All Gay Men's Health Questions:

In the last year or two it seems anytime I bottom for a guy, I bleed. Usually freaks a guy out when we go to change positions and he pulls out and there is blood on his penis/condom. Hence I don’t bottom much anymore. Why is this happening and is it something serious? Thank you.

Thank you for the question. This is probably nothing serious and can be the result of common things like hemorrhoids. However, I do recommend that you see a specialist who can do an exam to make sure. A gastroenterologist would be appropriate. I also recommend Dr. Steven Schechter who we refer a lot of people… Read more »

Are there any gay friendly primary care physicians in Providence, RI ?

“There are several gay friendly physicians in Providence. Unfortunately, there is no dedicated practice though. You can check the “Find a Doctor” page on the website. You can also try Dr. Drew Nagle or Dr. Tony Wu at 111 Plain Street in Providence, Phone 444-3355.”

My test result detected 1:2 vdrl for syphilis. The person who gave me the test told me that’s probably a false positive. But a nurse there told me that if I have never had syphilis, that result shows I’m infected. The results of the confirmation exams will come in 10 days! I’m very nervous. I had sex as bottom, with condom, but the top used a lot of saliva as lube. Is there a chance to get syphilis and other STD with the partner’s saliva inside the anus?

“We are seeing a large increase in syphilis in Rhode Island (and across the United States). If you are a gay or bisexual man who has a “positive” results for syphilis, even if it is a low level like “1:2″, it suggests you may have syphilis. This should be worked up by experienced medical providers…. Read more »

I think I may have sypyllis where can I get treated

We offer *free* testing and treatment for syphilis and other sexually transmitted diseases (STDs) at our clinic on 1125 North Main street in Providence. The clinic is open 12:30-3:30pm on Wednesday, Thursday, and Friday (walk-in, no appointment necessary).

Hello- I have a question. I am a gay male who is looking for a primary care physician in the Providence area. I prefer a male physician who is gay friendly. Can you recommend anyone at all?

Finding a gay friendly physician who you feel comfortable with is important to receive optimal care. Part of the goal of this website is to help men find doctors like that. Please check out our page, www.men2menri.org/get-health-facts. We have tried our best to populate this page with gay-friendly doctors, but make sure to leave us… Read more »

My doctor has recommended rubber band ligation for removal of a couple of hemorrhoids that are bothersome but not terribly so. I am wondering if there is any risk of long term pain or discomfort from the eventual (I am guessing) scar tissue that could make anal sex uncomfortable or even painful long term.

Hemorrhoids and treatment for hemorrhoids is extremely common. With ANY surgical procedure, there is always a concern for pain and discomfort. I am not specifically aware of any long-term side effects from rubber band ligation of hemorrhoids. However, the surgeon performing the procedure would know best.

My longtime partner is 49 just had a procedure done at the Miriam. He had a type of colonoscopy to look for colon cancer. At least one biopsy was taken. This was different than a regular colonoscopy . The prep was different in that he had to do two enemas instead of the drink that I remember taking for a regular procedure. He had to wash with antibacterial soap the night before and the morning of the procedure and could not smoke or eat after midnight the evening before. Since the procedure there has been a lot of blood (which apparently is expected with this type of procedure.) My question is , when can we engage in anal sex again? He is the receiving partner. Thank you.

Yes, I would say that you should be able to have anal sex again. The question is how soon. I would defer to the doctor that did the procedure. It depends on what type of procedure, where the biopsy was (close to the rectum?), how much bleeding, what exactly the bleeding is from, and how… Read more »

My friend is on Atripla and also takes a high-dose vitamin D prescription twice a week because Atripla blocks vitamin D absorbtion. Do you know what component of the drug is responsible for this? I take Stribild; should I be supplementing my diet with any particular vitamin?

The Viread (tenofovir) in Atripla is known to cause decreases in bone mineral density (osteopenia) at the hip and spine. This medication is also in Stribild. It’s not clear if calcium and/or vitamin D supplementation can help this, but there may be some benefit.

Enlighten me about different strains of HIV and poz-on-poz sex. In a sexually exclusive relationship between two HIV-positive men, both of whom are medicated and have no other STI’s, is it safe to have unprotected anal sex? I understand that there are different strains of HIV, but if both partners are on once-daily medication therapy, would that indicate that they have either HIV1 or HIV2(what I am understanding to be one of the common, most treatable varieties) and that they wouldn’t have to worry about becoming infected with multiple strains or developing some kind of mutant, drug-resistant super-virus?

This is a great question. There are many different ‘strains’ of HIV in the world. When we talk about HIV infection in the United States, we are generally referring to HIV type 1 (HIV-1). There is an HIV type 2 (HIV-2) that is really only found in Western Africa (people who live or have lived… Read more »

I turn 40 next year and my father passed away from brain cancer and my mother is a survivor of colorectal cancer. When should I begin getting colonoscopies? And I just learned from this site about anal pap smears. Should this be something I should also request to have?

These are great questions. The major medical guidelines (based on The US Preventive Services Task Force-USPSTF) suggests screening for colon cancer in adults age 50 years or older (i.e. with a colonoscopy). However, this is for people at “average” risk of developing cancer. If you are at higher risk, (i.e. have a first-degree relative with colon cancer… Read more »

My sexual partner has Hep.C . We always use condoms for anal intercousre, but not for oral sex. Hoewever, he doesn’t cum in my mouth. Is risk of transmission negligible?

The risk of hepatitis C transmission via sexual contact is low. The risk may be increased if you or your partner have HIV. The risk of transmission is probably higher with anal sex than oral sex, but we don’t know for sure. I would avoid oral sex if there are any mouth ulcers or other… Read more »

Hi Dr. Chan. I did a course of Post-Exposure Prophylaxis in February of this year. Since then, I have been experiencing lots of neurological symptoms and just got a diagnosis of B12 deficiency. Could the PEP treatment have caused this? If so, will I be B12 deficient forever? Thanks.

The typical medications for post-exposure prophylaxis (tenofovir/emtricitabine, Truvada) are rarely (if ever) associated with B12 deficiency. Many times it is tough to tell if it is the drug or something else causing it. I would recommend consultation with a specialist which may include a hematologist.