[Question #3944] Basis for safe sexual activity
31 months ago
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Hello,
If I may, I would like some clarification on the following topics:
First, it is my understanding that in order to contract an STI, there
must be orifice, that is oral, vaginal, or anal sex. If so, is the evidence
supporting this statement that sufficient sexual-oriented germs must
enter inside the body? That orifice is the incidence where that is
possible?
Second, it is my understanding that most STI’s are mild and/or with no symptoms. If so, is the evidence supporting this statement that there is orifice and there is sufficient transmission of infected fluid but the immune system doesn’t readily clear it? Conversely, for STI’s that are moderate and above, would incidences where sufficient fluids are transmitted always subsequently cause symptoms within a 2-10 day window? Is there a causal relationship between severity and symptoms? Lastly, is it possible to sufficiently transmit infectious fluid in one encounter?
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Edward W. Hook M.D.
31 months ago
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31 months ago
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You mention that transmission is rare
even with an infected person. However, if a typical encounter entails both
penetrative and frictional (direct) contact, how could transmission be rare if
the mechanisms for transmission exist in each encounter? Is there an
insufficient amount of any given virus spread in a single encounter typically?
Further, in the rare cases when transmitted, would that be due to a weak immune
system at that time or perhaps a genetically weak area at the site of
infection?
While symptoms are specific to
particular infections and the site of infections, it is not clear to me if there is a
causal relationship between severity or strength of an infection and symptoms. If
symptoms do exist, does that mean that the infection is either the appropriate
type and/or is located at the appropriate site where it is strong enough to
cause symptoms that the immune system cannot readily or at all clear without
treatment? Otherwise, I have no indication that there has been transmission and
implies that I must be comfortable with the risk of any activity and trust my
immune system to clear infections if most infections are asymptomatic and there
are no reliable tests to show conclusive results for some infections.
Essentially, I would like to avoid the
concern or need for testing and be confident in my understanding of how
certain sexual activity is safe. If there were a causal relationship between
severity of infections on the body and symptoms, no symptoms within a 2-10 day
window would suggest that the infection was mild and the immune system had
cleared it. Conversely, if there were symptoms by the 10th day, it
would suggest a more moderate to possibly severe case and then certain action
may be necessary. Am I oversimplifying this?
Thank you Doctor.
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Edward W. Hook M.D.
31 months ago
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31 months ago
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Dr. Hook,
I am simply looking for clarification with the information you provided so I
could integrate it with my understanding. I have no intentions of being
argumentative. I am just trying to make sense of how transmission is rare if
the mechanisms for transmission exist. I presume it is because the immune
system readily clears the insufficient spread or amount of the virus from the
infected person. (Like your analogy with the flu, colds, etc.) However, when
sufficient virus is spread, where the immune system cannot readily clear the
virus, thus transmission occurs, symptoms
would exist. That would mean there is a causal relationship as I am hoping
for. This is my explanation that I rationalized.
Can you answer if my presumption is correct, with all considerations you
mentioned factored in? This would give
me the basis and comfort I am looking for in this post.
Lastly, a male receiving superficial
oral from a woman, that is licking or sucking on testicles, for example, there
is virtually no risk because there is no opening allowing for the spread of viruses
as in penetration (involving mucosal surfaces) and in the case of a
micro-abrasion caused by friction with an infected lesion which is not
the case in this scenario. In other words, at the very least, there needs to be
an opening for the spread of viruses, correct?
Thank you doctor.
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Edward W. Hook M.D.
31 months ago
|