Thursday, June 27, 2013

Today is National HIV Testing Day - what Obama & Dr. Owen have to say

Public Domain - President Barack Obama, 2009
Today is the United States’ 19th National HIV Testing Day. A rally going throughout the country with even president Obama addressing the nation and reminds everyone between the age 15-64 to get regularly screened for HIV. There are nearly 1.2 Americans living with HIV and 50,000 new infections every year. Worst of all, a quarter of all people living with the virus don’t even know they have it

Reason enough for us to start a whole series on Smarten Up on HIV. So you think you know HIV? Its meaning, history, new developments like PEP and PrEP? We bring you up to date on today’s knowledge and are honored that Dr. William Owen, veteran in the HIV field is taking that journey with us!

So what is HIV and AIDS? Are they the same? What’s the difference?

So just like with our HPV and Michael Douglas’ cunnilingus post, let us start with the basics and that is the words themselves and how they differ from each other. You don’t want to read anymore? Then good news, we actually made a video for you:



So to summarize again:

  • HIV stands for Human Immunodeficiency Virus. So it is a virus that targets us (humans) and leads to a failure of the natural defense mechanisms of our body (immune system).
  • AIDS on the other hand stands for Acquired Immune Deficiency Syndrome. So it is an obtained condition caused by a failure of the natural defense mechanism of your body. In other words AIDS is the result of an untreated HIV infection.
  • As Dr. Owen points out, you can remember the difference easily by the V (think of ‘virus’) in HIV and the D (think of ‘disease’) in AIDS.
You might ask why the medical community makes it so complicated. After all, we don’t have two words for herpes either. Its herpes when you have the virus and herpes on your lip (or anywhere else) when it breaks out.

The reason for the two names is that AIDS was a description of that new condition witnessed in the 80ies before it was even known that a virus caused the syndrome. So the two names have an historical origin. Confusing, yes and its still hard for many to grasp the difference. Take the recently published comic book “AIDS in the End Zone”. Jacob from the HIVPlusMag correctly points out that the title should be “HIV in the End Zone” since none of the characters actually develops AIDS



So Who should get tested?

We will get into more details how HIV works and how to protect yourself in a later episode of Smarten Up. For Testing Day, let us focus on who should get tested.  The United States Preventive Services Task Force (USPSTF) recommends with the highest grade that
  • Everyone between the age of 15 and 65 should get screened for HIV as part of their routine health care.
  • All pregnant women who don’t know their status should get tested for HIV
  • Younger adolescent and older adults should get tested if they are at increased risk such as: men who have sex with men, using injection based drugs, having unprotected sex, having more than one sex partner, having a partner who has HIV infection (magnetic couple), and exchanging sex for drugs or money.
As Paul Wax summarizes in his post in The Body Pro, these recommendations largely follow those already set by other organizations such as the Center of Disease Control (CDC). However, the USPSTF is known to caution doctors from over-testing so having a clear testing guidelines from them carries even a bit more weight with doctors. Or how Paul puts it “it must be the right thing to do. Because these guys are tough.”


HIV Test Locator

To make it really easy, you can use the AIDS.GOV test locator below. Just put in your Zip code and it will show you the nearest test center. Of course, you can also obtain a saliva based HIV home test from us!




 

Your Mission for today

Thanks a lot for reading this far. I hope you now have a better picture of what HIV is and who should get tested. Also, you learned that about 300,000 Americans are estimated to live with HIV without knowing it. So let us work together to make HIV testing as normal as going to the dentist.

So here are your mission objectives:

  • If you are in one of the categories above, go and get tested TODAY! Either in a test center near you or with a home test.
  • Convince at least 3 family members or friends that fall in the category above to get tested. Share on Facebook and share on twitter to get the word out!

Alright, now its time for me to walk the talk. Looking at the recommendation above, that includes me. So I’m off to get tested... until next time!

Special thanks

  • Big thanks to Dr. William Owen for the advice and being part of the video
  • Many thanks to Gregory Go for being a badass video producer, camera man and sound technician!

Thursday, June 20, 2013

3 Steps To Find An STD Clinic Like a Hot, Friday Night Date

The following is a repost from the Fearless Press, a web magazine for intelligent voices to speak about the positive intersection of sex and life.
Alyssa Mompoint, Image by Greg Go
“Alyssa, Come here!”

