Safe Sex and Sex Related Discussions in Thailand

[AussieDoug]

HIV is not a huge problem anywhere in the western world wherever public health policy gives free treatment for usual STD's, most of the western world does that with the exception of America. The chances of HIV transmission thru vaginal sex is very very low. If you want to go banging boys and hanging around back doors and druggies you are asking for it. HIV started out as GRID, Gay Related Imune Deficiency, it had to become a heterosexual problem purely to get government funding. So, if you want to get started on being part of the first world on STD prevention back President O Bummer's health policy. It's plain stupid that it costs hundreds of dollars to get the clap treated in the USA when the pathology and drugs are worth peanuts. In Australia it costs $70 to see the doctor, the pathology is about the same fro a VDRL, the drugs are less than $30, and you get back about $60 from Medicare, that's why we have very little STD's around, including HIV. There has never been a documented case of female to male transmission in Australia of HIV where no other risk group was part of the equation.

[Wolvenvacht]

Surly you've made some mistake here? 38 in 10000 would be roughly 10 in 2500 (or 9. 5 in 2500, to be exact).

Oops, you are right. Jetlag has still paralysed my brain it seems.

[Werqweq]

38 in 10000 is about 1 in 2500, so not that much different to your 1 in 2000. These statistics are anyhow very "rough" and if you hunt around you will find many different ones and rarely if ever a link to the raw data so you can check the stats.

Surly you've made some mistake here? 38 in 10000 would be roughly 10 in 2500 (or 9. 5 in 2500, to be exact).

[Wolvenvacht]

I'm wondering where your "transmission rate of 38 in 10000" comes from. Was the Wikipedia number not 1 in 2000?

Also, how are you calculating your numbers. Is there on online source that you could refer me to, or a calculator to plug the figures in?

Finally, I was curious if you agreed with this math:

"If we take Degan's number of 1/2000, and use 10% infection in the target group (and that is probably too large, but we'll go with it) , we arrive at 13, 862. 6 sexual encounters to have a 50% probability of infection. That's a different partner every single day for about 38 years, and then it is only even money you are infected."

It seems that your 40 year rate has about the same percentage of 53, but is based on sex thrice weekly, whereas this calculation speaks of doing it "every single day".

Hi PinkPearl,

Just got back from the Land of Smiles and only now saw your comments. And yes, I only had protected sex. Even with my Thai girlfriend.

38 in 10000 is about 1 in 2500, so not that much different to your 1 in 2000. These statistics are anyhow very "rough" and if you hunt around you will find many different ones and rarely if ever a link to the raw data so you can check the stats.

Calculations are easy, if you calculate the chance to stay healthy (rather than the risk to catch HIV).

Let's go with your example:

1 in 2000 with a 10% infection rate is a chance to catch something of 1/20000, or 0. 00005. In other words you have 0. 99995 chance to remain healthy each time you make love. If you fuck two times, your chances to remain healthy are 0. 99995 x 0. 99995; for three times it is 0. 99995 x 0. 99995 x 0. 99995; etc. So the formula is 0. 99995 xx k with "k" being the number of times you made love and "xx" meaning "to the power of".

If you want to know how many times you can fuck before you reach a certain "risk threshold", you just have to solve the equation "chance-to-stay-healthy = 0. 99995 xx k" for the value of k. Using some basic math skills I remember, it goes as follows: "k = log (chance-to-stay-healthy) /log (0. 99995)". And indeed for a "chance-to-stay-healthy" of 0. 5, you will have to make love 13862. 6 times. Of course, I would never go for such a low chance.

If you do not want to run a risk of more than 10% of catching something, then you reach that after about 2100 sessions, or about 13 years at a steady rate of 3 sessions a week. If you want to stay really safe, and not have more than 1% risk, you exceed that already in little over one year of "3 a week" unprotected sessions.

To appreciate the difference between this calculation and my previous one: the previous one used a "chance-to-stay-healthy" of 0. 99989398 per sex act and this one (based upon 1 in 2000 transmission rate and 10% infected sex workers) of 0. 99995. The difference might seem small, but is significant.

[PinkPearl]

FDA panel endorses pill to prevent HIV infection.

