Category Archives: Health Concerns

What to do when your teen tells you they have a sexually transmitted infection

By now, most parents likely know that not talking about sex with their teens will not stop them from doing it. And, as a parent, you might even have done some reading on how to have The Talk with your kids. Maybe you think you’ve done everything right when it comes to having important conversations with your teen. Or maybe you’ve been avoiding the discussion because you’re not sure where to start.

No matter which category you fit into, you may still find yourself as the parent whose kid comes home and tells them they think they might have a sexually transmitted infection (STI), or that they have contracted an STI. The way you respond to that bombshell can make all the difference for your child going forward — in their relationship with you, with future partners, and with themselves. “Often, the response of the people that you confide in when you first have a diagnosis shapes how you see your condition from then on out,” says Myisha Battle, a San Francisco-based sex coach. “It’s important that parents have a response that can potentially produce a positive outcome for kids when they’re disclosing.”

That, of course, is easier said than done. Heather Corinna, founder of Scarleteen, a sex ed web site for youth, and author of S.E.X.: The All-You-Need-To-Know Sexuality Guide to Get You Through Your Teens and Twenties, says that the groundwork for a positive response begins before your child ever receives a diagnosis. In fact, the way you talk about STIs from the beginning may determine whether your child even comes to you if they’re worried about their sexual health. And that, says Corinna, includes things like not talking about any infectious illness in a stigmatized way. “The closer we get to people, the more susceptible we are to infections,” Corinna explains. So if you wouldn’t talk about getting the chicken pox or a cold from someone as something gross, you shouldn’t talk about STIs that way, either. “When STIs come up in media or if people make a stigmatizing joke, correct it,” Corinna says. “Also important is not assigning value to people who do or don’t have an STI.”

And, no matter how many safer sex conversations you have (or haven’t) had with your kid, even people who do everything right can contract an STI. “STIs can happen even if you use protection and get tested,” says Ella Dawson, a writer who was diagnosed with herpes at 20. According to the CDC, nearly all sexually active people will contract HPV in their lifetime; two in three people worldwide have herpes simplex I and half of new infections are genital. The CDC considers both chlamydia and gonorrhea to be common infections. But, as Corinna points out, “The tricky thing is that when we talk about STIs, we’re talking about easily treatable illnesses like chlamydia versus [something like] HIV.”

Something else that might affect how involved a parent is or needs to be is how a young person contracted their STI in the first place. Often, STIs are contracted during consensual sexual interactions, but they can also be contracted during abuse or an assault. Corinna says that the biggest concern that they hear at Scarleteen from teens who have STIs is that their parents or caregivers will be disappointed in them. But, more serious than that, are fears that they may be kicked out of their house for having sex. Or, “if it happens in a wanted or ongoing relationship,” says Corinna, “there is the fear that their parents will punish them by refusing to let them see the person anymore.” All of these things may prevent a young person from disclosing their status to their parent or caregiver, or to avoid seeking medical attention all together.

“Teens with STIs need two things,” says Dawson. Those things are “access to medical care, and support. Make sure that your child has gotten a quality diagnosis from a medical professional, and also make sure that they are being treated with respect by their physician,” she says. Then, bombard them with unconditional love and support. It’s also important to do what you can to avoid adding to the shame and stigma your child might already be feeling. “Believe me, they don’t need you to confirm their own feelings of shame and regret,” Dawson warns.

Of course, it’s normal for parents to panic when their kid comes to them with an unexpected revelation like an STI diagnosis, but “it’s important to keep that freak out away from your kid,” says Battle. Corinna encourages parents to put aside their emotional reaction and get themselves educated so they can best help the young person in their lives. “If you’re in denial about [your] young person having sex, try to move past it and help them with what they need. If it’s about you controlling their health care and not giving them access, fix that,” Corinna says. “If you didn’t have conversations about what it means to be sexual with someone else, it’s time to have this conversation.”

Everyone agrees that the best way to be helpful as a parent is to take your lead from your child. “If they are upset, validate that. If they don’t feel bad about it, don’t make it a big deal,” suggests Corinna. Demonizing the transmitter, especially if that person is a partner, is not a helpful tactic and may alienate your child. Also not helpful? Trying to implement behavior modifications that same day, like taking them immediately to buy condoms, because it may feel like blaming. Also, going behind the young person’s back and calling their healthcare provider or their partner or telling a co-parent without getting explicit permission are surefire ways to lose a teen’s trust.

If your child isn’t sure what their diagnosis means, it can be a great time to get educated together. If they’re unsure if they might have an STI, “ask, ‘What are your symptoms? Let’s go to trusted website and find out what next steps should be.’ Or if it’s a diagnosis, it’s still an opportunity to sit down and ask what they learned at the doctor and what they know, so you can understand the next steps,” says Battle. Check out the resources on Scarleteen, the CDC’s website, or the American Social Health Association.

If you haven’t had great sex education yourself, learn along with your teen. After there is some distance, you can initiate another conversation about safer sex and make sure your teen has access to the appropriate supplies to help them avoid an STI in the future.

