Make that about 20 million new cases a year, according to the CDC, including infections such as gonorrhea, syphilis, chlamydia — and genital herpes.

In terms of genital herpes, the American Sexual Health Association states that as many as one out of five people is infected, usually with the “simplex two” form of the virus (HSV-2).

Genital herpes, as well as other STIs such as syphilis and HPV (the human papillomavirus), can be transmitted via skin-to-skin contact. Condoms are effective at blocking transmission of fluid-borne STIs, like chlamydia, HIV, and gonorrhea, but with infections that are transmitted via the skin, while condoms can help, they won’t block infection from an uncovered area.

Increasing openness and awareness is crucial. Most STIs are treatable and catching an infection early can prevent more serious complications. The dermatologist’s office is a valuable resource, as many STIs have skin symptoms.

Organizations such as The STI Project, founded by the Herpes Activist Network’s Executive Director Jenelle Marie Pierce, and the American Sexual Health Association are making important inroads in providing resources and support.

In terms of stigma, genital herpes in particular triggers anxiety because it is what we call a ‘recurrent’ infection. Once a person has it, they have it for life.

In this regard, HSV-2 is similar to its oral relative, the “simplex one” form of the virus (HSV-1), which can cause cold sores and fever blisters. About half of adults have HSV-1, typically the result of non-sexual childhood exposure, for example from a relative’s kiss. Like HSV-1, genital herpes is also usually mild and manageable, so much so that a person may not even know they have it. Some are not symptomatic. And mild outbreaks can easily be attributed to other causes, like an insect bite.

To increase awareness and reduce stigma regarding genital herpes, I offer the following advice:

5 Tips for Understanding Genital Herpes:

1. See your doctor if you’re worried:

   Different tests have distinct parameters. If you notice a skin abnormality – a sore, a blister or a pimple – this can be swabbed and checked. DNA testing of the swabbed sample is the most accurate choice. In the absence of symptoms, a blood test for IgG antibodies can detect long-term infections.

2. Positive results? There are management options:

   For patients with regular outbreaks, there are effective means of limiting frequency. For example, daily anti-viral medications such as valacyclovir pills can reduce outbreaks by at least 75 percent.

3. Be aware of symptomless transmission:

   One challenge with HSV-2 is that at certain times the virus is present on the skin even though there is no visible outbreak. Skin-to-skin contact at such times can transmit the infection. Condoms can limit the extent of skin exposure. And daily anti-viral medications seem to decrease risk.

4. Pregnant? Ensure a safe delivery:

   Pregnant women can be tested for genital herpes because an outbreak is a health risk during delivery. Those who know they have the virus should inform their doctors. In most cases, there is no impact on the delivery, but if there is an outbreak at that time, many doctors will advise for a C-section to protect the baby from serious health problems.

5. Oral sex can cause genital infections:

   With genital herpes, we usually think HSV-2, but oral sex can transmit HSV-1 to the genitals. Awareness can guide people’s choices.

Genital herpes may not have a celebrity spokesperson. But a lot of regular people have it, and they’re leading full and happy lives.

Sonoa Au, MD, is a board-certified physician and a fellow of the American Academy of Dermatology

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com.

“Prior to today, there were no chlamydia or gonorrhea tests cleared for use on samples from the throat and rectum. The availability of these two tests will fill an unmet public health need, by allowing for more screening,” said Tim Stenzel, M.D., Ph.D., director of the Office of In Vitro Diagnostics and Radiological Health in the FDA’s Center for Devices and Radiological Health. “It is best for patients if both of these sexually transmitted infections are caught and treated right away, as significant complications can occur if left untreated. Today’s clearances provide a mechanism for more easily diagnosing these infections.”

According to the Centers for Disease Control and Prevention’s Sexually Transmitted Infections Surveillance Report, the rate of sexually transmitted infections is steadily increasing, with an estimated 1.7 million cases of chlamydia and more than 500,000 cases of gonorrhea in the U.S. in 2017 alone. Both infections can be contracted through vaginal, anal or oral intercourse. Typically, both infections can be easily treated, but if left untreated, both infections can cause serious complications for patients, including infertility.

The Aptima Combo 2 Assay and Xpert CT/NG were reviewed through the premarket notification (510(k)) pathway, the FDA said. A 510(k) is a premarket submission made to the FDA to demonstrate that the device to be marketed is at least as safe and effective, that is, substantially equivalent, to a legally marketed device.

