STIs

"Barebacking" vs. Sex Safety: Not Just Protection *From!*

Posted by figleaf | Tags:
Mon, 2010-04-26 19:01

Amanda Hess of Washington City Paper points out yet another one of those fascinating cases of gender blindness. This one’s over an article in the blog of well-established but new-to-me LGBT Just Out Newspaper. Hess quotes the article and says (emphasis mine)

“For all the flack gay men get for their sexual antics, it turns out the ladies have them beat for an oft-chastised but ever-present-in-porn act -— barebacking.” Hey, way to get personal! It takes two to bareback, so why focus all the shaming on the receptive partner?

Read the quotes in context here.

Before jumping all over the Just Out author’s assumptions I’m going to agree with the underlying message: heterosexual partners are at least as inclined to practice “barebacking” as are gay partners. But I have to agree with Hess that thinking about condoms and sex safety in general only in terms of the “receptive partner” isn’t just phallocentric and one-sided, it increases the risks for all concerned.

You might think it also takes two to transmit a sexually or socially transmitted illness. Instead it actually takes at least three since whoever gives the STI to the “recipient” (who, by the way, isn’t necessarily the sexually “receptive partner”) by definition will have received it from a previous partner.

You saw that, for instance, from both sides of the recent HPV vaccine debate. It was touted as “protecting girls” from cervical cancer, which is in fact a very real risk and which in fact the vaccine offers protection from. And yes, unlike many forms of HPV which can be transmitted from any skin-to-skin contact the varieties the vaccine was designed to stop are transmitted primarily sexually, and especially though penis-in-vagina insertions. And so in one way it made sense to focus on “receptive partners” to the exclusion of, I guess, “penetrating partners.”

But on the other hand the debate largely overlooked HPV in terms of women’s partners. Well, that’s not completely true. Most opponents of the vaccine were abstinence-only advocate who argued with passion verging on hysteria that the only way “real” way women could be safe from HPV was complete and thorough avoidance of Teh Cock. But even more rational proponents tended to miss that with STIs it always takes three or more to tango: every heterosexual man who gives a woman HPV pretty necessarily first got HPF from a different woman. Who, in turn, got it from a different man who in turn… through thousands, or tens of thousands or millions of turns!

That same focus on the “receptive partner” also disregarded the minor point that the same virus that causes cervical cancer also causes cancer of the penis, of the throat, of the anus, and very likely other parts of the body not normally associated with sexual activity.

HPV, like HIV and other STIs, isn’t a unique event of concern only for “receptive partners.” Nor is it something only one partner “gives” to their current partner. Instead it’s a chain with those same thousands or millions of prior links.

The point of practicing sexual safety isn’t just to protect one partner from another. It’s to protect everybody by breaking those chains. Not just the “receiving partner” but their next partners too. And not just the “receiving partner” but their current partners: infections aren’t all one-way — one partner who has HIV or syphilis will still need protection if his or her partner has herpes, or HPV, or chlamydia, or another strain of HIV, or…

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Oral Sex is Sex: Since Pleasant Associations Aren't Reminder Enough, Jayme Waxman Takes a Different Approach

Posted by figleaf | Tags:
Thu, 2010-04-08 13:39

Summary: An article in WebMD says only 20% of young adults believe oral sex “counts” as sex. Jayme Waxman sets the record straight.

While I’m not completely enthusiastic about the close association between sex and disease Jayme Waxman of Sex Matters does use it in a good cause:

I just want to go on record and say oral sex is sex. That means BJ’s and CJ’s (blow jobs and clit jobs – a term I hope I just made up, but I’m sure I didn’t, still it’s what I’m calling cunnilingus from now on, as in from right now on) are sex. You can get sexually transmitted infections like gonorrhea and chlamydia form oral sex, and you can give and receive herpes and HPV that way too.

Read the quote in context here.

And yes, yes, she could also have mentioned another forgone association: that both giving and receiving oral sex is a source of sexual enjoyment. For whatever reason that never really seems to come up in conversations involving definitions of sex. So kudos to Waxman for punctuating the bottom line: oral sex is sex.

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Agency and a New Way to Look at Responsibility for STIs

Posted by figleaf | Tags:
Wed, 2009-08-05 09:20

Juliana Piccillo of Whore Madonna, who I found via a Twitter link from Audacia Ray, makes a startlingly bold, pragmatic point about a Knoxville, TN, case where a sex-worker’s charges were upgraded from misdemeanor to felony because he or she turned out to be HIV positve.

I would argue it’s not criminal in any case. All sexually active adults in this country are well aware of the risks of STDS, STIs, HIV, etc. If they choose to not use protection or even if they choose to use protection and that protection fails, it was a risk they consented to.

