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.

So Bad, Even Introverts Are Here: The Rally at McSally’s

Planned Parenthood supporters at Rep. Martha McSally’s office in Tucson, March 7, 2017.

The Women’s March on Washington, D.C., was an occasion for people to be creative and even humorous with their signs. Quite a few made me laugh — “Ugh, Where Do I Even Start?,” “We’ve Made a Yuge Mistake,” and “I Shouldn’t Have to Write Pussy on a Poster” were among my favorites at Tucson’s sister march. But there was one that not only made me laugh, it also resonated with me: “So Bad, Even Introverts Are Here.” Someone tweeted it from the march in New York City, and last I checked it had 94,000 “likes,” meaning I’m not the only one who could relate.

There has been some criticism leveled at people for whom the Women’s March was their first public protest. Things were already bad enough for us to be rallying in the streets, they say, so what took you so long? While I understand that line of thought, I get a little prickly at the suggestion that attendance at a march or rally is the only way to “do” activism. Yes, the Women’s March in Tucson was my first protest, but it was not my first activism.


I’m glad I expanded the boundaries of my comfort zone and allowed myself to be publicly counted.


As a teenager, I was happiest with volunteer activities that kept me far from the limelight, like stuffing envelopes for Planned Parenthood and the ACLU. Crowds, chants, spectacles — not my thing. I didn’t want to be interviewed by the local news, and I didn’t want my photo in a newspaper. I tried my hand at going door to door, but it filled me with so much anxiety that I never did it again. My activism, such as it was, waned as I buckled down on my studies in university, and it wasn’t until after I moved to Arizona that I started seeking out more opportunities — and explicitly looking for behind-the-scenes work where my introversion and dislike of crowds and cameras wouldn’t hold me back.

While there was plenty of work for people who didn’t mind making cold calls or canvassing neighborhoods, I found adequate demand for my skills — writing, data entry, and even the occasional stuffing of envelopes. I’m glad there are folks who can throw themselves on the front lines, changing hearts and minds on a one-on-one, face-to-face level. I’m glad there are folks who go to marches and wave signs, adding their bodies to the throngs of other people standing against injustice. We need those people. But I always felt perfectly content behind the scenes, contributing in my own quiet way.

Yet on January 21, I found myself in Armory Park in Tucson, joining thousands of Women’s March protesters. And on March 7, I made the split-second decision to show up after work at a spur-of-the-moment protest at Rep. Martha McSally’s office, waving signs to passing cars on Broadway Boulevard.

So what changed? Continue reading

STD Awareness: The Surprising Sexual Transmission of Non-STDs

What is a sexually transmitted disease, or STD? If someone catches their partner’s cold during sex, is that cold an STD? According to the Office on Women’s Health, an STD is “an infection passed from one person to another person through sexual contact.” Unless the cold was passed through sexual contact, rather than mouth-to-mouth contact, it would not be considered an STD. Others say that, for an infection to be considered an STD, its sexual transmission must make it significantly more common in the population. So, a disease like the common cold would probably be just as common even if people never had sex.


MRSA, meningitis, and the virus that causes pinkeye can be transmitted sexually.


However, there are some infections, such as hepatitis C or bacterial vaginosis, whose status as official STDs is controversial. While researchers argue with one another over where to draw the line between an STD and a non-STD, let’s take a look at some bacteria and viruses that can be transmitted sexually, even though they’re not officially categorized as “STDs.”

MRSA: Methicillin-Resistant Staphylococcus aureus

MRSA bursting out of a dead blood cell. Image: Frank DeLeo, NIAID

MRSA bursting out of a dead blood cell. Image: Frank DeLeo, NIAID

You’ve probably heard of MRSA, which is pronounced “mersa” and stands for methicillin-resistant Staphylococcus aureus — a strain of bacteria that is resistant to every antibiotic in the penicillin family, as well as others. S. aureus, or “staph” for short, is the same bacteria responsible for TSS, or toxic shock syndrome, which has most infamously been associated with the use of highly absorbent tampons. But mostly, staph is a common cause of skin infections, which could be deadly in the pre-antibiotic era, but these days usually don’t raise too many eyebrows.

