sex

[that_slick_chick]

Sooooooo...  I was diagnosed with Hep C about a year and a half ago.  The whole time I've been seeing a man monogamously and he knows about it.  He does not however, like to use condoms ever.  He does know the risks, we've been over it all, but he seems to think it's no problem.  Now... I personally have agreed with him all this time, based on the fact that all my friends who have Hep (which is a lot cuz I'm an addict in recovery) seem to think it's pretty impossible to spread through sex.  Also because I was initially told my virus was dormant and non-threatening.  But now that I'm starting to experience symptoms and difficulties and just went for my first biopsy last week..... I'm worried.  Because what if he DOES get it?  I mean, I love him utterly and deeply but he's a man of little compromise.  He's a grandson of african royalty worth millions with appallingly good looks.  Our relationship is strange but wonderful and I don't want to lose it.  But I want him to be protected.  I don't want him to go through all the pain I've had in the last year and will probably go through for years to come.  I have type 1 and its apparently progressing faster than they thought.  Is there any other way besides condoms to ensure his safety?

[ladywhy]

...if he's not concerned...why should you be?
I would be very concerned about what diseases he may be carrying....
millions or no.....he could be detrimental to YOUR health.

[HCV_Newbie]

I've had Hep C for at least 15 years, possibly 25, and have been in a monogomous relationship 15 years (married for the last 10)  When I was diagnosed, he got a test and tested negative.  What a relieve that was.  I'm not saying it isn't possible to spread it sexually, but odds of that happening are very low.  Good luck with your decisions, your health and your relationship.  

[jmjm530]

Is there any other way besides condoms to ensure his safety?
-----------
Don't have sex during your period. Avoid anal sex or any sort of "rough" sex where blood might be involved or have sex with any exposed sores such as during a Herpes outbreak. Don't share toothbrushes, razors, nail files, combs or other personal items.

If you have found this helpful, you can PM me a few million from his account :)

[HCV_Newbie]

What jmjm530 said.  :)

[jmjm530]

Do you really think you can get some of the dough just by agreeing with me :)

[that_slick_chick]

thanks for the help!  I follow the rules with razors etc., and we never have sex on my period, but we do have anal occasionally...  That's kind of the reason I posted this.  We did it that way last nite and for the first time there was a little blood (it had been a while).  He showered and washed with soap afterward but it freaked me out.  He seems cool with it (and he's been tested since we've been together and come out negative for everything) but I dunno...  I don't want to make him uncomfortable with it or mess with what we have so I stay quiet, but I just imagine the guilt if he contracted it.  I don't know how I could live with myself if I did that to him.  He's not had many women, only like 6 before me and he's almost 30.  He's very intelligent, selective, and careful.  When I found out a few months into dating him, I thought for sure I would lose him.  But somehow he's still here through it all.  I just thought if there was some kind of disinfectant or cleanser that could be used afterward if would be less nerve-racking.

P:S: As for the millions, I don't actually have any of it.  I'm not in it for that.  He's offered, but it's not my style.  I work hard and pay my half of everything.  So no dice on cash for good advice sorry ;)

[Isobella]

Honestly, from what you say, this guy has all the facts and chooses not to wear a condom or worry about transmission.  You say "he does not like to use condoms, ever."  Well, with an attitude like that he may very well catch something at some point in his life.  

The control you have in this situation is your own behavior.  Either comes to terms with the fact that sexual transmission carries a slight risk and avoid known risky behavior or don't have sex with him.  

Altho Dr D says bleach will works wonders.........

[jmjm530]

If you know that anal sex can transmit Hep C then why do it? The fact that he doesn't want to wear a condom isn't the issue. It takes two to have anal sex.

[that_slick_chick]

First of all, we've only done it like that 3 times since we've been together.  Always very clean and prepared ahead of time.  This was the first time there was even a drop of blood.  He and I both know that of the possible ways to transmit it sexually, anal is the most common.  But it is only a 1% chance through sex all together.  Afterward he showers immediately with soap.  

The fact is, we both enjoy it more than any other thing we do in bed together, and it always ends up being not only a sign of our passion but our love.  It is SO much more intimate than vaginal sex.  You talk to me like I'm trying to poison him.

