What is SAFE SEX?

[lovedoctor]

Originally Posted by dave1234

Most people already have herpes - their bodies are just good at keeping it under control. Most of us had a few cold sores as kids and then they stopped. Susceptibility to frequent active herpes is probably a funtion of an individual's immune system.

OK, do you mean Herpes as the viral group or Herpes as Herpes Simplex II?(what is commonly thought of as "genital herpes")

The herpes viruses include EBV (Epstien Barr), CMV (cytomegalovirus), VZV (varicella virus - aka chicken pox and shingles), HSVI (common cold sores) and HSVII (as noted above) and I thnk, HHV VI (human herpes virus 6). There may be a few more - it has been a long time since Virology for me. However, these are the most common as far as the illnesses in humans go.

Now, for point of education -

HSV I lives above the belt about 80% of the time, and below the belt about 20%.
HSVII lives below the belt about 80% of the time, and above the belt about 20%.

The clinical end result of these two types of herpes viruses are essentially the same - painful vesicular lesions that contain active virus until scabbed over (which explains why genital herpes can live anywhere on the body and cold sores can live on the genitals or anywhere we can scratch, poke or rub.)

So, while almost 90% of the population are + for a type of herpes virus by the time they are 18, it is, in fact, largely comprised of VZV and CMV, those common childhood illnesses. MOST of the population is not + for HSVII. Just a clarification...


OK, I didn't mean to hijack the thread here, but this was a teaching moment and I loves me a teaching moment!! Thanks for bearing with me...

[tncinmd]

Originally Posted by lovedoctor

So you are saying that ONE airborne disease OR ALL aiborne diseases are more common than HIV OR ALL STDs?

Just asking so that I can get a handle on this...I'm not clear what you are saying.

And if ONE Airborne disease over a given period of time (very important)(say SARs) is more common worldwide than....mmmm let's say HIV infection (since not everyone that has HIV actually has AIDs), then please, for the sake of education, tell me specifically where you got your data - where can I prove to myself that this is true. It just seems counterintuitive; but that's just me.

Basically, all we're interested in is the different levels of reaction and precautions taken to contagious diseases. HIV seems to have created a very strong reaction in that people are strictly adhereing to precautions where something like SARS, as an example, provokes a kind of "well, what can you do about it ? You've gotta go out and breathe everyday" attitude.

It just raises the question as to whether it is due to the circumstances, a socially acceptable intercourse, rather than a generally tabu one. That's all, just curious to see if this has occured to anyone else.

[lovedoctor]

Originally Posted by tncinmd

Basically, all we're interested in is the different levels of reaction and precautions taken to contagious diseases. HIV seems to have created a very strong reaction in that people are strictly adhereing to precautions where something like SARS, as an example, provokes a kind of "well, what can you do about it ? You've gotta go out and breathe everyday" attitude.

It just raises the question as to whether it is due to the circumstances, a socially acceptable intercourse, rather than a generally tabu one. That's all, just curious to see if this has occured to anyone else.

That doesn't answer my question. You said that "Airborne diseases, such as SARS, certain flu strains, etc are by far more common and as dangerous as AIDS."

I don't mean to be unduly aggressive in my questioning, while it may be true given absolute numbers - not all respiratory illnesses, let alone one certain subtype, have the realistic potential to be as deadly as the HIV virus. If we are going to state something as a fact, there is a certain underlying responsiblity to actually have some data to back up the fact. I think it is important enough of an issue that we get it straight. So where is your data?

Also, I have a question about your statement on the misuse of antibiotics. You stated that " Misuse of antibiotics and overuse of antibacterial agents have produced increasingly resistant strains." OF VIRUSES? No, sorry. Antibiotics treat bacterial infections and not viruses. Overuse of antibiotic agents can create bacterial resistance, not viral resistance. Viruses replicate by a whole different mechanism than bacteria, with (as far as I know) the exception of micoplasma which is a viral illness with some bacterial traits. This may be a miniscule point, and I am glad to hear someone who believes in appropriate antibiotic use, but it is an important distinction for people to understand.

[dave1234]

Originally Posted by lovedoctor

OK, do you mean Herpes as the viral group or Herpes as Herpes Simplex II?(what is commonly thought of as "genital herpes")

The herpes viruses include EBV (Epstien Barr), CMV (cytomegalovirus), VZV (varicella virus - aka chicken pox and shingles), HSVI (common cold sores) and HSVII (as noted above) and I thnk, HHV VI (human herpes virus 6). There may be a few more - it has been a long time since Virology for me. However, these are the most common as far as the illnesses in humans go.

