The information below addresses specific information about STDs/STIs (sexually transmitted diseases, sexually transmitted infections) other than HIV and syphilis that frequently affect gay men in Palm Springs. Some of the links include graphic images of potential symptoms and should be viewed with caution.
If you feel that you or someone you know my have been infected with any of the conditions detailed on this page, click here for testing sites.
Chlamydia, which is caused by the bacteria Chlamydia trachomatis, targets the cells of the mucous membranes including the surfaces of the urethra, as well as the anus or rectum. Chlamydia sometimes even affects the mouth or throat.
How it's spread:
Chlamydia is easily transmitted through semen, pre-seminal fluid and vaginal secretions during unprotected anal or oral sex with an infected person. It can also be transmitted by touching an infected area with your own genitals, anus or by sharing sex toys contaminated with infected fluids. Someone with no symptoms can still transmit it. Chlamydia is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.
Symptoms may include:
- Discharge from the genitals, which may be yellow or white, watery or thick (see picture);
- Need to urinate (pee) more often;
- Thick yellow or white drip from the genitals
- Burning or pain when you urinate (pee) or have a bowel movement;
- Some may not experience any symptoms.
Treatment for Chlamydia:
A healthcare provider may prescribe a single-dose antibiotic, such as azithromycin (Zithromax), ta ken as a pill. On the other hand, the healthcare provider may choose an antibiotic, such as doxycycline (Atridox, Bio-Tab), to be ta ken as a pill twice a day for a week. Up to 95% of people will be cured after one course of antibiotics.
Abstinence is the only 100% effective way of preventing Chlamydia, however if you choose to engage in sexual activities and are unsure if you or your partner is possibly infected, consistent and correct use of condoms can effectively help reduce the risk of transmission.
Genital Herpes (HSV)
Herpes Simplex Virus (HSV) is a recurrent skin condition characterized by sores on the mouth or genitals. HSV-1 commonly causes “cold sores” or “fever blisters” on the mouth or face. HSV-2 is a closely related virus that is a much more serious infection causing painful sores on the genitals which can also be spread to the mouth or throat.
How it's spread:
HSV is primarily transmitted, both sexually and non-sexually, by direct contact with an active sore: mouth to genitals, genitals to genitals, mouth to anus or genitals to anus. It can also be transmitted when there are no active sores present as small amounts of the virus “sheds” onto the skin surface even when there is no active, visible sore. HSV is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.
Symptoms may include:
- Small, painful blisters on the sex organs (see picture) or mouth (see picture);
- Itching or burning before the blisters appear;
- Blisters generally last 1-3 weeks. When they do go away, HSV is still present in the body. The blisters may reoccur in the same area with varying frequency;
- An outbreak may be preceded by flu-like feelings.
Treatment for Genital Herpes:
There are medications available to treat genital herpes infections, preventing or reducing the frequency or recurrent outbreaks. However, herpes cannot be "cured." The decision to use one treatment over another for genital herpes depends on many factors that must be discussed with your healthcare provider. During an outbreak, keep the infected area as clean and dry as possible as this will help the natural healing processes. Some healthcare providers recommend warm showers in order to cleanse the infected area. Afterwards, towel dry gently, or dry the area with a hair dryer on a low or cool setting. To prevent chaffing, some people also find it helpful to avoid tight-fitting undergarments. Finally, a healthy immune system is important in controlling outbreaks of the virus. Don't ignore the need for proper nutrition, exercise, and rest.
There is no inoculation for herpes so abstinence is the only 100% effective way of preventing HSV infection. However, if you chose to engage in sexual activities and are unsure if you or your partner is possibly infected, consistent and correct use of latex barriers (condoms) can help reduce the risk of transmission. However, only areas covered by condoms, dams or gloves are protected from infection.
Human Papilloma Virus (HPV) is one of the most common sexually transmitted diseases in the world. HPV is now thought to play a role in increased rates of anal cancers in gay men because the virus is related to the virus that causes cervical cancer in women. More health professionals are screening gay men with anal Pap Smears similar to those done for women to detect cancers early.