CHICAGO. Condoms and other safe-sex practices accomplished only so much. Now the 30-year battle against AIDS is on the verge of a radical new phase, with the government expected to endorse a once-a-day pill to prevent infection with the virus.

Some doctors already are giving patients the drug, Truvada, to ward off infection. But Food and Drug Administration approval would expand that practice and could make the expensive medicine more affordable. Truvada costs $11, 000-$14, 000 a year.

The lifetime cost of treating one person diagnosed with the AIDS virus has been estimated at more than $600, 000.

Approval seems likely after an FDA advisory panel endorsed the use of Truvada for prevention Thursday.

"With this recommendation, we're nearing a watershed moment in our fight against HIV," said James Loduca, a spokesman for the San Francisco AIDS Foundation."We know this isn't a magic bullet, and it's not going to be the right prevention strategy for everyone, but it could save thousands of lives in the United States and potentially millions around the world."

Since 2004, Truvada has been FDA-approved for treating people infected with AIDS. Once a drug is on the market, doctors are free to prescribe it for off-label, or unapproved, uses, and that's what some have been doing in giving Truvada to patients who are healthy but in danger of getting the virus from their partners or through risky sex.

Official FDA backing of the practice would allow Truvada's maker, Gilead Sciences of Foster City, Calif, to market it for prevention. Approval probably would spur many more insurance companies to pay for the drug. And widening the market for Truvada could prompt Gilead to lower the price.

An FDA decision is expected by June 15.

In one USA government study of more than 1, 200 men and women in Botswana, Truvada lowered the HIV infection risk about 78. Another larger study in Africa found a slightly lower rate of effectiveness, but researchers say that if used as directed, the pill can be 90% effective or higher.

An estimated 1. 2 million Americans and millions more around the world have HIV. Unless the virus is treated with antiviral drugs, it can turn into full-blown AIDS. Antivirals made the disease more manageable and allowed patients to live much longer than when the epidemic began in the early 1980s.

Nevertheless, about 50, 000 new infections are diagnosed in the USA each year, a number that has held steady for about 15 years.

Truvada represents "a pretty radical step, but I think it's a necessary step," said Dr. Lisa Sterman of San Francisco, who treats HIV patients. She prescribes the drug to infected patients and those who are healthy but at risk.

"We've come as far as we can with condom use and safe-sex strategies."

The FDA also is considering approving the first over-the-counter HIV test for use at home.

FDA reviewers said Friday that the OraQuick In-Home HIV test could play a significant role in slowing the spread of HIV, according to briefing documents posted online. But they also raised concerns about the accuracy of the test, a mouth swab that returns results in about 20 minutes.

Public health experts estimate one-fifth of the 1. 2 million HIV carriers in the USA. About 240, 000 people. Are not aware they are infected.

http://www.freep.com/article/2012051...on?odyssey=mod

|mostview

[PinkPearl]

It might be of interest to consider the relative risks re HIV, such as in the following example which uses an estimated HIV infection rate of 5 in 10, 000 (from Wikipedia) , I. E. 1 in 2000, for an uninfected male having vaginal sex with a HIV positive female. Also assumed is a 10% figure for the liklihood a randomly chosen lady or FSW (female sex worker) is infected with HIV.

http://en.wikipedia.org/wiki/HIV

#Transmission.

"If we take Degan's number of 1/2000, and use 10% infection in the target group (and that is probably too large, but we'll go with it) , we arrive at 13, 862. 6 sexual encounters to have a 50% probability of infection. That's a different partner every single day for about 38 years, and then it is only even money you are infected."

http://www.thaivisa.com/forum/topic/...m/page__st__75

(ref posts 87, 89, 96)

The estimated rate of HIV in FSW in Thailand was listed as 2. 79% in the following study.

http://www.unaids.org/en/dataanalysi..._report_en.pdf

Using that percentage of 2. 79% the above quote would change to say:

"If we take Degan's number of 1/2000, and use 2. 79% infection in the target group, we arrive at 49600 sexual encounters to have a slightly less than 50% probability of infection. That's a different partner every single day for about 137 years, and then it is only even money you are infected."

