Sunday, January 25, 2009

But he said he was "clean"...

News flash - most don't really know if they are STD-free or not.

Most CAN'T possibly know for sure, despite thinking so.

Even if they had the routine STD panel test and it came back negative for everything!

Here's why.

First of all, there is a common virus which can't even be tested for in men - HPV. Although it is possible for women to be tested for it, they usually are not. Doctors will usually only diagnose it if there are telltale pre-cancerous cells or genital warts. But plenty of people have this virus but without those telltale symptoms, and they have the ability to transmit it to others. It is actually so common that most women have it at some point in their lives, and never know it.

That leaves an awful lot of people proclaiming to be STD free, who actually have HPV.

And we know that 20-25% of people have HSV2, and they can be blood tested for it, but usually never are unless they have the telltale blisters - which most who have this virus don't actually ever experience. But doctors don't test for it unless there are blisters, or if the test is specifically requested.

That leaves an awful lot of people proclaiming to be be free of STDs, who actually have type 2 genital herpes.

And we also know that HSV1 is so common that 65-90% of all people have it. It is the common virus which can cause "cold sores", and it is not considered to be an STD. But that virus can be transmitted to someone who doesn't already have HSV1 in their system, during oral sex, even without a cold sore present.

So most people do have the ability to transmit a form of genital herpes to someone, even if they don't have genital herpes themselves.

Makes your head spin.

People are proclaiming to be STD-free, when they have absolutely no way of knowing that. Even if they are fastidious about condom use - often, skin to skin contact is enough to transmit.

And even if they ARE being tested for these viruses (which the vast majority are not) - it can take months for the body to process them after exposure, and show up positive in a test.

AND even if they truly don't have a "disease" which was transmitted to them in a sexual scenario (cold sore virus), they can still have the ability to transmit it to others in a sexual scenario. This can happen from one virgin to another. So much for the idea of anyone being "clean."

Besides, the people who have these viruses, whether they know they have them or not, are not dirty or unclean. They are just like any other living creature with the ability to carry and transmit viruses. We get colds, we get the flu, we get cold sores, we get STDs. We are human. We don't live in cages, separated from one another. And last time i checked, sex was a normal, expected part of the human experience.

If you shower, you are clean.

And if you get checked for STDs and are clear, that only means that you are free of SOME STDs. NOT all of them. There is usually no way to even find out.

And those who are able to find out they have something, because they happened to have symptoms, are no different from so many others out there, who have the same exact virus but just don't know it.

Almost anyone who has sex, or oral sex, even just once, is at risk for getting or spreading an STD. Micro-organisms don't exactly look at resumes. (I didn't come up with that one!)

This whole concept of being "clean" or not is irritating and inaccurate. Do me a favor... don't let people get away with it.

Friday, January 16, 2009

It's all fun and games until someone gets herpes.

Or, I should say, it's all fun and games until someone KNOWS they have type 2 herpes.

Okay, here's what's really getting my goat lately.

Those who know that they have type 2 herpes have a moral obligation to tell sexual partners about it, usually having to take on the huge unrealistic stigma out there and do a ton of educating. Okay, we can agree on that.

But what about the HUGE amount of people who DON'T know that they have type 2 herpes, because they never had an outbreak and they never had the blood test, who somehow DON'T have this moral obligation, even though they have the SAME EXACT VIRUS and present the SAME EXACT RISKS to others who are negative.

Doctors will say, yes, those who have HSV2 must disclose this to partners.

So why don't doctors have that same moral obligation to test their patients for it?

They do NOT include HSV2 in STD testing, and they don't even tell patients that it isn't being included. The word coming to mind here certainly isn't "moral."

Doctors are enabling people to not know about their HSV2 status, and therefore to not tell partners about it.

The reason we are given that doctors don't test for it is that the psychological burden of knowing that you have it is usually much worse than any physical symptoms.

This is wacky, because if more people know they have it, then the psychological burden can start to become a thing of the past. And it still doesn't get around the moral obligation to notify patients that they have it.