Unfortunately, with the emergence of MRSA, which is difficult to treat with the usual drugs, we might once again have to worry about minor skin infections blossoming into life-threatening conditions. Additionally, MRSA has found a way to hop from person to person via sexual contact, and sexually transmitted MRSA has been documented in both heterosexual and MSM (men who have sex with men) populations. Untreated, it can lead to a form of gangrene in which tissue blackens as it dies. Continue reading

IUDs and Implants: It’s Not Too Late for LARCs

IUDAccess to contraception is coming under attack, and reproductive-health advocates are scrambling to find ways to protect it. In December, Obama did what he could to protect Planned Parenthood from losing its ability to serve Medicaid patients. In New York, the state’s attorney general has moved to ensure that New Yorkers will continue to receive no-copay birth control as part of their insurance benefits, and Massachusetts moved to defend Medicaid patients’ right to use Planned Parenthood’s services in the event of federal interference. And, across the country, people at risk for unintended pregnancy are clamoring for highly effective, long-term birth control to see them through the next four tumultuous years.


IUDs and implants can help you and your uterus make it through the Trump administration.


Tom Price, who was confirmed as secretary of health and human services last month, represents the most immediate threat to our birth-control access. As HHS secretary, Price has the power to declare that contraception is not a “preventive” service insurers must make available to their customers with no copay. In one fell swoop, Price could undo the enormous progress the Obama administration made in expanding access not just to all forms of contraception, but to highly effective forms of contraception that had for so long been out of reach to so many.

Before the Affordable Care Act, long-acting reversible contraception (LARC) methods like IUDs and implants were known to be highly effective — not just cost-effective, but also simply the most effective in terms of preventing pregnancy. However, the high upfront costs closed the door to many potential users. Let’s do some quick-and-dirty math: A copper IUD could set you back anywhere from $500 to $932, but it lasts for 12 years. That means it costs $3.50 to $6.50 per month, compared to the Pill, which can cost $10 to $50 a month out of pocket. Clearly, the IUD makes the most financial sense, but for many of us, a medical bill charging upward of $500 doesn’t fit into our budgets. Better to rely on methods like the Pill, which cost more over time, but aren’t as hard on the wallet of someone living paycheck to paycheck or on an otherwise tight budget. Continue reading

STD Awareness: Human Papillomavirus Grabs Headlines

Human papillomavirus, or HPV, is the most common STD out there — a fact made even more aggravating by the absence of a good test for it. Sure, Pap testing can detect cellular abnormalities triggered by HPV, and the HPV DNA test can find evidence of infection. But it’s not a definitive test — a negative Pap/HPV DNA co-test doesn’t rule out the possibility that you carry the virus. Ditto for the anal Pap test — which most people haven’t even heard of anyway!


There are more compelling reasons to vaccinate boys against HPV — and not-as-compelling reasons to think Gardasil could protect against skin cancer.


The lack of a good diagnostic test makes the HPV vaccine an even more valuable asset. If we can drive the virus to extinction through aggressive vaccination campaigns, our limited diagnostic abilities become a moot point. And recent headlines have given us reasons to love the HPV vaccine even more.

HPV and Men

Many people think of HPV as a women’s issue, as the virus causes cervical cancer, and for a long time, boys and men weren’t even targeted for vaccination. But HPV is everyone’s issue — genital warts don’t care what gender you are, and cancer-causing strains of HPV cause most cases of anal cancer, penile cancer, and oropharyngeal cancer. Recently, a large, first-of-its kind study published in JAMA Oncology analyzed penile swabs provided by 1,757 men to figure out how common HPV is in this population. (While there is no FDA-approved test for diagnosing male patients with HPV, scientists can still collect swabs for research purposes.)

The results: 45.2 percent of American men ages 18 to 59 carry genital HPV — for a total of nearly 35 million adult males. HPV carriers can transmit the virus to sexual partners through vaginal, anal, or oral sex — or even just rubbing genitals together, as the virus is spread by skin-to-skin contact. Furthermore, a quarter of men are infected with cancer-causing strains of HPV. And, while the female population sees a peak in HPV infections in their early 20s, men’s HPV prevalence increases with age. While 28.9 percent of men 18 to 22 years of age carried HPV, 50.8 percent of them carried it by the time they were 28 to 32 years of age, and 59.7 percent of 58- and 59-year-olds were carriers. Continue reading

STD Awareness: Shaving, Waxing, and Trimming, Oh My!

Last month, the connection between body-hair removal and sexually transmitted diseases (STDs) once again gave rise to a flurry of headlines. Media had previously reported on “studies” purporting that the popularity of waxing is leading to the extinction of pubic lice, or that shaving increases risk for a little-known STD called molluscum contagiosum.

