An article published in the July 2011 issue of the journal Sexually Transmitted Diseases found that adult film performers in California have chlamydia and gonorrhea rates 34 and 64 times higher than the general population in Los Angeles and 8.5 and 18 times higher than young people aged 18-29 who live in the city. Although some of the difference can probably be explained by the fact that adult film performers are more likely to undergo regular STD screening than the general public, annual incidence rates of 14.3% for chlamydia and 5.1% for gonorrhea are still disturbingly high. They also suggest that the 30 day rule is, unsurprisingly, simply not good enough.

The editorial which accompanies the article makes an excellent case for this being an occupational health issue - one which the government would be more likely to address in just about any other industry. Workplace safety is something that it is in the government's best interest to regulate, and although they shouldn't be telling you what you can and can't do in your own bedroom, they can set minimum conditions for what is acceptable when you're on the job. Mandating condom use would be a good start.

Finally, it's worth noting that the researchers also found that almost a quarter of adult performers who were diagnosed and treated for an STD during the study period were reinfected within a year. These are not low risk jobs, and individual performers are not always capable of advocating for their own safety. It would be nice if we could do a better job of protecting them in the same way that we protect other individuals whose work exposes them to health hazards on a regular basis.

• Chlamydia Basics
• Gonorrhea 101
• STD Screening Guidelines
• The 30 Day Rule for Adult Film Performers
• Talk Back: Should Condoms Be A Requirement for Adult Films?

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Gonorrhea is one of the most common bacterial STDs, but, although it is currently treatable, antibiotic resistance is on the rise. Because of this, some scientists have begun to investigate whether alternative antimicrobial products might be useful in treating gonorrhea infections.

One such study, published in the July issue of Sexually Transmitted Diseases examined whether a variety of the medicinal plants used by the Canadian First Nations could be potentially used as gonorrhea treatments. The answer looks like it may turn out to be yes. Although the results are still very preliminary - extracts of the various plants were used to inhibit bacterial growth in culture - two of the tested botanical extracts were found to successfully inhibit the growth of all strains of gonorrhea tested, including the antibiotic resistant ones.

Further tests will be needed to see how H. canadensis (goldenseal) and R. rosea (roseroot) might be used to treat actual gonorrhea infections, but this early study is a hopeful note in the continuing battle against antibiotic resistant gonorrhea.

• Gonorrhea 101
• Antibiotic Resistant Gonorrhea

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There is such a thing as over-screening, and a recent article in the journal Obstetrics and Gynecology suggests that many American doctors are doing just that. Instead of following current Pap smear and HPV testing guidelines, which tell doctors not to start HPV testing until women are age 30 or over, more than 66 percent of doctors performed such testing in women under the age of 30 years.

Why is that a problem? Many people, and apparently many doctors, assume that any testing is good testing. However, that's simply not the case. Early, high-risk HPV testing with intensive follow up can lead to unnecessary procedures that have the potential for serious side effects. That's pointless when many, if not most, HPV infections in younger women will resolve on their own within a few years.

I'm generally of the opinion that more information is better when it comes to STD screening, but HPV testing is sort of an exception. There's no point in treating even high-risk infections in young women, but doctors who find them may want to cover their butts. And knowledge of a low risk infection doesn't even help women discuss risk factors with their partners, since there is no commercial test for HPV in men.

Herpes screening is also controversial, but to me it makes sense because suppressive therapy can help prevent transmission and knowledge of an infection can aid in prevention. HPV however, is nearly ubiquitous, there's nothing much you can do about it until it causes problems, and it will often go away on its own without help. Testing makes sense in older women because it makes cervical cancer screening more efficient, but in younger women? Not so much. Hence the guidelines.

• Pap Smear Guidelines
• Pap vs. HPV Test
• STD Screening Guidelines
• HPV in Men

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Syphilis infections can be fatal in newborns. Although such deaths are relatively rare in the U.S., in Sub-Saharan Africa almost half a million infants die of prenatal syphilis every year. Increasing the sense of tragedy is the knowledge that these deaths are easily preventable with regular screening of pregnant women and antibiotic treatment.

Unfortunately, although almost all countries recommend screening pregnant women for syphilis, these recommendations aren't well implemented in low-resource areas. A recent news report says that less than 20 percent of women are appropriately screened, even though more than 2 million women across the globe are infected with syphilis each year and the risk of severe consequences to the infant are extraordinarily high.

Something can be done. A study by scientists at University College London found that offering women same day testing and treatment for syphilis could reduce the risk of early infant deaths and stillbirths by more than half. Doctors and local health workers just have to to a better job of implementing such testing... a change that probably can't be made until there is a loud, public acknowledgement of the fact that syphilis is still a major problem around the globe.

• Syphilis 101
• Congenital Syphilis

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