The Journal Of The InnKeeper

 No time!

Quick update - the AIM foundation is the organization that provides HIV testing & other sexual health services, primarily for the porn industry, but was open to the public as well.  They were single-handedly responsible for catching 2 HIV scares before it was spread throughout the industry and are the driving force behind the ridiculously high level of safety for the industry.  Their basic strategy is that porn producers opt-in to their testing services, then the actors are required to get tested every 30 days (the HIV test has only a 2-week window, which means it's accurate up until 2 weeks prior to the test), and a recent clean HIV test result must be submitted to the producer before an actor can work.

They also set up the system so that the *producers* get the results directly from AIM, to eliminate the possibility of fraudulent or forged test results from actors.

Then they track their patients.  This allowed them, in the past, to quarantine Patient Zeros, who got infected outside of work, so that the virus did not spread to other actors.  The frequent testing & open sharing of medical information has been shown to be just absurdly effective in maintaining safe working conditions even when condoms are not used (although AIM officially recommends condom use & many porn companies do voluntarily use condoms).

In this article I wrote about research studying carrageenan-based products that have anti-HPV properties & possibly anti-HIV properties. I listed 5 specific products that were undergoing this HIV testing and had the most promise.

In this one I announced that one of the products, Carraguard had failed the anti-HIV testing, but it did not indicate a failure for anti-HPV properties. I worried that it would be abandoned entirely & left to the SCAM industry to take over. Fortunately, I was wrong.

I posted about further testing on Carraguard for its anti-HPV properties that showed a significant protection level against HPV.

Well, those studies have now resulted in Carraguard being granted $4 million in funding to test the efficacy of this microbicide.

According to the World Health Organization, approximately 440 million males and females are infected with HPV worldwide. The Centers for Disease Control estimates at least 20 million Americans have HPV. ... While a recent phase 3 trial using [Carraguard] did not demonstrate effectiveness against HIV, it was shown to be safe. Recent laboratory tests indicate that carrageenan, the active ingredient in Carraguard®, is about 1000 times more effective against HPV than against HIV. ... Dr. Einstein's study will be a combined clinical trial and translational research project. Two hundred women will be assigned to use either Carraguard® or a placebo gel. At the end of one year, the participants will be examined to determine if Carraguard® was protective against acquiring HPV infections. In addition, assays will be done in the lab to assess the compound's activity and to develop a predictive test for efficacy.

In addition to this being Good News in general, it is particularly good news for Third World nations. An effective microbicide gives women control over the effects of sex, an activity they often do *not* have any control over. While we still need to work on the social aspects that allow, encourage, or ignore human rights abuses towards women, we can, in the meantime, try to protect them from some of the effects of these abuses, namely pregnancy and STDs. By giving women the ability to protect themselves when their partners are uncooperative, we take a step towards decreasing the imbalance of power and rights between the genders.

 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.

...

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?

http://hpv2010.org/main/index.php?option=com_conference&view=presentation&id=1110&conference=1&Itemid=100

Results: ...After adjusting for risk factors, Carraguard was found protective for HPV infection for women who inserted >80% of their returned applicators of test product with >30% confirmed covered sex acts. Within the latter category, Carraguard was almost 50% more efficacious than placebo. Carraguard users were 0.529 as likely to contract HR-HPV [95% CI (0.304, 0.920)] as women who used placebo (P=0.0176).

Conclusions: Carraguard was shown to be effective in protecting against vaginal transmission of HR-HPV. To our knowledge, this is the first report of successful protection against genital infection by a vaginal microbicide.

We haven't seen much lately about the carrageenan studies for use as a topical preventative for HPV. Last I'd heard, they were going to human trials and the results were supposed to be out early last year, but I haven't found anything, one way or the other, until now. This particular brand that this study was testing, was found to have failed its anti-HIV test, and I posted about it at the time that I feared they would not follow up on its anti-HPV properties.

Well, apparently someone did, and it seems to be holding up against HPV. I'm still looking out for BufferGel, which was my favorite of the brands being considered, so when I hear more, I'll let ya'll know!

http://cnmnewsnetwork.com/1548/guardasil-could-benefit-gay-men-and-older-women/

Last heard, the FDA did not approve Gardasil for women over 26. Men and boys were only recently given FDA approval, but for older women, the FDA wanted more proof that it would do any good. The reasoning behind the FDA's rejection is that, the older a woman is, the more likely she is to have been exposed to HPV, and the less likely the vaccine is to do any good once she already has HPV.

Yes, yes, I already know all the logical fallacies in that argument, I'm not agreeing with them, I'm reporting it.

So Merck, data in hand from all their existing research that says it helps a little, dutifully went back and researched some more.

And they found that the vaccine does, indeed, significantly protect older women and gay men.


Merck submitted their request for approval in January, and it typically takes 6 months to review the data & receive approval or rejection.

 Or, rather, for failing to disclose an STD.  I hate that this has apparently become necessary, I would rather see people just being responsible people, but frankly, I just can't get too upset at someone who knowingly hides an STD from a lover.

Since I expect to actually see my partners' paperwork, I am unlikely to ever fall victim to something like this, unless he's also good at forging medical documents.  In which case, I'm in deep shit anyway.

