STD Awareness: COVID-19 and Your Sexual Health

The world has found itself in the clutches of a pandemic, and every day we’re learning about the ripple effects this new virus is having in everyone’s lives, not just the lives of those who cross its path. These devastating consequences include millions of people losing their jobs and hospitals stretched so far past capacity that they can’t adequately treat all their patients.

There are plenty of other downstream effects, too. For example, some people are worried that we could be staring down the barrel of a shortage of a common antibiotic called azithromycin, which cures chlamydia — the most common sexually transmitted bacteria in the world. Nine drug manufacturers recently reported azithromycin shortages to the Federal Drug Administration. With chlamydia rates at a record high, 2020 is a bad time for the antibiotic that cures it to be in short supply. Untreated, chlamydia can cause infertility and chronic pain, and can increase risk for HIV transmission and acquisition.

Apparently, the president of our country, who is not a health expert by any stretch of the imagination, endorsed azithromycin as a treatment for COVID-19 in combination with a drug that treats lupus and arthritis. There isn’t much in the way of evidence that the drug combination recommended by the president actually can treat COVID-19, but there are currently clinical trials underway, so time will tell how effective that regimen actually is. Continue reading

STD Awareness: When Syphilis Goes North

The bacteria that cause syphilis are shaped like corkscrews. Image: David Cox, CDC

Last month, a “weird” medical case made headlines. An Australian man with unexplained headaches and eye pain got a diagnosis for his mysterious symptoms when his doctors discovered he had syphilis — and the infection had spread to his head. Syphilis had caused both optic nerves to become swollen, triggering pain that worsened whenever he moved his eyes.

It might seem strange that a disease most people associate with below-the-belt symptoms can wreak havoc above the neck, but syphilis is a wanderer that can travel all over the body, sowing chaos wherever it goes.


Syphilis can quickly enter the nervous system and travel to the head, where it can cause blindness, psychiatric problems, and other trouble.


Ocular Syphilis

The bacteria that cause syphilis can be passed from one person to another through contact with a sore, which can appear on or around the mouth, genitals, or anus. Any type of sexual contact, including oral sex, can transmit these bacteria. Sores are painless, contain a highly infectious liquid, and can appear between three weeks to three months after infection. These sores aren’t always visible, which means you can’t tell if someone has syphilis just by looking at them.

Although the bacteria typically land in the mouth, genitals, or anus, they can also be sexually transmitted directly into the eye, causing redness and vision problems. After infection, syphilis sores can appear on the eyelids, tear ducts, and soft tissues around the eyes. Bacteria can also travel to the eye by entering the nervous system and blazing a trail to the optic nerve — no direct contact between the eye and a sore necessary. Continue reading

STD Awareness: Is Withholding HIV Status a Crime?

If your sexual partner had HIV and did not tell you about it, how would you feel? Most of us would feel betrayed, lied to. We might be scared that we’d contracted the virus, too. If we had known, maybe we would have chosen not to have sex, or might have taken different precautions. Perhaps we’d be angry that someone took away our ability to evaluate the risk for ourselves, and instead decided for us that the sex was worth the risk.


Disclosing HIV status can make someone vulnerable to risks, but open communication forms the basis of healthy relationships.


Many people think it should be against the law for someone with HIV to withhold their status from a sexual partner. To do so seems like a violation of someone’s right to make their own decisions about the sex they have, a denial of pertinent information that needs to be factored into one’s decision-making.

Then why are organizations like American Psychological Association, the American Medical Association, and the U.S. Department of Justice opposed to these types of laws?

Meet Nick

In June 2008 in Iowa, Nick met Adam on a dating website. They hung out at Nick’s apartment, spent a few hours getting to know each other, and eventually had sex. A few days later, Adam heard through the grapevine that Nick was HIV-positive.

The next month, three armed detectives stormed Nick’s workplace, took him to the local hospital, and ordered nurses to take his blood. Meanwhile, police were searching his house for drugs — not illicit drugs, but lifesaving antiretroviral drugs. Nick was arrested. His crime? Criminal transmission of HIV.

Even though Adam never got HIV. Continue reading

STD Awareness: Can I Get Gonorrhea from Kissing?

Not all types of kissing feature the exchange of saliva.

Some pretty depressing news hit a couple of months ago, when headlines proclaimed kissing could allow gonorrhea to jump from one person to another.

We already knew gonorrhea could be transmitted during oral sex — a terrible fact, given that most people don’t use condoms or dental dams during oral sex. And we knew that oral gonorrhea is more likely to develop drug resistance, which could be helping to drive the possibly untreatable gonorrhea of the near future.


Mouth-to-mouth kissing could be transmitting gonorrhea right under our noses — literally.


Gonorrhea is most famous as an infection of the cervix or the urethra. But the bacteria that cause gonorrhea can thrive in other warm, moist areas of your body — not just the reproductive tract, but also in the mouth, throat, eyes, and anus. Unprotected oral sex can allow those bacteria to travel in either direction between one person’s genitals and another person’s throat.

But what about mouth-to-mouth kissing, like French kissing? Is that enough to allow these bacteria to hitch a ride from one mouth to another? Previous research, using a mathematical model, estimated that mouth-to-mouth contact might be a significant — and underappreciated — mode of gonorrhea transmission. But that was a mathematical model, a sophisticated equation using what we know about a population’s gonorrhea prevalence and sexual behavior to estimate how frequently the infection is transmitted from one mouth to another. Continue reading

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

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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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: 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.

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