Change that to BBFS once every other day and there is a 95% chance of not being HIV infected in 20 years. It would be 90% after 40 years & 86% for 60 years, a lifetime of being sexually active. After 200 years it would be only a 40% chance of getting HIV, but who lives that long.

Consistent condom use (CFS) that reduced the HIV risk relative to BBFS by 95% would give you a 99. 37% chance of not being infected with HIV, having CFS with SP's thrice weekly for 60 years, with a transmission rate of 1 in 2000 and a SP infected rate of 2. 79. For BBFS it would be 88, 94. 5% if circumcised.

As you can see, based on these figures alone, there is only a few percentage points separating BBFS and CFS. So they would indicate, apart from a consideration of other factors, that there is not a great amount of difference in risk between the two, during a lifetime of sex, except for the usual sensation factor absent in sex with a plastic baggie.

But how reliable are these figures, assuming the math has no mistakes? There is more to the story that would support the case that the difference between CFS & BBFS is wider than what these stats would imply. More to come later, regarding that.

Moreover, BTW, even a few percentage points difference, (though not of much significance betwen two individuals, one using a condom & one not) , will have a huge impact in the big picture of hundreds of millions of people, in terms of HIV and other infections, which is what 'the powers that be' concern themselves with. So those practicing BBFS should do it safely, such as in a monogamous relationship, or with other safe sex practices, as detailed before (I. E. 9 suggested ways).

The 1 in 2000 Wikipedia estimated rate of HIV transmission could vary depending on a number of factors.

Factors that could make the HIV transmission rate higher (or more likely) are vaginal sores, STIs, high viral load,"dry sex", sex during menses (female-to-male transmission) & bleeding during sexual intercourse.

Factors that could make the transmission rate lower are the absence of those problems, male circumcision, use of commercial lubrication, less friction, HIV immunity, and HIV ARV meds minimizing the viral load.

The "presence of other STDS or vaginal / cervical abrasions increases the risk of transmission. Obviously, women with a large number of sexual partners are more likely to have these than women without. Abrasions etc are virtually an occupational hazard of sex work."

http://www.thaivisa.com/forum/topic/...m/page__st__75

Hence the importance of those engaging in BBFS to see that a SP has recently tested negative for STDs, especially HIV (using both 1. Antibody and 2. NAT &/or p24 antigen tests).

An old (1994) study of sex workers in Thailand estimated the HIV transmission rate there was 1 in 100. It has been implied that may have been due to such things as an absence of male circumcision & the presence of STDs which increase the liklihood of HIV transmission. Some research has questioned the validity of the Thai study.

"The sharply increased infectivity reported among female sex workers' clients in an Asian setting may reflect differences by disease stage, as the infectivity study (33) conducted in Asia took place at the start of the epidemic when a large proportion of index cases were in early stages of infection (33, 34). The elevated infectivity in the Asian study also may reflect unmeasured STI co-factor effects, as a large proportion of sex worker index cases were infected with STIs during the study period (67)."

http://journals.lww.com/jaids/Fullte...f_HIV_.10.aspx

http://www.ncbi.nlm.nih.gov/pubmed/7904668

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744983/

A number of studies came up with estimates of 1 in 1000. A later (2008) report analyzed previous research on this topic & warned that the 1 in 1000 figure may be too high. Yet a recent (2010) study of couples found 1 infection per 2200 (5 in 11, 000) acts of BBFS with those known to be HIV positive. No infections resulted from 7000 thousand BBFS encounters with HIV infected individuals on ARV drugs.

"Our findings suggest that in many contexts – particularly in the absence of male circumcision or in the presence of STIs, anal sex, or early or late infection – the heterosexual infectivity of HIV-1 may exceed the commonly cited value of 0·001 (1 in 1000) by more than an order of magnitude."

http://www.ncbi.nlm.nih.gov/pubmed/20472675

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2744983/

As to the percentage of HIV infected SP's I think it likely that those SP's who engage in BBFS often are probably going to have a higher rate of HIV & STD infections than SP's in general. So the general rate of an estimated 2. 79% of infected FSW in Thailand is probably higher amongst those who offer BBFS than those who refuse this service. Consequently the above calculations based on 2. 79% for BBFS are inaccurate and should be recalculated at a higher percentage.

