Checking Attitudes About Herpes

[crazykatie]

Originally Posted by Chicup

That number is the number of people who are serropositive, in other words they have anti-bodies to HSV-2 in their system. This does not mean they have herpes only that they were exposed to it at some point.

Do you think serropositive means that you are not infected and, so long as you have never had a symptomatic outbreak, you are not infected and cannot transmit the disease? What is your source for this?

Serropositive means that your body has developed antibodies to the virus. Your body develops antibodies in response to the presence of the virus. So, to develop antibodies, you must have had the virus within your body. That means you were infected. That is what "exposed" means.

Whether your "exposure" was sufficient to give rise to a recurring case of HSV 2 capable of being transmitted to others, is not easily determined. Of course, doctors can prove the positive (that you are capable of transmitting the infection) if you have an outbreak and a positive culture can be developed from that outbreak. However, since no one can predict if or when the next outbreak will occur (if ever), it is impossible to determine, with certainty, that someone who has been exposed is incapable of transmitting the disease.

Most doctors will tell someone who is serropositive to assume that they are not "infected" unless or until they develop an active outbreak. This isn't because you do not carry the virus or they know for sure that you cannot communicate the disease. This is becasuse there is really nothing medical science can do to treat you (unless and until it turns symptomatic). Moreover, as everyone seems to understand, unless there is an active outbreak, the risk of transmitting the disease, even in the absence of condoms, is very, very low.

However, for the risk adverse out there, does the play/no play equation change if the person admits to being serropositive but claims to have never suffered an outbreak and to have never been diagnosed with the disease? Don't you have to assume that everyone who tests serropositive is infected and capable of communicating the disease?

Originally Posted by Chicup

The EXPRESSED incidence of genital herpes 2 is 1.8-.4% of the population.

What do you mean by the "EXPRESSED" incidence? That someone had an outbreak, that outbreak has been swabbed, and that a positive culture has developed from that swab? What is the source of your information?

At any one time, between .4% and 1.8% of the population is suffering from a symptomatic outbreak of the disease capable of communicating it to others (that's what this statistic means). Of course, a far larger percentage of the population is infected with the disease lying dormant. This is because the disease lays dormant for months or even years (or maybe forever for some) between outbreaks.

So long as you measure the risk of infection only in terms of playing during outbreaks, than your odds of running into an EXPRESSED case of herpes (one that is in outbreak and most communicable) is about 2 in 100--probably a lot less since symptomatic sufferers are likely to stay home. And, I agree that the EXPRESSED risk is probably your better risk measure since the risk of transmission drops dramatically if there is no outbreak.

But, everyone needs to understand what this statistic represents. It is not a measure of the population that is infected. It is not a measure of the population that has symptomatic outbreaks. It is the measure of the population with a symptomatic outbreak at any given time. Who comprises that population changes as outbreaks subside in some people and develop in others.

Of course, reliance upon this statistic suggest that you would be willing to play with a couple who does not have an EXPRESSED case of the disease. Is that how those infected with herpes should view themselves? If they do not have an EXPRESSED case, then they can call themselves "disease free"?

[crazykatie]

Originally Posted by good times

Herpes is reported to be highly contagious, so if I am mistaken most of us would already have it. You are correct that a lot of my evaluation of the reliability of these statistics is influenced by my personal experience. The fact is we are active swingers, we know literally hundreds of other swingers in our area, yet none of us have contracted Herpes from playing with others. This either means we are all extremely lucky, or that the statistics are wrong or exaggerated, I believe it is the later.

You are so wrong. Herpes is only mildly contageous WHEN THERE IS AN OUTBREAK. When there is not outbreak, it is generally not communicable (except, possibly, via viral shedding, which also occurs infrequently). Further, condom use greatly reduces the risk of transmission--even during an outbreak.

I am not saying these are reasons for playing during an outbreak. I am merely saying that your conclusions concerning the disease are based upon a very bad assumption.

