Sigurður Ýmir Sigurjónsson.

“Unsafe sex has become a fad because of PrEP,” says health employee

As public health focuses on Covid-19, STIs run amok in Iceland.

The past two years have put a huge strain on our healthcare system from the sheer number of patients with covid to massive staff shortages. Although the focus has shifted toward the most contagious virus affecting society, a few other contagions rage on. In Iceland rates of syphilis and gonorrhea have seen sharp increases in the past months. Posting in Hommaspjallið, the Icelandic gay men’s group on Facebook, Sigurður Ýmir Sigurjónsson noted cases of gonorrhea have been out of control lately. “Luckily the epidemic of syphilis has begun to slow down, but now gonorrhea has taken over,” Sigurður wrote.

Sigurður, or Siggi as he is called, is a registered nurse that works as an associate nurse manager at Hrafnista nursing home and has also been working as a nurse consultant at Samtökin ‘78, the National Queer Organization. Although Iceland doesn’t have an LGBT+ health clinic, Siggi acts as an intermediary for anyone coming into the center looking for health-related advice and counseling.

GayIceland sat down with Siggi to chat about sexual health, the pandemic’s strain on the system, and what exactly the community should be doing about it.

For most countries, the beginning of the pandemic coincided with a huge drop in STI numbers. With everyone locked down at home and extremely distanced, hook-ups were happening a lot less and infection rates of most STIs dropped. Being single at the beginning of the pandemic practically meant celibacy. Over time though, particularly after more rules were lifted and the vaccines were deployed, numbers of STI infections returned to normal. Siggi says that STIs are a bit like covid in that the less we all do to prevent them, the worse they’re going to get. It takes a community approach.

Sigurður Ýmir Sigurjónsson.

“One of the problems is if you’re constantly dealing with the same infection you have the off chance that a specific strain of syphilis or gonorrhea will develop resistance to the antibiotics we’re using,” he says.

This is what the current STI crisis is like in Iceland amongst the men that have sex with men (MSM) community. “We’re seeing that now with gonorrhea. It was mostly in the UK but has spread around. We most definitely have it here,” says Siggi.

“Unsafe sex has become a fad because of PrEP. People are regarding their sexual health as only what their HIV status is, which is not the case.”

Siggi also mentions that letting these diseases run amok only gives them more opportunity to evolve antibiotic resistance and become more of a strain on the healthcare system. Sound familiar?

Then there are still the STIs where antibiotics can’t be used at all. “Yes most things we have are treatable but then you have herpes, HPV, Epstein Barr virus (mono).”

Siggi says a lot of people don’t consider these or the long-term health effects that an STI can bring. “It’s the superman syndrome, you think you’re invincible until it happens to you,” he says.

The introduction of PrEP (Pre-Exposure Prophylaxis) in Iceland has also made unprotected sex “trendy.” “Unsafe sex has become a fad because of PrEP. People are regarding their sexual health as only what their HIV status is, which is not the case,” says Siggi. “If you get gonorrhea, maybe a new strain that is more difficult to treat, it can lead to swelling of the testicles, infertility, etc. Syphilis can actually be dormant within the body for a long time because it changes into several stages. That’s why I post things like “we have a syphilis crisis going on right now”.”

Overall, STI transmission is a burden on the health system that is preventable and it comes at a time when the system is already overwhelmed. When asked how it was working as a nurse in the middle of a pandemic, Siggi says “um, it’s not fun,” in a deadpan tone. “You just kind of saw the worst things of all. I mean when we say “we don’t have enough beds” it’s not that we don’t have enough beds. We don’t have enough staff to man those beds,” he explains.

That’s why Siggi and others are working with the infectious disease and sexual health departments to spread awareness, inform people of the symptoms, and promote getting tested for STIs. “Several months after [I posted about the syphilis outbreak] the infection rate started to drop, so people we’re definitely reading it,” says Siggi. Though he can reach most of the community in one place, Siggi also recognizes that there are plenty of people who count as MSM but aren’t out openly or don’t identify as gay/bi. “The people I’m not reaching are closeted, anonymous, discreet people. Unless I go on Grindr and educate there, which probably isn’t going to work,” he says and laughs.

