Gents, life is aleatoric, i.e. a crapshoot; nothing's guaranteed. Here is how the numbers work out on catching an STD.

You take the probability that your potential partner has a particular STD, multiply that by the probability that it will be transmitted to you in the sex act you contemplate and multiply that by the harm that can occur to you if you catch that STD (very high for HIV, low for getting a hickey from a blowjob). Now sum that formula over all potential STDs and don't forget to include some factor for unknown diseases. After all, HIV was not known until 1984 and who knows what else lurks out there waiting to escape from some obscure Asian or African mammal into the human population? That is your "expected harm" from any single encounter and you can try to make a judgement about whether the risk exceeds the reward. Obviously, the more encounters you have the higher your total expected harm becomes.

This is pretty abstract but think of it in terms of playing Russian Roulette. The number of encounters you have is analogous to the number of times you pull the trigger. The ratio of the number of bullets to cylinders in the revolver is analogous to the probability of an infected partner times the probability of transmission. I suppose that harm could be modeled by playing RR and pointing the gun at various body parts, not just your head.

Now I am not proposing that cruisers carry pocket calculators around with them to calculate the odds but there is an important lesson to be learned by looking at the formula. Your expected harm can be reduced in a number of ways, by not pulling the trigger, by removing bullets from the cylinders and by not pointing the gun at your head. All are equally effective (but estimating the probability of transmission is surer than estimating the probability of an infected partner since you have more control over it). If you want to be really safe you do all three. So I think that avoiding statistical populations of infected people is a reasonable part of a sexual hygiene program but certainly not the only or most important part.

Based on several postings on CFS and reports of a local syphilis epidemic being traced to a single bathhouse I was not surprised to read the results presented in the Southern Voice article and thought that others might benefit. In my effort to reduce my expected harm I am always interested in learning more information about where the risks are. Any time anyone has epidemiological information please feel free to post the link.

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Hey Pike,

I agree with your reasoning on the stats and probabilities. Well-written.

Yet, I would never stop thinking about the story of the Three Big Lies. A lie, a big lie and statistics.

I have little doubt that statistics very ultimately works. And I see every virtue in getting informed to the best of your ability about the environment you may (or may not) choose to step in.

The problem with all the facts and information is how to interpret them to your best benefit. If I know that a particular bathhouse is a dangerous spot for whatever reason, I will think twice about going there and if I choose to do so, I will double my usual levels of attention. That's all fine.

However, I must never disregard the fact that this presumption does not work the other way around, ie., that I can afford to be careless or even less careful, if I am not entering the 'red zone'. (I do not think you ever said that but am trying to emphasize this point.)

Scruffy is very right. This is so much more about your behaviour than about the environment. There is a substantial number of people on the go. There is no way on earth for me to know that the guy I messed around last night in Zurich did not come straight from the indicted bathhouse. Or that he has ever been in America at all, for that matter.

Getting to know someone is really a hardly viable alternative these days. I would stop short of placing my well-being upon the mercy of someone who has come up with a story of his life. Even if his story is true. Do we have to look into the stories of all of his previous partners and how do we go about doing that?

My bottomline: do inform yourself and make qualified decisions based upon the knowledge you have. But do not apply the laws of statistics literally. They work very well for groups and segments, strata of population or classes of objects. Their applicability to individual destiny is highly limited.

And we all agree that shit happens. And most of us here are willing to go a long way to make sure that the shit does not happen to us and those who are close to us. I cannot quite see a better working strategy. But I'd be more than happy to listen to all the other suggestions.

KD

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KewlDewd66 wrote:
Correct, I didn't say that and I have never said that. The other responders who somehow managed to infer that did so based on their own predilections or on the attitudes of the gay milieu. I'm a belt and suspenders kind of guy. Actually, I'm a belt and suspenders and duct tape kind of guy.
Mathematically, this is not so. The probability of an infected partner holds an equal weight with the probability of transmission; they are multiplied together. After all, you can't catch something from someone who hasn't got it!

Practically, as I mentioned in my probability essay, it is difficult to accurately know the disease status of any potential partner. You have much more control over the transmission probability. Still, safer sex is not safe sex (condoms do have some probability of breaking; it is possible to transmit AIDS by kissing) so it makes sense to use several methods to increase safety. The bottom line is that if I pick a partner out of a population that has half as many disease carriers then I have halved my chance of being infected, regardless of how small or large the transmission probability is. Reducing either probability increases your chance of health but reducing them both increases your margin of safety even more.
No, but you can get information about someone even before having anonymous sex. A guy you see in a bathhouse getting fucked bareback by a long line of guys is certainly riskier than someone who you meet in a bar who is just interested in oral. The guy in the bar might have spent last night being fucked bareback but the other guy did with 100% certainty. Why not choose the less risky alternative?
I have to disagree. After each event you are either infected or not but that does not mean probability is not involved. The disease transmission process is so complicated and depends on so many contingencies that you have to make probability estimates based on all factors and to skew the odds in your favor by taking advantage of every factor. There are no certainties; you have to use a probilistic approach. I think a reasonable goal is to reduce your chances of contracting HIV to 1 in 10,000 per year, about the same as being killed in a car wreck in the US.

