Syphilis makes a comeback

For a long time people thought that syphilis had practically been eliminated in Europe – but for a number of years now the number of reported cases of infection has dramatically increased. In Germany too there has been an alarming upswing in the infection rate. Current statistics from the Robert Koch Institute (RKI) show a huge increase in infection, particularly among men who have sex with men. On the other hand, a great many gay men seem to have no awareness of this infection which is mainly transmitted through sex or tend to downplay its seriousness and the risk of infection through contacts on the gay scene or in the private sphere. On the up side syphilis is relatively easy to treat. But if you wait around before getting treatment it can lead to very serious consequences for own health and generally means that you will pass on the infection to your own sex partners.

We’ve collected the main points you should know about syphilis in the question and answer format below.

How can I catch syphilis?
The short answer is – very simply sorry to say. Getting infected with the syphilis bacterium is a lot easier than getting infected with HIV (the virus that causes AIDS). Syphilis is transmitted through contact of the bacterium with the skin or mucous membranes (linings) of the genital area, mouth or anus. No kind of sex is syphilis-safe but transmission via the mucous membranes is a lot easier than transmission through unbroken skin. This is why most infections in gay men appear on the glans (tip) of the penis or on the penis shaft, in the anus or rectal passage and in the mouth or throat and much less seldom on the fingers or the hand – though such cases are also known to occur.

Syphilis is also known as the “great imitator” because its early symptoms are similar to those of many other diseases. In addition, the first symptoms disappear without any treatment within the first few weeks which means that many cases are simply not recognized or recognized too late when the infection is in an advanced stage and risks becoming chronic. Protection against this is offered with treatment with suitable antibiotics.

How do I recognize the first syphilis symptoms?
About three weeks after the time of infection a moist ulcer the size of a ten cent coin may appear on the place of infection. Although it may appear, it must not necessarily appear! When it does this ulcer is completely painless yet highly infectious – this is the period when syphilis can be transmitted through simple contact or rubbing. Generally the ulcer clears up without any need for treatment. Because of its small size and the fact that it generally appears on parts of the body that are awkward or impossible to see, it often goes completely unnoticed. In the first stage of the disease the appearance of the ulcer - or what the medical experts call the “primary effect” - can be accompanied by swollen lymph glands.

What are the further stages?
If the primary stage goes untreated, within around two to six months after the time of infection the secondary stage develops with general symptoms like an attack of flu. You feel sick, get a mild fever and have pains in your joints. You can also get a brown rash all over your body and your lymph glands become so swollen they can be felt. At the same time a rash of brown, wart-like sores (“papules”) may appear in the mouth, and on the cock and ass. This rash will disappear after a few weeks without any treatment, but it can reappear at any time, particularly on the palms of the hands and the soles of the feet. Sometimes it leaves discolored patches of skin behind. It's often associated with patchy loss of hair. In this stage all bodily fluids can be infectious.

When this secondary stage is over, the syphilis may lapse into a latent stage without any symptoms which can last for years or even decades.

The earliest tertiary stage is about two years after the time of infection. In this third stage syphilis damages the inner organs like the heart, blood vessels and nervous system. About one third of people who have had untreated secondary syphilis go on to develop the complications of third stage syphilis. This stage is characterised by the appearance of inflamed cancerous growths called “gumma” which can appear anywhere in the body – in the skin, in bones, in internal organs, in blood vessels or the central nervous system. As they destroy the body tissue in the place where they appear, they can lead to a wide variety of complications. They can also result in cardiac complications, including heart attacks and chronic arterial diseases.

The fourth and final stage of syphilis mainly occurs after ten to twenty years when the disease starts to damage the brain and the nervous system. The symptoms in this final stage include progressive paralysis, acute pain, blindness and disorientation, and mental illness resulting in death.

All the symptoms associated with the various stages of the disease can appear but must not necessarily do so! Single stages can go by completely unnoticed or can even be “skipped”. Because the progress of syphilis varies enormously from person to person. And this particularly true of people with HIV (see below).

I'm not sure if I've got syphilis. What should I do?
The best thing to do is to go to your doctor or a healthcare center and ask for a syphilis test. A simple blood sample is all they need for diagnosis. The diagnosis can also distinguish between a fresh infection and one that's considerably older.