[good times]

Originally Posted by crazykatie

You are so wrong. Herpes is only mildly contageous WHEN THERE IS AN OUTBREAK. When there is not outbreak, it is generally not communicable (except, possibly, via viral shedding, which also occurs infrequently). Further, condom use greatly reduces the risk of transmission--even during an outbreak.

I am not saying these are reasons for playing during an outbreak. I am merely saying that your conclusions concerning the disease are based upon a very bad assumption.

No, my conclusions are based on a thorough study of the available research on Herpes and its transmission. I have no idea where you got this information, but even the most enthusiastic condom proponents concede that condoms provide very limited protection for both HSV and HPV. Basically, if you cover the area that is shedding the virus with a condom, and you have not previously touched that area with your hands or other body parts (not likely), then it can serve as an effective barrier. Most swingers perform oral during foreplay without a condom, so putting a condom on for intercourse is like closing the barn door after the horse is already loose.

As far as how contagious it is, that is something one would only know after they get an outbreak. From what I understand, it depends a lot on the individual immune system, some folks are more susceptible than others. So, again it isn't unreasonable for people that don't have it to logically refrain from playing with those that do.

By the way, my comment above on the numbers one might encounter in the swinging community were based on the same generally accepted numbers that Chicup, our resident Doctor, related above. The only reason I think it would be less is because we are in a low risk demographic group, that being couples in a long term relationship.

[Chicup]

Lets stop beating around the bush here.

Sorry you have HSV-2, lower risk or not we wouldn't want to swing with you because its still a greater risk than not having it.

There was a period we thought we may have contracted HSV-2. It didn't make sense due to our lack of activity but the symptoms seemed to be there. If it was we decided we were done swinging, but tests turned out to be negative.

At best rather than playing semantic games with HSV transition rate, we would have only played with people who were HSV-2 positivity themselves.

[Tybee Swing]

Originally Posted by good times

Most of us, as long time married couples, are in an extremely low risk group for having STD's.

The researchers who mentioned longtime married couples as a low-risk demographic surely were not including swingers among this group. That stat would have been for the garden variety monogamous vanilla marriage.

Originally Posted by good times

The only reason I think it would be less is because we are in a low risk demographic group, that being couples in a long term relationship.

I truly don't understand your rationale at all in believing that swingers are in a low risk demographic group. First, you seem to be assuming that swinger couples are by-and-large coming from longterm relationships. Perhaps you're picturing most swinger couples as having been each other's one-and-only for decades, having little-to-no sex with others prior to marriage, being faithful, and then entering into the lifestyle much later, pristine and pure. In swinging, the couple mixes only with other pristine, very longterm couples who'd been monogamous all of those years. This picture seems 100% unrealistic to me.

In reality, many swinger couples are just dating each other, engaged, "SO's", or haven't been married that many years. Virtually all of these people had sexual histories long before they became Mr. and Mrs. Swing Couple. Many people experienced serial monogamy with different people before settling down. Many couples who swing got together after coming out of past divorces (my husband and I are one of these couples.) It's normal and typical in our culture, as well as for those of us in swinging, to have had sex with various and sundry people (each with our individual, varied sexual histories) - and I mean as Vanillas. We were "out there" when we were young and single before marriage, and in between marriages (single-again). A lot of swinger couples have threesomes from time to time, meaning that we're currently playing with singles who are still "out there" having sex with whomever. Some swingers were cheaters in marriage(s) at some point. How do any of us really know much of anything about our play partner's longterm sexual history? We don't. If we each could calculate how many sex partners we've had plus all of the people our lovers had before we were with them, that would be quite a number! When you factor in the nature of herpes and the fact that it lays dormant (outbreak-free) in so many people - possibly for decades without them realizing they have it - all the while potentially shedding the virus at unknown times, I think it's extremely easy to see just how much risk there is for anybody.

