Should Hollywood do more to portray safer sex?

There’s still something undeniably compelling about a good sex scene. Whether it’s to build intrigue or advance the plot, they remain attention-grabbing set-pieces.

 But even in the best sex scenes, the industry has generally eschewed condoms, a trend that climaxed, if you will, when fans pointed out that Issa Rae’s sex-heavy series Insecure has, over the course of one and a half seasons, failed to show its characters discussing, buying or applying protection. And the HBO series isn’t alone: if you’ve ever wondered how film and TV characters seem miraculously capable of bypassing foreplay, moving quickly from a shared glance of mutual desire to a carnal embrace, it’s because a) it isn’t real, and b) they don’t seem to use contraception.

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A Response from the TV Show Insecure

Of course, the dearth of contraception use in film and TV is hardly Issa Rae’s own cross to bear. But the show-runner and star of the Golden Globe-nominated hit responded nonetheless, explaining to her Twitter followers that she and her crew “tend to place condoms in the backgrounds of scenes or imply them”, attaching to the tweet two stills from the episode where open condom wrappers appear on a bedside table. “We hear you guys and will do better next season,” she added.

Prentice Penny, the show’s executive producer, took a less conciliatory approach, telling fans on Twitter that in the writer’s room it’s assumed characters use condoms. “We are not a PSA, documentary, or non-profit,” he added. “They should not look to ANY decisions our characters make as a compass.”

Condoms as a Gimmick

While Insecure’s been asked to shoulder the burden of promulgating safe sex recently, it’s still worth asking just how scarcely it’s practiced, or referenced, in pop culture. A dive into the annals of the cultural condom canon shows how regularly they’re utilized merely as a source for slapstick comedy or to cause an unintended pregnancy.


The plot of Judd Apatow’s Knocked Up is of course singularly driven by a misunderstanding between Ben (Seth Rogen) and Alison (Katherine Heigl) about not using protection during their one-night stand. “I assumed you were wearing a patch or, like, a dental dam,” Ben says. Then they have a baby. The opening scene of the Master of None pilot shows Dev (Aziz Ansari) having sex with Rachel (Noel Wells) before the condom breaks and they Uber to a convenience store to buy Plan B. One of the few times in recent years where condoms were shown without much fanfare was in the film adaptation of Fifty Shades of Grey, where the sex is otherwise mostly vanilla; twice Christian Grey puts on a condom, and there’s even a brief joke about the oral contraceptive clause in Ana’s “sex contract”.

Acknowledgement to STIs

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Fifty Shades acknowledged that using protection is a safeguard against not only unintended pregnancy but sexually transmitted infections too; Girls, Transparent and the British sitcom Lovesick have also addressed STIs in ways both big and small. And based on a 2016 report by the Centers for Disease Control and Prevention, STI rates recently reached an all-time high: in 2015, there were more than 1.5 million reported cases of chlamydia, nearly 400,000 of gonorrhea and close to 24,000 cases of primary and secondary syphilis. A study by the informational site BirthControl.com found that, in their past 10 instances of intercourse, women used condoms 58% of the time and men 79%.

No Condoms on Screen

But onscreen, you wouldn’t know it; characters mostly head straight to the sack without skipping a beat.The question of protection in Insecure was first raised by Jozen Cummings in an article last week for the Root. Some wrote off the op-ed as more pearl-clutching from the media police, while others argued that it’s worth Issa Rae’s time to show some compulsory condom application, even if it messes with the rhythm of the show’s sex scenes. But the trend’s too pervasive to fall on the shoulders of one show, since condoms are practically nonexistent across the industry when they’re not the butt of a joke.

A 2010 study conducted by the UK Department of Health – entitled “Mis-selling Sex” – analyzed 350 episodes of television with sex scenes and found that only 7% of them featured any sort of discussion of contraceptive use. More alarming still is that in 99 of 102 instances of intercourse examined for the study – which included British soaps such as EastEnders and Coronation Street, as well as American dramas such as Desperate Housewives and Grey’s Anatomy – condoms didn’t appear to be used at all. 

But some believe we overestimate pop culture’s capacity to normalize safe sex. And others, like Penny, argue that movies and television shows aren’t public service announcements but creative, for-profit entities, with no responsibility whatsoever to lead audiences towards contraception and safe sex.

There’s validity to both arguments. But truthfully, how hard can it be for shows to throw a condom in there for good measure, especially since the sex scenes – unlike the kind had in porn studios in the San Fernando Valley, where legislation’s been proposed to mandate contraception to stop the spread of STIs – aren’t real?

Standards for Condoms in the Industry 

As for whether calling for more depictions of contraception use constitutes an undue burden on a film or television show’s writers, Fortenberry believes that we already police sex onscreen in more established and indiscernible ways.

