STD Awareness: Can the HPV Vaccine Prevent Head-and-Neck Cancer?

Photo: Heather Hazzan, Self Magazine

The HPV vaccine Gardasil protects against human papillomavirus, a prolific virus that causes many types of cancer. In fact, although it was initially approved to prevent cervical cancer, the most common HPV-associated cancer is head-and-neck cancer. Last month, Gardasil 9 was finally approved for the prevention of head-and-neck cancer.

That certainly took long enough! We’ve known for a long time that HPV is behind the epidemic of head-and-neck cancers, and we’ve known that the HPV vaccine guards against infection with this virus. With HPV causing more head-and-neck cancers than any other HPV-associated cancer in the United States, this approval was long overdue.

Bearing the Burden of HPV


Gardasil 9 is now approved for the prevention of head-and-neck cancer, shining a light on this epidemic.


Although its routine use in boys and men has been recommended since 2011, the HPV vaccine is still primarily thought of as a “girl’s vaccine,” invaluable for its ability to prevent cervical cancer. For the first few years of its existence, Gardasil was only FDA-approved for girls and women, and since then it has struggled to escape its gendered connotations. While this new FDA approval doesn’t change who is eligible to receive the vaccine, it does shine some awareness on head-and-neck cancer, and gives parents more evidence that this anti-cancer vaccine is important to give to sons, not just to daughters.

Head-and-neck cancers can strike anywhere from the lips to the larynx, or voice box, and up into the sinuses and nasal cavity. According to the Centers for Disease Control and Prevention, an estimated 11,300 U.S. men are diagnosed with head-and-neck cancer every year, compared to 2,200 U.S women. Continue reading

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: COVID-19 and Your Sexual Health

The world has found itself in the clutches of a pandemic, and every day we’re learning about the ripple effects this new virus is having in everyone’s lives, not just the lives of those who cross its path. These devastating consequences include millions of people losing their jobs and hospitals stretched so far past capacity that they can’t adequately treat all their patients.

There are plenty of other downstream effects, too. For example, some people are worried that we could be staring down the barrel of a shortage of a common antibiotic called azithromycin, which cures chlamydia — the most common sexually transmitted bacteria in the world. Nine drug manufacturers recently reported azithromycin shortages to the Federal Drug Administration. With chlamydia rates at a record high, 2020 is a bad time for the antibiotic that cures it to be in short supply. Untreated, chlamydia can cause infertility and chronic pain, and can increase risk for HIV transmission and acquisition.

Apparently, the president of our country, who is not a health expert by any stretch of the imagination, endorsed azithromycin as a treatment for COVID-19 in combination with a drug that treats lupus and arthritis. There isn’t much in the way of evidence that the drug combination recommended by the president actually can treat COVID-19, but there are currently clinical trials underway, so time will tell how effective that regimen actually is. Continue reading

STD Awareness: Stigma and Sexually Transmitted Diseases

Stigma and disease have always gone hand in hand, with some diseases more stigmatized than others. Over the millennia, people living with diseases ranging from leprosy to AIDS have been burdened by moral judgments, while people with conditions like common colds or Alzheimer’s disease are seen as randomly — and innocently — afflicted.


Even the most “sex-positive” among us might find ourselves inadvertently stigmatizing others.


These days, stigma swirls around the novel coronavirus that causes COVID-19, arising from the fear and anxiety that has recently gripped the world. As reports of hate crimes against people of Asian descent show, some people are confusing vigilance about protecting public health with excuses to lash out at certain populations. This stigma can also show itself in seemingly benign comments, like apologizing for coughing and promising that it’s “only allergies” — which I have seen happen even in conversations taking place in “virtual spaces” like Zoom or Skype, where disease transmission wouldn’t have been possible. The idea is that a COVID-19 infection is shameful, while allergies are socially acceptable.