In California, case numbers rose so much legislation was passed to make at-home tests for STIs covered by insurance. In the UK, cases have also risen. Doctor Katy Sinka, Head of Sexually Transmitted Infections section at Public Health England has said that “no one wants to swap social distancing for an STI, and as we enjoy the fact that national COVID-19 restrictions have lifted, it’s important that we continue to look after our sexual health and wellbeing. If you are having sex with new or casual partners, use a condom and get tested – STIs can pose serious consequences to your own health and that of your current or future sexual partners.” Photo / Deon Black via unsplash.com

Progress is being made through the PrEP program at Fossvogur’s A3 ward, however. One of the doctors from the program, Bryndís Sigurðardóttir, said in an interview with HIV-Iceland that 280 men have participated and about 150 receive PrEP regularly. This has gone a long way in also recognizing other STIs says Siggi. “The PrEP project is delivering some gains for sexual health because people that are on PrEP have to get tested every 3 months. If any other STI comes up positive they have to get that treated and then the 3-month cycle begins again.”

Despite that silver lining, Siggi still thinks there’s room for improvement. For instance, access to the PrEP program is based on one location in Iceland and it’s difficult to participate in the program if you live in the countryside. “It’s slow-changing. If you live in Akureyri, for example, you don’t have access to the program unless you come to Reykjavik every few months. They don’t have the medication there and they don’t even have PEP (Post Exposure Prophylaxis)! I’ve called them and asked if they knew what PEP was and I was informing them about it. The ER just doesn’t have it.”

Access to PEP is important for those who’ve been exposed to HIV. It can be used within 72 hours of potential infection to thwart the virus from taking hold. When asked why the emergency departments of Akureyri and Selfoss don’t have these on stock, Siggi says he thinks “it’s just a lack of education. They don’t know that they should have it.”

From his perspective as a health care professional, Siggi thinks these drugs should be available not just for the LGBT+ community. “It’s also for IV drug users, sex workers. They should have access to this medication but in this case, they would have to get it from Reykjavik. It’s only available at one place in Iceland. It’s only the pharmacy in Landspitali that creates PEP packages,” he says. At-home tests for common STIs are not available in Iceland at pharmacies. PrEP and PEP cannot be ordered by mail as in many other countries.

“The people I’m not reaching are closeted, anonymous, discreet people. Unless I go on Grindr and educate there, which probably isn’t going to work.”

Siggi says he knows that awareness and education are the only things that will change these situations. That’s why he’s been advocating for the development of a title for nurses specifically trained in LGBT+ issues and healthcare. He says progress is on the way, but he can’t do it alone. “It’s never been done before. The University of Akureyri just put in its course list that people will be learning queer health within their classes and it’s mandatory. At the University of Iceland, the students are asking for it but the department has never asked me to come. It’s been on a voluntary basis.”

A lot of doctors and nurses have just never had to deal with these subjects before. “I hosted a lecture for health care workers while I was in Akureyri teaching. I’ve also been approached by nurses that are hosting a big Nordic nursing conference and they’ve asked me to be a lecturer talking about queer health. I was kind of surprised that this fell to me, like all of these people approaching me,” says Siggi. “I just did this because I thought this was missing and it turns out that it was really missing. My first goal was just to help patients within health care, but then the health care professionals needed me a lot too,” he clarifies.

With changes to increase access to testing, treatment, and prevention, the number of STIs should decrease. If we take a similar approach to covid, diseases like syphilis and gonorrhea can be kept under control and others irradicated from Iceland entirely. When push comes to shove it’s up to the community to stay protected on an individual basis and prevent the spread.

For more information about STIs, their symptoms, and treatments, check here or here.

For information about STI testing in Iceland, check here.

For more information about PEP, PrEP, and HIV check here.

The Hamburger Factory
- gourmet burgers

Ok. You’re in Iceland. Most likely for the first time.

You will probably bathe in the Blue Lagoon and take a road trip to Gullfoss and
Geysir. That’s all well and good. But neither Geysir’s nor waterfalls are
something you eat. That’s why we have 15 brilliant and creative hamburgers at
The Hamburger Factory. And they are all perfectly square. Don’t miss out on
Iceland’s most beloved hamburgers.

The Hamburger Factory is Iceland’s most innovative gourmet burger chain.
Packed with burger-craving customers since it’s opening in 2010, among the
regulars is Iceland’s best known fisherman, Eric Clapton. In our restaurants we
welcome tourists with our newspaper like menu and smiley service. They are
packed with fun items and memorable connections to Icelandic pop culture.

