STD Awareness: Sexually Transmitted Diseases and Pregnancy

Every month since January 2011, we’ve been sharing installments of our STD Awareness series, and each month, we’ve encouraged you to protect yourself from sexually transmitted diseases (STDs) by using dental dams and condoms. But what if you’re trying to get pregnant? In that case, you’re probably not using condoms! However, it is very important that partners know their STD status — being screened and treated for STDs prior to pregnancy is a good idea for your health, and can protect your future baby.


If you and a partner are trying to get pregnant, you might consider being screened for STDs together.


When present during pregnancy, certain STDs can have negative health effects for you or your future baby (including preterm labor, stillbirth, low birth weight, pneumonia, certain infections, blindness, and liver disease), especially if they are not cured or treated in time. Receiving prenatal care can help prevent these problems, so it is important to be screened and treated for STDs prior to or early in your pregnancy.

During pregnancy, the immune system undergoes changes, which are probably necessary to ensure that the body doesn’t reject the fetus — normally, the immune system recognizes non-self cells as potential pathogens and attacks. These immune system changes might make a pregnant person more susceptible to disease. Latent viral infections, like genital warts or herpes, might come out of dormancy. Additionally, anatomical changes lead to a larger exposed area of the cervix, which is potentially more vulnerable to initial infections. Continue reading

Over 90 Percent of What Planned Parenthood Does, Part 6: Vaccinations

Welcome to the latest installment of “Over 90 Percent of What Planned Parenthood Does,” a series on Planned Parenthood Advocates of Arizona’s blog that highlights Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

You know what they say: An ounce of prevention is worth a pound of cure. Public health experts agree that vaccines are one of the most important advancements in medicine, and are incredibly safe and effective in preventing infectious disease. Many infectious diseases that used to lay waste to their victims are now unknown to many of us in the developed world — polio, whooping cough, measles, and rabies struck fear in the hearts of our forebears, but most young people today barely know what they are (although low rates of vaccination can still lead to outbreaks, such as 2008’s measles outbreak in Tucson). Smallpox, once a terrifying scourge, has been wiped off the planet thanks to vaccination campaigns.


We offer vaccinations against hepatitis A and B, as well as HPV.


Vaccines work by introducing antigens to your immune system. An antigen is a substance, such as a protein on the surface of a virus, that the immune system can recognize as dangerous. It is then able to attack the pathogen and, often, create a “memory” of that pathogen so it can attack it in the event of reinfection. The antigens in vaccines are very safe, and can be derived from many sources, such as inactivated (dead) or attenuated (weakened) pathogens, or fragments of pathogens. Some vaccines, such as those protecting against human papillomavirus and hepatitis B, are made with laboratory-synthesized fragments of the surface proteins of viruses, which are sufficient to produce immune response despite being completely noninfectious.

Planned Parenthood Arizona offers vaccinations against hepatitis A, hepatitis B, and human papillomavirus (HPV). All three of these viruses can be transmitted sexually, and hepatitis B and HPV can cause cancer if the infections become chronic. The hepatitis vaccines have led to all-time lows in rates of hepatitis A and hepatitis B; the HPV vaccine is still new, but emerging evidence suggests a possible decrease in HPV rates as herd immunity grows. Vaccination doesn’t just benefit you and your partner(s) — it benefits society as a whole. Continue reading

World Hepatitis Day: The History of the Hepatitis B Vaccine

Hepatitis B particles are made of a protein shell with viral DNA inside. Image: CDC

A few hepatitis B virus particles amid an excess of surface proteins. Image: CDC

In the early 1970s, Ted Slavin, a hemophiliac, learned his blood was special. Over a lifetime of transfusions, he had slowly amassed a huge collection of antibodies, which are proteins produced by the immune system that attach to invaders, such as viruses and bacteria. When he started receiving transfusions in the 1950s, blood wasn’t screened for diseases, which meant that he’d been repeatedly exposed to some pathogens. His immune system manufactured large amounts of protective antibodies to battle these constant invaders, one of which was hepatitis B virus (HBV) — resulting in blood with extremely high concentrations of hepatitis B antibodies.


After sunshine and smoking, hepatitis B is the most common cause of cancer.


