The Get Healthy Tampa Bay Podcast

E83: Prevention, Symptoms, and Treatment of STDs with Dr. Reller and Hannah Beavers, APRN

• Kerry Reller

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Welcome to the Get Healthy Tampa Bay Podcast with Dr. Kerry Reller! This week, I am joined by Hannah Beavers, a family nurse practitioner, and my wonderful neighbor. In this episode, we delve into the world of STDs (Sexually Transmitted Diseases), discussing the most common types, their symptoms, and current trends. Hannah shares valuable insights on the impact of the COVID-19 pandemic on STD rates, the importance of regular testing, and effective prevention methods. Tune in to learn about common misconceptions, treatment options, and practical tips for maintaining your sexual health.

With over 15 years in healthcare and eight years of experience as a nurse practitioner in bustling Tampa, Hannah is dedicated to guiding patients toward healthier lifestyles and making a meaningful impact in their lives. A proud University of Tampa graduate with a master’s in nursing and board certified in family medicine, she excels in engaging with patients, leveraging technology to enhance care, and embracing virtual platforms to improve access. She believes that education is a crucial part of helping patients make informed decisions. Outside the clinic, Hannah enjoys exploring new places and embarking on adventures with family. 

0:00 STDs with ARNP Hannah Beavers
0:28 - Introduction to Hannah Beavers
1:11 - Hannah's Journey into Medicine
3:28 - Overview of Common STDs in Tampa
4:39 - Impact of the COVID-19 Pandemic on STD Rates
7:08 - Common Symptoms of STDs
8:35 - Frequency and Methods of STD Testing
9:35 - Addressing STDs in Older Adults
11:01 - Effective Methods of STD Prevention
17:54 - Dispelling Common Misconceptions about STDs
20:35 - Treatment and Long-term Health Effects of STDs

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Kerry:

Hi, everybody. Welcome back to the Get Healthy Tampa Bay podcast. I'm your host, Dr. Kerry Reller and today we have a very important, special and awesome guest. This is Hannah Beavers, family nurse practitioner, and she's so awesome because she's also my neighbor. So I'm very excited to have you today.

Hannah:

Hey, thank you, Dr. Reller.

Kerry:

I feel like we should have done it in person, but I didn't know how to operate zoom and record without doing it this way. So we are not in the same place, but maybe next time we will be.

Hannah:

Okay. Yeah. Hopefully there's a next time. We'll see how this goes

Kerry:

You're going to be great. So tell me basically, how did you get into medicine and a little bit of about you and your story before we get into anything?

Hannah:

Okay, I went into nursing in my early 20s right through school and my mom is an ER nurse. I really enjoyed the flexibility of her career, being able to help patients and Between both of those I have some different healthcare stories in my family that I wanted to go in to medicine in order to, like, make a difference. So I went into nursing, initially got into cardiac medicine, really enjoyed the cardiac component, and then there was an offer for a labor and delivery position. I transitioned to labor and delivery, very, very different practice, at least from a nursing point of view. And then from there, I went back to school to get my family practice nurse practitioner degree. And that was at university of Tampa. I had a great experience there. A lot of cool precepting opportunities. And one of those was in family practice which is what I ended up really loving, enjoying, and pursuing out outside of my graduate degree. So I started working in family practice about eight years ago, and I've been in the same practice now, and it's a large family practice in Tampa. A lot of patients, a lot of varying population. We have patients who come from outside of the county, inner city, so we have a varying degree of what we see in the practice. As family practice does, it changes very rapidly from patient to patient.

Kerry:

Yeah, absolutely. It sure does. And I think that maybe like we were talking about before, we both have a little bit different patient populations, but it's really neat that you get to see a little bit of everything. Right. And you guys do pretty much full scope, right. Pediatrics, but you don't do OB, is that correct?

