Demystifying DNA

Taboos Revisited: Advancing Our Talk on STIs and Health

• Dr. Tiffany Montgomery (P23 Health) • Episode 5

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Are you brave enough to challenge the taboos? This episode of 'Demystifying DNA' is doing just that, as we shed light on the often overlooked and misunderstood world of sexually transmitted infections (STIs). Together with my co-host, Nick Cuevas, we explore the alarmingly high rates of STIs among American young adults and the most prevalent ones, like genital herpes and HPV. We're breaking down barriers and stigmas, addressing the limitations of condoms, and emphasizing the importance of knowing your status with the availability of at-home tests. Let's strip away the myths and foster a more open dialogue around sexual health.

Now, let's tackle the elephant in the room - STI screening, early detection, and education. As we find ourselves in the middle of a pandemic, the conversations around viral strands like HPV have become more crucial than ever. We explore the various transmission methods and the potential risks of skin-to-skin contact. Testing isn't gender-specific - it's necessary for all. We advocate for proactive measures like vaccinations and a routine check-up regime. We also discuss the role of P23 Health in facilitating this early detection process. Integration of these practices into your relationships could be a game-changer. Let's make sexual health a priority, together.

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Dr. Tiffany Montgomery:

Welcome back to Demystifying DNA, the podcast, where we explore topics often wrapped in secrecy and stigma. I'm your host, dr Tiffany Montgomery, and in this second episode focusing on sexual health, we'll delve back into the world of sexually transmitted infections. We aim to share light on this crucial subject, breaking down barriers and challenging the taboos that often hinder open conversation. Join me and my co-host, nick Quavis, as we continue to foster a dialogue that's not only necessary but long overdue. I've introduced you all to Nick on our last episode and I will present him to you again today. Partner, spouse, dad, son, you name it. This man's got titles, he's got experience and he's going to work together with me and help us demystify these issues together.

Nick Cuevas:

How you doing doctor, How's it going? I just cannot complain.

Dr. Tiffany Montgomery:

I'm glad to be back here talking to you again.

Nick Cuevas:

Yeah, this is great. I had a great conversation with you last time. It was awesome. We got a lot of feedback, a lot of people liked it, and it was a great choice for you to want to continue this conversation. It's going to be a good one. I can't wait to get started. I have some good questions for you. Also, this whole DNA stuff and STI, how it all kind of marries in together, is kind of mind blowing. I just really can't wait to learn more.

Dr. Tiffany Montgomery:

You had some time to kind of digest and I think our listeners got to digest. I think that it's a conversation that's welcome and needed, because the United States has the highest rate of STD infections among first world industrialized countries. This is according to Rush University and also supported by the CDC. There are 20 million new sexually transmitted infections every year in the US, and almost half of them are among people 15 to 24.

Nick Cuevas:

Wow, that's 15 to 24. So you're talking about people that just became adults.

Dr. Tiffany Montgomery:

That's crazy, that's right, and in that age group the most common STD is genital herpes, so one in about every six people that are between the ages of 14 and 49. Have genital herpes. About 90% of people who have herpes don't know they have it, because they may not have any symptoms or very mild ones. The thing about herpes is that it can be transmitted even when there are no visible sewers, and it can be spread by oral sex. Herpes is not curable, but it can be managed with antiviral medications.

Nick Cuevas:

Hmm, so that means you're, you're stuck with it for life, you are period Wow you are and that's sad, but that's this part of what it is. I mean, at least the medicine that they do give out, it subsides it right. I mean it makes it you're livable, you're able to function.

Dr. Tiffany Montgomery:

Absolutely.

Dr. Tiffany Montgomery:

We have great antiviral medications and treatments, but you know, I'd have to argue, the best way to combat it is prevention being educated, being informed and Making sure that you don't contract it.

