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MSM STD rates up dramatically CDC finds

Decline in condom use seen as significant factor



STDs, gay news, Washington Blade
Decline in condom use is seen as a significant factor in the rise of STD rates.

NEW YORK — The number of combined cases of syphilis, gonorrhea and chlamydia in the United States rose to a record high last year with gay and bi men being disproportionately affected, the New York Times reports citing figures released this week from the Centers for Disease Control and Prevention.

Men who have sex with men (MSM) accounted for 54 percent of all syphilis cases in 2018, for example, the annual Sexually Transmitted Disease Surveillance Report notes.

More than 2.4 million syphilis, gonorrhea and chlamydia infections were reported in the United States in 2018, an increase of more than 100,000 cases from the previous year, the report notes.

It attributed the increase to several factors, including a decline in condom use among young people and men who have sex with men; increased screening among some groups; and cuts to sexual health programs at the state and local level, the Times reports. 

There were more than 115,000 syphilis cases reported to the center in 2018, a 71 percent increase since 2014. That included a 22 percent increase from 2017 in the number of newborn deaths related to congenital syphilis, which is passed from mother to child during pregnancy, the report notes.

The number of gonorrhea cases last year rose 5 percent to more than 580,000, the highest number reported to the center since 1991. The number of chlamydia cases also rose by 3 percent in 2018 over the previous year to more than 1.7 million cases, the most ever reported to CDC, it said. The center said it had seen a surge in both infections since 2014, with gonorrhea increasing 63 percent and chlamydia increasing 19 percent since then, the Times reports. 

The number of men with a diagnosis of gonorrhea has roughly doubled over the past five years, with data suggesting that gay and bisexual men were disproportionately affected by that infection as well, the center said, according to the Times.

The CDC said its figures might not capture the true scope of the STD epidemic in the United States because many cases of chlamydia, gonorrhea and syphilis go undiagnosed and so are not reported to health authorities, the Times reports. 

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Gay doctor elected AMA president-elect

Dr. Jesse Ehrenfeld joined organization 22 years ago



Dr. Jesse M. Ehrenfeld has been named president-elect of the American Medical Association (Photo courtesy of the American Medical Association)

Physicians and medical students have elected Wisconsin-based anesthesiologist Dr. Jesse Ehrenfeld as the first openly gay president-elect of the American Medical Association (AMA). 

Ehrenfeld was elected June 14 at the AMA House of Delegates’ annual meeting.

“Well, it’s certainly just an amazing feeling to know that you’ve got the confidence of your colleagues from such a broad array of practice types of modalities and perspectives,” Ehrenfeld told the Washington Blade during a telephone interview. “The association is a very diverse and increasingly diverse organization, and that’s a good thing. It’s more representative of the country and to see such broad support for a vision to move forward was really sort of heartening for me.”

The anesthesiologist and LGBTQ health expert will also serve as the first openly gay AMA president when he steps into the position later this month.

“When I joined the AMA 22 years ago, roughly, I didn’t think it was possible that a gay person could be the AMA president. And certainly 175 years ago, when the AMA was founded, that felt like something that wouldn’t have been possible,” Ehrenfeld said. “And so, to look at how the association, how medicine, health professional organizations have evolved, it’s pretty remarkable when you look at what that has looked like, and that’s a reflection of society in general. But certainly, you know, another pink ceiling has been shattered.”

Ehrenfeld previously served on the AMA’s Board of Trustee’s Executive Committee. He also worked on the AMA Recovery Plan for America’s Physicians; a long-term project that was unveiled at the annual meeting.

“A big component of that is helping physicians prepare the health system so that we can make sure that we can renew our commitment to achieving optimal health for all,” Ehrenfeld said. “To do that, we have to make sure that we prioritize the needs of physicians to improve patient care.”

Ehrenfeld is an associate dean and tenured professor of anesthesiology at the Medical College of Wisconsin and has advocated for issues affecting multiple marginalized communities, such as transgender representation in the military. He emphasized the importance of diversifying the medical field to ensure better service for patients.

“We need folks from every community but particularly marginalized communities to step forward and enter the profession. That’s how patients get better care,” Ehrenfeld said “There’s data that when we have a more diverse healthcare workforce, and when we’re a more diverse community, that those health disparities inequities, actually start to go away.”

