TER General Board

HIV and cocomitant infections
singleton 5 Reviews 3974 reads
posted
1 / 15


you probably already know this, but for those who may not know the distinction

3-month HIV-1 antibody (Elisa) testing is no more significantly vigilant than 6-month HIV-1 antibody testing. this is because in most people it takes up to 6 months for your body to develop anti-bodies to the HIV virus after being exposed

OTOH, the porn industry's MONTHLY tests are the PCR/RNA viral load microassay which test directly for the virus (so theoretically no incubation period is required).


this being said, i'm not sure that more frequent antibody testing (say every other or every 3 months as opposed to every 6 months) is necessarily being more vigilant. the pornofolks live (and die) by another standard, so that's a different thing altogether!


regardless, always practice SAFE SEX!

HerbertFaquat 2660 reads
posted
2 / 15

Yep, the rascals do slip off, see my Need Advice post below.
So now, if I read these threads correctly, I get to contact the porn industry's health providers in Van Nuys and arrange for an expensive PCR/RNA test. And then hope/pray it comes back negative.
And if not, begin rearranging life as I know it, right?
Seriously, thanks for the useful and open discussions here.  

greywolf 17 Reviews 2582 reads
posted
3 / 15

I wonder if the every 6 months concept is mostly based on the 'discovery' period for HIV.  There are a multitude of other STDs, albeit not of the deadly variety, which can be discovered within a matter of days after infection occurs.  I would hope that no one would limit their testing so that panels for these aren't included.

How often a person 'should' be tested would most certainly depend on the type of activties engaged in, but also on the number of people seen during a given time period.  All things being equal, it makes sense to me that the higher the volume, the more frequently testing should be done.

I typically get tested at about 4 month intervals depending on my activity level at the time.  But if I were more active or saw gals that I knew were high-volume themselves (which I don't) then I'd increase my testing frequency. Another factor that I take into consideration is how many of my contacts have been with someone new.        

GentleAman 3566 reads
posted
4 / 15

I am kind of new to this hobby.  Surprised to find out that the men with 50 to 60 reviews still do daty every providers.  Are the most providers that much clean and safe?  Just wonder what had happened to these veteran as far as STD is concerned.  Nothing?

-- Modified on 6/24/2003 1:21:00 PM

-- Modified on 6/24/2003 1:37:04 PM

elegantGFEelise 3374 reads
posted
5 / 15

If one presents to a doc that they have had a "high risk sexual contact", no further details, they'll likely be given every test available for any and all orafice that was exposed to the "high risk contact". As well as blood serum test for syphillis, HEP, and HIV.

Each and every new, no further detail "high risk contact" should, in theory, be treated the same.

Because of health care costs, and the taking of the risk being choice, most of our health care providers seem to recommend once every six months at the LEAST.

I have always been the type to go once a month or every six weeks, because, yes, even though I believe I'm practicing safety on dates, I want to be as certain as possible, without being celibate, that I'm clean and serial dating might put me into what MOST would consider "high risk contact" at least once a month.

I'm no doctor but I think this could occur:  Let's say a provider gets tested January and June but gets exposed in March..... the antibody shows up in her blood in August but
she's not scheduled to test again until January.

No matter who you are, just be comfortable.

*smoooch*
Elise

singleton 5 Reviews 2526 reads
posted
6 / 15


the question of testing aside, 10/month is so ridiculously low it's just adorable. i mean, that's only 2 dates a week!  like as with a CIVILIAN!  LOL

don't ever change ... (except your mind, every now and then! ;)



greywolf 17 Reviews 2649 reads
posted
7 / 15

You're right about the term 'high volume' naturally being open to individual definition.  Perhaps 'the higher the volume' would've been a better way of phrasing it. LOL

And realizing that none of us can ever truly know the extent of another's level of activity, I do put some weight on reviews as they are the only thing I really have to go on in that regard.  So if I were to see a gal who had dozens of reviews in a short time span (again, 'short' being open to individual definition), or who worked at an MP where I would imagine many clients are seen every day she's on the job, then I'd feel testing frequency should be increased.  

I don't have any formula per se, but suppose I gauge things on how long it's been for me, how often I've participated, how many new gals I may have seen, what specifics are on her/their menu whether new or not, what clients she/they may have seen & what I can determine of those clients' activity level..both how much & what gals they had been with.  

I'm not suggesting this is the 'right' way, just that it's my approach.    

greywolf 17 Reviews 2253 reads
posted
9 / 15

....nor is that the way I took it.  But I thought some further expansion on my meaning might be in order for anyone who was  interested enough to have read it. And certainly there's no true way of knowing the number of partners in someone else's life, whether personal life or in the hobby.  We can only use what evidence we do have, realizing that it's neither 100% accurate nor complete.  

sedonasandiego See my TER Reviews 2362 reads
posted
10 / 15

Well, and when you remember that the number of reviews SHOWING are just the clients who REVIEWED...there's a whole other group of clients who didn't...