Dr. Tiffany Montgomery:

And I think that was one of the biggest motivating factors behind P23 right removing those barriers so people know how to get those tests and they don't feel uncomfortable about doing it. You don't want people to Not get the test because they don't want to go to the doctor and talk about it and you know, maybe their mom is always in the room when they go to the doctor, or their spouse, or there are a lot of uncomfortable situations. Sometimes you buy yourself and you still don't want people to look at you because you need to request a test, right. And so we want to remove those stigmas. We want to remove those barriers and give people like private ways to really focus on educating themselves and being informed about their health, all parts of it, and that really includes sexual health. So I think it's just important to know your status, your options and be comfortable enough To investigate and challenge these things on your own.

Nick Cuevas:

Yeah, very true it's. It's a great thing to know that, because you know a lot of people Do struggle with that. I would assume. You know I I couldn't imagine having one and then having one and having to deal with that, with telling my spouse or Partner or you know anybody. That would be Something that would be challenging.

Nick Cuevas:

And then the good part about it is, as these at home tests that are around now Provide that's, you know, just that clarity finding out kind of in a discrete way where you don't feel kind of embarrassed or you don't have any of those things that are just stopping you from getting tested. I mean, you know used to be just go to the doctor, but you know you might not feel comfortable around the doctor discussing those things, and so the test that, that that we provide at P2 3, that's a great way to to not have to worry about things of that nature. I mean you could actually just do it on your own, find out the results pretty quickly and then know what to do next, take the next steps, and and the whole world doesn't have to know about it. I.

Dr. Tiffany Montgomery:

I think that one of the biggest things you know we used to educate our younger folks and our sexually active folks that condoms were the way to go right and use protection and go for the condoms. And while condoms are fantastic for things like chlamydia, hiv and gonorrhea, condoms don't provide 100% protection from herpes and human papillomavirus or HPV, which are the two most common sexually transmitted diseases or sexually transmitted infections. How are you saying Herpes and HPV can infect areas that are not covered by condoms, such as thighs, buttocks, mouth or the anus? Hpv is the virus that can cause genital warts and cervical, anal, throat and penile cancer. There are vaccines that help against that and those things are not even effective against all strands. So we have to be mindful of our status and our partner status.

Dr. Tiffany Montgomery:

I don't want you to feel like, well, I shouldn't even use the condom because condoms are great. I gave you the list of things that you could use the condom for, but you have to be informed about who you're with and share that information. So you have the information and you have to share it with the person that you're sleeping with if you want to be socially responsible. If you say well, doc, how do we stop the herpes. How do we stop the HPV? Right now there's no cure. We have vaccines. But how do we stop it is by having these conversations.

Nick Cuevas:

Yeah, facts Facts is good to know. I mean, listen, I need you to talk to somebody like myself who is not fully educated on all these different acronyms, hpv and all of these things. Can you at least highlight one or two of them and just specify the main differences? I know Chlamydia and syphilis, but HPV can you elaborate on that a little bit more?

Dr. Tiffany Montgomery:

Absolutely. I'm glad you asked because you use these acronyms and you think so many times that people are aware of them but, this is a great time to just stop and say what is it Right? So HPV is for the human papilloma virus. It is a common sexually transmitted infection that can cause warts or cancer in some cases. Okay, Thanks.

Nick Cuevas:

Chlamydia.

Dr. Tiffany Montgomery:

There are more than 100 types of HPV. So I think for lay people or for us common people, we didn't really talk about viral strands. It was more of something that was talked about in the medical community, in the public health community. But once COVID-19 came into the picture it became more of common or everyday conversation for us. With COVID-19, we know we started out with one strand and then you started hearing about mutations and now we have however many strands.

Nick Cuevas:

I don't wanna date the broadcast.

Dr. Tiffany Montgomery:

I say 21, and tomorrow four more strands will pop up, right, so we'll just say that there are numerous, and we keep hearing about mutations. We hear about the Omicron strand and et cetera, et cetera. All viruses mutate like this. This is how they survive, and that includes HPV. Hpv has been around so long that we now have 100 strands.

