Rectal Chlamydia!!!!

We just learned about gonoccocal urethritis in class and four things struck me: in our discussion of STDs and nursing care, we barely talked about HIV; we only talked about urethral and vaginal infections; the med class fluroquinolones (typical treatment for gonorrhea) is contraindicated in men who have sex with men with gonorrhea due to risk of resistance; and my standards are really low if I think the Christian rapper at school is hot with his awful skin.

Anyways... (via LifeLube, via AIDSMap)

Gay men should have rectal tests for chlamydia as part of their routine sexual health care, investigators recommend in an article published in the online edition of Sexually Transmitted Infections. Researchers found that more gay men had rectal infection with chlamydia than had urethral chlamydia or rectal gonorrhoea. Furthermore, the majority of rectal chlamydia infections were asymptomatic and would therefore have been missed without routine testing.

They also found that over a third of the men with rectal chlamydia were HIV-positive.

Right. So, I told you that.


What I should also tell gay men is this: you should probably have an anal pap smear done to check for carcinogenic growths related to anal HPV, and you should probably encourage the FDA to start testing the HPV vaccine on men against the above mentioned disease.


YEA! STDs!!! Aren't they fun?

Question For Friday: Incurable STDs

I got a lot of great responses to this week's Question for Friday. Just to review, this was it:

Question: would you date someone with a long term, incurable, non-HIV STD like herpes and/or genital warts?

And, a corollary, would you have sex with someone (let's assume short term -- maybe really short term relationship) with a long term, incurable, non-HIV STD like herpes and/or genital warts?

So, how do you think people answered?

• Dr_Jared, a little bit of fabulousness out of Alaska that I know on Twiter: "depends on the affected area of the body that is inflicted, and how to prevent further spread. Yes"
• JaytheBigLug, fabulous local queer blogger and a long time friend of mine in the city: "depends on the person- do they 'trump' the affliction?" AND "I'd like to think I'm noble enough to overlook such things... I'm probably not when it gets down to it, though. Few are."
• VeganJacob, somewhat liberal born again Christian and all around beautiful woman (and Cincinnati blogger): "wow. that's a loaded question. i've actually thought about it and i think TRUE/unconditional love really conquers all"
• ArtsyGemini, Twitterer and local photog, gives his abbreviated opinion: "no"
• Brandonlacycamp, who I, honestly, just started paying attention to on Twitter and runs a blog himself: "As a person living with HIV I would be hypocritcal to say no."
• From Daniel D. via Facebook: "If you have an intrest in the person there are many ways to work pass this issue, so I would day yes"
• From Ray N. from Facebook: "because love is stronger than any freakin disease....just be safe. love the one your with...."
• From Paul B. from Facebook: "First off very good question. And my answer is no. Sadly, it would always be on my mind whenever I was with that person. I wish it didn't bother me, but it does."
• From Montgomery Maxton via text message: "Btw I think itd be hard to date someone with herpes." (FOLLOW UP) "It's a tricky std."
• Update, forgot to put on JereKeys' response: From local queer blogger and twitterer, JereKeys: "I pretty much assume that anyone with more than 10 partners in the past has one of them, so yes."
• Update from fabulous friend of the blog: From Julie N. of Wine Me, Dine Me, Cincinnati... and an avid twitterati: "1. yes on permanent STDs. I've done it before. You have safe sex." AND "2. No on treatable STDs, because that shows a level of health irresponsibility I can't handle. ta da."

What's my take on the question? I would have to say yes, yes I would.

This is the point where my courage wanes, but I will charge on. See, we spend so much time talking about the empowerment of people with HIV, and we encourage people to "out" their serostatus, and we look down on people who "can't" date HIV+ persons, yet we don't do the same for other incurable STD's.

We don't at all, in fact. They remain somewhat in the closet, and there is some level of acceptance about their stigma.

True conversation: "Well, it was going real well, but then he told me he had herpes, so it was off." Rather than actually say, like I would expect if the word herpes was replaced with "HIV," "you know, it's a completely manageable disease and you can (somewhat) safely have sex with that person," the entire group of people around this commentator just nodded and accepted the fact. You see, though we are breaking down huge barriers for people living with HIV/AIDS (but still face a lot of stigma, don't get me wrong), I think there is some level of acceptance that herpes and HPV/warts are lines that are unforgivable.

Is it because they are not gay specific, or because we know so little about them, or because they are "tricky?" That is, they don't feel as easy to protect against as the "no body fluids" HIV prevention method.

You're right, figuring out the best way to protect against a skin-to-skin transmission is very difficult. But managable.

And here's where I shut down pretty much all future dating and fucking potential for anyone reading my blog. See, I have HPV... of the anal variety. Whoo-freakin-hoo. It's something that happened to me, and it's something I deal with and manage. My doctors are aware and, though there was a spell in my life where I didn't disclose this to people (but there were other contributing factors, as well, clearly), I have started telling people about the situation. Mainly because I think a lot of gay men deal with these two "other" STDs and don't talk about it.

