When most people think of sexually transmitted infections, they tend to think about infections that affect the genitals. They don’t tend to think of infections that affect the gut.
But a fascinating new article in Clinical Microbiology is drawing attention to how closely infections of the gut can be sexually transmitted.
Keep reading to find out more.
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The article’s lead author, Dr. Ferric C. Feng, professor of microbiology, laboratory medicine and pathology at the University of Washington School of Medicine, writes that the “[global] emergence of several multidrug resistant gut pathogens and the potential for crossover transmission among different at-risk populations underscores the importance of prompt diagnosis, appropriate treatment, and the need to consider community-level education and testing.”
The authors of the article drew particular attention to infections like Shigella and Campylobacter among men who have sex with men. The sexual transmission of enteric infections (STEIs) among this group has been reported and recognised since the 1960s. The “public health response to these infections and identification and identification of transmission networks fall between the traditional groupings of sexually transmitted and foodborne diseases.”
Some infections, such as Shigella and Campylobacter, can be transmitted sexually or through contaminated food.
This mode of transmission also exists for many other infections. Scabies, for example, can be passed on during sex, but can also be passed on through sharing bedding or extended periods of physical touch, like hugging or cuddling.
The article’s authors were initially concerned that HIV or drugs used to prevent or control HIV might contribute to the spread of these infections. However, there appears to be no increase in the rate of transmission of pathogens affecting HIV-positive or HIV negative men.
Rather, sexual behaviour seems to be the driving force behind the transmission of these infections. Oral-anal contact, or rimming, is the primary way these infections are passed on. Recent cultural changes make these kinds of behaviours more likely.
Sexual encounters with new partners are easily made through online dating and hookup sites and apps. Transmission is also helped by the decline in use of contraceptive barriers like condoms, as quick and effective treatments for infections like Chlamydia and Gonorrhoea become more readily available. Chemsex also plays a role in lowering inhibitions.
Men who have sex with men are more likely to contract these infections, tend to be younger, urban, and travel internationally. They also tend to have wider sexual networks.
People who are homeless, live in unsanitary conditions, and who exchange sex for money are also at more risk, as well as people who are immunocompromised.
STEIs are becoming increasingly difficult to treat and can persist for extended periods. Fang and his colleagues also note that many of these gut infections have become increasingly resistant to drugs in recent years. International travel has also made it easier for these infections to break free from national barriers, where they may have been isolated in the past.
Responses to STEIs have been hampered because they aren’t clearly defined as a single, specific infection. Treatment and prevention initiatives tend to focus on traditional STIs, like Gonorrhoea and Syphilis.
Health professionals may not seek the sexual history of people with these gut infections during consultations.
STEIs can have serious consequences if they’re not treated properly. Talk to your healthcare provider if you’re experiencing any of the symptoms listed above.
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