His physician relayed this discovery to Slavin — most doctors wouldn’t have bothered, and in fact might have surreptitiously sold his blood to researchers. Back then, scientists were at work on a hepatitis B vaccine, and hepatitis B antibodies were a hot commodity. Likewise, Slavin needed money — his medical condition precluded regular work, and treatments were costly. He contracted with labs and pharmaceutical companies to sell his antibodies directly, for as much as $10 per milliliter and up to 500 milliliters per order.

When someone has a chronic HBV infection, the virus has “hijacked” some of his or her cells, “tricking” them into manufacturing copies of the virus. A virus consists of an outer protein shell housing genetic information — the blueprint that cells follow when they produce virus copies. When hepatitis B viruses are manufactured in cells, an excess of surface proteins is produced — these waste products litter the bloodstream, and testing for their presence allows people to be diagnosed with HBV infections. These surface proteins are called antigens — and as luck (or evolution) would have it, the antibodies our immune systems produce can attach to viral antigens, helping us to keep pathogens at bay. Continue reading

The Slow Journey from HPV Infection to Cervical Cancer

Healthy cervical cells as seen under a microscope. Image: National Cancer Institute

Healthy cervical cells as seen under a microscope. Image: National Cancer Institute

January is Cervical Health Awareness Month. The biggest threat to cervical health is human papillomavirus, or HPV, a virus that is transmitted through a wide variety of sexual activities. If you haven’t yet been sexually active, the best thing you can do to protect cervical health (whether you have a cervix or not) is to be vaccinated against HPV. If you have been sexually active, the vaccine could still be effective, assuming you haven’t already been infected with the strains of HPV against which it protects. And, if you are, or have been, sexually active and have a cervix, it is important to be screened with regular Pap tests (also called Pap smears). When caught in its precancerous stages, cervical cancer can be avoided.


HPV may be tiny, but it packs a punch.


There are more than 100 strains of HPV, approximately 40 of which can be sexually transmitted; of these, 18 strains are thought to cause cancer. Chronic infections by cancer-causing HPV strains, such as HPV-16 and HPV-18 (which together are responsible for 70 percent of cervical cancers), can lead to the development of abnormal cells, which might eventually become cancerous.

In the United States, HPV is the most widespread sexually transmitted disease — 6 million Americans are infected with HPV annually, although most are asymptomatic and unaware they were infected. For most people, the infection clears up within 8 to 13 months, while for others, the infection can lurk undetected. If you are unlucky enough to develop a chronic HPV infection, then you are at increased risk for certain cancers — depending on the site of the infection, HPV can cause cancers of the cervix, anus, and other genitals, as well as the throat. Continue reading

STD Awareness: Intestinal Parasites

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library.

This colorized scanning electron micrograph shows Giardia lamblia reproducing asexually. Image: Stan Erlandsen, CDC’s Public Health Image Library.

Most sexually transmitted diseases are caused by bacteria or viruses, but some are caused by organisms that are classified as completely different lifeforms. Trichomoniasis, for example, is caused by a protozoan organism; protozoa occupy their own kingdom, separate from plants, animals, and bacteria. Intestinal parasites are often protozoan organisms, but can also include parasitic worms (which are members of the animal kingdom). They are spread through contact with fecal matter – and as such, they can be transmitted sexually as well as nonsexually. Intestinal parasites are usually transmitted by fecal contamination of food or water, and are most common in areas with insufficient sewage treatment and untreated water in the wilderness. Some pathogens, however, have low infectious doses, making their sexual transmission more likely.


What has eight flagella and can live in your intestines?


Oral contact with the anus, also called anilingus or rimming, is the primary means of the sexual transmission of these pathogens. Putting fingers or hands in your mouth after they have had contact with the anus is also risky. Other modes of transmission include oral sex, as genitals can be contaminated with feces, as well as sharing sex toys and other equipment. For these reasons, it is very important to use dental dams or latex gloves during contact with the anus; to clean the anus before engaging in rimming; to clean or use condoms on shared sex toys; and to use condoms or dental dams during oral sex. Continue reading

STD Awareness: The Future of Treatment for HIV/AIDS

This scanning electron micrograph shows HIV particles (colored yellow) infecting a human T cell. Image: National Institute of Allergy and Infectious Diseases, National Institutes of Health

This scanning electron micrograph shows HIV particles (colored yellow) infecting a human T cell. Image: National Institute of Allergy and Infectious Diseases, National Institutes of Health

In 2006, an HIV-positive man was diagnosed with leukemia. First he received chemotherapy, and when the cancer returned his doctor recommended a stem-cell transplant with tissues obtained from a bone-marrow donor. After finding an unusually high number of compatible donors, his doctor, Gero Hütter, had a simple idea that would change the course of HIV research. Dr. Hütter knew of a rare genetic mutation that confers immunity to many strains of HIV, including the strain that infected his cancer patient. And new blood cells, including immune cells, are manufactured by bone marrow. What if he could find a bone-marrow donor with this mutation? What effect would it have on the HIV infection?