Anal and genital warts are the most easily recognized sign of an HPV infection. About two-thirds of people who have sexual contact with a partner with HPV will become infected and develop warts. Genital warts are soft, moist, usually flesh colored and appear in the genital area within weeks or months after infection. The warts may be flat, small or large. They sometimes appear in clusters that resemble cauliflower-like bumps. In men, genital warts usually are seen on the tip of the penis. They also may be found on the shaft of the penis, on the scrotum, or around the anus. There are cases where genital warts have been found on the thigh and groin.
How it's spread:
HPV is very contagious and easily spread during sex with an infected partner. It is transmitted by skin-to-skin contact during anal, vaginal and less frequently oral sex with someone who is infected. HPV is not transmitted through casual contact such as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.
Symptoms may include:
- Small, bumpy wart like growths on the sex organs or anus (see picture);
- Itching or burning around the sex organs;
- Although warts may go away, either on their own or because of treatment, the virus has not necessarily left the body. The warts may come back and the person will still be infectious whenever warts are present.
Treatment for Genital Warts:
Treatment of genital warts removes the warts but does not cure the viral infection. A healthcare provider may choose one of several methods to treat genital warts:
- Liquid nitrogen treatment (cryotherapy) — The healthcare provider applies the liquid nitrogen to the warts over the course of multiple office visits until the warts are completely gone.
- Podophyllin — Warts on the genitals may be treated weekly with podophyllin by your healthcare provider. You may also be prescribed a medicine called podofilox (brand name: Condylox), which is applied to the warts at home twice a day for three days, and then rest for four days. This “do at home” process is repeated weekly until the warts are gone.
- Loop electrosurgical excision procedure (LEEP) — With this method for removing genital warts, the healthcare provider passes a sharp instrument shaped like a loop underneath the wart, cutting the wart out of the skin.
- CO 2 laser surgery — For large warts in the genital area, laser surgery may be needed for complete removal.
- Interferon injections — For genital warts that don't go away after they've been treated with other methods, your healthcare provider may try an interferon injection into the warts. Interferon is a chemical produced in our bodies, to help our immune systems fight infection. An injection of interferon into the wart may help your body's immune system fight the virus that is causing the wart. Generally, interferon is injected into warts twice a week for up to eight weeks, or until the warts are gone.
- Warts on the skin (such as on the fingers, feet and knees) and warts on the anus or genitals are not related and are removed in different ways. Do not try any home remedies or over-the-counter drugs for wart removal on HPV growths in the genital area. You could seriously damage your genitals or anus by applying skin wart removal chemicals on them.
While there is an HPV vaccination under development for women, it is not yet clear if it will also prevent warts and anal cancers in men. Vaccination has to be done before any sexual activity takes place so that abstinence is the only 100% effective way of preventing Genital Warts. HPV is passed on by skin-to-skin contact with an infected person. However, if you choose to engage in sexual activities and are unsure if you or your partner is possibly infected, consistent and correct use of latex barriers (condoms) can help reduce the risk of transmission. Warts may not always appear in the place where skin to skin contact occurred and only areas covered by condoms, dams or gloves are protected from infection. Washing your hands or showering right after sex can also help prevent transmission.
Gonorrhea is caused by Neisseria gonorrhea bacteria that grow in the warm moist areas of the body, including the urethra, vagina, mouth, throat and anus.
How it's spread:
Gonorrhea is transmitted through semen and vaginal secretions during unprotected anal and oral sex with an infected person. Gonorrhea is easily transmitted through engaging in anal, vaginal or oral sex. It can also be transmitted by touching an infected area with your own genitals, anus or by sharing contaminated sex toys. Someone with no symptoms can still transmit Gonorrhea but it is not transmitted through such casual contact as hugging, shaking hands, sharing food, using the same eating utensils, drinking from the same glass, sitting on public toilets, or touching door knobs.
