Testing, Testing: (It's As Easy As) 1, 2, 3

I get tested once per year, usually right around the time of my birthday. I do this even though I am a pretty low-risk kind of guy: Married, or as good as married anyway, for almost thirty years. But low risk is not zero risk: Once, years ago, in Provincetown, as I waded in the water just off a beach, I stepped on a discarded hypodermic needle. It freaked me out, and not because of HIV. As the doctor told me when I asked about it subsequently, HIV is not the only, or even the nastiest, bug out there.

When the subject of testing for STIs comes up (and one would hope it does come up, because it's important), one might find one's mind flashing on risk factors and possible results for an HIV test.

It's understandable. HIV and AIDS still get a lot of publicity. Not that they shouldn't; what I'm saying is, other pathogens don't get enough publicity, or get the wrong kind of publicity.

Let's start with what we all probably know. HIV is no longer seen as a probable death sentence. With early, effective treatment many HIV-positive people can now expect to live a normal life span. It's by no means a carefree life, entailing daily doses of medication, frequent checkups, the question of whether to PrEP or not to PrEP for those in committed relationships and, for those in the dating scene, the dreaded conversation about status -- not to mention to sticky, tricky, emotionally charged topic of whether, when, and to whom to come out.

But HIV, while still serious business, is not the only elephant in the room. It commands a huge share of attention and anxiety, which in some ways is a good thing; If infected, the earlier one knows about it the better one's prospects for effective, health-preserving treatment, and the less chance one has of infecting others. (Alarming statistic here: An estimated one in five HIV-positive people don't know their status. Hence they don't get treated. Hence they are much, much more likely to infect someone else than people who do know their status and are on an effective treatment regimen. Among those who don't their status are people who don't want to know -- an exasperating, if understandable, mindset, because avoiding knowledge doesn't change the problem. A virus is a virus: It does what it does, regardless of moralizing, condemnation, rationalizing, or any other form of human conduct. But that's a topic for a different column.)

On the other hand, such focus on HIV obscures the fact that the gay community... hell, every community of sexually active people... faces health risks from other STIs, too, such as syphilis and gonorrhea. (Remember syphilis? Back in the pre-"blame the gays" days, it was the AIDS equivalent among straights -- not that the "AIDS is God's Punishment" crowd bothers to remember or acknowledge this.) We've also seen mini-trends in recent years of other pathogens affecting our community: MRSA, which is a flesh-destroying, antibiotic-resistant form of staph, for instance. More recently, we've seen mini-waves of illnesses and death in our community caused by meningitis.

Viruses and other pathogens are opportunistic. The ones that can be passed around through every-day activities like breathing, drinking water, or having sex are going to thrive as compared to the ones that are harder to catch. Compared to herpes, or HPV, or hepatitis, HIV is kind of hard to catch. That's not license to have unsafe sex: It's a wake-up call as to how easily other pathogens can get around.

And sex, like drinking water or breathing air, isn't a gay thing or a straight thing: It's a human thing. Unlike most animal life forms, human beings have a 365-day-per-year estrus period, meaning we are horny all the time. That doesn't make us immoral. It's simply part of who we are as a species. I suspect that part of the reason we hear about STIs in the gay community is that ever since the AIDS epidemic, the media (and the general public) are primed to hear about STIs in the context of the gay community (or, for those who are determined to "love" us to death by condemning everything we do, to hear about the gay community pretty much solely in the contexts of sex and disease).

STI trends in the straight world don't command as much in the way of political lather or media headlines. That doesn't mean that straights don't also give each other sexually transmitted infections. There's a newly emergent, antibiotic-resistant strain of gonorrhea out there, now, that can be passed from person to person through oral sex, and it's affecting straight people as well as gays; where are the Fox News commentators? Where are the bogus "studies" about heterosexual sex / health / morality / relationship fitness by the likes of Mark Regnerus?

Aside from syphilis and gonorrhea, there's hepatitis, a disease that affects the liver; the worst of several strains is hepatitis C, which can go undetected and remain asymptomatic for years until it causes such major scarring and damage to the liver that it seriously impacts health or even kills the person if afflicts.

