Condom Broke - Should I Take Anti Retrovirals? Antibiotics?

[Orac]

Thank God this "broken condom" thing has never happened to me (yet) but this is an interesting thread nevertheless, and I found this online "assessment tool" to estimate the risk of HIV contraction for broken condom cases, and whether PEP would be helpful:

http://www.pep.chapsonline.org.uk/self_assessment.asp

Putting your faith in some omnipresent being that a condom won't break or believing that he provides some protection for sex-tourists sounds a touch naive to me

[Sheryl]

An unhelpful/judgemental post has been deleted along with responses it generated.

Members are reminded to review the health forum specific rules before posting. This is a place for people to seek and obtain information/advice on matters which are often highly sensitive. As such, there is zero tolerance for flaming (even when meant as humor) and criticisms of the type that would make people hesitant to post such matters here will likewise absolutely not be tolerated.

Tolley: the odds will vary enormously depending on all sorts of factors: viral load of the infected person, whether the man is circumcised, nature and vigorousness of the sexual contact, presence of sores or abrasions, etc etc. An "average" risk ratio doesn't really tell much since the variance can be very, very wide. Plus, it has not in fact ever been scientifically quantified. The research that would be needed to do so being obviously unethical.

[TheyCallmeScooter]

It's an interesting thread. Did I miss it or did no one mention Herpes?

Isn't he basically out of action for 6 months before he'll be cleared on that score?

Perhaps we can go native and say a 'face saver' is required, eg, dodgy dentist, came in to contact with blood, etc,

OP can no doubt think of something, after all has shown no lack of duplicity so far.

Yeah the OP didn't seem to be freaking out too much about the wife, but I was thinking maybe last night 'drunken' tattoo incident, came to senses only moments after needle breached skin, but very worried as shanty with apparent HIV scare recently, tattooist drunk could barely keep eyes open, I dunno.

I'd probably do something like that, if I ever become a cad.

I've had g/f's cheat and nice enough to encircle me in the 3-way, indirectly. Very sweet stuff.

Don't worry, i break condoms almost every time, because i am oversized and it's difficult to find good stuff here.

Mail will be your friend, I think...

http://www.condomdepot.com/reviews/best-condoms.cfm

The Japanese seem to approach the design / production process with an acceptable level of solemnity & sober due care. I'm impressed. Probably no OP incidents with the ones that won No 1 10 years in a row.

[mark45y]

It's an interesting thread. Did I miss it or did no one mention Herpes?

Isn't he basically out of action for 6 months before he'll be cleared on that score?

Perhaps we can go native and say a 'face saver' is required, eg, dodgy dentist, came in to contact with blood, etc,

OP can no doubt think of something, after all has shown no lack of duplicity so far.

Yeah the OP didn't seem to be freaking out too much about the wife, but I was thinking maybe last night 'drunken' tattoo incident, came to senses only moments after needle breached skin, but very worried as shanty with apparent HIV scare recently, tattooist drunk could barely keep eyes open, I dunno.

I'd probably do something like that, if I ever become a cad.

I've had g/f's cheat and nice enough to encircle me in the 3-way, indirectly. Very sweet stuff.

Don't worry, i break condoms almost every time, because i am oversized and it's difficult to find good stuff here.

Mail will be your friend, I think...

http://www.condomdepot.com/reviews/best-condoms.cfm

The Japanese seem to approach the design / production process with an acceptable level of solemnity & sober due care. I'm impressed. Probably no OP incidents with the ones that won No 1 10 years in a row.

If you include oral herpes I would imagine 50% of the Thai population has one or the other. Perhaps I am wrong. Isn't there some new herpes medication that one can take if you get it the first time and catch it early that actually kills the virus?

[TheyCallmeScooter]

It's an interesting thread. Did I miss it or did no one mention Herpes?

Isn't he basically out of action for 6 months before he'll be cleared on that score?

If you include oral herpes I would imagine 50% of the Thai population has one or the other. Perhaps I am wrong. Isn't there some new herpes medication that one can take if you get it the first time and catch it early that actually kills the virus?

I'm very interested in comments on this, because something is very confusing or simply incorrect about the published material online and what I've been told by docs.

I thought because it's a virus, you can't inoculate or treat...only alleviate symptoms right?