Five years after his cancer diagnosis, the man, known as the Berlin patient and recently identified as Timothy Ray Brown, is in remission from cancer … and the most sensitive tests have been unable to detect HIV anywhere in his body, despite the discontinuation of antiretroviral drugs. Scientists are a cautious lot, careful not to make grand statements without qualifying them with words like “seem” and “suggest.” But more and more, researchers are starting to say that Brown could be the first case in which a cure for HIV was attained.

Human immunodeficiency virus, or HIV, has been the focus of intense research since the 1980s, when it was identified as the causative agent of AIDS. Many anti-HIV drugs have been developed since then, though worldwide, less than a third of people who need the drugs have access to them. Those with access, however, have significantly improved health outcomes and longer life expectancy. Continue reading

What is HIV?

December 1st is World AIDS Day, so we’re focusing on HIV this month in our STI Awareness series.

Let’s break down the name:
H – Human: This virus only infects humans and is only passed from human to human.
I – Immunodeficiency: This virus weakens the immune system by destroying cells that fight disease and infection.
V – Virus: This is a virus. Unlike other viruses, however, this virus does not leave the body. This is the mystery that scientists and doctors are working to solve.

HIV is an immune system virus. It hides for a long time in your cells and attacks the T-cells, aka: CD4 cells. Over time HIV can destroy so many CD4 cells that your body cannot fight infection anymore. When that happens, HIV leads to AIDS. While all of this is very scary, the bright spot is that this is an easily preventable disease. Continue reading

STD Awareness: Cytomegalovirus and Molluscum Contagiosum

Most sexually transmitted diseases (STDs) are caused by microorganisms – lifeforms that are too small to be seen without a microscope. Many STDs, however, are caused by viruses, which technically aren’t even alive. Rather, viruses are pieces of genetic information that are stored in protein capsules. When these capsules come into contact with a host cell, the genetic information is able to enter the cell and hijack its machinery so that the host cell manufactures copies of the virus, as well as potentially harmful viral proteins. Many well-known STDs, such as herpes and HIV/AIDS, are caused by viruses, but this month we will focus on two lesser-known viral STDs, cytomegalovirus and molluscum contagiosum. Your local Planned Parenthood health center, as well as other clinics, health departments, and private health-care providers, can help you get a diagnosis and treatment for these STDs.

Cytomegalovirus leaves granules inside its host cells called inclusion bodies, pictured here. Photograph from the CDC’s Public Health Image Library.

Cytomegalovirus leaves granules inside its host cells called inclusion bodies, pictured here. Image: Public Health Image Library, CDC

Cytomegalovirus

The bad news is that most people are infected with cytomegalovirus (CMV) at some point in their lives. About 80 percent of the U.S. population is estimated to be carriers, about 4 in 10 Americans are infected with CMV before puberty (usually through contact with saliva), and adults can be reinfected through sexual activity. The good news is that among healthy adults, a CMV infection usually does not have any symptoms, though if they do they could seem like a mild case of mono. Being reinfected with the virus later in life also carries with it only a small risk for symptoms in healthy adults.

And back to the bad news: While an infection with cytomegalovirus usually does not have symptoms, if someone is infected while pregnant it can harm the fetus. About 1 in 100 U.S. babies is infected with CMV, but usually doesn’t show symptoms. Every year in the United States, around 5,500 babies are born with symptomatic cytomegalic inclusion disease (CID). Symptoms of CID vary, but the most severe include mental retardation and hearing loss. If the mother was already infected before conception, there is a 2 percent chance the virus will be transmitted to the fetus; however, if the infection occurs during pregnancy, this risk jumps into the 40 to 50 percent range. Continue reading