Nick Cuevas:

That's crazy.

Dr. Tiffany Montgomery:

As we talked, I said cervical, penile throat cancer, anal cancer. Hpv is spread from skin to skin contact. That means minus the ejaculation, minus the switching of saliva by the kissing. This is touching okay.

Nick Cuevas:

That's crazy, I'm sorry.

Dr. Tiffany Montgomery:

Back in my day we would hear things like oh, I sat on the toilet seat and got that right.

Dr. Tiffany Montgomery:

This is one of those things that you can almost do that with right Any scan to scan contact or surfaces, that kind of thing. You want to be mindful of it. Not all viruses live that long on surfaces so that's not a biggest risk or as big of a risk as skin to skin contact, but that's something you have to be mindful of. Sometimes it goes way on its own so you can get it and it'll be like a cold virus where you'll have it for a little while and it'll go away. Other times it'll stay and it'll cause problems. But the best way is to be screened and tested Again. It really lives at the base of the cervix so most women are tested.

Dr. Tiffany Montgomery:

With men we've started doing something where we do like a oral screening or we take a saliva test and we look for HPV in the throat area or mouth oral cavity. We also have a swab where we will look at the anal cavity. If you're using that for sexual contact of any kind and that's not just that's men, straight or gay A lot of people will have sexual practices or activities that involve anal stimulation. So you want to make sure that the areas of your body that you're using for sexual pleasure are areas that you test. A lot of men don't get an HPV test other than maybe oral or anal, because it is very hard to convince a man to do a swab of the penis and take that cotton tip and put it into the shaft of the penis right, it's painful, it's uncomfortable.

Dr. Tiffany Montgomery:

I see your face right now. I see a lot of guys' face when I talk about this so men it's not something that's commonly screened for or tested for.

Dr. Tiffany Montgomery:

But with women annually or every three years, depending on whatever the timeframe is that their gynecologist gives them they will be screened for this virus Most commonly. If your partner is tested positive, you two, both may have some treatments or some protocols or some monitoring that you do to make sure that those cells are not changing so that if cancer is detected is detected very early. That's the best type of cancer to detect is early cancer. But these are some of the STIs that are not well known or talked about because they're not immediately symptomatic. You may not have pain with urination. You may not have, you know, burning or itching or discharge. You won't see these types of things right.

Dr. Tiffany Montgomery:

It's a little quiet, sneaky viruses that tell yourselves hey, you should mutate, you should give us more cells so we have more time to you know partake. And as they're making that Environment perfect for them, mutations will happen and so you'll end up Triggering some type of cancer or some type of cellular change. So that makes it a very serious STI. You still want to watch out for it. You still want to take it very seriously. A lot of Providers will recommend that you get vaccinated, exinated. They all will recommend that you have a screening test performed, and those are the types of tests that p23 loves to support.

Dr. Tiffany Montgomery:

We believe in screening, early detection, prevention and education. That combination, right there, is our path to removing these barriers and Making healthcare a luxury for all.

Nick Cuevas:

Very true. That's exactly that was leading into something that I was going to ask you about, also because I'm not single. I have a fiancee. But if I was single right and the way that you're describing how STI is work in general and all the different Variables and all the different ones that they have out there If I was to get intimate with somebody, I wouldn't even know what to do. The first thing I would do is obviously Getting at home test kit and get screened and have my partner get screened before we start anything.

Nick Cuevas:

I mean it's it's just Crazy the the amount of stuff that's out there that we just don't know about. I mean, you're a doctor, so you study this and but the average common man and woman, you know, we know two or three of them that we've heard Just do out time chlamydia and syphilis and so on. But there's so much more to it and the fact that we do offer something that will Help you detect and just feel comfortable and feel free enough to go ahead and Do what you got to do with your partner without having that thing that's on top of your shoulders all the time Weighing you down or just being concerned about that because, remember, I mean when you're in a relationship or when you start a relationship, you don't really know what was going on prior, prior to you being there. You know, you might hear about it. They might say, yeah, you know, I had one partner such and such ago, but you're still Wondering, you know in the back of your mind. So these tests are are imperative in my estimation.

