I am not always in agreement with establishment medical views about STD screening. In particular, I question the reluctance of many doctors to screen individuals for the viruses that cause oral and genital herpes, although I do understand from whence it stems. The problem is this - the accuracy of a medical test is directly related to how common the disease is in the population. Commercially available herpes blood tests, for example, are relatively accurate if you assume that the prevalence of the virus is high (which it is across most of the country), but the tests will give a large number of false positives in areas where infection is less common. Now, for most other diseases this wouldn't be that big a deal - but herpes is so socially stigmatized that a positive test can be devastating, even if the individual never has any symptoms... or for that matter later learns that the test was wrong.

So what do you do? Do you risk damaging a person's psyche with a positive test for the possible benefit of being able to use suppressive therapy to reduce viral transmission, or do you decide to only screen people who you believe are at high risk? I'd like to offer a third possibility - education. If we can convince people that a herpes diagnosis does not say anything bad about them as human beings, then maybe we can start getting people to talk about the disease out in the open. Once we do that, perhaps screening can become less of a big deal, and then maybe we can actually start doing something about prevention. After all, the vast majority of herpes transmissions take place between asymptomatic partners. If we want to do something about reducing the number of people with the virus, it's going to require screening, behavior change, and even sometimes medical intervention to stop them from passing it on willy-nilly just because they don't even know they're at risk. There's a fine line, though, between destigmatizing the virus enough to deal with it and keeping people concerned enough that they're willing to change their behavior to try and avoid passing it on to new partners. For most people, living with herpes may not be that big a deal, but I suspect that they'd still rather live without it.

• How Accurate is the Herpes Blood Test?
• Understanding False Positive Tests
• STD Screening Guidelines
• Oral Herpes Overview
• Genital Herpes Overview
• Social Stigmatization & STDs
• Suppressive Therapy to Reduce Herpes Transmission
• Prevention Basics
• Asymptomatic STDs - The Hidden Epidemic
• Living with Herpes

A study that was recently published in the Journal of Health and Social Behavior highlighted, once again, the importance of self esteem when it comes to making health decisions. The author, Adam Isaiah Green, found that gay men who were not considered to be sexually desirable were more likely to make risky sexual decisions. Such decisions included excessive use of alcohol, failing to talk about safer sex, and deciding not to use condoms - particularly when sex with a more attractive partner was involved. This isn't just an issue for gay men. In general, people with low self esteem are more likely to make poor health decisions around issues of sex and sexuality. I sometimes think that teens, in particular, are subject to the desire to do anything at all that will make them more likely to be liked.

• Self Efficacy and Condom Use
• Understanding Sexual Risk
• Things to Talk About Before Having Sex
• How to Use a Male Condom

It's a very strange world we live in when anyone's definition of a "nice catholic girl," is someone who only has anal sex with her boyfriend until they get married so that she can preserve her virginity. Recent news reports of the Bradley Hasbro Children's Research Center study on sexual behavior in young adults continue to blow my mind. The study simply provides more evidence that a focus on virginity in sex education is phenomenally counterproductive. With the sole exception of the fact that it can't get the female partner pregnant, unprotected anal sex is actually riskier than vaginal sex. A focus on virginity and pregnancy prevention rather than providing comprehensive sex information does teenagers an enormous disservice. It's hard enough to make good sexual decisions when you have all the information you need. It's nearly impossible when you don't know that oral sex can give you an STD and think of anal intercourse as the safe option.

• The Problem With Virginity Pledges
• Why You Should Support Comprehensive Sex Education

People are constantly searching for new ways to encourage teenagers to practice safer sex. One novel idea, reported by the BBC, recently premiered in Manchester, England. A 15m high video of a graffiti artist painting "Want Respect? Use a Condom" was projected for three hours each evening one recent weekend. It certainly seems like an attention getting scheme, although I don't know how much it will actually effect behavior. Still, anything that gets people talking about condom use is a good idea in my book. I wonder what they will come up with next?

• Talking to Your Teen About Sex
• How to Have Safe Sex
• How to Use a Male Condom