She said it here.

It’s cool post and an interesting point: she’s clear that it’s certainly unethical, immoral, and outrageous not to disclose one’s status. And to at least a certain extent she, like I, may not mind that it’s illegal (though it shouldn’t be any more illegal when a sex-worker does it.)

But conceptually the law as it stands serves more to protect a mindset of denial — about condoms, about sex, about the “cleanliness” of all of us, about sex education, and especially, about male responsibility (sex-workers are roughly as likely to get STIs from customers as vice versa), and, for that matter, about expectations about protecting the “innocence,” ignorance or denial of sexually “virtuous” women.

This isn’t to “blame the victim” for failing to practice sex safety and it’s definitely not saying HIV, or really any illness, is a proportionate, let alone appropriate “that’ll teach you” consequence of failing to practice sex safety.

But let’s locate the agency for contraction of STIs where it belongs — with those who exercise sexual agency. Yes, not everyone who has sex has agency. But everyone else does. Certainly commercial-sex customers do (which is why singling out ill sex workers for prosecution is especially counterproductive.) But so does every other consenting adult.

Pretty useful way to look at it.

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Hey You IUD! Plus Possible Benefits of Decoupling Pregnancy and STI Concerns

Posted by figleaf | Tags:
Thu, 2009-07-30 17:57

Megan Carpentier of Jezebel says

Slate’s Kate Klonick wonders why more American women don’t use IUDs. As the recipient of one of the devices as well, I sometimes wonder the same thing.

She said it here.

Carpentier’s a good writer. IUDs are amazingly effective but pretty misunderstood. She does a great job laying out the many pros, laying out the few cons, and laying to rest some of the seriously out of date and never all that true myths about them. I’d say go read it even if you’re not in the market for a different, highly-effective, low-maintenance form of birth control. Because you might know someone who is.

—-

By the way, is it just me or does it seem like the standard “yeah but” objection about how you still need to use condoms to prevent STIs comes up sooner in discussions of IUDs? I mean, yeah, duh, but it’s just as true of every other non-condom form of contraception from the Pill to sponges to vasectomies to… oops… “abstinence-only” activities like oral and anal contact. But why let that be an objection at all? Not to sound too pundit-y but pregnancy and STIs are two different issues both in theory and practice: not everyone who needs to worry about STIs needs to worry about pregnancy, and not everyone who needs to worry about pregnancy needs to worry about STIs. And, again not to sound too pundity-y but STIs can be transmitted a lot more ways than pregnancy can. And not to sound too contrarian but very high-reliability contraceptive measures like sterilization and IUDs might make it easier for heterosexuals to pay closer attention to avoiding giving each other STIs.

Upate: About that STI link: In comments here Sugarmag explains that possibly dated information associates IUDs with greater chances of STI-derived pelvic inflammatory disease. But further down in comments here Kaija says more recent research says STI-related complications seem to come mostly from pre-existing STIs rather than infections transmitted after the IUD is in place.

[Note: 24 hours later I realize the title sounds awfully insistent. My titles are often a bit goofy or free-associative — possibly because I do them last thing after I’ve written the post. In this case I was thinking about the subject matter and the English vowel sounds, AEIOU, kept coming up, and then AE-IUD, then Hey Hee-IUD, and then Hey You IUD. So it was totally random but, I realize now, it sounds awfully bossy too. If it’s just me then forget about it, if it bugged you too then my apologies. —fl]

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Science and Sex: What Grows Where

Posted by figleaf | Tags:
Mon, 2009-06-15 16:53

TBK of The Beautiful Kind says

The other day I told my sexy microbiologist friend that the human mouth contained the same bacteria found in the ass and produced the same aromatic sulfur compounds. This, I said, explained halitosis.

He set out to prove me wrong. He took swab cultures from his cock n’ balls, mouth, and ass, and shared the results with me. In his words…

Read TBK’s scientist friend’s actually-not-that-surprising findings here.

Short answer: Mouth, ass, and genital bacteria aren’t the same at all. TBK’s version is a lot more fun to read though. Cool post.

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Making Vice Out of Necessity: 20th Century Assumptions In a 21st Century World

Posted by figleaf | Tags:
Sat, 2009-04-25 09:33

Diva of Debauched Domestic Diva notes a current law that one suspects has slightly, um, gendered origins

Did you know that in New York you can be stopped by the police on the street and if you have condoms on you they can be used as evidence that you were soliciting sex for money? Neither did I but I learned about it last night. SWP is working to try to get that law changed and that is what they are about. When Andrea Ritchie spoke last night and said this I thought to myself about the condoms I had in my pocketbook. I like to practice safe sex. I’m a huge advocate about sex safe just as I think all of us should be but I also should not be at risk for something just for the simple fact I carry condoms.

