Tag Archives: HIV

Condom Use Among Young African American Men

Today’s guest post was written a sex educator who specializes in peer-to-peer pregnancy prevention programs. He understands the cultural nuances that influence the decisions young people make and works to help youth realize their potential. 

Condom use can be a taboo topic, especially within certain cultures and ethnic communities, including the African American community. When you dissect the African American community into subsets (by age, for example) you see trends in attitudes about condom use. According to the Black Aids Institute, young African American men report a 20.5 percent condom usage rate. It’s alarming to consider that 4 out of 5 young black men are not using condoms during sexual intercourse. Lack of condom use among African-American men can be seen as a direct correlation to higher rates of unplanned pregnancies, HIV, and other STI’s within the African American community.

couple

Research done by the Pacific Institute for Research and Evaluation conducted a qualitative study on condom use behaviors among urban African-American men ages 18-24. That research revealed various reasons for non-condom use:

  • Lack of interest in condom use
  • Lack of immediate access to condoms
  • Inconvenience
  • The mood-killing length of time it takes to put on a condom
  • Partner’s disinterest in condom use

The most commonly expressed rationale for not using condoms among the research participants was their general disinterest in using condoms. It is evident that there may be some cultural perceptions among young African-American men that promote the non-use of condoms during sexual intercourse. Education is a critical component to refute many of the misconceptions that this population has in regards to condom use and it may be highly beneficial for Sexual Health Educators to consider the use of peer-to-peer education.

Some of the perceptions of condom use among young African-American men are driven by peer influence. A literature review of peer-to-peer programs done by Advocates for Youth revealed the following results:

  • Improved reproductive and sexual health outcomes, including reduced incidence of pregnancy, births and STIs
  • Reduced sexual risk behaviors, including delayed initiation of sex, increased contraceptive use and condom use, reduced number of new sexual partners as well as increased abstinence among sexually experienced youth, reduced incidence of unprotected sex, reduced frequency of sex, and increased partner communication
  • Increased incidence of testing and sharing test results, including testing for HIV, for STIs, and sharing positive test results with a partner

Lack of condom use among African-American men has far-reaching public health consequences and effective strategies must be implemented to mitigate the cultural behavioral norms that promote non condom use. Peer education appears to be a promising model to educate young African-American men about the benefits of consistent and appropriate condom use.

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HIV and Trans Women

Nearly a fifth of the world’s transgender women are infected with HIV. A recent analysis compiling the results of 39 studies involving 11,000 transgender women from 15 countries came to this startling conclusion. This number is 49 times higher than the general population, 36 times higher than males and 78 times higher than other females. For the study, transgender women were defined as individuals born as biological males who currently identified as female. Transgender women who engaged in sex work were also significantly more likely to be infected with HIV than male and other female sex workers.

So why are transgender women so much more likely to contract HIV? The authors of the report offered several reasons. They believe that many of the infections occurred through unprotected anal sex. Next to direct blood to blood contact through needle sharing, anal sex is the easiest route for transmission. Anal tissue is more easily torn during anal sex than through either vaginal or oral sex. If they have had a recent vaginoplasty/vaginal construction, they are also at greater risk of infection. Transgender women are more likely to be involved with sexual partners who are infected with HIV and engage in sex work.

hivprevalance

The stigma, discrimination, and fear of judgement associated with being transgender are significant factors that lead to many women avoiding routine health screenings. And to make matters worse, few health care workers, HIV counselors, and physicians are trained in transgender women’s health care issues.

Hopefully, this study will help open doors to future strategies to help address this overlooked population. To read the entire article, click here.

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HIV and Trans Women

Now that transgender issues are coming into mainstream conversation, here’s a repost of a topic that needs attention…

Nearly a fifth of the world’s transgender women are infected with HIV. A 2013 analysis compiling the results of 39 studies involving 11,000 transgender women from 15 countries came to this startling conclusion. This number is 49 times higher than the general population, 36 times higher than males and 78 times higher than other females. For the study, transgender women were defined as individuals born as biological males who currently identified as female. Transgender women who engaged in sex work were also significantly more likely to be infected with HIV than male and other female sex workers.

