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I am currently seeking information on latex free diaphragms & sodium bisulfite allergies as a result of using latex condoms. If you have anything to share please let me know. TIA

The Forbidden Fruit

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Very whacked "commercial" by indy producer. I believe this is supposed to be an AIDS awareness short but it doesn't do much for me. What you think?

For decades college campus health centers have been a resource for budget-conscious female students seeking birth control. Because of agreements with pharmaceutical companies, most campus clinics were able to distribute brand name prescription contraceptives, from pills to the patch to a monthly vaginal device like NuvaRing, for no more than a couple of bucks. That all ended earlier this year.

Sexing Up Safer Sex

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Male delegates hunched over a crudely drawn outline of the female body, attempting to reach consensus on a woman's 'places of sexual pleasure'. On the other side of the conference room, female delegates marked a sketch of the male body with liberal sprinklings of heart symbols to denote his hot spots.

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Free Your Mind, But Watch Out for Crabs

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"And no, you can't just lick all the dust off and have everything be OK. Unprotected oral sex is still a risk. Going down on a woman is a low risk activity for herpes and HPV, unless she's having an outbreak. Then you're getting a gift that keeps on giving (yes, HPV can blossom like a pretty bouquet in your throat). One in three men and women carries HPV (genital/oral warts), and many don't know it because the virus might not show up for years. Use a condom when giving a new male partner a blow job if you want to be absolutely safe. If he objects, you know you have a loser on your hands (but at least not in your mouth). Additionally, you lower your risk for contracting an oral virus if you do not brush your teeth -- tooth brushing opens tiny cuts around your gums to make you bleed, giving viruses the ultimate ticket to the burn in your bloodstream. So that naked guy with socks and Birkenstocks with the gnarly, clotted teeth? Mustache rides are free in the desert, ladies!


Herpes Camp isn't on the map, but you should know your way around it. It's true that you can contract herpes when the virus is shedding (the period prior to an outbreak when there are no visible sores), but generally, people with herpes can tell when they're shedding, and won't engage in sex during this time. Medications like Famvir are extremely effective in preventing outbreaks, so if your partner discloses their herpes status but is on a medication such as Famvir and are in the clear for sex, your chances of contracting herpes are extremely low."


Violet Blue on Burning Man.

Sex With a Large Black Man

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Okay here's the deal. When you call me and want to talk about the sex tape you made with your wife and the large black man it's okay. I mean I may get a bit turgid as you describe the set up. I may even betray a bit of interest. (Probably not but I understand your desire to have someone outside of your wife to share the tale with.) It's okay. I want you to feel comfortable to share your doings on the porn set. After all whatever your problem is I just may be able to be of assistance. And everyone knows I am a giver.

And yes I know he had a large penis. Yes of course he doesn't normally wear a condom. You see it is usually better to serve your customers, with their made to order porn shoots, when you are able to expose your huge cock instead of wrapping it in latex. (Unless of course you paid for the latex fetish option.)

But you see here's the deal. When you tell me the tale and ask my advice well then I am inclined to give it. When he fooled you about wearing the condom and came inside your wife he just may have gotten her pregnant. He just may have given her a disease. I mean I doubt he gave her a disease as he is a pro, after all.

But seriously if this happened 3 days ago and, since you asked my opinion, there is a time table for using the day after pill (3 days I think) then when I tell you drop what you are doing and go to the doctor to see about the getting the pill the thing you want to do is actually drop what you are doing and go to the doctor.

Don't tell me the story again. I heard it and understand. I don't need to know any more details. The camera angle when you noticed the big black man was losing the condom just doesn't contribute to my understanding of your problem. And to be sure I can't help you decide if the porn production company cheated you. Even if I could help you decide this you have a much more immediate problem. Got to the doctor, now.

Okay I hope that clears things up. You are welcome!

Dear Colleagues

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On August 4th, 2000 the Centers for Disease Control and Prevention in Atlanta distributed a letter, concerning the spermicide nonoxynol-9, to "colleagues" from Helene Gayle at the National Center for HIV, STD, & TB Prevention.

U.S. Teen Pregnancy Rate (1997)

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U.S. teen pregnancy rate hit record low in 1997"The fact that fewer teens are becoming pregnant is encouraging news," said Dr. Jeffrey P. Koplan, CDC director. "Few teens are ready for the challenges of parenthood. When they delay this responsibility it enables them to gain the education and maturity they need to be good parents and good citizens."

