Column: Black Gay Men
By Roderick A. Scott-Padilla
*BlackAIDS.org welcomes Roderick A. Scott-Padilla, a gay black man who has spent several years conducting HIV prevention outreach, as a monthly columnist. NEW YORK -- While the African American gay community deals with the threat of violence, racism and homophobia, it may be forced to handle another obstacle that could harm it both medically and physically. A recently discovered disease in New York, as reported by a New York Times article, Lymphogranuloma Venereum (LGV) is a form of the bacterium Chlamydia trachomatis. This disease is contagious and has debilitating symptoms, but it is curable. Doctors says it could spur HIV infections. LGV is a disease that is sexually transmitted during vaginal and anal sex. It is most prevalent in tropical and subtropical areas, such as Southeast Asia, Central America and the Caribbean. According to the New York State Department of Health, clinical manifestations include primary symptoms of small non-painful genital lesions occurring on the penis, vagina and in the rectum. These symptoms tend to go unnoticed until the infection spreads to the lymph nodes of the groin area and the surrounding tissue. If untreated, symptoms could include swelling, acute pain, draining and bleeding of the infected areas, including painful, bloody, rectal infections that may be confused with inflammatory bowel disease. The average incubation or onset period usually happens from 3 to 30 days after exposure. Once infected, the disease can remain within the body until fully treated, just as any other STD. Treatment includes several types of antibiotics, including Doxycycline and Azithromycin. It has only been recent that the disease became known internationally. The first major report was published on Nov. 5, 2004 by the Associated Press, which concluded that the Netherlands’ Institute of Public Health (IPH) discovered “an outbreak of a rare STD among gay and bisexual men” surfacing in the country. Last year, U.S. health officials expressed concern when the New York State Health Department and the Centers for Disease Control and Prevention (CDC) confirmed the presence of LGV in two gay men (“2 Cases of Rare Sex Disease Are Detected in New York,” The New York Times, Feb. 3, 2005). This phenomenon could contribute to a major medical concern affecting men who have sex with men (MSM) and who are at risk of HIV. Because LGV creates external ulcerations on the epidermis layer of skin and mucous membranes of the human body, HIV from infected blood or bodily fluids such as semen could have a greater chance of by-passing scout cells and connecting to CD-4 cells within the body. Due to the current rarity of LGV in either country, clinical evidence or data does not exist to support either theory. The Netherlands statistical data arguably suggests the possibility that already being infected with HIV could increase the risk of contracting LGV. According to Marita Van de Laar, the country’s IPH spokesperson, of the 92 cases of LGV infected men in the Netherlands, about 80 percent were HIV positive. So how does the existence of LGV in America potentially affect the U.S.’s men who have sex with men population? Epidemiological findings concluded that all of the Netherlands patients diagnosed with LGV were white (the nation’s largest infected ethnic group) and reported risky sexual behavior. Is there a connection between at-risk minority populations? Could LGV adversely affect America’s black population, which accounts for the highest rate of HIV infections. Dr. Sam Mitchell, an epidemiologist from the San Francisco Department of Public Health, said there is no indication for alarm in relation to HIV-patients being at higher risk for complications of LGV. Instead, he said during an interview with hivandhepatitis.com suggests the opposite, making a connection to Clamydia-infected patients and the high risk of contracting HIV due to the ulceration caused by the bacteria. “The idea is to knock it out quickly. If it circulates widely, it could be quite challenging,” Mitchell said. Statewide Health Departments are working hard to prevent the spread of LGV. Free, confidential STD screenings are being offered at health department clinics across the five boroughs of New York. As an immediate precaution, health officials are encouraging individuals to practice safer sex, and asking clinical practitioners to be on the look out for any signs of the disease. In addition, it is recommended that persons limit their number of sex partners, use latex or polyurethane condoms, and wash genitals after sexual contact. If there are any concerns of exposure or infection, it is recommended that there be an avoidance of sexual contact before visiting a local STD clinic, hospital or doctor. For more info about Lymphogranuloma Venereum, please visit the following: New York State Department of Health and Centers for Disease Control and Prevention.