WEBVTT - You’re Not 22…But STIs Aren't Over 0:00:08.193 --> 0:00:15.513 You're listening to a Mom with mea podcast. Everyone go 0:00:15.553 --> 0:00:16.714 get tested for syphilis. 0:00:16.834 --> 0:00:20.593 Yes, essentially exactly, everyone gets tested for syphilis as part 0:00:20.594 --> 0:00:24.594 of the STI screen. It's making its comeback and it's 0:00:24.714 --> 0:00:26.834 not fun. It's not the vintage kind. 0:00:27.274 --> 0:00:30.074 It's not like a cool retro Guys are getting around 0:00:30.074 --> 0:00:30.394 being like. 0:00:31.674 --> 0:00:35.314 I'm seeing it in people in their fifties, in their sixties, 0:00:35.354 --> 0:00:38.034 so it's not just a young person's disease. 0:00:43.793 --> 0:00:46.754 Well, hi there, welcome to Well your Full Body Health Check. 0:00:46.793 --> 0:00:47.954 I'm Claire Murphy. 0:00:47.754 --> 0:00:49.554 And I'm a doctor, Marriam. 0:00:49.873 --> 0:00:54.114 That was a very double O seven way. My name's 0:00:55.074 --> 0:00:59.394 My name's mactor Marriot. Today we are talking about STIs 0:00:59.554 --> 0:01:02.194 like old timey ones that are making a comeback and 0:01:02.234 --> 0:01:04.794 some I have never heard of being talked about before. 0:01:04.834 --> 0:01:08.194 On TikTok, we have a quick consult for Jenny today, 0:01:08.194 --> 0:01:11.554 who's on a mission to improve her microbiome. But next 0:01:11.594 --> 0:01:13.954 I found out that there is a cell in a 0:01:13.994 --> 0:01:17.634 woman's body that you don't even need a microscope to see. 0:01:18.234 --> 0:01:20.154 It is wild. Let's go to med school. 0:01:20.234 --> 0:01:21.834 Welcome to med school. 0:01:22.234 --> 0:01:26.194 There is only one individual human cell visible to the 0:01:26.274 --> 0:01:28.514 naked eye. Marry him any guesses as to which one 0:01:28.554 --> 0:01:28.874 it might be. 0:01:28.954 --> 0:01:31.714 You tell me it's human eggs. 0:01:32.794 --> 0:01:35.834 Yeah, so eggs are the largest cell in the human body. 0:01:35.874 --> 0:01:39.714 They are about zero point one millimeters in diameter. Now, 0:01:39.754 --> 0:01:43.434 there are technically bigger cells, so motor neurons, which like 0:01:43.474 --> 0:01:47.914 they're very, very long, but they are one hundred times thinner, 0:01:47.994 --> 0:01:52.394 so you actually cannot see. But I saw this video 0:01:52.554 --> 0:01:55.274 showing a cluster of them and then one egg sell 0:01:55.314 --> 0:01:57.314 individually like sitting in a peach tree dish. 0:01:57.354 --> 0:01:58.634 Yeah, I'm shook at. 0:01:58.554 --> 0:02:01.114 The size of a human egg, Like, no wonder if 0:02:01.194 --> 0:02:04.234 bloody hurts on our ovary shoot them out. They're quite large. 0:02:04.314 --> 0:02:07.074 It's amazing, and it's well that one of the largest 0:02:07.194 --> 0:02:09.594 and one of the smallest human cells. So you've got 0:02:09.633 --> 0:02:11.393 the egg and the sperm. Also sperms one of the 0:02:11.434 --> 0:02:13.914 smaller one the smallest ones, and they're literally made to 0:02:13.954 --> 0:02:17.914 me secure. They get together, the bigs and the littles. 0:02:17.914 --> 0:02:20.714 But don't you forget the eggs bigger. 0:02:20.794 --> 0:02:21.714 The egg is. 0:02:21.754 --> 0:02:24.434 Bigger and more powerful and apparently makes a lot of 0:02:24.474 --> 0:02:26.794 decisions when those sperms arrive. 0:02:27.514 --> 0:02:28.074 But I love it. 0:02:28.194 --> 0:02:29.834 We put the video off on our socials. Have a 0:02:29.834 --> 0:02:31.994 look at it. Like you will be actually shocked at 0:02:32.034 --> 0:02:35.394 how clearly you can see a human egg like. It 0:02:35.474 --> 0:02:37.874 is incredible. And we've just been storing them inside of 0:02:37.954 --> 0:02:41.394 us since we were inside our own mother's tummies. All right, 0:02:41.434 --> 0:02:44.234 it is check up time. We're discussing sti's today. Some 0:02:44.314 --> 0:02:47.194 have been added to the list very recently, some that 0:02:47.274 --> 0:02:49.114 I have never even heard of, and a few that 0:02:49.154 --> 0:02:51.354 are coming back from the almost dead to plague young 0:02:51.394 --> 0:02:53.874 Aussies in numbers that we have not seen in quite 0:02:53.954 --> 0:02:59.914 some time. It's time for the checkup. So STIs are 0:02:59.954 --> 0:03:02.194 our focus today. And if you don't know what STI 0:03:02.274 --> 0:03:05.274 stands for, it is sexually transmitted infection. We used to 0:03:05.314 --> 0:03:08.394 call them STDs sexually transmitted diseases. 