Sexual Healing

An important message from Dr. Gradstein about sexually transmitted infections

There’s no point in scaring people about Sexually Transmitted Infections, or STIs. Quite honestly, sometimes I tell people who come to
my clinic for an HIV test that they don’t need one, because after listening to their story, I find there is no real exposure. Some people get too anxious about certain topics such as HIV, and they just want to be certain that they don’t have it. As a rule, when somebody really wants to undergo an HIV test, I won’t oppose it-it’s good to test for HIV whenever people think they need it-but sometimes I think they should be more aware of other diseases.

I see a lot of patients who have engaged in risky behavior here under
the influence of alcohol or drugs-some
of them are on holiday, it’s an exotic country, and suddenly all their defenses and inhibitions disappear, and they only realize the day after that they’ve been exposed. It’s also the case that local people are very fatalistic, so they don’t always get tested even when they’re
at risk, perhaps for fear of the social consequences. The problem is that under these conditions, STIs can spread like wildfire-like Australia in the summer. This is what I see in my clinic.

First of all, I think-depending on the lifestyle-people should undergo routine STI testing. The frequency depends on the risk. The key thing is that if their lifestyle puts them at a high risk of exposure to diseases, they should do frequent screenings. There’s no benchmark on exactly how frequently, but I would recommend that people who lead a high-risk lifestyle in terms of exposure to STIs should get tested at least every six months.

I generally see two categories of patients consulting at my clinic. There are people who come in after a specific exposure, or if they think that they may have been exposed, and then they come to check if they have contracted anything. In these cases, the issue is how soon after exposure can you really make a diagnosis. These are asymptomatic people, but
they know that they have been exposed (because of a condom breakage, for example) and they want to have a test, either because they’re scared they contracted something, or they’re worried about bringing home a “souvenir” from overseas. When it comes to certain diseases we can offer a preventive treatment, if it’s early enough. HIV, for example, can be effectively prevented if you start the treatment within 72 hours after the exposure. Later than 72 hours, and it becomes less effective. But if it’s within 72 hours it’s almost 100 percent. It’s a bit heavy, because you have to take medication for a month, and there are side effects and costs-but it is effective.

Oi Vietnam-march2017_Family hospital_DSC6558_NT

The other category is people who suddenly realize that they have a symptom consistent with an STI. Mainly we’re talking about bacterial infections: All STIs can be asymptomatic, but bacterial infections more frequently give rise to symptoms that people can understand, like discomfort, discharge and skin lesions. In some cases, these people were not even aware that they had  been exposed, and they didn’t realize, for example, that oral sex can expose you to bacterial infection, because they’d always heard that when you have oral sex, you cannot get HIV. It’s true, HIV  is extremely unlikely after oral contact, having a very poor infectivity compared to bacteria. Other diseases can still be contracted in this way.

People with symptoms can show up
in the clinic ten days later, one month later. It depends on what they actually have. If they have gonorrhea, they may come three days later. Every disease has
a different incubation period. There are also some people who have the symptoms just because they used some new lube
or new condom, and they have a local reaction to it which is almost immediate- but they don’t know what it is, and so they get anxious. It’s important to try to get the whole story, even though some people don’t necessarily tell their doctor all the facts out of embarrassment. But when you do know the facts, it’s easier to inform them of what is suspected, and what they should do about it. Many people come with what is actually fungal thrush in the groin, convinced that they have AIDS. When you are not anxious and when you have the knowledge, you can think better!

HIV is really a different kind of problem. While the infectivity is low,
the average time between exposure and developing identifiable symptoms is very long-on average, around seven years. This is compared to acute infections
or infections with a high probability of symptoms that would usually prevent you from sexual contact. With HIV, you have a very long time during which you may not know you have it.

With bacterial infections, generally
I will prescribe an antibiotic. It’s a single dose, it’s easy, it’s not cumbersome. Some people are scared to take medication for several days, not wanting their family
to discover a stockpile of antibiotics, or visiting the bathroom in a suspicious way. A single dose given at the clinic on the first consultation, and that’s it, that’s the treatment, and there is no risk of disclosure.

