Updated: 12/3/96
Updated: 12/3/96
Sexually transmitted diseases or STDs present a unique Public Health problem. Before continuing I wish it to be CLEARLY UNDERSTOOD that I am dealing with the problem of STDs strictly as a medical and microbial issue and not as a moral or religious question. In spite of this disclaimer, there will be those who upon reading this material will take it that I am PREACHING MORALS to them. Let me assure you that the microbes involved are not the least interested in your or my morals, they only want to survive and they will adapt their pathogenic behavior to FIT THE BEHAVIOR OF THEIR HUMAN HOSTS. Therefore, from a strictly evolutionary standpoint we humans have it within our power through our SOCIAL ATTITUDES AND BEHAVIOR to CONTROL these diseases; a power we lack over many other diseases. Morality aside it is a BIOLOGICAL FACT that changes in human behavior could ELIMINATE STDs as a serious disease problem.
All forms of life have a powerful INSTINCT to procreate and I have presented the genetic reason for sex being a required part of the process of reproduction. In the case of STDs, human reproductive drive (instinct?) combines with human intellect and social development to produce a complex situation and one that we humans haven't yet dealt with successfully . The dilemma humans face are the facts that (1) STDs require sexual activity for their transmission; (2) humans require sexual activity to procreate and; (3) powerful reward systems are built in to the performance of the STD-transmission act (sexual intercourse). The STD microbes might best be viewed as DEADLY HITCHHIKERS on a natural process we are rewarded for doing.
To learn what sexually transmitted diseases are.
To learn the characteristics and epidemiology of some major STDs.
To learn, in detail the epidemiology and disease characteristics of the
HIV virus.
To learn how STDs may be dealt with both medically and socially.
EXTRA CREDIT:
Send me your answers via E-mail by the beginning of this lecture (no answers
accepted after). Those that get 11 or more correct get 4
extra points. See the correct answers
after the STD lectures have begun.
Answer the following: In your E-mail letter, put the answers in a column labeled #1-13, beside the appropriate number. Alternatively, copy the questions into your E-mail and delete the incorrect answers for each.
STDs are infectious diseases that are primarily transmitted through the ACT OF SEXUAL INTERCOURSE. Their portals of entry are the GENITOURINARY TRACK and the ANUS. They mainly infect the reproductive organs, but several STDs can spread throughout the body. STDs may be transmitted in other ways, usually involving the sharing of blood or other body fluids through the aggressive invasion of the body with needles, knives or other sharp instruments.
No discussion of STDs is possible without considering the impact of SOCIAL AND RELIGIOUS ATTITUDES. STDs are as much a social as a medical problem. We humans have trouble thinking rationally about anything having to do with sex. Sex pushes OUR BUTTONS in several significant ways. Sex is highly emotional, it makes us uncomfortable, it embarrasses us, it treads on all sorts of taboos and provokes irrational and often mean-spirited responses from people. The role of social and religious perspectives will be considered from the position of the EFFICACY OF TRANSMISSION of the STDs. Imposed upon this already horrendously complex problem are political issues, homophobia, myths, fears, guilt, economic considerations and malignant ignorance. I shall attempt to tread light through this virtual mine field, but please feel free to express your REASONED views and perspectives with me and the class either in class or via e-mail.
Let us attempt to put aside our prejudices and negative baggage on this issue and try for a while to deal with it strictly as a MICROBIAL PROBLEM.
WARNING:
Click
here to view the STD HOMEPAGE which contains graphic
pictures of STDs that some will find disgusting and all normal
people will find gross. If these picture "turn-you-on" please seek help
immediately!
Fig. 2 shows some recent relative STD numbers. Note that
although AIDS is receiving the most attention because of it fatal outcome,
it is still a minimal problem from a numbers standpoint. The estimate for
new AIDS cases in the US for 1995 is 97,800. The average cost for medical
treatment for a single AIDS case is $119,000
(Health Mag. Nov./Dec. 1995; Sci. Am. Feb. pg 62, 1991)).
