if a guy with an infection in his mouth or throat sucks your cock. 25

SEXUAL HEALTH Some cases of NSU are not preventable but most cases can be avoided by using condoms for fucking. NSU can be cured by antibiotics from your GP or GUM clinic. Syphilis is a bacterial infection which is most commonly transmitted through fucking without a condom and cock-sucking, but which can also be caught through rimming, fisting and even through skin to skin contact (although this is rare). Using condoms will prevent many cases of syphilis. If you wanted to reduce the risks further, you would have to use condoms for oral sex. Sucking cock carries a risk even if he doesn’t cum in your mouth. Syphilis, if treated early enough, is completely curable with antibiotics, causing no permanent damage. Even at the latest stage syphilis is still curable, but any damage done by the syphilis may be irreparable. If left untreated, it can cause blindness, deafness, brain damage, heart attacks, paralysis, lung problems and strokes. The number of gay men seeking treatment for syphilis has increased considerably. Over 2,000 cases were diagnosed at GU clinics in the UK in 2008. Higher rates of syphilis are seen in HIV-positive gay men than HIVnegative gay men.

Herpes is a virus that is spread by skin to skin contact. There are two forms of herpes – HSV1, which causes cold sores around the mouth, and HSV2, or genital herpes, which leads to sores around the cock and arse. You can get herpes by kissing, sucking cock, rimming, fucking without condoms and even if someone rubs their cock against you. You can also get it by sharing sex toys. Cold sores on your mouth can be spread to another person’s cock or arse, and genital herpes can be spread to the mouth. Condoms are recommended to limit transmission of genital herpes but are by no means completely effective. At the first sign of either form of herpes it is very important to avoid all sexual activities which involve the infected area coming into contact with your partner’s body. There is no cure for either form of herpes although anti-viral treatments in the form of creams or tablets can ease the pain and shorten the duration of the attack. If you have more than six outbreaks in a year you should ask about anti-viral suppression therapy at your GU clinic.

For more information about these and other STIs, visit www.gmfa.org.uk/sex.

SEXUAL HEALTH GOING FOR AN HIV TEST Going for an HIV test can be stressful for many of us. But it’s worth remembering that not going won’t change your HIV status – it just means you won’t know what it is. If you know your HIV status, you can make informed decisions about your health and your future. If you are HIV-positive, avoiding finding out is not an option. If you don’t test, you will probably find out when you become ill. It will be more difficult to deal with learning you have HIV if you are ill already. People who are diagnosed late are at a much higher risk of death in the short term and possibly of developing HIVrelated illnesses later in life. Also, about 90% of gay men in London who are unsure of their HIV status are actually HIV-negative. The only way you can know for sure is to get tested. 28

Ergo is an organisation conducting an evaluation of pan London HIV prevention services, including this booklet. The survey is designed to help us better understand the needs of gay men in London and what you as a reader have gained from reading the booklet. Please take a few minutes to complete the questionnaire and return it by FREEPOST (no stamp required). Many thanks. 1. Please tell us how you got this copy of the booklet: Picked up in a GU clinic Picked up in a gay pub, club or bar Picked up in a sauna Downloaded from a GMFA website From a GMI Partnership health trainer From another HIV or sexual health service (please specify):

Other (please specify :

2. How many times have you had the result of an HIV test in the last 12 months? None

Once Twice 3 times 4 times 5 or more times

3. What do you believe your HIV status is? Deﬁ nitely HIV-negative (I don’t have HIV) Probably HIV-negative Not sure/don’t know Probably HIV-positive Deﬁ nitely HIV-positive (I have HIV) I don’t want to say 4. And what is this belief based on? Please choose the option that most closely applies. I have tested HIV-positive I think I am HIV-positive although I have NOT had Continues over the page

Other (please specify :

2. How many times have you had the result of an HIV test in the last 12 months? None

Once Twice 3 times 4 times 5 or more times

a positive test result I have tested HIVnegative and have NOT fucked or been fucked by ANYONE since my last negative test I have tested HIV-negative

and have NOT fucked or

been fucked EXCEPT

WITH A REGULAR

PARTNER since my last

negative test

I have tested HIV-negative but HAVE fucked or been

fucked since my last

negative test

I have never had an HIV test and I think I am

HIV-negative because

I have NEVER fucked

or been fucked

without condoms

I have never had an HIV test and I think I am

HIV-negative because I

have ONLY RARELY

fucked or been fucked

without condoms

HIV-negative because

I have ONLY fucked or

been fucked without

condoms WITH A

REGULAR PARTNER Other (please specify):

5. In the last 12 months, how many men have you fucked or been fucked by without using a condom? None 1 2 3 or 4 5-29 30+ 6. Have you had a sexually transmitted infection (STI) in the last year? Yes No

I have never had an HIV test and I think I am

Syphilis Rectal Chlamydia Other (please specify):

If yes, which of the following STIs have you had? (tick all that apply) Rectal Gonorrhoea

7. Some of the following statements are true and SOME ARE FALSE. For each of the following please tick whether you think it is true (T) or false (F) or don’t know (?). Once you have completed this question, you can find the correct answers at the end of this questionnaire.

