In 2006, a vaccine called Gardasil made its debut. Its ability to protect against two of the most widespread strains of human papillomavirus (HPV) means that it doesn’t just protect against an infectious disease — it protects against cancer, too. A persistent HPV infection can trigger cell changes that could lead to cancers of the mouth, throat, cervix, vulva, anus, or penis. Gardasil also protects against two additional strains of HPV that cause most genital warts.
Cervical cancer is not as common in the developed world as it once was, thanks to an effective screening test. The Pap test catches “precancerous” cell changes, allowing the precancer to be treated before it develops into full-fledged cancer. So, while HPV vaccines have the potential to save hundreds of thousands of lives if they can be distributed in countries without widespread access to Pap testing, they have utility in the United States, too. Gardasil has spurred declines in high-risk HPV infections and genital wart incidence among American girls — which means less “precancer” and all the invasive, possibly expensive or painful, treatments that they entail, and a lot fewer genital warts. What’s not to like about that?
Despite this, a lot of people are curious about Gardasil’s side effects. If you enter a few key search terms into Google, you can easily find all kinds of websites warning you of Gardasil’s alleged dangers. So, you might be wondering: Is Gardasil safe?
What are Gardasil’s side effects?
Despite Gardasil’s relatively recent debut, many studies have already been conducted to evaluate its safety — and research continues so that we can consistently reassess its risks and benefits. So far, the consensus is that Gardasil is safe, with very few side effects. According to the Centers for Disease Control and Prevention, the most common Gardasil side effects are fainting, dizziness, nausea, headache, fever, and hives, as well as possible pain, redness, or swelling at the injection site. These reactions are not considered to be serious, some people don’t experience any of them, and they are only temporary. Continue reading →
Gonorrhea is that guy with the funny name who’s always up to something new and mischievous. Last year, the New England Journal of Medicine declared that it’s “time to sound the alarm” in response to emerging strains of gonorrhea that are increasingly resistant to antibiotics. Then, earlier this year, the medical journal JAMAreported the first North American sightings of gonorrhea that failed treatment with cefixime, one of the last drugs we have in our anti-gonorrhea arsenal. It’s a great time to be a gonococcus — the type of bacteria that causes gonorrhea — but the humans they infect probably don’t see it that way.
Last month, this bad boy rose to the top of the Most Wanted list when the Centers for Disease Control and Prevention proclaimed antibiotic-resistant gonorrhea an “urgent threat” — the highest threat level, which gonococci share with only two other bacteria types. To give you some context, the much more famous superbug MRSA was categorized as a “serious” threat, one notch below “urgent.”
Antibiotic-resistant gonorrhea is especially insidious for two reasons. One, gonorrhea often doesn’t have symptoms, which allows it to jump from one sexual partner to another, the hosts often none the wiser. Two, unless health care providers actually test the bug’s DNA, they have no way of knowing whether or not they’re dealing with a drug-resistant strain. This opens up the possibility for treatment failure — and for the antibiotic-resistant bacteria to be further propagated into the community.
The CDC estimates that the United States sees 246,000 cases of antibiotic-resistant gonorrhea infections annually — that’s about 30 percent of all gonorrhea infections in the country. For now, we seem to be able to cure them with higher doses or different combinations of drugs. So why does antibiotic-resistant gonorrhea deserve the “urgent” designation? While gonorrhea isn’t associated with a body count — unlike other drug-resistant pathogens, which collectively kill at least 23,000 Americans a year — it can have terrible consequences. Gonorrhea can cause pelvic inflammatory disease (PID) when it advances up the female reproductive tract, and epididymitis when it invades the male reproductive tract; both conditions can cause infertility. Also, gonorrhea infections make us more vulnerable to HIV. The CDC estimates that if the most resistant gonorrhea strain gains ground over the next decade, the country could see an additional 75,000 cases of PID, 15,000 cases of epididymitis, and 222 HIV infections, costing us $235 million. Continue reading →
You’ve probably heard of MRSA, which is a strain of Staphylococcus aureus that evolved resistance to all kinds of antibiotics. You also might have heard of other “superbugs,” like Clostridium difficile,
aka “C. diff,” or the emerging strains of bacteria that cause
antibiotic-resistant gonorrhea. However, other infectious diseases are
slowly evolving drug resistance too, but they’re not grabbing headlines.
