Harmony has been a prime subject of philosophers and psychologists through all recorded time. The following poem by Lao Tzu describes the quality of harmony to which I refer:

When we achieve harmony with another person sexually, we achieve a moment of immortality. During that moment we are at one with life, and we have “no place for death.” During that moment love and life are reborn, and death and destruction—along with all the rigid defensive postures that enact them—are rendered inactive, ceasing to have an influence on our relationships.

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Basically, these games are concerned with the expression of feelings connected with tenderness: need, fear, gratitude, respect, trust, love. Of course, these are not the only tender feelings, and there are as many ways to express these as there are couples. This is merely an outline that may or may not apply to each couple. Each will modify the games for their own purposes.

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Aim: Force husband to confront underlying fears by engaging in a sexual experience that exaggerates moral correctness.

Game Plan: This game is a variation on the previous one, but the goal is the same. The wife can pull this game on her morally self-righteous husband if she thinks that will work, or else elicit his mutual participation in it. In this instance, the wife gently mocks her husband’s attitude by being exaggeratedly compliant and religious.

One evening, when the husband comes to her for sex and is about to mount her without any warm-up, the wife stops him.

“Wait, dear. Let’s pray first.” “Pray? What for?”

“Because marriage is a sacrament and sexual intercourse is its holy shrine.”

“All right—if you insist.”

They both kneel down beside the bed.

“Lord, please bless this holy merger of male and female.”

“Amen.”

“And bless my dearest husband.” “Amen.”

“And bless his holy penis.” “Amen.”

“Which carries the holy seeds of life.” “Amen.”

“And bless this bed upon which we shall lie.” “I think that’s enough blessing, dear.” “All right, dear.”

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“Because you disgust me.” “So?”

“You’re a creep.” “So?”

“You’re a pig.” “So?”

“You’re a beast.” “So?”

“I couldn’t stand for you to touch me.”

“You’ll love me someday.”

“Never!”

This conversation (or a variation on it) may be repeated several times over a period of days. At the same time. Beauty repels all of the Beast’s advances. However, he takes good care of her in other ways, ingratiating himself to her—preparing meals fit for a princess, entertaining her, tucking her in at night, reading bedtime stories about princes and princesses.

“If you think all this kindness is going to get anywhere with me, you’re mistaken,” Beauty says. “You still repel me.”

“That’s all right. I just like being nice to you.”

“I don’t believe you.”

“It’s true, my dear Beauty. You will see!”

After days of this treatment, he begins to win her over. Gradually she begins to fall for him.

“You know, you have a nice smile for a beast.”

“Thank you.”

“And you are a very kind person.” “Thank you.”

“Kindness is very important.” “It’s nice to have it appreciated.”

“Every beast has some good in him, and it’s important to cultivate that goodness rather than picking at the badness.”

“What a wonderful thing to say. I wish my wife had said things like that.”

“You’re married?”

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In perverted sex, sexuality is turned into an experience whose aim is no longer primarily the expression of love and tenderness and/or the reproduction of the species. Rather, it is concerned with discharging aggression and assuaging envy, guilt, and fear, as well as with repeating compulsively certain sexual dramas that are rooted in unresolved childhood sexual experiences and conditioning. Children who are molested by an uncle or aunt often grow up to be pedophiles themselves. In molesting little boys or girls, they will not only reenact what was done to them but also will discharge repressed anger, displacing it onto their new sexual objects. A boy who is dressed in a girl’s clothing by a mother or aunt who was disappointed to have a male child often will grow up to be a transvestite. By wearing women’s clothing, he both reenacts his childhood conditioning and discharges aggression (by defying convention), castration fear (hiding behind a skirt), and envy of women. Children who are severely punished or humiliated for some kind of infantile sexual play will grow up to enjoy sadomasochistic sex. They will both reenact the abusive trauma of their childhood and discharge repressed aggression onto their new objects. (The favorite fantasy of couples who engage in S&M is for one of them to play the punishing parent and the other to play the naughty child.)

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When this course of metronidazole does not work, a higher dose of the medication must be taken over a longer time, and this is often best done in consultation with a specialist in sexually transmitted infections. Those being treated for trichomoniasis should not have sexual contact until they and their partners have been treated, have taken all their medication, and have achieved complete resolution of their symptoms.