In its evaluation of the devices, the FDA reviewed clinical data collected through a cross-sectional study coordinated by the Antibacterial Resistance Leadership Group, which is funded and supported by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH).

This study was a collaborative, multi-site clinical study of more than 2,500 patients that evaluated the diagnostic accuracy of multiple commercially available nucleic acid amplification tests for detection of Neisseria gonorrhoeae and Chlamydia trachomatis from throat and rectal sites. The results of this study, along with other information reviewed by the FDA, demonstrated that the Aptima Combo 2 Assay and the Xpert CT/NG for extragenital specimens are safe and effective for extragenital testing for chlamydia and gonorrhea.

The FDA granted clearance of Aptima Combo 2 Assay to Hologic, Inc., and clearance of the Xpert CT/NG to Cepheid.

Men are underserved by current HIV testing services in many areas with high HIV prevalence, leading to poor health outcomes. In the new study, 2349 women over the age of 18 receiving antenatal care at one of three health centers in urban Malawi were enrolled in a cluster randomized trial. Groups of women received standard of care–an invitation letter for their male partner to attend an HIV clinic for testing and follow-up care–either alone in the control arm or along with two HIV self-testing kits for their partners in the first intervention arm. Women in other arms of the trial also received self-testing kits together with different incentives for their partners to attend a clinic–either follow-up phone calls, financial incentives of $3 or $10, or entry into a lottery offering an opportunity to win $30.

RESULTS AFTR 28 DAYS

After 28 days, 17.4% of the partners of women in the control arm were reported to have tested for HIV, whereas 87.0% to 95.4% of those in the intervention arms were reported to have tested. As judged according to the trial’s primary endpoint, the proportion of partners testing within 28 days and linking to HIV treatment or prevention services, 13.0% of partners in the control arm visited the clinic within 28 days. Significant increases were seen with self-testing plus a $3 incentive (40.9% of partners; adjusted risk ratio [aRR] 3.01, 95% CI 1.63-5.57), self testing plus $10 (51.7% of partners; aRR 3.72, 95% CI 1.85-7.48), and phone reminders (22.3% of partners; aRR 1.58, 95% CI 1.07-2.33).

In contrast, no significant benefits as compared with the standard of care were seen in partners receiving the self-testing kits alone (17.5% of partners; aRR 1.45, 95% CI 0.99-2.13) or those in the lottery arm (18.6% of partners; aRR 1.53, 95% CI 0.93-2.52; this arm was terminated at an interim analysis). No serious adverse events were reported.

“Secondary distribution of HIVST kits, ideally accompanied by interventions promoting timely linkage into HIV care and prevention cascades, is a promising new approach for routine ANC services to reach male partners, intensify prevention of mother-to-child transmission, and contribute more broadly to country-level HIV prevention targets,” the authors say.

A clinical trial, funded by the National Institutes of Health (NIH), will conduct a study of 420 couples around the world.

The gel, called NES/T, includes the progestin compound segesterone acetate (brand name Nestorone), in combination with testosterone. Men who participate in the study will apply it to their back and shoulders once a day. It is then absorbed into the skin. NIH officials said that the progestin blocks natural testosterone production in the testes, reducing sperm production to low or nonexistent levels. The replacement testosterone will help maintain normal sex drive and other functions that are dependent on adequate testosterone levels in the blood.

NIH experts said the possibility of a new, reversible contraception method for men would be welcome. (See our story, “What You Need to  Know About Birth Control.”)

“Many women cannot use hormonal contraception and male contraceptive methods are limited to vasectomy and condoms,” said study investigator Diana Blithe, Ph.D., chief of the Contraceptive Development Program NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). “A safe, highly effective and reversible method of male contraception would fill an important public health need.”

Couples in the global study, funded by the NIH, will rely on the gel as their only method of contraception.

Male volunteers will use the NES/T gel daily for four to 12 weeks to determine whether they tolerate the formulation and to guard against unacceptable side effects. If sperm levels have not adequately declined, they will continue to use the formulation for up to 16 weeks. Once their sperm levels have declined to a threshold sufficient for contraception, they will enter the efficacy phase, which will evaluate the ability of the formulation to prevent pregnancy. This phase will last for 52 weeks, and the couple will rely on the male partner’s application of the gel as the only method of contraception. Men will remain in the study for observation for an additional 24 weeks after they discontinue the formulation.