A text from my friend’s recent one night stand read, “Do you have an STD?”, followed by a series of photos of his penis with red, open sores on it. This is definitely an awkward way to start the STI/STD convo.

“I’m a whore,” she cried.


I was horrified that my friend believed she was a whore because she may have contracted Herpes. He had never said he had tested positive for Herpes or Genital Warts nor had he ask her to get tested before they had sex. But afterward, he accused her of spreading herpes and called harassing her for several days.


Herpes is, in fact, very common with 50-80% of Americans having oral herpes and 1 out 6 people having gental herpes in the U.S. Since Herpes and HPV can be contracted through skin to skin contact, using a condom does not completely protect you. Also, once you develop symptoms, don’t be so quick to blame your current partner. In a previous post, we wrote how in most cases of HPV our bodies successfully keep the virus in check so it can be years or even decades before symptoms. In the case of Herpes, Dr. Marc F. Hirsch advises via Healthtap that “HSV-2 can be dormant and suddenly break out with physical or emotional stress. You might have had it before recent partner”. So the only smart thing to do was to get tested. After a couple days of frantically searching, we found a clinic that was just right - SF City Clinic.


Julep67 via Compfight cc

Now, we didn’t account for the 3-hour wait time which included getting a number, talking to a counselor about her risk, peeing into a cup to test for Chlamydia and Gonorrhea, getting her blood drawn for Syphilis and Herpes (HSV-1 and HSV-2), and receiving a rapid test for HIV (adding another 20 minutes in wait time for her result). Did I mention the guilt and shame in the room was almost tangible. So, what was the final result you ask? As advised by the nurse, she sent him a screenshot of her negative test results.  


Needless to say, navigating the STI/STD clinic search can be nerve wracking and very personal. It’s kind of like the dating world of Match.com or OkCupid, right? You don’t just go on a date with anyone. You want to be attracted and the person has to be available to you.


So, here are 3 steps to find the perfect testing clinic as you would your hot date:

Step 1: Decide if it’s Dating Material: What are the hours? Does it get good reviews? Does it make you pay or can you use your insurance? Is it on your way home or work? Does the clinic cater to women, MSM, transgender? Do your research. Otherwise, it’s like you trying to use a hook-up app like Grindr or Bang With Friends to find a committed long term relationship. You will leave feeling unsatisfied and frustrated because it doesn’t offer what you need. To simplify this process, use the CDC STI/STD clinic locator or AIDS.gov clinic locator start your search.

Step 2: Go On the First Date: Does it make you feel comfortable? Did you have a good conversation with the testing counselors? Were they considerate of your time? If you’re shy, go on a double date by bringing a friend you can trust who can ease any anxiety and take off some of the pressure. Schedule enough time so you’re not forced to skip work or ditch plans. If the environment or people make you feel uneasy then you know not to go back the next time. It is sort of like that date who only talks about themselves or picks the one restaurant you absolutely hate.

Step 3: Think About How the Date Ended. How fast did you get an email or phone call with your result? Did you feel like you could be yourself and ask questions? How easy was the testing process? Be sure you leave knowing what you got tested for, in what form you’ll receive the results, and how fast you’ll receive them. If you liked it enough and felt comfortable, go on that second date.

Caro Wallis via Compfight cc


Getting tested can give you a sense of pride, and based on my personal experience can certainly give you peace of mind. So, while it can be a pain, it may save you.

And, of course, if it’s HIV, Chlamydia, and Gonorrhea, remember you can scratch the whole clinic process and do it in the comfort and privacy of your own home with our easy delivery service at BeforeWeDo


Why is there such a strong sense of shame felt in clinics?









Tuesday, June 11, 2013

3 Biggest Myths on Having the STI/STD Conversation...Debunked


The following is a guest post from the Kali from the Kink Academy & Erotication.com.
Kali is a dynamic kink educator that focuses on power exchange, sexual confidence. With 10+ years exploring sexually alternative lifestyles & professions, her focus is on running her revolutionary sex education websites, Erotication.com.  Please note: All of the links in the article are connected to free PassionateU.com videos, some of them are NSFW (aka explicit!)

There are a lot of awkward conversations we might have in life. Socially taboo topics can be difficult to discuss or talk without feeling weird. Topics that usually fall under the “socially awkward” conversations may be about money, death, breaking up and definitely about STI/STDs. I think it’s time we change that.


