It may be Sars time now, but in fall 2002, a smaller epidemic erupted. That’s when Los Angeles infectious-disease specialist Peter Ruane, MD, noticed an unusual number of boils, abscesses and hard, red skin bumps among his gay male patients—especially the HIVers. The blemishes arose, atypically, on penises, scrotums, buttocks and chests. Diagnosis? Staphylococcus aureus—just plain staph to you—a bacterial infection normally found on the skin’s less erogenous zones and inside the nose.
A technique called molecular fingerprinting showed the infections to be identical from one patient to another. “There was a specific bug being transmitted from person to person,” Ruane says, “and the infections we’ve seen are more serious in people with HIV.” What’s more, the staph is drug resistant (it’s called MRSA, for methicillin-resistant staph aureus) and requires meds that many HIVers can’t tolerate—they’re either allergic (as with Bactrim) or unable to mix the med with HAART (rifampin can’t be taken with protease inhibitors).
But positive, negative, gay or straight, staph can cause severe illness, such as toxic shock. And MRSA can invade even if your skin isn’t broken. Staph isn’t sexually transmitted, but Nolan Lee, MD, an LA County health department epidemiologist, says this “gay outbreak” acts STDish because it spreads skin-to-skin. (Speaking of STDs, syphilis rates soared among gay men in spots like LA, Miami and New York last year, too.) At the gym, staph can travel in saunas and on towels, weights and benches; at the club, it hops from straws, spoons and other drug paraphernalia.
MRSA has also hit jails in at least six states, a Texas high school football team and day-care centers (it’s common in health care institutions, where antibiotic use promotes drug resistance). Now, says Kenneth Haller, MD, president of the Gay and Lesbian Medical Association, increased antibiotic use in outpatient clinics and homes has prompted MRSA to make house calls.
- Scrub Up (use soap and water frequently) and bathe immediately after going to the gym.
- Keep cuts and abrasions clean and cover them up with light bandages.
- Be aware of the health of sex partners and other close contacts, and don’t touch other people’s wounds or soiled bandages.
- If you think the stuff you’ve got is staph, see your doctor ASAP. A culture will tell which drugs your infection might resist. Switch meds at the first sign of resistance: An ineffective drug could make MRSA worse.