What's the deal with something like 80% of people being immune ? or they can't catch it ? but they're carriers still ? It's all very confusing and vague...

[mark45y]

It's an interesting thread. Did I miss it or did no one mention Herpes?

Isn't he basically out of action for 6 months before he'll be cleared on that score?

If you include oral herpes I would imagine 50% of the Thai population has one or the other. Perhaps I am wrong. Isn't there some new herpes medication that one can take if you get it the first time and catch it early that actually kills the virus?

I'm very interested in comments on this, because something is very confusing or simply incorrect about the published material online and what I've been told by docs.

I thought because it's a virus, you can't inoculate or treat...only alleviate symptoms right?

What's the deal with something like 80% of people being immune ? or they can't catch it ? but they're carriers still ? It's all very confusing and vague...

Herpes shows up 2-12 days after exposure. However after that outbreak is over it takes 3 months for the antibodies that they test for to show up.

You can control it with antivirals but not cure it. So if one takes Valtrex or acylovir before sex does that prevent one from catching it?

Most Thai drug stores have these medications right up front so I imagine they sell a lot of it. I read years ago that a large dose of one of the available prescription medications would stop it if taken quickly after the first exposure. I don't know if this is true.

Can you get genital herpes from oral herpes? You see a lot of cold sores here. Condoms don't protect against it.

Interesting topic. I asked a doctor to test a lady here for herpes and he told me to wait for an outbreak to show up. Well, that kind of defeats the purpose. I took another lady in for diagnosis and the doctor broke the blisters with a needle and put something like iodine on them and told me she didn't have herpes. I thought the doctor was in error.

Also it is my understand that the medical profession says you can pass on herpes without having symptoms. I don't believe this but that's what I have read. I think it is a case of the person with herpes not wanting to tell his partner that he had symptoms and ignored them because he wanted to have sex. So the doctors to keep everyone happy just say that you can infect people without having the symptoms.

[TheyCallmeScooter]

Herpes shows up 2-12 days after exposure. However after that outbreak is over it takes 3 months for the antibodies that they test for to show up.

You can control it with antivirals but not cure it. So if one takes Valtrex or acylovir before sex does that prevent one from catching it?

Most Thai drug stores have these medications right up front so I imagine they sell a lot of it. I read years ago that a large dose of one of the available prescription medications would stop it if taken quickly after the first exposure. I don't know if this is true.

Can you get genital herpes from oral herpes? You see a lot of cold sores here. Condoms don't protect against it.

Interesting topic. I asked a doctor to test a lady here for herpes and he told me to wait for an outbreak to show up. Well, that kind of defeats the purpose. I took another lady in for diagnosis and the doctor broke the blisters with a needle and put something like iodine on them and told me she didn't have herpes. I thought the doctor was in error.

Also it is my understand that the medical profession says you can pass on herpes without having symptoms. I don't believe this but that's what I have read. I think it is a case of the person with herpes not wanting to tell his partner that he had symptoms and ignored them because he wanted to have sex. So the doctors to keep everyone happy just say that you can infect people without having the symptoms.

You've mentioned a lot of the points of confusion / contradiction which comprise my current 'understanding' of the situation (and I'm not saying the medical industry's 'understanding' is any more enlightened; as the doctors above show, and it's disturbing how a specialist will be really adamant that another specialist is wrong. For f's sake.)

I was told by my doctors it was 6 weeks before it even shows after exposure, I spent a month of hell in vain it seems - after my ex-g/f casually mentioned one day she'd recently had her first outbreak in years. Just matter-of-fact like. In passing. First time it crossed her mind, guess it just never came up until then. Didn't come up then, for that matter, aside from her blurting out a random anecdote. She didn't credit my concerns as valid, and not because my stunned response was effectively stunned under-reaction. 2 months later, in response to a clipped reminded of why we were not together, in genuine disbelief and confusion, she's like "But you didn't even catch it...!? You're still emo about something that never happened?" She's very result-orientated, in her outlook, which is dangerous for someone who lives in the moment - but a lot more dangerous for those around them. Because the moments of others are of very little interest to people who live in the moment. Always their moment, of course.

My doctors then cleared me after 6 weeks with a test for antibodies that cannot have showed for another 6 weeks? vomit. What a joke industry.

