Homosexuality and proctitis

MSM is a medical abbreviation for men who have sex with men.

The Centers for Disease Control and Prevention (CDC) declared in 2015:

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Sexually transmitted gastrointestinal syndromes include proctitis, proctocolitis, and enteritis. Evaluation for these syndromes should include appropriate diagnostic procedures (e.g., anoscopy or sigmoidoscopy, stool examination, and culture)... Proctitis is inflammation of the rectum (i.e., the distal 10–12 cm) that can be associated with anorectal pain, tenesmus, or rectal discharge. N. gonorrhoeae, C. trachomatis (including LGV serovars), T. pallidum, and HSV are the most common sexually transmitted pathogens involved. In persons with HIV infection, herpes proctitis can be especially severe. Proctitis occurs predominantly among persons who participate in receptive anal intercourse. Enteritis usually results in diarrhea and abdominal cramping without signs of proctitis or proctocolitis; it occurs among persons whose sexual practices include oral-anal contact. In otherwise healthy persons, Giardia lamblia is most frequently implicated. When outbreaks of gastrointestinal illness occur among social or sexual networks of MSM, clinicians should consider sexual transmission as a mode of spread and provide counseling accordingly. Among persons with HIV infection, enteritis can be caused by pathogens that may not be sexually transmitted, including CMV, Mycobacterium avium–intracellulare, Salmonella sp., Campylobacter sp., Shigella sp., Cryptosporidium, Microsporidium, and Isospora.

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Gay bowel syndrome and proctitis

See also: Gay bowel syndrome

Stylized rendering of a cross-section of the Human Immunodeficiency Virus

A September 2010 report of the Centers for Disease Control and Prevention (CDC) declared : "Gay, bisexual, and other men who have sex with men (MSM) represent approximately 2% of the US population, yet are the population most severely affected by HIV and are the only risk group in which new HIV infections have been increasing steadily since the early 1990s. In 2006, MSM accounted for more than half (53%) of all new HIV infections in the United States..." In August of 2009, LifeSiteNews reported: "An official with the Centers for Disease Control and Prevention (CDC) announced the CDC's estimate Monday that in the United States AIDS is fifty times more prevalent among men who have sex with men ('MSM') than the rest of the population."

On March 15, 2004 Medscape published an article entitled New Look at "Gay Bowel Syndrome" by John G. Bartlett, M.D. which commented on the 2004 journal article Etiology of clinical proctitis among men who have sex with men published by JD Klausner and C. Kent in the journal Clinical Infectious Diseases.

The Medscape article on gay bowel syndrome declared:

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There were multiple studies of the newly recognized "gay bowel syndrome" in the late 1970s and early 1980s. However, subsequent attention and study has been sparse, in part attributed to reduced frequency thought to reflect changing practices by gay men in response to the HIV epidemic. This study clearly indicates that it is still an issue, since the cases were studied in 2001-2002. Also, the etiology is about the same as previously, although HSV is newly recognized as an important component. This finding not only affects management but also has HIV prevention implications. The authors note that two thirds of the participants were HIV negative and that proctitis increases the risk of HIV by up to 9-fold.

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Proctitis and HIV Infection Further Elaborated

As noted earlier proctitis is one of the maladies associated with gay bowel syndrome and greatly increases the chance of HIV infection. In 2004, Jeffrey D. Klausner, Robert Kohn, and Charlotte Kent reported in the journal Clinical Infectious Diseases the following: "Proctitis, or inflammation of the rectum, is a condition that is not uncommon among men who have sex with men (MSM), and, in HIV-negative men, greatly increases the risk of acquiring HIV infection. With the recent increases in bacterial sexually transmitted diseases (STDs) among MSM in the United States and Europe, there has been a concomitant increase in the number of cases of clinical proctitis."

Although homosexual men practice various sexual practices which may put them at risk, studies report that anal sex can be an important risk factor for the relay of many diseases. Also, according to the Mayo Clinic, "proctitis is an inflammation of the lining of the rectum... Sexually transmitted diseases are the most common cause, but other causes include inflammatory bowel diseases, such as ulcerative colitis, and non-sexually transmitted infections." Sexually transmitted diseases that cause proctitis include gonorrhea, syphilis, cytomegalovirus, herpes, chlamydia, lymphogranuloma venereum, shigella and amebiasis. According to the Mayo Clinic article, proctitis is a condition mainly affecting adult males

A Centers for Disease Control and Prevention analysis suggested that approximately 64 percent of all adult primary and secondary syphilis cases in 2004 were among men who have sex with men.

Syphilis, Proctitis, and HIV Infection

Syphilis and proctitis are both maladies associated with gay bowel syndrome as noted earlier. Syphilis can be a cause of proctitis and the disease significantly increases the probability of HIV infection which was mentioned previously.

The news organization Cybercast News Service reported the following about homosexuality and syphilis:

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The federal Centers for Disease Control and Prevention (CDC) says homosexual men accounted for 65 percent of the nearly 12,000 cases of syphilis in the United States in 2007, making them the “primary driver” of increased syphilis rates overall. In a report on sexually transmitted diseases (STDs) issued Tuesday, the government said syphilis, a disease that was almost eliminated as a public health threat less than 10 years ago, is on the rise -- with cases increasing each year since 2000.

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The CDC declared:

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"While surveillance data are not available by risk behavior, a separate CDC analysis suggests that approximately 64 percent of all adult P&S syphilis cases in 2004 were among men who have sex with men, up from an estimated 5 percent in 1999....Syphilis increases, especially among men who have sex with men, demonstrate the need to continually adapt our strategies to eliminate syphilis in the United States,” said Dr. Ronald O. Valdiserri, acting director of CDC’s HIV, STD and TB prevention programs."

