Sometimes, life doesn’t seem fair.

Your pregnancy has come at a difficult time. It’s unplanned, but we’re here for you. We care about you and your abortion decision. You probably have lots of questions about abortion, and we want you to be aware of the facts.

In order to know which type of abortion you would be eligible for, you need to have an ultrasound exam to confirm viability of your pregnancy (show a fetal heartbeat inside the uterus) and determine exactly how far along your pregnancy is (gestational age). We offer free pregnancy testing and ultrasound exams. Call today to schedule a confidential appointment. Until then, you can estimate the gestational age by counting the number of weeks from the first day of your last menstrual period (LMP).

95% of women, after having an abortion, said they wish they would have been given more information.

It’s possible that you may not even need an abortion! Approximately 1 in every 4 pregnancies will end naturally by miscarriage. Yes, NATURALLY!

Get all the answers you need to make the choice that’s right for you.

Before you call the abortion clinic call us.

We make no money from your choice.

Informed Choices Medical Clinic

Strength for life’s tough choices.

Call us for your personal solution at 319-337-0575.

Statistics courtesy of the Alan Guttmacher Institute and Planned Parenthood’s Family Planning Perspectives.

http://www.guttmacher.org/pubs/fb_induced_abortion.html

If you are young and sexually active or are considering becoming sexually active, this is a critical question. In the U.S. today there is a growing epidemic of STDs (sexually transmitted diseases). It is estimated that over 65 million people are now infected and 19 million new infections occur each year. Almost half of these new infections are in young people 15-24 years old. Some of these infections are simply embarrassing and treatable with antibiotics, but others are much more dangerous. Some STDs are incurable, life-long infections. Some can lead to life-threatening diseases and even death. Today the list has grown to perhaps 25 STDs that should concern every young person…

What are some of these diseases?

Chlamydia spreads from vaginal, anal and oral sex. Most men and women have no symptoms. In women, if left untreated, it can lead to PID (pelvic inflammatory disease) up to 40% of the time. PID can cause chronic pelvic pain, infertility and possibly fatal ectopic (tubal) pregnancy. An estimated 2,800,000 new infections occur each year.

Gonorrhea spreads from vaginal, anal and oral sex in men and women. An estimated 700,000 people in the United States are infected each year. In men, it causes a burning sensation while urinating and penile discharge. Most women do not have symptoms. It is another common cause of PID. Without treatment, gonorrhea can spread to the blood or joints and become life-threatening.

Genital Herpes spreads from contact with sores of an infected person, often from sexual contact. It causes sores and flu-like symptoms. It is a life-long disease, with typically 4-5 repeated episodes each year. It increases the chance of a person acquiring HIV virus (HIV causes AIDS) if exposed to that virus. An estimated 45,000,000 people have had genital herpes.

Syphilis spreads through contact with a syphilis sore mainly from vaginal, oral or anal sex. It progresses without treatment in three stages. The last stage has no symptoms but can cause paralysis, numbness, gradual blindness, dementia and death.

Trichomoniasis spreads from sexual contact, especially in women who have had multiple sexual partners. Symptoms may include a frothy, yellowish vaginal discharge with a strong odor. In men, a burning sensation and urge to urinate. An estimated 7,4000,000 new infections occur each year.

HPV-Human papillomavirus infections usually clear on their own. However, some HPV viruses are “high-risk” types and can lead to cancer of the cervix, vulva, vagina, anus or penis. About 20 million people are currently infected with HPV with 6.2 million new infections each year. At least 50 percent of sexually active men and women will have genital HPV infection at some point in their lives. Some people get visible wars on the genital that can spread to the mouth by oral sex. There may also be changes in cells of the cervix, vulva, anus or penis that could lead to cancer. About 10 of the genital HPV types can lead to the development of cervical cancer. The American Cancer Society estimated that in 2008 in the United States, about 11,070 women would develop invasive cervical cancer and about 3,870 women would die from this disease.

HIV causes AIDS, a weakening of the immune system.It is spread by vaginal, oral or anal sex. AIDS is routinely fatal. At the end of 2006 there were 1,106,400 people living with HIV/AIDS in the U.S. with over 545,805 deaths to date. Having other STDs can increase a person’s risk of becoming infected with AIDS as much as 5 times.

What is “slippage and breakage”?

