MRSA
(Methicillin Resistant Staphylococcus Aureus)

You’ve heard a lot about this skin eating virus in the news lately, and you should be concerned about it as well, especially if you are having sex in public where many people are using the same equipment. My sources say that cleaning equipment with a 10% bleach solution between uses greatly decreases risk of transmission.

What are the symptoms of a MRSA skin infection?
Signs of a skin infection include redness, warmth, swelling, and tenderness of the skin. Some people with MRSA might think they have a "spider bite." For most people, it isn't serious. Others may develop boils, blisters, pustules or abscesses. The infection can cause a fever and/or chills. People with fever and/or chills should see their health-care provider.

How is MRSA spread?
Staph, including CA-MRSA, is primarily spread when someone's skin comes in contact with the skin of someone who has Staph. That sort of skin-to-skin contact can happen when someone is playing sports, having sex, or doing other things. It can only be spread with skin-skin contact or skin-contaminated object contact.

What should I do if I think I have an active MRSA infection?
If you notice any of the symptoms of a Staph infection, you should contact your health-care provider. You may need antibiotics or other treatment. Your healthcare provider will discuss treatment with you. Do not try to treat yourself. Whenever antibiotics are prescribed, take all of the medication even if you think the infection has gone away. This will help prevent the Staph germ from becoming more resistant to antibiotics.

Is MRSA a sexually transmitted disease (STD)?
Data do not exist to determine whether sex itself - anal, oral, or vaginal intercourse - spreads MRSA. But we do know that skin-to-skin contact, which occurs during sex, can spread MRSA.

How do I protect myself from getting and spreading MRSA?
Practice good hygiene:

• Wash your hands frequently with soap and water. If soap is not available, use hand sanitizer instead.
• Showering or washing after contact sports, gym use, or sex may reduce the risk of skin-to-skin transmission.
• Practice safer sex. Always use gloves and condoms.
• Thoroughly clean and disinfect equipment and surfaces after each use.
• Keep wounds covered with clean, dry bandages.
• Take antibiotics only as prescribed by a healthcare provider
• Do not share personal items such as used towels, clothes, razors, or anything else that makes contact with skin.
• Clean and disinfect items that are shared before and after every use (athletic/workout equipment, slings, benches, tables, etc.) with disinfectant or detergent. A list of products approved by the Environmental Protection Agency that are effective against MRSA is available HERE. These products should be used only as directed. NOTE: At Hell Hole parties, we provide a quarternary disinfectant spray at every station, which should be applied before and after every session.
• Use lotion to keep skin moist; damaged skin can provide an opening for infection.
• Visit THIS SITE, sponsored by the San Francisco County Health Department City Clinic and the Stop AIDS Project to learn more.

Any sexual activity carries a risk of transmission of HIV or STDS. However, fisting is, in my opinion, one of the safest forms of sex–if you follow proper guidelines. The colon is lined with millions of tiny capillaries which are extremely close to the surface of the intestine. They are extremely susceptible to rupture during play. Overly rambunctious play, sharp fingernails or an inexperienced top can and do increase the likelihood of rupture.

There is a risk of hepatitis A, B and C infection. A is transmitted through ingestion of something that has been contaminate by fecal matter. Washing hands thoroughly and use of hand sanitizer is not only recommended, but mandatory.

Hepatitis B is transmitted through contact with infectious blood, semen, and other body fluids, from having sex with an infected person, sharing contaminated needles to inject drugs, or from an infected mother to her newborn.

C is most commonly transmitted when the blood of an infected person enters the body of an uninfected person--during fisting--through small scratches in the colon and open wounds in the top’s hands. Hepatitis C, unlike HIV which is a very fragile virus, is extremely hearty. Hepatitis C can live–and be contagious–for up to four (4) days in dried blood on an exposed surface such as a sling, counter top, floor, or bed sheets.

Vaccines are available to prevent transmission of Hepatitis A and B. There is currently no vaccine to prevent transmission of C. If you are sexually active it is an excellent idea to take the hepatitis A and B vaccines and to add the test for hepatitis C to the battery of tests for HIV and STD’s. Current experts in the field of prevention recommend testing every three months if you are sexually active with multiple partners. There is a high degree of success of cure for hepatitis C (between 50% and 80%) if the infection is caught early. Unlike other forms of hepatitis, exposure to C does not result in the development of antibodies to the virus. This means that even though you have been exposed, you may continue to be contagious to others and to carry the active virus in your body. GET TESTED!

Remarkably, there is currently considerable debate among doctors and public health officials as to whether Hepatitis C is sexually transmitted! As fisters we know (or should know) that at least through fisting, it can be. Currently, neither the SF City Clinic, nor Magnet, offer testing for Hepatitis C to anyone other than intervenous drug users (or others who inject drugs), so unless you are willing to put yourself into that category to get tested at one of these sites, the only alternative is through your private physician.

