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I cannot stress this enough: take your time with cleaning. Do not rush it. Not only can you hurt yourself if you rush the process, but a rushed cleaning job will probably not get you completely clean. After some practice, you will discover a frustrating truth: whenever you think you are all set, suddenly that second anal chamber will open and you will have to douche again. If you have time, clean once, then wait about thirty minutes and clean again.
Not only are anal prostate orgasms more intense for men, but some, like myself, learn to love the feeling of the anal spinchter (the circular muscle that opens and closes at the base of the colon, which is clenched tight and shut for most of your life and opens when you have to use the bathroom) opening around an object, whether it be a penis, a butt plug, or hand. The opening and closing of this muscle on its own can be very erotic.
Keep an eye out for blood. Every time you have anal sex, you get micro-fissures. These are tiny tears that may not bleed at all and will probably not cause any pain, but they are still gateways for HIV transmission. However, when you see red, it is a sign that you have gone too rough or perhaps have not used enough lube, and it is time to stop.
While anal fissures are quite common, some ass injuries can require a trip to the hospital. If you puncture your colon or are bleeding badly and in extreme pain, get yourself to an Emergency Room as soon as possible. Ass injuries are not to be scoffed at. But I must also stress that if you have smart, sane, and consensual sex, and only push your limits within reason without exceeding your abilities, you can enjoy bottoming for years without problems.
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Straight cis men may associate butt stuff with only the sexual pleasures of gay sex or anal sex with a women. Whilst this view is prevalent amongst my peers and friends, men are still hesitant to try fingering themselves.
I can remember as a younger gay man being completely consumed with being a first time bottom. Specifically, I'm talking about knowing how to do anal. I think part of my fascination with the topic was directly linked to my strong need to please the guys I had sex with.
Each year anal cancer is diagnosed in about 2 people out of every 100,000 people in the general population. Current estimates are that HIV negative MSMs are 20 times more likely to be diagnosed with anal cancer. Their rate is about 40 cases per 100,000. HIV-positive MSMs are up to 40 times more likely to diagnosed with the disease, resulting in a rate of 80 anal cancer cases per 100,000 people.
Anal cancer is caused by the same strains of Human Papillomavirus (HPV) that cause cervical cancer in women. HPV is the most common sexually transmitted infection2. There are over 100 different types of HPV, although only several strains are believed to increase the risk of cancer. Approximately 75% of all sexually active adults acquire HPV, often within the course of early adulthood, and often in the first two years of becoming sexually active and often without any symptoms3. In MSMs, it is transmitted through both protected and unprotected anal intercourse and skin-to-skin contact. Among heterosexual women, the vast majority of infections are cleared naturally by the body within a few years, usually by age 30, but this appears to be less true for MSM, where the infections are often still present in later adulthood2. Again, not all HPV infections lead to cancer.
Anal HPV is present in approximately 65% of HIV negative MSMs and 95% of MSMs who are HIV positive. Although HAART (highly active antiretroviral therapy) has decreased overall mortality from HIV, it has not reduced the incidence of anal squamous cell carcinoma4. And, since it is spread through sexual skin-to-skin contact, condom use only partially reduces the risk of transmission. Other factors that increase the risk of anal cancer include a high number of sex partners, alcohol, drugs and tobacco use. Although many men have no obvious symptoms, one of the most common manifestations of HPV infection is genital warts which can affect the anus, the penis and/or the peritoneum. Other possible symptoms are abnormal discharge from the anus, bleeding from the rectum and anus, itching of the anus, pain or pressure around the anus, and a sore or sores around the anus that do not heal5.
The anus and the cervix are biologically similar and both are target chambers for HPV infection1,2. The same screening methodology (pap smear) can be used to test the anus for cancer and pre-cancerous cell changes. A growing number of gay physicians and health activists now believe that routine screening, using an anal pap smear, could reduce the incidence of anal cancer as dramatically as it has cervical cancer in women. They recommend that all MSMs, especially those who are HIV+, be tested every 1-3 years depending on their immunological well-being and CD4 count. They suggest that HIV negative individuals be tested every 3 years. Still, there are some clinicians who are not convinced that routine screening of all MSMs is warranted. They cite the small number of positive cases, the shortage of facilities for follow-up procedures and the fear, cost and pain involved in pursuing small cell changes, called dysplasias. In addition, most health insurance policies do not cover anal pap smears.
What do the results of an anal pap tell the medical practitioner There are six possible outcomes: 1) insufficient cells; 2) a negative result; 3) atypical squamous cells of undetermined significance (ASCUS); 4) low grade squamous intraepithelial lesion (LSIL); 5) high grade squamous intraepithelial lesion (HSIL); and, finally, 6) squamous cell carcinoma (SCC).
