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PMs for STD and HIV questions - please...

Nov 19, 2009 - 11 comments

Please don't send me questions that have already been answered on one of the STD or HIV forums.  I will not disagree with correct info from Vance, Grace, 2terrifed, KDaily, Teak, Lizzie, Joggen, JeanClaude, Nursegirl, etc., and most certainly not Drs. Handsfield and Hook.  If you have been given incorrect information, it will be corrected on the forums by one of the regulars who is educated in that field.

Also, if your question hasn't been answered, post it on the appropriate forum.  I don't mean to sound harsh or offend, but I've been working a lot, just moved, etc.  I don't have much time to get on here and answer questions.  You will be doing yourself a big favor by posting your questions on the appropriate forum.

A few notes, as these are the questions I get most often -

HIV is not possible from oral sex.

No one - even a doctor - can tell you if you have an STD or HIV from a description of symptoms.  If you are worried, you have to test.

Herpes alone doesn't mean someone cheated.  HPV doesn't either.  Actually, no STD or HIV means someone cheated.  A lot of things go into determining that.

We can help you assess risk, figure out timing, test results, etc.  We just can not diagnose, and no one should diagnose you online.


STDs still on the rise

Jan 15, 2009 - 1 comments





incidence rates





Check this out.  What does it mean for you?  It means to use those condoms and test regularly if you are sexually active with more than one person, or are sexually active with one person who has more than one person.

This isn't cause for panic - just be aware and use condoms and test.

By Elizabeth Landau

ATLANTA, Georgia (CNN) -- In spite of prevention efforts, new cases of some of the most common sexually transmitted diseases are going up, according to a new report from the Centers for Disease Control and Prevention.
Much of the burden of STDs falls on adolescents and people in their early 20s, the CDC says.

The report, "Sexually Transmitted Disease Surveillance 2007," also said that women and minorities in particular are more likely to have sexually transmitted diseases, or STDs.

That fact isn't surprising, experts say, as studies on STDs in the past have also shown that women and minorities bear the greatest burden of STDs. The age of those affected hasn't changed much either -- nearly 19 million new sexually transmitted infections occur each year, and almost half of those affect 15- to 24-year-olds.

The CDC began a national syphilis elimination program in the late 1990s, targeted at African-American heterosexuals, especially women and their babies. As a result, the condition was nearly eradicated as an ongoing health problem in the United States.

But in the last two years, the trend has reversed, said Dr. John Douglas, director of the CDC's Division of STD Prevention.

"The success we've been experiencing for a number of years in African-American heterosexual populations, particularly women, is beginning to be eroded," he said. Video Watch more on the CDC's report ยป

Syphilis resurfaced as a danger in 2001, and cases went up by 15.2 percent between 2006 and 2007, the CDC said.

Reported cases of chlamydia and gonorrhea together surpassed 1.4 million in 2007, the report said. Both of these conditions can cause infertility when left untreated. The CDC will address HIV rates in the United States in a later report.
Health Library

A record number of chlamydia cases were reported nationally this year, the report said. But Douglas noted that a major strategy is detecting infection before it spreads, so each case is an opportunity to prevent ongoing transmission.

Chlamydia is the most common reportable STD and infectious disease, he said.

Since the early 1980s, there has been a dramatic downturn in gonorrhea cases, but for the last 10 years, the rates have leveled off, especially in African-American populations. The CDC is looking at a number of ways to create awareness of the problem, he said.

STDs affect not only individuals' health, but also the economy, the CDC said -- the conditions cost the U.S. health care system as much as $15.3 billion annually.

The report reflects what Dr. Yolanda Wimberly, assistant professor of clinical pediatrics at the Morehouse School of Medicine and the medical director for the Center for Excellence in Sexual Health, sees in the clinics where she works. In her 14 years of practicing, she has been diagnosing more and more cases of chlamydia, syphilis and gonorrhea, she said.

Based on the report and her own observations, it's safe to say that some of the prevention efforts are not working, Wimberly said. New, innovative methods will be required to get through to this generation of young people, for whom text messaging and the Internet are integral parts of daily life.

Many people hold the misconception that STDs come along with a visible sign, such as irregular discharge or a rash or bump. But, in fact, most STDs do not present symptoms, she said.

"That's how STDs are so easily spread," she said. "It's not people who know they have gonorrhea and who go out say, 'I'm going to spread it to all these people.' It's the people who don't even know, who maybe don't get checked up regularly."

It's important to be screened at least once annually, even twice a year for younger people, Wimberly said. She offers to test everyone who comes into her office for STDs, even if they do not have any symptoms or came to see her for a different reason, if they haven't been tested in at least the last six months.