Going Dutch

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Woman Bites Off Chicago Man's Testicles

09/29/98 - Subcommittee on Health & Environment

H.R. 4431 - HIV Partner Protection Act

Statement of Dr. Helene Gayle

Doctor

CDC

1600 Clifton Rd

Atlanta, Georgia 30333

I am Dr. Helene Gayle, Director of the National Center for HIV, STD, and TB Prevention at the Centers for Disease Control and Prevention. Thank you for the opportunity to testify today about issues related to HIV prevention partner counseling and referral services in the context of H.R. 4431, the HIV Partner Protection Act. I'm especially happy to be here because it's an opportunity for me to share with you CDC's updated guidance on HIV partner counseling and referral services -- which has just been released for public comment.


However, before we focus on partner counseling and referral services, let me briefly describe the major goal of HIV prevention in this country and the sound public health approaches that we think are needed to achieve this goal. Our goal is to prevent HIV infection by reducing behaviors likely to transmit the virus and assisting individuals at risk or already infected in gaining access to prevention services, medical care, and other needed services. This ambitious goal can be achieved only by using a comprehensive strategy. Elements of this strategy must include monitoring the epidemic; informing the public regarding risk and modes of transmission; conducting health education and risk-reduction activities, including school-based education efforts for youth; promoting and implementing HIV prevention counseling and testing; providing referrals for medical treatment as well as prevention and social services; and promoting and implementing STD screening and treatment. An essential component of HIV counseling and testing is reaching out to and counseling sex and needle-sharing partners of persons identified as HIV positive. These partners are often unaware that they have been exposed to HIV and some may already be infected. All must have access to counseling, testing, and other prevention or treatment services. Each of these elements contributes to preventing the spread of HIV. Together, they become a powerful prevention strategy. No single activity, by itself, will achieve the overall goal of preventing new HIV infections.


I will briefly describe CDC's current recommendations for partner counseling and referral services, or PCRS, and our current requirements for programs providing these services. The goals of PCRS are, first, to provide services to sex and needle-sharing partners of HIV-infected individuals so they can avoid infection or, if already infected, can prevent transmission of HIV to others; second, to help HIV-infected partners gain earlier access to counseling, medical evaluation, and other prevention, treatment, and support services. CDC has required States to establish standards and implement procedures for PCRS since 1988, when it was referred to as "partner notification."


PCRS is a process that begins when people receive HIV prevention counseling and testing. If a person tests positive, the PCRS provider and client together formulate a plan for reaching any sex or needle-sharing partners. The plan should be one that will result in each partner's being informed of possible exposure to HIV and provided with accurate information and counseling about HIV transmission and prevention. Next, the HIV-infected client voluntarily discloses identifying information about partners, and the client and/or the provider informs each partner of possible exposure to HIV. The next step is really the core of PCRS practice: assisting the partner in accessing additional counseling, testing, and other support services. Throughout this process, the confidentiality of the infected person's identity and that of their partners must be preserved.


Let me elaborate on a critical point here that has always been a cornerstone of partner services for HIV and all other STDs. The PCRS process, by its nature, is a voluntary one on the part of the client. A client who tests positive for HIV or any other STDs cannot be mandated to reveal names of partners. In the wake of receiving an HIV-positive test result, clients may fear discrimination, abuse, or domestic violence; they may fear the loss of a job and health insurance or the loss of important personal relationships. The success of the PCRS process absolutely hinges on the trust and cooperation of the person living with HIV, their partners, and their communities. We know that people will cooperate if they believe that their confidentiality will be protected; otherwise they may avoid the system altogether. The way to maximize the public health benefit is to have a valuable service -- one with skilled counselors fully supported by adequate resources -- that people perceive as beneficial and easy-to-use.


Partner counseling and referral services related to HIV infection have evolved from similar services, known as "contact tracing," that were begun in this country in the 1930s as a method of preventing the spread of syphilis. This prevention effort was called contact tracing because public health workers would, and still do, conduct analyses to determine which sex partners were most likely to be infected and then make confidential efforts to locate them and provide treatment. Contact tracing services later expanded to include partners of persons infected with gonorrhea and other sexually transmitted diseases, including HIV, and came to be known as "partner notification" in the 1980s. Today, the term "HIV partner counseling and referral services" more accurately reflects the range of services available to HIV-infected persons, their partners, and affected communities through this essential public health activity.