One such disease is trichomoniasis.
Trichomonas vaginalis is the single-celled parasite that causes trichomoniasis,
or trich (pronounced “trick”). Symptoms can include vaginal discharge
(which might have a bad odor), penile burning or discharge, spotting,
and itching or swelling in the genital area — but around 70 percent of trich infections are asymptomatic.
Despite its appearance on our list of 10 STDs you’ve probably never heard of, trich is actually the most common curable sexually transmitted disease out there — around 3.7 million Americans
are currently infected with trich. When you consider that trich rarely
has symptoms, its ubiquity might not even seem all that surprising —
there are millions of infections, right under our noses, but mostly
unknown and not being aggressively screened for. STD testing doesn’t
always include screening for trich, especially in males, who usually
don’t have symptoms and can transmit it to others unknowingly. This
might not be so bad if trich didn’t cause complications with pregnancy or make it easier to be infected with HIV. Continue reading →
Last month, actor Michael Douglas gave a frank interview in which he revealed that human papillomavirus (HPV) caused his throat cancer. And, he continued, he got the virus from performing oral sex — specifically, cunnilingus (oral contact with female genitalia). It’s unusual for celebrities to be open about their STD status — and Douglas’ spokesperson has since backpedaled on his comment — so Douglas is to be commended for bringing light to a taboo and little-understood topic. But there were a few things he got wrong, too.
HPV is a common virus that can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The majority of HPV-related cancers are caused by two strains of HPV: HPV-16 and HPV-18.
The good news is that there is a vaccine that can protect you from infection by HPV-16 and HPV-18. Furthermore, most people clear an HPV infection within two years. HPV-related throat cancer is rare, affecting just 2.6 out of 100,000 people.
Can oral sex really lead to throat cancer?
Unfortunately, it is absolutely true that oral sex can transmit HPV, and a chronic infection can cause cancer. Oral sex is indeed sex. It’s not “third base,” it’s not “almost sex,” it’s plain old, straight-up sex, carrying with it the potential for both pleasure and disease transmission. Unfortunately, because so many of us have a lax attitude toward it, fewer people take precautions when engaging in oral sex, and are less likely to use condoms or dental dams. Combined with low vaccination rates for HPV in the United States, the virus is even easier to acquire than it needs to be. Continue reading →
It’s important to be tested for HIV, the sexually transmitted virus that causes AIDS. For some people, periodic HIV testing is part of their regular health care, while others might be experiencing a scare after a high-risk encounter (for example, having unprotected vaginal or anal intercourse or sharing IV equipment with someone whose HIV status you don’t know). No matter what boat you’re in, waiting a week or more to get your results from a standard HIV test might be nerve-wracking. If that sounds like you, then a rapid HIV test — which can give you results in just 40 minutes or less — might be just what the doctor ordered.
Here’s a quick rundown on rapid HIV testing: A negative result on a rapid HIV test is just as accurate as a negative result from a standard test — you just don’t have to wait as long to get it. However, positive results are considered “preliminary” and another blood sample must be sent to a lab for confirmation. If that result comes back negative, you will probably be asked to come back for retesting to verify that negative result.
