STD Awareness: Syphilis Treatment Through the Ages

The spiral-shaped bacteria that causes syphilis.

When syphilis first descended upon Europe, questions surrounded this mysterious scourge. Was it a punishment from God? Was it introduced by a hated Other? Was it caused by the stars’ alignment or the presence of “bad air”? We now know that syphilis is not caused by supernatural forces, foreigners, or a harmful atmosphere, but rather by a species of corkscrew-shaped bacteria called Treponema pallidum, which is spread by sexual contact — vaginal, anal, or oral sex — in which one person comes into contact with a syphilis sore.


Thanks to penicillin, we don’t have to go back to the “good old days” of puke chalices, antivenereal underpants, and rat poison.


Before good treatments were developed in the 20th century, syphilis was the most feared STD out there. Its initial symptoms can include a painless sore filled with a highly infectious liquid. As the infection spreads, lesions and rashes might appear on the soles of the feet or the palms of the hand. After these first waves of symptoms, the infection enters a latent phase, which can lull people into a false sense of security, thinking the disease has disappeared. Unfortunately, 15 percent of people with untreated syphilis reach the late stage, which can occur up to 20 years after initial infection, and includes severe damage to the nervous system, brain, heart, or other organs, and can be fatal.

These days, a shot of penicillin is all it takes to cure syphilis. Back in the day, though, there were myriad “treatments” for syphilis — but they were highly toxic and ineffective. Unfortunately, thanks to the latent phase of syphilis, it often seemed like these treatments did work, which probably explains why folks tortured themselves with them for centuries. If only penicillin had been around: Countless people would have been spared the unpleasant — and often fatal — quackery that syphilis attracted. Continue reading

STD Awareness: How Common Is Herpes?

Those of you with an eye for weird news might have noticed recent headlines about wild monkeys in Florida suffering from a herpes epidemic.

Two things in that sentence might have tripped you up. One, Florida has wild monkeys? Yup. In the late 1930s, after a Tarzan movie was wrapped, three male and three female rhesus monkeys were released into the Florida wilds, giving rise to an estimated 1,000 monkeys roaming the Sunshine State today.


Both oral herpes and genital herpes are on the decline.


The second thing that might have given you pause: Monkeys can get herpes? Yes again! The Herpesviridae family is huge, with at least 100 members infecting mammals, birds, reptiles, bony fish, amphibians, and oysters — even dinosaurs are thought to have been infected by herpesviruses! The virus has been evolving alongside us since before the dawn of humanity, so it knows us like the back of its hand (metaphorically speaking), allowing it to stow away in our bodies and hide from the immune system.

The “Tarzan” monkeys suffer from a type of herpesvirus called herpes B, which can be deadly in humans, though it’s rare — just try not to find yourself on the receiving end of a monkey bite or scratch. Not so rare in humans are human herpesviruses, of which there are eight types. Types 1 and 2 — aka herpes simplex virus (HSV) 1 and 2 — can both cause genital herpes, one of the most common sexually transmitted diseases (STDs). HSV-1 mostly causes cold sores, but can also infect the genitals to cause genital herpes, while HSV-2 mostly causes genital herpes, but can also infect the facial area to cause cold sores. (A little confusing, I know.) Continue reading

STD Awareness: The Long Road to a Chlamydia Vaccine

Earlier this year, television personality John Oliver was the butt of an elaborate prank orchestrated by actor Russell Crowe. It started with an auctioned jock strap, and ended with Crowe funding the John Oliver Koala Chlamydia Ward at the Australia Zoo. If you want the full story, check out the video below (beware explicit language).

Despite Oliver playing it for laughs, koala chlamydia is very real and very serious. At least half of wild koalas are infected with a chlamydia type that’s related to the human version. As in humans, koalas can transmit these bacteria through sexual contact. And, similar to the havoc it wreaks in our species, in koalas chlamydia can cause blindness, urinary tract infections, and female infertility — and can be passed from mother to infant. Along with other factors, chlamydia is said to be responsible for plummeting koala populations in many parts of Australia. Continue reading

STD Awareness: The Good, the Bad, and the Ugly

Sexually transmitted diseases (STDs) have been with us since the dawn of time — or at least since the dawn of sex. And, as we continue to hone our approach to preventing and treating them, STDs will always grab headlines, whether the news is bad or good.

