Disclosure in the heat of the moment!

[pozguy75]

I saw the following in the November issue of POZ magazine (page 24) and I thought they were great and timely, especially with a couple of newer threads talking about the criminalization of HIV. I guess, we have to be the change we want to see. Additionally, I am not sure if anyone else saw this or not...afterall it's been a while since I have done a lot of posting.

The steps/guidelines below are insightful and are common sense.

1. Your tone has a lot to do with how people might hear you’re telling them. Being calm and matter-of-fact as in, “I need to let you know something about my health...” can help inform their reaction and minimize their fears.

2. If you are well educated about HIV and how it is - and is not - transmitted, you’ll be able to answer questions with confidence. It’s also a good idea to keep some third-party information on hand (like a pamphlet from an AIDS service organization or doctor’s office) and links to HIV-related websites (like poz.com, aidsmeds.com, hivictorious.org, poziam.ning.com).

3. Be sure that you will be emotionally and physically safe. f you’re telling someone you don’t know well, it’s harder to discern whether he or she can be trusted. If you don’t want someone to broadcast your status around town, you may want to wait until you know that person better before spilling the beans. Hearing that you are HIV positive can create a wide variety of responses, including anger. So, be sure, you’re in a location you can leave if you feel physically threatened.

4. Don’t only think about the emotional and physical well-being of other people; you have a right to be treated with respect and to know if others are aware of any sexually transmitted infections (STIs) they may have. Do not be afraid to turn the spotlight around and inquire the date and the result of their last tests for HIV and other STIs.

5. Beware of the sympathy reaction that can later turn to remorse. Sometimes, upon first hearing that you are HIV positive, people will react by wanting to get emotionally and/or physically closer to you. Cuddling by your side while hearing tales of your diagnosis and life with the virus can understandably endanger empathy. Know that sometimes, after people step away from the intimate situation, they may experience a different perspective, one that includes considering their own safety and health; that’s when people can be a little less compassionate. However, if people are initially sympathetic, the “recoil reaction” will often pass and they’ll return to a place of understanding or closeness. But it can be painful to experience the running away and then having to wait for their return.

6. Don’t take people’s reactions personally. Remember, they are reacting to the virus, not to you. Their reaction has largely to do with their knowledge of and experiences with HIV/AIDS - and not necessarily how they feel about you or wether or not they are attracted to you sexually.

7. Be prepared to have safer sex if the person hears the news and wants to continue to be close. There is nothing wrong - and everything right - about being armed with an arsenal of safer-sex tools, from condoms to dental dams.

8. Feel free to say “no”. Just because people accept your diagnosis doesn’t mean you’re obliged to have sex with them.

9. Know the laws of your home state. Many states require that HIV-positive people disclose their HIV status to a sexual partner before having sex. If you fail to do so in certain states, you sex partner can bring criminal charges against you if you have unprotected sex without first disclosing. Some states will prosecute people for non-disclosure even if a condom was used and even if HIV was not transmitted.

edited for grammar

www.pozitivelyspeaking.com

[GSOgymrat]

That is a good list. I especially like number 6.

[Ann]

If POZ.com are so worried about our physical safety, (Be sure that you will be emotionally and physically safe.) then WHY are they perpetuating the myth that hiv can be transmitted via cunnilingus?

#7 - Be prepared to have safer sex if the person hears the news and wants to continue to be close. There is nothing wrong—and everything right—about being armed with an arsenal of safer-sex tools, from condoms to dental dams.

WTF?

Dental dams are supposed to be placed over a woman's genitals before oral sex takes place. While this might save the oral sex giver from gonorrhea, syphilis or herpes, it makes no difference where hiv is concerned. Why? Because you cannot become infected with hiv from going down on a woman.

Damn-it! I feel like I'm banging my head against a very large brick wall.    I'm sick of the scare-mongering that goes on in the popular press and on the internet and I'm ashamed that POZ.com is a part of that. 

Ann

edited to say...   I've left a condensed version of this post on the comment section for that article. (condensed because they only allow 500 characters). Let's see if it passes scrutiny and actually appears. http://www.poz.com/articles/sex_partner_hiv_2261_15466.shtml#pagecomments

[John2038]

5 times I have disclosed my status this year to  girls dating me.
I disclosed as follow:

I have been infected by my ex with HIV.