Hannah:

Correct. Yes, we refer out quickly with OB other than a urine pregnancy testing and confirmation of pregnancy. That's about all we do with that. But otherwise, full practice, full scope. Yeah,

Kerry:

Thank you so much for coming on today. I think we had a fun topic that I was saying I don't see that much of because of my patient population, but you definitely see a lot more of that. And that was STDs or sexually transmitted diseases. So what's the scoop on it lately? What's the most common STDs currently going around? What would you say?

Hannah:

This is a tough topic because it's something that is around and very much prominent in the Tampa area, but not a lot of people talk about it. So I thank you for giving me the opportunity to share some of what's going on in the Tampa area and around and some of the ideas behind prevention with it. In the current trends, there are common STDs that circulates. Now there's quite a few, but the most common ones, at least I'm seeing in practice are chlamydia, gonorrhea, and syphilis. Of course, there's probably HPV is a very common one as well, genital herpes there is trichomonas, hepatitis and then we talk about HIV AIDS as well. So there's about seven STDs that we routinely screen for, and depending on symptoms, we'll add different screening measures as well.

Kerry:

Yeah, I was going to ask if you kind of do that all at once or based upon the symptoms, seems like you kind of tailor your ordering of all the type of screening tests

Hannah:

yeah, absolutely.

Kerry:

Okay. So how about prevalence? Has it been increasing recently? Or is it kind of always steady? Or what would you say?

Hannah:

I think really in the CDC is where I go for the information that you're going to hear today. But a lot of times in Tampa, we reflect a lot of what the CDC says, Tampa and Hillsborough County, Hillsborough County actually reports higher numbers than a lot of the other areas in the state. So large cities, Jacksonville, Tampa, Orlando, Miami are going to have a higher prevalence rate. And Hillsborough County being one of those larger counties they're reporting more syphilis, chlamydia, and gonorrhea especially post pandemic levels compared to pre pandemic levels. They're attributing that to quite a few different reasons, but one is decreased condom usage. It doesn't seem to, there hasn't been a big increase in educational push recently to the next generation on that because so many of them were confined for a while. So now everybody's getting out. There's more online dating platforms. So there's a lot of opportunity but the education hasn't been there. So it's kind of trying to catch up, play catch up with the current measures of prevention.

Kerry:

Yeah, that's really interesting. I was actually going to ask of kind of how the COVID 19 pandemic may have changed some of, you know, I guess everything about, you know, the STD world or anything, but that's interesting that they are not getting as much education about condom usage. And I think you're right. For the younger generation, you know, they were at home. I mean, we were all were stuck at home, right? But definitely more stuck at home and maybe not having as much interaction, especially like in the late teen years and then into like early college. And if they didn't have that education, then, you know, they aren't reinforcing these preventative measures, right?

Hannah:

Yeah, the other thing is, we also have more advanced screening, so we're able to find a lot of STDs much faster, much more efficiently, because we do have the screenings available that maybe weren't even available, you know, prior to that. So.

Kerry:

Can you expand on that a little bit? What do you mean?

Hannah:

It's just swabs and patient access to public facilities or with their primaries, the availability of blood testing, urine testing and swabbing. And. The results. Accuracy wise.

Kerry:

Okay. So it's all a little bit improved since then. I mean, obviously medicine's always changing. Okay. So what are some common symptoms of STDs that people should be aware of?

Hannah:

Sure. So there are common symptoms that actually between both males and females and then they can be very specific. between males and females. So some of the more general symptoms between both males and females are there can be an unusual discharge. It's different in color, consistency or smell than your normal burning sensation with urination, sores, blisters, warts in the genital area or on the mouth. Itching is a big another symptom that's pretty common, redness and irritation in the genital area. Just because you have itching doesn't mean you have an STD, but it is a concern. And then there's also as, as far as pain during intercourse and swollen lymph nodes as not as much as an obvious sign, but there can be swollen and tender lymph nodes, especially around the groin area. And then between males and females, they, those vary based on the STD.

Kerry:

Yeah. So those are mostly localized, but like you mentioned, the lymph nodes and rashes sometimes can be, right. That

Hannah:

palmar rashes specific based on, you know, the, the actual organism at play.