I find the deliberate refusal to disclose a KNOWN life-threatening illness combined with a deliberate engagement of an act designed to transmit the illness to be an act of evil.  Even if we're talking about an illness that doesn't actually *kill*, or has a high survival rate, this goes beyond ignorance and beyond misunderstanding.  This is a deliberate, pre-mediated act that threatens the life or the quality of life with long-term repercussions, that robs another human being of his respect and dignity in addition to his life, by using the trust and the intimacy of the act to perpetrate this evilness.

I have a hard time not agreeing to the punishment in the form of legal action, against someone like that.

http://www.usatoday.com/sports/olympics/2010-01-21-211181822_x.htm

 Not much *new* happening in the world of STDs at the moment, so I haven't had many updates.  Last time, I believe I mentioned that Merck's request for FDA approval for Gardasil for women over 26 was denied until Merck completed more study.  Well, the length of time for the study has been completed and Merk has re-applied for approval for women over age 26.  Here's hoping they get it this time!

http://www.reuters.com/article/idUSTRE60C6B420100113

So you've probably all already heard, but for those who haven't, there have been big news in women's healthcare this week.

Both the Pap Smear guidelines and mammogram guidelines have been adjusted. In both cases, they are now recommending that we don't get screened as often as we used to.

http://health.usnews.com/articles/health/healthday/2009/11/20/new-pap-test-guidelines-start-later-have-fewer.html

For the pap smear, they are now recommending that you don't need to start getting one until 21, and to get them every other year, not annually. The reasoning is that research suggests that younger women, even if they do get HPV, are pretty able to take care of it themselves. Even if it starts to progress to cervical dysplasia, younger women, apparently, are able to treat themselves without the need for biopsies or surgical procedures. And, women who have had surgical procedures for dysplasia have a higher incidence of premature births later on.

But, doctors and research scientists are very careful to point out that this is not a MANDATORY screening schedule. They recommend discussing with your individual doctor your individual health needs and adjusting your screening schedule accordingly. They also stress that a reduction in pap smears does not mean we should reduce how often we get tested for STDs. I, for instance, as a sexually active adult with multiple partners, who in turn have multiple partners, will continue to get screened annually and/or 3 months after the introduction of any new partners.

http://skepchick.org/blog/2009/11/no-ladies-the-new-breast-cancer-guidelines-arent-patronizing/

Now the mammogram guidelines say that we don't have to get screened until age 50 (it was previously age 40) and we can get it done every 3 years. That's a scary thought, that someone who had cancer at age 40 will now not be getting screened for it. But, once again, the experts have very clearly stated that each individual woman should discuss her own needs with her doctor and plan an INDIVIDUAL screening schedule based on risk factors. Plus, if you're doing a self breast exam, like we're all still supposed to be doing, if you find anything unusual, a doctor won't refuse to screen you just because you're under 50.

I have to admit that my knee-jerk reaction to hearing this news was negative, to put it mildly. I have had it drilled into me from before puberty that I have to be rigorous in my health standards, I have to get tested often, and I have to knock a few medical heads to get it done because the bureaucratic machine doesn't care about us and will try to whisk us through as quickly as possible, even at the expense of adequate medical care.

I'm still not sure how I feel about this. My emotions continue to rage at the idea that doctors are telling me not to worry my pretty little head about something I don't understand. But I really don't think that's what they're doing. Between social awareness of women's health issues, and the recommendation that each woman develop a personalized screening schedule based on her risk factors, I think they are legitimately trying to calm down hysteria and panic.

People are getting all up in arms over the phrase "causes anxiety" as if that was the only reason to stop screening regularly. I know that I was certainly pissed when I had doctors tell me that I didn't need to get screened for HPV or herpes because I probably already had it, so why worry about it until it actually does something? Let ME decide what I'll worry about or not and just give me my damn test, thank you very much. Even receiving a positive result is less worrisome than an unknown!

But it's not just anxiety. It's unnecessary medical procedures that go along with false positives and positives for things that the body will deal with on its own that are the problem here. Not only is it more expensive for no real gain, but it's also invasive and sometimes harmful for the body.

But we need to strike a balance between avoiding unnecessary medical procedures and catching stuff while the survival rate is still high. And as long as the guidelines continue to say, EXPLICITLY, that it does not PROHIBIT more frequent screenings, and that individual risk levels should be considered when developing a screening schedule, I can see the value of avoiding cutting into my body when my body might take care of it on its own.

Bottom line here is that I have mixed feelings about it. I'll probably write more as it plays out in real life and we see how it actually affects women's health.

the HPV vaccine is so important for both men and women.

http://www.eurekalert.org/pub_releases/2009-11/uhn-pfm110309.php

This is great news for people who already have tonsil cancer.  They discovered (I wrote about it before) that a significant number of people with tonsil cancer had HPV-16 in their cancer.  Now, they've discovered that cancer caused by HPV-16 responds really well to radiation WITHOUT THE NEED FOR CHEMOTHERAPY.

This greatly improves the quality of life for patients with tonsil cancer.

But if they had the vaccine, they might never have had to go through this at all.

Because smoking rates are declining, HPV as the cause of head and throat cancer is rising.  But it's also rising because of the increase in popularity of oral sex.  Pretty soon, with these two factors, HPV will be the leading cause of oral cancers in the US.

Because oral cancers are not screened as rigorously as cervical cancer is, the mortality rate for oral cancer is much higher due to not catching it as early.  This goes for men and women.

