**Sigh**
You're right - promiscuity and condom use play a big role in the risk of getting a "traditional" STI, which is caused by a virus or a bacteria.
However, we were talking about PARASITES. Condoms will NOT prevent sexually transmitted parasite infections, which are often transmitted by the fecal-oral route. (The exception, of course, being Trich vag).
All the articles that you posted dealt with syphilis, chlamydia, Hep, HIV, etc - none of which are parasites. If someone posts something on how to avoid bacterial infections or viral infections, then yes - they would become relevant then.
You're right, when it comes to parasites, sexual transmission (gay or straight) is not the most important route. I was mainly responding to Lifetimedoc's concern. He specifically mentions condoms and gays and sexuality in particular. You may not want to talk about it, but he raised the question, which is why I addressed it. Also, the bigger concerns are the "traditional" STD's, so this is really the more important public health topic, even if it wasn't in the subject of the original post of this thread. Parasitic STD's don't have nearly the mortality.
... Ever since the AIDS epidemic, I know many gay men that practice safe sex and monogamy and know straight men that scare the hell out of me about their unprotected romps with multiple partners. Just something to think about when you label it something gay men get and straight men get.
He quotes no studies and gives anecdotal information that seems to conflict with some of the articles that I quote above. That's why I cited the articles and why they are relevant ... I do give some sources; and I'm certainly willing to learn more about the subject (there may be better studies out there, for example). I also recognize that this is a sensitive issue and I'm not suggesting that I have anything against gays. Heterosexual men & women are also at risk for STD's; I'm also not going to suggest we all become celebate. However to suggest that gay men are less promiscuous than straight men doesn't seem to match the data from scientific studies.
I do have a complaint. You minimize the issue of promiscuity (ignore it?), which is an error, in my opinion. You can't tell me that promiscuity has nothing to do with rates of transmission of sexually transmitted parasites. It's an important factor that cannot be ignored or minimized if you look at the data. It would be stunning if promiscuity had nothing to do with rates of transmission of sexually transmitted parasites. Yes, I realize most parasites are not transmitted this way, but academic medicine studies all kinds of diseases and modes of transmission that are rare; just because it is rare doesn't mean that is isn't interesting.
I realize Lifetimedoc expanded the subject of discussion, and I think he addresses an interesting point even if you limit it to parasites since fecal-oral transmission of parasites could conceptually could be a concern in men who have sex with men (MSM's) given the nature of their sexual activity (anal).
From what I see in the literature, there is no reason to believe that MSMs have lower incidence of sexually transmitted parasites and many reasons to believe it would be higher, along with the risk for much more serious STD's. Higher promiscuity and the nature of MSM sex are almost certainly big factors.
Looking at the literature, it looks like for MSM's, giardiasis is an issue, although not a major one. Note that this diarrheal illness is caused by a one-celled, microscopic parasite, so I'm on topic here.
Here is a study demonstrating increased MSM promiscuity relative to men who do not have sex with men (cite me a better study if you have one). There are other studies like this, but not studies of U.S. & European men that I would like to be able to cite.
1: AIDS. 1995 Feb;9(2):171-6.
Same-sex behavior, sexually transmitted diseases and HIV risks among young northern Thai men.Beyrer C, Eiumtrakul S, Celentano DD, Nelson KE, Ruckphaopunt S, Khamboonruang C.
Johns Hopkins University, School of Hygiene and Public Health, Baltimore, Maryland, USA.