T F?

a) Most gay men with HIV get it through anal sex b) A properly used condom will normally protect you against HIV transmission c) A gay man who is HIV-positive would always tell me they have HIV before having sex without

condoms

d) You can’t get HIV if you are the active/insertive partner in anal sex e) HIV can be passed on through anal sex even when no one cums f) Oil-based lubricant is safe to use with condoms for anal sex g) You can always work out someone’s HIV status by how they look or what they say h) There is a course of medicine you can take immediately after exposure to HIV to lessen the chances of HIV infection

8. [Skip this question if you have been diagnosed HIV positive]. How do you feel Continues over the page

a positive test result I have tested HIVnegative and have NOT fucked or been fucked by ANYONE since my last negative test I have tested HIV-negative

and have NOT fucked or

been fucked EXCEPT

WITH A REGULAR

PARTNER since my last

negative test

I have tested HIV-negative but HAVE fucked or been

fucked since my last

negative test

I have never had an HIV test and I think I am

HIV-negative because

I have NEVER fucked

or been fucked

without condoms

I have never had an HIV test and I think I am

HIV-negative because I

have ONLY RARELY

fucked or been fucked

without condoms

HIV-negative because

I have ONLY fucked or

been fucked without

condoms WITH A

REGULAR PARTNER Other (please specify):

I have never had an HIV test and I think I am

Syphilis Rectal Chlamydia Other (please specify):

If yes, which of the following STIs have you had? (tick all that apply) Rectal Gonorrhoea

T F?

condoms

8. [Skip this question if you have been diagnosed HIV positive]. How do you feel Continues over the page

about becoming/being HIV positive? For each statement below please say whether you strongly agree (1), agree (2), neither agree nor disagree (3), disagree (4) or strongly disagree (5).

Write 1-5

I don’t think about it I don’t really care about what happens to me It’s just a matter of luck It’s too late for me to change anything It’s not such a big deal any more I worry about it but it doesn’t stop me taking risks Other (please specify):

9. How do you feel about using condoms? For each statement below please say whether you strongly agree (1), agree (2), neither agree nor disagree (3), disagree (4) or strongly disagree (5).

Write 1-5

I choose my partners carefully so I don’t need to use condoms each time Condoms don’t work for me Using condoms takes all the fun out of sex It’s not my job to look after other people, it’s their look out Sometimes I don’t use them – I can’t help myself After sex (or the next day) I often experience guilt, shame or anxiety about the level of risk I took Other (please specify):

10. How often do you end up having anal sex without a condom after you have said to yourself you were not going to? [Skip this question if you have never said to yourself that you will not have anal sex without a condom] I have not had anal sex

without a condom since deciding not to [go to question 12] Once or twice ever Once or twice a year Every 2-3 months Once a month or more I used to have sex without a condom but don’t any more

11. Thinking about when you have fucked without a condom in the last 12 months, which of the following factors played a part in your having anal sex without a condom? Please tick all that apply. I had been drinking I was using drugs I was very upset I was going through a bad time in my life I got carried away in the heat of the moment It felt better without a condom He didn’t want to use a condom and I went along with it

I knew he had HIV We’ve both been tested for HIV and were negative I thought it would be Ok with this person He was worth it It was with a regular partner I never use condoms with A condom wasn’t available

I was at a sauna, sex party or similar place In other circumstances (please specify):

12. In an average month, how many times do you have anal sex using a condom? None [go to question 14] Once Twice 3-10 times Continues over the page

about becoming/being HIV positive? For each statement below please say whether you strongly agree (1), agree (2), neither agree nor disagree (3), disagree (4) or strongly disagree (5).

Write 1-5

9. How do you feel about using condoms? For each statement below please say whether you strongly agree (1), agree (2), neither agree nor disagree (3), disagree (4) or strongly disagree (5).