She said it here.

It’s hard to imagine this law ever being invoked against men, given that as far back as World War II U.S. soldiers were routinely provided with condoms, and given that for much of the time since it’s been practically cliché for men to keep a condom in their wallets “just in case” (a bad idea by the way.) And I don’t know how old the law is (I’m assuming Giuliani-era or earlier) but one has to assume they didn’t imagine that women who aren’t sex workers might be brazen enough to have “just in case” considerations of their own.

And to be fair that’s not too big a stretch. If the law dated back to, say, the 1970s before either health concerns about the Pill or HIV became well-known (and when the line in sex-education circles was “condoms are better than nothing… but only barely) it might have been the case that only women sex-workers would routinely carry condoms. Who knows?

But jimminy crickets, if the law is still on the books that’s a bug not a feature.

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Maybe We Should Call It "Cranberry" Sex, Instead Of Vanilla

Posted by figleaf | Tags:
Sun, 2008-02-17 11:01

So one quick follow-up on my post about defining intercourse down, how ‘bout them urinary tract infections anyway?

A year or two ago you had the abstinence-only crowd absolutely shitting fishhooks over the terrible risk of sexually transmitted cervical cancer (via HPV, the genital-warts viruses) that condoms just weren’t good enough to stop. (While they simultaneously bitterly fought an HPV vaccine that would largely obliviate cervical and other easily-spread-via-sex cancers.) Even if cervical cancer deaths were measured only by the thousands per year (where adequate healthcare is available), they not-unreasonably point out, the associated cost for pap smears, colposcopies, surgeries, and chemotherapies associated with not dying of cervical cancer could be abated if people practiced more abstinence until marriage. (Heterosexual abstinence — the sexual connection was first noticed when it was observed that lifelong nuns and lesbians virtually never developed cervical cancer.)

Along the same lines, since the late, late 1970s when people first started noticing herpes the abstinence crowd has been braying, not-unreasonably, about the pain and misery it can cause and, again they not-unreasonably point out, the associated costs and discomfort could be avoided if people practiced more abstinence until marriage.

But then you pitch an ear to see what the abstinence-until-marriage crowd has to say about “honeymoon” cystitis and… even though, as the old-fashioned name for intercourse-associated urinary tract infections implies, this UTI results from failing to be practice abstinence you hear… nothing.

Hmm. Maybe that’s because UTIs have a lower medical footprint in terms of visits, expense, or fatalities than, say, cervical cancer. Um, nope, turns out UTIs are the #1 bacterial infection in women and the #2 overall reason for doctor’s visits. So that couldn’t be it.

Hmm. Maybe it’s because UTIs occur less frequently than herpes outbreaks and never hurt as much. Oops, nope, that’s not true either.

Hmm. Could it be that, unlike HPV or Herpes, honeymoon cystitis isn’t as closely associated with sexual activity. Definitely not — pretty much every site you visit that discusses UTIs in general and cystitis in particular mention frequent and prolonged heterosexual penis-in-vagina intercourse as by far the most common contributing factor.

Funny, you’d that considering their disproportionate antics about HPV or herpes the abstinence crowd would just be blowing doors down with warnings about the evil perils of intercourse for its incredibly inescapable link to PIV intercourse. And yet… crickets!

I dunno. If I was going to propose making the heads of the abstinence-only crowd explode by advocating an everything-but-intercourse variation on their nominally intercourse-for-reproduction-only message I’d set cystitis front and center in that campaign. Because, seriously, unless you have a vested interest in the cranberry-juice industry then compared to nearly every other perfectly delightful solo and partnered sexual activity PIV intercourse doesn’t really have a lot to offer.

Funny, huh?

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Request For Help With Homework: Best Seattle-Area STD/STI Test Assignment

Posted by figleaf | Tags:
Thu, 2008-02-07 23:21


Photo by Flickr user hugovk. Used under a Creative Commons license.

So one of the extra-credit assignments for my integrated communications theory / women’s studies / sex education class is to get tested for sexually transmitted infections, a.k.a. sexually transmitted diseases.

So what I’m wondering is, if you’re from the greater Seattle area, anyway, if there are any great, iconic places to go. For instance when I was at the peak of my sexual activity back in the mid-1970s, on the rare occasion our extended circle of friends in the Boston area had a “VD Scare” (which in those pre-virus days was far more of a major inconvenience than an actual scare) we’d spread the word and head out in mass for the local health department. I was never there for it but on at least one occasion friends told me the group was almost big enough to fill a Green Line subway car.

