FA 014 Safer Sex Practices and STIs

Feral  Attraction
Episode 014 - Safer Sex Practices and STIs 04/13

Intro 00:00:39

  • FurTheMore recap

    • Over 40 attendees

    • Lots of great participation

Topic 00:01:45

CDC Report from 2014 (http://www.cdc.gov/std/stats14/std-trends-508.pdf) show an upswing in STI infection in “Men that have sex with Men” (up 15.1% from 2013). Additionally, 55% of reported cases of Gonorrhea and 66% reported cases of Chlamydia are from individuals aged 15-24. It’s also estimated that over 20,000 cases a year go undiagnosed which can result in long term disability and death. While there are several hypotheses that exist to correlate this information, we’re here to inform on what STIs are prevalent, how to mitigate against them, and how to handle yourself when you are diagnosed with them

CDC often says that the only way to prevent STIs is through abstinence. If you choose to not be abstinent you assume risk in your contact-- let’s make calculated risks and learn more about the common STIs and mitigations out there today

Prophylactics (how to use them) 00:09:20

  • Condoms

    • NSFW VIDEO of how to put one on

    • The basics

      • Add drop of lube inside to help with heat transfer if you don’t like the feel

      • Squeeze tip, roll on. Hold base as you pull out. Don’t stay in long enough to lose your erection.

    • Latex

      • Standard condom

      • Often given out for free

    • Polyisoprene

      • If you don’t like condoms, try these! Feel much better than free / latex condoms e.g. LifeStyles SKYN

        • Feral Attraction is not endorsed or sponsored by anyone. We just feel very strongly about LifeStyles SKYN
           

    • Sheepskin

      • Viro’s article concerning Condoms

      • Pore size is too large to protect against certain STIs, e.g. hepatitis B, however these are likely effective for HIV, herpes transmission

        • Not officially approved for this use

  • Female Condoms (AKA Femidom)

    • FC2 (Nitrile material) is the “industry standard” for Female Condoms

    • These can be used for anal as well, but do not use a female condom and a regular condom because that will cause ripping and negate the purpose of using the condom!

    • NSFW Video of how to use one for receptive anal sex

  • Dental Dams

    • Small square latex pieces used for oral-vaginal or oral-anal sex

      • Use a water based lubricant before going to tongue-town

STI Risk and Prevention 00:41:00

  • HIV 00:41:30

    • How do you get it?

      • Blood-blood or blood-sexual fluid contact with an infected person

      • Risk varies according to infection route .

        • Receptive anal intercourse: 138/10,000 exposures

        • Insertive anal intercourse: 11/10,000 exposures

        • PIV sex: <10/10,000 exposures

        • Oral sex: very low (below ability to calculate)

        • Biting, kissing, cumming on: negligible

        • Sharing sex toys: negligible

    • Testing

      • Rapid tests, home tests, and most standard blood tests are indirect and rely upon the presence of antibodies to HIV to detect an infection; not possible to detect infection for first four weeks to three months

      • “4th gen. HIV EIA test” looks for HIV in the blood directly via p24 antigen, as well as for anti-HIV antibodies; can detect infection as early as two weeks

    • Risk reduction

      • Condom use: ≈80% risk reduction

      • Infected partner on antiretrovirals ≈ 96% risk reduction

      • Condoms + antiretrovirals ≈ 99.2% risk reduction

      • Truvada Pre-exposure prophylaxis: >90% reduced risk of HIV transmission, close to 100% in some studies

      • Post-exposure prophylaxis (PEP)

        • Started within 72 hrs after known or strongly suspected HIV exposure

        • Is a stronger antiretroviral regimen than PrEP, more side effects

        • Used only in emergency situations

    • Symptoms

      • Acute: Sometimes influenza-like illness (ILI), sometimes inapparent

      • Chronic: AIDS

    • Treatment

      • Antiretrovirals for life

  • Chlamydia 01:34:00

    • How do you get it?