Write 1-5

without a condom since deciding not to [go to question 12] Once or twice ever Once or twice a year Every 2-3 months Once a month or more I used to have sex without a condom but don’t any more

I was at a sauna, sex party or similar place In other circumstances (please specify):

12. In an average month, how many times do you have anal sex using a condom? None [go to question 14] Once Twice 3-10 times Continues over the page

11-20 times 21-30 times More than 30 times 13. In THE LAST 12 MONTHS how many times have you had a condom break, slip or otherwise fail while you were using it for anal sex? Never Once Twice 3-5 times More than 5 times 14. Do you now feel after reading this booklet that you need more information about any of the following? Please tick as many as apply. How HIV is transmitted Safer sex What to do after a possible exposure to HIV Advice on how to use condoms effectively Advice on how to use condoms consistently How to improve sexual choices

Strategies for preventing HIV transmission How to cope with situations where you get carried away How to get more control over the sex that you have None of the above Other [please specify]:

15. Now that you have read this booklet, to what extent would you be interested in using any of the following HIV prevention or sexual health resources or services? Say whether you are not interested (N), possibly interested (P), or very interested (V).

NPV

Reading booklets

Reading leaflets

Website

Newsletter

Calling a helpline

Talking with another gay man who

understands your situation

Talking with a trained professional

Having counselling

Talking with a group of gay men in the same situation as yourself

reduce the likelihood of unprotected anal intercourse Post Exposure Prophylaxis

17. Please tell us briefly in your own words what key things you have learnt from this booklet:

Having an HIV or other STI test Other (please specify):

16. After reading this booklet, do you feel you know more about any of the following? Answer no (1), yes but it wasnâ&#x20AC;&#x2122;t useful (2), yes and it was useful (3), yes and it was very useful (4).

18. As a result of reading this booklet, are you more likely to do any of the following? Answer no more likely (A), somewhat likely (B), very likely (C).

A BC

Write 1-4 HIV testing How to minimise the risk of transmission of STIs How to cope with high risk situations to

Have an HIV test Go to a GUM clinic Contact or access a service to help me deal with my drug/ alcohol use Use a GMFA website

Continues over the page

Strategies for preventing HIV transmission How to cope with situations where you get carried away How to get more control over the sex that you have None of the above Other [please specify]:

NPV

Reading booklets

Reading leaflets

Website

Newsletter

Calling a helpline

Talking with another gay man who

understands your situation

Talking with a trained professional

Having counselling

Talking with a group of gay men in the same situation as yourself

reduce the likelihood of unprotected anal intercourse Post Exposure Prophylaxis

17. Please tell us briefly in your own words what key things you have learnt from this booklet:

Having an HIV or other STI test Other (please specify):

18. As a result of reading this booklet, are you more likely to do any of the following? Answer no more likely (A), somewhat likely (B), very likely (C).

A BC

Write 1-4 HIV testing How to minimise the risk of transmission of STIs How to cope with high risk situations to

Have an HIV test Go to a GUM clinic Contact or access a service to help me deal with my drug/ alcohol use Use a GMFA website

Continues over the page

Go on a workshop or course Access counselling

19. We want to know if HIV prevention services are reaching gay men across the whole of London. Please let us know your borough of residence:

20. We also want to work out how many gay men are using HIV prevention services and resources across London. Because you are likely to be invited to fill in more than one instance of this survey, we need to make sure that

we don’t double count you when estimating levels of need and service use. To help us do this please give us the following information which we hope will create a unique code that you can remember but which can NOT be traced back to you. First two letters of your mother’s ﬁ rst name The number of the day of the month you were born on First two letters of your own ﬁ rst name Answers to question 7: a), b), e), h) are all true; c), d), f), g) are all false.

When you have completed the questionnaire please post it to:

ERGO, Freepost ERGO Consulting No postcode or stamp is required. Many thanks.

HOW OFTEN TO TEST If you are sexually active, it is recommended that you take an HIV test at least once a year. This may vary depending on the type of sex you have. If you only have one partner who you know is HIVnegative, then testing regularly may be less important to you. If you are having sex with lots of different partners, you may want to test more frequently. If you go for a sexual health check-up, most clinics now include an HIV test on an ‘opt out’ basis – they tell you they’re doing an HIV test and you have an option to decline – rather than you asking for one yourself. The different types of tests available To use the right test, the clinic needs to know how long it’s been since you were last at risk of getting HIV (the last time you took a sexual risk, such as fucking without condoms). It doesn’t necessarily take three months from becoming infected to get an accurate test, so it is worth getting tested if your risk was more recent. Combined p24 antigen/antibody test – this is the standard test offered by many clinics. It detects something called the p24 antigen about two to four weeks 29

Go on a workshop or course Access counselling

19. We want to know if HIV prevention services are reaching gay men across the whole of London. Please let us know your borough of residence:

When you have completed the questionnaire please post it to:

ERGO, Freepost ERGO Consulting No postcode or stamp is required. Many thanks.

