Patricia Nell Warren

Safe Food and Safe Sex: More Thoughts on Risk

Filed By Patricia Nell Warren | February 02, 2008 11:43 PM | comments

Filed in: Living, Marriage Equality
Tags: condoms, HIV/AIDS, MRSA, risk taking, safe sex, sexual health, STDs

There's a yardstick of health safety that is never mentioned in the LGBT sex world...which is surprising, because this yardstick is one that measures our lives every day. It's about food. No fewer than 120 animal diseases can be transmitted to humans, including some whose symptoms make for grisly reading. Today many Americans take for granted the firewall of food-safety regulations that has been built around us. We buy those attractively packaged steaks, eggs, bacon, etc. in the supermarket, or we feast on the beautifully presented entrée in the four-star restaurant. Or we drive up to the fast-food window and confidently grab a sack of burgers -- trusting blindly that those edibles are clean and safe to eat.

But many Americans also operate on this same MO of blind faith when they're going in search of sex - whether it's to a church social or online dating service, or just hooking up on the street or at a sex party. This includes many in the LGBT world.

Unfortunately, there's little in our social system to help an individual know beforehand whether he or she is about to "bite" into a person who has HIV, syphilis, herpes, gonorrhea, HPV or chlamydia, to mention just a few. A newer addition to the list is the MRSA "super bug." It's all over the news because of a UCSF-led study's appalling effort to stigmatize gay men as a major vector of this flesh-eating staph infection. Actually MRSA is out there in the general population, and it should concern everyone. But a human body doesn't come with a U.S. Dept. of Agriculture stamp on it, the way a side of beef does. Indeed, in the interests of constitutional privacy, the United States could never have a system that would require an individual to carry an updated and comprehensive health-test ID - unless it planned to become a totalitarian regime.

So the person looking for a sex meal is pretty much on his/her own. Sure, there are STD tests required for marriage licenses, the military, Foreign Service, Job Corps, blood and organ donations. But this limited testing system does little to help the hopeful mate-seeker or hooker-upper to know if that gorgeous person across the room is a heavenly dish...or a human hamburger loaded with food poisoning.

I grew up in the livestock business in Montana. When I was a kid, there was a short list of diseases that cattle raisers had to worry about -- mostly tuberculosis, brucellosis and anthrax. Brucella-infected cattle can transmit this bacteria to humans through raw milk. Trust me -- if you're a natural-products fan, you don't want to drink infected milk. In humans, brucella causes undulant fever, which is as nasty as malaria, and requires long-term heavy-duty antibiotics treatment. Bovine TB can also be transmitted to humans through raw milk. Both diseases used to be way more common in our country before pasteurizing milk and testing of cattle was introduced in the 1930s.

Today the list of dangerous-to-people animal diseases is hair-raisingly long. Many of them weren't even identified by science yet when I was a kid. Example: bovine spongiform encephalopathy, aka mad cow disease. BSE is proven transmissible to humans, which is why the FDA put it on their list of reportable diseases. But cattle aren't the only vectors of disease. Chickens can carry salmonella and avian flu, to name a few. Pigs can hit us with swine flu and trichinellosis. The latter is a parasitic worm you get from eating infected pork; it can invade your upper respiratory system and nervous system, even kill you. It used to be common in the U.S. before health control of the pork industry.

So today there is a vast network of state, federal and international regulations, including strict requirements for testing and vaccinating, that is supposed to keep these animal diseases away from us. Most of the time -- considering the enormity of the logistics presented by global agribusiness and global trade - this complicated system works fairly well. You and I can eat a tin of fois gras from France, or cheddar cheese from Canada, and we probably won't get sick as hell. But the system is far from perfect, as battles rage over safety of Chinese food imports. And here at home, things can sometimes go terribly wrong. As I wrote this, a California meat-packing facility is hitting the headlines for allegedly processing sick cattle on a routine basis.

Sometimes a food producer is guilty of real criminal intent. When I was living in rural New York State in the 1970s, a big dairy farm in my county bred replacement heifers that were sold to milking dairies. When the owner realized he had brucellosis in his herd, he didn't cull the infected animals. Instead he figured out a way to dupe his veterinarian and submit fraudulent blood samples to state authorities for testing. Finally he got caught. I never learned how many New Yorkers got sick, or how many other farms went under because of the infected heifers they'd been sold. But the farm owner was convicted of a felony and went to state prison. And nobody felt sorry for him.

When I was in the animal-breeding business myself, I went by the book. Nobody else's animals came near my animals without the requisite tests. In fact my own veterinarian did the tests and had them processed at his own lab. Why? Because I'd learned that you can't take somebody else's word for it on a test result. It's better to be safe than sorry.

