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

STD Awareness: The Curious Case of Chancroid

Haemophilus ducreyi arrange themselves in parallel rows, which researchers have called “railroad tracks,” “schools of fish,” and “fingerprints.” Image: Mike Miller, CDC

Earlier this year, I asked a room full of scientists and medical professionals to raise their hands if they’d ever heard of chancroid. Everyone sat there, motionless, confused by the odd syllables I had uttered — shan kroyd. If you’ve never heard of chancroid, you’re not alone.

Chancroid is a sexually transmitted disease (STD) brought to you by Haemophilus ducreyi, a type of bacteria that can pass through microscopic tears in the skin during sexual contact. When one partner is infected, there is a 1 in 3 chance the other will become infected. An infection can cause painful sores and swollen lymph nodes, most often in the genital region. About half of people with chancroid infections will experience “buboes,” or swollen lymph glands that might rupture. Before it could be cured with antibiotics, a persistent infection could cause permanent skin damage.


Humanity can make chancroid the first STD to go extinct.


One reason you probably haven’t heard of chancroid is that, in the developed world at least, it has mostly disappeared. In fact, researchers believe chancroid can be completely wiped off the planet — which would make it the first STD ever to be forced into extinction. How amazing would that be?

Chancroid has been hopping from loin to loin since at least the days of the ancient Greeks, and was common until the 20th century, when rates began to decline. Thanks to antibiotics, U.S. chancroid rates decreased 80-fold between 1947 and 1997, all but vanishing by the late 1950s. It was virtually unheard of until there was another spike in the 1980s, correlating with the crack epidemic. But, since 1987, cases have been steadily declining. Continue reading

STD Awareness: Is Chlamydia Bad?

chlamydiaPerhaps your sexual partner has informed you that they have been diagnosed with chlamydia, and you need to get tested, too. Maybe you’ve been notified by the health department that you might have been exposed to chlamydia. And it’s possible that you barely know what chlamydia even is, let alone how much you should be worried about it.

Chlamydia is one of the most common sexually transmitted diseases (STDs) out there, especially among young people. It can be spread by oral, vaginal, and anal sex, particularly when condoms or dental dams were not used correctly or at all. It is often a “silent” infection, meaning that most people with chlamydia don’t experience symptoms — you can’t assume you don’t have it because you feel fine, and you can’t assume your partner doesn’t have it because they look fine. If you’re sexually active, the best way to protect yourself is to know your partner’s STD status and to practice safer sex.


Chlamydia increases risk for HIV, leads to fertility and pregnancy problems, and might increase cancer risk.


The good news about chlamydia is that it’s easy to cure — but first, you need to know you have it! And that’s why it’s important for sexually active people to receive regular STD screening. Left untreated, chlamydia can increase risk of acquiring HIV, can hurt fertility in both males and females, can be harmful during pregnancy, and might even increase risk for a certain type of cancer. So why let it wreak havoc on your body when you could just get tested and take a quick round of antibiotics?

To find out just how seriously you should take chlamydia, let’s answer a few common questions about it.

Can Chlamydia Increase HIV Risk?

Chlamydia does not cause HIV. Chlamydia is caused by a type of bacteria, while HIV is a virus that causes a fatal disease called AIDS. However, many STDs, including chlamydia, can increase risk for an HIV infection, meaning that someone with an untreated chlamydia infection is more likely to be infected with HIV if exposed to the virus. 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

STD Awareness: Mycoplasma genitalium

“I’m not small, I’m just streamlined!” Image of Mycoplasma genitalium adapted from American Society for Microbiology.

In November and December of last year, headlines touting a “new” STD made an ever-so-minor flurry across the Internet. CNN referred to it as “mycoplasma genitalium, or MG” — Mycoplasma genitalium is the name of the teardrop-shaped bacteria that can cause several diseases in the urinary or reproductive tracts, such as urethritis and pelvic inflammatory disease.

M. genitalium is the smallest living organism known to science, having “devolved” from more complex organisms — but that doesn’t mean it can’t pack a punch! While these bacteria have surely been around for millennia, we only discovered them in the 1980s. Since then, we’ve known that M. genitalium fits the profile of a sexually transmitted pathogen — the only reason it made the news last year was that a team of British researchers published further evidence that this bug is indeed sexually transmitted and capable of causing disease.