Unfortunately, there’s no barometer to measure the extent to which real-life sexual practices are influenced by sex in film and TV. But the imprint left by seeing characters simulate intercourse – like the family movie night gone awry when teenagers are forced to watch a sex scene opposite their parents – is potent. Fortenberry thinks the issue’s akin to that of cigarette smoking onscreen, which Hollywood studios began to legislate when anti-smoking lobbyists framed it as a matter of public health.

“If you take, for example, cigarette smoking and the limits on advertising for and portrayals of cigarettes, that’s part of a larger social understanding of the harms of smoking and the importance of this approach for the prevention of those harms,” Fortenberry explained. 

And though he remains skeptical as to whether showing safe sex would affect viewers’ own practices, Fortenberry thinks it’s worth a shot, insofar as we continue to encourage contraceptive use in other ways too.

“I think by itself, showing more contraception use wouldn’t be all that helpful, but it would contribute to a larger social attitude that puts value on prevention and on sexual health, as a part of sexuality education in middle and high schools and access to this kind of information through a variety of public health venues,” he said. “I couldn’t easily support this with extensive data, but my impression is that parental values and influences, influences from peers at school and other places, sex education at schools, all of those I think are more immediate influences on young people’s attitudes and behaviors.” 

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What you should know about STDs and Your Fertility

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If you gain nothing else from from this article, please read the following five bullet points:

  1. Chlamydia and gonorrhea often have no symptoms.

  2. Long term infections of chlamydia and gonorrhea can lead to pelvic inflammatory disease (PID).

  3. Long term infection can lead to ectopic pregnancy.

  4. PID leads to infertility.

  5. Having chlamydia or gonorrhea and then becoming pregnant can lead to ectopic pregnancy.

The bottom line: If you have any history of STIs at all, talk to your doctor about what your options are. Don't freak out, and don't give up hope. There are often many different things you can do to help improve your odds of conception. The key is to communicate with your doctor and figure out what's going on with enough time to take care of business.

Maybe you're actively trying to conceive a child. Or maybe you are pretty sure you want kids down the line. Or maybe you just want to keep your options open. If any of those apply to you — whether you're a man or a woman, cisgender or transgender — here's what you have to know about how sexually transmitted infections (STIs) play a role in your future fertility, specifically how chlamydia and gonorrhea play a role in your fertility.

Understand that everything we're about to tell you is meant to inform you, not totally freak you out. We want you to be able to engage in sex safely and keep those baby dreams alive. STIs can sometimes make it harder to get pregnant naturally, but that doesn't necessarily mean you'll never have babies. Sit back and relax and read on about the basic facts about which STIs do what, how to keep yourself and your fertility safe, and what do if you’ve had any of these STIs and are or potentially will be trying to have a baby.

Chlamydia and Gonorrhea

Let’s start with chlamydia and gonorrhea. Both could potentially hurt your future fertility, regardless of your gender. For cisgender women and transgender men, gonorrhea and chlamydia can potentially cause scarring and damage to the fallopian tubes.This is why it's so important to get tested if you're at risk for STIs — and get treated ASAP if you happen to contract one. The sooner you can treat and cure chlamydia or gonorrhea, the less likely they are to cause damage to your reproductive organs.

Another reason to stay on top of your screening and treatment: In cases where these infections go unnoticed or untreated for long enough, they can migrate further into the pelvis and cause pelvic inflammatory disease (PID). "By the time PID happens, significant damage has happened to your tubes," Dr. Lubna Pal, reproductive science specialist, OB-GYN, and director of the Polycystic Ovary Syndrome Program at the Yale University School of Medicine describes. Additionally, if you have PID once, you're at a greater likelihood of developing it again.  Scarring or damage to the fallopian tubes can cause what is referred to as "tubal infertility." Scarred and damaged fallopian tubes can prevent sperm from reaching and fertilizing the egg. And if an egg does get fertilized, blocked tubes can also keep that fertilized egg from reaching the uterus. This can increase your odds of having an ectopic pregnancy — when the embryo implants in the fallopian tube wall, rather than in the uterus wall. Ectopic pregnancies are completely nonviable, and they're very dangerous — and can even be fatal.

For cisgender men and transgender women, gonorrhea and chlamydia can potentially damage your pipes as well, although it's very rare, and much less common than fallopian tube damage. "The male reproductive tract — the urethra and the ejaculatory duct — can be affected by STDs like gonorrhea and chlamydia; they can be scarred, which causes an obstruction," Dr. Thomas Molinaro, a reproductive endocrinologist at Reproductive Medicine Associates of New Jersey (RMANJ) in Eatontown said. "It's definitely less prevalent than gonorrhea or chlamydia affecting fallopian tubes in women, but it is still something that we see and that men should be aware of."If you have a penis and your urethra and ejaculatory duct are blocked, it can prevent you from actually releasing sperm. STI-related damage obstruction in men is rare, but not unheard of. "I've seen patients who have an inability to release the sperm; the outflow tract is scarred down from previous STIs," Molinaro says. "There are some surgeries that can be done, but oftentimes when you have an obstruction like that, it requires testicular biopsy to get sperm." Not so fun.

