Safe Sex

"I perfectly understand that the one in seven figure puzzles you. It puzzled me, too. I bought into it because of the credibility of the NIH. If there was an agenda to be had, it would be in favor of getting a bigger number than seven to support public health policy."

But that is definitely not the purpose of a literature review, and your conclusions on the possible agenda are incorrect. The purpose of a literature review is to look at the bulk of research and determine what it proves can be said for certain and what cannot -- and in this case, that 85% figure is a least common denominator. If there was a real underlying agenda, it was to call for more research, and expressly [i]not[/i] to support policy, there being a difference between scientific knowledge and policy-making. Again, this is why the report specifically cautions against using its conclusions for policy purposes.

As far as your statement on pregnancy rates, I'd point to the same review, which references studies on condom usage among married couples, and concludes that education on proper usage decreases breakage, slippage, and pregnancy. The review cites laboratory tests, and very specifically states that condom usage with no breakage and no slippage results in 0.0ml semen exposure and 0.0 relative risk of semen exposure (and by extrapolation, pregnancy) versus non-use. (So your statement on virus size versus sperm size is irrelevant.) Even the numbers with a [i]visible hole[/i] are very, very low, with relative risk versus non-use at 0.000008. It references what it considers rigorous studies which show 1.1% and 3% pregnancy rates -- lower than you cite -- among couples using condoms consistently and correctly.

Should I conclude, as someone who's never had a condom break or slip off, that it's safer for me than most people? The answer is probably yes. RN reported here that she never had a condom break in her thousands of encounters, which would mean according to the NIH conclusions she was consistently safe. The real trick here might be learning to use condoms properly, as opposed to learning to use the kits.

This points to a very key important difference -- efficacy versus effectiveness. Again, from the panel, "It is important to distinguish between condom's efficacy, which is the protection that users would receive under ideal conditions, and their effectiveness, which is the protection they provide under actual conditions of use."

The number we're arguing over is a deriviative measurement of effectiveness, not efficacy, whereas the numbers you're using from the testing kit studies are efficacy numbers. The truth is that you're presenting a comparison of apples and oranges -- there are no effectiveness numbers for the kits as there are as of yet no studies of their use by real people in the field, and the reality is that they will no doubt be improperly manipulated by folks who use them, just as condoms are. Thus the true effectiveness rate of the kits will no doubt be much lower than the efficacy rate, (as it can't be higher) just as is the case with condoms.

By the way -- I want to make sure that I say thank you, Sabio, for bringing a high-level concrete discussion here. Regardless of what anyone concludes, this is definitely both stimulating and informative, and my comments, even when I'm disagreeing, should also be taken as full of admiration for the work and thinking you've done.

joe_zop

Thank you for your post and your kind words. Please take my remarks in the same spirit. Even when we disagree, I benefit from your point of view.

[quote][i]"I perfectly understand that the one in seven figure puzzles you. It puzzled me, too. I bought into it because of the credibility of the NIH. If there was an agenda to be had, it would be in favor of getting a bigger number than seven to support public health policy."

But that is definitely not the purpose of a literature review, and your conclusions on the possible agenda are incorrect. The purpose of a literature review is to look at the bulk of research and determine what can it proves be said for certain and what cannot[/i][/quote]
I said "[b]if[/b] there was an agenda to be had" as I don't believe NIH has an agenda other than a research agenda, namely reaching objective conclusions by applying scientific methods to hard data. So I guess we are in agreement here.

[quote][i]It references what it considers rigorous studies which show 1.1% and 3% pregnancy rates -- lower than you cite -- among couples using condoms consistently and correctly. [/i][/quote]
Here, we are not in agreement. Both the 3% and the 1.1% are the [b]pregnancy rates[/b] (in one year for the former study, and in six months for the latter). You need to compare these numbers to the pregnancy rates of non-users over the same period to get the [b]effectiveness of condoms[/b] that I referred to.

[quote][i]The number we're arguing over is a deriviative measurement of effectiveness, not efficacy, whereas the numbers you're using from the testing kit studies are efficacy numbers. The truth is that you're presenting a comparison of apples and oranges -- there are no effectiveness numbers for the kits as there are as of yet no studies of their use by real people in the field [/i][/quote]
No, I am not talking about efficacy (ideal case) of test kits. I am talking about the actual field test numbers for the kits. These field tests were indeed conducted as part of the FDA approval process, and that's how the sensitivity of the test was calculated.

sabio

thanks for finding those numbers that i was unable to track down. your efforts are very much appreciated.

just as a caveat, however. alot of the numbers are actually estimates which may or may not be borne out/corroborated on further investigation. nevertheless, i was very interested when i heard them the first time just to get a rough idea of what was what.

so the caveat is that the estimates are guesses based on current information, and the degree to which they are innacurate may be greatly magnified or minimized when subjecting them to mathematical manipulation. trying to get a clear estimate of some other issue by extrapolating those numbers can lead to further innacuracies

so thanks again for finding that, i will go read it. hope this contributes a little.

hooky

ps i will also look more closely at your analysis, i admit i knd of fell off this thread for a while and just skimmed it when i came back. also, i agree with joe z in his concluding remarks.

