About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received her bachelor’s degree from the University of California and is now back in school studying science. As an ode to her fascination with microbes, she writes the monthly STD Awareness series, as well as other pieces focusing on health and medicine.

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

STD Awareness: Why Should You Care About Oral Gonorrhea?

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: Sexually Transmitted Infections and Seniors

For a while now, seniors plus sex has equaled a surefire route to punchlines and nervous giggles. Take, for instance, an episode of Amy Poehler’s old TV show, Parks and Recreation, titled “Sex Education.” In the opening scene, Poehler’s character Leslie Knope sets up the premise of the episode:

Soon, Knope and her team of public servants find themselves giving information about sexual health to an audience full of elderly citizens, which attracts the attention of abstinence advocates, who accuse her of moral depravity. Hilarity ensues. Funny stuff!

Funny, but based on a not-so-funny reality: Baby boomers and other older people are facing rising rates of sexually transmitted diseases (STDs), both here in Arizona and nationwide, as well as across the pond in Jolly Old England.

Earlier this year, the Arizona Department of Health Services released data showing an increase in STD rates among people 55 years of age or older. For example, in Maricopa County, this population more than doubled its gonorrhea rate, which climbed from 6.1 cases per 100,000 people in 2012, to 12.7 per 100,000 people in 2014. That’s still much lower than the overall rate for Arizona, which was 97.8 cases per 100,000 people in 2013, but the fact that the rates of gonorrhea and other STDs are spiking among the 55-plus population is alarming nevertheless. Continue reading

STD Awareness: Which STDs Are Vaccine Preventable?

scientistWouldn’t it be great if we could wipe sexually transmitted diseases off the face of the earth? If vaccinologists have a big “to-do” list out there, probably every single infectious disease is on it, including every STD. But some STDs have a higher priority than others, while other pathogens, unfortunately, don’t yield to our efforts quite as easily as other vaccine-preventable diseases.

Celebrate National Immunization Awareness Month by taking a look at a vaccinologist’s hypothetical “to-do” list below. While we already have a couple of STDs checked off that list, there is still more progress to be made!

check boxHuman papillomavirus: Gardasil, the most widely used HPV vaccine, introduced a new-and-improved version earlier this year. Gardasil 9 protects against seven strains of HPV that collectively cause 90 percent of cervical cancers and anal cancers, plus the two HPV strains that are jointly responsible for 90 percent of genital warts. Not only that, but vaccination against HPV will also reduce the frequency of “pre-cancers,” which are cellular abnormalities that can be treated before progressing into full-fledged cancer — meaning less time, money, and anxiety spent dealing with follow-up procedures and treatments. In fact, Australia is already seeing a huge nosedive in genital warts and pre-cancers — all thanks to their sky-high HPV vaccination rates.

check boxHepatitis A and B: Hepatitis, a disease of the liver, can be caused by several types of viruses, including hepatitis A virus and hepatitis B virus. Both can be transmitted sexually, but thanks to the vaccines, you can ask to be protected against them using a combination vaccine, meaning you’ll only have to get three shots over a six-month period rather than the five shots you’d receive if you were vaccinated for the two viruses separately. Continue reading

Teen Talk: Gardasil, a Shot of Prevention

pink vaccine cartoonOne of my least-favorite medical memories must have happened when I was 5 years old, give or take. All I remember is that I was very small, surrounded on all sides by my mom, my pediatrician, and a nurse, and shrinking into a corner as the nurse came at me with a needle. I was squirming and protesting and cringing, but she grabbed my arm and pierced it with a syringe, quick as lightning. Before I could howl in protest, it was over.

Arm yourself against genital warts with Gardasil!

But here’s the thing: It hurt. A lot. And for days afterward, I went about my business feeling as if I had been punched in the arm. When I complained to my mom about how sore I was, she said that my muscles were completely tensed up, and shots hurt more when your muscles are tense. That fact only compounded my annoyance — why had that mean old nurse pricked me at the height of my freakout? If someone had just explained it to me, maybe I could have calmed down enough to relax my muscles and minimize the pain.

That incident made a mark on me, and once I hit adulthood I saw no reason to continue inviting the painful sting of immunization if I didn’t have to. It wasn’t until vaccine-preventable diseases like pertussis and measles started making a comeback that I had to admit to myself that avoiding immunization wasn’t anything to be proud of, and I started getting all my booster shots and yearly influenza vaccinations. Continue reading

STD Awareness: Genetics and the Gonococcus

Illustration: CDC

Illustration: CDC

Ever since the discovery of effective antibacterial therapies less than a century ago, humans have been able to easily cure gonorrhea, the sexually transmitted scourge that laid waste to fallopian tubes and robbed newborns of vision. Most of us in the developed world have forgotten that this disease was once a leading cause of infertility in women and blindness in babies — and still is in much of the developing world.

Unfortunately, gonococci — the species of bacteria that cause gonorrhea — have been evolving resistance to every antibiotic we’ve thrown at them, including sulfonamides, penicillins, tetracyclines, macrolides, fluoroquinolones, and narrow-spectrum cephalosporins. We have one remaining first-line gonorrhea treatment left: extended-spectrum cephalosporins, which include cefixime, which is taken orally, and ceftriaxone, which is administered as a shot — and resistance is emerging to those drugs, as well.

Gonococci don’t swap potato salad recipes at family reunions — they swap genetic material!

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. Gonococci can acquire resistance to antibiotics in three ways.

First, a genetic mutation can endow bacteria with special antibiotic-fighting powers, making it harder for a drug like penicillin to attach to their cells and destroy them. Such a mutant is more likely to gain evolutionary traction if it finds itself in an antibiotic-drenched environment in which resistance to that drug allows it to “outcompete” other bacteria. Indeed, antibiotic resistance was first documented in the 1940s, just years after sulfonamides and penicillin were introduced as the first effective cures for gonorrhea. Continue reading

Teen Talk: The Truth About Tampons

tamponsIf you had told the 13-year-old version of me that someday, I’d be writing about tampons on a blog, my first reaction would be, “Eww, gross!” But here I am, writing about tampons. Life can take you in unexpected directions.

When I was growing up, tampons had a mixed reputation. There were those people who thought that tampons would somehow make you lose your virginity. Then there were fears about infections, or the chemicals that were used.

In a school or in a pool, tampons are safe and pretty cool.

Me, I was just worried they’d hurt, and I never wanted to use them. My refusal to use a tampon meant that I couldn’t go swimming in gym class — and everyone knew that I was on my period. There I was, sitting in the bleachers as everyone else was splashing around. I knew I wasn’t the only one who didn’t want to wear a tampon — during lunchtime, a few of us quietly talked about our fears, but none of those other girls joined me on the sidelines. I think they were more concerned about their classmates knowing their business. During our six-week swimming unit, only a few girls sat out their periods in the bleachers.

Tampons weren’t the right choice for me at that time, but for other girls, they were convenient and comfortable. If you’re curious about tampons but have some concerns, it might be worth looking into them so you can make an informed decision. I’m glad we have so many options to deal with our periods — my mom would tell me about these crazy belts with buckles or pins that they’d have to put up with every month. But you have a ton of things to choose from when finding the products that work best for you. Continue reading