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: HPV Testing vs. the Pap Test

I love writing about health and medicine, but I hate going to the doctor. I don’t like taking my clothes off for a dermatological exam, I don’t like rolling my sleeve up for a shot, and I don’t like opening my mouth for a dentist. I don’t even like having my blood pressure taken — it gives me the heebie-jeebies, and probably a case of white-coat hypertension too.


For now, pelvic exams are a mainstay — and an important part of cancer prevention.


So when it comes to something even more invasive, like the Pap test to screen for cervical cancer, I’m one of those people pining for a magic wand — a tool that a health care provider can wave over your fully clothed body to detect disease. The Pap test may have transformed a scourge like cervical cancer into one of the most easily detected and treated cancers — and for that I love it — but I still fervently wish for its demise. As long as it’s replaced by something better, of course.

Last month, an article in JAMA inspired a burst of headlines. “HPV test more effective than Pap smear in cancer screening,” said CNN. Or as WebMD put it more succinctly, “HPV Test Beats Pap.” Then, last week, the U.S. Preventive Services Task Force updated their guidelines to recommend that patients 30 and older can forgo the Pap test in favor of HPV testing alone. This news might be welcome to anyone who dislikes regular Pap tests and wishes to avoid stirrups and speculums. Unfortunately, HPV tests aren’t the noninvasive “magic wand” so many of us hope for. From the patient’s perspective, the experience of undergoing an HPV test is no different from the experience of undergoing a Pap test. They both require a pelvic exam — the stuff of stirrups and speculums. Continue reading

Meet Our Candidates: Sean Bowie for State Senator, LD 18

The time to fight back — and fight forward — for reproductive justice is fast approaching. The stakes are high in this year’s state election, with candidates for governor, secretary of state, attorney general, and other races on the ballot. The Arizona primary election will be held August 28, 2018, and voters need to be registered by July 30 to cast their ballots. Reproductive health has been under attack, both nationally and statewide, but Planned Parenthood Advocates of Arizona has endorsed candidates who put our health and our rights first. Get to know them now in our series of “Meet Our Candidates” interviews, and make your voice heard in 2018!

Legislative District 18 stretches from Chandler to Ahwatukee, just south of Phoenix. It is currently represented in the state Senate by Sean Bowie, who ousted former Sen. Jeff Dial in 2016. Sen. Bowie’s win in 2016 was a victory for proponents of reproductive rights and LGBTQ equality, as his predecessor helped block access to contraception and abortion, and voted to codify discrimination based on sexual orientation into law. In contrast, Sen. Bowie has upheld the rights of women and the dignity of LGBTQ folks.


“We can work to stop bad pieces of legislation at the state level.”


For example, earlier this year Sen. Bowie introduced a bill that would have banned conversion therapy for minors in Arizona. Conversion therapy is based on the idea that someone’s sexual orientation or gender identity can be changed, and its proponents have used the imprimatur of psychology in an attempt to legitimize the psychological torture of many LGBTQ youth.

Most Arizonans oppose this practice, recognizing conversion therapy as ineffective at best — and inhumane at worst, as the practice could be complicit in the high suicide rate within the LGBTQ population. If passed, the bill would have made Arizona the 10th state in the country to outlaw this harmful and pseudoscientific practice — but the bill did not get off the ground. A shift in the Senate might give a bill like this the support it needs, however — pointing to the importance of voting in every election, including midterms.

Due to his support for reproductive justice and LGBTQ rights, Sen. Bowie has earned our endorsement. He generously took the time to answer our questions on July 9, 2018.

Since we last spoke, how has your commitment to serving Arizona grown? What has happened during that time to give you hope, and what has happened to strengthen your convictions?

I’ve really enjoyed representing my community in the state Senate these past two years. As one of 30 senators for the entire state, I can really have an impact on public policy at the state level. And because I work across the aisle in a bipartisan way, I’ve helped improve legislation, stop some bad bills, and get some good bills over the finish line. We’ve made some progress on some key areas, particularly funding for K-12 education, but we still have a way to go to get to where our state needs to be. Since the Senate is so narrowly divided, we’ve also stopped a lot of bills that would have been harmful for the state. Continue reading

Meet Our Candidates: Richard Andrade for State Representative, LD 29

The time to fight back — and fight forward — for reproductive justice is fast approaching. The stakes are high in this year’s state election, with candidates for governor, secretary of state, attorney general, and other races on the ballot. The Arizona primary election will be held August 28, 2018, and voters need to be registered by July 30 to cast their ballots. Reproductive health has been under attack, both nationally and statewide, but Planned Parenthood Advocates of Arizona has endorsed candidates who put our health and our rights first. Get to know them now in our series of “Meet Our Candidates” interviews, and make your voice heard in 2018!

Richard Andrade represents Legislative District 29, which includes Glendale and West Phoenix. His roots in the Southwest are deep: His great-grandparents settled in Winslow, a small town on Arizona’s Route 66, to work for the Sante Fe Railroad. After high school, Rep. Andrade joined the U.S. Air Force, and was stationed at Luke Air Force Base outside of Phoenix. Afterward, he continued his family tradition with a job at the railroad, during which time he became heavily involved in unions.

Today he represents his West Valley constituents by standing for working families and health care access, and against discrimination in all forms. He earns Planned Parenthood Advocates of Arizona’s endorsement thanks to his strong stance in favor of reproductive rights and LGBTQ equality — two things that are in jeopardy as the Supreme Court is poised for a rightward shift. As Rep. Andrade told us, “I strongly stand with PPAA, especially during this time of uncertainty.”