The rapid test, just like the standard test, is an antibody test, which means it detects the presence of antibodies in your bloodstream. Antibodies are molecules produced by your immune system, and are specially designed to attach to viruses and other invaders. Each type of antibody is shaped in such a way that they can interlock with just one type of pathogen; some antibodies might specialize in attaching to a certain strain of a cold virus while others might be shaped especially for attachment to the surface of an E. coli bacterium. So, if you’re infected with HIV, your immune system will produce antibodies that are uniquely shaped to target HIV. An HIV antibody test can sort through the many types of antibodies in your bloodstream and identify only the antibodies that are shaped specifically for targeting HIV. Continue reading →
Today kicks off Men’s Health Week, which means it’s time to remind you that Planned Parenthood Arizona has plenty of men’s health services. Sexual and reproductive health are our bread and butter, and we’re here for you if you need condoms or routine STD screening, or if something is amiss in your nether regions and you’d like us to take a look! One thing we do is evaluate and treat penile skin lesions.
What is a lesion, anyway? “Lesion” is a general term that can refer to any kind of abnormality that appears on your skin or elsewhere in the body, like on an organ. Usually they’re well-defined, as in blisters, spots, bumps, warts, or what have you. A change of appearance on the penis can be caused by all sorts of things. Maybe it’s something minor, like an irritation or an allergic reaction. Or it could be a relatively benign dermatological condition, like pimples or skin tags.
But sometimes, an infectious agent might be at play. You might be suffering from a yeast infection, a sexually transmitted disease (STD), or even penile cancer. For the sake of your health — and your peace of mind — you should be evaluated by a health professional, just so you can know for sure what’s going on and receive treatment if necessary. Continue reading →
If you’ve been reading the news lately, you might have noticed an odd piece of reportage from CNBC, in which a naturopath claimed that antibiotic-resistant gonorrhea “might be a lot worse than AIDS” and might cause cases of sepsis that could kill “in a matter of days.” This quotation, uttered by a single naturopath, was then exaggerated in sources such as the United Kingdom’s Daily Mail, which ran the headline “Doctors warn that antibiotic-resistant strain of gonorrhea could be ‘worse than AIDS.’” In fact, the only person making this claim was one naturopath, not a doctor, and certainly not plural “doctors.”
There’s a lot to unpack here. First is the alarmism in the original CNBC article, and its dependence on an unreliable source. Second is the issue of antibiotic-resistant gonorrhea itself, which is a very serious public health problem. Thirdly, let’s look at the naturopath’s claim, which is that antibiotic-resistant gonorrhea could unleash a plague worse than AIDS and kill its victims in a matter of days.
Alan Christianson, the naturopath behind the hyperbolic claims of super-virulent gonorrhea, does not seem to be an actual expert in infectious disease (his website lists “natural endocrinology” and “male menopause” among his specialties), nor is he a medical doctor. The article identifies him as a “doctor of naturopathic medicine,” but what does that mean?
Naturopaths are not medical doctors, and degrees in naturopathic medicine aren’t awarded by institutions accredited by the Association of Medical Colleges, the body that accredits medical schools. Naturopathy is a philosophy that is not generally supported by scientific evidence, but rather is based in “a belief in the healing power of nature,” according to the National Center for Complementary and Alternative Medicine. It was developed in the 1800s and today encompasses many modalities of alternative medicine, including homeopathy and herbalism. For these reasons, it is odd that a journalist quoted a naturopath on the potential of antibiotic-resistant gonorrhea rather than someone more qualified, such as a microbiologist or epidemiologist. Continue reading →
Q: Can I catch herpes if my partner isn’t having an outbreak? A: Yes, your partner can transmit the virus even if he or she isn’t experiencing symptoms. In fact, most genital herpes infections are transmitted in the absence of symptoms.
When most people think about genital herpes, they think about the symptoms that are associated with it: clusters of blistery sores around the genitals or buttocks. But most genital herpes infections don’t have symptoms — they are asymptomatic — or the symptoms are so mild or nonspecific that the person suffering from them doesn’t even make the mental connection. It is estimated that only 10 to 15 percent of people with herpes exhibit symptoms, which may be a silver lining for the millions who unknowingly carry the virus, but it also helps it spread more easily.
What is genital herpes, anyway?
