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STIs are a Global Responsibility

Sexually Transmitted Infections are a Global issue, and, subsequently, need to be a Global responsibility.  The epidemic rates of STIs around the world speak to the seriousness of the issue.  Strategies have been put in place since 2006 with a target date of 2030 that “sets out a vision, goals, targets, guiding principles and priority actions for ending the sexually transmitted infections epidemic as a public health problem.”

According to a new World Health Organization (WHO) report, Global HIV, viral hepatitis epidemics and sexually transmitted infections (STIs) continue to pose significant public health challenges, causing 2.5 million deaths each year.  As well, four of the curable STIs – syphilis, gonorrhea, chlamydia, and trichomoniasis – account for over 1 million infections daily.

So why do numbers keep increasing? Where are the issues and disconnects that are resulting in STIs remaining an epidemic for so many years?

Why are STIs Escalating?

When the world was faced with a Covid Epidemic, there were immediate responses worldwide.  Yet STIs continue to rise, some are becoming or have become antibiotic resistant, and many result in long-term health issues.  STIs were already at epidemic proportions years ago, and yet they continue to rise with little to no awareness from the general public.

New data shows that STIs are increasing in many regions. In 2022, WHO Member States set out an ambitious target of reducing the annual number of adult syphilis infections by ten-fold by 2030, from 7.1 million to 0.71 million. Yet, new syphilis cases among adults aged 15-49 years increased by over 1 million in 2022 reaching 8 million.  

The issues surrounding the escalation of STIs are multi-faceted. They encompass funding, stigma, social and economic issues, misconceptions, and a lack of resources that result in a shortfall in education and awareness.  In short, they are entwined in every aspect of our lives and impact all of us in some manner. If we are to see the reduction or elimination of STIs as a Global public health concern the world needs to overcome the many political, sociocultural, economic, and operational barriers.

Health Impact

Due to the asymptomatic nature of a number of STIs many individuals are unaware of being infected. This results in higher transmission rates, long-term or chronic health issues, and ultimately a higher cost of treatment.  The diverse complications from sexually transmitted infections have a serious impact on the sexual and reproductive health of many.  If we are to see a global reduction in case numbers, we then need to have a series of guidelines and steps for all to follow. Is the concept of a universal strategy even feasible knowing it would require the cooperation of all countries with regards to prevention, diagnostic, treatment and changing behaviors?  From a humanitarian perspective we all would like to hope so!

The WHO’s report “Global Health Sector Strategy On Sexually Transmitted Infections 2016–2021” also speaks to the physical, psychological and social consequences of sexually  transmitted infections and how they severely compromise the quality of life of  those infected.

Human Rights Based Health Care

The right to comprehensive health care that encompasses all aspect of one’s well being should be something all people are able to access. Yet we know this is not the case, as well as being a large contributor to the epidemic status.  There needs to be strong partnerships developed between all other areas of health in order for this multi-faceted approach to work and offer all people access to basic health care.  We need interventions, policies and treatments that are built on human rights. Sexual wellness needs to be viewed as integral to one’s health as mental health, physical health, and emotional health are today.  Our sexual health directly impacts all of the other aspects of our health, so to continue to shroud it in stigma, shame, religious or political views negatively impacts our overall well-being.

The WHO recognizes that there is a gap in ensuring access to high-quality human rights-based and gender-sensitive services for STIs is essential. A greater focus is needed on implementing effective and efficient interventions, such as condom programming, comprehensive sexuality education and strengthened awareness around sexual health matters, targeted vaccination for HPV, hepatitis B virus and mpox, timely management of signs and symptoms of STIs, partner services, and population-focused and geographically focused screening and treatment, particularly for syphilis, gonorrhoea and chlamydia. This gap can only be filled by us all working together to take control of and eliminate the ongoing Global STI epidemic.

What is Gonorrhea?

Gonorrhea is a bacterial sexually transmitted infection. It is prevalent among young people between the ages of 15-24 and is transmitted through vaginal, oral and anal sex.  Gonorrhea can present asymptomatically, resulting in the increased spread of this STI and, if left untreated, can lead to infertility in women.  Gonorrhea can cause symptoms in the genitals, anus or throat and symptoms may present differently based on gender.  The World Health Organization (WHO) states that in 2020 there were an estimated 82.4 million new infections among adults globally.  So how do we reduce this number?