Mathesar 3190 reads
posted
11 / 15

How often should one get tested for HIV? That is a good question.

As Singleton pointed out there is no point in being tested more often than once every six months unless you get the PCR/RNA test used in the porn industry. I go to AIM ( http://aim-med.org ) where they do use this test, but I have decided that once every six months is sufficient for the number of times that I date.

I would argue that it is better to get tested after a fixed number of dates rather than after a fixed amount of time. In order to decide what the number of dates should be you have to do a risk analysis.

The best source of relative risk information that I am aware of is from the article "Reducing the Risk of Sexual HIV Transmission," Varghese et al, Sexually Transmitted Diseases, January, 2002. A summary of some of the important numbers is on the web at http://www.straightdope.com/columns/020301.html .

I will summarize.

For females the relative risks are estimated to be:
  Receptive fellatio (with condom): 2
  Receptive vaginal sex (with condom): 20
  Receptive fellatio (no condom): 40
  Receptive anal sex (with condom): 100
  Receptive vaginal sex (no condom): 400
  Receptive anal sex (no condom): 2000

For males the relative risks are estimated to be:
  Insertive fellatio (with condom): 1
  Insertive vaginal sex (with condom): 10
  Insertive anal sex (with condom): 13
  Insertive fellatio (no condom): 20
  Insertive vaginal sex (no condom): 200
  Insertive anal sex (no condom): 260

The authors have assumed that condoms reduce the risk by a factor of 20. Experimental data confirms this with gonorrhea (95% CI: 8.0 - 36.5) according to Wong et al. "Impact of Pharyngeal Gonorrhea Among Female Brothel-Based Sex Workers", Sexually Transmitted Diseases, June 2002. However, there isn't much experimental data for HIV and the data I am aware of ( http://www.niaid.nih.gov/newsroom/releases/haitihiv.htm ) indicates that the risk of HIV infection when using condoms may be three times higher than given above.

Relative risk doesn't tell us what we need to know in order to aswer the question you asked. We need absolute risk. HIV has a very low infectivity. (Gonorrhea has an infectivity at least 500 times as great as HIV.) In order to get the actual risk of infection from a single act with an infected partner divide the numbers given above by 200,000. For example, the actual risk of infection from a single act of unprotected receptive vaginal sex with an infected partner is about 0.002.

Of course, not everyone that one has sex with is infected with HIV. Varghese et al estimate that about 1% of the population is infected. The infection rate in our community could be either higher or lower. For whatever it is worth, public health workers classify us as high-risk because we have multiple partners.

At low probabilities you can get the total risk of infection by calculating the risk for each act and adding. This is not accurate for high risks but when the total risk is less than 20% it is sufficiently accurate.

Thus a female has a 1% risk of being infected after 5 acts of unprotected vaginal sex with a person known to be HIV positive. If you want to assume that condoms really do give a factor of protection of 20 and that only 1% of clients are infected an escort has a 1% chance of being infected after 10,000 acts of protected receptive vaginal intercourse.

Personally, I get tested once every six months. I date less than once a week so I have a maximum of 24 dates between tests. Even with multiple acts for each date the probability of being infected at the end of the six-month period just before I am tested is an extremely small number.

Unless a partner tells you that they have tested positive for HIV or you are doing receptive anal I don't see much reason in being tested more often than once every 40 or 50 dates. (You may have noticed that, at best, covered anal is 25% as risky as BBFS. I am surprised by the number of escorts in LA that offer it.)

Although, in general, I think that being tested every 40 or 50 dates is sufficient for HIV a strong argument can be made for more frequent testing for other STDs since many are much easier to transmit than HIV.

jaejae 18 Reviews 5591 reads
posted
12 / 15
seventhson 4155 reads
posted
13 / 15

it appears that the ease with which the HIV virus will pass from an infected partner to an uninfected is strongly influenced by the presence of absence of other STDs. In the case of lesion forming STDs in their active phases this is an unsurprising conclusion. There have been reports that suggest Syphilis infection may have a poorly understood effect on immune responses that make those with syphilis significantly more vulnerable to HIV transmission, even when no surface lesions are present.

Physical abrasion, small tears, cervical erosion, and related trauma to delicate membranes will also present an exponential
increase in transmission risk, and these overuse injuries are common both to the adult video industry and in underdeveloped regions where lubricants are unaffordable or thought of as detracting from the sexual experience.

greywolf 17 Reviews 2617 reads
posted
15 / 15
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