Amongst those engaging in BBFS with SP's, a lower (vs higher) millage SP would probably be safer. As would a first world vs third world SP. An SP who allows anal sex, even with a condom, is also high risk relative to those who don't, since even covered Greek appears to be about as risky as BBFS.

In conclusion, sex with or without condoms, especially BBFS, may not as safe for individuals as certain stats may imply, hence additional safety practices are recommended for personal safety as well as for your partner & the community as a whole.

[Horny Landoora]

Http://www.condomelite.com/condomeli...on-p30047.html

"The Pleasure Plus condom is specifically designed to enhance sensation. Pleasure Plus is a unique, patented, high-quality condom designed to enhance the pleasure of both partners. Pleasure Plus is considered by many as the best feeling condom. Pleasure Plus has a large, loose pouch of additional latex, positioned near the head and on the underside. During sex, the extra latex in the loose pouch slides back and forth against the very sensitive underside of the penis, increasing pleasure for men, while also increasing the pleasure for women."

http://www.undercovercondoms.com/rea...view.asp?ID=77

"I usually hate using condoms. They feel like doing it while trying to wear a sock. But this one almost feels like there isn't anything there at all."

"Feels like nothing at all. Woderful. Try them!"

This is interesting. I would try it out myself next time! Thanks!

[John Dough]

Don't get me wrong, condoms are a very effective method of protection against STI's for people who are not nuns, but I just don't like them anymore. I used to, but now I'd rather watch online porn while giving myself a bareback handjob than have intercourse with a piece of latex.

Http://www.condomelite.com/condomeli...on-p30047.html

"The Pleasure Plus condom is specifically designed to enhance sensation. Pleasure Plus is a unique, patented, high-quality condom designed to enhance the pleasure of both partners. Pleasure Plus is considered by many as the best feeling condom. Pleasure Plus has a large, loose pouch of additional latex, positioned near the head and on the underside. During sex, the extra latex in the loose pouch slides back and forth against the very sensitive underside of the penis, increasing pleasure for men, while also increasing the pleasure for women."

http://www.undercovercondoms.com/rea...view.asp?ID=77

"I usually hate using condoms. They feel like doing it while trying to wear a sock. But this one almost feels like there isn't anything there at all."

"Feels like nothing at all. Woderful. Try them!"

[PinkPearl]

It might be of interest to consider the relative risks re HIV, such as in the following example which uses an estimated HIV infection rate of 5 in 10, 000 (from Wikipedia) , I. E. 1 in 2000, for an uninfected male having vaginal sex with a HIV positive female. Also assumed is a 10% figure for the liklihood a randomly chosen lady or FSW (female sex worker) is infected with HIV.

http://en.wikipedia.org/wiki/HIV

#Transmission.

"If we take Degan's number of 1/2000, and use 10% infection in the target group (and that is probably too large, but we'll go with it) , we arrive at 13, 862. 6 sexual encounters to have a 50% probability of infection. That's a different partner every single day for about 38 years, and then it is only even money you are infected."

http://www.thaivisa.com/forum/topic/...m/page__st__75

(ref posts 87, 89, 96)

The estimated rate of HIV in FSW in Thailand was listed as 2. 79% in the following study.

http://www.unaids.org/en/dataanalysi..._report_en.pdf

Using that percentage of 2. 79% the above quote would change to say:

"If we take Degan's number of 1/2000, and use 2. 79% infection in the target group, we arrive at 49600 sexual encounters to have a slightly less than 50% probability of infection. That's a different partner every single day for about 137 years, and then it is only even money you are infected."

Change that to BBFS once every other day and there is a 95% chance of not being HIV infected in 20 years. It would be 90% after 40 years & 86% for 60 years, a lifetime of being sexually active. After 200 years it would be only a 40% chance of getting HIV, but who lives that long.

Consistent condom use (CFS) that reduced the HIV risk relative to BBFS by 95% would give you a 99. 37% chance of not being infected with HIV, having CFS with SP's thrice weekly for 60 years, with a transmission rate of 1 in 2000 and a SP infected rate of 2. 79. For BBFS it would be 88, 94. 5% if circumcised.