If it didn’t sound so in-retrospect unsanitary I’d wax nostalgic about the days the worst consequence of STIs was a sore butt from a big wallop of penicillin. But in retrospect? Eww.

But that was then and this is now, so…

Where does the responsible kinkster go to get screened?

Also, there used to be a blogger called TwiddlyBits who had a great post up years ago about all the ways, places, and things she insisted she get screened for. She got blood work, genital cultures, throat cultures, rectal cultures, visual inspections… in other words, da woiks.

I sort of assume you’d want to screen for HPV these days although if you were really being diligent (and assuming the screenings work that way) you’d obviously want to have your cervix screened if you’re a woman but men might want to have penises screened and everybody might want to know if they’re at risk for cancers of the ass or throat.

Any others spring to mind right away?

Now as it happens since the last time I had sex with a new partner (many years ago now) I came down with a bizarre and very scary set of symptoms that included cyclic fevers and (yikes!) classic “night sweats” when the fever broke where I’d sweat through my pillow! Since that’s evidently a classic symptom not only of HIV but of quite a few other horrible diseases I wound up having just about every kind of screening test you can imagine, including all the standard STDs (in case I’d had something for a very long time and hadn’t know it) plus quite a few others like various lymphomas and leukemias, liver diseases, and, I swear, rabies, TB, and leprosy!

Luckily, but nerve-wrackingly, all those tests came back negative (lemmie tell ya, you’re feeling pretty sorry for yourself when you feel let down that you don’t have HIV or leprosy either and you’re still sick. Anyway, I eventually got better, and a month or two after that my doctor called to let me know that a deep antibody assay had turned up active antibodies for cytomegalovirus — a disease that shows up as nothing but a case of the sniffles in the 99.999% of you who get it in early childhood but produces cyclic fevers and night sweats for adults who either have compromised immune systems (it’s a classic symptom for AIDS patients) and the .001% of non-immune-compromised adults like me who are just slow learners.

So anyway, the point of the homework isn’t to discover STD/STI’s (although if one has them it’s obviously a very good side benefit.) Instead it’s so we can understand the process and write a two-page paper about our experience.

Anyway, unless someone has a better suggestion I was thinking about picking one of these places. Specifically I’m thinking maybe the Public Health Department’s main STD Clinic at Harborview Hospital, although for years I’ve also driven by one of the neighborhood health clinics and it would be a nice excuse to drop by.

One way or another I’ll let you know how it turns out.

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Child sex education vs. childish sex education

Posted by figleaf | Tags:
Fri, 2007-07-20 11:46

Bradford Plumer of paleo-neoconservative The New Republic has done a pretty good job of what actual journalists used to be incredibly good at: reporting rather than regurgitation-punctuated-with-“to-be-sure”.

Back story: Illinois Senator and presidential candidate Barack Obama recently spoke favorably of age-appropriate sex education beginning in kindergarten. Presidential candidate and former Massachusetts Governor Mitt Romney has been wetting his pants about it.

Plumer reports:

Anyway, I was trying to find a better explanation of what Obama’s views actually were, since the ABC story wasn’t terribly clear, and came across David Brody of the Christian Broadcasting Network—that’s Pat Robertson’s outfit, mind you—who had the sensible, level-headed take on all of this. Apparently, Obama’s spokeswoman claims the senator was merely talking about teaching kids “the difference between appropriate and inappropriate touching.” And Brody thinks Romney was being “misleading” for suggesting that “Obama is ok with the condoms and cucumber approach.” So… there you go.

Plumer said it here

Now it’s worth pointing out that Massachusetts under Governor Romney had — and has — the kind of early sex-ed program Obama was talking about. But this post isn’t about what a fucking hypocrite Romney is (though he is that too.) It’s about why Massachusetts scores higher on teen and early adult public health and welfare outcomes than certain other states.

I know it sounds odd but by slowly trickling out information about human sexuality, beginning way, way before most children are exposed to impulses of their own, nominally “libidinous” parts of the country also have far less pressure build-up and therefore fewer omigodwhat’sthisfeeling-omigodlookwhatwecandowithout peepees-omigoditfeelssogood-omigodIwantitmoreandmoreandmore-omigodrubberswhatarerubbers-omigodthepregnancystripturnedblue-omigodhowcanthathavehappened eruptions than their more nominally “abstimentious” counterparts in other regions. And consequently they have fewer, and sometimes far fewer, far later in adolescent outbreaks of whatever it is Romney’s newfound “target demographics” are (justifiably) worried about.

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