Herbal Health

LGV is treated with antibiotics such as doxycycline and erythromycin. Close weekly follow-up by a health care provider is essential until the symptoms have cleared, and antibiotics must be continued until the infection has resolved. Surgical draining of swollen, pus-filled lymph nodes may be necessary.

Scarring is not uncommon, even when the treatment is started early and has been successful. Surgical repair of the scarring may be necessary after the infection has been successfully treated with antibiotics.

Anyone who has had sexual contact with an infected person, usually within the thirty days before that person became symptomatic, must be treated with antibiotics and should be tested for other STDs as well.

LGV is transmitted through sexual contact with a person who is infected. The infection can be transmitted through unprotected oral, anal, or genital sexual contact. Condoms decrease the risk of transmission. Pregnant women who are infected do not transmit the infection to the fetus while it is in the womb, but the infant may become infected by transmission as it travels through the birth canal.

*344\213\8*

Many studies are currently under way to find effective treatments for hepatitis C. Alpha-interferon is the medication we know most about when it comes to treating hepatitis C. Alpha-interferon is a protein normally made by cells of the body’s immune system in response to viruses. It has shown some limited success in the treatment of hepatitis C, but whether the patient’s

improvement will last is not yet known. Liver function in 40-50 percent of people with chronic hepatitis C infection who are treated with interferon returns to normal. The hepatitis C virus becomes undetectable in their bloodstream, usually eight to twelve weeks after treatment. Often, however, this improvement is not permanent. Only about 15-25 percent of those treated exhibit permanent loss of the virus.

Two possible reasons for this low success rate are, first, that the virus mutates into new forms that are more resistant to interferon, and, second, that the vims produces antibodies to interferon that render the medication ineffective. (The latter scenario has been documented in hemophiliacs who have hepatitis C and are treated with interferon.) In addition, therapy with alpha-interferon can cause significant side effects, such as fever, chills, and muscle aches,- therefore the decision regarding whether 01 not to try this treatment is an individual one. The people who seem to respond better to treatment with alpha-interferon are those who do not show evidence of cirrhosis on biopsy of liver tissue, have normal to mildly elevated liver function tests, and demonstrate a low concentration of virus on the PCR test.

Treatment response also depends on what type of hepatitis C a person has. Type lb, one of the most common types, appears to be less responsive to interferon than types 2 and 3. The decision regarding whether or not to treat is best made in consultation with a hepatolo-gist who is up to date on recent advances in this field. There is some hope that even if the interferon does not cure the infection, it may decrease the risk of developing cancer of the liver.

*250\213\8*

Blood tests can determine if a person has been infected with cytomegalovirus, and tests that are initially negative and then positive at a later date can help pinpoint when the infection occurred. The tests may be falsely negative or positive, so they are usually done only when a person is having symptoms for which CMV is a possible cause.

Testing for CMV is usually not recommended as part of a routine sexually transmitted disease screen because of the high rate of infection in the community and because CMV infection does not cause any problems for most people.

There are other ways to test for CMV including biopsying appropriate tissue in someone who is symptomatic, such as the liver if CMV is suspected to be causing hepatitis. Cultures for CMV can also be taken from body fluids such as urine or cervical secretions. Because the symptoms of CMV infection can mimic those of other infections (such as HIV and mononucleosis), testing for these infections may also be performed.

*159\213\8*

There are particular cultural taboos against using condoms and talking about sexual health. In certain cultures, whether people are living

in their country of origin or elsewhere, women are not permitted to request that a condom be used. And some men refuse to use condoms, because they believe that doing so diminishes their manliness. In other societies sexual intercourse is perceived as the exchange of energy, which a condom blocks. Furthermore, in certain religions, using birth control methods such as condoms is not acceptable, so preventing the transmission of STDs with a condom is not possible. Some people may also believe that if they choose partners of their own ethnic or cultural background they will not contract an STD, because STDs are infections that only “others” get. It can be difficult to bridge these cultural gaps, but through education about sex and STDs there are those who may decide to alter their behavior and also find partners who are willing to practice safer sex.

*70\213\8*

Not all burning with urination (called dysuria) signals a bacterial urinary tract infection, as is often assumed by both the public and health care providers. Several common sexually transmitted infections, such as herpes and chlamydia, can also cause burning. Dysuria can occur if there is infection inside the urethra [internal dysuria), or when there are sores or breaks in the skin around the urethra [external dysuria). A medical evaluation is necessary to sort out these possibilities.