Another reason some doctors will give is that the blood test is not accurate, and almost everyone has herpes anyway and will turn up positive. But today's type specific Herpeselect blood test is actually very accurate, and it does clearly differentiate between type 1 (the one 65-90% of people have) and type 2 (the one 20-25% have.)

Okay, so 20-25% of people are infected with type 2 herpes (HSV2), but only about 2% of people KNOW that they are infected with it.

By allowing this to go on, doctors are allowing the outdated and unrealistic type 2 herpes stigma to continue. In this day and age, many people continue to believe that type 2 herpes is somehow rare, or something to avoid at all costs, or freakish, or dirty, etc.

But the reality is, the amount of Americans who have HSV2 is about equivalent to the amount of those who have bachelor's degrees.

I bet you know plenty of people who have bachelor's degrees, right?

You know A LOT of people who have HSV2. Whether you know it, or whether they know it. In any given room, it is 1,2,3, HSV2.

So what does all this mean? I'm guess I'm just pointing out the hypocrisy here. We need to get in touch with reality when it comes to HSV2. It is very common, and transmission can be easily prevented almost 100% as long as you know you have it. The only people transmitting it are almost always those who don't know they have it, or are too afraid to do anything about it or be honest about it or treat it and have their heads in the sand. So go get tested, and ask your partners to, so you can know your status, and what precautions you can consider using.

And if someone is telling you they have HSV2, please know that so many others do as well, whether they know it, or are telling you, or not. Chances are, you have already slept with someone who has it. If you think that it is somehow a dealbreaker, then you are not being realistic or rational, unless you are requiring every single person you sleep with to get a Herpeselect type specific blood test, 6 months after having slept with anyone else (since that's how long herpes antibodies will take to form after exposure.)

Remember that hiding your head in the sand will still leave a certain part of you exposed...

;)

Thursday, October 30, 2008

What's so embarassing about an STD, anyway?

The young, lovely and talented Julianne Hough of Dancing With the Stars has been in the news lately for revealing that she has endometriosis, which caused a cyst on her ovary that need to be removed. This will cost her a couple of weeks on the show, in order to recover, and she wanted her fans to know why she would be temporarily off the show.

I heard this story reported by Teresa Strasser on Adam Corolla's radio show. She then commented on the fact that some people have expressed that this is too much information, or Julianne should be embarrassed about talking about this. Teresa then something along the lines of "Why should she be embarrassed? It's not like it's an STD."

Thankfully, Teresa then said something really quick and sort of undecipherable like "and even if it was that would be ok," but Adam had already begun talking. Like she caught herself and realized that maybe, just maybe, having an STD or STI is also a perfectly valid and normal medical concern which people might be allowed to possibly talk about as well.

I have read that STDs are so common that they come in 2nd place as far as commonality behind the flu! Yet we can't talk about it?

One of the most common topics of discussion amongst humanoids seems to be complaining about our health. Whenever someone has the slightest ailment, they talk about it. They tell their friends, family and coworkers exactly what is going on. Even if it's slightly embarrassing and has to do with nether regions (yeast infections, hemorrhoids). Even if it is contagious (the flu). Even if it has to do with having sex (UTIs.)

Where do they draw the line? Here's what I've noticed. People don't seem to be comfortable talking about problems which are something caused by sex AND are potentially contagious. That combo, for whatever reason, is not generally socially accepted.

For example, I've never heard a casual mention of having caught syphilis, gonorrhea, chlamydia, or herpes, even though they are common. We can talk about UTI's (usually caused by sex), but we CAN'T talk about type 2 genital herpes, even though 1 out of 4 women have it? We can talk about cold sores, but we can't talk about type 1 genital herpes, which are caused by the same exact virus that causes cold sores? (HSV1, which up to 60-90% of the population has depending on their age group.) Huh?

