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AIDS Watch: You Know What You Know

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But are you certain you’re right?

by Kelly A. McCann

Sometimes in life, we think we know something, but we later find out our previous beliefs were incorrect. For instance, a fourth-grade friend of mine believed that a woman inserted a tampon by swallowing it, and that the tampon simply made its way through the body to its ultimate destination. I don’t know how she got that idea, but you can imagine her embarrassment when she later learned the actual (and much more direct) method!

Inaccurate viewpoints are not always the product of an active childhood imagination. Sometimes our false beliefs are the result of outdated scientific thinking or conventional wisdom. Take Pluto, for example.

Throughout my childhood and adolescence, I greatly enjoyed stargazing. I spent hours with my telescope and star charts scanning the nighttime skies for celestial objects. In school, we studied rockets, the space program, and our solar system. As part of my education, I learned that Pluto was a planet, and I was certain of that fact for most of my life. Then in 2006, the International Astronomical Union decided that Pluto didn’t quite meet the criteria for a planet, and was instead a “dwarf planet.”

There are other examples of updated research changing our views. My planetary discussion provides a natural segue to next focus on your anus (get it? Uranus!) and examine some things we used to think we knew regarding HIV and safer sex.

In the very early days of the HIV epidemic, oral sex was thought of, and even marketed, as safe sex. The idea at the time was that unprotected anal penetration was required for sexual transmission of HIV. I’m sure many gay men engaged in unprotected oral sex, feeling safe in the knowledge that they were not at risk for HIV infection. Sadly, I’m also sure a few of them were infected due to that false belief. Later on, during the 1990s, scientific literature and safer-sex education began to relay the more accurate message that oral sex is not safe sex.

While oral sex is a relatively low-risk activity compared to vaginal or anal intercourse, it is possible for HIV to be transmitted through unprotected oral sex. Moreover, the risk of transmission increases if the person performing the “job” has cuts or sores in his mouth, since they can serve as a portal of entry into the body for the virus. It should also be noted that unprotected oral sex can easily transmit other serious infections such as HPV, gonorrhea, and syphilis. And those infections can be transmitted to either partner during oral sex.

Other cases of misinformation abound. In the mid- to late-1990s, I was employed as an HIV educator at the Montrose Counseling Center. I was trained through a much-respected program at the American Red Cross, and my training was regularly augmented through attendance at conferences and reviews of journal articles. As part of my job, I traveled all over Houston and southeast Texas doing HIV and safer-sex presentations. During that time, I educated persons in prisons and juvenile detention facilities, residents at assisted living and inpatient drug and alcohol treatment centers, students in high schools and universities, and members of churches and community groups.

In many of those presentations, I disseminated information about the benefits of using condoms lubricated with nonoxynol-9, a spermicide. The idea at the time was that nonoxynol-9, which killed sperm and had been shown to kill HIV in laboratory settings, offered added protection against HIV infection.

That way of thinking changed drastically on June 25, 2002, when the World Health Organization issued a statement that unequivocally communicated their findings that nonoxynol-9 did not protect against infection with HIV. More disturbingly, the report went on to state that “there is evidence that nonoxynol-9 may cause harm by increasing the frequency of genital lesions.” That meant the use of the spermicide may have actually increased one’s chances of becoming infected if exposed to HIV. Chilling.

And we were recently informed of yet another change in the conventional wisdom of safer sex. A study presented at the International Microbicides Conference in May 2010 found that people who used lubricants during anal sex were three times more likely to have sexually transmitted rectal infections (STIs) than those who didn’t use lube. What?! Why?! How?!

Another study presented at the same conference evaluated the safety of five different water-based lubes used for anal sex and found many of them may actually make one more vulnerable to STIs, including HIV. This study analyzed Astroglide, Elbow Grease, ID Glide, KY Jelly, and PRE, as well as one silicon-based lubricant, Wet Platinum. Tests examined the effects the lubes had on the epithelium cells lining the rectum.

It was found that lubricants with higher concentrations of dissolved salts and sugars than are found in skin cells dried out the rectal epithelium, possibly increasing oneís risk of contracting an STI via anal intercourse. According to the study, Astroglide was the most toxic to rectal tissues, while Wet Platinum and PRE were found to be the safest.

More research into the effect of lubricants on HIV transmission is desperately needed. In the meantime, however, please consider using one of the safer lubricants along with a latex condom.

And be sure to stay abreast of the latest studies. You just never know when the rules are going to change.

Kelly A. McCann is chief executive officer of AIDS Foundation Houston. To learn more, please visit the AFH website at AIDSHelp.org.

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