Figure 2. Relative numbers of several of the more common STDs. Although AIDS represents a relatively small number of STD cases, because of its high mortality rate it is receiving much more attention. The relative high cost of AIDS treatment increases its significance.
REQUIRED READING: Click here to go to the CDC
WONDER site. When at that site proceed as follows:
PULLMAN IS NUMBER ONE in the state in diagnosed C. urethritis. It is the No. 1 STD and the No. 1 cause of sterility. There is no immunity, no vaccine and one may get repeated infections.
The disease is RARELY FATAL
in adults, but it is OFTEN LETHAL to
new born babies who pick up the infection in the birth canal. Most women
with herpes choose to have Cesarean birth to prevent infection of the baby.
Certain anti-viral drugs lesson the period of attacks and some people take
these drugs prophylactically. There are Herpes Help Groups that put people
with herpes in contact with one another for dating etc. Try the Internet
for help groups. Anyone who has herpes and doesn't tell their sex partners
is not a person of HONOR in my opinion. Click
here for a discussion from the STD Homepage.
Although almost everyone has heard of AIDS by now, there is much confusion as to its nature, just how dangerous it is, how you catch it and when and if there will ever be a cure or a vaccination. These subjects will be discussed in this section. The effect of the HIV virus can only be understood through an understanding of the specific immune system.
For information on AIDS on the www:
Page on TB & relationship to HIV: http://www.brown.edu/Research/TB-HIV_Lab/About_TB/TB_Title.html
Biology of AIDS: http://www.bocklabs.wisc.edu/Tutorial.html
Listing of AIDS Web Information: gopher://odie.niaid.nih.gov/11/aids
CDC Reports on AIDS: gopher://gopher.niaid.nih.gov:70/11/aids/cdcds
Picture of HIV: http://pavlakislab.ncifcrf.gov/pictures.html
AIDS
IS A DISEASE OF HOMOSEXUALS & IS A PUNISHMENT FOR THEIR SINS:
This is a tough one to deal with since the concept of "SIN"
is a theological matter, not a scientific issue. The closest scientific
thing to a religious sin might be engaging in BEHAVIOR
that has been proven to be PHYSICALLY HARMFUL
such as smoking, overeating, under exercising, excessive drinking of alcohol
and engaging in promiscuous sex. Each of these activities has been proven
to lead FREQUENTLY to a DISEASE
STATE, and most of us engage in one or more of these "BIOLOGICAL
SINS" to some degree (guess which one(s) I do?). To the degree
that homosexuals, particularly the males, engage in promiscuous, unsafe
sex, they contribute significantly to the spread of the HIV virus.
"ONE OF THE FASTEST-GROWING
AIDS POPULATION IN THE US IS TEENAGERS….NUMBER OF AIDS CASES IN 13-19-YEAR-OLDS
INCREASED 524% IN 1ST SIX MONTHS OF 1995……MOST OF THIS INCREASE
OCCURRED AMONG GAY TEENAGERS…." From
Dateline: NIAID Sept.
1996
This situation is not unlike the epidemic of syphilis that struck the world in the 15th century, only in this case it was HETEROSEXUAL PROMISCUOUS sex that rapidly disseminated this disease. The major FLAW IN THIS MYTH is simply that AIDS strikes both homo- and heterosexuals ALIKE once they are infected, by whatever means, with the HIV virus. The growth of the virus and the course of the disease is EXACTLY THE SAME in both groups. It doesn't matter if the victim is a baby whose mother was an IV drug user, a hemophiliac, a surgeon who cut himself during an operation on a HIV carrier, a homosexual male prostitute, a heterosexual female prostitute, or a college student who got drunk and did a stupid thing only once.