But, with the vaccine, we could reduce the numbers of head and throat cancers, along with a decline in smoking, to a very small number of people.

http://www.upi.com/Science_News/2009/10/19/UPI-NewsTrack-Health-and-Science-News/UPI-96371255988640/

Gardasil OK'd to stop male genital warts
WASHINGTON, Oct. 19 (UPI) -- The U.S. Food and Drug Administration says it has approved the use of the vaccine Gardasil to prevent male genital warts due to the human papillomavirus.

The FDA said it approved Gardasil (condyloma acuminata) to stop warts caused by HPV in boys and men ages 9-26 years. Genital warts are diagnosed annually in approximately 2 of every 1,000 men in the United States, the federal agency said.

The FDA previously approved Gardasil for use in girls and women ages 9-26 for the prevention of cervical, vulvar and vaginal cancer caused by HPV, as well as pre-cancerous lesions and genital warts.

HPV is the most common sexually transmitted infection in the United States and most genital warts are caused by HPV infection.

"This vaccine is the first preventive therapy against genital warts in boys and men ages 9 through 26, and, as a result, fewer men will need to undergo treatment for genital warts," said Dr. Karen Midthun, acting director of the FDA's Center for Biologics Evaluation and Research.

Gardasil is manufactured by Merck and Company Inc. of Whitehouse Station, N.J.

http://www.reuters.com/article/healthNews/idUSTRE5905EN20091001

I've been holding off writing about this until the details came in. So by now, some of you may have already heard.

A 14 year old girl died shortly after receiving the HPV vaccine Cervarix in the UK. Naturally, everyone jumped on the coincidental timing and started accusing the vaccine. Article after article has gone up on the internet reiterating the same old, tired concerns about the vaccine that have been thoroughly debunked before.

Yes, there have been calls to the hotline about side effects and deaths that coincided with the vaccine. These "side effects" include "soreness at the injection site" and other things that are related to having a needle stuck in your arm, regardless of what's in the serum, or even if there is no serum at all. Dizzyness, nausea, etc., are all common side effects of having someone jam a needle into your arm or seeing or thinking about seeing your own blood.  There are a few other legitimate side effects too, but every single complaint was well within the expected (and disclosed) side effects of the HPV vaccine.

Yes, there are some actual allergic reactions to the vaccine, that range from mild to moderate (I do not have the statistics on any severe cases off-hand).  That is to be expected with any vaccine.  It's sad, but the number of cases of allergic reactions, and the response to it, are far outweighed by the number of cases of deaths and sufferers/survivors of cervical, vaginal, anal, penile, and oral cancers each year, not to mention the much larger number of people who don't develop cancer, but do develop pre-cancerous lesions and have to undergo expensive and painful procedures and years of regular follow-up testing..

Yes, there have been a couple of hundred deaths reported after taking the vaccine.  There have also been about a million or so deaths after not taking the vaccine.  Neither of these reports are related to the vaccine.  There are also several million deaths reported after taking a breath of air.

In every single case so far reported, not a single death has been confirmed to be related to the vaccine, and the VAST VAST VAST majority of them are outright proven to be not-related.  

This case, however, is a case of such tragic irony.  What killed this girl was not a cancer vaccine, but cancer.

It turns out that the poor girl had a severe, malignant tumor in her chest and she just happened to collapse a few hours after receiving the vaccine.  The autopsy reports that the vaccine had nothing to do with it.

I'm irritated that the media jumped all over the fact that she just happened to have received the vaccine several hours before her collapse.  Not a single newspaper reported that she collapsed right after eating her school lunch.  I remember school lunches.  I'd be more suspicious of them than the vaccine.

Naturally, though, Ceravix recalled the batch of vaccine that the girl had received, immediately as a precaution.  But rest assured, the vaccine is still safe.  Of course, their precautionary recall only fueled the fears that the vaccine had anything to do with it.  The recall was a perfectly reasonable and responsible reaction, even given the outcome.  But the lack of critical thinking skills of the general public and the media seemed to have prohibited them from understanding that, when you don't know what's wrong, you stop *everything* until you can find the actual problem, and you also aren't supposed to jump to conclusions - wait for the damn autopsy report!

I will say this again.  There have been SEVEN MILLION DOSES of the vaccine given in the US (yes, Gardasil is not the same as Cervarix, but Cervarix apparently has an even higher safety rating than Gardasil does).  Out of those 7 million doses, NOT A SINGLE DEATH has been attributed to the vaccine.

Frankly, I'm surprised.  There should have been at least one severe, bizarre, totally anomalous allergic reaction resulting in death by now, just by random chance.  But there hasn't been.  Not one.

Joseph Albietz said it best in an article debunking the anti-vaxxers claim against the swine flu vaccine. His statement stands for all vaccines:

"...in discussing only the children who die, Dr. Mercola implies that the only benefit of vaccination is the prevention of death in the person vaccinated. People aren’t either healthy or dead. Those who survive an infection are still subject to its inherent suffering and complications. Furthermore, survivors [and/or carriers] run a high risk of spreading it to others who then share in the risk and misery. ... We do not vaccinate “to prevent perhaps 100 deaths,” we vaccinate to prevent a disease altogether, and to help the entire population avoid all of these risks."

