As HIV becomes a more manageable disease, the difference in severity between its outcome and that of other sexually transmitted infections (STIs) also decreases. Syphilis, hepatitis C, and human papilloma virus (HPV) all pose serious health risks. Syphilis can damage the heart, the brain, and nervous system. From 1996 to 2016, diagnoses of infectious syphilis in Broward increased by 906 percent. Hep C can lead to liver cancer. HPV can lead to anal cancer. All can lead to death.
Science has developed STI services other than testing and treating. These new services include HIV pre-exposure prophylaxis (PrEP), HIV post-exposure prophylaxis (PEP), and vaccines for hepatitis A, hepatitis B, and HPV. Someone with an STI may be a good candidate for PrEP.
Given this new STI environment, SFGN investigated STI services other than HIV testing in Broward County. A Google search identified agencies offering STI services in Broward. A phone/e-mail survey followed, to clarify the services provided.
This investigation had two criteria for inclusion. Agencies had to accept walk-ins. Services had to be free, or have a sliding-scale/donation fee structure. Seven agencies met these criteria. Other agencies may provide some STI services, but they failed to meet the criteria or appear in the Google search.
Care Resource and all three AIDS Healthcare Foundation (AHF) sites (Wilton Dr, Sunrise, and SE 3rd Ave.) offer PEP. As someone has to begin PEP within 72 hours of exposure, weekend access is critical. The AHF sites on Wilton Drive and Sunrise are open Saturday and Sunday for people who need PEP over the weekend.
Care Resource and the Edgar Mills Health Center offer PrEP to people testing positive for another STI. All other agencies will refer out for PrEP.
Hepatitis A, Hepatitis B, and Hepatitis C
The Edgar Mills Health Center offers hepatitis A and hepatitis B vaccines. All three AHF clinics, Broward House, Care Resource, the Edgar Mills Health Center, and Latinos Salud offer testing for hepatitis C.
Care Resource and the Edgar Mills Health Center offer the HPV vaccine.
If a sore is present, all three AHF clinics will test for herpes. The Edgar Mills Health Center also offers a test for herpes.
All three AHF clinics, Broward House, Care Resource, the Edgar Mills Health Center, and Latinos Salud offer syphilis tests.
Gonorrhea and Chlamydia
These bacterial STIs can occur in the penis, throat, rectum, and vagina. In order to diagnose these STIs, clinics have to perform separate penile, oral, rectal, and vaginal tests.
All three AHF clinics, Broward House, Care Resource, the Edgar Mills Health Center, and Latinos Salud offer penile tests for gonorrhea and chlamydia. All these clinics, except for Latinos Salud, offer vaginal testing for gonorrhea and chlamydia. All three AHF clinics offer rectal and oral tests for gonorrhea and chlamydia.
Gonorrhea and chlamydia in the rectum or throat often produce few symptoms. STIs in the rectum or throat, however, can end up in somebody else’s penis. Control of these STIs among gay and bi men logically requires gonorrhea and chlamydia testing and treatment in the rectum and throat.
Ever since the early 80’s, HIV has loomed as the monster STI, but things have changed since then. For an unknown number of gay and bi men, monogamy is optional. Some of us only know the first names or screen handles of our sexual partners. In this context, regular STI testing may be the only way to control STIs. Gay and bi men probably should begin to think about STIs in new ways.
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