In another thread someone asked the question "what would be different if there were no HIV"? In my view not much because the male drive to promiscuity is so strong that if there were no HIV then there would be something else that would put a break on having unprotected sex. After all, HIV went from being an unknown, extremely rare, hard to transmit disease to a global pandemic in less than 20 years largely through the agency of gay male sexual behavior.

Basically, male promiscuity will expand until something stops it. What? I can think of several candidates right now: drug resistant syphilis or one of the rare viral hepatitises. There might have been a longer duration when no inhibitions were present but eventually they would be created or come to light.

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Now that I'm back, I must take umbridge with a few points. (Spelling is my greatest flaw, mathematical prowess is my second)

First, you are not going to get HIV via kissing. Having a dork rammed down your throat while lips are pressed together is kind of hard to imagine. And the odds of deepkissing a guy/gal, with bleeding oozing gums, cram packed with HIV virus, just after you get out of the periodontist's chair after having extensive gum work done is virtually inconceivable to me. You can make the same case for handshaking and mosquito bites. It doesn't happen.

Next, the global HIV transmission pandemic was not the result of gay male sexual behavior. It was in the US, where thank God, we have such a low HIV/AIDs burden when compared to the world.

This pandemic was well underway before that flight attendant stuck his dick into some poor schmuck in some unknown LA bathhouse in the mid 1970s. It "exploded" here with some 11 cases being reported in 1981. I haven't checked my stats lately, but here in the US we may be dealing with a cumulative 1,000,000 infections, a large number of whom progressed to AIDs and have subsequently died. The rate of tranmission here in the states is extremely low, when compared to the world in general. The reality for the planet is that in 10-15 years, all economic progress in Russia will cease to exist. India, which briefly lifted its head into a global techno economy will be decimated. China will bear the brunt of close to half a billion deaths within the next 20-30 years. Africa is gone. Southern/South Africa will not exist as we know it. All those democratic strides. End of aparthied. Waste of effort. Meaningless. Nothing. Nada. Today, 25% of the population is infected, 100% die, and most of em are still fucking without condoms.

No my friends. We may be a lot of things, good and bad, but we as a gay community did not unleash this horror on the world. Heterosexuals, and IV drug users did, and continue to do so. The gay contribution is miniscule (thought I admit, hardly non-existent)

Now have a good day.

Dr Danny

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cutguy wrote: Check out this: http://www.hivpositive.com/f-HIVyou/...u/Kissing.html
I'm not saying that it is at all likely, just possible.
My point was not that gays are the majority transmitters but that the speed was much greater due to gay promiscuity. The disease broke out of some ape population in Africa, spread thruout east Africa because of the Ugandan civil wars and the next thing pops up among gays in urban centers in the US and Europe. I'm sure that it would have spread all over the world eventually, just not in 20 years.

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Not sure if I have an STD or not but I did get sucked off on Monday. It is now Thursday and I am have some irritation in the urethrea (sorry, I am sure that is not how it is spelled). In the past, I have had clamydia and I know the symtoms for that. This has no clear discharge, just the irratation. My question is: will a 500 mg tablet of Levaquin clear up whatever I have. I was fortunate to date a doctor for several months and he gave me several sample packets (courtesy of his drug rep friends, but it was for a cold virus I had). Thanks for the advice.

p.s. I know....I should have been more careful but I had just broken up with my bf and was on the rebound. Not my normal behavior (at least not recently).

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I promised myself that I would be non judgemental in my answer on this BB. (I'll break the promise after answering the question)

A single levoquin tablet should cure a penile gonorrhea infection. However, there are a number of asian strains that are resistant to fluroquinolone therapy, and it is not recommended for people who acquire the infection in SE Asia, or Hawaii, and probably California.

You certainly could have been infected with gonorrhea from your insertive oral activity. Typically though, you have that thick, yellow-green, pussy discharge rather than the simple irritation you describe. Since you DON'T have classical symptoms, my recommendation is to NOT pop the levoquin, and DO see your doctor. Also, STDs love to travel in groups. You may well have GC, and have also been infected with chlamydia again. It's just too soon to be symptomatic from the chlamydia, and a single tab of levoquin will not knock it out. And you could also be harboring a host of other nasty things. Again, this good doctor recommends your seeing someone, before it becomes impossible to accurately diagnose you because of self medication.

