Gay & Lesbian sexual Health
Sexually transmitted illness and the GLBT population
At the clinic L’ Actuel, we have attempted to create a safe, comfortable clinical environment wherein we may provide expert care to the lesbian, gay, bisexual and transgender patient population. We remain dedicated to the evaluation, counseling, management and treatment of sexually transmitted illness, HIV/AIDS and hepatitis – regardless of your sexual orientation. We are not talking about "special" treatment, but "appropriate" treatment.
We believe that your health is not simply the absence of disease and that your health requires a balance between your physical, psychological and social state of well-being.
We provide a supportive place for people in the lesbian, gay and bisexual and transgender community regardless of race, religion, color, creed, origins, family status, marital status, financial status, nationality, disability, ancestry, sex, age or sexual orientation. We hope that our existence will improve your access to quality health care.
While members of the lesbian, gay and bisexual or transgender society have the same basic health needs as the general population, there are some specific needs. There are also documented barriers to adequate and professional health care secondary to both real and perceived homophobia, and/or discrimination towards these groups. Fear experienced by the patient may impede consultation and discrimination (unfortunately still a factor) by health care professionals may preclude appropriate medical care.
So you have been diagnosed with an STI…
The reality of sexuality is that activity comes with the risk of a sexually transmitted illness. This is nothing to be overly ashamed of! Sexually transmitted illnesses are extremely common.
The goal of our web-site is to educate you as to the symptoms of common STIs and how you might notice them. However, and this is very important to note, for most STIs, there may or may not be any symptoms at all. This is where STI screening tests play a vital role in the prevention and management of your sexual well-being.
If you are at all concerned, contact us at Clinic l’Actuel!
It is important to get early treatment to prevent an STI from getting worse or becoming complicated. Early treatment also helps to reduce the risk of transmission – this benefits public health in general.
If you do have an STI it is important, where possible, to inform your sexual partner(s) as soon as is possible so they too can get early treatment and inform their partner. As your surfing around the site will evidence, your partner(s) may not be aware of their condition (symptom-free). STI’s are infrequently intentionally transmitted – do everyone a favor and communicate!
Men who have sex with men (MSM)- Not everyone has the same set of risks…
Sexually transmitted infections (STIs)
The incidence of STIs in sexually active MSM is high – that is to say that STIs are frequent. Here we include the "easy to treat" or "curable" infections such as chlamydia, gonorrhea, scabies, pubic lice, syphilis and others. We may also talk about the "difficult to treat" or "no cure" infections such as HIV/AIDS, Genital Herpes, Genital warts(HPV), Hepatitis A, B, and C, etc. Prevention through safe sex is key!
HIV/AIDS
MSM are at an increased risk of HIV infection. The history of HIV/AIDS in the community since its description in the early 1980s is one of success through education and prevention. The last several years have evidenced a new wave of HIV infections in the young gay MSM population – tandem with the return, in many urban centers, of unsafe sexual practices (fucking without a condom or "barebacking"). Prevention is key: safer sex reduces the risk of HIV transmission and infection! Newer and potent medications available to treat HIV/AIDS are not the answer. (For detailed information on safer sexual practices please consult the chapter on HIV/AIDS.)
Hepatitis
MSM are at an increased risk of contracting hepatitis – particularly hepatitis A and B (STD section on hepatitis), and possibly hepatitis C. Hepatitis B may be transmitted through sexual relations including unprotected penetration(fucking) and oral sex (blow-job or fellatio)…only rarely is hepatitis B transmitted through saliva contact (kissing). MSM with multiple sexual partners have a 10-15 time greater risk of contracting hepatitis B than the general population. Hepatitis A is transmitted through the fecal-oral route (anus to mouth, or "rimming"and/or fingering the anal region) and typically requires direct or indirect contact with feces. Hepatitis A and B are preventable diseases – Universal vaccination of all men who have sex with men is recommended. Speak with your physician today! There is no cost to you, so don’t hesitate! Safe sex is an effective means of decreasing the risk of hepatitis. When discussing hepatitis C, there is no vaccination currently available, so safe sex is the only means to avoid infection with this difficult viral liver infection.
Hepatitis B - 100 times easier to catch than HIV! Get vaccinated against this disease!
