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Sexual Health: Gay and Bi Men and Young People Face High STD Rates

, by San Francisco AIDS Foundation

PeopleSMALLAccording to the latest report from the U.S. Centers for Disease Control and Prevention, gay and bisexual men and young people are populations most heavily affected by sexually transmitted diseases, which can increase risk for acquiring or transmitting HIV.

Looking primarily at gonorrhea, syphilis, and chlamydia—three infections reported to the CDC by health care providers, public health departments, and other sources—Sexually Transmitted Disease Surveillance 2012 provides insight into trends in STD rates among several groups, including gay and bisexual men, women, adolescents and young adults, and racial and ethnic minority populations across the United States. In 2012, gay and bi men and young people were at particularly high risk for gonorrhea, syphilis, and chlamydia.

Gay and Bisexual Men

The report paints a troubling picture of syphilis among gay and bi men, who in 2012 accounted for three quarters of all primary and secondary (P&S) syphilis cases and experienced an estimated 15% increase in syphilis rates. “Primary and secondary syphilis are the most infectious stages of the disease, and if not adequately treated, can lead to visual impairment and stroke,” a CDC fact sheet notes.

Our understanding of trends in other STD rates among gay and bi men is limited by a lack of data reported on sexual behavior, the report explains. In addition, the report calls testing strategies for STDs in this group “suboptimal”: Screening for gonorrhea and chlamydia primarily involves urine tests, which will diagnose infections in the urethra but will completely miss infections in the throat or rectum. (Head to the STD clinic with columnist Jake Sobo to learn more—and to advocate for smarter STD testing for gay men.)

Young People

Rates of STDs were especially high among adolescents and young adults in 2012. For example, 70% of all reported chlamydia cases were among people under 25 years of age. Women aged 20–24 years had the highest rate of gonorrhea compared with any other age or sex group, and as in previous years, 20–24-year-old men had the highest rate of gonorrhea compared with other males.

Men in this age group also experienced a heavy burden of both primary and secondary syphilis “Not only have men aged 20–24 years seen large increases in rates, they also have had the highest rate of P&S syphilis among men of any age group since 2008,” the report observes. “These changes reflect a shift in the age distribution of P&S syphilis; rates were highest among men aged 35–39 years during 2002–2006.”

Get Tested

To help people get the treatment they need and avoid transmitting STDs to their partners, the CDC offers the following screening recommendations for chlamydia, gonorrhea, and syphilis (excerpted from the 2012 STD report fact sheet):

  • Annual chlamydia screening for all sexually active women age 25 and under, as well as older women with risk factors such as new or multiple sex partners.
  • Yearly gonorrhea screening for at-risk sexually active women (e.g., those with new or multiple sex partners, and women who live in communities with a high burden of disease).
  • Syphilis, HIV, chlamydia, and hepatitis B screening for all pregnant women, and gonorrhea screening for at-risk pregnant women starting early in pregnancy, with repeat testing as needed, to protect the health of mothers and their infants.
  • Screening at least once a year for syphilis, chlamydia, gonorrhea, and HIV for all sexually active gay, bisexual, and other men who have sex with men (MSM). MSM who have multiple or anonymous partners should be screened more frequently for STDs (i.e., at 3-to-6 month intervals). In addition, MSM who have sex in conjunction with illicit drug use (particularly methamphetamine use) or whose sex partners participate in these activities should be screened more frequently.

Now, how can you put those recommendations in action? Use these resources to manage your own sexual health.

  • Gay Men’s Health “Virtual Library”: Personal perspectives, articles, and other resources on sexual wellness and overall health for gay and bisexual men.
  • Magnet: In San Francisco? Get a sexual health check-up at Magnet, San Francisco AIDS Foundation’s health and community center for gay and bi men.
  • Sex, Etc.: Personal stories, FAQs, forums, STD testing site finders, and other sexual health resources for teens. Check out the interactive communication tool to prep for conversations about sex and sexual wellness with partners, friends, parents, and doctors.
  • It’s Your Sex Life: From MTV and the Kaiser Family Foundation, comprehensive information and resources to help young people make informed decisions about their sexual health, including preventing, testing for, treating, and discussing STDs.
  • STD Test Finder: Enter your zip code to find an STD testing location near you.
  • CDC National STD Hotline: This 24-hour, toll-free hotline can help answer your questions about sexually transmitted diseases. Call 1-800-232-4636 to speak in English and Spanish or 1-888-232-6348 for TTY.


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