Now the lecture: More your doctor's fault than yours. Levoquin is a very potent drug. We are seeing levoquin drug resistance all over the place, especially in bugs that make themselves at home in HIV positive patients. Your doctor had no business giving you any antibiotic for a cold, much less this particular one! It would not have helped you, you could have had an allergic reaction to it- which would have been far worse than the "cold" it was (not) designed to cure- and it promotes the growth of bacteria that are resistant! Guys, antibiotics have a very narrow range of use; they don't cure everything known to man, and most things infectious that are known to man cannot be cured with antibiotics.

Do I sound pissed off enough? It's a major pet peeve of mine.

Please, don't pop the pill, call your doctor (or another one!), and get properly checked out. For all you know, you might have gotten a minor abrasion in a very tender spot that will heal by itself. Keep me posted

Dr Danny

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Thanks Dr Danny. I appreciate your candor. I hadn't taken the levaquin and I will wait a few more days to see what transpires. I figured it was too early to show symptoms too but thought I would ask the question anyways. I will get checked out next week too just to be safe.

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I decided to check out this board tonight because today's Washington Blade (7/16/2004) had two full page ads regarding a rise in syphllis cases and the need to be checked as sometimes STDs can be without symptoms. I immediately began worrying about my own sexual conduct which is almost always oral, if it occurs at all lately. Most people on these boards give the impression that they think of oral sex as a no-risk sexual activity. I know when I have cruised around an adult theater I have never noticed anyone getting out a condom before oral sex and with the openness of the people and the lighting it is possible to notice this. I know, however, that I have been influenced by the posts on this Web site that never seem to mention safe oral sex or even disparage the use of condoms in oral sex. I have not used them, but can't imagine that oral with a layer of latex is very good for either partner.

I did pick up some itching a couple of years ago after one encounter and went to the doctor, who found that it was a urinary infection. Unfortunately, he also found the my PSA had gone up to 8 and I began tests for prostate cancer that eventually showed that I had that much worse disease. (Not caught from somebody else, I assume). In this case a minor infection helped to find a much worse one, so maybe somebody was looking over me that night.

I see quite a few guys look for partners who are bi and married and older, (I am not married now, but bi and older). I suppose they think those are less likely to have HiV. I have read that older men actually have a higher rate of HIV because they often cannot get hard enough for a condom (like me).

In the countries where AIDS is wiping out millions of people the disease has gotten into the general population, including women (married and single) and children. I hope that does not happen here, but it could.

Finally, I am not sure what I will personally do, but believe it will hard for me to start using a condom in oral sex. I'll give it a try though. I have not even tried anal, but wouldn't without a condom. Getting an erotic massage can be relaxing and satisying and even when paid for, not too expensive. Even getting a jo from a partner can be nice, if not as good as oral.

I am glad this long thread was here as it had many good posts that were helpful for me to sort out my concerns. I guess I am convinced that unprotected oral sex is still risky, especially if there are a lot of those bugs out there.

Bi

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I have not posted here in a while but have now returned to weigh in on this topic. Here's my story:

I have done "oral" WITHOUT a condom twice. The first time was in 1979 (yes, 1979) with a friend and the last time in 1998 from a "hot college guy" (yes, 1998, 19 years later). After the 1998, oral session, I came down with a SEVERE throat infection in my tonsils 2 days later. I went to a walk-in clinic and and then had to go to an Ears/Nose/Throat guy to have them aspirated and was given some Clindalmycin (sp). After a week, everything was ok. I've not done oral since, condom or not.

Background:
I don't know how it is where you all are but I went to a walk-in clinic and the doc first game me Zirithromycin (sp) because he thought I might (MIGHT) have Gonorhea (the tests came back negative). I did tell him I had oral sex 4 days earlier and the next day got this bad sore throat, accompanied by a horrid mouth odor. He then referred me to a Ears/Nose/Throat guy who did the aspiration and gave me the Clindamycin. He NEVER told me what was in the fluid drawn out of my tonsils and treated me like I was some "slut" who was going to missuse the meds he gave me. He would not give me a refill but told me if I needed one I had to come back to see him. Personally speaking, I think the guy had issues with gay and/or black patients. It was embarrassing enough to have to fess up about my personal business but I wanted to get well and just got the meds and got the hell out of there. Some docs are real shits about sexual matters.