AIDS
IS A DISEASE MAINLY OF AFRICAN AMERICANS: There is no doubt
that HIV infection is much higher in poor communities, be they white, black,
Asian or Spanish American. But AIDS is a disease of poverty, ignorance,
drugs, life-style and hopelessness. The HIV virus is equally infective
in every race on this planet as far as we know today. It is truly an "equal
opportunity killer". The latest data however, indicates that one of
the fastest areas of HIV infection is occurring in the Black Inner Cities,
mainly among teenagers (NBC NEWS 12/1/1996).
I
CAN TELL WHO IS LIKELY TO HAVE AIDS; NONE OF MY FRIENDS ARE "DIRTY"; NO
ONE I KNOW WOULD HAVE SEX WITH SOMEONE WITH AIDS ETC.: These
are the myths of people who have decided they WANT TO HAVE SEX with someone
and no fact, logic or reason is going to interfere with their high time.
In effect the primitive reptilian parts of their brains have effectively
eliminated their "thought processes". Such "reasoning" often follows the
intake of a pint or so of strong drink in a brief period of time or an
excessive libido. When someone tells you this I would run, not walk,
to the nearest exit, because you're not dealing with someone whose operating
on all cylinders; they are a few cards shy of a full deck; they are half-a-bubble
off plumb; they're missing a CPU. Certainly I would not let such people
invest my money for me, drive my new car or baby-sit my kids. I will give
anyone an A in the course if they can provide me with a foolproof way of
telling who is infected with HIV just by looking at them; any takers?
AIDS
CAN BE CAUGHT BY GIVING BLOOD: Not unless you're using the Fly-By-Night-Vampire
Blood Mobile. If the nurse spit-cleans the site of inserting the needle
and wipes the needle off on her skirt before sticking it in you, you may
indeed have a problem with any number of diseases including AIDS. However,
this doesn't happen with legitimate blood collecting agencies. To my knowledge
no one has ever caught the HIV virus from GIVING BLOOD.
AIDS
WAS MANUFACTURED BY THE CIA AND KGB TO KILL AFRICAN AMERICANS or BY THE
WORLD HEALTH ORGANIZATION TO CONTROL POPULATION: These are a
very prevalent rumors which exists in several versions (my father happens
to believe this story). A survey in the Fall of 1995 reported that approximately
1/3 of African Am. believe the first one to be true. While it is THEORETICALLY
POSSIBLE to "make" a virulent virus, we simply don't know enough about
the virulence of HIV or any other virus, to modify it that way, much less
to manufacture one that could selectively infect humans of a certain skin
color. What-ever-the-case, the fact that it is EQUALLY VIRULENT to all
humans says something about the POOR QUALITY
of any research that produced it (maybe it was the CIA----just kidding
fellows?). If HIV was manufactured, the guys that did it were INCOMPETENT
and shouldn't expect the Nobel Prize committee to consider them for any
awards.
YOU
CAN CATCH AIDS FROM YOUR ROOMMATE, LAB PARTNER, PERSON WHO SITS BESIDE
YOU IN CLASS, FROM DIRTY DISHES, SHARING A BEER OR FROM THE TOILET:
There is always the off chance that under EXACTLY THE RIGHT KIND of conditions
you could catch AIDS in one of the ways described above, but it is HIGHLY
UNLIKELY, unless you are HAVING SEX
with any of those people. Actually the HIV virus seems remarkably difficult
to catch. If it wasn't that millions of humans were happily and enthusiastically
working night 'n day trying to give it to each other, the poor virus would
probably not survive for long. Why if we changed our behavior we might
even see the formation of a "SAVE THE AIDS VIRUS"
(or SAV) organization; they wouldn't ask you for money, only that you go
out and engaged in unsafe sex with a lot of people. They'd push for laws
fining anyone who didn't have unsafe sex at least 10 times a year (5 affairs
for married people).
I
CAN ENGAGE IN ALL THE UNSAFE SEX I WANT BECAUSE I CAN'T GET AIDS:
Anyone who thinks this is not just illogical, but is the type of person
who would go sky diving WITHOUT A PARACHUTE
and want you to join them. People who think like this (using the word "think"
to describe such a process is an oxymoron) are running on empty; their
one brain cell is asleep, they are retards etc.