SEXUAL HEALTH after being infected, as well as antibodies, which can take up to three months to show. The p24 antigen is a part of HIV. During the first few weeks after someone becomes infected with HIV, p24 is produced in excess and can be detected in the blood. Antibody test – this tests for antibodies to HIV, your body’s natural response to the virus, rather than for HIV itself. However, it can be less accurate if you’ve taken a risk in the last three months. Some clinics may still use this test if you have had no HIV risks in that window period. p24 antigen test – Some clinics may offer this test on its own three to four weeks after risk of HIV infection. However, it is more common for it to be combined with an antibody test (see above). Tests for HIV’s genetic material – these detect the building blocks that make up the virus around nine to twelve days after being infected. However, these tests are not routinely used.

WORRIED ABOUT GOING FOR A TEST? If you have been putting off going for an HIV test or just haven’t got round to it for a while, it might help you to think about some of the reasons why.

Here are some of the reasons that men often give for not testing: ➤ “I’m worried about

what my friends will think if I’m HIV-positive.” ➤ “I wouldn’t know how

to tell my boyfriend if I have HIV and, if I did, he’s bound to leave me.” ➤ “I couldn’t bear

having to cope with men rejecting me for being HIV-positive. My sex life will suffer.” ➤ “I’m worried that my

medical records will show that I’ve had an HIV test.”

➤ “If I’m positive,

I’ll have difficulty getting a mortgage or credit from my bank.” ➤ “I rarely get ill and if

I had HIV I’d have had some symptoms by now.” ➤ “I don’t see that

there’s any urgency to test. I’ll get round to it eventually.” ➤ “I’ve not taken any

risks so I don’t see the need to test.” ➤ “I don’t have time to

go for an HIV test.”

If you share any of these concerns, try comparing them with the disadvantages of not testing. We’ve included some information and thoughts over the next few pages to help. 31

WORRIED ABOUT GOING FOR A TEST? If you have been putting off going for an HIV test or just haven’t got round to it for a while, it might help you to think about some of the reasons why.

Here are some of the reasons that men often give for not testing: ➤ “I’m worried about

what my friends will think if I’m HIV-positive.” ➤ “I wouldn’t know how

to tell my boyfriend if I have HIV and, if I did, he’s bound to leave me.” ➤ “I couldn’t bear

having to cope with men rejecting me for being HIV-positive. My sex life will suffer.” ➤ “I’m worried that my

medical records will show that I’ve had an HIV test.”

➤ “If I’m positive,

I’ll have difficulty getting a mortgage or credit from my bank.” ➤ “I rarely get ill and if

I had HIV I’d have had some symptoms by now.” ➤ “I don’t see that

there’s any urgency to test. I’ll get round to it eventually.” ➤ “I’ve not taken any

risks so I don’t see the need to test.” ➤ “I don’t have time to

go for an HIV test.”

If you share any of these concerns, try comparing them with the disadvantages of not testing. We’ve included some information and thoughts over the next few pages to help. 31

SEXUAL HEALTH “I’m worried about what my friends will think if I’m HIV-positive.” Many HIV-positive men are reassured by the reaction from friends, and find that they are supported. That’s not to say rejection doesn’t happen. Lots of us get rejected for different reasons that are nothing to do with HIV status. It could be that you are under-estimating your friends. If you are HIV-positive, friends may need time to deal with it. If it turns out they reject you, maybe you need to question what your relationship with them is really based on. If you are positive and you choose to disclose to friends, think about why it is that you have chosen to disclose to that person and what you hope for from them in return. It might be support, advice or simply understanding. Sometimes people react badly because they’re not sure what response you’re looking for and don’t know how to deal with the situation. By being clear you can help them to support you effectively.

“I wouldn’t know how to tell my boyfriend if I have HIV and if I did, he’s bound to leave me.” Lots of HIV-positive men have happy, loving relationships so having HIV does not mean you’re destined to be single.

Going for an HIV test can play an important part in a trusting relationship with your boyfriend. There are lots of benefits and things to think about, so we’ve written a separate chapter to help you with this. Turn to page 40 for more information. About a third of gay men with HIV believe they were infected during sex with a regular partner. By knowing your HIV status, you are better informed to protect yourself and your partner.

“I couldn’t bear having to cope with men rejecting me for being HIV-positive. My sex life will suffer.” Rejection is something that we have to learn to deal with at different times in our lives, regardless of HIV status. However, rejection shouldn’t stop us from doing what we want or need to do. If you don’t go for an HIV test, it doesn’t change your HIV status – it just gives you information about it. If it turns out you are negative, it will give you peace of mind and you can get on with your life.

SEXUAL HEALTH “I’m worried that my medical records will show that I’ve had an HIV test.” HIV testing is confidential and can be anonymous if done at a GU clinic. It may not be if done by your GP.

