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
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
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!
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
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
PrEP can be prescribed by any primary care doctor, is generally safe and well tolerated, and ensures testing for STIs quarterly
Payment and co-payment assistance programs are available
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)
Estimated risk is ≈45% per sex act with infected person
Testing
Swab of penis (or urine test), anus, cervix (test each one you have!)
Will test positive 1-4 weeks after infection
Risk reduction
Proper condom use
Reduces risk, but not by 100% (estimates range from 15% to 100% risk reduction)
Often asymptomatic (but still infectious)
Can involve genital pain, discharge, particularly during urination
Anal infections tend to be asymptomatic, can involve discomfort and discharge
Curable with antibiotics
Gonorrhea 01:44:30
How do you get it?
vaginal, anal, or oral sex
Testing
Swab of penis (or urine test), anus, cervix (test each one you have!)
Will test positive 1-3 weeks after infection
Risk reduction
Proper condom use
Risk reduction of 13% to 100%
Dental dam use (oral transmission)
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
Curable with antibiotics
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
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
How do you get it?
Vaginal, Anal, Oral sex
Testing
Tests for the symptoms do exist
Pap Smear
Visual Genital Warts
Cancer
Cervical
Anal (diagnosis, not screening)
Oropharyngeal
Vaginal
Penile (diagnosis, not screening)
Risk reduction
Get Vaccinated
Gardisil-9 is a 9-Valent HPV Vaccination that is approved for boys and girls 11 to 12 with catch up vaccines for men up to 26 and females up to 26
Gardisil-9 is different from Gardisil (which is 4-Valent). Make sure you specify which one you are interested in with your doctor
If female: get checked for cervical cancer with a pap smear
Use condoms
These are not 100% effective as transmission can occur with skin to skin contact
Symptoms
Most people clear infection with symptoms; some develop chronic infection that can lead to genital warts, cancer
Genital Warts
Cancer
Cervical
Anal
Oropharyngeal
Vaginal and Penile
Treatment
There is no treatment for HPV, but there is treatment for the symptoms
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
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
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
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
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
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…
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
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