Sexual Health Made Simple(-Minded)

OK, here’s all you need to know if you want to be completely safe. Don’t engage in sex with anyone (or anything) except yourself. Come to think of it, do you really know where yourself has been lately? Better be safe than sorry.


Who would you rather believe? Movie stars or scientists and doctors?


Admittedly, this is a tad extreme. Fortunately, all you need do is go on Facebook or Google and you’ll find a plethora of cool-sounding, stylish, and evidence-based strategies to keep you safe. Well, maybe not the latter. But who needs evidence? Who’s got time to read dry, long-winded articles written by doctors and scientists about prissy, painstaking experiments taking years or decades when you could be out having fun? Besides, if something is on Facebook or Google then it must be true, right?

Condom Alternatives for Guys Who Hate Condoms

Need a sexual health tip fast? Just pull one off the ’net. Oh, here’s one for you guys who don’t like using condoms. Not to worry. There’s a little adhesive sticker called a Jiftip that you merely affix to the tip of your penis before sex. “Nothing gets in or out until you remove” it, the company claims on its website, which means that just before climax you must abruptly pull out of your partner as gracefully as possible under the circumstances so you can ejaculate wherever.

In all fairness to the company, which simply wishes to offer an alternative product for people who don’t like condoms, their website warns against using it to prevent pregnancy or sexually transmitted diseases.

Which does bring up a HUGE question: So why use it? Their answer? First, it’s cheap — only $6 a pack. So hey, what’s stopping you? Maybe, despite all biological facts to the contrary, the product just might work for you. “How can anyone know — until they try?” Best of all, “Jiftip has no side-effects” … that is, aside from getting pregnant or catching an STD. Continue reading

STD Awareness: STI vs. STD … What’s the Difference?

When it comes to sexually transmitted diseases, the terminology can be confusing. Some people use the phrase “STD,” some people insist “STI” is the proper set of initials, and every once in a while you might catch someone using the term “VD.” Over the years, the parlance has changed. What’s the deal?

VD: Venereal Disease

Blaming women for STDs (aka VD) is an age-old tradition.

“Venereal disease” has been in use since at least the 1600s (the Oxford English Dictionary cites a 1667 publication referring to a “a lusty robust Souldier dangerously infected with the Venereal Disease”). Around a century ago, Americans flirted with heavily euphemistic expressions, such as “social diseases,” but mostly, “venereal disease” was the terminology of choice for the better part of four centuries — slightly less euphemistic, as “venereal” was derived from Venus, the Roman goddess of love, sex, and fertility. Additionally, since at least the 1920s it was frequently shortened to “VD.” Those of us of a certain age might still remember hushed talk of VD among our grandparents, parents, or peers.

Around the 1930s, public health experts started wondering if referring to VD as a separate category of disease stigmatized these infections and those who carried them, dampening motivation to fight them with the same fervor with which the community battled other infectious diseases like influenza, smallpox, and scarlet fever. In 1936, Nels A. Nelson proposed replacing “venereal disease” with “genito-infectious diseases,” but that never caught on — you haven’t heard of GIDs, right? Continue reading

STD Awareness: “Sounding the Alarm” Over Another Antibiotic-Resistant STD

In 2012, the New England Journal of Medicine ominously stated, “It’s time to sound the alarm.” What followed was a description of the evolution of gonorrhea to all antibiotics we have used to treat it, including the last ones we had left. They closed the article with a warning: “The threat of untreatable gonorrhea is emerging rapidly.”

This summer, just five years after that alarm bell was sounded, the New England Journal of Medicine’s prediction came true. Reports of untreatable gonorrhea surfaced, shared in a World Health Organization press release: “Data from 77 countries show that antibiotic resistance is making gonorrhoea — a common sexually-transmitted infection — much harder, and sometimes impossible, to treat.”


An STD most people haven’t even heard of is rapidly evolving antibiotic resistance.


So maybe we should listen when a medical journal talks about the need to “sound the alarm.”