Chlamydia and gonorrhea often have absolutely no symptoms at all, so you might not even realize you're infected.This is why it's incredibly important to get tested and know your status — the longer you're infected with chlamydia or gonorrhea, the greater the likelihood that these infections can damage your tubes. It also means that you might inadvertently infect your partner, impacting THEIR future fertility as well.

You can lower your risk of contracting chlamydia and gonorrhea by practicing safe sex.What this means: Unless you're in a mutually monogamous relationship where you and your partner have both tested negative for all STIs, you should use a condom or barrier method every time you have sex, whether it's vaginal, anal, or oral. Condoms aren't 100% effective — they can break, for instance, and some infections, like HPV, can be transmitted from skin-to-skin contact that isn't always covered by a condom. But they can definitely help prevent the spread of chlamydia and gonorrhea, and they're absolutely better than going without.

Chlamydia and gonorrhea are TREATABLE diseases — and the sooner you detect them, the sooner you can get treated for them. Chlamydia and gonorrhea are both bacterial infections, which means that they can almost always be treated with antibiotics. If you or your partner are diagnosed with chlamydia or gonorrhea, make sure that you take doctor-prescribed antibiotics to treat the infection ASAP. The sooner you get treated, the less likely they are to cause damage to your reproductive organs. Your doctor will prescribe antibiotics to treat cases of PID, but as with chlamydia and gonorrhea, it's super important to address it quickly. The longer you go untreated, the more damage it can cause.

When you're taking antibiotics to treat an STI or PID, take the entire course of antibiotics. This is so important: DON'T STOP taking antibiotics just because you feel better. You can stop experiencing symptoms before the infection has been totally eradicated, which means that it can still cause problems for you.

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If you Want to have a Baby

Find out if you're currently infected with anything. If you are, get treatment ASAP. Talk to your doctor about any STIs you've ever had, even if you've never had chlamydia or gonorrhea.

Again: Exposure to one STI increases your risk for exposure to others — so even if you've never been officially diagnosed with chlamydia, you still might have contracted it at some point in the past. Because potential damage to your tubes increases your risk of ectopic pregnancy, your doctor might want to keep an eye on you during your efforts to get pregnant, as well as tell you what to watch out for.

Typically, fertility experts recommend that if you're under 35, you should try to conceive for a year before seeking fertility treatment. But if you have a history of STIs (particularly chlamydia or gonorrhea), your doctor might tell you to try for six months before coming in for testing. They might also suggest you get certain tests before you even start trying. These recommendations will differ depending on your personal circumstances, as well as other health, lifestyle, and family history factors, so again: Communicate with your doctor, and work together to come up with a plan that makes sense for you.

If you've ever had chlamydia, gonorrhea, or PID, your doctor might want to perform a test to check to see if your fallopian tubes are blocked.For instance, they can perform an ultrasound test or an X-ray test to check for blockages. That said, these tests don't give you the all-clear, and even if your test comes back saying your tubes aren't blocked, it doesn't mean pregnancy is going to be easy — "The X-ray can tell you if your tubes are open, but they can't tell you if your tubes are working well," Pal says. If you do have damage to your fallopian tubes, there are still things you can do to get pregnant.

When it comes to tubal damage, "in today's day and age, the safest and most effective strategy is IVF [in-vitro fertilization]," Pal says. IVF is when your doctor extracts eggs from your ovaries, fertilizes them with sperm in a lab, and then injects them back into your uterus — bypassing your fallopian tubes altogether.

IVF can be incredibly expensive, and it's possible that your insurance won't cover the costs. But that's why educating yourself about your options and your situation is important: "It's about planning," Pal says. "If a 22-year-old knows her tubes are blocked because she had PID, maybe she can plan and save, or find the best insurance." If you have blocked fallopian tubes, you should talk to your doctor about your options.

Ultimately, being informed about these issues at the outset can help you better plan for your future — emotionally, financially, and with your choices around timing. If you know that you might need a costly medical procedure down the line, for instance, you may start saving for it early. Or if you know that it might take you a bit longer than most people to get pregnant, you might want to plan to start trying a bit earlier. Things like that.

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Make sure to stay up to date for the leading information regarding all things sex with Sex+, a startup working to make at home STI tests that will let everyone test and find out the results in the comfort of their home.

