I am super pissed off. This post will be a doozy. You have been warned.
I am so frustrated with ignorant sluts. Ignorant sluts are the folks in the multiple partner sex party scenes who believe the little "d/d free" mention in their ad or post means shit. Ignorant sluts are those who reject partners who voluntarily disclose their sti status, while not inquiring the sti status of any other partners. Ignorant sluts pretend that their "safer sex practices" (putting on the condom eventually, although not necessarily at first penetration; unprotected blowjobs; etc) have kept them risk free and unexposed to any possible infection. Ignorant sluts think that since they "got tested" and nothing came back positive, they're clean.
But the most annoying thing about ignorant sluts is that these are very intelligent people. And they are my friends.
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The scenario
My friend Jefferson has been throwing sex parties for almost a year. I used to go back in the day, but lately life has gotten in the way. Many mutual friends and fucks make their way to his parties. It's one big happy incestuous family.
So, my friend of the blogosphere, Nadia, recently wrangled an invite to an upcoming evening. Nadia is super smart, wonderful, and educated about sexual health. She also has herpes. Her personal value system leads her to disclose her status to all potential sex partners, with positive and negative results. Nadia sends Jefferson an email:
I have a question for you, oh dear sex party host.... what is the protocol when someone attending has a minor std? I have herpes and I've always been good about informed consent of my partners and I'm not sure how to handle this situation. I only get outbreaks about once a year at this point, so most of the time I'm probably not contagious, but of course I can't ever guarantee that at a particular moment I'm not. So far I've never given it to anyone just by using condoms for intercourse.... but of course I'd like to keep that record going! I have no problem with people using barriers for oral sex or whatever, they can do what they need to feel comfortable.
Of course, should I suddenly get an outbreak around the time of the party I won't attend, but if everything's normal - I have no idea what to do.... ack. With herpes being so prevalent (20-25% of the population estimated to have it and 90% estimated to have oral herpes anyway which can be transmitted via oral sex to the genitals) I do hope this isn't a major deal but I want people to make the decision for themselves.... despite my fears of rejection. Some people see it as no big deal, others freak.... oy.
She's one smart cookie. Jefferson forwards to me with a request for advice. I say that since the risk of transmission between outbreaks is minimal (not to mention the same as folks who are asymptomatic carriers or folks between bouts of cold sores), let her come. He responds:
Thank you for lending your mind to this issue!
I will let her come. My feeling is that in the interest of informed consent, she should tell people about her STI before playing with them--which will likely cut out most potential partners.
Given what you say about the very low risk of transmission, is that asking too much?
Now, disclosure and informed consent are two push-button issues for me. I feel (and frequently verbalize) that people need to take responsibility for their own sexual health. Educate yourself to the risks, find a level of risk you're comfortable with, and stick to it. Don't assume anyone's status (unless you're assuming they have every infection under the sun). Don't assume your partner will disclose (or disclose honestly, even when asked). Don't assume your disclosure will prompt reciprocation. Don't assume your partner knows his/her/hir status. Don't assume your own status.
Additionally, you are responsible for your level of risk, including your level of information. If you are not asking questions, you do not have the right to know (although the information may be offered, it is a privilege). Informed consent is not so much about shared information between partners, but rather the knowledge level of each individual partner. I feel the same way about herpes or hpv as I do about hiv.
Someone who wants to bottom bareback (without a condom, that's what the "bb" means on all those acronyms, bbbj, bbfs, etc) knows they are placing themselves at risk for a variety of infections, including hiv (the big daddy of sexually transmitted infections, the one everyone is worried about, and the one that is easiest to prevent transmission of). They are responsible to inquire as to their partner's status, and have the right to request details of most recent test date and risk activities in the window period prior and since. I believe that an hiv positive person can top without a condom without volunteering their status, if their status has not been inquired (I'm not saying they should or shouldn't, but that's their choice; although they are legally obligated in certain states). An individual is only responsible for their own informed consent and sexual health.
Now, this does not mean I believe people should knowingly endanger their partners. Answer honestly to the best of your abilities. But it is impossible to ever really know all the details of your infection status (see testing section below).