Locations:

Omnom Chocolate
- award-winning chocolate maker

    Omnom Chocolate is an Icelandic craft chocolate company based in Reykjavík. We produce handcrafted chocolate from organic cacao beans sourced ethically and sustainably. We’ve developed direct relationships to create premium chocolate with fine flavor cacao beans.

    Our creative flavors are carefully crafted by meticulous chocolate makers. The cacao beans are roasted, winnowed, ground, and refined into melty-smooth chocolate.

    Omnom’s process is one of constant exploration, invention, and experimentation. If it doesn’t please us, if something isn’t absolutely delicious, there’s no reason to be doing it. So, we always start with our taste buds and follow our instincts. Our team searches for the finest ingredients in the world and new ways to improve chocolate. This obsession with knowing where our ingredients come from has led us around the corner to dairy farms in the Icelandic countryside and all the way to rainforest cacao farms of Nicaragua.

    In only a few short years, we’ve grown from our 50 sq. m. petrol station space and become an award-winning chocolate maker. Now, with our headquarters in 101 Reykjavík, our chocolate is sent out around Iceland and all over the world.

    At the end of the day, our goal is to make chocolate.

     

    Alfred’s Apartments
    - gay owned an operated

      Alfred’s Apartments and Alfred’s Studios is a gay operated and owned accommodation in the heart of Reykjavik.

      Alfred’s Apartments offers spacious apartments at a good price located just around the corner from Laugavegur shopping street. You can choose the apartment starting from a Small Studio for 2 persons to a large One-bedroom Apartment with balcony for 5 persons.

      Their staff will ensure your comfort during the stay and provide the most updated information about the city, gay and night life in Reykjavik.

      Each apartment has a private bathroom with a shower, fully equipped kitchen and free Wi-Fi. Guests can buy groceries at the local grocery store 50 meters from the apartments. Because of their very central location, numerous shops, restaurants and cafés are available in the surrounding area. The Church of Hallgrimur is located 350 m from the apartments, a tourist agency is just 50 m away and the nearest gay bar is less than 5 minutes walking distance.

      Laekur hostel
      In the hostel we have dorms for 4-8 persons with shared kitchen and bathroom facilities. The rooms are furnished with free internet, lockers, and a USB charger by each bed. The beds have linen provided and you can rent a towel in the cafe on the ground floor for 5 EUR.

      All the dorms are mixed with both genders. You can also book a whole room with 4-8 bunker beds.

      Nasdaq

         

        Nasdaq (Nasdaq: NDAQ) is a global technology company serving the capital markets and other industries. Our diverse offering of data, analytics, software and services enables clients to optimize and execute their business vision with confidence.

        With over 4,300 employees in 39 offices around the world, at Nasdaq we all contribute to the success of the company and its culture, and each one of us has the ability to make a difference. When it comes to our core mission and values, we embrace the role of Diversity, Inclusion and Belonging (DIB) as a fundamental driver of our corporate growth, workplace culture and market development. We strive to create a culture that embraces the power of different perspectives—a culture where people’s unique backgrounds and different experiences helps us fuel innovation and support our clients around the world.

        Our unique position at the center of the capital markets allows us to see firsthand how these values have redefined corporate culture and success, deepening and accelerating our own commitment to champion inclusive growth and prosperity, as we strive to create more equitable opportunities to help people of all backgrounds reach their full potential. Most notably, we published our diversity statistics for the first time in 2020. These metrics serve as a quantitative assessment of where we are today and help determine what strategies we need to adopt to enhance diversity in the workplace. We recognize that we have much work to do, but we are steadfast in our commitment to creating a diverse and inclusive culture—one that reflects the communities in which we live, allows all employees to be their true, authentic selves and fosters individual growth and achievement.

        As we move forward together, we will continue advancing diverse ideas and perspectives that help fulfill the promise of a more inclusive and prosperous world. We aim to set the pace for rethinking capital markets and economies anywhere and everywhere. To learn more about the company, technology solutions and career opportunities, visit us on LinkedIn, on Twitter @Nasdaq, or at www.nasdaq.com.

        Blue Lagoon
        - One of the 25 Wonders of the World

        Named by National Geographic as one of the 25 Wonders of the World, the Blue Lagoon is a shimmering expanse of warmth, relaxation, and rejuvenation. Its unique geothermal seawater
        comes from 2.000 meters within the earth where seawater and freshwater converge in a tectonic realm of porous lava and searing heat. Propelled by extreme pressure, the water ascends to the earth’s surface, emerging enriched with silica, algae, and minerals—the elements that endow Blue Lagoon geothermal seawater with its radiant, healing properties.

