STI statistics and best practices?

[slowtraveler]

@halfmoon, thanks for saving that. I saw the link too and your post looks accurate.

@Olaz
1. What's the best way to ask a person for a complete sti test before sex? Do you include oral in the don't-do-before-testing category? What about kissing or hand-play?

Kissing and hand-play are generally low risk. Unless there's cuts all over the place or dirt, it's typically safe. Common sense works here-wash hands before, maybe shower together, and that's about it.

Mono, hsv, and common colds are the main things I've seen spread through kissing but these are typically visible. I've heard that syphilis, gonorrhea, and hpv can spread through deep kissing but haven't known anyone personally get them this way.

Oral is sex and as risky for most stis. I've tried dental dams and covered oral but I'd rather kiss than do that.

HIV is the most dangerous sti but it also has a much lower chance of spreading than the others. This does depend on viral load, amount of contact/friction, immune system strength. If you're paranoid about HIV look into PrEP. https://www.cdc.gov/hiv/basics/prep.html
You almost certainly won't get HIV ffrom kissing, handplay, or oral due to the low blood-blood contact.

With mono, they'll be tired and won't feel well-typically easy to spot.

If HSV is blistering or chapped, it's likely to spread. Especially on a windy, chilly beach at night. I know multiple people who only got 1 hsv-1 breakout genitally and then never get it again who, ironically, actually got it on a beach at night. Also, hsv is rarely tested for. There are blood tests to know for sure but most people have hsv1 dormant most of the time and it won't spread this way. Chicken pox is a form of hsv that almost everyone has had. There's a lot of fear mongering and shaming around hsv but be patient and present and you won't have any problems.

If chalmydia, syphillis, or gonorrhea are present, they're likely to spread and half of people are asymptomatic for these. They're cured with a pill but oral spreads these easy. That include rimming.

Honestly, I like to go get tested with the person at Planned Parenthood or county's std testing services. I tell them I like to get tested before playing with a new partner and ask if they're open to that. We'll typically have kissed but not had sex yet. I know the hours of the local clinics by heart and have multiple options so it's pretty easy to do. At least we'll get hiv tested together as it's free here, quick, and most other things are curable. If getting tested together doesn't work, primary doctors have all of these tests available and delaying or covering up saves a lot of anxiety waiting for test results.

If I'm meeting someone out of town I'll bring paperwork and ask if they've ever gotten tested/when the last time was, listen and gauge how aware they've been with their sexual health. I've noticed people actually relax after getting tested since they know I'm conscious about it and they're more likely to feel safe. As long as it's brought up in a relaxed, patient, non-judgmental way, it ends up being a bonding experience that builds trust.

If there's any doubt about the person I always use a condom. Put a drop of lube on the inside and outside to make it less likely to rip.

2. I need to make an excel sheet of sexual history. How do you share that in a socially acceptable manner with people if they've probably never even thought about their history.

I'll start with a question-if they've ever been tested, then I'll share when I was tested and my history, I'll be curious about when they first had sex, how many lovers/sexual partners they've been with.

I'll listen with an open heart and no judgement. I'll share my full history openly as well, starting with when I first had sex up to recently. If they haven't thought about their history, all the more reason to go in for a quick check up together. I inspired a girl who'd never thought about this to get all her sex partners tested beforehand too.

I like to tell my own history as a story. It depends on the person. I've never developed an excel, they might feel like their experience with you will be on a record if I'm hearing you right and it might be a bit tenser.

3. Agreed, my PP and I disclose all partners and use protection even with each other. I should up vaccinations and testing, though. Why doesn't mainstream sex culture practice neither honesty nor testing nor protection? >~<

I wish these were more mainstream. I think honesty and testing acknowledge the risks and people like to pretend they don't exist. There's a lot of shame, hiding, judgment around sexuality and this leads to a different culture/mentality around the practice. You and me can lead others to be more conscious here. We get tested and help others bring awareness into their own sexual health before indulging in all its delights.

4. When you say don't hold it in, do you mean that stopping sexual activity to pee and cleaning is better than holding, continuing, and then going to the restroom?

It depends on how bad the urge to pee is. The risk of a uti is far higher for a woman because they have a shorter urethra than men so bacteria reach their bladder easier.

Tell her beforehand, if you have to pee, let me know and we'll take a pause, I don't want you getting a uti. She'll know you care about her health before your pleasure. Plus, if she squirts after peeing, it'll taste better and she'll know for sure it's not pee.

5. This is probably a feeling more than anything else, but how do you determine whether a person is "trustworthy to be sexual with" or not?

Whether they've told me something hard to share early and proactively. If there's a hard conversation to be had, do they hide or share? Are you constantly finding out little secrets about her or has her story been consistent with more detail developing over time rather than a fragmented picture? Do they have white lies or are you "catching" them hiding/lying about things or do they tell you something hard to share upfront without you even having to ask because they value honesty and open sharing?

Your gut will guide you well here.

One peculiar thing in my experience is the more trustworthy, loyal people have a softer, warmer look to their face rather than a hard, stiff look.