Sexually Transmitted Diseases, the medical journal of the American Sexually Transmitted Diseases Association, did just that in an editorial called “Mycoplasma genitalium on the Loose: Time to Sound the Alarm,” which accompanied two studies detailing antibiotic resistance in a little-known STD called mycoplasma genitalium, or MG for short.

“Let me get this straight,” you might be saying. “First you’re telling me there’s an STD called MG, which most people haven’t even heard of, and now you’re telling me I already need to worry about antibiotic resistance?” Continue reading

Some Good News About Three Sexually Transmitted Viruses

Scientists are hard at work finding ways to improve your health!

With so much bad news emblazoned across headlines in every newspaper you look at, the world might seem like a gloomy place. So let’s take one depressing subject — disease — and peel away the sad outer layer to find silver linings of optimism.

When it comes to infections, a lot of us blame one thing: germs, also known as “bugs” — “pathogens” if we’re fancy. Some people might not think of infectious diseases as being that big of a deal — after a round of antibiotics, you’ll be on the mend. Unfortunately, antibiotics only work for bacteria, but a lot of diseases are caused by other types of germs — for which antibiotics are no match. One type of germ is called a virus, and they can’t be cured. Sometimes they can be prevented with vaccines or treated with drugs. For example, the major strains of human papillomavirus (HPV) can be prevented with a vaccine called Gardasil, herpes simplex virus can be suppressed with antiviral drugs, and HIV can be controlled with antiretroviral drugs — but none of these infections can be cured. HPV is usually defeated by the immune system, but herpes and HIV are with you for life.

But it’s not all bad. Around the world, individual scientists have picked their “favorite” viruses and are devoting their lives to finding better prevention strategies, better treatments, and even cures. Let’s check in with some of the latest headlines touting the successes of science.

New Hope for a Herpes Vaccine

A herpes vaccine would be a blockbuster — given how common this sexually transmitted infection is, a preventive shot could help a lot of couples discuss their herpes status without as much fear of judgment and stigma.

Herpes might cause an “outbreak” — unpleasant symptoms that include genital sores — but afterward the virus goes dormant in the nerve cells, hiding from the immune system. In some people, the virus can come out of its dormancy to cause flare-ups of symptoms, but once it’s had its fun it retreats back to the nerve cells.

Earlier this year, media reported on a promising new candidate for a herpes vaccine. Using a completely different strategy than previous, failed herpes vaccines, the researchers behind this breakthrough targeted the part of the virus that allows it to hide from our immune systems. If this vaccine works as hoped, recipients will be able to mount an immune defense when exposed to the virus, blocking it from establishing a permanent home in nerve cells. It might even suppress outbreaks in people who already have herpes. Continue reading

STD Awareness: The Curious Case of Chancroid

Haemophilus ducreyi arrange themselves in parallel rows, which researchers have called “railroad tracks,” “schools of fish,” and “fingerprints.” Image: Mike Miller, CDC

Earlier this year, I asked a room full of scientists and medical professionals to raise their hands if they’d ever heard of chancroid. Everyone sat there, motionless, confused by the odd syllables I had uttered — shan kroyd. If you’ve never heard of chancroid, you’re not alone.

Chancroid is a sexually transmitted disease (STD) brought to you by Haemophilus ducreyi, a type of bacteria that can pass through microscopic tears in the skin during sexual contact. When one partner is infected, there is a 1 in 3 chance the other will become infected. An infection can cause painful sores and swollen lymph nodes, most often in the genital region. About half of people with chancroid infections will experience “buboes,” or swollen lymph glands that might rupture. Before it could be cured with antibiotics, a persistent infection could cause permanent skin damage.


Humanity can make chancroid the first STD to go extinct.


One reason you probably haven’t heard of chancroid is that, in the developed world at least, it has mostly disappeared. In fact, researchers believe chancroid can be completely wiped off the planet — which would make it the first STD ever to be forced into extinction. How amazing would that be?

