Friday, July 10, 2015

Fire Down Below

Last week, we took a brief glimpse at the long and convoluted history of prostitution, so I thought it only natural to follow up with an infectious postscript.

For as long as humans have been exchanging bodily fluids, pathogens have been part of the mix. And when it comes to bumping genitals, there are a whole slew of contagions getting in on the action. Because a comprehensive overview is beyond the scope of this blog (not to mention my short attention span), we’ll stick to the highlights while we explore the dark and daunting world of STDs.

First, let’s clarify the terminology. You may have noticed that the term STD has lately been supplanted by STI. What differentiates a sexually transmitted disease from a sexually transmitted infection is the presence of symptoms. However, since some STDs aren't accompanied by symptoms, it’s really splitting hairs. So for the sake of today’s post, we’ll stick to the tried and true acronym, STD.

Sexually transmitted diseases most likely evolved along with humans and historians have been chronicling their presence all the way back to the Bible. The Old Testament refers to “the running issue,” referencing the “clothing needing washing as did the man himself,” most likely referring to gonorrhea, which causes that telltale discharge from the penis. And it wasn’t until the Middle Ages (around AD 1200) that the disease was finally linked to sex.

But gonorrhea is only one of many STDs plaguing humans, for the list of potential pathogens is long and varied.

STDs come in three basic varieties: bacterial (gonorrhea, syphilis, and chlamydia, to name a few); viral (Hepatitis B and C, Herpes, HPV, and HIV); and parasites (such as trichomonas, a pesky protozoan that thrives within urethras and vaginas). And it’s the type of pathogen that determines the treatment.

Since the advent of antibiotics, the bacterial bugs can usually be wiped out with a simple prescription, as can trichomonas. Unfortunately, the viral pests are not so simple. Once a person is infected, herpes and HIV are here to stay, and one can only mitigate the symptoms. Hepatitis, however, forms a mixed bag. With Hepatitis B, most people can be cured, although a minority will become carriers for life. Hep C holds a more dismal future, as a majority will suffer long-term infection with chronic liver disease on the horizon.

But try to imagine what these maladies must have been like before the advent of modern medicine. So to keep things in perspective, let’s peruse some of the ancient treatments that were once believed to cure the “fire down below.”

The ancient Greeks were some of the first to record the treatment of venereal disease. In fact, the term “herpes” originates from the Greek, meaning “to creep or crawl.” And how did they attack the creepy-crawlers? By burning off the lesions using hot irons. Despite their torturous treatments, they get kudos for instituting public policies aimed at reducing the spread of herpes, although their “no public kissing” rules probably did little to curb the virus.

By 1746, London’s Lock Hospital was the first to establish public treatment programs for the infected. And the 18th and 19th centuries saw the use of mercury, arsenic and sulphur as the primary remedies, although these dangerous regimes caused serious side effects, even death. Despite the danger, arsenic, in the form of salvarsan, was used to treat syphilis well into the 20th century.

And as scary as these diseases can be, what scares people even more is the social stigma attached to them. However, for those of you harboring an STD, take heart. You are hardly alone in your affliction. Here are a few statistics to bring it all home.

According to the CDC, there are over three hundred million new cases of STDs in the world each year. The human papillomavirus (HPV) is now the fastest growing STD and nearly all sexually active folks will contract it at some point in life.

About one in five Americans has genital herpes, yet about ninety percent of them don’t know they have it. And health officials warn that by 2025, up to forty percent of men and almost half of all women could be infected with this permanent virus.

And of course, HIV is still rampant, still spreading, and still deadly. As the sun sets in South Africa, another fifteen hundred new infections will have taken place today. Yes, I said fifteen hundred per day. And that’s the conservative end of the statistic.

Let’s face it, STDs are scary, and the emotional toll they incur can be as burdensome as their symptoms. But pathogens, like us, are thriving members of the biome and will forever be a part of life on our planet.

So stay informed, stay healthy and, for god’s sake, use a condom.