Your Private GP and Sexual Health Clinic in Canary Wharf
Gay men’s sexual health
Dr Wayne Cottrell:
Gay Men’s Sexual Health
There is a lack of private medical services catering for the needs of the LGBTQIA community, who often find it hard to find a sympathetic medical professional who they can discuss their sexual habits with without fear of judgement or prejudice, or due to concerns re information they disclose to the NHS. I have many years’ experience working with the LGBTQIA community and I offer advice to all who seek information on sexual problems, safer sex, chemsex, HIV, PEP, PrEP, substance or alcohol misuse.
Everyone is welcome at my practice and you can feel relaxed and safe in the knowledge that I take your health seriously. Furthermore, anything you discuss with us 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 levels of risk.
There are certain health concerns that are particularly relevant to the LGBTQIA community and especially for gay men:
HIV still affects the gay community disproportionally. The good news is that over the past few years, with the introduction of PREP, easier access to testing, early treatment and other measures, the levels of new infections in London have dropped significantly. There has also been recent studies showing that undetectable means untransmittable (#UequalsU). However, there is still no cure, so although the armoury against HIV has grown, we should not get complacent. Regular testing is vital!
Hepatitis C can be sexually transmitted, with the risk being higher in gay men. The risk is higher in the presence of other STIs, such as syphilis, LGV and HIV. 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, sharing drug equipment/needles etc. I now recommend routine Hepatitis C screening for all gay/bisexual/MSM patients or people with other risk factors such as IVDU and the general population if you have never been screened.
The modes of transmission are similar to that of Hepatitis C, but it is easier to pass it on sexually, even via oral sex. Vaccination against Hepatitis B is recommended for all gay/bisexual/MSM persons and others that might have a higher risk, such as IVDU and certain occupations.
Human Papilloma Virus (HPV)
For most people, infection with HPV is a minor irritation leading to genital warts. However, it is much harder to clear the virus for HIV-positive patients due to an impaired immune system. Persistent anal HPV infection can lead to pre-cancerous changes in the anus. I am one of a few doctors that can offer anal smears to detect anal cancer early on. We also do Gardasil vaccination to prevent infection with HPV.
LGV (Lymphogranuloma venereum)
A systemic disease caused by a type of Chlamydia infection. It is mostly seen in gay men who have receptive, unprotected anal sex (bareback). It spreads particularly easily where there are multiple sexual partners (saunas, sex clubs, sex parties). 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 also enter the bloodstream and cause a systemic illness with fever. It is easily treated with a course of antibiotics, especially early on in the disease. 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 screening
We offer bespoke STI screens tailored to MSM community which includes:
- HIV Duo/P24 test
- Acute hepatitis screening ( A, B and C)
- Throat swabs and for chlamydia and gonorrhoea
- Rectal swabs for Chlamydia, Gonorrhoea and Mycoplasma Genitalium
- Rectal HPV testing and Anal smears
- Urine Screen for Chlamydia, Gonorrhoea and Mycoplasma Genitalium
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. You might also just want your bloods done more frequently or might have had a one-off sexual contact that concerns you. We are able to do a range of STI screens with most results available same day.
I have over 21 years’ experience in providing sexual health screening and we 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 consultation to discuss the possible risks and whether screening would be appropriate. We discuss and agree all costs beforehand. You know exactly where you stand. I will always provide you with clear and accurate advice based on current British Association for Sexual Health and HIV (BASHH)guidelines.