Both here and at Google Plus, a social network I honestly don’t understand, my posts on safer sex seem to have struck at least a few nerves. And I see from several people’s objections to what I wrote that I failed, still, to make my central point.
My point is NOT that sexually transmitted infections are not serious.
Rather, it’s that:
1) I behave as if I, and all of my partners, have every disease I might hope to avoid (in spite of my having tested negative consistently for everything for which I’ve ever been tested – which is everything but herpes, of which I’ve never had an outbreak), and I advise you do the same.
2) For me, that means disclosure of this general philosophy and religious use of condoms for vaginal or anal intercourse.
3) I believe we collectively overestimate the risks associated with sexual behavior. Note: this is not the same as saying there are no risks, or that the risks are small, or that STIs aren’t a big deal, or anything of the sort. It’s simply an assertion about our relative assessment of risk.
Finally, after all this discussion, I’m grateful for a slight evolution in and refinement in my thinking:
Because of the prevalence of STIs, and their danger, the centerpiece of my sexual safety strategy, other than rigorous condom usage, is constant testing. Not to keep from infecting others (though I imagine if I did test positive for something other than herpes or HPV, I’d take myself out of circulation ’til it cleared), but to ensure rapid, aggressive, and successful treatment of even asymptomatic infections.
I haven’t been tested frequently enough in the past. I expect I’ll change that prospectively.
I’m a little confused by the reactions the previous posts have elicited, which have ranged from judgment (I’m irresponsible) to judgment (I’m dissolute) to hurt (I’m overly casual about the potential impact of infections).
I see two basically correct criticisms among those I’ve heard:
- I am casual about the treatability of infections – caught early. The horror stories I’ve heard in the comments and elsewhere aren’t, to me, stories about the difficulty of treating infections; they’re stories about the importance of early detection.
Lizzie’s macro point about antibiotics – they weaken our herd immunity, strengthen the bacteria we fear – is true. I just don’t see it as having any real applicability here. I’m in favor of avoiding, not courting, infection, and of avoiding, not abusing, antibiotics. (Did I say otherwise anywhere?) I just think that when an infection is harmful untreated, and eminently treatable, the sane thing to do is to treat it.
And finally….
I am very concerned about pregnancy, more than any of this other stuff. Most of the women in my ambit are on the pill. But I have no desire ever to have to have even one more conversation in my life about an unintended pregnancy.
I just caught up on all 3 posts, I’ll just comment once here.
Veronica and I have had an open marriage for 4+ years and have each had, oh probably 3 dozen partners in that time. Our rule is condoms are mandatory for vaginal or anal sex with others. Neither of us has ever used protection for oral sex. We haven’t had an scares with any sort of STIs.
Life is full of risk, every day we expose ourselves to risk in so many ways that we don’t even think about. The fun we have with other partners is that, fun, which we greatly enjoy, and frankly the *small* risk that we expose ourselves to is worth it.
We’ve never had a ‘so when was the last time you got tested’ conversation with others. We get tested, occasionally but admittedly not as frequent as perhaps we should, and that’s it. If others are casual about condom use, we don’t fuck them. I turned down a very hot twitter friend because all of her pics showing her fucking others show that they never use condoms. No thanks.
By my count, I’ve broken my ‘condoms are mandatory’ rule with 6 partners. With 2 of them I was careless, with the others due to the circumstances (and recent testing) I don’t feel like I was careless at all.
Thanks for tackling this issue.
N.,
Your “safer sex” series is a whole lot of fail. While there are lots of things you state that I agree with, there’s quite a few things I take issue with. Since it was a series, I’m going to respond to statements from all three posts. My apologies in advance for jumping around and for the length of my response.
(in regards to HPV) “But if you’re like me, too old to be vaccinated, or even to hope that you’re not infected, then what’s there (honestly) to do?” (from “Redux”)
Perhaps there’s nothing for you to do, and/or nothing for men to do (since there isn’t really a test for HPV in men right now). But if you’re female… there IS something to do. GO GET TESTED.
“If you are sexually active and you haven’t been vaccinated, you should assume you have HPV. Sorry.” (from “Redux”)
Fuck no! If you’re female, you should not assume you have HPV.