The whole reason I posted this is because I want to keep doing it with him, but with some kind of further precautions.  If it wasn't considered as "risky" as it is, we'd probably be doing it like that once a week.  For now we keep it to birthdays and holidays.  

If you want to help me understand something better than I'm grateful for it.  But please don't judge me or scold me.  I thought this site was to help people.  

[jmjm530]

I'm not really sure anymore what your point is or what you're asking. You've already been told that unprotected anal sex is risky in terms of acquiring HCV. And you've also been told there is nothing you can do about it after the fact. I'm not "judging"or "scolding" anyone, just pointing out facts.

My one comment -- call if judgemental if you want -- is that it's not just your boyfriend's choice, it's also your choice whether or not you want indulge in risky behavior. To state the obvious, he has a lot more to lose than you do in this because he's the one currently not infected.

The reality is that blood and anal sex often go together as the anal membrane is quite sensitive. It appears that this happened once out of the three times you were together. So if you do it another three times, it's reasonable to assume it might happen again. I do not see how taking a shower after the fact is going to offer protection.

A related comment from our resident doctor:

http://www.thebody.com/Forums/AIDS/Hepatitis/Archive/HepCtest/Q163074.html

[CockSparrow]

Jim - unprotected anal sex is risky in terms of acquiring HCV

But how risky. If anal sex was a risk for acquiring HCV then why dont the Male homosexual community have far high rates of HepC than the rest of us.

All the stats i have seen the rates are similar apart from those with HIV.

CS

[Willy50]

CS;   http://www.janis7hepc.com/sex_and_hcv.htm
Transmission Among HIV Positive Gay Men
But the picture is different for HIV positive individuals. At the 13th Conference on Retroviruses and Opportunistic Infections (CROI) this past February, two research teams presented the latest data on clusters of acute hepatitis among gay men in England and the Netherlands, while a French team reported on apparent sexually transmitted HCV in heterosexual women.

Since 2002, more than 200 cases of acute hepatitis C have been reported among men who have sex with men (MSM) in London and Brighton in the UK. Mark Danta from London’s Royal Free Hospital gave an update on a cohort of 111 HIV positive men diagnosed with HCV between October 2002 and August 2005 (CROI abstract 86). The men who contracted HCV had three times more sex partners (30 vs 10) in the past year than men who remained HCV negative. Other significant risk factors included unprotected receptive and insertive anal intercourse, fisting, use of sex toys, group sex, and sexual activity under the influence of recreational drugs (92% vs 62%). What’s more, these factors appeared to interact: individuals who engaged in three or four of these practices in group sex settings had 23 times the risk of HCV infection. In addition, the men who contracted HCV were more likely to meet partners in sex clubs or bathhouses or over the Internet, and most (92%) had concurrent sexually transmitted diseases (STDs). “High-risk and mucosally traumatic sexual factors are significantly associated with the recent transmission of HCV,” Danta concluded.
------------------------------------------------------------------------------------------------

Hey Slick, I don't post the above stats to discourage the practice but to refute the notion that it's safe.  Personally..... my opinion is that the sexual event varies a lot from person to person.  In the case of the MSM transmission of HIV/HCV it often involved numerous partners, enduro sessions and the use of meth.  I'd suggest that reducing a few of the risk factors could dramatically reduce ones risk.

Even so.....I think Jim is attempting to inject a note of caution which he is hearing you also voice.  Very often people come here seeking help after an exposure event and wish that they had done things differently.  He is only asserting that you too have a voice in the discussion.  My own opinion is that you both have the right to proceed as you wish as long as you have a mutual consent and understanding of risk and consequence.  I don't like to suggest what you should do but....given there was blood following intercourse the one time you could simply re-enter into a discussion about the use of a condum when having anal intercourse.  It's merely about having the the talk to show that you have concerns about keeping him healthy as well as happy.  Even if he were to opt for no condum I think it could make you feel less culpable (if transmission were to occur) or make you less fearful knowing his wishes.  Both of you might also think about things which could increase risk (less foreplay, poor lubrication, enduro length sessions) or reduce the risk of transmission (use of a condom, adequate or periodic lubrication, slower or more gentle motion and/or shorter sessions).