6. Although many connections are of the cosistent and slower-to-progress intimate close friend norm set, some connections progress very quickly sexually, in the spur of the moment, so to speak. What are best practices with the latter situations - just don't do them, or?

Don't do them is not always realistic. If you're that in control of your urges, awesome. Enjoy the tension and let it simmer.

Proper use of a rubber will save you most of the time. Having paperwork on hand and asking when the last time they got tested can help initiate a conversation but this isn't always realistic if it's spur of the moment. HSV is the most likely thing to spread when using condoms but there will be sores around the pubic area for this that are typically visible.

[JasonR]

It's criminal for you to be a doctor.

It actually is. There is an ethics committee that reviews psychopath cases like this for residency/med school.
All you need is a name to report him to his medical school. They have no interest in graduating people like this.
You can be kicked out of residency programs for much less "unprofessional behavior" that this.
Find name, report to school. Done.

His personal site was a lulercoaster. It reads like one of those sites they find *after* the shootings. Three hate filled posts? I read 23. And the ones that weren't spewing hate filled racism against dalits and women and prison apes were about how AMAZING he is compared to normals. Did you know he's the strongest guy in every gym he goes to? AMAZING! When he was 9 months old he had a 300 word vocabulary. Doctors were stunned and declared him a prophet! (His is not sociciopathic ranting, it's just facts, dalit) Once he purges America of non whites he will purge the white race of Italians and Irish. Peace out Ego and jennypenny you filthy dalits!
Hopefully the moderators saved some of his hate before he ran away.

It's a shame really. Don't give up ShriekingFurryHotload! Nobody like a quitter. Hitler didn't quit did he? You can do it if you knuckle down and focus that "really good hate" as Kreiglepickle said in one of your posts and turn it into something productive. We're all rooting for you, you beautiful #NordicWarrior! You'll be a great doctor, don't listen to these dalits, female chattal, and skeletal beta males. God, I'll miss your luls in 2016.

[ShriekingFeralHatred]

I am having a hard time understanding why you are doing this.

In essence, anything I write in blogs or otherwise on the internet, assuming it is me doing the writing, is essentially a process of venting. It is not my person, it is the stream I blow off anonymously online to keep on going in a very stressful career. I think it is a little unfair to consider them the totality of my being, or to "dig for gold" to find reasons to attack my career.

I have never and would never harm a patient or anyone else. My religious beliefs expressly forbid it. Even in the event I might personally disapprove of a person or their behavior, I have to treat them appropriately or else I lose my license anyway, and I certainly cannot and will not harm them. I already have participated in treatment of patients whose behaviors I take ethical issue with, and I did not deviate from my standards. Having that ability to set aside personal differences is precisely what is demanded of the medical profession.

[Scott 2]

I think we can solve that licensing problem a little faster...

[ShriekingFeralHatred]

I think we can solve that licensing problem a little faster...

But I am the one with malice?

I have never sought to harm another person like you are now doing. I vented my antisocial feelings in a little diary and otherwise went about my day to day life causing no trouble for anybody.

[Scott 2]

Darn, out of time this morning. Sorry about the thread Olaz.

[ShriekingFeralHatred]

If.I did hate you - well first of all on what basis do you think I hate you?

Secondly, that hate is not being propogated. None of my "extreme" opinions are remotely popular with anybody and I do not foresee that changing.

Thirdly, even if I hated your guts verifiably - if you walk in my clinic door seeking treatment you will get it, to standard of care, and to the level of confidentiality you are entitled. Personal moral objections with the big picture direction of the world do not stand in the way of that.

You may be interested to know that when it comes to ethics of patient treatment, that is all decided by big ethics committees and dictated to us practitioners. Assuming I even had a mind to harm you or deny you care, I couldn't in the first place anyway because I have no moral agency at all in my profession. The laws and ethics boards have it all so locked down that anybody who couldn't deal with that reality was filtered out in the first six months. Essentially, what keeps everybody "safe" from an "evil psychopath" like myself is the rigorous screening we go through and the fact that literally everybody has a say in what is right except the doctors. Nobody has a chance of making it through unless they can practice medicine both how the scientists have established is best, and according to what the laws and ethics groups think is right. I am pretty sure a medical treatment decision others consider unethical could get you sued for malpractice just the same as one clinically unsound, on top of the heaps of laws that will fine and otherwise punish moral infractions by clinicians.

No, it is not the safety and confidentiality of you or my patients that is at risk, it is mine that is at risk.

[TopHatFox]

Darn, out of time this morning. Sorry about the thread Olaz.

No worries, I'm taking notes on what to put on the internet and what not to put.

[ShriekingFeralHatred]

Not buying what you're selling. There is absolutely nothing of your "moralism" that would make me feel safe. I'd rather be treated by a career-oriented doctor than one who believes that I deserve to have a dangerous and dirty abortion because I'm a whore.

So you would rather be seen by someone who over prescribes and over tests just to milk your insurance, sells you snake oil and enrolls you in dubious clinical trials to pad his resume than see someone who treats appropriately according to settled science while silently having negative thoughts about your lifestyle?

