Anal warts and anal gonorrhoea associated with HIV infection in gay men

by Roger Pebody, via Aidsmap

The two sexually transmitted infections most strongly associated with HIV acquisition in gay and bisexual men are anal warts and anal gonorrhoea, Australian researchers report in the online edition of the Journal of Acquired Immune Deficiency Syndromes.

Herpes infections did not emerge as significant in this study, but men with warts were three times more likely to acquire HIV, and men with gonorrhoea were seven times as likely. The authors suggest that more frequent screening for anal sexually transmitted infections in gay men should be investigated as a means of HIV prevention.

Numerous observational studies have suggested that sexually transmitted infections (STIs) facilitate the acquisition and transmission of HIV. However most studies have been conducted among heterosexuals, and previous prospective studies have not examined the full range of sexually transmitted infections that are common in gay and bisexual men.

In particular, genital or anal warts have often been overlooked, and many studies have not distinguished between genital and anal infections.

Warts are caused by infection with certain strains of the human papilloma virus (HPV). Infection with other strains of HPV may lead to cervical or anal cancer, but people with warts are not more likely to develop cancer. A recent study found that men infected with cancer-causing HPV are more likely to acquire HIV.

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Peter, I don't have symptoms - but should I be regularly checked for STDs?

[Peter Pointers is here 4 YOU, as a service to LifeLube readers - whatever question you may have regarding sexual health, physical health, mental/emotional and spiritual health - ask him. He will find the answers you are looking 4. Below is a recent Q&A you may be interested to read.]

Question: How do I know if I should be tested for syphilis, gonorrhea, chlamydia? I don't have symptoms but should I be tested regularly like I do for HIV?

Answer: Thank you for your question. I am happy to hear that you get tested regularly for HIV and think it's great that you are considering getting tested for STDs, also.

So, Howard Brown Health Center in Chicago recommends that men who have sex with men get tested for HIV every 6 months to a year. Similarly, they recommend getting tested for syphilis, gonorrhea, and Chlamydia each time you get tested for HIV, each year, at the start of a new sexual relationship, or at the onset of symptoms.

Just as a refresher, here is a good rundown of the symptoms of other STIs: click here. Some include burning during urination and any discharge from the penis or anus (especially on the inside of your underwear or pants).

Depending where you are located, there are places where you can get tested for STIs for free or low cost. One good source is www.hivtest.org, where you can search by zipcode for testing locations. If you have any trouble finding a place to be tested for STI's, let me know (include where you are located) and I will assist you the best I can!


Be Well,
Peter Pointers
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The CDC Says, "Swab that Booty!"

The CDC recommends screening of at-risk men who have sex with men (MSM) at least annually for urethral and rectal gonorrhea and chlamydia, and for pharyngeal gonorrhea. Although the standard method for diagnosis is culture, nucleic acid amplification (NAA) testing is generally more sensitive and favored by most experts. NAA tests have not been cleared by the Food and Drug Administration (FDA) for the diagnosis of extragenital chlamydia or gonorrhea and may not be marketed for that purpose. However, under U.S. law, laboratories may offer NAA testing for diagnosis of extragenital chlamydia or gonorrhea after internal validation of the method by a verification study.

To determine sexually transmitted disease (STD) testing practices among community-based organizations serving MSM, CDC and the San Francisco Department of Public Health gathered data on rectal and pharyngeal gonorrhea and chlamydia testing at screening sites managed by six gay-focused community-based organizations in five U.S. cities during 2007. This report summarizes the results of the study, which found that three organizations collected samples for NAA testing and three for culture. In total, approximately 30,000 tests were performed; 5.4% of rectal gonorrhea, 8.9% of rectal chlamydia, 5.3% of pharyngeal gonorrhea, and 1.6% of pharyngeal chlamydia tests were positive.

These results demonstrate that gay-focused community-based organizations can detect large numbers of gonorrhea and chlamydia cases and might reach MSM not being tested elsewhere. Public health officials could consider providing support to certain community-based organizations to facilitate testing and treatment of gonorrhea and chlamydia.

Read the rest at the CDC.