But of necessity, PCRS for HIV differs from partner services for other STDs. The primary difference is that, despite recent advances in treatment, we do not yet have a cure for AIDS, so HIV, unlike syphilis and gonorrhea, remains a life-long issue for those affected. For HIV-infected persons, PCRS needs to be continuously available. The process begins as soon as an HIV-infected person learns their serostatus, and it continues throughout that person's counseling and treatment. Also, because society frequently stigmatizes and sometimes discriminates against HIV-infected persons and their families and friends, counseling and support must be provided for clients who choose to notify their own partners. For exposed partners who test positive for HIV, PCRS provides assistance in reducing risks posed to others and accessing medical evaluation, treatment, and other prevention and support services to prolong life. As new prevention tools emerge, such as vaccines, better behavioral interventions, and even more effective antiretroviral therapies, PCRS will almost certainly become an even more important prevention tool.


States, territories, and local areas contribute to a national data system maintained by CDC that includes information on more than two million HIV tests reported annually from nearly 10,000 publicly funded counseling and testing sites. While this system does not differentiate spouses from others who are sex or needle-sharing partners, it does record the reasons for seeking HIV counseling and testing services, including referrals by partners and health departments. In 1996, 81,999 tests were conducted for people who were referred for PCRS; of these, 35,260 (43 percent) were referred by their partners, and 46,739 (57 percent) were referred by the health department. More than half of all the people referred were female. Many of these persons did not realize they might have been exposed to HIV and thus did not consider themselves at risk for infection until they received the referral. Nationally in 1996, 4 percent of these referred partners tested HIV seropositive, and in some areas up to 15 to 20 percent were HIV positive. This represents a much higher rate than the national average of 1.5 percent who tested HIV positive at publicly funded test sites that year. These data underscore the importance of the PCRS process in reaching high-risk populations and providing individuals with the critical linkage to appropriate prevention and treatment services. The data also illustrate the degree of success PCRS has already demonstrated.


Concerning the effectiveness of PCRS, we know that, in general, HIV-infected persons and their partners readily accept PCRS and, with appropriate counseling, will not only provide confidential and very sensitive information, but will actively assist in finding and encouraging partners and spouses to receive counseling and testing. Also, when located, sex partners are generally receptive to confidential notification by the client or the health department and will usually seek HIV testing. Another indication of the efficacy of PCRS is the fact that many people at high risk for infection are linked by this process to prevention services that have been proven to be effective.


Notwithstanding these benefits to public health, it is also important to note the practical limitations of PCRS. Frequently it is difficult or impossible to determine exactly when a person became infected with HIV and when specific sex or needle-sharing partners were exposed to the virus. During the potentially long period during which the virus could have been transmitted, the HIV-infected person may have had many partners. In addition, the HIV-infected person may not be able to identify all partners or know how to reach others who are known. Because of the long time periods involved, often it is difficult for the client or health department to locate all the partners, especially those exposed years earlier. Also, while many HIV-infected persons willingly participate in PCRS, fear or misunderstanding of health department policies and practices may keep some HIV-infected persons from coming forward or revealing information needed to reach partners and spouses. Another limitation is the lack of human and financial resources in the public health arena necessary to carry out this important prevention activity.


Let me now describe some of the numerous ways that CDC has been working to further strengthen and enhance PCRS activities. As a result of the reauthorization of the Ryan White legislation, each State is required to certify to CDC in writing the State's intent to comply with the spousal notification requirements contained in the legislation. Programmatic and legal staff of CDC and the Health Resources Services Administration have developed procedures and criteria for certifying each State's compliance with Ryan White CARE Act requirements that mandate that States make a good faith effort to notify spouses of known HIV-infected individuals. All States certified compliance by February 1997 and have taken action to implement spousal notification. No state opposed the requirements.


In addition to the specific activities related to spousal notification, CDC also provides technical assistance and guidance to help States achieve optimal performance in their PCRS programs. Spousal notification requirements have been reviewed and emphasized by CDC at numerous meetings, conferences, and workshops involving State and local HIV prevention programs and national organizations. CDC has published scientific articles on HIV prevention partner notification in peer-reviewed journals, emphasizing its importance, especially as it relates to primary prevention and linkage of HIV-infected persons to treatment. CDC has delivered training on PCRS through a satellite video conference and at national conferences, and training is currently being conducted at State and local health departments for staff who implement PCRS programs.