        From its humble beginnings in the shadows of a geothermal power plant, Blue Lagoon has evolved into a world of wonder, now encompassing two hotels, three restaurants, three
        geothermal lagoons, a subterranean spa, a renowned line of skin care, a thriving research center, and a wealth of spa and refreshment facilities.

        Achieving harmony with the volcanic landscape, the lagoon and its surrounding architecture embody the unification of the man-made and the natural, and adhere to the highest principles of sustainability.

        The Blue Lagoon. A wonder of the world. A world of wonder.

        Whales of Iceland
        - larger than life

        Whales of Iceland is the largest whale exhibition in Europe (and perhaps even the world), where guests can learn about the giants of the sea in a calm and modern environment. The permanent exhibition features whales like guests have never seen them before. It is truly a giant experience.

        Landsbankinn
        - leading financial institution
        Landsbankinn

        Landsbankinn is a leading Icelandic financial institution. It offers a full range of financial services and is the market leader in the Icelandic financial service sector with the largest branch network.

        The present bank was established on 7 October 2008 but the history of its predecessor dates back to 1886. The bank is owned by the National Treasury of Iceland, which holds 98.2% of its share capital, and other shareholders who own 1.8%.

        Landsbankinn’s strategy is to provide comprehensive financial services that meet customer’s needs. It emphasizes providing exemplary service to customers, developing e-banking for their convenience, increasing the efficiency of support functions, modernizing its technology and ensuring effective utilization of its balance sheet.

        The bank’s vision is to be exemplary and its role is to be a trusted financial partner.

        Special emphasis is placed on promoting a performance-oriented culture in the bank. To follow up on the implementation of this strategy, the bank has defined key goals which are measured regularly to determine progress. These goals include, for example, customer satisfaction and loyalty, profitability, cost efficiency and the correlation between risk appetite and employee satisfaction.

        Landsbankinn wishes to lead the development of a sustainable society in Iceland by integrating economic, social and environmental concerns in its operations. The Bank aims to ensure that both its owners and society at large benefit from its activities.

        It intends to achieve this aim by building solid infrastructure and a strong team of 1.100 employees, by listening to its customers and by respecting and encouraging its employees to actively participate in their community. Landsbankinn was a founding member of Festa, a Centre for Corporate Social Responsibility, and is a member of the UN Global Compact.

        Landsbankinn has been a proud sponsor of the Reykjavik Pride since it was first celebrated in Iceland.

        Aurora Reykjavik
        - northern lights center

          Aurora Reykjavik is a Northern Lights Center situated in downtown Reykjavík at the Old Harbor next to Icelandair Hotel Marina and Vikin Maritime Museum.

          Aurora Reykjavík is Iceland’s first educational and recreational Northern Lights Center where multimedia is used to explain when, why and how the Northern Lights work, with the highlights being large HD projection of the Aurora’s. We also share myths and legends about what our ancestor thought about those mystical lights.

          The Northern Lights Center is for all ages. Children are our favorite guests and we created the exhibition in a way that children can have a look freely and parents don’t have to worry about things being broken.

          Aurora Reykjavik offers a great selection of souvenirs that are designed and made by Icelanders along with nice little coffee corner, where you can enjoy free coffee and tea while browsing through the souvenirs or just planning your next step.

          Contact Aurora

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            Dohop
            - get inspired
            Dohop

            Dohop allows people to find the cheapest flights available with just one click. Founded in Reykjavik in 2004, it is the only Icelandic company of its kind and quickly became the go-to tool for finding cheap flights among the locals. Dohop finds the best deals among hundreds of different airlines and online travel agencies, to make sure that the user is getting the cheapest price. Dohop also offers hotel and car rental search engines, so users can make all of their travel bookings from a single website.

            Dohop‘s specialty is finding so-called “self-connect” flight options, which can save travelers money by booking a ticket through two or more different airlines. The ability to look for these self-connect option is what sets Dohop apart from its competition, as it can save people hundreds of dollars on certain routes.

