Roundups Sexual Health

Sexual Health Roundup: Say Goodbye to Your Annual Pap Test But Don’t Forget to Get Tested for Chlamydia

Martha Kempner

This week: Too few young women get tested for Chlamydia, circumcised men have lower rates of prostate cancer, new guidelines recommend less frequent Pap tests, and young people in the South fare worse than their peers when it comes to sexual health.

Welcome to our new Weekly Sexual Health Roundup! Each week, writer and sexual health expert Martha Kempner will summarize news and research related to sexual behavior, sexuality education, contraception, STDs, and more.  We will still report in depth on some of these stories, but we want to make sure you get a sense of the rest and the best.

Young Women Aren’t Being Tested for Chlamydia

A new survey from the U.S. Centers for Disease Control and Prevention (CDC) found that only 38 percent of sexually active girls and women were screened for Chlamydia despite the fact that the CDC recommends annual screening for sexually active women 25 and under.  Chlamydia is a very common bacterial infection that can be cured with antibiotics but it is often asymptomatic meaning that individuals do not know they are infected unless they get tested.  Untreated Chlamydia can lead to pelvic inflammatory disease and ultimately infertility.  “With only about one third of young women getting tested for chlamydia, two-thirds (9 million) are going without, noted study author Dr. Karen Hoover, a medical epidemiologist with the CDC. She called the results “alarming.”

The study was presented at the National STD Prevention Conference in Minneapolis along with another study that found that only a small proportion of men and women get the recommended follow-up testing after being treated for Chlamydia.  This study was based on a laboratory data from almost 64,000 men and women who had tested positive for Chlamydia. It found that only 11 percent of men and 21 percent of women were re-tested.  Among those who got a follow-up test, 25 percent of men and 16 percent of women were positive.  Re-infection with Chlamydia is common if either partner remains infected and can, again, lead to infertility. 

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Circumcised Men have Lower Rates of Prostate Cancer

As I have said in other pieces on circumcision, my great grandfather was a urologist who wrote a book in the 1920s arguing that circumcision reduced the rates of “VD” and cancer.  Recent studies have shown that Poppy Abe might have been on to something with reports that circumcision can lower transmission rates of HIV, HPV, and Herpes.  Now a new study has found that men who are circumcised before their first sexual encounter have a 15 percent lower incidence of prostate cancer than men who are uncircumcised or were circumcised after they first had sex.

Researchers say that these findings are a “natural extension” of findings that linked STDs to prostate cancer and those that linked circumcision to lowered rates of STDs.  One of the authors concluded: “It’s a procedure we have good reason to think would reduce exposure to potential sexually transmitted agents and thereby may prevent inflammation in the prostate, which is associated with a reduced risk of developing prostate cancer.”

New Guidelines on Cervical Cancer Screening

Say goodbye to your annual Pap test!  New guidelines from the U.S. Preventative Services Task Force (USPSTF) released this week change the recommendations on who should get screened for cervical cancer, how often, and what tests should be used. 

One of the biggest changes is that the group now recommends using the HPV test along with the Pap test to screen for the disease. Though HPV is the leading cause of cervical cancer, until now the group felt that there was not enough research to support recommending the HPV test as a screening method.  “The new recommendations are based on a review of the most recent scientific studies, which finds that HPV tests can reliably detect cervical cancer and spare lives.”  The HPV test, however, should not be used as a screening method in women under 30 because many of them will have HPV infections that will clear naturally without treatment.

The other changes recommended by the group reduce the frequency with which women are screened for cervical cancer.  The group explains that cervical cancer is a slow growing disease and there are risks associated with false positive test results. 

The new recommendations include:

  • Women aged 21 to 65 should get Pap tests no more than every three years.  (This is a change from the annual Pap test many of us are used to and the previous guidelines that said at least every three years.)
  • Women aged 30 to 65 may get screened only every five years if they use HPV tests in conjunction with the Pap test.
  • Women under 21 should not be screened for cervical cancer, regardless of sexual history. (This is a change from the previous guidelines that said women should be screened within three years of becoming sexually active.)   
  • Women over 65 should not be screened, as long as they have had consistently normal Pap tests and are not at high risk for cervical cancer.

The guidelines apply to healthy women who don’t have abnormal Pap tests. They do not apply to women who have a history of cervical cancer or other risk factors.

Sexual Health of Young People Worse in the South
A new study from Auburn University found that young people in 10 Southern states are faring worse than their peers when it comes to sexual health.  The study focused on young people in Alabama, Georgia, Kentucky, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, Virginia, and West Virginia.  It found that the teen birth rate is higher in the South than anywhere else in the country as are the rates of Chlamydia and gonorrhea in teens.  Researcher point out that this has real costs in terms of public funds; they estimate that it costs state, local, and federal governments $2.3 billion dollars in expenses related to teen childbearing alone.

They suggest that an investment in medically accurate sexuality education can turn things around in the South.  As one of the co-authors explained: “New federal funding streams, combined with strong public support, indicate that the South has the opportunity to make the changes necessary to improve the sexual health of young people across our region.”

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