0:03:08.434 --> 0:03:11.354 Why did we change that? Because the infection doesn't always 0:03:11.514 --> 0:03:13.154 lead to the disease. 0:03:12.914 --> 0:03:15.234 Okay, and so technically it's not quite right. 0:03:15.314 --> 0:03:17.114 It's not right. And also there's a lot of stigma 0:03:17.194 --> 0:03:21.714 attached to sexually transmitted diseases as well well STI. 0:03:21.754 --> 0:03:25.234 As it is, then there are some new ones, some 0:03:25.354 --> 0:03:27.754 old ones, yes, ones that are slowly on the road 0:03:27.754 --> 0:03:31.234 to extinction, which is fabulous. But Marian, I want to 0:03:31.234 --> 0:03:34.834 ask you this because you're a bit younger than me. Yeah, 0:03:34.874 --> 0:03:37.634 but do you remember or have you been told about 0:03:37.634 --> 0:03:38.674 the ads? 0:03:38.714 --> 0:03:40.874 I've been told about the ads. I was like born 0:03:40.954 --> 0:03:41.554 in that era. 0:03:41.714 --> 0:03:43.714 Okay, but you don't remember seeing them when they came 0:03:43.754 --> 0:03:44.194 on TV. 0:03:44.474 --> 0:03:49.074 My parents didn't put me as an infant I was. 0:03:49.434 --> 0:03:52.434 I think I was less than ten. Yeah, so I 0:03:52.474 --> 0:03:55.034 was still maybe eight or something when they started playing 0:03:55.074 --> 0:03:58.754 on free to air television. This is some of the 0:03:58.794 --> 0:04:03.874 most traumatic community health advertising I've ever seen in my life. 0:04:03.874 --> 0:04:06.714 So it's nineteen eighty seven. The Australian government commissioned tv 0:04:06.794 --> 0:04:09.794 AD to scare the living daylights out of Australians and 0:04:09.954 --> 0:04:12.514 educate us on the risk of HIV in its So 0:04:12.674 --> 0:04:14.994 back then there wasn't the treatment regime that there is 0:04:15.074 --> 0:04:18.113 now for people who have HIV and they can live long, 0:04:18.313 --> 0:04:21.113 very life lives with HIV now, But back then it 0:04:21.474 --> 0:04:23.794 was truly a very scary death sentence for a lot 0:04:23.834 --> 0:04:27.353 of people. But if you have never heard this ahead before, 0:04:27.354 --> 0:04:29.234 brace yourself, listen to this. 0:04:31.753 --> 0:04:35.234 At first, only gays and IV drug users were being 0:04:35.313 --> 0:04:38.313 killed by AIDS, but now we know every one of 0:04:38.393 --> 0:04:42.873 us could be devastated by it. The fact is over 0:04:42.953 --> 0:04:46.513 fifty thousand men, women and children now carry the AIDS 0:04:46.633 --> 0:04:50.714 virus that in three years nearly two thousand of us 0:04:50.753 --> 0:04:56.473 will be dead. That if not stopped, it could kill 0:04:56.594 --> 0:05:01.433 more Australians than World War Two. But AIDS can be 0:05:01.513 --> 0:05:04.913 stopped and you can help stop it if you have sex, 0:05:04.993 --> 0:05:08.553 have just one safe partner or always used condoms. 0:05:09.513 --> 0:05:15.713 There are little girls like with cute little braids, a 0:05:15.794 --> 0:05:19.474 mum holding a baby, and they're essentially all being bowled 0:05:19.474 --> 0:05:20.553 over because they are the. 0:05:20.513 --> 0:05:22.953 Ten pins in a bowling alley, these humans and they're 0:05:22.953 --> 0:05:25.553 being bowled at by big, giant, scary grim reapers and 0:05:25.594 --> 0:05:28.113 you literally see them get hit by bowling balls and 0:05:28.154 --> 0:05:31.753 they go flying off. Did it scare us, Yes, absolutely, 0:05:31.753 --> 0:05:35.714 one hundred percent. Did it mean we never had unprotected sex, Well, 0:05:36.154 --> 0:05:38.073 not one hundred percent of the time obviously, but it 0:05:38.193 --> 0:05:41.714 did put a dent in the numbers of STIs in 0:05:41.834 --> 0:05:45.473 general in Australia at the time. The HIV aid's scare 0:05:45.553 --> 0:05:49.354 of the nineteen eighties changed the way that we looked 0:05:49.393 --> 0:05:52.234 at sexual partners. And then we also were made aware 0:05:52.274 --> 0:05:54.674 of like this flow chart of if you have sex 0:05:54.674 --> 0:05:56.354 with someone, you don't know how many people they've had 0:05:56.393 --> 0:05:58.633 sex with. You don't know how many people those people 0:05:58.714 --> 0:06:01.153 have had sex with, and so there's this big exponential 0:06:01.154 --> 0:06:03.593 flow chart of like, if you've slept with one person, 0:06:03.633 --> 0:06:07.113 technically you might have slept with hundreds yep. From their background, 0:06:07.274 --> 0:06:09.953 so you just don't know. But it seems now, Marriam, 0:06:09.953 --> 0:06:12.153 a bit of that fear has worn off in twenty 0:06:12.193 --> 0:06:15.313 twenty five. Are you seeing what I'm seeing being reported 0:06:15.313 --> 0:06:18.393 in the news in that some STIs are presenting in 0:06:18.433 --> 0:06:20.234 your clinic that we haven't really seen in a while. 0:06:20.354 --> 0:06:24.354 Yeah, so I'm definitely seeing the shift. STIs are on 0:06:24.393 --> 0:06:27.594 the rise, So I'm definitely seeing a lot more positive tests, 0:06:27.714 --> 0:06:31.953 especially amongst young people onto the age of thirty. Chlamydia 0:06:32.154 --> 0:06:35.633 remains most commonly reported symptom. I'm probably picking one every 0:06:35.633 --> 0:06:39.753 week to be honest. I think the Kirby Institute reports 0:06:39.834 --> 0:06:44.154 eighty thousand cases a year of chlamydia gone a rearates 0:06:44.154 --> 0:06:47.914 have tripled in the past decades. Syphilis, something I'd never 0:06:48.234 --> 0:06:52.914 thought i'd see, is something I'm seeing like regularly. Well, 0:06:53.034 --> 0:06:55.393 I've picked up a few cases in the last year. 0:06:55.993 --> 0:06:58.794 We almost wiped it out. It's making a complete comeback, 0:06:58.914 --> 0:07:01.954 particularly in regional areas and among young women as well, 0:07:02.354 --> 0:07:05.593 what I find has changes the attitude. There's less stigma, 0:07:05.633 --> 0:07:08.873 which is amazing around sex. It's fantastic, but there's also 0:07:08.914 --> 0:07:12.474 a bit of complacency. I'm finding people think it's just chlamythia. 0:07:12.514 --> 0:07:15.834 I'll get anybody's like who cares, whatever life goes on. 0:07:16.354 --> 0:07:21.114 But untreated STIs I think people really need to realize 0:07:21.354 --> 0:07:25.314 they can lead to disease processes. You can get infertility, 0:07:26.074 --> 0:07:30.434 pelvic inflammatory diseases, chronic pain. It can increase risk of 0:07:30.634 --> 0:07:34.634 other STIs like HIV transmission. What we need now isn't 0:07:34.674 --> 0:07:38.034 another fear campaign. We don't need another one to meet someone. 0:07:39.434 --> 0:07:41.194 It's certainly scared of the Jesus out of. 0:07:41.114 --> 0:07:44.514 Me, But we need a kind of awareness, one that's honest, 0:07:44.674 --> 0:07:48.273 sex positive and grounded in science. People respond better to 0:07:48.314 --> 0:07:52.714 empowerment than to shame. So it's all about education, accessibility 0:07:52.754 --> 0:07:55.953 and open conversations that will make the real difference, especially 0:07:56.393 --> 0:08:00.594 having these conversations earlier on, so like before people start 0:08:00.674 --> 0:08:01.674 exploring sex. 0:08:02.354 --> 0:08:05.514 Yeah, it's so interesting we're talking about things like syphilis. 0:08:05.554 --> 0:08:07.714 Like when you're at school and you'll learn about like 0:08:08.274 --> 0:08:12.434 Mad King whatever, Henry Arthur George, whatever they might have been, 0:08:12.594 --> 0:08:14.514 like the reason they were mad half the time. 0:08:14.393 --> 0:08:18.274 Is because they had It's crazy. 