Part of taking care of yourself is being fairly educated when it comes to sexual health.

Obviously, STIs don’t make moral judgements about you or the sex that you’re having. Whether we’re in a long-term relationship or volunteering to be the cum-dump for Tuesday night’s gang-fuck, it’s a level playing field – we can all transmit and acquire the same STIs.

While there’s no moral hierarchy when it comes to sex and STIs, the more that you know about your own health and the health of your sexual partners, the more confident that you can be about where you stand in relation to STIs. Having an open and frank discussion about sexual health is much easier if you’re in a relationship or you have a regular fuck-buddy, but it’s not so straightforward when it comes to hookups.

One of the exciting aspects of a hookup is precisely the lack of information shared. It’s probably a one-off encounter. You might know his screen-name, but not much more. You might not even see his face – he could just be an anonymous hard cock pushed through a hole in the wall of the toilet cubicle. Random hookups are awesome, they’re a great no-strings-attached way to get off with other guys, but what are some of the STIs that you need to be regularly getting tested for?

Shigella

In worrying news from the US, the Centers for Disease Control (CDC) has issued a warning to healthcare providers about a rise in antibiotic-resistant shigellosis – often referred to as shigella.

Shigella affects the digestive tract and usually causes inflammatory diarrhea that can be bloody. The infection may also lead to fever, abdominal cramping, and tenesmus, a continual or recurrent urge to evacuate the bowels.

Most people that acquire a shigella infection will recover without any treatment or medication – effective medication helps shorten the illness’s duration. Those living with HIV, in particular, benefit from antibiotic treatment. Now, antibiotic-resistant strains of the virus seem to be emerging.

The CDC says that in 2015, all cases of shigellosis reported in the U.S. responded well to antibiotic treatment. As of 2022, about 5 percent of shigella infections did not respond to traditional therapies.

The data from the CDC indicates that the antibiotic-resistant strains are particularly prevalent in gay men.

Obviously, STIs such as shigella don’t make moral judgements about you or the sex that you’re having. Whether we’re in a long-term relationship or just having some hook-up fun on a Tuesday night, it’s a level playing field – we can all transmit and acquire the same STIs.

While there’s no moral hierarchy when it comes to sex and STIs, the more that you know about your own health and the health of your sexual partners, the more confident that you can be about where you stand in relation to STIs. Having an open and frank discussion about sexual health is much easier if you’re in a relationship or you have a regular hook-up buddy, but it’s not so straightforward when it comes to your more anonymous interactions.

What is Shigella?

Shigella is a bacterial infection.

The symptoms of a Shigella infection are diarrhoea and stomach cramps – it’s frequently mistaken for food poisoning.

Why is Shigella in the news?

The UK Health Security Agency (UKHSA) has published a report regarding a rise in cases of extremely antibiotic-resistant Shigella infections. Unsurprisingly, these infections are being detected in men who have sex with men.

According to the data provided by UKHSA, there have been 47 cases of the antibiotic-resistant Shigella detected in the 4-month period between 1 September 2021 and 10 January 2022.

This is a strain of infection that UKHSA has been monitoring since 2018. For the period of 1 April 2020 to 31 August 2021, a total of 16 cases had been detected. So the detection of 47 cases in the past four months is a significant increase.

“We have never seen a type of Shigella that is as resistant as this one, spreading at this rate…” said Mateo Prochazka, an Infectious Disease Epidemiologist at UKHSA.

According to the insights provided by Prochazka, several of the men infected with this strain of Shigella became so ill that they needed emergency care, with a number admitted to to hospital for treatment.

“You do not need to be immunosuppressed to get ill…” adds Prochazka. “Lots of very healthy adult men in their 20s and 30s are getting severely ill. Almost all HIV- and on PrEP.”

How is Shigella transmitted?

Shigella is a pretty aggressive bacteria – you only need the smallest amount of contact for the infection to be transmitted.

You can get Shigella by eating food that has been contaminated with the bacteria, but – for queer guys – our biggest exposure is during sex.

The Shigella bacteria is found in faecal matter – your faeces, your shit. So, if you come into contact with even the smallest amount of faecal matter that contains the bacteria, then it’s likely that you’ll pick up the infection.

Rimming is the most likely point of transmission – because your mouth is likely to make direct contact with the bacteria. But any scenario where ass play is involved – fingering, using toys, fisting – could involve you coming into contact with the Shigella bacteria.

How can I protect myself against Shigella?

It’s difficult. A focus on hygiene will help. Try and ensure that you’ve both had a shower and thoroughly washed before the fun gets underway. If you’re fisting, using gloves may help provide some protection.

If someone has been diagnosed with Shigella, it’s important that they avoid sexual contact until fully recovered – to avoid transmitting the bacteria to others. It usually takes about 10 days to get rid of the bacteria from your body – antibiotics can be prescribed.

What do I do if I think I’ve got Shigella?

Generally, you’ll have some symptoms – usually this manifests as diarrhoea or stomach cramps. If you think you’ve got Shigella, it’s important that you go to your doctor or local sexual health clinic for testing. Regular testing for STIs is also a good way to identify if you’re carrying the bacteria.

While your sexual health clinic will be pretty clued-up about Shigella, your doctor may not automatically make the connection between stomach cramps and sexual activity. You may need to make it clear to your doctor that you have sex with men and that you may have been exposed to Shigella.