And..... are you a monogamous couple?  You write that you are.... but I couldn't tell if he also is.  IF he were not....then a condum could also reduce your risk of exposure to STD's.

Finally..... you wrote; "Also because I was initially told my virus was dormant and non-threatening.  But now that I'm starting to experience symptoms and difficulties and just went for my first biopsy last week..... I'm worried"
------------------------------------------------------------------------------------
Strictly speaking I don't believe that the virus is "dormant" although you may now have minimal damage or symptoms.  It is also potentially threatening to you or to another should you transmit.  I'd also argue that the virus can indeed be transmitted sexually.  I normally tell people in normal hetersexual intercourse (where partners deny sex during menses and practice no anal intercourse) the odds are 2%, plus or minus 2% depending on many factors (frequency, duration, vigor, lubrication, and many other factors).  Unfortunately, the stats suggest that when one engages in anal intercourse one is entering into a area of higher risk for transmission.

Hope that helps; just my opinion.    I've tried to stay only on topic and stay away from any moralizing one way or another.  .

Good luck with your biopsy and recovery.

best,
Willy

[CockSparrow]

Prevalence and risk factors of hepatitis C in HIV-negative homosexual men in Sydney, Australia

Abstract
Objective:
To determine the prevalence and risk factors for hepatitis C (HCV) in HIV-negative homosexual men in Sydney.

Methods:
A cohort study was conducted in a sample of community-based, HIV-negative, homosexual men in Sydney. Participants underwent a face-to-face interview regarding sexual behaviour, sexually transmissible infections, and injecting drug use (IDU).

Results:
Eight hundred and twenty-four men consented to HCV testing, and the prevalence was 0.85% (95% Cl 0.34-1.74). HCV seropositivity was strongly associated with a history of IDU (OR=60.43, 95% Cl 6.70–544.79). All HCV seropositive individuals reported a history of either IDU or other means by which they may have had parenteral exposure to HCV. There was no evidence of an independent association between sexual behaviour and HCV infection.

Conclusion:
The prevalence of HCV in this cohort was about the same as in the general population in Australia, and there was no evidence for sexual transmission in this population.

Btw the prevalence rate of 0.85% is actually lower than the over all population in Aust which is around 1.1%. Cause this figure could be cr@p.

Here one from Canada
Lack of Evidence of Sexual Transmission of Hepatitis C Virus in a Prospective Cohort Study of Men Who Have Sex With Men
http://www.ajph.org/cgi/reprint/95/3/502.pdf

Objectives.
We studied the prevalence and incidence of hepatitis C virus (HCV) infection in the ongoing Omega Cohort Study of men who have sex with men (MSM).
Methods.
From January to September 2001, consenting men (n = 1085) attending a follow-up visit to the ongoing Omega Cohort Study were tested for HCV. If the test results were positive for HCV, we compared them with test results from previous serum samples collected from the time of entry into the original cohort study to determine the time of
infection.

Results.
HCV prevalence at entry was 2.9% and was strongly associated with injection drug use (32.9% vs 0.3%, P<.0001). Only 1 seroconversion was identified in 2653 person-years of follow-up (incidence rate=0.038 per 100 personyears).
The seroconverter was an active injection drug user who reported needle sharing.

Conclusions.
Sexual transmission of HCV among MSM appears to be rare. (Am
J Public Health. 2005;95:502–505. doi: 10.2105/AJPH.2003.020388)


From Annals of Internal Medicine Ann Intern Med. 2006;144:770-771.
Hepatitis C: A Bitter Harvest
http://www.annals.org/cgi/reprint/144/10/770.pdf
Armstrong and colleagues identify an independent (albeit weak) association between HCV infection and promiscuous sexual activity that seems to suggest that HCV is a sexually transmitted disease. Although sexual transmission can occur under unusual circumstances, dissecting the contribution of sexual activity in the setting of underlying, confounding injection drug use is difficult. Instead, sexual transmission of HCV is the exception rather than the rule
This study also showed that anti-HCV was not increased among men who have sex with men, a very telling observation that also weighs heavily against efficient sexual transmission of HCV infection. In other studies of men who have sex with men, the risk for HCV infection was very low compared with that for hepatitis B virus and HIV infections, which are efficiently transmitted by sexual contact.