The whole controlling symptoms which does not cure, but whether or not it assists with prevention...I cannot make heads or tails of. Well-respected online repositories contradict each other, or seem to contradict themselves - what I suspect is that yes, it greatly minimises chance of spreading, but the well-intentioned idiotic doctors give false information as they are worried that correct info will make people think they're saying an effective treatment plan for controlling symptoms allows them to be nauseatingly selfish. This is my gut read, fwiw - probably worth very little as some pretty established medical journals say it's transmitted during shedding, and shedding is invisible and cannot be controlled. So what do I know. Roughly ~ or = what they know. So very little, it would seem...

Everyone is in consensus I believe, that oral sex easily converts cold sores into the donkdown variety. I think infection not as likely, but...the % of people who get cold sores...and the % of people who use protection during oral...herpes should basically have become simply part of the wonderful human experience by now. Or... is that pretty much what it has become, as some statistic sites suggest...

If you take all the 'scientific' %'s for all the crap our intelligently-designed bodies are saddled with, anyone who isn't infected with a portfolio of incurable viruses, handicapped or restricted by a wide range of genetic defects, currently fighting multiple cancers, and on sick leave dealing with run-of-the-mill hive / haemorrhoid / hepatitis cocktail variants or otherwise racked with illness is ostensibly a freak outlier. On a sample where 90% of data samples are freakish outlier results. I think the %'s are a crock of sh...but that's not really helpful, either...

I could almost sympathise with my ex-g/f's inshallah approach to sex health, after spend dozens of hours getting frustrated studying the medical 'facts'. But then of course, she would find dozens of seconds to be a god-awful bore - spending hours? She'd demand someone "kill me now". And I would have been forced to (regrettably) decline. Probably not before some extended heated internal dialogue, and some audible sighs. At least, I hope so...

[Phil Conners]

AFAIK they're testing herpes vaccine but it's still not particularly effective judging by the articles I've been able to find.

At this time, once you got it you got it for life. You may not have outbreaks for extended periods but it's still there.

Acyclovir may sometimes alleviate the outbreak but the effect varies a lot depending on the individual.

You can pass it on anytime but the risk is higher during an outbreak.

[BigJohnson]

The general ignorance of how to contract HIV/AIDS is very alarming!

Facts:

1. HIV/AIDS can be contracted though any type of fluid exchange; i.e. sex, blood splattering into the eyes, needle prick, etc.

2. HIV/AIDS can be contracted from having sex with someone only once.

3. Condoms DO NOT 100% prevent contracting HIV/AIDS from someone who is infected, they do help reduce the risks.

4. Not only SEX WORKERS have HIV/AIDS; "Nice Girls" have it too and many do not know they have it.

JUST REMEMBER THAT YOU ARE HAVING SEX WITH EVERYONE THAT YOUR CHOSEN LADY OF THE EVENING HAS HAD PRIOR TO YOU!

ALSO, JUST BECAUSE A SEX WORKER HAS A CERTIFICATE OF CLEAN HEALTH (MOST ARE FORGED) AND/OR TELLS YOU SHE IS DISEASE FREE THE CHANCES THAT EVEN IF SHE IS INFECTED SHE IS NOT GOING TO GIVE UP HER NIGHT JOB JUST FOR A MORAL OBLIGATION.

[fishhooks]

OP is well home by now, left about 5 days back, wonder if he is still reading, or able to?

[mark45y]

The general ignorance of how to contract HIV/AIDS is very alarming!

Facts:

1. HIV/AIDS can be contracted though any type of fluid exchange; i.e. sex, blood splattering into the eyes, needle prick, etc.

2. HIV/AIDS can be contracted from having sex with someone only once.

3. Condoms DO NOT 100% prevent contracting HIV/AIDS from someone who is infected, they do help reduce the risks.

4. Not only SEX WORKERS have HIV/AIDS; "Nice Girls" have it too and many do not know they have it.

JUST REMEMBER THAT YOU ARE HAVING SEX WITH EVERYONE THAT YOUR CHOSEN LADY OF THE EVENING HAS HAD PRIOR TO YOU!

ALSO, JUST BECAUSE A SEX WORKER HAS A CERTIFICATE OF CLEAN HEALTH (MOST ARE FORGED) AND/OR TELLS YOU SHE IS DISEASE FREE THE CHANCES THAT EVEN IF SHE IS INFECTED SHE IS NOT GOING TO GIVE UP HER NIGHT JOB JUST FOR A MORAL OBLIGATION.

