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    TALK-TEST-TREAT & PREVENT

    by Ngozi Osuagwu, MD | April 11th, 2021

    TALK-TEST-TREAT & PREVENT

    I remember a few years back when I saw my gynecologist for my yearly exam. She obtained my pap smear and took out the speculum.

    I asked, “Did you check me for chlamydia and gonorrhea?”

    She replied, “No, I did not, I know your husband.”

    I replied, “I know him too, please check.”

    Please know, I love my husband and we have been married for a really long time and this is not to imply that I think he is sleeping with another woman. This is just to say that the only person I can be 100 percent sure of what they are doing is myself. Every person who is sexually active is at risk of getting a sexually transmitted infection (STI)*. STIs do not discriminate. They do not care what race you are or how much money you make. If you are having sex, you are at risk.

    April 11 – 17th is Sexually Transmitted Disease (STD)* Awareness Week. According to the CDC, this week provides an opportunity to raise awareness about STDs and how they impact our lives; reduce STD-related stigma, fear, and discrimination; and ensure people have the tools and knowledge to prevent, test for, and treat STDs.

    Here are some facts:

    • The United States has the highest rate of sexually transmitted diseases of any developed country in the world.
    • 1 in 5 people in the US have a sexually transmitted infection (STI).
    • There were 26 million new STIs diagnosed in 2018 and the number continues to rise each year.
    • Almost half of new STIs were among youth aged 15 – 24 years old in the US.
    • STIs cost the US healthcare system billions each year.  In 2018, the new infections totaled $16 billion in direct lifetime medical cost alone. $1.1 billion direct cost was attributed to chlamydia, gonorrhea and syphilis which are common, preventable infections.

    When I think of the amount of money spent dealing with STDs, it blows my mind. I would rather spend that money on education, affordable housing or making healthy foods available. We have to do something about this. We are all part of the solution in curbing this problem. The CDC encourages us to choose a campaign to spread the word. I have chosen once again – TALK.TEST.TREAT but have also added the word PREVENT.

    TALK – There should be no shame in talking about STIs. We all have to talk about it especially with our youth. I have always told young people who are around me, when you do adult things, there are adult consequences. Getting a sexually transmitted infection can be a consequence of having sex, but it can be prevented. Sex is beautiful and is part of life. We cannot be afraid to talk about sex. The majority of us would not be here if two people were not having sex to make us. Let us talk about relationships. Let us share our experiences. Let us talk about having a evidence-based sexual health curriculum in schools. Let us talk to our health care providers. Let us talk with each other. TALK.TALK.TALK.

    TEST – Not all STIs are associated with symptoms. I am a physician and I cannot look at someone and know they have an STI. Testing is important. Everyone has been talking about the COVID19 vaccine card. I believe we should have an STI card – a card that you present prior to becoming intimate. The card would need to be updated prior to a new relationship and at the end of a relationship. Just thinking out loud.

    According to the CDC, the following are the current STD screening recommendations:

    • All adults and adolescents from ages 13 to 64 should be tested at least once for HIV.
    • All sexually active women younger than 25 years should be tested for gonorrhea and chlamydia every year (I believe that trichomoniasis needs to be added). Women 25 years and older with risk factors such as a new or multiple sex partners or a sex partner who has STD should also be tested for gonorrhea and chlamydia (add trichomoniasis) every year.
    • All pregnant women should be tested for syphilis, HIV, and hepatitis B early in pregnancy.
    • All sexually active gay and bisexual men should be tested at least once a year for syphilis, chlamydia, and gonorrhea. Those who have multiple or anonymous partners should be tested more frequently for STDs. (i.e., at 3- to 6-month intervals).
    • Sexually active gay and bisexual men may benefit from more frequent HIV testing (e.g., every 3 to 6 months).
    • Anyone who has unsafe sex or shares injection drug equipment should get tested for HIV at least once a year.

    If you do not have a health care practitioner and looking for an STD testing site near you, please click here. You can be tested for additional STIs if you want. Do not let the fear of a pelvic exam stop you for getting tested.  You can be tested for some STIs through urine.

    TREAT – When you are getting treated for an STI, please take all the medication as directed. Please inform your partner so that they can be treated. I know sometimes you might be upset and not want to say anything, but we can only stop the spread by everyone involved getting treated. There is also expedited partner therapy (EPT) where the health care provider can provide treatment to your partner without having your partner as a patient.

    PREVENTION – HIV and herpes have no cure, however there are strategies to control symptoms and decrease the chance of transmission to the partner.

    • HIV – if you have HIV, take your medication. If you do not have HIV and your partner has HIV, then you can use Pre-Exposure Prophylaxis (PrEP) to help decrease your risk of getting HIV.
      • Herpes– If one person in the relationship does not have herpes and the other does, then the person who does can take therapy daily to help decrease the risks of transmission.
      • Human papilloma virus (HPV) – The vaccine is one of the ways that we can help prevent HPV. HPV causes majority of cervical cancer. Although the best time to get the HPV vaccine is before one is sexually active, you can get it between ages 9 to 26 whether or not you are sexually active or have been diagnosed with HPV. If you have not gotten the vaccine, please get the vaccine. Before age 15, you only need two shots. 15 and older, you will need 3 shots. If you are between 26 and 45 years old- ask your physician if you can get it. The age has been extended to age 45 years old, but not all insurances are covering.
      • Do not forget CONDOMS. Condoms can decrease the risks of getting an STI.

    I believe that we can turn things around. We do not have a choice. STIS have consequences, for example cervical cancer, pelvic inflammatory disease, pelvic pain and/or infertility to name a few. We can all make a difference whether we are sexually active or not. We can make a difference regardless of our age. Keeping My Sisters Alive and Healthy is all about sharing the information so that everyone benefits. TALK-TEST-TREAT and PREVENT.

    Source: Centers for Disease Control and Prevention (CDC)

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    Secure Your Copy of Letters to My Sisters by Dr. Ngozi Osuagwu.
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    The book discusses common gynecological and women’s health issues in a series of witty and entertaining letters. These letters, all educational, offer suggestions on what approaches to take in tackling the medical problems that typically bring women to an ob/gynecologist. The letters are spiced with art, a poem and quotes. Although its emphasis is on gynecology and women’s health, it touches on some other medical issues that make women visit their doctors.

    The second half of the book briefly discusses the most common gynecological conditions and also provides an overview of sexually transmitted infections. A list of annotated websites dealing with the different topics in the book is provided for the reader who wants to pursue each subject in depth.




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