A student from Wyoming wants to know:
What type of people get sexually transmitted diseases?
Dr. Caron's Answer:
Well, first of all, plenty of people get STIs. Each year, there are more reported cases of sexually transmitted infections than the common cold. Basically, anyone having body contact with someone who is already carrying an STI can get one. An estimated 10 to 15 million Americans contract some STI every year. As a group, STIs are the most commonly reported communicable infections in the nation. The statistics on STIs are probably understated for two reasons: (1) Many people don't show symptoms of an infection and go undetected, and (2) many don't seek treatment due to embarrassment and/or fear. But even though the statistics available are limited, they are still alarming because they are evidence of an epidemic no one wants to acknowledge. The current situation in the United States is such that it is as if someone is standing in the middle of the room screaming FIRE, and we are all sitting around pretending everything is fine. Scary.
students from the University of Maine wants to know....
Is there any other possible way to determine that you have a STD other than
to get tested?
This is a great question. Some people
who have contracted a sexually transmitted infection
may notice such signs as an unusual discharge, odor,
burning/pain in the genitals or with urination, or they
may see an unusual lump, bump, or blister. Other
people who have contracted an infection may not notice
any signs or symptoms. In fact, many of the sexually
transmitted infections can be carried by someone without
any signs or symptoms - at least not in the early days
or weeks after exposure. That's why it is recommended
that all people who are sexually involved get regular
checkups. It is unwise to try to diagnose and treat the
best way to find out if you have contracted an infection
is to have a medical exam performed - preferably by someone
who specializes in sexually transmitted diseases/infections
and is up-to-date on the latest signs, symptoms, diagnostic
techniques and treatments. The tests are pretty simple
and straightforward - including such things as a urine
culture, a swab of the cervix, a blood test, a visual
exam of the areas thought to be involved (vagina, penis,
anus, throat). There will also be a chance to talk about
your concerns, and good information will be provided
on treatment (if needed), as well as how to lower your
risks of future infections. If you have concerns
that you or your partner could be infected with something,
get it checked out.
A student from
an unidentified university wants to know....
I started seeing a guy who
has HPV. He has gone to his family doctor and has used
the cream. His
doctor said he can barely see them. The warts are located
on his mound (pubic) area. His doctor has referred him to see a specialist. My
question is: Because he is on medication can this be spread to me? Also, how
can we use protection when they are on his mound area?
Dr. Caron's response:
Genital warts are caused by the human papilloma virus (HPV). It is the most
common sexually transmitted viral disease in the U.S., with over 5 million
new cases annually. The warts usually appear on the genitals a few
months after exposure to an infected partner. They are not painful, but
some strains have been associated with a higher incidence of cervical cancer.
HPV is extremely contagious, so it is in your best interest to wait until
the small warts have been treated to proceed with genital contact. As you
realize, a male condom is not going to cover the mound where the warts
are located; and if you use a female condom, the rim may offer some protection
from coming in contact with his mound, but it cannot be guaranteed to keep
the area covered during sexual intercourse.
Although the cream he is using is effective in removing the warts, it works
slowly and may take months - and the warts are still contagious. In addition,
contact with him is not advised while he is using the cream that is designed
to burn off the warts; direct contact of this cream with your genitals would
not be pleasant. I am glad to know he is being referred to a specialist someone
who works specifically with sexually transmitted diseases who can verify
that these are genital warts and remove them more quickly. Genital warts
can be removed by laser surgery, cryotherapy (freezing), cauterization (burning),
or surgical excision. Once they are treated and the skin has healed, your friend
should plan regular follow-up visits and also check himself regularly since
recurrence is not uncommon. As his sexual partner, you should proceed with
caution once all signs of the warts are gone.
from many universities want to know..... about
Dr. Caron's Answer: February 14-21 is National Condom Week - so I'd like to focus today's column
on several questions I have received about condoms from college students
around the country - whether you go to college in Maine, Maryland, Massachusetts,
Michigan, Minnesota, Mississippi, Missouri, Montana or elsewhere, I'd like
you to take a moment to think about the issues related to condom use. Let
me start off by saying: Vows of abstinence break far more often than
condoms. Having said that, I would like to point out that the simple truth
is that, for sexually active couples, condoms are the best means we have
of preventing HIV/AIDS and other sexually transmitted infections (STIs). For
a couple who is committed to having sexual intercourse and who have any
concern regarding any of the STIs, latex condoms are the best means of
preventing infection. Abstinence and a mutually faithful monogamous
relationship with an uninfected partner, few would argue, are even more
effective; but if sexual intercourse is going to occur, whatever
the reasons behind the decision, condoms are the best approach to preventing
For condoms to
work, they must be used correctly and consistently. The
following instructions will help ensure effective use:
- Use latex condoms
every time you have sexual intercourse; this is
the key to any kind of successful contraception.
