Demystifying DNA

Taboos Revisited: Navigating the STI Landscape

• Dr. Tiffany Montgomery (P23 Health) • Season 1 • Episode 6

Share episode

Settle in as we aim to disrupt preconceived notions surrounding STIs with our distinguished guest, Gregory Masterson. We unbox the importance of routine STI tests and annual physicals, especially for same-sex couples. We also shine a spotlight on HIV prevention for gay men, dissecting the role of Prep, an antiretroviral medication, and its effectiveness in reducing the risk of HIV infection while underscoring that it doesn't confer immunity against other STIs. 

In this no-holds-barred conversation, we tap into the power of genetic research in helping design bespoke healthcare for the gay community. Together with Greg, we bust myths and challenge stigmas about STIs, substantiating that informed decisions are the first step to a healthy life. We encourage you to join us on this educational journey to redefine societal taboos. Here at P23 Health, we believe in the intersection of knowledge, access, and power to help navigate the health landscape.

Support the show

Theme Music:

P23 Knowledge, access, power. P23, wellness and Understanding at your Fingertips P23. And that's no Cap.

Dr. Tiffany Montgomery:

Welcome back to Demystifying DNA, the podcast where we unravel the mysteries of genetics and its impact on our lives. I'm your host, curious lady Dr. Tiffany Montgomery, scientist and epidemiologist, joined by the insightful Mr. Gregory Masterson. I call him Greg. He is not only the Director Of Operations for P23 Labs and P23 Health. He serves as my executive assistant, my right hand, helping us stay on top of everything. He is an uncle, a son, a partner, a twin sibling and an amazing man to know. He comes from an industry of not just life but also restaurant management entrepreneurship. He's been the owner of GoGo Bathers, a very successful dog grooming business, as well as working in the field of life sciences and genetic development. Greg's skills are very robust. Today he's going to bring with us the skills of just life and we're grateful to have him. Welcome, Greg.

Greg Masterson:

Thank you so much for having me, Dr. T, It's a pleasure to be here and I'm excited to talk with you today.

Dr. Tiffany Montgomery:

Well, thank you, Greg, for joining. We are so excited to have you because today in our special three-part STI series, we're focusing on taboos revisited. Navigating the STI landscape, we're going to delve into the intricate world of sexually transmitted infections, again aiming to dissect the genetic aspects and break down the societal taboos that often obscure our understanding. We've talked a little bit about being single in STIs, being in relationships or marriages with STIs. We've talked about it at length with Nick and today we're going to talk about it as it affects same-sex relationships. So we have a very special guest in Greg because he covers that aspect of it as well. We're going to explore the intersection of genetics, health and societal perceptions, providing a clearer and more informed view of STIs. Greg, can you tell us a little bit about yourself other than what I already said?

Greg Masterson:

Sure, that was a great introduction. I really appreciate it. I will say that I definitely am a family man, close with my siblings and my nieces and nephews, and also my partner. We've been together for 13 years. We just celebrated our 13-year anniversary this past October.

Dr. Tiffany Montgomery:

Congratulations. Thank you so much Thank you.

Greg Masterson:

It's really been an amazing thing to share my life with Nathan, and he does keep me sane in a lot of ways. I'm really proud that I get to share my life with him for sure.

Dr. Tiffany Montgomery:

Well, that's amazing. I think that when you think about being in a relationship for 13 years, that's commendable Congratulations. However you do, maybe we'll have a relationship forum and we'll bring you back on that when we can talk about all of the relationship tea. For this episode, I wanted to focus on some of the stigmas that are out there and delve into that are in a same-sex relationship with your partner, nathan. So I'm wondering are you aware of, or do you know of, any taboos or stigmas that are out there? Anything that you would like to discuss, questions that you may have or anything? We're open.

Greg Masterson:

Yeah, thank you. One thing I would definitely think would add value to our listeners would be talking through a recommendation from you about the importance of regular STI testing, specifically within the gay community, and even in a committed relationship, I think that people still should be tested regularly, so I'd love to hear your thoughts on that.

Dr. Tiffany Montgomery:

Well, I think that you are absolutely correct. If you were listening to the last podcast, we talked about how these things can literally be on toilet seats. We used to think back in my day when I was in school oh you didn't get anything off that toilet seat girl. We used to have a joke, it used to be like a running thing and I don't know if the kids are still doing it now, but somebody would say they're pregnant and it's like I didn't have sex. I must have sat on the toilet seat with teenage pregnancy and things like that.

