*290/196/1*

This letter should be followed, a week or so later, by a gift—perhaps a dozen roses delivered by hand, with a note:

“Always thinking about you.—Your Mystery Lover.”

When the husband sees the flowers, he might ask, “Who are these flowers from?”—to throw her off. Then, a week later, there might be a short poem. It should be simple and not overly sentimental:

“I think of you and wish/That you and I—/I think of you and wonder/What would be if we—/I think of your beautiful, intelligent eyes/And how it would be/if they looked at me/with love/Or surprise./I think of you. . . .”

*256/196/1*

Aim: In an exaggerated fashion, to mirror the wife’s need for politically correct sex so as to point up its absurdity.

Game Plan: One evening or weekend the husband approaches the wife and asks how she would feel about having sex. If she says she would like to, he continues to question her.

“Are you sure you want to have sex?” “Yes, I’m sure. Why do you ask?”

“Because Robin Morgan, the editor of Ms., says that even when a woman consents to having sex with a man, it’s still rape—since all men are in a position of dominance in our society, and hence even when a woman agrees to sex it constitutes giving in to the specter of male dominance and is a kind of psychological rape.”

“Yes, I can see the point of that statement.”

“So, how do I know you really want to have sex? How do I know you aren’t simply giving in to my male dominance now? How do I know it won’t be a form of rape?”

“You don’t know.”

“Then maybe we shouldn’t have sex.” “Maybe not. Unless I ask you.”

*222/196/1*

*188/196/1*

Activists: Both spouses. Setting: Hotel.

Aim: Play out a primary fantasy of impulsive couples, but with a twist: Instead of writhing and running, writhe and review.

Game Plan: This game can be played with or without an actual authority figure—a therapist or a nonprofessional friend. (This book may serve as the authority if no other is available.) The authority instructs the couple to go to a hotel or motel and play out their impulse to have a one-night stand—with each other. However, this time they are to end the sham affair different than usual. Usually, the morning after such an event is awkward as each partner finds the quickest way to the exit. This happens because in a one-night stand a couple quickly achieves a false intimacy based on their impetuous sexuality— but they have not really communicated and bonded so that they can sustain a relationship, and they are reluctant to do so. Hence, the next morning they find themselves having been sexually intimate but thinking all kinds of thoughts about one another that they do not want to talk about. Indeed, they fear that talking about these things would be harmful. (In reality, in many cases talking about these things would lead to a deeper, more realistic relationship.)

*154/196/1*

of membranes and premature delivery of the infant. Vaginal infection with trichomonas can also be passed to the newborn during delivery, causing either genital or lung infection in the child.

Men usually do not experience any symptoms of trichomonas infection, although a few men have symptoms of urethritis (urethral infection), such as burning with urination, discharge, or simply a sensation of irritation in the penis. Rarely, trichomonas may also be a cause of prostate and epididymis infection. If left untreated, trichomonas has been shown to cause scarring (called strictures) in the urethra, which may impair the flow of urine.

*389\213\8*

cause: virus (human immunodeficiency virus) symptoms: sometimes viral illness after infection, but often none initially;

later, weight loss, fever, lymph node swelling, recurrent

infections

treatment: no cure, but medications can slow disease process

WHAT IS IT?

The human immunodeficiency virus (HIV) is the virus that causes the acquired immunodeficiency syndrome (AIDS). HIV and AIDS are not the same thing, although people sometimes erroneously use the terms interchangeably. The first reports of people dying from AIDS emerged in the early 1980s, and the understanding that HIV was the cause of this syndrome came soon after. Recently tissue and blood samples from people who lived in Africa in the 1950s have been found to have evidence of the virus, so it appears to have been around longer than was previously thought. No one knows exactly how, when, or where HIV originated.

Two types of HIV are recognized: HIV-1 and HIV-2. There are also some variations among the HIV-1 types,- nine have so far been recognized. HIV-1 is the primary strain seen in all areas of the world except West Africa, where HIV-2 predominates. Only about forty cases of HIV-2 have been reported in the United States, and all of these were among people who had traveled to West Africa or had had sexual contact with someone from West Africa. Nevertheless, in most areas of the United States, testing for HIV usually includes testing for both types of the virus.

The virus infects certain cells of the body, specifically those that have a particular protein, the CD4 protein, on their surface. One cell type, CD4 lymphocytes or T helper cells, is an important part of the immune system, which is the body’s defense system against infections and the development of cancer. HIV is a type of virus called a retrovirus, a term used to describe the process by which it infects a target cell. When the virus attaches to a cell, its genetic material is incorporated into the genetic material of the cell. The infected cell then makes new HIV which can then go on to infect other cells.

When a person is first infected, a large amount of virus circulates in the system, and initially the number of CD4 cells declines; however, the body’s immune system then regains control and suppresses the vims for a period of about ten years. Eventually, however, the virus somehow “outsmarts” the body’s immune system and starts destroying the cells it has infected, a process that makes the infected person very vulnerable to other infections and malignancies. At this point, a person is considered to have AIDS. Why this happens, and why it occurs at different times for different people, is not clear, although genetic differences may determine a person’s susceptibility to infection with AIDS as well as how long it will take the person to develop AIDS if he or she becomes infected.

*296\213\8*

Much research is currently under way to determine whether testing for the higher-risk types of HPV in the cervix when there are abnormalities on the Pap smear can help identify women who are at high risk for progression of the disease. Tests such as the PCR, which looks for the genetic material of the virus, are being used to identify the type and quantity of HPV on the cervix. At this point, it is not clear how the information provided by this test can be useful, and the PCR is therefore not recommended as a routine screening tool.

*206\213\8*

Many people still think that STDs, particularly HIV, cannot be transmitted through oral sex. This may be assumed by some because, early in the HIV epidemic, unprotected anal and vaginal intercourse were seen as high-risk behaviors, and unprotected oral sex was seen as low risk or no risk, since saliva does not carry a sufficient quantity of HIV for it to spread infection. The risk of HIV transmission is probably lower with oral sex than with anal or vaginal sex, but it is not zero.

There are documented cases of HIV transmission from both receiving and giving oral sex, though there are few studies of how often people become infected after a certain type of sexual contact. Obviously it is not ethical to perform studies in which people are exposed to HIV horn a particular sex act to find out how many of them become infected, so reliable statistics are not available. The Centers for Disease Control includes oral sex on its list of risky behaviors for acquiring HIV But HIV is not the only sexually transmitted infection to consider; others—such as gonorrhea, chlamydia, and syphilis—can easily be transmitted via oral sex with an infected partner.

*115\213\8*

Mayo Clinic, doctors determined age-specific ranges for PSA: Lower than the current 4 for younger men (with a life expectancy of 25 to 30 years); and higher than 4—which probably is too severe—for older men. They recommended a cutoff of 2.5 for men aged 40-49; of 3.5 for men aged 50-59; of 4.5 for men aged 60-69; and of 6.5 for men aged 70-79.

“The age-specific reference ranges should make PSA a more selective tumor marker,” the researchers said, “such that significant prostate cancers can be identified at an early, curable stage in men who are most likely to have the greatest benefit from definitive therapy and unnecessary diagnostic procedures would not be performed routinely in men who are unlikely to harbor a life-threatening prostatic malignancy or benefit from therapy.” (One note here is that the higher upper limit for men over age 60 may mean that some potentially curable cancers are not detected as early. The investigators plan to confront this issue in further research.)

*47\201\8*