Tag Archives: barrier method

Enjoying the Condom of Today While Waiting for the Condom of the Future

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When the “consent condom” was introduced last month, it made a minor media splash. The developers of this new condom, packaged in a box that required four hands to open, sought to place the concept of consent at the center of all sexual interactions.

Almost as soon as it grabbed its first headlines, however, the consent condom attracted criticism from multiple sources. Is consent an ongoing dialogue rather than a one-time agreement? Can’t consent be revoked? Do these condoms marginalize people with disabilities that preclude them from opening the box? Couldn’t a rapist force a victim to help open the box, or enlist the assistance of an accomplice? Could they be used as misleading evidence against claims of sexual assault?

With STD rates skyrocketing, more people need to learn how to get the most from condoms — the most protection, the most comfort, and the most pleasure.

Despite the negative reaction, the fact remains that the consent condom succeeded in one goal: provoking public dialogue about the complexity and primacy of consent. It isn’t likely to be a commercial success: Even if a few are sold as novelties, a condom that comes with built-in obstacles doesn’t seem destined for popularity. After all, if regular condoms were too tricky for the inept baby boomers on Seinfeld to master, a complicated gadget requiring four coordinated hands to spring loose probably isn’t going to be a breeze for millennials.

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From HPV to Cancer to Dry Mouth

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Despite what a lot of people might think, oral sex is sex — not “third base,” not “everything but” — carrying with it the potential for both pleasure and disease transmission. That includes oral transmission of human papillomavirus (HPV), which can lead to head-and-neck cancer (aka oral cancer, aka oropharyngeal cancer). Unfortunately, because so many of us have a lax attitude toward it, fewer people take precautions when engaging in oral sex, and are less likely to use condoms or dental dams.

A head-and-neck cancer epidemic is striking younger people, spurred by HPV.

Head-and-neck cancer — which can strike anywhere from the lips to the larynx, and up into the sinuses and nasal cavity — is caused by several risk factors, chief among them oral infection with HPV. When HPV causes head-and-neck cancer, it usually occurs at the base of the tongue, at the back of the throat, in the tonsils, or in the soft palate.

HPV can be spread by most sexual activities, including vaginal, anal, and oral sex, as well as by rubbing genitals together. Although HPV is most famously associated with cervical cancer, it’s actually driving more cases of head-and-neck cancer in the United States.

It’s Oral, Head, and Neck Cancer Awareness Week — a time to learn about how head-and-neck cancer has changed over the years, what consequences it can have for survivors, and how it can be prevented in the first place.

A Changing Patient Profile

In 2017, scientists reported that oral HPV infections with cancer-causing strains of the virus are five times more common in men than in women, and that, likewise, HPV-associated head-and-neck cancers are more likely to strike men. That same year, researchers also reported that, in the United States, head-and-neck cancer among men has surpassed cervical cancer among women. As the years pass by, head-and-neck cancer rates are expected to continue to skew even more heavily toward the male population. Continue reading →

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

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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.

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Dental Dams Help Spread Intimacy, Not STDs

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It’s that time of the year when people focus on intimacy and romance. Most people think jewelry and roses are good gifts to give for Valentine’s Day. They’re nice, but you know what’s even better? Dental dams.

What’s a dental dam, you ask? Like condoms, dental dams are a way to prevent the spread of sexually transmitted diseases (STDs) by covering the vagina or anus during oral sex. Dental dams are usually made of latex, and some are made from polyurethane. Since they’re used for oral sex, dental dams often come in different flavors, and they’re flexible enough to fit in your purse.

Dental dams are an essential component of protecting your sexual health.

Dental dams are particularly useful for lesbian partners, since oral sex is a common form of sexual activity, but anyone who engages in cunnilingus (the oral stimulation of female genitals) can use them. Dental dams are also beneficial for consenting partners who enjoy anal play (aka “rimming”). Dental dams serve as a barrier against most STDs, since many sexually transmitted diseases, such as syphilis, human papillomavirus (HPV), and herpes, can be passed simply by skin-to-skin contact. Gonorrhea, chlamydia, and hepatitis A and B viruses can also be spread through oral sex. HIV can be transmitted through oral sex if blood is present.

