STD Awareness: New STDs on the Block, and STDs Making a Comeback

Lately, a lot of us have had tunnel vision when it comes to infectious diseases. We talk about how long the virus that causes COVID-19 can live on various surfaces, even though other viruses can live on those same surfaces for even longer. We wonder if it can be sexually transmitted, while there are dozens of other bugs out there that are even more easily passed through sexual contact. There are more microbes out there than just the one that causes COVID-19, and we need to be mindful of their risks, too.

Last month, the New England Journal of Medicine published a piece about “old-timey” STDs that are making a comeback (think shigellosis), newer STDs to hit the scene (think Zika virus), and “classic” STDs that are finding new ways to harm us (think antibiotic-resistant gonorrhea). Let’s meet this rogues’ gallery of sexually transmitted bugs.

Shigella bacteria. Image: CDC

Shigellosis is a diarrheal disease caused by Shigella species of bacteria, which can be found in abundance in feces — making it relatively easy to pick up these bugs during sexual encounters involving oral-anal contact (“rimming” or anilingus). While Shigella are mostly transmitted through nonsexual routes, researchers have discovered that sexually transmitted shigellosis is much more likely to be resistant to multiple antibiotics — making them a serious threat.

Reduce your risk by practicing good hand hygiene and keeping a clean kitchen and bathroom; using condoms and dental dams during sex. Continue reading

STD Awareness: COVID-19 and Semen

You might have read the headlines earlier this month that the virus that causes COVID-19 has been found in semen. Is that true — and if it is, does that mean COVID-19 can be transmitted sexually?

The short answers to those questions are yes, and we don’t know yet.


Several viruses that aren’t thought of as sexually transmitted can be found in semen.


JAMA recently published a short article about a small study conducted in China. The authors took semen from 38 people who were either recovered from COVID-19 or still in the throes of infection. Of those 38 people, six were found to have the novel coronavirus hiding out in their semen — adding semen to the list of bodily fluids in which the virus can lurk, including saliva, urine, and feces.

This study is too limited to make sweeping generalizations, but it does seem to show that it’s possible — though perhaps not overwhelmingly likely — for someone suffering from COVID-19 to be none the wiser as the virus wends its way to the body’s southern hemisphere, where it can hang out in the testes. Plus, the virus was detected not just in people with active disease, but also in people who had recovered, raising the possibility that someone can carry the virus below the belt even after symptoms are gone. Continue reading

STD Awareness: Sexual Transmission of Zika Virus

Zika

Zika virus. Image: Cynthia Goldsmith, CDC

I first heard of Zika virus in an epidemiology class, when another student made on offhand remark: “Did you know Zika virus can be transmitted sexually?” Ever vigilant for material for the STD Awareness column, I excitedly scribbled the name of the virus in my notes. But upon further investigation, I found that there were only a couple of documented cases of the sexual transmission of this virus that no one had heard of, and decided there was no reason to freak people out about yet another potential STD when rates of more common STDs, like chlamydia and gonorrhea, were on the upswing.

A year later, Zika virus was splashed across headlines on a daily basis, mostly for its newfound association with birth defects, but also in light of revelations that it could be transmitted by sex.


Access to condoms and reliable contraception is more vital than ever.


While Zika virus is usually transmitted by mosquito bites, the discovery that it can be sexually transmitted made it the only known virus that could be spread both sexually and by mosquitoes. It’s also the only known mosquito-borne virus that can cross the placenta to harm a fetus. Like several other viruses, including CMV and rubella, Zika is implicated in serious birth defects. But many health authorities worry that its potential as a sexually transmitted pathogen is dangerously underestimated. As of August 31, there have been 23 confirmed sexually transmitted cases of Zika virus in the United States — but sexual transmission will rise as the virus jumps into local mosquitoes, which will also make it difficult or impossible to tell if a sexually active Zika patient got the virus from sex or directly from a mosquito.

Earlier this year, sexually transmitted Zika virus in Texas made headlines, with many journalists incorrectly proclaiming it the first known case of sexual transmission. In fact, Zika’s sexual transmission was first documented in 2008, before “Zika” was a household name and the married couple who published their experience in a scientific paper thought they could share their STD status in relative obscurity. Despite referring to themselves as “Patient 1” and “Patient 3,” a science reporter quickly figured it out and (with their permission) revealed their identities in a 2011 article — still years before Zika-bearing mosquitoes would hit the Americas and trigger a microcephaly epidemic that propelled the virus to infamy. Continue reading

Teen Talk: I Can’t Get Pregnant … Can I?

teen pregnancy testIt’s wasn’t something you thought would happen. Your period is LATE!!! And you were sooooo careful — you didn’t use any contraception because you heard if he didn’t ejaculate or pulled out right away, you couldn’t get pregnant. And, just to be extra sure, you did jumping jacks for several minutes right after! What went wrong? Is it possible that the information you heard from your friends about how not to get pregnant was incorrect?


Sperm have one mission: to find and fertilize an egg. They don’t care what position you’re in, whether you have an orgasm, or if it’s your first time.


You know how babies are made, but you may have misunderstood some basic facts of human biology. The male body produces that tiny resilient sperm — actually millions of tiny resilient sperm — whose only mission is to find and fertilize a woman’s egg. They are so resilient that they can travel farther and live longer than you might think. They are present in men’s ejaculated fluid (semen) and also in the pre-ejaculate (the small amount of fluid that leaks out of the penis before a guy ejaculates). If any of that semen comes in contact with a woman’s vaginal area, there is a chance of her becoming pregnant. And if you don’t use some form of contraception with each and every act of intercourse, you are having unprotected sex, which increases your risk of getting pregnant. It only takes one sperm to fertilize an egg.