Studies also show that condoms break or slip 1.6 to 3.6 percent of the time. This represents a potential risk of pregnancy and transmission of STDs.

Are condoms actually used consistently?

For the last decade, the “safe sex” message (use a condom every time you have sex) has been taught to teens. What has been the effect? Most studies show that in the real world, people do not use condoms consistently. Worldwide studies show various low percentage of consistent condom usage in large populations from 4% to 16% to 40% to 63%. This clearly puts sexually active teens at a higher risk of infection than what the studies show for consistent condom use.

What about pregnancy?

The U.S. Food and Drug Administration publishes expected pregnancy rates with condom use:For each year of “typical” condom use, the pregnancy rate is 14% and if they used exactly as directed every time without fail, the rate is 3%.

You Decide

Condoms have been shown to provide some risk reduction for some STD infections. But, isn’t this like playing Russian roulette? That’s the “game” where one bullet is put in a six-shooter’s cylinder, the cylinder spun and the gun pointed at your head and fired. In chamber one you have a condom that breaks and you get syphilis, in chamber two, you have an STD that condoms don’t protect against very well, in chamber three you have a routinely fatal disease…

The health care philosophy in America assumes you are incapable of making choices that will completely protect you from STDs and pregnancy. It assumes that you cannot make a choice to save sex until you are married. That is why condoms have been so widely promoted, even when their many limitations are well known. The message is, “Teens can’t control their passions, so let’s tell them condoms really work so at least they’ll wear them.” Why not tell the truth about condoms and the truth about how you can truly protect yourself?

You can be infected with any STD even when using condoms 100% of the time.

If you have been using you still need to be tested.
Call today for your free STD testing at 337-0575.

For People Facing Tough Health or Social Decisions……..

At Choices you will be guided through four steps:

1 Clarify the Decision.

2 Identify your decision making needs.

3 Explore your needs.

4 Plan the next steps.

Here are the facts. Judge for yourself whether it is a “big deal” or not. But first, let’s define what we are talking about.

What is oral sex?

Oral sex is the contact of on person’s mouth or tongue with the genitals of another person.

Is oral sex really sex?

There is a common, growing idea among young teens that oral sex isn’t really sex. What they say is “real sex” or sexual intercourse, is technically called “coitus” (or vaginal sex – the penetration of the male genital into the female vagina). However, almost any dictionary contains the secondary definition for sexual intercourse: “Intercourse involving genital contact between individuals other than penetration of the vagina by the penis.”³ In other word, any contact is “sex”. Oral sex is really sex.

Am I still a “virgin” if I have oral sex?

The word dates back to the 13th century and has had many meanings. At one time, it meant simply “an unmarried woman”. Today, certainly one definition is one who has not had sexual intercourse.⁴ Sexual intercourse could include oral, anal and vaginal sex. Other people insist that the term “virgin” applies to anyone who hasn’t had coitus. But maybe it’s the next question that is the most important.

Is oral “sex” practicing abstinence”?

You hear so often that the only way to prevent the spread of sexually transmitted diseases (STDs) is to practice sexual abstinence while you are single. What about  oral sex? Here, the definition is clearer. Recent efforts to decrease teenage pregnancy and disease have resulted in “abstinence only” curriculum. “Abstinence” means “abstaining” from (not participating in) any sexual activity including oral, anal or vaginal sex or mutual masturbation. Anywhere genital contact is involved, a person is not practicing abstinence and puts themselves at risk.

Is oral sex “safe sex”?

On this point, everyone agrees. Oral sex, like other methods of sex, carries with it the risk of serious, untreatable and even life-threatening diseases in both men and women. Oral sex has been found to spread syphilis, gonorrhea, HIV (HIV causes AIDS), HPV, genital herpes, chlamydia and possibly hepatitis C. ^5,6,7 Below is an overview of some of these STDs.

