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Syphillis, gonorrhoea infections on rise

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From Bangkok Post

Health officials are looking to tighten preventive and control measures after finding higher rates of syphilis and gonorrhoea among young people, says Public Health Minister Cholnan Srikaew.

Continues at

https://www.bangkokpost.com/thailand/general/2715383/alarm-sounded-over-syphilis-infections

 

 

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51 minutes ago, reader said:

From Bangkok Post

Health officials are looking to tighten preventive and control measures after finding higher rates of syphilis and gonorrhoea among young people, says Public Health Minister Cholnan Srikaew.

Continues at

https://www.bangkokpost.com/thailand/general/2715383/alarm-sounded-over-syphilis-infections

The bacteria that cause these illnesses infest the closed,dark and dank areas of the genitals and anus. If these are scrubbed clean thoroughly, meticulously and constantly then the possibility of infection decreases.

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3 hours ago, Phoenixblue said:

The bacteria that cause these illnesses infest the closed, dark and dank areas of the genitals and anus. If these are scrubbed clean thoroughly, meticulously and constantly then the possibility of infection decreases. 

"Sexually active people can get syphilis through vaginal, anal, or oral sex without a condom with a partner who has syphilis."  Source: STD Facts - Syphilis (cdc.gov)

It seems to me that it's fashionable for (desired by) many in the gay community to have unprotected sex (i.e., without a condom).  Someone can give every appearance of being clean but still be contagious.

"No other STI combines incurability with near-100% lethality in the absence of treatment as HIV does. But other STIs can have serious health consequences. The bacterial STIs – gonorrhoeasyphilischlamydia and chlamydia’s ‘superstrain’, lymphogranuloma venereum (LGV), as well as other infections like Mycoplasma genitalium (MG) and trichomoniasis – are generally easily curable but may have serious health consequences in some people if left untreated. Syphilis may also cause serious symptoms in early disease, and drug resistance in gonorrhoea is of considerable concern.   Source: PrEP and sexually transmitted infections | aidsmap

For a long time now I've thought men on PrEP have been lulled into a sense of security, that it's safe to have any unprotected sex.  Not true.

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40 minutes ago, vinapu said:

you are correct but still some on PREP boast about barebacking like PREP would be cure-all treatment . Worst part of such attitude is lack of consideration for their partners who often agree to unprotected sex out of false sense of security or real sense of financial need.

To be on the safe side one must be on Prep, wear condoms for every sexual encounter, and practice personal hygiene. These steps are imperative if you care about your personal health as well as that of the person you're having sex with.  Common sense really. Be safe and well everybody.

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10 hours ago, kokopelli3 said:

I am aware that condoms are a good preventive measure and the use of doxycycline after sexual encounters is effective in reducing the chances of contracting syphilis; what other preventative measures are recommended?

You pretty much have it right there! 

You also need to watch what touches your lips or goes in your mouth.  👅🍆

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The biggest and alarming incidence escalation is in congenital syphilis, therefore the increase is considerably disproportionate among women of childbearing age. That skew alone reveals little in terms of MSM rate trends and their reproductive crossover.

In terms of gonococcal infection prophylaxis research the Meningococcal Group B vaccine (Bexsero) placebo-control trial underway, with results still a few years off, now has recruitment in 2 Bangkok locations. 

IMG_9930.jpeg

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15 hours ago, unicorn said:

Where did you get the information that scrubbing those places helps prevent infection?

"• Washing the genitals, urinating, or douching after sex
will not prevent any STD..."

I didn't say prevent infection but the perhaps reduce the chance of infection. Personal hygiene may not protect a person completely from contracting some STIs but it sure does prevent you from getting sick from other infectious diseases. Being physically clean won't harm you. Besides it's aesthetically attractive.

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16 minutes ago, Phoenixblue said:

I didn't say prevent infection but the perhaps reduce the chance of infection. Personal hygiene may not protect a person completely from contracting some STIs but it sure does prevent you from getting sick from other infectious diseases. Being physically clean won't harm you. Besides it's aesthetically attractive.

Well, if you put "perhaps" after a statement, the perhaps can be anything, no matter how outlandishly unlikely. Putting unfounded medical advice out there might lead someone to rely on that information, and get into real trouble. There is no evidence that scrubbing won't be harmful, either. One can imagine that tears in the skin could increase risk. I know of no evidence either way. What a person might find "aesthetically attractive" is entirely besides the point. 

 

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UK to proceed with MeningicoccalB vaccine for gonorrhoea (aka gonococcal, gonorrhea for search term optimization) based on the findings to date that have propelled the further ongoing research.

https://www.statnews.com/2023/11/10/u-k-recommendation-could-lead-to-worlds-first-use-of-meningitis-vaccine-to-curb-gonorrhea/

Meanwhile, I read a few months ago that Molina’s promising-looking findings on the MeningicoccalB vaxx component of his Doxycycline prophylaxis research had been challenged, and the methodology and vaccination results were to undergo audit. Haven’t seen any updates. It may be just a question of downgrading the efficacy metric. Lower vaxx efficacy for a disease tends to be more acceptable where infection recidivism is common. 