[b]My farewell post[/b]

The forum moderator suspended my instant posting privileges and sent me an e-mail that included the following
[quote][i]I reviewed all your forum posts and observed that the only subject that you seem to post about is the testing kits. Given the number of posts on essentially the same subject, I am suspicious of your agenda[/i][/quote]
I am stunned that an intellectual discussion at the core of the subject of safe sex draws this reaction from him. However, I do not wish to invest my time and effort in a place where I am not welcome, so this will be my last post. I guess the quality of Nibu's posts warrant creating new sections for him, and the quality of my posts are not up to par. Well, it is the moderator's prerogative to make that judgment.

Just because he raised the "agenda" issue, let me tell you that I am not affiliated with NIH or any test kit company, nor do I have financial interest in any of them (nor have I shorted any condom companies :) ). What started me on this was a post in another section
[quote]Originally posted by Z Ice Blue on February 18, 2003
[i]Hi
Can someone point me to a good quick HIV test kit, and where to buy it from, and its cost. Also, is it multi use, or for single use only.
thanks
z[/i][/quote]
My immediate impression was "Dream on." I just did not think that such kits (legitimate ones) existed. Then came a response
[quote]Originally posted by Surfer on February 23, 2003
[i]Z Ice Blue-What you need is Ora-Kwik, a one time test kit taking 20 minutes and with an accuracy rate of over 99%. JUST approved for use in US but you can't just buy them here. I have a few extra I'd sell you (I bought them in Thailand where they can be legally bought over the counter). I'll be in Rio on Wednesday the 26th so drop me an email (XTNsurfer@hotmail.com) if interested.[/i][/quote]
and I started looking into it. The result was my posts that started on February 26.

I would like to thank all the board members who took part in this stimulating discussion, including AddictedToWomen, denringer, Dick Johnson, Freeler, hooky, HeadGames, hysteromania, joe_zop, lookr, monkeyboi, joe_zop, PRBuck, purplengold, Prokofiev, RN, and skinless. Please forgive me if I inadvertently offended anyone during a heated discussion. The essence of a lively discussion is disagreement. As the saying goes "where everyone thinks alike, no one thinks very much."

Good bye.

[blue]Don't be so dramatic. Your membership will remain active, and you are encourage to continue making contributions in the future.

Jackson[/blue]

Jackson, I think you're following US foreign policy a bit too closely. Do we now root out suspected abusers before they actually do something? Sabio's always been on-topic, intelligent, polite and non-abusive, and it's not like he's going everywhere on the site yapping about testing kits or that he's been talking about only one manufacturer in some sort of veiled sales pitch.

Sabio, regardless of this move, which I absolutely don't understand, I hope you'll keep posting.

HERPES SCAIREd ok on my last trip i fucked 25 women safe sex and 1 from iquittos peru with out i did all the tests and alot of research herpes is not just the blisters on the dick you can have it by skin contact and never have the blisterS there is a test that you get it is a blood test that tests for both herpes 1 and 2 they say 40 mil people have herpes in the states or will get it well luckliy i am negative JUST WANTED TO STRESS IF YOU DONT SEE A RED INFLAMED UGLY PIMPLE CRUSTY PUSSY THEY STILL MIGHT HAVE IT AND NOT HAVE SYMPTOMS> justa freindley jab at people like me that think they know it all. like johny carson usta say I DID NOT KNOW THAT

Herpes is easily the most misunderstood std. The rules however are very simple. At age 21 90% of poeple in the U.S have Oral (type 1) herpies. 60% will have one outbreak upon thier initial exposure, and will never have another outbreak. These poeple are non transmitters. The other thirty percent will have intermittent outbreaks where they are able to transmit the disease when they have open sores. If they go down on you with open sores you can become infected with type two, genital herpes. Otherwise if the girl has type 2 she may have sores that she may not be aware of that can infect you. If you have safe sex, and the condom remains intact, there is a very low transmission rate. You probably can't get type one from kissing her either as if you are American, and have dated a bit, your chances of not having it already are very low. Bottom line the herpies virus is low on the scale of worries. Take this scenario for instance. Like her on top? Her Virus loaded vaginal secretions pool in you anus as they mix with her sweat, giving easy access to mucous membranes. Infected!

