Gay Men's STDs Often Escape Notice
Study Reveals Many Infections Undetected by Current Protocol
© Kat Long
Mar 21, 2008
Within the past four years, physicians and researchers in U.S. cities with have noticed a marked increase in certain sexually-transmitted diseases, like syphilis and gonorrhea, among gay men. A recent study by researchers at the Centers for Disease Control and Prevention (CDC) indicates a two-headed problem in preventing the spread of STDs among the gay population: one, fewer gay men are going in for testing, and two, the tests to detect the presence of STDs do not always find the infections.
In the twenty-five years since the AIDS crisis began, the gay male population in the U.S. has been the target of aggressive public-health and STD-prevention campaigns. By most accounts, these efforts have been successful in drastically decreasing the number of new HIV diagnoses among gay white men and fostering patients’ sense of responsibility for their own health. Since approximately 2004, however, doctors and journalists in the gay press have noticed a backlash against the stringent rules of safer sex, especially among young gay white men—the very population that enjoyed enormous reductions in new infections in the past decade. (Lack of comprehensive sex education in schools could be another cause behind rising infection rates: see the related articles Is Teaching Abstinence Effective? and Abstinence Teaching Ignores LGBTs).
The Report's Findings
The new study seems to concur with this backlash: though the CDC recommends gay men get annual blood tests for HIV and syphilis, as well as tests for bacterial infections like gonorrhea and chlamydia, fewer are doing so. And for those patients that do, the study finds that doctors are not always following protocol in the testing itself. Some doctors, in testing for gonorrhea for example, might swab only one site of possible exposure (the rectum), and ignore others (mouth or genitals).
Three reports, cited by the study, show an unusually low rate of detection. One found that among gay men with no symptoms of gonorrhea, one-third of rectal infections and one-quarter of throat infections were missed. Another found that within a population of HIV-negative gay men in fifteen U.S. cities, only 39 percent had been tested for syphilis and 36 percent for gonorrhea over a period of two years. The third showed HIV-positive men are not always tested for concurrent STDs such as chlamydia.
DNA Testing Could Improve Diagnoses
The second issue hindering STD prevention is the tests themselves. Researchers say that correct diagnoses could be much more easily achieved with a new type of DNA analysis. Called NAATs, for nucleic acid amplification tests, they are easier to administer and twice as accurate in diagnosing rectal and oral gonorrhea and chlamydia as current bacteria cultures. For now, the Food and Drug Administration (FDA) has only approved NAATs for gonorrhea and chlamydia in the genital area. Researchers are hoping that the FDA will soon approve them for STDs in the throat and rectal area as well.
Sexually transmitted infections are one of the greatest public health threats in the U.S., not just for gay men, but for any sexually-active person. Health experts agree the best STD-prevention methods for everyone are safer sex practices (including condoms), regular testing and diligent follow-up treatment.
Source:
Lawrence K. Altman, Sex Diseases in Many Gay Men Go Unfound, Experts Say, New York Times, March 13, 2008.