In many jurisdictions including Canada and USA, Bexsero (GSK Pharma) is authorized up to age 25 for meningitis prevention. Administering off-label for gonorrhea prevention efforts should be considered case-by-case and I expect many STI clinics and savvy HCPs will get on board.

Me, I can pass for minimally one year younger and I’m not sure if my occasional use of Depends briefs puts me in the running for childhood Bexsero uptake. My condom use is also far from occasional. 

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19 hours ago, unicorn said:

Well, if you put "perhaps" after a statement, the perhaps can be anything, no matter how outlandishly unlikely. Putting unfounded medical advice out there might lead someone to rely on that information, and get into real trouble. There is no evidence that scrubbing won't be harmful, either. One can imagine that tears in the skin could increase risk. I know of no evidence either way. What a person might find "aesthetically attractive" is entirely besides the point. 

 

Scrubbing yourself clean not to the point of tearing skin does indeed remove bacteria and other pathogens living there, not all of them and certainly not the resilient ones but most. I do not claim to be a medical professional but I fail to see how maintaining a personal hygienic regiment would lead to any sort of real trouble health-wise or otherwise. If it is your preference to not clean yourself diligently then that is your prerogative.

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Two opposing concepts cannot easily be both true. The second part is true because there exists no extant research that substantiates the claim of the first part, likely simply an extraneous comment on the general merits of cleanliness’ adjacency to godliness. 

IMG_9991.jpeg

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5 hours ago, Riobard said:

UK to proceed with MeningicoccalB vaccine for gonorrhoea (aka gonococcal, gonorrhea for search term optimization) based on the findings to date that have propelled the further ongoing research...

Yikes. I'm all for more research, but according to that link (of a lay press article): "In theory, the similarity of the two bacteria suggests that the meningitis B vaccine could offer some protection against gonorrhea... But to date all of the data supporting the use of the vaccine to protect against gonorrhea have been observational, meaning researchers have looked at gonorrhea rates in cohorts of people who received the vaccine for meningitis-control purposes." Observational studies can only suggest areas for further research in the form of randomized clinical trials. They never suggest causation. The observation that those who are vaccinated against MGC have 33% to 42% fewer gonorrhea infections that those who don't only raises the question. It does not provide an answer. One obvious interpretation of the observation is that people who've received the meningococcal vaccine are simply more cautious, and could be doing any number of other helpful behaviors, such as partner selection, condom use, and so forth. 

Of course, one might argue that vaccination against meningococcus is very unlikely to cause harm, so why not. That's true. However, any help the vaccine may or may not provide is still quite speculative. I would get the vaccine with the idea that it'll protect me against MGC. Even if it were to provide some 38% protection from GC (probably best-case scenario, and theoretical at this point), that's not something to count on. 

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4 hours ago, Riobard said:

Two opposing concepts cannot easily be both true. The second part is true because there exists no extant research that substantiates the claim of the first part, likely simply an extraneous comment on the general merits of cleanliness’ adjacency to godliness. 

IMG_9991.jpeg

"And while there are some hygiene measures you can take to reduce your chances of contracting an STI......."

That is what I said. Would you like to give a guy a blowjob if his ***k is unwashed? Or eat Ass when it hasn't been cleaned? Washing up with soap reduces the amount of pathogens on your body, reduces the probability of you falling ill and makes you more attractive in general.

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3 hours ago, unicorn said:

Yikes. I'm all for more research, but according to that link (of a lay press article): "In theory, the similarity of the two bacteria suggests that the meningitis B vaccine could offer some protection against gonorrhea... But to date all of the data supporting the use of the vaccine to protect against gonorrhea have been observational, meaning researchers have looked at gonorrhea rates in cohorts of people who received the vaccine for meningitis-control purposes." Observational studies can only suggest areas for further research in the form of randomized clinical trials. They never suggest causation. The observation that those who are vaccinated against MGC have 33% to 42% fewer gonorrhea infections that those who don't only raises the question. It does not provide an answer. One obvious interpretation of the observation is that people who've received the meningococcal vaccine are simply more cautious, and could be doing any number of other helpful behaviors, such as partner selection, condom use, and so forth. 

Of course, one might argue that vaccination against meningococcus is very unlikely to cause harm, so why not. That's true. However, any help the vaccine may or may not provide is still quite speculative. I would get the vaccine with the idea that it'll protect me against MGC. Even if it were to provide some 38% protection from GC (probably best-case scenario, and theoretical at this point), that's not something to count on. 

Yes. Plus one. Did you think I was on a soapbox? 

Plus Molina’s research similarly tripped into the same observation more by accident than design, and as I indicated it’s Eff around 50% was (and is) apparently questioned by external peers.

The product innocuousness level factor concomitant with preliminary and refutable effectiveness findings does not substitute for the rigour of currently running focused trials. 

One study (Oregon unis?) observed a lower GC incidence rate comparing Outer Membrane Vesicle MBV (the format driver of contemporary research) to non-OMV MBV, thousands in each category subgroup of MBV recipients. Observational but not a VaxxPoz vs VaxxNeg binary scenario that, as you astutely point out, introduces behavioural confounder effects.

Unfortunately, it’s taking several years to execute the research yet one must not succumb to impatience by recklessly accepting prematurity.

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