MRSA spike among gay men: More effective prevention needed for MRSA, HIV and other STDs

Jan 15 2008

AIDS Healthcare Foundation (AHF), today expressed concern over a recent study first reported publicly today in an 'Annals of Internal Medicine' article which found that sexually active gay men in San Francisco were 13 times as likely to contract methicillin-resistant Staphylococcus aureus (MRSA), a drug-resistant strain of bacteria, than their heterosexual counterparts.

On the heels of recent increases in both HIV infections and syphilis among men-who-have-sex-with-men (MSM), AHF believes a multi-pronged public health approach to the prevention of infectious diseases and STDs targeting this and other at-risk populations must be undertaken. AHF also believes that it is crucial that such an effort be sustained for the longer term, and that despite potential budgetary cuts on a state and federal level, significant public health resources and funding must be targeted to help break the chain of new infections in the MSM community, and which according to today's report, also have the potential to spread into the general population.

According to Reuters ("Drug-resistant Staph Passed in Gay Sex - US Study," Amanda Beck, Reporter, 1/14/08), "Incidence of MRSA is rising along with the resurgence of syphilis, rectal gonorrhea, and new HIV infections partly because of changes in beliefs about the severity of HIV and an increase in risky behaviors, such as illicit drug use and having sex that abrades the skin, Diep's team wrote."

"I am concerned by this latest report showing a significant increase in MRSA infections among men-who-have-sex-with-men, a population already at higher risk for possible HIV exposure," said Dr. Homayoon Khanlou, Chief of Medicine for AIDS Healthcare Foundation. "We know that co-infection with HIV and other STDs can also decrease a patient's overall well-being and make it easier for an individual to transmit or contract any of these infections. We need to work together to step up our public health outreach and adopt innovative, multi-pronged approaches to the prevention of these infections before they have a chance to become entrenched and endemic both in the MSM and general populations."

"This report should serve as a wake up call and as a catalyst to fast-track and develop innovative, broad-based approaches to public health outreach programs nationwide," said Whitney Engeran, III, Director, Public Health Division for AIDS Healthcare Foundation. "Sustained and focused prevention efforts and effective risk-reduction initiatives must be scaled up across the country if we are going to reverse this trend in infections among MSM. Better leadership is required at all levels: federal, state, local and within communities themselves. The efforts should not only be made when the spotlight is on, such as after a report like this one. We need a sustained, unified commitment that doesn't flag when the numbers begin to decrease."

"In February, 2003, Los Angeles County faced an outbreak of MRSA among inmates in its county jail system. At the same time, an escalating outbreak of syphilis, a highly transmissible, yet readily curable sexually transmitted disease was wreaking havoc in the County's general public health system. Many of those cases of MRSA and syphilis were identified in individuals who also had HIV," said Michael Weinstein, President of AIDS Healthcare Foundation. "That confluence of co-infections underscored a crucial need for an aggressive response from County public health officials and leaders. Today's study, which indicates that MRSA is now appearing more regularly outside of traditional populations in San Francisco, Boston, New York and Los Angeles, prompts us to renew this urgent call to a develop more responsive and effective overall public health strategy nationwide."

Today's 'Annals of Internal Medicine' article also comes as the CDC prepares to release its latest data on HIV incidence in the US—figures which the Wall Street Journal, the New York Times and Bloomberg recently reported may be up to 50% or more higher than the previous CDC estimate of 40,000 new HIV cases per year.

"The CDC is preparing to announce that there are as many as 15,000 to 20,000 more HIV infections per year here in the US than previously thought. Yet last week, California Governor Arnold Schwarzenegger proposed a 2008 budget that contains ten percent across the board cuts to the state's entire public health budget, including an $11 million cut in AIDS services as numbers and infections continue to rise," added AHF's Weinstein. "Despite a significant state budget shortfall, we need to ensure an effective response to the AIDS epidemic as well as related and increasing public health threats such as MRSA. We need to take a long hard look at reallocating and restoring critical resources to make HIV, STD and general public health screenings for all populations a routine part of medical care, and normalize the process of prevention, testing and treatment."

AIDS Healthcare Foundation (AHF) is the US' largest non-profit HIV/AIDS healthcare, research, prevention and education provider, as well as the operator of California's largest alternative HIV testing program, administering over 15,000 tests per year. AHF currently provides treatment, care and support services to more than 62,000 individuals in 20 countries worldwide in the US, Africa, Latin America/Caribbean and Asia.