So, Jefferson's reply got me a little razzed. I wrote back:
my feeling on the matter is if a person isn't asking everyone they go up to at the party if they have an sti, then their partners are not responsible for the silent person's sexual health. i believe she is not obligated to tell anyone (even you). this is only emphasized by the low risk of transmission. she thinks differently and will probably disclose (or at least has already begun to disclose by outing herself to you).
the fact that she is aware of her status and gets screened regularly and knows her body, she's probably putting herself at greater risk by fucking all your guests who may only occasionally get tested, if at all, without inquiring their status (assumes anyone else will also disclose).
would you allow a person to attend your party if they were hiv positive? would it matter if it was a woman or a man? how do you know no one with hiv has attended already? have you inquired as to the last time your guests were tested and listed the various stis one can be tested for (cause many you have to ask specifically, especially for boys)?
plus, i know its cliche and simultaneously melodramatic and under-estimating, but everyone has herpes and hpv in one strain or another. i have had cancor sores along my gum lines since i was an itty bitty child. this is a strain of herpes. one that could potentially be passed to a partner even with an unwrapped blowjob if i happened to have one in my cheek that i didn't think about. if you have ever had a cancor sore or a cold sore, you also have herpes. and you are just as likely to pass it on to your guests as nadia.
He ponders and replies (don't you love posts with email chains):
Very good points. I think in this case, Nadia is guided by her own ethics to inform people, which sets my mind at ease somewhat. I just feel a little burdened by my responsibilities as host.
And you are right: while we do tell everyone that is a "d/d free" group, we don't ask for evidence of recent testing. That may be unrealistic, given that we are not closed to new members. I don't lose sleep, though, because I watch closely, and everyone plays safe, if not by the most rigid guidelines (ie unprotected oral sex).
Under no conditions would I knowingly permit an HIV positive person to attend. Just as I wouldn't attend a poz party.
At this point, steam began coming from my ears. So I left my computer for the night, watched the sandlot with Dacia, slept, did work for the office, went to the dyke knitting circle, wrote my take-home Spanish test, and realized I was still pissed off about this. At that point, the blogging etiquette kicked in. I sent little heads-up emails to Jefferson and Nadia, inquired requested pseudonyms, and prepped them. (Jefferson, sweetie. I still love you. I am just very frustrated right now. Nadia, darling. You are a saint and a martyr. Not fun, but very admirable). Then I started writing what has become this eight page essay, until two in the morning last night. I completed and edited it this morning. Now, posted for your viewing pleasure.
So, here comes the meat and potatoes (yes, there's more).
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the facts
Sexually transmitted infections ("stis", formerly known and occasionally referred to as sexually transmitted diseases or stds) are a part of a sexually active lifestyle. If you are having sex (including oral sex) you are potentially exposing yourself to a variety of infections. All of these infections can be treated, and many can be cured. However, most of these infections also carry a social stigma.
the stats
HPV: Studies suggest that three quarters of the adult American population has been infected with HPV. Similar to herpes, HPV can not be tested for without symptoms present (including cervical dysplasia that the individual may not be aware of). Consequently, most people with HPV do not know they have it.
Herpes: Over 45 million Americans have the strain of herpes called HSV-2. Furthermore, up to 80 percent of Americans have the strain of herpes associated with cold sores and cancor sores. Previously HIV-1 was synonymous with "oral herpes". However, HSV-1 can be transmitted to the genitals via oral sex. Consequently, "oral herpes" and "genital herpes" no longer differentiates between HSV-1 and HSV-2 but refers to the area of outbreaks. Finally, it is estimated that four out of five people with herpes do not know that they have it.
Chlamydia: According to plannedparenthood.org, three million American women and men become infected with chlamydia every year. Chlamydia is:
four times as common as gonorrhea
more than 30 times as common as syphilis
most common among women and men under 25
For every person with herpes, there are six with chlamydia.
Also, Chlamydia infections are asymptomatic (don't present any pus or painful urination or other fun side effects of an infection) for 75 percent of women and 50 percent of men with Chlamydia. It can lead to infertility and crippling arthiritis if undiagnosed and untreated.
HIV: More than 40,000 men and women contract HIV each year. It is estimated that one third of people with HIV do not know they have it.
This is a very condensed list of the "top three" infections and everybody's favorite, HIV. The point being: many people have sexually transmitted infections AND many people do not know that they have sexually transmitted infections.
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"d/d free" my ass
I hate the phrase "d/d free" almost as much as I hate the term "abstinence". They are both open to interpretation and no two people define them in the same manner. And they both provide a false sense of security. I know some of you are out their scratching your heads (or your asses), saying "d/d free, huh?" To define, "d/d free" is web/personals slang for "drug and disease free". The fact that some of you don't know what it means illustrates point one: never assume someone knows what the fuck you're talking about, especially when speaking in acronyms.
