STD Awareness: Will STDs Go Away on Their Own?

teensCan gonorrhea go away without treatment? Does chlamydia eventually clear up? Can trichomoniasis go away on its own? These are the kinds of questions people pose to Google before Google sends them here — at least that’s what I learned by looking at the blog’s stats. They’re tricky questions to tackle, and for so many reasons.

Some viral STDs stay with you for life, such as herpes and HIV. Others, such as hepatitis B and human papillomavirus (HPV), can be prevented with vaccines but cannot be cured. It’s also possible for the immune system to defeat hepatitis B virus and HPV — but in some cases, these viruses are able to settle in for the long haul, causing chronic infections that can endure for life and even lead to cancer.


Left untreated, syphilis can kill, and gonorrhea can cause infertility.


Non-viral STDs, like chlamydia and gonorrhea, can be cured. However, they usually don’t have symptoms, or symptoms can come and go, making it seem like an infection went away when it actually didn’t. You can’t know your STD status without getting tested, and you can’t self-diagnose an STD based on symptoms and then assume the infection went away when symptoms subside. Getting tested can uncover a problem and clear the way for treatment.

Nonetheless, people want to know if an STD can go away by itself — but there aren’t many studies on the “natural history” of curable STDs like gonorrhea, chlamydia, and trichomoniasis. Studying the natural course of a curable infection would require that scientists put their subjects at risk of the dangers of long-term infection, and no ethics board would approve such an experiment. Continue reading

Hepatitis B Vaccine: The Importance of the Birth Dose

babiesDid you know that Saturday kicked off National Infant Immunization Week, which is part of a worldwide observance that shines the spotlight on the importance of vaccination? Most of us think of infant immunization as a tool to protect babies from childhood illnesses like chickenpox and whooping cough. But did you know that one infant immunization protects them from cancer later in life?

Globally, hepatitis B virus (HBV) is one of the top causes of cancer. Every year, it kills more than three-quarters of a million people worldwide. An HBV infection might be defeated by the immune system, but when it’s not, it can become a chronic infection. And chronic infections can lead to serious health outcomes, including cirrhosis and liver cancer. The younger you are, the less likely you’ll be able to fight off an HBV infection — 90 percent of infants infected with HBV will develop chronic infections, and 25 percent of them will go on to die prematurely after developing liver disease. Compare that to 2 to 6 percent of infected adults who will develop chronic infections.


Because infants are so vulnerable to developing chronic infections, vaccinating them against hepatitis B at birth makes sense.


Most people think of hepatitis as a bloodborne disease, and it is spread very efficiently when IV drug users share needles, during needle-stick accidents and other occupational injuries, or by using contaminated piercing needles, tattoo equipment, or acupuncture needles. Even sharing items like razors, toothbrushes, and nail clippers can do it, as the virus can survive outside of the human body for a week. HBV can also be spread by sexual contact, including vaginal and anal sex.

Lastly, babies and children can be at risk as the virus can be transmitted from mother to infant during birth, and during early childhood when risk of chronic infection is high. A significant number of people with chronic infections acquired them during early childhood, but we don’t know exactly how they got them, as their parents and other household contacts were negative for the virus or its antibodies. Since infants and children are at the highest risk for developing chronic infections, focusing on that population for prevention is very important.

Luckily, there’s a vaccine. Continue reading

Square Pegs, Round Holes: Building Trans-Inclusive Health Care

transgenderFor the first time in history, trans persons are being recognized in the mainstream and their identities are being embraced like never before. Laverne Cox’s cover story for Time and Amazon Prime’s original series Transparent winning four Emmys are examples of this recognition.

Kinda.


Today is National Transgender HIV Testing Day.


Truth is, the trans persons in the media are not representative of the norm. The findings of the National Transgender Discrimination Survey — a survey that collected responses from more than 6,000 transgender and gender-nonconforming individuals — give a clearer picture, and it’s not pretty. The authors of this study found trans persons faced adversity in almost all aspects of life, from experiencing double the rate of unemployment to suffering through a high rate of violent attacks (26 percent and 10 percent of the respondents reported being physically and sexually assaulted, respectively) because of their gender identities. Among all these results, I found one to be particularly unsettling:

“Respondents reported over four times the national average of HIV infection, with rates higher among transgender people of color.”

To me, a person born after the AIDS epidemic of the ’80s and privileged with a world that now has readily accessible condoms and HIV prevention medication (i.e., Truvada), HIV seemed like a relic of the past. Examining the amount of new HIV infections in the cisgender population (0.4 percent for females and 1.2 percent for males), this is an easy assumption to make. I was wrong. Other studies echoed the large disparities of HIV incidence and prevalence in trans persons. One systematic review uncovered four studies that found that 24.8 to 30.6 percent of male-to-female (MTF) transgender persons tested positive for HIV. Another study — conducted in Ontario, Canada — sampled 433 trans persons and found 7 percent of female-to-male (FTM) transgender persons and 19 percent of MTF persons had a high-risk sexual experience in the last year. Yet another found that 35 percent of MTF persons (and 2 percent of FTM persons) had HIV, and again, persons of color — in this case, African-American identified individuals — were at a greater risk. Indeed, in this study, African-American trans persons (FTM and MTF) were approximately three to 12 times more likely to have HIV. Given these data, the cynic in me questions, “Is anyone even trying to prevent HIV in trans persons?” Continue reading

Ten Things Your Mother Never Told You About Condoms

holding condomThere are so many claims made about condoms these days that it’s hard to separate fact from fiction. Perhaps you first heard some of these things from your mother, who sat you on her lap one day and calmly demonstrated proper use, with guidelines for when appropriate. Yeah, right. She probably would have spanked you for even mentioning the word. As for your dad, get real.

