On By the Bay, KDLG talked to Dr. Cathy Hyndman about how people can get tested for sexually transmitted infections in Bristol Bay, why they should get tested, and why there is so much stigma around STIs.
Izzy Ross: Dr. Hyndman, thank you so much for coming in.
Dr. Cathy Hyndman: It is my pleasure.
Ross: We wanted to talk a little bit about sexually transmitted infections, and what people can do to prevent them, and also just a little bit about destigmatizing the conversation around STIs. Can you give a little background into STIs in Bristol Bay?
Dr. Hyndman: Yes I can. When we talk about STIs, what we're talking about is sexually transmitted infections, which is the current, proper phrase. It used to be called sexually transmitted diseases, and prior to that it was called venerial disease, which has to do with, essentially, sin.
However, what is important to remember is that anybody can get a sexually transmitted infection from having sex with somebody that has a sexually transmitted infection already. They do not get spread except by mucus membrane to mucus membrane contact, which means lips contacting private parts, be it penis or vagina, or penis contacting vagina or anus.
So that is how you get a sexually transmitted infection. And there are a multitude of them. The most common ones in Bristol Bay are gonorrhea or chlamydia. Both of those are diseases that can be symptomatic but sometimes are not symptomatic. Gonorrhea tends to show up in a man as a burning with urination or a dripping pus from the penis. In a woman, they may not actually have much beyond an increased vaginal discharge and they may not have symptoms as all.
Chlamydia is also a disease that can be associated with vaginal discharge or penile discharge, but most often is not symptomatic for either the man or the woman.
The good news is, both of those are easy to test for — all you have to do is pee in a cup. And in fact, if you're shy, you can go to iknowmine.org or iwantthetest.org and get a test kit that you can do at home. Now, when it comes to getting treatment, you will need to contact someone in the medical field, and in Dillingham that would take the form of either coming to the hospital, going to the village clinic if you're in a village, or talking to Public Health.
The other piece of really good news about gonorrhea and chlamydia is that they are cureable. For gonorrhea, it takes one shot, once. For chlamydia, it takes one dose of medicine by mouth, once. And that will cure you. But you've got to follow the rules after that. It's important that you do not have sex with anyone for seven days after you have taken the medicine.
It is also important to get your partner treated, or your partners. There are ways to get medicine for your partner or partners, and you can also let the hospital or the public health department be kind of the bearers or bad news with regards to that. Because what will happen is, number one, gonorrhea and chlamydia are both mandated to be reported to the state in an effort to control disease. It's not to shame anybody, it's just to get people treated. And the partners that you name will be called by public health or by the hospital, and be told, 'You've been named a contact of somebody that's got a sexually transmitted infection.' They won't say your name, they won't tell them anything else, other than they have been a contact and they should come in and get tested and treated themselves.
The other diseases that are more feared, I guess, would be HIV and syphillis. Both of these have been seen in Bristol Bay, although we have not had a case of syphillis recently in Bristol Bay, and I don't believe we've had any new cases of HIV in Bristol Bay.
The good news with syphillis is that it, too, can be treated with a shot of penicillin. One shot.
Ross: What great news. We are no longer living in Shakespearean times.
Dr. Hyndman: That is correct. And the good news with HIV is that there are excellent collections of medicine to treat HIV so that this can be lived with in the long term. This is not an automatic death sentence.
The other disease that's important to get tested for is hepatitis C. Now, those three that I just mentioned -- HIV, syphillis, and hepatitis C — all require a blood draw. That means you have to go to the lab and get your blood drawn. You can come to the walk-in department at Kanakanak Hospital, or to your village clinic, and say, 'I want to be screened for sexually transmitted infections.' The people who see you should say, 'Do you want to just pee in a cup? Or do you want to get your blood drawn?' Do them both. Get tested. Because you can change your life. You can change the life of your partner or partners. You can change the life of your children, because children who are born to women who are infected with these diseases can be protected from them if we know about them.
Ross: So a lot of really great information there, and a lot of hope, I think, for people who are living with STIs or who are worried about having an STI. But obviously the most important thing is that you go get tested, and that you get the right treatment.
Having worked in Bristol Bay for many years, and practiced medicine here, what are some of the things you've heard from people as far as STIs go? Is there any overriding concern or reason that people don't come in to get tested?
Dr. Hyndman: I think people are mostly concerned about confidentiality. And they're afraid that they may have some terrible disease. Like I say, all of the disease that we've talked about so far, if not cureable -- like gonorrhea, chlamydia, and syphillis — are treatable — like HIV and hepatitis C. And in fact, there's some signs that hepatitis C is also cureable.
But I believe that most folks just are scared that they might have something. They're scared of what their partner or partners might think. They're scared that their partner or partners might retaliate upon them. And they're scared that people in the community will find out.
Ross: Is there anything that listeners can take away in terms of going to get tested?
Dr. Hyndman: If you're going to enter a new relationship, get tested, and get your partner to get tested. If you can't talk to your prospective partner about sexually transmitted infections, should you be having sex with that person? This seems a reasonable thing, in this day and time, to go and make sure that you yourself are healthy and make sure your partner is healthy.
Ross: Well we hope that everyone has a very healthy Valentine's Day. Thank you so much for coming in.
Dr. Hyndman: Thank you so much.
And a note on safer sex practices: condoms are very effective in protecting against STIs. You can learn more by going to a health clinic in your community, the public health clinic in Dillingham, or by talking to a medical professional.
Contact the author at isabelle@kdlg.org or 907-842-2200
