Lymphogranuloma venereum (LGV) is a sexually transmissible infection (STI). It has occurred in outbreaks in Western Europe and North America. Since talking about sexual health lately is no longer a taboo in our area, I visited a clinic in Hamra (close to Costa cafe, same building as SGBL) recommended by a friend to talk to a young doctor who reported recently the first case of LGV in Lebanon in an HIV-negative MSM (Man who has sex with a man). A very calm and welcoming environment you get its vibes once you get the “blue-ashy” clinic of Dr. Ismaël Maatouk, a Dermato-Venereologist who works in Beirut, and welcomes all patient with no discrimination based on sexual orientation and gender identity for more than 3 years. Dr. Maatouk, have in his records more then 40 publications and several appearances in worldwide conferences talking about STI’s.
Below are his answers to some of my questions:
What is LGV?
It is an infection caused by three types (L1, L2 and L3) of the bacterium Chlamydia trachomatis.
IS it the same Chlamydia we know?
Yes, the same bacteria, but different sub-types.
Is it a new described infection?
No, it is an old infection and since 2003, initial clusters of LGV cases in MSM were reported in the Netherlands followed by a series of outbreaks in Europe, North America and Australia, mainly among HIV-positive MSM. However, it is not an MSM disease: it can infect sexually active people.
Is this infection frequent in MSM in those countries?
A large study in MSM from London and Brighton showed an estimated prevalence of LGV of 0.90% in the rectum and only 0.04% in the urethra.
Is it also present in the pharyngeal area, like the other types of Chlamydia?
Yes, Chlamydia is known to be found during standard STI screening of the urethra, rectum, pharyngeal mucosa. The prevalence of pharyngeal Chlamydia in London MSM is 1.2%.
What is the clinical presentation of this infection?
The classical presentation of LGV is inguinal lymphadenitis and abscess formation sometimes preceded by anogenital ulceration. Which means that we rarely find the genital ulceration associated with LGV because it is transient. Following this transient ulceration, we have an inflammation of the lymphatic ganglia that drains the region, which can be painful and can lead the patient to ask for a consultation. This inflammation looks like an abscess.
Is there any test we can perform to confirm the diagnosis?
Yes, a test based on PCR.
Is the treatment difficult?
No, it is a 3-week course of doxycycline.
Do we search for this disease in Lebanon?
In a routine consultation, No. The test is expensive.
I have read that recently, you reported the first case of LGV in Lebanon. Was it in a HIV-positive MSM as well?
No, it was in a HIV-negative MSM. However, it can infect any patient, regardless of HIV status and sexual orientation.
Do you see other STIs in your clinic? I mean severe cases like syphilis? Are these cases frequent?
We have syphilis, they are definitely not frequent, but they exist.
What do you think of LebMASH?
I really appreciate the work that these doctors are doing. Helping and being there for the LGBT community is what we need in our days. I support them to the maximum.
Special thanks to Doctor Ismaël Maatouk
I think that people such as Mohamad Sibai who at first confuse secularism with sexual freedom and personal rights, are ignorant.
What Mohamad doesn’t seem to understand is that many people feel the same way he felt when he saw the gay couple, but towards a straight couple holding hands. If a man and a woman were in modern cloths and holding hands in let’s say Tehran, a man just like Mohamad could pass by and be HORRIFIED by this act and possibly ignorantly blame secularism or go to such extremes as accusing the woman of sexual addiction and perhaps finally this man would post online a story about how some women would willingly become prostitutes because of their sex addiction.
In general, we should all feel sorry for people like Mohamad Sibai, whether they oppose gay couples or women’s rights, or believe that women driving in Saudi could bring an end to the values and culture.
You are all alike, close minded and ignorant.
I would like to address the article “Viewpoint: Please me at any Price By Mohamad Sibai”, and specifically address certain key issues the article misinforms its readers about.
To start with, this phrase, “They both had short hair, facial hair, and rough voices. The sight was disturbing. Call me sexist, call me whatever you like, I couldn’t get that image out of my head for the whole day”, makes me think that Mr. Sibai has no idea what he is talking about from the start, since the issue he is talking about is not sexism, but homophobia.
Mohammad then goes on to speak about how“I couldn’t believe what I saw, I know that Lebanon aims to be an ideal ‘secular’ country, but if this is what
‘secular’ is then maybe it’s not such a good idea.” Let me tell you something, there are many secular countries where homophobia is still considered a major taboo and a controversial subject for open discussion, and so generalizing that homosexual life is altogether accepted in secular countries is a general fallacy, and Mr. Sibai seems to love generalizing.
Moving on, Mohammad goes on to state how “In the United States some states have legalized sexual marriage while others have outlawed the act”. First of all, its not called “sexual marriage”, it’s called “same-sex marriage”. Mohammad goes on to write about how every religion has condemned homosexual acts, but he is missing a crucial point because he is ultimately talking from a subjective, religious (shall I dare say Muslim conservative) point of view (which is backed up in his closing paragraph). Religion has indeed condemned homosexuality, but the main point of any religion is continuity, and how would this certain religion keep on growing if men were to lie with other men? Solution: make it seem like an abomination, and instead encourage massive procreation. Let me stress on a point, only Semitic religions seem to have a negative view on homosexuality, albeit a negative subjective view, and so this cannot be taken as background information for an article that wants to be taken seriously. Mohammad may as well be preaching in a church, mosque, or synagogue.