As I mentioned at the beginning, CDC, with input from a wide range of partners, also has developed comprehensive guidelines for HIV PCRS and recently mailed the draft to all health departments for comment. The HIV Partner Protection Act of 1998 and this new PCRS Guidance share important goals of notifying partners, including spouses, who may have been exposed to HIV and linking them to appropriate prevention and medical services. CDC believes that the new PCRS Guidance elevates partner counseling and referral services to a higher standard of public health practice and a greater degree of potential effectiveness. We will receive comments on the Guidance and will then finalize and implement it. If fully funded with adequate resources, we believe that PCRS would be very effective in achieving the goal of the HIV prevention while enactment of legislation such as the Partner Protection Act of 1998 would not add further public health benefit.


Let me now briefly address some other issues related to the HIV Partner Protection Act. The Act departs from the CDC Guidelines and science-based public health practice by mandating reporting of all HIV-positive tests, by client name, without any provision to support the continuation of anonymous testing. The resulting effect will be to discourage and drastically reduce anonymous testing opportunities. Anonymous testing has been strongly encouraged by CDC Guidelines and is integral to public health practice because it has been proven to bring people for testing earlier in the course of infection and also bring in people who might never access such services or who might access them only when symptoms of disease develop. CDC currently recommends that people who test positive in anonymous settings be linked with medical care so they can receive life-prolonging clinical services. In States that require name reporting, the names of clients who tested positive anonymously are reported to State health departments at the point of interacting with medical care providers.


In addition, we are concerned that directive legislation may inadvertently constrain the application of sound public health activities that require greater flexibility. For example, studies have shown that clients might fear having their partners notified because they have reason to anticipate a violent reaction from the partner. Providers must be sensitive to the threat of violence and other issues of concern to the client. PCRS providers should have the flexibility to make an assessment prior to notifying the partner and seek expert consultation before proceeding with notification. Legislative mandates could decrease the flexibility that public health staff require to apply sound judgment in complicated situations, as are frequently encountered when providing PCRS, especially those situations involving the potential for interpersonal violence. Passage of this or other legislation that might reduce this flexibility could prevent clients who fear such violence from seeking counseling and testing for HIV.


What then are our recommendations? We would like to have the opportunity to implement the new PCRS Guidance and then evaluate its outcomes and impact. CDC will provide technical assistance to State and local programs to build the service delivery capacity of PCRS programs and will continually assess PCRS practice across the country as programs are further developed and strengthened. Knowing the subcommittee's interest and concern, we would be happy to provide a progress report in six months from the date the Guidance is finalized, which we anticipate to be by year's end.


CDC is committed to strengthening HIV prevention efforts in reaching sex and needle-sharing partners, providing them with counseling about prevention, and, if they are infected, linking them to medical care and treatment. For this to be accomplished, CDC could support State and local health departments in expanding counseling and testing services, increasing the number of skilled counselors who establish that all-important trust with clients, providing more access to antiretroviral treatment and other needed services, and establishing new data collection systems. A significant investment of resources is needed to cover the costs of this large but essential piece of a comprehensive HIV prevention strategy.


Thank you for the opportunity to present our views on this important public health topic. I will be glad to respond to any questions you or other members of the subcommittee may have.


The House Committee on Commerce

2125 Rayburn House Office Building

Washington, DC 20515

(202) 225-2927

[email protected]

Society's Enormous Problem

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Joseph McNamara, a Hoover Institute fellow, sees the connection as simple common sense. "Many years ago, when I was police chief of San Jose," McNamara remembers, "I cooperated with Planned Parenthood, and I said: 'Your organization prevents more crime than mine does.' Children need love and nurturing. If there's no one there to provide that [because a child is unwanted], many are going to commit crimes and violent behavior. You don't have to be a criminologist to see that the children growing up under these conditions are at high risk. It's an enormous problem for society to have children born that no one wants and no one's able to take care of."

David Weisberg on Schneebaum

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What Schneebaum sought in these remote and hauntingly alien places was not some erotic Eden, like Margaret Mead's Samoa, but merely a positive version of his youthful subway sex. The negative anonymity of the homosexual act, in the midst of a crowd hostile to men fucking men, became, in Peru and Asmat, the welcoming anonymity of fucking men who he would never really know—except in the one way it mattered, the disinterested but connecting closeness of bodies. Or at least that's my theory. Schneebaum himself gently rebuffs all attempts to rationalize his obsession. "There is some element of all that," he said when I offered my interpretation, " but I do not want to understand it. I just want to do it. And now it's getting late in my life and I'll never do anything like it again. It was the best sex I've ever had. What can I say after that?"

Nude Weddings

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The coalition urged Mr Patterson to stop the nude weddings; so far the prime minister has not responded.

Kegels

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Exercise your hidden muscles.

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