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About Anna C.

Anna first volunteered for Planned Parenthood as a high school student in the 1990s. Since then, she has received a bachelor’s degree from UC Berkeley and a master's degree in epidemiology from the University of Arizona. 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: 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

STD Awareness: Is Withholding HIV Status a Crime?

If your sexual partner had HIV and did not tell you about it, how would you feel? Most of us would feel betrayed, lied to. We might be scared that we’d contracted the virus, too. If we had known, maybe we would have chosen not to have sex, or might have taken different precautions. Perhaps we’d be angry that someone took away our ability to evaluate the risk for ourselves, and instead decided for us that the sex was worth the risk.


Disclosing HIV status can make someone vulnerable to risks, but open communication forms the basis of healthy relationships.


Many people think it should be against the law for someone with HIV to withhold their status from a sexual partner. To do so seems like a violation of someone’s right to make their own decisions about the sex they have, a denial of pertinent information that needs to be factored into one’s decision-making.

Then why are organizations like American Psychological Association, the American Medical Association, and the U.S. Department of Justice opposed to these types of laws?

Meet Nick

In June 2008 in Iowa, Nick met Adam on a dating website. They hung out at Nick’s apartment, spent a few hours getting to know each other, and eventually had sex. A few days later, Adam heard through the grapevine that Nick was HIV-positive.

The next month, three armed detectives stormed Nick’s workplace, took him to the local hospital, and ordered nurses to take his blood. Meanwhile, police were searching his house for drugs — not illicit drugs, but lifesaving antiretroviral drugs. Nick was arrested. His crime? Criminal transmission of HIV.

Even though Adam never got HIV. Continue reading

STD Awareness: Fighting STDs with Education

Here in Arizona, Tucson Unified School District has been taking steps toward adopting a comprehensive, inclusive, age-appropriate, and medically accurate sex education program, but it’s been repeatedly delayed by a vocal minority. In September, a vote was put on hold after the superintendent recommended changing the proposed curriculum to focus on abstinence as the preferred method for avoiding STDs and unintended pregnancies.


You can make your voice heard. Learn how!


Additionally, many opponents of TUSD’s proposed curriculum believe its inclusiveness of LGBTQ kids is tantamount to “indoctrination,” that this type of education “sexualizes” children, and that discussions of gender identity will confuse students. LGBTQ kids have traditionally been ignored or demeaned in sex education programs, and their health matters too. Presenting medically accurate and age-appropriate information does not indoctrinate or sexualize children — it simply helps them make healthy decisions, no matter who they are. And these days, students need to be empowered with as much knowledge as possible to make decisions that protect their health.

Confronting the STD Epidemic

Last month, the Centers for Disease Control and Prevention (CDC) released its annual report on sexually transmitted diseases. It did not contain good news. For the fifth straight year, STD rates are climbing.

Continue reading

STD Awareness: Can Gene Editing Cure HIV?

For the first time in history, someone with HIV has been treated with cells edited in the lab. It was a bold attempt to try to replicate previous successes in “curing” HIV through bone marrow transplants, but the results were a mixed bag.

Your DNA is like a book, and each sentence is a gene. Imagine a word is misspelled. Sometimes, a misspelling won’t affect your ability to understand the sentence, but other times, it will be so bad that you’ll have trouble figuring out the intended meaning. Think of the difference between “I drive a car” and “I driv a car,” or “I like food” and “I like flod.” You might not be able to tell what that last sentence is even trying to say! Those misspellings are mutations, and sometimes mutations are relatively benign (“I driv a car”), while other times they can cause diseases (“I like flod”).


A mutated version of the CCR5 gene confers near-immunity to HIV — but increases susceptibility to other viruses.


CRISPR, pronounced crisper, is a powerful new technology that can edit genes. By cutting DNA at a specific location and replacing some of the letters in the genetic alphabet, CRISPR can edit genes like you can edit a document using “find and replace.” The hope is that, someday, CRISPR could be used to fight disease by tweaking faulty genes. Continue reading