Worried about girlfriend with multiple sex partner history

[surferle]

I have been seeing a woman for 4 months now.  We recently talked about our sexual histories, and she has been more active than me.  She is 28 (like me), has had 10-12 lifetime partners, with 5-6 of them in the last 20 months.  [I am relatively sexually conservative, with 5-6 lifetime partners, most in monogamous, long term relationships].  Due to deliberate experimentation, several of her recent partners were older men in New York city's artist community, who are especially sexually active and have likely had many, many partners themselves.  She claims she was "always" safe, except one incident after which was tested (not clear for what) upto 6 months out.

I am, in general, more anxious about STDs than average due to a previous scare.  I have a few questions:

1.  How worried should I be about HIV, and STD transmission in general?  Do multiple recent sex partners (who are themselves with many partners) indicate high risk of STDs?  

2.  She seems willing to get tested (as I have been recently).  What should I ask her to get tested for?  

3.  We haven't had full intercourse yet.  However, after one long session of deep kissing, her lip (which was chapped) was bleeding, with visible amounts of blood.  I have poor gums, which often bleed after brushing.  I am not sure if they were bleeding at the time.  We stopped kissing, she sucked the blood in and applied some vaseline to her lips.  After about 45 mins, we again engaged in deep kissing for a long session.  Is there any risk of HIV (or other STD) transmission through this incident?  (Separately, I have also fingered her, with definite transfer of a lot of vaginal fluid, a few times.  My fingers had no obvious cuts or abrasions).  If she will not get tested, and we do not go further, do you feel these exposures warrant my getting tested (again) in 3 or 6 months?

4.  A more psychological question which you may or may not have the answer to:  while we both really like each other and see something deeper possible here, this area of her life makes me very uncomfortable.  To the extent that I am considering breaking up with her.  Is this normal?  I want to remove the fear of STDs from my decision, to see if I am uncomfortable with other aspects of her choices.  How can I best do that?

Thank you,
Highly educated disease-paranoid but caring, well-meaning guy.  

[surferle]

Could I please request you take this thread off the forum? Or at least my previous comment?

Thanks,
surferle

[carnageofthepast]

Can't add much more than whats already been said regarding the emotional/psychological aspects.  You are not alone in your feelings regarding fear of hiv, concern about a partners past etc.  These are all normal, healthy fears as long as you dont let them get out of perspective.

My advice would just be to go ahead with an std screening for both of you and then you'll be able to start with an honest beginning.

Sometimes it seems easier to not discuss these types of things because its so uncomfortable.  However, I speak from experience when I say that its much less anxiety-provoking to know for sure instead of worrying about something unknown

[surferle]

Thanks, monkeyflower.  I think these are the right sorts of issues for me to think about.  

I have been thinking a lot about what it says about me, rather than her, that I am so uncomfortable with her history.  I don't think I have double standards for men and women, but I do think that I have a different kind of double standard.  While I profess to be sexually liberal, and don't judge and even encourage many of my friends who are very experimental--I have personally always made relatively sexually conservative choices and have chosen to be with women who have made similarly conservative choices.  I think this relationship is forcing me to clarify my position.  Either I should be true to my liberal ideals, and not judge my girlfriend and try and get over these doubts.  OR I should accept to myself that I have to revise my idea about what my honest attitudes towards sex really are, and be more consistently conservative in my choices.

It has also brought home to me that I am excessively worried, even paranoid, about STDs (including especially HIV), which has been an issue before.  Which is why I want a medical opinion here about what the rational basis of these worries are.  But, here again, I think it's one that I need to confront squarely -- either I should say these fears are irrational and I should get over them, OR I should accept to myself that these are the limits of my comfort zone with sexual safety and I won't push myself to overstep them.

And, yes, I am seeking some counseling -- for myself.  I haven't asked my girlfriend, partially becuase we are long distance which makes it impossible to go to counseling together.

Thanks,
Kaustuv.

[monkeyflower]

Personally, I think you're within your rights to have and hold any standards you want, no matter how arbitrary. If you want a virginal gf, that's fine. Some guys do.

However, there just aren't a lot of virgins out there, and I think her relationship history is FAR from extreme. So, before you throw away a relationship you find otherwise satisfying, I think it is important to figure out exactly what bothers you about her past. Is it that she's had more partners/experience than you? Even in 2005, there still exists a real double standard in our society that says it's okay for men to have multiple partners, but not women. It might be subtle, but it still exists.

Related to that is the fact there's also still a real bias against women who know themselves and their bodies, who have an appetite and appreciation for their sexuality. I think sometimes that can feel threatening to guys who are perhaps less than secure in their own sexuality, or in their own sense of self.

However, that said, some people are just plain more free-spirited than others. I have a feeling some of your concerns arise from what you termed her "deliberate experimentation". I personally think it's totally okay if you decide that she's too adventurous for you, and thus the relationship won't work out. That's a pretty big difference that will likely show up in many ways, not just sexually.

I think it would be a good idea to do a couple of things. First, I'd suggest journaling. Stay in the moment and pay close attention to exactly what's going through your mind and body, and write it down. Second, I'd talk with your gf about your concerns, as openly and non-judgmentally as possible. And finally, I'd strongly urge you to see a counselor, with your gf if she's willing, but alone if she isn't. I think you deserve to fully explore your feelings about this, both for yourself and for any current or future relationships. Everyone can benefit from a little introspection ;-)

[surferle]

Thanks very much, Dr HHH.  She is getting tested soon, and we have discussed my concerns a little.  I am doing some soul searching on the more psychological/emotional aspects, but am reassured by your answer on the physical health risks.

[H. Hunter Handsfield, M.D.]

1) I have no way of estimating the risk that your partner is harboring an STD at this time.  It's a good bet she has had HPV, but so have you (everybody with 3-4 or more life partners acquires HPV at least once).  Otherwise, there are no valid data that predict chronic STD risk based on number of lifetime sex partners; it depends too much on how she selected those partners, their lifestyles, what protection was used, and so on.  Your description implies she has been pretty careful, however, and it would be statistically a big surprise if she has HIV.

2) You can ask her to get tested for any and all STDs, if you like; any woman with her lifestyle should have routine testing for common STDs once a year, and she doesn't need retesting if it has been done recently.  But consider the implications of asking her, and think about how you do it.  What if she had an abnormal pap test indicating HPV?  Or a positive test for HSV-2?  Would you really make inititation of a sexual relationship contingent on the results?  If you really care for her, do you want to insist on testing?  If she really cares for you, would she refuse?  Think about how you deal with these issues.

3) Don't worry about oral exposure to blood.  Few STDs are so transmitted, including HIV, and you certainly don't need testing on that account.

4) Monkeyflower and others have already responded to this question.  I will simply repeat the information that the sexual experience of your partner seems more or less average for urban young women in the past 2-3 decades.  If you hold to less sexually experienced standards, you will greatly minimize the pool of potential life partners who will be acceptable to you.

The overall tone of your comments suggests a pretty obsessive concern about STD, perhaps overtly irrational.  Your own question ("Is this normal?") implies that it's not; if you have to ask at all, then you should consider seeing a mental health professional and ask him/her the same question.  I suggest it out of compassion, not criticism.

Best wishes--  HHH, MD