mypersona

Thanks for the response. I agree it would be horrific to be in that scenario. But... (and I'm being a bit Devils Advocate here, because as I said before I'm still in two minds) sex is an inherently risky act. When you sleep with someone, regardless of the precautions you take, you expose yourself to the risk of sti's, including HIV, and even cancer (oral sex). If the risk increases as a result of my status then that's something to definitely disclose. If the increase in risk is very minute - then I'm not so sure. Thanks for treating this as a genuine appeal for discourse. I'm not here to push an agenda, or start a fight!

@inka Are you trying to work out if I'm someone you know in real life? If so - it's highly unlikely! I'm certainly not an aspiring geneticist, or a scientist of any kind - but I'm flattered that you would think so.

Thanks for the responses. Let me address a few points: "I understand you're coming from a place of wanting a healthy debate, but you aren't doing the research to properly debate this in a healthy way." Frankly that's flat out patronizing. I've backed up everything I've said with well-researched facts, and I even seem to have drawn your attention to one or two things you weren't quite aware of ;-). It might surprise you to know that your handout is not the only quality source of information on the subject. "It doesn't help to look at percentages broken down per sexual act, only over a span of time." So you say - but I'm interested in looking at the actual risk that an individual enters into with regards to a one-off sexual encounter. I find this *highly* relevant with regards to disclosure responsibility in casual sex situations (the subject of this thread). "And your no. 2 assumption above is incorrect. [edit]... — The 10% DOES take into consideration not having sex during an active outbreak." Have another read of my post - I'm afraid your logic has let you down again - I was also arguing that the 10% took into consideration no active outbreaks (in this instance we are both making the same point!). "I wonder how much of this debate you're wanting is fueled by a genuine desire for knowledge and how much of it is fueled by fear of disclosing?" Wonder all you like - or even better, have a re-read of my posts - I've been completely open about why I'm pursuing this as a conversation, so there's really no need to speculate. "Disclosing doesn't have to be the dealbreaker you're making it out to be in your mind." Since I haven't mentioned it - you have no idea what's going on in my mind. Stick to medical advice - your mind-reading skills turn out to be not that great! "Just as a bit of info for you, Adrial is in close contact with Dr Peter Leone, one of the top HSV researchers in the country...." I have no doubt that the resources and info on this site are well researched, well thought-out, well meaning, and up-to-date. To be honest I wouldn't be spending time here if it wasn't. I have enormous respect for the work you do, and support it in every way. You aspire to be a community founded on openness, which is admirable and crucial. But let me tell you - accusing people who present alternate points of view (backed up with considerable and accurate research) that they are 'not equipped to debate in a healthy way' is a way of shutting down debate. So is putting words in my mouth (or in my 'mind', lol). Just to be clear - I am not arguing against disclosure. I am questioning (and for me it's still a question) whether the risk level in the circumstances I've been discussing amounts to a cast-iron obligation. It's a big question - so my appeal to you is to please live up to your ambitions of encouraging debate in an open manner.

lol - I meant lesions, not legions. If you're having sex with legions, then you really are increasing the risk factor!

I take all of the above comments onboard. "Sil88's comment shows just how often your theory would be thrown off." - Well, yes and no. For a start, we are not a typical cross-section of the population - we're here for a reason ;-). Whether the odds of transmission were a million to one or ten to one, this site is where you would find the recipients. Taking his case as an example (I'm going to have to make some assumptions here, so correct me if I'm wrong @Sil88) - first I'm going to assume that like most people the woman involved was not taking daily antivirals. That doubles the risk up to 5000-1 straight away. Then I'm going to assume they had sex like, ten times during that first week together (I know what new love is like!) - then the odds have dropped all the way to 500-1 - still a high number, but you can see how we are operating in a whole new ball game now (expressed as a percentage that's 0.2%). I imagine that a number of things conspire to make transmission so widespread - no.1, sex without condoms - it's such a natural mistake to make (I can attest to that); no.2, symptoms in place - make love when there are active legions and all of the above transmission stats are irrelevant. Even the highest figure of 10% (no condom, no antivirals) doesn't allow for the presence of active legions. I imagine that there are instances where people are unaware that their sexual partner is displaying symptoms, as crazy as that may seem; no.3, ignorance of status - as widely noted, most people who are carriers don't actually know they have it, which in turn leads to unsafe practices and transmission. So if the odds are low, they're low. There's no use denying it. Unless you have solid evidence to back it up. Serious disclaimer: I haven't done any math like this since school days, and I really wouldn't want anyone to risk their sexual health (or that of others) based on my musings at this stage. I'd be really grateful if someone (who actually knows statistical mathematics!) could go through my workings. At some point I would like to join in more with the debate about the importance of disclosure, and the emotional implications of 'casual' sex. But I really had to get this idea off my chest first and discuss it.