Big Johnson you may be a Medic but you don't have much experience with Thai bar girls. No, most health certificates are not forged. You may have gotten that from an NGO site dealing with some part of the world where health certificates are mandatory as I imagine you did. Thailand does not require health certificates to work in a bar. A few bars and go go's require the ladies are tested before employment and monthly after that. Normally they test for HIV and Syphilis before employment and then every 6 months. Some bars test for other STD's weekly or monthly. Some bars bring in a doctor to the bar others require the ladies go to a clinic where they have a discount rate set up. Almost always the ladies are required to pay for the test themselves but since they get a group discount it is not much.

I would suggest before you begin posting as an expert on sex and STD's in Thailand that you have some actual experience in the country. You can get this experience working at a Thai hospital in a night life area such as Pattaya or Bangkok or in the business by being a bar owner or manager.

My experience suggests that out of 200 bars in Pattaya 10 require tests.

Edited March 29, 2011 by mark45y

[mark45y]

3. You could also have done this before you had sex with the lady.

.......:....yes I do that on the way to the short time hotel every time......

I, of course hear what you are saying but it is surprisingly easy and quick to test as there are clinics close to most bar areas and they are open at night. 10 minutes could save you a lot of trouble. A lot of guys do this, thinking punters as it were. I know I do. I also date a couple of the nurses at the clinics and require them to be tested also. Never seems to create a problem. One doctor smiled a bit when the nurse balked at the test and he told her in no uncertain terms that it was a good idea. HIV tests only take a couple of minutes but the others require a lab and that is usually a next day thing unless you go straight to Pattaya Memorial hospital which is close but you have to go in the daytime to get the results quickly. Pattaya Memorial also uses very small Q tips which don't hurt a man as opposed to the big Q tips used at most clinics. The big ones hurt as the nurse has a tendency to go a long way in. Men are far easier to check for any bacterial infections than women because the location for infection is smaller.

[Phil Conners]

A large number of irrelevant and off-topic posts have been deleted.

Please try to remember this is a health forum, not a jokes forum.

Also, rule #18 applies:

18) Not to discuss the specifics of prostitution.

Thailand has a visible sex industry, and acknowledgment of that fact is not forbidden. However ThaiVisa is not the place to seek or give information on this topic, regardless of your sexual habits, preferences or orientation.

[BuckarooBanzai]

I only post this for other posters who may be reading the thread because I imagine you don't have the time. 1. You could have the lady tested and find out if she has any STD's. 2. If you pay her for her time and trouble she won't give you much hassle about it. 3. You could also have done this before you had sex with the lady. 4. Condoms break all the time (especially if you mix oral and vaginal sex with the same condom. Change condoms when the lube wears off). 5. The treatment for chlamydia is a shot (IV drugs) and pills (in my experience). 6. Zithromax (azithromycin) may or may not cure depends on the person. It is not a sure thing 100% of the time. 7. Two condoms don't work better than one condom.

8. The drugs you get here may or may not be real depending on where you get them. 9. Wear white underwear and look for a stain. 10. Milk your penis a few times a day and check for a discharge from clear to white or yellow/green. 11. Also check for pimples, warts, sores on a daily basis. Good luck.

Very good advice!

If you have been circumsized your chances of infection are greatly reduced. The lack of a foreskin eliminates the exceptionally humid protected environment provided by having one.

You are making a potential life changing decision in what you do - get the girl checked and avoid the potential disaster a foreclosure could entail which would change the rest of your life.

Edited March 29, 2011 by BuckarooBanzai

[BigJohnson]

The general ignorance of how to contract HIV/AIDS is very alarming!

Facts:

1. HIV/AIDS can be contracted though any type of fluid exchange; i.e. sex, blood splattering into the eyes, needle prick, etc.

2. HIV/AIDS can be contracted from having sex with someone only once.

3. Condoms DO NOT 100% prevent contracting HIV/AIDS from someone who is infected, they do help reduce the risks.

4. Not only SEX WORKERS have HIV/AIDS; "Nice Girls" have it too and many do not know they have it.

JUST REMEMBER THAT YOU ARE HAVING SEX WITH EVERYONE THAT YOUR CHOSEN LADY OF THE EVENING HAS HAD PRIOR TO YOU!