Yikes, I was trying to reduce the fear. Now I am more scared than before - HHV VI!?!? Is there a III, IV, and V I should worry about?

Seriously, I think people should be careful. Take a decent look and feel of what is going in your mouth before it does. Always use a condom for intercourse. Avoid any anal with swing partners. But since body condoms and celibacy are not on the agenda we take a calculated risk.

I just wish someone would post some good statistical problems here then I could have a teaching moment.....

[tncinmd]

Originally Posted by lovedoctor

That doesn't answer my question. You said that "Airborne diseases, such as SARS, certain flu strains, etc are by far more common and as dangerous as AIDS."

I don't mean to be unduly aggressive in my questioning, while it may be true given absolute numbers - not all respiratory illnesses, let alone one certain subtype, have the realistic potential to be as deadly as the HIV virus. If we are going to state something as a fact, there is a certain underlying responsiblity to actually have some data to back up the fact. I think it is important enough of an issue that we get it straight. So where is your data?

Also, I have a question about your statement on the misuse of antibiotics. You stated that " Misuse of antibiotics and overuse of antibacterial agents have produced increasingly resistant strains." OF VIRUSES? No, sorry. Antibiotics treat bacterial infections and not viruses. Overuse of antibiotic agents can create bacterial resistance, not viral resistance. Viruses replicate by a whole different mechanism than bacteria, with (as far as I know) the exception of micoplasma which is a viral illness with some bacterial traits. This may be a miniscule point, and I am glad to hear someone who believes in appropriate antibiotic use, but it is an important distinction for people to understand.

Well, yes, it does seem you are being picky. Hopefully you'll answer the question at some point.

The latest statistics (CDC 1999) I could find showed that across all ages, genders and races, influenza/pnuemonia (CDC lumps them together) came in at number 8 of the top ten causes of death. HIV doesn't make the top ten overall.

Now, admittedly, flu/pneumonia is a less significant factor in age groups 20-44 and doesn't make a really significant impact until 55+. HIV, however, plays a significant role starting about 25 and peaks in the 35-44 age group. Figures are somewhat different when broken down by race and gender.

Now, if the impact is far more significant than HIV for our age group (55+), it would seem we should be walking around wearing face masks and avoiding kissing, n'est-ce pas ? Obviously we don't. Again, the question is, is it the activity that results in exposure to the perceived risk rather than the risk itself ?

[lovedoctor]

Originally Posted by tncinmd

Well, yes, it does seem you are being picky. Hopefully you'll answer the question at some point.

The latest statistics (CDC 1999) I could find showed that across all ages, genders and races, influenza/pnuemonia (CDC lumps them together) came in at number 8 of the top ten causes of death. HIV doesn't make the top ten overall.

Now, admittedly, flu/pneumonia is a less significant factor in age groups 20-44 and doesn't make a really significant impact until 55+. HIV, however, plays a significant role starting about 25 and peaks in the 35-44 age group. Figures are somewhat different when broken down by race and gender.

Now, if the impact is far more significant than HIV for our age group (55+), it would seem we should be walking around wearing face masks and avoiding kissing, n'est-ce pas ? Obviously we don't. Again, the question is, is it the activity that results in exposure to the perceived risk rather than the risk itself ?

CDC Data from 1999 to 2003 shows about an even distribution of 18,000 deaths per year in the USA from AIDs.

CDC Data from 2003 March - July, shows a total number of probable SARS cases at 398 for that time period in the USA. ---I didn't see the deaths posted but if it was a percentile of that 398 even if we extrapolated out for the remainder of the calendar year, it still would not come close to the 18,000 for AIDS deaths.

[dave1234]

OK, I got this from another BB:

HIV Infection From Receiving Oral Sex is Rare, Study Says

August 14, 2001 News Office: Jeff Sheehy (415) 597-8165

A study by researchers from UCSF's Center for AIDS Prevention Studies (CAPS) found the probability of HIV infection through unprotected receptive oral sex with a man to be statistically estimated as zero.

"Our study looked at exclusive receptive oral intercourse with a male partner, and we found that the probability of acquiring HIV through that specific sexual activity is very, very low. Given that the results are based on a relatively small sample, we can not rule out the possibility that the probability of infection is indeed greater than zero," said study lead author Kimberly Page Shafer, assistant professor of medicine at UCSF's CAPS. The study is ongoing and the findings will be amended by the researchers with greater numbers.

