Long before AIDS made an entry into our dictionaries and our daily
paranoias, there were other sexual scares: syphilis, gonorrhea,
chlamydia and genital warts, to name a few. But no one really talked
those days about safe sex (although some of these other
sexually-transmitted infections could also eventually cost victims their
lives). In stopping sexual permissiveness dead in its tracks, AIDS may
well have done us a favour: because, the careful sexual behaviour that
is our best security against AIDS also constitutes our best protection
against other Sexually Transmitted Diseases (STDs).
The essence of
safe sex is avoiding high-risk partners and practices, and using
condom-management strategies. But when it comes down to the specifics,
many questions arise:
Who are the high-risk sexual partners?
The
high-risk groups are homosexuals, bi-sexuals, prostitutes, intravenous
drug abusers; heterosexuals from Central Africa where AIDS is common;
those who have had multiple blood transfusions in areas where AIDS is
rampant. Sexual episodes with high-risk partners are the most common way
the infection is passed on.
The risk of acquiring AIDS from one
penis-vaginal intercourse episode with someone from a high-risk group
has been estimated to be: (with condom) - 1 in 100,000 to 1 in 10,000;
(without condom) - 1 in 10,000 to 1 in 1000. (The wide range of odds is
because of different rates of infection among high-risk groups).
Of
course, someone who's not a high-risk partner is not necessarily a
no-risk partner. When two people sleep together, it's essentially group
sex: they are in effect sleeping with everyone each of them has slept
with in the past five to ten years.
How many sexual encounters with a high-risk partner would it take for the virus to be transmitted?
The
virus can be transmitted through just one sexual encounter with an
infected person. But the chances are less than in the case of multiple
encounters with high-risk persons. In one study at the University of
California, less than 10 out of 100 persons were found to have
contracted the virus through a single sexual encounter with an infected
person. But another study found that the odds got steadily worse with
continuous sexual activity with an infected partner over a two-year
periods - 12 out of 14 people ended up infected.
That is why
another cardinal commandment of safe sex: avoid multiple sexual
partners. Especially if they are unknown, casual partners, you have no
way of knowing which of them is infected, and with every encounter, the
laws of probability favour you less and less. Sex with a single, known,
trustworthy partner is one of your best armour devices against serious
infection. So, if you've tried the rest, now try the best: monogamy!
Is a man more likely to give the infection to a woman than the other way round?
Sperm
does appear to contain a higher concentration of the virus then vaginal
secretions and the virus does appear to be more efficiently transmitted
from men to women then from women to men. But men shouldn't get too
smug about this. In Africa, where the disease has had more time to do
its work, there's a one-to-one infection ratio between men and women.
Which is the most risky sexual practice?
Without
question, anal intercourse without a condom. The walls of the rectum
are thinner than the vaginal walls and therefore more prone to abrasions
and tears. So, the AIDS virus from an infected partner's semen is
absorbed more easily during anal sex.
Other high-risk practices
(with an infected partner) are condomless vaginal intercourse fellatio,
cunnilingus, the sharing of insertive sex toys and anything that would
involve blood contact.
Moderate-risk practices are French kissing,
oral sex using condoms, vaginal sex using condoms and spermicide, and
anal intercourse using condoms and spermicide.
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