Gay Men

Gay Man Health

Having unprotected penetrative sex is the easiest way that HIV and other sexually transmitted infections (STIs) can be passed on.

Using a condom not only helps protect against HIV, but also cuts the risk of getting many other STIs.

There are more gay men living with HIV than ever, so having sex without using a condom is extremely risky.

Gary Williams from Birmingham’s Healthy Gay Life project says many STIs are more difficult to treat if you’ve got HIV. Some, like syphilis, may even accelerate HIV's progression.

“We’re also seeing a rise in cases of hepatitis C, particularly in men who have HIV. Hepatitis C is treatable in some cases but it’s a long and drawn-out process. So to prevent its spread, use a condom."

Screening for hepatitis C isn’t routinely carried out, but if you think you're at risk or have been exposed, speak to your GP.

“Gay men should have a check-up at least every six months at a sexual health clinic, because for some infections you will not see any symptoms," says Williams.

Discharge

Discharge from the penis can be caused by:

Gonorrhoea (the clap):

This bacterial infection can cause stinging when urinating or the feeling you want to urinate but can’t. Symptoms can start two to seven days after sex with an infected person and it can affect the rectum, throat and urethra. It's treated with antibiotics.

Non-specific urethritis (NSU):

This is an inflammation of the urethra that’s caused by bacteria. It's caught in the same way as gonorrhoea, and often gives similar symptoms, which may start about five days after sex with an infected person.

Sometimes symptoms may not be noticeable. NSU can also be caused by having lots of sex or masturbating a lot, which causes the urethra to become inflamed. It can be treated using antibiotics.

Chlamydia:

This is a bacterial infection of the urethra, rectum or throat. There may be a discharge and pain on passing urine and/or pain in the testicles (although chlamydia can be symptom-free). It can be caught during sex with an infected person in the same way as gonorrhoea and NSU. It's treated with antibiotics. Recent evidence has shown that untreated chlamydia may lead to fertility problems in men.

Rashes

Rashes or blisters on the penis can be caused by:

Genital herpes:

A viral infection that causes redness and itching then blisters on the penis (or lips and anus). After two or three weeks, the blisters will burst, oozing infectious clear fluid, gradually scab over, then heal.

You may also get aches, swollen glands or flu-like feelings.

Genital herpes can be caught after oral sex with someone with a cold sore around or in their mouth or by having anal sex.

Sometimes there will be no symptoms. There’s no cure once you're infected as the virus stays in your body for life, but you can remain symptom-free.

Syphilis:

Syphilis is a bacterial infection that causes a painless ulcer, usually in the genital area. It will disappear on its own but other symptoms may appear, such as a rash on the body and swollen glands.

These too will disappear leaving no symptoms, but the bacteria itself will remain. If it is not treated, syphilis can cause serious nerve and body organ damage later in life.

In its early stages, syphilis is very infectious and can be passed on by close skin contact during sex. Treatment is with antibiotic injections or tablets.

Allergy:

Some people are allergic to the latex in condoms or the spermicides in some lubricants and on some condoms.

Polyurethane condoms (sold in the UK under the Avanti trademark) have been created for people who are allergic to latex. Many condoms come without spermicide (it will say this on the packaging).

Growths

Growths on the penis can be caused by:

Genital warts:

This is a common infection that appears a few weeks or months after sex with an infected person. It can cause pinhead-sized growths, mostly on or around the head of the penis but also in and around the anus.

They can become larger, cauliflower-shaped pale growths which may itch.

Contact with an infected person’s skin during sex can pass them on, even if you can’t see any warts. The virus responsible, HPV, can stay in your body for years. Warts can come back after they've been treated.

The sooner warts are treated, the easier they are to deal with. You can’t treat genital warts with the same cream you use for warts on the hands. A doctor will freeze them or use a cream to remove them.

Don’t confuse warts with harmless pearly penile papules (small, pale bumps on the underside of the head of the penis).

Itching

Itching around the penis can be a sign of:

Pubic lice (‘crabs’):

Crabs are the most common STI and live in body hair. They only grow to pinhead size so can be difficult to spot, although their tiny dark eggs can be seen stuck to hair.

Crabs prefer pubic hair (hair around your testicles and anus) but also body hair in general (but not head hair). The lice can be picked up from clothes, towels and bedding, and symptoms include itching or a rash.

Treatment can be done at home with lotions bought at a chemist (no prescription needed).

Brands include Quellada, Derbac M, Lyclear and Prioderm and the lotions are usually left on the whole body for up to 24 hours, with another treatment a week later.

Scabies:

This is an infection caused by invisible mites that burrow under the skin causing intense itching for most people (though some hardly notice it).

Itching usually starts two or more weeks after sex with an infected person. You can get scabies from sharing beds and towels, but this is less common.

You may see red lines in the skin, with the penis, anus and testicles possibly infected, as well as on the hands and feet.

Treatment is similar to treating crabs, although you may continue to itch for a few weeks after the mites have died.

Get Tested

If you think you've got any of the symptoms listed above or are worried you may have an STI, speak to your GP or visit a GUM clinic. Getting tested regularly is a good idea to ensure you have a healthy sex life.