My point is, we'd all be a lot sicker, and the mortality rate in the U.S. would be higher, if the present food-safety system wasn't there at all.

Because of these hard life-lessons I got in the food business, I always feel shaken when I listen to debates around "safer sex" in the LGBT community. Some of our citizens would run screaming into the night at the thought they might eat a salmonella-laced salad or a steak infected with BSE -- yet they will run, not walk, to have unprotected sex with somebody whose disease status they know nothing about. This disconnect from reality on a single area of personal health is something that still baffles me after years of the AIDS epidemic. It means accepting "high risk" for sex, yet demanding "zero risk" for food.

Some of us are made to feel apologetic if we dare to ask a pre-sex question about the other person's status. Worse yet, some of us are even willing to take somebody else's word about an HIV or syphilis test - especially if that somebody is cute and both parties are in the heat of the moment. Because we all know that some people lie in their teeth about their status.

Amid our community's fight for the legal liberty to enjoy same-gender sex, some of us have gone a step farther. Some are willing to risk their health in order to enjoy what they define as absolute sexual liberty. This can even translate as, "Nobody has the right to stop me from deliberately infecting myself with HIV if I want." As an activist, I stand for everybody's right to do with their personal lives whatever they choose, as long as they don't hurt somebody else while doing it. That ranges from the right to stand in front of a speeding train, to the right to cut loose at a barebacking party. In 2008, seroconversion seems like less of a death sentence than 20 years ago. So some risk-takers comfort themselves with the thought that "people with AIDS can now live many years because of drug treatment."

But on another plane, speaking as a writer, I've had enough private conversations with HIV+ gay men to know that some of them regret a risk they took 10 or 15 years ago. One guy told me, "Patricia, I would give anything - ANYTHING -- to get out from under the symptoms and drug side-effects that I live with now. I'd give anything to recover my health, and the wonderful career that I lost because my health isn't up to the corporate battles any more. And I traded it all away for 15 minutes at a bathhouse with a guy whose status I didn't know."

Since sex is almost as much of a basic need as food, life has to find a way. So some HIV positives have a different kind of yardstick -- they limit relationships to others who are also positive. Many others follow the party line on using condoms. It's true that condoms may protect against HIV transmission (if they're used properly and they don't break). And let's face it -- condoms are better than nothing. But they don't necessarily protect against herpes, HPV and MRSA, which may be transmitted during intimacy by simple body contact (hands, etc.).

At the age of 71, I'm not out there walking the mine-fields of dating and relationships any longer. But if I was, I'd be measuring those mine-fields with the agriculture yardstick that I was handed at an early age. To me, it doesn't make sense to take less care of myself than I would of that global herd of food animals out there.

Maybe if more of us started thinking of sex as "food," we'd be more careful about what we "consumed." If more of us -- especially young people -- had the courage to stand our ground on asking questions first and wanting to see tests, it would have a positive effect on community health. Unromantic? Sure. Life-saving? Definitely. Maybe this is a point that has been missing from all those "safer sex" PR campaigns that are said to be not working.

The phrase "I am what I eat" can be rewritten as "I am what I fuck." But both contain that all-important word "I."


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Ms. Warren,

Thank you for providing this wonderful analogy. It should be required reading in every school in America. The message I get is that in lieu of an updated and comprehensive health-test ID, abstinence and monogamy are the only meaningful methods of actual safe sex. Anonymous sex is akin to Russian roulette. Your essay should serve as a reminder to all of those within our community how many have lost at that game. An HIV quilt today would probably blanket the State of Texas.

I don't know if comparing other human beings to consumables is the answer - I mean, it's a relationship model common in the het world (that women are objects, like food, to be consumed, food advertising that compares animal body parts to women, etc.) and it doesn't seem to be doing any good there where it occurs.

It's an utterly dehumanizing, to me, way of looking at sex to just see the pleasure that another person can give as a product being sold. I know, I'm sure there are some people out there who love being compared to a hamburger, but I don't think that they're the majority of people.

If more of us -- especially young people -- had the courage to stand our ground on asking questions first and wanting to see tests, it would have a positive effect on community health. Unromantic? Sure. Life-saving? Definitely. Maybe this is a point that has been missing from all those “safer sex” PR campaigns that are said to be not working.

The phrase “I am what I eat” can be rewritten as “I am what I fuck.” But both contain that all-important word “I.”

I don't see how it's missing - they're always talking about individual responsibility.

