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You're sexually active. Happy to hear it, guy! Sure, you've been careful, but if you are having sex with other guys and you haven't had an STD test in the last 6 months, get one! You know how many guys there are in SF who have sex with other guys (latest estimate is 63,000 gay men live in SF, by the way!). Anyway, it's a huge number, so keep this in perspective...but there were 471 cases of syphilis mostly among gay or bisexual men in the first six months of 2007 (data as of January 24, 2008). Jeez, there were just 10 cases in 1998! Now this is down a bit from previous years, but still... The increase in syphilis is a global issue...not limited to San Francisco. Syphilis is easier to pass than HIV, including through kissing and sucking. (By the way, you only get syphilis from person-to-person contact, it can NOT live outside the human body on, say, a dirty toilet seat.) The good news is that one shot of penicillin will cure it in the first year. (There are other antibiotics if you're allergic to penicillin.) Some of the alarm in the mainstream press around this subject is due to the fact that understanding the issues requires pretty frank discussions of various types of sex and depends on the sero-status of the guys. But, we're not the mainstream press, so here's a bit more detail as we understand it. First, we know that some (most? all? <grin>) guys are going to continue to have sex, even if others tell us we can't. For those who fall into that camp, it's important to know the risks so you can make smart decisions. Regardless of your sero-status and that of your
partner(s), if you're sexually active: Poz guys with poz guysSince the syphilis in gay guys in SF is disproportionately impacting the poz community (four times as prevalent!), it appears that part of the spread of syphilis is between poz guys barebacking. (You know that BUDDIES doesn't allow barebacking, of course.) Some say that poz guys barebacking isn't good because of the risk of "superinfection" (getting another strain of HIV that is resistant to the meds you may be on). Others say that there's little or no evidence of superinfection and the issue is really more around other STDs -- like syphilis -- which add more for the immune system to deal with. Secondly, there are some indications that syphilis can progress to the more problematic later stages more quickly in poz guys. There are studies going on right now to determine the real risks of superinfection, but the other issues are pretty much understood. Thus, condoms are still the safer bet -- even for two poz guys. That said, the risks aren't as clear for two poz guys barebacking as for other combos. Any other combo of guys (neg/neg or neg/? or neg/poz)For other combos, it is as important as ever to follow the rules we've all come to know about safer sex (use a rubber for butt fucking, etc.). When when an STD is active, there is "HIV viral amplification" -- more HIV virus in a poz guy -- which increases the chances of HIV transmission. The catch is that the rules about safer sex for HIV don't protect you as well against syphilis. Since you can get syphilis and not know it, it is important to get tested regularly if you are sexually active. If you've got it, get treated and tell your partners to get tested. SFDPH has an innovative program around helping you get your partners treated...distributing pills that cure syphilis for you to give to partners. Something a lot of guys don't know is that recent evidence has shown that the the infectiousness of HIV peaks a few weeks after infection...HIV is almost 20 times as infectious at that time as later...and that is long before most guys know they have HIV. Your partner may think he's negative and, in fact, be 20 times as infectious as the guy who knows he's positive. Don't take the chance! One aspect of syphilis is that if: ...the sore greatly increases the chance of a negative guy getting HIV. But you already knew that ANY sore will increase your chances of HIV, right buddy? If you're negative and you've got a sore from whatever (syphilis, shaving, catching your cock in your zipper...whatever), wait till it heals before you allow anybody else's body fluids anywhere near your sore. And if you've got a sore and you don't know what it's from, get tested for STDs. Syphilis is Easy to Get + Easy to Get Rid Of => Get Tested! Read more:
Don't Let Confidentiality/Anonymity Concerns Be a Reason Not to Get TestedWhile the testing for STDs is confidential, it isn't officially anonymous...but nobody will ask for an ID. If your tests come back positive for an syphilis, you'll be asked about who you've had sex with and where by health officials, but providing that information is voluntary. As Nancy Reagan might say, you can "just say no". So, don't let confidentiality/anonymity concerns be an excuse...get tested every six months. Here's Some Times and Places to Get Tested for SyphilisOf course, you can go to your doctor. When you go in for a physical, take your health into your own hands and ask your provider for screening for STDs. More on what to ask for here. City Clinic hours each week - Monday, Wednesday & Friday, 8am-4pm But for guys who have to work 9 to 5 type jobs, those hours can be pretty inconvenient. So, check out Magnet's times as well! Check out online syphilis testing (sign-up online confidentially, drop your specimen off at a lab, get results online). Sex Health links
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