Symptoms may include:
- Need to urinate frequently;
- Discharge from the penis or rectum which may be yellow or white, watery or thick (see picture);
- Burning or pain when you urinate or have a bowel movement,
- Some may not experience any symptoms.
Treatment for Gonorrhea
Gonorrhea is now treated by a large number of new and very potent antibiotics. Depending on your healthcare provider, administering treatment can include an intramuscular injection or a series of pills. It is important to see your health care provider for a follow-up visit 7 days after treatment to re-check cultures and confirm the cure of infection.
Abstinence is the only 100% effective way of preventing Gonorrhea, however if you choose to engage in sexual activities and are unsure if you or your partner is possibly infected, consistent and correct use of condoms can effectively help reduce the risk of transmission, as can washing hands and sex toys or showering right after sex.
LGV, The New Chlamydia
LGV or Lymphogranuloma Venereum is one of the newly recognized bacterial STIs caused by a previously unknown strain of chlamydia.
How It’s Spread:
LGV is transmitted in the same way as chlamydia: through unprotected oral or anal sex or other sexual contact.
Symptoms May Include:
- Swollen Lymph Glands in the Groin Area
- Flu like symptoms
- Irritable Bowel Syndrome
- Lesions on Your Penis
- Lesions on The Inside Your Urethra
- Severe Gastrointestinal Distress
- Long Term Exposure Can Cause Permanent Bowel Dysfunction
LGV can be spread as long as an infected person has an open or active lesion. Symptoms are often confused with other ailments and may take up to 30 days for them to appear. The long incubation time may also increase the chances of transmission. Contracting LGV can increase your chances of contracting HIV due to exposed and open lesions.
Treatment for LGV:
If you suspect you may have LGV or have had sexual contact with someone who has, consult your medical professional to obtain a specialized test for LGV. LGV can be treated using tetracycline or sulfamethoxazole.
LGV has become a global phenomenon with reports of greatly increased cases among gay populations in the United States and Europe. Abstinence is the only 100% effective way of preventing LGV but limiting the number of sex partners, washing or showering after sex and using male or female condoms can effectively reduce the risk of transmission of LGV.
MRSA — Staph Infections
Staph (pronounced "staff") is medical quick speak for staphylococcus aureus bacteria. This pesky little bacterium is very common. Everyone has some varieties living on their skin all the time, but when it enters the human body, usually through an open cut or break in the skin, it can cause serious infection anywhere in the body. Staph infections tend produce lots of pus and very ugly sores (see picture). Common skin infections caused by staph include:
Folliculitis: Infections of hair follicles that cause itchy white pus-filled bumps on the skin (often where people shave or have irritations from skin rubbing against clothes)
Boils: Infections deeper within hair follicles that leave large, frequently red inflammations (often occur on the face or neck)
Sties:Infection of the follicle surrounding the eyelashes, causing a sore red bump in the eyelid
Impetigo: The infection kids often get around their mouths and noses that causes blisters and red scabby skin
Abscesses: Infection characterized by pus and swelling that can occur in the skin and in any other organ.