“If I’m positive, I’ll have difficulty getting a mortgage or credit from my bank.” It used to be very difficult for people with HIV to get a mortgage as mortgage lenders wanted you to take out life insurance. These days, some mortgage lenders don’t require you to get life insurance. So if you do have HIV, you can still get on the property ladder. It’s another way to plan for your future, no matter what your HIV status. If you are diagnosed HIV-positive, you may want to speak to a financial advisor. You can find gay friendly financial service providers through the Gay Business Association on 08707 429 249 or at www.gba.org.uk.

“I don’t have time to go for an HIV test.” Going for an HIV test can be just as convenient, if not more so, than going to a GP, a dentist, or even to get your hair cut.

There are many walk-in clinics in London so you don’t always have to make an appointment in advance. As a general rule, if you want to use a walk-in service rather than wait for an appointment, it is advisable to arrive at the clinic as early as possible. Ask yourself if this is the real reason for not testing. Perhaps you’re worried about the result. But remember, if you do have HIV, you will find out eventually – probably when you become ill. If you are HIV-negative, knowing for sure will give you peace of mind.

“I rarely get ill and if I had HIV I’d have had some symptoms by now.” Not everyone gets symptoms if they are infected with HIV. If you haven’t been ill, it’s no guarantee that you are HIVnegative if you’ve taken any sexual risks. Going for an HIV test is the only way to be certain of your HIV status. People with HIV who are diagnosed late are at a much higher risk of death in the short term and, it seems, at a higher risk of developing HIV-related illnesses later in life.

“I don’t have time to go for an HIV test.” Going for an HIV test can be just as convenient, if not more so, than going to a GP, a dentist, or even to get your hair cut.

SEXUAL HEALTH “I don’t see that there’s any urgency to test. I’ll get round to it eventually.” If you are HIV-positive, you will find out eventually – it’s just a question of when. If you are HIV-positive but don’t test, you will probably find out when you become ill. It will be more difficult to deal with learning you have HIV if you are ill already. If you are diagnosed early you can start treatment before HIV seriously damages your immune system. This makes it more likely you’ll live longer and enjoy better health. People with HIV who are diagnosed late are at a much higher risk of death in the short term and, it seems, at a higher risk of developing HIV-related illnesses later in life. Also, if diagnosed late, you may have very little time to prepare for starting treatment. Getting diagnosed early means you will have more time to consider treatment options properly and prepare for the new routine of taking pills every day.

“I’ve not taken any risks so I don’t see the need to test.” Getting fucked or fucking without a condom carries the greatest risk of HIV transmission. If you have done either, or if a condom broke during sex, you should go for an HIV test.

There are also some risks involved in other types of sex, such as fisting and sucking cock. If you’re unsure of how risky the sex you have is, you can get lots of information at www.gmfa.org.uk/howrisky. If you have not taken any sexual risks since your last HIV-negative test result, it is less important to test again. However, it is still recommended that you test every year to be sure. Even if you have taken many risks before and have tested negative, it doesn’t mean you can take risks and keep avoiding infection. If you have safer sex all of the time, you can still pick up other STIs so you should go for regular sexual health check-ups to look after your health.

Even if you use condoms things can go wrong, such as a condom breaking. If this happens to you, or you make a mistake and take a risk, you need to know about PEP (Post Exposure Prophylaxis). This is a course of HIV medication which you can take if you have been at risk of infection. The course lasts about 28 days and, if taken within 72 hours of the risk taking place, may prevent you from becoming infected with HIV. PEP is not a substitute for condoms and there is no guarantee it will work. For more information, visit www.gmfa.org.uk/pep. 37

SEXUAL HEALTH Even if we know we should do something, it’s easy to keep putting it off. Try making a list of five things you do regularly (such as going to the dentist, getting your hair cut or checking the smoke alarm):

1. 2. 3. 4. 5. Now compare the importance of each of these with going for an HIV test. With lots of clinics to choose from, it doesn’t need to take a lot of time so it is an easy goal to achieve. There are lots of benefits to knowing your HIV status so it is well worth a little effort.