Dr. Tiffany Montgomery:

But I mean, it's common, just like we just had a whole pandemic with COVID-19 and those things going around. Covid-19, at the end of the day, is a virus, right, and STIs are just viruses and bacterias that are transmitted through bodily fluids. So sex, sexual contact, sharing different items, could also lead to the same effect that you would see with a sexually transmitted infection. So, just being mindful that there are so many avenues and ways to attract these viruses, I think we're way beyond thinking about. Oh, I'm monogamous, I've only slept with one person and it's going to be extremely important to embrace those regular testing opportunities.

Dr. Tiffany Montgomery:

There are annual physicals that are always recommended where you see your doctor once a year and just get a checkup when you're doing your annual physicals. That's an excellent time, even if you're 100% monogamous, to just have that STI checkup, depending on your sexual lifestyle or choices that you make and routes for sexual penetration, because there are multiple routes. So you got your oral, your anal, your vaginal. You've got things going on with the penis, you've got things going on with the vagina. So those are ever changing environments. It's going to be very important to have those monitored and come up with a schedule to do that. You could work with your primary healthcare physician, you could work with your gynecologist, you could also work with your P23 health coach or any type of health and wellness coach that you have to answer those questions to help understand the right cadence. Is it weekly, is it monthly, is it semi-annually or is it annually? Right, but even at a bare minimum, everybody should be checking in once a year.

Greg Masterson:

Thank you. That's great advice and I think that that's really helpful for our listeners, because a lot of people wrongly assume that they can get tested once and then they wait five, 10 years or longer maybe, and then they just don't give it the importance that it deserves.

Dr. Tiffany Montgomery:

Yeah, and I think that if we continue to have talks like this and remove those stigmas, it's going to really open up the dialogue so that people look at it just like you would go and have a teeth cleaning every six months. Right, we all brush our teeth regularly, some people once a day, some people twice a day, some people every time they eat, they're going to stop and they're going to go brush your teeth. Flossing we have to fight with people about flossing, but flossing is a really good thing, okay, but we want it to be as routine and as regular as even your hygiene check. Right, when you tell the spouse or the husband or the boyfriend or whatever, hey, I gotta go get my teeth cleaned, nobody looks at you like you have eight eyes Nobody. They might not enjoy going to the dentist, but we all do it. We have to have that same type of view or attitude when it comes to our STI testing, because it's going to be important for maintaining good sexual health, preventing the transmission of infections and then treating them as early as possible.

Dr. Tiffany Montgomery:

It's important to understand that you can have an STI without any symptoms, so you may not even know that you're infected. Not all STIs are transmitted every time you have sex, so you may have not contracted the STI from your current partner. Some of these STIs have a longer latency period, or period that they're dormant, so it could be months or years from when you were exposed to that infection to when it actually develops or manifests in your body. Some STIs can cause serious complications of left untreated, such as infertility, pelvic inflammatory disease or PID, or an increased risk to other diseases such as HIV. Your propensity to these diseases and how long it would take you for it to manifest is all in your DNA. It's all in your code. You have genes that are already triggering what that is gonna look like for you. You might talk to people and they might say I've had COVID five or six times, and you'll talk to other people and they'll say I've never had COVID. Why is that? Scientists are now understanding the true power of genetics and some of that is going to be directly related to your genes. So you cannot make these generalized statements or objectives like we used to.

Dr. Tiffany Montgomery:

We have to really focus on the information that we have in hand, the testing that's available, and making the testing a regular part of our good health lives. Getting tested can help you make informed decisions about your sexual health and protect yourself and your partners from future infections. Getting tested can also reduce the stigma and the shame associated with STIs, because we want to encourage more people to just get tested in treatment regularly, right? Same way, when you go to the dentist and they clean your teeth and they say you need a fluoride treatment or you have a lot of plaque buildup, so we're gonna do some testing or some treatment or give you a special toothpaste to help reduce this amount of plaque. So we wanna treat and view our sexual health, whether we're straight or gay or curious or bisexual, however you identify sexually. If you're a non and you're abstinent but using public toilet seats, I'm gonna still recommend testing on a regular basis. Right, it's just. That's just real, that's just how we live, that's just the society that we're in now.