That's it or few details after that on how it has happen. I try to just disclose, and not to talk about HIV.
In a relation, I never talk about hiv, excepting if necessary, that is, almost never. She just know, we are having safe sex, that's it.

Got 0 rejections.

The last time I disclosed my status, was to a girl I met 14 days ago, at the airport. We took the same taxi, exchanged our phone number, met and I disclosed.

This on-going story is really big, maybe the biggest of my life. She was a bit worry but I told her it gonna be fine.

My conclusions after 1 year of disclosing:

As long as people are attracted by you, there are no reasons why they won't accept you as you are.

It's my personal conclusion, I can't generalize, but just hopes it's applicable to everyone.

I'm personally thanksfull to all these girls who haven't reject me and have love me.
They all have a great heart.

And thanks to the last one, so pretty, so nice, but she said yes.

Wishes you all the best !

[BT65]

Dental dams are supposed to be placed over a woman's genitals before oral sex takes place. While this might save the oral sex giver from gonorrhea, syphilis or herpes, it makes no difference where hiv is concerned. Why? Because you cannot become infected with hiv from going down on a woman.

Ann

edited to say...   I've left a condensed version of this post on the comment section for that article. (condensed because they only allow 500 characters). Let's see if it passes scrutiny and actually appears. http://www.poz.com/articles/sex_partner_hiv_2261_15466.shtml#pagecomments

You go Ann!

[pozguy75]

Dental dams are supposed to be placed over a woman's genitals before oral sex takes place. While this might save the oral sex giver from gonorrhea, syphilis or herpes, it makes no difference where hiv is concerned. Why? Because you cannot become infected with hiv from going down on a woman.

What about rimming? Dental Dams are not just for girls you know...boys can use them too. And what if a girl has herpes, I sure wouldn't to touch those with my naked lips and toungue.

Any way, I think the real point of all of this is to ensure all safer sex practices are thought about...in the heat of the moment...

But Ann, you do raise a very good point!

[jkinatl2]

Has rimming been implicated in HIV transmission? I have not seen any hard documentation (pardon the pun) to support this. Hep C? Absolutely. Other STDs? Uh huh. But HIV? In the AM I asylum, um, forum, it's referenced as not legitimate risk for HIV infection, either for the rimmee nor the rembrant.

[SteveA]

Bigger Picture here folks. "Safe Sex" isn't JUST ABOUT HIV! Some of us want to be safe from Herpes, syphilis and gonorrhea and all the other nasties out there. NOT Just HIV. Lest we forget, untreated Syphilis, back in the day, could kill you just as dead as HIV can now. Playing safe is about not catching anything new that would worsen our health. Not Just HIV.

[Miss Philicia]

That's what masturbation is for.

[SteveA]

That's what masturbation is for.

Mater Bation and I are the best of friends these days! 

[Ann]

Bigger Picture here folks. "Safe Sex" isn't JUST ABOUT HIV! Some of us want to be safe from Herpes, syphilis and gonorrhea and all the other nasties out there. NOT Just HIV. Lest we forget, untreated Syphilis, back in the day, could kill you just as dead as HIV can now. Playing safe is about not catching anything new that would worsen our health. Not Just HIV.

Maybe so, but the article is about disclosing hiv status. It's not about safer-sex in general. If they were advocating dental dams in regards to the other more easily transmissible infections, they should have said so. Dental dams are unnecessary when it comes to hiv transmission.

er... damn it!

[skeebo1969]

Ann,

    I was in my doctor's office the other day and up on the wall was one of those fancy charts with colored arrows encircling one of those pictures of the human body with the organs exposed.  Anyone who's been in a doctor's office knows what I am talking about.  SO WE KNOW THE ONE.  At the bottom of the sign, sex with condoms  was classified as a moderate risk for contracting HIV.   As I sat there waiting for the doc to come in I couldn't help but to chuckle to myself wondering what Ann would have done to that sign.
   

[Ann]

As I sat there waiting for the doc to come in I couldn't help but to chuckle to myself wondering what Ann would have done to that sign.
  

Well Tom, let me just say that I never leave home without a pen. Mainly because I'm a daily-newspaper crossword addict, but it comes in handy at other times too.

