Syphilis Outbreak – originally posted in April of 2008

Officials at the Centers for Disease Control and Prevention (CDC) recently reported that syphilis rates continued to rise in 2007. The disturbing fact is that the surge is being driven by cases among men who have sex with men (MSM), who accounted for 64 percent of the known syphilis infections last year.  That’s up from five percent in 1999. It is important to note that Symptoms of syphilis can go unnoticed or misdiagnosed. The CDC’s website notes: “Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated. […] Thus, transmission may occur from persons who are unaware of their infection.” 

 What is the danger?

Syphilis is especially worrisome because, if it goes untreated, it can lead to serious health conditions later on in life.  It can also complicate other infections such as HIV.  It is also important to note that Syphilis can be transmitted through a variety of sexual acts, not just intercourse.  So a condom won’t necessarily protect you. 

Signs of Syphilis

Syphilis usually begins with the appearance of a single sore (called a chancre), but there may be multiple sores. The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days. The chancre is usually firm, round, small, and painless. The chancre lasts 3 to 6 weeks, and it heals on its own. Note, however, that the infection doesn’t’ go away without proper treatment.

As the disease progresses, it may include fever, swollen lymph glands, rash, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs of this “secondary stage” of syphilis will resolve with or without treatment, but, again, it doesn’t go away.

In its later stages, many years after the initial infection, the disease can cause damage to internal organs, the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the “late stage” include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.

What can you do?

Get tested.  All sexually active MSM should receive testing for a wide range of sexually transmitted diseases at least once a year (as recommended by the CDC).

You’re not going to hear much about this in the mainstream media and, chances are, your doctor isn’t going to recommend being tested for an STD. So it’s up to you to take matters into your own hands. Syphilis is easily cured in its early stages. A single injection of penicillin will cure a person who has had syphilis for less than a year. Additional doses are needed to treat someone who has had syphilis for longer than a year. For people who are allergic to penicillin, other antibiotics are available.    

Your doctor can perform the test for syphilis. The Allegheny County Health Department also provides free testing. You can find other local testing sites (some will maintain your anonymity) at http://www.stopHIV.com in the drop-down resources menu, under “PA Service Providers.”    

For more information about MSM and syphilis, you can go to the CDC’s Syphilis and MSM web page

Rights of People With HIV Under Assault?

Although a recent New York Times article (posted below) suggests immediate treatment for HIV-positive men has a long-term beneficial effect on health, activist Sean Strub argues the policy focuses too much on prevention and not on the needs of persons living with the disease. His editorial, Medical Ethics and the Rights of People With HIV Under Assault was posted on POZ blogs on April 28th.

HPV and Men – originally posted January 2008

What is HPV?

Human papillomavirus (HPV) is a sexually transmitted disease that infects the genital area of both men and women (including the skin on and around the anus). Over half of the men in the United States will have HPV at some time in their lives.  Often the virus clears up on its own without a health problem but, depending on the strain of HPV, it can cause genital or anal warts.  Some strains of HPV can also cause abnormal changes in cells which can become precancerous and result in cancer of the penis or anus. HIV positive men are more likely to get severe and prolonged cases of genital warts which may be resistant to treatment. 

How is HPV spread?

HPV is passed through vaginal or anal intercourse but can also be spread through simple skin to skin contact.  Because HPV infections often don’t have symptoms, they can be passed on unknowingly. 

What are the symptoms?

Genital warts are the first symptoms seen with low-risk strains of HPV infections.  They are soft, raised growths that are usually painless.  These lesions can also appear in the mouth and throat, although this is rare.  Warts usually take 3 weeks to 6 months to appear after exposure but, in some cases, can also take years. 

What can I do?    

If you are diagnosed with HPV, it is important to tell your sexual partner(s).  Transmission of HPV can be minimized by finding alternative ways to express intimacy and avoiding contact with a wart.  Condoms are also effective for preventing infection with HPV if they are used correctly and consistently.  However, genital warts not covered by a condom can still transmit the virus 

14 percent of gay men in DC are HIV positive

DC Department of Health: 14 percent of gay men in DC are HIV positive–that’s almost five times as high as the overall rate. A quote from their study reads “complacency that the HIV/AIDS epidemic is under control for men who have sex with men has taken a toll.”

It’s pretty convincing evidence that HIV is still very much with us. The pdf link to the official report takes an extra minute to open.