The rate of syphilis infection among urban gay men has shown a remarkable increase (in some areas over 40% up!) so it's really advisable for men with one of two sex partners a month to take a syphilis test every three months. All other sexually active men should take a test every six months or at least once a year.

What kind of treatment will I get?
If syphilis is diagnosed early on, treatment is simple. In the primary stage treatment involves a course of penicillin injections in the buttocks which usually lasts from two to three weeks. Later stages can also be treated with penicillin but the treatment is much longer and a stay in hospital for a course of infusions will also be necessary. Plus complications to inner organs caused by the disease cannot be reversed. So it's obviously better to start treatment as soon as possible!

How can I protect myself and others from syphilis?
Avoid any kind of contact with open cuts and wounds! Condoms and rubber gloves can reduce the risk of infection but cannot completely eliminate it. Dildos and other sex toys should either be used by one person alone or should be thoroughly disinfected before being used with another partner.

Information, awareness and early, full and proper treatment are the three factors that can lead to a sharp drop in the rate of new infections. If you find you're infected, it's absolutely vital that you inform all your sex partners so they can take a test and get early treatment if necessary. And until the treatment course is really finished and you get a clean bill of health from your doctor or healthcare provider, you really should abstain from sex.

Does syphilis increase the risks of infection with HIV?
Yes it does! If you're HIV positive and also have syphilis, then it's much easier to transmit HIV to your sex partners via the syphilis sores. If your sex partner has syphilis (or another sexual transmitted disease) then it's much easier for him to get HIV than via unbroken skin or mucous membranes. Protecting yourself – and others – from the risk of HIV infection is another reason why it's vital to get treatment for your syphilis very early on.

If I'm HIV positive what special things should I watch out for in connection with syphilis?
Blood samples from HIV positive people don't always show a clear syphilis antibody diagnosis. So it's important that you get the test carried out by a competent doctor or healthcare provider who is specialised in HIV and syphilis. What's more, the course of syphilis can run much quicker with people who have an HIV immune system deficiency and the third or tertiary stage (see above) can happen much more rapidly. Plus there are also special precautions to be taken in treating syphilis in someone who's HIV positive. That's another reason why it's so important for people who are HIV positive to seek out a doctor who is specialised in both HIV and syphilis.

PLEASE REMEMBER: People with HIV/AIDS need special kinds of syphilis treatment and if syphilis is not treated it will make much quicker progress than in people without HIV/AIDS. If you are diagnosed with syphilis and you don't know your HIV status, it makes sound sense to take an HIV test. Talk to your doctor or healthcare provider about this.

Frequently Asked Questions (FAQ's) and answers about Syphilis
Q: Penicillin is freely available in Germany – hasn't that taken care of syphilis?
A: Sad to say, it hasn't. The infection rates for syphilis have risen dramatically in the past few years and show no sign of abating – especially in urban centers like Berlin, Frankfurt, Cologne, Hamburg and so on. It's a sad fact but it's getting much easier to catch syphilis than many people realise. Obviously the risk is at its most intense in places where a lot of sex takes place – like darkrooms, saunas, porno cinemas, and sex parties.

Q: I know all my sex partners personally because I meet them on the Internet, and I never have sex in darkrooms or saunas. So aren't I really minimizing the risks of catching a sexually transmitted disease?
A: No you're not! Just because you know your sex partners doesn't mean that they couldn't have syphilis or some other STD. And even if you ask your partner if he's got an STD doesn't mean to say that what he tells you is really up-to-date.

Q: If I get syphilis then won't I be sure to notice it?
A: That ain't necessarily so! The symptoms of syphilis can be blatant or latent or might not show themselves at all. That's why, if you're sexually active with changing partners (at least two a month), it's important to take a syphilis test once every three months.

Q: Syphilis isn't as serious as breaking your leg is it?
A: True enough! Even so, syphilis still remains a serious infectious disease that will lead to life-threatening consequences if it's not treated early on.

