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Promoting Intimacy and Other-Centered Sexuality
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STD's & AIDS
Update From Lifestyles 97 Convention Speaker
In August, 1997, at the Lifestyles Convention in Palm Springs there was an excellent speaker whose ideas are worth sharing.
Presentation: Update on AIDS & STD's by Norman Scherzer, Ph.D..
Dr. Scherzer is a professor of biology at Essex County College, teaching anatomy, physiology, and pathophysiology as well as being a Visiting Professor at Rutgers University where he teaches Human Sexuality and Human Health and Disease. He was named Outstanding Teacher of the year in 1995 at Rutgers. He has coedited various sexology books, has made many television appearances and has lectured on AIDS at numerous universities, AIDS task forces and national conferences for the last 15 years.
AIDS Overview
With the current decline in AIDS he is more concerned with other STD's. He also stressed the real risk for heterosexual AIDS is the fact that STD's greatly enhance the risk of transmission if one partner is infected. He showed a comparison chart of worldwide diseases showing AIDS is the 8th largest killer in the world but far below the fraction of deaths from acute respiratory diseases, Diarrhea, and TB.
Steady Decline in U.S., But Could Change
While new AIDS cases are on a steady decline in the U.S. and most Western countries, he is concerned they could increase again, due to the increased cases in the gay population. When AIDS first hit the U.S., it sadly wiped out many gays that were having lots of casual anal sex. Often these were young men enjoying lots of partners. For a number of years new gay cases have declined as those unaffected have been responsible and practice safer sex, often with a smaller number of partners. But now there is a new group of younger gay men reaching puberty that may be less responsible and spike up the number of new AIDS cases.
How Many At Lifestyles Convention Are HIV+?
One person from the audience asked Dr. Scherzer "With about 3000 people at this swing convention, how many do you think are HIV+". His answer, "none or very few". He said he often shows his students a chart of different activities such as swinging, going to prostitutes etc., or the local bar and discussing the relative risk. The bar is by far the most risky for heterosexuals..
Heterosexual Link: Drugs and STD's
HIV transmission in the heterosexual community is primarily associated with drug use. However, there are heterosexual non-drug related cases, with the risk for women much higher than for men. But these cases are usually with people who have other STD's which makes the risk much higher. The reason for the higher risk is easy to explain. When you have any infection, such as an STD, the ... I think I have this medically correct from my notes...certain cells rush to the site of infection to transport the infectious agent to the T4 cell which then send a message to the immune system to send out "killer" lymphocyte cells to attack and destroy the infection. This works very well for most diseases and infections. But with HIV, the virus is sucked into the T4 cells, but the virus cannot be successfully killed but instead actually remains in the T4 cells. What is worse is that the RNA from the AIDS virus actually changes to DNA and splices itself into your own DNA to become part of your DNA. Its the new protese inhibitors that offer the most hope to stop the AIDS virus from being part of the DNA.
That was a long explanation but the point is, any inflammation, and especially an STD, sends cells to the surface of the skin to transport the HIV to the T4 cells where the terrible results occur.
Anal intercourse also is very high risk since there is a very abundant blood supply in that area, making it easy to transfer HIV.
Real Sex Education Needed In the U.S.
Dr. Scherzer is very concerned about the lack of STD education in public schools. In the U.S. we have a 50 times higher STD rate compared to most of Europe where real sex education is taught.
Worldwide AIDS - Cultural Differences Explain
Most cultures where AIDS is rampant is related to different cultural norms. For example, in India AIDS is increasing rapidly. That is linked to the practice of infanticide, where many of the baby girls are killed at birth since they are not valued by the culture. The result is a huge male/female ratio, just like in prisons, where you have almost no females available, and anal sex is often used for sexual pleasure.
In Mexico, there is also lots of anal sex by heterosexuals. Heterosexual males become the active partners in anal intercourse since this is more macho, and gays are the receptors. This is a fast way to spread AIDS, especially to the receptive partner.
n Brazil there is a Portuguese word ... which is best translated to English as "horny pleasure." Due to the very strong Catholic influence girls are taught to become experts at flirting, but being a virgin till marriage is also very important, except for the 10 days of Carnival when the church sort of ignores what is going on and people wear masks and have lots of sex with just about anyone. The rest of the year, you have women skilled in the art of flirting, but they won't have sex. So men go to the large number of transvestites and have anal sex to relieve the sexual frustration from all the flirting women. They become AIDS infected and may pass it on to their wives.