For full listings of sexual health clinics in London, and links to clinics around the UK, visit www.gmfa.org.uk/clinics. You can go to any sexual health clinic you like – it doesn’t have to be the one closest to your home. For more information on HIV testing, visit www.gmfa.org.uk/testing. There are lots of other services in London that can help you with any concerns you have around safer sex and HIV: ➤ Free counselling, mentoring and health trainer

services are provided by the GMI Partnership. For further information or to book appointments, call 020 8305 5002, email info@gmipartnership.org.uk or visit www.gmipartnership.org.uk. ➤ There are lots of different groups and courses in

London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit www.gmfa.org.uk/gwk. ➤ For advice over the phone, try London Lesbian and

Gay Switchboard on 020 7837 7324 or THT Direct on 0845 12 21 200. 38

London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit www.gmfa.org.uk/gwk. ➤ For advice over the phone, try London Lesbian and

Gay Switchboard on 020 7837 7324 or THT Direct on 0845 12 21 200. 38

RELATIONSHIPS For many of us, having a regular partner or romance in our life is important. However, finding and maintaining a healthy relationship takes work. If you are having difficulty with relationships, whether you have a boyfriend or can’t seem to find the relationship you want, it’s worth spending some time

thinking about whether there are things you can change. To identify what it is that you want in a relationship, it helps to be aware of yourself and your own needs first.

Below are a few areas to get you thinking. How would you describe yourself in each? Physical/lifestyle habits: Do you smoke? Drink? Take recreational drugs? Is exercise a big part of your life? Are you a social go-getter who’s out all the time or more of a stay at home and potter-about type of guy?

Social skills and interactions: Do you know lots of people? Go out a lot to bars and clubs? Have a few close friends that mean a lot to you? Is your family a big part of your life? Are you shy and retiring?

Sexual needs/attitudes: Are you a really sexual person? How much sex do you really want and how often? Monogamous? Flirty? Faithful? What’s your HIV status? Do you always use condoms? Do you like saunas and sex clubs? Aspirations: Are you working towards something in your life? What are your career goals? What would you really like to do with your life? What would you like to be doing in 2 years? 5 years? 10 years? Hobbies, interests and faith: Do you do anything that could be called a hobby? Huge film buff? Love opera? Theatre? Do you have strong political beliefs? Are you artistic or creative? Love food and eating out? Are you religious, an atheist or follow any spiritual process? Now repeat this to describe your boyfriend or what you want in a boyfriend.

Relationship – attitude and skills: Do you like lots of cuddles? Hold hands and kiss in public? Want to lead in the relationship or be led? Do you find it easy to talk about your emotions with others? 40

thinking about whether there are things you can change. To identify what it is that you want in a relationship, it helps to be aware of yourself and your own needs first.

RELATIONSHIPS It can also help to think about what you want from a relationship. Here are some questions to help: ➤ What kind of commitment do I want? ➤ How independent do I want to be in

my relationship? ➤ Should the relationship be monogamous

or non-monogamous? ➤ How much intimacy do I want in the relationship? ➤ What do I want the sexual relationship to be like? ➤ What emotional support and confidence do I want

in the relationship? Take some time to review your answers. Are there any areas which may bring about conflict and tension? Where are you well-matched and where do your differences complement each other? Here are some questions that may help you come up with some answers:

➤ Think about your current or last boyfriend. Does he

have the qualities that you say you are looking for? ➤ Look at what you want from a relationship. Do you

think it matches what you want in a boyfriend? ➤ Are you looking for a boyfriend in the right places?

If you are looking for a relationship, exploring these areas ahead of time can be useful in helping you create strategies for the future. For example, are you looking for a boyfriend in saunas or sex chatrooms? Do you want to be led but find that you always do the chasing? Is there a common reason why any past relationships have not taken off?

If you are having any difficulties in your current relationship, it could help pinpoint the causes of these so you can talk them through together. Does your boyfriend always hit the town on a Saturday night while you stay at home? Do either of you wish the other would make more romantic gestures? Does one of you have more commitments to friends and family?

➤ Do you think you are compatible with what you are

looking for in a boyfriend?

RELATIONSHIPS It can also help to think about what you want from a relationship. Here are some questions to help: ➤ What kind of commitment do I want? ➤ How independent do I want to be in

my relationship? ➤ Should the relationship be monogamous

or non-monogamous? ➤ How much intimacy do I want in the relationship? ➤ What do I want the sexual relationship to be like? ➤ What emotional support and confidence do I want

➤ Think about your current or last boyfriend. Does he

have the qualities that you say you are looking for? ➤ Look at what you want from a relationship. Do you

think it matches what you want in a boyfriend? ➤ Are you looking for a boyfriend in the right places?

➤ Do you think you are compatible with what you are

looking for in a boyfriend?

RELATIONSHIPS KEEPING IT SAFE In relationships, it’s important to know how to keep both of you safe from HIV and other STIs. This requires trust and plenty of honest, open discussion. If you know you have HIV, it’s important to know how to look after your health and protect yourself and your partner.

HIV-NEGATIVE? Roughly a third of gay men infected with HIV thought that it happened while having sex with a regular partner. If you’re in a long-term relationship and are thinking about ditching the condoms, be warned – there are lots of risks involved with this. These are ways of reducing the risk of passing on HIV but they won’t necessarily be as reliable as using condoms.