- Use spermicide
containing nonoxynol-9 with the condom. Foam and film
are both easy to apply. Spermicide protects against pregnancy
and a number of STIs.
- Do not put
a condomless penis into a vagina or anus. Even
if a man has great "control" there is always the possibility
- Leave about
a half-inch of space at the condom tip, and roll the
condom all the way down to the base of the penis.
- Soon after
ejaculation, the penis should be withdrawn. Make
sure someone holds the base of the condom firmly against
the penis as it is withdrawn.
- Do not re-use
- Keep condoms
in a cool, dry and convenient place.
If you and your
partner are uncomfortable with condom use, consider the
is crucial. It may seem "unromantic," but planning
your contraception/STI protection strategy before you
are sexually entangled is essential. Sex is too
important to be left up to your genitals. Giving
or getting a disease or worrying about pregnancy is about
as unromantic as you can get. Explore your feelings
together; share your knowledge. Consider
visiting your local health center for information - together. Neither
partner should be forced to use a form of birth control
he or she is truly unhappy with. But the issue
of protection must be dealt with - by both of you.
- Don't forget
your sense of humor and playfulness. Condoms can
actually provide lots of laughs; laughter and sex go
well together. Fancy condoms - lubricated, ribbed,
flavored, colored (have you seen the black "tuxedo condoms" for
formal affairs?) - are popular for their entertainment
value. Let yourself be entertained.
- Stand your
ground. Unless you want to be pregnant and are
sure your partner is free of STIs, you need protection
during sex. If your partner says "no" to using
a condom, you can just tell them: "None of my other
partners have minded. What's wrong with you?" If
your partner cares about you, he'll want to use a condom.
if he really is against wearing a condom, she can wear
one - the female condom offers great protection from
pregnancy and infection as well.
A student from
Miami University of Ohio wants to know.....
Can you get genital herpes from someone with a cold sore giving you oral sex?
Dr. Caron's Answer: Yes. Genital herpes infection is caused by exposure to the herpes simplex virus
type 1 (HSV-1) or herpes simplex virus type 2 (HSV-2) through sexual contact.
HSV-1 initially was associated with oral infection (cold sores and fever blisters
around the mouth) and HSV-2 with genital infection (blisters on the penis or
vulva). Over the past 30 years, however, the increased popularity of oral sex
has led to transferring HSV-1 from the mouth to genitals. The two viruses are
not different clinically, as both cause the same painful symptoms. A 2-12 day
incubation period follows transmission of the virus. There is no cure, but
there is treatment to speed the healing of the painful blisters. It should
be noted that outbreaks of genital herpes caused by HSV-1 are usually less
recurrent, produce less viral shedding, and in general are less of a problem
for the person (and their partners). An estimated 50 million people are presently
infected with genital herpes caused by HSV-2 in the U.S. - if you ad din the
percentage of those with genital herpes du to HSV-1, the percentage is number
is even larger. You should know that the virus can be easily spread by even
a quick, casual kiss and thus it should not be assumed that a person with oral
herpes got it from performing oral sex. By the way, not all mouth ulcers are
caused by the herpes virus; they can also be caused by bacteria, allergic reactions,
or autoimmune (canker sores) responses. However, "fever blisters" and
most cold sores are herpes.
A student from Princeton
wants to know:
What do you do when you find out that
you have a sexually transmitted infection and your partner
won't get tested?
Answer: This is a very serious situation. Have you tried to find out
why your partner won't be tested? Is it fear? Shame? Denial?
Is she/he afraid to know that they may be infected? Are there
issues of who gave this disease to who? Is there an issue
of faithfulness? Maybe your partner has no symptoms - do they
realize some people show no signs when infected? Why is your
partner willing to risk being infected (and the potential
damage to the reproductive organs) and also willing to risk
passing it back to you if you continue to be sexually involved?
If your partner won't be tested, how can you continue in a
sexual relationship? Why is your partner willing to risk disease
and possibly infecting others (you and future partners)? I
can only imagine how this has impacted your relationship.
