This article was published on November 16th, 2017
When it comes to STI’s and HIV, there are plenty of common myths. Over the years, especially recent years, there are been significant developments in the treatment and prevention of both STI’s and HIV. These medical advancements are happening so quickly, and with much success, that past myths have become common misnomers. Here are the top 5 myths about vaccinations that you should know about, especially if you are a gay man and concerned about your sexual health, the sexual health of your partners, and to be able to speak to facts about vaccinations for STI’s and HIV.
- Men older than the age of 26 don’t need the vaccine against HPV
False: Full HPV evaluation should be standard during your yearly physical exam. The HPV virus can be detected with either an anal swab or a pap smear. The Gardisil vaccine currently protects against nine subtypes, including high-risk types 16 and 18—the two strains that have been linked to the development of anal cancers. If you test negative for any of the subtypes in the vaccine, then you should be vaccinated. Other factors, like your preferred sexual position, your age, and your relationship status should be taken into account. If you are a bottom, more friction and injury occurs, which can increase the spread of the virus. Your age and level of sexual active not only contribute to your risk of contraction, but also the subsequent development of anal issues. And if you are in an open relationship, the risk of new exposure to different HPV types is elevated. The biggest obstacles to obtaining the 3-shot series are lack of a regular physician and individual knowledge, as well as the cost. Since insurance companies only cover the vaccine for those 26 and younger, you may be out of pocket between $200-$300 a shot. Also of note: Oral testing should be done as well to screen for HPV and help with the prevention of developing oral cancers—after all, the majority of us are both oral and anal individuals. In theory, the vaccine would be protective on this front as well. A true “two-fer”!
- Meningococcal disease only affects young children and not our community
False: While it is most common in infants younger than one year of age, anyone can get meningococcal disease, and recently contraction has heavily increased in men who have sex with men, along with people who are living with HIV. The bacteria that causes meningitis can easily spread between people sucking face (i.e., in saliva or respiratory droplets) and symptoms can include a fever, body aches, stiff neck, headache, and/or rash. The departments of health in several urban areas have issued warnings identifying the following as potentially contributing to increased risk, based on studies of those affected in recent clusters:
- Regularly having close or intimate contact with multiple partners. The more people with whom you share oral fluids, the more likely it is that you will be exposed
- Individuals who use dating apps (like Grindr, Scruff, etc.) generally have more sexual partners, so are more likely to have infections they can spread
- Regularly visiting crowded venues, such as bars and parties, and sharing cigarettes, marijuana, or other substances
- And any of the above for an individual living with HIV just increases their risk even more
The meningitis vaccine is safe and effective. A single dose is recommended for HIV-free individuals and 2 doses for people living with HIV (second dose between 8 and 12 weeks after the first). If your first dose was administered more than five years ago, you might need a booster to stay protected.
Meningococcal disease is rare, but in fact, the risk of getting it increases in adolescents and young adults. The disease can progress rapidly, killing an otherwise healthy individual in 24-48 hours. The vaccine prevents such a catastrophe, so if the above risk factors describe you, then speak with your primary care physician for administration.
- Viral hepatitis isn’t a sexually transmitted disease
False: Gay, bisexual, and other men who have sex with men have a higher chance of getting viral hepatitis, including hepatitis A, B, and C—all diseases that affect the liver. About 10% of new hepatitis A and 20% of all new hepatitis B infections in the United States are among gay and bisexual men. Many men have not been vaccinated against hepatitis A and B, even though a safe and effective vaccine is available.
Hepatitis A can be spread through sexual activity, like rimming, fingering, using dildos, and any other possible ass-to-mouth contact. The virus can also be spread through contact with objects, food, or drinks contaminated by the feces of a person who has the virus.
Hepatitis B is spread through body fluids, such as semen or blood. The hepatitis B virus is very infectious and is easily spread during sexual activity. Hepatitis B can also be spread through sharing needles, syringes, or other equipment used to inject drugs.
You should periodically be checked during your annual physical examination for antibodies to hepatitis A and B, which infers immunity. If antibodies are not present, then obtaining the vaccine will correct this, allowing for continued play without hesitation.
- A vaccine for herpes is impossible
False: According to the World Health Organization, over two-thirds of the global population have HSV-1 (commonly known as oral herpes or cold sores) and more than 10% has HSV-2, or genital herpes. Herpes is able to evade your immune system so well that it can hide in your body for an entire lifetime, which makes it easy to transmit and therefore the most common sexually transmitted infection. Most people with HSV-2 never get symptoms and never know they have it.
This also makes creating a vaccine very difficult. Most attempts have failed because scientists weren’t targeting the molecules that help herpes hide from antibodies. However, a vaccine may finally be on the horizon, thanks to Harvey M. Friedman, a professor at UPENN, who has been studying herpes for a decade. In a recent study, he and his team designed a new strategy: attack the usual cell-entry proteins, but also attack the so-called “evasion molecules” that help herpes hide. Now, they are waiting for their vaccine to be tested in humans. Pending funding, the drug could be tested in humans in less than two years.
- Daily PrEP and condoms are the only defense against HIV
True–for now: The injectable form of PrEP is closer than you think. Daily PrEP reduces the risk of getting HIV from sex by more than 90%. Among people who inject drugs, it reduces the risk by more than 70%. Your risk of getting HIV from sex can be even lower if you combine PrEP with condoms and other prevention methods. Still, with scant knowledge on its availability, limited access, and ridiculous unaffordability, the ones who do have the privilege of taking PrEP have trouble with its daily dosing, which obviously translates to lower efficacy when not taken as prescribed. In order to assist with inconsistent daily use and improve or maintain statistical coverage and efficacy, long-acting injectable PrEP (LAI-PrEP) has been developed and is going through Phase 3 of clinical trials. Rather than Truvada, which is currently available as a once-daily pill, the injectable form is known as Cabotegravir and requires an 8-week dosing schedule. It’s important to continue to find additional ways to prevent HIV that can accommodate everyone’s lives.