The gel formulation was developed by the Population Council and the NIH’s NICHD institute. The Population Council will collaborate with NIH to conduct the study in NICHD’s Contraceptive Clinical Trials Network.

The number of reported cases jumped from 362 in 2013 to 918 in 2017, according to the annual Sexually Transmitted Disease Surveillance Report from the federal Centers for Disease Control and Prevention (CDC). The 2017 figure represents the highest number of reported cases in 20 years. The cases were reported in 37 states, primarily in the West and the South.

The numbers are all the more heartbreaking since syphilis is highly curable, the CDC said.

“When passed to a baby, syphilis can result in miscarriage, newborn death, and severe lifelong physical and mental health problems,” said Jonathan Mermin, M.D., M.P.H., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “No parent should have to bear the death of a child when it could have been prevented with a simple test and safe treatment.”

The numbers are all the more heartbreaking since syphilis is highly curable.

Experts stressed that all pregnant women should receive early and regular prenatal care, including syphilis testing at their first visit. Women who are at high risk for syphilis or who live in “high-prevalence” areas should be tested at their first prenatal visit, early in the third trimester and at delivery.

Recent CDC research shows that one in three women who gave birth to a baby with syphilis in 2016 did get tested during pregnancy, but either acquired syphilis after that test or did not get treated in time to cure the infection in the unborn baby.

Syphilis during pregnancy is easily cured with the right antibiotics, the CDC said. But if left untreated, a pregnant woman with syphilis has up to an 80 percent chance of passing it on to her baby.

“To protect every baby, we have to start by protecting every mother,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention.

Sexually active women can lower their syphilis risk by being in a long-term, mutually monogamous relationship with a partner who has been tested for syphilis and by using condoms when they have sex.

The report also noted that women of reproductive age who were not pregnant had a rate of syphilis similar to that of pregnant women. Additionally, the overall increase of syphilis is higher than STDs in general.

For more information from the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, click here.

FDA officials said that the expanded application of the vaccine would prevent thousands of cases of cancer caused by nine types of HPV (the human papillomavirus) that are sexually transmitted.  Gardasil 9 prevents certain cancers and diseases, including, in women, cervical cancer, vaginal and vulvar cancers, anal cancers, precancerous cervical, vaginal, vulvar and anal lesions, as well as genital warts. In males, the vaccine helps protect against anal cancer, precancerous anal lesions and genital warts.

“Approval represents an important opportunity to help prevent HPV-related diseases and cancers in a broader age range,” Peter Marks, M.D., Ph.D., director of the FDA’s Center for Biologics Evaluation and Research, said in a statement.

“The Centers for Disease Control and Prevention [CDC] has stated that HPV vaccination prior to becoming infected with the HPV types covered by the vaccine has the potential to prevent more than 90 percent of these cancers, or 31,200 cases every year, from ever developing.”

Figures from the CDC show that about 14 million Americans become infected with HPV every year. About 12,000 women are diagnosed annually and 4,000 women die from cervical cancer caused by certain HPV viruses.  A total of 79 million Americans have the virus, which often shows no symptoms.

Gardasil, a vaccine approved by the FDA in 2006 to prevent certain cancers and diseases caused by four HPV types, is no longer distributed in the U.S. In 2014, the FDA approved Gardasil 9, which covers the same four HPV types as Gardasil, as well as an additional five types, for use in males and females aged 9 through 26.

In a study of approximately 3,200 women 27 through 45 years of age, followed for an average of 3.5 years, the vaccine was 88 percent effective in the prevention of a persistent infection, genital warts, vulvar and vaginal precancerous lesions, cervical precancerous lesions, and cervical cancer related to HPV types that are covered by the vaccine, the FDA said.

The agency’s approval of Gardasil 9 in women 27 through 45 years of age is based on these results and new data on long term follow-up from this study.

The effectiveness of Gardasil 9 in men 27 through 45 years of age is inferred from the data described above in women 27 through 45 years of age, the FDA said.

The safety of Gardasil 9 was evaluated in about a total of 13,000 males and females. The most commonly reported adverse reactions were injection site pain, swelling, redness and headaches.

