Sex Counseling

I've been working in the field of HIV for the last decade. I'm not a scientist, nor a doctor. I'm just a regular guy who's passionate about people and community. I began as a program coordinator for populations at risk of contracting HIV. This included facilitating groups, counseling and testing in the community and in our office, speaking in college classrooms, and providing condoms and lubricant at nightclubs, concerts, and other venues.

When you're testing someone for HIV, it's important to know their sex history and what puts them at risk. A large part of testing involves sitting down with the patient and interviewing them on their sexual preferences. It's assumed everyone will engage in sex with anyone. As humans, we're all sexual beings. So, regardless of a person's preferred sexual identity, preconceived notions of what makes a woman heterosexual or a man gay should be forgotten. A man who identifies as bisexual may have been exclusively engaging in homosexual activity for the past year. Likewise, a woman who reports she's straight may have had that one encounter with another woman over a wild night in August.

I always enjoyed the responses I received while conducting these conversations. Some people are very matter-of-fact in identifying their sex acts: "When's the last time you had vaginal sex with a woman?" "Last night."
Sometimes with that single initial response, you become aware of how to pose the line of questioning. Rather clinical.
"When's the last time you had anal sex with a woman?" "Never."
"When's the last time you had penetrative anal sex with a man?" "Never."
"When's the last time you had receptive anal sex with a man?" "Never."

At other times, the responses I elicited were more animated and amusing: "When's the last time you had vaginal sex with a woman?" "Uh, uh, vaginal?! I haven't seen a vagina in years! Haha."
That response simplifies my job and provides entertainment. Skip the question about anal sex with a woman. Drop the clinical terminology.
"When's the last time you topped?" "Six months ago."
"When's the last time you bottomed?" "This morning. This glow doesn't come naturally, honey! Haha!"

As counselors, we learned to meet our clients where they are when addressing them to discuss their sexual histories. I always maintained professionalism, regardless of who I was interacting with. Once, I was out in the community at a testing event in an urban park. We had a 32 foot long RV with a couple tiny testing rooms in the back. We were in a poor neighborhood to provide testing during National HIV Testing Day (June 27 annually). After testing a few younger men and women, an older female stepped into the room.

I asked her all the typical questions regarding her demographics. African American female, 67 years old. And then, "When's the last time you had vaginal sex with a man?"
The little woman shook her head, perplexed. "Huh?" she replied.
I repeated myself, "When's the last time you had vaginal sex with a man?"
Again, blank stare.
"In your vagina?"
"In my what?"
At that point, I finally realized this woman did not know the medical name for her body part. And as inappropriate as it is for a 30-something homosexual white male to discuss heterosexual sex with a 60-something black female in any other setting, I knew I needed to meet this client where she was. And to use terminology I hoped she'd understand. So, again, I repeated myself and with slight hesitation, I reframed my question.
"When's the last time you had sex with a man in your pussy?"
The old lady laughed hard. "Oh! Last night! He fucked my pussy last night!!" Again, more laughter.
Soon, we were both laughing. "Pussy" broke the tension and proved to be a unifying term.

Talking about sex needn't be awkward or clinical. We are all sexual beings. It's something worthy of exploration and helps make us relatable. Sure, it's taboo in many contexts, but perhaps it wouldn't be so if people were more willing to be open.