HPV – Human papillomavirus

This is a group of more than 100 different viruses. Most infections clear themselves. However, some HPV viruses are “high-risk_ types, which may lead to cancer of the cervix, vulva, vagina, anus or penis. About 20 million people are currently infected with HPV with 6.2 million new infections each year.⁸ At least 50 percent of sexually active men and women will have genital HPV infection at some point in their lives. HPV spreads primarily through genial contact. Most HPV infections have no symptoms so most people are unaware they are infected. Some people get visible warts on the genitals that can spread to the mouth by oral sex. There may also be changes in cells of the cervix, vulva, anus or penis that could lead to cancer. About 10 of the genital HPV types can lead to the development of cervical cancer. The American Cancer Society estimated that in 2008 in the United States, about 11,070 women would develop invasive cervical cancer and about 3,870 women would die from this disease.⁹ A new vaccine which will protect against four types of HPV viruses was approved by the FDA in June, 2006. But, because the vaccine does not protect against all cancer causing types of HPV, about 30% of the cases of cervical cancer cannot be prevented by the vaccine.¹⁰

Syphilis

In the U.S., over 40,920 cases of syphilis were reported in 2007.⁷ Syphilis is passed by direct contact with sores that occur mainly on the genitals, vagina, anus, in the rectum or on the lips or in the mouth. Syphilis can spread during vaginal, anal or oral sex. Many people infected with syphilis do not have symptoms for years, but are at risk for later complications if they are not treated.

During the primary stage of syphilis one or more sores appears. During the second stage, skin rash and mucous membrane lesions (wounds) occur. In the late stages, it may damage internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints. Syphilis can be cured in the early stages (infected less than a year) by a single injection of penicillin, but this cannot undo damage done before treatment.

Gonorrhea

An estimated 700,000 people in the U.S. are infected each year.⁶ Gonorrhea is spread through contact between the penis, vagina, mouth (oral sex) and anus. In the U.S., the highest rates are among sexually active teenagers, young adults and African Americans. Symptoms in men include a burning sensation when urinating or a white, yellow or green discharge from the penis. In women, the symptoms are often mild or absent.

Untreated gonorrhea can cause permanent health problems. In women, it can cause pelvis inflammatory disease (PID) with very severe abdominal pain, fever and long-lasting, chronic pelvic pain. PID can cause infertility or ectopic (tubal) pregnancy. In men, gonorrhea can cause a painful condition of the testicles that can lead to infertility if left untreated. Several antibiotics can cure gonorrhea, although drug resistance strains are developing world-wide.

HIV/AIDS

HIV (human immunodeficiency virus) is the virus that causes AIDS. This virus may be passed from one person to another through sexual and blood-to-blood contact. The estimated number of AIDS cases through 2006 in the U.S. is 1,106,400¹¹ with 583,298 deaths through 2007.12  The most common ways that HIV is transmitted from one person to another is by having anal or vaginal sex with an HIV-infected person. However, it can also be spread through oral sex. AIDS (Acquired Immunodeficiency Syndrome) is a disease caused by the HIV virus that weakens the immune system. It is a routinely fatal disease.

“In a recent survey, 41% of teens 15-17 years though you couldn’t get HIV from oral sex, or were unsure if you could”¹³

GENITAL HERPES

Genital herpes is caused by the herpes simplex viruses type 1 and 2. Type 1 is often associated with oral herpes infections, type 2 with genital herpes. However,the strains are now intermixed. Oral sex is an important risk factor for Type 1 infections. Most people have few symptoms. Others have one or more blisters on or around the genitals or rectum. At least 45 million people ages 12 and older have had genital herpes infection (1 in 5 adolescents and adults). Most people infected with Type 2 are not aware of their infection. If symptoms do occur during the first outbreak, they can be quite pronounced. In many adults genital herpes can cause painful genital sores that reoccur. Worldwide, herpes may play a role in the spread of HIV.

CHLAMYDIA

Chlamydia can be spread during vaginal, anal or oral sex and can affect men and women. It can also be passed from an infected mother to her newborn during vaginal childbirth.  More than 1,030,911 cases were reported in 2006, with most of the people infected under the age of 25. Many people have no symptoms. Some women might have an abnormal vaginal discharge or a burning when urinating. When the infection spreads, some women may have lower abdominal or back pain, nausea or fever. Chlamydia can be treated and cured with antibiotics. If not treated, the infection can cause an infection called pelvic inflammatory disease (PID) up to 40% of the time. PID can cause permanent damage to the fallopian tubes, uterus and tissues surrounding the ovaries. Chlamydia may also increase the risk of acquiring HIV infection (HIV causes AIDS) from an infected partner.

How Can STDs be Prevented?

