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Unsafe Sex
A Flurry of New Research Suggests that Sex is Getting Riskier in Unanticipated Ways

March 3th, 2004

By Ken McGrath :eCureMe Staff Writer
March 3th, 2004 : Physician Approved

Human papillomavirus (HPV) and trichomoniasis, a duo of less well known STDs that are difficult to diagnose, have few outward symptoms and can cause long term damage are besetting Americans - especially the young and sexually active - according to a recent study published by CDC researchers. The report, released in the February issue of Perspectives on Sexual and Reproductive Health estimates that there 18.9 million new STD infections among Americans in 2000. 48% of them - 9.1 million - occurring among 15 to 24 year olds; a disproportionately large share, as teens and young adults make up only 25% of the sexually active population. 70% of all new cases among youth were cases of either HPV or trichomoniasis.


While the potentially life-threatening HIV / AIDS has been in the public spotlight for years, and commercials touting drugs to treat widespread genital herpes air around the clock, the STDs the report identifies as most common don’t often make headlines.

HPV is an umbrella term for a group of 100 viruses, 30 of which can be transmitted sexually and cause infections, and is more commonly known by its primary symptom - genital warts. According to study estimates, HPV infected 4.6 million young people in 2000. 50% of sexually active men and women will acquire the viral infection at some point in their lives. 80% of women will have had it at least once before they turn 50.

In those infected, the virus lives on the surface of the skin or in mucous membranes and can be spread to others by genital contact. Generally, HPV doesn’t cause any symptoms and most who are infected don’t know it. Only in some cases does the virus cause its signature ulcerations - small, moist swellings that can appear on the penis, scrotum, vulva, groin, thigh and anus. Since, it travels from skin surface to skin surface, condoms may provide a false sense of security. Transmission can occur through contact of body parts not covered by latex - such as the thigh and scrotum.

Since the source of HPV infections is viral, nothing can be done to cure them - only the symptoms can be treated. However, the dangers of HPV lie mostly in an elevated risk of developing cancer later in life - cervical cancer being the most likely. In 90% of women the virus disappears from the body within two years of infection. However, in a small number of cases, long-term persistent infections can cause pre-cancerous changes in cervical cells. A similar infection process can, though much less frequently, elevate the risk of anal and rectal cancers.

Another recent study suggests that engaging in oral sex with HPV infected partners can also increase the likelihood of mouth cancers. Though the risk scientists found was small, the data was expansive. French researchers studied over 3,000 subjects with and without oral tumors. Those with tumors that contained a particular strain of HPV were three times more likely to have engaged in oral sex than others. Analysis concluded that fellatio and cunnilingus could both lead to oral infections.


Like HPV, trichomoniasis isn’t a household name, but it should be. More than 180 million new cases of the disease - caused by a single-cell parasite - develop worldwide each year, 7.4 million of those in the U.S. Behind HPV, it’s estimated to be the most widespread STD among youth. Young women are most at risk, with experts estimating that one in five will contract the disease.

Also similar to HPV, trichomoniasis can go largely unnoticed. 50% of infected women and 90% of infected men don’t exhibit symptoms. Female infections usually occur in the vagina or cervix - and when they do produce noticeable symptoms, vaginal discharge, odor and itching occur along with discomfort during urination and intercourse are the most common. Male infections usually occur in the urethra - the tube in the penis that channels urine and semen - and produce irritation at the head of the penis as well as unusual discharges and urinary discomfort.

Once diagnosed, infections can be cleared up easily. An orally administered medication called metronidazole is up to 95% effective in killing the protozoan organisms that cause the disease, often in a single dose. Untreated cases can contribute to future pregnancy problems, such as infertility and premature delivery. They can also increase the risk of contracting HIV through unprotected sex and some evidence suggests that the disease can cause prostate inflammation in men, as well as boost the chances of an HPV infection nudging healthy cells towards cancer

The difficulty is in making the diagnosis. Even if a patient noticed the symptoms, the procedure most widely used by doctors to identify the disease misses 50% to 60% of cases. Currently, the diagnostic standard is a process known as wet mount microscopy, wherein a fluid sample taken from a patient is put under a microscope and examined for the protozoan that causes trichomoniasis. If the concentration of organisms in the sample isn’t high enough, the test can miss their presence. Tests that catch 85% to 95% of cases are available, but can take days to provide results and are more expensive, and are thus much less frequently used.

As long as diagnostic tests come up short, and symptoms go unnoticed, HPV and trichomoniasis will likely continue to fly under most people’s radar. Until their dangers are widely realized, keeping aware and practicing safe sex is the best defense - especially for the young.

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