Sound off!

Estimating how many sexually transmitted disease or infection cases occur is not a simple or straightforward task. First, most STDs/STIs can be 'silent,' causing no noticeable symptoms. These asymptomatic infections can be diagnosed only through testing. Unfortunately, routine screening programs are not widespread, and social stigma and lack of public awareness concerning STDs/STIs often inhibits frank discussion between health care providers and patients about STD/STI risk and the need for testing.

-- ASHA. Sexually Transmitted Diseases in America: How Many Cases and at What Cost? December 1998.

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More than half of all people will have an STD/STI at some point in their lifetime. [1]
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The estimated total number of people living in the US with a viral STD/STI is over 65 million. [2] Every year, there are at least 19 million new cases of STDs/STIs, some of which are curable. [2,3]
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More than $8 billion is spent each year to diagnose and treat STDs/STIs and their complications. This figure does not include HIV. [4]
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In a national survey of US physicians, fewer than one-third routinely screened patients for STDs/STIs. [5]
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Less than half of adults ages 18 to 44 have ever been tested for an STD/STI other than HIV/AIDS.
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Each year, one in four teens contracts an STD/STI. [6]
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One in two sexually active persons will contact an STD/STI by age 25. [7]
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About half of all new STDs/STIs in 2000 occurred among youth ages 15 to 24. [8] The total estimated costs of these nine million new cases of these STDs/STIs was $6.5 billion, with HIV and human papillomavirus (HPV) accounting for 90% of the total burden. [9]
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Of the STDs/STIs that are diagnosed, only some (gonorrhea, syphilis, chlamydia, hepatitis A and B) are required to be reported to state health departments and the CDC.
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One out of 20 people in the United States will get infected with hepatitis B (HBV) some time during their lives. [10] Hepatitis B is 100 times more infectious than HIV. [11]
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Approximately half of HBV infections are transmitted sexually. [12] HBV is linked to chronic liver disease, including cirrhosis and liver cancer.
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Hepatitis A, hepatitis B and HPV are the only vaccine-preventable STDs/STIs. (Not all HPV types are covered by the vaccine, so women who receive it still need Pap tests.)
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It is estimated that as many as one in five Americans have genital herpes, a lifelong (but manageable) infection, yet up to 90 percent of those with herpes are unaware they have it. [13]
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With more than 50 million adults in the US with genital herpes and up to 1.6 million new infections each year, some estimates suggest that by 2025 up to 40% of all men and half of all women could be infected. [14,15,16]
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Over 6 million people acquire HPV each year, and by age 50, at least 80 percent of women will have acquired genital HPV infection. [17] Most people with HPV do not develop symptoms. Some researchers believe that HPV infections may self-resolve and may not be lifelong like herpes. [2]
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Cervical cancer in women, while preventable through regular Paps, is linked to high-risk types of HPV.
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Each year, there are almost 3 million new cases of chlamydia, many ofwhich are in adolescents and young adults. [8] The CDC recommends that sexually active females 25 and under should be screened at least once a year for chlamydia, even if no symptoms are present.
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About two-thirds of young females believe doctors routinely screen teens for chlamydia. [18] However, in 2003 only 30% of women 25 and under with commercial health care plans and 45% in Medicaid plans were screened for chlamydia. [19]
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At least 15 percent of all American women who are infertile can attribute it to tubal damage caused by pelvic inflammatory disease (PID) , the result of an untreated STD. Consistent condom use reduces the risk of recurrent PID and related complications: significantly, women who reported regular use of condoms in one study were 60 percent less likely to become infertile. [20]
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Consistent condom use provides substantial protection against the acquisition of many STDs, including statistically significant reduction of risk against HIV, chlamydia, gonorrhea, herpes, and syphilis. [21,22,23]
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Some studies show that, for those who already have a clinically apparent genital HPV infection, using condoms promotes the regression of HPV lesions in both women and men. [24,25]

