Let’s face it: Sexually transmitted diseases are not something most people are comfortable talking about. But as a wellness counselor at Mazzoni Center, I genuinely enjoy engaging with folks about their health and well-being. Every day I have the opportunity to meet all kinds of people, listen without judgment to their questions and concerns and work with them to establish concrete goals toward achieving better health.
Well-being encompasses many things — from diet and nutrition to behavioral factors, sexual activity and more. For LGBT folks, and particularly for men who have sex with men, knowing your STD risks and keeping up to date on screenings is a critical piece of the puzzle.
April is STD Awareness Month, and here in Philadelphia we have the unfortunate distinction of ranking fourth in the nation when it comes to rate of STD infections. That’s according to the most recent figures compiled by the Centers for Disease Control and Prevention, which dates to 2011. While the incidence of STDs in our city goes well beyond the queer community, it’s important to understand the particular ways LGBT individuals may be at risk — and what we can all do to stay healthy, avoid infection and ensure we’re not infecting others.
There are individual behaviors (such as higher numbers of lifetime sex partners or unprotected sex) that contribute to disparities in the sexual health of MSM, as well as social and cultural factors such as access to health care, fear of discrimination or stigma that sometimes play a role. Thankfully, here in Philadelphia, we have many LGBT-friendly providers, as well as STD testing centers — so there’s no need to avoid testing or treatment, regardless of your orientation or gender identity. If you are sexually active, being aware of your risks and getting regular screenings is a must.
So let’s start with the basics. There are bacterial STDs, which can be cured. These include chlamydia, gonorrhea and syphilis. Viral STDs — which can’t be cured, but can be treated and managed through medical supervision — include HIV, hepatitis, herpes and HPV/genital warts. We’re going to look at bacterial STDs here, as they’re the most common and can easily be screened for on a walk-in basis, by visiting the Washington West Project (1201 Locust St.) or one of the City Health Centers (1400 Lombard St. or 1920 N. 20th St.).
Syphilis is spread from person to person, male or female, by physical contact during vaginal, anal or oral sex. CDC data show that MSM make up 75 percent of all primary and secondary syphilis cases nationwide. Syphilis infection can also place a person at increased risk for acquiring or transmitting HIV infection. According to CDC data, approximately four in 10 MSM with syphilis are also infected with HIV.
The first sign of a syphilis infection is a skin sore called a chancre (pronounced shank-er), which usually shows up from two to 12 weeks after exposure. You can have one or more of these, but you might not spot them at all, as they typically appear on or around the area that was first infected, which might be inside your anus or vagina. Chancres generally don’t hurt, and they’ll disappear after several weeks (without any treatment) — but this doesn’t mean the infection has gone away.
Secondary signs and symptoms of syphilis (which appear four to 12 weeks after infection) include a rash on the palms of your hands and soles of your feet; warts and white mucous patches in the mouth or the anus; as well as flu-like symptoms such as swollen glands, fever, fatigue, patchy hair loss, weight loss and headaches. If you notice any of these things, it’s important to get tested right away. Syphilis can be treated and cured at any stage of infection with penicillin shots. But, if untreated, it can lead to serious health problems.
Chlamydia is a bacterial infection that can be spread from person to person during vaginal or anal sex. It can be spread from skin-to-skin contact alone, and in some cases it can be transmitted to the throat during oral sex. That’s why it’s important to use a condom from the very beginning to the end of sexual contact, to be completely safe.
Symptoms of chlamydia can appear between one and three weeks after infection. For men, typical symptoms would be discharge or pain or itching at the head of the penis. Women may experience pain and itching in or around their vagina or discharge. As with syphilis, these symptoms sometimes go away on their own. And approximately half of people infected with chlamydia won’t have any symptoms at all! But it can still cause health problems and can be spread to others, so it’s important to get tested and treated.
Last (but not least), gonorrhea. This infection can be spread from person to person, male or female, during vaginal, anal and oral sex. Infections may occur in the throat, vagina, urethra (inside the penis) or anus. CDC data shows that youth (ages 15-24) are at the highest risk for getting gonorrhea, as well as chlamydia, which is why most experts recommend that any sexually active person under 25 get screened. Both chlamydia and gonorrhea can be cured with antibiotics, and the sooner you start the sooner you’re clear.
Now, a few words about STD screening: It’s a simple process, and your test results are completely private and confidential. So there is no reason for any sexually active person not to get tested! Since I work at Washington West, I’ll walk you through how it goes there.
Just by walking through our doors, you’ve taken the first and most important step! You will be asked to sign a consent form, then asked to give your full name, date of birth, address and phone number. (Again, this is kept confidential). You’ll meet with a counselor who will ask some questions as part of a brief health assessment. This helps them determine what tests should be run, and what other information you may need to help keep you STD-free in the future. If you’re having any symptoms, you should let the counselor know.
Next comes the test. For syphilis, you’ll have blood drawn from your arm. For gonorrhea and chlamydia, depending on the type of sex you had, you may need to pee in a cup, give yourself a throat swab or give yourself an anal swab. (The swabs are very small and you will do the swabbing of your throat and/or anus yourself). The person conducting the test will give you a card with a phone number you can call for your results, which will take about two weeks to be processed.
If your test is positive, you will contacted by the Health Department. If you do get a call from them, it’s important to respond quickly. They will provide treatment as well as support around telling your sex partners.
The takeaway: If you are having sex, the best way to stay STD-free is to use condoms correctly every time. Get STD check-ups every three to six months (that means at least twice a year, up to four times a year) so that any infections are caught early and treated fast. If you have sex in conjunction with illicit drug use (especially meth), or if your partners engage in these activities, you should be screened more frequently.
If you have questions or concerns, or just want to learn more about your risks and how to better manage them, our Wellness Counseling Program is a great place to start. We offer individual and couples counseling and can refer you to all kinds of resources. Email me ([email protected]) or give me a call at 215-563-0652, ext. 277.
For more information on STDs, check out www.cdc.gov or www.xyz.comwww.takecontrolphilly.org.
Richie Rotonta is a wellness counselor at Mazzoni Center. For more information, visit www.mazzonicenter.org or call 215-563-0652.