Swingers don't exist in their own special, unique demographic of society, and we aren't in a special group that's somehow safer than the rest of society. We are society - we really are just like everybody else. We come from all walks of life and have all sorts of backgrounds. We are just as "dirty" and exposed as everybody else in our culture. Personally, I believe we're exposed much moreso. After just one swinger convention/hotel takeover weekend, an average 30-something newbie couple could have more sex partners in two nights than the sum total of their lifetime before that weekend. Perhaps there does exist among swingers those special couples who hooked up at Prom at age 16, stayed together and 100% monogomous ever since, right until that moment 20 years later when they set foot in their first swing club, as pure as the driven snow (they are that special low risk demographic). In that moment they're virtually guaranteed to be 100% clear of having anything. But, if they take to the lifestyle like a pair of ducks to water as the rest of us swingers have, *poof*, the moment is gone. No more guarantee.

The vast majority of we who swing, know little-to-nothing about the sexual pasts of any of our play partners. We see Mr. and Mrs. Hottie right before us, they're attractive, nice, sexually selective, "clean"-looking and willing, and that's all we're thinking about, it's all that matters. Married and faithful for 20 years, Mrs. Hottie may have picked up herpes 22 years ago from her college boyfriend. She's never had an "outbreak" or anything like that, nothing to cause alarm or make her wonder (a couple of times thought she had a bug bite down there, and occasionally she got that "mysterious female rash"). A few times over the years, Mr. Hottie was "chafed". Herpes never crossed their minds.

None of us want to think about risk in the lifestyle, it's a real mood-killer. But it seems irresponsible and frankly dangerous to live in denial and pretend that being a longterm couple who swings with a variety of other longterm couples somehow improves the odds against something like herpes.

[good times]

I guess I am not making my point clear enough. No, I do not think swingers are in any more low risk group than the average married person in society. In fact, I am fairly certain that swingers are at slightly higher risk than your average monogamous couple ( although that is an assumption, as I know of no case were swingers were ever studied). Even totally monogamous couples are not totally safe and can contract the virus though. You can use a bathroom towel that someone shedding the virus used previously and contract Herpes. The fact is their are many higher risk groups than your average married couple, which I believe skews the numbers in these estimates of how many people on average have the disease. My point is I can't find any reason to believe that my wife and I, who only play with couples, are at significantly more risk than anyone else. It is true that some people have Herpes and never or rarely have an outbreak. Odds are, even if I played with them I wouldn't contract the virus, because the chances are, they wouldn't be shedding at the time.

The basic point here is that people come to forums like this and make claims like, "1 in 4 people have Herpes" like every forth person you have sex with is shedding the virus, when in fact, even the most pessimistic estimate is that 1 or 2 in 100 people you encounter may be currently shedding the virus, and my understanding is that the common cold sore (HSV-1) is included in that number. Some may live in denial, but I certainly don't. Each time I have sex with someone I am taking a risk. Fortunately, I have studied this subject enough to know that the odds are not 1 in 4, or whatever the current scare claim is, and have determined to my own satisfaction that the risk is acceptable to me. That I am comfortable with the odds does not mean I am in denial, it just means I have come to terms with the risk enough to be able to play with others.

The alternative is to not play at all, because you really have no way of knowing if a person is shedding the virus or not, unless they are having an obvious outbreak that you can see.

The only people I see that I would consider being in denial are the people who believe that once they slip that condom on they are safe. I realize that some, in fact many on this board, know that the amount of protection a condom provides is somewhere between 2% and 50%, depending on who you believe. I can't tell you how many people I have run into at clubs though that really believe that if they use condoms they are 100% safe from contracting STD's.

Frankly, what boggles my mind is that some people can believe that 20% of the people around them have active genital herpes, and they are still willing to play with them. For my part, if I believed that, I sure wouldn't be swinging. Fortunately for me, the actual statistics don't support that claim.

