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Originally Posted by good times If I play with people who are not infected, my chances of contracting the virus are 0%. |
The problem is that you cannot
know that the person you are playing with is not infected. Accordingly, you can never take your chances to 0% so long as you choose to play. But, of course, you don't want to deal with that point because--once you acknowledge the truth of it--you must face the reality that you
will play with the infected, you just won't know it.
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Originally Posted by good times It probably won't surprise you that I totally disagree with your numbers above. Furthermore, many of the numbers you give above are so out of context that they are meaningless.
For example,
you said, "The risk that an individual with herpes and not on a suppressant is shedding the virus is 3.1% [approximately 1 in 32] whereas the risk with individuals on the suppressant is between 0.52% and 0.35%. [Between 1 in 192 and 1 in 285]
See: http://www.natap.org/2004/HIV/051004_05.htm"
But that isn't supported or even claimed by the study you referenced. Those numbers have nothing to do with a persons risk of encountering someone who is shedding. Those numbers represent the number of days that 73 of the 169 subjects of the 16 week study were shedding the virus. Of the 169 subjects with abnormally high recurrences (at least 3 outbreaks in 6 months) of genital herpes that started the study, only 73 are included in those numbers because the rest did not shed the virus during the study, or were excluded for other reasons. Furthermore, those numbers represent the percentage of the 112 days of the study that the subjects that shed the virus were actively shedding, which does not correlate at all to my risk of encountering someone who is shedding amongst the general population, nor was that the claim made by the study. In fact, the study went on to say that although the suppressive drug studied reduced the number of days the patients actively shed the virus, it did not reduce the frequency of their outbreaks. |
You're right; I am not surprised. Frankly, I think your mental health depends upon your ability to ignore or reject the studies on the subject.
I'm not sure whether your complaint with the study is that it likely over estimated the rate of viral shedding or underestimated it. In point of fact, the study was attempting to quantify the reduction in the shedding rate when using suppressants when compared to the rate in individuals not taking suppressants.
If anything, the exclusion of certain subjects on the grounds that you have identified would tend to reduce the rate of shedding, both in those that were taking the suppressants and those that were not. Thus, the overall risk of potential exposure to viral shedding would be reduced. That the researchers rejected those subjects because they questioned whether they had been properly collecting the samples probably is of no difference to you. Also, the study's focus on higher risk patients would, if anything, tend to indicate a lower overall shedding rate in the general population (both for those on suppressants as well as those not taking anything).
So, if your point is that you think the odds are more likely 1 in 200 or 1 in 250 that your partner who does not think they have herpes actually has it and is shedding during your play, I would probably tend to agree with you. But, similarly, the associated reduction in the shedding rate of those on suppressants would mean that the equivalent odds of a person who knows that they have herpes and is on a suppressant shedding during play is more likely 1 in 300 to 1 in 400.
But, if one is going to make decisions about playing based upon a worst case assessment of the risk, there is no reasoned basis for rejecting the shedding rates identified in the study as they are more likely to be conservative estimates of the risk.
Since you didn’t like my first study, I’ll cite a second (so that you can continue to take shots at more scientific information). This one involves men and older, second-generation suppressants.
http://www.yoshi2me.com/research/shedding-in-men.pdf
This study expressly discloses its findings with respect to the shedding rates of men without lesions both on and off the then available suppressants.
“When days without lesions were examined separately, the subclinical shedding rate declined from 2.5% on placebo to 0.6% with valacyclovir and 0.7% with acyclovir treatment.” (p.S38)
It should be noted that this is an older study dealing with two of the second generation suppressants, not the third generation suppressants which are now available. Still, the 2.5% unmedicated shedding rate found in this older study compares favorably with the 3.1% unmedicated shedding rate found in the later study which I previously cited. Also, the viral suppressant rates with men (using the older suppressants) compares favorably with the rates found with women (using the newer suppressants) in the newer study.
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Originally Posted by good times And no matter how you look at it, playing with someone that I know has Herpes, on suppressant therapy or not, increases my chances of contracting the virus. |
Interestingly, statistically you are wrong. If you were to choose to exclusively play with individuals who knew that they had herpes and were taking a suppressant, you will actually have a lower risk of exposure to shedding over time than you have making the decision to play exclusively with those who think they are not infected. This is because the higher incidence of shedding in those who don’t think they have the disease (and to which you would be exposing yourself) more than off-sets the limited risk of exposure that comes with playing with someone on a suppressant. Add in the potential of playing with someone who is in the midst of an outbreak and doesn't even know it, and the odds aren't even close.
Still, I understand that you do not accept any of the science or statistics underlying this proposition.