References

1. Koutsky L. (1997). Epidemiology of genital human papillomavirus infection. American Journal of Medicine, 102(5A), 3-8.
2. American Social Health Association. (1998). Sexually transmitted diseases in America: How many cases and at what cost? Research Triangle Park, NC: American Social Health Association.
3. Weinstock H, et al. Sexually transmitted diseases among American youth: incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health 2004;36( 1):6-10.
4. Institute of Medicine. (1997). The hidden epidemic–Confronting sexually transmitted disease (edited by Thomas R. Eng and William T. Butler). Washington, DC: National Academy Press.
5. St Lawrence JS et al. (2002). STD screening, testing, case reporting, and clinical and partner notification practices: a national survey of US physicians. American Journal of Public Health, 92, 1784-1788.
6. Alan Guttmacher Institute. (1994). Sex and America's Teenagers. New York: Alan Guttmacher Institute.
7. Cates JR, Herndon NL, Schulz S L, Darroch JE. (2004). Our voices, our lives, our futures: Youth and sexually transmitted diseases. Chapel Hill, NC: University of North Carolina at Chapel Hill School of Journalism and Mass Communication.
8. Weinstock H, Berman S, Cates W, Jr. (2004). Sexually transmitted diseases among American youth: Incidence and prevalence estimates, 2000. Perspectives on Sexual and Reproductive Health, 36, 6-10.
9. Chesson HW, Blandford JM, Gift TL, Tao G, Irwin KL. (2004). The estimated direct medical cost of sexually transmitted diseases among American youth, 2000. Perspectives on Sexual and Reproductive Health, 36, 11-19.
10. Centers for Disease Control and Prevention. Hepatitis B Frequently Asked Questions. Updated April 1, 2005. Retrieved April 22, 2005 from http://www.cdc.gov/ncidod/diseases/hepatitis/b/faqb.htm
11. Centers for Disease Control and Prevention. Hepatitis B Prevention for Men Who Have Sex With Men. Online Fact Sheet. Updated April 1, 2005. Retrieved April 22, 2005 from http://www.cdc.gov/ncidod/diseases/hepatitis/msm/hbv_msm_fact.htm.
12. Centers for Disease Control and Prevention. Tracking the hidden epidemics, 2000: Trends in the United States. Retrieved April 22, 2005 from http://www.cdc.gov/nchstp/od/news/RevBrochure1pdfHepatitisB.htm.
13. Fleming DT et al. (1997). Herpes simplex virus type 2 in the United States, 1976–1994. New England Journal of Medicine, 337, 1105–1111.
14. Corey L

Nope. In fact a lot of gals, including self, do not think is or was HIGH on the radar of things to look out for.

I think the main point here is for women to educate themselves on all the different ways to protect yourself while having sex with women. Don't just assume the person you are sleeping with has been tested and dive in au naturel. Good luck. :)

It would be interesting to find out how much research has been conducted on the spread of STI's in queer women's communities. I'd bet it's minimal and part of the reason why we sometimes end up with doctors who don't get it.

I think more people need to examine their own definitions of 'safe sex.' From my experience, everyone has their own interpretation and I think that's a problem. I've met people who don't always feel disclosing their STI's is necessary until after having sex on the basis that they're using barriers and I've met people who think all 'lesbian sex' is low-risk and don't take any precautions! Personally, I appreciate the kind of people who stock up on all four sizes of nitrile gloves.

Hmmm.. it's strange to me that there seems to be so much disagreement.

ummm, just wanted to state that I don't think it is the queer womens community's responsibility to educate health care professionals, such as doctors, but if the only question they have to ask to avoid liability issues is 'are you pregnant' we might be in big trouble here. What does the medical school curriculum cover in terms of lesbian sexual health? Hopefully not the just the history of doctor's vibrator treatments for hysterical ladies/women with mental health problems.

Exactly, winddancer. I understand that doctors need to cover all bases but that means ALL bases, not just heterosexual ones. I must say that the doctor I have now is very good that way but I'm sure we've all encountered those who are not.

y'know, when i read this question, i read 'often', not 'highly'. i certainly have not practiced safe sex 'highly', although, it should be noted that i get a little paranoid so maybe highly isn't such a bad idea for once. hmm.

