Doctor Interview: Dr. Ina Park by Ray Mwareya
Since 1500s penis claps, STIs are still a shame-loaded subject.
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Dr. Ina Park is an associate professor of family medicine at the University of California San Francisco and a medical consultant for STI prevention at the CDC. In March, they released an intriguing book titled: “Strange Bedfellows: Adventures in the Science, History, and Surprising Secrets of STDs”. In it, Dr. Park charts the history of unorthodox gonorrhea or herpes cures, and ultimately today´s enduring shame over STIs.
For Zero Spaces, I sat down with Dr. Park.
RAY: For this book, you had young audiences in mind too?
DR. PARK: My original title was "Clap" which is the old term used to describe gonorrhea, but after conferring with my editor and my agent, we thought that younger people wouldn't be familiar with the term, and we came up with Strange Bedfellows as a substitute.
RAY: Your motivation to write this book is?
DR. PARK: I decided to write this book to try and combat the pervasive stigma associated with these infections. I had been in the field of STI research for almost 10 years, and I was frustrated that STIs were continuing to go up while the stigma around them had not budged.
RAY: STIs in America is still a shame-loaded subject. Why?
DR. PARK: In the US, STIs are seen as a consequence of "promiscuity" or sex out of wedlock. I would love for us to view STIs in the same way that we view any other infectious disease. We must normalize STIs as a natural consequence of being sexually active. It's going to happen to all of us at some point.
RAY: According to your book, the history of STI treatments is whacky. 1500s-era condoms were made from chemically soaked linens, the contraption held together with ribbons. What was the purpose?
DR. PARK: These older condoms would have ribbons to fasten/tie them onto the body, and sometimes had chemicals soaked into them which might act as a spermicide.
RAY: For benefit of younger readers, how did ancient treatment for gonorrhea go?
DR. PARK: Primitive treatments for gonorrhea involved “clapping a hapless penis between two wooden paddles, pair of hands or books in an attempt to expel unwanted discharge”.
RAY: Sounds like a strange remedy?
DR. PARK: It did not work, and certainly caused a lot of pain. I think people thought that expelling the discharge might be enough to also expel the bacteria, which we know is not enough to eradicate the infection.
RAY: Throughout the Second World War, soldiers’ privates get smeared with mercury ointment and inexplicably wrapped in wax paper, your book says. Why?
DR. PARK: The wax paper was placed so that the medicine didn't leak out onto their underwear. I'm not sure whether the ointment caused pain worse than the affliction
RAY: HIV is one of those diseases that has seen this shaming from the media and corporate world even today. Why?
DR. PARK: I think we have come a LONG way in destigmatizing HIV, at least in the US, with famous athletes and celebrities disclosing their HIV status, as well as a huge community of support for people living with HIV. Of course, there is still much stigma to be fought, but it is much better than it was in the 1980s and 1990s.
RAY: You dive into the complicated optics surrounding the groundbreaking HIV prevention drug PrEP. Critics fear it will deter condom use and help fuel other STIs –Which side of the PreP debate do you land?
DR. PARK: I think PrEP is a huge win for prevention, I encourage patients to take it. Yes, it has led to less condom use, but the trade-off in preventing HIV is worth it, at least in my opinion.
RAY: You urge closer consideration for anal cancer screening and pharyngeal gonorrhea, which is typically contracted during fellatio when a penis deposits bacteria on the tonsils. What´s your special concern?
DR. PARK: Anal cancer is uncommon in the general population, but it's about 70-100 times more common among HIV-positive men who have sex with men. We need to figure out what the best screening test is for this cancer and ensure all young people are vaccinated to prevent as many cases as possible.
RAY: You are a CDC doctor – do unscientific STI rituals still get used in trying to treat syphilis, gonorrhea in America? Do some of your patients dabble in this before coming to the hospital?
DR. PARK: Luckily, I have not seen people attempt many home remedies before coming to see me. People certainly buy creams over the counter and try them before they come to the clinic.
RAY: Your book is an energetic addition to a canon of bodily science writing. Why does bodily science self-restrict when it comes to writing freely about STIs and culture?
DR. PARK: It's easier to have sex than to talk about it. Talking about sex and STIs can make people feel vulnerable and fearful of rejection and judgment.
About the author: Ray Mwareya is a freelance science and tech journalist in Ottawa, Canada. His work appears in Brainfacts, Soule.LGBT magazine, and Codastory. Twitter: @rmwareya