0:08:18.514 --> 0:08:20.794 It can get into your brain. No, like you need 0:08:20.834 --> 0:08:23.074 to think about this stuff. But what advice do you 0:08:23.114 --> 0:08:25.913 have for young Aussies in particular listening to this who 0:08:26.634 --> 0:08:29.434 might be taking some risks and having some unprotected sex. 0:08:30.274 --> 0:08:32.754 Just really about what not getting tested? 0:08:32.914 --> 0:08:37.473 Yep does? Okay, So unprotected sex. I know for a 0:08:37.514 --> 0:08:39.634 lot of people it's sexually active. In the moment, it 0:08:39.674 --> 0:08:41.634 can feel like, what's the worst thing that can happen 0:08:41.714 --> 0:08:45.194 right now? Quite a bit can happen, Okay. So it's 0:08:45.234 --> 0:08:48.994 not just about risking a pregnancy. You're opening the door 0:08:49.034 --> 0:08:51.554 to a whole range of infection. And here's the sneaky 0:08:51.554 --> 0:08:55.434 part most STIs they don't announce themselves. You're not gonna 0:08:55.434 --> 0:08:58.354 get symptoms the next day. There's no flashing lights, no 0:08:58.474 --> 0:09:01.914 dramatic symptoms. They just hang out and they can cause 0:09:02.034 --> 0:09:05.234 damage while you feel totally fine and go about your day. 0:09:05.874 --> 0:09:08.594 Chlamydia is a big one. It's super common, especially in 0:09:08.714 --> 0:09:11.594 young people like we mentioned, but if it's not treated, like, 0:09:11.674 --> 0:09:14.994 it's a really common cause for pelvic inflammatory disease, which 0:09:14.994 --> 0:09:18.514 can cause infertility or long term pain. So thirty year 0:09:18.514 --> 0:09:20.354 old you is going to be pretty pissed off at 0:09:20.354 --> 0:09:23.394 twenty year old you for not taking it more seriously. 0:09:23.834 --> 0:09:25.994 Gonorrhea can do the same thing, and just to make 0:09:25.994 --> 0:09:28.953 them more fun, it's getting much harder to treat because 0:09:28.994 --> 0:09:32.914 of anybody resistant. Then there's herpes that one's loyal that 0:09:32.954 --> 0:09:35.754 will stick with you for life. And then there's HPV, 0:09:35.914 --> 0:09:38.674 which most people will get at some point in their life, 0:09:38.674 --> 0:09:41.794 and if it's not screened properly or during the time 0:09:41.874 --> 0:09:45.434 frames for screening, it can lead to cancers and HIV. 0:09:45.674 --> 0:09:48.794 While we've made amazing progress in treatment, it can still 0:09:48.874 --> 0:09:51.794 change your health for life as well. So yes, skipping 0:09:51.874 --> 0:09:54.474 the condom isn't just a small risk. It's a big one. 0:09:54.514 --> 0:09:57.994 And oh god, I want to reiterate this. The birth 0:09:58.074 --> 0:10:03.154 control pill prevents pregnancy. It does not stop you from 0:10:03.234 --> 0:10:06.514 getting an STI unless you consider a babying infection. That's 0:10:06.554 --> 0:10:10.674 not not how it works. So great for preventing pregnancy, 0:10:10.714 --> 0:10:16.354 but zero protection against STIs and getting tested is a 0:10:16.394 --> 0:10:20.674 big deal. It's super easy, it's quick, it's confidential, no 0:10:20.754 --> 0:10:25.154 one's judging you. I actually offer the conversation because I 0:10:25.194 --> 0:10:27.714 know a lot of people get awkward and uncomfortable. But 0:10:27.794 --> 0:10:30.274 I love it when I see young people coming in 0:10:30.354 --> 0:10:31.834 saying I'm here for an STI check. 0:10:32.274 --> 0:10:34.754 So you might be in that moment where someone is 0:10:34.794 --> 0:10:37.114 coming in to talk to you, like, yeah, you potentially 0:10:37.114 --> 0:10:41.714 are exposing an uncomfortable situation where our partner's been unfaithful exactly. 0:10:41.794 --> 0:10:46.353 So I say, for every person who's started a new relationship, 0:10:46.354 --> 0:10:50.794 we're about to engage in a new relationship, get tested beforehand. 0:10:50.874 --> 0:10:53.234 It saves a lot of awkward conversations for down the 0:10:53.234 --> 0:10:56.234 track if anything was to happen. And let me tell you, 0:10:56.314 --> 0:10:58.714 it happens more often than you think. And it also 0:10:58.754 --> 0:11:01.114 gives you that comfort as well, knowing you're going into 0:11:01.154 --> 0:11:04.234 this relationship and you're not going to be transmitting anything 0:11:04.314 --> 0:11:08.954 to your partner. So people should be getting tested often. 