Tag Archives: oral gonorrhea

STD Awareness: Can I Get Gonorrhea from Kissing?

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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 →

STD Awareness: The Good, the Bad, and the Ugly

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Sexually transmitted diseases (STDs) have been with us since the dawn of time — or at least since the dawn of sex. And, as we continue to hone our approach to preventing and treating them, STDs will always grab headlines, whether the news is bad or good.

The Good

Can the HIV epidemic be stopped?

For more than a decade, AIDS, the illness caused by HIV, was seen as a death sentence. It wasn’t until the mid-’90s that antiretroviral drugs kept the virus in check, prolonging lifespans for people with access to these medications and transforming the infection into a chronic disease. Now, those dreaming of an end to HIV are seeing reasons for optimism. No, a cure isn’t in the works — but many researchers believe we can end the epidemic through prevention.

Ending HIV transmission will take money and an efficient health care infrastructure, but we have the tools to do it. It starts with expanding access to HIV testing — an estimated 15 percent of Americans with HIV are unaware of their status. The next step is to ensure that everyone testing positive has access to antiretroviral drugs. When used correctly, these medications keep viral levels so low that the chances of transmission are virtually nonexistent. More recently, medications called PrEP — pre-exposure prophylaxis — enable people without HIV to protect themselves from infection. Condoms, of course, are a time-tested prevention tool. Gathered together, we have a pretty mighty arsenal. Here in the United States, we could stop HIV transmission in its tracks in just a handful of years. Of course, people all around the world will need access to testing and treatment to halt this scourge on a global level. Continue reading →

STD Awareness: Is Mouthwash a Match for Gonorrhea’s Superpowers?

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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 →

STD Awareness: Are Condoms Really Necessary?

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condoms in packetsCondoms are one of the best ways for sexually active people to avoid sexually transmitted diseases (STDs), but many worry that people are becoming more lax about protecting themselves. There are all kinds of myths swirling around about condoms — such as that they aren’t effective or that they kill the mood. And, thanks to anti-HIV medications, some people no longer see condom use as a matter of life or death.

The Centers for Disease Control and Prevention (CDC) recently announced that 2014 saw record highs in chlamydia, syphilis, and gonorrhea, which is a stark reminder that condoms protect against more than just HIV. So, even if you’re using medications to protect yourself from HIV, remember that syphilis is making a comeback, and can cause serious damage or even death when untreated, and that gonorrhea is rapidly evolving resistance to the last good drugs we have to treat it. Condoms are just as relevant as ever!

HIV

In 2014, the CDC announced it would start using the term “condomless sex” instead of “unprotected sex” to recognize that people could engage in condom-free sex, but still protect themselves from HIV by using Truvada, or pre-exposure prophylaxis (PrEP). Truvada is the first drug approved by the FDA to prevent HIV, and it can be taken by HIV-negative individuals to help their body ward off the virus before an infection can establish itself. The pill must be taken daily — using it inconsistently reduces its effectiveness. Continue reading →

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

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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: Why Should You Care About Oral Gonorrhea?

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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 →

STD Awareness: An Update on Antibiotic-Resistant Gonorrhea

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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 →