Hepatitis A - Get vaccinated against this disease!
Anal-genital warts or Human Papilloma Virus
Anal warts are a very common sexually transmitted infection – they are easily spread between sexual partners. While these infections are often felt to be purely a cosmetic or aesthetic problem, they may actually have important long-term consequences. It is felt that the presence of anal HPV warts (certain types) may be implicated in the risk of anal cancers (more frequent in MSM). Studies are currently underway to evaluate the potential benefit of routine screening tests in an attempt to detect and treat early uncomplicated cancers (similar to cervical PAP tests routinely performed on sexually active women). Treatments exist, erradication is at times difficult and recurrences are not uncommon. Don’t ignore this part of your body! Examine yourself, or have your physician evaluate for the presence of HPV/warts both anal and genital at your next STI visit.
Substance abuse
Substance abuse occurs in all populations. It is felt that MSM consume illicit substances at a higher rate. Regardless, the use of substances including Ecstasy, Ketamine, amphetamines (speed), pot or marijuana and amyl nitrate (poppers) is common. The potential long-term consequences of many of these recreational drugs is unknown. It is hoped that ongoing research may help to determine the potentially serious outcomes that may be associated with regular use over time. What is known is that several of these substances (including alcohol) are associated with disinhibition and increased sexual risk taking. If you think you have a substance problem, consult your physician!
Lesbian health care
Lesbians are less likely to seek medical care because of their perceived and/or real fear of discrimination in society – particularly when consulting for medical care. It is important that you discuss your sexuality with your physician, particularly if a presumption of heterosexuality is made.
Many of the health-care concerns in lesbians are the same as for those addressed in heterosexual women.
Human Papilloma Virus (HPV) and Cervical Cancer
Women who have sex with women(WSW), undergo fewer Pap tests or cervical screening tests than heterosexual or bisexual women. One recent study documented that 13% of WSW were infected with HPV. As is discussed in the chapter on condyloma or HPV, certain strains of HPV increase the risk of progression towards cervical cancer. Routine cytology or Pap smears are able to detect early lesions, and thereby ensure adequate treatment and an effective cure of this type of cancer. WSW foregoing Pap smears or HPV testing may be at increased risk of progressive cervical cancer. Prevention is key! - once every 2-3 years is reasonable - discuss the frequency of Pap testing with your physician. HPV may be transmitted from woman to woman, through contact with infected vaginal secretions, genital warts and/or shared insertive sexual toys. Safer sex techniques include washing sexual toys between use and/or using a condom for toys used for penetration.
Herpes simplex – genital herpes
Genital herpes in the population of WSW is common. While type 2 genital herpes may be transmitted through genital-genital contact, or via contact with contaminated genital secretions, the most common infection is type 1 herpes transmitted from a "cold-sore" to the genital region. Remember, a "cold-sore" is a type of herpes and can be transmitted to the genital/anal region through direct contact particularly during an outbreak.
Hepatitis
Hepatitis A is transmitted via the fecal-oral route (contact with feces) whether direct or indirect. Transmission in WSW has been reported but has not been studied extensively. Vaccination against hepatitis A is an effective means of preventing infection – speak with your physician!
Hepatitis B is transmitted via the exchange of contaminated body fluids(vaginal secretions) or blood(cuts, wounds or menstrual flow), whether direct or indirect. Avoiding contact with blood and fluids is important if the hepatitis B status of your partner is unknown. While not studied extensively, the transmission of hepatitis B amongst WSW has been reported. Hepatitis B can be prevented with vaccination – speak to your doctor!
Hepatitis C is still being evaluated as per its risk through sexual relations. It is known that hepatitis C is primarily transmitted through contaminated blood contact, so avoidance of menstrual blood flow in the WSW partner whose hepatitis C status is unknown would be prudent. There is no vaccination against hepatitis C!
HIV/AIDS
There are few case reports of WSW transmission of HIV/AIDS. Infection may be transmitted via contact with infected bodily secretions (vaginal secretions), or blood (menstrual flow or other). Once again, prevention is key! Safe sex practices including the use of 100% latex barriers, whether dental dams for oral sex or condoms for insertive sexual toys are a proven method of decreasing the potential risk of HIV/AIDS transmissin/infection.
