There has been much attention paid to AIDS and HIV in the general public. This attention has often exaggerated the dangers from multiple heterosexual partners and specifically exaggerated the dangers from the lifestyle. See the following web site for more information.
We have correctly challenged the claim of high AIDS risk from unprotected heterosexual sex. However, we have probably erred by implying that sexual play with multiple partners is risk free. Intimate contact with others frequently spread germs. There are disease risks with intimate contact. There are also strategies to reduce the risks. The highest disease risks (all of which we have seen at our couples massage events) are the following:
There are strategies to prevent infections and reduce risks. These strategies still allow couples to enjoy erotic pleasure with others. We have listed three categories of strategies and we have named them "minimal, moderate & highest." Each strategy provides a different level of protection. The "highest" strategy provides the most protection. Strategies can be mixed or matched depending on comfort levels.
Minimal Prevention Strategies
1. Check your genitals, labia, penis and anus for cuts, sores or open wounds. Check your mouth, lips and tongue for sores. Do not participate in sexual play involving direct skin contact with open sores. Do not participate in sexual play when you have cold or flu symptoms.
2. Check your spouses and sexual partners for sores. Do not participate in sexual play with a partner where there is direct skin contact with open sores.
3. Wash your hands and urinate after sexual play. Use this strategy before playing with a different or new partner. Drink plenty of water. There is evidence that urinating after sexual play reduces the risk of UTI.
4. Use lubricants particularly when playing with multiple partners. Avoid frequent hard or rough play. Both of these methods will reduce the risks of abrasions.
Moderate Prevention Strategy
1. Use male or female condoms with intercourse.
2. If you are attending a massage weekend and you plan to use condoms, please bring your own condoms. We usually have condoms available, but DO NOT DEPEND ON US TO HAVE CONDOMS AVAILABLE WHERE AND WHEN YOU NEED THEM. You need to plan ahead with supplies. You need to inform your "playmates" you require condoms. You need to not depend on anyone else to offer condoms or "model" the use of condoms, including US as leaders.
3. Create a means to communicate to new partners your preference for condoms or other strategies, BEFORE THE HEAT OF PASSION. Therefore, in the heat of passion all participants would share in the responsibility to use such strategies.
Highest Prevention Strategies
1. Use latex shields when having oral sex.
2. Avoid intercourse and/or oral sex with multiple partners.
3. Use erotic massage as a substitute for oral sex or intercourse with multiple partners.
4. Use same room sex with your monogamous partner, watching and being watched, as a substitute for oral sex or intercourse with multiple partners.
Choosing A Strategy That in Comfortable for You and Your Partner
In all aspects of living there are risks. There are risks in driving your car to work. There is virtually no activity, particularly recreational activity, that is risk free. There are risks in downhill skiing, swimming in the ocean, playing golf and hiking in the woods. There are also great pleasure and great enjoyment gained from recreational activities. It is sensible that we evaluate recreational sex in the same way we evaluate other pleasurable activities. We cannot expect it to be risk free. However, we can minimize the risks. From our experience, here are the factors that allow us to take greater risks:
# We can take greater risks when we have more information about our new sexual partners.
# We can take greater risks if we believe our new sexual partners can be longer-term supportive friends.
# We can take greater risks when we as a couple have talked about it and are taking the risk jointly.
# We can take greater risks if we are gaining greater enjoyment.
# We can take greater risks when we accept the possible need for medication or other treatment, just as one accepts the possible need for sunburn medication when vacationing at the beach.
# We can accept greater risks when we know we also have the option of accepting lower risks if we are uncomfortable. We are not locked into only the two options of monogamous sex and unprotected intercourse. We can develop a full menu of erotic pleasuring options depending on our sense of safety.
Couples who attend our massage events use a variety of strategies. Some use condoms, some do not and some only enjoy erotic massage.
Of the four highest risk infections, Genital Herpes raise the most fears and concerns. This is not because it is more dangerous. In fact, a server bronchial inflection or flu infection is harder to treat and will likely result in more sever symptoms. Genital Herpes however, raise more fears because it is contacted only through sexual play and therefore is more embarrassing.
Herpes type 2, or genital herpes, is a viral infection caused by the herpes simplex virus 2 (HSV-2). It's transmitted sexually, and typically causes blisters on the male and female genitals that rupture into painful red sores. HSV-2 is closely related to HSV-1, the virus that causes cold sores around the mouth. Both viruses can infect either the genitals or the mouth. HSV-2 may be transmitted even by people who have no symptoms and are unaware they are infected. Most people who have herpes find that it recurs; while there are effective treatments, there is no cure. Most people see one to three outbreaks of this in the first six months and then with medication (frequently) never see it again.
