STD Awareness: Can the HPV Vaccine Prevent Head-and-Neck Cancer?

Photo: Heather Hazzan, Self Magazine

The HPV vaccine Gardasil protects against human papillomavirus, a prolific virus that causes many types of cancer. In fact, although it was initially approved to prevent cervical cancer, the most common HPV-associated cancer is head-and-neck cancer. Last month, Gardasil 9 was finally approved for the prevention of head-and-neck cancer.

That certainly took long enough! We’ve known for a long time that HPV is behind the epidemic of head-and-neck cancers, and we’ve known that the HPV vaccine guards against infection with this virus. With HPV causing more head-and-neck cancers than any other HPV-associated cancer in the United States, this approval was long overdue.

Bearing the Burden of HPV


Gardasil 9 is now approved for the prevention of head-and-neck cancer, shining a light on this epidemic.


Although its routine use in boys and men has been recommended since 2011, the HPV vaccine is still primarily thought of as a “girl’s vaccine,” invaluable for its ability to prevent cervical cancer. For the first few years of its existence, Gardasil was only FDA-approved for girls and women, and since then it has struggled to escape its gendered connotations. While this new FDA approval doesn’t change who is eligible to receive the vaccine, it does shine some awareness on head-and-neck cancer, and gives parents more evidence that this anti-cancer vaccine is important to give to sons, not just to daughters.

Head-and-neck cancers can strike anywhere from the lips to the larynx, or voice box, and up into the sinuses and nasal cavity. According to the Centers for Disease Control and Prevention, an estimated 11,300 U.S. men are diagnosed with head-and-neck cancer every year, compared to 2,200 U.S women. 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

Dental Dams Help Spread Intimacy, Not STDs

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: Is HPV Now a “Men’s Disease”?

Human papillomavirus, or HPV, is most notorious for causing cervical cancer — making it, in many people’s minds, a “women’s disease.” But this gender-blind sexually transmitted virus can cause cancer in any cell it infects, and is associated with cancers of the cervix, anus, vagina, vulva, penis, and mouth and throat — aka oropharyngeal cancer.

While oropharyngeal cancers used to be caused mostly by tobacco, as people quit smoking an increasing proportion is caused by HPV. In the 1980s, only 15 percent of oropharyngeal cancers were caused by HPV, but nowadays the virus is behind 70 percent of them. A 2011 study predicted that the number of HPV-positive oropharyngeal cancers will surpass cervical cancers by 2020.


HPV is rapidly gaining prominence among men.


It’s only 2017, but we’re ahead of schedule. Earlier this year, researchers reported that, in the United States, oropharyngeal cancer is more common among men than are cervical cancers among women — and oropharyngeal cancer rates are increasing in the male population, while they are relatively stagnant among women. These rates are projected to continue climbing, which will skew oropharyngeal cancer even more heavily toward the male population. But, in the public’s imagination, HPV is most well-known for its association with cervical cancer — while most people haven’t even heard of oropharyngeal cancer.

Oropharyngeal Cancer and HPV

Oropharyngeal cancer can strike the inside of your mouth and throat. Risk factors include tobacco (including cigarettes, snuff, and chewing tobacco), marijuana use, alcohol, and oral infection with HPV. HPV can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as “French kissing” and rubbing genitals together. There are many strains of HPV, which come in two main categories: low-risk HPV, which can cause genital warts; and high-risk HPV, which can cause cancer. Continue reading

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

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: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading

STD Awareness: Why Should You Care About Oral Gonorrhea?

Image: CDC

An illustration of Neisseria gonorrhoeae, the bacteria that cause gonorrhea. Image: CDC

When I say “gonorrhea,” you might think of genitals that feel as though they have been set ablaze, or perhaps a viscous fluid oozing from the urethra. But gonococci, the bacteria that cause gonorrhea, can also set up camp in the pharynx after being transmitted into a mouth and down a throat when its new host gave oral sex to its old host. Indeed, performing oral sex on multiple partners has been found to increase risk for an oral gonorrhea infection (more properly called pharyngeal gonorrhea).

If you read our September 2012 article on gonorrhea of the throat, you might remember these fun facts: Oral gonorrhea goes away within three months, even without treatment! Plus, these infections rarely have symptoms. Why, then, should you care about a gonorrhea infection in your throat? You’re not likely to notice it’s there, and it’ll go away on its own anyway.


Many researchers believe that the throat is an incubator for antibiotic-resistant gonorrhea.


Well, aside from the possibility of transmitting a gonorrhea infection from your throat to someone’s genitals, there’s one other thing to care about: the development of antibiotic resistance.

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,” and indeed, gonorrhea seems to be evolving resistance to drugs at quite a rapid clip. If gonorrhea evolves complete resistance to the drugs we use to cure it, we could find ourselves sent back in time, to the days when gonorrhea was untreatable — and responsible for infertility, blindness, and chronic pain. While scientists figure out how to address this emerging threat, you can do your part by avoiding gonorrhea in the first place — and that includes using condoms and dental dams to prevent oral gonorrhea infections.

So, while it sounds like a blessing that gonorrhea of the throat rarely has symptoms, there’s actually a drawback: An oral gonorrhea infection probably won’t be effectively treated — or even identified in the first place. And these hidden throat infections are likely to be helping to drive the development of antibiotic resistance. Continue reading