 

How oral helps you catch them all

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Oral sex is considered safer than sex, sex. While you do have a much lower chance of contracting HIV from oral sex, clinicians find gonorrhea in the throat more than any other place on the body. What? Unprotected oral sex can lead to the contraction of sexually transmitted infections! You do not need to have penetrative sex to reach for a condom. Unlike the legend that pre-ejaculation leads to pregnancy, having unprotected oral sex can lead to STIs such as chlamydia, gonorrhea, syphilis, herpes (I and II), and  the Human papillomavirus better known as HPV. While HIV can be contracted through oral sex it is VERY, VERY, did we say VERY?,  rare. Many of these STIs are curable, but herpes, HPV, and HIV have no cure and can only be managed with medication once they have been contracted. The good and the bad news is that most of these STIs are VERY common. The best thing  you can do is to know your status, get treatment, and communicate with your partner(s) about how to have the most fun and with least drama in your life :)

Why Do People Avoid Condoms

Two reasons people avoid condoms are 1) they take away pleasure during sex, and 2) they believe having oral sex does not have a high rate of STI contraction. These two reasons are not worth the potential of spreading disease to your sexual partner(s). It has been cited that some misconception about risk can be from the fact there are different risk levels for different sexual acts, so while oral sex is not the riskiest act, the risk still exists and should be taken into account when engaging in this type of sexual activity. Check out this great article about more condom myths from Teen Vogue

Few advancements have been made in the last few years regarding reason one. However, in 2013 Bill Gates had put a call to action for someone to develop a condom that would better the sexual experience for people using. In addition, holistic sexual education is needed to address point number 2. People need to be educated by communities such as Sex+  that oral sex still can transmit STIs.

Why You Should Practice Safe Oral Sex

Only 31% of people practice safe sex based on statistics from a 2017 survey from YouGov. If you are going to be sexually active in college, you must know about the importance of condoms to protect yourself. There is more to consider than pregnancy when having unprotected sex. For starters, herpes can be passed from mouth to genitals, and HPV can even go as far as to develop into different types of cancer when transmitted via oral sex. When STIs are transmitted from oral sex, they not only can develop in the mouth, but they can infect as deep as the throat in the cases of chlamydia, gonorrhea, herpes, and HPV.

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Get Educated about Oral Sex Protection

Oral sex protection can include regular condoms or dental dams. You can even cut a regular condom into a dental dam, but protection is necessary for any type of sex being had. Some STIs are asymptomatic, meaning there will not be any indication that you have been infected. This being said, if you continue being sexually active, and do not use a condom, you have the potential to spread an STI through not only penetrative sex but oral sex as well.

Links to Learn about Different Condom Types

  1. http://www.cosmopolitan.com/sex-love/advice/g3117/different-types-of-condoms/
  2. http://www.health.com/sexual-health/condom-types

Stay Up to Date with Sex+

We will be doing some special articles on fun techniques, great communication tips for in and out of the bedroom, and some pointers on how to looks out for symptoms of STIs so you can have all the knowledge and none of the drama in your sex life :) Make sure to stay up to date for the leading information regarding all things sex with Sex+, a startup working to make at home STI tests that will let everyone test and find out the results in the comfort of their home.

 

Top Tips To Keep In Mind When Heading Back to School

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With most colleges and university beginning their fall semester, it is important for all students to remember that if you are having sex, you are at risk for sexually transmitted infections (STIs). As a college student, you are not required to take a mandatory class on sexual health and if you previously attended a private institution, you might not have received any sexual health information at all. When students with little sexual health education enter college with parties full of alcohol and drugs, it is crucial that there are sexual health resources on campus to educate students with and without sexual health knowledge. In order to keep yourself in balance, maintaining your sexual health is just as important as keeping your mental and physical health in check.

Condoms

Condoms are the easiest way to be sexually active and prevent STIs. Many colleges and universities offer free male and female condoms in campus health and around campus. If you are struggling to find access, it is smart to check with your university’s campus health because you don’t want to risk the spread of STIs. Another tip is to carry a few extra condoms with you. It is much better to be prepared than to take that risk, even once. Also, it is very important to remember that you cannot tell whether the person(s) that you are being sexually active with has an STI on the surface. Your eyes do not have the power of today’s microscopes, which are used in diagnosing STIs (if they do, go tell your news stations, you are about to be a legend).

Condoms and knowing the implications of drugs and alcohol are very important in preventing sexually transmitted infections (STIs). Alcohol is a leading drug in rape, so having proper information available to all students is imperative.

However, it is important to remember that it is very possible to be sexual without having sex, and there are ways to still have fun, feel sexy, and not be carrying a condom. Stay tuned for #humpwednesday to read more about communication games and sexting. 

Be Aware of Your Surroundings, Yourself, and the Resources Available To You

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The first few weeks of school have an increased number of parties as people settle back into the semester. Drinking high amounts and using drugs can lead to lack of clarity. Be careful making decisions when you have been under the influence of drugs or alcohol.

Along with your surroundings, you need to be aware of yourself. Know what you want because there is nothing you have to do. Your partner(s) should respect the consent and limits you set. It is important to communicate in order to have the best experience for yourself. Being on the same page can prevent uneasiness, STIs, and awkwardness.