He also says later on:

"I’ll take the opportunity to point out that pharmaceutical companies, doctors, and hospitals stand to make a lot more money from an uncontrolled pandemic than from its prevention. The money spent on antivirals, antibiotics, sedation and pain medications, physician and hospital billing for the 200,000 people hospitalized in the US during a normal flu season would compensate them far better than profits from vaccine sales. It’s almost as though, against our financial interest, all of our efforts are designed to keep people from getting sick…"

All of my journaling and ranting doesn't say it any better, any more concisely, or any clearer, than this.

http://www.eurekalert.org/pub_releases/2009-08/uou-ahg080709.php

"SALT LAKE CITY, Aug. 10, 2009 – University of Utah scientists developed a new kind of "molecular condom" to protect women from AIDS in Africa and other impoverished areas. Before sex, women would insert a vaginal gel that turns semisolid in the presence of semen, trapping AIDS virus particles in a microscopic mesh so they can't infect vaginal cells."

Dude!  I SO hope this passes the human clinical trials!

Basically, it's a gel that's inserted prior to sex that, when the pH balance of the vagina increases (this happens when semen is introduced to the vagina), a reaction happens between the polymeres in the gel that cause them to form a tight mesh that traps semen, HIV and possibly other viruses!  This then prevents the HIV from attaching itself to vaginal tissue, which prevents a woman from acquiring HIV even if she's been exposed to it.  Even at lower pH levels, the gel slows down the movement of HIV.

"After sex, the vagina gradually becomes acidic again, and any residual HIV particles would be inactivated both by acidity and an antiviral drug within the remaining gel, which still impedes HIV to some extent at normal vaginal acidity."

These findings will be published in a peer-reviewed journal later this week and will hopefully begin human clinical trials in 3 to 5 years, with marketing the gel for public use (pending favorable outcome of human testing) just a few years after that.

This will be first marketed towards women in Africa and other impoverished areas because women have so little power in their own reproductive and sexual functions.  Not surprisingly, it's awfully hard to stop the spread of HIV when your male partner refuses to wear a condom and you have no ability to refuse him sex.  So, although HIV is a big deal here in the US, the most important step is to stop the spread at its source.  

So I really hope the human trials go well.  In the past, microbials have had a hard time making it through the human stage because, as this article says, either it doesn't work inside actual humans, or the humans don't bother to use it (or use it properly) so accurate data is not available.

Someday we'll eradicate this and other plagues and today we are one step closer to that goal.

Here is a hip hop song about safe sex that doesn't fall into the abstinence-only / promiscuity dichotomy. It's refreshing to see popular media take the stance that sex is good and fun and enjoyable, but we should be responsible at the same time.

I have some Constant Readers out there who share their lives with animals, hence today's postings about dogs and horses.

http://www.horsetalk.co.nz/news/2009/07/003.shtml

Apparently, horses can catch HPV. It's known as aural plaques and is spread to them through biting flies and affects their ears (the link has a picture). It is extremely resistent to treatment and causes some horses to become very head-shy and difficult to bridle.

But in a recent study, doctors used 5% strength imiquimod cream (marketed as Aldera) to treat aural plaques (which is typically used on humans to treat HPV warts) on 16 horses and the lesions cleared up on all 16 horses.  They were treated 3 times a week on alternate weeks for 6 weeks to 8 months and the lesions only returned on 2 horses after 12 months.

Unfortunately, it's expensive.  A 2-month supply costs $250.  The horses ears became sensitive during treatment and they didn't like the crusties scraped off, and the cream caused an inflamatory response.  However, after treatment, the horses' whose ears were bothering them before treatment all improved, got less head-shy, less ear-sensitive, and easier to bridle.  

Says one doctor, "Luckily they seem to forgive us!"

There's a debate going on in the comments to this article I read and it's really pissing me off.

The article is titled "Is It Necessary To Always Tell Partners About Your STD?"

In this short article, the writer mentions a friend who has herpes who hasn't had an outbreak in 8 years but still tells all potential partners about it, even though her OB-GYN said she wouldn't have to as long as she isn't currently experiencing an outbreak. Then she references an advice columnist who answers a letter from a girl who said she contracted genital warts, called her past partners to notify them, then when she talked to her boyfriend about it, he said "oh, yeah, I was gonna say something about that ... sorry!" The writer takes the position in this example that the advice columnist was right to come down hard on the guy.

But then she points out that scary statistic that says 80% of women will probably catch HPV at some point in their lives, so if it's so common and we can't avoid it, she asks, are there ever any circumstances that justify not disclosing an STD?

Most of the responses are adamantly on the side of Always Disclose, but what is pissing me off is a vocal minority of responses that say "well, yes, you should always disclose, but don't be so hard on the people who don't.  After all, it's scary to disclose".

And this just infuriates me.

"If you disclose, you'll never get laid again"
"If you disclose, no one will ever date you and you'll live alone forever"
"If you disclose, there's a social stigma that makes people not like you and that social pressure is scary"
"If you disclose, you risk rejection"
"If you disclose, you might get your feelings hurt"
"If you disclose, you could destroy a budding relationship"

And I'm supposed to be sympathetic to people in this position, apparently.

FUCK THAT.

Point 1) not all STDs are permanent.  Some are easily treatable with antibiotics and will go away in time, so this is hardly a life-long celibacy punishment.

Point 2) not all STDs result in death.  Some people are willing to trade the risk of exposure to certain STDs in exchange for what they perceive is a life-long or long-term relationship.  Plus, there is that 80% statistic, which means that some people out there have accepted that they will probably get it, so they just don't worry about preventing it.

