Dustin Hoffman in “Outbreak”. Not as exciting as my life.
When I arrive at the New Zealand AIDS Foundation Auckland office, reception is crowded. I fill in the visitors’ register and sheepishly ask Steve, the receptionist: “Where’s the um, ah, meeting?”
“The gonorrhea briefing?” he replies loudly. “Just through there,” he smiles and gestures through the door behind him.
All sense of decorum lost, I fill in “clap clinic” on the visitors register underneath the bit where you’re supposed to write who you’re seeing and head on through.
Mike, the communications officer, ushers me into a small office that used to be mine when I worked here. It’s now a meeting room, bare but for a small table in the centre and four chairs.
I’m soon joined by Hannah, editor of Express Magazine, and Jacqui, senior writer for GayNZ.com. We discuss being called to this secret squirrel event.
Dawn, the communications manager, had phoned us all yesterday to be briefed on an “emerging gay men’s health issue”. This was exciting. It was like being in an Agatha Christie novel.
Of course, both Jacqui and Hannah had had to ruin the surprise for me by asking what the whole thing was about, so now we were all waiting awkwardly in the room, just before 10am, trying not to think about discharges from the penis.
I tell Hannah and Jacqui my idea for writing up this post, by starting with an old Billy Connolly joke about the clap. I repeat it to them. They don’t laugh. I mentally revise my plans.
I know, I think. I’ll ring Dr George.
“Hi mate.”
“What’s the funniest gonorrhea story you’ve ever heard?”
“Ah, I’m just about to see a patient.”
“Oh good, you can ask them. I need to make this blog post funny, or people won’t read it.”
“It’s a woman.”
“Ask if her husband’s got any funny gonorrhea stories. Hello? Hello?”
The door opens, and Mike is back. He leads us into a larger meeting room where NZAF staff Tony Hughes, research director, Jason Myers, policy analyst (and author of a really interesting study I blogged about last year on the lives of HIV positive men), are waiting. Also in attendance are Dr Sally Roberts, clinical head of microbiology for the Auckland District Health Board, and Dr Nicky Perkins, clinical director of the Auckland Regional Sexual Health Service.
The excitement mounts. It’s just like being in Outbreak, only without Dustin Hoffman and exciting string music.
“So where are the hazmats?” I ask. Blank stares.
As it turns out, they just want guys to go and tested, because gonorrhea is making a rather unpleasant comeback. You can get it in your knob, your arse or your throat, and the latter two locations don’t usually produce symptoms. It also increases the risk of HIV infection, and left untreated can lead to testicular, blood and joint infections.
It’s completely treatable with a single dose of antibiotics, as are other common STIs like Chlamydia. If you’re a sexually active man, you should be going for a screening every 3-6 months. Stride in there, drop your pants, and tell them to swab everything. (*) Pee in a glass if you have to. You don’t want to be spreading this stuff onto other guys.
(*) If the idea of someone shoving a swab up your bum embarrasses you – although given what else you get up to, I can’t think why – you can actually do it yourself now through the service NZAF and Auckland Sexual Health Service are providing.
In terms of prevention, condoms and lube for anal sex will help curb the spread of rear-window gonorrhea. For the rest though, regular testing is the best option as the occasional STI comes with the territory if you’re playing about.
And if there happen to be any moralists reading this – of whatever sexual orientation – please get down from your horse if it happens to be named Abstinence or Monogamy.
As author Sam Harris points out in his new book Free Will
“There are more bacteria in your body then there are human cells. In fact 90 percent of the cells in your body are microbes like E. coli (and 99 percent of the functional genes in your body belong to them).”
Irritating infections are a part of life, and there’s no difference between a sexually transmitted one and the stomach bug you’ve just picked up from touching your little niece’s pooey hands. It’s called life.
For more information, head to the Gonorrhoea Is Back website (ooh, I can hear the string music again now!)
[PS. Bits of the above may have been fictionalized for dramatic purposes. Except the disease-y bits.]
Well written as usual
Perhaps the most important thing I get from your post today Chris is the value of being honest about your level of sexual adventure with your doctor.
I had a patient recently who had rectal pain. Had I not asked if he was gay and whether he had anal sex the fact he had anal gonorrhoea may have never been picked up.
Many gay men will see a GP and they never consider offering anal swabs or throat swabs. Without checking you never know. As they say “nobody has a fever if you don’t take their temperature”.
Gefsmith – my friend who got gonorrhea this way, his doctor who confirmed the transmission, and an expert from the Prostitute’s Collective would all disagree with you. What happen’s in real life is more important than what the theory says. It is “very unlikely” for anyone to win Lotto but someone does and people keep buying tickets in case the luck goes their way.
I think it’s safe to say that if you’ve been engaging in rimming, you’ve been engaging in other sexual activities as well, so you should be getting checked anyway – which renders this whole argument moot. I’ve yet to meet someone who only rims and does nothing else!
The point of this post is: sexually active guys, when was the last time you had a sexual health check-up? If it’s longer than 3-6 months, then go have it done. You don’t need a slide rule or a ready reckoner to calculate your risk, just make the damn appointment.
I’m making mine today.
Kay that could very well be the case. The thing with all things sexual is that it’s highly unlikely that people ever only commit to one sexual act.
Fingering, if the person has wanked, got some discharge onto their finger then placed it into the ass of another can be a vector. Oral sex is a great vector, unprotected anal sex is also a vector.
The point of the matter is that sexual activity is fluid and there are always going to be risks.
The good news is that your friend would have been able to be offered treatment and I am sure the he or she is now a lot better for it.
We all make decisions about levels of risk we are willing to take on. Gonorrhoea with rimming is not the first risk I would associate with rimming.
Kay the type of epithelium or “skin” needed to allow gonorrhoea is not found at the anus. It needs the epithelium found about 5-7cm deep into the rectum, the urethra, throat or cervix.
This makes gonorrhoea very unlikely to be spread via rimming. The main risks of rimming are from intestinal parasites, syphilis and herpes depending on where the lesions are.
The website is quite correct in not listing rimming as a risk.
Just checked the Gonorrhea is back website for how it avoid it, what to watch for. No mention of rimming. If the so-called experts aren’t giving full information, how can they expect active players to be aware of the risk? http://www.gonorrhoeaisback.org.nz/how-to-avoid-it/
I know someone who got gonorrhea from being rimmed by a guy with it. He knew to insist on condoms for anal sex but didn’t know that rimming could spread bugs too. NZAF info didn’t mention this either. HIV is too fragile a virus to get spread that way but some STIs are hardier and if you get one of them, you’re more vulnerable to other infections.