August #26 : Viva la Vagina - by River Huston

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August 1997

Viva la Vagina

by River Huston

Read my lips: Make more microbicides, don't douche and beware demon semen

I love my vagina. Charming, brilliant, witty -- it's one of my best features. Vaginas are on my mind because I just returned from yet another AIDS conference. This one was the third attempt at a first National Conference on Women & HIV; the previous "firsts" were utterly forgettable due to the constant "We really don't know" refrain whenever anyone asked "How does this drug affect women?" This conference definitely had its share of disappointments, but the bright spot was all the vaginal news: Microbicides, lavages and just plain vaginal enthusiasm. Until now researchers have tended -- rudely -- to view the vagina as a piece of plastic tubing rather than the exquisite ecological system it is.

I suppose I got a little giddy at a panel on microbicides -- I offered to donate my vagina to science on the spot. But I genuinely believe that microbicides are the key to ending the epidemic: Every 10 seconds another woman on the planet gets HIV -- needlessly. An effective, cheap and, above all, woman-controlled method of prevention would work wonders. And, I might add, it would improve my sex life.

Ms. Science will now brief you on the ins and outs of microbicides. A microbicide, after insertion, coats the vagina, cervix and osculum ("What's that?" you ask; beats me, but now you know you've got one) and prevents HIV, HPV, herpes and other STDs from entering the bloodstream through the mucosal surface or by way of dendritic cells or macrophages. Got it? (Microbicides have been tested only in vaginas because, of course, women never have anal intercourse.)

Don't think there weren't plenty of problems with the microbicide studies. First, because of all the dangers posed by having sex with no protection other than an untested gel, the women in the study were encouraged to persuade their partners to use condoms. (Wouldn't it be great if you could catch something benign like knowledge of a foreign language or how to play the guitar?) An amazing 90 percent reported success. That's good prevention but bad science -- such a high rate of condom use makes it impossible to tell whether the microbicide works. At this point in the presentation, a transsexual activist suggested that volunteers could be infected with curable STDs to test if the microbicides are effective. This provoked pan- demonium in the hall. Before I knew it, I was up on my chair waving my arms. "I have an STD," I shrieked. "Use my vagina!" I was so excited -- "Test me! Test me!" -- but the eggheads onstage seemed doubtful. I handed out my business card anyway -- after having marked "Vagina Donor" in red ink -- and trudged on to the next meeting: Vaginal ecology.

The payoff? An acidic vagina offers better protection than a nonacidic one against everything from candidiasis to credit-card fraud. Plus, this lecture had slides. The audience oooh'd and ahhh'd at the glory of a vagina with a proper pH of 5; the less-attractive vagina with a more neutral pH made us shiver and shudder -- there was evidence of fecal matter, a yeast infection... I even saw a faint outline of Jesse Helms. How I lusted after the pink, perky picture of health and wished for a Polaroid showing what shape my own vagina was in. Such services were not available; however, they did inform us that lactobacillus is good for vaginal ecology. Now, don't go shooting your vagina up with Dannon, girls, it doesn't work like that. The lactobacillus has to be vagina friendly. And douching is out. Vaginas self-clean and -- as I have told you many times -- are supposed to smell that way.

Sex, no small matter, is bad for the vagina. It's sad but true: Semen lowers the pH so the sperm can survive their perilous, secretion-tossed odyssey in pursuit of that elusive egg. Unfortunately, this lower pH makes the vagina more vulnerable to HIV, candidiasis and many other infections. But cheer up. This can serve as another salvo in your personal artillery to persuade your boyfriend that condoms are good. The doctor said by way of closing that a lactobacillus-based microbicide would be a wonderful natural alternative and she was working on one. I left the meeting deliriously happy.

The trip's high point? Seeing all my girlfriends. We sat around the pool at the Pasadena Hilton soaking up subtropical rays and discussing our vaginas and other pertinent issues. There were some 425 HIV positive women at the conference. I wish the rest of the world saw these women not as vectors of disease and modern-day Typhoid Marys but as who they are: Hot babes working hard for humankind.




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