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About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.

STD Awareness: When Syphilis Goes North

The bacteria that cause syphilis are shaped like corkscrews. Image: David Cox, CDC

Last month, a “weird” medical case made headlines. An Australian man with unexplained headaches and eye pain got a diagnosis for his mysterious symptoms when his doctors discovered he had syphilis — and the infection had spread to his head. Syphilis had caused both optic nerves to become swollen, triggering pain that worsened whenever he moved his eyes.

It might seem strange that a disease most people associate with below-the-belt symptoms can wreak havoc above the neck, but syphilis is a wanderer that can travel all over the body, sowing chaos wherever it goes.


Syphilis can quickly enter the nervous system and travel to the head, where it can cause blindness, psychiatric problems, and other trouble.


Ocular Syphilis

The bacteria that cause syphilis can be passed from one person to another through contact with a sore, which can appear on or around the mouth, genitals, or anus. Any type of sexual contact, including oral sex, can transmit these bacteria. Sores are painless, contain a highly infectious liquid, and can appear between three weeks to three months after infection. These sores aren’t always visible, which means you can’t tell if someone has syphilis just by looking at them.

Although the bacteria typically land in the mouth, genitals, or anus, they can also be sexually transmitted directly into the eye, causing redness and vision problems. After infection, syphilis sores can appear on the eyelids, tear ducts, and soft tissues around the eyes. Bacteria can also travel to the eye by entering the nervous system and blazing a trail to the optic nerve — no direct contact between the eye and a sore necessary. Continue reading

STD Awareness: Is Withholding HIV Status a Crime?

If your sexual partner had HIV and did not tell you about it, how would you feel? Most of us would feel betrayed, lied to. We might be scared that we’d contracted the virus, too. If we had known, maybe we would have chosen not to have sex, or might have taken different precautions. Perhaps we’d be angry that someone took away our ability to evaluate the risk for ourselves, and instead decided for us that the sex was worth the risk.


Disclosing HIV status can make someone vulnerable to risks, but open communication forms the basis of healthy relationships.


Many people think it should be against the law for someone with HIV to withhold their status from a sexual partner. To do so seems like a violation of someone’s right to make their own decisions about the sex they have, a denial of pertinent information that needs to be factored into one’s decision-making.

Then why are organizations like American Psychological Association, the American Medical Association, and the U.S. Department of Justice opposed to these types of laws?

Meet Nick

In June 2008 in Iowa, Nick met Adam on a dating website. They hung out at Nick’s apartment, spent a few hours getting to know each other, and eventually had sex. A few days later, Adam heard through the grapevine that Nick was HIV-positive.

The next month, three armed detectives stormed Nick’s workplace, took him to the local hospital, and ordered nurses to take his blood. Meanwhile, police were searching his house for drugs — not illicit drugs, but lifesaving antiretroviral drugs. Nick was arrested. His crime? Criminal transmission of HIV.

Even though Adam never got HIV. Continue reading

STD Awareness: Fighting STDs with Education

Here in Arizona, Tucson Unified School District has been taking steps toward adopting a comprehensive, inclusive, age-appropriate, and medically accurate sex education program, but it’s been repeatedly delayed by a vocal minority. In September, a vote was put on hold after the superintendent recommended changing the proposed curriculum to focus on abstinence as the preferred method for avoiding STDs and unintended pregnancies.


You can make your voice heard. Learn how!


Additionally, many opponents of TUSD’s proposed curriculum believe its inclusiveness of LGBTQ kids is tantamount to “indoctrination,” that this type of education “sexualizes” children, and that discussions of gender identity will confuse students. LGBTQ kids have traditionally been ignored or demeaned in sex education programs, and their health matters too. Presenting medically accurate and age-appropriate information does not indoctrinate or sexualize children — it simply helps them make healthy decisions, no matter who they are. And these days, students need to be empowered with as much knowledge as possible to make decisions that protect their health.

Confronting the STD Epidemic

Last month, the Centers for Disease Control and Prevention (CDC) released its annual report on sexually transmitted diseases. It did not contain good news. For the fifth straight year, STD rates are climbing.

Continue reading

STD Awareness: Can Gene Editing Cure HIV?

For the first time in history, someone with HIV has been treated with cells edited in the lab. It was a bold attempt to try to replicate previous successes in “curing” HIV through bone marrow transplants, but the results were a mixed bag.

Your DNA is like a book, and each sentence is a gene. Imagine a word is misspelled. Sometimes, a misspelling won’t affect your ability to understand the sentence, but other times, it will be so bad that you’ll have trouble figuring out the intended meaning. Think of the difference between “I drive a car” and “I driv a car,” or “I like food” and “I like flod.” You might not be able to tell what that last sentence is even trying to say! Those misspellings are mutations, and sometimes mutations are relatively benign (“I driv a car”), while other times they can cause diseases (“I like flod”).


A mutated version of the CCR5 gene confers near-immunity to HIV — but increases susceptibility to other viruses.


CRISPR, pronounced crisper, is a powerful new technology that can edit genes. By cutting DNA at a specific location and replacing some of the letters in the genetic alphabet, CRISPR can edit genes like you can edit a document using “find and replace.” The hope is that, someday, CRISPR could be used to fight disease by tweaking faulty genes. Continue reading

STD Awareness: The Vaginal Microbiome and Cervical Cancer

Cervical cancer is caused by human papillomavirus (HPV), which has been nicknamed “the common cold of STDs” — because pretty much every sexually active person will get it at some point. Luckily, that scary stat is poised to change as more people receive the HPV vaccination, which protects against nine major strains of the virus.