After drawing a mustache in the appropriate place, I would have scribbled the misinformation out and replaced it with my four favourite catch-phrases... you know the ones...

To agree to have unprotected intercourse is to consent to the possibility of being infected with an STI.

Sex with a condom lasts only a matter of minutes, but hiv is forever.

Use condoms, correctly and consistently, and you will avoid hiv infection. It really is that simple!

And last, but not least...

It just is, ok?

[SteveA]

Maybe so, but the article is about disclosing hiv status. It's not about safer-sex in general. If they were advocating dental dams in regards to the other more easily transmissible infections, they should have said so. Dental dams are unnecessary when it comes to hiv transmission.

er... damn it!

Did you totally miss the posting above mine about rimming? Dental Dams are NOT unnecessary. 

[Ann]

Steve,

Did you see MY post above? Or Jonathan's? Rimming is NOT a risk for hiv infection for either person.

As I said, the article is about hiv disclosure, not STIs in general. If they were advocating dental dams in regards to the other more easily transmissible infections, they should have said so. The way it is written makes it sound like dental dams are necessary for hiv prevention. THEY ARE NOT!!!

Ann
(who has a brick-wall headache - again. )

[SteveA]

Well maybe you need to be a little less myopic about how you read articles. I took number 7 to be about safer sex in "General" and not just about HIV. Just because it's about HIV disclosure, doesn't mean that the author wasn't talking about safer sex all around, especially in light of the fact that HIV is not the only STD mentioned in the article. See Number 4.

The fact is this, if you're HIV+, it would behoove you to do everything in your power not just to prevent HIV exposure to others, but also to prevent adding to your own health risks by acquiring other STI's that can and will have detrimental results to your health.  HPV can and does result in cancer in people and that CAN be acquired through rimming and can affect the health of everyone in a serious manner.

[Grasshopper]

I asume the "Staff" copied these guidelines from some offical Healthcare agency ?

http://www.poz.com/articles/348_2127.shtml

[Ann]

Yeah, POZ and AIDSmeds have some discordance where this stuff is concerned. I've been meaning to raise the issue with Tim Horn for some time now. I guess I need to get my ass in gear...

[jkinatl2]

I hardly consider it "myopic" to concentrate on HIV when discussing safer sex procedures in an HIV forum.

As far as other STDs are concerned, dental dams are, excuse the pun, damned poor protection against other STDs. Fluids can easily leak from the sides of these absurdly small pieces of latex, carrying with them the possibility of Hep C, gonorrhea, syphilis, chlamydia, and other STDs. The only truly safer rimming is to take a LARGE piece of saran wrap and making certain NO fluids are allowed to leak out. This means covering not only the vagina, but the anus and likely the legs as well.

Best of luck with that.

As for HPV, i would posit that the vast majority of HIV positive people will also test positive for HPV. There are tests available, I believe, for that. And for those fortunate enough to test negative, vaccines as well.

In addition, the only truly safe sex is masturbation. As kissing and frottage and other "safer" activities can spread most other STDs, including HPV.

As far as the AIDSMEDS/POZ link Grasshopper pointed out, there is simply no verification and documentation of these events. These are reported events, and not documented events.  I am frankly surprised that AM/POZ would publish that, considering the vast amount of research and work that went into the AM transmission lessons, which were obviously overlooked in favor of trumpeting conservative, patient-report-as-fact party lines.

Someone in charge needs to communicate with someone else in charge, I think.

*edited for spell check

[Ann]

As far as other STDs are concerned, dental dams are, excuse the pun, damned poor protection against other STDs. Fluids can easily leak from the sides of these absurdly small pieces of latex, carrying with them the possibility of Hep C, gonorrhea, syphilis, chlamydia, and other STDs. The only truly safer rimming is to take a LARGE piece of saran wrap and making certain NO fluids are allowed to leak out. This means covering not only the vagina, but the anus and likely the legs as well.

Best of luck with that.

And if you've ever tried using plastic wrap in this capacity, you'll know it's a complete waste of time as there is no pleasure to be had for either party. If you're hankering for a bit of oral and are that paranoid about other STIs, you may as well just go suck your thumb. Please remember to wash your hands first.