SOME
PEOPLE SURVIVE AIDS: This may indeed be true, but it is in the
category of saying that "some people have fallen 3 miles from an air
plane without a parachute and survived". Which, even though it is TRUE,
leaves the person who hears it wondering if their hearing is functioning.
Among the 5.6 billion people on this planet there are some who have survived
HIV infection for >15 years. Eight individuals have an unusual weakened
strain of HIV that may protect them from the virulent form. However, unless
you travel to Australia where they live and have sex with them, the odds
you will contact a NONLETHAL HIV appear to be so small that this would
be you (or me) that to even consider it has to raise serious questions
about one's sanity and intelligence.
AIDS is caused by the HIV virus or Human Immunodeficiency Virus. There are a few other hypotheses kicking around that other agents cause it, including environmental ones (industrial pollution), but there is no SCIENTIFIC EVIDENCE to back any of them up. Obviously Koch's Postulates can not be used to prove that HIV is the etiological agent of AIDS, since we can not use humans as test animals and our near primate relatives don't seem as susceptible to HIV as are humans They do suffer from a simian form called SIV. The overwhelming epidemiological, and biochemical data supports the conclusion that HIV is the etiological agent of AIDS. Recently (Nov. 10, 1995) it was reported that the first chimpanzee given the HIV virus has comes down with a classical case of AIDS after 9 years.
AIDS is a disease of the immune system. Its method of attack is DIABOLICAL. If I were to design the perfect pathogen it would resemble the HIV virus. For example, most HIV positive individuals progress to AIDS over a 10 to 15 year period, during most of that time they are reasonably healthy, capable of being sexually active, and HIGHLY INFECTIVE. This 6 to 10 years of infectivity meets perfectly the requirements of an efficient pathogen; one that doesn't kill its host before it can past the pathogen on. Further, the fact that the HIV virus is not highly infectious supports its subtle, but effective spread; i.e., by spreading out the time of transmission it insures that large "clusters" of victims don't die all at once and produce a "shock effect" that might change people's sexual behavior.
We now know that HIV has the FASTEST MUTATION RATE of any virus known. This means that it can change its antigenicity rapidly, developing new varieties quickly to meet new immunological and drug treatment challenges. But how does HIV cause AIDS and why does the disease progress so slowly? Within these questions apparently lie the terrible secret of the success of HIV.
Upon infection with HIV the body recognizes a foreign agent and immediately
launches a vigorous counterattack. First, macrophages
and
related cells engulf and digest the HIV into smaller proteins.
The HIV epitopes are presented to the special T
HELPER CELLS or HELPER T LYMPHOCYTES.
The Th cells secrete chemicals that stimulate the appropriate epitope-recognizing
Tk and B cells to proliferate. The B cells proliferate and differentiate
into plasma cells and begin secreting large quantities of antibody against
HIV. The Tk cells or killer T lymphocytes seek out, attack and kill any
cells that harbor HIV. The HIV-antibodies bind to these infected cells
and target them for destruction by complement and Tk cells.
However, the major target cell of HIV are the Th cells THEMSELVES and Th-cells
initially die by the thousands, until the Tk cell and HIV-antibodies are
produced and counterattack. Victims may show some mild to severe (e.g.
flu-like) symptoms during this early attack. However, many show no symptoms
and they all recover and remain SYMPTOM-FREE for an extended period.
During the second phase the immune system continues to function well (this
is the phase Magic Johnson is currently in). How then does HIV survive?
Why isn't it DESTROYED COMPLETELY early
in the struggle? The virus level remains low, however the NET
VIRUS LEVEL begins to slowly increase and the helper T cells
continue a SLOW DECLINE. The decline is apparently brought about by a COMBINATION
of the effects of HIV infection and destruction of the Th by the Tk cells
they have activated. Recall however, that the Th cells are required for
the ACTIVATION OF BOTH the Tk and B
cells.