Q: Nowadays nobody talks about sexual transmitted diseases any more – are they really as widespread as all that?
A: The simple answer is yes they are! It's a sad fact but many people are still reluctant to talk about STD's because they feel embarrassed or ashamed of them. But feeling sorry for yourself or wasting your time with useless self-recrimination won't help one bit. One the contrary you should feel downright glad when your sex partner tells you he has syphilis, because he's given you the opportunity to do something about it straight away. And likewise you should get in touch with all your sex partners immediately if you're diagnosed with an STD. It's the only way to work quickly and effectively to curb the new infection rate of syphilis and other STD's –and to keep the fun and pleasure in sex! 





http://www.nhs.uk/news/2007/January08/Pages/Syphilismakesacomeback.aspx

Hepatitis - Know your ABC!

Men with multiple sex partners run a relatively high risk of infecting themselves with a hepatitis virus that can lead to serious health complications depending on the type of hepatitis virus involved. What kind of risk situations there are and how you can best protect yourself are briefly explained below.

What is "Hepatitis"?
Hepatitis is a disease of the liver (= "hepar" in Greek) which is the organ responsible for the exchange and transformation of substances in the body. A number of liver diseases are caused by viruses which explicitly target the liver. There are a number of types of these viruses: Hepatitis A Virus (HAV), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV) and so on. We will focus here on Hepatitis A, B and C because they are the most frequent types and are also sexually transmissible.

Hepatitis A
Type of transmission: mainly fecal-oral - i.e. transmission of hepatitis A virus through contaminated water in areas with poor sanitary conditions and through oral-anal sexual contact (rimming/ass licking).

Symptoms: often there are no symptoms or only slight ones similar to flu (fever, tiredness, nausea, loss of appetite). In a few cases there may be jaundice symptoms (yellowing of the skin and eyes, dark urine and light coloration of the stool/shit). Symptoms usually last around 4 weeks.

Treatment: No specific therapy available. Keep off alcohol, medicines that affect the liver, and drugs.

Protection: Excellent protection with Hepatitis A vaccination (can be combined with Hepatitis B vaccination).

Hepatitis B
Type of transmission: mainly through sexual contact and through blood.

Symptoms: in the acute phase often with no symptoms or flu-like symptoms (fever, tiredness, nausea, loss of appetite) and abdominal pain. In approx. one third of all cases jaundice symptoms (yellowing of skin and eyes, dark urine and light coloration of stool/shit). Chronic infection occurs in around 5% of all cases (or 25% of those infected with HIV). Symptoms usually last from 4-6 weeks.

Treatment: no specific therapy in the acute phase. Keep off alcohol, medicines that affect the liver and drugs. If you have chronic hepatitis you may need a course of therapy.

Protection: Excellent protection with Hepatitis B vaccination (can be combined with Hepatitis A vaccination). Using condoms minimizes risk of transmission.

Hepatitis C
Type of transmission: through blood and blood contact (also from injecting drug use); transmission also possible through sexual contact. People with an immunodeficiency syndrome (e.g. people with HIV) are more liable to infection.

Symptoms: In 50-80% of cases acute hepatitis C has no symptoms. In 10-20% of cases flu-like symptoms appear and in 10% of cases jaundice symptoms occur (yellowing of skin and eyes, dark urine, light coloration of stool/shit). 50-80% of cases involve chronic hepatitis C which can result in serious liver damage after several years. Otherwise symptoms last up to 6 months. Chronic hepatitis C in conjunction with a HIV infection can result in quicker liver damage and complications.

Treatment: drug-based therapy.

Protection: Condoms reduce the risk of transmission during sexual contact. Avoid coming into contact with blood (use rubber gloves especially for fist fucking); do not share syringes and needles for IV drug use. There is no vaccine for hepatitis C.

Vaccination against Hepatitis A and B
You can protect yourself by getting vaccinated against hepatitis A and B. There is no vaccination against hepatitis C! The Deutsche AIDS-Hilfe recommends vaccination against hepatitis A and B. However, if you've already had hepatitis A or B (and possibly haven't even noticed it!) you will be immune to renewed infection. That's why before getting vaccinated you should always get a check-up with your doctor to see whether you already have hepatitis A/B antigens (or to see if you still are immunized from an earlier vaccination!). There's no need to put an unnecessary burden on your immune system, especially if you are already HIV positive.