“We have an opportunity to flip one or even both chambers in the Legislature.”


We endorsed Rep. Andrade in 2014 and 2016, and are proud to endorse him again. He generously took the time to answer our questions on July 9, 2018.

What have you accomplished in your previous term?

I am the only House Democrat who for the last two years has had legislation signed by the governor. These two bills, HB 2341 from 2017 and HB 2421 from 2018, protect all National Guard members’ jobs upon completion of their deployments — including National Guard members who are members from National Guard units from other states but work and reside in Arizona. I also had two House Concurrent Memorials from 2018, HCMs 2007 and 2008, pass out of both chambers, House and Senate, to the secretary of state, urging Congress to support two important issues regarding our veterans. Continue reading

STD Awareness: Is Mouthwash a Match for Gonorrhea’s Superpowers?

Since the 1930s, we’ve enjoyed around eight decades of easily cured gonorrhea — at least in places with easy access to antibiotics — but experts fear those days are numbered. In the past year or so, cases of untreatable gonorrhea have occasionally made headlines.

Thanks to the powers of evolution, some bacteria have acquired the multiple genes necessary to withstand the onslaught of the pills and shots administered by doctors. Gonococci, the bacteria that cause gonorrhea, are starting to win this “arms race” with humans, whose antibiotic arsenals are losing effectiveness. And with gonorrhea on the rise, gonococci may be evolving at an ever-quickening clip.


In 1879, Listerine claimed to cure gonorrhea. Today, scientists are finally testing that claim. We await the results.


Oral Gonorrhea: The Silent Scourge

Many experts believe oral gonorrhea is a key driver of antibiotic resistance. These infections usually don’t cause symptoms, and without symptoms people usually don’t seek treatment. Without treatment, gonococci can hang out in a throat for up to three months.

After transmission by oral sex — and possibly even by kissing  — gonococci can set up camp in the throat, which is an ideal environment for acquiring antibiotic resistance. They might not be causing symptoms, but they’re not sitting there twiddling their thumbs, either. If there’s one thing gonococci love to do, it’s collecting genes like some of us collect trading cards, and the throat is a gathering place for closely related bacteria species that hand out antibiotic-resistance genes for their expanding collections.

Gonococci can easily scavenge DNA from their surroundings — say, from a dead bacterium — and patch long segments of these genes into their own DNA, creating genetic hybrids between themselves and other organisms. Last month, scientists from Indiana University caught this phenomenon on video for the first time.

Continue reading

STD Awareness: Eliminating HPV-Related Cancers

Earlier this month, every major cancer center and organization in the country released a joint statement calling for the elimination of cervical cancer, along with all other HPV-related cancers. The elimination of a large swath of cancers might sound like a tall order — so far, we’ve only eradicated two viruses from the planet: smallpox and rinderpest. And we’re on the brink of getting rid of a third, the virus that causes polio.

But doing away with human papillomavirus (HPV) would herald a new chapter in disease eradication, because HPV causes cancer, meaning that eradicating HPV will eradicate the cancers caused by it. And the good news is we have all the tools we need to wipe HPV off the face of the earth — we just need to use them.


The tools to wipe a large class of cancers off the face of the earth are right under our noses — we just have to use them.


A quick rundown on HPV is in order. It’s the most common sexually transmitted infection in the world, and causes multiple cancers — cervical, head and neck, anal, vulvar, vaginal, and penile. While it’s most well-known for causing cervical cancer, here in the United States it is transitioning away from its old job, causing more head-and-neck cancers than cervical cancers. Nearly all sexually active people will be infected with HPV at least once in their lives, and though only a fraction of infections progress to cancer, its ubiquity means it still causes hundreds of thousands of cancers every year. In the United States, around 41,000 HPV-related cancers are diagnosed annually, while more than 600,000 are diagnosed worldwide. Continue reading

Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

STD Awareness: UK Announces “Worst-Ever” Case of Gonorrhea

In late March, the BBC reported a story that was widely repeated in headlines across the world: “Man has ‘world’s worst’ super-gonorrhoea.”

The article told the story of a British man whose symptoms started in early 2018, about a month after he had picked up the bug during a visit to Southeast Asia. Once back home, his doctors were unable to cure it with the standard combination of azithromycin and ceftriaxone — “the first time the infection cannot be cured with first choice antibiotics,” the author wrote.


In most of the world, we don’t have a good picture of antibiotic resistance in gonorrhea.


Actually, a similar case of multidrug-resistant gonorrhea had been documented in the United Kingdom in late 2014, as noted in the New England Journal of Medicine. It was the first verified case to fail to be cured by the azithromycin/ceftriaxone combo — the infection didn’t go away until after the patient was given a double dose of both antibiotics, but by then it had been 112 days and the infection could have cleared on its own. By July 2017, the World Health Organization (WHO) had noted that there had been multiple documented cases of gonorrhea that were “untreatable by all known antibiotics.”

What was different about the man in the BBC story was that his case of ceftriaxone-resistant gonorrhea had a higher level of azithromycin resistance than those that came before. While it may not have truly been the first case of multidrug-resistant gonorrhea that couldn’t be treated with the standard dual therapy of azithromycin and ceftriaxone, it was the “most serious.” Continue reading