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Is Asking People to Have Sex with Less People Appropriate for STI Prevention?

This question came up at work yesterday, in relation to an article on HPV and Gardasil.  I felt kind of uncomfortable about the advice “limit your number of sexual partners” related to HPV prevention, because to me, it feels like a value judgement.  But what’s the equivalent?  My instinct is to say “have mature, open conversations about safer sex with all your partners, no matter their number.”  But numbers-wise, this technique doesn’t achieve the same goal as reducing partners.  HPV transmission isn’t fully prevented by the use of barriers, though they certainly help.  It’s also hard to know whether you have HPV, because a lot of people do have it, and thus screening tests aren’t common under the age of 30.  It doesn’t show up on a Pap smear.  So technically speaking, limiting your number of partners is the most effective thing to do, in addition to practicing safe sex.

On the other hand, when it comes to something like HPV, I’m unsure what the risk/benefit calculus really is.  For example, many women who have sex with women don’t use barriers because frankly, it’s a pain in the ass.  It’s not a community standard, and STI risks are low enough that some people don’t think using a dental dam or gloves is really worth it.  You might make a similar choice about HPV–I probably have it or have had it, it’ll probably clear up, what’s the big deal?  Maybe this is more about stigmatizing STIs than anything.  It’s all well and good to give advice for prevention, but maybe what’s more important advice than anything is “get tested after 30, look for lingering cases, have regular Pap smears in case an issue does show up before then.”

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