Genital herpes can be caused by two types of herpes simplex viruses — either herpes simplex virus type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2). The difference between the two viruses is that HSV-1 is more active when it infects the facial region, where it can cause cold sores; HSV-2 is more active when it infects the genitals. Genital infections with HSV-1 tend to be milder than genital infections with HSV-2. The Centers for Disease Control and Prevention states that, among Americans 14 to 49 years old, 1 out of 5 women and 1 out of 9 men have a genital HSV-2 infection. Because that stat doesn’t count genital HSV-1 infections, the overall number of people with genital herpes is actually higher.
An “outbreak” occurs when genital herpes symptoms appear. The most well-known symptom is a cluster of blisters or open sores in the genital or rectal area. Continue reading →
Being diagnosed with a sexually transmitted disease (STD) can be upsetting. Some take it as evidence that they’ve been cheated on; others wonder if they can ever have sex again. Some people who have long dreamed of having children might worry about what impact, if any, their STD could have on future fertility. The bad news is that certain STDs can make it difficult or impossible to have children. But the good news is that STDs are avoidable — and regular STD screening can ensure that infections are caught and treated before they have time to do damage.
Fertility can be impacted in several ways. The ability to become pregnant and bear children can be affected by a condition called pelvic inflammatory disease, which is usually caused by untreated gonorrhea or chlamydia infections. If you have a cervix, an infection with a high-risk strain of HPV can require invasive treatment, which in some cases might affect the ability to carry a pregnancy. If you have a penis, an untreated STD might lead to epididymitis, which in extreme cases can cause infertility.
Pelvic Inflammatory Disease (PID)
Many sexually transmitted infections are localized; for example, the bacteria that cause gonorrhea usually just hang out on the cervix. But untreated infections can spread on their own, and bacteria can also hitch a ride on sperm or the upward flow of a douche, which can take them into the cervix, through the uterus, down the fallopian tubes, and to the ovaries. At any of these locations, microbes can stake claim on your reproductive real estate, establishing colonies deep in your reproductive system. As these colonies grow, the bacterial infections become more widespread, and can cause scarring and other tissue damage. To keep these interlopers from getting through the front door, sexually active people can use barrier methods, such as latex condoms — especially with spermicides. There’s no need to host an open house for sexually transmitted bacteria in your uterus. Continue reading →
Herpes simplex virus is mystifying, fascinating, and sneaky. Mystifying because we have yet to unravel all of its secrets; fascinating because when we do uncover one of its mysteries, we are amazed by the capabilities of such a tiny, microscopic object; and sneaky because it enters our bodies by stealth and conceals itself in our cells, taking us by surprise when it comes out of hiding and causes outbreaks of blisters and other lesions.
It can also be confusing. Herpes simplex virus actually comes in two flavors: HSV-1 and HSV-2. HSV-1 is associated more with oral herpes, which can cause “cold sores,” a type of blister that appears on the lips or face. HSV-2 is associated more with genital herpes, which can cause blisters and other lesions in the genital area. It used to be standard to describe HSV-1 as an “above-the-waist” infection and HSV-2 as a “below-the-belt” infection — but now many researchers are pointing out that it’s more appropriate to say that HSV-1 is both an orally and genitally transmitted infection while HSV-2 is a predominantly genitally transmitted infection. If HSV-1 enters the body in the genital area, it can cause a genital herpes infection — and likewise, if HSV-2 enters the body in the facial area, it can cause an oral herpes infection.
What exactly is a cold sore, anyway? A cold sore, also known as a fever blister, is a cluster of blisters that can pop up around the lips or even in the mouth. Sometimes, cold sores are so painful that eating or drinking is difficult, and in extreme cases sufferers must be treated for dehydration. An especially severe infection could also cause high fever or swollen lymph nodes, and in young adults a first oral HSV-1 infection might be misdiagnosed as tonsillitis, possibly leading to unnecessary tonsillectomies. Most symptomatic first-time cold-sore outbreaks occur during childhood, and take about two or three weeks to clear up. Luckily, the first infection is almost always the most severe, and when the infection is reactivated it usually happens without symptoms.
