TMVII: what every gay male needs to know

Yes, here we go again. Sometimes it feels as if every time gay men turn around, we are faced with another sexually transmitted illness that we must learn about and protect ourselves and our partners from. Welcome to life as an adult homosexual male.

Fortunately, information and research are being published that allow our demographic to gain the necessary facts we need to make informed decisions about our sex lives. Getting yourself educated about maintaining proper sexual health practices is a part of life that should not be avoided or feared.

So, add TMVII to the list of STIs that you are well informed about.

THE BASICS:

TMVII is a SKIN infection, similar in transmission to Mpox, but it is a fungus, not a virus.
TMVII is transmitted through INTIMATE contact with a lesion, including anal & oral sex, kissing, and handjobs.
Fungal spores can also spread on surfaces (e.g., shared razors, sex toys, or linens).
It is highly contagious, even when on treatment.
Intimate shaving of genitals and buttocks increases the risk of infection.
Infection rates are NOT at epidemic or pandemic numbers. So far, the number of cases is relatively small, with some being clustered.
Misdiagnosis, which may result in improper treatment, worsening of symptoms, and the continued spread of TMVII.
TMVII infections are treatable but generally require 6-12 WEEKS of oral antifungal therapy. NOT traditional antifungal medications or creams.
It is the perfect STI for SUPER SPREADER events like gay sex parties, saunas, orgies, etc.

The goal of this article is not just to educate you about TMVII but to prevent it from becoming a major health concern for our demographic. Lack of care or medical treatment, misdiagnosis, incomplete usage (adherence) of medication, and/or having sex while still contagious will create the perfect storm for mass infections and even treatment failures.

What is TMVII?

Trichophyton mentagrophytes genotype VII (TMVII, pronounced “TM seven”) is a new type of fungal skin infection that can cause tinea (ringworm). We say this STI is “newish” because it has not just recently been discovered, but has been known since around 2016 as a medical concern for homosexual and bisexual males. This means there is reputable research, understanding, and treatments for TMVII.

TMVII is also known colloquially as the “Thailand fungus”. This is because the first cases of infection in Europe were detected among travelers returning from Thailand. However, most infections with the skin fungus now occur through sexual contact within national borders, and this term is being considered to be insensitive in the same way as Mpox was with “monkeypox.

“Around 10 years ago, we were the first to identify and publish sexual transmission with skin fungi. Those affected were mainly travelers returning from South Asia, especially Thailand, who had had sexual contact there,” says Philipp Bosshard, senior assistant at the Dermatology Clinic of the USZ. “For a few years now, however, we have been seeing an increase in infections within Switzerland.”

Currently, TMVII has been documented across Asia, including Japan, in European countries such as Germany, France, Italy and Spain, and in the United States. But, like all communicable illnesses, there has been a documented association between infection and travel.

So, even if TMVII has not been officially documented where you live, you should still remain vigilant with your sexual practices as you travel or because you may encounter other guys who have either traveled themselves or had sexual contact with guys who have.

TMVII symptoms

Symptoms of TMVII are typical of a skin rash (infection). It begins with itching, redness, or scaling, often in the genital area or on the trunk, followed by purulent and very painful skin lesions

TMVII can cause ringworm involving the face, genitals, buttocks, trunk, arms, and legs.

Ringworm appears with round, coin-like rashes that are red and irritated, sometimes with bumps or pimples on top. Ringworm rashes might be itchy and painful.

TMVII rashes can be mistaken for other conditions, such as eczema, psoriasis, or other skin infections.

It is very important for you to know the physical signs of TMVII and IMMEDIATELY seek medical attention if you have, or SUSPECT you may have, this infection. Quick diagnosis results in earlier treatment, and easier, more successful therapy.

Other symptoms include:

Fistulas and abscesses
Swollen lymph nodes
Fever

Transmission

TMVII is a skin infection spread through direct skin-to-skin contact with the rash. Fungal spores can also spread on surfaces (e.g., shared razors, sex toys, or linens). A tantric masseur in France infected 15 clients and his roommate!