At the end of the day, what’s most important is letting your child know that an STI does not change the way you see them. This “does not mean your child has erred, ruined their future, or shown their true, negative character. Anyone can get an STI, even if you’re on the Dean’s list,” says Dawson. “What’s really important is that your kid is having a respectful, consensual and healthy sex life.”

Complete Article HERE!

Bats and BALLS

Today, we have a follow-up question from a fellow with a ball problem.

Last week this guy writes me to tell me he thinks he might have an abnormality in his nut sack. I wrote back to him: “I applaud you taking note of your balls in an inquisitive sort of way. Good for you! But you should also have at least a rudimentary understanding of your testicular anatomy. So that when you do your self-exam, you can have some sense about what it is you are examining.” To that purpose, I offered a medical diagram for him to look at. Despite my promptings to take his huevos to a doctor for a look see, he decided to write to me once again. D’oh!

Name: anoras
Gender:
Age: 47
Location: Northridge CA
Hey doc,
Thank you so much for your previous reply and for the diagram. Yes, I’ve seen it before but really didn’t look at it precisely — Ooops. So let’s see, the thing that goes into the testicles and that gangs up to the top of the testicle, that must be what I am referring to. Feeling my balls now I realize that it is at the top and not the bottom. Can I conclude that maybe I did feel it at that time on the top and thought it at the bottom, and/or that at that time maybe I my testicle turned around for some reason? Next, at the area where it is globulous, if pressure is placed on it, would it have a pain feeling rather than applying pressure anywhere else on the testicle? That is the question I’m asking, whether there are any areas on the testicle that you would naturally feel lumps and/or pain with any pressure. The next question would be if there are ways that the testicles can be turned around and when they do can they be readjusted. Thanks in advance for your understanding and great responses.

Sheesh, darling, take your nuts to a freakin’ doctor already, why don’t cha? Since I’m not there, while you root around in your groin, to see what you’re referring to, I’m not sure what you’re referring to. And even if I were there watching you poke and prod and I could feel what you feel, I wouldn’t hazard a guess about what’s going on with you. Ya know why? Because I am not a physician, that’s why!

You ask again about lumps. Here’s a rule of thumb for us all: If you got lumps of any sort see a doctor. You ask again about pressure and pain. Since I have no way of knowing what kind of pressure you are applying, all I can say is, if you’re applying lots of pressure, it’s probably gonna hurt. If your applying only light pressure and it hurts, I’d guess there’s a problem — see your doctor.

And no, I’ve never heard of inverted testicles — see your doctor!

Ok, audience, what have we learned in today’s lesson? If any of us has a concern about what we think might be an abnormality in our naughty parts…or any other part for that matter, don’t write me…especially more than once…go see the doctor. Get it? Got it? GOOD.

Good luck

Men who have sex with men account for over 80% of syphilis infection rates in the US

MSM are 106 times more likely to get syphilis than men who exclusively have sex with women

Doctors advise waiting for the skin to heal after shaving before having sex

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A new study of syphilis transmission rates reveals men who have sex with men account for 81.7% of cases in the United States.

This study found gay, bisexual or men who have sex with men are 106 times more likely to get the sexually transmitted disease.

Researchers analyzed data collected in 2015 and compiled the first of its kind state-by-state report on syphilis rates.

The study found gay and bisexual men living in the South had the highest rates of the disease, such as North Carolina, Mississippi and Louisiana.

North Carolina, for example, had 748 cases per 100,000 gay and bisexual men.

Alaska had the fewest cases, with only 73 cases per 100,000 gay and bisexual men.

HIV infects healthy immune cells in the human body by inserting its DNA into the cell’s genome

Fred Wyand, spokesman for the American Sexual Health Association urged people to look at the broader picture.

Wyand said: ‘Better access to healthcare, more welcoming attitudes, better support systems are all important, of course,’ WebMD reports.

‘We need to understand there are challenges faced by many gay and bisexual men greater than what most folks endure,’ Wyand concluded.

For a full list of State-specific cases of syphilis, check out the Morbidity and Mortality Weekly Report.

Why do men who have sex with men report higher numbers of syphilis?

A further breakdown highlights men who have sex with men accounts for 309 cases per 100,000.

This is in contrast to men who only have sex with women accounting for 2.9 cases per 100,000.

And women with 1.8 cases per 100,000.

Dr Robert Grant, chief medical officer of the San Francisco AIDS Foundation explains why this might be the case.

Grant told CBS News: ‘Now that we have effective therapies for HIV, people who were previously untested and tested infrequently are now getting tested.

‘Sexually transmitted infections tend to go together.

If they come in and ask for HIV testing, we test for syphilis, chlamydia and gonorrhea as well.

‘People have everything to gain and nothing to lose by getting an HIV and syphilis test.

‘This report will help reinvigorate people’s awareness and hopefully send the message that by getting a test and following through with treatment, we can decrease or even eliminate syphilis as a problem,’ Grant said.

Complete Article HERE!

Undoing the STIgma: Normalizing the discourse surrounding STIs

April is STD/STI Awareness Month.

