Friday, June 26, 2009

Post sex STD tests are a strategy--but what do they cause a person to do? Give up sex? Have less sex? Have more sex in order to "get even"?

Testing before sex is a way to keep some sex from happening, and, consequently, prevent an STD. Post sex STD tests don't do that. Pre sex STD tests will save some lives--some people will back out of the possibility of sex with that partner. Others may be way more cautious. Still others might wait for non-HIV STDs to be cured, if available.

Wednesday, June 03, 2009

Getting thrown out from a lot of online interactions gives me a certain perspective about those folks claiming to lead and advocate.

People I know who died from acquired immune deficiency syndrome

People I know who died from acquired immune deficiency syndrome
. Larry
. Don
. Scott
. D's brother

Thursday, May 28, 2009

Friday, May 22, 2009

Have you observed POTENTIAL sex partners coming in saying we haven't had sex yet and want to get tested TOGETHER, for A VARIETY of STDs?...

>
http://www.stdpreventiononline.org/index.php/forum/posts/35,15
> Testing
> Absolutely! I've heard it over my years in this field and I suggest doing it in my risk reduction portion of my DIS or HIV counseling interviews. I also train new DIS [Disease Intervention Specialist] to include it instead of simply focusing on condoms. Too many counselors/DIS focus only on condom use. There needs to be alternative discussions, since condom use is not realistic for everyone!
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> definitely
> That's a lot of what our clinic does, yes. And of course we applaud it!
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> Partners Testing before Starting a Sexual Relationship
> While I routinely advise patients to bring their new partners into STD Clinic I have only had one couple that mentioned they specifically came to the clinic for that reason. A young MSM couple in their early 20s. After both received an evaluation, they went on to get Rapid HIV tested. One of the partners was Reactive and the venous draw was confirmed. It put such a cloud over "Doing the Right Thing." I still recommend it and now utilize this example with patients coming into clinic as to the importance of knowing not only their STD status but also their HIV status.
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> Of Course
> All the time! The last time it happened it was an elderly couple who were both ready to have sex, and get married. They just wanted to make sure that they both were HIV free. It was cool because I also gave them some really good information about transmission and older adults which they volunteered to give to friends.
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> Potential partners attending together
> Absolutely! It's quite a common reason for attendance at Australian Sexual Health Clinics (my experience is with public free clinics, but I think it's the same in private clinics). Here in Cairns I have seen many over my years working here. It's important to establish ground rules over results though first up and whether both members of the partnership are happy to let partners know their results! When I first encountered a young 'heterosexual' couple quite a few years ago who attended for this reason (when it was less common) and requested a joint consultation and testing, we hadn't discussed that the delivery of results would have to be separate; the young man's HIV result came back unexpectedly positive (and it subsequently became clear he was bisexual and had had more experience and some unsafe sex with other males than with females - a fact he hadn't disclosed in the initial joint consultation)! The result giving required delicate handling and in the event it worked out OK in that he was keen for the prospective female partner to know his result, but the whole event would have been much better handled if I'd laid some ground rules from the start! I learned a valuable lesson!! Cheers
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> Observing potential sex partners getting tested together.
> YES...On the 2nd and 4th Fridays of each month I run a "youth only" test site and I have seen men and women, who are with their partners come in and get tested together. I highly encourage that among the youth. That helps them come up with ways together to reduce their risks of contracting not only HIV but STD's as well.
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> testing together
> As a health educator, I recommend this to the teens I work with. I think it shows that each partner sees this as a normal step in any relationship that is going to become sexual. Also, even if one person knows their STI status, they volunteer to go with their partner and also be tested so that testing doesn't become a lack of trust issue.
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> testing before sex
> Yes, at my private STD clinic we see this all the time! A large part of our practice is testing people who have no symptoms, but wish to begin a sexual relationship knowing what one "brings to the table".
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> 1st date at the Health Department
> I have seen two over the last year- both have come from group presentations on STD/HIV by a DIS. In both cases, it was the women generating the appointments and noting that the STD presentation made such an impact that testing for both of them made sense. Here is some of the logic used: - you don't know where your potential partner has been - you don't know if your potential partner ahs an infection and it is asyptomatic - such an offer (to get tested) is a great discriminator... if the potential partner has a fit- then get rid of them now- before you have sex - the subject promotes an honest discussion about sex and sexual history BEFORE exposure - testing as a couple implies a committment and level of concern about each other BEFORE sex - reinforces that sex is not the relationship but is something that can be planned as part of a relationship
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> HIV Testing
> We are more likely to get partners who say they want to stop using condoms and come in for testing to be certain each is HIV negative.
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> partners testing together prior to sex
> I have, but not that often. My recolition over the past 10 years I would say approxamently a dozen couples of all ages,
http://www.stdpreventiononline.org/index.php/forum/posts/35,15
>