When I was first diagnosed, I was given a little bag full of dental dams. They were fairly heavy plasticky (that's plastICKY!) GREEN opaque sheets, approximately 3x3 inches square. My partner and I laughed at them and filed them under G - groundsheets for mice. If anyone knows any mice who like to go camping, drop me a line.

As far as the AIDSMEDS/POZ link Grasshopper pointed out, there is simply no verification and documentation of these events. These are reported events, and not documented events.  I am frankly surprised that AM/POZ would publish that, considering the vast amount of research and work that went into the AM transmission lessons, which were obviously overlooked in favor of trumpeting conservative, patient-report-as-fact party lines.

The transmission information on the POZ site pre-dates the POZ/AM merger and I don't believe the POZ pages have been reviewed. That's what I keep meaning to talk to Tim about, but hell, some days I'm lucky I remember to feed the cats. Or rather, the cats are lucky.

Ann

[mecch]

I dunno what to think about the contentiousness of some of these issues and discussions.  I dunno what I feel ethically about disclosure and casual sex.

Some of my uncertain mind has to do with science I read while I was in bed seroconverting, having to do with the rates of HIV POZ guys who have HPV and how some of them are always shedding HPV, despite successful HAART and a successfully controlled, former anal wart condition.

Seems to me somehow, talking only about gay sex here, by the way, if poz guys are going to disclose about HIV and then put all stock into "condoms are going to make our sex as safe as can be" - and thats pretty damn safe, and "by the way we aren't going to exchange cum in the mouth, to boot" then -- do we also need mention HPV is still a risk if we rim?  Neg guys are pretty naive about what goes on between some Poz guys in some sero-sorting communities, and some of the other VD's they are at risk for. 

So if all that is going to be discussed with a neg partner, well geez, I highly doubt casual sex is possible. 

There was a wave of HPV anal warts among gay guys when i was in University. I got it and several of my friends got it.  From rimming most likely. None of us got HIV.  HPV was a pain in the ass for all of us. I happily only had one treatment and it never returned. A friend of mind had to go through several years of anal helll to controll it.

Now comes news on the gay grapevine that Hep C is sexually transmissable in gay sex in Europe, at least, and Poz guys are more likely to have Hep C, thought transmission is probably happening in fisting and unprotected anal screwing. 

What I'm saying is that the fear factor seems to be rising about diseases related to the butt and tangentially to HIV, although the HIV transmision is prevented through condom use.

So when are the "safer sex" guidelines going to be revamped to include such challenges as HPV and Hep C on some par with HIV, and with some science behind standardised safer sex recommendations that will be publicly viable - understandable... poster friendly... followable...

Are POZ guys as a community (not individually) a "reservoir" somehow, for spreading other infections such as HPV, Hep C, syphillis (and ?) - and if so, is "condom use" the only thing we should be talking and teaching about with potential partners...

Almost all gay guys laugh off the idea of a condom being necessary for a blow job. 

But is fear of rimming kinda smart, these days, all things considered?  And so what to do, laugh off the fear or accept the risks of other VDs.... Or obstain. 

I dunno I am confused.

[Ann]

Just to bring this whole rimming thing into focus, rimming, once again, is NOT a risk for hiv infection. However, it IS a proven risk for Amebiasis, Cryptosporidium, Giardia, Hepatitis A, and Shigella. It is NOT a proven risk for HPV.

Cunnilingus is also NOT a risk for hiv infection. It IS a proven risk for herpes (although rare for the person doing the licking). It is NOT a proven risk for HPV.

End of story.

~sigh~

http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp


edited to add link

[Grasshopper]

Just to bring this whole rimming thing into focus, rimming, once again, is NOT a risk for hiv infection. However, it IS a proven risk for Amebiasis, Cryptosporidium, Giardia, Hepatitis A, and Shigella. It is NOT a proven risk for HPV.

Cunnilingus is also NOT a risk for hiv infection. It IS a proven risk for herpes (although rare for the person doing the licking). It is NOT a proven risk for HPV.

End of story.