Hepatitis B: A Much More Real Concern To All
Hepatitis B is 100 times more contagious than HIV. Often it is at a subclinical level, with no symptoms but still contagious by saliva and most all body fluids. He strongly recommends everyone should get a Hepatitis B vaccine which consists of an initial shot and two follow-up shots. The cost should be about $150-$160 for the vaccine plus whatever the Dr. charges. But it is well worth it. The vaccine is about 70% effective. If the other 30% contract Hepatitis B, they usually will get a very mild case. Even more dangerous is the Delta strain. But it is usually only a risk if you also have Hepatitis B.
Women's Concerns
Every women should get a pap smear every 6-12 months. This is vitally important, not only for STD's but for cervical cancer. The good news is that cervical cancer is very slow to grow, taking 8 years before it becomes very dangerous. One woman in the audience said her doctor didn't recommend the test that often since it can irritate or cause an inflammation. Dr. Scherzer didn't agree, saying that if the pap smear is done right its like taking a pencil and lightly stroking the skin. The doctor shouldn't do it hard enough to cause any inflammation concern.
Every woman should also have a speculum and examine herself frequently. Many STD's, yeast infections etc. are easily seen. If you aren't totally "pink" see your doctor. I (Dave) was first introduced to speculums and the beauty of the female vagina many years ago at the Stan Dale workshops, but at that time they were controlled medical supplies that only a physician could obtain. I was thrilled to learn they are now readily available. I asked where, and someone suggested that two of the Bondage supply exhibitors at the convention had them. Yep, I brought home both a metal and plastic version...now just need a woman to learn with. They don't look very vagina-friendly...those big tongs going in....but I'm told they aren't that bad to insert.
Nonoxynol-9 (non-9)
Dr. Scherzer highly recommends using Nonoxynol-9 with any sexual activity or toy. It acts as a detergent that kills most viruses and bacterial infections even herpes. It is very effective as long as you don't use too much and cause vaginal irritation which can actually increase the AIDS risk due to inflammation which was the case in one study. In the test tube it instantly kills HIV. But so does just spitting on it. In the body the evidence is not conclusive about its effect on HIV, but its is very effective against most other STD's. He recommends vaginal contraceptive film (VCF) that should be found in most any drug store.
Other Brief Comments:
The female condom is very hard to use since its hard to keep in. You have to hold it tight the entire time while having intercourse. Even a strap on version hasn't worked well.
AIDS risk for oral sex very low unless have open sore and bleeding gums. Dr. Scherzer suggests that you don't brush your teeth immediately before oral sex since this could cause gums to bleed. If you want to see if you have a sore in your mouth use a vinegar and water mouthwash. The vinegar will turn any mouth lesion very white. A physician does the same thing in the vagina, but calls it an acidic asset smear, which sounds more medical.
Never use vaginal deodorants since they double the risk of ovarian cancer. It is not yet understood why this is the case. Don't even use deodorant tampons which often cause yeast infections.
Birth control pills raise the pH of the vagina which makes it less acidic so its harder to kill some STD's and often results in more frequent yeast infections. The natural pH is more acidic which kills off many of these infections. Patches and implants have the same bad reaction.
The window period for HIV (where you can transmit but not be positive on an HIV test) is usually only 3 months. Some sources are saying it can be much longer, but that is rare and usually only if you have a weak immune system. New tests will soon be available with a much shorter window period
DAVE'S NOTES
AIDS is defined as various conditions that usually result in a depressed immune system. In some cultures, such as in Africa, these conditions that are now included in the "AIDS" definition have always existed due to poor nutrition etc. HIV is the virus that most medical scientists believe also causes "AIDS". I realize there is a very vocal, but small number of researchers that insist that HIV does not cause AIDS and in fact some of the drugs such as AZT are what is the cause of AIDS. I choose not to get into this debate but concentrate on issue of who is at risk for HIV, which most medical experts believe may be one of the primary causes of AIDS, at least in developed countries.
Non-monogamous people are encouraged to get tested routinely for HIV antibodies *and for other STD's*, and communicate the results to all their partners. STD's and unwanted pregnancy are much more real issues for non iv drug using heterosexuals than HIV. If in doubt about either STD or HIV status, condoms and other safer sex practices should be fully utilized.
Regular Subscribers (the $20/yr hardcopy snailmail type) also are being sent our 12 page extensive updated AIDS/STD report which consolidates the best of the various AIDS articles we have published over the last few years and includes the latest 1996 CDC data showing the continuing decline in new AIDS cases in the U.S. and how it is more and more isolated in known high risk groups. Heterosexual transmission as the only risk continues to be at a very low level.
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