College campuses’ campus health units need to be an open facility for students to know they can gain information and knowledge as well as get tested and advised on STIs. At a university’s’ campus health building students should be able to get male and female condoms and birth control in addition to information on STIs and how to prevent them. In addition to STI information, there should also be information available on sexual assault.

Getting Tested

While birth control does prevent pregnancy, it does not protect against STIs, so it is still imperative to continue using condoms even while your partner uses birth control. In addition, getting tested is key. Currently, you will have to go to the school clinic, a clinic off campus, or submit a test in the mail and wait for the STI results. 

One of the first things you should do when getting to campus is familiarize yourself with the resources on your campus. Are there free condoms? Is there free access to birth control? Is there access to STI tests? Is there access to sexual assault information? Are there informational pamphlets on sex and STIs? These are all very important when beginning your new or continuing experience at university. If the answer is no to any of these questions there are resources for finding clinics near you. Clinics are a great option that can provide these resources if your university does not.

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Make sure to stay up to date for the leading information regarding all things sex with Sex+, a startup working to make at home STI tests that will let everyone test and find out the results in the comfort of their home. Check out our website

 

 

Know Your Status in 30 minutes: Sex Positive Delivers a Diagnostic for Home Use

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What happens when you need to get screened for sexually transmitted infections? Whether you have symptoms or are getting screened between partners, it requires waiting at the clinic and a week of waiting for your phone to ring for results. This waiting is stressful no matter who you are. Relationships change quickly and with Chlamydia and Gonorrhea on the rise globally, people need tools to know their status fast. 

Sex Positive has designed a tool that takes the full laboratory process for diagnosis and puts it into a pen. We chose to focus on sexually transmitted diseases for a couple of reasons. First, we are building a consumer product. Unless you are a healthcare professional, it is unlikely that you know many diseases by name. If you went to public school, you had a chance to learn about sexually transmitted diseases in health class., you learned how they are caught, and where they can live on the body. Secondly, unlike other pathogens, STDs are associated with sex and personal sexual behavior remains a taboo subject. This is the cause of projected stigma, felt shame, and steady rate of under-diagnosis. When you need to be tested or elect to be screened, you are silently admitting to sexual behavior, and sexual behavior that is not the Puritan sort. We want to allow you to keep your privates private, but still take care of your health. You should have all the tools to make testing comfortable, so there are no excuses when it comes to you taking care of you. This is more important than it ever was, since the bacteria that cause STDs are the most prevalent and the most contagious infectious diseases diagnosed.

Sex Positive received 100k from RebelBio, the primary funder of female founders and coordinator of venture-backed  biotech accelerator program. There, the lean team of Sex Positive used their expertise in design, hardware, and molecular biology to build an integrated prototype. They plan their market release in Q3 2019 once they have passed regulations that show the government that their design is reliable. Until then, look for helpful articles on sexual health and communication as well as tools and services that help you #StayPositiveTestNegative on their social media accounts and website.

 

UK to Cut Funding for STI Clinics

Sexual health services in England are "at a tipping point", according to local councils in England, who say visits to clinics have increased while funding has been cut. 

The Local Government Association warns that patients could face longer waiting times.

Chlamydia is the most common STI in the UK and is easily passed on during sex. It can be tested for by providing a urine sample or a vaginal swab. The latest data shows diagnoses of sexually transmitted infections (STIs) have fallen in the past year. This is due to the UK's investment in wide spread screening programs. These services are now being cut, when they are shown to be effective.

Responsibility for public health in England has rested with local councils since 2013 - but the Local Government Association says it has not been given adequate resources to run proper services.

Council leaders say it is good news more people are taking responsibility for their sexual health, but they warn that higher numbers are turning up at clinics and putting a strain on resources.

The LGA says patients could face a poorer quality service and wait longer for tests and treatment if additional funding is not provided.

Cllr Izzi Seccombe, chairman of the LGA's Community Wellbeing Board, said: "The reduction in public health funding could also compound problems further and impact on councils' ability to meet demand and respond to unforeseen outbreaks."

How can you make sure that your diagnosis is not delayed due to budget cuts? Sex Positive want to put give you the tools to diagnose yourself. Most people test negative, and that is a fact. Why wait through National Health Service Bureaucracy, when you can have your piece of mind with a visit to our online store and 30 minutes at home?

source: http://www.bbc.com/news/health-40802193

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Millennial Women Are Facing An STI Crisis

  • A new survey reveals how few young people discuss sexually transmitted infections with their partners.
  • Women are more likely to get tested and talk about testing.
  • Experts warn that young people are at risk of asymptomatic infections — which could cause serious problems later in life.

