Online Dating and STIs: On the Line

By now, everyone has realized that online dating is, in the parlance of today’s youth, a thing. A big thing. As of 2013, at least 11% of all American adults, 20% of those aged 25-34, had used an online dating site or mobile app. A full 5% of Americans that are married or in a committed relationship met their partner online4. But while people go online looking for love, that may not be the only thing they find. With intimacy comes risk, including sexually transmitted infections (STIs), and online dating is no exception. In this post, I’ll delve into the relationship between online dating and STIs. It turns out, it’s complicated.

Crossing the line

While little research has explored the connection, it looks like online dating can increase the likelihood of getting a sexually transmitted infection. In a study of men who have sex with other men, those that used geosocial networking applications, like Grindr, had a greater risk of contracting gonorrhea and chlamydia compared to those who met partners at in-person venues2. Another study, this one on Singaporean men, found that those who used online sex forums were more likely to have oral and anal sex and sexually transmitted diseases than those who frequented brothels. This seems cut and dry, but it may not be so simple. The men who went online were also more likely to engage in risky behaviors (such as not using condoms), making them more prone to STI, and knotting up these conclusions in a web of correlation. It’s unclear if online dating increased the risk of STI on its own, or if the relationship simply reflects the overlap between people that date online and those who practice unsafe sex5.

Online dating isn’t just the province of men or the young. American adults aged 45-54 are about as likely to use online dating as those aged 18-244, and that number is sure to rise, with many older people interested in re-partnering after divorce or the death of their partner. The uptick in online dating in this age group may partially explain the increase in STI prevalence in some demographics, including older Australian women. But again, this conclusion is complicated by risky behavior. While Australian women over 40 who that date online are more likely to discuss STIs with a new partner before sex, they are less likely to refuse sex without a condom compared to younger women1.

online dating
The Internet: it’s not just for cats anymore.

Putting it all on the line

It’s not all bad news. Although the Internet may be contributing to the rise in STI incidence globally, it may also offer some solace for afflicted. The number of STI cases worldwide is staggering: there are about 20 million new STI cases a year in the US alone, and around 110 million new cases per year internationally. Although nearly every sexually active person will contract an STI at some point in his or her life (usually HPV), diagnosis with an STI can still come with severe stigma. Many STI positive people fear that disclosing their status to a potential partner will inevitably lead to rejection. In the face of these concerns, the Internet offers a space for solidarity; a suite of niche dating sites has emerged, specifically for people with incurable STIs3.

Although they are considered specialty sites, there are a lot of them, and they are popular. PositiveSingles, which includes people positive for any incurable STI, has 30,0000 members in the UK alone, and gained 100,000 new members globally in the last year. There are also sites for specific conditions, like H-YPE and H-Date, which cater to people positive for the two most common STIs, herpes and HPV. These sites offer more than a chance to meet your match; some sites provide support networks, and many have online counselors. Unfortunately, while the intention of these sites is an admirable thumbing of the nose to stigma, they may actually be circuitously reinforcing it, by insinuating that people positive for STI should only date other positive people. They may also inadvertently encourage unprotected sex between people with a positive diagnosis, who (for whatever reason) don’t appreciate the risk of multiple or superinfections3.

At its best, online dating, like everything else on the Internet, is a tool. It can help or harm depending on how it’s used. And while it can offer a good way to meet people, not everything is best done online. When it comes down to brass tacks, avoiding STI relies on prevention through safe sex, and that can only happen face-to-face. The conversation might be challenging, but it’s worth it. After all, your health is on the line.