Unfortunately, dental dams aren’t distributed as widely as condoms are. You’re not likely to find a dental dam dispenser in a public restroom, and many community organizations provide dental dams on a request-only basis because they’re more expensive than condoms. And most drug stores don’t carry dental dams in the same aisle as condoms and lube because dental dams were originally created to be used during dental procedures. (Get it — dental dams.) Continue reading →

STD Awareness: Do IUDs and Implants Prevent STDs?

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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 →

STD Awareness: Can I Use Plastic Wrap as a Dental Dam During Oral Sex?

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plastic wrapIf you read this blog — or any sexual health website, really — you’ll probably see dental dams getting a lot of props. A dental dam (not to be confused with a female condom) is a square piece of latex that can cover the vaginal opening or the anus. Anyone wishing to avoid the oral transmission of STDs like herpes, gonorrhea, HPV, syphilis, chlamydia, and intestinal parasites, dental-dam advocates say, should use a latex barrier. Most people, however, have probably never even seen a dental dam, and they are not widely used. Perhaps their unpopularity is related to myths about oral sex being safe sex (it’s not!); perhaps it’s due to dental dams being expensive or difficult to find.

Plastic wrap hasn’t been evaluated by the FDA for STD prevention, and no studies have assessed its effectiveness in reducing disease risk during oral sex.

Some safer-sex aficionados have found ways around that, though. They might cut the tips off of condoms and make incisions along the sides, creating little latex rectangles. An even easier and cheaper option lies in plastic wrap, which many people use as a barrier while performing cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus). It is inexpensive, easy to find, odorless, and tasteless, and can be purchased without even a hint of embarrassment (unless perhaps your other purchases include duct tape, cucumbers, and clothes pins). And it can be pulled off the roll in sheets as long as your heart desires!

Planned Parenthood endorses the use of plastic wrap for oral sex when dental dams aren’t available. The Centers for Disease Control and Prevention and AIDS.gov both recommend plastic wrap for use during rimming. Health authorities, such as AIDS.gov and the Idaho Department of Health & Welfare, recommend non-microwavable Saran Wrap, because microwave-safe Saran Wrap has tiny pores to let out steam — which might also let viruses and bacteria through. Continue reading →

STD Awareness: Ceftriaxone-Resistant Gonorrhea

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Nestled in the throat of a Japanese woman was a collection of clones that scientists abducted from their temporary habitat and christened H041 — a humdrum moniker for a strain of bacteria that would burn headlines in medical journals. Though the bacteria never caused symptoms in their host, they lingered in her throat from at least January until April of 2009, when a swab finally tested negative. Rather than succumbing to repeated bombardment by an antibiotic called ceftriaxone, the infection probably just went away on its own — as oral gonorrhea infections tend to do.

Resistance to ceftriaxone, our last good gonorrhea drug, has been reported in Japan, Australia, Sweden, France, and Spain.

The emergence of antibiotic-resistant gonorrhea is considered one of the most pressing problems in infectious disease — just two years ago, the Centers for Disease Control and Prevention named it an “urgent threat.” We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot. Resistance to cefixime was first documented in 1999, leaving ceftriaxone as our best remaining option, and the CDC’s first choice for treating gonorrhea. There are no good alternatives to ceftriaxone remaining, which is why reports of ceftriaxone-resistant gonorrhea are so deeply troubling.

What made H041 special was that it was the first extensively drug-resistant strain of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. With an unusually high level of resistance to ceftriaxone — four to eight times higher than the previous record holder — the strain was also resistant to a slew of other antibiotics: penicillin and its relatives, fluoroquinolones, macrolides, tetracycline, trimethoprim-sulfamethoxazole, chloramphenicol, nitrofurantoin, cefpodoxime, cefixime, ciprofloxacin, and levofloxacin — and had reduced susceptibility to azithromycin to boot.

Another thing that made H041 special — as special as clones can be, anyway — is that it never reappeared. After its discovery, researchers in Kyoto and Osaka intensified their surveillance, trying to uncover it again and track its spread through the population. However, their search for H041 turned up empty handed. But other ceftriaxone-resistant strains have been documented around the world. Continue reading →