Another STD Post

 Ah ha! I'm stuck awake way too early on a Saturday morning without my external hard drive that has all the files and projects I'm currently working on.  And because it's so fricken early on a Saturday morning, the internet is not sufficiently entertaining me.  What a great time to post about a couple of websites currently cluttering up my browser as open tabs!

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First we have http://www.reuters.com/article/idUSTRE65M6NX20100624 - a news story that says that STD rates are higher for swingers than prostitutes.

The reason, they suspect, is because swingers are too afraid to get tested or admit to their doctors who could then advise them on how to maintain proper safety practices for the multi-partnered.

Higher than prostitutes.

As in, prostitutes, who know they're doing something dangerous, and are marginalized, discriminated against, and criminalized, have fewer health problems - prostitutes with their high numbers of anonymous stranger-partners.

(Keep in mind that this study was done in the Netherlands and prostitution is legal, so prostitutes can admit to their doctors that they need medical care for their profession but swingers are still marginalized)

What this says to me is that education, proper safety procedures, and openness and honesty are integral to safer sex. Openness and honesty are the keys to being safe, and lack of such is more dangerous than just the number of partners. This also says to me that society in general has their priorities all fucked up and that monogamy is still more highly valued than practiced.

The number of sexual partners is not the most important factor in a person's health risk profile. Using proper safety procedures, and exchanging accurate medical information between partners and with medical practitioners are more likely to keep you safe than just reducing the number of partners.

This part wasn't mentioned in the article, but the porn industry (those production companies that comply with the AIM foundation - a self-regulated medical facility for the porn industry) has a lower HIV incidence rate than the general public, in spite of non-mandatory use of condoms. I don't have the link off-hand, but some academic researcher actually did a study in preparation for the upcoming legal battle dealing with mandatory condom use, and found that their practice of regular HIV testing, and open test results resulted in lower incident rates.

If your partner is HIV-free, you can't catch HIV. People who have been tested for HIV, and who have the lab results to prove it, are more likely to be HIV-free than people who have not been tested. Your chances of catching an STD go significantly down with regular testing and open test exchange practices. Having 3 partners who have been tested negative for STDs are less likely to give you something than having a single partner who has not been tested simply because 3 partners who don't have anything can't give you anything while a single partner *can* because he might have something and you wouldn't know it to protect against it. Monogamous partners are less likely to use proper precautions because they believe themselves to be monogamous, but either they are unaware of the presence of other sexual partners, or they are not accounting for past partners. Your chances do not go up with numbers of partners. Your chances go up with shoddy practices, like not using protection and not getting tested regularly.

Even monogamous people should require test results of their partners prior to engaging in sexual activity, and regularly just as a matter of regular health maintenance. Only a small portion of people who catch an STD got it from a cheating partner. The majority caught it from ignorance. Get tested, be honest with your health providers, and exchange test results with potential and current partners.

**EDIT**
emanix ade a point in the comments below that the title of this article SHOULD have been "Prostitutes have HALF the STDs that straight people have!"  The article focused on how high the STD rate was with swingers, most likely as a scare tactic to reinforce the idea of punishment for immoral behaviour, but they neglected to emphasize that professional sex workers in this study are actually SAFER than either swingers OR regular heterosexual people.

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Speaking of STDs, here's the latest on the HPV research front.

http://www.physorg.com/news196855852.html

"A cluster of carbon nanotubes coated with a thin layer of protein-recognizing polymer form a biosensor capable of using electrochemical signals to detect minute amounts of proteins, which could provide a crucial new diagnostic tool for the detection of a range of illnesses, a team of Boston College researchers report in the journal Nature Nanotechnology.

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The detection can be read in real time, instead of after days or weeks of laboratory analysis, meaning the nanotube molecular imprinting technique could pave the way for biosensors capable of detecting human papillomavirus or other viruses weeks sooner than available diagnostic techniques currently allow. As opposed to searching for the HPV antibody or cell-mediated immine responses after initial infection, the nanotube sensor can track the HPV protein directly. In addition, no chemical marker is required by the lebel-free electrochemical detection methods."

That pretty much summed it up. Carbon nanotubes are being used to detect HPV immediately, rather than waitng for the body to develop the antibodies or destroyed cells on the cervix. And soon after reliable early detection methods are developed, early treatments will come. Wouldn't it be nice to be able to detect HPV before it does any damage and eradicate it before it replicates enough to become problematic?

It's All About Choice

This will not be well-fleshed out. It's in my head, so I'm writing it down before I forget it.

Someone once said to me that the FDA should not be prohibiting companies from offering a variety of health options. They should, instead, focus on offering information so that customers can make informed decisions about their own health without being held back from tempting new therapies that might work but haven't been tested yet because when someone is about to die, they don't have the time to wait for FDA approval. His exact words were "because it's all about choice, right? I should have the freedom to make my own choices about my health".

No, sorry, it's not all about "choice".  Also, the FDA doesn't do that, but that's besides my main point.

When I have a headache, I have the choice to take Aspirin, Acetaminophen (Tylenol), or Ibuprofin (Advil). I can go to the drug store and choose between 3 options that have been tested and shown to work on relieving headaches, and I can choose which one I want based on what I think is right for me using the information guidelines on the back of the box, including potential side effects and recommended doses.