0:11:09.114 --> 0:11:12.074 So every time you have unprotected sex, you need to 0:11:12.114 --> 0:11:12.874 get tested. 0:11:12.954 --> 0:11:15.034 Yeah, And we talked about this like it's a young 0:11:15.074 --> 0:11:16.034 people's thing, but it's not. 0:11:16.274 --> 0:11:16.634 It's not. 0:11:16.914 --> 0:11:19.994 And I've got some friends around me who have been 0:11:20.074 --> 0:11:22.594 divorced from a partner and have back in the game, 0:11:22.594 --> 0:11:24.354 back out in the game, and that's great and they're 0:11:24.354 --> 0:11:26.754 having a great time. But I've had you know, a 0:11:26.754 --> 0:11:30.794 friend contract an STI from that experience, and so like, 0:11:30.834 --> 0:11:32.554 this is not just a young people's game. 0:11:32.594 --> 0:11:34.314 We've not got to be on that. And I think 0:11:34.434 --> 0:11:36.953 people that go back in the game have that kind 0:11:36.994 --> 0:11:39.354 of attitude where like these things weren't around back then. 0:11:39.514 --> 0:11:44.034 Well things have changed, things are increasing. Do not trust 0:11:44.274 --> 0:11:47.594 that person if they're like, I'm tested, I'm fine, No, 0:11:47.954 --> 0:11:48.434 wrap it. 0:11:48.434 --> 0:11:50.994 Up, yeah unless you actually see their results. 0:11:51.114 --> 0:11:55.274 Yeah, like dated exactly the day before, Like don't yeah, yeah, 0:11:55.314 --> 0:11:58.994 So wrap it up, get tested. It will just save 0:11:59.074 --> 0:12:01.754 you so much stressed later. 0:12:01.674 --> 0:12:04.754 Later down the trade again. Amazing. Okay, next to ericspert, 0:12:04.754 --> 0:12:06.314 doctor Possess is going to take us through some of 0:12:06.354 --> 0:12:08.714 the sdis make and they'd comeback. How to treat them, 0:12:08.714 --> 0:12:11.754 what happens if you don't. We'll discuss a new STI 0:12:11.834 --> 0:12:14.194 that was recently added to the list and someone have 0:12:14.194 --> 0:12:16.834 been talked about on social media that I have never 0:12:16.954 --> 0:12:25.634 even heard of. Our expert today is doctor Melanie Possessor. 0:12:25.754 --> 0:12:27.834 We started off our chat with her by asking about 0:12:27.874 --> 0:12:30.394 the comeback of some old school STIs that we thought 0:12:30.474 --> 0:12:35.834 we'd never hear from again. We want to start off 0:12:35.834 --> 0:12:38.274 today because there's been quite a few headlines getting around 0:12:38.314 --> 0:12:41.794 about the resurgence of certain STIs that we thought were 0:12:41.914 --> 0:12:46.834 kind of fading away into obscurity almost but things like syphilis, 0:12:46.914 --> 0:12:49.914 gon rihea and chlamydia, things that we associate with like 0:12:50.394 --> 0:12:54.554 Victorian royalty. Do we have any idea in Australia what's 0:12:54.594 --> 0:12:57.954 happening to impact those numbers and how bad is it 0:12:57.994 --> 0:12:58.634 actually getting? 0:12:59.034 --> 0:13:03.754 Yeah, it is bad because the statistics showed rising trajectories. 0:13:04.514 --> 0:13:06.714 So we need to get in there to try and 0:13:07.394 --> 0:13:12.314 curb this degree of activity. So basically it's syphilis that 0:13:12.354 --> 0:13:16.674 we most worried about, because syphilis has got serious complications 0:13:17.154 --> 0:13:21.754 if left undetected, and especially when it comes to mother 0:13:21.834 --> 0:13:25.834 to child transmission because babies can be born with congenital syphlis. 