There is a difference between “active” and “passive” forms of vaccination. In an active vaccination harmless virus fragments (inactivated or “dead” vaccine) stimulate the body to produce its own antigens. The incubation period for these antigens lasts around one month and they generally offer a ten year period of immunity. In a passive vaccination antigens are directly injected into the body. Immunity is immediate but the period of immunity only lasts from one to three months.

Vaccination and HIV
An HIV positive status is no hindrance to getting vaccinated. But the success of the vaccination will depend on the state of your immune system. About 30% of HIV positive people show an insufficient reaction to a hepatitis B vaccination. If the vaccination is not effective, repeat vaccination with higher doses in several stages is recommended. Thus it is vital that when you have been vaccinated you should always get a check-up to see that the vaccination has been successful. Vaccination should always be carried out by an experienced doctor.

Vaccination: What it Costs
The Robert Koch Institute and the World Health Organization recommend that people who are at higher risk of infection should be vaccinated against Hepatitis B. This includes people who inject drugs, people who are sexually active with different sex partners, and dialysis patients. You do not have to tell your doctor about your sexual orientation, it's enough to say that you may be at risk. Often your health insurance scheme will cover the costs. If your risk of infection is higher because of your job (e.g. hospital personnel) perhaps your employer will pay the costs for you.

IN SHORT
The best protection against hepatitis A and B is vaccination. To date the best protection against hepatitis C is safer sex and safer use

• Fuck with a condom
• Don't get sperm in your mouth
• Use rubber gloves for fist fucking
• If you use drugs use your own sterilized equipment (not only sterilized syringes and needles for IV drug users but also sterilized notes, tubes etc for drug sniffing).

http://technorati.com/lifestyle/article/know-your-hepatitis-abcs1/

What is AIDS and HIV?

The red ribbon
stands for loss, mourning, sadness, pain, fear and illness – but also for kindness, compassion, understanding and countless acts of positive practical support. People who display the red ribbon show they are aware of the social problems connected with AIDS.

What is AIDS and HIV?
Aids is the English acronym for Acquired Immune Deficiency Syndrome (a “syndrome” = a complex of various different symptoms). The immune system is there to protect you against the various infections – like bacteria, fungi and viruses – that can get into your body.

Aids is caused by an infection with HIV, the Human Immunodeficiency Virus. HIV-1 was discovered in 1983/84 followed a little later by HIV-2. Both types of virus and their subgroups (subtypes) show special features and appear with degrees of frequency that vary from continent to continent. But whatever type the virus might be, the selfsame ways of protecting yourself against it still apply. Aids refers to the stage of HIV infection where the body can develop certain life-threatening infectious diseases and tumors.

How does HIV weaken the Immune System?
HIV infects the white blood cells (also known as CD4 cells or T4 cells) and uses them to make new copies of HIV. The white blood cells are important because it is they that set the immune system in motion when the body is invaded by organisms like bacteria and viruses.

When HIV infects a body, the white blood cells mount a defense against it. But the antibodies produced by the defense mechanism cannot rid the body of HIV. A small number of infected CD4 cells are directly destroyed by the virus while many more have their indirect mechanisms damaged by the virus so that the defense they provide is inadequate or faulty. In this way the number of healthy CD4 cells is greatly reduced. And as the number of CD4 cells decline this means that the body is less and less able to defend itself against infection. In an advanced stage of immunodeficiency life-threatening diseases or “opportunistic infections”, allergies and various cancerous growths can occur.

What is the course of an HIV infection and what symptoms are there?
The course of an HIV infection can vary widely from person to person and each single case generally shows a wide degree of fluctuation. Symptoms can – but must not necessarily – appear. And between the various stages of the illness there are often long periods when no symptoms at all appear. A fully developed immunodeficiency can even occur without there being any signs of sickness (= symptoms) until the outbreak of very serious illness.

Measuring the “virus load” (= the number of viruses per milliliter of blood) is a way of showing how far the virus has reproduced itself and damaged the immune system. The greater the virus load is, the quicker the body’s immune system will be destroyed. But also counting the number of white blood cells per milliliter of blood tells us about the condition of the immune system – the fewer CD4 cells there are, the more the immune system is damaged.