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Gonorrhea and Proctitis

Gonorrhea and proctitis are both maladies associated with gay bowel syndrome as noted earlier. Gonorrhea can be a cause of proctitis and the disease significantly increases the probability of HIV infection as was mentioned previously.

In 2006, the American Association of Family Physicians reported: "Men who have sex with men (MSM) have high rates of gonococcal infection. In San Francisco, more than one half of these infections occur in MSM, and previous cross-sectional studies have reported a prevalence of up to 15.3 percent in this group."

In respect to homosexuality and gonorrhea, Concerned Women of America issued an article entitled Health and Homosexuality which stated the following:

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In a study published by the Canadian Medical Association Journal in 1991, "...gonorrhea was associated with urethral discharge ... and homosexuality (3.7 times higher than the rate among heterosexuals)."

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Lymphogranuloma Venereum Outbreaks Among Homosexuals and HIV Infection

There are three different sub-types of the bacteria Chlamydia trachomatis that cause lymphogranuloma venereum.

Lymphogranuloma venereum (LGV) is a sexually transmitted disease that can cause proctitis and proctitis significantly increases the probability of HIV infection which was mentioned previously. Lymphogranuloma venereum and proctitis are both maladies associated with gay bowel syndrome as stated earlier. In March of 2007, the Journal of Clinical Microbiology reported that there was an ongoing epidemic of lymphogranuloma venereum in men who have sex with men (MSM) in Europe, the United Kingdom, and North America. In August of 2007, the Norweigan medical journal Tidsskrift for den Norske laegeforening stated that LGV has been a rare condition in the western world but since 2004 there have been frequent reports from larger cities in Europe and the United States and the outbreaks have been limited homosexual men. The abstract for the January of 2007 journal Clinical Infectious Diseases states that "We found a significant burden of this once-rare sexually transmitted infection among MSM in the United Kingdom. LGV may be contributing to the epidemic of human immunodeficiency virus infection by facilitating transmission." The reports of levels of proctitis in the homosexual men infected with lymphogranuloma venereum varied in the different outbreaks of lymphogranuloma venereum.

Amebiasis, Proctitis, and HIV Infection

See also: Homosexuality and parasites

As mentioned earlier, amebiasis and proctitis are both illnesses associated with gay bowel syndrome. In addition, it was also indicated previously that amebiasis can cause proctitis which increases the risk factor in regards to HIV infection.

The abstract for the 2017 Eurosurveillance journal article Outbreak of intestinal amoebiasis among men who have sex with men, Barcelona (Spain), October 2016 and January 2017 indicates:

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Entamoeba histolytica has been recently recognised as an emerging sexually transmissible pathogen in men who have sex with men (MSM), causing sporadic outbreaks in countries where it is not endemic.

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In 2006, the The Medical Journal of Australia reported:

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High rates of intestinal parasitism are found in MSM [men who have sex with men] throughout the world. Amoebiasis has become endemic in MSM in Japan and causes significant morbidity and mortality; complications such as colitis and liver abscesses occur more frequently in homosexual and bisexual men than in heterosexual men. Similar findings on amoebiasis are reported from Taiwan, with MSM at increased risk for invasive amoebiasis and intestinal colonisation with E. histolytica.

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In 2001, The journal Internal Medicine (Tokyo, Japan) published an article entitled Amebiasis in acquired immunodeficiency syndrome in which they declared:

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While the overall prevalence of amebiasis is approximately 4% in the United States, certain high-risk groups have a much higher incidence of infection and disease. Prevalence of E. historylitica or E. dispar in the gay population of New York City and San Francisco approached 40-50% . Some Japanese literature also showed homosexual contact was an important risk factor for amebic infection.

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Amebiasis is a disease caused by the one-celled parasite Entamoeba histolytica.

The 2004 article an entitled Present characteristics of symptomatic Entamoeba histolytica infection in the big cities of Japan which was published by the medical journal Epidemiology and Infection. The abstract for the article states the following:

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Medical records, for 2000 and 2001, of symptomatic amoebic patients who were treated at our hospitals in Tokyo, Yokohama and Osaka were studied retrospectively for the purpose of gathering epidemiological data on symptomatic Entamoeba histolytica infection. A total of 58 patients were treated. Fifty-five of them were male, and 96% of the male patients were Japanese. The mean age of patients was 44.9 years old, and 91% of patients contracted the disease in Japan. Fifty-six per cent of the male patients indicated that they were practicing homosexuals, and 44% of the male patients denied these practices or left the question unanswered. The serum Treponema pallidum haemagglutination test was positive in 45% of the patients, and antibody to human immunodeficiency virus (HIV) was positive in 45%. Our study revealed that recent symptomatic E. histolytica infection almost exclusively afflicted middle-aged males in the big cities of Japan, that a majority of the patients were probably exposed to the causative organism during homosexual activity, and that an increasing number of patients will be co-infected with HIV.

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In 1985, the peer reviewed medical journal Gut, which is an international medical journal for gastroenterology and hepatology, had an article entitled The Gay Bowel authored by I V Weller which stated the following: "Guardia lamblia and Entamoeba histolytica have long been regarded as 'exotic' organisms, but are 'hyperendemic' among gay men attending STD clinics with up to 20 excreting cysts."

For more information, please see: Homosexuality and parasites