Then there's HPV, the human papillomavirus. This was in the news a few years ago because some parents, in a moralistic and religious panic, objected to their daughters (or sons) being inoculated against HPV at an early age, claiming that to take preventative measures to safeguard their kids' health would encourage sexual promiscuity among the young. (This is a stripe of idiocy and recklessness that also deserves a separate column.) In the straight world HPV can cause soft-tissue cancer; actor Michael Douglas was very public about his bout with cancer, which he said stemmed from exposure to HPV via heterosexual oral sex. (Again: Moralists? Sex-fearing politically motivated gay bashers? Anything to say? Anything?) Of course, in the gay world, HPV can also cause soft tissue cancer, especially for people who are immuno-compromised. (That is: People living with HIV are more susceptible.) Again, we are talking about a virus -- not a punishment, a decree, a referendum, or anything else that stems from the human tendency to categorize, demonize, and persecute.

So why isn't the conversation around testing taking on a wider focus than just HIV? Well --�now it is, at least in Boston.

Boston's MALE Center, affiliated with the city's AIDS Action Committee, recognizes that there are more health threats out there than just HIV. A recently launched program offers a once-weekly opportunity for one-step testing for a slate of STIs -- HIV, yes, but also syphilis, gonorrhea, and hep-C. The MALE Center also recognizes that the subject of human sexuality, much like the subject of epidemiology, is far more complex (and potentially complicated) than neatly drawn compartments and categorizations might suggest.

When I heard about this program, I became curious about it, so even though I'm about the least likely person to contract an STI of any stripe, I stopped in on the first Tuesday the new testing program became available.

The nurse -- a good looking young fellow named Jake Tinsley with a fashion-forward haircut and a gently, supportive demeanor -- discussed numerous aspects of the testing with me, going over the diseases we'd be looking for (what they are, how they can be transmitted, why they are harmful), as well as asking me detailed clinical questions about my sex life and sexual orientation and identity. (Do I identify as male? Was I born male? How many sexual partners have i had in the last year? How many of them were female? This was all done with utmost respect and professionalism.)

Jake drew my blood, did an oral swab on me, and sent me off to the restroom to provide a urine sample and do an anal swab on myself. (Not before he gave me detailed, easy-to-follow instructions on how to do an anal swab. I was just glad I was allowed to tend to this myself.) In a week or so, he told me, I'd get the results: There would be an email, and that email would direct me to an online site where, after setting up a username and password, I could access the facts about my status for all these STIs.

Two weeks later, there they were: Results for HIV, hep-C, oral and anal syphilis, oral and anal gonorrhea, and chlamydia. All negative. I knew this result in advance, or at least thought I did since there was no reason to think anything else, but it seemed justifiable to access this free resource in order to write a column about it and help spread the word.

Because let's face it: Viruses and other pathogens can be spread around, some of them fairly easily, and a number of them through intimate contact. It's vitally important that we learn how to spread information with equal ease so that efforts to counteract, and maybe one day eradicate, these diseases can be as effective as those viruses are at getting into the population -- not just the gay population, but the straight and bi populations as well, in all their own rainbow stripes (such as MSM, guys on the DL, etc.).

The best place to start with life-saving information of this sort? With ourselves. Don't be scared of testing: It really can save your life and the lives of others you come into contact with. Don't be fooled, shamed, or side-tracked by people with messages of religious condemnation or political agendas who want to stuff gays, science-based knowledge of sexuality, and sex itself into some antiquated pigeonhole inimical to human life. As the AIDS Action slogan has it, "Know AIDS / No AIDS." Knowledge is power, and there are plenty of people out there who want to keep you powerless: Don't collaborate with them against yourself.

Get tested, even if you don't think you need to, even if you'd rather not know. Especially if you'd rather not know. And get tested for as many STIs as you can, not just for HIV. The best rebuttal of those who continue to pathologize our lives and our families is to stay healthy.