Chlamydia and gonorrhea. These common sexually transmitted bacteria can cause infection of the urethra as well as the cervix. Sometimes, the only symptom a woman may notice with gonorrhea or chlamydia is burning with urination. Some of the other symptoms of these infections—such as discharge, spotting between periods, or pelvic pain—may or may not be present. (Sometimes these infections cause no symptoms at all.) A urine sample will show pus cells, as with a routine bladder infection, but a culture of the urine for bacteria commonly associated with urinary tract infections will be negative. Special tests must be done for gonorrhea and chlamydia.

Herpes. Herpes outbreaks may occur in the urethra and cause burning with urination. If the herpes outbreaks are on the vulva, the woman may experience burning when urine hits the lesions. Thus, herpes can cause both internal and external dysuria. Other symptoms of herpes outbreaks are itching or tingling in the genitals, a discharge, swollen lymph nodes in the groin, pain in the back of the legs, and flulike symptoms.

Urinary tract infection (UTI). Because in women the openings of the urethra, the vagina, and the anus are so close together, infection of the urethra by bacteria that are commonly present in these other areas occurs fairly easily. Other symptoms of a UTI are increased frequency of urination and lower back pain. Wiping back to front instead of front to back after urinating or defecating can cause an infection of the urethra and. bladder; sexual intercourse can also move bacteria from the anal area to the urethra. About one-third of women will get a bacterial UTI in their lifetime. The best way to test for a UTI is to evaluate the urine for white blood cells and culture the urine for bacteria. A UTI may progress and cause infection of the kidneys, called pyelonephritis. Symptoms of this infection include fever, chills, nausea, vomiting, and upper back pain.

Vulvar and vaginal irritation. Anything that causes vaginal and vulvar irritation—such as yeast and trichomonas infections, or allergic reactions to latex or spermicide—may cause burning when urine hits these areas.

*24\213\8*

Many of the sex laws in America have been in place for more than 100 years. They are based on the conservative English laws that the early Puritan colonists brought to this country. They vary widely from state to state and are not always enforced. During the last 25 years, certain states have liberalized their sex laws. Twenty-six states have eliminated all penalties for voluntary, private sexual behavior between adults—gay or straight.

Many states continue to keep their old statutory sex laws, even though most people generally ignore them. But keeping outdated sex laws “on the books” is dangerous. These laws are often used to harass certain individuals or groups. People are easily entrapped because they are unaware that they are breaking the law. They do not know that they may be punished for private sexual behaviors that they mistakenly believe are legally acceptable. Many lawmakers fail in their attempts to get outdated laws off the books because conservative groups fight to keep strict limitations on personal sexual expression.

Fornication

Sex between unmarried people, called fornication, is still against the law in 12 states. Each of these states defines fornication differently. For example, cohabitation is against the law in several states. Since 2.9 million unmarried couples live together in the United States, cohabiting couples in these states may not be aware that they are breaking the law against fornication. In California, a man may not know he is committing a crime if he promises to marry a virgin and has sex with her before their wedding. But he is guilty of sexual seduction and can be fined and put in jail. As recently as 1996, a 17-year-old single mother in Idaho was found guilty of fornication. She was given a 30-day suspended jail sentence under a 75-year-old law. The young woman said that she did not even know what fornication was.

Adultery

Adultery is sexual intercourse between a married person and someone who is not his or her spouse. In the past, divorces were granted based on a husband charging his wife with “criminal communication” and the other man with “alienation of affection.” It was not until the Fourteenth Amendment to the U.S. Constitution was passed in 1868 that wives were given the same legal right to divorce their husbands. Women were extended the same rights in divorce as their husbands had always enjoyed.

In 1969, adultery was a crime in 45 states, but by 1985, only 25 states punished people for adultery. In states such as Massachusetts, adultery is still a crime, punishable by a three year prison sentence and a fine of at least $500.

A more common term for sex outside of marriage is extramarital sex. Most extramarital sex is clandestine, or hidden from one’s spouse. In some marriages, however, extramarital sex, or co-marital relationships, are agreeable to both partners. These marriages are called open marriages and became popular during the 1970s.

