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Bad Reporting of MRSA Study in Gay Men

Blog Category: HIV Health, media — Blogged by: eric on January 18, 2008 at 12:01 pm

I’m blogging to vent about what I consider shoddy reporting on the occurrence of MRSA infections among gay men. MRSA is short for “methicillin-resistant Staphyloccus aureus.” It is a type of bacteria that is resistant to the antibiotic methicillin, which is commonly used to treat Staphyloccus (staph) infections. Some strains of MRSA are multi-drug-resistant (MDR), meaning that they are also resistant to other antibiotics.

Clusters of MRSA cases among gay men aren’t new. They’ve been the subject of research reports and news stories for several years. The most recent stories were sparked by a study in the Annals of Internal Medicine. In a nutshell, the study found high rates of a particular strain of MRSA called USA300 among gay men in Boston and San Francisco. The USA300 strain includes an MDR type that is resistant to many antibiotics.

This is very troubling news that deserves media attention. MRSA is a major cause of serious illness not just in gay men, but in the general population. During 2005, MRSA accounted for more than 94,000 life-threatening infections and nearly 19,000 deaths in the U.S.

But from reading some of the recent headlines, you might have thought that the end of the world was at hand – and that gay men were the bringers of doom.

Of the press coverage I’ve seen, my vote for the worst headline goes to the British tabloid Metro, which proclaimed: “Strain of superbug may be new HIV.” I detest the word “superbug,” whether it is applied to HIV, MRSA, or any other germ. What makes a germ a superbug? Drug resistance? Ease or speed of transmission? Serious health consequences? Or simply the fact that it is new or difficult to treat? The word has no consistent or practical meaning. Its main effect is to incite fear and sell newspapers. And, by the way, there’s no evidence whatsoever that the USA300 strain is the “new HIV”: It’s not a virus, it doesn’t specifically attack the immune system, etc.

The British Telegraph’s headline was also outrageously overblown: “’Flesh-eating’ MRSA strain threatens Britain.” Interestingly, the Telegraph article noted that a grand total of two cases of the MDR USA300 strain have been recorded in England. Leading the headline with the words “flesh-eating” is certainly an attention-grabber. This lurid term is all too often used to refer to a severe skin and tissue infection called necrotizing fasciitis, which can destroy soft tissue.

Like many other types of bacteria – including both nonresistant and drug-resistant staph – the USA300 MRSA strain can, in severe cases, cause necrotizing fasciitis if it is not recognized and treated properly. But there is nothing inherently “flesh-eating” about USA300 MRSA. The New York Times also earns a dishonorable mention for its alarmist description of the MRSA strain as “flesh-eating” in the lead sentence of its story.

The Philadelphia Inquirer’s headline was also far from stellar: “Possible MRSA link to gay sex seen.” Granted, it’s less alarming. But what do they mean by “gay sex”? Anal intercourse? Fellatio? Last I heard, straight and gay folks alike engage in these and a broad spectrum of sexual activities. Of course, there’s nothing like a little “gay sex” in a headline to stoke people’s imagination and get fundamentalists all riled up.

Both the Inquirer and Times articles also failed to mention that the USA300 strain has been reported in athletes, military recruits, and heterosexual couples. Simply mentioning this fact might have helped reduce the tendency for people to blame gay men or “gay sex” for this health concern.

Oh, and if you read the research study, you’ll find that “anal sex” (no specific type mentioned) is just one of the possible explanations given for the high rates of USA300 MRSA seen among gay men in Boston and San Francisco. Other possibilities include “skin-abrading sexual practices” (rough sex? body shaving?) and “increased frequency of intimate skin-to-skin contact.”

But I suppose the Inquirer’s headline could have been worse: How about this one?: “Possible MRSA link to intimate touching.” That headline might have led to generalized panic rather than gay panic.

So what’s the bottom line about MRSA in general, and multi-drug-resistant staph among gay men in particular?

• The recent reports of multi-drug-resistant MRSA in gay men deserve our attention. But they should not be a cause for panic. Nor should they be used as an excuse to stigmatize gay men or demonize “gay sex.”

• MRSA infections are a serious health concern. If you have signs of a skin infection, such as pimples, boils, or rashes, see your doctor promptly. They can diagnose the condition and provide appropriate treatment. If a particular treatment doesn’t appear to be working as it should, let your doctor know.

• Washing with soap and water is the best way to keep from getting or spreading staph infections, including MRSA.