However, not all doctors are so conscientious about STD testing, Douglas said.

Particularly in nonminority populations, doctors are inclined to think, "The young woman sitting in front of me looks pretty healthy, she looks pretty respectable -- she wouldn't have a sexually transmitted disease, right?" Douglas said. "We simply miss those screening opportunities."

Other doctors simply don't want to broach the subject of sex with their adolescent female patients, he said. There's also the problem of access to health care -- some women do not have physicians for this reason.

Current prevention efforts include promoting awareness of STDs, personal protective behaviors such as limiting partners and using condoms, and screening programs, Douglas said. A key area to work on is normalizing conversations about STDs and sexual health, he said.

"If the parents assume that's the doctor's business, or the teacher's business, and don't roll up their sleeves and get in there themselves, and if our schools aren't giving comprehensive education, and if our clergy and other community leaders who are interested in youth well-being aren't including sexual health on the agenda, we're going to create missed opportunities."

Happy Holidays and Thanks!!

Dec 22, 2008 - 0 comments

I'd like to wish everyone in the STD, Chlamydia and Herpes fourms a wonderful holiday season!!

Thank you so much to the regulars who help - Vance, Dallas, Emma, Waring, Slacker, Daisy - there are more, but you know who you are.  :)  These forums wouldn't be nearly as helpful and informative without your input, and I hope you know how much you are appreciated.  


STD Testing - what, when, where, why, how

Nov 08, 2008 - 10 comments




The STD community gets so many questions about when to test, how to test, where to test.  Here is a basic list, and all can be done by your regular doctor, or at an STD or GUM clinic -

Gonorrhea, chlamydia and NGU/NSU (men only):

* This testing is done by urine or swabbing the vagina or the urethra in men.  This can be done at about a week past the possible exposure.  Some countries are still doing blood testing for gonorrhea and chlamydia, but if you can get a urine or swab test, you should do that instead - its far more accurate.

Syphilis -

* This is a blood test, and is usually accurate by about 6 weeks, though it may take longer in rare cases.  

The 2 most common are the RPR (rapid plasma reagin ) and VDRL (Venereal Disease Research Laboratory test).  If this comes back positive, or "reactive", then a confirmatory test must be done.  (A negative test will most likely read as "non-reactive".)

Confirmation tests could be either an FTA-ABS (Fluorescent treponemal antibody-absorption) test, TPHA and MHA-TP (Treponema pallidum hemagglutination assays), TP-PA (Treponema pallidum particle agglutination assay).  There are others, but those are the most common.  

If you have a chancre (sore), they can culture it, but that isn't done as frequently as it used to be.


*This can be a blood test, a finger stick or oral swab.  The blood test will take around a week to come back, and the finger stick and oral swabs take 20 minutes to give results.

All of those tests are the ELISA.  If the ELISA is positive, a confirmatory Western Blot must be done, and that is a blood test.

All can take up to 3 months to be positive, but many will test positive before that.  By the end of the first month, 90% will be positive if infected.  There are other tests, but you should see the HIV Prevention forum for more info on other testing - .  Keep in mind that most people do not need other testing.

Herpes -

* Viral culture - this is a swab of the fluid within a blister.  You should make sure that your doctor is ordering a type specific viral culture (see the herpes health page for more into on this - )   These have a high false negative rate, so unless you have a positive test, you will need follow up testing if you have symptoms that might be herpes.  Its is best to culture a new sore within 24-48 hours to insure the highest accuracy rates.

* Type specific IgG blood test - This will tell you if you have type 1, type 2 or both.  (See the herpes health page listed above).  It can not tell you where you have the infection (mouth or genitals), but can tell you if you have either.  This can take up to 4 months to be accurate, but many will test positive long before.  See the herpes forum - for more info on herpes test results.

There are other herpes blood tests, but most don't need them.  See the herpes health page or the herpes forum if you are having difficulty getting consistent test results.

A note about the IgM test - this test is wrong at least as often as it is right, so it shouldn't be offered to you or drawn for you.  If you get a positive IgM, please disregard it, as it is not enough by itself for a conclusive diagnosis.

Hepatitis -

There are 3 types of hepatitis viruses - A, B, and C, and testing is done by a blood test.  Hepatitis B, the most commonly sexually transmitted of the hepatitis viruses, will be accurate by 9 weeks.

Hepatitis A is rarely sexually transmitted, as it is found in feces.  Hepatitis C is found in blood, and is also rarely sexually transmitted.  For more information on these, please see the appropriate hepatitis forums.

There are vaccines for hep a and b, and you might consider talking to your doctor about these.

For more info on stds, please post on the STD forum - - and not as a comment here.