"While our study is the first to attempt to systematically define the risk, case reports exist of infections acquired through oral contact. I want to emphasize that, while rare, acquiring HIV infection orally is possible and that many other sexually transmitted diseases (STDs) such as gonorrhea, chlamydia, and syphilis are transmitted orally," added Shafer.

The study, presented today (August 14) at the Second National Prevention Conference in Atlanta, enrolled 198 participants from anonymous testing and counseling sites in San Francisco. The participants, 98 percent male and 100 percent identified as gay or bisexual, reported no anal or vaginal sex and no injection drug use in the six months prior to entering the study. The participants reported a median of two receptive oral intercourse partners and 98 percent reported unprotected receptive oral intercourse. Twenty percent of the participants reported receptive oral intercourse with an HIV positive partner. Of that group, 89 percent did not use a condom and 40 percent swallowed ejaculate.

The participants were screened for HIV infection and also for recent HIV infection using both the standard test for HIV and a test for HIV that is "detuned" to detect only those HIV infections that have occurred within the six months prior to taking the test. Out of the 198 participants, only one HIV infection was reported, and that infection had not been recently acquired and could not be attributed to the period of exclusive oral receptive intercourse. No recently acquired HIV infections were reported by any of the other participants in the study. Statistically, the study yielded a zero probability of acquiring HIV orally.

The study is funded by the National Institute of Dental and Craniofacial Research.

[tncinmd]

Originally Posted by lovedoctor

CDC Data from 1999 to 2003 shows about an even distribution of 18,000 deaths per year in the USA from AIDs.

CDC Data from 2003 March - July, shows a total number of probable SARS cases at 398 for that time period in the USA. ---I didn't see the deaths posted but if it was a percentile of that 398 even if we extrapolated out for the remainder of the calendar year, it still would not come close to the 18,000 for AIDS deaths.

You asked about not only SARS but other airborne diseases, if you remember. And the figures for 1999 alone on flu/pnuemonia deaths are in excess of 66,000.

Since you don't appear to want to answer the original question, further interchange on this point would be useless. Let's just leave it at that.

[lovedoctor]

Originally Posted by tncinmd

...HIV seems to have created a very strong reaction in that people are strictly adhereing to precautions where something like SARS.....

You said it (SARs), I just looked up the stats...

Deaths due to respiratory illness can be due to myriad processes - hundreds of viruses, bacteria, chemicals, fungi, autoimmune, asthma, heart disease.... etc, etc -

- so it is really apples and oranges to compare them to deaths caused by one virus (HIV) to all respiratory deaths, even if you exclude causes other than infectious.

[lovedoctor]

Originally Posted by tncinmd

Now, if the impact is far more significant than HIV for our age group (55+), it would seem we should be walking around wearing face masks and avoiding kissing, n'est-ce pas ? Obviously we don't. Again, the question is, is it the activity that results in exposure to the perceived risk rather than the risk itself ?

Sorry I didn't mean to put you off, I was still waiting for you to clarify your original question. But I will answer your question to me, which I felt was actually rhetorical.

--No, it would be silly to walk around with masks on everywhere. Respiratory/droplet spread would not be stopped in that manner. But it would reduce the risk in specific instances. For example, if I go into a hospital room where the patient has TB, I am going to wear a mask, clean my equipment upon leaving, and wash my hands, which is the best way to avoid transmitting something that is spread in this manner.

--No one is going to get HIV because someone coughs on them. So, when having sex, the best precaution is to apply a condom immediately prior to intercourse and to remove the penis from the vagina immediately upon ejaculation and dispose of the condom appropriately. For oral sex, the risk is low (although it cannot be said to be nonexistent), so less precaution is needed. Anal can be carried out in the same manner as vaginal, but is potentially more risky even with a condom, due to microscopic tears in the rectal mucosa. Oh, and for blood transfusions, we reduce the risk by set testing criteria with donated samples.

So, if your question was do more people get concerned over transmission of HIV b/c it is, mostly, sexually transmitted, then I can only answer for myself: it doesn't matter what virus we are dealing with. We should take appropriate and reasonable precautions to prevent it's spread.

[lovedoctor]

I'm sorry I didn't have time to search for anymore specific data to Influenza (A & B), my other search was specifically for SARs.