[crazykatie]

Originally Posted by good times

The basic point here is that people come to forums like this and make claims like, "1 in 4 people have Herpes" like every forth person you have sex with is shedding the virus, when in fact, even the most pessimistic estimate is that 1 or 2 in 100 people you encounter may be currently shedding the virus, and my understanding is that the common cold sore (HSV-1) is included in that number. Some may live in denial, but I certainly don't. Each time I have sex with someone I am taking a risk. Fortunately, I have studied this subject enough to know that the odds are not 1 in 4, or whatever the current scare claim is, and have determined to my own satisfaction that the risk is acceptable to me. That I am comfortable with the odds does not mean I am in denial, it just means I have come to terms with the risk enough to be able to play with others.

So far as I can tell, no one has claimed that one in four or one in five people are, at any given moment, contageous. However, the CDC reports that one in four women and one in five men have contracted the virus at some time in their lives.

Good Times: You appear to equate "having Herpes" with being capable of communicating the disease. So, is it your view that when one believes that they are not contagious (no active outbreak, no signs of viral shedding), they are not suffering from Herpes? Further, if someone is seropositive for HSV2 but has never had an outbreak (so they never had a cultured confirmation that they are contagious) can they continue to think of themselves as "disease free"?

[crazykatie]

Originally Posted by Chicup

Lets stop beating around the bush here.

Sorry you have HSV-2, lower risk or not we wouldn't want to swing with you because its still a greater risk than not having it.

There was a period we thought we may have contracted HSV-2. It didn't make sense due to our lack of activity but the symptoms seemed to be there. If it was we decided we were done swinging, but tests turned out to be negative.

At best rather than playing semantic games with HSV transition rate, we would have only played with people who were HSV-2 positivity themselves.

No problem. I completely understand and could see myself thinking the same way if the roles were reversed. I am not trying to convince you to play with me or anyone. Frankly, I'd rather play with couples who are seropositive, too. It would save a lot of talking.

However, the problem appears to be that the stigma associated with the disease actively prevents those who have it from being able to associate with others who have it. Very few who have the disease are willing to openly acknowledge this fact (even to others with the disease) for fear of being "outed." Consider SLS. Over twenty percent of the population is infected. Yet, no where near that percentage of profiles disclose the condition. Is it because swingers are disproportionately healthier than the rest of society? Or is there something else at work here?

Clearly, the stigma prevents those who might otherwise be willing to associate with one another from doing so. Go figure. I have learned so, so much in the last month...

I only wish to make these points....

First, if you are an active swinger (have played with more than seven other people/couples), statistically chances are that you have played with at least one person who is seropositive for the virus.

Second, by stigmatizing the disease, you all but ensure that no one will openly admit to being seropositive. No one wants to admit to being seropositive for fear that the community within which they play will learn of their condition and they will be shunned. Like Good Times, they will define themselves as not infected ("disease free") so long as they do not have an outbreak or symptoms of viral shedding. Provided that they have accurately judged their condition, they will be practically correct since they will not be contagious.

Please don't misunderstand me. In hindsight, I understand why it is that the stigma is unlikely to lift. And, as I said, I certainly see and understand your view.

Still, if you become infected, it will most likely be the result of play with someone who does not know they are/were infected and not because of play with someone who knows they have it. It is the ones that don't know they have it (or refuse to seek treatment) who are truly dangerous. They are the ones who are not on suppressive therapy, who have not been educated on the symptoms to watch for with the onset of an outbreak/shedding, and who do not pay close attention to issues of condom etiquette (like changing condoms with every play partner). If you believe the CDC (which I understand some people don't), one in four women and one in five men are infected and most don't even realize it.

If you are going to play, you will inevitably play with someone who has herpes. Once everyone accepts this basic proposition, it will be easy to lift the stigma. It is absolutely and undeniably true that you are better off playing with someone who knows they have it over someone who has it but thinks they are clean. But, I understand that there are those of you who are active swingers and still believe that you have never played with someone who is seropositve.

[good times]

Originally Posted by crazykatie

Good Times: You appear to equate "having Herpes" with being capable of communicating the disease. So, is it your view that when one believes that they are not contagious (no active outbreak, no signs of viral shedding), they are not suffering from Herpes? Further, if someone is seropositive for HSV2 but has never had an outbreak (so they never had a cultured confirmation that they are contagious) can they continue to think of themselves as "disease free"?

