STI Awareness: Viral Hepatitis

Posted on May 22, 2012 by Anna

Hepatitis A virus particles are pictured in this electron micrograph. Image: Betty Partin, CDC

Hepatitis isn’t commonly thought of as a sexually transmitted infection (STI) — for most people, hepatitis conjures images of contaminated food or unsanitary restaurants. But hepatitis should be on the radar of anyone who is sexually active. There are several different viruses that cause hepatitis, and some can be sexually transmitted, including hepatitis A (HAV), hepatitis B (HBV), and, to a lesser extent, hepatitis C (HCV).

While HBV is most efficiently transmitted through blood, it can also easily hitch rides from person to person via sexual fluids. However, we covered HBV in depth last year in observance of World Hepatitis Day. As May is Hepatitis Awareness Month, we’ll turn the spotlight on HAV and HCV for this month’s installment of our STI Awareness series.

Hepatitis A (HAV)

HAV spreads through fecal-oral contact and is more widespread in parts of the world with poor sanitation. It is relatively rare in the United States, although in 2003 there was a hepatitis A outbreak outside of Pittsburgh — the largest in the United States — that was traced to improperly washed raw scallions. All told, there were 650 confirmed illnesses and four deaths. HAV is very resilient and can survive outside a host for long periods of time – other foodstuffs it can contaminate include filter-feeding shellfish, which can concentrate HAV from contaminated seawater in their tissues. When these shellfish are undercooked, they can pack quite a punch as billions of virus particles are released into the unsuspecting diner’s body.

Vaccination against hepatitis A confers lifelong immunity while sparing you from illness caused by a natural infection.

Unfortunately, no matter how well you clean your fresh produce or how long you cook shellfish, certain sexual activities can increase your risk of acquiring HAV. As with intestinal parasites, which can be present in minuscule amounts of fecal matter, so too can virus particles be present in microscopic bits of feces. Oral contact with the anus (“rimming” or anilingus) is the riskiest activity in terms of HAV transmission — oral-genital contact can also do the trick, as can manual contact between the anus and the mouth. While hepatitis A outbreaks have been reported among MSM – men who have sex with men – populations, oral-anal contact is associated with increased risk for HAV infection regardless of sexual orientation. To reduce your risk of sexual HAV transmission, use latex condoms or dental dams during oral activities. HAV can also be transmitted via blood, and hepatitis A outbreaks have been reported among IV drug users. Continue reading →

STDs 101: An Introduction to Sexually Transmitted Diseases

Posted on April 10, 2012 by Anna

It’s April, which for Arizonans means a gradual increase in temperature as we head toward summer. But at Planned Parenthood Arizona it also means that it’s time to focus on sexually transmitted diseases (STDs) in observance of STD Awareness Month. While we regularly provide information about sexual health with our monthly STD Awareness series, April is the time of year to fix the spotlight on sexually transmissible microbes and the infections they cause. April is also the time of year when Planned Parenthood Arizona offers coupons for discounted STD screening, so if you’ve been putting it off, now’s the time!

Symptoms of Sexually Transmitted Diseases

First, some basic facts. STDs can be transmitted through all sexual activities — vaginal, anal, or oral sex, as well as activities involving skin-to-skin contact. STDs are most commonly caused by viruses or bacteria, though they can be caused by other agents as well, including animals! Each STD is unique, with unique symptoms, but common symptoms include:

rashes, open sores, blisters, or warts in the genital area
swelling or tenderness
pus, bleeding, odor, or abnormal discharge
itching in the genital region
burning sensation during urination

It’s best not to focus too closely on symptoms, though – most people with STDs actually don’t experience any symptoms whatsoever! As they say in the biz, “The most common symptom of an STD is … no symptom.” For example, most people with herpes either have no symptoms or have mild symptoms that go unnoticed. Ten percent of males and 80 percent of females with gonorrhea don’t experience symptoms, and most people with chlamydia are asymptomatic. And HIV symptoms usually take a decade to show up. If you are, or have been, sexually active, you can’t assume that the absence of symptoms means you’re in the clear. To know for sure if you have an STD, the best thing you can do is to get yourself tested. Continue reading →

Book Club: The Origins of AIDS

Posted on April 3, 2012 by Anna

The Origins of AIDS
By Jacques Pepin
Cambridge University Press, 2011

Most sexually transmitted infections go back thousands of years. Gonorrhea, for example, was first described by a Greek physician in A.D. 150, and pubic lice have been evolving right along with us since before we became Homo sapiens. This might have been one reason why it was such a shock when a strange new virus came to our attention in the early 1980s. We soon discovered that it was transmitted sexually and through infected blood, but where did it come from?

We have intriguing evidence that HIV as we know it has been in existence since at least the 1930s.

HIV has been around since before the 1980s, though it remained unnoticed and unidentified by medical science. The earliest confirmed case of HIV was in 1959, the proof found in a sample of blood from the Belgian Congo, saved in a freezer for decades and later analyzed for the virus. Other early cases of HIV infection that have retrospectively been confirmed include that of a Norwegian sailor, who must have been infected while visiting African ports in the early 1960s. He, his wife, and his child (who was apparently congenitally infected) all died in 1976, and their tissues were tested 12 years later and found positive for HIV.