I’m sexually active. I haven’t been vaccinated. But, no, I should not, and will not assume I have HPV… because I don’t have HPV. I’ve been tested and I don’t have it. Knowing that is important to me in making informed decisions about my sexual partners and my safety.
“I could tell the actual truth: “Yes, I get tested once or twice a year, and the last time I was tested was about six months ago, and I was clean then. ” (This is the truth for me.) .” (from ”Safer Sex”)
But you also said your doctor refuses to test for herpes (in ”Safer Sex”).
I have no idea how long you’ve been with that doctor, but I think it’s reasonable for me to assume that you’ve been with your doctor for more than six months, and since your doctor doesn’t test for herpes, it’s reasonable for me to assume that when you were tested six months ago, you were not tested for herpes.
So, your statement of “actual truth” isn’t the truth because you weren’t tested for herpes and you don’t know that you’re “clean.”
Do you inform potential partners that your version of “tested” does not include testing for herpes? Do you tell potential partners that your version of “clean” doesn’t include the possibility of having herpes?
I hope you do, but from what you wrote, it doesn’t sound like it.
“It’s ironic that, even among us sex-positive people – people who profess opennness to swinging, polyamory, non-monogamy, monogamish-ness, whatever – we still believe that the best practice when it comes to sexual safety is monogamy. Or at least, keeping the numbers down. .) .” (from “Redux”)
How is this “ironic”?
Sure, lots of people who claim to be “sex-positive” believe the best practice for safety is monogamy… because it is! As you said at least once in your posts, that’s a fact.
The way you phrased this (“It’s ironic” and “we still believe”) sounds like you’re suggesting that 1) people who believe the best practice for safety = monogamy (or no sex) aren’t really sex positive, or 2) the “belief” in the best practice for safety = monogamy (or not having sex at all) is mistaken.
Monogamy (or no sex) is the best practice for safety. That’s a fact. Also, just because someone states that fact doesn’t mean they aren’t sex positive – it just means they recognize reality.
“In the end, though, I suspect all this is just morality masquerading as ‘health concerns.’” (from “Redux”)
So? Does an underlying moral impetus negate possible health concerns? I understand you believe people overestimate risk, and perhaps they do. However, that doesn’t mean there isn’t risk.
More than that, to me, health concerns ARE a morality issue, and particularly in this case (the case you’ve presented of yourself). Again, please excuse me if I’ve made an incorrect assumption here, but I assume you don’t tell your partners you haven’t been tested for herpes when you cite the test six months ago. I assume when you tell partners that you’re “clean,” you don’t include the “might have herpes” caveat.
That’s both a health concern and a morality concern. For the record, I don’t give a flying fuck if you’re “moral” or not, as long as you aren’t risking people’s health.
But you are risking people’s health! Even if YOU don’t believe you’re risking people’s heath, you aren’t allowing those people to make informed assessments about their own potential for risk when they engage in sexual activity with you.
“I behave as if I, and all of my partners, have every disease I might hope to avoid (in spite of my having tested negative consistently for everything for which I’ve ever been tested – which is everything but herpes, of which I’ve never had an outbreak)” (from ”Last Installment”)
I call BULLSHIT.
You say you behave as if your potential partners have a disease. So you assume all of your potential partners have HIV? Really???
So, if one of your potential partners told you she had HIV, you would still have sex with her? You would put on a condom and have sex with a person you knew to have HIV?
I doubt it. If I’m right, then what you said is false: you do not behave as if your potential partners have a disease. If I’m wrong, then you are foolish and dangerous.
“the centerpiece of my sexual safety strategy, other than rigorous condom usage, is constant testing.” (from ”Last Installment”)
No it isn’t! “Constant testing” isn’t part of your “strategy.” You haven’t been tested for herpes. Perhaps it will be the centerpiece of your strategy, but it isn’t right now.
“Not to keep from infecting others (though I imagine if I did test positive for something other than herpes or HPV, I’d take myself out of circulation ’til it cleared), but to ensure rapid, aggressive, and successful treatment of even asymptomatic infections.” (from ”Last Installment”)
Yeah, I already know you aren’t pleased with “moaning” about cervical cancer. I get that. However, because there isn’t a rapid, aggressive, and successful treatment of cervical cancer, perhaps you might consider “not infecting others” as an additional rationale for your “sexual safety strategy,” whenever you decide to actually implement it. (And yes, I know there isn’t an accessible HPV test for men. However, you’re inclusion of HPV in the above statement and link to “treatment” is misleading, and your general disinterest in keeping other people safe is really fucking shitty.)
