Dr. Spinelli’s blog is here. The questions are inspired by his book, The Advocate Guide to Gay Men’s Health and Wellness. Spoiler alert: he won’t fuck patients.
Hey Doctor. When it comes to gay guys and STDs, is it feasible advice to say, ‘Dude, stop being such a slut’?
You know what, if someone comes in once a week or once a month with an STD, then yeah, you have to sit down with them and say, ‘Look, whats going on?’ But people have their own ways of living; it’s important to understand that.
Your book endorses doing kegel exercises for the lovehole.
Well, its a muscle,and its going to respond. If you can imagine your anus as a muscle and you learn to really control it, imagine what that would be like if you were receiving anal sex and what that could do to your partner’s sexual response by tightening it. It might be enjoyable for both of you. And it takes really getting to know your body, so that’s the bottom line for that.
Are enemas the new facials?
Sure, but you have to be smart about it, though, because you can do a lot of damage. If you’re going to use enemas for the sake of sex, use warm tap water and not the ones filled with laxatives.
You talk about axillary intercourse in your book.
Yes, having sex with someone’s armpit.
Right. Moving on, You tell a pretty intense story in your book about accidentally sticking yourself with a needle that you had just stuck into a patient with AIDS and Hepatitis C.
He was dying of Hepatitis C and AIDS. He was on a respirator, and I remember the needle went right through his skin, through the vein and then into my finger. And luckily I was was with the staff at St. Vincent’s in New York who had gone through a lot with the AIDS crisis in the 80s. The president of the hospital knew just what to do. I went through three drugs. It was the longest 28 days of my life. But I was glad that i went through that, because it gave me a lot of sympathy for people who have to go through that regimen every day, not just for 28.
You have to walk the line in your book in emphasizing the good news about advances in HIV treatment while still reminding people that it’s a bad disease that you don’t want.
It’s very hard to talk about HIV to gay men, and when you’re in an open forum there are two groups you’re talking to. So when talking about HIV you have to remember there’s a group of men who are positive, and they want to hear optimistic news. They want to hear that they’re going to live longer, that great meds are available. But if you’re HIV negative, the message has to be that you want to stay negative, that you don’t want this disease, and that anyone who’s positive would tell you that if they had a choice they would not be positive. You know, I don’t think anyone wants to have any disease. I wouldn’t choose to be diabetic or to have hypertension, but you can’t address everyone’s needs at one time.
By the way, you’re a hunk.
Do patients ever ask you out?
Well, you know, gay guys are very sweet and can be flattering, and, you know, yeah. But it’s my objective to make you feel more comfortable in this relationship and to set the boundaries. You have to be clear about what the relationship is. You can’t date patients.
Would you be annoyed or flattered if someone called you a silver fox?
Well, I’ve never turned down a compliment in my life, so go right ahead. As long as you call me a good doctor as well.
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