OBJECTIVES: To assess the risks for HIV infection and sexually transmitted diseases (STD) among young northern Thai men who have sex with men (MSM), and to examine the possible role of male same-sex behavior in the northern Thai HIV/AIDS epidemic. METHODS: Two cohorts of northern Thai military conscripts and one cohort of recently discharged conscripts, a total of 2047 men, were studied. Data were collected by interview on behavioral risk factors, and sera were examined for syphilis and HIV-1 antibodies. Univariate and multiple logistic regression analyses were used to determine risk factors associated with HIV and STD, and to assess the frequency and patterns of same-sex behaviors among these men. RESULTS: Of 2047 men, 134 (6.5%) reported one or more male lifetime sex partners. Of these MSM, 130 (97.0%) also had female partners, and four (3.0%) had exclusively male partners. Compared with men who reported only female sex partners, MSM had a higher number of lifetime sex partners, a higher mean number of female sex partners, more female and male commercial sex worker (CSW) partners, and were more likely to be married. MSM were significantly more likely than exclusively heterosexual men to report having had any STD [odds ratio (OR), 2.72], gonorrhea (OR, 2.05), syphilis (OR, 3.17), non-gonococcal urethritis (OR, 4.54) and penile discharges (OR, 6.24). They were at borderline increased risk for HIV infection [OR, 1.51; 95% confidence interval (CI), 0.95-2.41]. Men with more than one lifetime male sex partner compared with those with only one partner were significantly more likely to be HIV-infected (OR, 2.81; 95% CI, 1.09-7.19). CONCLUSIONS: Northern Thai MSM are a high-risk population for STD, including HIV. Reported same-sex behavior in this population appears to vary considerably with data collection techniques. HIV and STD prevention strategies aimed at changing unsafe sexual practices may need to be targeted to the general population of young Thai men.
PMID: 7718188 [PubMed - indexed for MEDLINE]
Here is an article that shows that MSMs are at increased risk for giardiasis. Further down, another older article talks about amebiasis (also caused by a parasite):
AIDS Educ Prev. 2005 Dec;17(6 Suppl B):49-59. Links
Trends in infectious diseases and the male to female ratio: possible clues to changes in behavior among men who have sex with men.Beltrami JF, Shouse RL, Blake PA.
Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
[email protected]
Men who have sex with men (MSM) are a priority population for HIV care and prevention programs. This report describes HIV and other sexually transmitted disease (STD) trends among MSM in metropolitan Atlanta by analyzing nine databases. We describe the use of the male-to-female (M:F) ratio, a surrogate marker for MSM in databases without standardized MSM variables that is recommended as an indirect measure of HIV risk behavior in the CDC/HRSA Integrated Guidelines for Developing Epidemiologic Profiles. During 1997 to 2001, there were increases among MSM for reported syphilis (from 9% to 17%), anti-biotic-resistant gonorrhea (from 4.8% to 8.6%), and HIV seroprevalence (from 33% to 43%). During 1998 to 2001, the M:F ratio for cases peaked at 12:1 during a hepatitis A outbreak among MSM, increased for shigellosis (from 1:0 to 18:1) and giardiasis (from 1.7 to 2.1), and did not appreciably change for hepatitis B, salmonellosis, or chlamydia. HIV and several other STDs appear to have increased among MSM in metropolitan Atlanta. When standardized MSM variables are not available, an M:F ratio is useful.
PMID: 16401182 [PubMed - indexed for MEDLINE]
An old article about incidence of giardisis and amebiasis being greater among MSMs:
Rev Med Brux. 1989 Oct;10(8):327-34.Links
[Sexually-transmissible anorectal diseases][Article in French]
Paulet P, Stoffels G.
Several anorectal diseases are described. Most are sexually transmitted (gay bowel syndrome or heterosexual transmission). The clinical aspect of nearly all of them is similar. Thus, the diagnosis usually cannot be done on clinical grounds alone: one has to request the help of the laboratory. Amebiasis, giardiasis, chancroid and donovanosis are frequent in Africa but rare in our countries, except in male homosexuals. ...
PMID: 2682913 [PubMed - indexed for MEDLINE]
So, while sexual transmission of parasites is not a huge public health issue, within the realm of medical trivia reported in the literature, MSMs are at a greater risk for sexual transmission of parasites and several other important sexually transmitted diseases.
