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

Maternal Mortality: A National Embarrassment

Americans spend more money on childbirth than any other country, but we’re not getting a good return on our investment.

Less than a century ago, approximately one mother died for every 100 live births — an occurrence so common that nearly everyone belonged to a family, or knew of one, that was devastated by such a loss. Fortunately, in most nations, those tragedies have declined over the years. In fact, in the decade between 2003 and 2013, only eight countries saw their maternal mortality rates rise.

Unfortunately, the United States was one of those eight countries, joining a club that also includes Afghanistan and South Sudan. Within the 31 industrialized countries of the Organization for Economic Cooperation and Development, an American woman is more likely to die as a result of pregnancy than a citizen of any other country besides Mexico. Among developed countries, the United States has one of the highest maternal mortality rates — and those rates are only getting worse.

Graph: CDC

U.S. maternal mortality has attracted the attention of organizations whose oversight you wouldn’t expect. Amnesty International, which most Americans associate with the fight against human rights abuses in far-flung authoritarian regimes, considers our high maternal mortality rates to be a violation of human rights. Additionally — and pathetically — one of the biggest sources of funding for maternal health in the United States comes not from taxpayers but from the pharmaceutical company Merck. The Economist quoted a Merck spokesperson as saying, “We expected to be doing all our work in developing countries.” Continue reading

STD Awareness: STI vs. STD … What’s the Difference?

When it comes to sexually transmitted diseases, the terminology can be confusing. Some people use the phrase “STD,” some people insist “STI” is the proper set of initials, and every once in a while you might catch someone using the term “VD.” Over the years, the parlance has changed. What’s the deal?

VD: Venereal Disease

Blaming women for STDs (aka VD) is an age-old tradition.

“Venereal disease” has been in use since at least the 1600s (the Oxford English Dictionary cites a 1667 publication referring to a “a lusty robust Souldier dangerously infected with the Venereal Disease”). Around a century ago, Americans flirted with heavily euphemistic expressions, such as “social diseases,” but mostly, “venereal disease” was the terminology of choice for the better part of four centuries — slightly less euphemistic, as “venereal” was derived from Venus, the Roman goddess of love, sex, and fertility. Additionally, since at least the 1920s it was frequently shortened to “VD.” Those of us of a certain age might still remember hushed talk of VD among our grandparents, parents, or peers.

Around the 1930s, public health experts started wondering if referring to VD as a separate category of disease stigmatized these infections and those who carried them, dampening motivation to fight them with the same fervor with which the community battled other infectious diseases like influenza, smallpox, and scarlet fever. In 1936, Nels A. Nelson proposed replacing “venereal disease” with “genito-infectious diseases,” but that never caught on — you haven’t heard of GIDs, right? Continue reading

Some Good News About Three Sexually Transmitted Viruses

Scientists are hard at work finding ways to improve your health!

With so much bad news emblazoned across headlines in every newspaper you look at, the world might seem like a gloomy place. So let’s take one depressing subject — disease — and peel away the sad outer layer to find silver linings of optimism.

When it comes to infections, a lot of us blame one thing: germs, also known as “bugs” — “pathogens” if we’re fancy. Some people might not think of infectious diseases as being that big of a deal — after a round of antibiotics, you’ll be on the mend. Unfortunately, antibiotics only work for bacteria, but a lot of diseases are caused by other types of germs — for which antibiotics are no match. One type of germ is called a virus, and they can’t be cured. Sometimes they can be prevented with vaccines or treated with drugs. For example, the major strains of human papillomavirus (HPV) can be prevented with a vaccine called Gardasil, herpes simplex virus can be suppressed with antiviral drugs, and HIV can be controlled with antiretroviral drugs — but none of these infections can be cured. HPV is usually defeated by the immune system, but herpes and HIV are with you for life.

But it’s not all bad. Around the world, individual scientists have picked their “favorite” viruses and are devoting their lives to finding better prevention strategies, better treatments, and even cures. Let’s check in with some of the latest headlines touting the successes of science.

New Hope for a Herpes Vaccine

A herpes vaccine would be a blockbuster — given how common this sexually transmitted infection is, a preventive shot could help a lot of couples discuss their herpes status without as much fear of judgment and stigma.

Herpes might cause an “outbreak” — unpleasant symptoms that include genital sores — but afterward the virus goes dormant in the nerve cells, hiding from the immune system. In some people, the virus can come out of its dormancy to cause flare-ups of symptoms, but once it’s had its fun it retreats back to the nerve cells.