References

  1. Bateson, DJ, E Weisburg, KJ McCaffery, and GM Luscombe. (2012). When online becomes offline: attitudes to safer sex practices in older and younger women using an Australian internet dating service. Sexual Health, 9: 152-159.
  2. Beymer, MR, RE Weiss, RK Bolan, ET Rudy, LB Bourque, JP Rodriguez, DE Morisky. (2014). Sex on demand: geosocial networking phone apps and risk of sexually transmitted infections among a cross-sectional sample of men who have sex with men in Los Angeles county. Sexually Transmitted Infections, 0: 1-6.
  3. Heyden, Tom. “Online dating for people with sexually transmitted infections”. BBC News Online. 28 March 2013. Web. 23 February 2015.
  4. Smith, Aaron. “5 facts about online dating”. Pew Research Center. 13 February 2014. Web. 2 March 2015.
  1. Wong, ML, TT Koh, S Tjahjadi, M Govender. (2014). Men seeking sex online practice riskier sexual behaviours than men frequenting brothels: survey findings from Singapore. Sexually Transmitted Infections, 90: 401-407.

Image source: Creative Commons, http://dailynewsdig.com/20-funny-shocked-cat-memes/

Takotsubo cardiomyopathy: Heartbroken

Aliases: takotsubo cardiomyopathy, TC, stress cardiomyopathy, broken heart syndrome, left ventricular apical ballooning (it’s hard to see why this one hasn’t caught on)

Everyone knows that hearts can break, but sometimes the pain is more than just psychological, sometimes they really break. In an unfortunate display of mind over matter (seriously, why doesn’t this work with something cool, like Jedi mind tricks?), takotsubo cardiomyopathy takes the pain of heartbreak to the next level, layering physical injury on top of emotional insult. Dramatically called broken heart syndrome, takotsubo cardiomyopathy (TC) can literally arrest your heart in the wake of emotional or physical stress.

The first case of TC was documented in Japan in 19902, and by 2008, about 800 cases had been reported globally1. However, this may be a vast underestimate, as TC is difficult to diagnose and easily overlooked. One study detected the condition in 23% of intensive care unit patients with no history of structural heart disease. Because of the similarity in symptoms, TC is often mistaken for a heart attack, and accounts for 2.2% of hospital patients admitted due to a presumed heart attack1.

TC gets its name from its characteristic malformation of the heart: the left ventricle is distorted into a shape resembling a Japenese takotsubo pot, traditionally used to collect octopus2. Thankfully, while the effects of TC are serious, they are rarely fatal. In-hospital mortality is less than 1%1. The condition is often referred to as a “stunned heart”, because the injury, while profound, is temporary2. As it turns out, time may actually be the best medicine for a broken heart.

takotsubo cardiomyopathy
Love hurts.

Cause: TC is usually triggered by an emotionally (e.g. grief, fear, or relationship conflict) or physically (e.g. surgery, chemotherapy, or stroke) stressful event. While the underlying causes of TC are still unclear, it may be be a reflex response resulting from an excessive flood of hormones, such as adrenaline, released after stress2.

Consequence: The most common symptoms of TC are similar (and often initially mistaken for) a heart attack: abrupt and unpredictable chest pain, and shortness of breath. TC is distinguished by its lack of severe plaque buildup and the malformation of the heart, which causes the left ventricle to be unusually shaped (narrow necked with an enlarged lower portion that contracts poorly). Although TC can injure a large amount of heart muscle, it has very low mortality. TC mostly affects women over 50 (usually post-menopausal); only 10% of cases occur in men2.

Cure: TC is diagnosed with ultrasound and MRI, and treated with beta-blockers and angio-tensin-converting enzyme inhibitor drugs that promote heart muscle recovery. Recovery is usually rapid and complete; heart function is typically normal within 3-7 days, and 95% of patients never have recurrence, despite subsequent stress2. The heart is battered, but not broken.

References

  1. Dorfman, TA, & AE Iskandrian. (2009). Takotsubo cardiomyopathy: state-of-the-art review. Journal of Nuclear Cardiology, 16: 122-134.
  1. Sharkey, SW, JR Lesser, & BJ Maron. (2011). Takotsubo (Stress) Cardiomyopathy. Circulation, 124: e460-e462.

Image source: Creative Commons, http://pixabay.com/en/heart-broken-love-romance-damaged-297313/