Point 3)  There are dating websites out there specifically for people with STDs so that they can safely have sex without infecting someone else ... because their partner is already infected.

Point 4) There are things people can do to minimize the chance of infection while still maintaining a romantic relationship, including using condoms and medications for certain STDs, and limiting activity during the most contagious times.

Point 5) Non-disclosure to avoid destroying a budding relationship is hardly likely to yield better results than scaring off potential partners ... when you infect your new girlfriend and have her find out from her doctor that you lied to her and intentionally threatened her life, health, and fertility, all to get laid (as she will probably see it).

Point 6) I don't fucking care if you get your feelings hurt.  This is part of what being a grown up is all about, taking responsibility for your actions.  Some things are scary, sometimes we feel bad.  DEAL WITH IT.  This idea that we're supposed to cushion ourselves from ever feeling bad is completely ridiculous, unrealistic, and childish.  I have a news flash for you all ... YOU WILL SOMETIMES FEEL BAD.  Get used to it.

Now, this is a totally separate issue from needing to remove the stigma from having an STD (which contributes to people feeling scared) or creating better sex education for our society.  This is about someone who has chosen the path of least courage.  This is about someone who is choosing to protect their own ego or hurt feelings AT THE DIRECT EXPENSE OF THE LIFE OF ANOTHER HUMAN BEING through their actions (and by "life", I include the quality of life as well as the life itself - affecting someone's quality of life *is* affecting their life).

This is absolutely reprehensible to me.  The fact that someone might be scared is totally irrelevant.  I've been there, I've had to disclose, I've faced rejection, I've been rejected.  FUCK THAT.  Be a fucking grown up.  There is no excuse whatsoever that deserves my sympathy or compassion.

Having an STD, or any illness of any sort, earns a level of sympathy from me because of the difficulties faced with living with that illness, including public perception of said illness.

But the instant you knowingly infect someone with a potentially life-threatening illness (or even just an "inconvenient" illness) without giving them the information necessary to make an informed decision about their exposure levels, you lose not only whatever sympathy I might have had for you regarding your illness, but you lose all sympathy and compassion I have for any human just for being human.  This falls under the category of "evil", in my book.

Being "scared" does not give you a free pass.

Being a responsible, ethical, courageous person does not mean doing the right thing when it's easy.  It means doing the right thing when it's hard.  It means being afraid of being rejected AND DISCLOSING ANYWAY because it's the right thing to do.  Because if someone else had disclosed to you, then you wouldn't be in this position of potentially being rejected and feeling scared and alone in the first place.

I'm being told that, because it's so scary, that I should have some compassion for people who have to face that scariness and that I should understand why people might want to avoid disclosure.  I'm being told that not everyone is as courageous as me, and that it's not easy to learn to overcome one's fears.

FUCK THAT.  I know EXACTLY how scary it is, how hard it is, how isolating it is.  I was in that position.  And I overcame it.  The fact that some people are not as strong or courageous as I supposedly am is not a reason to allow our society to protect that cowardliness or to reward it by excusing poor behaviour.  When you done bad, you done bad.

And absolutely no reason or excuse justifies non-disclosure.  Ever.

Someone pointed out "misinformation", as in, the person doesn't understand that they are contagious and therefore doesn't disclose based on those grounds.

My rage at that person might be lessened, but not removed.

First of all, how many people do you know keep people at arms-length away before hugging when they have a cold?  They might not know exactly what's wrong with them, but they know a runny nose isn't normal and they tell people about it so that other people can choose to expose themselves to the cold virus, or the flu virus, or strep throat, or even non-contagious allergies, or not as they see fit.  People "disclose" all the time, even amid ignorance of the condition.  Yet, when it comes to STDs, people treat total strangers with more consideration than the people they want to be intimate with, by disclosing a cold but not an STD.

Disclosure and self-educating/self-education is all part of being a responsible and ethical adult.  Engaging in a sexual relationship requires being educated about the process.  Now, I might allow society, or their parents, or the church, or whatever, to share the blame in this case.  But that still doesn't absolve the person from not taking it upon themselves to learn about the activity they are engaging in.

Plus, if you're in the Abstinence-Only camp, then you're not supposed to be having sex at all, so you're a hypocrite on top of it.  But that goes back to what I prefaced this rant with - that education of the ignorant is a different issue and one I also address in other venues (such as the entire STI tag of this journal and the Safe-Sex sections of my poly lectures).

Several years ago, I began dating a guy, and I sat him down to have our Safe Sex, Sex History, & Disclosure talk prior to sharing in below-the-belt sexual activity, as is my custom.  He seemed like a reasonably intelligent person and earnest in his efforts to be responsible.  He had no problems with getting tested, with sharing his history with me, etc.  But then I started to talk about HPV, which, as my Constant Readers will know, is my little Pet Research Project, the STD I spend the most time on.  

He had no idea that HPV is what caused genital warts, or that other strains of HPV caused cervical cancer.  As I continued to talk, he got more and more nervous, until he told me the story of his most recent girlfriend.

He had been out of town for a while, long enough for he and this girl to break up and get back together.  When he came back into town, they started to have sex, and he was using his hands.  He noticed some small, hard bumps along the vaginal walls.  Naturally, he stopped what he was doing and asked her about it.  She said that, while he was gone and they were broken up, she slept with someone else and subsequently developed these little bumps, called genital warts.  But don't worry, she says, they're not contageous.  I'm taking these all-natural, herbal remedies that render them non-contageous and they'll go away soon.  Here's a pamphlet from my natureopath doctor.

