STD Awareness: Gardasil and Males

menIt’s Men’s Health Month, and yesterday was the last day of Men’s Health Week, which means we’re going to look at a men’s health issue that is usually ignored: the impact of human papillomavirus (HPV) on the male population.

You’ve probably heard of HPV in discussions about cervical cancer and Pap testing. But HPV doesn’t care about gender, and is perfectly content to invade cells in anyone’s genital tract, mouth, throat, or anus. In males, HPV can cause genital warts as well as anal, oropharyngeal (mouth and throat), and penile cancers.


HPV will cause more oral cancer than cervical cancer by 2020.


The good news is that most HPV infections can be prevented by a vaccine called Gardasil, and you don’t need to be female to get it. However, few males are actually getting the HPV vaccine: In 2012, 20.8 percent of U.S. males 13 to 17 years of age had received at least one dose of the HPV vaccine, but only 6.8 percent completed the three-dose series.

Gardasil Is for Everybody: Good News from Australia

This huge disparity in promoting Gardasil to female patients rather than male patients has real-world consequences. In Australia, girls have been vaccinated with Gardasil since 2007, covered by their national health system. Four years into the program, genital wart rates fell by 93 percent in females less than 21 years of age. Even though males weren’t being routinely immunized, genital wart rates fell by 82 percent among heterosexual males in the same age group. That’s because their female partners had received the vaccine, which had the effect of protecting much of the male population. That might sound pretty nifty, but the female-only vaccination policy left out gay and bisexual males, whose genital wart rates saw no corresponding decline. Continue reading

National Infant Immunization Week: A Timely Reminder to Protect Your Child

babyVaccinations, or immunizations, are important for the health of your baby. National Infant Immunization Week, in its 20th year, continues to educate and inform parents of this important information. In the first two years of your infant’s life, vaccines can protect against 14 diseases.


How wonderful that science enables us to protect our little ones from serious diseases like polio, tetanus, and diphtheria!


Under five years of age, a child’s immune system is not developed enough to defend against some infections that can cause disability and even death. Vaccination schedules for infants are designed to protect them at times when they are most vulnerable to potentially serious diseases — diseases that are easily transmitted and quickly overwhelm an immature defense system. Vaccines contain “germs,” such as inactivated or weakened bacteria or viruses, that can stimulate an immune response. The amount and type of “germs” in vaccines are designed to help infants’ immune systems develop protection from the serious consequences of getting that disease.

Watching your baby undergo painful injections that may give them some uncomfortable reactions like fever and aches can make any parent worry, but these short-term effects are much less serious than getting the disease. For example, mothers — who may not even know they have hepatitis B because they do not show symptoms — can transmit the disease to their baby during childbirth. Years later, that child may develop serious liver disease. By routinely receiving a hepatitis B vaccine at birth, babies are protected from this life-threatening disease. Continue reading

STD Awareness: HPV and Smoking

cigaretteThursday, November 21, is the Great American Smokeout, a day to abstain from smoking — and, one hopes, to quit for good. “That’s great,” you say, “but what do cigarettes have to do with sexually transmitted diseases?”

Good question!

First, let’s talk about HPV. Human papillomavirus (HPV) is known as the “common cold of STDs” — because pretty much every sexually active person will contract it, even people with very few sex partners. Aside from complete abstinence, the best way to avoid an HPV infection is to be vaccinated with Gardasil, which protects against four common HPV strains — two that cause genital warts, and two that cause certain cancers, such as cervical cancer and oropharyngeal cancer. You can further reduce risk by using condoms and dental dams during all sexual activities, limiting sexual partners, and choosing partners who have had few or no previous partners — however, these risk-reduction methods don’t guarantee that you’ll remain HPV-free.


Harmful chemicals from cigarettes can end up in your cervical mucus!


