Sexually Transmitted Diseases Among Gay Men Go Underreported since sexually active Gay Men Skip Being Tested Annually

From the article below, all the more reason to play safe and stay healthy.

Sex Diseases in Many Gay Men Go Unfound, Experts Say
'Many cases of sexually transmitted diseases are escaping detection because gay men are not being tested each year as advised, federal health officials said Wednesday.'


By LAWRENCE K. ALTMAN
Published: March 13, 2008
Many cases of sexually transmitted diseases are escaping detection because gay men are not being tested each year as advised, federal health officials said Wednesday. And if the men do show up, the officials added, many doctors and clinics are not following screening recommendations.

But more cases could be detected if the government approved new ways to use a type of DNA test that is already on the market, the officials and researchers said in a news conference at a scientific meeting in Chicago.

They said the test, used in new ways, could detect twice as many cases of gonorrhea and chlamydia as standard tests.
Those diseases, along with syphilis, whose incidence continues to increase, are “a major threat to gay and bisexual men’s health,” said Dr. Kevin Fenton, a top official of the Centers for Disease Control and Prevention. Dr. Fenton noted that such diseases increased the risk of contracting and spreading H.I.V., the virus that causes AIDS.

Screening for sexually transmitted infections is a critical part of medical care for sexually active men. The C.D.C. recommends annual blood tests for H.I.V. and syphilis, and other tests for gonorrhea and chlamydia.

Gonorrhea tests should include specimens from all potential sites of exposure — throat, genitals and rectum — because identifying and treating all such infections is essential for preventing spread of the disease.

“There are circumstances where the recommendations are not being followed,” said Dr. John M. Douglas Jr., who directs the Division of S.T.D. Prevention at the disease control centers.
Dr. Douglas added that some doctors did not recognize the problem while others seemed to think “that maybe the guidelines do not apply to my patient population.”

Supporting evidence came from C.D.C. researchers, who reported three studies at the meeting showing that the screening rates were too low.

Dr. Kristen Mahle’s study found that among gay men who showed no symptoms of gonorrhea, more than a third of rectal infections with the disease, and more than a quarter of throat infections, were missed because many were not tested at all anatomical sites of recent exposure.

Dr. Eric Tai’s study surveyed non-H.I.V.-positive gay men in 15 cities from 2003 to 2005 and found that only 39 percent reported having been tested for syphilis, and only 36 percent for gonorrhea.

Dr. Karen Hoover found that while doctors tested 82 percent of H.I.V.-positive gay men in eight cities for syphilis in 2005, they tested 22 percent or fewer for gonorrhea and chlamydia.
One problem is that public health departments that run sexual disease clinics do not have adequate staffs and budgets to do comprehensive testing.

“Let’s be honest, resources are a challenge at a federal, state and local level,” said Dr. Douglas, of the disease control centers. “We are trying to be as innovative as we can with public health resources,” but “we need help from others.”

Another problem is that newer tests are not being used as much as they should be, Dr. Douglas said.

The DNA test that Dr. Douglas and others described as promising is called NAAT, for nucleic acid amplification test. It is generally more accurate and easier to use, and it can detect at least twice as many gonorrhea and chlamydia infections in the throat and rectum, according to studies by Dr. Julius Schachter of the University of California, San Francisco, and others. Moreover, it is faster than the traditional bacterial culture tests.

The Food and Drug Administration has approved three NAATs to screen for gonorrhea and chlamydia in the genitalia, but not the throat or rectum.

Dr. Schachter’s team, which included the San Francisco Department of Public Health, sought to determine whether the marketed NAATs were also effective in throat and rectal screening.
The C.D.C. is working with the food and drug agency and with test manufacturers to gather, analyze and coordinate the submission of data for federal approval of NAATs for use in the throat and rectum.

The San Francisco Department of Public Health has conducted a study that met F.D.A. requirements for such use. Now the health department uses NAATs to test for chlamydia and gonorrhea at all three anatomic sites.

So guys, for all of our sakes, fuck with a condom, have plenty of foreplay, and love your partner as much as you love yourself. Enjoy each other for years to come.