According to the Center for Disease Control, in the U.S., 45 million people aged 12 and older, or one out of five of the total adolescent and adult population, is infected with genital herpes. It is more common in women (25%) than in men (20%). So, in a group of 10 couples, 20 people, (likely) 5 people are positive for genital herpes. People should then act with the assumption others are positive rather than that others are likely negative. Many people who have tested positive for the virus that causes genital herpes, but say they have no symptoms of the disease, may in fact have the virus in their genital tracts (The New England Journal of Medicine, March 2000, Dr. Wald). This is important, researchers say, because it means that -- contrary to popular belief -- asymptomatic people are potentially infectious, and they could be unknowingly fueling the herpes epidemic.
Before people quickly rush into getting "emergency" blood tests, please keep in mind that the article published in the New England Journal of Medicine was only published in March 2000. The most recent US Public Health Guidelines of several years ago referenced that type 1 and type 2 could not be distinguished by a blood test, thus culture of an active lesion was the best way to positively diagnose HSV 2. Even that was not 100%. The average good up-to-date practicing physician would be following US Public Health Guidelines regarding testing, which do not recommend screening of asymptomatic people. The guidelines do not recommend blood testing, either. The year 2000 Griffen's "Five Minute Consult" book also says that the blood test for Herpes cannot reliably distinguish type 1 from type 2. Dr. Wald's research was possible only because a better blood test became available recently, allowing her to study asymptomatic people with positive blood tests.
A 2005 review of CDC statistics show:
Population based blood tests show + in 22% of adults aged 17-74. (Up from 13% ten years ago or so.) 30-40% of the below the waist lesions are the common mouth cold sores HSV1, so condoms don't provide absolute protection and other activity that we all love is also risky. Rate of transmission to
a frequent partner of a blood test positive person is 10% women to men and 17% men to women. Over 70% of people who become blood test positive don't have any symptoms. Contrary to previous "wisdom", only about 30% of people have any symptoms at the time they are "shedding" the virus and could pass it on to
a partner. In women who are known to have HSV2 or HSV1, the swabs for viral shedding occurs 2% of days. That would mean that about six days a year a woman who doesn't know she has it could pass it on. They haven't done shedding frequency in men, but it must be a little higher by those statistics.
None of us wants to hurt someone. Yet it is so hard to think that something that isn't hurting you could hurt someone else. Of course, fear of colds or cold sores never stopped us from kissing our children or our partners. Yet we routinely pass other viruses and bacteria to our friends and loved ones all the time, with a relative clear conscience. And, of course, all the studies from hospitals show that health care workers routinely pass on deadly bacteria to vulnerable patients, (which causes
almost comical-looking efforts to correct.)
We have found the following web sites to be helpful. Please note that the second and third are sponsored by pharmacists companies who are selling products. Nonetheless, their information is helpful.
A Personal Comment on Our Chosen Strategy: Condom Use
We hate to use condoms. However, we use them about 95% of the time. Though they are not perfect, condoms significantly reduce the risk of genial herpes and warts (recent studies of women show 1 in 7 are positive for HPV virus). We hate condoms because they are hard to put on, reduce the erotic pleasure and often cause an erect penis to become not erect. Nonetheless, we have come to the conclusion that they are the safest method for couples active with many partners, yet still allow for significant sexual fun. We have also experimented with female condoms, which reduce the likelihood of erection difficulties. We would like to dialogue with other couples about their experience with condom use, female condoms and other ways to use condoms without decreasing erotic pleasure.
A few final comments on condom use;
1. Buy the large size with easy tear-open package. This has nothing to do with your penis size. It has to do with the ability to slip it on quickly. Large size condoms slip on easily, and therefore are most likely to be used. A struggle to put on a condom will result in loss of erection.
2. Condoms only go on one way. No one has ever told me this fact, and I have yet to see this fact stated on the packaging. Practice with a condom. You can easily determine which way it rolls by starting the roll down your thumbs. If it doesn't roll flip it over.
3. Tell your new partner (at a lifestyle event or any party) that you use condoms. Tell this to your partner before you begin to play. Get your supplies close by before you begin to play. This information will help you and your new partner to anticipate the need to put the condom on.
4. If you are a man, "forgive" yourself if you loose your erection. If your a women, tell your partner "condoms make men loose erections, it's ok, I very much appreciate you using one."