DD:
First, thank you so much. I fucking love when people disagree with me intelligently, thoughtfully, when they take the time to read what I’ve written, to think, and then to reply. Especially if they’re smart, funny, and good writers. So let me start there.
Now, just to clear up an apparent misapprehension, about my relationship to herpes: I’ve never misled anyone about my status with regard to herpes, actively or passively. When I discuss my sexual health with prospective partners, I give a speech very similar to these posts. My partners know exactly what I know when they decide whether I represent an acceptable risk. As I wrote in a tweet to you, it is an ironic and sad aspect of my CPOS years that the only person I’ve ever lied to about my sexual health and risks is my wife.
On HPV, testing, and assuming you have it…. I don’t have a particular quibble with what you write, except this: as I understand it, the only effective means of preventing infection for straight men and women is abstinence, since testing is (as you write) challenging in men. So you may choose not to assume you have HPV; I don’t really have that luxury, do I? So I assume I have it. And I tell potential partners. But here’s a question: if you did assume you had it, what would you do differently? I’ll tell you what I do: I tell people that I don’t get tested for herpes, but otherwise, my doctor tells me I’m clean, or did at my most recent test, now about six months ago. But I agree – women, get tested. And then keep on having sex. And until then? Also, keep on having sex….
On numbers of partners: of course, you’re right. I mis-used ironic. It’s not ironic that we believe “keeping the numbers of one’s sexual partners down” is the most effective risk mitigation strategy. But it certainly is ironic that some of us (not me, but you, apparently) believe that “monogamy is the best strategy.” MONOGAMY IS A TERRIBLE STRATEGY, BECAUSE IT IS SHOCKINGLY UNRELIABLE. IT’S THE RHYTHM METHOD OF RELATIONSHIPS. Most monogamous relationships aren’t actually monogamous. Of course, I know yours (and yours, and yours, he says, pointing to the others in the room) are the exceptions to this rule. But seriously: I’m not questioning any individual relationship; I’m pointing out that this is an area of underappreciated risk.
You know what else is ironic? Lumping together monogamy and abstinence as you do, as if they were either the same, or as if they represented a similar level of risk. Neither is true. Monogamous people DO have sex, DD, and – as I just said – there’s risk in ostensibly monogamous relationships, considerably more than abstinence presents. So don’t present them as if they were equivalently risk-free strategies. One is risk-free; one is not (and perhaps more – most? – dangerously, we all are hard-wired to underestimate systematically the risk that our monogamous relationship isn’t monogamous because we so want it to be).
Let me say this again, in different words, because I think it’s really important: a huge risk to sexual health is misplaced faith in partners’ monogamy. And this is a risk that monogamous people collectively are virtually powerless to avoid.
No question, the safest (but hardly the best) practice is abstinence. Second-best is perfect monogamy with a perfectly monogamous partner. But the salient question isn’t what’s safest. That’s a straw man.
Very few people in any sexual subculture, from monogamous to swinger, straight to gay, use condoms when giving or getting blowjobs. Clearly, it’s safer to use condoms when giving or getting head, but people don’t do it because they make a sensible, informed (or perhaps ill informed, in some cases) decision to shoulder that particular set of risks. Just as very few people refuse to drive because it’s so fucking dangerous, or to ski, or to bungee jump, or to skydive, or to eat trans fats, or whatever.
So the question isn’t what’s safest – it’s what practices expose me to the risks I’m comfortable bearing while maximizing my pleasure? And what level of disclosure is appropriate?
To be clear, DD, the only people I have sex with who know less about my sexual history, behavior, tests, than you do are anonymous people I’ve met in swing clubs or at sex parties. And the truth is, if there’ve been a dozen of those in the last two years, I’d be shocked. And that was at swing clubs and sex parties. Where, I’m pretty sure, the safe thing to do is to assume that everyone present has every disease you don’t want.
I’m not sure what the knowledge that your assumption about how I handle my herpes status is wrong does to the parts of what you wrote that pertain to morality, but….