Thanks for that info on herpes. I just got back from Costa Rica (see report) and had quite q bit of BBBJ. I always wondered what the true risk was if there was no outbreak visible.

Another things that I wondered is why are more women likely to give BBBJ than DFK. Is this more an emotional thing do you believe? Seems like more could be caught from pre-come during BBBJ than saliva exchange.

The disease I am quite worried about is something like Hepatitis B. It is said that the chances of catching it are 100 times more than HIV and that it can stay on the surface of an area for up to 1 month! I can imagine in hot and humid place like SE Asia, these figures are probably even more scary as bacteria thrive in these environments.

My questions though are:
Is it cureable?
Can it be caught more than once?
Is it a terminal illness?
Why are 3 vaccinations necessary- taken first, 1 month later, then 6 months again

http://www.immunize.org/catg.d/p4115.htm

Hepatitis B isn't "curable" per se -- you don't get it completely out of your system, but if you recover from the infection and are not a chronic infectee then you're no longer a carrier. There are treatments for it and for its physical effects, but not cures. It can definitely be caught more than once, and that's generally where you get more serious health problems.

About 30% of the people who get it show no symptoms. Those who do, however, can definitely have serious problems, including chronic liver disease, which kills 15-25% of chronically infected people. (6% of adults who get it become chronic, so that means about a 1 to 1.5% overall fatality rate for adults.) A quarter of the people who get it become ill with jaundice, about 15% of those requiring hospitalization, and a small percentage do die from that. About 5000 people die from it each year in the U.S. Supposedly, Hep B is responsible for 80% of all liver cancer worldwide.

The reason for the three treatments is to provide maximum protection and duration -- it's cumulative in effectiveness, with three treatments protecting about 90% of people. The first shot provides up to 50% protection, the next up to 80%, and the last up to 100%.

By the way -- Hep B is spread only via blood and body fluids, so though it is robust and can survive once exposed to the air, the transmission that way is more limited. (It can survive a week in dried blood!) It's Hepatitis A that can be spread more easily in food, drink, unclean surfaces, etc.

Bottom line the herpies virus is low on the scale of worries. Take this scenario for instance. Like her on top? Her Virus loaded vaginal secretions pool in you anus as they mix with her sweat, giving easy access to mucous membranes. Infected! [/i][/QUOTE]Here's another one. Condom fully engaged, Penis fully inserted>>>going long and deeeeep> a week later with a full outbreak around the base of the shaft and scrotum> no muccous membranes necessary.

Had to explain that one to the "significant other", not fun.

Thought I was having safe sex. If I hadn't a been making her come and scream at that time I didn't even NEED to be going that deep (that's the worst part).

Herpes is a horrible virus, it's painful and disgusting and depressing and it makes me feel guilty and ashamed. Even though it is controllable with Valtrex, I wouldn't wish it on anybody.

Hello.

I was wondering if anyone had heard of any web sites, or had any information regarding the prevalence of HIV/AIDS as relates to prostitution specifically. I have been doing this for a couple of years now, and recently had the frightening experience of a condom breaking. I got tested, and it came up negative, but I know it takes a few months before it shows up on a test. How scared should I be?

Any help would be appreciated.

I had intercourse without a rubber last week in Tijuana, Mexico. I didn't mention it over in the Mexico forum, I thought I'd get feedback here first. A girl, 28, from India charged only $60 for the half hour and when I couldn't cum she offered to take the condom off. She asked me if I was clean. I thought to myself a lot of good that will do her if I say yes. I've tested negative for STDs including AIDS. I told her I'm clean of course. And as I took off the rubber I'm thinking my god what if I get vd and how would these forums react if they found out I did this. So I went ahead inside her in missionary, it felt great and I climaxed inside.

She gave me her home phone in Tijuana and later in the Adelita Bar next to the hotel she started talking about her baby girl, having no money, her rent and marriage to someone like me. Well maybe the whole thing was to get me to be a regular customer I can see that. But I don't have the money to pay her rent or even half of it. I won't play the boyfriend after reading the forums here. Anyway was that a stupid thing to do, sex with no condom? I guess so. So far no lesions or sores on the pecker after 7 days.

PhilT

Phil . . .

Do you really need to ask that question? I think you are well aware of the answer . . .

Good Luck, -P

Phil...

Did you stop and think....was SHE clean?? I'd worry more about catching STD's like herpes, gonnorea(sp?) and such when not using a condom.

I've read in some places that unless your penis is nicked or cut or is sore, its difficult for you to catch HIV because the virus cannot enter any other way. I've also heard that HIV can enter through the urethra opening but I'm not too sure about this fact, maybe some of the members would care to shed some light on this topic.....

anexpat