0:13:25.954 --> 0:13:28.554 When we look at the data over the last ten years, 0:13:29.154 --> 0:13:31.794 according to the Kirby Institute, which is the institute in 0:13:31.794 --> 0:13:35.674 New South Wales, they've told us that the syphilis incidence 0:13:35.754 --> 0:13:39.874 has trebled in the last ten years and is now 0:13:40.114 --> 0:13:43.274 in the order of twenty seven point two per one 0:13:43.314 --> 0:13:46.714 hundred thousand, compared to zero point two per one hundred 0:13:46.754 --> 0:13:51.034 thousand Australia wide. In twenty twenty four, we had about 0:13:51.114 --> 0:13:55.674 six thousand syphilis diagnoses Victoria had the highest number in 0:13:55.714 --> 0:13:59.474 twenty twenty three. So as a result of that, the 0:13:59.834 --> 0:14:02.874 Chief Health Officer at the time put out a treat 0:14:03.394 --> 0:14:07.234 indicating that we need to be very vigilant about syphilis, 0:14:07.554 --> 0:14:10.434 and we need to be very vigilant about syphilis, especially 0:14:10.474 --> 0:14:13.914 in women in the reproductive age, because of the risk 0:14:13.994 --> 0:14:15.434 of congenital syphlis. 0:14:15.754 --> 0:14:19.074 What exactly would syphilis do to you if let's untreat it. 0:14:19.594 --> 0:14:24.554 So basically syphilis has got various stages, but the problem 0:14:24.634 --> 0:14:28.354 is that those stages either get missed or they get misdiagnosed. 0:14:28.914 --> 0:14:33.074 So somebody may have genital ulcer disease or an oral ulca, 0:14:33.194 --> 0:14:36.714 but because it's often painful, it gets missed so the 0:14:36.754 --> 0:14:39.514 patient doesn't go to the doctor. Then the next stage 0:14:39.554 --> 0:14:41.794 it can cause a rash on your body. But that 0:14:41.994 --> 0:14:45.274 rash is called the great mimica, so it can mimic 0:14:45.394 --> 0:14:49.474 dermatoses of like psoriasis, et cetera. So people think, oh, 0:14:49.554 --> 0:14:53.474 this is just my dermatitis and they don't seek care. 0:14:54.074 --> 0:14:57.874 Then the next stage is where it disseminates and there's 0:14:57.914 --> 0:15:01.434 no symptoms, and that's when it's dangerous because that's called 0:15:01.514 --> 0:15:06.474 latent syphilis. And when we don't treat latent syphilis, then 0:15:06.594 --> 0:15:10.434 you and end up with tertiary syphilis in ten to 0:15:10.474 --> 0:15:13.714 twenty years time, which can affect the heart, the brain, 0:15:13.914 --> 0:15:14.714 the bones, etc. 0:15:15.154 --> 0:15:17.634 When we're talking about congenital syphilis, what are the risks 0:15:17.674 --> 0:15:19.274 of mother to child transition? 0:15:20.114 --> 0:15:24.114 So basically, if you have early syphilis that means you've 0:15:24.154 --> 0:15:27.994 got syphilis in the last two years, then the chances 0:15:28.034 --> 0:15:31.394 of the baby getting infected are very very high and 0:15:31.594 --> 0:15:34.234 the baby can be very sick. So the baby either 0:15:34.274 --> 0:15:37.914 can die in neutral or be still born, or be 0:15:38.034 --> 0:15:41.474 born with several anatomical abnormalities and end up with a 0:15:41.474 --> 0:15:45.914 disability which is very difficult to sustain. Preconceptually, you should 0:15:45.954 --> 0:15:49.394 have a syphilis test and then every trimester. 0:15:49.314 --> 0:15:52.554 Is treatment pretty straightforward for syphilis. 0:15:51.914 --> 0:15:55.834 Very straightforward basically with syphilis. If you get the stage 0:15:55.874 --> 0:15:59.394 of syphilis right, you'll get the treatment right. And the 0:15:59.394 --> 0:16:04.074 treatment for syphilis in pregnancy and in non pregnant people 0:16:04.514 --> 0:16:08.634 is exactly the same stage syphilis and treat syphilis with 0:16:08.754 --> 0:16:14.354 benzathine penicillin. Fortunately, Trepanema paladum, which is the organism that 0:16:14.434 --> 0:16:19.434 causes syphilis, has not shown any resistance to benzethiine penicular. 0:16:19.074 --> 0:16:21.234 I've read some headlines that it might be a little 0:16:21.274 --> 0:16:23.194 bit of a different story for gonerreea though, that there 0:16:23.274 --> 0:16:26.314 might be some antibiotic resistant Goneria during the realms. 0:16:26.314 --> 0:16:30.234 Now, Goneriea is called the superbove. It's called the superbove 0:16:30.354 --> 0:16:35.794 because the Niceria species can exchange genetic material. It is 0:16:35.834 --> 0:16:41.634 on that basis that gonorrhea becomes resistant to the antibiotics. 