[TopHatFox]

You and me can lead others to be more conscious here. We get tested and help others bring awareness into their own sexual health before indulging in all its delights.

Ahh, I really like it when potentially life altering problems can be largely minimized using honesty, open communication, and some of the more helpful benefits of technology. After reading your narrative, I feel a lot more confident gently broaching the subject of STIs with intimate friends and partners, or to ask if they'd be open to getting tested together. Thankfully my college has a clinic right on campus, so we could simply go to that -- and it's free! (Perhaps it'd be better to go separately, though, to reserve privacy on a tiny campus?).

[daylen]

You guys are suppressing the freedom of everyone by attacking this guy. What if someday one of you develops an unorthodox opinion and wishes to vent it on the Internet? This is how intolerance starts.

[Lemon]

You guys are suppressing the freedom of everyone by attacking this guy. What if someday one of you develops an unorthodox opinion and wishes to vent it on the Internet? This is how intolerance starts.

There is however a difference standard set for medical professionals, while identifying themselves as such online, at least in my country there is!

[daylen]

@Crazylemon Should rules determine behavior? Or should behavior determine rules? Or perhaps rules and behavior should be related by abductively, like theory to data? Or maybe they are unrelated?

[Lemon]

@daylen both. Rules exist to modify behaviour and are decided at least in part by what is current behaviour.

At least in my country 'bringing the profession in to disrepute' is against the duty of the Doctor and can thus be penalised. Now that definition is of course open to interpretation.

The difference between 'I am a doctor and I advise X' and 'random unverified internet man advises X' is vast

[ShriekingFeralHatred]

At least in my country 'bringing the profession in to disrepute' is against the duty of the Doctor and can thus be penalised. Now that definition is of course open to interpretation.

The difference between 'I am a doctor and I advise X' and 'random unverified internet man advises X' is vast

But nothing was advised.

Besides - are you a physician? If not, why take it upon yourself to police the internet for anyone making doctors look bad? Why go after a guy with unpopular private opinions yet appropriate professional treatment of patients and not the people getting 10,000+ hits a day advising people not to take their vaccines because doctors are evil profiteers?

[Lemon]

At least in my country 'bringing the profession in to disrepute' is against the duty of the Doctor and can thus be penalised. Now that definition is of course open to interpretation.

The difference between 'I am a doctor and I advise X' and 'random unverified internet man advises X' is vast

But nothing was advised.

I haven't said anything was, I haven't read any of the posts, deleted before I got here and I don't want to get involved in any part of the episode.

The example was to indicate one reason why the above rule is part of my countries regulatory body's rules.

[Spartan_Warrior]

On the one hand I'm almost certain Jacob is against doxxing of the sort that's going on here and I predict much of this thread will be deleted.

On the other hand, I'm a little proud of my anti-fascist brethren for going to town on what I recognized as an obvious psychopath from his first posts. The sad thing is, I don't think people like him are nearly as unique in his profession as some of you seem to believe. I'm not about to read the hate rants--I got bored of that in his first few journal posts here--but I wouldn't be surprised if some of his criticisms of the health profession are quite valid, if perhaps lacking self-awareness...

I expect to see more and more of his type of thinking out in the open.

[daylen]

@Crazylemon There is a conflict of perspective present, hence logical argument is unlikely to resolve indifferences. Consider my first comment on one particular perspective not directed towards you personally, and my second as merely a curiosity of your own perspective.

[Lemon]

@Crazylemon There is a conflict of perspective present, hence logical argument is unlikely to resolve indifferences. Consider my first comment on one particular perspective not directed towards you personally, and my second as merely a curiosity of your own perspective.

I don't take I personally at all!

The current situation I am disinclined to express an opinion.

As for the regulation in my country. It exists for a reason. Does it silence what otherwise could be valuable as a side effect? Without at doubt. Is it worth it? My governing body clearly feels so.

@hatred I am in no way out to get you.

[TopHatFox]

As far as I understand it, the first amendment in the constitution of the US protects constituents from the federal government infringing on the rights of people who say what they want, with the limitation of yelling fire in a theater or other physical threats. With that in mind, free speech still comes with immense responsibility, because there is nothing stopping a community from responding negatively to hateful, unsupported rhetoric, like the ones we discovered:

"In a lot of ways liberalism is about removing natural consequences for things like being dumb, irresponsible, black etc

It is not enough for fags to get aids, they must be mocked for it and enslaved for the rest of their days

I say I am glad they will be forced to have dangerous and crude abortions behind shady bars, because
they deserve it."

-----------------------------

I have very little tolerance for baseless hate speech like the above. At the very least, if a person introduces an unorthodox point of view, it is expected that they will need to present robust, credible sources to support their claims to the larger community, should they even be supportable.

All of that said, a few months ago I attended a statewide community gathering calling for people to "call others in" rather than "calling them out." In other words, instead of expunging the person from the community as a pariah, first give them a chance to challenge their current opinions with alternative views, should they be willing to. (In that context, it was meant to change campus "rape culture" from men who were very likely socialized to believe that being confident means not taking no for an answer, a la Trump).

Thoughts?