One exception - I've noticed it's okay to talk about having gotten an abnormal pap and having had pre-cancerous cells detected and removed, even though that means that they caught a dangerous strain of HPV, a common STD. I have even heard more than one coworker give this as a reason for being out for a few days. (I suspect I would never hear of a coworker being out for a few days because of a primary herpes outbreak.) Maybe this is just because people didn't know for a long time that HPV was the cause of most cases of cervical cancer, and that you get HPV from sexual contact? (since sexual contact is so BAD and all.) Or maybe it's because it is so common that it is just accepted, and people don't think of it that way. ...Or maybe, just maybe, they just don't care that HPV is an STD and they are starting to get over the attitude that STDs are somehow embarrassing and we need to hide away and never talk about having had one.

Ironically, some strains of HPV cause genital warts rather than cancer, but it would be a cold day in hell before I walk into work and hear a coworker complaining of having genital warts. It's kind of strange to think it's okay to talk about cancer, but not warts.

People don't talk publicly about these things because of puritanical attitudes still deeply ingrained in society. But I want you to know it does NOT mean that other people aren't getting STDs. You don't have to feel awkward when one ignoramus makes some stupid comment or joke about STDs. Chances are very, very high that most people who are laughing along are just doing so so they won't stick out or be suspected of having actually had one, or having one. People have sex. They get STDs. They are treated and cured, or managed. Just like any other infection or disease that people get. And that's that. It doesn't mean they are having sex with everyone they meet. You don't have to have sex with everyone you meet to get an STI. It only takes one person, and a bit of bad luck. (Remember, condoms don't totally prevent transmission of herpes or HPV, and these things can be had or spread with zero symptoms.) And many times, that one person is our monogamous partner. It doesn't make either of you a bad person. If you gave one another the flu, it wouldn't make you bad people, either.

Sex is everywhere we look, and people don't seem to be ashamed about having sex. I think they are more embarrassed or self-pitying when they are NOT having sex. So why are they so embarrassed about being exposed to things that come along with having sex?

People have been marginalized in many ways for many kinds of things, and are often gradually more and more accepted until it becomes strange to NOT accept them. I hope that in time, as people can finally face the fact that genital herpes is more common than diabetes, we will get real and just let it go, already. I don't need to talk about it with everyone I meet, but I certainly don't need to feel marginalized for it or that I need to be embarrassed. And I won't.

Sunday, September 21, 2008

Would you take a 1% risk?

If there was an actual 1% risk of the following, would you still:
-cross the street despite possibly getting hit by a bus?
-go camping despite getting potentially mauled by a bear?
-have a child despite the chance of it being stillborn?
-eat lettuce despite the chance of getting a deadly dose of salmonella?

In all of these cases we are talking about DEATH. yet i'm guessing the answer is still yes... right?

If it's not, most would admit that there is a severe phobia coming into play.

So if there is a 1% chance that a woman with HSV2 (genital herpes) could transmit the virus to you per year, would you take that risk?

We are talking about a very common, mostly non-symptomatic, not recurring very often if at all, mostly mild, mostly dormant, and not even remotely life threatening virus. we are NOT talking about death.

I have yet to meet anyone in my life who would not take a 1% risk of ANYTHING, including death.

But it's somehow ok to not take the 1% risk of getting a mild fucking rash.

Think about it. How much of a wuss would one have to be?

Let's believe in science over stigma.
Knowledge over naivete.
Rational thought over out-of-proportion fear.
Reality over old wives takes and urban myth.

Let's just get real. If someone you love has herpes, please - enlighten yourself!



***
Want to know more about the 1% risk I am referring to?
An extensive study that was done shows that simple precautions can be taken to get the average risk of contracting HSV2 from a female partner who has it to a mere 1% per year of frequent sex.
Vice versa gender is 2%.
For more info on these studies, go to http://racoon.com/dcforum/tech/2824.html

Monday, August 25, 2008

Those Three Magic Words...

So your partnter has told you those three words... no, not "I love you" - not yet, anyway.

They have said "I have herpes."

What now? Well, good news - it's probably not nearly the unpleasant or scary scenario you're thinking of.