ALSO, JUST BECAUSE A SEX WORKER HAS A CERTIFICATE OF CLEAN HEALTH (MOST ARE FORGED) AND/OR TELLS YOU SHE IS DISEASE FREE THE CHANCES THAT EVEN IF SHE IS INFECTED SHE IS NOT GOING TO GIVE UP HER NIGHT JOB JUST FOR A MORAL OBLIGATION.

Big Johnson you may be a Medic but you don't have much experience with Thai bar girls. No, most health certificates are not forged. You may have gotten that from an NGO site dealing with some part of the world where health certificates are mandatory as I imagine you did. Thailand does not require health certificates to work in a bar. A few bars and go go's require the ladies are tested before employment and monthly after that. Normally they test for HIV and Syphilis before employment and then every 6 months. Some bars test for other STD's weekly or monthly. Some bars bring in a doctor to the bar others require the ladies go to a clinic where they have a discount rate set up. Almost always the ladies are required to pay for the test themselves but since they get a group discount it is not much.

I would suggest before you begin posting as an expert on sex and STD's in Thailand that you have some actual experience in the country. You can get this experience working at a Thai hospital in a night life area such as Pattaya or Bangkok or in the business by being a bar owner or manager.

My experience suggests that out of 200 bars in Pattaya 10 require tests.

Normally I would not justify a comment, but this is an issue I am passionate about.....so, to clear up any misgivings:

1. I DO work with the medical community in Bangkok teaching UNIVERSAL PRECAUTIONS (+6 YEARS IN BANGKOK!)

2. I did not say that the bars required health certificates; I said that many girls tend to produce one to show their "clients"

3. I didn't claim to be an "EXPERT" (BTW does medical school count as some kind of expertise?) but I think I have a little more experience than a bar owner/manager AND I am not just a "medic".

4. I volunteer to educate sex workers on STD's and find them sponsors (ones without sexual intentions) to help them get out of the sex trade.

There is a post in the news section about 1.1 million HIV/AIDS cases in Thailand and it is not just confined to sex workers....it is up to everyone to educate themselves on this pandemic and a morally right for those who have "EXPERTISE" on the subject to try to help as many people as we can...YOU MIGHT NOT BE ABLE TO CHANGE THE WORLD, BUT YOU CAN MAKE A DIFFERENCE!

[cyberia]

Man

first, stop panicking,

your most worry right now should be chlamydia, trich and claps.

get Flagyl for trich, and Azithromycin for chlamidia,

I think they have generics here, called something like Azicin for Azithromycin and Flagyl is availavle here it's actually Metronidazole.

Flagyl you can buy by the pill, you need 2g as one dose, so 5 pills 400mg each. thats about 50-60 Baht here.

But check the dosage on the Web, don't ask the pharmacist, they may not know.

As for Azithromycin you need 1g as one dose again to get rid of Chlamydia. a pack will set u back 200 - 300 baht. depends on where u buy

Check the dosage on the Web again.

it's best not to have sex for a week, don't know if you can accomplish that

The reason is as the doctor explained it to me some time ago is that, you take the treatment as a single dose but it will take a few days for the meds to do the work.

shit happens

Good luck

Edited March 30, 2011 by cyberia

[TheyCallmeScooter]

AFAIK they're testing herpes vaccine but it's still not particularly effective judging by the articles I've been able to find.

At this time, once you got it you got it for life. You may not have outbreaks for extended periods but it's still there.

Acyclovir may sometimes alleviate the outbreak but the effect varies a lot depending on the individual.

You can pass it on anytime but the risk is higher during an outbreak.

Thanks for the concise summary Phil, it's about where I had gotten to after circle-jerking around the field of certain yet not always concurring medical facts.

I read up on some of those studies as they're mildly interesting - and wow, if one arrives within a decade I'd be stunned. All the "realist but positive thinking" estimates seem to be 4-5 yrs, crossing fingers. The $ just mustn't be there, and I wonder just now whether the development of a vaccine for what they're already providing "treatment for period of life"... disincentive, I wonder? Maybe I'm too cynical...

The general ignorance of how to contract HIV/AIDS is very alarming!