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Let’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

Why men and women lie about sex, and how this complicates STD control

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When it comes to reporting the number of sex partners or how often they have sexual intercourse, men and women both lie. While men tend to overreport it, women have a tendency to underreport it. Although the story is not that simple and clear-cut, I have discovered some interesting reasons why this is the case – and why it matters to doing research on sexual health.

Lying is an inherent aspect of reporting sexual behaviors. For instance, more females report being a virgin (i.e., had not had sexual intercourse) despite having had genital contact with a partner, compared to males.

I have studied sexual avoidance and also frequency of sex in patient populations. In this regard I have always been interested in gender differences in what they do and what they report. This is in line with my other research on gender and sex differences.

The low validity and usefulness of self-reported sexual behavior data is very bad news for public health officials. Sexual behavior data should be both accurate and reliable, as they are paramount for effective reproductive health interventions to prevent HIV and STD. When men and women misreport their sexual behaviors, it undermines program designers’ and health care providers’ ability to plan appropriately.

Pregnant virgins, and STDs among the abstinent

A very clear example is the proportion of self-reported virginal status among pregnant women. In a study of multi-ethnic National Longitudinal Study of Adolescent Health, also known as Add Health, a nationally representative study of American youth, 45 women of 7,870 women reported at least one virgin pregnancy.

Another example is the incidence of sexually transmitted diseases (STDs) which are not expected among young adults reporting sexual abstinence. Yet more than 10 percent of young adults who had a confirmed positive STD reported abstaining from any sexual intercourse in the last year before STD testing.

If we ask youth who have had sexual experience, only 22 percent of them report the same date of first sex the second time we ask about it. On average, people revise their (reported) age at first sex to older ages the second time. Boys have higher inconsistency reporting their first sex compared to females. Males are more likely than females to give inconsistent sexual information globally.

Why don’t people tell the truth about sex?

Why do people lie about their sexual behavior? There are many reasons. One is that people underreport stigmatized activities, such as having multiple sexual partners among women. They overreport the normative ones, such as higher frequency of sex for men. In both cases, people think their actual behavior would be considered socially unacceptable. This is also called social desirability or social approval bias.

Social desirability bias causes problems in health research. It reduces reliability and validity of self-reported sexual behavior data. Simply said, social desirability helps us look good.

As gender norms create different expectations about socially acceptable behavior of men and women, males and females face pressures in reporting certain (socially accepted) behaviors.

In particular, self-reports on premarital sexual experience is of poor quality. Also self-reports of infidelity are less valid.

Although most studies suggest these differences are due to the systematic tendency of men and women to exaggerate and hide their number of partners, there are studies that suggest much of this difference is driven by a handful of men and women who grossly inflate and underreport their sexual encounters.

Even married couples lie

Men and women also lie when we ask them who is making sexual decisions regarding who has more power when it comes to sexual decision-making.

We do not expect disagreement when we ask the same question from husbands and wives in the same couples. But, interestingly, there is a systematic disagreement. More interestingly, in most cases when spouses disagree, husbands are more likely to say “yes” and wives “no.” The findings are interpreted in terms of gendered strategies in the interview process.

Not all of the gender differences in reported sexual behaviors are due to men’s and women’s selective under- and over- reporting of sexual acts. And, some of the sexual behaviors do vary by gender. For instance, men have more sex than women, and men less commonly use condoms. Men have more casual partners, regardless of the validity of their report.

Secretive females, swaggering males

Studies have found that on average, women report fewer nonmarital sexual partners than men, as well as more stable longer relationships. This is in line with the idea that in general men “swagger” (i.e., exaggerate their sexual activity), while women are “secretive” (i.e., underreport sex).

Structural factors such as social norms shape men’s and women’s perceptions of appropriate sexual behaviors. Society expects men to have more sexual partners, and women to have fewer sexual partners.

According to the sexual double standard, the same sexual behavior is judged differently depending on the gender of the (sexual) actor (Milhausen and Herold 2001). Interestingly, men are more likely to endorse a double standard than women.

In the presence of sexual double standards, males are praised for their sexual contacts, whereas females are derogated and stigmatized for the same behaviors, “He’s a Stud, She’s a Slut.”

Research suggests that lifetime sexual partnerships affect peer status of genders differently. A greater number of sexual partners is positively correlated with boys’ peer acceptance, but negatively correlated with girls’ peer acceptance.

Self-serving bias is common

As humans, self-serving bias is a part of how we think and how we act. A common type of cognitive bias, self-serving bias can be defined as an individual’s tendency to attribute positive events and attributes to their own actions but negative events and attributes to others and external factors. We report on sexual behaviors which are normative and accepted to protect ourselves, and avoid stress and conflict. That will reduce our distinction from our surroundings, and will help us feel safe.

As a result, in our society, men are rewarded for having a high number of sexual partners, whereas women are penalized for the same behavior.

The only long-term solution is the ongoing decline in “double standard” about sexual morality. Until then, researchers should continue questioning the accuracy of their data. Computerized interviews may be only a partial solution. Increasing privacy and confidentiality is another partial solution.

Complete Article HERE!