So why are transgender women so much more likely to contract HIV? The authors of the report offered several reasons. They believe that many of the infections occurred through unprotected anal sex. Next to direct blood to blood contact through needle sharing, anal sex is the easiest route for transmission. Anal tissue is more easily torn during anal sex than through either vaginal or oral sex. If they have had a recent vaginoplasty/vaginal construction, they are also at greater risk of infection. Transgender women are more likely to be involved with sexual partners who are infected with HIV and engage in sex work.

transgender_HIVPrevalence

The stigma, discrimination, and fear of judgement associated with being transgender are significant factors that lead to many women avoiding routine health screenings. And to make matters worse, few health care workers, HIV counselors, and physicians are trained in transgender women’s health care issues.

Hopefully, this study will help open doors to future strategies to help address this overlooked population. To read the entire article, click here.

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What We’re Reading via The New York Times

If you don’t follow The New York Times, you should. One of the reasons we love it is because they publish excellent and timely articles on health, and we sex educators rely on it to stay up on the latest news. It is a reliable and sound resource for us. Here are a few of our recommendations from the last month or so…

Searching for Sex, by Seth Stephens-Davidowitz, January 25, 2015

If you’re fascinated by all things sex ed like I am, you MUST read this article. I’m not even going to prep you with a little introductory paragraph because I want you to be totally blown away. The article is a bit long so if you don’t have time now, bookmark it for later.

Medicating Women’s Feelings, by Julie Holland, February 28, 2015

There are lots of things our society doesn’t talk enough about and mental health tops the list, in my opinion. This article, written by an experienced psychiatrist, says enough is enough! She says, “The new, medicated normal is at odds with women’s dynamic biology; brain and body chemicals are meant to be in flux. By evolutionary design, we are hard-wired to be sensitive to our environments, empathic to our children’s needs and intuitive of our partners’ intentions. Women’s emotionality is a sign of health, not disease; it is a source of power. But we are under constant pressure to restrain our emotional lives.” I highy recommend this read…share the article, talk about it, reach out to a friend.

Two Strains of H.I.V. Cut Vastly Different Paths by Carl Zimmer, March 2, 2015

Two strains of HIV-2 have made it to gorillas from chimps, and it's created two rare strains, O and P.

Two strains of HIV-2 have made it to gorillas from chimps, and it’s created two rare strains, O and P, both of which have jumped to humans in Cameroon

We’ve posted many articles about HIV before, including this one the origin of HIV. What I like about Carl Zimmer’s article is that he retraces what we already knew about HIV’s origin, but helps us fill in the gaps by exposing us to new research. HIV-2 didn’t just take one giant leap from primate to human, IT TOOK NINE! HIV-1 was trickier to track down. Scientists have been sifting through chimpanzee and gorilla feces for years looking for answers and now they finally have definitive proof that they can use to reconstruct the path that HIV-1 took. It’s a very fascinating read so be sure to check it out!

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The Challenges with a Cure for HIV

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

Since the discovery of Human immunodeficiency virus (HIV) as the cause of Acquired Immune Deficiency Syndrome (AIDS) in 1983, it continues to pose a huge threat worldwide to the health of millions of people. Data from the World Health Organization (in 2013) revealed that worldwide 35 million people were living with HIV, there were 2.1 million new cases and 1.5 million deaths.

hivThe development of multi-drug combination therapy known as Highly Active Antiretroviral Therapy (HAART) for treatment of HIV/AIDS in 1996 was one of the major successes of modern medicine leading to a dramatic drop in the death rate by 50 to 80% between 1996 and 2006. This period is known as “the decade of HAART.” This changed the view of HIV/AIDS from a fatal and catastrophic disease to what is now a manageable chronic illness.

After this initial success, the next step was to find a cure and/or an effective preventive method. Currently the best way to avoid HIV/AIDS is to take conscious steps to avoid contracting the virus in the first place. This has been the aim of a lot of efforts all around the world teaching safe sexual health practices and healthy lifestyle behaviors. However, changing human behavior is quite difficult.