0:16:41.794 --> 0:16:45.874 It's like a survival mechanism. The majority of antibiotics have 0:16:45.914 --> 0:16:50.434 not lasted more than ten years before Goneriea becomes resistant 0:16:50.474 --> 0:16:54.114 to it. At the moment, we've only got kef triaxone left, 0:16:54.834 --> 0:16:58.594 and already there have been resistance to kef triaxone as well. 0:16:59.354 --> 0:17:02.634 The one thing that we encourage all gps and doctors 0:17:02.674 --> 0:17:07.874 to do, or clinicians, nurse practitioners, nurses whenever the treating 0:17:07.954 --> 0:17:12.194 gonerreea is to do a Gonerrea culture test, because the 0:17:12.234 --> 0:17:16.274 culture test not only confirms that this is viable gonerriea 0:17:16.354 --> 0:17:20.634 because it has grown, but it also confirms some antimicrobial 0:17:20.674 --> 0:17:24.554 susceptibility because it actually gives us a report, so we 0:17:24.634 --> 0:17:27.553 know that the treatment we provided would have actually worked. 0:17:28.194 --> 0:17:31.474 Can we repond to some other STIs now Herpes is 0:17:31.514 --> 0:17:35.034 one of the more common STIs that Australians suffer, and 0:17:35.114 --> 0:17:37.073 I believe it's up to about eighty percent of us 0:17:37.114 --> 0:17:41.034 will carry the HSP one version of herpes, which can 0:17:41.154 --> 0:17:45.874 cause genital herpes as well. What long term health impacts 0:17:45.914 --> 0:17:47.954 does having the herpes virus have. 0:17:48.714 --> 0:17:51.553 I have to say that when I first started here 0:17:51.634 --> 0:17:54.594 in sexual health, my supervisor at the time set to 0:17:54.674 --> 0:17:59.114 me mel herpes is overrated, but it is our generation 0:17:59.394 --> 0:18:04.634 that's actually stigmatized by herpes. The herpes virus is a 0:18:04.754 --> 0:18:09.714 very benign virus, very rarely does it cause problems, but 0:18:09.954 --> 0:18:14.273 it is more the stigma the patient feels about having herpes. 0:18:14.794 --> 0:18:18.874 Oral herpes is very common because seventy percent of young 0:18:18.954 --> 0:18:21.714 children get coal sores around their lips when they're younger. 0:18:22.314 --> 0:18:25.434 And then now because of oral sex deemed to be 0:18:25.514 --> 0:18:30.194 a safer form of sex, more young people are engaging 0:18:30.194 --> 0:18:34.474 in oral sex, or or vaginal sex, or oro anal 0:18:34.594 --> 0:18:38.794 sex or oral penile sex. You can spread the HSV 0:18:38.994 --> 0:18:43.834 the herpes type one to the genital area, causing genital herpes. 0:18:44.714 --> 0:18:48.514 If you've not had HSV one as a child, then 0:18:48.554 --> 0:18:52.194 you actually don't have the antibodies to protect you from 0:18:52.234 --> 0:18:56.474 getting it genitally. The only thing is though, if you 0:18:56.794 --> 0:19:01.074 have herpes coals herpes as a child. By the time 0:19:01.114 --> 0:19:03.994 you reach adulthoods there's a little bit of discussion about 0:19:04.034 --> 0:19:09.434 waning antibodies so that protection can be lost and that's 0:19:09.474 --> 0:19:11.914 when the individual is at risk of genital herpeys. 0:19:12.674 --> 0:19:17.994 What about HIV, Melanie, because we've been reading about how 0:19:18.434 --> 0:19:22.114 it is so much more treatable now people live very long, 0:19:22.154 --> 0:19:25.394 healthy lives with HIV, whereas it was a very different 0:19:25.434 --> 0:19:29.513 story in the nineteen eighties for example. But are we 0:19:29.674 --> 0:19:33.994 seeing it fade from existence in Australia or are we 0:19:34.074 --> 0:19:37.394 still dealing with HIV AIDS now? 0:19:37.474 --> 0:19:40.394 I think in Australia we're still dealing with HIV AIDS, 0:19:41.194 --> 0:19:46.314 but it is definitely decreasing in incidents and people are 0:19:46.314 --> 0:19:51.154 living longer with HIV. And as the outfit, I must 0:19:51.194 --> 0:19:57.234 say the treatment has revolutionized HIV treatment and prevention. So 0:19:57.314 --> 0:20:00.874 basically starting off with HIV treatment, for somebody who is 0:20:01.074 --> 0:20:06.194 HIV positive, when they go on to