Firstly, do you know each other’s status and have you discussed this? Unless you have already tested HIVpositive, the only way you can know your HIV status for sure is to go for an HIV test, then test again 1 to 3 months later as that’s how long it can take for the virus to show up.

You might both be worried that the test will come back positive. Remember, if you do have HIV, not going for a test won’t change that. If you don’t test, you will probably find out when you become ill. It will be more difficult to deal with learning you have HIV if you are ill already.

Before going for a test, it can help to discuss how you will support each other if one of you is HIV-positive. If either of you do have HIV, knowing your status will put you in control. For more information about going for an HIV test, see page 28.

If you are both HIV-negative, have you agreed whether you are going to be monogamous or have sex with other guys? Either way, you need to be able to trust each other so neither of you has unprotected sex with other guys.

If you have sex with other guys and always use condoms outside the relationship, you can still catch other STIs. You might then pass these on to your partner. It’s a good idea to go for regular sexual health check-ups as part of your plan.

RELATIONSHIPS WHERE TO NEXT?

HIV-POSITIVE? If you are both HIV-positive, there are other risks to your health if you don’t use condoms, such as co-infection with another STI and re-infection with a different strain of HIV. Hepatitis C is a serious illness caused by a virus passed on through infected blood that attacks the liver.

or sharing sex toys or pots of lube. Early diagnosis and treatment is vital so, if you have HIV, test for Hep C.

HIV-positive men are more likely to catch Hep C during sex than men who are HIV-negative. Hep C can be sexually transmitted by fisting, group fucking, fucking without condoms,

Re-infection is being infected with another strain of HIV in addition to the one you already have. While research has shown that this is probably not very common, it can happen.

SERO-DISCORDANT RELATIONSHIPS If you and your boyfriend have different HIV statuses, this is known as a ‘sero-discordant’ relationship. If you fuck, using condoms is the most reliable way to prevent passing on HIV.

If you want further advice or information on relationships, there are organisations that can help.

➤ There are lots of different groups and courses in

London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit www.gmfa.org.uk/gwk. ➤ Free counselling, mentoring and health trainer

Gay Switchboard on 020 7837 7324 or THT Direct on 0845 12 21 200. ➤ The GMFA booklet “Let’s Talk Sex” also contains

lots of information for men, both HIV-positive and HIV-negative, in relationships. You can pick a copy up for free in gay venues across London or download it at www.gmfa.org.uk/talksex. 47

RELATIONSHIPS WHERE TO NEXT?

or sharing sex toys or pots of lube. Early diagnosis and treatment is vital so, if you have HIV, test for Hep C.

HIV-positive men are more likely to catch Hep C during sex than men who are HIV-negative. Hep C can be sexually transmitted by fisting, group fucking, fucking without condoms,

Re-infection is being infected with another strain of HIV in addition to the one you already have. While research has shown that this is probably not very common, it can happen.

If you want further advice or information on relationships, there are organisations that can help.

➤ There are lots of different groups and courses in

London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit www.gmfa.org.uk/gwk. ➤ Free counselling, mentoring and health trainer

Gay Switchboard on 020 7837 7324 or THT Direct on 0845 12 21 200. ➤ The GMFA booklet “Let’s Talk Sex” also contains

lots of information for men, both HIV-positive and HIV-negative, in relationships. You can pick a copy up for free in gay venues across London or download it at www.gmfa.org.uk/talksex. 47

FRIENDSHIPS Friends are the main source of support and advice for lots of gay men. They are really important to us and the way we feel about ourselves. A lot of things can complicate gay friendships. If you feel something is missing from your friendship circle, are trying to deal with a difficult situation, or just want to meet more people, this chapter can help. Start by thinking about what you want from friendships. This might be trust, companionship or someone to share a hobby with. Write down up to 5 in the space on the next page. Donâ&#x20AC;&#x2122;t be restricted by what you think others want â&#x20AC;&#x201C; this is your list.

1. 2. 3. 4. 5.

How well do you think these needs are met by your current friendships? You can draw a diagram on a piece of paper to help with this. Draw a circle in the middle of a piece of paper. This represents you. Then draw at least 3 and no more than 5 other small circles around that central circle. These represent current or past friendships that are or have been important to you. Write the name of the friends in those outer circles. Think about one of the needs from your list above and how well this need is met within each of these friendships.

1. 2. 3. 4. 5.