Genital mycoplasmas can be cured — but a doctor needs to know what she’s looking for in order to prescribe the correct antibiotic!


An infection with M. genitalium could more generally be called a “genital mycoplasma.” The term “genital mycoplasmas” refers to a category of several different species of sexually transmitted bacteria, most notably Mycoplasma genitalium, but also less common species, such as Mycoplasma hominis, Ureaplasma urealyticum, and Ureaplasma parvum. M. genitalium is considered an “emerging pathogen,” because it is only over the past couple of decades that technology has allowed us to study these bacteria, along with other genital mycoplasmas.

Risk factors for infection include multiple sexual partners and not using condoms during sex. It is thought that most people with an M. genitalium infection don’t have immediate symptoms — 94 percent of infected men and 56 percent of infected women won’t notice anything amiss. That doesn’t mean it can’t do damage. Continue reading

Teen Talk: What Is Kissing Disease?

kissing diseaseIf you’re a total dork like me, you might have some plush microbes hanging out on your desk or in your bedroom. The one that represents Epstein-Barr virus is especially adorable (look to your right and try not to coo in delight!). I just want to grab it, cuddle up to it, and fall asleep in its pillowy purple-pink embrace.

In reality, Epstein-Barr virus, or EBV for short, is not the most warm-and-fuzzy microbe of the bunch. I’d way rather have a cold. Why? Because EBV causes mono, which is more whimsically known as the kissing disease. And, despite that cute moniker, kissing disease can be most unpleasant.


Take it from one mono survivor: “Mono stinks!”


First, an explanation of why mono is also called the kissing disease. Merely being in the presence of someone with mono won’t put you at risk, even if you’re both in the same room — you need to be actively swapping spit with them to be exposed to the virus. Kissing is probably the most famous way for two people to exchange saliva, but sharing cups, eating utensils, or toothbrushes can do it, too. After exposure to the virus, symptoms could show up in 4 to 6 weeks.

Second, an explanation of why mono can be so terrible. While not all teenagers and young adults who are infected with EBV will develop symptoms, those who do probably won’t enjoy the experience. Symptoms include extreme fatigue, head and body aches, sore throat, and fever. It’s bad enough to have those symptoms for a few days, but mono might seem to go on and on with no end in sight. Most people are better in 2 to 4 weeks, but even then it could take another few weeks to get back to 100 percent. And some unlucky people can experience these symptoms for six months or even longer! In addition to these nasty symptoms, serious complications are possible. Continue reading

STD Awareness: Is Bacterial Vaginosis a Sexually Transmitted Disease?

Not to scale: Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Gardnerella vaginalis under a microscope. Image: K.K. Jefferson/Virginia Commonwealth University

Bacterial vaginosis, or BV, is the most common vaginal infection among people 15 to 44 years of age. It’s caused by an overgrowth of harmful bacteria, such as Gardnerella vaginalis. A healthy vagina hosts thriving populations of Lactobacillus bacteria species, but when these “good” bacteria are crowded out by certain types of “bad” bacteria, the vaginal ecosystem can be shifted, causing BV.

There is a lot of confusion about BV. Is it a sexually transmitted disease (STD)? What are the symptoms? How can you avoid it?

All good questions. Let’s examine them one by one.

Is BV an STD?

The consensus seems to be that BV isn’t officially an STD, but even reliable sources have somewhat contradictory information. Planned Parenthood doesn’t list BV as an STD on their informational webpages. The Centers for Disease Control and Prevention (CDC) does include BV on their STD website, but also says that “BV is not considered an STD.”

On the other hand, the Office on Women’s Health says that “BV can … be caused by vaginal, oral, or anal sex” and that “you can get BV from male or female partners.” And there’s an entire chapter devoted to BV in the premier medical textbook on STDs, and its authors say that, while sexually inexperienced females can get BV, “the weight of evidence supports sexual transmission” of G. vaginalis, the bacteria species most famously implicated in BV infections.

The same webpage on which the CDC declared BV not to be an STD also says that it can be transferred between female sexual partners. Indeed, women who have sex with women have higher rates of BV. Since vaginal fluid could spread BV, partners can change condoms when a sex toy is passed from one to another, and use barriers like dental dams when engaging in cunnilingus (oral contact with the female genitalia) or rimming (oral contact with the anus).

What about heterosexual transmission? Continue reading