The Good

Can the HIV epidemic be stopped?

For more than a decade, AIDS, the illness caused by HIV, was seen as a death sentence. It wasn’t until the mid-’90s that antiretroviral drugs kept the virus in check, prolonging lifespans for people with access to these medications and transforming the infection into a chronic disease. Now, those dreaming of an end to HIV are seeing reasons for optimism. No, a cure isn’t in the works — but many researchers believe we can end the epidemic through prevention.

Ending HIV transmission will take money and an efficient health care infrastructure, but we have the tools to do it. It starts with expanding access to HIV testing — an estimated 15 percent of Americans with HIV are unaware of their status. The next step is to ensure that everyone testing positive has access to antiretroviral drugs. When used correctly, these medications keep viral levels so low that the chances of transmission are virtually nonexistent. More recently, medications called PrEP — pre-exposure prophylaxis — enable people without HIV to protect themselves from infection. Condoms, of course, are a time-tested prevention tool. Gathered together, we have a pretty mighty arsenal. Here in the United States, we could stop HIV transmission in its tracks in just a handful of years. Of course, people all around the world will need access to testing and treatment to halt this scourge on a global level. Continue reading

STD Awareness: Can Older Adults Receive the HPV Vaccine?

female-patient-with-female-doctorWhen the human papillomavirus (HPV) vaccines were introduced, a lot of people were excited about protection from a sexually transmitted virus that could cause cancers, including cervical cancer, anal cancer, and head-and-neck cancer. It wasn’t just any old vaccine, it was a shot that could prevent cancer. Cancer!

In fact, a lot of people were disappointed they were too old to take advantage of an anti-cancer vaccine, which was initially approved for people as old as 26. We were given a lot of reasons why people above that age were “too old,” such as the assumption that anyone older than 26 has probably been sexually active for years and would have already contracted the most common strains of HPV.


While getting vaccinated before becoming sexually active is optimal, the HPV vaccine can still benefit people who have already had sex.


But there are compelling reasons to vaccinate people in their late 20s and beyond. In fact, Gardasil 9 was recently approved for people as old as 45. That’s great news for those of us who missed out on the HPV vaccine the first time around. We might never have had any sexual contact, and therefore were never at risk for catching the sexually transmitted virus. We might have found ourselves widowed or divorced after years or decades of monogamy. We might have been sexually active with multiple partners during that time. Whatever our circumstances, those of us who are 45 or younger can now consider HPV vaccination.

HPV and the “Older” Individual

When Cervarix and Gardasil, the first HPV vaccines, were released, they only protected against two cancer-causing HPV strains, HPV-16 and HPV-18, which are responsible for 70 percent of cervical cancers (Gardasil protects against two additional wart-causing HPV strains). A few years ago, Gardasil 9 hit the market, targeting five additional cancer-causing HPV strains — increasing the chances that even sexually active recipients could be protected from HPV strains they hadn’t encountered. Continue reading

STD Awareness: Confronting Sky-High STD Rates

For the past five years, Americans have been breaking records left and right — a good thing when we’re talking about athletic feats or scientific breakthroughs, but not so great when we’re shattering records for catching sexually transmitted diseases (STDs). Chlamydia, gonorrhea, and syphilis are all on the upswing, with a combined 2.3 million cases in 2017 — and those are just the cases that were reported. Since most people with these infections don’t know they have them, the real number is thought to be much higher. The United States has the dubious honor of boasting the highest STD rates of all industrialized countries — though rates are also climbing in England and Western Europe.

The good news is that these three STDs are preventable and curable. Sexually active people can dramatically reduce their risk by using condoms and dental dams, or by being in mutually monogamous relationships in which partners test negative for these infections. And, because many STDs don’t show symptoms, it’s important for them to receive regular STD screening to ensure infections are caught and cured before they can do any damage.

But there’s also bad news. First, while the symptoms of these infections can be awful, they compel you to seek prompt treatment — making these awful symptoms a good thing, in a weird way. Unfortunately, most people with these infections don’t have symptoms, allowing the bacteria that cause them to spread silently from person to person. If not caught, chlamydia and gonorrhea can lead to chronic pain and fertility problems, and syphilis can lead to organ damage and even death. These infections can also increase HIV risk and be passed to a baby during childbirth. Continue reading

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