Kerry:

And also we should mention, you know, sometimes it can be asymptomatic, right? Yeah. So someone's going in for, you know, maybe this, their cervical swab for cervical cancer screening, they may not have any symptoms or perhaps they're pregnant and you have to do all those STD testing and, you know, they may not have anything symptoms too, right?

Hannah:

Absolutely.

Kerry:

So how often should we be testing for STDs or how can someone go about getting tested? You kind of alluded to that already, but

Hannah:

Yeah, so general guidelines for sexually active adults at least once a year if it's multiple or new partners, much more frequent testing every 3 months, a. k. a. 90 days or so then specific populations based on knowing your patients and what their sexual preferences are based on that specific STD guidelines and screening guidelines and testing really any high risk behaviors, more frequent testing as well.

Kerry:

so sometimes I'm seeing an older patient and, you know It's hard to bring up the subject, right? But it happens, right? So there is STDs in the older community too, and if they don't bring anything up, you know, sometimes we need to as a provider, right? But how do you approach that? Like, do you think that the patients who are older should also be tested once a year? Or do you bring that up with them at all?

Hannah:

Yeah, so that is a very unique challenge that we are finding more, more common for a var a variety of different reasons. A lot of times there's a lack of awareness. Older adults aren't informed of the risk of STDs or mistakenly believe that they weren't at risk. There's also misconceptions about STDs and they only affect younger people. There is a decreased protection. You know, women that are postmenopausal aren't concerned about pregnancy, so they may not be using protection or barrier methods. There's the stigma associated with the older population and embarrassed about talking about sexual health. And then oftentimes just overlooking symptoms thinking it's a part of aging. So I think that unique challenges with the older adult, if they come in for their physical do discuss whether they're in a monogamous relationship, if they're sexually active and what that activity may look like so that you're able to guide them based on based on those answers.

Kerry:

Yeah, those are, those are really good points, especially making it a safe environment to be discussing these things is important. And I forgot or didn't even think about that, but you're right, like with women older, right, they're mostly thinking about pregnancy prevention. So maybe they may more or less likely to, you know, insist that condom usage be, you know We'll use condoms during sex. So that makes that makes a lot of sense. So what are the most effective methods of preventing it since we kind of already alluded to that as well?

Hannah:

Yes. So prevention. There is a few belief systems out there and of course abstinence is the only way to prevent STD. You have to Abstain from all sexual activity. But practicality of that monogamous relationship being in a long term, mutually monogamous relationship decreases your risk or eliminates the risk of STDs. There are vaccinations. There is an HPV vaccination and a hepatitis B vaccine out there, which with HPV, it can help prevent human papillomavirus, which can cause genital warts and certain cancers. And then the hepatitis B vaccine can cause chronic liver disease. So those two vaccines are available. The consistent and correct use of condoms reduces many of the STDs, including HIV, chlamydia, gonorrhea, and syphilis regular testing and screening, early detection and treatment are very important with that. I talk a lot to my high risk populations about what's called PrEP and PEP, but more often I talk about PrEP. So pre exposure prophylaxis is that acronym and it's basically medication for people at high risk of HIV and it helps to prevent that infection. So I have that conversation frequently. And there are medications available and oftentimes are covered by insurance, and there are community resources where that medication is free and available to those patients in a higher risk population limiting number of sexual partners. Avoid sharing needles. Those are all sort of probably the higher, safer practices and most affected for preventing STDs.

Kerry:

Who is the right age group of patients for the HPV vaccine? Because they used to have some age limitations on it. I think they've expanded it.

Hannah:

The latest, yeah, that's a good, oh, that's a good question. You put me on the spot with that

Kerry:

That's okay.

Hannah:

I would say 20.

Kerry:

I think when it first came out, we were just really doing it up to like, maybe 26,

Hannah:

yes.

