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» Got Questions? Get Answers. » SCARLETEEN CENTRAL » Safer Sex & Birth Control » Why use dental dams?

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Author Topic: Why use dental dams?
eryn_smiles
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Was reading a recent paper from an Australasian journal, "Sexual health"- "The practical and symbolic purpose of dental dams in lesbian safer sex promotion"

http://www.publish.csiro.au/view/journals/dsp_journal_fulltext.cfm?nid=164&f=SH09073#R19

I see that AIDS service organisations in New South Wales are no longer distributing dental dams as part of their safer sex packs. It seems that most women who have sex with women don't really use dams. I'm not sure what the evidence is for them for a low-risk activity (oral sex) and why we recommend them. It sounds like the main infection of concern is transmission of oral to genital herpes, which perhaps can be minimised through awareness to avoid sex when you have an active coldsore.

Also didn't realise that "dental dams are not manufactured, registered or tested for STI prevention purposes. No studies exist on their permeability to STI pathogens, although it is likely that they are at least as impermeable as condoms, which are also made of latex but thinner."

I'd be interested to hear what others think.

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"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

Audre Lorde

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Heather
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Eryn: this is a big question, and I haven't had a chance to read that link yet. I'll take the time today, then do a little more digging around on this.

I have not heard before that dams have never been studied to see if they're actually effective, and have certainly read plenty of studies where latex barriers were put in one group, not expressly just condoms, if you catch my drift.

But let me look and revisit this later.

One thing I can say now is that, for sure, with women who have ONLY slept with other women, herpes is the main concern. And by all means, a person who has herpes avoiding sex when they have or are getting an active sore covers that base well, even if not completely. But that also assumes that that person would inform partners, and there's the rub. As well, women who have only ever had any kind of sexual contact with other women are a very small population.

[ 09-19-2010, 09:17 AM: Message edited by: Heather ]

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Heather Corinna, Executive Director & Founder, Scarleteen
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eryn_smiles
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Sure, take your time [Smile] .

If women had slept with men also, what would the main concern be? Transmission of HIV between women by any sexual route is rare. I understood that it is also unusual for hepatitis, HPV and bacterial STIs to be transmitted through woman/woman oral sex.

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"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

Audre Lorde

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Heather
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Well, when women have slept with men also, there are much higher rates of chlamydia, gonhorrhea, molluscum, trich and HPV (if you have read HPV in women who sleep with women OR women who sleep with women AND men is rare, could you show me where so I can read, too? So the opposite message I have ever gotten). In some populations, syphilis, too, to my understanding.

I haven't forgotten about this, by the way. I've actually been searching for other references and have so far come up empty-handed. In asking around with other educators, I keep being given basic fact-sheets which don't reference any studies, which obviously isn't helpful. I do have some studies I found about dams and protection per dentistry uses, but that obviously only gets us so far.

Mind, given they are made of the same material as latex and cover more area, I think we can make some safe assumptions about this, but that is still not at all the same as studies. Alas, per usual, the big barrier to finding/having studies on dams is the same as on any topic that is not primarily about heterosexual people: if it isn't about, mostly about, or could likely impact straight folks, the studies are rare to middling.

But I'm not giving up yet, because you're so right, having actual data to look at is a big deal, and if it's really not out there, we need to change our statements about this to make clear that while we're making reasonable assumptions, they are not backed up by study.

[ 09-23-2010, 07:59 PM: Message edited by: Heather ]

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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eryn_smiles
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I haven't read that WSW and bisexual women have negligible HPV risk and fully agree with your link that they need pap smears too.

However, I wasn't talking about this group's overall sexual activity and risk of STIs- only about transmission of STIs through oral sex between women.

Here are my references-
1. Edwards S, Carne C. Oral sex and transmission of non-viral STIs. Sex Transm Infect 1998; 74 95–100. http://sti.bmj.com/content/74/2/95.full.pdf
2.Oral sex and the transmission of viral STIs. Sex Transm Infect 1998; 74 6–10.
http://sti.bmj.com/content/74/1/6.full.pdf
3. http://www.cdc.gov/std/treatment/2006/specialpops.htm#specialpops5

Basically, they use the words 'probable' and 'plausible' frequently and quote small case reports. Then they suggest that condoms and dams may be useful.

Another problem I have with this..if dental dams are so important, why don't we promote them to hetero men giving women oral sex and to people of any gender who practice anal rimming? According to the second review, 73% of men reported having experienced cunnilingus. Isn't that a significant proportion? Why is this a lesbian thing?

(PS- thanks for looking into this too, it's really interesting!)

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"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

Audre Lorde

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Heather
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quote:
if dental dams are so important, why don't we promote them to hetero men giving women oral sex and to people of any gender who practice anal rimming? According to the second review, 73% of men reported having experienced cunnilingus. Isn't that a significant proportion? Why is this a lesbian thing?
Well, I don't know who we is, but I've never been lesbian specific in safer sex information about dams. For that matter, I don't -- and rarely see others do it either -- put out safer sex info based on orientation, but based on sexual activity, regardless of the gender or orientation of those engaging in an activity.

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Heather Corinna, Executive Director & Founder, Scarleteen
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Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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eryn_smiles
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For example, why would the AIDS council of NSW distribute free dental dams at lesbian community events/dances rather than in a more general setting? Why does dam packaging here feature 2 women together?

That's a fair call and I understand that you put out information based on activity not orientation. I think it feels a little personal to me as I went through high school and six years of university including sexual health teaching and gynaecology with never a mention of dental dams. Always condoms only. The first time I heard of them was when I looked them up myself (probably here!) because I thought I might be gay.

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"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

Audre Lorde

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Heather
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I'm getting the feeling that the NZ/AU approaches to safer sex are a bit different than we have in the states. Obviously, too, in cultures where homosexuality (and kinds of sex outside intercourse) are unaccepted or less accepted I'd expect us to see very different approaches.

So, happy to keep talking about this, looking into it, reading, and appreciate doing so, but I also think I'm automatically going to have some disconnects as someone western, someone who came of age in the dawn of HIV/AIDS and as a sex educator who has always come from a perspective of being queer and very diverse in that, with colleagues more often queer than straight, etc.

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Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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eryn_smiles
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Yes, that's understandable. It must be empowering and great to work with out queer colleagues. I'd like to have that chance.

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"Caring for myself is not self-indulgence, it is self-preservation and that is an act of political warfare."

Audre Lorde

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Heather
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It'll happen! [Smile]

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Heather Corinna, Executive Director & Founder, Scarleteen
About Me • Get our book!
Never doubt that a small group of thoughtful, committed citizens can change the world. Indeed, it is the only thing that ever has. - Margaret Mead

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