Guest guest Posted February 25, 2003 Report Share Posted February 25, 2003 Thanks for the correction Geoff. Point well taken. Geoff Heaviside <gheaviside@...> wrote: Hello to members of this very interactive list.I'm very sure that for everyone who makes a response to this list there are many others who are just reading and absorbing the pearls of wisdom that appear here.From time to time there are statements made that deserve to be critiqued because there is a tendency for our warnings to be interpreted as fear of anything sexual.Part of my job is to teach sexual health and safety and most of my listeners would be people who are not in permanent monogomous relationships. The premise for the teaching is that sex is good and fun and potentially dangerous and we need to be very clear about several things. Two that come immediately to mind is right relationships and safe behaviours.Of course in Australia more than 80% of our epidemic centres on men who have sex with men and as Ed so correctly pointed out in his message to Joe on 13th February, not all men who have sex with men identify as homosexuals.I want to critique something in that email with all due respect to Ed and I reproduce the bits that are relevant -"Remember, all that is needed for exposure to the virus is bodily fluid contact with a mucous membrane or open wound of another person. I work with paper all day long. On average I get a paper cut at least once a day. Should I be one of these men who engages in casual sexual conduct (such as mutual masturbation of another man) then I would be at high risk for contacting HIV"I know that mutual masturbation is the most common way that MSM's engage in sex play and I would not want people whose behaviour includes this activity to be fearful of this practice. In my understanding of the science of sero conversion, Ed, if he had a paper cut and his hand was exposed to HIV+ve semen in an act of mutual masturbation his paper cuts would not likely lead to a sero conversion experience. The reason is that the virus is extremely sensitive to oxygen as well. True mucous membranes in the absence of air are problematic and we have had to address the practice of 'docking' with that in mind.Part of the reason that I highlight this opinion is that we need to leave some safe activities so that people whose hormonal make up makes sexual fun an important part of their daily ritual ought not be over sensitised to risks that are non existent.I realise that this is a debatable opinion and I would be interested in other people's opinions of what constitutes risk and why.One of the reasons that I make an issue of accuracy is that it is easy to over generalise particularly if our predominant disposition is to heterosexual behaviour our perceptions of homosexual behaviour might be limited and we need to include all forms of sexual game playing if we are to provide accurate advice to our service users.I was reminded about this lesson when I was doing drug counsellor training. It was common to hear people say that using soft drugs such as cannabis always leads on the the harder drugs such as heroin. Now there is a fault with this statement because whilst all heroin users may well have started using cannabis before they graduated to the harder drugs the converse is not true that all cannabis users move on to heroin use. If we make inaccurate statements then our credibility for the rest of what we say is dubious in the minds of our listeners.Now I'll wait to see what this post generates in the way of sexual health and safety facts and myths, remembering that our audience is both hetero and homo sexual.Geoffreyfrom AustraliaGeoff HeavisideFlat 10 Kash Towers93 South West Boag RoadT.Nagar 600017Chennai IndiaCell 9840 097 178AUSTRALIA -Brimbank Community Initiatives Inc5 Brisbane Street, P.O. Box 606SUNSHINE 3020 AustraliaPh: +61 3 9449 1856Cell +61418328278AIDS treatments welcome your opinion. Join us athttp://www./group/Other groups to join:Aids-Africa-the largest hiv/aids community research group. To join simply click http://www./group/aids-africaInterested the Swahili language? join the East community group Kiswahili at http://www./group/kiswahili Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2003 Report Share Posted February 25, 2003 Geoff, I agree that overstating risks will be unproductive. This could lead to bad attitudes about safe sex in general, if restrictions are perceived as ridiculous or " safety " not achievable with any quality of life. HIV is a very fragile virus, and does not survive long outside the body. The risk of semen vs. paper cut transmission is low. Mutual masturbation is considered " safe sex " by AIDS clinicians here in San Francisco. Has anyone EVER gotten HIV by this route? Impossible to say; and not inconceivable. But highly unlikely. Hepatitis B is frequently co-transmitted with HIV. This is a much more " contageous " virus, survives much better under various conditions, and, over the long term, is also devastating. Same routes as HIV, but more easily transmitted. All Best, Dawn McGuire MD Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2003 Report Share Posted February 25, 2003 Dawn, When I started my course on sexual health and safety we deliberately kept the groups small and asked them to commit to each other in confidentiality and mutual respect. The first groups were hard to