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Don’t wait, get vaccinated! Meningitis vaccine recommend for people living with HIV, gay men

, by Chris Hall, MD

meningitisMen who have sex with men in Orange County, the San Francisco Bay Area and other urban areas around the U.S. are urged to get vaccinated for meningococcal disease as an outbreak of meningitis and other invasive forms of the disease continues to disproportionately affect gay men in Southern California.

Since March 2016, 27 cases of meningitis have been reported in people in Southern California—two of which resulted in death. Most of the people who have contracted meningitis have been gay or bisexual men. People living with HIV are also urged to get a meningitis vaccine.

What is meningitis?

Meningitis is an inflammation of the membranes that cover the brain and spinal cord. Bacterial meningitis is potentially fatal and is treated as a medical emergency. One form of bacterial meningitis is fatal in about 10 – 15% of cases.

How is meningitis spread?

The bacteria which causes meningitis can spread between people in saliva or respiratory droplets. That means things like kissing, sharing drinks or cigarettes, sharing eating utensils, and coughing can spread the bacteria.  Risk increases when exposure is prolonged, in a closed setting.

People who are living with HIV are at an increased risk of meningitis. Men who have sex with men may also be at an increased risk. The San Francisco Department of Public Health identifies the following as potentially contributing to increased risk, based on study of those affected in recent clusters:

  • Regularly having close or intimate contact with multiple partners;
  • Seeking partners through the use of online websites or phone apps;
  • Regularly visiting crowded venues such as bars and parties; and,
  • Smoking cigarettes, marijuana or other substances or spending time in smoky settings.

Have any cases of meningitis been reported among gay men in San Francisco?

Recently, there have not been epidemiologically linked cases of meningitis among gay men in San Francisco.

However, the San Francisco Department of Public Health has issued a health advisory for men who have sex with men and people who are living with HIV in San Francisco. The Department of Public Health recommends that all people living with HIV receive the meningitis vaccine. The agency also recommends that all men who have sex with men with possible risk factors (see bulleted list above) receive the vaccine.

What are the symptoms of meningitis and invasive meningococcal disease?

Symptoms of meningitis can include a fever, body aches, stiff neck, headache, and/or rash. People experiencing these symptoms should seek medical attention immediately.

Invasive meningococcal disease is another serious form of infection that can result in death. The symptoms of invasive meningococcal disease happen between two and 10 days after exposure to the bacteria. Symptoms include sudden fever, drowsiness, irritability, intense headache, vomiting, stiff neck and a skin rash.

What do I do if I start to feel symptoms?

Seek medical care right away. Minutes and hours count! Early treatment can prevent serious complications and can prevent death. If you have been in contact with someone known to have bacterial meningitis, your health care providers will give you preventative oral antibiotic therapy which can prevent infection.

About the meningitis vaccine

The meningitis vaccine is safe and effective.

People living with HIV should receive two doses of the vaccine, 8 – 12 weeks apart. If you’re living with HIV and have only received one dose of the vaccine over two months ago, get the second dose as soon as you can, regardless of how long it’s been since your first dose.

People who are not HIV-positive need only a single dose of the vaccine. If it’s been more than five years since you received your vaccine, talk to your health care provider, as you might need a booster dose to still be protected.

Where to get a meningitis vaccine

People with health insurance are encouraged to speak with their primary care provider first about getting vaccinated. People who are uninsured, or whose insurance does not cover the vaccine, may receive the vaccine at a few public health and community clinics.

San Francisco

AITC Immunization and Travel Clinic at the San Francisco Department of Public Health offers the vaccine. Call 415-554-2625 to make an appointment, and check here for prices.

City Clinic offers the vaccine for free to at-risk San Francisco residents who do not have insurance. Visit City Clinic during their drop-in hours: Monday, Wednesday and Friday from 8 am to 4 pm; Tuesday from 1 pm – 6 pm; and Thursday from 1 pm to 4 pm.

Strut/San Francisco AIDS Foundation offers the vaccine to people who do not have insurance. Vaccine supply varies. Call Strut at 415-437-3400 to check if the vaccine is in stock. Strut is located at 470 Castro Street in San Francisco.

Southern California

Los Angeles LGBT Center offers meningitis vaccines by appointment only. To schedule an appointment, call 323-329-9900.

Santa Ana Clinic at 1725 W. 17th Street in Santa Ana offers the vaccine to qualified individuals. For more information, please call the Health Referral Line at 800-564-8448.

Additional public health and community clinics offering the vaccine can be found here.

Chris Hall, MD, is the medical director of Magnet for San Francisco AIDS Foundation.

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