I don't really know that I have a view regarding that, in my opinion, they either have it or they don't. On the other hand, if I play with someone and they aren't shedding the virus, then technically, from my risk point of view, it would be the same as if they didn't have the virus at all. In other words, how would I know if anyone was infected, if they had no signs and were not actively shedding the virus? I wouldn't, but do I think it would be right for someone to knowingly deceive people? No, but it wouldn't surprise me to find out it happens. That is a risk we take, but as I said before, it doesn't appear to me from the research available to be as big a risk as some would have us believe. The reason for that is, my risk is only in relation to those who are actively shedding the virus, the rest of the people I might come in contact with, whether serropositive or not, don't make any difference, because I can't contract the virus from them. So, while it might freak me out if I believed 1 in 5 of the people I had sex with had herpes, the fact is, I have less than a 1 in 100 chance of having sex with someone who can actually give me Herpes. And unlike some other STD's, if I educate myself to the signs and symptoms of Herpes, I can substantially reduce my chances of coming into contact with it even further.

My view is, I would not knowingly play with someone who has Herpes. Whether someone is on suppressive therapy or not doesn't make any difference to me, because either one of them could be unknowingly shedding the virus on the night I play with them, their is no way for either them or me to know if they are currently shedding or not. If, on the other hand, the drugs caused the person infected with herpes to never shed the virus, I would have a totally different view and would probably have no problem playing with them. The suppressive drugs do not work that way though, a person on the drugs can still be shedding the virus at any time. With that in mind, it is true that the person on suppressive therapy may shed the virus less often than if they weren't taking the drugs, so odds are, that I am less likely to contract the virus from them than another person who has the same outbreak frequency without the drugs. The problem is, I am not an odds player, to me, the person with herpes that is on surppressive therapy is no different than one who has it and isn't on medication, they are both a risk I do not need to take. Therefore, I don't believe these people are being stigmatized, that would presume that we believe something that isn't true. The fact is, whether one is on suppressive therapy or not, they can pass the virus, so it is not stigmatization, it is facts that drive my decision not to knowingly play with them. I agree that it is a bummer for someone who has herpes and wants to play, but the risk is there, so the best risk avoidance is to not go there.

[Tybee Swing]

Originally Posted by good times

Therefore, I don't believe these people are being stigmatized, that would presume that we believe something that isn't true.

Hi good times,

I'm not commenting on herpes or how/why we make our choices about who to play with (or not), but rather the definition of stigmatizing and being stigmatized.

To stigmatize a person doesn't necessarily involve believing something that's not true. Regardless of facts/truth, stigmatization is merely the act of identifying in terms of being scurrilous, reproachable, scandalous, offensive, disgraceful, infamous, contemptable, deserving of scorn. To be stigmatized is basically to have a bad reputation and to be "branded" or marked as unfavorable; to be socially ostracized or avoided.

This can occur with or without the presence of truth.

[good times]

Thanks for the definition Tybee, I stand corrected. I was looking at it more from the perspective that my unwillingness to play with someone with Herpes is not because they are stigmatized, but is because of the fact that they can transfer the virus. But I see that my reference to stigmatization is incorrect. So I guess I am stigmatizing them, doesn't change the way things are though.

[crazykatie]

Good times, I really appreciate your candor as, I believe, your viewpoint is shared by the vast majority of swingers who do not believe they are infected.

I do not find it hard to believe that the vast majority of swingers or lifestyle couples would choose not to knowingly play with someone who is seropositive. What I find frustrating is the apparent lack of understanding or realization of what the true risks are in contracting the disease and the clear and obvious prejudice within the community against those who have it. The prejudice appears to extend beyond a mere personal preference against playing with the infected. As I understand it, an individual or couple who openly acknowledges their condition can expect word to spread within their local community to the point that they should expect everyone will know they have it. Because they will be “outed,” anyone who openly associates with them may become suspect and, by virtue of the association, be shunned as well. It is this form of stigmatization that I find reprehensible.

