Miramistin against HIV: 11 myths about genital infections
According to various sources, every minute 40-80 thousand people in the world have sex, and every day more than a million people are infected with any sexually transmitted infection. Every year, 357 million people become owners of chlamydia, gonorrhea, syphilis or trichomoniasis pathogens; 500 million people are infected with the virus that causes genital herpes, 290 million women with the human papillomavirus. Like any other sphere, sex and its dangers are surrounded by many controversial facts and legends. And while some people quietly use the already used condom, others do not stop treating non-existent diseases. Meet 11 myths about STIs, which we have analyzed in detail.
Text: Ekaterina Khripko
Sexual infections can be infected through a dish or a kiss.
An infectious disease physician and project manager of the AIDS Foundation. Center. Nikolai Lunchenkov suggests memorizing a simple wording: sexually transmitted infections are transmitted mainly through sex. It is impossible to get an STI through glasses, towels or a toilet seat. As for kisses and airborne droplets, concerns have arisen due to confusion in different types of viruses. For example, Chlamydia trachomatis (Chlamydia trachomatis) is a genital infection that can cause inflammation, sterility or pregnancy complications. But Chlamydophila pneumoniae (Chlamydia pneumonia) is the causative agent of pneumonia and a completely different class of chlamydia, which is transmitted by airborne droplets.
There are strains of HPV and herpes virus that cause warts or ulceration on the skin or mouth - but they differ from those that affect the genitals. It is impossible to get infected by speaking or, say, shaking hands with HIV, a genital HPV strain, genital herpes or a gonorrhea pathogen.
Infections are always accompanied by unpleasant symptoms.
As long as we live in a relatively prosperous environment, we feel good and do not see obvious manifestations of an STI in our partner and we can create the illusion of complete health. But, like many other infections, STIs are often asymptomatic. Oncogenic HPV types can lead to cervical cancer, but are not accompanied by the appearance of papillomas; Chlamydia or gonorrhea can show up only at the stage of identifying the causes of infertility; HIV may not manifest itself for years. According to WHO estimates, about 7.5 million people on the planet do not know that they are HIV-positive - what to say about carriers of other infections.
There are no definite recommendations on how often one should be tested for STIs - no, this depends on the number of partners, contraceptive methods and the presence of risk factors. For example, all women periodically changing partners should be checked annually for the presence of chlamydia and the causative agent of gonorrhea. HPV tests are recommended to take after twenty-five years - at a younger age, the body often cope with the virus itself.
All infections are easily treated.
It would seem that medicine has gone far ahead, and today those diseases from which historical and literary characters of past centuries died have been treated with antibiotics or have practically disappeared due to vaccination. But, unfortunately, it is still impossible to finally get rid of a number of infections, and those that are cured sometimes require long observation.
So, treatment of syphilis can include from one injection to 2-4 weeks of treatment with antibiotics - and a year or two observations after that. You can not completely eliminate from the body of HIV and the herpes virus. Although the HPV system can cope with the HPV alone, it is not yet possible to predict who the infection will disappear and who will progress.
Cytomegalovirus and Epstein-Barr virus - genital infections
Some viruses exist in almost all people and do not require treatment - this is a cytomegalovirus, Epstein-Barr virus, various herpes viruses, and about 80% of people during the course of their lives are infected with HPV (and they are often referred to as safe strains). There is no point in actively detecting CMV and Epstein-Barr virus: for a healthy person without severe immunodeficiency, they are not terrible. They are not only sexually transmitted, so they are not related to STIs. Cytomegalovirus and Epstein - Barr virus, the majority of infected in childhood - it is enough to drink from a cup of an infected person.
In the external environment, the viruses are alive as long as the humid environment remains, for example, until the edge of the glass is dry. But there is no special reason to sweat about the sterility of the glass either: transmission by airborne droplets is not excluded. After infection, a person within a few weeks becomes a disseminator of the infection (in parallel, he may develop fatigue, inflammation in the throat, swollen lymph nodes and other symptoms similar to the common cold), then the virus goes into inactive, sleep mode. In some cases, the virus can be activated, and then the person becomes infectious again, but, as a rule, does not feel this.
Condom misses viruses
According to statistics, condom use protects against HIV in 80% of cases. The remaining 20% of the risk gave rise to a lot of talk about the inefficiency of latex (and other materials) and about the porous structure, which misses various viral particles. In fact, the pores in the condom - a myth. If you delve into the manufacturing technology of condoms, it becomes clear that at least two layers of latex are used - even if they have rare micropores, they are unlikely to superimpose exactly on each other; in addition, they are filled with grease. Finally, the electronics check just the ability not to miss viruses.
Nikolai Lunchenkov explains that if used correctly, the condom protects by 100% - and the statistics are generated taking into account data from the entire planet, including the improper use of condoms. According to the doctor, there are still places where, due to lack of resources and education, condoms are washed, dried and reused. Recall how to use a condom correctly: do not put it inside out (i.e., do not have to look inside the semen collection tank), do not take off until the end of sexual intercourse, do not use water or oil-based lubricants, do not use two condoms at the same time - they will soon tear. And of course, look at the expiration date and buy condoms from well-known manufacturers in safe places.
But condoms are not omnipotent against syphilis, genital herpes and human papillomavirus. If the infection is in an open form, rashes or bubbles appear far beyond the areas protected by a condom. During sex, a healthy partner will be in contact with the affected areas - and in this case, infection is likely. Gonorrhea, chlamydia, trichomoniasis, and HIV can be transmitted, for example, through urethral secretions (and not just sperm or vaginal secretions), so not sharing “fluids” with a partner is important both before and after sexual intercourse.