get 10 people to come. Then word got out and now there is no difficulty in getting people enrolled. Of course most of our groups centre on young gay kids who get very little encouragement from anywhere else but the principles can be adapted to hetero practice as well. We always try to reinforce the message that there is life after HIV because we don't know unless they disclose that there might be some +ve people in the group. We also encourage folk to think that there is still sex after HIV and that there is a lot more to sex play than just f...ing. In a small group we can also reinforce the fact that HIV is not something to be feared if you follow the rules and that +ve people are not dangerous. Such has been the level of trust over the weeks of the course that some people have felt safe enough to disclose their status. Of course we reinforce also that what is said in the room stays in the room and so far that trust seems to be honoured although there is a lot of follow up queries from people who meet each other socially in a larger group and wonder about communicating there. All very healthy discussion and all the knowledge is able to be owned, applied and discussed. We also deal with the complete range of sexually transmissable infections and in the process hopefully we don't turn young people off sex for good. It makes for much more thought and care when they are hormonally active. Counselling services are available for people who may have a question that they are not comfortable talking about in the group setting and sometimes these discussions can be introduced by doing a role play in which the questions are played out within the whole group. The big problem we have is staying with the prerscribed times for the sessions. We also don't use cucumbers or carrots or fingers for condom demonstrations and these days there are larger than life (for some people anyway) dildos that make the sessions much more fun and much easier to talk about sexual practices that have evolved such as docking where we perceived some additional risks may arise that would not be covered in the normal manuals. Thanks for writing back to me. I am not sure where you email is coming from and I apologise for the long winded reply, but this list appears to be a very interactive list and we need to use the benefits of ICT as much as possible for none of us knows where these electronic messages end up. I do sometimes of course when I get a letter or an email or a phone call from someone who wants to sus out something that they've read. Blessings Geoffrey On Tue, 25 Feb 2003 Dawn Mcguire wrote : >Geoff, >I agree that overstating risks will be unproductive. This could >lead to bad attitudes about safe sex in general, if restrictions >are perceived as ridiculous or " safety " not achievable with any >quality of life. > Geoff Heaviside Flat 10 Kash Towers 93 South West Boag Road T.Nagar 600017 Chennai India Cell 9840 097 178 AUSTRALIA - Brimbank Community Initiatives Inc 5 Brisbane Street, P.O. Box 606 SUNSHINE 3020 Australia Ph: +61 3 9449 1856 Cell +61418328278 Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 25, 2003 Report Share Posted February 25, 2003 Dear Dawn, dear all, The only safe sex is (solo) masturbation. Safer sex is what we are trying to achieve (I think the term was coined in Denver, Colorado, in 1983). Getting HIV through cuts is, as far as I understand, perhaps possible if one insists on getting it in, but not really an issue. The issue is that in many countries the old story about not sharing tooth brushes and razors is still advocated for. This of course takes the attention off the real issue: HIV is mainly transmitted through unprotected penetrative sex. In order to avoid that, people need to know more about their bodies and minds, live in communities or have access to groups where sexual matters can be discussed and where individual behaviour changes are accepted. They further need access to condoms and lube. And even with all that we will still see new infections. Back to the razor: sure one can get HIV in a barber shop (or anywhere else) one just have to have unsafe sex with someone who has HIV and be unlucky enough to get it. Discussions about possibilities and probabilities can perhaps be interesting, but we do discuss a virus that so far has infected millions of individuals, thus masses of people, and we still need to hammer in the essential: it is mainly a sexually transmitted virus and we have to do what we can to stop this virus passing from one person to an other when we have sex. Cheers Calle Accuracy of Risk Advice Hello to members of this very interactive list.I'm very sure that for everyone who makes a response to this listthere are many others who are just reading and absorbing thepearls of wisdom that appear here. From time to time there are statements made that deserve to becritiqued because there is a tendency for our warnings to beinterpreted as fear of anything sexual.Part of my job is to teach sexual health and safety and most of mylisteners would be people who are not in permanent monogomousrelationships. The premise for the teaching is that sex is goodand fun and potentially dangerous and we need to be very clearabout several things. Two that come immediately to mind is rightrelationships and safe behaviours.Of course in Australia more than 80% of our epidemic centres onmen who