In short, I'm talking about it so other people will, too. (It feeds so nicely into my martyrdom syndrome.)

I'm trying to start dating again, rather than just fucking. I'm trying to get out there, and this question was partially out of academic curiosity and partially out of self interest. Is there a dating pool out there? What are the perceptions of other people when it came to these diseases? And, generally, it doesn't seem good. HA. It's still quite taboo, and I'm sure I'll get a "TMI" comment or two.

Especially since most people gave me answers that assumed some sort of sexual experience within the context of love and relationship. . . which I also thought was interesting.

Would I date someone with HIV? Of course. And have.

Would I date someone with herpes (HSV)? Of course, and probably have (estimates, again, are somewhere between 10-25% of the sexually active population has it.)

Would I date someone with warts (HPV)? Of course, and I would hope the same of the other side. And, clearly, have, though I didn't have a choice in the matter.

Would I date someone with a curable STD -- gonorrhea, chlamydia, trich, syphilis, etc.? Absolutely not. Because you can go to the clinic and get that dealt with. And you should. Soon. But we can wait to fuck around until you get that shit taken care of it. And, don't worry, I've had one of the above before and I'll laugh about it with you later.

Point: it's nice to wax poetic on the sexual health of gay men, and the diseases we get and are at risk for, but the rhetoric always seems to be about HIV.

It's nice to get it off my chest, I supose. It would be nice to get it off my ass when it flares, though. HA!

GENERAL STUFF: Carcinogens

I don't know why I've been reading so much of Slate.com lately, but they had an interesting article about the causation of cancer how quickly people freak out about minor things whilst ignoring major solutions.

The obsession with man-made toxins not only reflects a small-minded view of cancer's causes but hints at a worrisome theme in American public health. Our scattershot approach to preventing cancer subscribes to the cult of personal responsibility, albeit with a recent eco-friendly twist: To really help themselves, goes the thinking, people must simply take charge of their health and avoid cancer-causing, artificial products. Somewhat insidiously, we're starting to believe that cancer mostly is prevented by informing individuals to change their consumption habits—not by proactive, broad-based public-health measures like widespread vaccination or agricultural reform.

I've been following the HPV vaccine, Gardasil (also mentioned in the article), fairly closely, for a couple of reasons:

1) It is only the second vaccine that's been proven effective against an STD (the other one being the Hepatitis A/B vaccine -- we're still waiting on Herpes, HIV, and Hepatitis C, remember).

2) It helps treat a really important aspect of women's health, but...

3) It is being maligned and torn apart in the political arena because of the theory that it will encourage the onset of sexuality.

To my mind, this encourages the ongoing stupefication of the American populace. Same thing with the anti-condom campaigns. No, condoms do not protect against every STD and they do not protect 100% for the ones that they do help with -- but they are the best we have. No, Gardasil does not protect against every form of HPV, and not even against every form that can cause cervical cancer -- but it is the best we have. And rather than own up to the positive benefits they cause and accept them and educate people about them, we would rather cover them up and pretend sex doesn't exist... and not admit to the drastic public health efforts necessary to continue developing comprehensive sexual education that treats people as adults rather than foolish children.

I am 100% for a freer understanding of sexuality, and I like the BDSM's community's idea of sexuality being "Safe, Sane, and Consensual," but part of consent is owning up to your behavior and understanding fully the possible ramifications of your actions. If consent is simply limited to saying yes to fucking, then it's not truly consent. In no definition or use of the word "consent" in the modern world does consent imply a lack of understanding of the ultimate possible consequences of an action. Think about it -- if you enrolled in a medical study and they didn't tell you, "BTW, you may die from this," they are not properly allowing you to consent. Rather, they are withholding information to prevent you from fully understanding the situation you are putting yourself into.

By learning about sex at all -- and sex/sexuality is fully imbued into our culture in a way that is inextricable -- without the proper educational background, we are, in essence, handing people guns and hoping they don't figure out where the trigger is. And by not ignoring the public health ramifications of denial in favor of a few persons morality -- which, btw, no one is arguing should be trumped -- we are just crossing our fingers and hoping nothing bad happens.

When it comes to sex and when it comes to the public health mandates that we rely on certain bodies to perform -- the CDC and the FDA -- we should choose to do what most social work students are taught their first year -- unconditional positive regard.

In other words, we should assume that they are attempting to help the best they can without political motivations. If we choose to start sensationalizing or politicizing basic public health principles, then we are leading to a path where the minor -- cell phones=brain tumors -- become the only knowledge of health that we have, rather than pursuing comprehensive health in the form of funding things like universal mammograms for women over 50 (Ohio's state program to offer them for free for the most needy is constantly fighting for more money and we used to regularly get notice that "we have no more money, please stop enrolling people in this program"). Because though cell phones may be linked to brain tumors, it would be silly to say that not using them is the only thing we can do. It is not entirely the individual's fault for getting XYZ...

...sometimes we, as a society, fail those individuals.

(And besides, shouldn't we be sensationalizing more important things, like il Papa or the homosexual menace?)