It turns out that the reverse
transcriptase that makes DNA from the retrovirus's RNA is seriously
error prone. This means that it makes more mistakes (mutations) than any
virus known. To understand the significance of this we must invoke the
theory of evolution
The high mutation rate means that HIV has a tremendous evolutionary potential.
This evolutionary potential is seen in the production of mutant strains
of HIV that are not longer recognized AS FOREIGN
by the immune system. When one of these strain arises it infects Th cells
and produces more HIV. The immune system responds in its normal manner
described above. But there is a difference, and that is that the immune
system is now weakened by the loss of Th cells so its response is slower
and less effective.
Figure 2. The evolutionary cycle of HIV mutation. Mutants arise spontaneously.
A rare mutant is not recognized by the immune system and is able to infect
more Th cells. This mutant is eventaully recognized as foreign antigen
and an attack is mounted against it. However, new mutations continually
arise until the bulk of the Th cells are destroyed (as shown by some viruses
escaping destruction by a weakened immune system in bottom left) and the
immune system collapses.
The cycle of mutations producing new strains, re-infection and fresh replication
of the new HIV strain followed by a response by the damaged Immune system.
The cycle continues relentlessly and the numbers of Th drops inexorably
lower and lower.
When it reaches 200 Th per microliter from a high of 1000, the victims
fate is sealed. The symptoms of AIDS becomes full blown, the viral level
climbs sharply and all the measures of immunity (e.g. antibody level, Th
cells etc.) drop precipitously. The victims rarely survives for more than
two years after this stage is reached.
Death occurs when the victim succumbs to opportunistic infections that
overwhelm the victims last defenses.
Figure 3. The course of AIDS through the effects on the various components
involved. The key data are the patterns of HIV and Th concentrations over
time. HIV levels initially show a sharp rise, but once the immune system
is fully activated the HIV level falls to very low levels. However, a few
mutant HIV survive and infect the Th cells. The body again responds to
the mutant HIV-antigen and the HIV level falls; as indicated by the wavy
character of the HIV data line (blue). During this repeating cycle of mutation,
re-infection the number of Th cells decline as they are killed by HIV and
by the bodies own Tc cells (red). Eventually, the concentration of Th cells
declines to a point where it can no longer activate the immune system,
which then collapses and allows many different opportunistic
pathogens
to overcome the host.
PREVENTION
OF INFECTION CURING
THE INFECTION LIVING
WITH THE INFECTIONSome drugs have had the effect of making the late stages of an AIDS's victim less painful and there has been some success at fighting certain of the most common opportunistic infections that afflict those in their final stages. The drug AZT inhibits the transfer of HIV from the infected mother to the fetus if given early in pregnancy.
Currently drugs like AZT are aimed at the enzyme reverse transcriptase .Newer drugs include HIV-proteinase inhibitors. HIV-proteinases are required for the virus to mature. Because both these enzymes are unique to the virus they are reasonable points to attack. However, the rapid mutation rate of HIV results in it becoming resistant to AZT within ~18 months on average. Another approach has to do with inhibiting the binding of the virus to the target cells; to blocking or otherwise stopping the binding to the unique receptors on the cells that HIV attacks.
It also appears that some babies born with HIV are able to totally eliminate the virus. How they manage this is being intensely studied in hopes it will provide clues to HIV treatment. However, currently not even the most optimistic scientist believes that a cure is anywhere in the near future.
As discussed above the most logical, simplest and most effective approach would be a CHANGE IN THE SEXUAL BEHAVIOR OF HUMANS. That this can work has been shown by the effects of an aggressive educational campaign among the American homosexuals. In the 1980s the homosexual community sought to educate that group in safe sexual practices. It appears to have been successful as the number of new AIDS cases among homosexuals FELL SIGNIFICANTLY. However, as older gays have died from AIDS and the numbers of gays with AIDS declined, the younger gays are reported to have lost their fear of this disease and there is evidence that the old ways of unsafe sex are returning.
