STD Awareness: Can Lesbians Get STDs?

couple WSWA couple of months ago, in time for Valentine’s Day, the Centers for Disease Control and Prevention announced that it would start using the term “condomless sex” instead of “unprotected sex.” The move was hailed by many HIV advocacy groups for taking into account other risk-reduction practices, such as medications that decrease the chances of HIV transmission.


Women can transmit just about any STD to one another.


However, while medications can reduce HIV risk, condoms still offer protection from both pregnancy and many other sexually transmitted diseases (STDs), such as chlamydia and gonorrhea. One reason that condoms are so valuable is that they can be placed over a penis to collect fluids before and after ejaculation — dramatically reducing risk for both pregnancy and many STDs. So, even when using anti-HIV meds, engaging in “condomless sex” can still be risky.

But what if partners are engaged in sexual activities that don’t involve penises? Not all sexual couplings involve a cisgender man, and even those that do might not utilize a penis at every encounter. When two people without penises have sex, they’re probably going to be engaging in condomless sex — though condoms can be placed over penetrative sex toys or cut along the sides to be converted into dental dams, they might not figure too prominently in this couple’s safer-sex arsenal. Lesbians protecting themselves with dental dams are technically engaged in “condomless sex,” but it’s still a far cry from being “unprotected.” Continue reading

STD Awareness: An Update on Antibiotic-Resistant Gonorrhea

Last year, we shared the fascinating and frightening story of the emergence of increasingly antibiotic-resistant gonorrhea, an STD caused by the gonococci bacteria. The sexually transmitted scourge, which we only so recently reined in with the development of antibiotics, has been performing some genetic gymnastics to defeat almost every drug we’ve thrown at it. We douse it with certain drugs, and the bacterium literally spits them back out at us, and it inactivates other drugs by snapping the active molecules in half. Sulfa drugs, penicillins, tetracyclines, fluoroquinolones — they all make a gonococcus heave a bored sigh. Luckily, cephalosporins were still an effective treatment, but recently there have been reports of stubborn gonorrhea infections caused by the latest and greatest (and some might say most hated) strain of gonococci.


The bacteria that cause gonorrhea continue to evolve, right under our noses!


Well, the story isn’t over — just like the bacteria that cause gonorrhea, the tale is rapidly evolving. The latest class of antibiotics that the gonococci are chipping away at is the cephalosporin family, which includes several chemically related drugs that work in similar ways — and that can likewise be defeated by microbes in similar ways. Cephalosporin-resistant gonorrhea was first reported in Japan and documented in a few European countries. The Japanese case that inspired the New England Journal of Medicine to declare last year that it was “time to sound the alarm” was an oral gonorrhea infection that was resistant to one member of the cephalosporin family: ceftriaxone.

Earlier this month, the prestigious medical journal JAMA reported the first North American sightings of gonorrhea that failed treatment with another cephalosporin: cefixime. Yeah, I know, you’d rather hear about Big Foot or UFO sightings, not evidence that something as real and unmythical as Gonorrhea 5.0 has landed in your back yard. Luckily, there’s plenty you can do to protect yourself from it, and we’ll tell you all about it toward the end of this article. (Spoiler alert: It involves using condoms!) Continue reading

STD Awareness: Gonorrhea of the Throat

Editor’s note: For more information on oral gonorrhea, please see our post Why Should You Care About Oral Gonorrhea? For more information on whether a gonorrhea infection can go away without treatment, please see our post Will STDs Go Away on Their Own?

Gonococci can band together to attach themselves to a human cell. Image: Dustin Higashi, University of Arizona

My fellow Generation Xers might remember an episode of Chicago Hope in which a very young Jessica Alba portrays a teenage girl with a gonorrhea infection in her throat — also called pharyngeal gonorrhea. The actress later reported being shunned by members of her church, disillusioning her from the religion she grew up with. It is a testament to the power of taboo that even a fictional association with a sexually transmitted disease (STD) can elicit such negative reactions.

Taboos can affect the ways we relate to one another sexually, as well. Many of us conceptualize of disease as “dirty,” and the flip side to that is to think of people without disease as “clean.” This kind of stigmatizing language can be found in phrases like “She looked clean” and “Don’t worry, I’m clean” — all to describe people who are perceived to be or who claim to be free of STDs. With all the baggage we put on STD status, it can be difficult to ask a partner to use a condom or dental dam during oral sex. Some people might think we don’t trust them or are underhandedly questioning their “cleanliness.” These sorts of fears can cloud our judgment when it comes to protecting our health, but there is nothing wrong with asking your partner to use protection during oral sex — especially if you don’t know one another’s STD status. There are many good reasons to use barrier methods when engaging in oral sex, and pharyngeal gonorrhea is just one of them.


Unprotected oral contact with a penis puts you at the most risk of acquiring pharyngeal gonorrhea.


Gonorrhea is most famous as an infection of the cervix or the urethra. But gonococci, the bacteria that cause gonorrhea, can thrive in other warm, moist areas of your body — not just the reproductive tract, but also the mouth, throat, eyes, and anus. Gonococci can be transmitted to your mouth or throat via oral sex — most likely via unprotected oral sex. Symptoms might include a sore throat, but 90 percent of the time there are no symptoms at all. Continue reading