Rare STD diagnosed in two New York City gay men (15020)

Two New York City gay men have been diagnosed with a rare sexually transmitted disease that can scar the genitals and is of the same strain recently found in Europe, the city's health commissioner said Wednesday. Lymphogranuloma venereum, or LGV, is a form of chlamydia that also can damage the bowels and scar the anus. Among the six patients identified with the STD so far in the United States most also are HIV-positive, health department commissioner Thomas Frieden said at a news conference. "We know LGV increases the risk of the spread of HIV because it causes ulcers and bleeding," he said.

In the past, New York had a few cases reported in males and females, but those were never laboratory-confirmed, health officials said. The recent two cases in New York have been laboratory-confirmed as LGV and are consistent with the pattern of LGV being found in men who had sex with other men, health officials said. Frieden said the federal Centers for Disease Control and Prevention have confirmed three LGV cases in San Francisco and one in Atlanta, all among gay or bisexual men. He said men who have sex with men are urged to abstain from sex or limit their number of sex partners and use condoms.

Unprotected anal intercourse is the key risk factor for the spread of LGV, which is difficult to diagnose. Symptoms include painful bloody rectal infection that may be confused with inflammatory bowel disease. The first symptom may be a painless pimple or lesion on the genitals, and the onset of symptoms varies widely, health officials said. The initial lesion may appear from three to 30 days after exposure. An individual remains infectious as long as there are active lesions. If identified early, LGV can be treated with antibiotics. Untreated, it can cause permanent damage to the bowels and swelling and scarring of the genitals. Death is rare.

Susan Blank, New York's assistant commissioner for sexually transmitted disease control, said the health department is treating the two cases as an "outbreak" in an aggressive effort to prevent the spread of what she called "a bad disease." An alert has been sent to physicians in New York that encourages doctors, particularly those who care for HIV-positive or gay patients, to think about LGV if there are symptoms consistent with it, Frieden said.

The president of the Latino Coalition on AIDS, Dennis DeLeon, urged gay men to be diligent about screening for sexually transmitted diseases. "It sounds like a tired message, practice safe sex, but this is a disease that can leave permanent scarring on the anus," DeLeon said. "Gay men should be asking their doctors about this."

Ana Oliveira, executive director of New York's Gay Men's Health Crisis, said the new STD cases should serve as reminders to sexually active gay and bisexual men to practice safer sex. "Prevention is more than just about protection against HIV," she said in a statement "It's about protecting oneself against all kinds of sexually transmitted infections, including LGV. These two local cases of LGV should enlighten men who have sex with men that practicing safer sex is the best way to stay alive and stay healthy."

In the past two decades LGV has been uncommon in industrialized nations and primarily has been found in the tropics. But in November the National Institute for Public Health in the Netherlands said 92 cases of LGV among gay and bisexual men had been reported there over the preceding year, compared with the usual two or three cases a year. Health officials said cases also have been found in the United Kingdom, Belgium, France, and Sweden.

Free, confidential STD exams and treatment, and confidential or anonymous HIV antibody testing are available at New York City health department clinics, which are located in all five boroughs of the city, according to health officials. Health insurance, proof of citizenship, or parental consent are not required for testing. For a list of clinics and hours go online to www.nyc.gov/health. (AP, with additional reporting by Advocate.com)