But this is from the CDC's MMWR (the world, not just the US, when we start adding in 3rd world populations, we cannot even extrapolate to our population, there are so many other confounding variables) April, 2003: Prevention and Control of Influenza
Recommendations of the Advisory Committee on Immunization Practices (ACIP)


"Influenza-related deaths can result from pneumonia as well as from exacerbations of cardiopulmonary conditions and other chronic diseases. Older adults account for >90% of deaths attributed to pneumonia and influenza (1,50). In a recent study of influenza epidemics, approximately 19,000 influenza-associated pulmonary and circulatory deaths per influenza season occurred during 1976--1990, compared with approximately 36,000 deaths during 1990--1999 (1). Estimated rates of influenza-associated pulmonary and circulatory deaths/100,000 persons were 0.4--0.6 among persons aged 0--49 years, 7.5 among persons aged 50--64 years, and 98.3 among persons aged >65 years. In the United States, the number of influenza-associated deaths might be increasing in part because the number of older persons is increasing (56). In addition, influenza seasons in which influenza A (H3N2) viruses predominate are associated with higher mortality (57); influenza A (H3N2) viruses predominated in 90% of influenza seasons from 1990--1999, compared with 57% of seasons from 1976--1990 (1). "

With Influenza, it is more common to trend data than to report specific years, just because of the viral shift from season to season, yet another variable.

-So, it comes down to apples and oranges again... OK, I'm done with all my research for now...thanks!

[tncinmd]

Originally Posted by lovedoctor

-So, it comes down to apples and oranges again... OK, I'm done with all my research for now...thanks!

Once again, you didn't read my responses fully nor answer the question. I outlined the facts you've already stated. I answered your questions fully. The question remains, does the emphasis on AIDS prevention versus other diseases have more to do with the act that is involved in transmission than with the threat ? In other words, is there a moral component involved ? It's just an interesting slant that I wished to draw comments on. Obviously I was wasting my time.

[Four Aces]

My understanding is that swingers are generally in the low-risk category when compared to the normal singles bar-hopping crowd, and especially when compared to the male gay community. This is not just with regards to AIDS, but also for all other STD's.

I think the key here is judgment and in being selective.

4A

[lovedoctor]

Originally Posted by Four Aces

My understanding is that swingers are generally in the low-risk category when compared to the normal singles bar-hopping crowd, and especially when compared to the male gay community. This is not just with regards to AIDS, but also for all other STD's.

I think the key here is judgment and in being selective.

4A

That is interesting about swingers being low-risk. I certainly hope it is true, and I do agree that it is key to be selective. That has nothing to do with moral judgement (for me anyway) - it just has to do with thinking smart about how to go about taking a calculated risk. At least until that fool proof HIV vax comes out! (Thank God, Penicillin is still working great for syph and trich/GC/Chlam are treatable. I wouldn't like getting HSVII or HPV, but I could live with them!)

[Carol_Danny]

Sorry, but I think we need to get back on track with the original intent of this thread. It's all well and good to discuss other diseases and viruses, but that has as much to do with all this as does the chances of dying in an automobile accident! Basically nothing. It's like saying that my chances of dying in a car accident are much greater than dying from unprotected sex, so I had better stop driving! Well, that is silly, but to reduce those chances, we wear seat belts and take other precautions when we drive. The same goes for sex, take the precautions you are personally comfortable with.

We all have our preferred practises, and our own thoughts on what "Safer-Sex" means to us. We have been "Swingers" for well over 20 years, and in that time, have had hundreds of partners. We aren't couple exclusive, and also play with both single men and women. In 1997, we made the conscious decision to only do any penetration with condoms, and we have stuck with that since that day. We do enjoy unprotected oral sex, and are willing to take our chances for that enjoyment. I would say that the only difference these days is Carol goes for the "Facial" instead of the swallowing (with others). That is her choice and meets her comfort level, and we really don't need to defend that choice as you aren't required to defend yours.

As someone mentioned earlier in this topic, he doesn't like to wear condoms, so doesn't engage in much penetration with others. I'm really the same way. Since penetration is such a small and unimportant part of being with others, there is many times that the only person I "penetrate" is my own wife.

These days we also ensure condom use for another reason. When Carol hit 40, she decided to stop using birth control pills, and I went and had a vasectomy. So our worry these days is just not disease related, it's also pregnancy related

Danny & Carol