antiretroviral therapy, as 0:20:06.234 --> 0:20:09.954 soon as they are diagnosed, within a few months, their 0:20:10.034 --> 0:20:15.513 viral load becomes undetectable. And if that undetectable viral load 0:20:16.154 --> 0:20:19.593 is sustained over a period of six months, then that's 0:20:19.594 --> 0:20:26.313 called undetectable equals untransmittable. You is equal to you. So 0:20:26.754 --> 0:20:31.234 individuals with HIV can safely have sex without a condom 0:20:31.914 --> 0:20:35.074 with someone if their viral load is less than two 0:20:35.154 --> 0:20:40.834 hundred copies. Honestly, that has revolutionized HIV incidents too. It 0:20:40.834 --> 0:20:44.234 has reduced stigma and those individuals that were HIV positive, 0:20:44.874 --> 0:20:48.434 and now we can safely tell patients that you is 0:20:48.474 --> 0:20:52.834 equal to you, is safe and should be highly considered 0:20:52.874 --> 0:20:56.594 when they're having sex. But that is a caveat is 0:20:56.954 --> 0:21:01.154 that they need excellent adherence to the antiretroviral therapy. 0:21:01.474 --> 0:21:05.714 Let's move on to a relatively new infection that we 0:21:05.754 --> 0:21:09.594 are now discussing in in terms of being a sexually 0:21:09.634 --> 0:21:15.074 transmitted infection, and that's bacterial vaginosis, which we always really 0:21:15.114 --> 0:21:17.874 saw as an issue with women alone, but now we're 0:21:17.914 --> 0:21:20.553 finding that through sex it can be passed not just 0:21:20.594 --> 0:21:22.874 from a partner, but back and forth between partners over 0:21:22.914 --> 0:21:25.834 time to reinfecting each other. Do we think now that 0:21:25.834 --> 0:21:28.394 we kind of have a better idea of how it 0:21:28.434 --> 0:21:30.394 could be transmitted and it's not always the case, but 0:21:30.434 --> 0:21:33.874 how it can be transmitted that numbers of BV might 0:21:33.914 --> 0:21:34.834 start to fall, you. 0:21:34.754 --> 0:21:39.914 Think absolutely, sexual transmission is just one of the mechanisms 0:21:39.954 --> 0:21:43.554 by which someone gets BV, because individuals who've never had 0:21:43.594 --> 0:21:47.513 sex can get BV. But in individuals who get recurrent 0:21:47.554 --> 0:21:52.114 back to your vaginosis, this treatment has also helped them 0:21:52.674 --> 0:21:56.274 in the sense that they're found that by providing male 0:21:56.394 --> 0:21:59.553 partner treatment through a massive study done at our clinic 0:21:59.554 --> 0:22:03.114 at Melbourne Sexual Health. So what happened at our clinic 0:22:03.234 --> 0:22:06.474 is that we did a small pilot study looking at 0:22:06.674 --> 0:22:11.594 treaty individuals who were in a couple and were monogamous 0:22:11.634 --> 0:22:15.994 for at least two months. So we treated the individual 0:22:15.994 --> 0:22:18.354 who came to us with BV and we treated their 0:22:18.394 --> 0:22:21.834 male partner, and then in the other arm, we only 0:22:21.874 --> 0:22:26.273 provide a treatment to the patient with bacterio vaginosis. And 0:22:26.314 --> 0:22:31.234 we found that those with male partner treatment and treatment 0:22:31.274 --> 0:22:34.313 of the index, they had a much lower risk of 0:22:34.394 --> 0:22:39.154 recurrence than only treating the index. So definitely, in couples, 0:22:39.514 --> 0:22:42.354 we know that by treating the male partner we're going 0:22:42.394 --> 0:22:44.594 to reduce the incidents of recurrent BV. 0:22:44.914 --> 0:22:48.274 And is that only if someone is in a hetero relationship. 0:22:48.314 --> 0:22:51.194 Do we know can we pass it between say, lesbian couples. 0:22:51.634 --> 0:22:54.754 Well, at the moment, we running studies in individuals who 0:22:54.794 --> 0:22:58.874 are not in a heterosexual relationship. We think that the 0:22:58.914 --> 0:23:02.754 results might be similar, but we haven't completed those studies yet. 0:23:03.154 --> 0:23:05.234 Can I ask about a couple of seis that I've 0:23:05.274 --> 0:23:07.754 been heard talked about a little bit on on social 0:23:07.754 --> 0:23:10.513