Signs & Symptoms

As mentioned, gonorrhea can often present without symptoms. This is problematic because without testing to confirm its presence, the infection is then spread unknowingly. So testing is a critical component of stopping the spread of gonorrhea. If symptoms are present,  they can vary as to how they present between genders. The WHO lists the symptoms as:

In men, common symptoms may include the following:

• pain or burn when urinating
• a white, yellow or greenish discharge from the penis
• painful or swollen testes

Although most women with gonorrhea do not have symptoms or do not notice them, if they do present, they can include the following:

• pain or burning when urinating
• vaginal discharge
• vaginal bleeding between periods or during sexual intercourse

Anal infections may present in any gender as the following:

• discharge
• bleeding
• itchiness
• soreness
• painful bowel movements.

Throat infections are often asymptomatic. Otherwise, they may just present as a cold with pain, redness and a sore throat.

Treatment

Gonorrhea is one of the treatable and generally curable STIs. Yet it continues to rise. In 2021 a total of 710,151 cases of gonorrhea were reported, making it the second most common STD in the U.S. The CDC noted that rates of gonorrhea have increased 118% since a historic low in 2009.

Gonorrhea is treatable with antibiotics as it is bacterial in nature.  The biggest issue that has arisen over the years is that gonorrhea is becoming resistant to the medications available, resulting in less options for treatment.  This awareness has at least been the impetus behind the testing of new drugs to help treat this STI.  

Prevention

Condoms continue to offer the one of the most effective methods of prevention as long as they are used consistently and correctly for anal and vaginal sexual activity.  Oral barriers (aka dams) are the most effective prevention method for any oral/anal or oral/vaginal sexual activity when used consistently and correctly.

Another effective prevention path is through communication. Talk with your sexual partners about using condoms and dams, ask about testing and their health status, and be open about yours.  Although these conversations may seem daunting at first, discussing one’s health, any aspect of it, needs to be normalized. Removing the stigma and shame surrounding STIs and sexual wellness will aid in the transmission of the infections and normalize prevention activities.

And lastly, education needs to be expanded to include sexual health and wellness for all to increase the awareness of the prevention and treatment options available.  Increasing awareness, normalizing sexual health, and communicating and offering treatment and prevention options to all demographics, specifically any vulnerable demographics, will provide the necessary information and awareness of preventative options.

All aspects of our health are intertwined. Sexual health can impact one’s physical health, emotional health, mental health, and reproductive health.  Sexual health needs to be recognized as an integral part of our wellness so that everyone can make informed and comprehensive decisions.

Period Poverty & Its Impact

Period Poverty is a reality for many all around the world! Period Poverty can be defined as the lack of access to safe and hygienic menstrual products during monthly periods and inaccessibility to basic sanitation services or facilities as well as menstrual hygiene education.  This directly impact one’s ability to navigate daily living activities. The lack of access to hygiene products can cause feelings of both seclusion and exclusion. People stay home from school or work, unable to participate in daily activities.  Period Poverty can impact one’s mental health, resulting in anxiety, shame and isolation.  One’s physical health can also be impacted with a lack of access to proper hygiene, including water and basic hygiene supplies.

How Then Do We End Period Poverty?

Education and awareness are the most effective ways to help remove the stigma surrounding menstruation.  The removal of this stigma and shame that is attached to it is only the beginning.  In any given month more than 1.8 billion people are menstruating. We need to create and share with all genders a message of normalcy around menstruation so that everyone can have dignity, health and an ease of access to supplies to fill their needs.  But again, this is only the beginning. Understanding that these products are a necessity and, therefore, need to be accessible to all in need is the next step.  This requires making them readily available to everyone, especially anyone struggling financially or impacted by harmful social misconceptions or ideologies.  Menstruation should never limit anyone’s potential or ability to function in any situation.

US Statistics and Period Poverty

A 2019 US study found that 64% of menstruators noted that they struggled to afford menstrual products within the last year. Stemming from the cost of products, stigmas, education, and the world pandemic, those who menstruate struggle to afford menstruation products and have adequate education on the subject. 