If you’re sexually active, you could have contracted HPV without ever knowing about it. Most infections are asymptomatic (meaning that you never develop symptoms) and transient (meaning that they go away on their own after a year or two). When symptoms do appear, they can manifest as genital warts, penile skin lesions, cervical abnormalities, and signs of cancer elsewhere on the body. And, sometimes, an HPV infection can become persistent, meaning that it doesn’t go away. Luckily, there are steps you can take to decrease risk of developing HPV symptoms, and to increase your chances of fighting off an HPV infection. And one of those things is to quit smoking! Continue reading

STD Awareness: The Latest on Gonorrhea

Neisseria gonorrhoeae, the bacterium that gangs up on your body to give it gonorrhea. Image: CDC

Neisseria gonorrhoeae, the bacterium that gangs up on your body to give it gonorrhea. Image: CDC

Gonorrhea is that guy with the funny name who’s always up to something new and mischievous. Last year, the New England Journal of Medicine declared that it’s “time to sound the alarm” in response to emerging strains of gonorrhea that are increasingly resistant to antibiotics. Then, earlier this year, the medical journal JAMA reported the first North American sightings of gonorrhea that failed treatment with cefixime, one of the last drugs we have in our anti-gonorrhea arsenal. It’s a great time to be a gonococcus — the type of bacteria that causes gonorrhea — but the humans they infect probably don’t see it that way.

Last month, this bad boy rose to the top of the Most Wanted list when the Centers for Disease Control and Prevention proclaimed antibiotic-resistant gonorrhea an “urgent threat” — the highest threat level, which gonococci share with only two other bacteria types. To give you some context, the much more famous superbug MRSA was categorized as a “serious” threat, one notch below “urgent.”


Antibiotic-resistant gonorrhea is an “urgent” threat; meanwhile, researchers develop a gonorrhea vaccine that works — on mice.


Antibiotic-resistant gonorrhea is especially insidious for two reasons. One, gonorrhea often doesn’t have symptoms, which allows it to jump from one sexual partner to another, the hosts often none the wiser. Two, unless health care providers actually test the bug’s DNA, they have no way of knowing whether or not they’re dealing with a drug-resistant strain. This opens up the possibility for treatment failure — and for the antibiotic-resistant bacteria to be further propagated into the community.

The CDC estimates that the United States sees 246,000 cases of antibiotic-resistant gonorrhea infections annually — that’s about 30 percent of all gonorrhea infections in the country. For now, we seem to be able to cure them with higher doses or different combinations of drugs. So why does antibiotic-resistant gonorrhea deserve the “urgent” designation? While gonorrhea isn’t associated with a body count — unlike other drug-resistant pathogens, which collectively kill at least 23,000 Americans a year — it can have terrible consequences. Gonorrhea can cause pelvic inflammatory disease (PID) when it advances up the female reproductive tract, and epididymitis when it invades the male reproductive tract; both conditions can cause infertility. Also, gonorrhea infections make us more vulnerable to HIV. The CDC estimates that if the most resistant gonorrhea strain gains ground over the next decade, the country could see an additional 75,000 cases of PID, 15,000 cases of epididymitis, and 222 HIV infections, costing us $235 million. Continue reading

STD Awareness: How Can I Protect Myself if My Partner Has Herpes?

herpes protectionHas your partner, or potential partner, recently informed you that he or she has been diagnosed with genital herpes? After thinking about it, did you decide to continue with the relationship, despite not being infected with the virus that causes genital herpes yourself? Congratulations — the two of you are now a “discordant couple,” which means that one of you has genital herpes and the other doesn’t. While you might have come to the conclusion that acquiring a herpes simplex virus (HSV) infection below the belt won’t be the end of the world, you still might want to stay discordant — and do everything you can to minimize chances of virus transmission.


Condoms, medication, and abstinence during outbreaks can reduce risk for herpes transmission.


You can read all about herpes elsewhere on this blog, but here’s a quick rundown: Genital herpes can be caused by one of two strains of the herpes simplex virus: HSV-1 or HSV-2. While HSV-1 is more commonly associated with cold sores and HSV-2 is more commonly associated with genital herpes, either virus can infect the genital area. One estimate states that 1 out of 6 Americans between 14 to 49 years of age has a genital HSV-2 infection. Since genital herpes infections can also be caused by HSV-1, the number of people with genital herpes is actually higher.