Definitely not! I havent found one lesbian who does practice safe sex. And have suffered concequences from it... going to the doctor and finding out that i had contracted something from a women was one of the most embarrasing experiences ive had. And when i asked about what to do about safe sex so that i wouldnt have to ever go through it again he was rude and said to not have sex was the only way. He wanted to leave as soon as he gave me the prescription... i had to ask him question after question while he was trying to get out the door... normally i wouldnt admit to something like this but i do think its important to know that we can get things from each other and we should be taught about safe sex without feeling like scum

*I just want to add that I came out of the education system still baffled about safe(r) sex with women.

That shouldn't still be happening...

There is such a lack of education about safe lesbian sex out there.

When about to have sex with a guy, CONDOM CONDOM CONDOM CONDOM CONDOM pops into my head, and I'd never go for it without one.

However, with women, that sexually knowledgeable part of my brain never lights up.

It's a shame, and as others have already said, doctors don't always have very useful information, either.

dani that is your opinion the point i am making is that doctors assume that any sexual activity is heterosexual.

Thinking your older wiser and trusting that someone your about to jump after the 2nd or third date, women are no different than men when it comes to lying their asses off about history. How many of us have gotten checked out after dating a liar?

I know there are ignorant doctors out there but asking if you are pregnant is one of those questions they have to ask. My doctor has known I am a lesbian pretty much as long as I have and she still asks because she has to. We laugh about it together but I know she is just covering all the bases. We all know that just because someone identifies as a 'lesbian' does not mean they do not have sex with men. That's a whole different conversation!!

lol issyvoo is so right; i moved recently and unfortunately am with a male doctor right now. He asks me if im sexually active to which i replied 'yes'. Then he goes on to say, 'could you be pregnant?' talking on about female issues etc. Assume away... unless it is the immaculate conception, er, no. lol That is our society tho; heteronormativity.... ::yawn ::

Honey28 brings up a whole issue that I'm sure most of us have faced: ignorant doctors. It is really annoying to have medical professionals assume that 'sexually active' means 'heterosexually active.' If you're shy or upset, it can cause you to avoid asking the questions you want to ask. It can also make you simply less inclined to like and trust this doctor, or that's my experience anyway.

In need of antibiotics, my physican (surprisingly female and to my 'gaydar', dyke-like) meandered at length about the precautionary measures I would need to take to prevent pregnancy. So I figured this would be a good time as any to remind her that I have not come to her for a form of birth control for the last three years. I also proceeded lightly by saying, that 'I don't have sex with men, but women'. Her shock value was priceless, and so I figured I'd have a little fun by asking her what she knows about safety measures when it comes to sex with women. She literally stumbled on her words, and said she'd look it up and get back to me. She did say however, that I should be 'less worried about catching an STD from a female, than a guy'. 'Oh gee... yeah, thanks. Put my mind right at ease'. WTF?! I will also add, that I get attitude for booking an appointment for an STD check only six months from the last. What can I say or do? We broke up. This is now inconvienient? Imagine how many appointments I'd need if I became infected with AIDS. So how do you know REALLY that the girl you've been seeing did in fact get screened? You know without a doubt that she went. Does that raise your eyebrows? I mean, unless you went up to the office with her? How many of us really wonder, 'did she, or didn't she?' Trust, you say? That's a another question. I even had one person say she had been tested after her last partner, and I 'trusted' her. Only, later to find out that she had used a strap on with someone else, but that did't disqualify her from possibly being a carrier of a sexually transmitted disease. *(Note to self: To use a strap on, is indeed, a sexual act.)* Sadly, she still valued herself as 'safe', or at least safe enough to have sex with me. 'Hmph', to that nonsense. In my experience, not one person has asked me if I was 'safe' or not. Ahem! A dental dam? Gloves? Yikes. I suppose this would be why I raised this question on SD in the first place. I think sex education in school should be a manditory full course; family management simply just isn't enough. Hmm...I ofter wonder where Dr. Wilson went to, she never did get back to me. Perhaps she got lost in the closet? Flashlight.

I don't think is practice so much on young women because some of them don't know how to practice safe sex or they think that 'girl on girl action' is already safe compared to having sex with a male. I was shocked when I heard a young lesbian saying that is ok to have sex with another women without any protection beacuse girls can never get any contagious disease between them.