Facts:

1. HIV/AIDS can be contracted though any type of fluid exchange; i.e. sex, blood splattering into the eyes, needle prick, etc.

2. HIV/AIDS can be contracted from having sex with someone only once.

3. Condoms DO NOT 100% prevent contracting HIV/AIDS from someone who is infected, they do help reduce the risks.

4. Not only SEX WORKERS have HIV/AIDS; "Nice Girls" have it too and many do not know they have it.

JUST REMEMBER THAT YOU ARE HAVING SEX WITH EVERYONE THAT YOUR CHOSEN LADY OF THE EVENING HAS HAD PRIOR TO YOU!

ALSO, JUST BECAUSE A SEX WORKER HAS A CERTIFICATE OF CLEAN HEALTH (MOST ARE FORGED) AND/OR TELLS YOU SHE IS DISEASE FREE THE CHANCES THAT EVEN IF SHE IS INFECTED SHE IS NOT GOING TO GIVE UP HER NIGHT JOB JUST FOR A MORAL OBLIGATION.

Hyperbole will have the reverse effect on the chances of your message being picked up by the desired recipients. You don't need to scream something many know is true but are treating it on a matter of scale - all you do is reinforce their conviction that you lied (you didn't, though it's circuitous) when they sleep with a positive active infection and slide through without impact. . People don't like being indirectly manipulated into bracketing across their preferences after they've preferences out.

Your first sentence above they claim is valuable in high school scare sex ed. I am not only not convinced I'm quite sure it's bullshit. Because...think about it. It's riddled with valueless dismissed nonsense, critical minds won't get as far as to work out what went wrong. I mean, for starters...the house would be taking a cut, or the cops or something. I can't have a 300 person orgy without endless complaints which suck the romance out of the affair by the time number 88 was called (and I bribed my way up the list to ensure some romance was still on the cards. ANd then she made me stop for a condom. And I said "that's it. Also, are the 300 invoked? What if some have moved on, to John Edwards or down the queue?

FORGED certificates aren't necessary because have you ever even seen a "CLEAN BILL OF HEALTH" ? I haven't. I don't even think there'd be a group whch you can slot into a shared group.

Teach intelligently. Otherwise there is no point, or even worse. As overheard but uncomprehended warnings get blurred into a bit batch file of errors and faulty isolations and errors

as your message will present in unsuccessful / increased resistance to immunization if one doesn't get it right on the first or however many goes.

I will try and post balanced argument in my next post. Against every decent-leaning fibre's yelling at your approach to the 'problem'. At the sheer, complicit, facilitating tragedy of your method for 'helping' the victims of a nationwide, SYSTEM-ENDEMIC issue that goes so far beyond mere tangibles into a world of complex duplicities and double meanings and contradictions and lies, one who delves into the world of Thai culture and tradition, the incubator for the only nation in the world where there is a genuine accepted cultural value which is more or less purely about a single issue, the prostitution of girls, by families, extended families, networks, village hierarchies, and BEYOND. I don't run nations, I never have and can't see how I ever will. In Britain there is corruption that can be traced with a marker pen to the top. And I do not mean to the government, when I say to the top. But perhaps it might be clearer if I correctly say it can be traced to and ALMOST EVERYWHERE one might alight upon, at the TOP.

[Fookhaht]

Go see a real physician at a reputable hospital or clinic. The "doctors" here on Thaivisa generally have no idea what they're talking about.

In many cases, correct, but don't paint everyone here with your broad brush. Specifically, you can have confidence in moderator/poster Sheryl's advice. I've seen her qualifications & experience and we are very lucky to have her input on TV.

Edited March 30, 2011 by Fookhaht

[mark45y]

The general ignorance of how to contract HIV/AIDS is very alarming!

Facts:

1. HIV/AIDS can be contracted though any type of fluid exchange; i.e. sex, blood splattering into the eyes, needle prick, etc.

2. HIV/AIDS can be contracted from having sex with someone only once.

3. Condoms DO NOT 100% prevent contracting HIV/AIDS from someone who is infected, they do help reduce the risks.

4. Not only SEX WORKERS have HIV/AIDS; "Nice Girls" have it too and many do not know they have it.

JUST REMEMBER THAT YOU ARE HAVING SEX WITH EVERYONE THAT YOUR CHOSEN LADY OF THE EVENING HAS HAD PRIOR TO YOU!