Because both cold sores and genital herpes are caused by herpes simplex viruses, and because oral herpes is so common, many people are concerned that they might be more vulnerable to acquiring a genital herpes infection than they previously thought. They might have a lot of questions, and if they’ve sought answers to those questions, they might have heard a lot of conflicting answers. Let’s see what the scientific literature has to say.
Can I get genital herpes if someone with cold sores performs oral sex on me?
Because HSV-1, the virus responsible for most oral herpes infections, can also cause genital herpes, many people wonder if someone with cold sores can transmit the virus to someone else by performing oral sex, resulting in a genital herpes infection. Other people wonder if HSV-1 can be transmitted via oral contact with the anus, resulting in a herpes infection in the rectal area. The answer to these questions is: Yes! Continue reading →
One of the most common sexually transmitted diseases is herpes, which most people associate with “outbreaks” in the genitals. In actuality, most cases have no symptoms, and the majority of people with genital herpes don’t know they have it. Herpes simplex virus, which causes genital herpes, can also infect facial nerves around the mouth, and its “outbreaks” include blisters called cold sores.
A cold sore outbreak involves an “eruption” of blisters around the mouth, which slowly heal as the virus returns to dormancy. Most cold sores are caused by herpes simplex virus type 1, or HSV-1. Around 60 percent of Americans are infected with HSV-1, and most of these infections are oral, asymptomatic, and acquired in childhood through nonsexual contact. Despite how common this infection is, only 20 to 40 percent of us actually get cold sores — and an even smaller percentage experience cold sores more than once a year. The rest of us don’t get cold sores at all, even if we are infected with HSV-1. That’s one quirk about HSV — an infection is permanent and incurable, but most people never have symptoms!
Making matters more confusing, there’s a related virus called HSV-2, which most people associate with genital herpes. However, HSV-1 can also cause genital herpes, and anyone with an HSV-1 infection in the facial area has the potential to transmit the virus to a partner’s genitals while performing oral sex — whether or not cold sores are present. However, when HSV-1 strikes the genitals, the infection is usually milder, with fewer (if any) recurring outbreaks. Additionally, a previous HSV-1 infection in the facial area might make you more resistant to acquiring an HSV-1 infection in the genital area — but it doesn’t confer total immunity. Continue reading →
The Internet is brimming with contradictory claims about sexual health, and you don’t know what to believe. Your friends give you advice, but you’re not sure if it sounds right. To make things worse, you might not have had evidence-based, medically accurate sex education in your school. In this edition of our STD Awareness series, we’ll take on a few myths about sexually transmitted diseases to help you sort fact from fiction.
1 MYTH: You can tell if someone has an STD by looking at them. You might expect that if someone has an STD, their genitals would have blisters, warts, or noticeable discharge. But your partner looks fine, so you might think there’s no need to ask when his or her last STD test was.
However, while many people with STDs do have visible symptoms, they’re the exception rather than the rule. For example, three out of four women and half of men with chlamydia have no symptoms. Herpes is often spread when there are no symptoms present. Someone can be infected with HIV — and capable of transmitting it to others — and go years without showing any signs. A quick visual inspection can’t tell you very much about someone’s STD status.
3 MYTH: Condoms can’t prevent the spread of HIV. Many proponents of abstinence-only education state that condoms don’t protect against HIV, claiming that latex condoms have holes that are large enough for viruses to pass through. This claim isn’t backed by evidence. An intact latex condom dramatically reduces your risk of being exposed to sexually transmitted viruses such as HIV. (It is true that a lambskin condom does not provide adequate protection against HIV.) Continue reading →
Last year, we shared the fascinating and frightening story of the emergence of increasingly antibiotic-resistant gonorrhea, an STD caused by the gonococci bacteria. The sexually transmitted scourge, which we only so recently reined in with the development of antibiotics, has been performing some genetic gymnastics to defeat almost every drug we’ve thrown at it. We douse it with certain drugs, and the bacterium literally spits them back out at us, and it inactivates other drugs by snapping the active molecules in half. Sulfa drugs, penicillins, tetracyclines, fluoroquinolones — they all make a gonococcus heave a bored sigh. Luckily, cephalosporins were still an effective treatment, but recently there have been reports of stubborn gonorrhea infections caused by the latest and greatest (and some might say most hated) strain of gonococci.
