Please Follow Us to Our New Home on the Internet!

Planned Parenthood Advocates of Arizona has moved this blog. Its new home on the Internet is now
blog.advocatesaz.org
Please join us there!

Over 90 Percent of What Planned Parenthood Does: Part 2, Condoms

packets of individual condoms

Welcome to the second installment of “Over 90 Percent of What Planned Parenthood Does.” In this series we will highlight Planned Parenthood’s diverse array of services — the ones Jon Kyl doesn’t know about.

It’s National Condom Week! So it’s only fitting that the second installment of our “Over 90 Percent” series honors the humble condom, that mainstay of anyone’s safer-sex arsenal. By providing a barrier between body parts and reducing skin-to-skin contact, condoms dramatically decrease risk of acquiring a sexually transmitted infection (STI). On top of all of that, their use during heterosexual intercourse can keep sperm from entering the vagina, making them essential components in family planning. Condoms can be used in a wide variety of sexual activities — they can be worn on penises or put onto sex toys, and with a couple of scissor snips they can be converted into dental dams. They are inexpensive and widely available without the need for a prescription. If you need to replenish your condom supply, or if you’re using them for the first time, you can walk into any Planned Parenthood health center to pick them up.

---

Learning how to use condoms correctly will maximize their effectiveness. Are you aware of the finer points of condom use?

---

There are tons of contraceptive options for people with uteruses, from pills to IUDs, but condoms are one of the few options that people with penises have — although there is exciting research being done on expanding these options. If you are heterosexually active and capable of getting someone pregnant, using condoms consistently and correctly will allow you to take control of your reproductive future. In a given year, 2 out of 100 females whose male partners use condoms will become pregnant if they always use condoms correctly — with imperfect use, this number increases to 18 out of 100. Combining condom use with other birth control methods, like diaphragms, birth control pills, or IUDs, will dramatically boost the efficacy of your contraception.

STI Awareness: “Can I Get an STD from Oral Sex?”

As tools to reduce risk for STI transmission, dental dams are not to be ignored.

Many consider oral sex to be a safer form of sexual activity compared to vaginal or anal intercourse. For this reason, they might put less emphasis on the use of latex barriers, such as dental dams and condoms, during oral sex. Unfortunately, this idea is misguided and can lead to the transmission of preventable infections.

It is generally true that oral sex presents less of a risk for contracting sexually transmitted infections (STIs) – but this risk is not trivial, especially when people are under the impression that they don’t need to use barrier methods during oral sex. Most sexually transmitted infections can be passed along by oral sex, including chlamydia, gonorrhea, syphilis, hepatitis B, herpes (which can be transmitted back and forth from the mouth, as cold sores, to the genital region, as genital herpes), human papillomavirus (HPV), and HIV. Even pubic lice can be transferred from the genital region to eyelashes and eyebrows! Additionally, intestinal parasites are more likely to be transmitted via oral sex than through vaginal sex. A microscopic amount of fecal matter containing parasites can be infectious, and can be unknowingly ingested when present on genitals.

---

Seventy percent of adolescents who reported engaging in oral sex had never used a barrier to protect themselves from sexually transmitted infections during oral sex.

---

Some bacterial STIs, such as gonorrhea and syphilis, can do permanent damage if not treated in time. Furthermore, gonorrhea of the throat is much more difficult to treat than gonorrhea in the genital or rectal areas. And some viral STIs can’t be cured (such as herpes and HIV), while others can cause chronic infections that have been linked to cancer (such as hepatitis, which is associated with liver cancer, and HPV, which is associated with throat cancer as well as cervical cancer and anal cancer).

Book Club: The HPV Vaccine Controversy

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.

HPV Vaccines: Separating Fiction from Fact

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.

Planned Parenthood Services for Men: We’ve Got You Covered

At Planned Parenthood, we’re passionate about women’s health, and indeed, our health care centers are well known for their top-notch services aimed at the female population. But not a lot of people associate Planned Parenthood with men’s health — despite the fact that we offer a wide range of services for men, ranging from those you expect (like condoms) to those you might not expect (like smoking cessation).

---

Planned Parenthood offers cancer screening and family-planning options for men, as well as an array of services that include cholesterol screening, diabetes screening, and even smoking cessation.

---

Sexually active people should be screened for sexually transmitted infections (STIs) — even if your partner has negative test results, that doesn’t mean you’re in the clear, so you can’t rely on your significant other to provide your STI screening “by proxy.” Especially because so many STIs are asymptomatic, it’s better to get yourself tested. We can screen and treat for STIs, as well as offer preventive vaccines for hepatitis A, hepatitis B, and human papillomavirus (HPV). Most people associate the HPV vaccine, Gardasil, with females, since HPV is behind 99 percent of cervical cancers. But males can benefit from Gardasil as well. Not only will they be protecting their partners, but they will also be protecting themselves from the viruses that can cause precancerous penile lesions as well as the majority of genital warts and anal cancers.

Men’s services also include life-saving cancer screening — we can check you out for prostate cancer, colorectal cancer, or testicular cancer. We can also evaluate penile lesions, which might lead to penile cancer if left untreated. These might not be the kind of check-ups anyone looks forward to, but they represent the kind of preventive health care that can save your life — or just your money — down the road.

The Slow Journey from HPV Infection to Cervical Cancer

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.

---

The human papillomavirus 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.

A Spotlight on Folic Acid

A cup of cooked lentils contains 358 micrograms of folate.

In the late 1920s, the London School of Medicine for Women graduated a brilliant student named Lucy Wills. This newly minted physician embarked on a trip to Bombay to investigate reports of anemic female laborers whose condition seemed to be exacerbated by childbirth. Thinking the anemia could be a sign of a nutritional deficiency, she fed her patients Marmite, which at the time was a fad among British and Australian health nuts. It seemed to help, and because she didn’t know which chemicals in Marmite were responsible for her patients’ improvement, she called that unknown ingredient the Wills factor — which we now know is folic acid.

---

Prenatal folic-acid supplements are thought to prevent 50 to 75 percent of neural tube defects.

---

January 8 marked the start of Folic Acid Awareness Week. Folic acid is essential in cell division, so we need it in order to grow or simply to repair damaged tissues. It is especially important that anyone who might become pregnant consumes at least 400 micrograms of folic acid daily, as it can help prevent certain types of birth defects.

Neural tube defects, including anencephaly and spina bifida, occur in about 1 in 1,000 births, and can affect an embryo when it is just a few weeks old, often before pregnancy is even detected. Anencephaly is an especially tragic and usually fatal condition in which an embryo fails to develop parts of its brain or skull. The prognosis for spina bifida is better — some people with spina bifida are unable to walk, while other cases are so mild that they might never be diagnosed.

STI Awareness: Intestinal Parasites

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

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

---

What has eight flagella and can live in your intestines?

---

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

STI Awareness: The Future of Treatment for HIV/AIDS

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

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.