HPV jumps easily from person to person, spread by pretty much all types of sexual contact. For most people, the infection clears up within 8 to 13 months, but sometimes the infection develops into a chronic condition, which increases risk for certain cancers — including cervical cancer, but also cancers of the anus, genitals, and throat. Unfortunately, it’s hard to predict if your immune system will vanquish your infection, or if you’ll develop a chronic infection.

Members of the lactobacilli family, keeping vaginas healthy across the globe. Image: Josef Reischig

Luckily, the vagina has some tricks up its sleeve to protect itself from HPV, and some of its best weapons are bacteria. Yep — a healthy vagina isn’t germ-free. To the contrary, it needs lactobacilli and other beneficial microbes to maintain a healthy environment. Bacteria from the Lactobacillus genus produce lactic acid and other chemicals, which help keep dangerous bugs away. Vaginal environments in which Lactobacillus gasseri dominate, for example, are more likely to clear HPV infections. L. crispatus helps trap HIV in a thick mucus, reducing infection risk. Other lactobacilli species secrete chemicals that ward off yeast infections. Sometimes, however, good bacteria lose this turf war, and “bad guys” move in.


The population of microbes that live in your vagina are known collectively as the vaginal microbiome.


University of Arizona researchers in Phoenix performed a “census” of the vaginal microbial communities of 100 premenopausal women. They learned that women who have cervical cancer or precancerous abnormalities have drastically different vaginal microbiomes. Healthy vaginas were generally dominated by lactobacilli, but as cervical health declined, their populations declined, and “bad” bacteria took over. One such bad guy, called Sneathia, was linked to HPV infection, precancer, and cervical cancer.

Which Came First?

Finding a new vaginal “bad guy” was exciting, and Sneathia had previously been linked to other gynecological problems, ranging from bacterial vaginosis to pregnancy complications. But the researchers were looking at a snapshot in time — they didn’t know what came first, the Sneathia or the cervical abnormalities. Were lactobacilli protecting the cervix whereas Sneathia were harming it, or did a chronic HPV infection set the stage for Sneathia to move in and thrive? It’s a real “chicken-and-egg” conundrum. Continue reading

Katharine Dexter McCormick: Fierce Feminist and Secret Smuggler

Katharine Dexter McCormick was born into a life of wealth and privilege — and progressive politics. The family home in which she was born in 1875 had once been a stop on the Underground Railroad. Her parents encouraged her education, and she was among the first women to attend the Massachusetts Institute of Technology, and, in 1904, one of its first female graduates, having earned a bachelor’s degree in biology.


Katharine McCormick harnessed stereotypes about wealthy women to hide subversive acts of civil disobedience in plain sight.


Katharine wanted to be a doctor, but in 1904 she married Stanley McCormick, a Princeton-educated man and heir to a vast fortune. Her oath to stay by his side in sickness and in health, until death did them part, was tested just two years into their marriage, when Stanley’s mental health had deteriorated to the point that he was institutionalized. He was diagnosed with what today is called schizophrenia, and his family sent him to their mansion outside Santa Barbara, a “gilded cage” run by an all-male staff of doctors and nurses who provided round-the-clock care.

The all-male staff was necessary, as Stanley had developed violent tendencies that seemed to be directed primarily toward women. Katharine went nearly two decades without any physical contact with her husband — though she could write letters, talk to him on the phone, or crouch in the bushes and watch him through binoculars. Katharine stayed married to him until his death in 1947. The entire time, she was heavily involved in directing his care — despite constant clashes with his family — and remained optimistic for a cure.

But outside of her marriage, Katharine cultivated a rich life, devoting herself to women’s rights and becoming a high-ranking leader in the fight for the right to vote. After women’s suffrage was won, she was eager to turn her attention to the next fight — and was invigorated by the energy of the birth control movement, which, like the suffrage movement before it, drew ire and outrage from both church and state. Continue reading

STD Awareness: Winning One War on Cancer

Cancer starts with the uncontrolled division of cells.

The developed world is in the midst of a huge nosedive in genital warts and cervical “precancer” — all thanks to the human papillomavirus (HPV) vaccine. This simple shot trains the immune system to defend itself against HPV, a virus that causes genital warts and several types of cancer. Most sexually active people will be exposed to it in their lifetimes — it’s even been nicknamed the “common cold” of sexually transmitted infections.

Gardasil 9 protects against seven strains of HPV that collectively cause 90% of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90% of genital warts. Vaccination also reduces the frequency of “precancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments.


The HPV vaccine is an anti-cancer vaccine.


The vaccine is safe and effective — and when we say “effective,” we mean it could lead to the eradication of HPV, and with it the cancers it causes. A recent analysis of 66 million vaccine recipients published in The Lancet points to plummeting rates of genital warts and precancer. Among teenage girls, there was an 83% drop in HPV-16 and HPV-18 infections (the two strains of HPV that together cause 70% of cervical cancers) — and cervical precancers were cut in half.

The most dramatic gains were made in countries that offered the HPV vaccine to both boys and girls. Additionally, there were even decreases in the HPV strains that aren’t covered by the vaccine — evidence of “cross-protection,” the phenomenon in which the immune system recognizes close relatives of the viruses it has been trained to attack. Even people who did not receive the vaccine were less likely to catch the virus, simply because their risk was reduced if their partners were vaccinated. Continue reading