Earlier this year, media reported on a promising new candidate for a herpes vaccine. Using a completely different strategy than previous, failed herpes vaccines, the researchers behind this breakthrough targeted the part of the virus that allows it to hide from our immune systems. If this vaccine works as hoped, recipients will be able to mount an immune defense when exposed to the virus, blocking it from establishing a permanent home in nerve cells. It might even suppress outbreaks in people who already have herpes. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 25: Lost Tampons

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl never knew about.

tamponPlanned Parenthood Arizona offers a wide variety of services, and someday we hope to cover every last one of them in this series. But today, I’d like to talk about one of the odder services: helping you with a lost tampon.

OK, so “lost” might be a weird word. I mean, you probably know the general area where that tricky tampon is lurking … But it happens even to the best of us: Sometimes, when you go to retrieve a tampon, you just … can’t find it. Maybe it was forgotten about, and then pushed farther up the vaginal canal by a subsequent tampon, or smooshed against the cervix during intercourse, and now you can’t find the string to remove it.


The presence of a certain strain of bacteria in one’s vagina can increase risk for toxic shock syndrome, especially when absorbent tampons are used.


The vagina can be a hiding place for all kinds of things — not just tampons, but sex toys, the remnants of broken condoms, and other foreign objects. And vaginas aren’t the only cavity with magical, or possibly just embarrassing, powers of concealment. When I worked at a medical journal, I came across ample (and very, very detailed!) documentation of all sorts of things getting “lost” in people’s rectums, urethras, ears, and throats. Believe me, a seasoned health care provider has probably seen it all, so if you can’t for the life of you remove something from your vagina on your own, don’t be afraid to ask Planned Parenthood for help. (You might ask about making an emergency, same-day appointment.)

Tampons aren’t designed to be used in a vagina for more than a few hours, and leaving them in for too long might increase risk for certain infections. For example, you might have heard of toxic shock syndrome (TSS), which is probably the No. 1 condition that comes to people’s minds when they think of tampons being left in for way too long. While it’s true that TSS is associated with tampons, tampons aren’t the only cause — they play just one role in the infection process. Continue reading

World AIDS Day: Fighting the Stigma Is Half the Battle

RibbonThey say words can never hurt you, but in certain parts of the world, there are three letters that can take away everything dear to you: HIV.

Can you imagine having your family disown you? What if doctors refused to treat you, even with basic care? What would it feel like if you were not allowed to pursue any form of education? How about if you had no possibility of a future with a romantic partner?


We will never make strides in preventing HIV transmission until we confront the taboos that surround it.


This is reality for millions of men, women, and children in sub-Saharan Africa who have been diagnosed with HIV/AIDS. As of 2013, that number was 24.7 million, which accounts for the vast majority of the world’s total reported cases, which by 2014 approached 37 million people, 2.6 million of whom were children. In 2013 alone, 1.5 million sub-Saharan Africans were newly infected. Since the first case was reported in 1981, a certain stigma has always lingered around the disease. Many in the United States refer to it as the “gay disease” or accuse those infected of bestiality. They may say that someone who has been diagnosed should avoid intimacy, believing that a person with HIV is incapable of functional relationships without infecting their partner. In Africa, the implications are even more harsh. Often believed to be a “curse from God,” many regions exile an infected person from their community.

Worse, the stigma does not stop with individuals. It bleeds into the legal, political, and economic arenas as well. This is true worldwide. Some places have prosecuted women for transmitting the virus to their child, or have prosecuted individuals for not disclosing their positive status even if they have reached an undetectable viral load through antiretroviral therapy (ART). The discrimination surrounding a positive diagnosis is cited as the primary hurdle in addressing prevention and care. Continue reading

Teen Talk: The Truth About Tampons

tamponsIf you had told the 13-year-old version of me that someday, I’d be writing about tampons on a blog, my first reaction would be, “Eww, gross!” But here I am, writing about tampons. Life can take you in unexpected directions.

When I was growing up, tampons had a mixed reputation. There were those people who thought that tampons would somehow make you lose your virginity. Then there were fears about infections, or the chemicals that were used.


In a school or in a pool, tampons are safe and pretty cool.


Me, I was just worried they’d hurt, and I never wanted to use them. My refusal to use a tampon meant that I couldn’t go swimming in gym class — and everyone knew that I was on my period. There I was, sitting in the bleachers as everyone else was splashing around. I knew I wasn’t the only one who didn’t want to wear a tampon — during lunchtime, a few of us quietly talked about our fears, but none of those other girls joined me on the sidelines. I think they were more concerned about their classmates knowing their business. During our six-week swimming unit, only a few girls sat out their periods in the bleachers.

Tampons weren’t the right choice for me at that time, but for other girls, they were convenient and comfortable. If you’re curious about tampons but have some concerns, it might be worth looking into them so you can make an informed decision. I’m glad we have so many options to deal with our periods — my mom would tell me about these crazy belts with buckles or pins that they’d have to put up with every month. But you have a ton of things to choose from when finding the products that work best for you. Continue reading