Well, being a hippie-anti-Big-Pharma-conspiracy-theorist (which I didn't really understand at the time, or I would have never have dated him in the first place), he just accepted that her treatment was working, that her doctor had the right information, he didn't even read the pamphlet, and they had unprotected sex.

My jaw dropped.

I then had to explain to him (totally unable to keep the incredulousness out of my voice) that she was at her *most* contagious when the warts were present, but that she needed no symptoms at all to still be contagious, and that HPV is a virus that does not "go away" with herbal suppliments.  The only treatment is to have them burned or frozen off, just like regular warts (convenient, since they're the same virus), and, maybe, if she's lucky, the virus will become undetectable to our current testing methods approximately 2 years after her final outbreak (but you won't know it's your "final" outbreak until the next one doesn't come).  He was horrified.  He was mostly pissed at her for not researching it properly, but he was also upset at himself for taking her at her word and not educating himself about something that affects his own genitalia.  He blamed them both equally for his predicament.

Sure enough, about 2 years later, he developed warts.

As for me, I chose to maintain HPV Boundaries in place for the duration of our relationship and have since had only 1 abnormal pap smear in the intervening years (for which they followed up with an HPV DNA test, that turned out negative).

So, my point is that ignorance is not a valid excuse, because *I* am not ignorant and I asked him the kinds of questions that, even with his lack of knowledge, I was able to get his status that only a baldface lie could have hid.  I felt sympathy and compassion for him in his ignorance, but his willingness to discuss sexual safety, and my own self-education on the subject, prevented this from spreading any further.  

His ex-girlfriend, however, allowed him to have sex with her without disclosing up front that she had an STD, all mis-information aside.  If she had told him prior to their sexual encounter, perhaps with his blood flowing properly to all his organs instead of just one, he might have been clear-headed enough to do some independent research before allowing himself to be exposed to something he didn't really understand.  She intentionally engaged him in sexual activity and only disclosed after she couldn't hide it.  She might have been ignorant about the STD's contagion, but she was not ignorant about having it, and I believe she willingly hid this information out of a fear that he would reject her because of it, since they both claimed to be each other's "best friend" and they told each other "everything" (I knew both of them while they were dating).

And now *he* suffers through the fear of rejection and a limit to his dating pool because *she* didn't disclose to him.  Yet, even with his own ignorance on the subject, *I* do not suffer this same punishment because I questioned him, and I did so in a manner designed to bring us both to the same level of education on the subject, so only a lie on his part would have put me in his position.  Yet, he took the path of greater courage and disclosed the information when I removed his ignorance from him, thereby saving me from suffering the same fate.  For all his other flaws, I give him that.  He didn't, however, think to disclose his exposure in the first place - I had to ask the right questions, share the right information, for him to be aware that this was something he needed to disclose, which is part of the education problem that is a different subject, as I've repeatedly said.

Ironically, she once condemed me for having vengeful thoughts about someone who was harassing me, and for wishing harm to another human being, yet I never took any action against that other person, although I almost did.  

When I open myself up to another person, figuratively and literally, I take my responsibility for how my actions affect them very seriously.  I allow them the dignity to choose how their own life should look and what risks they should take, even if it means I risk losing the type of relationship I might want from that person.  My care and consideration is for the other person above my own desires, because what I desire above that is the happiness and safety of people I care about.  

I can't even fathom the idea of liking someone enough to want their bits and pieces inside of my own yet willfully endangering them without their input on the subject.  Part of the concept of "caring" about someone, or loving them, or even just liking them as a person is the idea that I care about their happiness and well-being too.  How can anyone rationalize "love" (or even like) co-existing with actively harming someone else?  And for the casual-sex crowd, I can't fathom allowing someone inside of me that I dislike enough to want to harm them by infecting them with an STD yet liking them enough to want those bits inside me in the first place.  Either they are a human being, deserving of being treated with dignity or respect, or they are not.  And if they are not, then why do they have access to my vulnerable parts in the first place?


And atheists & polyamorists are the immoral ones.  I've got your "immorality" right here, you fucking weak, cowardly hypocrites.

OMG did you know that millions of people are NOT DYING from vaccines every day!

Srsly!  And, like, most of them don't even experience the side effects that the vaccine companies WARN YOU ABOUT!

It's scary!  I mean, like these scientists are all like messing around with viruses and stuff and looking at them and analyzing them and cutting them up and rearranging them and doing spooky things with them!  They totally take them apart and then build these chemicals that trick your body into thinking it has the virus when it really doesn't so that your body makes its own ANTIBODIES against the viruses.

They actually put these chemical mixtures into your body at FRACTIONS of the potency of the REAL VIRUS!  And your body BELIEVES it and starts producing ANTIBODIES!!!!!  They're, like, building this microsopic army INSIDE you, using YOUR OWN IMMUNE SYSTEM!

And some people even have REACTIONS to them!  Really, I'm not making this up guys, they even ADMIT it!

It's totally freaky what science is up to these days.  I just had the Hepatitus B vaccine and I was told to expect soreness around the injection site and maybe even a light fever!  Then, they even said, right to my face, that I should call them if I got a fever over 99 degrees or if I was vomiting!  How scary is that!  I'm totally going to avoid dying of a virus that causes painful and prolonged liver failure, but I might get a fever instead!  That's just whacked!