The FDA granted approval of this supplement to the Gardasil 9 Biologics License Application to Merck, Sharp & Dohme Corp. a subsidiary of Merck & Co., Inc.

The findings, from a University of Chicago Medicine study, were published in the Journal of the American Geriatrics Society. This study is the first to look at a nationally-representative sample of people with dementia who are partnered and living at home.

“Until now, most of what we knew on this topic came from studies or legal cases involving people with advanced dementia living in nursing homes,” said lead study author Stacy Tessler-Lindau, MD, MAPP, and UChicago Medicine professor of obstetrics/gynecology and geriatrics.

“In the next 30 years, more than 80 million people in the U.S. will be 65 or older. A growing number of people with dementia live at home, cared for by a spouse who, like doctors and society more generally, doesn’t have the knowledge they need to manage the sexual aspects of life with a person with dementia.”

The number of home-dwelling people with Alzheimer’s Disease (the most common type of dementia) is expected to grow to more than eight million by 2050.

Researchers found that of partnered people with dementia in their study, 59 percent of men and 51 percent of women were sexually active. More than 40 percent of partnered men and women ages 80 to 91 also reported being sexually active. But the likelihood of partnered sexual activity declined with lower cognitive scores for both women and men in the study.

“The lack of basic information about sexual behavior, function and desires in this growing population is a problem,” said Lindau, “because these aspects of life with dementia raise ethical, legal, clinical and even moral questions that we as a society are largely unprepared for.”

For example, Lindau said, can a person with dementia consent to sex or be deprived of sex because we’re not sure he or she can consent? Should a doctor treat a person with dementia for sexual dysfunction? Does a person with cognitive impairment have an obligation to fulfill “marital duty?”

The study’s authors looked at data from more than three thousand home-dwelling people in the United States between the ages of 62 and 91. In a previous study, Lindau and co-authors found later-life sexual activity to be positively associated with physical and mental health. It was regarded by most men and women as an important part of life.

The majority of people, across all cognition groups in the current study, reported positive attitudes about sex but said that they were having sex less often that they would like.

“Physicians may be asked to determine whether a patient with dementia has the capacity to consent to sex and have to balance the obligation to protect the patient from harm with the obligation to protect the person’s autonomy,” Lindau said. “We now have normative evidence that should help counter negative bias and inform important decisions about sex for people with dementia.”

According to a news release from the University of Chicago Medical Center, more than one-third of men and one in 10 women in the study’s dementia group reported bothersome sexual problems, but only 17 percent of men and one percent of women with dementia talked to a physician about sex-life changes that result from a medical condition like dementia.

Lindau said there are a growing number of FDA-approved treatments for sexual dysfunction, and that many of these are targeted to older adults.

“Sometimes the person complaining about the patient’s sexual function problems is the partner, not the patient with dementia. Doctors need to be prepared for how to handle that,” she said.

Electrodes aren’t the first thing most people think of when it comes to achieving sexual arousal. But if the results of a pilot study done at the University of Michigan in September 2018 are any indication, that may soon change.

A release from Michigan Medicine at U-M notes that female sexual dysfunction (FSD), a condition that ranges from a lack of libido to an inability to achieve orgasm, affects 40 to 45 percent of women, especially as they age.

FSD can be tough to diagnose and even more difficult to treat.

And while clinicians have attempted to help women by prescribing sildenafil (better known by its brand name, Viagra), hormones, and flibanserin these methods don’t always work and can have undesirable side effects.

That’s why two University of Michigan researchers were intrigued after learning that neuromodulation treatments for bladder dysfunction occasionally led to improvements in sexual function.

The release quotes Tim Bruns, Ph.D., an assistant professor of biomedical engineering at U-M, as saying, “In this particular treatment, a patient receives nerve stimulation therapy once a week to improve neural signaling and function in the muscles that control the bladder. The nerves controlling the pelvic organs start out in the same location in the spinal cord and branch out.”

Interestingly, Bruns notes, one form of stimulation is effective for bladder dysfunction despite an odd placement of the electrodes: near the tibial nerve in the ankle.

The current theory, Bruns explains, is that the nerves that travel down to the foot overlap near the spinal cord with some of the nerves to the pelvic organs, leading to a possible overlap in synaptic routes.

