3 ms·

> emergency department for ulcerative genital and anal lesions. At the time, he was treated for a presumed herpes infection—but his herpes test was negative and

> emergency department for ulcerative genital and anal lesions. At the time, he was treated for a presumed herpes infection—but his herpes test was negative and he was not tested for syphilis. The article ends sighting the rise in STIs and yet this walking Petri dish wasn't tested for syphilis? The test can't be *that* expensive, especially in the context of public health. Why wouldn't such ppl get a broader range of tests? Are the doctors prevented from ordering such tests? Either at the same time, or as a follow up? The guy had physical malformations that tested negative for herpes and there was no, "Well, what is it then?"

bhpm 3y ago
> this walking Petri dish Don’t do this. Stigmatizing infectious disease leads to people not getting tested, which leads to more disease and more suffering. This patient was treated for the concern that he presented and, for reasons we don’t know, didn’t follow up. Some people don’t have a lot of time and money to pursue the details of something that appears resolved, and it’s not clear that the tests would even been covered. Standing around at a hospital and then fighting with your insurance company isn’t anybody’s idea of a fun.
- olliej 3y ago
  Outside of Alabama syphilis is an extremely treatable and if you are actively having sex with multiple partners you should be getting tested continuously. If you aren't getting tested in this scenario, then you _should_ be shamed as you are putting the health and lives of your partners at risk.
  - chownie 3y ago
    Does shaming people about their sexual hygiene increase openness and willingness to get tested? Or does it encourage people to hide from the problem, exacerbating it? I know weight shaming is in this category, tends to make people gain rather than lose. Do you know if this actually works? Is this definitely positive behaviour, or does it just feel like it?
    - olliej 3y ago
      I'm not critiquing their personal hygiene, I'm critiquing their refusal to take basic steps to protect their partners. If you want to sleep with different people on a regular or semi-regular basis, you should be getting STI checks, and you should be practicing safe sex. That is a basic element of being a decent person. What you're saying is that I am shaming someone for bad driving when I tell them they should stop at red lights. After they've repeatedly run red lights. If you are having sex with other people, you have a duty to them to ensure that you aren't transmitting a variety of different diseases and illnesses, at least not without consent. Many STIs are easily and quickly, detected and treated, but many others are permanent and carry life long risks, and if you are too lazy or "embarrassed" to get tested, then you have no business sleeping with other people.
      - chownie 3y ago
        I think you've misunderstood, I didn't make any claims. My only question was if shaming people is effective, and we seem to have sidestepped that.
        olliej 3y ago
        you literally replied with "Does shaming people about their sexual hygiene ..." I did not mention their hygiene, sexual or otherwise. If you 1. Have multiple sexual partners 2. Don't get regular STI tests you are in the wrong. I am not shaming hygiene, shaming STIs, shaming the number (high or low, I literally do not care what consensual adults are doing with or without clothes), shaming the frequency (again, don't care). I am saying that the basic social contract of sleeping with someone is that you are open and honest about your sexual health, and in the absence of explicitly saying you have an STI the reasonable assumption your partners are making is that you have a reasonable belief you are not carrying anything transmissible. To be able to do that you need to have regular STI checks. You're right that shaming someone for having an STI is not helpful, especially given a number of STIs aren't curable, but not getting tested is a _choice_, and shaming people at risk of STIs for not getting tested is no different from shaming people for drunk driving. You are making a bad choice and expecting no consequences.
- chiefalchemist 3y ago
  Fair enough. You're right. I could have done better. My apologizes. Thank you for taking a moment to point this out to me.
civilitty 3y ago
> The test can't be that* expensive, especially in the context of public health.* The tests are free in almost any other context. Planned Parenthood and tons of other NGOs offer them no questions asked and Obamacare made their coverage by insurance mandatory. Many (most?) states even subsidize the tests for the obvious public health benefits. Emergency rooms are just a special case where the economic incentives are even more completely out of wack than in the rest of healthcare. It could have been something as trivial as understaffing - the full STD panel might have required two vials of blood and a genital swab so they went with the simpler test as labor triage.
Manuel_D 3y ago
This seems strange from my experience, too. Once a year my doctors orders testes for Syphilis, HIV, Herpes, Gonorrhea, and Chlamydia. When I went to the doctor to check out a suspicious lesion on my genitals (turned out to be acne) they did a full battery of tests as well. The rationale is that testing is cheap, and an untreated STD is expensive. Then again I have pretty good insurance.