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Take Pride in Your Health: Tips from a Primary Care Physician

Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 



Navigating health care can be daunting, especially for those who identify as LGBTQ+. Historically, the LGBTQ+ community has been marginalized and discriminated against, which has led to mistrust and unease for many who seek medical care. 

In Washington, DC, individuals identifying as LGBTQ+ comprise 9.8% of the population, a greater percentage than in any state. Individuals from this community are almost three times more likely to report poor quality of care and discrimination by healthcare providers. Nearly three in 10 of those who identify as transgender reported being refused healthcare because of their gender identity. Patients who identify as LGBTQ+ are less likely to seek preventive services such as cancer screenings and treatment for chronic conditions. And are more than two times more likely to delay getting care.

As we recognize Pride Month, I want to offer a few suggestions for finding healthcare providers committed to care equity and navigating the healthcare system so you can get the support you need to be healthy. Below are three tips to guide your care.

Find a doctor who’s an ally: The first important step is to find a doctor with whom you can speak honestly about your sexual health, gender identity, and health concerns. Look for a caring practitioner with special expertise in treating the LGBTQ+ population. Review the physician’s profile, looking for their level of interest and experience in treating the LGBTQ+ community. To get started with a new provider, I suggest scheduling a meet-and-greet appointment with a primary care provider to review your personal medical history, family history, specific concerns and health goals.  From there, you and your doctor can establish a health regimen that includes any necessary lab work, screenings, and office visits to best support your total health. Gender-affirming healthcare, if desired, should be discussed. 

Kaiser Permanente offers Pride Medical at Capitol Hill Medical Center, a welcoming, judgment-free, compassionate, and supportive medical practice devoted to meeting the unique health care needs of adult patients who identify as LGBTQ+. Kaiser Permanente’s gender-affirming care program, Gender Pathways, takes an innovative approach to providing care to transgender, nonbinary, and gender-expansive patients. Their services include behavioral health care, hormone replacement therapy, and gender-affirming surgeries. 

Know your risk factors: Understanding the unique health needs within the LBGTQ+ community is key to staying healthy. As people within the LGBTQ+ population face daily discrimination, some cope with these challenges by using tobacco and substances. In fact, there are higher rates of substance abuse for individuals who identify as LGBTQ+ than among heterosexual adults.Some populations within the LGBTQ+ community have a higher risk of sexually transmitted diseases, including HIV. The LGBTQ+ population also has a higher risk of developing certain cancers.To address your specific health risks and goals, your doctor can develop an individualized care plan that will include preventative screenings and routine appointments designed to identify and address problems early, leading to better health outcomes.Kaiser Permanente’s electronic medical record system proactively identifies the need for general health screenings and sends personalized reminders.

Manage your mental health: At Kaiser Permanente, we encourage preventive health measures to avoid developing health conditions like heart disease or cancer – and the same goes for mental health. Members of the LGBTQ+ group are more than twice as likely as cisgender heterosexual adults to have a mental health condition, such as depression or anxiety disorders. And, adults who identify as transgender are nearly four times as likely as cisgender adults to have a mental health condition. You can manage stress through exercise and using self-care digital apps, such as Calm or myStrength, free to Kaiser Permanente members. These tools can guide meditation and find support for building resilience, setting goals, and making minor changes to improve sleep, mood, and relationships. Prioritize frequent exercise, talking to someone you trust, journaling, and making time for self-care. As always, talk to your doctor if your mood or behavior changes affect your ability to participate in everyday activities.

You can become a self-advocate and receive the healthcare you need by establishing a rapport with a doctor you trust, knowing your specific health risks, and managing your mental health. Live a joyful, healthier life by seeking support from a primary care doctor and maintaining your routine screenings. Learn more about Pride Medical and LGBTQ+ care at Kaiser Permanente here. 

Dr. Keith Egan, a primary care physician at Kaiser Permanente and assistant medical director of Pride Medical at Capitol Hill.