While condoms have been shown to reduce the risk of some sexually transmitted diseases during vaginal sex, much less is known about their effectiveness in oral sex. The surest way to avoid infection with any sexually transmitted disease is to practice sexual abstinence (abstain from any sexual contact, including oral sex) while single. If you marry, select a partner who is not infected with an STD and remain sexually faithful during marriage.

 If you have had oral sex and have not been tested for STD’s please call Choices today for your free to you STD testing.

Sources and Resources

1.  Mosher, W. et. al., Advance Data from Vital and Health Statistics, National Center for Health Statistics, Number 362, September 15,2005, p. 34, found at :http://www.cdc.gov/nchs/data/ad/ad362.pdf,accessed 6-23-09.

2.  Remez L, “Oral Sex Among Adolescents: Is It Sex or is It Abstinence?” Family Planning Perspectives 32(6) November/December 2000, found at: http://www.guttmacher.org/pubs/journals/3229800.html,accessed 6-23-09.

3.  “sexual intercourse.” Merriam-Webster Online Dictionary. 2006-2007.http://www.merriam-webster.com, accessed 11-24-08.

4.  “virgin.” Merriam-Webster Online Dictionary. 2006-2007.http://www.merriam-webster.com, accessed 11-24-08.

5.  Edwards, S., Carne, C., Oral sex and the transmission of viral STIs, Sexually Transmitted Infections, 1998,74(1)6-10.

6.  Disease information: Centers for Disease Control and Prevention, National Center for HIV,STD and TB Prevention Division of Sexually Transmitted Diseases, Fact Sheets found at: http://www.cdc.gov/STD/HealthComm/fact_sheets.htm,accessed 6-23-09.

7.  Centers for Disease Control and Prevention. Sexually Transmitted Disease Surveillance 2007. Atlanta, GA: U.S. Department of Health and Human Services,found at: http://www.cdc.gov/std/stats07/tables/1.htm,accessed 6-23-09.

8.  Centers for Disease Control and Prevention, Department of Health and Human Services, National Center for HIV,STD, and TB Prevention , Division of STD Prevention, Division of Sexually Transmitted Diseases, Fact Sheet, Genital HPV Infection, found at: http://www.cdc.gov/STD/HPV/STDFact-HPV.htm accessed 6-23-09.

9.  American Cancer Society. Cancer Facts & Figures 2008. Atlanta,Georgia: American Cancer Society; 2008. Found at http://www.cancer.org/downloads/STT/2008CAFFfinalsecured.pdf, accessed 6-23-09.

10.  Centers for Disease Control and Prevention, National Center for HIV,STD and TB Prevention Division of Sexually Transmitted Diseases, HPV Vaccine Information for Young Women, found at: http://www.cdc.gov/std/hpv/STDFact-HPV-vaccine-young-women.htm, accessed 6-23-09.

11.  MMWR Mortality and Morbidity Weekly Report. October 3,2008, Vol. 57, No. 39. page 1073, found at: http://www/cdc.gov/mmwr/preview/mmwrhtml/mm5739a2.htm, accessed 6-23-09.

12.  Centers for Disease Control and Prevention, National Center for HIV/STD and TB Prevention, Divisions of HIV/AIDS Prevention, Basic Statistics, found at: http://www.cdc.gov/hiv/topics/surveillance/basic.htm accessed 6-23-09.

13.  Centers for Disease Control and Prevention, National Center for HIV/STD and TB Prevention, Divisions of HIV/AIDS Prevention, HIV/AIDS, Update Preventing the Sexual Transmission of HIV, the Virus that Causes AIDS What You Should Know about Oral Sex, found at: http://www.cdcnpin.org/Updates/oralsex.pdf, accessed 6-23-09.

How common is PID?

Each year in the United States, it is estimated that more than 1 million women experience an episode of acute PID. More than 100,000 women become infertile each year as a result of PID and many of the ectopic pregnancies that occur every year are due to PID.  Annually more than 150 women die from PID or its complications.

How do women get PID?

PID occurs when bacteria move upward from a woman’s vagina or cervix (opening to the uterus) into her reproductive organs. Many different organisms can cause PID, but many cases come from gonorrhea and chlamydia. A first episode of PID increases the risk of another because the reproductive organs may be damaged during the first bout of infection.