So how big a risk is it in reality.
CS

[Willy50]

"Although sexual transmission can occur under unusual circumstances, dissecting the contribution of sexual activity in the setting of underlying, confounding injection drug use is difficult."

"So how big a risk is it in reality?"
--------------------------------------------------------------------------------------
I don't claim to know the answer.  There seems to be some range......extreme range .....in some of the data.  The data could be skewed since many of those who are used in studies are already infected.  One could assert a range of causes merely because one admitted risk factors.  The best case study would be where there was no HIV, no STDS, no IDU, no multiple parters and limiting other such risks.  Unfortunately finding that "ideal population" is tough.  My only point of writing is to bring up that there is a greater potential for tearing and blood and therefore a greater potential risk factor.  There is an element of risk even in hetersexual sex that ranges from....say 4% down to nearly zero percent.  I would assert that anal sex is no safer and is likely less safe, but so much depends upon the great variety of factors that accompany the sexual event.  Sound fair?  Education and communication is important in any sexual relationship where there is risk for transmission.

As they say...... your milage may vary.

best,
Willy

[Trish77]

"First of all, we've only done it like that 3 times since we've been together.  Always very clean and prepared ahead of time.  This was the first time there was even a drop of blood.  He and I both know that of the possible ways to transmit it sexually, anal is the most common.  But it is only a 1% chance through sex all together.  Afterward he showers immediately with soap.   "

Clean and prepared ahead of time has nothing to do with tearing of the skin while you're in the act.  Hep C is transmitted by blood into bloodstream.  How much soap and showering you do ahead of time has zip, zero nothing to do with being protected from transmitting Hep C.

Also the fact that he showers afterward with soap for the same reason. That is not going to help him one bit with protecting him from Hep C. Washing any blood off his body isn't going to help him a bit with any blood of yours from a tear in your anus that may have entered his bloodstream through any fractional tear on his penis.  All the soap in the world isn't going to help him at that point.

I'm not sure why you're even mentioning soap and showering as a means of protection - it doesn't seem as if you really understand how this is transmitted here.  

"The fact is, we both enjoy it more than any other thing we do in bed together, and it always ends up being not only a sign of our passion but our love.  It is SO much more intimate than vaginal sex.  You talk to me like I'm trying to poison him."

You don't have to stop doing it.  Have him wear a condom during that only.  With all the options these days for condoms on the market, surely you can come up with something that's not only barely noticeable but also adds to your pleasure?

"The whole reason I posted this is because I want to keep doing it with him, but with some kind of further precautions.  If it wasn't considered as "risky" as it is, we'd probably be doing it like that once a week.  For now we keep it to birthdays and holidays.  

If you want to help me understand something better than I'm grateful for it.  But please don't judge me or scold me.  I thought this site was to help people."

Hey.  You're the one who asked the question. This site IS to help people and Jim is being directly honest with you.  If you had a gun and someone said I'm okay with you shooting me in the head with it, would you do it?  Because this guy is okay with you risking his life... are YOU okay with that?  You seem to be.  That's Jim's point and I think it's a good one too.  If someone gets in my car, I make them wear their seatbelt, whether they want to or not.  You say you'd never forgive yourself if he caught it from you and yet you risk it anyway. You should be making this guy wear his bullet-proof vest on birthdays and holidays.  You're the one with the loaded weapon and no idea when the "bullet" will eject from the chamber into him.  You may not like hearing that, but that IS the situation.

Trish

[jmjm530]

Trish:  If someone gets in my car, I make them wear their seatbelt, whether they want to or not.
-----------
EXCELLENT Analogy. I think I'll steal it sometime with or without your permission :)

[jmjm530]

CS: Jim - unprotected anal sex is risky in terms of acquiring HCV

But how risky. If anal sex was a risk for acquiring HCV then why dont the Male homosexual community have far high rates of HepC than the rest of us.

All the stats i have seen the rates are similar apart from those with HIV.

---------------------------
I don't know but I have seen conflicting studies and medical advice. Maybe the subset of the homosexual community that does not have HIV is more apt to practice safer sex? Just a guess but I think when blood transfer may be involved, best to play it safe. I don't think you're advising slickchick and her boyfriend to continue unprotected anal sex with blood droplets and all?