As you can see, based on these figures alone, there is only a few percentage points separating BBFS and CFS. So they would indicate, apart from a consideration of other factors, that there is not a great amount of difference in risk between the two, during a lifetime of sex, except for the usual sensation factor absent in sex with a plastic baggie.

But how reliable are these figures, assuming the math has no mistakes? There is more to the story that would support the case that the difference between CFS & BBFS is wider than what these stats would imply. More to come later, regarding that.

[Chill Out]

You are a doctor? That's funny. Do you smoke but limit the damage by exhaling really fast?

[PinkPearl]

So let me try to understand. Since no one is a doctor or part of the Research on the subject, why post this stuff? Obviously its a copy from Google?

Why bother?

I'm a doctor. What's your problem? HIV? Under 25 YO?

[NicFrenchy]

So let me try to understand. Since no one is a doctor or part of the Research on the subject, why post this stuff? Obviously its a copy from Google?

Why bother?

[PinkPearl]

OK. Updated the figures.

Assuming 2. 79% of Thai sex workers are HIV-infected and a transmission rate of 38 in 10000 (uncircumsized men, unprotected vaginal sex) , gives you a chance of not catching it of 0. 99989398 per sex act. At 3 times sex per week over 20 years, you have a 73 per cent of not getting infected. At 40 years exposure, it goes down to 53 per cent. At 60 years of exposure, it becomes 39 per cent. 3 times sex per week during 60 years will probably kill you from exhaustion already.

Circumcision lowers the transmission rate by (average) 55 per cent. Plugging that in the formula gives you the following chance to escape infection:

20 years: 87 per cent. (that is a 1 in 8 chance to catch HIV)

40 years: 75 per cent. (that is a 1 in 4 chance to catch HIV)

60 years: 65 per cent. (that is a 1 in 3 chance to catch HIV)

Condom use lowers the transmission rate by (average) 85 per cent (at least. I think with some care it will be much better). Plugging that in the formula gives you the following chance to escape infection:

20 years: 95 per cent. (that is a 1 in 20 chance to catch HIV)

40 years: 91 per cent. (that is a 1 in 11 chance to catch HIV)

60 years: 87 per cent. (that is a 1 in 8 chance to catch HIV)

Condom use is still significantly better than circumcision: using a condom gives you as much chance to catch HIV in 60 years of mongering as someone being circumcised and having unprotected sex in 20 years.

I'm wondering where your "transmission rate of 38 in 10000" comes from. Was the Wikipedia number not 1 in 2000?

Also, how are you calculating your numbers. Is there on online source that you could refer me to, or a calculator to plug the figures in?

Finally, I was curious if you agreed with this math:

"If we take Degan's number of 1/2000, and use 10% infection in the target group (and that is probably too large, but we'll go with it) , we arrive at 13, 862. 6 sexual encounters to have a 50% probability of infection. That's a different partner every single day for about 38 years, and then it is only even money you are infected."

It seems that your 40 year rate has about the same percentage of 53, but is based on sex thrice weekly, whereas this calculation speaks of doing it "every single day".

[PinkPearl]

I grant you that your 7 step program for safe sex is not bad and may even be equal in risk as having casual sex with a condom, but please explain me how to put your plan in motion when I have taken a fancy to barfine an agogo-girl from Soi Cowboy?

I've added a couple items to the 7 to make it 9 steps now:

"Those who engage in bareback FS sex in this business would make us all much safer if they were (1) recently tested negative for STDs, especially HIV, (2) did not finish inside the vagina, (3) avoided drug users, especially intravenous users (IDUs) , (4) abstained from BB anal, (5) were circumcised, (6) have low millage partners who (7) seldom if ever do BBFS with anyone else, (8) do not engage in BBFS often, & (9) one or both partners are fixed as far as pregnancy is concerned, or at least she's using some form of birth control."

Regarding item #1 if you wanted to have BBFS with that gogo girl that same evening, you'ld want to see her recent STD test results. If she didn't have them handy, perhaps she could go to the clinic or hospital where they were done & show you the results. But if she hadn't been tested recently, that is not a good sign, although if you are still interested in her, it may be possible to go with her while she gets tested. If it were too late to do it that evening, then it would have to wait till the next day, in which case you may wish to play safer & abstain from BBFS that night. If she's not willing to get tested, it sends up red flags and you may want to find yourself another playmate. FL ladies I've known for some time have been very cooperative with me re them getting tested, but I haven't tried this with someone I've just met, nor those who work in the gogos.