Let's say the scenario is a woman telling you she has it:

A quarter of all women you sleep with are carriers of HSV-2, whether they share that with you or not. Most are asymptomatic and therefore go undiagnosed, as herpes is NOT included in standard panel STD testing. If someone is telling you that she has HSV-2, it actually means that she is less likely to spread it to you, since she will be on the lookout for mild symptoms that those who are undiagnosed may miss. It also means that she may be likely to be using daily valtrex or other antiviral medication, and/or condoms to further lower your risk.

The official studies done by Valtrex show that per year of regular sex, the average female to male transmission rates are extremely low, even without using condoms or medication. (which doesn't really help their cause!) Here are the stats:

If ONLY avoiding sex during signs of an outbreak: 4% chance of transmission per year of regular sex
If ALSO using condoms OR daily antivirals: 2%
If using condoms AND daily antivirals: 1%

So, if using all three precautions, there is a 99% chance per year that the virus won't be transmitted! And if the meds and condoms aren't preferable, a 96% chance ain't too shabby either.

For ladies being told that their man has genital herpes, all the same info applies, except the transmission rates are about double. That means you can get your yearly risk of contracting HSV-2 from him down to 2% at the lowest. Also pretty darn low.

And if you're thinking that a lifetime of condoms or dental dams during oral sex is unappealing... those precautions are actually pretty unnecessary. HSV-2 does not prefer to live in the oral area, and there are very few cases of HSV-2 being transmitted that way. When it does manage to happen, the chance it would ever recur is slim to none. Not something worth worrying about in a relationship.

You may also want to ask your partner if she or he has had a type specific diagnosis. It is possible that their genital infection is actually HSV-1 (the extremely common cold sore virus), in which case the chances he or she would ever transmit it, orally OR genitally, is almost zero, even if you are in the minority of people not already infected with HSV-1. My blog has lots of postings about genital HSV-1 if you're looking for more info on that.

I hope this posting helps someone out there who is looking for answers. Genital herpes truly does not have to stand in the way of a relationship. For thousands upon thousands of happy and enlightened couples in the year 2008, it is entirely a non-issue.

Sunday, August 17, 2008

Misinformation.

Sadly, misinformation is rampant when it comes to herpes. Many otherwise credible people are just not updated on herpes, I guess because it tends to be a taboo topic. A stigma. So it's another case where ignorance is bliss, even amongst doctors. And now The New York Times, who have recently published a comprehensive overview about genital herpes on their website which, sadly, is absolutely chock full of misinformation. Shouldn't this be illegal?

I'm going to clarify some of the misinformation in the article here on my blog, although I wish there was a way I could edit their site. It makes me sad that when newly diagnosed people, or those who have a new love interest diagnosed with it, go to google this virus, they will find lies on otherwise credible websites.

Women have an 80 - 90% chance of contracting HSV-2 after unprotected sexual activity with an infected partner and are 4 times more likely to be infected than men.

This is only referring to a partner who is having an active, obvious outbreak. What person in their right mind would engage in sex with someone who has open sores on their genitals? Why isn't it mentioned that there is only a 8% chance PER YEAR that a woman will become infected if she just avoids sex during outbreaks? Those odds are lowered to 4% if a condom is used OR if the man is on daily suppresive meds, and down to 2% of both of those precautions are taken. Again, that's PER YEAR. a very, very small risk. (And those numbers are halved when talking about female to male transmission!)

Shedding of genital HSV-1 is less common than with HSV-2, but transmission obviously still occurs, as evidenced by the rising prevalence of genital HSV-1.

Grrr. Actually, genital HSV-1 is almost always transmitted via someone's oral cold sores. The source of GHSV-1 is VERY RARELY another person with GHSV-1. I know it would be easily assumed that the cause of GHSV-1 is GHSV1, especially when the New York Times is assuming such, but it's not. It's cold sores.

Pregnant women who are infected with either herpes simplex virus 2 (HSV-2) or herpes simplex virus 1 (HSV-1) genital herpes have a higher risk for miscarriage, premature labor, retarded fetal growth, or transmission of the herpes infection to the infant while in the uterus or at the time of delivery.

