Dear folks,

I want to make a few comments about STI's and STI testing discussion.

First, we are no longer calling it STD (Sexually Transmitted Diseases), but STI (Sexually Transmitted Infections). Under this new view, many new things are STI's, including a cold and or flu. This means that when someone says they have been checked out and are "clean," it is a meaningless statement unless you know what orifices have been checked for what bugs. Not to mention when they were checked and when was their last possible exposure.

For obvious reasons we cannot do a scientific experiment to expose a group of people to an STI, and then see how long it takes for the test to turn positive. So all the arguments about when the test turns positive are somewhat arbitrary best guesses. There are also differences among people, two people infected at the same time even by the same person, may become symptomatic or test positive at different times. Although it may be possible to detect an HIV infection in 10 days, not everyone infected will be positive in 10 days. The experts have designated 6 months as the arbitrary limit, but more than 95% (if memory serves me) become positive by 6 weeks.

In medicine, we never say never. It is true that oral sex is a very poor way to transmit HIV, but it probably has happened. Hepatitis C is rarely sexually transmitted, but sharing bloody toys can increase the infection risk significantly.

The analogy that I like to use, is driving a car. If you do not want to die in a car wreck, do not get in a car. If you like the convenience of tooling around town, there are many things you can do to reduce your risk. Do not drink and drive, wear your seat belts, keep your car in good repair, obey traffic laws, etc. All these things reduce your risk, but not to zero. You have to be comfortable with the level of risk. You are much more likely to die in a car crash than get HIV via oral sex or Hep C by vaginal or anal sex, but the risk is not zero. Unfortunately, no one can quantify the risk accurately.

Doing safer sex is a good idea, but condoms break and condoms do not protect completely against some diseases (Herpes). If you like sex, enjoy, but like everything else there is always some danger. No one can guarantee complete safety, but we do not seem to worry about getting hit by lightning, maybe a similar attitude is helpful with STI's. Hope this helps. I can answer specific questions if anyone has them.

Take care,
Charles Moser, Ph.D., M.D.