            More recently, Dohop has developed a unique product called Dohop Go!, which allows users to check for the cheapest available flights from their home airport. This tool is perfect for those who are looking for travel inspiration but are not willing to overpay for their flight ticket. Dohop Go! is now available in the Dohop Flights App, both for Android and iOS, along with its traditional flight, hotel, and car search engines. “

            VSÓ Ráðgjöf

               

              VSÓ Ráðgjöf er alhliða ráðgjafar- og verkfræðifyrirtæki sem leggur áherslu á trausta og faglega þjónustu sem tryggir viðskiptavinum hagkvæmustu lausnir hverju sinni, skilar raunverulegum árangri og stuðlar að samkeppnisforskoti.  Á skrifstofum VSÓ í Reykjavík og í Noregi starfar yfir 80 manna samhentur hópur verkfræðinga og annarra tæknimenntaðra starfsmanna.

              Macland
              - for all your Apple needs
              Macland

              From starting out as a proper startup with only a good idea and the need to change things, to becoming an established company with 6 employees. Starting from scratch and expanding organically has allowed us to love our expansion and take our customers on the ride with us.

              Macland is located at Laugavegur 23 (101, Downtown Reykjavik)
              For all your Apple needs. We are here.

              Ísey skyr
              - once tasted never forgotten

              Our Story
              Once upon a time, 1,100 years ago in fact, Nordic settlers began arriving in Iceland. They brought with them the skills and knowledge for producing skyr. As time passed, the know-how and recipe for this nutritious food slowly faded out elsewhere in the Nordic region. Luckily, the Icelandic skyr-making tradition continued.

              For centuries, Icelandic skyr formed a cornerstone of the national diet, helping to keep people strong in living conditions that were often harsh. On family farms countrywide, it was the women who nurtured this dairy and passing on both the recipe and the original Icelandic skyr cultures from mother to daughter.

              Ísey skyr builds on this remarkable legacy. It was some of those very same women, the recipients of their mothers’ expertise, who, around 90 years ago, taught Icelandic dairy scientists the art of skyr-making. The production process is more high-tech these days, and the quality standards more rigorous. However, the basic recipe and the use of original cultures to ferment the skimmed milk remain the same. Protein rich, fat-free, creamy and delicious – Ísey skyr is as relevant to consumers now as it was all those centuries ago.
              This is our secret and you are in on it

              You can read more about Ísey skyr on our website.

              Núðluskálin
              - noodle bar
              Núðluskálin

              Núðluskálin is a small gay owned and operated fusion noodle bar.

              All of our courses are individually made from fresh ingredients and therefore highly customisable.
              We offer fully Vegan versions of all courses.
              Though originally a take-away we now seat over 30 people.

              Núðluskálin is located right in the heart of Reykjavík on Skólavörðustígur 8 (street leading up to the big Church) near the junction with Laugavegur (main street).

              Seatours
              - adventure cruise

              Ferry Baldur – the gate to the West fjords
              and VikingSushi Adventure – Bird & Nature watching Tour for everyone all year around

              The “VikingSushi Adventure” is the right boat tour for travelers who are adventurous and want to experience something new – close up to the nature seafood simply doesn’t come fresher than this! The archipelago area of the Breidafjordur Bay always surprises her visitors during winter or summer with spectacular sights. Where else you get to try delicious fresh scallops and sea urchin roe straight from the ocean served with soy sauce, wasabi and ginger.

              600x400-seatours-tasting

              This old volcanic area, characterized by the typical basalt formations of the islands, is the home of countless birds. Here you will also find the strongest currents in Iceland. The VikingSushi Tour takes roughly two hours and our captain is also the tour guide.

              600x400-seatours

              The VikingSushi Tour is a true adventure through incredible nature which should not be missed by any traveler to West Iceland.

              Birds, possible to spot:
              -puffins (from the middle of April until the middle of August)
              -eider ducks
              -shags
              -kittiwakes
              -fulmars
              -white-tailed eagle

              The car ferry Baldur is the bridge to the West fjords via the island Flatey
              Ferry Baldur crosses Breidafjordur Bay daily from Stykkisholmur on the Snæfellsnes peninsula to Brjanslaekur in the north. A ferry ride considerably shortens the route between the south and mid-west of the country and the West Fjords region. It also gives you the opportunity to experience a floating restaurant.

              Take a stopover at the charming island Flatey when you are crossing the bay or go to a day tour to Flatey and back to Stykkishólmur. At Flatey are no cars allowed and between the houses of the 18th century you get the feeling of a journey back in time.

              Contact Us


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