The problem safe-sex education is complicated by religious. political and moral views that feel that anything but TOTAL SEXUAL ABSTINENCE is wrong and that all sex education is wrong except that performed by parents. Such groups also feel that it is immoral to teach people how to use condoms or any other safe-sex procedures because it promotes immoral behavior. Do you have views on this subject? If so let me know and I'll pass it on to the class (without your name attached).
Southeast Asia and India are predicted to be the next centers of AIDS outbreaks. In Thailand over 1 million people out of a population of 60 million are infected with HIV. There they have found infection rates of 38% in commercial sex workers, 12% in Royal Thai Army recruits and 16% among men using STD clinics. In Asia HIV infection is almost EXCUSIVELY HETEROSEXUAL in nature and the virus seems to have evolved to be more infective in the heterosexual situation. The Thai government has undertaken an extensive educational program of safe sexual practices which is reported to be having a significant effect.
Further, new strains of HIV are being reported, some which seem better able to establish an infection via the vaginal route and others the anal route. It would appear that either evolution is working pretty much as predicted or, if you believe that the CIA/KGB made the virus, they are still at it and someone should find out where they're doing this work and ask them to please stop (I'm being sarcastic here folks, so don't take that last statement seriously).
One glimmer of hope has come from a recent finding (Sci. Nov. 1995) that 8 people in Australia that were infected with a weakened mutant of HIV 15 years ago have not developed AIDS and may even be resistant to catching the virulent form of HIV. It is speculated that this weakened form of HIV, or some derivative of it, might serve as a LIVE VACCINE to immunize people against HIV. How many of you would allow yourself to be vaccinated with a LIVE HIV? See TIME Nov. 20, pg 100 1995. http://pathfinder.com/@@RZ4NcnHtIwMAQL9V/time/magazine/domestic/1995/951120/medicine.html
ANSWER: Well that attitude might be all right if biology wasn't involved or if the person asking that question never had to worry about meeting other humans. However, there are serious CONSEQUENCES if nothing is done about HIV.
THE COST: It now costs >$100,000 to treat a person with AIDS and that cost
is usually borne by society (read TAXPAYER or just fill in your name).
It doesn't take a rocket scientist to multiply the number of HIV infected
people by 100,000 to come up with a rather humongous, I mean seriously
huge, like mind-boggling monstrous, number that has to come out of our
pockets. At a time when society is trying to limit spending on medical
care, it would seem this presents somewhat of a fiscal dilemma.
TUBERCULOSIS: The TB bacterium is, unlike HIV, ridiculously easy to catch.
Further, it is tough as nails and lasts one hellish long time outside the
host. TB is spread through the air, food and water. Finally, if you're
not pale, and feeling sick to your stomach yet, consider that new antibiotic
resistant forms of TB have developed which makes treatment virtually impossible.
"What does this have to do with AIDS anyway?" you alertly ask? Gee I'm glad you asked that question (pick your bribe up after class); let me tell you a SHORT STORY with a definite MICROBIAL TWIST.
ONCE
UPON A TIME it seems there were all these sick people with this nasty disease
called AIDS, which we good and decent people didn't get (we told ourselves)
because we are so darn cute, neat and wonderful. However, the evil witch,
Mother Nature and her toady companion Evolution, didn't think we good people
were all that wonderful except as nutrient-rich mobile-lumps of juicy meat.
So the two of them brewed up something rather nasty to get our attention.
It seems that people who have AIDS are immunologically COMPROMISED (but you knew that) and all sorts of microbes love to grow in them, including the TB bacillus. So when Joe, one of our friendly homosexual, homeless AIDS patients, goes in for treatment at the local free-clinic, it's found that he has a bloody awful fulminating case of TB (bummer!). Antibiotics are prescribed and Joe is told that he has to take the medication every day for the rest of his short miserable, pain filled life. Poor Joe stumbles out of the clinic, takes the crowded subway and, being at heart a friendly, sharing person, infects the 50 or so people pressed up against him with his TB. He's rather depressed at the additional rotten news, so he goes on a two-week drunk & forgets to take his medication. But he has taken just enough to begin to select out RESISTANT STRAINS OF HIS TB BACILLUS. He doesn't bother to return to the clinic to pick up more TB medication since he knows he's going to die soon and they can't do anything about it. In the meantime he's become a one-man-coughing-walking-sitting-beside-you-on-the-bus/subway/movie foci of antibiotic resistant TB. Joe will be remembered by many of us when we get our next chest X-ray and find out that he's left us with something that just keeps on giving.