Probably no set of diseases is more stigmatized than sexually transmitted diseases (STDs) — despite the fact that they’re also some of the most common infections across the spectrum of humanity. In fact, we’re in the midst of an STD epidemic, with tens of millions of cases every year in this country alone. Gynecologist Jen Gunter writes about how an STD diagnosis, like no other disease save cancer, has the unique power to bring a patient to tears. A common STD like herpes or genital warts can make someone feel like “damaged goods.” But clearly it’s not the virus itself that makes someone “damaged goods” — it’s the way it was transmitted. For proof, look at the way people react to infections caused by genetically related viruses, such as the herpesvirus that causes chickenpox or the strains of HPV that cause warts on someone’s fingers or toes.

Using Stigma to Punish

Even the most “sex-positive” among us might find ourselves inadvertently stigmatizing others when we talk about having a “clean” STD test or make people with herpes the butt of a joke. When we do that, we participate in a system that frames STDs as just punishments for engaging in the “wrong” kinds of sexual activities. Continue reading

STD Awareness: How Do I Tell Someone I Have Herpes? Or HPV? Or HIV?

Image provided by Katie to Vice

Of all the novel ways to jump-start a difficult conversation, presenting someone with a hand-drawn comic about herpes is among the most creative. A couple of weeks ago, Vice shared the story of Katie, a millennial with genital herpes who struggled to find the optimal way to disclose her status to potential partners. In a fit of inspiration, she wrote and illustrated a pamphlet that not only shared her history and status — it also included important stats and other facts about genital herpes, a highly stigmatized and widely misunderstood condition. Her pamphlet has been received well by potential partners, dispelling myths while also lightening the mood during what can be a highly fraught conversation.


Begin your relationship with transparency and respect.


Katie’s struggle is shared by a lot of people with treatable — but incurable — STDs, such as genital herpes, human papillomavirus (HPV), and HIV. (Herpes and HIV stay in the body for life, but 9 out of 10 times HPV will be defeated by the immune system. But sometimes, HPV lingers for years or even life.) Most of us don’t want to disclose too early, when we haven’t yet established trust, but we also might be wary of waiting too long, lest we be accused of dishonesty. And disclosing before it seems like sex is in the cards might seem presumptuous. It can be a fine line to walk.

Whether you design your own comic like Katie did, or try another route, the ability to disclose your STD status to a potential partner is an important communication skill to develop. Healthy relationships are built on a foundation of honesty and respect, and your potential partners need to make their own decisions when it comes to their comfort with possible exposure. To make an informed decision, they must be armed with all the facts — and you can help them! Continue reading

STD Awareness: When Syphilis Goes North

The bacteria that cause syphilis are shaped like corkscrews. Image: David Cox, CDC

Last month, a “weird” medical case made headlines. An Australian man with unexplained headaches and eye pain got a diagnosis for his mysterious symptoms when his doctors discovered he had syphilis — and the infection had spread to his head. Syphilis had caused both optic nerves to become swollen, triggering pain that worsened whenever he moved his eyes.

It might seem strange that a disease most people associate with below-the-belt symptoms can wreak havoc above the neck, but syphilis is a wanderer that can travel all over the body, sowing chaos wherever it goes.


Syphilis can quickly enter the nervous system and travel to the head, where it can cause blindness, psychiatric problems, and other trouble.


Ocular Syphilis

The bacteria that cause syphilis can be passed from one person to another through contact with a sore, which can appear on or around the mouth, genitals, or anus. Any type of sexual contact, including oral sex, can transmit these bacteria. Sores are painless, contain a highly infectious liquid, and can appear between three weeks to three months after infection. These sores aren’t always visible, which means you can’t tell if someone has syphilis just by looking at them.

Although the bacteria typically land in the mouth, genitals, or anus, they can also be sexually transmitted directly into the eye, causing redness and vision problems. After infection, syphilis sores can appear on the eyelids, tear ducts, and soft tissues around the eyes. Bacteria can also travel to the eye by entering the nervous system and blazing a trail to the optic nerve — no direct contact between the eye and a sore necessary. Continue reading