The idea that waxing one’s nether regions is tantamount to habitat destruction for the lowly pubic louse makes a certain amount of sense. But was it really true that waxing was leading to diminished pubic-lice populations, or just a case of the media blowing an obscure medical factoid out of proportion? Ditto with the claims about molluscum contagiosum — though they were based on perfectly plausible premises, having to do with shaving causing microscopic skin injuries that create openings for infectious viruses, the average reader might not have been able to rely on a journalist’s ability to translate a scientific article from “medical-ese” into an easy-to-understand, yet fully nuanced, magazine blurb.


The case isn’t closed on the link between body-hair removal and STDs.


As we’ve written before, the reporting in the popular media left out important details — such as the fact that these weren’t studies at all, but rather educated guesses based on observations, published as letters to the editor. No one was comparing pubic lice infestations or sexually transmitted infections between groups of people with and without pubic hair.

Until now.

The medical journal Sexually Transmitted Infections recently published a study based on a survey of 7,470 American adults who had had at least one sexual partner. The salient point the media pounced on was that removing pubic hair increases STD risk by 400 percent: NPR screamed that “Going Bare Down There May Boost The Risk Of STDs,” Time proclaimed “Grooming is linked to a higher risk of STIs,” and The Guardian spooked readers with a rather tasteless piece about “the health dangers of bikini waxing.” Even Saturday Night Live’s Weekend Update got in on the action, albeit with a crude joke about old men’s genitals.

But let’s leave headlines behind and delve right into the medical journal itself. Continue reading

STD Awareness: Fully Antibiotic-Resistant Gonorrhea Is on the Horizon

shot-in-armWe’ve been anticipating its arrival for years now, but earlier this fall, the Centers for Disease Control and Prevention (CDC) finally made an announcement: Cases of gonorrhea resistant to the last drugs we use to cure it are emerging.

Over the years, gonorrhea has evolved resistance to every drug we’ve thrown at it — sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. The last line of defense we have is a one-two punch of a pair of antibiotics: azithromycin and ceftriaxone. By using two drugs, we can delay the inevitable evolution of antibiotic resistance by attacking the bacteria in two vulnerable locations, rather than just one, making it more difficult for the bug to mount a defense and pass on its superior survival skills to subsequent generations.


Prevention is paramount: Stop the spread of antibiotic resistance by practicing safer sex!


Unfortunately, we could only stave off the inevitable for so long. At their conference in September, the CDC announced a cluster of gonorrhea infections that are highly resistant to azithromycin, and that fall prey only to high doses of ceftriaxone. As gonorrhea’s tolerance to ceftriaxone increases, the infection will get more and more difficult to cure.

This cluster of drug-resistant cases was identified in Honolulu in April and May of this year, with five infections showing “dramatic” resistance to azithromycin, as well as reduced vulnerability to ceftriaxone. The good news is that these cases were cured with higher-than-usual doses of antibiotics, but the bad news is that dosages can only climb so high before a drug is no longer considered to be an effective treatment. Continue reading

Ovarian Cancer, Endometrial Cancer, and the Pill

birth-control-pillsThe most popular method of birth control in the United States is the Pill, followed by tubal ligation (permanent sterilization, or getting your tubes tied) and condoms. The Pill is a hormonal method of contraception, while sterilization and condoms are nonhormonal. The distinction between hormonal and nonhormonal methods of birth control are simply that the former contain synthetic versions of human hormones, while the latter do not.


By suppressing ovulation and thinning the uterine lining, the Pill can reduce risk of ovarian and endometrial cancers.


Glands in our bodies, called endocrine glands, produce hormones; additionally, testes and ovaries — which are parts of the human reproductive system — manufacture hormones. Human hormones are powerful chemicals, which do all sorts of jobs, from triggering puberty to helping us extract energy from the foods we eat. So it’s not a huge stretch to wonder if exposure to the hormones present in certain birth control methods — such as the Pill, in addition to the patch, the ring, the shot, the implant, and some types of IUDs — might have unintended effects on the body. Because hormones can play a role in cancer — either in protecting against it or aiding in its development — researchers are very interested to know if the Pill might increase or decrease risk for various types of cancer.

It’s actually a bit tricky to investigate the possible associations between the Pill and various types of cancer. First of all, there are dozens of types of birth control pills, all with different versions of synthetic hormones, at different dosages, and in different proportions to one another. Furthermore, the types of oral contraceptives on the market change over time — today’s birth control pill is not your mother’s birth control pill. Studying “the Pill” as a single entity could obscure differences between brands. Secondly, most cancers tend to develop later in life, many years after someone may have taken oral contraceptives. Researchers need to be careful to control for all the variables that might increase or decrease cancer risk. Continue reading