The alarming rate of sexually transmitted infections (STIs) among Sydney’s gay male population has prompted physicians to change the guidelines of STI testing.
Dr Chris Bourne, senior specialist at Sydney Sexual Health Centre and chair of the STIs in Gay Men Action Group (STIGMA), said gay men with multiple sexual partners need to be tested more frequently.
And men shouldn’t wait until they’re showing symptoms, as up to 40 percent of some STIs are being detected in gay men who aren’t showing any signs of infection.
There are alarming rates of STIs in gay men in inner Sydney, Bourne said.
Gonorrhoea and chlamydia rates are high, and infectious syphilis rates have risen more than seven-fold in four years.
Out of the 1,400 HIV-negative gay men who took part in the 2005 Health In Men study, almost one in 10 had gonorrhoea while six percent tested positive to chlamydia.
As a result of the high STI rates STIGMA has released new testing guidelines for men who have sex with men.
With or without symptoms, all men who have had sex with another man in the previous 12 months should have at least one STI test a year, according to the guidelines.
Men who have multiple sexual partners should get tested every three to six months, especially if they have been attending sex-on-premises venues, use recreational drugs or seek partners on the internet.
STI tests should include an anal swab (for chlamydia and gonorrhoea), a urine test (chlamydia), a throat swab (gonorrhoea), and a blood test (HIV, syphilis, hepatitis A and hepatitis B).
STI tests are free at the Sydney Sexual Health Centre at Sydney Hospital.
People who test positive to chlamydia or gonorrhoea should be retested in three months.
The new guidelines have been endorsed by the Royal Australasian College of Physicians and are being distributed to GPs across NSW.
Chlamydia, gonorrhoea and syphilis are most commonly transmitted via anal sex but can be passed on through oral sex and skin-to-skin contact.
Bourne said there are several reasons for the rise in STIs.
STIs have re-established themselves in gay men with particular characteristics. Those include men with multiple sexual partners, he said.
There’s changing sexual networks, with people moving from saunas, clubs and beats to internet. So it’s easier to get more partners.
Thrown in with that is changing drug use patterns and senses of pleasure.
There’s also a generation of gay men who aren’t familiar with regular testing for STIs and aren’t familiar with STIs in general, Bourne said.
This is because there’s been a low prevalence for so long of the major bacterial infections -“ chlamydia, gonorrhoea and syphilis -“ because they went down very quickly in the days after HIV was discovered in the 80s.
During that time more people used condoms, some stopped having anal sex and some had fewer partners, Bourne said.
In the last few years some gay men have begun partaking in more risky behaviour, he said.
For more information contact the Sydney Sexual Health Centre on 9382 7440 or visit its website.