Because TMVII is a skin infection easily spread through direct skin contact with a lesion, those who shave their genitals and/or buttocks before sex place themselves at considerably greater risk, as shaving is known to create minor tears on the skin, creating easier access for infection.

INCUBATION PERIOD

An incubation period (also known as the latent period or latency period) is the time elapsed between exposure to a pathogenic organism, a chemical, or radiation and the first appearance of symptoms and signs. In a typical infectious disease, the incubation period is the time required for the multiplying organism to reach a threshold sufficient to produce symptoms in the host.

Research into TMVII has shown the incubation period to be between 4 and 14 days, but as few as 2 days and as long as 52 days. Furthermore, there is evidence of contagion during the incubation period.

PREVENTION

An ounce of prevention is worth a pound of cure. Since Trichophyton mentagrophytes VII is transmitted particularly effectively during sexual intercourse, the most effective protective measure is to refrain from sexual activity if there are skin lesions in the genital or anal area. CONDOMS PROVIDE ZERO PROTECTION AGAINST TMVII.

Avoid skin-to-skin contact, including sexual contact, if you or your partners have a new rash.
Consider pausing or limiting sexual activity if there are individuals in your network reporting recent or new rashes. Individuals with new rashes consistent with TMVII should ensure the rashes remain covered with bandages or clothing to minimize the risk of unintentional spread.
Notify sexual partners to seek care if you develop a new rash.
Avoid sharing personal items such as clothing, towels, bedding, razors, etc.
After touching an area with TMVII infection, wash your hands with soap before touching another area of your body. Touching or scratching the affected area and then touching another area can spread the infection from one part of your body to another. Washing your hands well can prevent this spread.

Fungal spores can be killed with common disinfectants like diluted chlorine bleach (1/4 cup per gallon of water), benzalkonium chloride (a disinfectant used for cleaning hard surfaces), or strong detergents. Soak any shared items, such as sex toys or razors, in a bleach solution.
Clothing, towels, bedding, and other shared linens should be laundered at 60°C/140°F.

Treatment

Successful treatment begins with an accurate diagnosis. Because TMVII is still relatively rarely seen by most Western medical providers, its physical symptoms have been attributed to other rashes and to bacterial and fungal infections. This results not only in improper treatment and the prolonging of the suffering of those infected, but also inadvertently increases the risk of others becoming infected.

Traditional anti-fungal treatments, including creams, are ineffective against TMVII. Medical providers may provide steroid creams for other skin rashes, but these will WORSEN a TMVII infection.

Patients remain contagious even after starting antifungal treatment. You may still transmit TMVII EVEN WHEN YOU ARE ON MEDICATION, and the lesions have reduced or gone away. This is why you must take AND complete the full prescription and be cleared by your medical provider to re-engage in sexual activity. It is not uncommon for patients to require multiple courses of treatment due to recurrence.

Most published regimens use oral terbinafine 250 mg daily; case series indicate many patients require 6–12 weeks of therapy, with some requiring longer for deep or highly inflammatory lesions.
In cases with an inadequate response after several weeks of terbinafine, itraconazole has been successfully used as a second-line therapy, despite the absence of confirmed terbinafine resistance in TMVII to date.
Topical antifungal agents may be helpful as adjunctive therapy but are not recommended as monotherapy for TMVII given limited evidence of efficacy.
Some experts recommend extending therapy 2–4 weeks beyond clinical resolution to reduce relapse risk, although evidence is limited.

Before you go…

At this stage, TMVII is an STI that our demographic can definitely get a handle on and control outbreaks. All it takes is getting educated about transmission, recognizing the symptoms, and getting a proper diagnosis for treatment.

The hard part, for some, will be curbing their sexual activity while they are being treated for TMVII and taking their medications as prescribed for as long as it takes to clear the infection.

Doctors found that patients still tested positive for TMVII cultures up to 8?weeks during treatment of TMVII infections. Contagiousness could therefore persist for several weeks during treatment.

Recurrence of infection after discontinuation of treatment is highly likely!

We have the tools to stop TMVII in its tracks before it becomes a major sexual healthcare issue for us, but we must believe and follow the science. Otherwise we will all be fucked…in the worst possible ways!