Like most of us, you probably first heard about condoms in the locker room or from your friends. Or you read something in a magazine or on social media. As a result, your poor head is filled with various myths, rumors, half-truths, and bad jokes, interspersed with a few actual facts. So, herewith are 10 more half-truths or untruths to add to your noggin.

1 Condoms have a high failure rate. According to one website, “18 couples out of 100 who say they use condoms as their primary contraception method will experience an unintended pregnancy in the first 12 months.” Of course, this includes folks out of this same 100 couples who happened not to be using a condom at the time they got pregnant (or during the whole time) — which greatly reduces a condom’s effectiveness — as well as those who were not using the condoms correctly when they got pregnant. (By the way, though this informative website refers to condomology as “the study of condoms,” starting a sentence with “condomologically speaking” is probably not a good idea.) The failure rate decreases substantially, however, when condoms are properly used: “If used correctly every time you have sex, male condoms are 98% effective. This means that two out of 100 women using male condoms as contraception will become pregnant in one year.” Continue reading

April Is National Sexual Assault Awareness Month

A Planned Parenthood Arizona supporter shared her story of sexual assault with us in observance of National Sexual Assault Awareness Month.

AllSexWantedSexI had never had a boyfriend before and it was flattering to have someone dote on me and give me all of his attention. And he was a wonderful friend. We could talk to one another for hours, especially about music and art. Was I attracted to him? Not really, but did I need to be? He was someone to hang around with; a kindred spirit. College was my first priority. But, after a couple of months of friendship, he was insistent on more. I held him off for a few weeks, but he was not leaving the topic alone.

“I love you. Don’t you love me? If you love me, then sex is the next step. It is the ultimate connection.” Continue reading

“Instrument of Torture”: The Dalkon Shield Disaster

This Dalkon Shield is archived at the Dittrick Medical History Center and Museum at Case Western Reserve University. Photo: Jamie Chung

This Dalkon Shield is archived at Case Western Reserve University. Photo: Jamie Chung

These days, IUDs, or intrauterine devices, have stellar reputations as highly effective contraceptives. Along with implants, IUDs can be more effective than permanent sterilization, and their safety record is fantastic. We also have powerful regulations in place to keep dangerous medical devices off the market, and the FTC can keep manufacturers from making false claims in advertising.

But a previous generation of birth-control users might associate IUDs with dangerous pelvic infections and miscarriages. That’s because a single device, called the Dalkon Shield, almost single-handedly destroyed an entire generation’s trust in IUDs. At the time of its debut, there were dozens of IUDs on the market — but the Dalkon Shield unfairly tainted the reputation of all of them. With no FDA or FTC regulations reining in untested devices or false advertising, women in the late 1960s and early 1970s didn’t enjoy the protections that we take for granted today. And it was actually the Dalkon Shield’s string, which was made with a material and by a method that hasn’t been used in IUDs before or since, that made it dangerous.


Today, IUDs are the most popular form of contraception among physicians wishing to avoid pregnancy.


We’ve known about IUDs for more than a century, and have made them out of ebony, ivory, glass, gold, pewter, wood, wool, and even diamond-studded platinum. These days, IUDs release hormones or spermicidal copper ions, but these older devices were simply objects inserted into the uterus that acted as irritants, possibly enlisting the immune system to kill sperm. They were not as effective as modern-day IUDs.

The Dalkon Shield was invented in 1968, was made primarily of plastic, and had “feet” — four or five on each side — to prevent expulsion. In 1970, after being marketed independently, it was sold to family-owned pharmaceutical giant A.H. Robins Company, of Robitussin fame. It was manufactured in the same factory where ChapStick was produced, and retailed for $4.35.

Dr. Hugh J. Davis, the Dalkon Shield’s primary inventor, claimed that users of his device had a 1.1 percent pregnancy rate — but that number was based on a small, methodologically flawed study conducted over eight months. In fact, the Dalkon Shield had a 5.5 percent failure rate over the course of a year. The fact that the Shield didn’t provide high protection against pregnancy was a huge problem, but its design also dramatically increased risk for pregnancy complications. Of the tens of thousands of users who became pregnant while wearing the Dalkon Shield, 60 percent of them had miscarriages. Continue reading

Shouting My Abortion

shout your abortionI’ve always been a T-shirt kind of guy, wearing my shirts to proclaim allegiance to everything from my favorite rock groups to science, humor, politics, and the organizations I support, one of which is Planned Parenthood. My collection currently includes four Planned Parenthood shirts, and I wear them proudly whenever I can. While some might view this as confrontational, I see it as a potential means to open up communication. Most of the time, people don’t even notice. Occasionally, though, someone will notice, as for instance when someone thanks me for wearing my shirt. So far, no one has vocally challenged me, but every once in a while I get one of those icy stares — the kind that bore straight through you. Even a stare has value, however, in that someone who may not support Planned Parenthood must still acknowledge the fact that here is someone who does — a male, no less. Besides, my wife thinks I look good in pink. How can I argue with that?


I would not want my body ever considered to be a mere vessel for childbirth, with fewer rights than the fetus within me.


When I saw a photo of my hero Gloria Steinem wearing an “I Had an Abortion” T-shirt, my first thought was, I want one, too. The shirt was designed by Jennifer Baumgardner, co-producer of the award-winning 2005 documentary I Had an Abortion. The photo was taken by Tara Todras-Whitehill, who contacted Baumgardner and suggested photographing all of the women in the film wearing their “I Had an Abortion” T-shirts.

I did find a men’s version of the shirt still available online, though the merchant warned that it was “controversial,” a fact that has never stopped me before. Continue reading