I agree that health concerns are a moral issue. For example, I think that everyone under 26 – female and male – should get vaccinated against HPV. As I understand it, the science is in, and the vaccine is effective and safe, and if everyone doesn’t get it, we won’t achieve herd immunity, and that would be a damned shame. So I think people have a moral obligation to get vaccinated. And I think that disclosure and honesty are vital.
Do you still believe I’m risking people’s health because of my doctor’s stance on herpes? I don’t. (Incidentally, in my entire life, exactly one prospective sexual partner has told me that she had herpes. I’m not sure what to do with that except to say, given what I know about statistics, it reinforces my belief that I might just as well behave as if we all have it.) I tell people what my doctor said. I tell people, explicitly, that I assume I have herpes, though I’ve never had an outbreak. And I don’t ask if they do. And then, if we fuck? I wear a condom.
You call bullshit on my claim that I behave as if my partners have every disease I might hope to avoid. I’m not sure what to say. One day, perhaps, I’ll be confronted with an HIV-positive prospective sex partner. I have no idea how I’ll proceed. Maybe you’re right. Maybe not. Maybe it’ll depend?
Should I refine what I say? I behave as if my partners might well have every disease? The hypothetical you pose is too hypothetical for me to know what the true answer is. But here’s what I can say: I don’t assume that anyone I have sex with doesn’t have HIV. Maybe that’s not exactly logically equivalent to assuming that anyone I have sex with does have HIV, but honestly, aren’t we splitting hairs a little now?
In conclusion!
No sex is safer than less sex.
Less sex is safer than more sex.
More sex is more fun than less sex.
Among the un-vaccinate-able, HPV is really hard to protect against other than by having a small number of partners. And it’s really prevalent, so having any partners is definitely risky. Having more partners is more risky.
Herpes is virtually impossible to protect against, like HPV, because it occurs at sub-clinical levels, is communicable when lesions are not present, and is even more prevalent. So if you don’t want herpes, the best strategy is abstinence. If you’re sexually active, you’re deciding to put yourself at risk. And, based on everything I’ve said and written, you might choose not to have sex with me. That would be your right, and I will give you enough information to make that decision. But I think you’d be making a silly decision. (Unless, of course, you just don’t want to fuck me in the first place, in which case I respect your decision.)
Finally, you say I have a “general disinterest” in keeping other people safe. I call bullshit on you. Sorry – I talk with everyone, I let people make their decisions. What I have a “general disinterest” in is presuming what the right answer is for others. All I know is myself. But what have I done, what do I do, that indicates said “general disinterest”? Honestly – I don’t get it.
Is it not getting tested for herpes? My doc persuaded me it’d be silly, and I tell anyone who’ll listen that’s my status.
Is it having unprotected oral sex in sex clubs and exposing people with whom I haven’t even had a conversation to unacceptable risks? (I don’t think so – I think they decided to go to a sex club and are presumably protecting themselves as they see fit against the risks they imagine they are likely to encounter there. I certainly am.)
Is it having unprotected oral sex outside of sex clubs after having done it in sex clubs? (I’ve never had unprotected oral sex outside of a sex club with anyone who didn’t know I also go to sex clubs on occasion.)
I have the sense that you imagine there’s some deception, or omission of information, at play. I’m sorry, but there just isn’t.
Fuuuuck. I fucked up my formatting. Can you delete the previous post and leave this one?
”Now, just to clear up an apparent misapprehension, about my relationship to herpes: I’ve never misled anyone about my status with regard to herpes, actively or passively. When I discuss my sexual health with prospective partners, I give a speech very similar to these posts. My partners know exactly what I know when they decide whether I represent an acceptable risk.
I’m sure you can understand my “misapprehension,” as this is not the picture you painted in your previous posts.
”So you may choose not to assume you have HPV; I don’t really have that luxury, do I?”
I don’t “choose.” I know. It’s not an assumption. I got tested.
And I’m sorry you don’t have the “luxury” of testing, but more for your female partners than for you. As females, we enjoy the luxuries of HPV testing and the luxuries of cervical cancer. Be thankful you don’t have luxuries in kind.