FRIENDSHIPS It goes both ways – so think about what support you provide them as well as what they provide you. Then draw arrows to represent that in the diagram. So the arrow points from you to your friend and from your friend to you. The thicker the arrow – the more that need is met. Here’s an example:

Are there any particular needs that are not met? Are you providing more support than others give to you? If so, think about what changes you can make to your existing friendships or ways you can expand your social circle.

STARTING FRIENDSHIPS Fred

Sarah

If you want to expand your social circle, here are some suggestions:

Adam

Tom

You can repeat this for different needs if you wish so that you build up a more detailed picture of your friendships. 50

There are no set rules for making new friends. We can meet people at work, in bars or clubs, through volunteering, at events – anywhere we interact with each other. We all have skills for making friends – we’ve been meeting new people for most of our lives.

Join a gay social or sports group. There are lots to choose from and they are a great way to meet other guys with similar interests. For listings, visit www.gmfa.org.uk/theguide. Accept more invitations. If you get invited to a party or event, whether through work or in your social life, make the effort to attend even if you think you won’t enjoy it. You may surprise yourself and meet some great people.

STARTING FRIENDSHIPS Fred

Sarah

If you want to expand your social circle, here are some suggestions:

Adam

Tom

You can repeat this for different needs if you wish so that you build up a more detailed picture of your friendships. 50

FRIENDSHIPS Try volunteering. There are lots of organisations around that would welcome you lending a hand. Volunteering can be a great way to interact with other gay men that doesn’t revolve around alcohol or drugs.

Throw a party. Try inviting a few friends over for dinner or a small social gathering and ask them to bring other friends.

Write down five things you’ve learnt from this chapter or changes that you want to make.

MAKING A PLAN If you’ve read some or all of the chapters in this booklet, you’ve most likely thought about a few things you’d like to improve. Maybe you’ve set yourself lots of goals and are keen to put them into action. If you have, great! Try to keep your plan focused and achievable. To do this, write down or remember one thing you’ll do differently for each of the areas you’d like to improve. This may be something you wrote down earlier or something completely different. ➤ Keeping fit

➤ Eating well ➤ Drugs and alcohol

2. 3. 4. 5. As with relationships, friendships take commitment and compromise and often change over time. Some may end naturally as others develop. Accept that this will happen and focus on the positives in your social life.

➤ Smoking ➤ Sexual health ➤ Relationships ➤ Friendships

It’s a good idea to check back in with your plan regularly. You may want to alter some goals or set some new ones. Keep it personal. Remember, making even one or two small changes that you’ve been putting off can make a big difference. 53

Throw a party. Try inviting a few friends over for dinner or a small social gathering and ask them to bring other friends.

Write down five things you’ve learnt from this chapter or changes that you want to make.

➤ Eating well ➤ Drugs and alcohol

➤ Smoking ➤ Sexual health ➤ Relationships ➤ Friendships

HELP & SUPPORT WHERE CAN I GET MORE INFORMATION? There are many services in London that offer support to help you have safer sex. A full guide to services in London is available at: www.gmfa.org.uk/londonservices Web Information about HIV and safer sex can be found at: www.gmfa.org.uk/sex Helpline London Lesbian and Gay Switchboard: 020 7837 7324 THT Direct: 0845 12 21 200 One-to-one Free counseling, mentoring and health trainer services are provided by the GMI Partnership. For further information or to book appointments, call 020 8305 5002, email info@gmipartnership.org.uk or visit: www.gmipartnership.org.uk Groupwork There are lots of different groups and courses in London offered by PACE, THT and GMFA. They are advertised regularly in the gay press or you can visit: www.gmfa.org.uk/gwk

Booklets Booklets offering sexual health information and advice can be picked up free from racks in gay venues around London. They can also be downloaded at: www.gmfa. org.uk/booklets Magazine FS (the fit and sexy gay man’s health magazine) is full of information and advice about sex, relationships, drugs and HIV. It is available free in gay venues every other month. Condoms You can get free condoms and lube in London from many gay bars, clubs and saunas. You can buy very good value condoms and lube online from: www.freedoms-shop.nhs.uk We want to keep improving the quality of our booklets. Please fill in the questionnaire in the centre pages of this booklet. The results of the survey will help us refine the information we provide in the future. © 2010 GMFA – the gay men’s health charity Charity number: 1076854. Company limited by guarantee: 2702133. The information in this booklet was correct on 1 March 2010. Design: Vortex Creative Ltd. Additional design: no.star All photographs posed by models. No inference can or should be made about their HIV or other infection status. This resource is funded by the Pan London HIV Prevention Programme. To express your views on HIV services in London, go to: www.ergoclear.com/express

GMFA projects are developed by positive and negative volunteers. To volunteer or donate, call 020 7738 6872 or go to: www.gmfa.org.uk/aboutgmfa