History of Sexually Transmitted Diseases

1. History of Sexually Transmitted Diseases Early history of syphilis and gonorrhea Originally believed to have come from the New World because it became virulent and very prevalent after 1492 Like AIDS, believed to have come from contact with animals Unlike AIDS, women were believed to be transmitters of syphilis, especially prostitutes Led to customs of men seeking virgins to protect themselves or even cure the men of STDs Recent archeological digs in British port cities suggest the rise of trade is the culprit

2. Early Descriptions of Syphilis • Originally blamed on conquerors or travelers • Often called the French Pox, or the Italian Pox, etc. • Initially was as deadly as HIV • Survivors gave birth to children with secondary syphilis—one of leading causes of infant mortality before the invention of penicillin • Gonorrhea often called “the clap” indistinguishable from syphilis until the invention of the microscope • More visible in males than females • Women often left infertile, and if they had children, they were often born blind until doctors routinely put mild solution of silver nitrate in all newborns’ eyes

3. Early Treatment for Syphilis and Gonorrhea • Because syphilis sores appeared to disappear on their own for a while, people often thought they were cured with just about any remedy • Condoms before the 20th century not as effective, often tore • Treatments: long, painful and uncertain: mercury, arsenic (salvarsan invented ca 1909–the magic bullet) often as long as a year in “Lock Hospitals” • Women often caught the disease from their husbands, and were rarely told about their husband’s condition by their doctors

4. VD as a Sexual Panic • Treatment of VD often accused racial or ethnic minorities as being the spreaders of syphilis • In the U.S. African American males were believed to develop syphilis differently from white men–Result “Tuskeegee Experiment” • In Argentina, VD was blamed on the foreignprostitutes—’Their girls wouldn’t engage in prostitution’ • African prostitutes in 20th century British controlled Nairobi not subjected to the same medical regulations as established in other parts of the empire–believed to be “beyond” the modern medical system • In Europe, Jewish women were accused of spreading the disease and other crimes

5. Cures for Syphilis • Metals such as gold and silver were often made into a solution and injected—very painful • Mercury was injected, and patient often was bled with leeches—mercury poisoning could be as deadly as the disease • Calomel, a pomade of mercury, as well as “French Letters” or condoms were often added to the provisions given to soldiers. • 1909 Paul Erlich discovered a form of arsenic treatment that was called the “magic bullet”-needed only one week of treatment, although cures were not guaranteed • Not until invention of penicillin was it possible to cure syphilis with one injection—not used for that until 1943.

6. Syphilis and War-French Ad

7. US Anti-Syphilis War Poster

8. Primary Syphilis

9. Secondary Syphilis

10. Legalized Prostitution • One of first public health campaigns designed to control behavior • In the Middle Ages, the Catholic Church controlled the bordellos—closed down in Protestant countries • City authorities permitted prostitutes to work with medical examinations-often found in Catholic countries • Men never examined in 19th and early 20th century • Often regulated, even in Great Britain, in port cities with large numbers of single men • Medically regulated prostitution designed by the French during the Napoleonic Wars and then spread throughout Europe and other parts of the world

11. Prostitution and the Military • Legalized prostitution usually a response to either the presence of military barracks, or the rise of urban populations that often had many male migrants • British set up special military bordellos in their imperial holdings to service army officers • U.S. did the opposite, and tried to curb prostitution in and around military bases at home and abroad • During the World Wars, commanders particularly concerned about the men lost to venereal disease

12. Impediments to Effect Prostitution Regulation • Clandestine prostitution • Painful medical treatment for infected women-ones that could not guarantee a cure until 1940s • Prostitutes learned how to hide evidence of venereal disease • Upper class prostitutes and courtesans rarely registered. • Men, except during war time, were not inspected

13. Cultural Conflicts Between European Ideas and Other Cultures • European attitudes toward prostitution conflictedwith local values in many parts of the world. • Japanese Geishas, male prostitutes • Chinese female entertainers-considered upper class and rarely had sex with customers • Many patriarchal societies thought it was honorable for a daughter to engage in prostitution toprovide income for the family. Many families“sold” girls into prostitution. • African prostitutes in Kenya were usually monogamous women who offered food, lodging, and sex in rapidly growing urban areas–were important landowners- often converted to Muslim religion

14. Syphilis Rates US-By Sex

15. Gonorrhea Rates, US—By Sex