The First Weeks
Shortly after infecting a body the HIV virus begins to reproduce itself heavily. In this period the risk of infecting someone else is particularly high! Usually in the first weeks after infection flu-like symptoms appear (“primary effects”) which then disappear by themselves after one to two weeks. Many people hardly notice these symptoms or take them to be signs of an ordinary cold or flu. But in each case where there is an HIV infection the body reacts by producing antibodies. And these can usually be reliably diagnosed by an HIV antibody test [Link] about 12 weeks after the initial infection.

Symptom-free Phase
The HIV infection then enters into a discreet phase – in other words there are no noticeable symptoms. This phase can last a few months or a few years. But the virus still continues to reproduce and damage the immune system.

Phase with General Symptoms
At some point symptoms can occur. They are usually general symptoms like prolonged lymph node swellings at various points of the body (under the armpits, around the top of the legs), heavy night sweats and prolonged periods of diarrhea. The symptoms which appear with an HIV infection are all non-specific – in other words they can equally occur with many other forms of illness. This is why only doctors who are experienced in this field are able to tell whether the immune system has been damaged or not.

Chronic Immunodeficiency
If certain opportunistic infections occur in a person whose immune system has been badly damaged by HIV we speak of “Aids”. These opportunistic infections include pneumocistis carinii pneumonia (PCP), a rare form of pneumonia, and infections of body organs like the gullet with the fungus candida albicans. Viruses like herpes simplex and herpes zoster can also cause serious infections. The most common tumors occurring in connection with AIDS are virus-caused forms of cancer like kaposi sarcoma, cervical cancer and lymphomas (malignant immune system tumors). Because HIV also infects the central nervous system, during the course of an HIV infection this can also lead to nerve damage and brain damage which usually begin slowly and without any symptoms.

How is HIV NOT transmitted?
HIV is one the infections which is very difficult to transmit. The virus itself is sensitive and cannot live long outside the human body under normal conditions. Standard hygiene at home and in hospital is enough to make it ineffective. Even so, the virus can still survive for several days in blood smears in used injecting needles!

Although HIV has been detected in urine, shit, spit, sweat and tears, it has been in such very small quantities that there is generally no danger of transmission. This means that there is no danger of transmission through shaking hands, hugging, play and sport, coughing and sneezing or using the same plates, cutlery or glasses. Equally there is no danger of transmission from using the same toilet, towel, bed linen, using the same swimming pool or sauna or working and living with people with HIV/Aids. Nor is there any danger of HIV transmission with kissing (so long as there are no cuts on the lips or in the mouth). And insects like mosquitoes and animals cannot transmit HIV either.

How can HIV be transmitted?
HIV can only be transmitted when a sufficient quantity of it enters into the bloodstream or comes into contact with a mucous membrane. Infection is possible with blood – including menstrual blood – sperm, vaginal fluid and breast milk – all of which can hold high concentrations of the virus. The risk of infecting yourself and others with HIV is also much greater if you already have a sexually transmitted infection like syphilis, gonorrhea or herpes. This is why it is very important to recognize these infections at an early stage and get them treated!

The HIV Test
An HIV test tells you for sure whether you have an HIV infection (“positive” test result) or not (“negative” test result). Knowing that you have an HIV infection enables you to start an early course of treatment which will stop or slow down serious damage to the immune system and the resultant chronic opportunistic infections.

Whether you take an HIV test or not is your own decision to make. An HIV test should never be made without your knowledge and consent, and nobody should force anyone to take a test. What is truly vital is that you should be given enough information about the test and feel that you have been adequately counseled. A counselor should also inform you about the possible social and legal disadvantages that could result from the test or a possible positive test result. If you want to know for sure about your HIV status you should take the test three months after the last HIV risk situation at the earliest. But the HIV test is not a preventive measure. You can only protect yourself against HIV by practicing Safer Sex and sticking to the Safer Sex guidelines.

Costs/Anonymity (Germany)
To find out the place to take the test that’s best suited to your own circumstances, you should consult with your local charity or trust specialized in helping people with HIV / Aids.
As a general rule, though, public health agencies usually offer the test for free or for a small charge (around € 10-15). The big advantage here is that the test is made anonymously – in other words your name is not mentioned and the result is not “documented”. If the test is made for instance at a GP’s, it will indicate your name – in other words the test and its result will be documented and this can have all kinds of consequences (for instance for your insurance). If you have reason to believe that you have been infected, your health insurance scheme will bear the costs of the test.

