Posted by shy_guy on February 03, 2001 at 01:03:15:
In Reply to: Re: Hey Dr. Dick! posted by HornyMike on February 02, 2001 at 20:35:19:
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Mike: I wanted to congratulate you on one of the most sensible posts I have seen on this board by a layperson about STD's. I think you summarized my long-winded, technical post very well. You clearly got my points. Now a few more responses. "Who's the Doc in SD that offers the HSV2 test? Will they give it to anyone who asks? What's it cost? I would see a value in being screened, just for the peace of mind of knowing you're clean, as long as the result came back negative." I will answer such questions via email, since I am not comfortable putting a particular physician's name on this public board without their express permission, even though it might put them into another tax bracket. Be happy to discuss it privately however. "4) It seems the health inspections are useless. If you use a condom, you're not going to get syphilis, gonorhea, or HIV, even if the chica has it. Thus, they provide no additional protection for me, because I always use a condom. But a chica told me that the process does include a visual inspection. Of course, in view of the above, that is close to meaningless." One correction. Syphilis, although it is bacterial (and easily curable with penicillin), is actually spread via contact with mucocutaneous lesions, not with bodily fluids, thus its mode of transmission is closer to that of herpes or warts than gonorrhea, chlamydia, HIV, or hepatitis B. Condoms definitely help, but if the primary lesion of syphilis (chancre) is on a site on your partner where it will rub against your unprotected skin, the condom won't make a difference. As far as visual inspection goes, well the gonorrhea test is done via a cervical swab, so unless the public health workers are doing the exams with their eyes closed, I guess they are looking at the women's twats. However, they could only diagnose HSV if they noted a characteristic outbreak and they are not going to do a herpes culture even if they do see lesions. They are not going to diagnose HPV unless they see warts and there is no specific test to perform even if they do see warts. If they do diagnose these diseases I don't believe they would provide treatment. And most chicas with these infections won't be diagnosed anyway because they won't have any symptoms when they get their check up. The only thing I don't know is: if an examiner did see these infections would they withhold the health card. They would need to do so for life since these infections are not curable. There is no legal imperative to do so, we can argue if there is a moral imperative. Furthermore, I suspect it is probably not physicians doing these check ups but rather nurses or other allied health professionals who are trained to obtain specimens for testing but not trained in physical diagnosis of STD's in general. (Everything in this paragraph is just my speculation. I have no factual information to provide here.) "6) Further question, what if any value does taking the shower afterwards have? i know herpes is easily killed with soap and water. Does it need to remain on the skin a certain period of time to infect the person? Will a good scrub kill it? I bet no one knows the answers to these questions either." A shower can't hurt. I don't know if it will affect your risk of genital herpes infection. Certainly, hand washing can help avoid autoinoculation of herpes simplex from one anatomic site (eg. genital) to another (eg. eye) thereby avoiding such serious infections as herpes keratitis, an extremely painful condition of the cornea that can cause permanent scarring and decreased visual acuity. By the same token a good wash of exposed areas may make a difference, but I don't think it's been studied in any controlled fashion. You are correct that the virus is quite fragile. It will quickly dry out and die outside the body including on intact skin. And even a mild detergent (like soap) will destroy it. Frankly, catching the virus is not that easy. (This fact of course is of no comfort to the 30% if adult americans with HSV-2 infection.) We know of many discordant couples (one has it, the other does not) that have active sex lives for years and the partner without herpes never develops herpes. And generally, we can assume that these monogamous couples do not always use condoms. Avoiding sexual contact during an outbreak is probably the most important thing to do. Furthermore, just getting the virus on your skin does not mean you have caught it. It needs to get through your skin or mucus membrane. It has no mechanism to break through intact skin (unlike the spirochete that cause syphilis, which burrows through intact skin quite efficiently). If nothing else, this indicates that microscopic tears in the thin sensitive skin and mucus membranes of the genitalia is a common event during normal sexual activity, or this infection would not be anywhere near as prevalent as it is. "The bottom line to me appears to be that the risk is low, but is always present." I couldn't have said it better. Shy Guy |
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