It would have been nice to mention that neonatal herpes is EXTREMELY RARE. It is almost always caused by a brand new infection - in other words, if you are 9 months pregnant and JUST contracted genital herpes. If you already have it, the only risk is if you happen to be having an outbreak at the time of delivery. This can be almost 100% prevented from happening with medication. But if it still does, a C-section would prevent transmission from occuring. Therefore, the only herpes threat to a baby would be an incredibly stupid doctor who is ignoring a blatant herpes outbreak. Since a quarter of all women carry genital HSV-2 and many others carry genital HSV-1, and women are not even TESTED for it when pregnant, it is safe to say that this is not much of a concern.

Not least among the damaging effects of genital herpes is its impact on the social and emotional life of patients. In one survey of patients with herpes, 82% felt depressed, and 75% were worried about rejection. Over 25% had suicidal thoughts. In nearly 80% of the respondents, the disease had a profound effect on their sexual lives. The patient must notify sexual partners, past and present, about their condition, a deeply humiliating experience. Guilt and anger are common emotions, and relationships may be shattered.

Does this article somehow know better than those with herpes do as to how they should be feeling? The statistics which are quoted here are most likely from a group of very recently diagnosed people, who are still uneducated, fearful, and buying into the irrational stigma. But once one gets educated and sees firsthand how little this will affect their lives, the reality is not nearly as harsh as is being painted here. It is also wrong to assume that it is "deeply humiliating" to tell others. Personal, and possibly a little embarassing, sure. But having genital herpes means that you share the same virus as 25% of the population. It also means you have had sex at least once in your life. What is humiliating about that?

The bottom line is that when it comes to herpes, we must cut through a lot of bullcrap to get to the truth. People say "talk to your doctor" when it comes to medical matters. Unfortuantely, my doctors gave me so much misinformation about herpes, I don't even know where to begin. One told me you can't get it if you used a condom, another claimed that only 1 in 10,000 cases of genital herpes are type 1, and a third stated that since I have type 1 genitally, it will travel up and "disappear." And these are DOCTORS specifically trained in sexual health!

So, sure, you can talk to your doctor about herpes, but understand that many were last educated about it over 20 years ago, when less was known. Even those who were recently educated might have only gotten a brief textbook lesson on it. (Including relative who recently finished nursing school, actually gets cold sores, and had no idea that they could be transmitted to others genitally.) Do not take their word as the bottom line. And do not take what you hear from friends or read on the internet as the bottom line, because many of them are relying on inaccurate and outdated sources.

If you are newly diagnosed with genital herpes or just looking for ACCURATE information, I highly recommend:
http://www.westoverheights.com/freebook.html
www.racoon.com
www.herpesdiagnosis.com
www.ashastd.org

Friday, August 15, 2008

An "innocent childhood infection," or an STD?

Isn't it funny how "diseases" are defined by how they are aquired ONLY in the case of those sexually transmitted?

HSV1 (more commonly known as the cold sore virus) becomes an STD ONLY if one is infected with it genitally. (Meaning that one managed to be extra cautious or lucky, and avoided getting cold sores for their entire life - which made them susceptible to getting type 1 genitally as an adult. How ironic.)

Another thing that bugs me - why does it suddenly become a "disease" once transmitted genitally? I have never heard anyone refer to someone with cold sores as having a disease. And cold sores are the same exact virus, but recur much more frequently and are way more contageous than is someone with an HSV1 genital infection.

So why is it being defined simply on how it was transmitted, but only when it was done so sexually? When orally transmitted, we don't call it a KTD (kissing transmitted disease.) I know a small number of people also get it orally from sharing forks and cups and whatnot, but the majority get it from kissing, even if it's an aunt's innocent peck.

We don't call malaria or lyme disease ITDs (insect transmitted disease) or typhoid fever a FTD (feces transmitted disease.)

But we do need to forever label those who happened to aquire a common infection during, god forbid, a sexual scenario - no matter how "innocent" that scenario was, including between husband and wife?

I'm not buying into it.