According to a fact sheet from the Massachusetts Department of Public Health, other ways to prevent infection, include:
• Avoiding contact with other people’s wounds or bandages.
• Keeping scrapes and cuts clean and covered with bandages until they have healed.
• Avoiding the sharing of personal items, such as towels and washcloths, which can transfer staph from one person to another.
• Keeping your skin healthy. Healthy skin helps keep any staph on the surface of the skin from causing an infection beneath the skin.

Here are a few other links with additional background on MRSA:

MRSA – an on-line fact sheet from The Fenway Institute with links to other resources

For other critiques of media coverage on the recent MRSA study, you can check out the following blog items:

Shock horror, superbug fears greatly exaggerated

Gay Sex Panic and Drug Resistant Staph

If you’d like more information about MRSA, please contact AIDS Action’s HIV Health Library. We have compiled a set of reliable articles and fact sheets about MRSA in general, as well as the USA300 strain in gay men.

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7 Comments »

Comment by Bill Cattey

January 18, 2008 @ 5:13 pm

Thanks for that additional perspective!

The info from the Mass Dept. of Public Health is quite re-assuring,
and most necessary information to disseminate in the face of what
you’ve identified as blatant sensationalism.

Comment by David

January 21, 2008 @ 2:46 am

I found my way here after reading the story in the Sunday Herald.

Now I’m more confused than ever. Is there or isn’t there a particular strain of MRSA that is circulating in the Boston and San Francisco gay community? I see complaints about the sensationalism, but not its veracity.

Michael Shankle is quoted “It is really reminiscent of the demonizing qualities of the HIV/AIDS epidemics. In the early years of the epidemic there was this idea that this is somehow a gay men’s or gay sex kind of disease.”

Isn’t it? Wasn’t (unprotected) anal intercourse an important vector? Didn’t AIDS hit gay men (and hemophiliacs) particularly hard?

Comment by the zak

January 21, 2008 @ 10:47 am

A thought experiment http://en.wikipedia.org/wiki/Thought_experiment imagine the disease of the future, an organism both parasitic and canabalistic and if you don’t have sex you die.

So A calls up B
“You’ve got to come over.”

B says
“I can’t I’m going over to C’s.”

A cries
“You’ve got to come over now! It’s beginning to gnaw at me!”

Comment by Eric

January 22, 2008 @ 3:09 pm

Thanks for your comments on my blog. I am writing to respond to David’s questions and comments.

It is true that a particular strain of MRSA (USA300) has been seen among gay men in Boston and San Francisco. However, like other types of MRSA, that strain is not limited to gay men. It has also been seen in athletes, military recruits, and heterosexual couples.

As noted in my blog item, I think that the cases of USA300 MRSA in gay men deserve our attention. But I believe that much of the original press coverage was sensationalistic, misleading, and potentially stigmatizing for gay men.

What gay men - and everyone else, for that matter - most need to know about MRSA are: what it is, the ways it is passed from one person to another, ways to prevent the spread, and what can be done when a person gets a MRSA infection.

Regarding your final questions about HIV in gay men and whether HIV might be considered a “gay disease”:

It is true that early in the epidemic gay men had - and continue to have - relatively high rates of HIV infection. It is also true that unprotected anal intercourse is a high-risk behavior for transmitting HIV.

That being said, it would be a mistake to consider HIV infection to be a “gay disease.” Here’s why:
- Both straight and gay people may engage in unprotected anal intercourse.
- There are also other high-risk behaviors, such as unprotected vaginal sex and sharing drug needles and works, that have nothing to do with being gay.
- HIV affects persons of every sexual orientation, gender, race, ethnicity, and nationality.

Seeing HIV as a “gay disease” has some important negative consequences. It can lead people to stigmatize gay men or blame them for being “the cause” of the HIV/AIDS epidemic. It can also lead people who aren’t gay to assume that “it can’t happen to me” and engage in behaviors that place them at risk for HIV infection.

Comment by Sidnei

January 22, 2008 @ 8:56 pm

I first read about it on a Brazilian online newspaper, and was amazed on how badly reported it was shown.
At first I thought it was so only on that online newspaper, but I found out other online news in Brazil were reporting it the same way, and basically clearly saying the gay community “created and is to blame” for the whole thing.
Now reading this article I see it was almost the same all over. This is a shame.

Comment by Van

January 23, 2008 @ 6:36 pm

Good information, thx!

Comment by as

January 30, 2008 @ 4:12 am

I first read about it on a Brazilian online newspaper, and was amazed on how badly reported it was shown.

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