STDs and chemsex

The most common STIs: Syphilis, Gonorrhea and Chlamydia
Syphilis, gonorrhea and chlamydia are the most common sexually transmitted diseases among gay and bi men. They can be transmitted through fucking, as well as oral sex and sharing sex toys.  

All three of these STIs can cause symptoms: 

  • Syphilis: painless ulcer 3 weeks after infection. Can easily go undetected if it is in the mouth or anus. In a second stage, fever and muscle pain may develop. In third stage, syphilis can affect organs such as heart, brain and blood vessels.
  • Gonorrhea: pain when urinating, 2 or 3 days after infection, possibly accompanied by discharge of yellow-green pus. If the infection is in the anus, stool may be painful. A sore throat may be the result of an infection in the throat.
  • Chlamydia: pain and a colorless discharge may be a symptom of an infection in the throat or penis.Urination may also feel painful or burning.

Most STIs result in unpleasant feelings and symptoms ranging from sores, rashes, pimples, itching and warts. These are temporary and can be easily missed. Often STDs do not produce any symptoms at all. Initial symptoms may be mild, but in the long run, untreated STIs can have a devastating effect on the body.

Most STIs are asymptomatic. Regular testing is the best way to get rid of STIs. Depending on your sexual behavior, an STI test is recommended every 3 to 6 months. Get tested if you experience symptoms that may indicate an STI.

Hepatitis A and B
Hepatitis is a family of viruses. Hepatitis A is highly contagious, while B is transmitted only through sex. Hepatitis B is common in men who have sex with men.

Infections with hepatitis A and B lead to similar symptoms: loss of energy and appetite, fever and nausea. After 2 to 6 weeks, stomach upset may occur, combined with dark urine or light-colored stools. Hepatitis infections can go unnoticed. The body clears the virus, after which you are protected from further infections.

There is a very effective vaccine against both hepatitis A and B. The vaccine provides lifelong protection. Most young Belgian men are vaccinated with it in their school years. The vaccination includes an antibody test beforehand (to rule out previous undetected infections) and 3 vaccine injections. If you have an adventurous gay sex life, vaccination is highly recommended. Vaccination outside of school programs is not reimbursed, but it is a health investment that pays off.

Fisting? Gangbangs? Check for Hepatitis C and LGV
Hepatitis C and LGV are STIs that are more common in men who engage in specific homosexual sexual practices, such as fisting and long sex sessions. Both STIs can cause serious damage to the body. If you engage in fisting or gangbangs, it is advisable to have your STI doctor test for these STIs.

Hepatis C can be spread by fisting, sharing sex toys and lubricants, or by sharing needles. With shared use of sniffing attributes, there is a low risk of infection through wounds in the nose. Symptoms may occur two or three months after infection and are usually vague and very similar to the symptoms of other forms of hepatitis: lethargy, loss of appetite, nausea. Hepatitis can lead to permanent liver damage. 

Fortunately, there is now a very effective treatment for hepatitis C. After cure, however, one remains vulnerable to new infections.

LGV stands for lymphogranuloma venereum; it is an aggressive variant of chlamydia. The first symptoms are a small ulcer on the penis or in the anus or throat, which is easily missed. In later stages, infections of the lymph nodes and ulcers in the rectum may occur. LGV can be cured with antibiotics, but may require a long recovery period.

Genital warts and HPV
HPV (human papillomavirus) is the most common STI. Eight out of ten Belgians will be affected by HPV in their lifetime. There are more than 100 types of HPV. Some types cause genital warts, others can lead to cancers in the throat or genitals.
Genital warts can be unpleasant, unattractive and highly contagious. Usually, they do not disappear on their own. There are several treatment options. 
There is a vaccine that protects against the 9 most common types of HPV. It is best applied before children become sexually active. Belgian boys and girls are vaccinated for HPV in school programs. Even if you have had genital warts before, it is worth considering getting vaccinated, as the vaccine also protects against other HPV types.

Genital herpes
Genital herpes is another common sexually transmitted disease caused by the herpes simplex virus (HSV). Sexual contact is the main way the virus is spread. After the initial infection, the virus slumbers in your body and can reappear several times a year.

Genital herpes can cause burning, pain, itching and sores/bladders in the genital area. However, you may also have no signs or symptoms of genital herpes. If you are infected, you may be contagious even if you have no visible sores.

There is no cure for genital herpes, but medications can relieve symptoms and reduce the risk of infecting others. Condoms can also help prevent the spread of genital herpes infection.

HIV: medications and PrEP offer protection
HIV is transmitted mainly through semen, blood, pre-seminal fluids and in contact between mucous membranes (not through kissing, insect bites, sharing toilets, etc.). Condom use is more complicated when you are under the influence of chems. Some chemsex event organizers have a bareback policy. If you are HIV negative, you are strongly advised to choose PrEP to protect yourself from HIV. As a PrEP user, you will be tested regularly for STIs.

Men who have HIV but are successfully treated have so little virus left in the body that it becomes undetectable. An undetectable viral load means that HIV can no longer be transmitted through sex. With PrEP and HIV treatment, HIV has a limited impact on the chemsex scene. 

Long chemsex sessions can make you forget about time. This can cause you to forget to take your pills on time, whether it’s PrEP or HIV medication. Set an alarm in your cell phone for the exact time you take your pills.

Most STIs are asymptomatic
Most STIs are asymptomatic or have symptoms that are easy to miss. To get STI treatment on time, it’s best to get tested regularly, every 3 to 6 months. Talk to your STI doctor about your sexual behavior. Some sexual acts, such as fisting, have specific STI risks. You will remain infectious as long as your STI is not fully cured. Do not have sex until your STIs are fully treated.

Traveling: what to pack?
Here are some tips to keep it safe when having sex on vacation abroad:

  • Bring your own condoms; you’re always better off with your own brand. The same goes for your favorite lubricant.
  • If you are flying, keep your condoms in your carry-on luggage, it may be too cold in the storage area of the plane.
  • Keep your medications (for HIV, PrEP) in your carry-on luggage. Checked-in suitcases may be lost or delayed. 

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