ALSO, JUST BECAUSE A SEX WORKER HAS A CERTIFICATE OF CLEAN HEALTH (MOST ARE FORGED) AND/OR TELLS YOU SHE IS DISEASE FREE THE CHANCES THAT EVEN IF SHE IS INFECTED SHE IS NOT GOING TO GIVE UP HER NIGHT JOB JUST FOR A MORAL OBLIGATION.

Big Johnson you may be a Medic but you don't have much experience with Thai bar girls. No, most health certificates are not forged. You may have gotten that from an NGO site dealing with some part of the world where health certificates are mandatory as I imagine you did. Thailand does not require health certificates to work in a bar. A few bars and go go's require the ladies are tested before employment and monthly after that. Normally they test for HIV and Syphilis before employment and then every 6 months. Some bars test for other STD's weekly or monthly. Some bars bring in a doctor to the bar others require the ladies go to a clinic where they have a discount rate set up. Almost always the ladies are required to pay for the test themselves but since they get a group discount it is not much.

I would suggest before you begin posting as an expert on sex and STD's in Thailand that you have some actual experience in the country. You can get this experience working at a Thai hospital in a night life area such as Pattaya or Bangkok or in the business by being a bar owner or manager.

My experience suggests that out of 200 bars in Pattaya 10 require tests.

Normally I would not justify a comment, but this is an issue I am passionate about.....so, to clear up any misgivings:

1. I DO work with the medical community in Bangkok teaching UNIVERSAL PRECAUTIONS (+6 YEARS IN BANGKOK!)

2. I did not say that the bars required health certificates; I said that many girls tend to produce one to show their "clients"

3. I didn't claim to be an "EXPERT" (BTW does medical school count as some kind of expertise?) but I think I have a little more experience than a bar owner/manager AND I am not just a "medic".

4. I volunteer to educate sex workers on STD's and find them sponsors (ones without sexual intentions) to help them get out of the sex trade.

There is a post in the news section about 1.1 million HIV/AIDS cases in Thailand and it is not just confined to sex workers....it is up to everyone to educate themselves on this pandemic and a morally right for those who have "EXPERTISE" on the subject to try to help as many people as we can...YOU MIGHT NOT BE ABLE TO CHANGE THE WORLD, BUT YOU CAN MAKE A DIFFERENCE!

I justify my comments all the time so it doesn't bother me.

I only took issue with your statement about sex workers and health certificates being forged. I have never had nor have I heard of a sex worker showing someone a forged health certificate.

Perhaps that exists but it is certainly so small a number as to be negligible.

I completely agree with education of everyone about STD's and that includes both parties involved.

I also agree with your statement about not being able to change the world as prostitution is the oldest profession and people have been trying to help get people out of it since human time began.

There have been a number of posts on this thread about self treatment and self diagnosis. Since it so easy to get tested in Thailand I wonder why everyone would not do it even in the short term.

It doesn't hurt. The last time I was treated for chlamydia the doctor put a little individually packaged IV in my vein in my arm and injected a medication into the little IV thing. I didn't even feel it. He also gave me a choice of one week of pills or two. He was treating for chlamydia and Trichomoniasis.

Since I have more experience with Pattaya I will discuss that area. It is easy, quick and simple to go to Pattaya Memorial to be checked out. No one stares at you or laughs at you. The doctors are business like and the lab is quick and efficient and painless owing to good needle techniques and little Q tips instead of big ones. Also the clinics I have been to on Soi BuaKhow are well equipped and have volumes of knowledge about STD's. Both of the above options treat hundreds of STD's on a daily basis and I would imagine that leads to some expertise.

I think we both have the same end goal in mind of reducing STD's. The majority of Thais have little knowledge of infection prevention and also superstition coupled with that small base of knowledge of sanitation and sterile conditions.

Education of sex workers should include training on putting on condoms and the fact that a different condom is needed for each woman. In other words if the condom does not go on the first time because it is backwards, don't turn it around, get a fresh condom. And a separate condom is needed for each partner involved, not one for the man shared among a number of women or other partners. I am trying not to get too graphic but if the man changes partners he should also change condoms. The ladies don't seem to realize this on a regular basis.