Now, breaking it down. What exactly is "drug free"? Or even more basic, what qualifies as a "'drug"? Pot, Viagra, ridalyn, adderal, alcohol, tobacco, poppers, meth, ecstasy, coke, uppers, downers, xanax, heroin… At this particular series of parties, there is open alcohol, tobacco, pot, and ecstasy use, not to mention the occasional person who wanders in already having popped a pill or done a line. At other "d/d free" parties, I have seen poppers and Viagra passed between guests like a hor'dors (I have no idea how to spell this word, sorry). Where is the proverbial line drawn that divides the "social drugs" from the "real drugs" implied in "d/d free"?
So, if "drug free" isn't enforced, how can one assume that the "disease free" portion will be adhered to?
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"getting tested"
Can we ever really know our sexually transmitted infection status? Only in two situations. The first involves having a history absent of all sexual behavior, including kissing (even with parents and family members) and assumes the mother was not infected at the time of birth. The second is having every known sexually transmitted infection actively presenting itself and its symptoms. But what about getting tested?
First, you are not automatically tested for anything, even at your yearly physical. If you ask to "be tested" for stis (sexually transmitted infections, in case I haven't defined that earlier), chances are you will be swabbed for gonorrhea and Chlamydia, and have blood taken for syphilis and maybe hepatitis, if you have a good health care provider. You must specifically request to be tested for hiv (this is a legal issue as a positive test is reported to the DOH in most states and all AIDS diagnoses are reported to the CDC). But what about HPV and herpes? Well, chicks can have a pap smear to check for cervical lesions caused by some strains of hpv (see my "hpv and me" post for more info), and if you can find a health care provider with the equipment and the savvy, anyone can have an anal pap. But you can only be tested for the hpv strains that cause genital warts when warts are present. Similarly, you can only be tested for herpes when lesions are present (although there is a blood test now available, it is hard to find access to and is more often used for typing herpes as hsv1 or hsv2 for purposes of treatment than original diagnosis due to cost efficacy issues).
Additionally, several sexually transmitted infections have "window periods". This is the time between initial infection to the point that one tests positive. During this period, one can transmit the infection to partners but would receive negative test results. The most notable window period is the three months for hiv. Moral of the story? You can not assumed that because you have been tested you are free of sexually transmitted infections.
Furthermore, asking, "have you been tested?" is not specific enough to garner any worthwhile information. One must ask, "when were you last tested?" "what were you tested for?" (if they answer "everything" quiz them, "gonorrhea, Chlamydia, hiv, syphilis, herpes [throw that in there to trip them up], hepatitis, etc?") "did you engage in risk activities in the three months prior to testing?" "have you engaged in any risk activities since being tested?" And, ultimately, what do the answers mean? I find it easier to assume that everyone has everything, and protect myself according to my own levels of comfortable risk. Which brings us to our next point.
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"safER sex"
Remember "safe sex"? That phrase that helped America get its groove back post 1980's hiv-induced panic. You know, wear a condom and everything will be fine. Well, as George Bush and his buddies like to remind us, "the only safe sex is no sex". I think this may be the sole point Georgie boy and I agree upon. Sex is not safe. It is a series of risks. Personal, emotional, and physical. The physical risks include the risk of infection. Consequently, the sex savvy cohort may have notices a recent shift in vernacular.
In the past few years, "safe sex" has grown up and become "safer sex". Safer sex is more than using a rubber. The term encompasses a plethora of risk-reduction behaviors. From withdrawal to latex-encased-elbow-rubbing, the spectrum of safer sex is infinite and shifting. For example, condoms coupled with withdrawal are highly effective for reducing the risk of transmission of hiv and preventing pregnancy, however doesn't offer shit for an open herpes sore outside the condom with direct skin-to-skin contact at every ball-to-ass-smack.
For a comprehensive list of which activities put you at risk for what, check out
http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp. My only criticism of the chart is the combination of the strains of hpv linked to warts and the other twenty some odd strains, including those that can lead to cervical dysplasia. Lesson, wearing condoms for all penetrative vaginal and anal intercourse does not insulate the group from infection.
Furthermore, suggesting that closing the party to new members would serve to eliminate the risk of infection is naïve at best. Although limiting the number of immediate partners could somewhat reduce the risk, it is hardly an effective means of prevention. A sex party group is not insular. Most people who attend sex parties, also have multiple partners outside of that particular event. Think of it as the cast for a porn flick. How does hiv occasionally make it's way into one of the most heavily tested populations on the planet? Via risk activities with outside partners. Even by closing the guest list, there will still be risk.
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The frustration
It is so frustrating when people that I know and care about, whom I have spoken with and answered questions and handed brochures and references for years, can still fail to internalize the information. If Jefferson is still thinking like this after three years of me, how can I expect to impact anyone in a single workshop or class. Argh!