OK, I get that everyone who isn’t infected wants to remain that way. What are your options? The only absolutely sure way to avoid infection is to never play outside a committed, monogamous relationship. Because of the asymptomatic nature of this disease, many people who don’t think they have it and don’t have any outward signs of infection are, nonetheless, contagious at any given time. http://www.herpesweb.net/general/facts/general.htm Moreover, because the body requires time to develop sufficient anti-bodies to the virus to test positive after an initial infection, even individuals with recent negative blood tests can still be both infected and contagious. http://www.webmd.com/genital-herpes/Herpes-Tests So, limiting your play partners to those who claim not to be infected and also claim to have recent blood tests to prove it does not assure yourself that you are playing with the uninfected (assuming they are telling the truth).

My point....everyone who is engaging in this lifestyle has accepted, on some level, a risk of contracting this disease. The only question is what do you consider an acceptable level of risk?

With that as an introduction, I want to respond to some of good time’s points.

Originally Posted by good times

The problem is, I am not an odds player...

I think this statement reflects the thinking of a large percentage of the swinger population. It is also demonstratively not true. Good times, you admit yourself that you are and "odds player" when you write:

Originally Posted by good times

....if I play with someone and they aren't shedding the virus, then technically, from my risk point of view, it would be the same as if they didn't have the virus at all. In other words, how would I know if anyone was infected, if they had no signs and were not actively shedding the virus? I wouldn't, but do I think it would be right for someone to knowingly deceive people? No, but it wouldn't surprise me to find out it happens. That is a risk we take, but as I said before, it doesn't appear to me from the research available to be as big a risk as some would have us believe. The reason for that is, my risk is only in relation to those who are actively shedding the virus, the rest of the people I might come in contact with, whether serropositive or not, don't make any difference, because I can't contract the virus from them. So, while it might freak me out if I believed 1 in 5 of the people I had sex with had herpes, the fact is, I have less than a 1 in 100 chance of having sex with someone who can actually give me Herpes.

At the end of the day, you acknowledge both the risks and the odds. You know that the choice you face is to play or not to play. The only way to take your odds to zero is to decide not to play. You have evaluated the information and have correctly assured yourself that, all things taken together, your personal odds of playing with an infected partner who is contagious is about 1 or 2 in 100. Against the option of not playing at all, you are willing to accept those odds. So, don’t try to tell me that you are not an odds player.

In point of fact, what you really don’t want to acknowledge is that you are playing the odds. And, here is how they work for you or against you. Every time you play with a new partner there is a roughly one in five chance that they are infected. So, your chance of playing with an infected person is approximately 20%. Play with two people and the odds of one of them being infected rises to 36% (the odds of them both being uninfected is 80% times 80% or 64%). By the time you have played with eight people, the odds that at least one of the eight was infected has risen to 83%.

Fortunately, the odds of them being infected is (as you have pointed out) much higher than the odds of them being contagious. A recent study investigated the relative risk that someone infected with herpes is actively shedding. The study was undertaken in connection with one of the suppressive drugs. http://www.natap.org/2004/HIV/051004_05.htm The incidence of viral shedding in individuals not taking suppressive medications was 3.1%. So the odds of interacting with someone who is both infected and shedding asymptomatically is roughly 00.64% (20% times 3.1%). Stated differently, you have a 99.36% chance of playing with someone who is either not infected or infected and not contagious. Pretty good odds, huh? This is why you swing and everyone else does, too. Even if you hit that one in one hundred situation, there is still a relatively good chance that with safe sex practice, you are protected!

Here is where it gets interesting. If a person has herpes, knows they have herpes, and is on suppressive therapy, the risk of them asymptomatically shedding (depending upon the dosage of the drugs) is between 00.52% and 00.35%. Stated differently, you have between a 99.65% chance and a 99.48% chance of playing with a partner who is actively shedding virus when your partner knows that they have it and is taking suppressive medications. Your risk of playing with a partner who is actively shedding the herpes virus is actually lower when the person knows that they are infected.