~sigh~

http://www.dph.sf.ca.us/sfcityclinic/stdbasics/stdchart.asp


edited to add link

You (a forum moderator) are categorigal about this, while the professionals at the US CDC are more cautious and use words like "potentially"

"case reports of female-to-female transmission of HIV and the well-documented risk of female-to-male transmission [1] indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (for example, oral, vaginal) exposure to these secretions has the potential to lead to HIV infection."

This is dated: june 2006
http://www.cdc.gov/hiv/topics/women/resources/factsheets/wsw.htm

[mecch]

Just to bring this whole rimming thing into focus, rimming, once again, is NOT a risk for hiv infection. However, it IS a proven risk for Amebiasis, Cryptosporidium, Giardia, Hepatitis A, and Shigella. It is NOT a proven risk for HPV.

With all due respect, on what science does your linked guideline base its placement of HPV in "unkwown" - oral-anal sex not a proven risk for HPV. ?

If I understand what I have read correctly in science, then HPV has multiple routes of transmission, but oral-anal is surely one of them.  That said, it seems science can find high-risk HPV in young girls -- so non-sexual transmission and vertical mother/daughter transmission are also possible. 

http://www.health-science-report.com/alotek/topics1/article51/

Therefore, I guess if we have a case of HPV warts in an individual, it would be difficult to know exactly how it was contracted... so many possible routes.   

Well I guess I feel better now, less confused about what VD experience I might need to disclose. Surely HIV. As for HPV, well it is therefore more in the mono and herpes categories - just risks that come along in the course of life....

thanks for the info

[carousel]

"case reports of female-to-female transmission of HIV and the well-documented risk of female-to-male transmission [1] indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (for example, oral, vaginal) exposure to these secretions has the potential to lead to HIV infection."

I wasn't aware that there was an issue of female to female transmission of HIV, beyond passing it through pregnancy.  I seem to remember a lot of angry people, who were furious that HIV organisations were promoting the use of dental dams for women have sex with other women, as it was considered a waste of vital funds.  As far as I am aware, the only risks for lesbians is such things as sharing needles and those who also have unprotected sex with men. 

Beyond whether it is safe or not, is anybody seriously going to use a dental dam for going down on anybody?  I can't really think of anything more of a turn off, except maybe someone with open sores on their botty.  And if that was the case, I think I'd give it a miss, dental dam or no stupid piece of rubber.

[Ann]

You (a forum moderator) are categorigal about this, while the professionals at the US CDC are more cautious and use words like "potentially"

"case reports of female-to-female transmission of HIV and the well-documented risk of female-to-male transmission [1] indicate that vaginal secretions and menstrual blood are potentially infectious and that mucous membrane (for example, oral, vaginal) exposure to these secretions has the potential to lead to HIV infection."

This is dated: june 2006
http://www.cdc.gov/hiv/topics/women/resources/factsheets/wsw.htm

"Case reports" are just that, reports. This means a patient has reported that's how they think they were infected. In every such case, there were other, more likely routes of infection and the oral-vaginal route was NOT proven. There have only been a few such case reports. If the oral-vaginal route were a true risk, it would have been PROVEN by now. There's a huge difference between "case report" and "documented" occurrences of hiv transmission.

You have to remember who has been funding the CDC for the past eight years - the Bush "Abstinence Only" brigade, those conservative CYA merchants who don't want you to have sex outside a christian, m/f marriage.

Ann

[Ann]

With all due respect, on what science does your linked guideline base its placement of HPV in "unkwown" - oral-anal sex not a proven risk for HPV. ?

If I understand what I have read correctly in science, then HPV has multiple routes of transmission, but oral-anal is surely one of them.  That said, it seems science can find high-risk HPV in young girls -- so non-sexual transmission and vertical mother/daughter transmission are also possible. 

I'd say we need more research on this. We have to remember that there are many different types of HPV and not all of them are cancer-causing. There are bound to be some types that are more easily transmitted than others but the question is, are the potentially deadly ones transmissable via oral/anal or oral/vaginal routes?

If this is something that worries you, the obvious answer is to use a barrier when you lick someone's body - anywhere, because according to that article, HPV can be found in a variety of places on the human body - or just never use your mouth on another human being. It's your call.

On a side-note, I'd like to see the HPV vaccine being given to young men as well as young women. It's unnecessary and unfair sexism if you ask me.

Ann