The summary of takeaways from that study are:

• Period poverty, or the lack of information and education about menstruation as well as access to menstrual products, in the US affects all menstruators but especially those who are low-income, homeless, in college, imprisoned, or transgender. 
• With the recent inflation problems, Bloomberg reported that prices for pads rose 8.3% and tampons prices rose 9.8% in 2021. 
• A study done by St. Louis University on period poverty found that 36% of those surveyed who were full-time or part-time employed had to miss one or more days of work a month because of a lack of menstrual products during their periods. 
• Research done on the financial benefit of using menstrual cups estimates over 10 years found that a reusable cup would be 5% of the purchase of pads and 7% of the purchase cost of tampons. A reusable cup would also produce 0.4% of the plastic waste used for pads and 6% of the plastic waste used for tampons. 

The lack of access to period products is directly linked to many social and economical factors.  Period Poverty can be either a lack of access to or an inability to afford to purchase products. As having to choose between food or hygiene products is more and more an increased reality, we all need to work on reassessing how to overcome this issue.  

Next Steps?

Period poverty is a multi-faceted issue. What does that mean? It means it will take a multi-faceted solution.  This includes education, dispelling of myths and misconceptions, normalizing menstruation around the world, addressing basic access to hygiene necessities, economical solutions, eradicating social prejudices, and ultimately creating an environment where menstruation is simply a biological process. Period Poverty is a basic human rights issue that needs to be addressed with the following:

• They need to have the right to use safe menstrual products during their monthly menses.
• They need to have the right to a safe and private place to manage their menses, as well as clean water sources and facilities.
• Everyone needs to have good knowledge about menses to understand the difficulty that a woman has to go through every month.
• Knowledge of menses can also help avoid negative stigma about menstrual periods. As long as people have a mindset that menstrual products are not a priority, women will always be discriminated against, and it will not be easy for them to purchase menstrual tools, seek help when they are in need, and learn correct knowledge about menstrual health. 
•  

Only by all working together can we help to find solutions to ensure these basic needs are met for all.

What is a Latex Allergy or Sensitivity?

Latex Allergy Awareness Week

October 1-7 is Latex Allergy Awareness Week.  This week is focused on bringing an increased awareness surrounding latex allergies and sensitivities.  Latex allergies can range from mild to life threatening, and continued exposure has been shown to increase the severity. This is called sensitization.  The Mayo Clinic explains this process as your immune system identifying latex as a harmful substance and triggering certain antibodies to fight it off. The next time you're exposed to latex, these antibodies tell your immune system to release histamine and other chemicals into your bloodstream. This process produces a range of allergy symptoms. The more times you are exposed to latex, the more strongly your immune system is likely to respond.

What is Latex

Latex is a naturally occurring substance that is found beneath the bark of the rubber tree.  This milky white substance is harvested by tapping the trees.  The bark is scored and peeled back to create a channel that allows the sap to run into buckets attached to the trees.  The sap is collected and then processed  into latex that is used in many common day-to-day items.  Latex possesses a great many attributes that allow it to be used for a wide variety of items from gloves to balloons to condoms and dams.  But it also can be life threatening to people who have a latex allergy.

What are you allergic to in latex?

A latex allergy is actually an allergic reaction to the proteins present in the milky sap of the rubber tree.   Simply put, your body views the latex as something harmful.  This response causes a release of histamines to fight the “intruder”. Histamines and other chemical responses are what trigger the allergic reactions and symptoms.  It is the latex protein that creates this allergic reaction, one that can worsen over repeated exposure.  This protein is very similar to proteins in some nuts, fruits and vegetables.  It is not uncommon for people who have a latex allergy to also have allergies or sensitivities to the following foods:

• Avocado
• Banana
• Chestnut
• Kiwi
• Apple
• Carrot
• Celery
• Papaya
• Potatoes
• Tomatoes
• Melons

What is Polyisoprene?

Interestingly enough, polyisoprene is created either by removing the allergy producing protein from natural rubber or as a totally synthetic product created in a laboratory setting.  But polyisoprene retains the many attributes that natural latex has with its softness, tear and tensile strength, and comfort.  Polyisoprene condoms and dams are a safer option for anyone who has latex sensitivities or allergies.  They provide a necessary alternative for the growing number of individuals who suffer from latex allergies.

Pros & Cons of Polyisoprene

There are far more pros than cons when it comes to polyisoprene condoms and dams!  The pros are obvious!  You can enjoy safer sex without the concerns of a latex allergic reaction to the condoms or dams being used.   Polyisoprene condoms and dams are a safe replacement for any latex condom or dam.   The cons are very few and far between!   The one that first comes to mind is that they are a bit more costly than their latex alternatives.

Protect Your Health!

