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I have been in sort of an ongoing discussion with someone about how safe it is to have multiple sexual partners. He insists on a very basic math formula that simply says "more people = more risk". I maintain that there are several variables to the safety probability, and one of the most important variables is how well you know the other person and what their own criteria for taking on additional partners is.
In an open and inclusive poly network, where regular testing is done before a new partner is added, I maintain that more people does not necessarily = more risk, as long as those people do, in fact, require tests beforehand and do, in fact, notify all people when an incidence does come up.
If you have 3 people in a group, he believes, this is inherently safer than having 5 people in a group because that is two more people who the group has to monitor to ensure they are following the safety rules.
However, if you have 3 people in a group, one of whom is prone to cheating or taking on partners without testing first, I state that this is inherently more dangerous than a group of 5 people who have shown a consistent pattern of testing and notification. As the number of people rises, at least within a certain range, the risk level does not, in my opinion, significantly increase when all people consistently use regular testing and disclosure.
To illustrate my point, a couple of researchers actually wrote a book about it. Well, they wrote a book about sexuality and within the book was a segment on HIV risk for a variable number of partners. It's called With Pleasure: Thoughts on the Nature of Human Sexuality by Paul R. Abramson & Steven D. Pinkerton. The premise of this math formula is that each person's HIV status is unknown and the partners are randomly selected from the population at large.
This, of course, only affects those STDs that are fluid-borne, like HIV. The incidence of contact-borne STDs like Herpes is only partially reduced by condom use, not the 90% quoted above. And for the untestable or hard-to-test STDs like HPV, I assume we cannot significantly lower the incidence rate by changing the variable from "unknown status" to "known status", but none of that was discussed.
In an open and inclusive poly network, where regular testing is done before a new partner is added, I maintain that more people does not necessarily = more risk, as long as those people do, in fact, require tests beforehand and do, in fact, notify all people when an incidence does come up.
If you have 3 people in a group, he believes, this is inherently safer than having 5 people in a group because that is two more people who the group has to monitor to ensure they are following the safety rules.
However, if you have 3 people in a group, one of whom is prone to cheating or taking on partners without testing first, I state that this is inherently more dangerous than a group of 5 people who have shown a consistent pattern of testing and notification. As the number of people rises, at least within a certain range, the risk level does not, in my opinion, significantly increase when all people consistently use regular testing and disclosure.
To illustrate my point, a couple of researchers actually wrote a book about it. Well, they wrote a book about sexuality and within the book was a segment on HIV risk for a variable number of partners. It's called With Pleasure: Thoughts on the Nature of Human Sexuality by Paul R. Abramson & Steven D. Pinkerton. The premise of this math formula is that each person's HIV status is unknown and the partners are randomly selected from the population at large.
According to the calculations (which use math symbols that I can't enter here because I write in plain text editors), "the risk resulting from 100 protected [sexual] contacts is about the same as that arising from only 10 unprotected [sexual] contacts". They go on to say:
"For sexually active individuals with more than one partner, the situation is slightly more complicated. Although the probability of becoming infected as a result of sexual contact with any one of these partners can be calculated using [this equation], the rules of probability calculus prevent us from simply adding them together to arrive at the overall risk of infection. ...The part that really impacts the poly community is that all of these scenarios and formulas are done with choosing a partner totally at random from the entire population without knowing his or her HIV status. With regular condom use, regular testing, and open and honest communication about status, the probability of becoming infected with HIV drops to a very small number close to zero. With a known status of HIV-negative, and no exposure to HIV since testing, the probability drops to a small number close to zero even without the condoms.
As might be expected, the probability of infection arising from N one-night stands is greater than the risk from N contacts with a single partner (monogamy). However, the difference is not nearly as great as one might suppose. ... the relative risk reduction achieved by engaging in N sexual contacts with a single partner rather than N one-night-stands is greater in the high infectivity condition (a=0.01) and increases as the number of one-night stands gets large, but is less than 40% in any case. In contrast, the relative risk reduction due to the consistent use of condoms is about 90% regardless of the infectivity or number of partners. In other words, in this situation even the most dramatic change in the number of sexual partners - from 100 to 1 - provides LESS protection than does the simple expedient of always wearing a condom.
These results highlight the inadequacy of educational programs that focus on getting people to limit the number of sexual partners as a means of reducing HIV risk. Although there are conditions for which this is sound advice (such as populations with a high prevalence of HIV and other STDs) the simple strategy of always using condoms is usually a superior means of reducing risk. ...
