Hoo, boy! The Katz have gone and stirred up some trouble. In episode 6 of Pedestrian Polyamory Gavin and I talked about HPV, HSV1 & HSV2; discussing dirty details and facts as well as our personal struggle in figuring out how to date people affected by these STI's. We got quite the explosive (and awesome!) response, some of which we shared on episode 7.
In an effort to not talk about HPV and HSV on the show nonstop for months (believe me, we could!), we're going to start picking up the conversation here. We'll start off with a really awesome letter from a regular listener at Life on the Swingset and Pedestrian Polyamory.
And now, ‘an earful from the unwashed (not to mentioned diseased!) masses'.
I'm midway through the episode 7 but did want to make a few comments related to the letter you opened the show with and episode 6. After episode 6 I did have a lot of the same concerns that the writer mentioned about the podcast. I also realized how difficult it must be to do a “thorough” piece on STDs and risk, being sensitive to all the statistics and angles.
I probably empathized with Shira's position a bit more than the other listener did since I've also turned down some prospective partners who disclosed their HPV/HSV-2 infections and also felt guilty about turning down someone for being responsible and honest when statistically speaking I know I've slept with a number of other HSV or HPV carriers who either didn't know or didn't disclose.
I can also understand Gavin's perspective somewhat since it seems like it's partially formed (as he mentioned on this episode) from being exposed to the risks while experiencing little of the benefits (read: hot sex) to outweigh them.
That said, while my wife and I do have some of the same concerns and I mostly interpret the show as your personal perspectives/explorations. It does seem like you two are in a much different position when speaking on your podcast due to your (seemingly reluctant) status as part of The Media ™ and your ability to help promote or diffuse the stigma as educators and *gasp* role models. (With great power comes great responsibility?)
A few points I did have in relation to both episode 6 and the response at the beginning of 7 are:
1. Rather than being unique to your community, it seems like HSV and HPV are generally feared in non-monogamous communities because they are common, untreatable and can't be prevented even through correct condom usage.
2. While HSV-2 tends to prefer the genital area, some recent studies indicate that HSV-1 is becoming a more prevalent source of genital herpes infections (causing around 50% of genital herpes infections in some regions according to some sources cited here: http://en.wikipedia.org/wiki/Herpes_genitalis ). The majority of Americans are infected with HSV-1 (I've seen estimates in the 57% to 70%) range, so it is almost completely unavoidable if you are sleeping with multiple partners. While I've tested negative for both HSV-1 and HSV-2 antibodies, my wife has had (HSV-1) cold sores on her mouth since she was a child. She is very careful about not kissing, sharing towels,utensils, etc. or performing oral sex from the time she feels a blister coming on until long after it has healed and has never knowingly transmitted it to a partner, I realize that this is a risk with her and most potential partners that I meet.
3. Of course in addition to the high HSV-1 statistics, there's the 1/6 infection rate you mentioned for HSV-2. While this number is probably true across the entire population, this statistic also vary widely across communities, genders and ages. It makes sense that the rate generally goes up with age and number of partners. If you look at the epidemiology statistics (http://en.wikipedia.org/wiki/Epidemiology_of_herpes_simplex ), the numbers do bear this out and my guess would be that within the non-monogamous communities you can expect numbers much higher numbers than the 1/6 figure generally quoted for the general population due to the increased number of partners you tend to see.
4. In general, exposure to herpes is unavoidable outside of abstience or life-long monogamy with an uninfected partner. The fact that Shira has met so many potential partners who have disclosed their status to her seems more like a testament to the caliber of people she's meeting rather than a specific epidemic running around the SF poly crowd. It sucks that it's so prevalent, but it seems like one of those things you eventually need to accept if you want to date. And again I say this as someone still trying to come to terms with it.
5. I don't believe you mentioned the fact that there's a vaccine that can prevent most of the strains of HPV that cause cervical cancer. (It's also believed that it reduce the risk of throat, anal, etc. cancer caused by HPV in men as well as women although it hasn't be approved for this yet.) When I disclosed that my wife and I aren't monogamous, my doctor said that he would be willing to give me the vaccination as well despite not being in the approved age range, so it may be something that other non-monogamous types can seek out to reduce the risk of catching the more dangerous HPV strains.
6. I believe Gavin may have somewhat defensively overstated the cervical cancer risk in his response to the listener (“You shouldn't be able to think ‘Eh, I can beat cancer'”). As she mentioned, cervical cancer is highly preventable and treatable with regular pap smears and the women at risk are generally those who don't have access to or seek out regular exams. While I don't think her 12,000/year statistic was the most useful one, 12,000/156,000,000 isn't a 7% risk. It's a 0.0077% risk. The question shouldn't have been about a 93% chance of winning the lottery but a 99.9923% chance of winning the lottery. Including the vaccine and regular pap smears, the annual incidence of cervical cancer should be lower than that. (Insert statistics about greater risk of death by car accident.)
At any rate, I'm assuming you've already gotten an earful from the unwashed (not to mentioned diseased!) masses, so sorry to add to that. I do appreciate your candor, even when you're saying things that people don't want to hear. I also enjoy listening to Shira's gut wrenching guilt about her feeling since it reminds me of the most sadomasochistic aspects of Catholic school. Please keep up the excellent work!
I’m glad he brought up the HPV vaccine. I caught HPV two years ago and at first thought it was the end of the world (“An uncurable STI!”). However, I got an outbreak of papillomas, then my body cleared the virus on it’s own. I no longer have the virus and test clean. Since then, I’ve gotten the HPV vaccine (even though I’m 38 and outside the age range recommended). It prevents the kinds of HPV that are most likely to cause cervical cancer and warts,so it’s a great idea. I would recommend it to anyone who has any partners they do not absolutely know the HPV status of. That means anyone sleeping with men because there is no HPV test for men, and anyone sleeping with women who haven’t been recently tested.
I totally agree more people in the lifestyle should get the HPV vaccine. My doctor suggested to me after knowing my lifestyle, it just makes sense.
Shira, another fact you missed is the fact that the viruses act very differently outside their preferred locations. Most people with genital HSV-1 will have one outbreak and no more. Viral shedding is less as well. If you take suppressive therapy the risk of transmission goes to almost 0. Significant information also exists that if you have oral HSV-1, it is much more difficult to get genital HSV-1. What I have found from a lot of personally driven searching is that the details of each individual’s circumstances make a significant difference so it is important to learn what kind of herpes the person has an in what location. Finally, I want to point out that I am disappointed that one of the most sex-positive people I have heard of allows themselves to be sucked into a stigma that at least in the case of HSV-1 is based purely on location of the exact same thing. I do hope you do some more research and do a follow up as the information you presented is incomplete and will only add to the stigma. Thanks guys!