Know Your STD :: Lymphogranuloma Venereum (LGV)
FAST FACT:
LGV is more common in other countries, but an outbreak in gay/bi men in the Netherlands & U.S. (2003-2004) has put it back on the radar for our community.
WHAT IS IT?
Lymphogranuloma Venereum is a specific type of the bacterium Chlamydia trachomatis (Chlamydia). LGV is a systemic, sexually transmitted disease (STD) most common in Africa, Asia, South America and the Carribean, with the U.S. and Europe combined averaging less than 1000 cases per year.
WHY DO GAY/BI MEN NEED TO KNOW ABOUT IT?
A small outbreak in gay/bi men in the Netherlands and the U.S. (MMWR Oct. 29, 2004) put LGV back on the radar of the gay/bi men's community. Untreated LGV is a concern because it can cause serious, system-wide complications. Because of the rectal and genital ulcerations caused by LGV, it makes it easier to both get and give HIV, Hep C, and other STDs.
Most cases over the last couple of years have been in HIV+ (poz) gay/bi men, so it is definitely good to know about LGV if you are poz or if your partner is poz.
HOW DO I GET IT?
LGV is spread from person to person during unprotected oral, anal, or vaginal sex. Using a latex or polyurethane condom will help prevent transmission if used correctly, and used every time.
A guy does not need to ejaculate (cum) in order for transmission to occur during unprotected sex.
Communicate with your partners about current or previous risks for STDs, and familiarize yourself with the symptoms of LGV.
WHAT ARE THE SYMPTOMS?
The first stage symptom is a primary lesion or ulcer that shows up 3-30 days after infection. Many people do not have the initial sore or do not notice it, as it is hard to detect if it's inside the mouth, the rectum (inside the butt) or urethra (inside the penis). From this point on, a person is able to infect others.
Symptom progression in the second stage depends on where you were initially infected, and the following can happen in as little as 10 days or as long as 6 months:
IN THE BUTT
- Painful inflammation inside your butt (proctitis)
- Constipation or diarrhea, often with a bloody or pus-filled discharge
- Internal abcesses and/or ulcers
IN THE PENIS
- Genital lesions (on or in penis, scrotum)
- Swelling (masses) in the groin, may push through skin and leak fluid
- Discharge (discolored or clear fluid) from tip of penis
IN THE THROAT
- Swelling of glands in the neck and/or armpits
SYSTEMIC (ENTIRE BODY) SYNDROME
- Fever
- Chills
- Headache
- Joint pain
- Loss of appetite
Left untreated, the third stage of infection is often characterized by painful swelling of the penis and/or testicles, hemorrhoid-like growths, and serious internal rectal damage. Often times, LGV leaves genitals permanently scarred and deformed. There have also been rare cases where LGV has caused brain inflammation.
HOW DO I KNOW IF I HAVE IT?
LGV is diagnosed by a blood test, a rectal swab, and/or a fluid culture from masses in the groin.
Symptoms in the first and second stages of infection can be easy to miss, so it's important to get tested if you suspect you've been exposed to LGV. If symptoms are present, get tested immediately. If a partner tells you they have LGV, get evaluated for presumptive treatment immediately.
HOW IS IT TREATED?
LGV is treated with a long course of a specific antibiotic that is taken by mouth. It is extremely important to finish all medicine that you are given, even if your symptoms are gone. Followup with your medical provider is essential after symptoms have resolved to make sure treatment was effective.
Treatment cures the infection and prevents ongoing tissue damage, but does not reverse scarring or deformations caused through the course of infection. Buboes (swollen lymph nodes) may require drainage by a medical provider.
It is possible to be re-infected with LGV after treatment if a person is exposed again.
For more specific information about treatment, consult your medical provider. You can also read more in the CDC's 2006 Sexually Transmitted Diseases Treatment Guidelines.
WHAT ABOUT SEX PARTNERS?
It is best to wait two weeks after treatment, but at the very least wait at least one week after treatment before having any kind of sex (oral, anal, or vaginal) to avoid infecting others and avoid becoming re-infected.
It is also important that anybody that you have had sex with in the last two months (or your last sex partner if more than two months ago) be notified about your infection.
Each of your sex partners will need to be tested and treated. Do not have sex with anyone you have had sex with that has not been treated.
Click here for information on how to notify your partners through InSPOT.
WAYS TO REDUCE YOUR RISK
- Use latex or polyurethane condoms every time to help prevent transmission
- Use a new condom or latex glove with each new partner in group settings
- Limit the number of people you have sex with
- Get a full STD exam on a regular (at least annual) basis, depending on your risk
- Get your partners tested on a regular basis
For more information about LGV, check out the Minnesota Department of Health's LGV Fact Sheet.
Questions about your risk? About testing? Contact the HIM Program or call us at 612.348.9100.
Content updated: May 08