Kerry:

And then since then, they've allowed it to, older ages, I guess, but I'm not sure of it either. But they still doesn't really go beyond 40. I don't think really, we don't for some do that. And I, I don't really know the guidelines on that. So it may be it's the way that test was done, or I'm not sure. But it's very, you know,

Hannah:

So when it first came out, I believe it was either 24, 26, like you said. And now really up until age 40 to 45, people can get that vaccine. Of course, it's most effective the earlier it gets and males between like up to the age of 26 is still that number. But yeah, I don't know the specific number. I think I always look that up every time just because it's not, I don't actively immunize the patients that I see. It's more of a conversation, but yeah.

Kerry:

So that, I mean, we can look at, you know, the guidelines. Sometimes I use the United States Preventative Task Force to see those age groups of who we should be vaccinating and that can help to

Hannah:

And it might even be like a who should be versus what age they recommend. And I know the recommended age is still that 24 to 26 timeline of, you know, that's the earlier you can do it, the better the prevention of it.

Kerry:

Right. Yeah. I think in summary, you know, if you're not sure, ask your provider and then we'll direct you.

Hannah:

me and then I will look it up.

Kerry:

And then we'll look it up. You know, that's good too. I mean, I often don't know the answer to things and this might be something I wouldn't know the answer to. And I would look it up on the spot. That's what is wonderful about having the computer in front of me when I see a patient

Hannah:

yeah.

Kerry:

Yeah, for sure. So anyway, we're talking about HPV. We're talking about preventing cervical cancer, some penile cancers, and like you mentioned, some like genital warts and things like that as well. So it is an important thing. And I know that some parents are always hesitant on what to do with their children with getting that vaccine. Do you have Anything that you usually say to them with that?

Hannah:

I don't commonly educate parents. That's not actually really something I'm commonly doing but I do encourage my patients who are asking questions about that to have that open conversation if they're able to and they have that relationship to have that conversation with their parent and discuss it. And. if they are comfortable with it, it is an actual vaccine that we have to prevent cancer, which is pretty incredible. Again, though, there's a lot of beliefs and personal aspects to that, that leaves it to being a much more open ended conversation with patients.

Kerry:

Yeah, it definitely can get, I guess, complicated, but you're right. I mean, there aren't very many cancers we can prevent with a vaccine. So it is kind of exciting that we have that. So at least in our, Repertoire, but yeah, so you mentioned already some misconceptions, at least with the older population about STDs. Are there any other things that you would like to mention?

Hannah:

Oh yes, absolutely. So there are common misconceptions that are often addressed in the practice where I am at least. One of them is, I'm not really promiscuous, I'm not promiscuous. How did this even happen? Regardless of the number of partners someone has, any sexual activity does open up the opportunity for an STD. I couldn't tell that they had one by looking at them. Another common misconception, STDs are, don't have to be visible, especially in the male population. Oftentimes they are not visible. Then you can't get an STD from. oral sex. That's another one common misconception that can incur herpes, gonorrhea, syphilis, HPV. I've seen all of them the oral route in practice. And that would con, that would actually is the sore throat and a persistent sore throat that was resistant to treatment that led us to swab and find that that is what the causative agent. And then Once you're treated for say gonorrhea or chlamydia or syphilis, you can't get it again, but you can continue to be exposed, especially to those bacterial agents or specifically to the bacterial agents. Birth control pills, prevent STDs. I don't know how many people think that, but that is a common misconception and then, if I don't have symptoms, I don't have an STD but many STDs can be asymptomatic, and you actually spoke about that earlier and they don't show symptoms, and yet they can still be transmitted, and they can still cause long term health issues and then STDs cause symptoms immediately. I see patients too, they'll come in the next day, and they're like, you know what, I made a mistake, I need to be tested. you know, this, this and this today. And sometimes it can take weeks, months or even years to show symptoms. And then with the aging population, only young people get STDs. And that is a common misconception as well.