What's even more crazy, tho, is that I'm totally not sick or sore or anything!  And that happens to thousands of people ALL THE TIME!

Dude, science is scary and has just manipulated my body into being all defensive and stuff against a deadly virus.  That's totally wierd!

http://www.fiercevaccines.com/story/bioengineered-plant-produces-antibodies-against-hiv/2009-05-20?utm_medium=nl&utm_source=internal

Bioengineered plant makes antibodies against HIV
May 20, 2009 — 12:50pm ET | By John Carroll

A group of Swedish researchers say that they have developed a new HIV vaccine that can be produced in plants and has proven effective in mice.

"A major problem with the HIV virus is that it mutates rapidly and therefore exists in several different variants. In other words, it's not possible to create an effective vaccine that is based on the entire virus. Moreover, this would be far too risky. Instead, we have selected a protein, p24, that exists in all HIV viruses and looks roughly the same in the various virus lines," says Ingrid Lindh, author of the dissertation.

It's impossible to transfer a gene directly into a plant. But the researchers got around that obstacle by putting the gene into bacterium and then into a plant. Mice which consumed the plant material produced antibodies that protected them from HIV.

Their next step will involve adding new proteins and molecules into the mix to boost the efficacy of the plant-based vaccine and increase the probability of its success in humans. They also are seeking an ideal plant that could fit easily into a variety of diets and grow around the world. The carrot may be ideal.

Dear Joreth:

Thank you for contacting me. I appreciate hearing from you regarding abstinence education programs and would like to respond to your concerns.

Federal funding for abstinence education programs was first authorized by the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104-193). This law defines abstinence education as a program that teaches the social, psychological, and health gains that can be achieved through abstention from sexual activity. Currently, 49 of 50 states sponsor various programs focusing on abstinence education.

The President’s budget for fiscal year 2009 requests $204 million for abstinence education through the Department of Health and Human Services (HHS) for developing research-based standards for abstinence education curriculum and for ensuring the consistency of messages in all youth programming that addresses teen pregnancy prevention, sexually transmitted diseases and HIV/AIDS prevention. This request is a $28 million increase from the fiscal year 2008 funding level.

You may also be interested to know that I joined a number of my colleagues in the Senate in sending a letter to the Appropriations Subcommittee on Labor, Health, Human Services and Education. This letter urged the Committee to continue to support Community Based Abstinence Education (CBAE) funding. Abstinence education is an important primary health message and is taught to more than two million youth across the country and it is crucial that funding for these programs continue.

Each week, I hear from many Floridians expressing their thoughts regarding the effects of abstinence education programs on students in Florida. I appreciate your interest in this matter. As a parent and a grandparent, I too recognize the importance of this issue for Florida's parents, students, and teachers. We have a national obligation to see that all young Americans receive the preparation they need to succeed in life. I can assure you I will keep your comments in mind as we proceed with the fiscal year 2009 appropriations process.


Again, thank you for sharing your views with me. If you have any additional questions or comments, please do not hesitate to contact me. In addition, for more information about issues and activities important to Florida, please sign up for my weekly newsletter at http://martinez.senate.gov.

Sincerely,

Mel Martinez
United States Senator

http://www.sciencedaily.com/releases/2009/05/090503132626.htm

Gene interference therapy is moving rapidly from basic research to application. The PLGA packaging these researchers chose is already approved as safe and non-toxic by the FDA, speeding the path to clinical trials for infectious agents such as HPV and HIV. ... This approach holds promise for global health and the ability of people to self–apply antimicrobial treatments. Woodrow said, "It is safe and effective and much easier than getting an injection of vaccine."

This is still several years off, but it's very exciting.  A very, very, basic summary of what's going on, is that these researchers figured out a way to program RNA molecules to run around a female's reproductive organs and basically interfere with the STDs (or whatever they program them to interfere with).  They run around the mucosal tissue and they hang out for 2 full weeks, cock-blocking viruses from inserting themselves into cells and reproducing.

It's way safer than vaccines (which are already really fraggin' safe) and takes advantage of a delivery method that has already been approved by the FDA.  So, all that needs to happen now is to prove that the drug agents themselves work reliably and don't cause harm to the person they're being introduced into.  The first step is animal testing, then, if all goes well, a couple of years study on humans.

http://www.fiercevaccines.com/story/texas-institutions-partner-merck-chlamydia-vax/2009-04-29?utm_medium=nl&utm_source=internal

Merk, the people who brought us the HPV vaccine, has now recruited researchers to work on a chlamydia vaccine.  All attempts in the past have been unsuccessful, but Merk thinks they can change that with new information from animal testing studies.

It's STD Awareness Month and many cities are offering free or low-cost STD testing.  So check your local health clinics and Planned Parenthoods to see what they offer.

April 7, 2009

http://insciences.org/article.php?article_id=3987

So, not too long ago, I posted about how HPV is now the leading cause of oral cancers, primarily due to a drop in smoking making tobacco use a decreasing cause of cancer.  But this sort of implies that the total number of oral cancers is more or less stable and only the causes have shifted.

Well, a Swedish study says otherwise.

This is merely a preliminary study and more research with larger sample populations needs to be done, but it's implications are frightening.

Not only is HPV the leading cause of oral cancers, but oral cancers in general are on the rise in spite of tobacco use declining.  This means that the rate of HPV infections of oral tissue is even faster that we thought.