Re items 2, 4 & 5, it's a bit late to get circumcised for sex that same day, if you are not already cut, since getting circumcised may put you out of commission for a while. But it's not too late to avoid BB anal and to not blow your load of cum inside her, if you have the self-control to accomplish that.

Re item 3, this is where your detective skills, if any, come into play. Sherlock Holmes would not miss those track marks on her exposed skin, or the signs of drug abuse. Admitedly not all of us have been born with or acquired the necessary abilities in this field, or to be able to read others like a skilled interviewer would.

Re item 6, a gogo bar may not be the best place to look for a low millage P4P TG. I've read of guys who go to the smaller towns to do it with virgins & of reports on ISG where part timers & uni girls can be found in BKK. Comments re item 3 would also come into play here.

Re items 7 & 8, refer to item 3 as well. For example, if you find in the bedroom the lady is very reluctant to agree to BBFS, you might question her to determine if the reason for her refusal is that she has HIV or other STDs. If she fails that test, you weed out a bad apple. If she passes that test, and depending on her answer, you might promise not to blast off inside her or tell her you've recently tested negative for STDS and, if necessary, show her your test result papers.

It may seem simpler to just slap on a condom, or slap your rod in BB, than to go to the trouble of things like testing, circumcision, or getting to know a sex worker, but if a guy wants a safe BBFS experience enough then it will be worth it to put in the effort.

To me your system seems as realistic and practical as abstinence as a way to avoid teenage pregnancies.

Like with abstinence, for those without the discipline to practice it, some items won't be doable, such as the guy who cannot keep himself from exploding inside the girl, or from engaging in anal sex, or too scared to be circumcised, or too lazy to get STD tested.

STD testing is a very basic safe sex practice:

"If you're sexually active, particularly with multiple partners, you've probably heard the following advice many times: Use protection and make sure you get tested. This is important because people can have a sexually transmitted disease (STD) without knowing it. In many cases, no signs or symptoms occur."

http://www.mayoclinic.com/health/std-testing/ID00047

I think STD testing is very "realistic and practical". For example, consider two members who recently posted in this thread. One guy was concerned about herpes. He could have his sex partner in Thailand tested for that. The second guy has a SO (significant other) , also uses condoms, & was more worried about minor STDs than HIV. This type of guy could also reduce his risk factor significantly via testing.

[John Dough]

I'm a virgin looking to possibly lose it in Bangkok. Not so much HIV, but the prospect of getting herpes is what is giving me doubts though. I read that 60% of people in the US have HSV-1. If the rate is that high in the US then just about every one of these working girls in Bangkok must be infected with either HSV1 or HSV2. Is that probably right? And if all it takes is skin contact, even with a condom, what do I do? Is herpes part of the admission price to the world of prostitution? This might sound silly but I've been thinking about buying some antiseptic, or iodine and just dousing my whole groin right after sex. When you're done laughing at this post please give your advice.

Some suggestions:

This report illustrates particularly well why repeatedly in the Safe Sex section of the International Sex Guide and elsewhere I urge everybody to use FEMALE CONDOMS: The standard male condom leaves the base of your penis unprotected, leaving you vulnerable to any STD that goes through skin such as herpes, syphilis, or genital warts. The female condom protects the entire penis because the larger of the two loops stays on the outside of the woman's body. The smaller loop inside the condom can be removed (use a clean finger you have not touched her genitals with) and the female condom placed on the penis before intercourse like a male condom. Often the female condom sticks to the inside of the vagina more than to the penis, so you're sliding back and forth inside the female condom feeling friction as well as pressure. Standard male condoms usually ruin the sensation because you feel no friction, only pressure. Another advantage of the female condom is you don't have that super tight still-rolled part of the condom hurting your penis like tourniquet. But the most important advantage of the female condom is vastly superior STD protection.

I will continue the practice of washing my dick, after full service, whether I use a condom or not. My attitude rests on the fact that I've never experienced any STD symptoms. Cleaning up after sex is the key to it, not condom use.