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New HIV - MRSA
Jan 28, 2008

Dear Dr. Bob,

I ran through this article at abcnews.com and would like your opinion about is (as I believe you are the only source of true information about HIV).

In a study released by the Annals of Internal Medicine Jan. 14, researchers at the University of California at San Francisco looked at populations of men in both hospitals and a clinic for HIV-positive patients. What they found was that men who had sex with men were 13 times more likely to get a certain form of MRSA.

" (...) Immediately, news organizations reported that the infection (MRSA) was passed through gay sex -- even though no hard evidence of such a route of transmission existed. One U.K. paper labeled the strain as "the new HIV."

Dr. Bob, is there any truth behind this statement?

Stay well!

Response from Dr. Frascino

Hi,

Is there any truth to the MRSA story? Yes, some.

Is MRSA "the new HIV?" No, not even close.

Here's the scoop. The new study you quoted does suggest that gay men are significantly more likely to become infected with MRSA (methicillin-resistant staphylococcus aureus) than our hetero counterparts. It also suggests much of the transmission could be due to sexual contact, even though historically MRSA has been transmitted via non-sexual contact. The way this study was covered by some news organizations fanned the flames of homophobia. (I'm sure it won't be long before Mike Huckabee will want to round up all MRSAers for isolation to protect the general Christian population.)

The recent study looked retrospectively at medical charts from patients with MRSA for the period of 2004 to 2006 at hospitals and clinics in San Francisco. It randomly sampled 532 (21%) of the 2, 495 cases for extensive review and genetic sequencing of the MRSA. In non-healthcare settings, the "USA 300" strain of MRSA is dominant (community acquired MRSA). It is resistant to some antibiotics (methicillin), but still relatively easy to treat with others. A subgroup of USA 300 has acquired a genetic sequence termed "pUSA03" that renders it resistant to a greater number of drugs and therefore more difficult to treat. This is known as multi-drug-resistant (MDR) USA 300. The researchers tabulated the incidence of these subtypes and by overlaying census information data found higher infection rates in areas of San Francisco with higher numbers of male same-sex couples. However, the total number of cases in an individual zip code were small, so statistical confidence intervals are large. In other words, we need to be wary of drawing too many conclusions from this type of subset analysis data.

There is no doubt MRSA is on the rise and can be contracted in bathhouses, sex clubs, gyms, etc. by coming into contact with surfaces contaminated with the bacteria. Sexual activity is not required for transmission, but could play a role. Is this a "new HIV?" No. Or to more precise, hell no! No way. No how.

Dr. Bob



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