In the United States, the incidence of extramarital sex is dropping. Prior to the 1990s, married men and women reported increasing rates of sex outside of marriage. Married women were catching up to married men in the number of their extramarital partners. More recent surveys show that extramarital sex is decreasing for both men and women.

This may be happening for several reasons. More people are marrying later in life, after they have had a variety of premarital sexual experiences. As a result, they may be more willing to commit to a sexually exclusive marriage. Others may be afraid of sexually transmitted infections, particularly AIDS.

*154/155/5*

Cytomegalovirus (sigh-tow-MEG-a-low-VI-rus), or CMV, is an infection that is transmitted through many bodily fluids. It is also sexually transmitted. Every year, CMV causes permanent disability, including hearing loss and mental retardation, for 4,000 to 7,000 babies. It is the most common infection in the United States that is spread from a woman to the developing fetus—from 10 to 20 percent of infants born to women with CMV will become infected. CMV is also very dangerous for people with weakened immune systems. It can cause blindness and mental disorders. CMV can remain in the body for life.

Common Symptoms

• swollen glands, fatigue, fever, and general weakness. CMV causes 8 percent of the cases of mononucleosis.

• irritations of the digestive tract, nausea, diarrhea

• loss of vision

There are usually no symptoms with the first infection. But reinfection with CMV, or infection with other sexually transmitted infections such as HIV and hepatitis B, may reactivate the virus and cause illness.

How CMV Is Spread: In saliva, semen, blood, cervical and vaginal secretions, urine, and breast milk by:

• close personal contact

• vaginal, anal, and oral intercourse

• blood transfusion and sharing IV drug equipment

• pregnancy, childbirth, and breast-feeding

Between 40 and 80 percent of Americans get CMV through contact (usually through saliva) with other children by the time they reach puberty. Adults, however, usually get CMV through sexual activity.

Women who want to become pregnant and who may have the virus should consider testing for CMV

Diagnosis: Blood test.

Treatment: There is no cure. Symptoms may be managed with a variety of intravenous drugs, including foscarnet and ganciclovir. Treatment is not successful during pregnancy.

Protection: Condoms can provide protection during vaginal, anal, and oral intercourse, but kissing and other intimate touching can spread the virus.

*122/155/5*

Expectations for marriage and the sexual relationship had to be based on the obscure and highly sentimentalized teachings of the times. It was not uncommon for a bride to experience

her wedding night totally unprepared for the realities of sexual intercourse, her first experience with sex being closer to rape than to her romantic dreams of sanctioned closeness. What she knew was fiction, gathered from casual talk, overheard conversations, romantic stories and novels, sermons, what her parents and teachers taught her, and her own integration of all these resulting in an utterly unrealistic expectation of what her future as a wife and a sexual partner would be like.

Advice on sexual matters for the married couple was plentiful. Unlike the contemporary emphases on both quantity and quality of sexual experience, nineteenth-century authorities, almost to a man, laid down spartan rules for permissible frequency of intercourse and discussed its quality not at all. Dr. Sylvester Graham, for example, thought that once a month was just about right, and Dr. John Cowan advised complete abstinence during pregnancy, lactation, and for an additional year after weaning. “This may not be required in a perfectly healthy woman, but healthy women being an exception, the rule holds good” (in Walter). Since women were held to be asexual (except in rare and pathological cases), there was no obligation to arouse her or to be concerned for her satisfaction.

Because a pretentious and repressive morality was the official position of family, school, and church, it is still not possible to know the extent of its influence on married couples. That even the educated were often ignorant and uninformed about sex is doubtless true. When one considers the hold that fear, guilt, and shame of sex continues to have, it seems likely that most conventional marriages of the time were affected by the prevalent attitudes.

It is worthwhile to note, however, that the Victorian era had another side, less often mentioned in chronicles of the times. Prostitution flourished, as did the institution of the mistress, at least in Europe. Pornography, the organized sexual use of children, and ritual flagellation all were common. There existed, too, a free love movement which flourished briefly toward the end of the century, a harbinger of the loosening of restraints which would appear again in the 1920s. Finally, the era brought forth the most scholarly and progressive work on sex yet to appear, the classic six-volume Studies in the Psychology of Sex, by Havelock Ellis. Appearing between 1898 and 1910, this monumental work covered a panorama of human sexuality and demolished most of the myths cherished by the proper Victorians.