Jacques Pepin — a professor and microbiologist, not to be confused with the chef of the same name — does some serious detective work to find the most plausible explanation for HIV’s origins. While he doesn’t skimp on the science, the story of AIDS’ origins can’t be told without getting into the history of Europe’s colonization of Africa in the 20th century. This period, followed by the era of post-colonization, found many societies in upheaval. Urbanization, unemployment, and migration facilitated the spread of HIV in Africa during much of the 1900s, and once it left the continent it was able to hitch a ride from host to host, traveling the world. Continue reading →

Book Club: The HPV Vaccine Controversy

Posted on January 25, 2012 by Anna

The HPV Vaccine Controversy: Sex, Cancer, God, and Politics: A Guide for Parents, Women, Men, and Teenagers
by Shobha S. Krishnan, M.D.
Praeger Publishers, 2008

The HPV vaccine, released in 2006, was ripe for controversy, at least in places like the United States. Here there is a strong anti-sex undercurrent from certain segments of society, and fears abound that a vaccine that protects against a common sexually transmitted infection — especially one whose symptoms disproportionately affect females — would encourage sexual promiscuity among our nation’s teenage girls. In addition, there is a segment of society that is deeply suspicious toward vaccines, a fear that is often fueled by misinformation or misunderstanding.

The HPV Vaccine Controversy is an excellent resource for anyone considering vaccination, as well as those who have already been exposed to human papillomavirus.

While Krishnan’s book is an invaluable guide for anyone considering the vaccine for themselves or their child, it covers much wider territory than just the vaccine and its attendant controversies. The first half of the book is devoted not to a discussion of vaccination but to a thorough and accessible description of female anatomy (although apparently her claim about the teenage cervix is controversial), the lifecycle and transmission of human papillomavirus (HPV), cancer screening techniques such as the Pap test, and the slow development of cancer caused by HPV infection. It also has good information on genital warts, which are caused by certain strains of HPV (such as HPV-6 and HPV-11) that often get overlooked in discussions of their cancer-causing cousins (such as HPV-16 and HPV-18). This makes the book an excellent resource for anyone who has had an abnormal Pap test and has questions — the detailed descriptions of the various cervical-cell abnormalities and the different stages of cervical cancer will assist the lay reader in making sense of her diagnosis. Continue reading →

HPV Vaccines: Separating Fiction from Fact

Posted on January 24, 2012 by Anna

Gardasil is one of two HPV vaccines. It protects against two cancer-causing strains of HPV and two wart-causing strains.

You’ve probably heard a lot about the HPV vaccine, which protects against the sexually transmitted pathogen human papillomavirus — which itself can lead to cancers of the cervix, anus, throat, and more. Unfortunately, there is a lot of misinformation about the vaccine, such as Michele Bachmann’s debunked claim that it causes mental retardation. But, even before Bachmann gave us her two cents, there have been plenty of falsehoods flying around about the HPV vaccine.

Myth: Vaccination against HPV will increase sexual promiscuity among vaccine recipients.

Fact: Studies show that this fear is unfounded.

A study published this month in the American Journal of Preventive Medicine contradicts this claim. In a group of more than 4,000 young females, there was no significant difference between the vaccinated and the unvaccinated in terms of number of sexual partners or the age at which sexual activity began.

There are around 150 strains of HPV, about 15 of which can cause cancer. Together, HPV-16 and HPV-18 cause about 70 percent of cervical cancers.

Besides, the vast majority of teenagers who choose abstinence do so for reasons other than a fear of contracting HPV. Additionally, HPV is one of many sexually transmitted infections (STIs); if fear of contracting an STI were the only factor in teenagers’ celibacy, a vaccine that protected against only one STI would not remove this fear.

(It might bear pointing out that when the HPV vaccine was approved for boys and men, fears about male promiscuity didn’t seem to run as rampant.)

Myth: Because the HPV vaccine only protects against two cancer-causing strains of HPV, it isn’t useful in cancer prevention.

Fact: The two cancer-causing strains of HPV that the vaccine protects against account for 70 percent of all cases of cervical cancer. Furthermore, Gardasil protects against two additional strains of HPV, which together are responsible for 90 percent of genital warts. Continue reading →

The Slow Journey from HPV Infection to Cervical Cancer

Posted on January 18, 2012 by Anna

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 infection – 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 →

Over 90 Percent of What Planned Parenthood Does: Part 1, Flu Shots

Posted on January 12, 2012 by madelaineelizabetharchie

Image: National Institutes of Health

Welcome to the first installment of “Over 90 Percent of What Planned Parenthood Does,” a new series on Planned Parenthood Advocates of Arizona’s blog. In this series we will highlight Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

If you’re like me, you’ve been scared to get your flu shot ever since seeing that Fox News story about the woman who developed a rare neurological disease after getting a standard flu shot. I’m not even going to link to it here because if you’ve already seen it you know what I’m talking about, and if you haven’t, you don’t want to. Trust me. Go look for it yourself if you want to see it so bad.

It’s not too late to get a flu shot.

Anyway, I hadn’t gotten one for years because I was afraid of being one in a million and contracting Guillain-Barré syndrome (GBS), a rare, paralyzing illness that causes fever, nerve damage, and muscle weakness. Obviously, as has been pointed out to me by parents, friends, and doctors, the chances of that happening are so small that they aren’t even worth worrying about. Risks from getting the flu, especially if you’re a child or senior, are much more definite. (Furthermore, a 2011 study found no link between GBS and the flu shot.)

Last year I got the flu, and it was so awful that in my fever-induced haze I vowed I would not let it happen again.

You can get a flu shot pretty much anywhere this time of year, including Walgreens, Fry’s, and Safeway. Even Planned Parenthood Arizona carries the flu shot now, and offers them for $20 to both walk-in clients and those who have made an appointment. Continue reading →

STI Awareness: The Future of Treatment for HIV/AIDS

Posted on December 6, 2011 by Anna

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 →

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