If you’ve got the bacteria, it’s generally not a major drama. You should start to feel better fairly quickly and you should be fully recovered from the infection in about 10 days. However, this antibiotic-resistant strain complicates things a bit.

If you’re feeling unwell, seek medical advice early. Stay hydrated. Antibiotics may not address the problem.

Do I need to tell anyone if I’ve got Shigella?

Shigella isn’t anything to be embarrassed or ashamed about. It’s pretty likely that we’re all going to encounter it at some stage.

Don’t have sex while you’re still in the recovery phase. Make sure that you’re not transmitting the bacteria to anyone else.

You should also contact anyone that you think you might have exposed to the bacteria during a sexual encounter. From when you first began experiencing symptoms, contact anyone you had sex with in the week prior to that. Letting them know will be a good prompt for them to go and get tested and make sure that they’re not unwittingly transmitting the bacteria to anyone else.

What else should I be watching out for?

HIV:

While we are seeing a decline of HIV transmission rates in some cities. HIV remains the most serious STI that men who have sex with men are likely to encounter.

You’re probably not going to know the HIV status of your sexual partners. There’s no visual indicators, and even if they tell you what their status is, you’ve got no way of verifying their testing history or viral load.

What’s essential is that you know what your status is. If you have acquired HIV, then your treatment will most likely mean that your viral load will be undetectable and you won’t be able to transmit the virus to anyone else. If you don’t have HIV, then you’ll be able to use PrEP to protect yourself against the virus. Condoms can also help to prevent the transmission of HIV.

You’re most at risk of acquiring HIV if you get fucked by a guy who has HIV but is not on treatment (and so is likely to have a high viral load) and you’re not on PrEP and a condom isn’t used.

Gonorrhoea and Chlamydia:

Gonorrhoea and Chlamydia are both bacterial infections – they’re different, but there’s a lot of similarities between them. You could acquire a Gonorrhoea or Chlamydia infection in your dick, your butt, your throat, or your eyes.

The infection can be transmitted through any sort of contact. Condoms are effective in preventing transmission of the bacteria when it comes to fucking or getting fucked, but you’re still exposed when sucking cock or rimming.

Symptoms could range from having a sore throat, to discomfort when you’re urinating, to a discharge from your butt. You may be infected but not have any noticeable symptoms. Gonorrhoea and Chlamydia are pretty common infections, so this is something you should be proactively thinking about.

Both Gonorrhoea and Chlamydia can be cleared up through antibiotics, although strains of drug-resistant Gonorrhoea are now emerging. If you present to your sexual health clinic with symptoms, or if it’s picked up during your regular testing, once you’ve completed the course of antibiotics for Gonorrhoea, they’ll test you again to make sure that the drugs have worked and that you’re good to go.

Monkeypox: This is not technically an STI but does seem to be effectively transmitted through sexual contact. There’s effective vaccinations against Monkeypox so make sure you’ve got yourself covered.

Crabs: These are pubic lice that are transmitted through physical contact. You can get a cream from your pharmacist without a prescription.

Genital warts: Transmitted by physical content, these are abnormal skin growths caused by the human papilloma virus (HPV). Treatment is difficult, so best to avoid touching anything that looks like genital warts. A vaccine has been developed and is becoming more widely available.

Herpes: This is a virus that is spread by skin to skin contact. There are two forms of herpes – HSV-1 which causes cold sores around the mouth, and HSV-2 which causes sores around your dick and butt. Glandular Fever is also a member of this family of viruses. There’s no cure for Herpes, although antiviral treatments can help to keep outbreaks under control.

Hepatitis: There’s three different types of Hepatitis – Hep A, Hep B, and Hep C. Hep A is found in faeces and Hep B is found in pretty much all bodily fluids. There is a vaccine that will protect you against both Hep A and Hep B. There’s no vaccine against Hep C – it’s primarily a blood-related risk if you’re injecting drugs, but can be transmitted through cum. Hepatitis can be treated, but if left untreated it can cause long-term damage to your liver.

MCV: This stands for Molluscum Contagiosum Virus. MCV is a skin infection that’s caused by a virus – the virus is transmitted through physical contact. The virus only lives in the outer layer of skin and causes small bumps or lesions on the skin. Treatment is relatively straightforward.

Scabies: Scabies is a skin disease caused by a tiny parasitic mite that lives just under the surface of your skin. Scabies can be spread by any form of skin-to-skin contact and can also be caught from infested clothing, sheets or towels. An infestation by the parasite causes a red, bumpy and very itchy rash in the affected areas. Treatment is readily available.

Syphilis: This is a bacterial infection that can be transmitted through all forms of sexual activity. Using a condom would help prevent the transmission of Syphilis when fucking or being fucked. Symptoms can be difficult to detect, but your routine testing will pick it up. Detected early, it is easily treated with antibiotics.

How often should I get tested for STIs?

The CDC – the Centers for Disease Prevention and Control in the US – recommends that men who have sex with men should be tested for STIs at least every 12 months. If you’re having sex with multiple partners – that means if you’re active on the hook-up and dating apps and enjoying regular encounters – then you should be getting tested more frequently, such as every three to six months.

Testing is easy and straightforward. Home testing kits are widely available, sexual health clinics will generally provide free testing, or your local doctor will be able to complete the tests. If the tests return any positive results, then you’ll be treating early, getting on top of any problems, and ensuring that you’ve got the all clear to get back out there and get amongst it.

Don’t ignore your sexual health. Get tested.

Ready to see the doctor?

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