Finally, to return to the question posed at the beginning of this discussion: is everyone at risk? Obviously that depends on her sexual behaviour, including who she has sex with, what kind of sex, and whether or not her partners wear condoms for penetrative activities. For the sake of argument, suppose the infectivity is 1 in 1,000 and she selects 10 male partners at random from a population in which 1 out of every 200 men is infected with HIV. If she has intercourse 100 times with each of these men and never uses condoms, she faces an infection risk of 0.0047 (in other words, out of 211 such women, we would expect one to become infected with HIV as a consequence of her sexual behaviour). If, instead, she and her partners used condoms for every act of intercourse, her risk would be reduced by about 90%, to 0.0005 (1 out of 2010)."
This, of course, only affects those STDs that are fluid-borne, like HIV. The incidence of contact-borne STDs like Herpes is only partially reduced by condom use, not the 90% quoted above. And for the untestable or hard-to-test STDs like HPV, I assume we cannot significantly lower the incidence rate by changing the variable from "unknown status" to "known status", but none of that was discussed.
Anyway, this book sounds pretty fascinating and I plan to pick up a copy sometime soon. One of the other thoughts they propose in the book is that the primary purpose of sex has evolved to be pleasure and procreation is a by-product. When I did a search for the title, I didn't find any negative reviews of the book, no blog entries claiming they're hacks and peudo-scientists, so I'm curious to see the research they used to reach this conclusion. Here's the link to read what I quoted above, just click on the cover image and you will access a preview of the book that you can scroll through: https://amzn.to/2IInG7n
no subject
Date: 10/13/08 09:47 pm (UTC)From:I also have met and fallen for people who then said they would not sleep with me because of the HPV. I understand that completely and have no problem with it, as everyone has the right to decide for themselves their own risk assessment. For the record, my HPV no longer shows up, because that's what HPV does after a couple of years and it's been 15 years since I had it.
There are lots of people I will not get into relationships with who have behaviour patterns that are destructive and I don't see choosing partners based on sexual compatibility to be any different, nor do I see anything wrong with people making judgements based on a person's behaviour when choosing a romantic partner. We all have to assess our own risk level, and insisting that people be open to dating someone that they feel is not compatible on a sexual, moral, behaviour, political, any kind of scale just to avoid hurting someone's feelings is just silly. I don't drink alcohol or do drugs, for instance, and I choose not to date people who do. That's a "judgement" of their behaviour. If we didn't judge anyone, we would never have a method for removing destructive, or perceived destructive, elements from our lives.
If a poly network comes up with an infection, the more likely point of entry is, in fact, the person with the more frequent and less safe partners. That's just a fact, whether someone wants to feel bad about it or not. With some STDs, we can actually trace the point of entry, and with others we cannot. HPV, for example, cannot be traced to the point of entry because there is no test for men and because it can lie dormant for a long time, in addition to being transfered by simple contact and not intercourse.
So when an infection can actually be traced back to the point of entry into a network, and the point of entry is a person who tends to have more partners, casual partners, and more lax screening standards, then, in fact, that person is responsible for introducing the infection into the group. Now, when those behaviours are approved by the other members of the group, this isn't necessarily "blame" in a morally judgemental way, but it is, in fact, the result of a single person's behaviour and choices.
What asking for test results does in a practical way is give each member of the group a solid baseline for estimating risk potential. There is no confusion, no misunderstanding, and everyone begins on the same page. Regular testing should be done by everyone, not just poly people, and not to find blame, but for basic health, just as a PAP should be done once a year and a regular physical. So, since we're all supposed to be getting tested anyway, trading the test results only evens the playing field by making sure everyone knows exactly what everyone else is talking about.
continued
Date: 10/13/08 09:47 pm (UTC)From:"Have you been tested?"
"Sure!"
"For what?"
"I told the doctor to test me for everything"
"And?"
"I'm clean"
When, in reality, that person didn't actually ask the doctor what tests were being performed. Many clinics, for example, only test for 4 STDs and do not give PAPs to women, so when you say "give me everything", the doctor gives you everything they test for, not all tests that exist. So these people were not actually tested for "everything". The test results clearly show which tests were adminstered and what the results were, so no one's faulty memory or misunderstanding can muck up the disclosure process.
It's not about assigning blame or "sluttiness", it's about realizing the very human tendency to not understand and convey information accurately. But test results on paper are clear.