Kerry:

Yeah, those are really good. I like the one where you said, I couldn't tell by looking at them. I'm like, what are you talking about? Oh, you mean, yeah, a person is engaging in sex with someone and they just, you know, assume that there's nothing going on. And yes, indeed, they could be carrying something. They could not let you know, or they would have no idea as well. And remove symptoms, like you said. So yeah, those are really good myths to, you know, dispel basically about STDs. It's important for sure. And you mentioned like long term health consequences. I think Well, I would like to go over that, but we'll, I mean, I'll wait on that, but how can we better educate on prevention, especially young adults about, you know, safe psych practices?

Hannah:

How can we better educate?

Kerry:

Yeah, you kind of mentioned the open discussion, right? No,

Hannah:

my patient education is one of the things I really enjoy doing in practice and do enjoy discussing not only prevention, importance of regular testing, safer sex practices really just not trusting what your partner says and going with what you're being educated on. And that is I need proof, you know, I need to see that you don't have an STD and be okay with standing up for yourself and your body and wanting to know that that that new partner that you have does not carry that or if they do, they communicate that with you so that you're able to take those necessary steps for protection routine testing and screening

Kerry:

yeah. So definitely, you know, protecting yourself, right? Speaking for your own, you want to know that you're going to be healthy and okay by having a sexual encounter with another individual and that alone is enough. So asking for proof and things like that, that's as important. And I mean, you know, I don't know if they still do sex education in schools or anything like that, but it's clearly between parent and child that needs to happen.

Hannah:

I think school is a wonderful opportunity to educate, whether it's confidential, nonjudgmental or any of those things, but I, social media has so many positives. Where a lot of people are getting education, so providing the correct guidelines, correct research, correct treatments, correct ideas on what to look for signs and symptoms on social media and having that be publicly funded because it is a health concern that there is money towards for that engagement with the public on education.

Kerry:

Yeah, absolutely. I mean, these are preventable things. So, you know, the education is key there for sure. So what are some of the common treatments that we use? I know it would be hard to pick out for each thing, but what are, in general, I guess, if you want to speak upon that?

Hannah:

Yeah, so some of the treatments are really are based on what the actual diagnosis is if they're bacterial you can treat them with an antibiotic based on their staging, chlamydia, gonorrhea are treated with antibiotics. With syphilis depending on the stage There's actually four stages of syphilis and I have seen latent stage syphilis in practice. So based on the presentation and What their lab work shows because that's actually a very specific lab that you look at and how it trends there's treatment there and HIV, the prep, the pre exposure medications to hopefully prevent it, but once it's there, then there are specialists that monitor that way and have a very specific treatment there. But I would say for the common ones, chlamydia, gonorrhea herpes is very common. And that one is an antiviral. You don't necessarily, you can't get rid of that, but when it does, if it does, again, one of those asymptomatic, most of the time there are medications called antivirals that can help suppress that outbreak so that it doesn't last as long as, and it doesn't impact you as much as it could without that medication.

Kerry:

Yeah, that's a really good point. And then for HPV, I mean, that's not one that lives in there forever, but it can be cleared. Correct.

Hannah:

Yep. And HPV, I don't discuss it as much because it's just so prevalent and I probably should. And when I do talk about it with pap smears, I tell women it can come up at any point and it can activate and it can show up in a pap smear. That's why it's so important for regular screenings with via pap smear. And women are often concerned because they don't know who they got it from or that their partner had it. But it's one of those that is really only, not only detected, but mostly detected through pap smear. So and, and the statistic for that one, at least in the last 10 years, if you've had more than one partner and your partners had more than one partner, there's a 50 percent chance of exposure to HPV. So it's the most popular of the STDs and again, very, very important when it comes to your pap smear and screening. And for men to understand that even though they don't see it and they don't know they have it, they are the carriers and they can carry and transmit it. And then it has long term implications on their female partner.

Kerry:

Yeah, absolutely. And potentially for them as well. But if you,

Hannah:

Correct.