have sex with men and as Ed so correctly pointed out inhis message to Joe on 13th February, not all men who have sex withmen identify as homosexuals.I want to critique something in that email with all due respect toEd and I reproduce the bits that are relevant -"Remember, all that is needed for exposure to the virus is bodilyfluid contact with a mucous membrane or open wound of anotherperson. I work with paper all day long. On average I get a papercut at least once a day. Should I be one of these men who engagesin casual sexual conduct (such as mutual masturbation of anotherman) then I would be at high risk for contacting HIV"I know that mutual masturbation is the most common way that MSM'sengage in sex play and I would not want people whose behaviourincludes this activity to be fearful of this practice. In myunderstanding of the science of sero conversion, Ed, if he had apaper cut and his hand was exposed to HIV+ve semen in an act ofmutual masturbation his paper cuts would not likely lead to a seroconversion experience. The reason is that the virus is extremelysensitive to oxygen as well. True mucous membranes in the absenceof air are problematic and we have had to address the practice of'docking' with that in mind.Part of the reason that I highlight this opinion is that we needto leave some safe activities so that people whose hormonal makeup makes sexual fun an important part of their daily ritual oughtnot be over sensitised to risks that are non existent.I realise that this is a debatable opinion and I would beinterested in other people's opinions of what constitutes risk andwhy.One of the reasons that I make an issue of accuracy is that it iseasy to over generalise particularly if our predominantdisposition is to heterosexual behaviour our perceptions ofhomosexual behaviour might be limited and we need to include allforms of sexual game playing if we are to provide accurate adviceto our service users.I was reminded about this lesson when I was doing drug counsellortraining. It was common to hear people say that using soft drugssuch as cannabis always leads on the the harder drugs such asheroin. Now there is a fault with this statement because whilstall heroin users may well have started using cannabis before theygraduated to the harder drugs the converse is not true that allcannabis users move on to heroin use. If we make inaccuratestatements then our credibility for the rest of what we say isdubious in the minds of our listeners.Now I'll wait to see what this post generates in the way of sexualhealth and safety facts and myths, remembering that our audienceis both hetero and homo sexual.Geoffrey from AustraliaGeoff HeavisideFlat 10 Kash Towers93 South West Boag RoadT.Nagar 600017Chennai IndiaCell 9840 097 178AUSTRALIA -Brimbank Community Initiatives Inc5 Brisbane Street, P.O. Box 606SUNSHINE 3020 AustraliaPh: +61 3 9449 1856Cell +61418328278AIDS treatments welcome your opinion. Join us athttp://www./group/Other groups to join:Aids-Africa-the largest hiv/aids community research group. To join simply click http://www./group/aids-africaInterested the Swahili language? join the East community group Kiswahili at http://www./group/kiswahili Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2003 Report Share Posted February 26, 2003 Dear Dawn, dear all, The only safe sex is (solo) masturbation. Safer sex is what we are trying to achieve (I think the term was coined in Denver, Colorado, in 1983). Getting HIV through cuts is, as far as I understand, perhaps possible if one insists on getting it in, but not really an issue. The issue is that in many countries the old story about not sharing tooth brushes and razors is still advocated for. This of course takes the attention off the real issue: HIV is mainly transmitted through unprotected penetrative sex. In order to avoid that, people need to know more about their bodies and minds, live in communities or have access to groups where sexual matters can be discussed and where individual behaviour changes are accepted. They further need access to condoms and lube. And even with all that we will still see new infections. Back to the razor: sure one can get HIV in a barber shop (or anywhere else) one just have to have unsafe sex with someone who has HIV and be unlucky enough to get it. Discussions about possibilities and probabilities can perhaps be interesting, but we do discuss a virus that so far has infected millions of individuals, thus masses of people, and we still need to hammer in the essential: it is mainly a sexually transmitted virus and we have to do what we can to stop this virus passing from one person to an other when we have sex. Cheers Calle Quote Link to comment Share on other sites More sharing options...
Guest guest Posted February 26, 2003 Report Share Posted February 26, 2003 Dear Calle, I couldn't agree more-- anything that steers significantly away from sexual transmission issues is a side issue at this stage of the epidemic. Creating communities-- or changing existing ones-- so that sexuality is not stigmatized, real information can be transmitted without fear, real choices are possible for women and for men, children are not raped: This is powerful " antiretroviral " medicine. All Best, Dawn Dawn McGuire MD Quote Link to comment Share on other sites More sharing options...
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