    Bree was hooking up with a coworker for the first time when she asked, “When was the last time you were tested for STIs?” It’s a standard question for Bree, 18, who gets tested every year, but her partner seemed suddenly flustered. “He said, ‘I’m OK, I don’t think I have any STIs,’ and I said, ‘That’s not the question I asked you,’” Bree recalled. They were on his couch, an hour before they had to head out for a shift at the restaurant where they both worked, and Bree’s partner began to explain that he had never needed to get tested because he always hooked up with “nice girls.” Bree was floored. “I couldn’t believe that he was 20 years old and had been sexually active for a while, but he had never been tested,” she said. “I had to tell him that this wasn’t about him — this is just something that we both have to do for our own safety.”

    Her experiences are part of a troubling trend in sexual health — one that could lead to serious long-term health problems for young people with untreated, asymptomatic STIs. A 2016 CDC report shows cases of sexually transmitted infections (STIs) reached an all-time high in the United States and those between the ages of 15 and 24 acquire half of all new STIs. A new Cosmopolitan.com survey reveals that despite this risk, a surprisingly high number of young people don’t talk about STI testing with their sexual partners. And the onus to both talk about testing and get tested falls mainly to women.

    KATIE BUCKLEITNER



    The survey of 1,454 respondents between the ages of 18 and 35, recruited from Cosmopolitan.com's and Esquire.com’s social media accounts, found that 47 percent said none of their past partners asked about their STI testing results before having sex. And while 58 percent of women say they’ve been tested in the past year, only 33 percent of men said the same. Men were also three times likelier than women to say they’ve never been tested (33 percent versus 11 percent).

    KATIE BUCKLEITNER

    Nearly one-third of survey respondents said they’ve either had an STI or don’t know if they have an STI. The most commonly reported STI was chlamydia (18 percent), followed by HPV (11 percent), genital or oral herpes (5 percent), gonorrhea (4 percent), trichomoniasis (3 percent), and genital warts (2 percent). One percent of respondents said they had pelvic inflammatory disease (PID), scabies, or pubic lice. Women were also twice as likely as men to say they’ve had an STI (36 percent versus 18 percent).

    The risks of not getting tested can be devastating. Many STIs can go unnoticed for long periods of time, with no visible symptoms. Left untreated, they can cause serious problems in women, explains Leah Millheiser, ob-gyn and clinical assistant professor of obstetrics and gynecology at Stanford University. “Only 20 percent of women with gonorrhea have symptoms and chlamydia is often a ‘silent’ infection with no symptoms,” she said. “But if they’re left untreated, they can lead to more serious infections that can require hospitalization and cause infertility.”

    “It makes me feel like they expect all of the responsibility to fall on me, as the girl."

    Jessica, 22, who began getting tested regularly at a local clinic after one of her friends contracted chlamydia, said she’s continually surprised by how many of her male partners don’t ask about testing or carry condoms. “How hard is it to just go buy a box of condoms?” she said. “It makes me feel like they expect all of the responsibility to fall on me, as the girl — I’m supposed to be taking care of their health and my health. ”

    Most men (81 percent) know where to get tested — they’re just not doing it at the same rate their female partners are. Women have a built-in opportunity for testing at regular gynecological visits. When asked why they had their most recent STI test, 24 percent of respondents overall said it was because a doctor suggested it at a routine appointment. Doctors are unlikely, however, to suggest a full STI screen for men who have sex with women because CDC guidelinesonly recommend an HIV test for sexually active heterosexual men, according to Hayley Mark, who is the chair of the department of nursing at Towson University and a researcher on STI testing practices. This is because men who have sex with women are less likely to get STIs like gonorrhea and chlamydia, and the health stakes are higher for women, because these infections can lead to infertility. “A lot of STI testing is done at publicly funded facilities and you need to put your resources where you will get the most ‘bang for your buck,’” Mark explained. As a result, men are unlikely to get an STI test at an annual physical unless they believe they were exposed or they ask for it.

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    KATIE BUCKLEITNER

    Men are also used to their partners initiating a conversation about testing. Although 82 percent of respondents said both partners are responsible for testing, a majority (52 percent) of women say they initiated a conversation about STI testing with their most recent partner, compared to only 27 percent of men.

    Gender socialization may help explain this difference, said Hayley Mark. “Because sex and sexuality have such significant implications for women, for example, pregnancy, many women have to become comfortable talking about it,” she said. “Given the implications, women may be more determined to take care of this aspect of their health and their partners.”

    The cost of testing isn’t prohibitive for most respondents. Nearly two-thirds (64 percent) of respondents who had been tested for STIs paid nothing for their most recent test, while 15 percent said their test cost $1 to $30, and 20 percent said it cost more than $30. (Information about free or subsidized STI testing is available on the CDC’s website.) Nicole, 25, gets tested for STIs at her annual gynecological appointment and again if she has a new sexual partner. Her insurance policy covers one test per year and each additional test costs about $20 depending on her co-pay, which she views as a worthwhile expense. “I am really, really cautious,” she said. “I’d rather spend the money on the test than something like going out for coffee a couple times a week.”

    “If you’re hooking up with a friend ... it doesn’t seem as necessary to have that conversation."