Wednesday, May 13, 2009

Post sex STD tests are a strategy--but what do they cause a person to do? Give up sex? Have less sex? Have more sex in order to "get even"?

Testing before sex is a way to keep some sex from happening, and, consequently, prevent an STD. Post sex STD tests don't do that. Pre sex STD tests will save some lives--some people will back out of the possibility of sex with that partner. Others may be way more cautious. Still others might wait for non-HIV STDs to be cured, if available.

Wednesday, February 18, 2009

Axel Schmidt
1021
HIV Serosorting among German Men Who Have Sex With Men. Implications for Community Prevalence of Sexually Transmitted Infections and HIV Prevention

Axel Schmidt*^1,
U Marcus^2,
J Töppich^3, and
M Bochow^1
1Social Sci Res Ctr, Berlin, Germany;
2Robert Koch Inst, Berlin, Germany; and
3Federal Ctr for Hlth Ed, Cologne, Germany
http://www.retroconference.org/2009/PDFs/1021.pdf
http://www.retroconference.org/2009/Abstracts/33962.htm


Background:
Serosorting, i.e. seeking to only engage in sexual activities with partners of concordant HIV serostatus, has been described as a risk reduction strategy increasingly used by men who have with men (MSM).

If replacing condom use, the implications of this practice for the risk of HIV transmissions are controversial.

Few data exist on the effect of serosorting on the incidence of bacterial sexually transmitted infections (STI).


Methods:
In Germany, large national cross-sectional surveys on "Gay Men and AIDS" have been conducted since 1987.

In 2007, a self-administered questionnaire was distributed via magazines and Internet sites for MSM.

Questions included risk reduction strategies, condom use, numbers of sexual partners, and communication about HIV test results.

We analyzed 8170 questionnaires.

Adjusted odds ratios were calculated to estimate the influence of serosorting on frequencies of bacterial STI and HIV.


Results:
A substantial minority of participants engaging in anal intercourse with casual partners reported their last intercourse was unprotected because of presumed seroconcordancy (self-reported HIV– 16%; HIV+ 20%).

Pure guessing accounted for 55% of serostatus estimates among HIV+, and 36% among HIV– MSM.

However, among MSM not diagnosed HIV+, 62% had a test result older than 18 months or were untested.

Contrastingly, 3% of HIV–, but 21% of HIV+ MSM reported serosorting as a main risk-reduction "strategy."

Compared with traditional safer sex strategies and adjusted for the number of sexual partners, serosorting was strongly and significantly associated with a recent history of bacterial STI among HIV+ MSM (OR 4.3, 95%CI 2.2 to 8.3); and with a recent HIV+ result among all participants with a recent HIV test (OR 5.0, 95%CI 2.7 to 9.4).

Recent syphilis diagnoses were reported by 26% of MSM with a recent positive, and by 3% with a recent negative HIV test result, suggesting high rates of co-infection.


Conclusions:
Serosorting is not uncommon among German MSM, but seems to qualify as "strategic" only among MSM who are HIV+.

However, serosorting is frequently based on assumptions instead of disclosure.

(Effective) serosorting among HIV+ MSM increases incidence and prevalence of bacterial STI, and hence the per contact risk for HIV transmission.

Serosorting among MSM who believe they are HIV– is highly ineffective and therefore may further increase the risk for HIV transmission.


Session 189 Poster Abstracts
Recent Discoveries in HIV Transmission
Session Day and Time: Monday, 1-2:30 pm
Poster Hall

16th Conference on Retroviruses and Opportunistic Infections
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http://www.retroconference.org/2009/PDFs/1021.pdf
http://www.retroconference.org/2009/Abstracts/33962.htm
Axel Schmidt