”But here’s a question: if you did assume you had it, what would you do differently? I’ll tell you what I do: I tell people that I don’t get tested for herpes, but otherwise, my doctor tells me I’m clean, or did at my most recent test, now about six months ago. But I agree – women, get tested. And then keep on having sex. And until then? Also, keep on having sex….
I’m relieved to hear that you disclose to your partners that you don’t get tested for herpes. It wasn’t clear from your previous writings, and honestly, I’m so glad to hear this is the case.
What would I do? I have no fucking idea. I’m not you. I’m female, and my partners are male. I’m absolutely sure I don’t have HPV, and you’re sure you do. As a straight male, you have an exponentially lower risk of the serious negative health consequences of HPV than I do. Besides all of that, I don’t have your history of sex addiction or your want of multiple partners. That isn’t in my current disposition. So, I don’t know. I can’t answer that.
”women, get tested. And then keep on having sex. And until then? Also, keep on having sex….”
Sure, maybe. But maybe not. Is lots of sex worth the risk of dying young from cervical cancer? Is great sex worth forcing your partner to endure your illness? Is sex worth leaving your children motherless far too soon? Even if it’s a teeny tiny risk, is it worth it?
I suspect that if you ask a woman in her twenties having lots of awesome sex with lots of awesome partners, and then ask a woman in her forties or fifties with young children, the answer would be very different.
So no… I wouldn’t advise women to just “keep on having sex.” It depends on the woman, it depends on her plans, it depends on the partner(s) and depends on the sex.
”But it certainly is ironic that some of us (not me, but you, apparently) believe that “monogamy is the best strategy.” MONOGAMY IS A TERRIBLE STRATEGY, BECAUSE IT IS SHOCKINGLY UNRELIABLE. IT’S THE RHYTHM METHOD OF RELATIONSHIPS. Most monogamous relationships aren’t actually monogamous.”
Ok. How do you want to define monogamy, N.?
Do you want to use its actual definition? Or do you want to use something else?
I define monogamy by its accepted definition: Two people only having sex with only each other.
By that definition of monogamy, fuck yes, monogamy is the best strategy (second to abstinence).
As you suggested, “Most monogamous relationships aren’t actually monogamous.” So those relationships, the relationships you suggested above, aren’t monogamous. They are excluded from being monogamous by definition. After a partner cheats (or whatever we’re calling it), the relationship is no longer monogamous (even if the cheated-on partner is unaware, even if the partners are loving, even if they are married, etc.).
So no, N., monogamy isn’t unreliable. It’s just that lots of people aren’t monogamous. They may be partnered, they may be married, they may not be polyamorous, they may be in love, they may be committed… but they aren’t monogamous.
For that reason, you can’t say that monogamy fails to keep people safe from STIs. You could say that people fail at monogamy, or perhaps, that the belief in the monogamy of a partner fails to keep people safe. But actual monogamy (as it’s defined and commonly understood) doesn’t fail to keep people from STIs.
”You know what else is ironic? Lumping together monogamy and abstinence as you do, as if they were either the same, or as if they represented a similar level of risk. Neither is true. Monogamous people DO have sex, DD, and – as I just said – there’s risk in ostensibly monogamous relationships, considerably more than abstinence presents. So don’t present them as if they were equivalently risk-free strategies. One is risk-free; one is not (and perhaps more – most? – dangerously, we all are hard-wired to underestimate systematically the risk that our monogamous relationship isn’t monogamous because we so want it to be).”
I don’t think you understand what irony means. Totally unimportant to the larger discussion, but how is this ironic?
Anyway, for the same reasons that support my earlier statement, you’re incorrect. Actual monogamy – by definition – and abstinence do present similar levels of risk.
Sure, ”monogamous people DO have sex,”… but if they’re monogamous, they only have sex with each other – not with anyone else. Otherwise, they aren’t monogamous.
Again, how are you defining monogamy?
”But the salient question isn’t what’s safest. That’s a straw man.”
Really? Because I thought the discussion was about safety.
Also, how is safety (or the question of safety) a straw man? If it’s because you’re using an incorrect or nontraditional definition of monogamy, then you’re definition/usage is incorrect or nontraditional. You’re error (or alternate usage) does not equal a logical fallacy… it just means that you’re wrong.
”So the question isn’t what’s safest – it’s what practices expose me to the risks I’m comfortable bearing while maximizing my pleasure?”