A word about metronidazole and its side effects: This medication should not be taken with alcohol, since the combination can cause violent nausea and vomiting. It is a good idea not to have any alcohol forty-eight hours before taking the medication, while you are taking it, and forty-eight hours after taking it. It can also cause stomach upset and a metallic taste in the mouth.

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A person with AIDS is usually monitored by measuring the level of his or her CD4 cells. A healthy person typically has a count of more than 500 cells; as this number declines, the body becomes vulnerable to outside infections and also to malignancies.

Some infections are more likely to occur at certain times during; a person’s illness, depending on what the CD4 count is. The only symptoms that a person with a CD4 count greater than 500 may have are lymph node swelling and, for women, recurrent vaginal yeast infections. Many people in this category, however, experience no symptoms. When the CD4 count drops into the 200-500 range, infected persons are more likely to be vulnerable to pneumococcal pneumonia, pulmonary tuberculosis, herpes zoster (shingles), oral Candida (yeast) infection, cervical cancer, anemia, Kaposi’s sarcoma, and non-Hodgkin’s lymphoma among other diseases. Persons with CD4 counts that fall within the 100-200 range are more vulnerable to Pneumocystis carinii pneumonia, AIDS dementia, and wasting syndrome (the inability to maim-tain a normal body weight).

People with CD4 counts between 50 and 100 are more likely to develop cytomegalovirus retinitis, toxoplasmosis, and cryptococcosis.

And those with CD4 counts less than 50 may develop Mycobacterium avium complex infection, cryptosporidiosis, progressive multifocal leukencephalopathy, and primary central nervous system lymphoma.

Careful monitoring of the CD4 counts makes it possible to take prophylactic medications at the appropriate time to help protect against many of these infections or at least delay their onset.

Medications to treat the HIV infection and keep the immune system functioning can help protect against these infections for some time.

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Class IV

CIN system: CIN IV

Descriptive system: carcinoma in situ (CIS) Bethesda system: high-grade SIL

Although this is not a finding of cancer, it indicates more worrisome changes than those described previously and has a higher chance to progress to cancer. A colposcopy should be performed, and treatment is indicated if any malignant changes are found.

Class V

CIN system: invasive squamous cell carcinoma or adenocarcinoma Descriptive system: positive for malignant cells Bethesda system: squamous cell carcinoma or adenocarcinoma This finding indicates invasive cervical cancer—either squamous cell carcinoma, which results from malignant changes in the outer cells of the cervix, or adenocarcinoma, which results from malignant changes in the inner cells of the cervix. A colposcopy must be performed, and treatment is indicated if any sign of malignant changes is found.

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Receiving anal sex from and giving it to an infected partner is the highest-risk sexual practice for becoming infected with HIV with receiving anal sex a higher risk than giving it. This may be because there is a higher risk for small tears to occur in the anal mucosa while receiving anal sex, and these tears can facilitate the transmission of infection. Having unprotected anal sex with a partner whose status for infections is unknown puts you at risk for acquiring a sexually transmitted infection.

If a couple are in a monogamous relationship and both have been tested for HIV and other infections and are not infected, then anal sex is safe and can be practiced if it is mutually enjoyable to both partners. (This last condition of course applies to all types of sexual practices.) Once again, if you are not certain that your partner is or will be faithful, then it is a good idea to stay safe and use condoms.

Condoms should be used during anal intercourse with anyone whose status for infection is not known. The only way to know a person’s status is for her or him to be tested for STDs (all of them, not just HIV); being symptom free is not enough. If the person has not been tested, or has been tested and is known to have an infection, then condoms with adequate lubrication offer the best protection against becoming infected during anal sex. As noted previously, condoms are not 100 percent reliable, but they are the best protection available for anyone engaging in anal sex with unknown or untested partners.

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“We’re not looking at radiation as a primary treatment,” comments the internist who’s heading the study, “because studies indicate that radiation is at least not better than radical prostatectomy.” Instead, the PIVOT study will “compare watchful waiting with the most frequently recommended, and probably the best, of the early intervention approaches—radical prostatectomy.”

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