Due to the rapid and constant mutation of HIV, the human immune system finds it very difficult to defend against it and scientists have found developing an effective vaccine very problematic. Also, HIV is able to create reservoirs in its hosts leading to latency of the disease, which is the main reason HAART can’t eliminate the virus but only reduce its load in the human body to very low levels. For this reason HIV positive patients are unable to stop HAART therapy to avoid dramatic increase in their viral load.

Despite all these issues, promising advances in therapy are being made. Drugs like Prostratin, which are able to reactivate latent HIV and therefore increase the effectiveness of HAART therapy, are being developed. There are also a small group of people who are known to be immune to HIV due to the absence of the cell receptor necessary for HIV to infect cells known CCR5. This knowledge was used in the case of Timothy Ray Brown, the first case of a cured HIV positive patient. Although the therapy used on Timothy is very risky and expensive and therefore can’t be applied on a large scale, it has given researchers ideas on how to modify a patient’s immune system to resist HIV.

Continuing research in this field, including various promising results from numerous clinical trials show that there is hope for an effective cure for HIV. Tests in the lab have shown promise at a cellular level and the aim is to replicate these results at the macro level. This process may take years but with each passing year we get a better understanding of the virus and the disease mechanisms which would bring us closer to developing a cure and possibly a vaccine. Until then, maintaining a healthy lifestyle approach and engaging in healthy sexual behaviors (using condoms) will be the mainstay of HIV prevention.

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3 Things Everyone Can Do to Prevent HIV

December 1st was World AIDS Day so we are reposting this one from a couple of years ago to highlight that not much changes in terms of HIV prevention… 

Although HIV has been a part of our lives for over 25 years, people in this country are still getting infected at about the same rate they have been for several years. Many people still have misinformation about the virus or don’t feel they are at risk. Here are a few things everyone can do:

• Encourage people to get tested and get tested yourself
Planned Parenthood of Southwest & Central Florida offers 3 types of HIV testing: a rapid test (results in 20 minutes), blood draw sent to a local lab (results in 2-3 days) or the free state test (results in about 3 weeks).

• Learn the facts about HIV so you can educate yourself and others
There are still many myths about how HIV is spread, who’s at risk, and how it’s prevented.

• Promote condom use
Many people worry more about becoming pregnant than becoming infected with a STI. If they or their partner are using contraception, they may believe they have taken care of all their reproductive needs. If they have a same sex partner or are past childbearing years, they may figure they have nothing to worry about.

Out of all the STIs, HIV is the most difficult to acquire, and it has a dramatic impact on someone’s life as well as the lives of those who love them. Despite fears of many to the contrary, a positive HIV test isn’t a death sentence; with medical attention, proper medication, and taking control of their health, someone can live a long and healthy life with HIV.

The best medication for HIV, though? Not getting the virus at all. Let’s all do our part to reduce the spread of HIV.

For the most current information on the virus, check out the CDC website on HIV.

For living with HIV, read this CDC brochure on HIVas well as Avert, the international HIV & AIDS charity, to answer common questions about living with HIV.

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STD Testing During Pregnancy

cdcSo you just found out you or your partner is pregnant. There are so many things to think about, but one thing many people never think about is getting tested for STDs. Most prenatal visits include testing but it’s also important for a new or old partner to be tested so infections are not spread to mom during her pregnancy. To varying degrees, all infections have the potential to affect a developing fetus. Knowing what tests to ask for depend on risk factors such as age, number of partners, use of condoms or barriers, possible exposure and drug use. Here are the Centers for Disease Control and Prevention’s 2010 STD Testing Guidelines:

Chlamydia 

Screen all pregnant women at first prenatal visit; 3rd trimester rescreen if younger than 25 years of age and/or high risk group.

Gonorrhea 

Screen all pregnant women at risk at first prenatal visit; 3rd trimester rescreen women at continued high risk. Risk factors include: young women aged 25 years or younger, living in a high morbidity area, previous GC infection, other STDs, new or multiple sex partners, inconsistent condom use, commercial sex work, and/or drug use.