*70/187/5*

The child’s first ideas about marriage are based upon what he or she observes in the parents’ behavior and on the encounters with the parents. He or she is aware that emotion and affection are or are not displayed, that sharing does or does not take place, and that thoughtfulness and concern are or are not shown. Later on, he or she seeks to emulate or reject their patterns of behavior. On the other hand, most children do not learn much about sexual behavior even from parents who accept their own sexual activity and enjoy it, if the parents desire privacy and need to keep their sexuality secret from the child. Children often contribute to the parents’ felt need of secrecy by showing disgust or rejection of the sex displays of their parents. Young people often report that any sight of their parents showing affection toward each other embarrassed them as children.

From survey data and from case histories we must conclude that usually whenever a young child in the United States engages verbally or physically in a sexual encounter with a parent, the situation is usually one of conflict rather than accommodation, cooperation, and affection. Most sexual encounters between children and their parents are with the parent not as a participant in the encounter but as an observer of a sexual encounter between the child and a peer. The parent often makes his appearance unexpectedly and puts a stop to the activity.

The child also learns what the prevailing adult attitudes are toward sex even without parental interference in direct encounters. The tone of voice in which gossip is relayed warns him to avoid becoming a subject for similar gossip. The care and circumlocution with which certain matters of sex are avoided in books, in the press, and in other public communications subtly reminds the child of the state of public opinion on these matters. Discussions of such things as divorce, marital discord, sexual scandals in the community and gossip about public figures probably have more influence in controlling the child’s behavior than any specific action that society may take or any legal penalties. Given a framework of repression and avoidance by parents and other adults and by adult-sponsored agencies, the child receives the bulk of its sexual information, though not attitudes, but through peer relationships. The parents do not provide cognitive information about sexuality for the child, but they create attitudes and orientations through which information from other children is filtered.

*39/187/5*

When a boy enters school, he is thought to move from a situation of more or less unconditional acceptance within the family (an “ascribed” status) to one in which he must earn others’ approval (an “achieved” status). The primacy of secure family relationships is gradually replaced by a world of school and neighborhood peers, of gangs and cliques, of other children who judge him by often relentless standards.

Relationships outside the family have been viewed as providing boys with many developmental opportunities: to become increasingly independent of their parents, to modify their parents’ moral values, to solidify their gender identity through new identifications with other males, to develop self-confidence through rewarding friendships, and to move from close relationships with other boys to similar ones with girls. According to this view, the typical developmental sequence for heterosexual males includes involvement with buddies in a male subculture. During grade school, boys reinforce one another’s growing autonomy, physical daring, athletic prowess, disdain for females, and other “masculine” behaviors. In adolescence, they often reward each other for heterosexual exploits and may even make such adventures an important criterion for acceptance.

Certain opposite circumstances, it has been hypothesized, contribute to the development of homosexuality among males. According to this view, during the grade-school years prehomosexual boys, especially if they are not conventionally “masculine,” are less likely to be involved with other boys and more likely to limit their social contacts to girls. Such social isolation from peers and involvement with girls is thought to generate a sense of estrangement from other boys and to reinforce a boy’s uncertainty about his masculinity. This view considers male homosexuality an attempt to make contact with other males so as to feel less estranged from them.

A somewhat different model also relates homosexual development to isolation from male peers during adolescence. It emphasizes the extent to which, association with other boys enhances learning about, interest in, and reinforcement for heterosexual sex. Hearing his buddies talk about their sexual experiences may encourage a boy to have some of his own, and he may feel rewarded or acclaimed when he recounts them. Thus, a teenage boy who lacks this kind of preparation and reinforcement may develop little sexual interest in girls.

A number of empirical investigations have supported the notion that the peer relationships of prehomosexual boys differ from those of their heterosexual counterparts. Several studies have reported that prehomosexual boys are more likely to have been loners and to have been rejected by other boys. Another study found that during childhood, prehomosexual boys were more likely than prehetero-sexual boys to have spent most of their time with girls and less likely to have had any male buddies. Finally, psychiatrists have described their homosexual male patients as more likely than their heterosexual male patients to have been social isolates during childhood and adolescence, to have played mostly with girls, to have avoided competitive group games, and to have been clinging children, afraid to venture out beyond the safety of their households.

*13/158/5*