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Wednesday 08 October 2008

Talk of new "Gay Disease" premature

Posted in: Living Well
By Chris Banks - 6th February 2008

MRSA bacteria up close. (Photo: Reuters)
It was the stuff of tabloid wet dreams: "Flesh-Eating Bug Spreads Among Gays", "Experts Fear New Super-AIDS" and "Strain Of Superbug May Be New HIV" ran some of the headlines around the world at news of a new antibiotic-resistant bacterial infection hitting gay men in several large US cities.

The headlines were quickly followed by fearmongering from homophobic pressure groups. "Epidemic Feared - Gays May Spread Deadly Staph Infection To General Population", ran a press release from the Concerned Women of America, saying that the "sexual deviancy" of gay and bisexual men has led to HIV/AIDS, syphilis and gonorrhea. "The medical community has known for years that homosexual conduct, especially among males, creates a breeding ground for often deadly disease," they added.

Meanwhile, the researchers in San Francisco whose studies lit the blue touch paper for this worldwide hysteria apologised, and said their research had been misinterpreted: the infection was not labelled a sexually transmitted disease and it was possible for anyone – not just gay and bisexual men – to fall prey to the infection, particularly those in closed communities involving a lot of physical contact.

So what is it? The infection is known as MRSA (methicillin-resistant Staphylococcus aureus) and for the past forty years has been connected with hospitals. However, newer strains have, in recent years, seeped out into the community, plaguing those who have repeated contact with health professionals, children in daycare centres, military personnel, athletes, and now men who have sex with men.

The infection can be spread from skin-to-skin as well as surface-to-skin contact, often looking like raised red dots on the skin or resembling a pimple or boil. If left untreated, the dots can swell and fill with pus. At this stage, medical advice needs to be sought to treat the infection. Trying to squeeze out the pus can deepen the infection or spread it to other parts of the body. (If a description isn't enough for you, try looking up "staph infection" on YouTube for some footage guaranteed to make you squirm.)

Staph bacteria thrives in warm, moist environments - which helps to explain an outbreak that occurred among an American football team in 2005. According to a study on the outbreak published in the New England Journal of Medicine, "infection occurred only among linemen and linebackers, and not among those in backfield positions, probably because of the frequent contact among linemen during practice and games….All MRSA skin abscesses developed at sites of turf burns."

The latest study, of two groups of gay men in San Francisco and Boston between 2004 and 2006, was published in the Annals of Internal Medicine in mid-January. Of particular concern was that this particular strain of MRSA (MRSA USA300), which has been around since 2002 and has been seen in upwards of 38 American states among patients both straight and gay, is resistant to front-line antibiotics.

Many of the men infected with this strain developed abcesses in the area of the buttocks, genitals, or perineum. Lead study author Dr Binh An Diep said it seems likely that the infections were transmitted during anal sex, as these areas of the body make contact during that activity.

However, because sexual activity is not required for the transmission of staph, infection via surface-to-skin is also an issue. Sex-on-site venues, saunas and gyms are possible locations for staph infection due to the possibility of contaminated surfaces.

Is there cause for alarm in New Zealand? With gay men being a highly mobile population, and travel at this time of year between San Francisco, Sydney and Auckland for Mardi Gras and Hero being particularly prevalent, gay and bisexual men should be taking extra care about their personal hygiene.

The University of California researchers were alarmed by the rapid rate in which the bacteria spread among the particular population of gay men they studied, and the case is a salient reminder of how our close, interconnected sexual networks can make gay men vulnerable. In commenting on his study, Dr Diep said that the relatively concentrated and closed nature of the gay community often allows it play the role of canary in the coal mine, alerting the broader population to emerging public health pathogens.

The good news is that simple hygiene will keep this nasty infection at bay. "Wash hands often, limit the sharing of personal items and seek medical attention when a blemish or pimple seems to get worse quickly," advises New York Times health columnist Tara Parker-Pope. Washing well with soap and water after sexual activity or working out at the gym is highly effective against all strains of MRSA, irrespective of your sexual orientation.

Chris Banks is the Communications Co-ordinator for the New Zealand AIDS Foundation.

Chris Banks - 6th February 2008