HIV, the virus that causes AIDS

March 14, 2009 by admin · Leave a Comment 

HIV infection is, by far, the most deadly STD, and considerably more scientific evidence exists regarding condom effectiveness for prevention of HIV infection than for other STDs. The body of research on the effectiveness of latex condoms in preventing sexual transmission of HIV is both comprehensive and conclusive. The ability of latex condoms to prevent transmission of HIV has been scientifically established in “real-life” studies of sexually active couples as well as in laboratory studies.

Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of HIV.

Theoretical basis for protection. Latex condoms cover the penis and provide an effective barrier to exposure to secretions such as urethral and vaginal secretions, blocking the pathway of sexual transmission of HIV infection.

Epidemiologic studies that are conducted in real-life settings, where one partner is infected with HIV and the other partner is not, demonstrate that the consistent use of latex condoms provides a high degree of protection.

 

Other Diseases transmitted by genital secretions, including Gonorrhea, Chlamydia, and Trichomoniasis

Latex condoms, when used consistently and correctly, reduce the risk of transmission of STDs such as gonorrhea, chlamydia, and trichomoniasis.

STDs such as gonorrhea, chlamydia, and trichomoniasis are sexually transmitted by genital secretions, such as urethral or vaginal secretions.

Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.

Theoretical basis for protection. The physical properties of latex condoms protect against diseases such as gonorrhea, chlamydia, and trichomoniasis by providing a barrier to the genital secretions that transmit STD-causing organisms.

Epidemiologic studies that compare infection rates among condom users and nonusers provide evidence that latex condoms can protect against the transmission of STDs such as chlamydia, gonorrhea and trichomoniasis.

Genital ulcer diseases and HPV infections

Genital ulcer diseases and HPV infections can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Consistent and correct use of latex condoms reduces the risk of genital herpes, syphilis, and chancroid only when the infected area or site of potential exposure is protected. Condom use may reduce the risk for HPV infection and HPV-associated diseases (e.g., Genital Warts and cervical cancer).

Genital ulcer diseases include genital herpes, syphilis, and chancroid. These diseases are transmitted primarily through “skin-to-skin” contact from sores/ulcers or infected skin that looks normal. HPV infections are transmitted through contact with infected genital skin or mucosal surfaces/secretions. Genital ulcer diseases and HPV infection can occur in male or female genital areas that are covered (protected by the condom) as well as those areas that are not.

Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.

Theoretical basis for protection. Protection against genital ulcer diseases and HPV depends on the site of the sore/ulcer or infection. Latex condoms can only protect against transmission when the ulcers or infections are in genital areas that are covered or protected by the condom. Thus, consistent and correct use of latex condoms would be expected to protect against transmission of genital ulcer diseases and HPV in some, but not all, instances.

Epidemiologic studies that compare infection rates among condom users and nonusers provide evidence that latex condoms provide limited protection against syphilis and herpes simplex virus-2 transmission. No conclusive studies have specifically addressed the transmission of chancroid and condom use, although several studies have documented a reduced risk of genital ulcers associated with increased condom use in settings where chancroid is a leading cause of genital ulcers.

Condom use may reduce the risk for HPV-associated diseases (e.g., Genital Warts and cervical cancer) and may mitigate the other adverse consequences of infection with HPV; condom use has been associated with higher rates of regression of cervical intraepithelial neoplasia (CIN) and clearance of HPV infection in women, and with regression of HPV-associated penile lesions in men. A limited number of prospective studies have demonstrated a protective effect of condoms on the acquisition of genital HPV.

While condom use has been associated with a lower risk of cervical cancer, the use of condoms should not be a substitute for routine screening with Pap smears to detect and prevent cervical cancer, nor should it be a substitute for HPV vaccination among those eligible for the vaccine.

Male Latex Condoms

March 14, 2009 by admin · Leave a Comment 

Male Latex Condoms and Sexually Transmitted Diseases

Consistent and correct use of male latex condoms can reduce (though not eliminate) the risk of STD transmission. To achieve the maximum protective effect, condoms must be used both consistently and correctly. Inconsistent use can lead to STD acquisition because transmission can occur with a single act of intercourse with an infected partner. Similarly, if condoms are not used correctly, the protective effect may be diminished even when they are used consistently. The most reliable ways to avoid transmission of sexually transmitted diseases (STDs), including human immunodeficiency virus (HIV), are to abstain from sexual activity or to be in a long-term mutually monogamous relationship with an uninfected partner. However, many infected persons may be unaware of their infections because STDs are often asymptomatic or unrecognized.

This fact sheet presents evidence concerning the male latex condom and the prevention of STDs, including HIV, based on information about how different STDs are transmitted, the physical properties of condoms, the anatomic coverage or protection that condoms provide, and epidemiologic studies assessing condom use and STD risk. This fact sheet updates previous CDC fact sheets on male condom effectiveness for STD prevention by incorporating additional evidence-based findings from published epidemiologic studies.