-- Jim

[meki]

Just to clue you in - I had unprotected sex with my husband (now recently an EX-Hubby) for MANY years... like 15 of them

And we know that I was HCV free in '95.

We had wild monkey sex with no protection during menses and every which way you could imagine --- he had a prince Albert piercing at one point also.

We were in a major car accident - and everything...

None of my famly --- nor did my husband - ever had or have HCV.

So - I think it's probably a safe bet to say that it is not caught that way.

However - if you are having sex during your menses - you should probably watch out for him if he has cuts and scrapes --- or if you are having "rougher" sex...

Where blood might be exchanged...

THen I would worry.

But --- if he does not use condoms - and there is a chance that he is with others - then I would seriously consider whether he was worth keeping.

Much luck - and hopefully GREAT SEX.... and hopefully - you will keep a very close eye on your disease - and decide to treat or not soon.

Hugs,

meki

[jmjm530]

Are you then suggesting that unprotected anal sex is safe and responsible if one partner is HCV positive? That is what this thread is about.

[Willy50]

There is a story about the guy that offers a woman 10 dollars to have sex with him.  She is offended..... and tells him so. "I'm no prostitute!!!"she declares.

He responds; "Yeah, but would you for a million dollars?"

She says "For a million?  Hell yes!!!!"  She laughs.....

And he responds..... "Then really...... all we are haggling about is the price."
(my friends overseas are permitted to substitute Euros for dollars- Willy)
----------------------------------------------------------------------------

It seems to me that one may be on a slippery slope (or slick at the very least ; ) ) when arguing that with regard to HCV anal receptive sex is irresponsible but that unprotected hetersexual sex IS responsible.  You may find yourself in an argument with someone who claims that ANY risk of transmission renders sex an "irresponsible act".  Where does one draw the line?  At exactly what point....what transmission rate.....does the act go from irresponsible to "responsible?

My point is that there is no rigid cutoff point where hetersexual sexual transmission rate can be quantified for all people and all events.  Is it possible that some BANG BANG BANG 4 hour hetersexual enduro could transmit HCV easier than a slow, soft and easy anal short term receptive event?  IF so..... the hetersexual event would be more dangerous and the anal would be less dangerous (and therfore more "responsible").

If one cannot quantify the danger it may also be difficult to quantify what is and isn't "responsible".

Personally (as I mentioned) I believe that Slick is looking at a higher risk for transmitting HCV.  I still feel that it is a personal choice that both parties must arrive at and decide between themselves.

The part where "responsibility" comes in is that both parties should understand the risks and consequences of either endangering themselves or their loved one.  

That is what I thought to be the point of this thread.  I agree that Slick has an equal right to her (and would the answers in this thread still ring true if "Slick" were a guy?) own choices; whether to dictate when and where condum use would occur.

best,
Willy

[Trish77]

"(and would the answers in this thread still ring true if "Slick" were a guy?)"

Hell yes.  Why would gender matter?  The comments were directed at the increased risk of transmission via anal sex and that increased risk is an accepted fact.  Doesn't matter what gender is the receiver or the giver.  I don't understand why you think gender would play into it.  

"The part where "responsibility" comes in is that both parties should understand the risks and consequences of either endangering themselves or their loved one.   "

I begrudgingly accept your point here from a purely academic point of view. Personally, I wouldn't care if the other person said "that's okay, I'll take the chance".  Not something I can personally live with.  

However, in the poster's case, this was the question:

"Our relationship is strange but wonderful and I don't want to lose it.  But I want him to be protected.  I don't want him to go through all the pain I've had in the last year and will probably go through for years to come.  I have type 1 and its apparently progressing faster than they thought.  Is there any other way besides condoms to ensure his safety?"

Seems to me she got the answers expressing that kind of concern for her partner warranted.  I do agree however that the key is that he's been made fully aware of his risks and she has done that at least to the best of her ability however not sure either of them get it after reading the soap and water comments.

[CockSparrow]

Jim - I think when blood transfer may be involved, best to play it safe
------------------------------------------------------------------
That was the point i was trying to make but in a more indirect way.