Greg Masterson:

So Thank you. That really does help take a lot of the scary part away, and when you're armed with knowledge, that can only ever help you be less afraid, for sure. One thing I wanted to ask you, doctor, was about PrEP. I'm not sure if you've heard about this I'm sure you have but a lot of younger people in the gay community believe wrongly that because they are taking PrEP, which is pre-exposure prophylaxis, it helps prevent the HIV infection that causes HIV and AIDS. But a lot of people wrongly assume that PrEP helps protect them from everything. Maybe you can help clear that up for our audience a little bit and help them understand that that's not the only way to be safe or to help prevent the spread of STIs.

Dr. Tiffany Montgomery:

Well, greg, I think you summed that up better than I could sum it up. Really, to be honest with you, as I stated, and I always say, I am not a medical doctor. I'm a researcher, a scientist and an epidemiologist. But I will still say I can talk to you very fluidly about disease and disease transmission, and one of the things is that pre-exposure prophylaxis or PrEP is a preventative approach when individuals are at high risk of contracting HIV. So you take the antiretroviral medications to reduce the risk of infection, but the medications used are typically the same ones used to actually treat HIV, but when you take them in your HIV negative person before your potential exposure, it can prevent the virus from establishing itself in the body. I think that there's a good purpose. The medications are out there. The usage is gonna be once a day. However, it's important to understand that it does not protect against other STIs. You wanna think about it like the same way you would the vaccines that we get and there are a large number of vaccines, right, you have your COVID vaccine, you got your RSV vaccine. Now We've got a flu vaccine that we have to, or encourage to, take once a year, every flu season. We're still trying to figure out the cadence of the COVID vaccine. So we've got a lot of things going on when it comes to our vaccines. Right, you can say that, okay, hey, I had my flu vaccine, get the respiratory infection, and you find out you have COVID. Wow, we never say but I got the flu vaccine, because we all understand you didn't get the flu, you got COVID. There are also different strands. So even when you get your flu vaccine or your COVID vaccine, guess what? You could still get COVID or the flu because there's so many different strands. Same thing with HIV.

Dr. Tiffany Montgomery:

I think that COVID helped more people speak in simple terms about very complex things like viruses that are always a part of who we are and where we are, and it's important to really understand that these things are designed to reduce the risk of that one particular thing, but it doesn't eliminate that one particular thing and it has nothing to do with the 99 million other things that you can get right. So, while we do not want anyone to contract HIV, there are other things out there. There's HSV, herpes, symplec virus, which is very common. If you listened to our last podcast, we talked about some numbers around that one in six. So you have to make sure that you're protecting yourself all the way around with all of the viruses and you're taking full precaution, not just thinking, okay, I took a prep and so I can just go get busy, because it doesn't give you a blanket card to getting busy. You've got to understand that. It just reduces the risk, making everything else you do that much more effective.

Greg Masterson:

Thank you, doctor. That really does help clear it up. Excuse me, and it's almost like wearing a seatbelt it doesn't protect you from everything, but it can certainly help if you are in an accident.

Dr. Tiffany Montgomery:

Great analogy. Greg, did you have? We have time for about one more question. So if you wanted to do one more question that maybe you had, or that someone had asked you, or that came in from one of the viewers, I'm happy to.

Greg Masterson:

Yeah, as you look at the genetic research initiatives, anything specifically that you could recommend tailored to the needs of gay men, maybe something that P23 offers?

Dr. Tiffany Montgomery:

When you're thinking about gay men and the gay male community. What are some of the types of needs that the community has?

Greg Masterson:

Well, I mean, one thing that comes top of mind is HIV and AIDS, but also recently, in the past year or so, there was a big outbreak and you know a scare about monkeypox. I know that was something that the gay community faced, I think at a larger rate than the rest of the population, but that's something that definitely comes to mind.

Dr. Tiffany Montgomery:

That's a great one, and you know we were one of the labs also testing with that monkeypox. I think when monkeypox first came out we thought it was going to be more like COVID and then we found out it was something that was specifically targeting or at higher risk in the gay male community, and the thing about these diseases or infections is that they're always lurking in the background like the burglars. They're here, we don't know where they are, you don't know when they're going to hit your house, but unfortunately burglars exist. Viruses are the same way, very unfortunate they're out there, but they're out there lurking, waiting for an opportune time to attack. It could be because your immune system is already low. It could be because you are stressed out, and so when you're stressed your body is not protecting you as much because it's trying to comfort you and calm you down. There are a number of factors, but when you trigger them, that's when you get these very, very nasty encounters with these opportunistic viruses. So, for gay men in particular, some of the things that we offer and that may be beneficial are HIV testing. Not only does P23 have an at home kit that can be mailed to you and mailed back to the lab for PCR testing. We also have rapid testing, so, but HIV testing is extremely beneficial.