Oi Vietnam-march2017_Family hospital_DSC6571_NT

It Can Happen to Anyone

I’m often asked how family members can be protected. After taking preventive treatment and the antibiotics, they ask, when will they be safe? This I cannot guarantee 100 percent, never. It’s quite
a personal decision, but generally with regards to HIV, if you’ve taken the preventive treatment, which takes one month, and then tested yourself after
one more month and that test comes back negative, then your chance of passing on an HIV infection is equivalent to winning the lottery. Some people, however, still cannot deal with that level of risk.

I am not a provider of excuses, but in general, you can never prove anything based on an STI-you cannot draw any conclusions or take any steps based on STIs to solve emotional problems. You should never mix the two. If you have problems and you’re a couple, you should solve those problems. The STI sometimes comes as a revelator, revealing the problem. It should not in itself be the reason for breaking up a couple.

Children, by and large, are safe even
if a parent has an STI. STIs by definition are transmitted by sexual contact. They can only be transmitted to children from mother to the fetus or to the neonate during birth. The placenta is quite a good filter; very few infections are transmitted across it. However, a baby can be exposed

to an STI during labor, during birth. Other than that, if a child is ever diagnosed with an STI, you should always suspect abuse. In normal circumstances, parents with an STI can rest assured that their infection cannot be passed on to their children.

There isn’t any clear profile of an STI carrier, it can happen to anyone. For example, people in high society tend to be more aware of the risks than people
in more straitened circumstances, but they also have more money to engage in risky behavior, so sometimes they are at a lower risk in one parameter and a higher risk in another. I think the best advice is that nobody is immune or safe if they are not actively protecting themselves. STI carriers may look like criminals, or they may look like angels. You cannot say.

Self-medication in Vietnam is not an advisable option because people may get one antibiotic for the wrong reason and for the wrong amount of time, and the result can be that your infection will become resistant to conventional treatment.

If you have any cause to believe you may have been exposed to an STI, my best advice is to get tested, even if you have not had any symptoms. Regular testing can prevent transmission and provide reassurance.

TEXT BY DR. SERGE GRADSTEIN (INFECTIOUS DISEASES AND SEXUAL HEALTH, FAMILY MEDICAL PRACTICE)

IMAGES BY NGOC TRAN

Share this story, choose your platform!

Share on facebook
Share on twitter
Share on pinterest
Share on tumblr
Share on google
Share on linkedin
Share on reddit
Share on vk
Share on email
About the author:

Leave a Comment

What Happens If Fibromyalgia Is Left Untreated?

Fibromyalgia is a common condition, affecting more than four million Americans alone. The principal symptoms of this condition include joint pain, muscle ache, sleep disturbances, and fatigue. All of these affect your overall quality of life. The cause of fibromyalgia is still under debate by many people, and researchers are on their way to looking

Read More »

Improve Your Driving Experience by Using a Truck Seat Cushion

Driving is a difficult task that many people dread. If you suffer from back pain, you know all too well the reasons why driving is so uncomfortable. Sitting in an uncomfortable position for an extended period can cause pain and stiffness in your back, hips, and neck. Luckily, an easy way to improve your driving

Read More »

5 Rewarding Careers in Healthcare Where You Can Make a Difference

Eleven out of the top 20 jobs on the Bureau of Labor Statistics list of the fastest growing careers are in the health care industry. Analysts say that there are two reasons for this expansion: one is that the huge baby boom population is aging, and the other is Obama’s health care initiative. There is much more to a

Read More »

The Benefits of CBD for Better Concentration

Do you often find yourself distracted when you’re supposed to be focusing? You know the feeling. One second you’re working on a task, and the next, your phone is in your hand, you’re scrolling your favorite website, and you barely remember picking it up. The problem is that you’re trying to concentrate, and your brain

Read More »

Benefits of regular assessment for students

Receiving a quality education is not limited to listening to the teachers in the class, and memorizing the lessons. To review and examine how much we are gaining educationally, and what must be done to improve and excel in academics, assessments play a very important role in the lives of students. There are two types

Read More »