I don't know if Herpes can be protected against by taking anti virals prior to exposure. I would think not but would appreciate some factual information on the issue. I also don't know if oral herpes, a cold sore, can be transferred to the genitals and would appreciate some information on that.

Sex workers should also be educated about all strains of the herpes virus and I don't think this is done in any detail but again I could be wrong. I also don't know if sex workers are advised to get vaccinated against the types of hepatitis that one can vaccinate against. Are they?

Since we have a person who educates sex workers perhaps you could answer my questions. To re state, 1. Are sex workers educated about the various forms of herpes and how they are contracted and what to do about them?

2.Are sex workers educated about the varieties of hepatitis and what to do about them and the vaccinations available?

3.Are sex workers informed about correct procedures in using condoms and the necessity of not sharing condom usage?

4.Are sex workers offered free testing for herpes and hepatitis and vaccinations?

Thanks for your above post.

[Sheryl]

The more important issue re health certificates/having a prospective partner tested is that the tests commonly performed are antibody-based and will not show a very recent infection. Newly infected people can be highly infectious. So a negative result, even if legitimate (i.e. not forged) doesn't really change the picture any.

In fact, a person with known HIV who has long been on treatment with antiretrovirals ma be far less infectious to partners than someone recently infected who doesn't know it yet (as the antiretrovirals can reduce viral loads to near nil). How infective someone is relates to their viral load while test results reflect antibody titers. There are tests that directly measure the presence of the virus but costly and time consuming, not practical for a quick screen on the way home from the bar!

The false confidence that a negative HIV test may inspire, if it leads the man to forego condom use, could be far more dangerous than not having the woman tested at all.

I am aware if at least 1 TV member who acquired HIV by relying on a negative antibody tests of a new partner. Either she was in the early stages of infection at the point of testing or she became so soon thereafter.

[BigJohnson]

mark45y,

Thank you for your excellent post; I hope the following helps clear up some questions:

My answers are based solely on my experiences in Bangkok and are in no way meant to be taken as a generalization.

Q:. Are sex workers educated about the various forms of herpes and how they are contracted and what to do about them?

A: Most workers that I have met are educated about Herpes and have pretty good access to affordable medications.

Q: Are sex workers educated about the varieties of hepatitis and what to do about them and the vaccinations available?

A: In my experience many workers are not very knowledgeable when it comes to the different types of Hepatitis, but many do know that there are vaccines.

Q: Are sex workers informed about correct procedures in using condoms and the necessity of not sharing condom usage?

A: Many sex workers I have talked to have said that they rely on the man to take care of the protection; some know of the different ways of increasing protection by using lubricants, etc. and finally, using the same condom during repeated sex with the same person is somewhat common amongst workers.

Q: Are sex workers offered free testing for herpes and hepatitis and vaccinations?

A: I usually recommend the Thai Red Cross to workers, it is low cost and offers testing and vaccinations. If workers cannot afford the testing and or vaccinations there are many generous people that always step up to help.

A: "YES" oral Herpes can be transmitted to the genitals.

In regards to the "Certificates" that have seemed to fuel some debate, my information is based upon people telling me that they have had girls show them a "health certificate" and I have actually seen a couple of them which are not official certificates; I was told that these "informal certificates" were used to put the client's mind at ease.

The life of a sex worker is not an easy one, aside from the STD's the workers are also having to deal with emotional and psychological ISSUES. I know that the women did not dream about becoming a prostitute when they were a little girl. With this in mind, I have met some sex workers that have an apathetic outlook regarding STD's and the leave it up the the client to take the precautions.

If you go to the CDC (Center for Disease and Control) website they have all the information you need on STD's.

ONCE AGAIN, THANKS FOR YOUR GREAT POST!

EVERYBODY STAY SAFE!

[Sheryl]

A completely off topic post has been deleted. this is a health-related thread dealing with possible exposure to STIs. It is not a thread about the hows and whys of the sex trade in Thailand ad the Health forum is not an appropriate venue for debates concerning same.

If we can't stay on topic, the thread will have to be closed. I would rather keep it open a bit longer in case the OP might post an update once he has been able to obtain a PCR test and thus give it full closure.

[Phil Conners]

More off-topic posts have been deleted.

This forum is for discussing medical issues, not for politics. There are other places for that.

// closed.