I don't think that it is practiced as much because women's sexuality is so limited in our culture (let alone lesbian or queer sexuality) that it is just not talked about. In fact, I was in the pharmacy yesterday looking for backache medication and looked at the condom section -- they have a whole wall of condoms, yet no dental dams anywhere (or latex gloves for that matter). Also, I would say that the majority of lesbian imagery out there is found in pornography for men. There are very few images of women practising safe sex in those images, nor in many women-produced erotica sites. And even then, images of lesbians generally are sexually gratuitous -- (ie someone makes money off them). Practising safe sex requires a level of communication that is even more rarely talked about than sex (ie intimacy). So, it makes complete sense as to why safe sex is still something that the community needs to talk about.

my post was cut off!
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Probably not. Why? It's a practice decided by a 'person' in relation to whatever views/info they believe. Very subjective.
And we're trying to intoduce rules

here's one: become friends first. less lesbian drama, less people to worry about catching a disease from.

It should be practiced more often. But then again same goes for straight sex. The world in general just doesn't care much for sexual awareness, and the attitude still is that its not that big of a deal. I guess it would also help if more people were open minded about it when it gets brought up in sexual relationships.

if im having sex its safe

Wow! now that's some expensive sex!!

Safe sex: $1511.72 cell phone bill ;)

If my girlfriend at the time watch well two of her friends beat me up that not love why didn't I see that

Thanks dykeacess-it is an oxymoron because wrapping a vagina in a a condom seems difficult.

oh wow. good question!

there is a reason it's called 'safer sex' for the other orientations and 'safe' for lesbians. well, at least for this one...

... if i ever confused 'safe' with 'safer' and actually went to the store and got the dam and the gloves--i know that whilst standing in line to pay for it, i'd probably get to thinking about how effing weird it's going to be to have someone's potentially diseased nubbly bits squiggling beneath my warm, wet, potentially disease-vectored mouth, separated only by a thin film--that would be the end of the potential sex, thus i would be properly engaging in safest of the safer sex, which is awkward sex (for me), which is the no sex (for me), which is safe sex.

so, definitions established, in the past, i have to admit that there are a few times i wish i made 'a trip to the store', but, against my better judgment, i didn't. to make up for it, i make trips to the doctor to make sure my pap/blood work is always up to date (i.e. i get a doctor to confirm my cleanliness before i jump someone new--it would be nice if more lesbians took their sexual health a bit more seriously in this respect). and i make a lot more intellectual/theoretical 'trips to the store', if only to avoid emotional hang overs.

sate.

