Posted by shy_guy on February 02, 2001 at 14:34:58:
In Reply to: Hey Dr. Dick! posted by HornyMike on February 01, 2001 at 20:06:35:
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"What do you know about the diseases you can get even wearing a condom? Like herpes and nasty warts. What can the prudent monger do to avoid these?" Wear a condom and take your chances. "Will inspecting the chica lower the risk?" Only if you see something and then only if you choose not to have sex when you do. In that case, it will help alot to protect against herpes since transmission is much less likely when no outbreak is present. On the other hand a mild outbreak or internal lesions you won't see anyway. With HPV, it won't matter much since many strains don't cause warts to grow but are still contagious. I change my mind, it won't make much difference if you don't know what you are looking for. "I always check them out, and I've never seen anything I regarded as funky. Certainly, when I use the chica-on-top position, which I like, I always get a little fluid on my skin around the condom. Is this a serious risk?" Any skin to skin, skin to mucus membrane, or fluid to skin or mucus membrane is a risk. I am not sure what "serious" means to you. "Short of giving up the hobby, what can a guy do?" Wear a condom and take your chances. I would stay away from women that have heavy discharge, open sores, or cauliflower growing out of their vaginas. Might want to avoid women with a strong fishy odor as well. Might just be a bacterial infection, but might be trichomonas as well. Those measures will probably supply some, although not very significant, protection against STD's. "Also, is there a blood test for herpes and warts? Can one just go to a clinic, give a blood sample and have a titer done?" Herpes blood tests have been around for some time. Unfortunately, the first generation tests that were used up until very recently were terrible at differentiating between HSV-1 and HSV-2. Discovering infection with HSV-1 is generally useless since somewhere around 70-90% of people have this by adulthood and it is an oral infection the vast majority of the time. (A small but significant amount of genital herpes is caused by type 1, however. Certainly spread by oral sex in many cases.) On the other hand, we can say with some confidence that HSV-2 infection is going to correspond to genital (or perineal or perianal; let's just say below the waist) herpes the large majority of times (well over 90%). So, there may be some use in identifying HSV-2 antibodies in the blood, since you can at least assume with fair confidence that it means genital herpes. No guarantee though. In fact, as Doc Cock correctly reveals, the antibody test itself gives zero information as to site of infection (genital herpes? oral herpes? other?) outside of the general proabability I mention above, zero information as to duration of infection (won't know who to blame), zero information as to virulence or activity of your infection (don't know how often or when you are likely to get an outbreak or how likely you are to give it someone else.) For those reasons, I agree with Professor Penis and don't generally recommend a herpes blood test. Now, in the past year there have been at least three different tests marketed that accurately differentiate between the two types. And there is a school of thought in the STD community that thinks general screening for HSV is important. The advent of these new clinical tests has infused a hot debate that had been going on for some time in STD circles as to what the proper use of such HSV screening tests are. Stay tuned. It probably has some value in screening certain populations, but most efficient use is yet to be decided. I know of one doctor in the San Diego area that offers a blood test for HSV-2 in their office. There may be others but it can't be many and I only know of one. As far as HPV tests go, there are antibody blood tests available but I don't know of any clinical labs that are offering them. As far as I know they are really just used for research protocols at this time. This means that they are available, but probably very expensive and accessing a lab that would do it for you may be a real pain in the ass. Keep in mind some facts: There are roughly about 100 different strains of HPV that infect humans. Some are very aggressive in causing warts to grow, some less, and some probably never cause warts. Some are permanent infections, and some probably run a certain course and resolve. Some are associated with human cancers. For example, HPV-16 by itself is probably responsible for about half of all cases of cervical cancer. A few other strains combine for an additional 40-50%. To be useful, an antibody test would really need to be strain specific requiring greater standards and cost on research and development. Again, like the HSV test, demonstrating antibodies to any or all strains of HPV in the absence of visual warts tells you nothing about where the infection is, how long you have had it, how likely you are to pass it on, etc. Remember, other strains of HPV are what cause verruca vulgaris (common warts on the hands and elsewhere), plantar warts, etc. There are tests for doing vaginal swabs that will check for viral antigens but it has not gotten much use yet in the US. Like with HSV serology, debates over the most appropriate use of such tests are ongoing. Tests that sample or scrub the skin of the male genital area and also check for viral antigens are again, to the best of my knowledge not really used outside of research at this time. "Is it really possible the chicas are inspected for this stuff?" No, they are not. In other words, No, they are not. On the other hand. . .NO, they are not. Now, the obvious rebuttal to this long boring post is the testimonial by fellows who have had sex so many thousand times over so many thousand years in so many thousand cities bareback with menstruating chicas who chew on their cocks till they bleed themselves and yet they have never ever caught anything. My only response: Nothing I have put in this post would contradict such a testimonial. My only counsel was wear a condom and take your chances. I know that I cannot tell you what the probability of catching herpes is during q minutes of intercourse in r position with chica x from bar y. I don't think anyone can tell you that. I do get the impression that that is really what many of you want to know. The odds are that for almost any STD, the answer to that particular question is likely to look like a very small number on paper. It seems like a much larger number when your doctor is examining your brand new symptoms. Now, you can help me with my research. What facts, message, info, advice, would actually make you (generic you, I'm not addressing this to anyone in particular) change your behavior? I have a theory that people choose a level of risk that they can live with and that health messages don't mean a damn thing. They may be interested in the info, but it won't really change anything. Shy Guy
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