The high frequency of infections without symptoms makes it imperative for infected individuals to inform their sexual partner(s) once they are diagnosed with an STI. Partner notification, which is beneficial in reducing the spread of all STIs, is an espe­cially imperative prevention tactic for curtailing the spread of HIV infections (Bird & Voisin, 2011; Obermeyer et al., 2011). Partner notification can be conducted by the infected person, by health-care providers, or by specially trained city, state, and federal employees called disease intervention specialists (DISs) (Kissinger et al., 2003). The Let’s Talk About It box, "Telling a Partner," which appeared earlier in this chapter, offers suggestions that may be helpful to a person who elects to notify a partner about an STI infection. A potential benefit of partner notification conducted by a health­care provider or DIS is that informed people typically receive counseling about how to reduce the risk of exposure to STIs and are often provided with options for health-care services, including testing and treatment (Hoxworth et al., 2003).

A number of studies have found that partner notification often facilitates several desirable behavior changes, including increased condom use, reduction in number of

sexual partners, and reduction in the incidence of STIs following notification (Niccolai et al., 2006; Semaan et al., 2004). Even though partner notification can be a powerful STI prevention strategy, we cannot assume that a sexual partner will be forthcoming about a diagnosed STI.

A survey of a national sample of 1,421 people receiving medical care for HIV infec­tion found that 42% of gay or bisexual men, 19% of heterosexual men, and 17% of women participants reported engaging in sexual interaction without disclosing their HIV-positive status to their sex partners. This nondisclosure occurred primarily within nonexclusive partnerships (Ciccarone et al., 2003). In general, research indicates that even when people diagnosed with an STI inform a primary partner, other sexual con­tacts are likely to be left uninformed (Niccolai et al., 2006).

Summary

Sexually Transmitted Infections

CHAPTER 15

Sexually Transmitted Infections

Preventing Sexually Transmitted Infections

■ Taking the time to carefully assess your risk status and your partner’s risk status for transmitting STIs is perhaps the most important preventive strategy.

■ Because it is often difficult to accurately assess risk sta­tus from conversations alone, couples are encouraged to undergo medical examinations and laboratory testing to rule out STIs before engaging in any sexual activity that puts them at risk for STIs.

CHAPTER 15

What Constitutes Atypical Sexual Behavior?

What are the primary distinguishing characteristics of atypical sexual behaviors?

What impact do atypical sexual behaviors have on both a person who exhibits them and others to whom they may be directed?

Noncoercive Paraphilias

How do noncoercive paraphilias differ from coercive paraphilias? How does fetishism develop?

How does transvestic fetishism differ from female impersonation, transsexualism, and homosexuality?

What factors might motivate people to engage in sadomasochistic behavior?

Coercive Paraphilias

What characteristics are common to individuals who engage in exhibitionism?

What are some helpful strategies for dealing with obscene phone

‘ ills?

Are there characteristics and causative factors common to people who engage in voyeurism?

Sexual Addiction: Fact, Fiction, or Misnomer?

Can people become addicted to sex?

Is there widespread support among professionals for the sexual addiction model?

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My last sexual partner was very much into golden showers. Having spent a little of my time watching G. G. Allen movies, I was well acquainted with the existence of water sports, but somehow it never occurred to me that I would like to partake in them. When my partner revealed his desire to drink my urine, I was taken off guard. I have been known to try some things I would deem a little atypical, so I gave it a shot. I was very nervous about the actual art of the procedure, though. Thoughts such as "What if he was joking — he would think I’m nuts" and "What if I completely miss" entered my head. It was nerve-racking and made it especially hard to pee. Eventually, my anxiety subsided and I was able to participate. His reaction was amazing to me. He began to masturbate feverishly and lapped up my urine ecstatically. I had never seen him so turned on. More surprising, though, was how much I enjoyed it. Although I cannot imagine being on the other end, it was really an empowering and enjoyable experience. (Authors’ files)

This description of a rather unusual sexual experience, provided by a student in a sexuality class, may strike our readers as reflecting an abnormal or perhaps even devi­ant form of sexual behavior. However, we believe it is more realistic to consider this anecdote an account of uncommon or atypical sexual behavior. One note of caution: Because HIV has been found in the urine of infected persons, it is prudent to avoid contact with a partner’s urine unless he or she is known to be HIV-negative and not infected with any other STIs. Now let us consider for a moment what constitutes atypical sexual behavior.