Syphilis

Screen all pregnant women at first prenatal visit; during 3rd trimester rescreen women who are at high risk for syphilis or who live in areas with high numbers of syphilis cases, and/or those who were not previously tested or had a positive test in the first trimester.

Bacterial Vaginosis

Test pregnant women who have symptoms or are at high risk for preterm labor.

Trichomoniasis 

Test pregnant women with symptoms.

Herpes (HSV)

Test pregnant women with symptoms.

HIV 

Screen all pregnant women at first prenatal visit; rescreening in the third trimester recommended for women at high risk for getting HIV infection.

Hepatitis B

Screen all pregnant women at first prenatal visit: retest those who were not screened prenatally, those who engage in behaviors that put them at high risk for infection and those with signs or symptoms of hepatitis at the time of admission to the hospital for delivery. Risk factors include: having had more than one sex partner in the previous six months, evaluation or treatment for an STD, recent or current injection-drug use, and an HBsAg-positive sex partner.

Human Papillomavirus

There is not enough evidence to make a recommendation.

Hepatitis C 

All pregnant women at high risk should be tested at first prenatal visit.

To find out more information about STDs during pregnancy, visit the CDC website.

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The Condom That Kills STDs

condomsBIG NEWS from the condom world! An Australian condom manufacturer is about to start producing a LifeStyles brand condom with Viva-Gel. Viva-Gel is a microbicide that is shown to disable viral STDs such as Herpes, HIV, and  HPV. Although laboratory results prove that the condom inactivates 99.9% of the viral STDs it comes in contact with, at least one doctor is skeptical.

gelDr. Anna-Barbara Moscicki gives us reason to exercise caution. Her research using the antiviral compound as an intravaginal cream for women showed that it caused mild irritation and inflammation after two weeks of daily use.

So what’s a little inflammation? What’s the big deal? Well, inflammation attracts our healing cells, our white blood cells. And if you recall from 5th grade health class, HIV uses white blood cells to disguise itself and replicate. Inflammation also breaks down the already-thin vaginal walls, leaving them susceptible to HPV infection. Essentially, inflammation of the sexual parts is like an open invitation for HIV infection.

But there’s good news! Starpharma, the pharmaceutical company who conducted the clinical trials on the groundbreaking condom reported to Huffpost that they used a fraction of the gel on their condoms that Moscicki did in her clinical trial (1% versus 3%) and subsequently found that irritation and inflammation weren’t problems among their 1,000 clinical participants. And though they tested the safety at a 1% concentration, the amount on the condom is actually .5%. If the results prove positive, you can bet that the Viva-Gel condoms will soon be available all over the world.

Remember, next to abstinence, correct and consistent condom use is the best protection against contracting STDs. However, condoms do not provide great protection against STDs that are transmitted by skin to skin contact (like Herpes and HPV), because they do not cover the entire genital area that may be infected. Know your status, talk to your partners, and use protection for the best combined protection.

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The ABC’s of STD Prevention

Today’s post is by “Obi,” a Nigerian doctor conducting his field experience at Planned Parenthood as part of his MPH program. He was a general practitioner in his home country with main interest and expertise in maternal and child health.

When it comes to STD prevention purposes, what defines safeOne of the most concise mnemonics for STD prevention is the ABC Rule (one of the most basic ways couples can have safe sexual experiences and healthy sex life).

  • Abstain from sex
  • Be faithful if you don’t abstain
  • Use a condom if you aren’t faithful
A roadside sign in Botswana promoting the ABC approach.

A roadside sign in Botswana promoting the ABC approach.