Reasons for taking an HIV Test
To be certain after being in a situation where a risk of transmission was involved.
You’re not sure whether you’re infected with HIV because you’ve been in a situation where a transmission risk was present – and you want to know for sure.

The “Stock-taking Test” / “Engagement Test”
You are in a closed relationship and want to do away with using condoms. And you want to be certain that neither of you is HIV positive.

Symptoms/ Starting Therapy
You have symptoms that could indicate a HIV infection and/or want to start early treatment. The HIV test has a high therapeutic significance.

Taking out a Health Insurance Policy
Some insurance companies require you to take an HIV test or present the result of a recent test before you can take out a policy.

Safer Sex protects against HIV and lowers the risk of catching another sexually transmitted infection (STI). We’ve put together some info about risks and tips on how to protect yourself in the most common forms of sex.

Oral Sex
Aka cock sucking. Stimulating a cock with your mouth or tongue is seen as low-risk provided no blood comes into play. What’s important is not to get sperm in your mouth or on any cuts, on mucous membranes or in your eyes. If you do get cum in your mouth, don’t swallow it but spit it out quickly and wash out your mouth – ideally with alcohol. If you get cum in your eyes, wash them out quickly under water. To be completely safe, use a condom for oral sex – this will also eliminate the chances of picking up oral gonorrhea.

Penetration with Fingers
Fingering the ass is also seen as low-risk, even if the skin has cuts (but make sure your finger nails are well clipped!).

Anal Sex
The risk here of picking up HIV or some other sexually transmitted infection is particularly great. The arse is well supplied with blood and its mucous membranes can very easily be torn. The “active” partner too – that’s the one who introduces his cock in the arse – can also become infected. This is because the sensitive glans (penis head) and meatus (opening of the urethra or “piss pipe”) can also come into contact with the virus. Condoms used together with a non-fatty lubricant provide good protection for anal sex.

Fisting
Whether it’s anal or vaginal, fisting is a low-risk sexual practice as long as no blood-with-blood or blood-with- mucous membrane contact occurs. Rubber gloves give good protection (keep those finger nails well clipped!). If you use a fatty lubricant (like Crisco), anal or vaginal intercourse after fisting is high risk as the fat damages most condoms and removes their protective function.

S/M (Sado-Maso)
S/M rituals are no-risk as far as HIV is concerned – but only provided there are no cuts on the skin where blood or sperm can get in or no blood or sperm comes into contact with the eyes, mucous membranes or the mouth. S/M toys are safe too – as long as no blood comes into play. If your toys have been used by or on other people, always give them a good cleaning with soap and water before using them again.

Games with Sex Toys
As far as HIV is concerned, dildos, vibrators and other sex toys are safe if they are only used by or on the same person. If they are going to be used by or on other people, slip a new condom on them or wash them properly with soap and water.

Other Sex Practices
Practices involving piss (golden showers) and shit (scat) like arse licking (rimming) involve no risk of HIV infection (provided always no blood is in play). Even so, you can still infect yourself with other STIs like hepatitis. You can get yourself vaccinated against hepatitis A and B.
Deep kissing, mutual masturbation and massage, rubbing yourself against your partner and other such practices all carry no risk of HIV infection so long as no blood or cum comes in contact with your mouth, eyes, mucous membranes or with any cuts.

Bi-Sex: Sex with Women
No, that’s not a misprint! In general I want to pack every woman-related topic in this section and not have ‘em scattered throughout the text. I’ll just touch on the main issues and refer you to the links for more in-depth information. If I put this info under all the separate headings, there’d be complaints!

The same rule applies here too – using condoms for anal or vaginal sex offers the best protection. Licking female genitals is seen as low-risk except during menstruation (if you want to be completely risk-free, place a cut-open condom or a sheet of food wrap between your mouth and the clitoris). Penetration of the vagina with fingers is also low-risk, but during menstruation finger caps, condoms or rubber gloves should be used.




http://en.wikipedia.org/wiki/HIV/AIDS