Dr. Tiffany Montgomery:

Gay men, especially those who are sexually active, should consider regular HIV testing. Somebody has to help you define what regular is. Regular for you, depending on your number of partners could be every week. Regular for you could be once a month. Regular for you could be every six months. So it's where you're defining this word regular that I would recommend working with the P23 health coach or your primary care provider or any knowledgeable medical professional that can help you navigate through the landscape and really understand your risk. Sti testing so regular testing for other sexually transmitted infections is important, especially those who have multiple partners. Common STIs testing, such as chlamydia, gonorrhea, syphilis and hepatitis is highly recommended, and those are all tested or offered at P23. You would have an at home test kit mailed to you. You would provide a sample whether it would be a rectal swab or a saliva sample or urine sample and you would mail that back to the lab for comprehensive PCR or genetic testing. High risk activities so individuals engaging in any high risk sexual activities unprotected sex, unprotected anal sex, multiple partners may need more frequent testing. Hepatitis screening is gonna be something that's gonna be really important for you and it is also offered at P23. That's just testing for your hepatitis B and C, which is recommended especially if you're engaging in activities that increase the risk of transmission, such as unprotected anal sex. Vaccination is gonna be something that's gonna be important. Gay men may wanna consider getting vaccinated against hepatitis A and B, if they haven't already. Unfortunately, p23 does not offer vaccinations at this time, but being vaccinated is something that's gonna be extremely beneficial.

Dr. Tiffany Montgomery:

And then HPV testing. So we talk about it in women quite often, but for gay men, you really wanna use that anal swab or get that anal pap smear so that you can be screened for HPV, which is a virus that leads to cancer anal cancer, penile cancer. Gay men, particularly those with HIV, detect and prevent anal cancer associated with HPV by having the screening test. Now, the swab is something that P23 offers. We do provide the molecular genetic testing for the HPV that is found in the anal cells. That is something that you would wanna talk to your health coach about or to your primary provider about and make sure that you're on a regular schedule for that, whether that's yearly or every two or three years, just making sure that you're regularly screened if you are receiving a penis in your anus, and that goes for women too. If you are a woman that's receiving a penis in your anus, you still wanna be screened for anal HPV Syphilis testing.

Dr. Tiffany Montgomery:

So finding a regular cadence for syphilis testing and that is something that P23 offers we would be looking at. Also having regular physical exams, because with the syphilis it might even include sores or rashes. So you wanna be which can be similar to monkeypox. You wanna be prepared to kinda look at that and be screened for that. Herpes testing one thing we talked about herpes earlier, but that's gonna be something that it might not even have symptoms. You could have symptoms. So you definitely wanna be tested if you have symptoms but you might not.

Dr. Tiffany Montgomery:

So just stand on top of those regular checkups, regular sexual health checkups, even if your absence of symptoms are important for overall well-being. And then keeping that open communication with your healthcare providers. If you're having a health coaching session with your P23 health coach, even if you haven't come out to your family yet or you haven't exposed that you're gay or maybe you think people don't know, it's important when you talk to your providers that you disclose that because your treatment frequency or your checkup frequency or your testing frequency may vary depending on the sexual activities that you participate in. If you have a hard time talking about it, write it down. Put it on a piece of paper and slide that paper right to the doctor. They'll read it. Have that open conversation or have somebody in your corner that you could really rely on and share these things, because, I'm telling you, open communication is gonna be essential for personalized assessments and testing needs. It's so individual.

Dr. Tiffany Montgomery:

Greg, I wanna thank you for your time today and those amazing questions, being so open with your life, with your partner, with your situation. You didn't have to do that, I didn't ask you. So I am just so grateful because you never know who's listening or how many people that we've helped. As we conclude today's insightful episode of Demystifying DNA Taboos Revisited Part Three Navigating the STI Landscape. Myself and Greg wanna thank each of you listeners for joining us in this crucial discussion. In our special three-part series on STIs, we aim to provide a comprehensive understanding, debunk myths and address the stigmas associated with sexually transmitted infections. Remember, knowledge is a powerful tool in navigating these complex health issues. Stay informed, stay engaged and continue with us on this journey to demystify the intricate connections between genetics, health and society. And remember we are with you every step of the way.

Theme Music:

P23, knowledge access power. P23, wellness and understanding at your fingertips P23,. And that's no cap.

People on this episode

Head Shot

Dr. Tiffany Montgomery

Host