Staph infection is also one of the leading culprits behind cases of food poisoning and are responsible for life threatening conditions, such as Toxic Shock Syndrome (TSS), pneumonia, bone infections (osteomyelitis), mastitis in nursing mothers, endocarditis (infection of the inside of the heart), bacteremia (blood infection), and even Flesh Easting Bacteria infections. People who are otherwise healthy typically do not usually become severely ill from staph infections, but those at special risk, who have wea kened immune systems, include:
persons with chronic illnesses, such as diabetes, cancer,
lung disease or kidney disease
people with other skin conditions
people recovering from major surgery
injection drug users (especially those who reuse needles)
people whose immune systems are wea kened due to steroid use, radiation therapy, cancer treatment, immunosuppressive medications or HIV/AIDS
women who are breastfeeding
Health care professionals can determine that staph (and not some other bacteria) is the cause of an infection by taking a culture from the infected site. Once staph has been diagnosed, the provider will prescribe antibiotics that are known to work on that specific strain of the bacteria. These antibiotics (usually either pills or creams applied to the infected body part) typically kill the bacteria and cure the infection within a week or two unless it is a drug-resistant strain of the bacteria. Drug resistant staph is a strain of the bacteria that isn’t killed by one or more of the antibiotics commonly used to treat staph infections
MRSA (Multiple Drug-Resistant Stapholoccus Aureus)
Hospitals are working to stamp out staph infections, in part because the majority of hospital patients fall into at least one "at-risk" category, but also because drug-resistant strains of staph are becoming an increasingly common threat. These multiple drug-resistant strains of staph (MRSA) do not cause worse or different infections than non-resistant strains but they can be much more difficult to treat. Standard antibiotics may be effective in suppressing the bacteria, but not curing the infection. People with MRSA may require hospitalization to receive antibiotics through an IV or by injection for up to two or more weeks of treatment. It is crucial to determine the variety of staph involved in any infection because resistant strains, like MRSA and the closely-related so-called “Flesh Eating Bacteria”, can lead to life-threatening systemic infections or loss of limbs in a matter of several days.
Because improper use of antibiotics can help produce resistance to drugs making future infections much harder to treat, the American Medical Association recommends that patients:
- follow the directions for any prescription exactly
- take all of the medicine prescribed (even if one feels better after only a few days)
- never save old, leftover prescriptions for future use
- never take anyone else's prescription antibiotics
Other preventative measures are careful and immediate treatment of all skin conditions, including wound care after trauma or surgery. Those getting tattoos, piercings and all injection drug users (including steroid and vitamin injections) should take extra precautions to avoid life-threatening abscesses by cleaning the injection site thoroughly with alcohol wipes and always use clean needles.
For a more complete treatment of proper antibiotic use, check out the American Medical Association's fact sheet on the following site: Antibiotics: Facts You Should Know.
Epididymitis is an infection of the epididymis, the coiled mass of tubes over the testicles where sperm mature before being ejaculated through the urethra. It can come from various infections of the prostate or urethra and so is often sexually transmitted. Epididymitis affects gay men at a much higher rate than straight men most likely because of increased incidence of STDs that affect the urethra as well as unprotected anal sex among many gay men. Feces in the anal canal are the source of E. coli (Escherichia coli) bacteria that can also cause epididymitis.
- Swelling, tenderness and severe pain in the testicles (see picture);
- Discharge from the penis.
Treatment for Epididymitis
Your doctor will culture the urethral discharge to find out which kind of bacteria is causing the infection to prescribe the appropriate antibiotic. Warm water soaks and pain medication can also reduce symptoms which may persist for up to two weeks.
Prevention of Epididymitis
For a more complete discussion of epididymitis and related topics, click on the following link: www.gayhealth.com.
Treat any STDs that you may have contracted before it can spread into the epidiymis. Avoid trauma to the area when lifting weights or riding bicycles. In older men, pay close attention to common infections of the urethra, prostate or bladder and be sure to talk to your doctor about any problems with urination. Avoid unprotected anal sex that might involve contact with feces that are loaded with E. coli and other types of bacteria. This is especially true if you have piercings in the penis or urethra that may harbor various kinds of bacteria including E. coli. Always try to urinate after unprotected anal sex to flush any bacteria from the urethra that may cause epididymitis.
| Erectile Dysfunction (ED) / Impotence
Failure to get or maintain an erection long enough to ejaculate can happen to men at any age at any time, which in itself is not considered to be a health issue. However, the consistent inability to get or sustain an erection in order to have an acceptable sex life can be a major health concern for gay men at any age. Also there is evidence that the incidence of impotence among young gay men is higher than in straight men of similar age. In addition, ED may be symptomatic of other serious conditions such as high blood pressure or low testosterone levels that tend to increase with age. Only a urological medical specialist can diagnose erectile dysfunction and prescribe useful medications that can alleviate the situation given its underlying causes. Much erectile dysfunction does not have a physiological cause, so a urological examination is always in order if the condition persists over a long period of time and disrupts a healthy sex life.