None of my research so far has given me hard and fast numbers as to the probability of catching HPV orally, which activities transmit it, nor how often that oral infection turns into cancer.  I can only get vague words like "low risk" or "moderate risk", which are highly subjective words.  Just how easy is it to catch HPV in oral tissue?  And does it transfer by giving oral sex to someone with HPV on their genitals or can it transfer by kissing too?  This information is just not readily available in the journals I have access to.

But, according to a study done in Stockholm, which they admit limits their results to Stockholm residents but claim that Stockholm is a representative city for Europe in general, the number of tonsil cancers caused by HPV in 1970 were only 23%, but the number of tonsil cancers caused by HPV today are a whopping 93%.  This makes HPV as the cause of tonsil cancer just as prevalent as HPV being the cause of cervical cancer.  And since tonsil cancer is on the rise in general, that makes for a shit-load of HPV-caused oral cancer.

This is not a woman's disease.  Because there is no regular screening in place for oral cancer, most oral cancers are not diagnosed until they are already well advanced, which lowers the survival rate.  And, the average age of HPV-postive tonsil cancer victims is ten years younger than those with HPV-negative cancer.  The good news is, however, that the cancers caused by HPV have a better prognosis than HPV-negative tonsil cancer patients.  According to this study, 81% of HPV-postive cancer patients have a 5-year survival rate, as opposed to 36% of the HPV-negative patients.

Once again, this article does not make any mention at all about how the HPV is transmitted to the oral tissue, or how easily.  It also doesn't say how common tonsil cancer is in general, so it could be that HPV-positive cancer is on the rise but only .01% of the general population gets it.  Personally, I'm inclined to believe (lacking any other data) that the rate of cancer from HPV in oral tissue is probably similar to the rate of cancer forming from HPV in genital tissue.  So until I see contradictory data, that's the hypothesis I'm running with.  Which means that the majority of HPV infections probably do not turn into cancer, but the number of infections that do is similar to the number of women who get cervical cancer from HPV.

But for those who have it, it's small consolation to tell them "well, you were statistically unlikely to get this, so sorry".

Fortunately, Gardasil, the vaccine, protects against the only strain this article mentioned, which is HPV-16.  Gardasil is also showing signs of protecting against 10 other strains that it was not specifically designed to protect against.  Apparently those other strains have something in common with the 4 included in the vaccine, that the vaccine is somewhat effective against them too.  This article even specifically claims that they expect to see a decline in oral cancers following the rise of vaccinations.

And, there is finally talk about vaccinating boys.  My inbox has been flooded with articles about this issue for the past week or two, but I haven't written about it because I get too pissed off every time I start.  Many feminists and those of an egalitarian mindset have made not-really-jokes that if men had to get pregnant, we wouldn't have this whole debate about abortions - they'd be legal and cheap and easy and only a small minority of people would be shouting about "life is sacred".

Well, the double standard certainly seems true in the vaccine debate.  The debate over giving Gardasil to boys is heated, and revolving around the efficacy of the vaccine, but no one anywhere seems to be concerned that this vaccine will make boys more promiscuous.  No one has made that complaint, no one is calling for a protection of boys' virtue, nothing.  The debate is based on the evidence of whether or not the vaccine is effective enough to be worth the cost, just as the debate should.

So, since I've already posted that trials have begun over giving the vaccine to boys, I haven't posted much about the debate itself, because it's not really much of an STD issue - at least, not any more than I've already said about the vaccine with regards to girls, the same issues apply.  I haven't posted because it's more of a gender issue, and I'm just so fed up with defending equal treatment for both genders that I can't quite stomach even getting into another rant about it.

So, the bottom line for this post is that HPV is proving to be a rising danger for both men and women, and for health issues other than cervical cancer.  The days of "well, the odds are that you'll get it eventually, so just don't worry about it" are coming to a close as we learn that more and more cases of cancer are caused by this once-thought "harmless", "easily-treatable", and "woman's issue" virus, and more and more medical researchers are pushing for better screening processes and proactive treatments like the vaccines.

It's about time someone started listening.  I've been yelling about this for about 15 years and everyone looks at me like "dude, what's the big deal?  So you get warts, that's just annoying.  So you get a virus, it doesn't *always* turn into cancer so relax.  And besides, it won't hurt me, I'm a guy".  It's certainly not an automatic death sentence, the vast majority of people survive this virus.  But it is also most certainly not "not a big deal".


****EDIT****
http://news.myjoyonline.com/health/200904/28521.asp
As someone pointed out, the above article talks about a pretty small study, so here's another one.  This was done by John Hopkins University on about 300 people that seems to suggest that HPV is a "much stronger risk factor than tobacco or alcohol use".  Those who had HPV in the past had a 32-fold increased risk of throat cancer. 

 

A strange factoid is that smoking and alcohol are not additional risks, "suggesting that the virus itself is driving the cancer".

This article is unique in that it explicitly addresses the question of how HPV is transmitted, although it is still vague and doesn't give any hard statistics.  They know that oral sex is the "main mode of transmission", but this article specifically states that transmission from oral-to-oral (i.e. kissing) is unknown, but could not be ruled out.  Great.

This article also points out that it is unknown how well the vaccines prevent oral cancers, since they were specifically tested for cervical cancer, but the researchers still recommend that girls and boys get the vaccine.  This article also points out that this type of throat cancer is extremely rare.