Chancroid has been hopping from loin to loin since at least the days of the ancient Greeks, and was common until the 20th century, when rates began to decline. Thanks to antibiotics, U.S. chancroid rates decreased 80-fold between 1947 and 1997, all but vanishing by the late 1950s. It was virtually unheard of until there was another spike in the 1980s, correlating with the crack epidemic. But, since 1987, cases have been steadily declining. Continue reading

STD Awareness: Is Gonorrhea Becoming “Impossible” to Treat?

Image: National Institute of Allergy and Infectious Disease

Health authorities have been worried about it for a long time now, and we’ve been following it on our blog since 2012. The boogeyman? Antibiotic-resistant gonorrhea, a strain of the sexually transmitted bacteria that is becoming more and more difficult to treat. Higher doses of the drug will be needed to cure stubborn cases of gonorrhea — until the doses can no longer be increased. Then, untreatable gonorrhea could be a reality.


“Little now stands between us and untreatable gonorrhea.”


The World Health Organization (WHO), in a press release last month, finally used the word “impossible” when describing treatment of antibiotic-resistant gonorrhea, referring to documented cases of gonorrhea that were “untreatable by all known antibiotics.” Worse, these cases are thought to be the proverbial “tip of the iceberg,” as there aren’t good data on antibiotic-resistant gonorrhea in many developing countries, where gonorrhea is more prevalent and epidemics could be spreading under the radar. Adding to this problem is the fact that gonorrhea rates are climbing worldwide, which is thought to be due to a number of factors, including the decline in condom use, the frequent absence of symptoms, inadequate treatment, and increasing urbanization and travel.

What will happen if gonorrhea can’t be cured? Your infection could clear up on its own, after a lengthy battle with your immune system, but we don’t know a lot about how long this could take (weeks? months? never?). Unfortunately, despite your immune system’s best efforts, gonorrhea doesn’t go out without a fight. Gonorrhea can lead to pelvic inflammatory disease, which can cause tissue damage to the reproductive organs resulting in infertility, ectopic pregnancy, and chronic pain. It can also cause scarring that blocks sperm’s movement out of the testes, resulting in epididymitis, which is associated with infertility, chronic scrotal pain, and testicular shrinkage. Furthermore, gonorrhea increases risk for HIV transmission and can be passed to a baby during childbirth. The CDC estimates that, in the United States alone, untreatable gonorrhea could cause 75,000 cases of pelvic inflammatory disease, 15,000 cases of epididymitis, and 222 extra HIV infections over a 10-year period. Worldwide, where gonorrhea and HIV disproportionately affect developing countries, these problems could get even more out of control. Continue reading

STD Awareness: Do IUDs and Implants Prevent STDs?

Highly effective birth control methods, namely intrauterine devices (IUDs) and implants, have received a lot of well-deserved attention in recent years. They are as effective at preventing pregnancy as permanent sterilization, but can be stopped at any time, and can last from three to 12 years. They are the contraceptive of choice for female family-planning providers, who should know a thing or two about choosing an optimal birth control method. They are fantastic options for teenagers and others hoping to delay pregnancy for at least a few years. And the best news is that, for now anyway, these pricey birth control methods are still available at no cost to Americans covered by Medicaid or health insurance.


For the best protection against unintended pregnancy and STDs, combine condoms with IUDs or contraceptive implants.


If IUDs and implants prevented sexually transmitted diseases (STDs), they would pretty much be perfect — but, alas, like most forms of birth control, they don’t protect you from viruses, bacteria, and other bugs that can be passed from person to person through sex. To reduce their risk for STD exposure, sexually active people must employ other strategies, including (1) being in a mutually monogamous relationship with a person who does not have STDs; (2) being vaccinated before becoming sexually active to receive protection from hepatitis B virus and human papillomavirus (HPV), two sexually transmitted viruses; and, last but definitely not least, (3) condoms, condoms, condoms!

A study published this month looked at college students using IUDs and implants and found that most of them didn’t use condoms the last time they had vaginal sex — 57 percent of women who were not using IUDs or implants used a condom, compared to only 24 percent of women who were using IUDs or implants. That’s not too surprising if pregnancy prevention were the only concern, but condoms are an important addition for anyone seeking to reduce their STD risk. Continue reading