STDs make having sex a real gamble

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BY MARK ANDERSEN / Lincoln Journal Star

The condom broke: That’s the excuse a Lincoln man infected with HIV has offered four times to investigators tracing new cases back to their source.

“They do break,” said Thurman Hoskins Jr. of the Lincoln-Lancaster County Health Department. “But condom factories couldn’t stay in business” if they failed as often as people say they do.

Hoskins can’t identify the man spreading the virus that causes AIDS — or get him off the streets.

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Disease Investigation Specialist Thurman Hoskins Jr. (left) and Community Health Educator Shannon Williams stand near locked filing cabinets in the basement of the county health department as Williams prepared to add case files to the HIV reports the agency is required to keep. (Eric Gregory)

Disease Investigation Specialist Thurman Hoskins Jr. (left) and Community Health Educator Shannon Williams stand near locked filing cabinets in the basement of the county health department as Williams prepared to add case files to the HIV reports the agency is required to keep. (Eric Gregory)

“With the laws on the books, it’s up to you to protect yourself,” he said.

Hoskins and Shannon Williams, the city-county health educators who seek out those at risk for sexually transmitted diseases, urge all sexually active people to follow that advice.

They know that, in a society that glorifies risk takers and prizes sexuality, people infected with HIV and other STDs often had one misconception in common: We’re the good people, and good people don’t get diseases.

And that denial isn’t protecting anyone.

So what are the odds of catching an STD?

These are the numbers of new cases of sexually transmitted diseases in Lancaster County in 2006, through October:

AIDS: 12 cases

HIV: 14 cases

Chlamydia: 811 cases

Gonorrhea: 324 cases

Genital herpes: 175 cases

Syphilis: 1 case

Some of those lower numbers can lull us to sleep, Hoskins said. But the number of cases of chlamydia and gonorrhea — both infections that can be spread through several types of sexual activity and can show no symptoms — has gone up 20 percent and 66 percent, respectively, from 2005 numbers. And Hoskins dealt with three more syphilis cases this past month.

The Health Department tracks all potentially infected partners of people with syphilis and HIV. But it lacks the resources to track chlamydia, said Tim Timmons of the Health Department. That disease — and many other STDs —can cause problems later: Left undiagnosed, they can cause infertility and other serious medical problems.

While more typical in those ages 17 to 29, STDs transcend age, gender, race and class, Hoskins said. The youngest Nebraskan identified with HIV was 17. The oldest was 63. The last two people he told were HIV-positive were women ages 21 and 24.

Hoskins said he and Williams hear the excuses often: People didn’t think they were at risk for an STD because their partner was a doctor, successful, highly educated, married, drove a nice car.

In their minds, Hoskins said, “Being well-connected is the same thing as wearing a condom.”

The Centers for Disease Control and Prevention once believed educating people could halt AIDS, Hoskins said. But it turned out that people know the risks but justify their risky actions — until they find out they’re infected.

“If you’re having sex,” Hoskins said, “you’re at risk.”

And the ability to judge risk is often clouded.

Drugs and alcohol were risk factors “in 80 percent of the people we see,” Williams said. Patients admit to not knowing anything about their sexual partners — and not using a condom.

Hoskins and Williams try not to preach — often the patients are ashamed, he said. So they try to nurture them.

Williams hears stories from young girls — some as young as 12 — who just want to be loved, she said. Sometimes, they try using sexuality to make themselves feel good momentarily.

“If you could just let them know the end result: It’s not going to end up good,” she said.

The two educators often use role-playing to get girls to practice saying things that might reduce risk. “No” works. So does “We’re using a condom, period.”

The term abstinence doesn’t work, Hoskins said. Instead, they speak of postponing sex, so they don’t exclude people already having sex. They ask them: Can you postpone sex for at least a month? Get to know the person first?

Sometimes a person taking the gamble will get lucky. A patient’s risk-assessment questionnaire may be covered with checkmarks and he or she will test negative for STDs, Williams said.

But then: A person will have just one check on the assessment. He or she will have had sex — sometimes with only one partner — and will catch an STD.

“It’s ending up with that wrong person,” Williams said.

To get tested

The STD clinic at the Lincoln-Lancaster County Health Department provides, for $35, a confidential test for gonorrhea, syphilis, HIV and chlamydia, plus a doctor’s exam. Women also receive tests for bacterial and yeast infections.

HIV-only tests are available for $10 on Monday nights.

For more information or to make an appointment, call 441-8065.

How to protect yourself

-- The only sure way to avoid STDs is to abstain from any sexual contact or be in a long-term, mutually monogamous relationship with a partner who has been tested and is known to not have an STD.

-- Use a latex condom every time, with every partner and during any type of sexual activity.

-- If you have any symptoms, such as discharge, painful urination, abdominal pain (in women), or genital sores, don’t have sex and see a doctor. It’s important for your health and to stop the spread of disease.

Source: Centers for Disease Control and Prevention

By the numbers-- More than half of all people will have an STD at some point in their lifetime.

 

-- In a national survey of U.S. physicians, fewer than one-third routinely screened patients for STDs.

-- About half of all new STDs in 2000 occurred among those ages 15 to 24.

-- Estimates show as many as one in four Americans has genital herpes, a lifelong (but manageable) infection, yet up to 90 percent of those with herpes are unaware they have it.

-- Each year, almost 3 million new cases of chlamydia are diagnosed, many in adolescents and young adults.

-- Women who reported regular use of condoms in one study were 60 percent less likely to become infertile.

— from the American Social Health AssociationJustifications of risky sexThurman Hoskins and Shannon Williams of the Lincoln-Lancaster County Health Department hear a few common rationalizations for risky sexual behavior.

 

 

-- “She just had a baby, so she must be OK.” There’s a huge assumption, Williams said, that women are tested for STDs when they have a baby. Many aren’t. Many women also don’t get tested for STDs during their annual exams.

-- “Oral sex isn’t real sex and therefore not a risk.” More people are turning up with STDs in their throats, Williams said. One woman told Hoskins she got HIV through oral sex.

-- “I’m protected. I get tested all the time.” Whoa! Why is he or she getting tested all the time?

-- “Woman on woman sex is safe.” Actually, any genital contact can spread disease, as can use of sex toys.

Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.