Well, the story isn’t over — just like the bacteria that cause gonorrhea, the tale is rapidly evolving. The latest class of antibiotics that the gonococci are chipping away at is the cephalosporin family, which includes several chemically related drugs that work in similar ways — and that can likewise be defeated by microbes in similar ways. Cephalosporin-resistant gonorrhea was first reported in Japan and documented in a few European countries. The Japanese case that inspired the New England Journal of Medicine to declare last year that it was “time to sound the alarm” was an oral gonorrhea infection that was resistant to one member of the cephalosporin family: ceftriaxone.
Earlier this month, the prestigious medical journal JAMAreported the first North American sightings of gonorrhea that failed treatment with another cephalosporin: cefixime. Yeah, I know, you’d rather hear about Big Foot or UFO sightings, not evidence that something as real and unmythical as Gonorrhea 5.0 has landed in your back yard. Luckily, there’s plenty you can do to protect yourself from it, and we’ll tell you all about it toward the end of this article. (Spoiler alert: It involves using condoms!) Continue reading →
HIV, just like any other virus, is made up of a tiny capsule with a small piece of genetic code inside. While most viruses we’re familiar with store their genes on a molecule called DNA, HIV contains two pieces of RNA, which is another type of gene-storing molecule. The HIV capsules also contain an enzyme called transcriptase, which “translates” the RNA into a strand of DNA that our cells can read. Our cells are then tricked into reading this DNA and producing more copies of the virus — which are then released from the host cell, at which point they are free to infect other cells. In this manner, an HIV infection slowly grows.
When a virus is introduced into a host’s body, immune cells pick it up and carry it to the lymphoid organs — which are a sort of meeting place for other types of immune cells, including CD4+ T helper cells (also called helper T cells). Helper T cells enlist the help of other immune cells, called killer T cells, which destroy cells infected with viruses. Helper T cells also activate the production of antibodies, molecules that are specialized to attach to a specific pathogen so that it can be destroyed. Normally, this is where the virus meets its end. Unfortunately, HIV is different from run-of-the-mill viruses in that it is specialized to invade helper T cells. Now, instead of coordinating an attack against HIV, the helper T cells have been hijacked — converted into factories for the production of yet more HIV. Continue reading →
Our immune systems are beautiful things, refined through millions of years of evolution. The immune system’s complexity is testament to the “arms race” that has been taking place between our species and the harmful pathogens that surround us. Last century, a virus called human immunodeficiency virus (HIV) emerged, and it found a weak spot in our immune system’s armor. HIV has been exploiting this weakness ever since, and an HIV infection can eventually progress to a disease called AIDS, or acquired immune deficiency syndrome. AIDS is a condition that disables our immune system’s ability to function properly, rendering us vulnerable to a host of opportunistic infections and cancers.
HIV is transmitted via bodily fluids: blood, semen, pre-seminal fluid (which can be present without ejaculation), breast milk, vaginal fluids, and rectal mucus. (It can also be present in bodily fluids like amniotic fluid, cerebrospinal fluid, and synovial fluid, to which health-care workers might be exposed.) The virus is not transmitted by fluids like snot, saliva, sweat, tears, and urine — unless blood is present.
Activities that can bring you into contact with HIV-infected bodily fluids include injection drug use and sexual activities like anal, vaginal, or oral sex. It can also be transmitted to a fetus or baby during pregnancy, childbirth, or breastfeeding. In the early days of HIV, many infections occurred as a result of blood transfusions or organ transplants — though nowadays this is a rarity thanks to tissue screening. Lastly, health-care workers might be exposed to HIV through accidents involving needlesticks or cuts. Continue reading →