The links between HIV and other STDs have long been clear, according to Schacker. In the late '80s, for example, as gay men began to respond to safe-sex campaigns, CDC studies showed that rates of gonorrhea declined among men who have sex with men. An article published in the New England Journal of Medicine last year indicated that in a study of women with HIV, 50 percent had contracted HPV or another STD. The link is twofold, Schacker says: On the one hand, it's a matter of behavior. A person engaging in sex with multiple partners increases their risk of contracting HIV or another STD with each new partner. Additionally it's a physical problem: Sores and lesions caused by STDs can create a gateway into the body that facilitates HIV transmission.
STDs can also impact child-bearing--a particular concern to lesbians considering giving birth. Chlamydia is the leading cause of female infertility and female genital tract infections. For child-bearing women with chlamydia, the most commonly reported STD in Minnesota, there's a 60 to 70 percent chance that they'll transmit the STD to their unborn infants.
STDs may also be related to other health problems in lesbians, says Dr. Jeanne Marrazzo, a University of Washington researcher who, a few years ago, organized a pilot study of 150 women who have sex with women. Marrazzo found that 30 percent tested positive for HPV, the virus responsible for the majority of cervical cancers. She scoffs at the suggestion that lesbians don't get STDs, noting that such a statement presumes that the women have never had sex with a man and that they don't engage in risky behaviors during lesbian sex. "It's a combination of homophobia and sexism," Marrazzo says. "People believe you can't have sex if there's not a penis involved. If there's no penis, they say, it's not really sex."
Queer youth are also believed to be at high risk for STD infection. A Minnesota Student Survey conducted in 1995 found that one in five teens in the state reported having an STD.
This month, the Minnesota Department of Health launches an expanded initiative on STD research and testing with a $300,000 appropriation from the Minnesota Legislature. The one-time funding, approved by lawmakers this spring, will be used to conduct a statewide assessment of the need for STD prevention services and to conduct research on the prevalence of STDs within particular populations. Fifty thousand dollars of that amount will be used to conduct free STD screenings at health-care clinics.
Boosting STD research, prevention programs, and education across the state is not only important in and of itself, according to Tracy, it may also help spread the word about HIV in greater Minnesota. Many small-town doctors, for example, see HIV as an urban issue and, therefore, irrelevant to their practices. "But rural physicians will show up for a training on STDs," Tracy says. "By getting them in the doors to talk about STDs, it's a natural extension to talk about HIV."
The same logic applies when it comes to STD/HIV prevention among young people. "Young people may not see HIV as an immediate risk," Tracy says. "But if you're dealing with STD prevention, you're contributing to HIV prevention."