      • Anal sex, vaginal sex, oral sex (rare), eye contact (rare)

    • Testing

    • Risk reduction

      • Proper condom use

        • Reduces risk, but not by 100% (estimates range from 15% to 100% risk reduction)

    • Symptoms

      • Often asymptomatic (but still infectious)

      • Can involve genital pain, discharge, particularly during urination

      • Anal infections tend to be asymptomatic, can involve discomfort and discharge

    • Treatment

      • Curable with antibiotics

  • Gonorrhea 01:44:30

    • How do you get it?

      • vaginal, anal, or oral sex

    • Testing

    • Risk reduction

    • Symptoms

      • Some men with gonorrhea may have no symptoms at all. However, men who do have symptoms, may have:

        • A burning sensation when urinating;

        • A white, yellow, or green discharge from the penis;

        • Painful or swollen testicles (although this is less common)

        • Symptoms are rare in women

    • Treatment

  • Syphilis 01:49:50

    • How do you get it?

      • Vaginal, oral, or anal sex

      • Contact with a syphilis sore (can be present on penis, vagina, anus, lips, or mouth)

    • Risk Reduction

      • Condom use can reduce risk

        • Not entirely preventable through condom use

          • Sores can occur in places not covered by condom / dental dam

        • Check it before you wreck it

    • Testing

      • Blood test

      • Possibly detectable at 1-2 weeks, usually by 6 weeks

    • Symptoms

      • Primary: Sore at site of infection, usually painless, lasts 3-6 weeks

      • Secondary: Skin rashes, sores, influenza-like illness

      • Latent stage: 10-30 years

      • Late stage: paralytic disease, madness, dementia, death

    • Treatment

      • Curable with antibiotics

  • Herpes 01:57:10

    • Exists as HSV-1 and HSV-2

      • Prevalence in the US is high for each

        • HSV-1 “oral”    - 54-62% prevalent in the U.S.

        • HSV-2 “genital” - 16-22% prevalent in the U.S.

    • How do you get it?

      • Skin-to-skin contact with an infected person, particularly during an outbreak

    • Risk reduction

      • Condoms and dental dams

        • Condoms and dental dams are not entirely effective at prevention (herpes can infect skin not covered)

        • Risk ≈ 4% over 8-month period with nearly perfect condom use

      • Avoid sex with someone who is having an outbreak

        • Be aware that asymptomatic shedding is still possible; this is by no means foolproof

      • Have sex with an infected person only when that person is taking antiviral therapy (e.g. acyclovir / Valtrex) and only when asymptomatic

        • Risk ≈ 0.4% over 8-month period with nearly perfect condom use (10-fold more than with condoms alone)

      • Truvada PrEP has been shown to reduce odds of HSV-2 transmission by as much as 36 percent in a clinical trial

        • This is not an on-label use and is Truvada PrEP is not FDA approved for this purpose

    • Testing

      • There is a swab and a blood test available for HSV-1 and HSV-2

        • Detectable as soon as sores are present for swab test

        • Detectable in as few as 2-6 weeks; greater accuracy at 12-16 weeks for blood test

      • The CDC does not recommend these tests for routine screening in asymptomatic individuals (>90% of those who have HSV-2 are unaware)

      • The test may be useful to individuals with multiple partners, individuals with partners who suspect they are infected, or individuals whose partners are immunocompromised and for whom HSV-2 infection would present a serious health risk

    • Symptoms

      • Genital herpes sores usually appear as one or more blisters on or around the genitals, rectum or mouth. The blisters break and leave painful sores that may take weeks to heal. These symptoms are sometimes called “having an outbreak.” The first time someone has an outbreak they may also have flu-like symptoms such as fever, body aches, or swollen glands.

      • Many have one outbreak, may not notice, and never again

    • Treatment

      • Daily antiretrovirals (e.g. acyclovir / Valtrex)

        • Reduces risk of outbreak by >80%, reduces odds of transmission 10-fold

  • HPV 02:19:00

  • Crabs 02:27:45

    • How do you get it?

      • Most commonly sexual contact or contact with bed linens, clothing, or towels

    • Testing

      • Visual inspection of groin area

    • Risk reduction

      • Nothing is proven

      • Don’t fuck someone with crabs; aka check it before you wreck it

    • Symptoms

      • Itching

      • Visible lice and nits (eggs)

    • Treatment

      • A lice-killing lotion containing 1% permethrin or a mousse containing pyrethrins and piperonyl butoxide can be used to treat pubic ("crab") lice.