Protection is available for everyone, even those with a latex allergy or sensitivity.  The options are growing for access to polyisoprene condoms and dams.  Harmony Polyisoprene Dams are available in both retail and bulk options.  Your health, all aspects of it, is worth protecting. 

Choice

Choice is something everyone should have the right to when it comes to making decisions about one’s sexual health and wellness, including contraception.  Choice can be defined as the following:

• an act of selecting or making a decision when faced with two or more possibilities.
• the right or ability to make, or possibility of making, such a selection.
• a range of possibilities from which one or more may be selected
• a course of action, thing, or person that is selected or decided upon.

September 26 is World Contraception Day and the theme for this year is “The Power of Options”. It is absolutely crucial to be empowered when it comes to one’s sexual health. And empowerment comes through choice, education and knowledge. 

Education is Key

Education is a key component of empowerment.  It is only through awareness and knowledge that one can make an informed decision regarding the best options for one’s health.  When you have access to correct, informative and useful information, then you can make decisions based on how best to fill your needs.  This also means you must always make sure that the sources you are accessing are credible. Information is available from health practitioners, clinics, and sexual wellness facilities.

Types of Contraceptives

Contraceptives are available in many different formats, offering options based on factors such as lifestyle, health considerations, availability, future plans, and, ultimately, preference.  These include different hormonal options, IUDs, assorted barrier methods, and surgical options to name a few.   The good news is that there are options to choose from that best fit one’s lifestyle. Even within each group of contraceptives there are choices available, allowing one to further tailor their contraceptive needs.  One very important thing to remember is that not all contraceptives aid in the prevention of STIs. Always make sure to use a condom or dam (oral barrier) when engaging in penetrative or oral sex.

The Power of Options

The theme of 2023’s World Contraception Day is The Power of Options.  This theme is based on more than just the varied contraceptive options. It also focuses on the power those options allow to be formative in choosing one’s life path. These could include family planning, child spacing, increased reproductive health, gender equality and continuing to aid in open communication around sexual wellness.  When there are options and choices that allow individuals to choose what works best for them, then the odds of healthy practices being implemented rise.  In order for something to work, it needs to work for the individual. Offering choices in contraception simply allow everyone to choose what will work best for them.

STIs and Testing

How to Begin the Testing Path

We have all heard how testing is an important component of our Sexual Health, but often times we do not know where to get tested.  Testing is available in many places within North America. You can begin by asking your doctor, going to a clinic or public health facility for guidance. Testing is free at many facilities including family doctors’ offices, walk-in clinics, sexual health clinics, and other public health units and community centres. 

What Types of Testing Do I Need?

The type of test needed is directly dependent upon what you are being tested for.  There are a few different types of STI Test procedures; most of them are simple and easy to have done.

• Blood tests are done for the following: hepatitis B, hepatitis C, HIV, syphilis and herpes (HSV).
• Urine tests or genital swabs can be done for the following: gonorrhea, chlamydia and trichomoniasis.
• Oral swabs can be done for the following: gonorrhea, chlamydia, HSV and HPV.
• Anal swabs can be done for the following: anal chlamydia, gonorrhea and HPV.
• Lesions swabs can be done for the following: HSV, HPV and syphilis.

It is important to get tested if having multiple sexual partners, the condom or dam breaks or slips, you are not sure of the status of your partner, at an annual checkup, if showing symptoms or know of recent exposure, and/or as part of your routine ongoing health care.

The bottom line is that folks of all genders and sexual orientations should be tested once a year, after unprotected sex, or in between new partners — whichever comes first!

Exposure to different STIs also come with different timelines for testing.  There are different incubation periods for the different STIs.  This incubation period means the time between infection and the appearance of symptoms.  This ranges between a couple of days to a few months. This is something to discuss with your healthcare provider to get specific answers about in order to test within the appropriate time to avoid false negative results.

How Long Before I Get Results?

Most of the test results are completed between 2-5 days.  But never assume you are negative if you do not hear back from your test provider. Always call and confirm the results before engaging in sexual activities.  Tests are also available for use within the privacy of your home.  These ones are generally something that requires payment.  The in-home testing is an alternative for folks who are uncomfortable going to a healthcare provider for testing. 