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Monkeypox cases rise amid calls for equitable treatment & vaccine equity

2,166 cases have been recorded globally



Dr. Tedros Adhanom Ghebreyesus, Director-general of the World Health Organization gives briefing on Monkeypox June 16, 2022. (Screen capture via YouTube)

As of June 16th, 2,166 cases of monkeypox have been recorded globally, spanning 37 countries, including places where it is not usually seen. The United States currently has 100 recorded cases of monkeypox — California, New York, and Illinois are hot spots with 21, 17, and 13 cases respectively. 

Infections are currently concentrated in Europe: the U.K. has reported 524 cases, and Spain, Germany, Portugal, and France have reported 313,303, 241, and 183 cases respectively. Many of the infections in Europe and the Americas can be traced back to LGBTQ+ events where men gathered — specifically a LGBTQ+ fetish festival in Belgium and a gay pride event in the Canary Islands. 

No deaths have been reported, and most monkeypox cases are mild — symptoms include rashes, initial flu-like symptoms, and lesions or sores.

According to the CDC’s latest report, most of the reported cases have occurred in men who have sex with men, but monkeypox can be transmitted to anyone who has had close skin-to-skin contact with an infected person.

Although cases are currently concentrated in gay and bisexual men, Kyle Knight, senior LGBT and health researcher at Human Rights Watch, stressed the importance of managing the outbreak without stigmatizing gay men — or deepening the divide between wealthy and poor countries. 

“Whether it’s lessons drawn from HIV, Covid-19, or other public health issues, it is essential to place human rights at the center of the response to infectious disease outbreaks,” Knight said, in a statement.

In an email to the Blade, Dr. Sarah Henn, Chief Health Officer for Whitman-Walker Health, reiterated the need to spread awareness of monkeypox within the LGBTQ+ community while simultaneously eradicating stigma.

“When dealing with an outbreak of any infection it is important to recognize risk factors for infection and specific communities where the infection is being seen. This must be done without stigmatizing those affected. This is the delicate balance that public health authorities are currently trying to walk with the outbreak of monkeypox. There is nothing intrinsic to the monkeypox virus that makes it a sexually transmitted infection, but it is transmitted by close skin to skin contact with the pox lesions, which obviously sexual intimacy involves,” she said. 

“People in the queer community need to know what to look for and understand what the potential risks are to their own health. We want to empower the community to help control the outbreak and protect themselves from possible infection without creating stigma or unnecessary fear.”

In addition to its prevalence among gay and bisexual men, monkeypox has a history of unequal treatment options in poorer countries. While some wealthy countries have stockpiles of the smallpox vaccine leftover from when the disease was eradicated in the 1980s, the vaccine — which is effective against monkeypox — is currently unavailable on the entire continent of Africa, where monkeypox is an endemic disease.

Dr. Matshidiso Moeti, World Health Organization, (WHO) regional director for Africa, advocated for a unified global approach that includes vaccine equity.

“We must avoid having two different responses to monkeypox – one for Western countries which are only now experiencing significant transmission and another for Africa,” Moeti said. “We must work together and have joined-up global actions which include Africa’s experience, expertise and needs.”

In countries such as the U.S. and Canada, “ring vaccinations” are being used to prevent outbreaks, in which close contacts of infected people are given a smallpox vaccine within four days of exposure. This approach prevents serious infection and reduces the risk of further spread, but in places where smallpox vaccines are not readily available, it is not an option.

In Chicago, where the state of Illinois’s monkeypox cases are concentrated, officials are also focusing on providing information about prevention and safer sex to gay and bisexual men. With the San Francisco and New York Prides happening next weekend — the country’s two largest — the future of monkeypox outbreaks in the U.S. appears uncertain.

Guidance from the Chicago Department of Public Health encourages people attending “festivals or other summer events” to be mindful of skin-to-skin contact, get tested for monkeypox if exposed, and monitor for symptoms after exposure. Additionally, the CDPH has printed cards with links to the CDC health tips for gay and bisexual men, for organizers to hand out at events.

In Washington D.C., the outbreak is currently smaller — four cases to Chicago’s seven — but officials are still taking preventative measures to diagnose and treat the illness. 

“As of today, 4 cases of monkeypox have been diagnosed within the District of Columbia,” Dr. Henn said. “We are working closely with DC Health to screen people for monkeypox who are presenting with rashes that could possibly represent infection and have been coordinating with the city around vaccination of those who have been exposed to a diagnosed case.”

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