Odd Question: I thought the "hot college guy" was acting strange like he was trying to "give me something". I know that sounds strange but I should have trusted my instincts and not have hooked up with him. Luckily, whatever it was I got from him was cured but this just goes to show you it could have been worse. When I went to the doc at the walk-in clinic, I was telling him that along with the horrid mouth odor, I also had an "oily/metal" taste in my mouth. Evidentally, this bit of info signaled something in him that he decided to give me some Zirithromycin. Whenever a doc gives meds and DOES NOT tell me the side affects or much of anything about them, I go to my local bookstore and research the med before going to the pharmacist. One of the side affects of a Climydia medication is an "oily/metalic" taste in the mouth (I forgot which med it is). I often wonder if this guy I hooked up with had "something" he was being treated for and his meds had not kicked in yet. If any of you happen to know what that medication is that leaves this "oily/metalic" taste in your mouth, please provide that info to us readers of this thread - Dr Danny, can you help?

Aftermath
Unless you absolutely positively know the person you are doing oral or anal with is d&d free - BE CAREFUL - protect yourself or use 1 or perhaps 2 condoms. You'll get laughed at and some guys may pass you up; at least you'll live and not end up potentially catching something you CANNOT GET RID OF - - AIDS!

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Voyeurism_R_Us
Love to watch people have sex and even join in if I get the urge to. See picks in my cfs.com gallery.

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This thread sits far too high on the paranoiaometer for my own personal taste, so rest assured I'm not going to get into a lengthy discussion here.

I DID think it important, however, to mention that you should NEVER use TWO condoms for anal sex. The last poster here is vague regarding which form(s) of sex he is including with his recommendation to maybe use two condoms.

Two condoms actually increase the chances of breakage. One is quite sufficient. Friction, heat... latex upon latex... not cool.

Furthermore, condoms do not necessarily protect against EVERY possible sexual infection that exists. HPV would be just one example with which we are probably all familiar by now, as it has been discussed quite often.

Just use a single condom for anal sex, and make your own personal choice as to what level of risk you are willing to accept for other forms of sex.

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Yeah V, you probably had a Climydia Infection. The symptoms in the urinary tract are similar to the big G.....but from the time I had each, I think that gonnorreah is worse! 2.5 million cases of Gono reported each year. Think of all the non reported cases.

Scruffy, its not being parinoid but many people do not realize that these 2 common sexually transmited bacteria are quite common in oral contact. Married men beware!

__________________
40 something, 6' 175 brn/brn hairy looking for other married wm or younger guys to play.

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Question To Dr Danny:
Regarding my previous post, please provide the name of the VD medication that leaves an "oily/metallic" taste in your mouth. I found the name of it in a book "Best Pills / Worst Pills" but forgot what the name of it is.

Regarding the "2 Condoms", as for "anal", I know if you use an oil-based lube then 1 or 2 condoms for anal is assentially useless as the oil will dissolve the condom. I assumed (and I could be wrong) that 2 condoms used during anal (if you use a water-based lube) would be better but still not a 100% sure bet to not catch an STD. I'm familiar with using a water-based lube w/Nonoxynal 9 but then all these articles came out about that not being a good thing to do so I'm really sure what to do now. I won't use just 1 comdom because (other than shit) you never know what else is up in some guys ass (VD, Crisco, etc). That reminds me of something else. I went to a clinic in the late 1980's and this nurse (very professional acting) told me how women come in with all kinds of infections and "burns" because they use spermicides and don't douche to wash that stuff out. So you can only imagine what's up in some male or female's ass! I have used 1 condom for oral and when I say "I won't do oral or receive oral unless a condom is used", the guys think I must have something. It's a real turn off. I don't care. I've learned my lesson.

__________________
Voyeurism_R_Us
Love to watch people have sex and even join in if I get the urge to. See picks in my cfs.com gallery.

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probably Biaxin. It's pretty characteristic. The drug is secreted in saliva, and thats what about 10% of us taste. I've been on it once (NOT for an STD; sinus actually) and it's pretty raunchy stuff. Flagyl/Metronidizol, used for trichonomonas, more common in women rather than men also give you a really awful metallic taste. I'm not aware of Zithromax (azithromycin) causing a bad taste.

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Dude... I have already told you why it is not a good idea to use two condoms: the friction between the two increases the risk of having them break. Friction creates heat. Both heat and friction degrade the integrity of the condoms. If you don't want to believe me, hit the net, do some research on your own. One condom is enough. The only additional comfort two condoms provides for you is in your mind. Obviously, you are very much afraid of not only STDs (which is a healthy fear), but you seem to be afraid of just about anything that might be found in the human body, male or female (this is an irrational and unhealthy fear).

Your best solution, then, would be to consider celibacy.

It seems obvious that you aren't going to listen to reason, however, so rest assured this is my last attempt to explain the error in your way of thinking about your problem. Someday, when you pull out and find tattered condoms hanging off your penis, feel free to email me. I'll help you out getting through the waiting period for your HIV test results. You'll REALLY be freaking out then.

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