The points that I would like to make have also been made by other HIV/AIDS researchers, some of whom I have worked with in the past. You can find the articles associated with these researchers online:
Anne Harris: “By November 1993, 40 percent of AIDS cases worldwide were among women, and three out of four women in this country with AIDS were women of color. The few avaliable statistics offer crypic clues about the persistent invisiblity of the lesbian AIDS population: By the large, HIV-positive women comprise pre-exisiting minorities of gender, race, class, and sexuality.While HIV-positive women do get many of the same infections that their male counterparts experience, hormonal differences in women create different absorption rates of medicine. And as almost all AIDS research has been conducted with white male subjects, much of what is known about AIDS and immunodeficiency disease in general is not specific to women's bodies.�
2) 'Dr. Jeffrey Laurence (M.D.) explained that studies have shown that a reliable laboratory can isolate HIV in the saliva samples of about 25% of HIV-positive people. The same labs can isolate HIV in 100% of blood samples from the same people. In those saliva samples in which virus can be found, the concentration of virus is much lower than in blood, semen, or the already low concentrations found in vaginal or cervical secretions. The low concentration of virus in saliva may mean that saliva is less likely to cause infection than blood or other body fluids. This is certainly supported by test tube and animal studies of infectivity.' As Crow points out, tests with monkeys and humans show that chemicals within saliva inhibit the transmission of the HIV-virus, not prevent transmission entirely.
3).In the same article from the fall of 1995, Crow described her visit to the National Gay and Lesbian Health Association's 17thLesbian and Gay Health Conference in Minneapolis. She tried to add validity to her assertions that HIV was transmissible through unsafe sexual relations between women by writing about the HIV-positive lesbians she met at the conference. Describing the event, she recalled, 'I sat in a room with about forty other lesbians and listened in awe to the stories shared there. Over half of the women in that room were HIV-positive' ('Attention'). Using the anecdotal story, Crow tried to prove to her critics that women who contracted HIV from other women were not figments of the medical community's imagination, but rather living breathing women who suffered just like any other HIV-positive person. Logically, Crow argued, if she met these people herself, they had to exist. In addition to highlighting the existence of HIV-positive lesbians, Crow's statement that 'over half of the women' present at the conference were HIV-positive likely shocked female readers who doubted her assertion. The decision to quantify the HIV-positive lesbians she met at the conference created an image of a specific number of people in the readers' minds. This gave lesbian and bisexual readers a more concrete idea of the extent to which the HIV/AIDS epidemic affected their lives.
'Throughout the same fall 1995 article [from Outlines], Crow continually referred to the misconception within lesbian and bisexual women's communities that sex between women did not transmit HIV. For example, after referencing the lack of medical documentation related woman-to-woman HIV transmission, Crow asked, 'Wouldn't we be 'special' if lesbians could not pass the virus on to one another?' ('Attention'). Using this rhetorical question designed to point out the flaws in her critics' logic, she implied that some lesbians and bisexuals believed that sexual relations between women possessed a mythical protective quality that other sexual acts did not. The implication that there was something especially protective or innately 'cleaner' about sex between women likely served to validate and empower female lesbian and bisexual readers, though only temporarily.'
4) As to the transmission of herpes simplex I and II in the lesbian community, there is a good discussion on the message forums under STI's and STD's under 'nasty dykes,etc.'
5). I've been doing HIV/AIDS research at the university for 15 years; I do not have any sexually transmitted diseases or infections because of my largely monogamous sexual history, but I recommend regular, sexual testing for women who do and do not identify with the lesbian community, for every woman who is sexually active. Hope this helps-- it's an old discussion that's been around since the early '90s, and acid_burn is right, researchers have not done the epidemiological, biomedical and statistical research with lesbian-identified women because the funding or interest does not exist.

Though I am not sure I should have posted on here, seeing as Im a tguy, not a lesbian. I hope theres still some identification to what Im saying

Dykeacess: Very good point. When someone says 'STI' It's easy to think of all the stereotypes of people and STIs they get. I'm not assuming everyone automatically thinks those stereotypes, just to be clear. I'm going to through caution into the wind here: When I was in my late teens I was a sex trade worker. I've caught my share of STI's, I unfortunately caught one I will live with for the rest of my life and I know all the precautions I need to take when having sex. Thankfully I don't enjoy receiving oral so it's a matter of my partner either wearing gloves or washing thier hands after. In terms of giving oral sex, if I feel even the slightest bit achy or sick, I won't do it. At this point I'll wear a strap on for whomever I am with but after my final surgery I will have to learn a whole new ball game (No pun intended). I know I have been very careful and protecting my partner is the very top of my priority list. One of the first things I do when I start dating someone is tell them about my STI, and if they are fine with it I always check back in a couple weeks later just so they've had time to think. Respect for them is paramount.

I got my info from a private lecture I attended that BCPWA spoke at. I've also been a full time caregiver of a family member who passed away from AIDS complications and have a number of friends who have HIV. I also worked as a professional in the mental health/addictions field and a lot of my clients had HIV or HEP C. I know JUST saliva alone poses no risk, but if there are open sores, bleeding, etc, that definetly poses a higher, but still very small small risk. Perhaps I could have worded my original post differently as I'm not sure I communicated my point correctly. Sorry about that!

