STDs have been around since the days of cavepeople swiping right with their clubs, but there are a lot of new developments. The past 30 years, especially, have seen the coming of age of new diseases, new cures and treatments, and new ways to access information (both credible and audaciously bogus) about the fire you're feeling down below. I thought it would be fascinating/terrifying to take a look at ten monumental developments in sexual health in the millennial age, so I talked to Ned Hook—an internist and professor of infectious diseases at the University of Alabama, Birmingham, whose focus is sexual health—for an educated perspective on the highs and lows of modern-day STDs.
The Gloriously Non-Invasive Pee Test
Hook says the "diagnostic revolution of PCR [DNA analysis] testing—the so-called nucleic amplification test," aka the piss test—was a glorious development. Its 1993 Nobel Prize-winning invention means, among other things, that we can pee in a cup to find out if we have an STD now instead of having to go through a *trigger warning* full blown pelvic exam or penile swab.
"The ability to collect these specimens quickly and easily in ways that people can sometimes even do for themselves has allowed us to expand testing to places where [it] might not be done otherwise," Hook says. This has led to more widespread detection and treatment of STDs overall.
Warts and All
Hook's second favorite discovery in sexual health over the last 30 years is the HPV vaccine. Different strains of HPV can lead to problems as uncomfortable as genital warts or as serious as cervical cancer. Hook says the vaccine is important not only because it's led to a reduction in infections, but because it's brought greater attention to HPV-related cancers.
"HPV is a huge area of discovery and it's also an area of ongoing research," he says. "These same viruses that cause virtually all cervical cancer in women also occasionally cause penile cancer in men, rectal carcinoma in men and women, and even cancer of the throat."
A 2013 CDC report states that seven years after the vaccine was introduced in 2006, the rates of HPV prevalence dropped by 56 percent. The National Cancer Institute says that the HPV vaccine has the potential to prevent more than two-thirds of cervical cancer cases worldwide.
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The Evolution of HIV
The first rumblings of HIV popped up in 1981 with a handful of cases being referred to as a rare new kind of "gay cancer." It was exactly 30 years ago that the FDA approved AZT, the first antiretroviral drug for treatment of HIV. Today, AIDS has dropped off the World Health Organization's list of the top ten causes of death. AZT was first approved for treatment of HIV in the 1987, and then for post-exposure prevention in the 90s.
"The last 35 years have witnessed the discovery of the HIV virus, the development of a test, the development of the therapies that are highly effective that have transformed the treatment," says Hook. "When I initially diagnosed patients with the infection, before we even knew what was causing it, it was a death sentence, and now it's been transformed into a chronic disease with which people can live a virtually normal lifespan as long as they take their medications and respond therapeutically to them."
Condoms Still Won't Go Viral
One of the greatest sexual health fails of the latest 30 years has been the decline in condom use. In spite of the fact that condoms now come in ribbed, dotted, lubed, and multi-flavored varieties, the use of the highly effective STD prevention method is still trending downward. Recent studies have shown that condom usage rates are dropping among college students and teenagers and that condom use becomes even less popular for people over 40—more evidence that inhibitions lower with age (while a gift in general, not so much in this case).
Sexual health researchers cite reduction in pleasure during sex as the most common reason for the lack of love glove popularity. And we can't talk about condom fails without giving a hat tip to Scroguard. This latex male panty-type contraption emerged in 2014 and was designed be paired with a condom to provide a protective barrier to a man's entire pelvic area. It's also effective in preventing any type of sexual arousal whatsoever. I asked the distinguished Hook for his take on Scroguard to which he responded with great integrity: "I'm not aware of that one."
The downside of our advanced ability to detect STDs is that we're discovering previously unseen sexually transmitted infections that are freaky as hell—and not the good kind of freaky. Mycoplasma Genitalium, for example, is a rising star in the world of bacterial infections for your fuckparts. It was originally discovered in 1983, but incidences have sharply increased in the past few years with as much as 1 percent of the populations of the UK and US showing exposure. MG can lead to Pelvic Inflammatory Disease in women, which can lead to fertility issues and has also been shown to increase the risk of endometriosis 13-fold. And then, of course, there's super gonorrhea—a new, antibiotic-resistant strain of the infection that swept through Northern England in late 2015.
Syphilis and chlamydia are also back with a vengeance. Syphilis, you guys. That's a straight-up old-timey disease. The rates of syphilis infection shot up 19 percent between 2014 and 2015. In Indiana, the syphilis rates shot up 70 percent. The CDC attributes this in part to ongoing budget cuts that have limited the treatment and prevention of these highly preventable STDs. Yup, thanks Tom Price.
"I think it's cause for some reflection that the federal agency that really guides us in most of our STI control efforts are the Center for Disease Control and Prevention, and they're funding, especially if you correct for inflation, has not changed much in the last 30 years," Hook says. "And yet we have more STIs and more problems due to them. So that's a continuing challenging and a little bit disconcerting."
The Koala Chlamydia Vaccine Is Working
Koalas are having some trouble down under (sorry, had to). Between 2003 and 2013, the koala population in Australia is estimated to have dropped by as much as 80 percent due to a widespread outbreak of chlamydia, which can result in infertility. Perhaps even more serious than the potential extinction of one of the world's most adorable species, the koalas nearly gave chlamydia to several members of One Direction. But a new vaccine being used to treat the disease in koalas has been showing promising results, and that could mean advancements for a human chlamydia vaccine as well.
We're Super Close to a Herpes Vaccine
Researchers have been working towards a treatment for both strains of the virus for years, but one in six Americans between the ages of 14 and 49 have it. It may not be a killer, but the physical pain and social stigma associated with it are a real turn off. A new clinical trial is showing promising results in providing what could serve as a "functional cure" for both types 1 and 2 of herpes simplex virus.
Driving to an urgent care clinic for your inflamed genitalia is so 1987. In the digital era, we can get your sexually transmitted infection diagnosed right online and have a prescription sent to your closest pharmacy. New "telemedicine" sites like BeSafeMeds.com offer online diagnosis of your STI for just $20. Just check off "burning during urination" or "unusual discharge," enter your credit card info, and help is on the way. No more awkwardly avoiding eye contact with your peers at the free clinic. While this approach is sometimes dicey—as you could get misdiagnosed since a doctor is physically examining you—it does encourage more people to at least seek diagnosis.
Wax On, Pubic Lice Off
The free love, full-bush pubic hairstyling of the 60s and 70s may have been a popular expression of natural sexuality, but studies have shown that the millennial trend towards bikini waxing may have actually had a significant impact in reducing incidences of public lice. One study of pubic lice trends points to the popularity of Brazilian waxing for both men and women as a potential factor. Think about that the next time you're feeling crabby about a painful trip to your local aesthetician.
Hepatitis B is the strain of the virus most commonly spread through sexual contact, although Hepatitis A transmission via sexual contact is possible and there is some evidence of increased risk of Hepatitis C transmission through sexual intercourse in certain populations. The CDC states that 1.2 million Americans are currently infected with Hepatitis B—and it's 240 million worldwide.
The current form of the Hepatitis B vaccine was licensed in 1986. In 1991 interferon alpha, the first treatment for Hepatitis B, was approved and made available through a series of injections followed by the first oral medication, lamivudine, in 1998. As of today, there are seven drugs available for treatment and in 2016 the Hepatitis B Foundation released an article stating that a cure is "within reach," although they didn't give an exact estimate of how long those with the virus will have to wait.
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