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STD Increases in Gay Community Concern Health Officials
by Ryan Gierach


The incidence of sexually transmitted diseases (STDs) has declined in much of the nation but remains a problem in select urban areas and among men who have sex with men (MSM), according to several studies presented at the National STD Prevention Conference. Co-sponsored by the Centers for Disease Control and Prevention (CDC) and the American Social Health Association, the conference was held in San Diego from March 4 to7.

Public health officials expressed concern at some of the findings presented at the conference. “We see increased STDs in various MSM communities and among those with HIV,” said Dr. Ronald O. Valdiserri, deputy director of CDC’s National Center for HIV, STD, and TB Prevention. “We know the presence of STDs increases the likelihood of HIV transmission and acquisition. And because we find more risky sexual behavior taking place, we are concerned that these trends could point to increased HIV infection in MSM communities.”

Studies from throughout the country were presented at the conference, including:

From San Francisco, the first-ever barebacking study, indicated that while the number of barebackers was lower than many thought, the practice was deeply imbedded in a small population of MSM.

“There are many definitions of barebacking used in the community,” said CDC’s Dr. Gordon Mansergh, the study’s lead author. “We focused our research on a strict definition; awareness of the term ‘barebacking’ and self-reported intentional unprotected anal sex with a non-primary partner.”

Fourteen percent of those who had heard of the term barebacking had done so in the previous two years. Twenty-two percent of HIV positive and 10 percent of HIV negative men barebacked in the previous 24 months. Of the HIV-positive men, 38 percent had unprotected insertive anal intercourse with partners of unknown or HIV-negative serostatus in their most recent bareback encounter. Among HIV-negative men who had barebacked, 39 percent had unprotected receptive anal intercourse with partners who were HIV positive or of unknown serostatus in their most recent bareback encounter.

“We are seeing intentional sexual ‘Russian Roulette’ out there,” added Mansergh. “Many men who bareback do so with partners of the same serostatus; however we are also seeing a sizable group of these men barebacking with partners of different or unknown serostatus.”

Of the men who barebacked, the two most common reasons were for physical stimulation and for emotional connectedness with a partner.

From a study of syphilis cases in New York in 2001, more than half of MSM infected with syphilis were co-infected with HIV. Thirty-three percent of those men were unaware of their HIV status before testing positive for syphilis.

“This points to a need for providers to offer testing for HIV and syphilis among populations at risk, since syphilis increases the risk of transmitting or acquiring HIV,” said Dr. Gabriela Paz-Bailey of CDC’s STD Prevention Program. “Additionally, where syphilis has traditionally been a disease of disadvantage, we now see more whites with higher education and income levels infected.”

From Chicago, a 2001 chart study of 1,283 clients of the city’s largest MSM clinic, Howard Brown Community Health Clinic, found that two percent of patients tested positive for syphilis, well above the national syphilis rate for all populations of 2.2 cases per 100,000 people. Forty-seven percent of those were co-infected with HIV. Additionally, 17 percent tested positive for gonorrhea and over ten percent for chlamydia, which can cause ulcerations in the anal region. Thirty-nine percent of MSM infected with STDs in this study had engaged in receptive anal intercourse, and 25 percent of those reported never using condoms.

From New England, one study of MSM attending a Boston clinic showed a three-fold increase in gonorrhea since the mid-1980s and the highest number of syphilis cases in over a decade. In Maine, another study showed increases in gonorrhea among MSM in urban areas and among MSM in rural areas after traveling to an urban area.

Also at the conference, CDC released the first national data on the seroprevalence of human papillomavirus (HPV) type 16. If not cleared from the body’s immune system, this type can lead to penile and anal cancer in men. Researchers found that 38 percent of MSM in the United States have been infected with HPV-16, nearly five times the seroprevalence in heterosexual men and twice that in women - eight percent and 19 percent, respectively.

The study’s findings were based on a representative sample of the U.S. population, which included 83 MSM, surveyed in CDC’s National Health and Nutrition Examinations Survey. The authors indicated that the findings are preliminary and that more research is needed into the clinical implications of HPV-16 for MSM.

“We must develop, in collaboration with local public health officials, better and more appropriate prevention and education messages that resonate with communities and develop new approaches to sexual health for MSM communities,” concluded Valdiserri.

I think this article is needed and should be read by more people. AIDS is being slowly found to not be caused by HIV alone, but by many of these STDs put together. When people start to realize that they take their lives into their hands just by having sex they will start to live different in hopes of living longer.
Ed