Sexually Transmitted Diseases, Including HIV Infection

There are two primary ways that STDs are transmitted. Some diseases, such as HIV infection, gonorrhea, chlamydia, and trichomoniasis, are transmitted when infected urethral or vaginal secretions contact mucosal surfaces (such as the male urethra, the vagina, or cervix). In contrast, genital ulcer diseases (such as genital herpes, syphilis, and chancroid) and human papillomavirus (HPV) infection are primarily transmitted through contact with infected skin or mucosal surfaces.

Laboratory studies have demonstrated that latex condoms provide an essentially impermeable barrier to particles the size of STD pathogens.

Theoretical and empirical basis for protection. Condoms can be expected to provide different levels of protection for various STDs, depending on differences in how the diseases are transmitted. Condoms block transmission and acquisition of STDs by preventing contact between the condom wearer’s penis and a sex partner’s skin, mucosa, and genital secretions.  A greater level of protection is provided for the diseases transmitted by genital secretions.  A lesser degree of protection is provided for genital ulcer diseases or HPV because these infections also may be transmitted by exposure to areas (e.g., infected skin or mucosal surfaces) that are not covered or protected by the condom.

Epidemiologic studies seek to measure the protective effect of condoms by comparing risk of STD transmission among condom users with nonusers who are engaging in sexual intercourse.  Accurately estimating the effectiveness of condoms for prevention of STDs, however, is methodologically challenging. Well-designed studies address key factors such as the extent to which condom use has been consistent and correct and whether infection identified is incident (i.e., new) or prevalent (i.e. pre-existing). Of particular importance, the study design should assure that the population being evaluated has documented exposure to the STD of interest during the period that condom use is being assessed. Although consistent and correct use of condoms is inherently difficult to measure, because such studies would involve observations of private behaviors, several published studies have demonstrated that failure to measure these factors properly tends to result in underestimation of condom effectiveness.

Epidemiologic studies provide useful information regarding the magnitude of STD risk reduction associated with condom use.  Extensive literature review confirms that the best epidemiologic studies of condom effectiveness address HIV infection.  Numerous studies of discordant couples (where only one partner is infected) have shown consistent use of latex condoms to be highly effective for preventing sexually acquired HIV infection. Similarly, studies have shown that condom use reduces the risk of other STDs. However, the overall strength of the evidence regarding the effectiveness of condoms in reducing the risk of other STDs is not at the level of that for HIV, primarily because fewer methodologically sound and well-designed studies have been completed that address other STDs. Critical reviews of all studies, with both positive and negative findings (referenced here) point to the limitations in study design in some studies which result in underestimation of condom effectiveness; therefore, the true protective effect is likely to be greater than the effect observed.

Overall, the preponderance of available epidemiologic studies have found that when used consistently and correctly, condoms are highly effective in preventing the sexual transmission of HIV infection and reduce the risk of other STDs.

HPV and Men

July 29, 2008 by admin · Leave a Comment 

Genital human papillomavirus (HPV) is a common virus. Most sexually active people in the United States (U.S.) will have HPV at some time in their lives. There are more than 40 types of HPV that are passed on during sex. These types can infect the genital areas of men, including the skin on and around the penis or anus.

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What are the health problems caused by HPV in men?

Most men who get HPV (of any type) never develop any symptoms or health problems. But some types of HPV can cause Genital Warts. Other types can cause penile cancer or anal cancer. The types of HPV that can cause Genital Warts are not the same as the types that can cause penile or anal cancer.Anal cancer is not the same as colorectal cancer. Colorectal cancer is more common than anal cancer, but it is not caused by HPV.

How common are HPV related health problems in men?

  • About 1% of sexually active men in the U.S. have Genital Warts at any one time.
  • Penile cancer is rare, especially in circumcised men. In the U.S., it affects about 1 in every 100,000 men. The American Cancer Society (ACS) estimated that about 1,530 men would be diagnosed with penile cancer in the U.S. in 2006.
  • Anal cancer is also uncommon—especially in men with healthy immune systems. According to the ACS, about 1,900 men will be diagnosed with anal cancer in the U.S. in 2007.

Some men are more likely to develop HPV-related diseases than others:

  • Gay and bisexual men are 17 times more likely to develop anal cancer than heterosexual men.
  • Men with weak immune systems, including those who have human immunodeficiency virus (HIV), are more likely than other men to develop anal cancer. Men with HIV are also more likely to get severe cases of genital warts that are hard to treat.

Whar are the signs and symptoms?

Among men who do develop health problems, these are some of the signs to look for:

Signs of genital warts:

  • One or more growths on the penis, testicles, groin, thighs, or anus.
  • Warts may be raised, flat, or cauliflower-shaped. They usually do not hurt.
  • Warts may appear within weeks or months after sexual contact with an infected person.