Live Fast, Die Young, and Leave a Beautiful Corpse

walking on sun sun shine, originally uploaded by JKönig.

by: anon

I am a member of the real Uptown community in Chicago, not the gentrified Andersonville that people like to call Uptown. I am talking Lawrence and Broadway, baby, and I have been here most of my life. I am an African American and 47 now, so needless to say I have seen a lot of change here over the years. I went to high school at Rizen Orr on the West Side, but Uptown is where I call home. I did a little college and I am looking to go back, but I am not in a hurry. I am satisfied with my job, and my home. It’s a nice one-bedroom apartment, just enough for me. I am a single man, and I am way past the roommate stage, and as far as relationships go, I am sure God will put that man in my life when the time is right.

Single don’t mean abstinent—I have a high sex drive, and I try to get off at least three times a day. I hunt, no shame in my game, shit, grocery stores, bathhouses, even walking down the street. No strings attached, I just need to cum, then—bye! I come from a time when it was fabulous to be gay, it was chic. Even if you were not gay, you wanted to be. Fashionable, good-looking—we brought that to the map. As far as sex went, I remember when the only thing you had to worry about was the clap, or gonorrhea. Life was just free, you could meet someone out discothequeing, and the next thing you know you were ten toes up and ten toes down in the alley.

I remember the first time I got burnt, me and my guys were cruising, looking for a caper at the Bijou Theater, next thing you know we were fucking this white boy, all in the aisle. About a day or two later my dick was spitting out all kinds of junk, so I ran to the clinic. That was the first time I got gonorrhea, but it sure wasn’t the last. Back then I was working at a porno book store, and for some reason I picked up this magazine called The Advocate—it had to have been in the late seventies or early eighties, because I was going to school to study medicine. It was talking about AIDS, and they labeled it the gay disease, profiling us and shit. I had a lot of friends that died in the years following, but a lot of us still didn’t use condoms. We had a saying—“Live fast, die young, and leave a beautiful corpse.”

I didn’t see any disadvantage in using condoms—it was something about that flesh—but to me there is no disadvantage, just excuses. To think about it, I don’t know why I didn't catch HIV, I was doing all I could to get it. I am a top, and a few of my friends who were tops got infected with HIV, and I watched them transition. Before that, I just saw bottoms catching it and dying from it. That made me think a little bit, and my family was in my ear about strapping up, too. Now, I am not going to claim a saint, I use them now, but not all the time.

I’ll say two out of three encounters I use condoms, and I still play Russian roulette and bet on my own intuition with the other one. It feels good to have made it to this age, and I know that condom usage had a lot to do with it.

Q: What are the symptoms of gonorrhea?

A: Most men develop symptoms of gonorrhea (sometimes called "the drip" or "the clap") within two to five days after being exposed, with a possible range of one to thirty days. Although most women are asymptomatic (without symptoms), for those who do have symptoms, they usually appear within 10 days after being exposed.

If you're infected with gonorrhea in the throat, there are usually no symptoms, except a possible sore throat.

Men who have gonorrhea in the penis or anal area may experience:

A discharge from the head of the penis or the anus;
Pain or itching of the head of the penis;
Swelling of the penis or testicles;
Pain and/or burning upon urination;
Frequent urination;
Anal or rectal itching;
White to green anal discharge (often seen on the inside of underwear or pants); and/or
Pain during bowel movements.

Men with untreated gonorrhea can occasionally develop epididymitis, a painful infection of the testicles. Untreated gonorrheal infections can also cause inflammation of the prostate and urethral scarring, sometimes leading to infertility.

Gonorrhea and HIV

If you are HIV+ and have genital inflammation due to gonorrhea, the inflamed tissues contain highly concentrated amounts of the HIV virus. If the gonorrheal infection is in your penis, you can shed 8-10 times more HIV in your semen.

If you are HIV- but have gonorrhea, the disease-fighting cells of your immune system are especially susceptible to HIV if you have unprotected sex with an HIV-infected partner. Rectal gonorrhea increases the risk of contracting HIV by ten to twenty times.


Thanks to Howard Brown Health Center for providing this information.

Check out more gonorrhea info via the CDC.

Offer presumptive treatment for STIs to gay men testing HIV-positive

Gay men testing HIV-positive at point-of-care testing centres (which provide test results the same day) should be given presumptive treatment for gonorrhoea (pictured, in stuffed toy form) and chlamydia, investigators in the US are recommending in a study published in the May 1^st edition of the Journal of Acquired Immune Deficiency Syndromes. The investigators issued this recommendation after finding a high prevalence of these sexually transmitted infections amongst gay men testing HIV-positive in San Francisco.

Read the rest on aidsmap.