But I do not think people should be presented with the "choice" between chemotherapy for their cancer, and homeopathic pills. That's not a choice between competing modalities that have more or less equal efficacy. That's fraud. One has been shown to work, and along with the offer of chemo comes the likelihood of its success, which is different for everyone. Homeopathy has no plausible mechanism and has been shown, definitively, not to work.

And I do not think the FDA, or any other governing body, should allow these two options to compete for a consumer's attention on an equal playing field.

Besides, the FDA serves a very important function, and that's to spank those companies that make false claims. The FDA, while not perfect, is there to *protect* us from harmful and fraudulent claims. It is not "restricting our personal freedom", it is restricting the freedom of charlatans to take advantage of an unsuspecting and vulnerable public, much like our justice system restricts the freedom of those who have been proven to be a danger to society (in theory).

Providing something like homeopathy with the same platform and legitimacy as chemotherapy, and simply giving the consumer "all the information" to allow him to make "his own choice for his own health" is counterproductive. This person is already sick, vulnerable, possibly desperate, and easy prey for fancy buzz words, pretty charts, and slick-talking, sciency-sounding "authorities". Any attempt to correct the misinformation can be easily spun as "trash talk" from their "competitor".

If there is no oversight by an independent agency to say "look, these guys over here with the chemotherapy are telling the truth. We checked it out, and their product does what they say it does. But those guys over there with the bottle of pills are lying - the pills are just sugar pills and don't do shit for your cancer." - if we don't have something like this in place, the average consumer is simply bombarded by companies vying for their attention and their dollar. There is *too much* information, and people cannot distinguish between the crap and the roses without the appropriate medical background.

The "free market" does not weed out those products that don't work, not in the health sector. It just doesn't. It's not like a TV that you can buy in the store where you know it doesn't work because you plugged it in and nothing happened. And even when a company is *known* to sell crap products, people still buy them. But an independent agency that reviews these things at least makes companies *recall* them when they're actively harmful, because you won't know that until after you've bought it - not unless there's someone out there specifically tracking this kind of thing, which, btw, is what these agencies do.

And with the health industry, it's a lot more complicated, and things that are known not to work, and things that are known to cause harm, are continually purchased and used by consumers, and many attempts to unmask these hucksters are quashed, often using our legal system for "free speech", which those who are touting the merits of "choice" in these matters are also fond of supporting.

The information *is* out there, for anyone to find if they're so inclined. But many are not, and many are not capable of understanding it even when they find it, and that's besides the point: we shouldn't *have* to dedicate our lives to biology and medicine in order to make decisions like which cold remedy to buy at Walgreens. We should have a method in place that prohibits and limits the exposure these quacks have, a method that does not allow them to compete with legitimate medicines as if they were actually comparable and a suitable alternative. SCAM artists (supplemental, complimentary, & alternative medicine) should not be allowed to play with the big boys because they are not playing the same game.  

It's as if the medical community is the NFL, playing by an established set of rules that are complicated, but transparent, and anyone can watch a team to make sure it's playing fairly.  But the SCAM industry is playing some bizarre version of Duck, Duck, Goose, only it randomly calls out "Antelope!" and that means something but since the rules aren't transparent, no one can tell.   So SCAM comes to the doctors and says "we want to play on your football field with you.  Yeah, we're totally playing football too!  Pinky swear!", and then kicks out all the referees and enlists the audience in judging who the winner is by popular vote.  

They don't explain what their Duck, Duck, Goose, Antelope, Pickup Truck game is or how to play it, but they like to spend a lot of time getting the audience up to participate in group cheers and booing the stuffy doctors with their rules for being all "restrictive" and "elitist" by denigrating their years of study and specialization as if that were a bad thing for medicine.  The SCAM artists know what the crowd *really* wants!  They want more kicklines and cheerleaders in short skirts!  Not that boring old run from one side of the field to the other like every other game!  And what about painting a hopscotch court onto the field?  Those yardage lines are so *restrictive* and they stifle creativity!

Meanwhile, the legitimate doctors are standing on their field saying "what the fuck just happened?  We have the rules right here.  This is how you play the game.  Hey, pipsqueak!  Get off the field before you get hurt, or worse yet, drag some poor crowd member onto the field and *he* gets hurt!  Go back to the playground and let the grown-ups get back to the real game here!"

OK, I think I've taken that analogy further than it should have gone.  As I said, this isn't fleshed out yet, it's just my brain ramblings over being told "it's all about choice, right?"  Anyway, back to the point.  And that is that alt-med and legitimate medicine are not "all about choice" because they are not comparable options.  One works, and the doctors will tell you how *well* it works, and the other either doesn't work, or hasn't been proven to work yet.

Sure, some alternative treatments turn out to be valid, after all, aspirin is the active ingredient in willow bark, which was often drunk as a tea for pain relief. When we discover that an alt-med practice works, it becomes ... medicine.

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**UPDATE** Check out Common Questions about Science and "Alternative" Health Methods, which covers the "freedom of choice" issue, along with a few other common misunderstandings of science-based medicine vs. so-called alternative medicine.