There is a lack of private medical services catering for the needs of the LGBT community. Gay men and women often find it difficult to discuss their sexual habits with their NHS GP either for fear of rejection or prejudice, or because they are concerned about what information will be held in their NHS records. I have many years experience working with the LGBT community and I offer advice to all who seek information on sexual problems, safer sex, HIV, PEP, PrEP, substance or alcohol misuse.
It is my aim is to ensure that everyone can feel relaxed and safe in the knowledge that I take your health seriously and to address any specific concerns you might have. Furthermore, anything you discuss with me remains completely confidential and doesn’t enter your NHS notes.
Although sexually transmitted infections in heterosexuals and homosexuals are the same, due to different sexual practices ( such as rimming, fisting, Chemsex, etc) , there might be different issues that need to be addressed.
There are certain health concerns that are particularly relevant to gay men:
- HIV: We know that HIV is a still a big problem, and that it affects the gay community disproportionally. Despite years of education and prevention strategies, large numbers of gay men are being infected with HIV every year. A survey conducted by the HIV charity THT, found that 1 in 7 gay men in London is HIV positive (Source: Gay Men’s Sexual Health Survey 2009). The number of diagnoses is as high as ever with 3250 new cases reported in 2013. As part of a responsible attitude to sex we promote regular testing for HIV and other STI’s.
- Hepatitis C: Until a few years ago no one even considered this to be a sexual risk. Now we are seeing many new diagnoses every year. We now know that Hepatitis C can be sexually transmitted, with the risk being higher in gay men, especially in people co infected with HIV, or in the presence of other STI’s such as syphilis and LGV. As the virus is mainly spread through contact with blood, the main risk factors are traumatic unprotected anal sex, fisting , as well as injecting drug use, which is becoming increasingly more common at sex parties.The sharing of drug equipment such as bullets and straws are also considered a risk factor. I now recommend routine Hepatitis C screening for all my gay/bisexual/MSM patients.
- Hepatitis B: The modes of transmission are similar to that of Hepatitis C but it is much easier to pass it on sexually, even via oral sex. I recommend and offer vaccination against Hepatitis B for all gay/bisexual/MSM patients
- Human Papilloma Virus (HPV): For most people infection with HPV is a minor irritation leading to genital warts. However for HIV positive patients, due to an impaired immune system, it is much harder to clear the virus. The problem with a persistent HPV infection is that eventually this could lead to anal dysplasia and pre-cancerous changes in the anus. At the moment there are very few NHS clinics that will offer the testing for HPV or Gardasil vaccination to prevent infection with HPV. This is unacceptable and I offer both HPV testing as well as HPV vaccination to male and female patients, if appropriate.
- LGV (Lymphogranuloma venereum): is a systemic disease caused by a type of Chlamydia infection. It is mostly seen in gay men who have unprotected anal sex (bareback), multiple sexual partners especially in saunas, sex clubs, sex parties and fisting without gloves. Symptoms can take from a week to several weeks to appear. The initial symptoms are usually blood or pus coming from the rectum, painful inflammation of the rectum (proctitis), a feeling that you have to go to the toilet (tenesmus), and eventually it can lead to ulceration and or abscesses. It can enter the bloodstream and cause a systemic illness with fever. It is easily treated with a course of antibiotics, especially early on. Left untreated it becomes much more serious and can cause lasting damage to the rectum. It is possible to get LGV in the penis too.
MSM specific STI screen
Due to the different risks and different areas exposed through MSM sex, I offer a screen tailored to MSM community which includes:
- HIV Duo/P24 test
- Hep B antigen test
- Hep C antibody
- Throat and rectal swabs for Chlamydia and Gonorrhoea
- Urine Screen for Chlamydia and Gonorrhoea
Many of my patients use me as an add on to the services they receive through the NHS. Often times there are tests the NHS will not do such as testing for HPV, anal smears or HPV vaccination. I am able to do all of these on a private basis in my clinic. You might also just want your bloods done more frequently or might have had a one off sexual contact that concerns you. I am able to do a range of STI screens with results available quickly. I am also able to give advice on PEP and provide advice on genital warts and treatment with cryotherapy or medication.
I can now offer same day results for all of the above tests as long as you are screened before 12pm ( higher fee applies)
I have over 14 years experience providing sexual health screening and I offer a completely confidential, professional, non judgemental service from start to end. If you are not sure if you have been at risk, then I offer a normal consultation to discuss the possible risks and whether screening would be appropriate. We discuss and agree all costs beforehand so you know exactly where you stand and I will always provide you with clear and accurate advice based on current British Association for Sexual Health and HIV (BASHH )guidelines.