Q: I keep hearing about harm reduction, harm reduction. Whatever happened to "no means no"? As in, don't have anal sex. Or don't do drugs. I don't do those things anymore because they're too dangerous for me. Hello, gay men? Clue phone. It's for you.
                        --Nathan Reagan

Dear Nathan,
Every pleasure, or even things that are useful without always being pleasurable, comes with risk. That's why so many people drive in cars despite thousands of annual deaths in auto accidents. Gay men have a lot of practice in balancing risk and pleasure, such as gauging the
safety of going home with a stranger, or coming out at work, or other things that seem both important and potentially dangerous.

How quick you are to give up a particular activity usually depends on how important it is to you. If it's not important -- as anal sex may not be to you -- it's easy to give it up. Those decisions vary from person to person.

Harm reduction is based on the idea that change is not all or nothing It may be harm reduction when you decide to suck someone but not let him cum in your mouth. It may be harm reduction when someone decides not to do that fourth line of coke, but to go home
instead. There may still be risks involved, but steps toward change still count as change. More people are able to make that kind of gradual change than to give up an activity altogether.

If you're interested in harm reduction, try this at home.

Compare two different sexual interactions, one where you felt good about the sex, and one in which it felt risky or worried you. In each instance, try to go back to the experience, and lead yourself --or better yet, someone else -- through the details. It sounds contrived, but telling it to a friend can help you hear it in a different way. Find someone to listen who isn't going to reassure you, or judge you, or try to "fix" the situation. You want them just to help you get
through the story, the way someone would spot you while lifting weights at the gym.

1. Be Honest About the Pleasure.
In both instances, start with the positive. Focus on what you wanted that day or night. What were you hoping to feel? Bring yourself back, not just to the moment, but to the lead-up. What was attractive about the situation? Who was it with? What drew you to him or them?
Play with yourself -- not literally, but in the telling. It can vivid, not just dreary. And it's not vivid enough to say "I loved sucking him. " What exactly did you like so much about it? The feeling of making him come? Feeling like you "had him"? Feeling romantically merged? Taken

2. Spell Out the Risks.
What risks did you accept or manage well in the situation you felt good about? How did those compare to the situation that made you worried? Were your worries related to the sex itself or about something else: the time and energy or money it took to get it? Were you worried from the start, only worried afterward, or was there some point in between were things got uncomfortable? Would it have changed if you had known the other person's HIV status? Or was
the issue that you did know?

3. How Might You Hold Onto the Pleasure and Cut Down the Risk?
Return once more to the course of events. If you had stayed on the phone-sex line for half an hour instead of four hours, would that have worked better? If you had felt less used, more like he knew you better, would that have helped? If it was a risky encounter for HIV, how might you have held on to the pleasure and reduced the risks? If, for example, you loved sucking him but freaked out when he came in your mouth, could you have said, "Tell me when you're close, OK?" as you started? If you were afraid that stopping for a condom would make you lose your hard-on, might you have asked him to put one on you? If you like to be with "straight" guys but worry that they'll pull off the condom, could you limit it to oral sex until you know them better?
This may not sound as easy as "just don't do it. " But talking about the sex you have in front of someone else can be a much more effective way to reduce risks than just telling yourself to "shape up!" or swearing you'll never do something again (until you do).

-- Asking for It, pamphlet produced by Gay Men's Health Crisis