Not to stray away from the topic of religion, I’d like to stress on the story of the prophet Lut, mentioned in both the bible and the koran. Lut lived in a city called Sodom & Gomorah, and his people engaged in a WIDE range of “sinful” habits. One day, two angels were sent upon Lut in order to try and control his people, but instead the people wanted to sleep with the angels, and we all know that God tells Lut to flee the cities because he wants to burn them down as punishment and then his wife turns to stone for defying him etc etc… What
homophobic people choose to ignore from this story is the factor of incest that happens after Lut and his two daughters flee the city, whereby his two daughters get Lut drunk and sleep with him in order to KEEP THE CONTINUATION OF THEIR BLOODLINE. So basically, homosexuality is bad bad bad, and incest is good good good. Mr. Sibai needs to brush up on his theology, since that story is the main argument against homosexuality for many religious conservatives.
Furthermore, by quoting the bible, saying that “The bible States ‘if a man also lie with mankind, as he lieth with a woman, both of them have committed an abomination: they shall surely be put to death; their blood shall be upon them.’ (Leviticus 20:13)” is just plain weak. The bible also says that we should burn witches, divorce is a sin, sex before marriage (albeit straight sex) is very very frowned upon (and I am sure Mr. Sibai has not refrained from doing that).
We should not take everything the religious scriptures tell us into consideration today, because they were written as a product of their time, with all due respect to his religious beliefs. They were put forth in order to control the people of their time, and scriptures written over 1500-2000 years ago are hardly a background for our modern day society.
Third, Mr. Sibai says that “People are not born homosexual, usually one changes as he is growing from the infant stage up until puberty, some even later than that. This is, according to psychologists, due to certain factors during infancy and homosexuality can be treated in various ways.”Hold up, so he’s basically saying that I choose to be gay, right? So tomorrow I’m going to wake up and go “Okay, today I’m going to be attracted to a whole lot of women and sleep with them, but that’s okay because I’d be straight!”. Why, Mr. Sibai, would I choose to be a minority, a minority that is frowned upon. made illegal, has its rights revoked, punished, persecuted, bullied, put to death. Does this seems like fun to you Mr. Sibai? Have you ever tried to put yourself in a gay Arab’s shoes for a single day? In my shoes? The American Psychological Association ruled out homosexuality as a mental illness in the mid-70s or 80s,
and has been working against homophobia ever since. It is true that there are some contributing factors to the makings of homosexuality in children, but did Mr. Sibai knows that scientists have found a gene on the X chromosome that codes for sexuality? I don’t think so. Also, sociologists and anthropologists have found a consistent rate of homosexuality across all cultures. Consistent. That rate is 1 homosexual person for every 10 straight people. That is true for all cultures across the globe. Some people choose to hide it, some people choose to flaunt it, some choose to ignore it. It doesn’t matter, it stays the same.
Fourth, to address the following statement: “The pair (if not more) would never have offspring, the rate of STDs would skyrocket, and any morality that society still had would disappear amongst a myriad other plights”, well, I don’t know what Mr. Sibai is studying but it certainly is not human biology or even sex-ed 101, since Mr. Sibai would know that sexually transmitted diseases are already skyrocketing without the help of homosexuals thank you very much. A very blunt example of that is Africa, and that is why condoms were made Mr. Sibai, and that is why we also use them. Saying that homosexuality would spread STDs even further is, again, a general fallacy. Unfortunately, Mr. Sibai has shown himself to very misinformed on this topic, and should stick to areas he might come off as smart in. Furthermore, saying that homosexuality disrupts morality in society is quite quite unfortunate, since Mr. Sibai has obviously never been to Harvard University. Harvard boasts one of the largest homosexual communities in any university across the globe, and Harvard only graduates the best students that do nothing but pump morality into
industrialized, and often marginalized, societies. The worst societies often have a reputation of NOT including homosexual people as part of “normal society” and marginalizing them. Just look at the Middle East. The best societies, the most forward societies, the most industrialized societies, have accepted homosexuality as a societal norm, and has many homosexual persons in high ranking positions. Just look at Western Europe and North America. Why, the CEO of Apple is gay.
And then… “In that logic, if homosexuality is legalized world-wide, ten let’s legalize marijuana as well.” Well this is just wrong. Comparing homosexuality to marijuana. No. Second of all, Mr. Sibai does not know that Marijuana has way less side-effects than smoking a simple cigarette or Narguileh, not to mention that it does not have any lasting effect on the brain or a person’s health, while smoking causes cancer in the long run. Homosexuality is not a cancer Mr. Sibai, it is the key to a diverse, open, tolerant society.
While this statement… “The point is, religion has done well in keeping society working well and efficiently in a respectable manner. God has set the rules for us to abide by, not to make life hard on us, but to make it better and easier” only serves to reinforce the religious prejudices Mr. Sibai hides behind in order to defend his argument.
And while quoting this… “homosexuality in Russia is a crime and the punishment is seven years in prison, locked up with other men. There is a three year waiting list’ Yakov Smirnoff.” did Mr. Sibai ever stop think that, if this quote is even the least bit realistic, that men are only doing that because they cannot do it out in the open, freely? No.
Finally, the closing sentence and the coup-de-gras: “The lust, the hunger, the addiction. Men hungering for gay pleasure are willing to withstand the freezing environment of a metal cell in Russia just to pleas e their insides. Is this what the human race has become?” Comparing homosexuality to an addiction, a hunger, a primal lust, is totally misinformed. Mr. Sibai is a perfect example of how not opening up and discussing the topic of homosexuality openly does to society, what it makes people think. Yes, Mr. Sibai, this is what the human race has become, it has become a race filled with people of many diverse background, ethnicities, races, and sexualities. If you cannot get with the program, then I feel sorry for you. Fighting the current of change will get you nowhere in this modern life.
By Ralph Haddad