I'm not going to pretend to have all the solutions (I think comprehensive sex ed is a good start, though), but a model that says that a person living with an STD is "a human hamburger loaded with food poisoning," that sex is a consumable just as food is, use it and throw away the rest, and that short-circuits people's ability to care about risk for others isn't a model that I find attractive and doesn't feel like the solution to me. But, then again, I'm not the only person out there.

(And when did people start demanding that food be perfectly safe? Food kills a lot more people in the US each year, through obesity and related diseases, than sex does. Maybe people should start modeling their relationship with food on their relationship with sex?)

MauraHennessey | February 3, 2008 11:25 AM

Alex;
I think that Patricia did a good job setting up a comparasion for safety, not emotional investment.

If we are careful about our food or have expectations of that safety, then why do we not have the same expectations or take the same precautions about something as emotionally important as sex?

In answer to your question, by the way, Amreicans began demanding that food be safe in the early 20th century during the administration of President William McKinley and particualrly effectively during that of Theodore Roosevelt.

Most women who develop cervical cancer have HPV. Most women with HPV are completely unaware that they would test positive for it.

Having a chronic STD does not preclude sex, but morally it does demand precautions.

And it is hard to argue with the hamburger model when we discuss sex parties and bathhouses, or worse, are expected to defend them.

Comparing sex partners to food-meat may seem dehumanizing ... but it is also, in large measure, good science. I think Patricia's message is a hard one that will cause many to flinch. That does not mean that the message is invalid.

As a young boy growing up on a dairy farm in southern Indiana, I rarely drank pasteurized milk at home until the dairy herd was sold, about the time I entered high school. Luckily, my parents had their herd tested constantly.

There is, however, one major difference between food safety and sex safety: The "consumable" food product is indeed an "object": we kill the animal in order to use it as food. The sex partner, in contrast, whether free of or laden with disease, is a human being just as I am. Alex's comment speaks to this important distinction, and Patricia warns against the totalitarianism that ignoring this point will invite.

What is missing in this discussion is this: When I eat a hamburger, I'm not worried about the fate of the hamburger, that has already been determined. When I have sex, however, I am responsible for the safety of two people, not only my own. Without the general acceptance of this assertion, there is no possible answer that can maintain both safety and freedom. It is admirable to take one's own health seriously; but even more admirable to regard the other person's health seriously also, even if that person is a "stranger" or a fellow trader in a sexual marketplace.

Unless one is celibate, the sexual marketplace cannot be avoided. Being responsible as possible for both parties has to be the universal M.O. Even the most conservative abstinence and marriage-monogamy only changes the rules of the marketplace: it does not remove the marketplace itself.

I find it amusing sometimes that Alex and I are the "leaders" of the blog, and yet see things so differently sometimes... I thought this was one of the best posts this week - hands down. In fact, I sent it out to several other folks...

John R. Selig | February 3, 2008 1:16 PM

I think Patricia made some strong points in her commentary. Some of us seem to be more careful with the food we eat than with our sexual behavior.

I am in a committed monogamous relationship with my husband so we no longer practice safer sex. However, when I was single and engaging in sex with multiple partners I always assumed that my partner was HIV+ and behaved accordingly.

As with everything else in life, every sexual activity has a calculated risk associated with it. Each of us must take responsibility for our actions and the consequences that follow. Unfortunately it is far too easy to become sexually aroused and allow oneself to think with their wrong head!

Bil~

And I think that tension makes this place awesome.

Allen said:

What is missing in this discussion is this: When I eat a hamburger, I'm not worried about the fate of the hamburger, that has already been determined. When I have sex, however, I am responsible for the safety of two people, not only my own. Without the general acceptance of this assertion, there is no possible answer that can maintain both safety and freedom. It is admirable to take one's own health seriously; but even more admirable to regard the other person's health seriously also, even if that person is a "stranger" or a fellow trader in a sexual marketplace.

This is part of what I'm getting at. A hamburger, if it tastes bad, is something I throw away after I have one bite (actually I'm veggie, so we can make it a Boca burger, but the point is the same) If it has a disease and I get sick from it, the blame is on the people who produced the burger, oversaw the factory, etc. Like Patricia's neighbor, they take the person who's (ir)responsible off to prison.

Suppose I sleep with someone with a disease and I get sick - do we blame the hamburger itself, the someone with the disease? Do we drag him off to prison like Patricia's neighbor?

Allen gets to the problems of this model when discussing the marketplace in his comment - the marketplace is a cold place, every person for him or herself, no morality, no rules except greed. By comparing having sex to a "sexual marketplace", it's imposing the same anti-communitarian mindset on the whole process, IMHO, it's all about I, I, I and me, me, me.

