Did read somewhile ago though, that prostitutes in South Africa regularly having unprotected sex with men in the mining industry contracted a remarkably low level of STIs. What was peculiar was that once these women came off the game and resumed more 'normal' sexual activities, the rate of contraction of STIs increased markedly. No one really able to provide a rigorous thesis as to why this should be, but it was thought that the bodies immune system seems to work out when activities are getting a bit 'dangerous' and goes into overdrive in developing its own antibodies to combat invading organisms.
I did a piece of work with prostitutes (they like to be called working women by the way) in 2001 - although I found very little pathology (9 chlaymdia infections) the actual source of infection was difficult to ascertain - I was sure in view of their sexual histories that most of the women picked up the infection from their regular partner who in some of the cases was also their pimp and 'managed' other girls
I have seen many working women in the GUM clinics who get infections - they are extremely careful though in relation to their sexual working practices but will distinguish between work and pleasure by not using condoms with their boyfriends/husbands - quite often though they feel guilty and are often blamed by their partners as being the source of the infection when this isn't the case.
Interestingly though, I was helping my colleague with his Msc dissertation - he wanted to see how aware the men were re STI that visited massage parlours - I took out about 100 questionnaire for him - he got about 35 replies - we were stunned as well over 50% of theses men were married and admitted to have unprotected sex at the massage parlours - whilst I knew it went on I wasn't aware that it was that common.
In relation to HIV transmission - I certainly know of patients who are HIV positive and have negative partners who are having regular unprotected intercourse and just don't pick it up - it is exactly the same with other STI -why they don't pick it up is possibly related to their immunity - but the general consensus of medical opinion is that you will eventually pick it up.
There are also some people with HIV that are called 'non progressors' which means that they haven't needed any medication in relation to their HIV infection, all of their blood results are within 'normal limits' - I still know a few from 19 yrs ago when I cam into the speciality that are absolutely fine - HIV is such an individualised infection - you can have several people infected at the same time but how they progress with the infection is different for each one but I suppose you could say the same for other such like terminal problems.
Damocles - you are right in relation to spermicidally lubricated condoms - when I take condoms to the massage parlours I give out the non spermicidal condoms as research has shown (when undertaken with working women) that spermicide can damage the vaginal (and anal)mucosa - which can facilitate HIV transmission.
Flavoured condoms are ok for sex but lots of people use them for oral sex as the standard lubricant doesn't taste very nice. But using them for intercourse can induce some non sexual infections in women (thrush, bacterial vaginosis) as the flavouring alter the vaginal PH allowing the normal flora to flourish.
I give out all sorts of flavours blueberry, banana, mint, vanilla, chocolate, strawberry and even cocktail flavoured! - the women in the saunas do use them for oral sex and the darker ones are used when they are on their periods.
You can also get condoms in large and for the man who is 'penaly' compromised they do come in a trim size!!
Julie
