Let's talk about SEX

Now that I have your attention, let's talk about the new and evolving risks of having unprotected sex, particularly oral and anal sex.

This week scientists isolated a new antibiotic resistant strain of Neisseria gonnorrhea from a professional sex worker in Japan. According to Professor Peter Leone, speaking on Science Friday today, the bacteria was isolated from the woman's throat. Penile gonorrhea is typically easy to detect, because of pus and a burning sensation at the site of the infection. However, vaginal, anal and oral infections frequently present without symptoms and thus are more difficult to detect and treat.

Why does this matter?

Most throat infections and anal infections may be asymptomatic, as in the case of the sex worker from whom the bacteria was isolated. This means that someone could be infected and transmit, unknowingly, an antibiotic resistant infection to multiple partners. I bring this up here, because some single men and women in the service do visit professional sex workers, or have sex with multiple partners (some married people do as well). If proper protection is not used (i.e. condoms, dental dams, etc), these people may be putting themselves at imminent risk of infection. Gonorrhea can cause pelvic inflammatory disease and sterility, preventing the spread of this microorganism is important.

Moreover, because most doctors check for STDs by swabbing just the sexual organs, they may miss infections in the mouth or anus, which could foment spread of this new strain. Since the detection of this new strain, if you are told you have contracted the resistant strain of gonorrhea, your doctor should now prescribe a two antibiotic combination treatment, one of which needs to be delivered intramuscularly. 

If you do decide to visit a sex worker, or have sex with multiple partners, the best things you can do are:

1.  Use protection. Dental dams and condoms are not that expensive. They can be purchased at the drug store or can be procured for little or no cost at Planned Parenthood.
2. Get checked for STDs at least once every 3 months. Make sure to explain to the person doing the STD screening if you have engaged in oral or anal sex, so that they can test these areas as well.
3. If you do contract a STD, man up and tell your partner(s). The only thing that's worse than that news is finding out later that someone exposed you without telling you.
4. When given antibiotics for any condition (sexually related or not), take the full prescription as prescribed. The spread of antibiotic resistance is in part driven by people who do not take their medication for the full 7-10 days required to kill all of the microorganisms that cause the disease.
5. If you don't finish your medication for some reason, take that prescription to the hospital and ask them to dispose of it appropriately. Do not flush it or throw it out. Soil and water bacteria can pick up antibiotic resistance genes from exposure to low levels of antibiotics in the soil and water. They can readily swap these genes with other bacteria and spread antibiotic resistance.

Do your part to prevent a public health crisis by protecting yourself and your partner(s). 

In addition to this, I would just like to point out that isolation of this strain suggests what many microbiologists have feared for years: We are running out of antibiotics to kill infections, because of the development of antibiotic resistance. As we approach the end of the age of antibiotics it is important for average people, regardless of whether they are at risk for STDs or not, use antibiotics appropriately as outlined in #4 and #5 above. These are stop gap measures which will slow the spread of resistant genes among microorganisms while scientists work to develop new therapies to combat bacterial infections.