Sexually active women in their childbearing years are most at risk. Those under age 25 are more likely to develop PID. The more sex partners a woman has, the greater her risk of developing PID. Research has shown that douching can negatively affect the vaginal flora (organisms that live in the vagina) and can force bacteria into the upper reproductive organs from the vagina.

What are the symptoms of PID?

Symptoms of PID vary from none to severe. When PID is caused by chlamydia, a woman may have mild symptoms or no symptoms at all, while serious damage is being done to her reproductive organs. Because of vague symptoms, PID goes unrecognized by women and their health care providers about two thirds of the time. Women who have symptoms of PID usually have lower abdominal pain. Other signs and symptoms include fever, unusual vaginal discharge that may have a foul odor, painful intercourse, painful urination, irregular menstrual bleeding and pain in the upper abdomen (rare).

What are the complications of PID?

Early and complete treatment can help prevent complications of PID. Without treatment, PID can cause permanent damage to the reproductive organs. Infection-causing bacteria can silently invade the fallopian tubes, turning normal tissue into scar tissue. This scar tissue blocks the normal movement of eggs into the uterus. If the fallopian tubes are totally blocked by scar tissue, sperm cannot fertilize an egg and the n woman becomes infertile. Infertility also can occur if the fallopian tubes are partially blocked or even slightly damaged. About one in five women with PID becomes infertile and, if a woman has PID multiple times, her chances of becoming infertile increase. A partially blocked or damaged fallopian tube may also cause a fertilized egg to remain in the fallopian tube. If this fertilized egg begins to grow in the tube as if it were in  the uterus, it is called an ectopic pregnancy. As it grows, an ectopic pregnancy can rupture the fallopian tube causing severe pain, internal bleeding and even death. Scarring in the fallopian tubes and other pelvic structures can also cause chronic (on going) pelvic pain that lasts for months or even years. Women who have PID over and over are more likely to suffer infertility, ectopic pregnancy or chronic pelvic pain.

How is PID diagnosed?

PID is difficult to diagnose because the symptoms are often mild. Many episodes of PID go undetected because the woman or her health care provider doesn’t understand how important mild symptoms can be. Because there are no precise tests for PID, a diagnosis is usually based on clinical findings. If symptoms such as lower abdominal pain are present, a health care provider should perform an examination to find out the nature and location of the pain and check for fever, abnormal vaginal or cervical discharge and for signs of gonorrhea or chlamydia. If the findings suggest PID, treatment is necessary.

The health care provider may also order tests to identify what is causing the infection (chlamydia or gonorrhea for example) or to tell if it is really PID or another problem with similar symptoms. A pelvic ultrasound is helpful for diagnosing PID. In some cases, a laparoscopy may be necessary to confirm the diagnosis. A laparoscopy is a minor surgical procedure in which a thin, flexible tube with a lighted end is inserted through a small incision in the lower abdomen. This allows the doctor to view the internal pelvic organs.

What is the treatment for PID?

PID can be cured with antibiotics prescribed by a health care provider. However, antibiotic treatment does not reverse any damage that has already happened to the reproductive organs. If a woman has pelvic pain and other symptoms of PID, it is critical that she gets care immediately. Prompt antibiotic treatment can prevent severe damage to reproductive organs.

The symptoms may go away before the infection is cured. Even if symptoms go away, the woman should finish taking all of the medicine prescribed. This will help prevent the infection from returning. Women being treated for PID should be re-evaluated by their health care provider two to three days after starting treatment to be sure the antibiotics are working to cure the infection.

Hospitalization to treat PID may be recommended if the woman (1) is severely ill(nausea,vomiting and high fever); (2) is pregnant; (3) needs intravenous antibiotics; or (4) has an abscess in the fallopian tube or ovary. If symptoms continue or if an abscess does not go away, surgery may be needed. Complications of PID, such as chronic pelvic pain and scarring are difficult to treat, but sometimes they improve with surgery.

How can PID be prevented?

The main preventable cause of PID is an untreated STD (caused by chlamydia or gonorrhea). Women can protect themselves from PID by taking action to prevent STDs or by getting early treatment if they do get an STD.

The surest way to avoid infection with any sexually transmitted disease is to practice sexual abstinence (abstain from any sexual contact) while single. If you marry, select a partner who is not infected with an STD and remain sexually faithful during marriage.

Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of chlamydia and gonorrhea. However,condoms do not provide complete protection from STDs. Infection can occur in both males and females whether or not a condom is used.