See report on recent spread
of TB: http://www.the-scientist.library.upenn.edu/yr1996/feb/hot2_960205.html
So what do we as a society with the Joes out there? Do we leave those with HIV infections to the not-so-tender mercies of mother nature, who uses Joe and his buddies as walking cultures for things like new strain of TB and other nasties which may eventually infect you and me?
THE
LOSS OF TALENT: AIDS has taken a terrible toll of creative male
homosexuals in this country and is on its way towards taking many lives
of young heterosexuals around the world. Is this a loss we want to have
happen? Will the world be better off with the death of these young people,
who after all are our brothers, sons, cousins and uncles?
DISRUPTION
OF SOCIETIES: As societies have to expend increasingly amounts
of their limited resources in caring for those ill from AIDS and related
diseases (e.g. TB), and as many of its CREATIVE young professionals die
from AIDS, it will DESTABILIZE these societies once those costs exceed
a certain amount. For example, they will not be able to pay off their debts
which may, in turn, disrupt the world's banking system. Since the world's
economy seems to be IRREVOCABLY LINKED, can we expect to avoid problems
from these disruptions in banking and trade?
SHIFTING
OF RESOURCES TO MEDICAL CARE FROM OTHER NEEDS: As limited resources
are required to treat the burgeoning ill population, this takes money and
manpower from other creative activities such as education, maintaining
the industrial infrastructure, research etc.
The
prevention of STDs is actually VERY SIMPLE. It doesn't require morals,
ethics, that you be a religious or non-religious person, or that you are
even a law abiding person. It does require that you HAVE KNOWLEDGE and
that you UTILIZE THAT KNOWLEDGE. The microbes that are responsible for
STDs all depend upon humans ENGAGING IN OODLES OF UNPROTECTED SEX to transmit
them. Without that activity most STDs would VIRTUALLY DISAPPEAR from the
earth in one or two generations. Consider that the microbes evolve to take
advantage of human behavior not vice versa. The following is a list of
simple steps you can take to minimize your chances of contracting a STD
(please avoid laughing until you've finished reading them).
Avoid having sex until marriage and then remain MONOGAMOUS within the marriage
(I'm serious).
Know the ENTIRE SEXUAL HISTORY of everyone with whom you are going to have
sexual intercourse. Remember that MICROBIOLOGICALLY you are having sex
with EVERYONE your partners have had
sex with in their past. When you buy a used car you inquire into its history
and it can't give you a fatal disease.
Sexually active individuals planning to have sex together should have an
exam for STDs, including an AIDS test, and, if either has had sex with
anyone else, they should NOT HAVE SEX with anyone for three to six
months before having a second AIDS test to VERIFY that BOTH ARE FREE of
the HIV virus. (This defines WILL POWER).
Never have UNPROTECTED sex unless you have followed I through III. Condoms
offer some degree of protection against all STDs. However, the "heat of
passion" often renders condoms less effective.
I'm sorry that I can't offer you any easy answers to A VERY DIFFICULT PROBLEM. I am very aware that the ABOVE CHOICES are, in today's social & moral climate, so difficult as to make them comical. However, I know some people who have followed these rules and they seem perfectly normal, well adjusted and happy. However, the characteristics of the STDs don't leave me any alternatives. You may choose not to take the above advice seriously, but that will be like not taking gravity seriously when you're sky-diving.
Phone: 509-335-5108
Fax: 509-335-1907
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