bhpm 3y ago

> this walking Petri dish Don’t do this. Stigmatizing infectious disease leads to people not getting tested, which leads to more disease and more suffering. This patient was treated for the concern that he presented and, for reasons we don’t know, didn’t follow up. Some people don’t have a lot of time and money to pursue the details of something that appears resolved, and it’s not clear that the tests would even been covered. Standing around at a hospital and then fighting with your insurance company isn’t anybody’s idea of a fun.

olliej 3y ago
Outside of Alabama syphilis is an extremely treatable and if you are actively having sex with multiple partners you should be getting tested continuously. If you aren't getting tested in this scenario, then you _should_ be shamed as you are putting the health and lives of your partners at risk.
- chownie 3y ago
  Does shaming people about their sexual hygiene increase openness and willingness to get tested? Or does it encourage people to hide from the problem, exacerbating it? I know weight shaming is in this category, tends to make people gain rather than lose. Do you know if this actually works? Is this definitely positive behaviour, or does it just feel like it?
  - olliej 3y ago
    I'm not critiquing their personal hygiene, I'm critiquing their refusal to take basic steps to protect their partners. If you want to sleep with different people on a regular or semi-regular basis, you should be getting STI checks, and you should be practicing safe sex. That is a basic element of being a decent person. What you're saying is that I am shaming someone for bad driving when I tell them they should stop at red lights. After they've repeatedly run red lights. If you are having sex with other people, you have a duty to them to ensure that you aren't transmitting a variety of different diseases and illnesses, at least not without consent. Many STIs are easily and quickly, detected and treated, but many others are permanent and carry life long risks, and if you are too lazy or "embarrassed" to get tested, then you have no business sleeping with other people.
    - chownie 3y ago
      I think you've misunderstood, I didn't make any claims. My only question was if shaming people is effective, and we seem to have sidestepped that.
      - olliej 3y ago
        you literally replied with "Does shaming people about their sexual hygiene ..." I did not mention their hygiene, sexual or otherwise. If you 1. Have multiple sexual partners 2. Don't get regular STI tests you are in the wrong. I am not shaming hygiene, shaming STIs, shaming the number (high or low, I literally do not care what consensual adults are doing with or without clothes), shaming the frequency (again, don't care). I am saying that the basic social contract of sleeping with someone is that you are open and honest about your sexual health, and in the absence of explicitly saying you have an STI the reasonable assumption your partners are making is that you have a reasonable belief you are not carrying anything transmissible. To be able to do that you need to have regular STI checks. You're right that shaming someone for having an STI is not helpful, especially given a number of STIs aren't curable, but not getting tested is a _choice_, and shaming people at risk of STIs for not getting tested is no different from shaming people for drunk driving. You are making a bad choice and expecting no consequences.
chiefalchemist 3y ago
Fair enough. You're right. I could have done better. My apologizes. Thank you for taking a moment to point this out to me.

civilitty 3y ago

> The test can't be that* expensive, especially in the context of public health.* The tests are free in almost any other context. Planned Parenthood and tons of other NGOs offer them no questions asked and Obamacare made their coverage by insurance mandatory. Many (most?) states even subsidize the tests for the obvious public health benefits. Emergency rooms are just a special case where the economic incentives are even more completely out of wack than in the rest of healthcare. It could have been something as trivial as understaffing - the full STD panel might have required two vials of blood and a genital swab so they went with the simpler test as labor triage.

Manuel_D 3y ago

This seems strange from my experience, too. Once a year my doctors orders testes for Syphilis, HIV, Herpes, Gonorrhea, and Chlamydia. When I went to the doctor to check out a suspicious lesion on my genitals (turned out to be acne) they did a full battery of tests as well. The rationale is that testing is cheap, and an untreated STD is expensive. Then again I have pretty good insurance.