Sensing an opportunity, Bruns and his colleague, Nicholas Langhals, Ph.D., looked into whether the technique had been investigated in women without bladder problems.

Surprisingly, there was almost no research.

Testing a theory

Bruns decided to study the technique in rats and humans.

In the rat studies published last year and earlier this year, Bruns’ team stimulated nerves in the genital and ankle region. After 15 to 30 minutes, the rodents experienced a strong increase in vaginal blood flow.

Then, working with Michigan Medicine obstetrician-gynecologist Mitchell Berger, M.D., Ph.D., and urologic surgeon Priyanka Gupta, M.D., the researchers recruited nine women with FSD (and without bladder problems) for a pilot study.

Each woman received 12 half-hour sessions of transcutaneous electrical nerve stimulation in which participants had electrodes placed either in the genital region or on the ankle.

A 53-year-old woman who got involved with the study after reporting difficulty achieving orgasm to her gynecologist, described the experience as “a bizarre, pressure vibration sensation.”

Still, she managed. “After a few minutes, however, you get used to it,” the participant recalled. “Then, you sit there for 30 minutes. I brought a book to read during my session.”

Electrodes boost sexual function

Results of the sessions showed substantial promise: Eight of out the nine women reported some improvement in arousal, lubrication and orgasm.

“Across a variety of clinical studies, if you get a 50 percent improvement in symptoms, you can consider that a successful response,” Bruns says. “We had four participants meet or exceed that threshold.”

Overall improvement in score was comparable or greater than prior studies of different types of drugs or neuromodulation for FSD, he adds. However, future studies with blinding and a placebo control are needed to rule out any placebo effect.

This study, published in the journal Neuromodulation, was funded in part by a grant from the Michigan Institute for Clinical and Health Research, which is funded by the National Institutes of Health.

More research planned

Bolstered by these early findings, the Michigan team is currently seeking funding to carry out a larger study.

Says Gupta: “This study presents an alternative method for treating female sexual dysfunction that is non-pharmacologic and non-invasive. Through studies like this we can further understand female sexual arousal and offer treatments for a disorder that has very few options.”

The treatment definitely has at least one fan: the participant interviewed about her experience.

“It worked for me,” she says. “I’m not one-hundred percent back to the way I was, but I can have orgasms again and they are pretty good ones.”

This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases (STDs).

“We are sliding backward,” said Jonathan Mermin, M.D., M.P.H, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “It is evident the systems that identify, treat, and ultimately prevent STDs are strained to near-breaking point.”

The CDC analysis of STD cases reported for 2013 and preliminary data for 2017 shows steep, sustained increases:

Gonorrhea diagnoses increased 67 percent overall (from 333,004 to 555,608 cases according to preliminary 2017 data) and nearly doubled among men (from 169,130 to 322,169). Increases in diagnoses among women — and the speed with which they are increasing — are also concerning, with cases going up for the third year in a row (from 197,499 to 232,587).

Primary and secondary syphilis diagnoses increased 76 percent (from 17,375 to 30,644 cases). Gay, bisexual and other men who have sex with men (MSM) made up almost 70 percent of primary and secondary syphilis cases where the gender of the sex partner is known in 2017. Primary and secondary syphilis are the most infectious stages of the disease.

Chlamydia remained the most common condition reported to CDC. More than 1.7 million cases were diagnosed in 2017, with 45 percent among 15- to 24-year-old females.

Chlamydia, gonorrhea, and syphilis are curable with antibiotics, yet most cases go undiagnosed and untreated — which can lead to severe adverse health effects that include infertility, ectopic pregnancy, stillbirth in infants, and increased HIV risk. Prior studies suggest a range of factors may contribute to STD increases, including socioeconomic factors like poverty, stigma, and discrimination; and drug use.

The threat of untreatable gonorrhea persists in the United States, and reports of antibiotic-resistant gonorrhea abroad have only reinforced those concerns. Over the years, gonorrhea has become resistant to nearly every class of antibiotics used to treat it, except to ceftriaxone, the only remaining highly effective antibiotic to treat gonorrhea in the United States.

In 2015, CDC began recommending health care providers prescribe a single shot of ceftriaxone accompanied by an oral dose of azithromycin to people diagnosed with gonorrhea. Azithromycin was added to help delay the development of resistance to ceftriaxone.

