Opening Up: A Guide to Creating and Sustaining Open Relationships (38 page)

After the chancre hardens, heals, and disappears, the secondary
stage begins. This stage is marked by a general skin rash, with sores the
size of pennies that may be itchy and painful. You may experience
fever, swollen glands, aching joints, headaches, nausea, and constipation. People are most contagious during the secondary stage. The third
and fourth stages, which are latent stages of tertiary syphilis, are very
serious and can be deadly if untreated. Syphilis is diagnosed by blood
testing and testing fluid from the sores. People who have had syphilis
for less than a year can be treated with antibiotics, usually penicillin,
doxycycline, or tetracycline.

Five types of hepatitis, an inflammatory liver disease, have been identified: A through E. The most common are hepatitis A, B, and C. The
hepatitis A virus (HAV) is transmitted when infected fecal matter gets
into the bloodstream, usually by ingesting contaminated food. If you
practice unprotected oral-anal sex with an infected person and come into
contact with their fecal matter you are at risk. There are conflicting studies about how many cases of HAV are spread through sexual contact.

On average, the incubation period is 30 days, but it can range from
14 to 60 days. An individual is most infectious two weeks before and
one week after he or she develops symptoms. Symptoms include
fatigue, nausea, vomiting, abdominal pain, dark urine, light stools,
fever, and jaundice (yellowing of the skin and eyes). You may become
ill with several of these symptoms suddenly Doctors can diagnose hepatitis A with a blood test. There is no treatment for hepatitis A, and
it usually clears up on its own in weeks or months, depending on a
person's immune system; the liver repairs itself and there is no permanent damage. Once you've had it, you develop antibodies for it and
cannot become ill with it again. In the United States, nearly 100,000
new cases of HAV are reported every year. There is a vaccine for the
virus.'

The type of hepatitis most likely to be sexually transmitted is hepatitis
B, caused by the hepatitis B virus (HBV). The virus is present in all
bodily fluids of an infected person, including semen, saliva, vaginal
secretions, blood, feces, menstrual blood, and sweat, though it can
only be transmitted through blood, semen, and possibly saliva. It can
be spread through vaginal and anal intercourse and analingus, and
through manual penetration if there is a cut on the skin and a tear in
rectal tissue or rectal bleeding. HBV is 100 times easier to transmit sexually than HIV About 80,000 Americans become infected with HBV each year. One out of 20 people in the United States will become
infected with HBV sometime during their lives. Most of these infections occur among people 20 to 49 years old. There is an HBV vaccine
to prevent hepatitis B; it is given in multiple scheduled doses over four
to six months.

About 50 percent of adults with HBV never develop symptoms.
When symptoms do occur, they appear between six weeks and six
months after infection and may mimic flu symptoms: fatigue, nausea,
vomiting, loss of appetite, headache, fever, tenderness and pain in the
lower abdomen or joints, and possibly jaundice; more severe symptoms
include hives, severe abdominal pain, dark urine, and light stools.
Hepatitis B is diagnosed by a blood test.

About 95 percent of adults who contract hepatitis B acquire the
acute form of the disease; they develop antibodies to the virus and
recover within two to six months without medication or treatment.
While their blood will always test positive to the virus, they are
immune and are not infectious. The other 5 percent become chronically infected. They may or may not continue to show symptoms, but
they will always be a carrier of the virus and can infect other people;
they are at risk of developing cirrhosis, liver failure, and liver cancer.
There are about 1.25 million HBV carriers in the United States. While
there is no treatment or cure for acute hepatitis B, people with chronic
hepatitis are prescribed various medications to eradicate or suppress
the replication of the virus.6

Hepatitis C, caused by the hepatitis C virus (HCV), is passed from
person to person through direct contact with an infected person's
blood. It is primarily spread through unsafe IV drug use, including
sharing needles. Researchers disagree on the number of cases transmitted through sexual contact. Some studies "failed to detect the presence
of HCV in either saliva, semen, or urine of HCV-infected people except when those body fluids have been contaminated by the person's
blood."' Other sources state that it is present in blood, semen, and
vaginal fluids, but that semen and vaginal fluids are much less effective
at transmitting the virus.' It may be spread through vaginal and anal
intercourse, but only when there are tears in the tissue or bleeding, and
through finger-fucking with bleeding and cuts on the skin of the finger.
HCV is more likely to be spread during sex if one partner also has HIV
or another sexually transmitted infection.

Most infected people are asymptomatic or show mild symptoms
that resemble the flu: nausea, fatigue, loss of appetite, fever, headaches,
and abdominal pain. HCV is diagnosed by a blood test. Twenty to 30
percent of infected persons can become disease-free with medication
that contains the viral activity and reproduction and decreases inflammation in the liver. A large percentage, about 70-80 percent, contract
chronic hepatitis C, and many of this group develop cirrhosis (scarring
of the liver) or liver failure. Hepatitis C can be fatal in some cases.
There is no vaccine for HCV9

HIV, the virus that causes AIDS, is transmitted through bodily fluids
and is most concentrated in blood and semen, and present in menstrual
blood, breast milk, and vaginal secretions. HIV is transmitted in several
ways: through unprotected sexual contact with the bodily fluids of an
infected person, by sharing needles with an infected person (engaging
in intravenous drug use), by receiving infected blood (through a transfusion), or from mother to baby via amniotic fluid during delivery or
breast-feeding.