        • Available OTC

  • Hepatitis 02:35:10

    • Hepatitis A

      • Acute, not chronic

      • How do you get it?

        • Ass to Mouth or consumption of fecal matter (contaminated food or water)

        • Sexual contact with someone who is infected with Hepatitis A

      • Testing

        • Blood test for hepatitis A infection is called the "Hepatitis A IgM Antibody test." Antibodies are present within two weeks of exposure and are no longer present 6-12 months

      • Risk reduction

        • Washing your hands after the bathroom

        • Proper use of dental dams

          • Practice proper hygiene

      • Symptoms

        • Acute infection of the liver

        • Fatigue, fever, vomiting, jaundice, dark urine, low appetite

      • Treatment

        • Vaccine

          • Two part vaccination that does not prevent other types of Hepatitis given six months apart

          • Three part vaccination that is a combination vaccination for Hepatitis A and B that is given during a six month period

          • Neither vaccination is “live” and is safe for individuals with immunocompromised systems

        • Post exposure prophylaxis exists in immune globulin or vaccine within two weeks of potential exposure

    • Hepatitis B

      • Can be either acute or chronic based on the individual’s age

        • The younger you are, the more likely it is this will be a chronic disease

      • How do you get it?

        • Transmission of blood, semen, or other bodily fluid

          • Unprotected sex

          • Sharing needles

          • Mother to baby at birth        

      • Testing

        • Hep B blood test

          • Multiple variants that can be ordered for testing

      • Risk reduction

        • Don’t share needles with other people

        • Proper hygiene

        • Proper use of condoms and dental dams

        • Vaccination

          • Three to four shots over a course of six months

          • Combination shot for Hep A exists

      • Symptoms

        • Fever, fatigue, vomiting, dark urine, jaundice

          • Symptoms occur anytime between six weeks and six months from exposure

      • Treatment

        • No treatment once exposed

          • Doctors will recommend rest, hydration, and proper nutrition

    • Hepatitis C

      • Mostly chronic (75-80% of individuals that contract Hepatitis C will develop chronic symptoms)

      • How do you get it?

        • Blood-borne virus only

          • Sharing needles is the primary source of contraction

          • Unprotected sex with an infected individual

          • Sharing other things that have come into contact with blood, like razor blades

        • Higher with rough sex, blood play, etc…

        • Easier to contract if immunocompromised or as a co-infection

      • Testing

        • Blood tests to detect the presence antibodies

      • Risk reduction

        • There is no vaccine for Hepatitis C (yet)

        • Practicing good hygiene

        • Safer sex practices

        • Do not share needles, etc…  

      • Symptoms

        • Fever, vomiting, jaundice, joint pain, dark urine

          • Can occur from 2 weeks to 6 months from exposure

      • Treatment

        • There are multiple drugs that can be prescribed to help with the long term symptoms of Hepatitis C

  • Bacterial meningitis 02:48:45

    • How do you get it?

      • Prolonged intimate contact with infected person (respiratory and throat secretion)

      • Outbreaks have been reported among men who have sex with men

    • Testing

      • Symptoms, confirmatory spinal tap

    • Risk reduction

    • Symptoms

      • The most common symptoms are a stiff neck, high fever, sensitivity to light, confusion, severe headache, and vomiting. Rash may also occur. The symptoms usually develop within three to seven days of infection.

    • Treatment

      • Antibiotics immediately upon suspicion of disease

Question(s) 02:53:30

  • I've been single for 7 months now. I've usually been able to bounce back, but my every attempt to meet someone has been met with debilitating failure. Do you have any advice? Are there any dating sites out there that I might not know about?

    • Similar question received from multiple people this week

Closer 02:59:05

  • Next week’s topic: Trust

Metriko Oni

Metriko Oni is a former government environmental disaster mitigations expert with a focus on outreach, education, and policy writing. He now works with computers. He has been active in the fandom since 2013 and has been an advocate for transparent lines of communication. His interests include philosophy, media, futurism, and speculative fiction.