As simple as this may seem, it is not well understoody by some. Let’s break it down…

Abstain from sex: This means ‘not engaging in any form of sexual practice with a partner’. The notion of abstinence is misinterpreted by a lot of people to mean not performing any sexual practice that could lead to pregnancy (vaginal intercourse), while some include abstaining from any penetrative sexual practice (both vaginal and anal intercourse). This, therefore, gives room for oral sex for abstinent individuals. However, STDs like Syphilis, Gonorrhea, Human Papilloma Virus (HPV), Herpes and Hepatitis can be contracted through oral sex. I do get a surprised look from teens and young adults when I say that like vaginal sex, oral sex should be performed with protection because of risks of contracting an STD.

Be faithful: It takes two to tango, so the saying goes. Two partners who are in a monogamous relationship and want to start a physical relationship should consider the following:

  • A consentual decision to start a sexual relationship
  • Undergoing testing for STDs including HIV
  • Using a reliable contraceptive method that works best for them (if they are not planning to get pregnant)
  • Working on maintaining a faithful monogamous relationship with your partner

Here comes the twist, the definition of being faithful also varies depending on whose point of view you are looking at it from. By definition, being faithful, with regards to safe sex, refers to not being sexually involved with anyone except your partner. Since we know that STDs can be contracted through oral sex, and use of barrier methods (condoms) isn’t 100% effective, it is imperative that partners who practice ‘Being Faithful’ as their method of STD prevention do so in the strictest way possible.

Please remember we are all humans and we all can make mistakes, it is advisable to have routine STD including HIV testing, health screenings and see your physician if you have any symptoms or concerns.

Use a condom: If you choose not to be abstinent and are unable to be faithful to your partner, it is advisable to use a condom with all your sexual partners. Latex condoms, when used consistently and correctly, are highly effective in preventing the transmission of HIV, the virus that causes AIDS. In addition, consistent and correct use of latex condoms reduces the risk of other sexually transmitted diseases (STDs), including diseases transmitted by genital secretions, and to a lesser degree, genital ulcer diseases. Incorrect and inconsistent use of condoms increases risk of contracting STDs including HIV.

Condoms should be used during vaginal, anal, and oral sex and also when sharing sex toys (condoms should be changed before use by each partner). Condoms should be properly stored, expiration date checked before use, and the right steps followed when putting on, using, and disposing of used condoms.

It’s important to note that condoms offer protection over areas where it covers and offers lesser protection against genital ulcers and bodily secretions outside this area.

What do you think of using the ABCs for STD prevention?

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The App That’s Helping Syphilis Spread

dsc_0094-e1367819041812Some scary news is coming out of Onondaga County, NY. Between 2012 and 2013, the number of syphilis cases nearly doubled, and the smart phone app called Grindr is partly to blame. Grindr is a global positioning app that allows users to locate other users (within feet) who want to meet up. Many times, these meet ups turn into hook ups. The app is targeted to men who have sex with men, very similar to other apps like Tinder, which targets a more heterosexual base. Grindr boasts over 7 million members across 192 countries. You can see why health officials are concerned.

Health officials in the Syracuse area confirmed that nearly all the cases involved men, and more than 70 percent involved men who reported having sex with other men. Many of these men reported using Grindr (and similar apps) to find their recent sex partners. In case you need a refresher, syphilis can be deadly if left untreated by antibiotics. It is a bacterial infection, like chlamydia and gonorrhea, but left untreated, syphilis has much worse consequences. To learn about the symptoms associated with syphilis, please visit this CDC fact sheet.

This news is especially hard to hear considering that the U.S. was doing so well at reducing syphilis cases that the CDC officially ceased its Syphilis Elimination Effort just months ago in December 2013.

The Grindr website encourages its users to stay safe by getting tested and using protection, but only specifically mentions HIV and hepatitis. Here are two tips to keep you (sexually) safer when using meet up to hook up apps: 1- Know your status by getting tested often. If you’re testing positive, don’t spread the infection. 2- Use condoms. Asking someone you’re dating to reveal their status is one thing, but expecting a complete stranger to be honest about their status is completely unrealistic. And remember, given the opportunity, sexually transmitted diseases will spread, regardless of who you have sex with.

If you do test positive and aren’t sure how to tell your past partners, alert them anonymously with inSPOT. For testing, visit your local health department or Planned Parenthood.

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