While you cannot force your partner to be tested, you can
decide if you want to continue to participate in this relationship.
You need to seriously think about this relationship and stand
firm on your desire to take care of yourself.
A student from Northlake wants to know....
is the percentage of sexually transmitted diseases (STDs)
in college students?
Response: Let me start off by saying there are nearly 15 million new
cases of STDs each year in the United States and most (two-thirds)
of those occurring among those younger than 25. Some researchers
have estimated that, among sexually active college students,
about one in three will contract an STD by the time they graduate.
I also want to point out that the U.S. has the highest rate
of STDs in the industrialized world - it is 50 to 100 times
higher than other industrialized nations... WHY? Many people
point to a lack of prevention efforts (i.e., lack of education
about the diseases and low condom use). Not long ago, I heard
a person from the Centers for Disease Control speak at a conference
on this very issue. They said that an analogy for how the
U.S. is dealing with this issue would be that they are screaming
"FIRE!" and everyone is just sitting around ignoring
them. It is an epidemic. Just think about the estimates of
the number of cases: Chlamydia, with 3million new cases a
year, is as common as the common cold. Trichomoniasis: 5 million
new cases; Gonorrhea: 650,000 new cases; HPV which causes
genital warts: 5.5 million new cases a year; Genital herpes:
1 million new cases; Hepatitis B: 100,000new cases a year;
and Syphilis: 20,000 new cases a year. I should also point
out that HIV is a very real and active problem on college
I am very concerned
that things are only going to get worse before they can get
better due to our current administration's "war on condoms"
- which is trying to convince people that condoms do not work.
Take for example what happened to the Centers for Disease
Control website: A fact sheet on condoms was removed and,
eventually, replaced by one that emphasized that condoms may
not work. How could this happen in America - that such misinformation
could be allowed to spread - despite cries from credible health
organizations who know that condoms are our best defense against
diseases? Until we take our collective heads out of the sand
and really take a look at the seriousness of the issue, I
don't see much hope for lowering the rates. By the way, such
misinformation about condoms will lead to not only an increase
in disease, but also an increase in pregnancy. Only when we
are willing to educate young people about the seriousness
of these infections, and encourage all people who are sexually
active to use latex condoms every time, will we see a reduction
in the numbers.
from Texas A&M: What are the symptoms
of genital warts?
Genital warts are determined by visible inspection. HPV (human
papilloma virus) causes genital warts, which is a very common
virus, infecting about 1 out of every 4 sexually active people.
The warts typically appear on the genitals as soft, pink,
painless single or multiple growths resembling a small cauliflower.
In men, they may appear on the penis, foreskin, and scrotum,
and within the urethra. In women, they may be found on the
vulva, in the vagina, and on the cervix. The warts begin to
appear 1-3 months after contact and are diagnosed visibly
at a health clinic specializing in sexually transmitted infections.
They may be removed by freezing, burning, dehydration with
an electrical needle, or surgery. Although such treatments
may remove the warts, please be aware that they do not rid
the body of the virus - so there may be recurrences.
from a student at the University of Maine: Can
you get genital herpes from someone with a cold sore giving
you oral sex?
Genital herpes infection is caused by exposure to the herpes
simplex virus type 1 (HSV 1) or herpes simplex virus type
2 (HSV 2) through sexual contact. HSV 1 initially was associated
with oral infection (cold sores and fever blisters around
the mouth) and HSV 2 with genital infection (blisters on
the penis or vulva). Over the past 30 years, however, the
increased popularity of oral sex has led to an almost equal
probability of transferring either form from mouth to genitals
and vice versa. The two viruses are not different clinically,
as both cause the same painful symptoms. A person with
blisters on the mouth cannot only transfer the virus to
another person's genitals, and vice versa, but a person
with herpes can transfer it to other parts of his or her
own body by touch, including the eyes, as well (this is
called autoinoculation). A 2-12 day incubation period follows
transmission of the virus. There is no cure, but there
is treatment to speed the healing of the painful blisters.
An estimated 20-30 million people are presently infected
with genital herpes in the U.S. You should know that the
virus can be easily spread by even a quick, casual kiss
and thus it should not be assumed that a person with oral
herpes got it from performing oral sex. By the way, not
all mouth ulcers are caused by the herpes virus; they can
also be caused by bacteria, allergic reactions, or autoimmune
(canker sores) responses. However, "fever blisters" and
most cold sores are herpes.