Sexual transmission even amongst the Homosexual community doesnt appear to be that high.

Its a blood borne virus and anything that risks blood to blood contact is a risk.
And I guess that could well include some sexual practices.

CS

[Willy50]

"I don't understand why you think gender would play into it.  "

----I don't.

And where I wrote;  "The part where "responsibility" comes in is that both parties should understand the risks and consequences of either endangering themselves or their loved one."   That also includes hetersexual sex even though the risk is minimal.

"I begrudgingly accept your point here from a purely academic point of view. Personally, I wouldn't care if the other person said "that's okay, I'll take the chance".  Not something I can personally live with."

For all of us there is nothing academic in these choices.  These are all real life choices we all must make while we are infected, after EOT, and after SVR.  I didn't want to go deeper into risks but they also depend on anatomical size and shape, age of the participants, viral load, fitness of the immune system or even genotype (do people spontaneously clear geno 2 easier than geno 1?)  One cannot ever clearly point at a clear cut transmission rate for sex.  We will likely all have slightly different comfort levels on this topic..... as well as our loved ones.  I've sometimes wondered if a person who has gone through TX may have a greater aversion to further risk and may wish to never risk a new HCV infection.  That's a topic for another thread however....

You and I agree.  We all must decide for ourselves and we all must have the talk and then walk that walk.  ; )

And the point of the thread is also discussing these little interesting points as well.   Thanks for doing that so well..

Willy

[jmjm530]

Child: How in the heck do you have sex for 4 hours? :)
------------
Certainly not with the person you are married to :)

-- Jim

[FlGuy]

3:59:30 credited as thinking about it.

[Marcia2202]

oops... ..... too fast

[Willy50]

Perhaps I am speaking in the "theoretical" now......

First of all, I meant coitus, not the foreplay Holy Trinity which leads up to coitus; pouting, whining and begging.  Those would not be included in the tally.  ; )

The rest is pretty simple math;  4 hours X 60 minutes= 240 minutes divided by about 8 climaxes by the guy = 8 - 30 minute "sessions".  Some of course, will require a brief rest between, possibly a snack, some fluids, or a transfusion.  ; )  HA!!

My point is..... that if one is old....or "infirm" one may have more trouble imparting some trauma.  Even so, in the good old days I seem to remember a LOT more activity, greater frequency, fewer rest breaks and don't recall needing a bottle of oxygen by the bed. (or stairs, kitchen table, hood of the car, etc.

OK..... now I'm waxing nostalgic.  

Willy

[GoofyDad]

Jim: Certainly not with the person you are married to :)

True enough. Four hours is a lont time to hang with someone who's not gonna get you a snack & beer or change channels to the next football game.

-------------------------------------------------------
Elaine: however when Nick got
older he would not let me near him nor his fiance'

Not sure why he kept you away from the fiance, but what happens in Sacramento, stays in Sacramento :)

------------------------------------------------------


    

[Willy50]

LOL; oh.... I wasn't supposed to tell you was I?  I guess that I kind of blew that eh?

That's what can happen when something strikes you as funny and ya post it on a board where ya can't modify your posts.  I'm embarrassed and fear that no one will want to eat at my kitchen table anymore. ; )  

Like John Prine said; "I was just trying to have me some fun".

best,
Willy

[meki]

4 hours --- means repeat performances - and quite possibly viagra?

Right?

[Willy50]

Goofy/Willy isn't so far off.....

Hey..... I was just laying out a hypothetical.  My point (without mentioning the number of hours or number of times that a couple has sex) was that there can still be plenty of wear and tear during so called "normal sex".  

Don't get me wrong; I'm not diminishing 5 minute sex but come on...... I'm hoping ya'll have some happy memories or more than 30 minutes and some repeat performances ( and followed by an encore)  ; )  You guys were young once; right?  (and by young..... I mean under 40) : )  And now it's my turn to say don't answer that!!!!!!  That's a whole different thread.......

And yes Meki..... in addition to coke or meth, viagra is also a newer abused drug which can also increase the risk of HCV transmission.  Kind of like the energiser bunny, but instead of ......

Willy

[meki]

Make that the Energizer Monkey.

*G*