Treatment for ED:
Given the specific cause of the erectile dysfunction, your urologist might prescribe oral medications such as Viagra, Cialis or Levitra. These drugs are widely advertised and available but should only be used in consultation with a physician as they can have serious interactions with other medications or party drugs. Viagra interacting with crystal meth and/or prescription medications can result in life-threatening complications such as heart attack or stroke. Oral medications for erectile dysfunction should never be ta ken with nitrates, most readily available in “poppers” or amyl nitrate and some heart medications.
If headaches or other side effects of the oral medications are intolerable or if you are taking other medications that will interact with oral erectile dysfunction drugs, your urologist could prescribe an injectible drug such as Tri-mix or Caverject. Both of these medications, which are injected directly into the base of the penis, have the same effects as the oral drugs for erectile dysfunction and will result in erections that can last for hours but without the cardio-vascular effects of the oral medications.
For a more complete discussion of Male Impotence click on the following link: www.gayhealth.com.
| Shigella (Shigellosis)
Shigellosis is an infectious disease caused by a group of bacteria called shigella. Most people infected with Shigella develop diarrhea (often bloody), fever, and stomach cramps within a day or two after infection. For some, the diarrhea can be so severe that they may need to be hospitalized. Conversely, others may experience no symptoms at all, but are still able to transmit the Shigella bacteria.
How it's spread:
Shigella are present in the feces of infected persons while they are sick and for a week or two afterwards. Most Shigella infections are the result of the bacterium passing from feces or soiled fingers of one person to the mouth of another person. Contaminated food is one common source of this infection, but it can be readily spread through sexual activity, such as direct or indirect oral-fecal contact during rimming or by sharing contaminated sex toys.
Symptoms may include:
- Diarrhea (often bloody);
- Stomach cramps.
Treatment for Shigella:
Shigellosis can usually be treated with antibiotics. Appropriate treatment kills the Shigella bacteria that are present in the patient's stool and shortens the illness.
There is no vaccine to prevent shigellosis. However, the spread of Shigella can be reduced by use of condoms or latex gloves and by frequent and careful hand washing with soap and water after using the restroom and before handling food. In regards to sexual exposure, Shigella transmission can also be reduced by showering after sex and by not engaging in risky activities while an individual is experiencing symptoms and for several weeks after symptoms have stopped. Washing the anus and surrounding areas well with soap and water, as well as washing sex toys before and after use will also help to reduce the spread of Shigella.
| Trichomoniasis (Trich)
Trichomoniasis, also called Trichomonas, is caused by a parasitic protozoan trichomonas vaginalis. While it mostly affects women, it increasingly affects sexually active gay men as well.
How It’s Spread:
Usually passed by direct sexual contact with contaminated sexual fluids but it can also be transmitted by objects infected with Trichomonas such as shared sex toys or douching equipment. It is not transmitted by blood or saliva or other non-sexual body fluids.
Incubates in 4 to 20 days, the average being 7 days before symptoms appear. Most men have no symptoms, especially if the infection is located in the anus. Where there are symptoms, they might include:
- Itching in the urethra, painful urination or clear discharge from the penis.
- White or greenish-yellow, odorous discharge, itching, soreness in the anus.
Treatment for Trichomoniasis:
Curable with oral medications like Metronidazole.
Abstinence is the only 100% effective way of preventing Trich, however, if you choose to engage in sexual contact and are unsure if you or your partner is possibly infected, consistent and correct use of latex barriers (condoms, gloves) help reduce the risk of transmission. Only areas covered by condoms, dams or gloves are protected from infection and sharing sex toys is not recommended. Thoroughly washing all sex toys and showering after sexual contact also helps to minimize transmission. If under treatment for Trichomonas infection, avoid having sex for at least two weeks.