Signs and symptoms of anal cancer:

  • Sometimes there are no signs or symptoms.
  • Anal bleeding, pain, itching, or discharge.
  • Swollen lymph nodes in the anal or groin area.
  • Changes in bowel habits or the shape of your stool.

Signs of penile cancer:

  • First signs: changes in color, skin thickening, or a build-up of tissue on the penis.
  • Later signs: a growth or sore on the penis. It is usually painless, but in some cases, the sore may be painful and bleed.
  • There may be no symptoms until the cancer is quite advanced.

HOw do men get HPV?

HPV is passed on through genital contact –most often during vaginal and anal sex. Since HPV usually causes no symptoms, most men and women can get HPV – and pass it on – without realizing it. People can have HPV even if years have passed since they had sex.

Is there a test for HPV in men?

Currently, there is no test designed or approved to find HPV in men. The only approved HPV test on the market is for women, for use as part of cervical cancer screening. There is no general test for men or women to check one’s overall “HPV status.” But HPV usually goes away on its own, without causing health problems. So an HPV infection that is found today will most likely not be there a year or two from now.

REMEMBER: HPV is very common in men and women. Most men with HPV will never develop health problems from it. Finding out if you have HPV is not as important as finding out if you have the diseases that it can cause. Scientists are still studying how best to screen for penile and anal cancers in men who may be at highest risk for those diseases (see below).

Is there a test to find genital warts?

Most of the time, you can see genital warts. Some doctors may use a vinegar solution to help find flat warts—but this test can sometimes wrongly identify normal skin as a wart.

Is there a test to screen for HPV-related cancers in men?

Screening tests can find early signs of disease in people who are not yet sick. Screening tests for penile or anal cancer are not widely recommended.

Some experts recommend yearly anal Pap tests for gay, bisexual, and HIV-positive men, since anal cancer is more common in these groups. This test can find abnormal cells in the anus that could turn into cancer over time. If abnormal cells are found, they can be removed. CDC does not recommend anal Pap tests because there is not enough research to show that removing abnormal anal cells actually prevents anal cancer from developing in the future. More studies are needed to understand if anal Pap tests and treatment of abnormal cells prevent anal cancer in men.

You can check for any abnormalities on your penis, scrotum, or around the anus. See your doctor if you find warts, blisters, sores, ulcers, white patches, or other abnormal areas on your penis—even if they do not hurt.

Is there a treatment or cure for HPV?

There is no treatment or cure for HPV. But there are ways to treat the health problems caused by HPV in men.

Genital warts can be treated with medicine, removed (surgery), or frozen off. Some of these treatments involve a visit to the doctor. Others can be done at home by the patient himself. No one treatment is better than another. But warts often come back within a few months after treatment—so several treatments may be needed.  Treating genital warts may not necessarily lower a man’s chances of passing HPV on to his sex partner. Because of this, some men choose not to treat genital warts. If they are not treated, genital warts may go away on their own, stay the same, or grow (in size or number). They will not turn into cancer or threaten your health.

Penile and anal cancers can be treated with new forms of surgery, radiation therapy, and chemotherapy. Often, two or more of these treatments are used together. Patients should decide with their doctors which treatments are best for them.

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Are there ways to lwoer my chances of getting HPV?

Because HPV is so common and usually invisible, the only sure way to prevent it is not to have sex. Even people with only one lifetime sex partner can get HPV, if their partner was infected with HPV. Condoms (used all the time and the right way) may lower your chances of passing HPV to a partner or developing HPV-related diseases. But HPV can infect areas that are not covered by a condom—so condoms may not fully protect against HPV.

I hears about a new HPV vaccine, can it help me?

The new HPV vaccine was developed to protect against most cervical cancers and genital warts. At this point, it is only licensed to be used in girls/women, ages 9-26 years. Studies are now being done to find out if the vaccine is also safe in men, and if it can protect them against genital warts and certain penile and anal cancers. The FDA will consider licensing the vaccine for boys and men if there is proof that it is safe and effective for them.

I just found out that my partner hs HPV…

What does it mean for my health?

Partners usually share HPV. If you have been with your partner for a long time, you probably have HPV already. Most sexually active adults will have HPV at some time in their lives. Men with healthy immune systems rarely develop health problems from HPV. But you should check regularly for any abnormalities on your penis. If you have a weak immune system or HIV, ask your doctor about checking for anal and penile cancers.

If your partner is new, condoms may lower your chances of getting HPV or developing HPV-related diseases. But not having sex is the only sure way to avoid HPV.

What does it mean for our relationship?

A person can have HPV for many years before it is found or causes health problems. So there is no way to know if your partner gave you HPV, or if you gave HPV to your partner. HPV should not be seen as a sign that you or your partner is having sex outside of your relationship.

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