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Half way through Biology 1622 – Microbes: The Good, The Bad and The Ugly, I invited a doctor from the UNB Student Health Centre to come and give a talk about sexually transmitted infections (STIs). I asked students to read this pamphlet and come prepared with four questions each to ask the doctor. With well over 50 students in class that day, there was a huge number of questions. Since we didn’t get to them all, I summarized them and tried to answer as many as I could in the next class. As with so many aspects of teaching this class, I was pleasantly surprised. I appreciated the thoughtfulness and frankness of their questions.  I went through the questions, edited them for minor typos (but left the wording as is in most cases) and organized them into a few broad categories. I thought people would be interested in seeing what the students wanted to know about. These students represent all year levels (first through fourth) and are not science majors.

Here are their questions:

Prevalence:
What is the most common STI:
        Among University students?
        In New Brunswick?
        In Canada?

How prevalent are STIs among:
        High school students?
        Over someone’s entire life?
        In Canada generally?
Why does it seem that most of these infections occur in individuals aged 15-24?
Is Chlamydia the most prevalent because it is often asymptomatic?
Are all STIs on the rise or just Chlamydia?

Treatment
Antibiotics
What kind of antibiotics are used to cure infections?
Are antibiotics the most common treatment for STIs?
Are there many/any side effects to the antibiotics taken for STIs?
With the misuse of antibiotics, what is the likelihood that STIs will become resistant?
Since Chlamydia and Gonorrhea have similar symptoms and are both bacteria, does the same antibiotic kill them both? What is the difference between the two?
If someone wanted to get treated with antibiotics can it lead to other STIs?

General treatment questions
How treatable are STIs?
Which STIs are curable?
What is the most curable STI?
Which STI is the easiest to treat? Hardest?
Are there STIs that can not be cured? What happens in that case?
Why is there no cure for herpes yet?
Is there a stage at which treatment is most effective or times when it is ineffective to treat an STI?
Why is it so difficult to combat STIs compared to colds and other infections?
What is a culture swab?

Sex and risk factors in transmission
General inquiries about transmission
Once you get an STI and are cured, can you get it again?
Why are STIs so contagious in comparison to other infections?
Does your risk for STIs decrease or increase with age?
What can women do to avoid passing on an STI to their babies? (Assuming the woman is already infected.)
Are some people immune to STIs?
Even with protection, you can still get HPV, is there anyway to reduce chances of infection?
Can you get an STI from a toilet seat? If so which ones?
Can STIs be transferred by sharing cigarettes?

Questions about sex and not having sex
Can STIs be spread without having sex?
How many of these infections can be passed on by means other than sexual contact?
Can STIs be transferred through oral sex?
How do “crabs” get started?
Can someone still have sexual intercourse after being infected with an STI?
In the pamphlet it suggests to “skip” kissing when dating to avoid infection. Is there a more practical way to avoid infection without skipping kissing?

Social, behavioural and emotional factors
Checkups
Is it recommended that someone who does not consider him/herself highly sexually active get a check up?
How often should you be checked?

STIs and everyday life
Is it shameful to have an STI?
If you have cold sores, does that mean you have herpes and need to tell all of your partners?
Can you have a “normal” sex life and never acquire an STI?
Is there a relationship between being dirty and getting lice/scabbies?
If you have chronic hepatitis B does that mean you can never consume alcohol again?
What if you have regular hepatitis B and the 6 month healing process has passed?
If me and my partner went for STI testing and we are both negative do we still need to use condoms?
If you have sex with someone and are unknowingly carrying an STI and you pass it on to them, can they sue you? If you get annual STI tests, does this make a difference?
Where can I get additional information on campus?
Why have we just recently started hearing about HPV more?
How much does the knowledge of STIs affect the decisions of people in their choice to have sex?
When people know more about these infections do they take sex more seriously?
As knowledge of STIs spreads do you notice any declines in certain infections?
What is the most common misconception about STIs?

Emerging or new STIs
What STIs other than the ones we mentioned in lecture are there?
Have any new STIs emerged in the last five years?
Is it possible that there are more STIs out there that just haven’t been discovered yet?
Can new STIs just appear through time?
Have there always been STIs or have they become a greater concern now than in the past?
Are there any newly discovered STIs?

Signs and symptoms
What is the difference between an infection and a disease?
When it comes to infections that cause discharge, does the discharge occur anytime or only during sex?
What are some of the signs and symptoms of having contracted HPV?
Are all genital warts and sores painful or are some barely sore at all?
How serious are warts and sores?
How long can you be infected before you feel sick?
Does gonorrhea give a green discharge?

Causes and Effects
What causes herpes?
Does herpes go away?
Are yeast infections considered STIs?
Can men get yeast infections? If so, is it common?
What is the difference between Hepatitis B and C?
How many different STIs can occur in a person? Can two infections occur at once?
How long does it take for syphilis to affect the brain?
How does syphilis cause damage to the heart, brain etc.?

Risks associated with STIs
Do all STIs cause infertility if not treated?
How do STIs lead to infertility in people?
How long does it take for Chlamydia to affect your fertility if you are asymptomatic and it could be inside you for a long time?
Aside from spreading infections to others, what are health risks associated with STIs?
What are some health complications of HPV?
By contracting any of these STIs, can it be a precursor to cancer?
What are the major health risk for Gonorrhea?
What are the long term effects of STIs left untreated?
Can any of the STIs mentioned in the pamphlet cause or lead to death?
Which STIs can cause death?

HIV
How can you estimate that 30% of the population has AIDS/HIV and are unaware?
How does HIV destroy people’s immune systems?
Can HIV be spread through saliva?
Why is there no cure for AIDS?
I have heard of someone who was “healed” from HIV (white blood cell count became normal). How is this possible?
Is there ever going to be a cure for AIDS? Are researchers taking many steps today in helping prevent this disease?
Is unprotected intercourse the most common way of contracting HIV/AIDS?
Why is it so hard to develop a vaccine for HIV?
How long does it take to get HIV test results back?
Do we know how and where the HIV virus originated from?
Are gay men more likely to get AIDS or is that a myth left over from the 1980s?

Prevention methods
Barrier methods
What is a dental dam?
What is a female condom?
What is the difference between a female condom and a diaphragm?
If you are allergic to latex, are there other types of condoms that are available?
Do the female and male condom have the same effectiveness or is one better at protecting you from STIs than another?
Is spermicidal lubricant effective?
What are your chances of getting an STI when you use a condom?
Do condoms prevent all forms of STIs?

Vaccines
When were vaccines developed for HPV and Hepatitis B and have there been any long term studies of side effects?
Are there any vaccines that prevent STIs?
Are there any risks with the new Gardasil vaccine since it is so new? What about long term side effects?
Is it true that Gardasil is causing harm to the body?
If you have are in a monogamous relationship, is there still a point in getting the HPV vaccine?
Is there any method to prevent men from getting HPV? Any treatments?

STI testing
Since the symptoms of several STIs are similar, how can doctors know which one you have?
Which STIs are tested for when a Pap is administered?
Why is testing not done usually for males for the STI trichomonas?
Why don’t I get blood tests done when I get a Pap done?
What happens when there are abnormal cells in the Pap? What is the next step?
Why is testing not done usually for males for the STI trichomonas?
If you are young, can you get tested without your parents knowing?
How are STIs tested for?
Do STI tests cost money?