    Still, for some, other barriers to testing exist. Ben, 19, doesn’t get tested since he’s on his parents’ insurance and fears they’ll intercept a statement for his tests. He doesn’t always talk to his sexual partners about testing. “If you’re hooking up with a friend and know their sexual history, it doesn’t seem as necessary to have that conversation,” he said, adding that his lack of testing has been OK with his partners, as long as they use protection.

     

    KATIE BUCKLEITNER

    The survey found that women are generally more conscientious than men not just about STI testing, but about safer sex practices: 31 percent of women said they would have sexual intercourse with a partner who couldn’t remember the last time they were tested, compared to 57 percent of men. Similarly, only 30 percent of women but 61 percent of men said they would have oral sex with a partner who could not remember the last time they were tested.

     

    KATIE BUCKLEITNER

    Tyler, 30, said he hasn’t been tested in a few years because he’s been in a monogamous relationship but before that was more comfortable having unprotected oral sex than intercourse with a partner who couldn’t remember the last time they were tested. “It’s just not something I do as often, so once I’ve decided I want to have oral with a woman, I am pretty sure I’d be able to trust her,” he said. (The risk of HIV transmission is lower for oral sex than other forms of sex, according to the CDC, but many STIs, including chlamydia, gonorrhea, and herpes, can be spread through oral sex.)

     

    KATIE BUCKLEITNER

    Women were less likely to distinguish oral sex from intercourse. “All sex has risk,” said Rene, 23. She’s part of a polyamorous community and participates in threesomes, and said it’s common for sexual partners to ask for screenshots of testing results. When partners don’t want to share their testing status, she said, it’s a serious red flag. “If you’re nervous talking about this, maybe you have something to hide.”

    Further adding to the risk, a small but significant group — 9 percent of respondents — admitted that they have lied to a sexual partner about the last time they were tested. When asked why they lied, 5 percent of respondents said they didn’t want to delay sex, 3 percent said they couldn’t remember when their last test happened, and 1 percent said they had an STI and didn’t want their partner to know.

    These findings highlight the need for young people to get comfortable with routine STI testing and talking with their partners about STIs. But given the burdens women have been tasked with, men especially need to take responsibility for their own sexual health.

    “It’s great for women to be empowered about getting tested themselves,” Dr. Millheiser says, “but it means absolutely nothing if your partner isn’t getting tested.”

    Credit to Amelia Thomson-DeVeaux and Cosmopolitan Magazing

    A new vaccine in the rounds to fight Gonorrhea

    • Around 400,000 Americans were diagnosed with gonorrhea in 2015.
    • Infection rates are rising, and public health experts think it's only a matter of time until a strain emerges that is completely resistant to all known antibiotics.
    • Researchers found that people vaccinated with the MeNZB were 31% less likely to get gonorrhea than those who weren't.
    • Given the current trend in gonorrhea infections and resistance, a vaccine like this could come just in time.

     

    In a twist of fate, there is new hope for developing a vaccine to protect people from the sexually transmitted disease gonorrhea, a disease eluding the medical community that has now become a sex superbug.

    The vaccine, called MeNZB, was developed to control a meningitis epidemic in New Zealand from 2004 to 2006 and is no longer available. Researchers found that people vaccinated with the MeNZB were 31 percent less likely to get gonorrhea than those who weren't.

    In the study, 1 million people who had been diagnosed with gonorrhea or chlamydia received the vaccine in a mass immunization program. Nearly 15,000 people were included in the analysis.

    It's not clear yet how long the immune response from this vaccine might last, but this is an important breakthrough. According to the World Health Organization, there are about 78 million new cases of this STD worldwide each year. Around 400,000 Americans were diagnosed with gonorrhea in 2015.

    Rise of a superbug

    Over the past few decades, Neisseria gonorrhoeae, the bacterium that causes gonorrhea, has grown resistant to nearly every type of antibiotic used to treat it. That's bad news, because if gonorrhea is not treated, it can cause pain and fertility problems in both men and women; in pregnant women it can cause complications for mother and child alike. Now infection rates are rising, and public health experts think it's only a matter of time until a strain emerges that is completely resistant to all known antibiotics.

    The Centers for Disease Control and Prevention lists N. gonorrhoeaeamong the three bacteria that are urgent drug-resistant threats to the United States, deserving of the highest concern.

    Preventing infection in the first place seems to be the best option, "and the most proven, reliable and cost-effective method of prevention would be the implementation of an effective vaccine," according to a 2016 study. Though the bacteria's biology makes it a particularly difficult adversary, scientists are optimistic about their prospects. Several hope to get a gonorrhea vaccine into clinical trials within the next decade.

    Conceptual visualization of the gonorrhea bacterium that causes the sexually transmitted disease gonorrhea.