Dr. Tiffany Montgomery:

I mean, I have to agree with you. I would just say, make it a common, normal practice, like, for example and maybe we have this discussion and we invite a single person, cause I don't even know what that's like.

Nick Cuevas:

I'm married.

Dr. Tiffany Montgomery:

I'm a research scientist, you know, and I'm I don't know, I guess what you call old school maybe. But what even my long-term married self does is we just make it a fun regular thing that we do. I'm monogamous. I believe my husband to be monogamous I'd be devastated if he wasn't. But we still do regular testing, whether it's for research and development, for new essays at P23, or if it's just us having fun, just kind of looking at what that sample collection looks like or what that workflow looks like or what we can learn from these samples. It's fun for me, and so he kind of plays along. You know how your wife might like, or your girlfriend might like, movies that are love stories, right, and they make her cry, but she makes you sit there through them.

Dr. Tiffany Montgomery:

So he kind of tuffs it out with me with all these things that I like to do and it's not for me. It's not a trust thing, it's just a staying current with different things. For example, one of the newer essays that we test for at P23 is something called Mycoplasma genitalium. This used to be something that was tested in the micro lab and maybe it cultured in 14 to 30 days. If it was provided enough time and the right conditions to grow, you would be able to detect it and do something about it. But as we've provided innovation in the world of clinical diagnostics and molecular clinical diagnostics, this bacteria that can cause sexually transmitted infections. It infects the genital and the urinary tract of both men and women.

Nick Cuevas:

Wow.

Dr. Tiffany Montgomery:

Very similar to gonorrhea. It can cause symptoms like inflammation, pain, discharge, bleeding. I remember decades ago people would say in college my girlfriends would say I know something is wrong, but I tested negative for chlamydia and gonorrhea. Well, we didn't even know then that this organism was out there or that we could test for it. There was no PCR available. We're able to identify more organisms, provide more testing, and when you have these symptoms, how do you treat them, and so this is something that is fun, it's exciting, it's intriguing for me, and you only have these types of tests through research, development and innovation. It's transmitted through vaginal and anal sex without a condom through from an exposed person. It can be diagnosed now with the molecular samples and we can detect it in urine or swabs. It's treated with antibiotics, but some are resistant to antibiotics. So it's important to really get your PCR, and especially at a place such as P23, where you're going to have the organism and the antibiotic resistance to go with it, so you'll have that insight on not only what you have and how to treat it. There are a number of bugs and infectious diseases out there. So I would recommend single, married, curious. Make it just a regular thing that you do Once a month, once a year. Come up with your own testing schedule. Work with your healthcare provider or your health coach at P23, and come up with that right cadence for when you should be tested, how often and what that mix looks like for you. There are a lot of great resources to provide a lot of details about STIs. Don't look at them as like nasty things that nobody can get or that you can't get. Let's say you actually do sit on that public toilet seat right. These are things that you have to be mindful of now and I want to raise that awareness and give people a comfortable, private and safe place to have those educated and informed discussion.

Dr. Tiffany Montgomery:

As we bring today's enlightening discussion to a close, I, Dr. Tiffany Montgomery, along with my co-host, Nick, would like to inspire all of our listeners to take a proactive stance on their health. Has our dialogue today sparked your interest or raised concerns regarding your sexual health? There's a straightforward and private solution at your fingertips. Are you keen to understand more about your sexual health from the privacy of your own home? Consider the simplicity and convenience of an at-home testing kit with P23. These kits are designed for confidentiality and ease. We offer crucial insights into your sexual health. You can purchase these valuable kits at P23health. com Thank you for being with us today. Embrace curiosity, arm yourself with knowledge and step forward in taking control of your health journey, gene by gene, and remember we are with you every step of the way. ["kissing P23".

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