If you think you are infected, see a health care provider immediately and notify anyone that you have had sex with so that they can also get treatment.

Any genital symptoms such as an unusual sore, discharge with odor, burning during urination or bleeding between menstrual cycles could mean an STD infection. If a woman has any of these symptoms, she should consult a health are provider immediately. Treating STDs early can prevent PID.

Women get PID when bacteria move upward from a woman’s vagina or cervix (opening to the uterus) into her reproductive organs. Many different organisms can cause PID, but most cases are from gonorrhea and chlamydia. A first episode of PID increases the risk of another because the reproductive organs may be damaged during the first bout of infection.  Sexually active women in thier childbearing years are most at risk. Those under age 25 are more likely to develop PID. The  more sex partners a women has, the greater her risk of developing PID.

If you are in need of your yearly Pap test, call us today!

How do you know if you need a Pap test?

If you have been sexually active for over 3 years and are over 21, or if you know you have HPV.

1. _ out _ sexually active young women has had genital Human Papilloma Virus (HPV).

A. 1 out of 30

B. 1 out of 15

C. 1 out of 7

D. 1 out of 2

2. T/F : The younger a person is when they start having sex, the greater the chance of getting a STD.²

3. T/F : You can get a STD if you have oral sex.³

4.  _ out of _ teens who have sex wish they had waited.⁴

A. 1 out of 4

B. 2 out of 3

C. 1 out of 3

D. 1 out of 2

5. At least 20 million people nationwide are infected with HPV.⁵

A disturbing fact is that more than _ % of cases of cervical cancer are linked with HPV.⁶

A. 30%

B. 60%

C. 95%

D.99%

How did you do? Comment and let us know how well you did!

Answers:

1.D

2.True

3.True

4. B

5. D

We did this quiz with 300 young people at the Johnson County Fair 2010.

27% got #1 right

37% got #2 right

81% got #3 right

51% got #4 correct

and 27% got #5 right

¹Center for Young Women’s Health. Accessed 8/14/09

²Children’s Hospital Boston. Accessed 8/14/09

³Centers for disease Control. December 2007.

⁴The National Campaign to Prevent Teen Pregnancy. 2007

⁵US Department of Health and Human Services. January 2009

⁶American Cancer Society. June 2009

Human Life Alliance

Get Answers!

Sometimes, life doesn’t seem fair.

Your pregnancy has come at a difficult time. It’s unplanned, but we’re here for you. We care about you and your abortion decision. You probably have lots of questions about abortion, and we want you to be aware of the facts.

In order to know which type of abortion you would be eligible for, you need to have an ultrasound exam to confirm viability of your pregnancy (show a fetal heartbeat inside the uterus) and determine exactly how far along your pregnancy is (gestational age). We offer free pregnancy testing and ultrasound exams. Call today to schedule a confidential appointment. Until then, you can estimate the gestational age by counting the number of weeks from the first day of your last menstrual period (LMP).

95% of women, after having an abortion, said they wish they would have been given more information.

It’s possible that you may not even need an abortion! Approximately 1 in every 4 pregnancies will end naturally by miscarriage. Yes, NATURALLY!

Get all the answers you need to make the choice that’s right for you.

We make no money from your choice.

Choices Medical Clinic

Strength for life’s tough choices.

Call us for your personal solution at 319-337-0575.

Statistics courtesy of the Alan Guttmacher Institute and Planned Parenthood’s Family Planning Perspectives.

http://www.guttmacher.org/pubs/fb_induced_abortion.html

In the late 1990s and early 2000s, ciprofloxacin resistance began to arise in Hawaii and the West Coast, and by 2004, ciprofloxacin resistance was elevated in MSM (men who have sex with men). In 2006, 13.8% of isolates exhibited resistance to ciprofloxacin, and was present in all regions of the country, including the heterosexual population. On April 13, 2007, CDC stopped recommending fluoroquinolones as treatment for gonococcal infections for all persons in the United States.

A major challenge to monitoring emerging antimicrobial resistance of N. gonorrhoeae is the substantial decline in capability of laboratories to perform essential gonorrhea culture techniques required for antibiotic testing. For more information check out website: cdc.gov/std/Gonorrhea

Call for your free Gonorrhea test 319-337-0575