Results and Next Steps

Once you have received your results, the next steps depend upon what they were.  If you are positive, then there are steps that need to be taken. These are dependent upon the diagnosis, and often times involve medication, sharing your diagnosis with past sexual partners and/or a host of treatment options to help manage symptoms and future outbreaks.  The reality is that 1 in 2 people will experience an STI within their lifetime.  With that representing 50% of the population, we need to continue to remove the stigma from STIs, create awareness about them and the prevention options available, make testing easily accessible and known, and work together to lessen the epidemic proportions of STIs worldwide.

Together we can make a difference!

What is Chlamydia?

“Chlamydia (kluh-MID-e-uh) trachomatis (truh-KOH-muh-tis) is a common sexually transmitted infection (STI) caused by bacteria. You might not know you have chlamydia because many people don't have signs or symptoms, such as genital pain and discharge from the vagina or penis.”

How do you get it?

Chlamydia is spread through vaginal, anal or oral sex when one of the partners has the infection. If an individual has previously been treated for the bacterial infection, they are still at risk of contracting it again. 

Symptoms

According to the Centers for Disease Control and Prevention (CDC):

Most people who have chlamydia have no symptoms. If you do have symptoms, they may not appear until several weeks after you have sex with an infected partner. Even when chlamydia causes no symptoms, it can damage your reproductive system.

Women with symptoms may notice

• An abnormal vaginal discharge;
• A burning sensation when urinating.

Symptoms in men can include

• A discharge from their penis;
• A burning sensation when urinating;
• Pain and swelling in one or both testicles (although this is less common).

Men and women can also get infected with chlamydia in their rectum. This happens either by having receptive anal sex, or by spread from another infected site (such as the vagina). While these infections often cause no symptoms, they can cause

• Rectal pain;
• Discharge;
• Bleeding.

You should be examined by your doctor if you notice any of these symptoms or if your partner has an STI or symptoms of an STI. STI symptoms can include an unusual sore, a smelly discharge, burning when urinating, or bleeding between periods.

What are some complications that can arise?

Mayo Clinic has created a list of complications that Chlamydia can be associated with: 

• Pelvic inflammatory disease (PID). PID is an infection of the uterus and fallopian tubes that causes pelvic pain and fever. Severe infections might require hospitalization for intravenous antibiotics. PID can damage the fallopian tubes, ovaries and uterus, including the cervix.

• Infection near the testicles (epididymitis). A chlamydia infection can inflame the coiled tube located beside each testicle (epididymis). The infection can result in fever, scrotal pain and swelling.

• Prostate gland infection. Rarely, the chlamydia organism can spread to a man's prostate gland. Prostatitis can cause pain during or after sex, fever and chills, painful urination, and lower back pain.

• Infections in newborns. The chlamydia infection can pass from the vaginal canal to your child during delivery, causing pneumonia or a serious eye infection.

• Ectopic pregnancy. This occurs when a fertilized egg implants and grows outside of the uterus, usually in a fallopian tube. The pregnancy needs to be removed to prevent life-threatening complications, such as a burst tube. A chlamydia infection increases this risk.

• Infertility. Chlamydia infections — even those that produce no signs or symptoms — can cause scarring and obstruction in the fallopian tubes, which might make women infertile.

• Reactive arthritis. People who have Chlamydia trachomatis are at higher risk of developing reactive arthritis, also known as Reiter's syndrome. This condition typically affects the joints, eyes and urethra — the tube that carries urine from your bladder to outside of your body.

Prevention Methods

As the most common sexually transmitted infection, and one of the most difficult infections to diagnose early on, it’s incredibly important that safety precautions are set in place when you are sexually active. Some good measures to take to stay safer include;

• Condoms. When used correctly, male or female condoms decrease your risk of contracting Chlamydia.

• Screenings. When you are sexually active, it’s very important to have regular discussions with your doctor in regard to your sexual health. If you have multiple partners, you should talk to your doctor to schedule regular screenings for chlamydia as well as other STI’s.

• Treatment. If you have concluded that you have contracted Chlamydia, the good news is that it can be easily cured with antibiotics. According to the CDC, once you have received your antibiotics:

“Persons with chlamydia should abstain from sexual activity for 7 days after single dose antibiotics or until completion of a 7-day course of antibiotics, to prevent spreading the infection to partners. It is important to take all of the medication prescribed to cure chlamydia. Medication for chlamydia should not be shared with anyone. Although medication will stop the infection, it will not repair any permanent damage done by the disease. If a person’s symptoms continue for more than a few days after receiving treatment, he or she should return to a health care provider to be re-evaluated.”