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.”

About Avory

Avory Faucette is a queer feminist activist, writer, and public speaker. Zie graduated from the University of Iowa with a JD in 2009, focusing on international human rights and gender/sexuality issues in the law. Hir current work focuses on queer identity, policy, and marginalized identities under the queer umbrella. As a genderqueer person, zie comments frequently on non-binary identity, transgender and genderqueer issues, and media coverage of these populations. Zie also speaks at colleges, universities, and events on transgender and queer issues and conducts trainings on related topics.

Posted on December 16, 2010, in sex and tagged , , , , , , , , , . Bookmark the permalink. 2 Comments.

  1. I don’t think doing patient/client education about the fact that having fewer partners reduces one’s risk of HPV is at all the same as passing judgement. I think it’s completely possible to say, without judgement, “If you want to reduce your risk of HPV, you can use barrier methods (although they are not all that effective), you can limit the number of sexual partners you have, or you can be completely abstinent (which is not all that realistic).” “Limiting your number of sexual partners” is not a value judgement, it’s public health data. I also agree that having mature open conversations is GREAT.

    HPV IS tricky. All sorts of myths reverberate in the queer lady community. “We don’t need paps, especially if you, me or my friend’s sister’s girlfriend is a goldstar lesbo” (who came up with that concept anyway??). And you’re right, all the wsw I know pretty much suck at safer sex. HPV infections can and do show up on paps, so the best advice for ALL sexually active women is to get regular paps starting at 21 (the guidelines on how often keep changing, ask your doctor/NP). The incidence of HPV among wsw is about the same as all other women (although we are a poorly studied subpopulation). HPV is fairly ubiquitous, and many young women catch it and clear it (like a cold for your vagina), so I don’t think STI stigmatizing is at all useful. I think educating people and empowering them with information is the best thing to do. Then they can do their own risk-benefit assessment.

  2. Gardasil is a horrible, horrible vaccine, and I would never get it or recommend others do so. 90% of all cases of HPV will clear on their own. Also, Gardasil does not prevent against all strains of the remaining 10% of cases. Is it worth the possible neurological side effects? Oh, the other thing, is that even with it’s limited protection against some strains…it only lasts for 5 years. It’s ridiculous.

    I think to advocate safe sex is really important in the lesbian community, because we often see ourselves as immune to the many difficulties that seem more rampant in other sexual groups…but we can catch things too. HIV, HPV, whatever the STD is.

    To me, I think that whether someone believes it to be ‘judgmental’ or not, to tell someone to reduce their partners is likely an irrelevant conversation. People will do what they will. In the heat of the moment, no one will say “oh, I have to keep my partners to 6, and you are number 7.”

    To me, it’s about education and making resources available so that women can make smart choices and have the availability of safe sex preventative tools, like dental dams, on hand.

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