Emerging resistance to ceftriaxone has not been seen since the dual therapy approach was implemented, and there has not yet been a confirmed treatment failure in the United States when using this recommended therapy.

New CDC findings released today, however, show that emerging resistance to azithromycin is now on the rise in laboratory testing — with the portion of samples that showed emerging resistance to azithromycin increasing from 1 percent in 2013 to more than 4 percent in 2017.

The finding adds concerns that azithromycin-resistant genes in some gonorrhea could cross over into strains of gonorrhea with reduced susceptibility to ceftriaxone — and that a strain of gonorrhea may someday surface that does not respond to ceftriaxone.

“We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention. “We can’t let our defenses down — we must continue reinforcing efforts to rapidly detect and prevent resistance as long as possible.”

A renewed commitment from health care providers — who are encouraged to make STD screening and timely treatment a standard part of medical care, especially for the populations most affected — is an important component to reverse current trends.

Romantic lyrics don’t include the statistics: According to the CDC’s Sexually Transmitted Disease Surveillance Report released in September 2017, after decades on the wane, STDs are making a comeback: There are more than 100 million STD infections across the country on an annual basis with 20 million new cases, half among young people between 15 and 24 years old. Cases of chlamydia, gonorrhea and syphilis – all of which can include skin symptoms – have hit an all-time high.

It’s important to know that STD skin symptoms go far beyond herpes and warts, and may show up on areas of our body that we might not associate with sexual activity.”

In addition to herpes simplex 1 and 2 and the human papillomavirus (HPV) responsible for genital warts, STDs with skin manifestations include syphilis, gonorrhea, chlamydia, HIV – and others. Scabies and the virus molluscum contagiosum can also be acquired through sexual contact.

Beyond affecting our bodies in areas associated with sexual activity, STDs may also affect our skin in other ways: Chlamydia and gonorrhea can cause pink eye. Gonorrhea and syphilis can cause rashes on different parts of the body, including the hands and feet. And HIV’s effect on the immune system can result in a variety of skin problems.

Staying alert for skin symptoms and getting timely medical attention is an important means of preventing the more serious complications that STDs can cause.

Dermatologists’ expertise includes identifying and treating STDs that cause skin complications. With this in mind, I share the following tips.

5 Recommendations Regarding Skin STDs

1. Work with a doctor you trust: Open communication is key. Many STDs are easily treatable with antibiotics. For viruses such as herpes, there are medications that can control outbreaks. Sex is a healthy part of adult life, and there shouldn’t be stigma regarding STDs.

2. Take prompt action: Don’t wait for skin symptoms to go away. Skin outbreaks may pass, but the disease still needs treatment. Certain strains of HPV can promote cervical and other cancer. Chlamydia can cause infertility and blindness. And – at their worst – syphilis, gonorrhea, and HIV are life threatening. Untreated, STDs also pose a serious risk to pregnant women and their babies.

3. Remember: Skin outbreaks can occur outside of “intimate” areas: Sexually transmitted diseases can cause a variety of skin problems affecting not only intimate areas, but also eyes, hands, feet, and other sections of our body. Dermatologists are experts in evaluating skin problems, including those caused by STDs.

4. Stay aware of prevention options: For young people, there is a vaccine for HPV. And condoms can help prevent fluid-borne infections like chlamydia, gonorrhea, and HIV. However, condoms are less effective at preventing skin-to-skin diseases, like herpes, which can spread without sexual intercourse. Getting tested for STDs and maintaining a mutually monogamous relationship should decrease your risk.

5. Traveling? Pack STD awareness, too: Some skin STDs are more prevalent abroad. Chancroids and donovanosis, for example, are more common outside the United States. If you do develop symptoms like a sore on your private parts, make sure that you share your travel history with your doctor.

The good news is that STDs are treatable. Sexually active adults should stay aware and communicate with their doctors.”

Joshua L. Fox, M.D., F.A.A.D., Medical Director at Advanced Dermatology PC. He is board certified and specializes in skin cancer, cosmetic surgery, and laser procedures.

Advanced Dermatology P.C. and the Center for Laser and Cosmetic Surgery (New York & New Jersey) is one of the leading dermatology centers in the nation, offering highly experienced physicians in the fields of cosmetic and laser dermatology as well as plastic surgery and state-of-the-art medical technologies. www.advanceddermatologypc.com .