Unfortunately, testing for Hepatitis C is completely off the radar for most physicians, unless you happen to be HIV+ in which case your doctor is probably recommending an annual Hep C test. If you are negative, insist that your doctor include testing for Hepatitis C the next time you get your regular HIV and STD screening. You may be carrying Hep C--and exposing other people--and not even know it.

HIV is transmitted when blood or semen from an infected person comes into contact with the blood of an uninfected person. Unlike Hepatitis C, HIV is a very fragile virus and once exposed to air (and many other things) dies very quickly. There are still risks of HIV infection among fisters. The most common routes are:

• Colon-to-hand (and vice versa) through small cuts, tears or scratches in the colon or hands.
• Sharing lube among bottoms.
• Unprotected fucking and fisting.

Prevention:

• Always wear gloves. If you are not wearing gloves, make sure your fingernails have been clipped short and filed smooth. Make sure you don't have any small cuts on your hands (including hangnails) and arms. You can do this by liberally applying hand sanitizer or rubbing alcohol on your hands and arms before play. If you get a stinging sensation, glove up. As there is a possibility of transmission even with gloves, if you have any large or recent cuts, we suggest you postpone play until they are sufficiently healed.
• Don't share lube among bottoms. Every bottom should have his own container which is clearly marked with his name on the container (not on the lid). As fragile as HIV is, it can live in lube long enough to be transmitted to others.
• Don't fist and fuck in the same scene. Even if you're using gloves and condoms it is not good practice. It is kind of like playing Russian roulette with a completely loaded gun. Most of us don't have crisco-friendly rubbers lying around, and even if you do--which ones are they?? In the heat of the moment it is not always easy to tell--or to remember. Latex condoms break down quickly. You probably can't fist someone without causing some internal abrasians and a little bleeding, so why tempt fate by adding semen to the mix. We all know that fucking is the most common means of transmitting the virus. So don't do it.

There are so many resources that I won't attempt to list them all here, but an excellent starting point is the Stop AIDS Project and Project Inform.

Primary Syphilis
Symptoms usually show up 2-12 weeks after being exposed. The first sign is often a skin sore called a chancre (shank-er). You may have more than one, or you may have chancres and not notice them because they are inside your anus or vagina. Chancres can also appear on your scrotum, penis, vaginal lips, anus or in your mouth. They are usually not painful. The sores will go away after several weeks without treatment, but you would still be infected.

Secondary Syphilis
Most people who have secondary syphilis notice a skin rash covering their body 4 to 12 weeks after infection. The identifying feature of this rash is that it shows up on the palms of the hands and soles of the feet. Often it is not itchy. Other common symptoms of secondary syphilis are swollen glands in various areas of the body, fever, fatigue, patchy hair loss, weight loss, and headache. Since these symptoms are so similar to those of many other health problems, syphilis has sometimes been called "the great imitator."

Additional symptoms during secondary syphilis that are particularly important are syphilis warts and white patches (condylomata lata and mucous patches, respectively). These warts and patches are highly infectious and can occur in moist areas of the body like the mouth, side of the tongue, anus, etc.

Secondary syphilis symptoms usually last anywhere from 1 to 3 months, but sometimes they last longer, and once in awhile the symptoms come and go over a year or two. But even after the symptoms of secondary syphilis clear up, if left untreated, the infection continues in your body.

Latent Syphilis
Latent syphilis causes no symptoms. The infection can be detected only by a blood test. If not treated, latent syphilis continues for life. Many people with latent syphilis never have serious problems, but some progress to the final stage, called tertiary syphilis.

Tertiary (late) Syphilis
About one-third of untreated people with syphilis experience serious damage to various organs and body systems. Tertiary syphilis can appear any time from a year to 50 years after becoming infected; most cases occur within 20 years. The brain, heart, liver, and bones are the most commonly involved organs. Tertiary syphilis can cause paralysis, mental problems, blindness, deafness, heart failure, and death.

How do I avoid getting syphilis?
The risk for syphilis is directly related to the number of sex partners you have: The more sex partners, the greater the risk on contracting it. Having more sex with fewer partners reduces your risk of getting syphilis. Abstinence is the only surefire way to avoid getting syphilis or other STDs. If you're sexually active, using condoms consistently and correctly for oral, anal and vaginal sex is your best bet for staying sexually healthy. Also, regular STD checkups at least every six months if you're sexually active with more than one monogamous partner is recommended. Syphilis and other bacterial STDs are curable with proper diagnosis and treatment.

Courtesy, San Francisco Department of Public Health and the San Francisco City Clinic.