Barring total abstinence from all sexual activity, you won’t be able to protect yourself completely from acquiring HSV — but there are many steps that you and your partner can take to decrease risk. Studies on discordant couples show that viral transmission can be reduced with condoms, antiviral herpes medications, practicing abstinence when symptoms are present, and patient education.

Condoms

Latex condoms protect against most STDs, especially fluid-borne infections like HIV and gonorrhea. But condoms also provide some protection against STDs that are transmitted by skin-to-skin contact, including genital herpes. One large study found that condom usage was associated with lower rates of HSV-2 acquisition — the more frequently someone used condoms, the lower the risk. Unsurprisingly, risk was also associated with frequency of sex acts: People having vaginal or anal intercourse more than twice weekly were 77 percent more likely to acquire HSV-2 than people having less sex. Continue reading

Arm Yourself Against Genital Warts and Cancer!

RosieVaccineBWVaccines are pretty nifty: Injecting a few tiny particles stimulates your immune system to build antibodies, which can bind to and help destroy harmful pathogens. A well-oiled immune system can neutralize these invaders before they have a chance to make you sick! In the war against infectious disease, we should be boosting our immune systems at every opportunity, and vaccines are one of the best weapons in our arsenal.

You’ve probably heard of HPV, or human papillomavirus, which causes genital warts and certain cancers. HPV has the dubious honor of being the most common sexually transmitted pathogen — some call it “the common cold of STDs.” According to the Centers for Disease Control and Prevention, “HPV is so common that nearly all sexually-active men and women get it at some point in their lives. This is true even for people who only have sex with one person in their lifetime.”


You might not know how easy it is to contract HPV — vaccination allows you to take charge of your health.


There are many strains of HPV. “Low-risk” strains can cause genital warts, which aren’t usually harmful but might be upsetting. “High-risk” strains can cause cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The good news is that a vaccine called Gardasil protects against HPV-6 and HPV-11, which cause 90 percent of genital warts, and HPV-16 and HPV-18, which cause 70 percent of cervical cancers and 90 percent of anal cancers.

With protection available against a common virus that can cause upsetting warts or fatal cancer, you’d think that everyone would be lining up for Gardasil shots — but, unfortunately, vaccination rates are very low in the United States. Many of us opt out of vaccination for ourselves or our children because we don’t realize how easily HPV is acquired, or we minimize its potential to harm.

HPV is easier to contract than you might think, so if you think the risk is too small to outweigh other justifications against immunization, read on — you might not be aware of just how easy it is to acquire this wily virus. Vaccination is an empowering option for those of us who want to do all we can to take our health into our own hands. And, by being immunized, we can play a role in driving cancer-causing viruses into extinction, which would be feasible with sufficiently improved vaccination rates. Continue reading

STD Awareness: Can Oral Sex Cause Throat Cancer?

mouthLast month, actor Michael Douglas gave a frank interview in which he revealed that human papillomavirus (HPV) caused his throat cancer. And, he continued, he got the virus from performing oral sex — specifically, cunnilingus (oral contact with female genitalia). It’s unusual for celebrities to be open about their STD status — and Douglas’ spokesperson has since backpedaled on his comment — so Douglas is to be commended for bringing light to a taboo and little-understood topic. But there were a few things he got wrong, too.


No matter your gender or sexual orientation, performing unprotected oral sex can increase cancer risk.


HPV is a common virus that can be spread by most sexual activities — including vaginal, anal, and oral sex, as well as 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 cancers of the cervix, anus, vagina, vulva, penis, mouth, and throat. The majority of HPV-related cancers are caused by two strains of HPV: HPV-16 and HPV-18.

The good news is that there is a vaccine that can protect you from infection by HPV-16 and HPV-18. Furthermore, most people clear an HPV infection within two years. HPV-related throat cancer is rare, affecting just 2.6 out of 100,000 people.

Can oral sex really lead to throat cancer?

Unfortunately, it is absolutely true that oral sex can transmit HPV, and a chronic infection can cause cancer. Oral sex is indeed sex. It’s not “third base,” it’s not “almost sex,” it’s plain old, straight-up sex, carrying with it the potential for both pleasure and disease transmission. 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. Combined with low vaccination rates for HPV in the United States, the virus is even easier to acquire than it needs to be. Continue reading