    The challenges in creating such a vaccine are great. That's because N. gonorrhoeae quickly swaps genetic code with other bacteria with which it comes into contact, populating its surface with different proteins and effectively masking it to the host's immune system. All bacteria do this to some extent — that's how they're able to develop resistance — but N. gonorrhoeae does it much faster than others. That means gonorrhea is a disease you can get more than once.

    Traditional approaches of vaccines, which work on the principle that dosing a patient with dead versions of the pathogen to train the immune system to recognize it in the future don't suffice. And because N. gonorrhoeae has evolved to only live in humans, it's challenging to test on animal models (there is a strain of genetically modified mice on which researchers currently experiment).

    Scientists get creative

    Armed with a few more decades of basic knowledge about how N. gonorrhoeae interacts with the body, plus more detailed DNA sequencing, researchers are applying creative new tactics to developing a vaccine. "What we found in our studies is that N. gonorrhoeae has the capacity to suppress the development of an immune response against it. This gives us an entirely new way of looking at the infection," says Michael Russell, a professor emeritus of microbiology and immunology, and oral biology at the Witebsky Center for Microbial Pathogenesis and Immunology at the University of Buffalo.

    For the past several years, Russell and his collaborators have beendeveloping a new kind of vaccine, based on a cancer treatment. It's designed to boost the immune response at the same time as the body is faced with inactive cells of N. gonorrhoeae, countering the bacteria's typical immunosuppressive mechanisms.

    So far, mice have retained immunity for up to six months with this technique. Russell speculates that his lab could have a vaccine in clinical trials in the next five to 10 years, but there are some important questions to answer first. They want to better understand the mechanisms that make their vaccine successful, and make sure the immune response the technique elicits doesn't itself cause damage.

    Scott Gray-Owen, a professor of molecular genetics at the University of Toronto, has come up with another possible target for a vaccine. He and his collaborators have found a unique protein on the surface of N. gonorrhoeae that the bacteria uses to retrieve iron from its host. It's one of the few things that stay constant on the surface of N. gonorrhoeae, which makes it a good target for a vaccine, Owen says.

    His team is now working on isolating the protein from a few different strains of N. gonorrhoeae and creating a proper adjuvant, the chemical in a vaccine that indicates to the immune system that something is hazardous. Because of how the vaccine works, they've been able to test it on pigs and cows, addressing other bacterial infections that bind to their cells the same way. "Economically, it's important for the health of these animals, but it's also exciting because it's a proof of concept," he says. He hopes to start clinical trials within a decade.

    There are similar and related research efforts under way. Peter Rice and Sanjay Ram, at the University of Massachusetts Medical School, are testing a vaccine candidate of their own. Other researchers are working to better understand the bacteria's biology — Kate Sieb, a microbiologist at the Institute for Glycomics at Griffith University in Australia, is analyzing N. gonorrhoeae's genetic code to identify possible new targets for future vaccines.

    "Given the high cost of clinical trial, it is likely that public–private partnerships will be required to drive development of a gonococcal vaccine."-Kate Seib, microbiologist, Institute for Glycomics, Griffith University

    Russell believes the work in his lab is the most mature and stands a good chance of being the first to the clinic. But to Gray-Owen, in practice the techniques would be complementary, perhaps providing immunity to different groups of people within the larger population.

    Once a vaccine becomes available, there might be hurdles in getting people to use it. One element might be the delivery method — Russell's treatment is administered vaginally in the mouse models, and he thinks that probably wouldn't be acceptable in humans, "in part because it's not applicable in 50 percent of the population to start with," he says. There might be ethical issues to address, like if everyone should get it or only those at the highest risk, or if it's acceptable to put out a vaccine that only works on men or women but not both.

    Parents also might be wary of vaccinating kids against a sexually transmitted infection, as was the case with the HPV vaccine, Gray-Owen says. "It might be difficult to convince parents that their young child should get a vaccine for gonorrhea. But as [the children] get older and start to realize the concern, if gonorrhea becomes untreatable or if the prevalence goes up in North America, I think that makes it not a crazy idea anymore," he says.

    Researchers in this field are overwhelmingly optimistic. Whereas their work might have seemed Sisyphean or irrelevant in the past, a successful vaccine seems closer at hand than ever.
    "There are a lot of potential vaccine targets that have been identified, and we really need to get data from human trials as soon as possible. Given the high cost of clinical trial, it is likely that public–private partnerships will be required to drive development of a gonococcal vaccine," says Seib of Griffith University.

    "I think it's going to be possible. I can't tell you exactly when it will be, but I think the findings that have emerged from our lab and elsewhere in recent years have made it likely to be feasible. There's been a lot of pessimism around for many years, but I think the tide is beginning to turn," Russell says.

    Given the current trend in gonorrhea infections and resistance, a vaccine like this could come just in time.

    — By Alexandra Ossola, special to CNBC.com

    Original Article: http://www.cnbc.com/2017/07/25/a-new-vaccine-to-fight-americas-hidden-health-crisis-gonorrhea.html