By the way, this analysis does not take into account the risk that the partner who does not think they are infected is, in fact, infected and having an outbreak!

The reality of how this disease is spread has caused one medical website to openly acknowledge the following....

Originally Posted by www.medscape.com

But here's an interesting way to look at that risk. Let's say that Diane, who is truly uninfected (ie, HSV-2 seronegative), meets Bob who has HSV-2. Bob tells Diane about his infection. He offers to use condoms every time they have sex, take daily antiviral therapy, and agrees to try to be aware of any symptoms that may signal the beginning of an outbreak. Diane says that she just can't handle any risk, even though she really likes Bob. So she says goodbye and moves on. Then she meets Bill. She asks him right away whether he has herpes because now she's really worried about getting infected. He replies that he's "not that kind of guy" and is certain that he is not infected, only he really is (as approximately 1 in 4 adults are) but doesn't know it. Now we know that Bill is shedding virus at the same rate as Bob, but because he is unaware of his infection and doing nothing about it, he is more likely to infect Diane than Bob ever was. But Diane likes Bill's answer. She has sex with him with birth control pills instead of condoms, and within 2 months is infected with HSV-2. She's the one sitting in your exam room, waiting for the news. And the circle continues. http://www.medscape.com/viewarticle/489964

Let’s attack another myth....

Originally Posted by good times

And unlike some other STD's, if I educate myself to the signs and symptoms of Herpes, I can substantially reduce my chances of coming into contact with it even further.

Simply not true. Over 70% of the time, the disease is transmitted during periods when there are no outward signs of infection. http://www.ncbi.nlm.nih.gov/sites/en...indexed=google While being knowledgeable about the disease can certainly help the infected know when they are likely to be contagious, all that the partner has to go on is whether an open sore is visible on their partner. That is not enough to substantially reduce the risk of contracting the disease.

Originally Posted by good times

My view is, I would not knowingly play with someone who has Herpes. Whether someone is on suppressive therapy or not doesn't make any difference to me, because either one of them could be unknowingly shedding the virus on the night I play with them, their is no way for either them or me to know if they are currently shedding or not. If, on the other hand, the drugs caused the person infected with herpes to never shed the virus, I would have a totally different view and would probably have no problem playing with them. The suppressive drugs do not work that way though, a person on the drugs can still be shedding the virus at any time. With that in mind, it is true that the person on suppressive therapy may shed the virus less often than if they weren't taking the drugs, so odds are, that I am less likely to contract the virus from them than another person who has the same outbreak frequency without the drugs.

It is here that you previously stated that you were not an odds taker, which notion I think I have already completely debunked...

Originally Posted by good times

....to me, the person with herpes that is on suppressive therapy is no different than one who has it and isn't on medication, they are both a risk I do not need to take.

The question isn't whether you need to take a risk; you decide to take a risk each and every time you play. Instead, the question is: how much of a risk can you afford to take?

The risk that your partner who has herpes and is not on a viral suppressant is shedding is about: 1 in 32

The risk that your partner who does not think he has herpes actually has herpes and is shedding is approximately: 1 in 156

The risk that your partner who knows that they have herpes and is on a suppressant is shedding is approximately: 1 in 192 to 285

Of course, with safe sex practices, the odds of actually contracting the disease even if there is shedding approaches zero.

Still, if you can afford to take the 1 in 156 chance of playing with someone who is shedding even though they think they are clean, then you certainly should be able to afford the 1 in 192 to 285 chance of playing with someone who knows they have the disease, is treating it appropriately, and is (nonetheless) shedding. Conversely, if the 1 in 192 to 295 chance of exposing yourself to shedding with someone on suppressive therapy is too much for your taste, then you shouldn't be able to accept the 1 in 156 chance resulting from play with those who don't think they are infected.

Given the odds that swingers must be willing to accept just to play, there is absolutely no reasoned basis to avoid contact with the individuals and couples who know they are infected. You really are safer playing with the people who know they have the disease than you are playing with people who say that they don't.