Let’s look at some common misconceptions you may have heard about how not to get pregnant. Continue reading

Does Douching Work?

illustration of a douching apparatus from an 1882 medical handbook

As a newly minted teenager, I was helping my mother go through some of my recently deceased great-grandmother’s things. I held a mysterious object in my hands and studied it curiously, puzzling over its unfamiliar form, pastel color scheme, and floral pattern. Finally, I gave up: “What is this?” I exclaimed. My mom, instantly uncomfortable, muttered her answer through clenched teeth: “It’s a douche bag,” she replied.

I remember being rather scandalized, but also a bit amused to be holding a piece of ancient misogynist history in my hands. Even as a junior high student, I knew that douching was marketed toward women with the message that their vaginas were “dirty” and in need of “cleansing” — scientifically invalidated ideas to which we surely no longer adhered. It seemed fitting that we were sorting through the belongings of a person born in the 19th century, dividing them into the useful and useless. Surely the douche bag belonged in the latter category.


Just because douching products are available in drugstores doesn’t mean they’re safe or effective.


Little did I know, more than 20 years ago, that douching hasn’t exactly been relegated to a historical footnote. Overall, nearly 25 percent of American women 15 to 44 years old douche regularly — which is down from nearly a third in 2002. Douching rates may vary by ethnic group: CDC data from 2005 found that 59 percent of non-Hispanic black women, 36 percent of Latinas, and 27 percent of white women douche. Socioeconomic status and education level can also be a factor.

For those of you who don’t know, vaginal douching is the practice of flushing the vagina with a liquid, which is administered through a nozzle that is inserted into the vagina. Some people believe that douching cleanses or deodorizes the vagina, or can prevent pregnancy or infections. Some might think their partners expect them to douche, or that douching will “tighten” or “rejuvenate” their vaginas.  Continue reading

AIDS Denialism: Conspiracy Theories Can Kill

This scanning electron micrograph from 1989 reveals HIV particles (colored green) emerging from an infected cell. Image: CDC’s C. Goldsmith, P. Feorino, E.L. Palmer, W.R. McManus

We’ve all heard various conspiracy theories; we may or may not find them credible, and we might chalk up opposing viewpoints to simple differences in opinion. Sometimes, however, conspiratorial narratives are woven around matters of life and death — and in such cases, the spread of such ideas can influence dangerous changes in behavior and even government policy.

AIDS denialism is based on the idea that human immunodeficiency virus (HIV) does not cause AIDS. Although the existence of HIV and its causal connection to AIDS has been thoroughly demonstrated by scientists, denialists either reject the existence of HIV altogether, or cast it as a harmless virus that doesn’t cause illness. Denialism often relies upon rhetorical strategies that are superficially convincing but intellectually hollow, including the cherry-picking of evidence, appeals to unreliable “experts,” and untestable claims. Denialists also might cite early AIDS research from the mid-1980s while ignoring more up-to-date findings and improved medical procedures. Such rhetoric creates a sense of legitimate debate in an area where there is none, and the only new evidence welcomed into the discourse is that which confirms preconceived notions.


Health decisions must be shaped by the best available evidence, and when denialism misinforms, one cannot make an informed decision.


If AIDS isn’t caused by HIV, what do denialists claim is behind the unique symptoms that characterize it? Some say that conditions such as malnutrition, or diseases that have been around for a long time, are simply being labeled as AIDS. Other denialists cast antiretroviral drugs as the cause, rather than the preventive treatment, of AIDS. Some claim that AIDS is caused by behavior, such as drug use or promiscuity — with some even saying that an accumulation of semen in the anus can cause AIDS. None of the claims is true — while AIDS can leave someone vulnerable to a wide variety of diseases, and while sharing IV equipment and engaging in unprotected sex can increase risk, there is only one cause: HIV. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 11: Diagnosing and Treating Epididymitis

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 doesn’t know about.

Planned Parenthood Arizona treats epididymitis.This statement might raise a few questions:

Q: What’s epididymitis?
A: Epididymitis is the inflammation, or swelling, of the epididymis, resulting in pain in the scrotum.
Q: That’s great, but what the heck is an epididymis?
A: The epididymis is a tube that is connected to the testicle, and is where sperm are stored before ejaculation. The epididymis is 12 to 15 feet long, but is coiled tightly enough to fit inside the scrotum alongside the testes!


Chlamydia causes 70 percent of epididymitis cases in young heterosexuals. This STD is easily treated but frequently asymptomatic — and prevented by condoms.


So, basically, epididymitis is a condition that can strike anyone whose reproductive anatomy features an epididymis. It is generally caused by a bacterial infection — which may be sexually transmitted, such as gonorrhea and chlamydia, or may not be sexually transmitted, such as tuberculosis. Very rarely, epididymitis can be caused by other pathogens, such as viruses, fungi, or parasites. Inflammation of the epididymis can also be caused by the heart medication amiodarone (also known as Pacerone).

Epididymitis most commonly affects males between the ages of 14 and 35. Risk factors, regardless of age, include being uncircumcised, a history of prostate or urinary tract infections, having had surgery in the urinary tract, having a history of a neurogenic bladder, an enlarged prostate, regularly using a catheter, and not using condoms during vaginal or anal intercourse.

The symptoms of epididymitis usually develop over one or two days and can include: Continue reading