Which has been the main take-home message of the HIV prevention I've encountered in the US (maybe my experiences aren't representative). And yet STD's are on the rise.

But if food consumption is a good model for other sorts of safety, then why are so many people killing themselves with food? Why are heart disease and cancer, both of which are exacerbated by poor diet, the top two killers of Americans under 85?

I think it's because the consumption/marketplace mentality posits immediate individual gratification as the highest good and the only things that can shock a market into changing are those things that are, well, truly shocking. While the news media go crazy with the latest E. coli infection found in lettuce from California, even though it ends up killing one or two people, no one really gets excited about heart disease, which kills more people than any lettuce scare has. The last thing most Americans think about in the marketplace is long-term well-being.

In a marketplace, the only responsibility that a vendor has is to make the biggest profit, not protect the safety of the customers. If the fines and risk of getting caught doing wrong hurt the bottom line, then their activity changes. But they really have no reason to care about others, so the sell to the buyers' immediate gratification as much as they can, push the limits of safety, and scheme not to get caught.

Is that a system we want to model for sex?

Yes, people should be asking questions and having discussions about safe sex, etc. But will making them think that they're in the market for food convince them to? I doubt it, and people being as irresponsible with sex as they are with food is a pretty scary thought.

Is that a system we want to model for sex?

I think we already do. In the sexual marketplace, we don't insist that the responsibility is for both people - instead we protect our own safety (if we do that!). When we meet someone for casual sex - whether after a few drinks, in a bath, online or whatever - we are completely seeking immediate gratification.

I think that's what I'm seeing differently here than you, Alex. I don't think this is about modeling a sexual system based on our food safety standards. Instead, I saw it more as a wake-up call that our food safety standards are rather low to start with and they're infinitely more prudent than the standards we hold our own sexual health to.


I don't think this is about modeling a sexual system based on our food safety standards. Instead, I saw it more as a wake-up call that our food safety standards are rather low to start with and they're infinitely more prudent than the standards we hold our own sexual health to.
>>>>>>>>

Bil got it 100 percent right about my intentions with this commentary. I'm not proposing a new model. I'm merely offering a the idea of a yardstick used in another arena of health, to show that we might measure more carefully in the sex arena.

Allen gets to the problems of this model when discussing the marketplace in his comment - the marketplace is a cold place, every person for him or herself, no morality, no rules except greed. By comparing having sex to a "sexual marketplace", it's imposing the same anti-communitarian mindset on the whole process, IMHO, it's all about I, I, I and me, me, me.

Well, yes and no.

An open marketplace usually attracts many different types of traders. Some will take a "dog eat dog" attitude ... leading to the sage saying, "Caveat emptor!" ... Let the buyer beware! But there will be others in the marketplace that strive to do business in honorable ways; these are the folks that realize that healthy and happy customers are the best way to do business long-term. Also in the marketplace are businesspeople that are so incompetent, in every sense of the term, that they will go out of business in short order. And a few are so cut-throat that they are indeed thrown into prison or essentially run out of town.

Previously, I asserted that the standard should be that I accept responsibility for both myself and my partner. That is the ideal standard --- but the marketplace being what it is, one would be naive to assume that most, or even many, vendors live up to that standard. Thus, it is prudent to do whatever is necessary to protect oneself. Still, I can set that ideal standard for myself, and I can encourage others to set that ideal standard for themselves. The ideal standard will never be adopted by 100% of the market, but it might be adopted by a large enough segment that the nature of the marketplace itself is significantly influenced for the better.

Similarly, the Better Business Bureau does not eliminate scams in the business marketplace --- but it does influence the marketplace enough that it is worth operating a BBB in each major economic zone. The BBB does its job via general business education, referrals, and dispensing advice on how to protect oneself from unscrupulous businesspeople.

As the primary promoter of sexual safety and health, the AIDS service organizations and related sex education programs, both governmental and private, and within both the GLBT and straight communities, serve the same function as the BBB does to monetary transactions. They, too, must encourage people to strive for an ideal, while at the same time being realistic and telling people how to protect themselves as a minimum. In this sense, it is necessary for them to operate on two planes simultaneously.

Thank you, Patricia, for yet another thought-provoking post. Americans are inconsistent to the point of schizophrenia in their attitudes toward risk --- requiring total safety in some areas (such as highway safety and child vaccinations), while at the same time insisting on "not being protected from myself" in others (such as smoking, sex, gambling, helmetless motorcycle riding, and certain aspects of stock market trading). The alarming discrepancy we hold between food safety and sexual safety is hardly the only such example --- and yet, taking a look at this facet of the picture is very enlightening.