If the results show insufficient cells, the procedure should be repeated. For an HIV negative, gay male, the usual recommendation for a negative anal pap result is to repeat the procedure every 3 years. For an HIV positive gay man with a CD4 of over 500, it is recommended to repeat the test every 2 years. For an HIV positive individual with a CD4 of fewer than 500, the recommendation is to repeat the test once a year.
The best form of prevention for anal cancer may be a vaccination against HPV infection. Currently, Gardasil by Merck, has been approved as a prophylaxis against HPV and cervical cancer for girls between the ages of 9 and 26. The FDA is considering its use in boys, ages 9 to 26 also, based on preliminary research showing that it was effective for them as well. The large study included 500 self-identified gay men. While that will prevent boys from developing anal cancer later in their lives, it is unclear how Gardasil may help adult MSMs over 26 years old, HIV+ men and those already infected with HPV. Gardasil and its competitor, Cervarix by the pharmaceutical company, GlaxoSmithKline, are both expensive, between $360 and $500 for the three injections required. It is unclear if they will be covered by health insurance for adults who choose to be vaccinated.
In order for health care providers to offer anal cancer screening to their patients who warrant it, it is critical that MSMs talk to their medical providers about their sexual orientation, HIV status and sexual practices. This does not happen often enough. The NYC Dept of Health found that nearly 40% of MSMs do not come out to their provider8. Those that are open about their sexual orientation often do not know enough about anal cancer to request a screening. It is critical that the gay community be educated, both HIV negative and HIV positive MSMs, about HPV, anal cancer risk factors and the options available for screening and treatment. Then individuals can make an informed decision about whether to be screened and seek out a provider who is familiar with the options. Some who choose to be screened may ask that their current medical providers shift practice policies to include routine anal HPV and cancer exams. Finally, it is critical and essential that the association between HPV infection and anal cancer receive more research and that there be increased education of both providers and consumers.
Jonathan Allan's Reading from Behind: A Cultural Analysis of the Anus is a timely addition to sexuality, gender, affect, queer, psychoanalysis, and cultural studies. Allan probes what the anus signifies through a variety of cultural texts and theoretical genealogies. I write this in the aftermath of the feuding derrieres of Kim Kardashian and Nicki Minaj attempting to "break the Internet" and the barrage of "booty selfies" emerging from the likes of Justin Bieber, Orlando Bloom, and Nyle DiMarco. This rise in visibility of the ass has led to popular media companies such as Vogue and The New York Times publishing on "belfies" (a combination of "butt" and selfie" [Connor]), to the rise in cosmetic surgeries involving the butt (Meltzer), to the virality of what I would call anal horror in films such as the Human Centipede trilogy, through to bell hooks leading a panel entitled "Whose Booty Is This" And in the wake of RuPaul's Drag Race becoming mainstream, I cannot not hear All-Stars winner Alaska Thunderfuck telling me "anus thing is possible" while writing this review. It then comes at no surprise that we are baring witness to the hyperpopularization of all things anal in our current cultural productions.
Allan grounds us in all things anal by reminding us that the anus was, and remains, a site of contestation and surrounds itself with affects that include shame, anxiety, fear, and paranoia. He argues that the anus works to orient sexualities, calling it "the very ground zero of gayness" (8). In his introduction, "No Wrong Doors: An Entryway" he asks if there are methods to "engage the anus but not fall victim to a hermeneutics of suspicion, a paranoid, anxious, or nervous reading practice, one that always insists on a certain orientation" (9). Allan insists that in order to read from behind, we must procure a blend of theoretics to shift our optics from our phallocentric trainings to this very ground zero from which he asks us to peek. Producing a methodology for reading from the bottom, Allan aligns himself closely with the work of Eve Kosofsky Sedgwick, primarily her essay "Paranoid Reading and Reparative Reading; or, You're So Paranoid, You Probably Think This Essay is About You." Reading from Behind seeks to reset the affective interpolations of the anus in its homophobic and effeminophobic understandings to produce a new kind of reading, one motivated by the reparative and its unknowing. This new methodology works within the boundaries (re: buttocks) of affects, both negative and positive, to "negotiate our relations to these affects, thinking through the complicated and complex ways in which affect informs idea... it is worthwhile to benefit from the tension" (14). In doing so, Allan affords us a rich and complex constellation of readings by highlighting those affects that make us uncomfortable in texts we hold dear, in order to further our understanding that... 153554b96e
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