Thanks @WCSDancer2010 . I'm talking about this here because the site encourages a high quality of debate. I'm wary of putting out any data or perspective that discourages people from disclosing, as ultimately it's a very important thing. But it's also very complex - there's a world of misinformation and prejudice out there. Disclosure exposes you to prejudice, potential breaches of trust by people you don't know particularly well, and sometimes unwarranted rejection. Emotionally it's not a one-way street. If transmission rates for a sexual encounter were as high as most people (including seemingly some experienced people in the field) assume, then disclosure would be an absolute no-brainer. It would be criminal and immoral to expose someone knowingly to a 5%, 3%, or even a 1% risk of infection. But I believe the minute nature of risk for individual encounters *is* somewhat relevant to the morality of the debate. I had conservatively used once a week as a base for my 'per year' calculations. Your post, and further info on the page I linked to, now leads me to believe that twice a week is the standard reference. That actually halves the risk quoted in all my calculations. For perspective - that makes the female --> male transmission likelihood (for a single encounter) 1 in 10,000! That's significantly low. Amazingly low in my opinion. Out of interest - that figure is very similar to the one quoted in my post above. If I were to sleep with someone as a one-off, I would have to think long and hard about whether I had an actual *obligation* to inform them about something so infinitesimally unlikely to occur. I know that all of this goes against the established culture - and that it might even annoy or upset some people. Believe me - that is not my intention. Like many, I am struggling to make best sense of how best to navigate all of this. I'm also aware that I haven't discovered some magic 'get out of jail' card. Relationships are unpredictable - what starts as a single night of passion can turn into something much deeper and more lasting. Those percentages soon start to add up (like the dice in my previous analogy). As others have rightly said - what then? I can't even imagine broaching this subject with someone, having already taken the above decision without their knowledge - not a great way to try to start a relationship! But I'm still convinced my calculation method is correct, and that the figures are in the right ball park at least. I'd be interested in further examination of them, and the topic as a whole.

Thanks for the response Adrial. You're right, I'm really eager to be clear, and very much welcome the debate. With respect - I still think you're wrong. There's a difference between atributing a percentage chance to a single act of sex, versus an accumulation of percentage chances building up over a year. What's the percentage chance of rolling a 6 on a single dice? 16.7% (approx.) If you roll the dice once, what is the percentage chance you will hit 6? - 16.7% If you roll the dice twice, what is the percentage chance you will hit 6? - For each roll it remains 16.7%, but the accumulated total (the chance of either of your dice rolls coming up 6) doubles. If you roll the dice every day for a year, what is the accumulated percentage chance of a 6 then? (virtually 100% of course). Stats for transmission are not based on a single contact, but rather the accumulated risk over the period of a year for a 'typical' couple. This quote further illustrates the point, from an 18 month study of couples, the result of a quick search: "Women acquired the virus at a rate of 8.9 per 10,000 sex acts--almost six times the rate of men (1.5 per 10,000 sex acts)." from: http://www.guttmacher.org/pubs/journals/2721301b.html Those figures are way, way lower than the 5% - 2% range, and much nearer to the sub - 0.05 range I was predicting. None of this is intended as a license to act without responsibility. I just want to try to get the facts straight in my head. I appreciate your input.

Thanks for the response Adrial, but I actually think you've got the math wrong! If the figures are for a year then each instance does break down smaller. To use your analogy as an example - you said that 'if the odds on a casino game are 50% chance of winning...', but that is not the same as saying 'if the odds of playing a casino game at regular intervals for a year give you a 50% chance of winning...'. That would be a more reasonable comparison. Imagine that scenario - your odds of winning are 50% *if you play for a year* - do you really think you would have a 50% chance of winning every time you played? Would the person who played 3 times have the exact same chance of winning as the person who played a hundred times? I'm very happy to be proved wrong on this (well, I wouldn't be that happy, as it would mean a higher transmission rate!). In fact one of the reasons I'm posting is because I want to challenge my own ideas. But at the moment I think my workings are sound. The other things that you and others have posted are all very valid of course.

I like that this is being discussed in a thoughtful and frank manner. I too wonder about casual disclosure. The sheer math has me thinking. Please correct me if I'm wrong about this... [seriously - math is not my strong suit, so forgive me if I'm making dumb errors here!] The odds for a woman contracting from a positive man (unprotected sex, outside of breakouts) is around 10%, halving to 5% with condom use, halving again to 2.5% with suppressive therapy (regular antivirals). The odds for a positive woman passing on the virus are even lower (starting at 4%, halving to 2% with condoms, and 1% with antivirals). It's a pretty low risk - but it's still a risk, right? But, hold on - if I understand correctly, then these figures are taken from studies of risk *over the period of a year*. That means that each single instance of sex carries a significantly lower chance of transmission. Taking what I think is a fairly conservative estimate of average sex sessions for a couple, say - 50 times per year (that's less than once a week), the chances of transmission for a one-off sexual encounter (assuming no breakouts, with condom use, and antivirals) look like this: Positive man ---> woman (2.5% / 50) = 0.05% Positive woman ---> man (1% / 50) = 0.02% Now the risk is looking particularly tiny. For the smaller of the two numbers that's one chance in 5,000 that transmission will take place. For further context - if a positive woman sleeps with a non-positive man (with the above conditions in place), she has *twice the risk of becoming pregnant* than he does of contracting herpes ( - yes, that's despite the condom!). I still haven't made my mind up fully about total and always disclosure. But the above has given me food for thought. I would be happy if someone would check my reasoning and calculations.