Each year in the United States there are about 40,000 new cases
of HIV/AIDS; 930,000 cases of AIDS have been reported to the Centers
for Disease Control and Prevention to date. Some people develop
symptoms soon after they are infected, but it can take up to 10 years
to become symptomatic. Early symptoms include headaches, fever, diarrhea, muscle pain, weakness, fatigue, night sweats, and swollen
glands. A patient in the later stage of the disease may experience a wide
range of more serious symptoms that differ depending on the person.

It's easier for women to get HIV from men through vaginal intercourse than vice versa. The tissue of the vagina is more susceptible
than the tissue of the penis to trauma, tears, and minute sores, which
provide infected precum and semen a direct route to the bloodstream.
During anal intercourse, it's easier for the receptive partner to get HIV
from the insertive partner for similar reasons: the tissue of the rectum
is even more delicate than that of the vagina. In addition, the viral load
of HIV is higher in semen than in vaginal fluids, so infected semen is
more infectious than infected vaginal secretions. Both women and men
can also get the virus, much less commonly, through oral sex, and possibly through sharing toys and rubbing and fingering if there are cuts
on the skin and in vaginal or rectal tissue.

AIDS can be diagnosed through oral swab, urine, and blood tests.
The most common tests detect the antibodies for HIV, not the HIV
virus itself. In most cases, antibodies appear in the body within four
weeks; however, it can take up to three months for an infected person
to develop antibodies. A more expensive test, the PCR-DNA test, tests
for the HIV virus itself, detecting its presence in the blood within three
to seven days of exposure. However, it is not currently approved by the
Food and Drug Administration (FDA). An infected person can infect
others between the time of infection and the detection of antibodies
or virus.10

There is no cure for AIDS, but there have been many advances in
the treatment of the disease. For many, HIV has become a manageable
chronic illness. With various combinations of prescription medications, people with HIV and AIDS are living longer, healthier lives now
than in the past.

THE INSTITUTIONS OF MAINSTREAM SOCIETY, including the law,
conspicuously fail to acknowledge or support people in nontraditional
relationships. People in polyamorous relationships are often unable to
marry the partner of their choice to legally protect their relationships
and share in certain benefits. They may marry or register as domestic
partners with one of their partners, leaving other partners out in the
cold, legally speaking. Whether you are a polyamorous person with
three partners, one member of a committed quad, or living with your
chosen family, you should know what your options are for protecting
yourself, your loved ones, and your assets. Laws, policies, and procedures that affect everyday life as well as critically important life
decisions are not set up for unconventional relationships-you must
educate yourself and be creative. This is a brief overview of some of the
practical and legal issues people in nonmonogamous relationships face.

Federal Fair Housing Acts prohibits housing discrimination on the basis
of race, religion, national origin, gender, age, familial status (whether you have children), and physical or mental disability These federal laws
do not protect people based on their marital status. A landlord can ask
about your marital status and choose not to rent to you based on the
fact that you are unmarried or in some form of alternative relationship.
A few states have legislation on the books that bans discrimination
based on marital status, but the language often refers to unmarried
couples-not an unmarried triad, for example. When applying to rent,
is probably safer not to out yourselves. If you're in a triad, you could
tell a potential landlord you are a couple with a roommate, or three
friends. Leases usually specify the maximum number of occupants, so
make sure to read the fine print carefully before you sign one.

When two or more persons jointly purchase real estate, there are several
options for how to structure ownership. If you purchase the property
together, the structure you choose will be recorded on the property
title. If one partner owns property and you want to add additional
partners to the title, you should consult a lawyer about legal issues and
procedures and an accountant about possible tax implications.

In joint tenancy, also referred to as joint tenancy with rights of survivorship, each person owns an equal share of the property. When one tenant
dies, his share goes to the surviving tenants. The main benefit of joint
tenancy is that property shares are distributed to the surviving owners
without having to go through probate court, which can be expensive
and time-consuming. Some states have specific guidelines for joint
tenancy, and others limit the number of parties to joint tenancy with
rights of survivorship, so make sure to research the laws in your area
and check with a legal advisor.

There is no limit to the number of people who can hold the title of a
property as tenants in common. And tenants in common do not have
to hold equal shares of the property; it can be divided however the
owners want. When one owner dies, his share of the property goes to
whomever he specifies in his will or trust. Unlike joint tenancy, property owned by tenants in common must go through probate court. If
you or another partner want to leave your share of the property to children or other heirs, this may be a better option for you. You might also
consider tenancy in common with life estate provision: upon your death,
the other owners can remain in the property until they die, whereupon
all shares are passed to the designated heirs.

Some towns, counties, and cities have zoning laws that limit the
number of adults unrelated biologically or by marriage who can live in
a single-family residence. This means your dream of a five-person poly
collective in that big Victorian house may actually be against the law
or in violation of a housing ordinance. Especially when purchasing
property, make sure you educate yourself in the local zoning laws and
read the fine print in a property's deed restrictions. If the property is
part of a subdivision, community, or other entity with a governing body
(such as a homeowners' association, condo board, or co-op board),
investigate the rules before you sign on the dotted line.

All health insurance companies recognize and provide coverage for
married couples, and some now extend coverage to domestic partners
as well, provided you are registered in your city, county, or state. In some cases, a state may not recognize domestic partnerships, but an
employer recognizes them for the purposes of spousal benefits. Talk to
your employer about their particular policies and eligibility requirements. No health insurance company extends benefits to more than
one partner or spouse of an employee.

Most life insurance companies permit co-beneficiaries or multiple beneficiaries to receive the proceeds of a life insurance policy The same is
true for retirement accounts and pensions. Alternatively, you may designate a trust as the beneficiary and, through a will, name multiple
partners to share in the trust. If you don't have a will, these benefits go
to your next of kin.