But, I understand that as logical as this argument is, many of you simply don't want to knowingly play with fire. You want to believe that you are safer playing with those who do not believe they are infected because the idea that you are safer playing with someone who knows that they have the disease is fundamentally unsettling. So, you make a personal decision not to play with the infected.

However, your personal decisions (this comment is directed to the swinger community as a whole, not just good times)--to be irrational and ignorant of the real odds of contracting this disease--does not (in my mind) justify shunning or stigmatizing the open and honest couples playing with this disease. Yet, it appears from my research, that is exactly what is happening. The swinging community has allowed its ignorance of this disease to fuel an irrational fear that clouds all judgment. It has also fueled a prejudice which drives honest individuals underground when, I think, many of them would much rather be open and honest about their conditions.

I think it is wrong for this community to so stigmatize this disease that the stigma prevents people from openly acknowledging their condition--not because they are afraid that some will decide not to play with them--but because they are afraid that once they are “outed,” no one will dare risk to associate with them. That is wrong because, among other things, it raises prejudice over reason.

[crazykatie]

Originally Posted by JustAskJulie

I think there's an option missing.
- Both create the same risk.

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

So, both do not create the same risk.

Moreover, statitically, your risk of playing with someone who is sheding virus is higher when you play with someone who does not think they are infected than when you play with someone who knows they are infected and is on a suppressant. The risk associated with playing with someone who does not think they are infected is found by multiplying the risk that they are actually infected when they think they aren't (about 20% for men and 25% for women) with the shedding risk when not taking a suppressant (3.1%). The resulting risks are 0.77% [1 in 129] for men playing with women and 0.62% [1 in 162] for women playing with men.

[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.

One more example,

You said, "Simply not true. Over 70% of the time, the disease is transmitted during periods when there are no outward signs of infection. http://www.ncbi.nlm.nih.gov/sites/e...&indexed=google While being knowledgeable about the disease can certainly help the infected know when they are likely to be contagious, all that the partner has to go on is whether an open sore is visible on their partner. That is not enough to substantially reduce the risk of contracting the disease."

Again, a totally out of context and misleading number, it actually says that of the people in the study, having sex with a partner known to have herpes, 70% report they observed no signs of an outbreak when they contracted the virus. The previously infected partner usually went on to show signs of an outbreak within hours of the time when sex occurred and the observation was made, and the subjects of the study would have refrained from sexual activities had the signs of an outbreak been present. So it is no surprise, that among observant educated people having sex with someone known to have Herpes, that 70% of them would contract the virus during the period when their partner was shedding asymptomatically just prior to having visible signs of an outbreak. This has absolutely no correlation to what one might encounter outside of a controlled study, or when one is unaware that his partner has Herpes, nor do the researchers claim it does. The time that an infected person sheds the virus asymptomatically is far less than when they shed the virus symptomatically. So, if I am observant and knowledgeable about what to look for, the research data shows that a person having an outbreak is far more likely to be showing obvious signs of having an outbreak while shedding than not.

That being said, from my perspective, the following are the actual numbers important to me;

If I play with people who are not infected, my chances of contracting the virus are 0%. If someone has the virus, whether they are on suppressive therapy or not, the chances that they will be shedding the virus at some time in the future is close to 100%. No one can tell me for certain what the chances are that I personally may end up playing with someone on the day they happen to be shedding. So the only way I have to reduce my risk in relation to people known to have the virus is to not play with them. I realize that their is a possibility that I may end up playing with someone who has Herpes and is shedding asymptomatically, and in that sense you are correct, I am playing the odds. My only point is, that my study of the research available has proven to me that the odds aren't anywhere near as bad as your numbers above make them out to be. 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. In that respect, for me, their is no difference in risk between someone on suppressive therapy or not.

The only thing I can really agree with you about is that the people who admit they have Herpes will most likely be shunned by other swingers. Unfortunately, unless they find a cure or vaccine for Herpes, I don't know of anything that can be done about that.

[crazykatie]

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.

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 th