Perhaps that isn’t your question. Is it your partners’ question? Is the balance of your risk and your pleasure the same as your partners’ balance of their risk and their pleasure?
”And what level of disclosure is appropriate?”
Appropriate? What the fuck does that mean? Are you using “appropriate” to mean that which “expose[s] me to the risks I’m comfortable bearing while maximizing my pleasure.”? I hate to keep asking the same thing, but how are you defining “appropriate”? Perhaps your definition isn’t the same as everyone (or anyone) elses.
Done. I’ll reply, but this is all just a bit casuistic? I feel like you’re more interested in arguing than agreeing, and like we actually mostly agree.
I’m not interested in agreeing or disagreeing with you — I was interested in a discussion.
But in reading your responses, I realize your posts are really unclear. Some of your statements are unintentionally misleading and you contradict yourself in places.
It would be a waste of time to continue a discussion for that reason.
With that said, it’s an interesting issue, and I applaud you for being honest about it.
I apologize – you said you’re interested in a discussion, and I’m totally game. I felt a bit attacked (you accusing me of misleading partners and all), and I responded defensively. I think you added a lot of value to the discussion about a woman’s perspective on all this stuff, and, in particular, on HPV. I’m not sure where/how you feel I contradict or mislead. But I’ve now written a LOT of words, and I’m not a lawyer. So I may well have.
Anyway, all this boils down to, I’m comfortable bearing – and inflicting – the risks associated with unprotected oral sex, with partners who are educated and informed; I’m not comfortable bearing the risk of contracting diseases through unprotected vaginal or anal intercourse with anyone other than my wife.
I get tested regularly, if not regularly enough (though this discussion likely will result in my increasing the frequency of my being tested) for everything but herpes. I don’t believe a positive test result for anything – by me or by a partner – would change my behavior, because I behave as I expect I would if all my partners were infected with everything under the sun.
And I never intentionally mislead anyone, and generally seek to over-disclose to my partners or prospective partners. I’m a little baffled that anyone could object to that stance, and yet, you and others have.
I’m very interested in what other people do, think, etc. I’m much less interested in what they think is right, or wrong, about my assessment of risks.
Only a couple of replies here:
I seem to have offended you with my relatively casual discussion of HPV. I’m sorry. I don’t mean to be casual about the disease, or its implications, for the people who contract it. And you’re right – it’s far worse for women than for men (though, as I understand, there’s growing concern about the risk of HPV-linked throat cancer in men). I have no right to say anything about what anyone else should do. All I can do is make the general point that if one wishes to engage in sexual activity with other humans, HPV is, at this point in time, a relatively likely outcome of that. And nothing that I have to say on the subject should have much relevance to the practices of any of my partners.
Ditto with herpes. I don’t think that I’d be behaving very intelligently if I DIDN’T assume all my partners have been infected with it. (Particularly given that I’ve only received the “I have herpes” speech once in my life, and it was about two weeks ago.)
Disclosure is interesting, and worthy of a whole separate discussion. In the world in which I date, some people bring up questions of safety and status; others don’t. This seems fine to me. I generally don’t. I think the onus is on each of us to seek the information we feel we need, and to be honest in the information we provide. Do I have an affirmative obligation to tell people about my status vis a vis herpes? Honestly, I don’t know. As I said, I generally imagine that people are responsible for asking to know that which they want to know. Certainly, in the community of promiscuous swingers, all of what I’m describing is effectively the norm. Once in a while, I encounter a woman who is only comfortable performing oral if a condom is present, or who isn’t comfortable receiving oral.
On the question of the definition of irony, Alanis, yes, I think I know the definition, and I think I’m using it correctly. You may not agree that what I think ironic IS ironic, but it’s not a definitional disagreement. It IS ironic for someone who paints herself as sex positive and thoughtful about questions of sex and safety to suggest that monogamy (as practiced) has anything in common with abstinence in terms of level of safety, relative to, say, open and honest polyamory/swinging/promiscuity. Yes, I think that ironic. Because I think that what you say belies itself.
More, in a stand-alone post to come on the question of monogamy. But I think your point and mine are closer than you imagine on this. It’s just that you’re using the word in a way that, though correct definitionally, has limited (and dangerous) use empirically, imho.