My boyfriend and I have been together for about 8 months. I love him and I trust him completely, but he just recently told me that he just got an HIV test … he thinks I should get one, too. Does this mean he's cheating on me? I don't understand why we should get HIV testing if we are a monogamous couple.
—Confused and Scared
No, CaS, your boyfriend getting an HIV test and encouraging you to do the same doesn't mean he's cheating on you. It means he knows the only way to be certain of one's HIV status is to be tested regularly. In fact, the Center for Disease Control and Prevention recommends routine screening for all sexually active adults, regardless of statistical risk.
You're right that sexually monogamous or fluid-bonded couples have exceedingly low STI risks, but don't forget a) you or your partner may have had prior partners, b) ""monogamy"" means different things to different people and c) some STIs, including HIV, can be spread in ways other than sexual contact. An HIV test is a simple blood draw (alternatively, some locations can do an oral swab), and it's free at University Health Services.
Speaking of STI testing, I need to correct an error I made in last week's column. When discussing the herpes antibody test, I stated ""over half of initial positives in the campus population (adults under 24) turn out to be negatives."" This is incorrect.
Health care providers tend to avoid common use of the herpes antibody test because it can be unreliable. What I should have stated last week is that if we were to screen the general population using the herpes antibody test, then we would expect that over half of initial positives in adults under 24 would turn out to be true negatives with further testing. However, since the herpes antibody screen is only offered to individuals whose circumstances make it likelier that they actually have herpes (i.e. a positive result is more likely to be true), we don't see a 50 percent false positive rate in practice; the observed false positive rate is lower than the expected rate.
Additionally, some astute readers wrote in to caution against extrapolating the overall U.S. herpes prevalence (1 in 5) to the campus population. Taken as a whole, students at UW are younger, whiter, wealthier and more educated than the U.S. population as a whole. Thus, it is inappropriate to apply general prevalence data to this specific subset of the population. According to Craig Roberts, the UHS epidemiologist whose expertise I sought in last week's column, a better estimate of the campus prevalence of herpes is along the lines of 5-10 percent when one accounts for the lower prevalence of herpes in groups with the cited demographic characteristics.
From an epidemiological standpoint, this criticism is valid. However, I question the importance of such a distinction for the average student like me. Campus does not exist in a sexual vacuum. UW students do not have sex exclusively with other UW students and though we may always be Badgers at heart, most of us are UW students for only a small portion of our sexual lives. Thus, in my opinion, data specific to the campus population paint an incomplete picture.
I leave it to you, dear readers, to make your own decisions regarding the appropriate use of these data. However, please be aware that making your own decisions may be a serious moral problem, as one reader made it a point to tell me:
No wonder you have herpes if you are having casual sex right and left. It is unconscionable, though unsurprising, that you [did] not mention this … Want to know a 100% effective way to not get herpes? Don't have sex. But no … It would be wrong to tell people promiscuous sex has consequences…
Yawn. So according to the American Academy of Dermatology, most people acquire herpes simplex (type 1) infection during infancy or childhood from kissing family members. People define ""sex"" in lots of different ways, but I don't think kissing family members usually qualifies. At a simple factual level, you're the one who's wrong, my friend: even if last week's question had actually asked about how to prevent herpes, ""don't have sex"" would not be a 100 percent effective answer.
Now, that's not meant to say I think abstinence is wrong. If a person makes a choice not to engage in sexual activity, that deserves respect, whatever the reasons behind that choice are. Sexual activity should always—always, always, always—be a choice, and it should be a choice we feel good about making.
However, there are some things I do think are wrong—for example, criticizing people for their sexual choices as well as creating arbitrary hierarchies of dogmatism and applying them to other people's consensual activities. Not to mention trying to establish the supremacy of one's sexual choices over someone else's. Those are things I think are wrong. And while I make mistakes from time to time, I prefer to avoid being wrong.
More questions? E-mail sex@dailycardinal.com.
