By: Al Ballesteros

Los Angeles County is experiencing an STD crisis. Gay and bisexual men are being affected at high levels, particularly with respect to Syphilis.

For Calendar Year 2021, and presumed to continue up in CY 22, the overall case rates of Gonorrhea are estimated at 298 per 100,000 persons in LA County. The case rates for Early Syphilis are estimated to be 60 per 100,000 persons. Chlamydia is way high with 556 estimated per 100,000 persons.

With respect to gay and bi men, Early Syphilis case rates in Los Angeles County are estimated to be 80 per 100,000 persons. This is higher than Syphilis case rates overall which are 60 per 100,000 persons. Gonorrhea rates among females is estimated at 431 per 100,000 persons and among men, 169 per 100,000 population. The highest case rates of Gonorrhea are among men 25-29 years of age and females aged 20-24.

If you are a gay or bi male, it is important that you understand your risks through education and commit to getting tested regularly to keep yourself healthy. There are many different non-profit health clinics that can offer you free or low-cost services to stay sexually healthy. Money or lack of medical insurance are not a barrier if you contact or visit these organizations. Please check out our community directory.

Know the facts:
Syphilis is a sexually transmitted disease, even though it’s simple to prevent and can be cured with the right treatment, it can cause very serious health problems if not treated. Untreated syphilis can eventually spread to the brain and nervous system or to the eye. This can cause problems like hearing loss, stroke, and blindness. And there’s another big concern: Having syphilis can increase a person’s risk for getting HIV or giving it to others.

Sexually Transmitted Diseases (STDs) have been rising among gay and bisexual men, with increases in syphilis being seen across the country. In 2014, gay, bisexual, and other men who have sex with men accounted for 83% of primary and secondary syphilis cases where sex of sex partner was known in the United States. Gay, bisexual, and other men who have sex with men often get other STDs, including chlamydia and gonorrhea infections. HPV (Human papillomavirus), the most common STD in the United States, is also a concern for gay, bisexual, and other men who have sex with men. Some types of HPV can cause genital and anal warts and some can lead to the development of anal and oral cancers. Gay, bisexual, and other men who have sex with men are 17 times more likely to get anal cancer than heterosexual men. Men who are HIV-positive are even more likely than those who do not have HIV to get anal cancer. (source, CDC).

How are STDs spread?
• STDs are spread through sexual contact (without a condom) with someone who has an STD. Sexual contact includes oral, anal, and vaginal sex, as well as genital skin-to-skin contact. While condoms are effective, HPV and HSV can be spread by contact with the area around the genitals not protected by the condom.

• Some STDs—like HIV, chlamydia and gonorrhea—are spread through body fluids, such as semen (cum). Other STDs, including HIV and Hepatitis B, are also spread through blood. Genital herpes, syphilis, and HPV are most often spread through genital skin-to-skin contact.

What are the signs and symptoms of STDs?
• Most STDs have no signs or symptoms, so you (or your partner) could be infected and not know it.
• The only way to know your STD status is to get tested – You can get services, even if you have no insurance or other financial resources from many of the organizations listed in our Medical Directory.
• Having an STD such as herpes makes it easier to get HIV.

When should I be tested?
All sexually active gay, bisexual, and other men who have sex with men should be tested regularly for STDs.
The only way to know your STD status is to get tested (See our Medical Directory for locations). Having an STD (like gonorrhea) makes it easier to get HIV or give it to others, so it’s important that you get tested to protect your health and the health of your partner. The CDC recommends sexually active gay and bisexual men test for

• HIV (at least once a year);
• Syphilis;
• Hepatitis B;
• Hepatitis C if you were born between 1945 to 1965 or with risk behaviors
• Chlamydia and gonorrhea of the rectum if you’ve had receptive anal sex or been a “bottom” in the past year;
• Chlamydia and gonorrhea of the penis (urethra) if you have had insertive anal sex (been on the “top”) or received oral sex in the past year; and
• Gonorrhea of the throat if you’ve given oral sex (your mouth on your partner’s penis, vagina, or anus) in the past year.

Health experts recommend testing for all STDs at least annually or more frequently depending on your level of sexual activity. It is important to become comfortable learning about and seeking testing for STDs. It is important to have a doctor or provider you are comfortable with. Many of the organizations listed in our Adelante Medical Directory work with hundreds of gay and bisexual men, so they will understand your needs.

Can STDs Be Treated?
Some STDs (like gonorrhea, chlamydia and syphilis) can be cured with medication. If you are ever treated for an STD, be sure to finish all of your medicine, even if you feel better. Your partner should be tested and treated, too. It is important to remember that you can get the same or a new STD every time you have unprotected sex (not using a condom) and/or have sex with someone who has an STD.
Other STDs like herpes and HIV cannot be cured, but you can take medicines to manage symptoms. (

Doxy-PEP is used for preventing gonorrhea, chlamydia, and syphilis infections (bacterial STIs). It can drastically reduce the risk of gonorrhea, syphilis and chlamydia among transwomen and gay and bisexual men and other men who have sex with men. This treatment has to be taken 24-72 hours after unprotected sex. The drug, Doxycycline is a common antibiotic used to treat skin, respiratory, and dental infections. It is a relatively inexpensive medication and is often covered by insurance. You will need a prescription from a health care provider to take it. If you are sexually active, Doxy-PEP may be for you. Ask your doctor about getting a prescription for this STI prevention medication.