Oral sex is safe
The risk of being infected in this way is somewhat lower, but it is still significant. According to the gynecologist Tatyana Rumyantseva, with oral sex, you can get herpes, syphilis, gonorrhea, chlamydia; infection with HPV is possible, and even, theoretically, HIV - if there are sores or inflammations in the oral cavity. According to Lunchenkov, sometimes infected patients due to stigma do not talk about other types of contact and say that they only had oral sex. For this reason, it is not possible to accurately determine the risk of HIV transmission during oral sex, and in general it is considered low.
To prevent infections with oral sex, you can (and should) use condoms or special latex wipes. It is necessary to understand that the transmission route of the same HPV or syphilis pathogen is contact, and the diseases they cause are dangerous not only for the reproductive organs. Syphilitic foci may appear anywhere on the body (this is why, prior to the appearance of gloves, syphilis of the fingers was an occupational disease of doctors of certain specialties); HPV causes not only cervical cancer, but also cancer of the oral mucosa or pharynx.
To protect enough miramistina after sex
There are legends about the effectiveness of antiseptics - allegedly they are more effective than condoms, and even PubMed can be found by Russian authors calling Miramistin a potential means of preventing HIV infection. Nevertheless, such drugs, although they can give some kind of protection, do not guarantee it - and still can do harm.
It is important not to get involved - there is no need to pour antiseptics into the vagina or urethra and use products based on alcohol or peroxide, which can cause burns to the mucous membranes. In the work on protection against STIs after sex, the ONN information network says that such methods can be used in emergency situations, but they should not be a regular way to prevent infections - that is, nothing is better than a condom until it is invented. On sites of organizations such as the CDC or the FDA, there is no mention of Miramistin at all - so the world medical community does not consider this tool seriously.
Gardnerella is dangerous
According to Tatyana Rumyantsev, the diagnosis of “Gardnerella” is not found either in international or in Russian guidelines (which does not often prevent polyclinics and clinics for women from setting it up). According to venereologist Sergei Agapov, since the definition of bacterial vaginosis as an independent disease, its main causative agent was considered to be vaginal gardnerella (Gardnerella vaginalis). However, later it was found that this microorganism is present in small quantities in the vagina of many healthy women.
In bacterial vaginosis, an equilibrium shift in the vaginal microflora occurs: the number of “bad” bacteria becomes less and the number of “bad” ones increases, among which the leading ones take the leading position. This can occur due to extreme heat, stress, or a change of partner. In this situation, really need treatment. If the analysis simply revealed the presence of gardnerella in the vagina, but at the same time the number of lactobacilli exceeds them, then no treatment is required; need to treat bacterial vaginosis, and not "Gardnerella", sums up Rumyantsev.
In some cases, you can really talk about sexually transmitted infections, and from woman to man. According to Agapov, the male urethra, unlike a healthy vagina, has an alkaline environment that favors the reproduction of bacteria - and if the partner has bacterial vaginosis, his pathogens can cause unpleasant symptoms in a man. Men with chronic prostatitis who have had some infections (chlamydia or gonorrhea), as well as those who abuse local antiseptics like miramistina or chlorhexidine are susceptible to infection in the first place.
Mycoplasmosis and ureaplasmosis should be treated
Sometimes you can hear that ureaplasmas lead to infertility, miscarriages, premature birth, intrauterine infections. In fact, this is not the case, ureaplasma is a common component of the microflora, which does not affect the course and outcome of pregnancy. As for mycoplasma, a lot of its species inhabit the human body, but in the genitals two of them are important, which differ greatly from each other - this is Mycoplasma genitalium and Mycoplasma hominis. The latter species is a component of the normal flora of a woman, although occasionally it can take part in bacterial vaginosis. Nevertheless, the scheme of action is as in the previous paragraph: it is necessary to treat vaginosis, and not to try to get rid of mycoplasma.
Much less common is another type Mycoplasma genitalium (mycoplasma genitalium) - and this is really a sexually transmitted infection that needs to be treated both in oneself and in one's partner (even if the results of his analysis show “not detected” - unfortunately, not all research methods are correct). This mycoplasma can lead to the development of serious complications, such as affecting the course of pregnancy. Detect this pathogen can not any analytical method - it is best to use the PCR method.
HIV positive partner is always contagious
If an HIV-positive person takes antiretroviral therapy, then usually, in a milliliter of blood, no more than 200 copies of viral particles are found, which means that the risk of transmission of the virus to the sexual partner during unprotected sex is reduced to zero. With such a low viral load, the fetus is protected during pregnancy. Reports about it and the Center for Disease Control and Prevention in the United States, and private research, such as this or that.
There is no prevention against HIV
Another good news from the world of HIV prevention. There is a so-called pre-contact prophylaxis recommended for certain groups of people, says Nikolai Lunchenkov. These are men who have sex with men, people who use drugs, sex workers and sex workers. Antiretroviral therapy (a combination drug based on tenofovir and emtricitabine) must be taken regularly throughout the period at which there is a risk of becoming infected with HIV. Due to the concentration of the drug in the blood of infection does not occur. It is believed that the effectiveness of such prophylaxis is higher in men - in women, the concentration of tenofovir may decrease under the influence of estrogen.
There is post-exposure prophylaxis. To do this, as soon as possible after unprotected contact with a partner, whose HIV-negative status you are not sure of, start taking antiretroviral therapy, which is usually prescribed to people with HIV infection. Therapy should be started in the first 72 hours, but then as with emergency contraception - the sooner the better. In the first 5-10 hours the probability of suppressing the virus, if the infection really was, is the maximum; The medicine must be taken within a month.
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