Kerry:

yeah, with the screening for that, I think that's 1 of the reasons why we screen a little more frequently the younger population. I mean more frequently, and then as you get older, they space it out, but the younger population is also able to clear it, a little bit better, so that, but it's still recommended to do those frequent cervical swabs for sure.

Hannah:

Yeah. And men are really only tested by visual inspection, you know, checking for specific lesions. There's really no way to test directly for HPV in men that's actually been approved, you know, in clinical use.

Kerry:

What about for men who have sex with men, can't you do a swab for HPV as well?

Hannah:

There is an anal pap test that's quick. So yes.

Kerry:

Okay. So yeah, so that's another classification of a group who would have to do some different type of testing based

Hannah:

And that's going to look for like normal cells precancerous cells or cancerous cells that swab does. Yeah,

Kerry:

so you mentioned syphilis. And I remember, you know, in my training with syphilis is like one of those great masqueraders kind of like lupus, like anything can go for that. Can you speak a little bit about like the stages and then you mentioned you had a patient who was I guess, latent syphilis or tertiary.

Hannah:

absolutely. And both of those are, yeah, late in syphilis really tertiary. So there are stages and what I've seen in, in practice a few times is the Palmer rash. There's this very specific rash that occurs on the palm or surface of the hand. And that is. I've seen that two or three times in the last few years, just patients presenting only with that symptom, which you wouldn't say screams and STD. So I think that's important for people to know that that's very, you know, that's one of the concerns there. So getting back stages of syphilis and their presentation, there's stage one tooth, like a tertiary and then a latent stage and the primary you can have sores or what we call kinkers form at the site where the bacteria or the body this can come up anywhere from like, Up to three months of that initial, but it doesn't always have that sore. They're a person's very contagious during the primary phase of syphilis. And it can easily pass this infection on to others. So high. frequency sexual activity without checking. That's where it primarily spreads. It'll often the, the sore will often appear appear right in the genital area. And a lot of times they're, they don't cause pain. So that's another thing is I have a sore there. It's not painful. It is raised, but sometimes people don't even know that. that occurs. And then if you have the vague lymph node swelling without any kind of a sore, that is also very nonspecific to the fact that syphilis is there. The, the sore can last a few weeks and usually heals without treatment. So again, that's one of the concerns is a lot of times it can go unnoticed. There's a second, secondary stage which is the rash. It's a reddish brown rash. It's very small, flat and it can have some sores, but again, they're very small. It could look just like a regular skin problem. And then depending on the color of the skin, the sores may appear lighter in color. So very nonspecific in terms of a systemic rash, but the palmar rash is that very specific syphilis symptom or sign.

Kerry:

Oh, go ahead.

Hannah:

The rash usually heals, but you'll, you might have a fever, a sore throat with that, just general malaise or that feeling of discomfort. Some people have Headaches or weight loss, but again, they're non specific symptoms. And then there's that latent stage, which we call the hidden stage. And that's where the bacteria, the actual bacteria that causes syphilis stays in the body. And there's no symptoms here. And it can last this way for years. And often this stage can only be done by blood testing or if there's a personal history or birth of a child with somebody with syphilis. So the tertiary or late stage, If a person doesn't get treatment, it can turn into a later stage, and that one will cause blood vessel and heart problems, mental disorders. It can cause blindness, nervous system problems and some of the issues that develop are neurosyphilis, which affects the nervous system, cardiovascular syphilis, which affects the heart and the blood vessels and then there can be larger sores inside the body or on the skin with that tertiary or late stage syphilis.

Kerry:

Yeah, syphilis can be pretty scary and complicated. So I'm glad you pointed out all these different things and we will call it the great masquerader because like you mentioned like fatigue, fever, sore throat, weight loss, hair loss even and like There's so many things. I hear people tell me this all the time. And guess what? Syphilis has not been on my mind.

Hannah:

no, absolutely not. Mm mm. No. That's why that history and the patient feeling comfortable with their providers is vital for diagnosis like syphilis.