I'd like to say with myself it is as well, is it practiced enough no, there is the base assumption that becasue we are 2 women engageing in sex it is not necessary to protect ourselves...I think women such as strawberry, who think that safe sex among women is like an oxymoron, need to check into mouth diseases as well as vaginal diseases...I have been laughed at for pulling out gloves, I'm sorry but I like biting my nails and I'm not willing to put my hands in my mouth after havng sex with someone I barely know..

http://www.lesbianhealthinfo.org/your_health/stis.html

but still no info about numbers, scope of 'issue'

Just to respond to the the two comments below. Thanks for saying these two myths around HIV. They're really common.
clean_sober_transguy - you're right in the 90's doctors used to say that you could get HIV if you drank a gallon of someone's saliva. They were basing that on the fact that every body fluid contains traces of HIV (NOT enough for transmission) so it seems logical that if exposed to enough saliva transmission would be possible. However, doctors now know that HIV is NOT spread through saliva. So go ahead and drink a gallon of it, no judgement. You're not at risk.
HIV is only transmitted through 4 body fluids. Blood, Semen, Vaginal Fluids, and Breast Milk.
That's it.

Just to respond to the the two comments below. Thanks for saying these two myths around HIV. They're really common.
clean_sober_transguy - you're right in the 90's doctors used to say that you could get HIV if you drank a gallon of someone's saliva. They were basing that on the fact that every body fluid contains traces of HIV (NOT enough for transmission) so it seems logical that if exposed to enough saliva transmission would be possible. However, doctors now know that HIV is NOT spread through saliva. So go ahead and drink a gallon of it, no judgement. You're not at risk.
HIV is only transmitted through 4 body fluids. Blood, Semen, Vaginal Fluids, and Breast Milk.
That's it.

Just to respond to the the two comments below. Thanks for saying these two myths around HIV. They're really common.
clean_sober_transguy - you're right in the 90's doctors used to say that you could get HIV if you drank a gallon of someone's saliva. They were basing that on the fact that every body fluid contains traces of HIV (NOT enough for transmission) so it seems logical that if exposed to enough saliva transmission would be possible. However, doctors now know that HIV is NOT spread through saliva. So go ahead and drink a gallon of it, no judgement. You're not at risk.
HIV is only transmitted through 4 body fluids. Blood, Semen, Vaginal Fluids, and Breast Milk.
That's it.

I don't think it's as highly practiced. As for aeden's comment on saliva, you would have to drink at least gallon of someone's saliva for it to pose any risk. However open cuts/sores definetly pose a higher risk.

Herpes is a fairly easy one to catch (Not that any of us go out attempting to rope it in...at least I hope not). Between outbreaks there can still be viral shedding which would pose a high risk to your partner.

NO! it's not! And it's because of lack of education - especially about HIV. HIV might be least prevalent among exclusive-lesbians, but it *is* possible to contract HIV from simply an extended night of all out deep kissing. *If* you exchange bodily fluids - even saliva - *then* you are putting yourself at risk for HIV. Period. It's less likely, but still possible, and it happens. So educate yourselves. Get tested, and play safe. (Please?)

It's definitely not practiced. I've never once had somebody even bring it up. I do request that the person has an STD test. But that isn't fool proof since people could lie, or go sleep with somebody after. Plus certain STD's don't show up for months. But the reality of it is that even if the person had something like HIV, it's pretty unlikely you would get it from oral sex. The things you are likely to contract are herpies and the like. But really, straight couples never even practice safe sex around herpies since a condom does not cover everything.

So I'm not sure that I think it needs to be practiced more in terms of using dental dams. I mean, they aren't overly affective anyway given that there is no reservoir type thing to direct any bodily fluids. I do think that people should be getting tested more often! Especially if you are also sleeping with men given the higher risk of contracting something.

with me it is

So how do you have safer sex with a woman then?

*would help

no, it is not. it seems like most women feel it is too much of a hassle to practice safe sex. And we are so often taught that lesbian sex is very 'low-risk' and that we don't need to use dental dams, etc. personally, I think more comprehensive sex education (including practicing safe sex with toys) in school and better availability of dental dams/gloves etc (lower prices would be nice).

No! Safe sex with women is an oxymoron.

anyone want this as a thesis topic? i would say no, and it's not good enough. What about lesbian sexual health research, stats, we don't even have anything going on, it's terrible. can't even buy a dental dam at the shoppers...why? this is someone else's research gap, i hope.