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NOT B4 WE KNOW
Dec 11, 1996

First, before attempting a draft of this question, the word above should always be "Safer" sex, because there's never zero risk. 9 months after Magic Johnson's press conference was there a dip in the birth rate? Only the columnist Ann Landers has written more than once about what could be called NOT BEFORE WE KNOW. It's been said Dartmouth and some other colleges' and universities' health services have observed the unreported phenomenon both mixed and same sex couples are getting tested together before sex for everything, all sexually transmitted diseases including A. I. D. S., tuberculosis and vaccinated for hepatitus. These couples said they've not yet had contact sexually. They want to know what could possibly happen before it's too late to do anything about it. They want to reduce ambiguity. Neither people in public health nor A. I. D. S. advocates have reported the strategy potential partners get tested together before sex. It could have to do with a mythic ideal about the reliability of mutually faithful relationships. As partners move from what they might have previously thought to be a mutually faithful relationship to another one there's often at least a partner in the dark, overlap and exposure to infection. If a public health official was to mention the strategy potential partners get tested together before sex, his or her spouse might ask, "What about you, dear? Have you ever had another sexual opportunity?" That would end the nuclear family. Raising the standard of the potential relationship using test results worked for me. My partner says the same thing. We got tested together for everything before sex. We're both male. All our test results were negative. There's no test for the reliability of a relationship but there's tests for infections that can be prevented from being spread to another person. People could die from some infections which can be detected by getting tested. The researcher David Imagawa, M. D. studied the latency or window period so often used as an excuse to delay getting tested. It was reported by Dr. Altman in the New York Times that public health officials misinterpreted David Imagawa's studies. If you get tested together and an infection is detected earlier than later that's an effective course of action. There's no evidence of any lack of efficacy for getting tested. There's pleny of evidence of lack of efficacy and failure to use safer sex practices diligently. There's a failure rate for couples attempting to use condoms to prevent pregnancy. We're not internally programmed to use safer sex practices every single time from beginning to end. E. O. Wilson's writing on sociobiology has a lot of ideas about how our species and other species have evolved. Sex and death have always been intertwined. The biological imperative is too powerful for most people in the general population to take a course of action like the strategy getting tested together before sex. But for those that take the course of action, they reduce ambiguity. It can be that people as a result of what genes or genetic combinations they have develop very early on their capabilities or qualities from various sets of behaviors. Behavior can tend to eliminate genes from the gene pool or tend to diversify the gene pool. With an individual's free will for changing behavior, risk could be lowered and the odds raised in favor of any one individual or couple. Capability of Behavior change itself may be a quality some have and some not. Rick, have you and your partner been tested together for everything and vaccinated for hepatitus? What were the test results? Questions that come up from this attempt to draft these comments are very interesting. What other readers have done and think about it are very interesting. If testing worked to protect the blood supply it can work the same way for people in a potential relationship. Would there be any way of finding out if a dip in the birth rate occurred 9 months after Magic Johnson's press conference?

Response from Mr. Sowadsky

Hi. Thank you for your question.

People in public health have long stated that couples consider testing for HIV and other Sexually Transmitted Diseases (STD's) before getting sexually involved. We are now seeing more couples getting tested prior to sexual involvement. Not all couples want to do this, but we are seeing this more and more. In fact, some couples are going together to a clinic, as a kind of new "ritual in dating". And I always emphasize not to limit testing for HIV. It's important to include testing for other STD's as well. But people need to remember that for HIV, it can take up to 6 months to show positive on a test. If it's been less than 6 months after any possible exposure, we still do recommend using condoms consistently and correctly, to reduce the chances of acquiring HIV and other STD's (if the couple chooses to be sexually active during this 6 month period). And just because a person tests negative for HIV, doesn't mean they don't have other STD's. They have to be tested for oth er STD's as well, if they are considering not using condoms during sex.

I am also a strong advocate for vaccinations, including vaccinations for both Hepatitis A & B. So if a person will potentially be at risk for either Hepatitis A or Hepatitis B, they should consider vaccinations.

Without going into details, I do take steps to reduce my risks for HIV and other STD's. And yes, I have been vaccinated for both Hepatitis A and B. Because I have also traveled overseas to several developing nations (including those in Africa and South America), I have also been vaccinated for just about everything else, ranging from Typhoid Fever, to Yellow Fever, to Cholera.

I have also been tested for HIV. I got tested in a health department, through my private doctor, and through the new home tests. I got tested each way to get a personal insight as to what it's like to get tested each way.

I do not know of any study that has looked at birth rates in conjunction with the Magic Johnson announcement. But birth rate data are available at each states Vital Statistics Office. If you have any further questions please e-mail me at "nvhotline@aol.com" or call me at 1-800-842-AIDS.



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