Kerry:

How about some other complications of some of the other ones? Like, what are the effects on long term health if they're untreated? Yeah

Hannah:

infertility is a big one that they're still actively researching, but there are Potentials for infertility there. We discussed some of the cardiovascular concerns mental there's, we, we don't talk about it a lot, but there are the issues where you have something like herpes and you do Make maybe make a decision that leads to you contracting herpes and then you're not with that partner and then you have to. Have that conversation with each and every partner after, and that mental load of carrying HIV or one of these STDs that plays a factor in your long term health and mental health and well being in your future relationships where it's not just a, oh, I can take an antibiotic and get rid of it, it kind of carries with you and you do have to bring it up from time to time, and every time people bring that up, it can be an emotional toll that is, you can't treat. You just have to go through it and, and process it each and every time it's discussed.

Kerry:

you bring up the point of, you know, having that discussion. I think it's one thing that's really important is To have that discussion. If you were sexually active with someone and you came up with any STD, you need to be informing your partner so they can go ahead and get tested as well. Right. I don't want to leave out that.

Hannah:

Yeah. Yeah. And then not only infertility, the possible long term cancer and the side effects of having a cancer there that could potentially spread.

Kerry:

I think one thing also like that pelvic inflammatory disease that can happen after gonorrhea, chlamydia is sometimes like non specific abdominal pain kind of thing, and that is, you know, left from untreated bacterial infections I think that's a big common one. And then with the pregnant patients, right, they can have risk of preterm delivery, you know, problems with the baby, depending upon which one we're talking about, like congenital syphilis can be, is pretty bad. HSV is, you know, definitely a big problem in the postpartum period and could be transmitted to the baby causing real neurological complications too. And then There's obviously that's why they're doing all the screening for the prenatal visits, right? Because a lot of the stuff, the risk of transmitting into the baby is also a concern to I'm not going to go into all the details of those unless you want to, but yeah, I think this is all a lot of good information. So are there any specific populations that are more at risk for certain ones? Certain STDs.

Hannah:

Yeah, so, not, well, of the populations, those that are high risk and engage in high risk sexual activity but specifically 15, age 15 to age 24, those are still considered those high risk population, whatever their sexual preference is they're typically the higher risk patients that really are more on our, our radar when we're looking at, into those But going back to, you know, you mentioned the preterm laborers, a lot of that has to do as well as like the cervical interventions that are required. If there is HPV that's high risk and they aren't unable to freeze those cells off, they'll have to go into a little bit more of a complex treatment. Where it does make that cervix not. As strong, a little bit more susceptible or very much more susceptible to either preterm labor or failure to dilate which can increase risk for cesareans. If, if anything else, that increased risk with labor and labor progression is there.

Kerry:

Yeah. Speaking of cesareans with, with the HSV or if they have an active lesion or anything like that, you know, they do recommend the cesarean over vaginal delivery

Hannah:

Absolutely. If there is any kind of a lesion, they will, they will automatically go straight to a cesarean.

Kerry:

So where do you normally point someone who's trying to get more information about STDs and safe sex?

Hannah:

I do a lot of Planned Parenthood referral in terms of that's a great resource for STD awareness and education, but most of the information's from the CDC. Most websites out there and even local organizations get their information based on the CDC website. So that's my go

Kerry:

Awesome. Okay. Is

Hannah:

to.

Kerry:

Anything else that you want to educate us on regarding this topic?

Hannah:

Think we've been pretty pretty thorough with this specific conversation.

Kerry:

Awesome. Well, thank you so much for being a guest today. Is there anywhere that people can find you? I know you're working in Tampa, but you're not too active in the social media.

Hannah:

Nope, not active in the social media. No, there's really nowhere to find me. No, there's

Kerry:

stay hidden.

Hannah:

Eh,

Kerry:

All right. Well, I appreciate your time very much. Thank you. And I'll see you on the street in the neighborhood. But yeah, thanks everybody for tuning in today. And please tune in next week for another great conversation.

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Dr. Kerry Reller

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