To start breaking the taboo, we can at least we can find a way to talk about STIs & STDs that leaves that awkwardness behind. STI/STD rates are currently at 20 million new infections a year so it’s more important than ever to “have the talk”. However, even that kind of emphasis contributes to the discomfort in bringing up the conversation. It doesn’t have to be an oh-so serious discussion, in fact the ideal is to make it a normal part of your sexual experience so you can protect your health & future sex life.
lulazzo [non vede, non sente, non parla] via Compfight cc

Here are 3 myths about bringing up the topic of safe sex & STIs/STDs:
Myth #1 If you bring it up, you must have slept with a lot of people. Or you think your partner has slept with a lot of people and you don’t want to feel like (or make them feel like) a “slut”.  

That’s a very shaming approach and GOOD sex is about shamelessness!
Myth #2  It has to be a super serious, nerve racking conversation.

Hell No! It can be more light-hearted and does not need to be treated like the ‘end of the world’. Being honest doesn’t mean you have to be grim about it, even and especially if you’re the one bringing up an STI/STD you have.

Myth #3 If you have an STI/STD, you’ll automatically be rejected as a sexual partner.

This is definitely not true. If we segregated everyone with some kind of STI or STD then there would be way less sex in the world and we don’t want that! We want healthy, open sexual experiences, regardless of STI/STD status. There are plenty of people that understand most STIs and STDs can be treated and/or have a STI/STD themselves. There are also a lot of people who don’t believe in the current stigma!

So.…how do we bring it up? If you’re getting hot & heavy with a new partner don’t put the conversation off. You don’t have to lead with it “Hi, I’m Tom. Do you have any STI/STDs?” but it’s one of those things that the more you do, the more natural it will be. Plus, talking about it sooner rather than later lets you see how your potential partner responds to conversations about sensitive topics.  

One of the best ways I’ve seen is from Reid Mihalko, a well-respected educator from the Bay Area. He’s come up with what he calls the “Safer Sex Elevator Speech” and even though it’s used a lot in the kink and polyamory worlds it’s also completely useful for any date or possible romance.
If you’re sharing your positive STI/STD status with a new partner, don’t come into the conversation with a pessimistic attitude. Timing is important so don’t broach the subject when you’re going to feel rushed. Give the other person space to share their feelings or thoughts. Most importantly, remember that you are NOT your STI/STD and that you have a lot to offer a sexual partner & as an awesome person. If they can’t get past it, then it’s their loss.
Koshiro.kun via Compfight cc
Being prepared is also a great way to bring up the subject. If you’re already in your bedroom (or in theirs) make sure you’re equipped with safer sex supplies nearby. It really can be done in a sexy way, pulling condoms or a dental dam out and saying how much it turns you on to have safer sex. You can even put a condom on with your mouth (just be careful not to put a hole in it) so you don’t break the sexual rhythm!


Remember, there are some STIs that can be transferred even with a condom like Herpes and HPV, so it’s important to be proactive about your health. Part of being proactive in your sexual health is to also make sure to get tested at a frequency appropriate to your sex life. Knowing about options, such as the HPV vaccination will help you know about your own status.

So, stay updated about your own status, educate yourself as much as possible about sexual health, and don’t be afraid to be straightforward about the STI/STD conversation. Honesty is sexy!
What are some sexy and easy ways you’ve asked your partner about their sexual health status?

Thursday, June 6, 2013

Will You Wait As Long As This AIDS Educator To Get HIV Tested?


The following is a guest post from Isabel Berney from TheThump.com who shares her experience of getting tested for HIV in New York City. Like many of us, she did not want to think about the possibility that she could have been exposed to HIV but did not know her status. It’s so easy to think you are immune but getting tested is the only way to know for sure.  



I don’t know what compelled me to wait 23 years to get tested for HIV. Fear played a factor (at 16, I’d already had a few wild nights under my belt) and self-delusion, presumably. It’s not something you went around asking people, but I’d bet that many of my other sexually-active friends had never been tested. We all labored under the misconception that people like us— White, upper-middle-class Jews from Long Island—simply don’t get AIDS. It wasn’t until junior year when one of my classmates—a good-looking jock from an ΓΌber-wealthy family— was discovered to be HIV-positive that our attitudes shifted. But even this traumatic event, coupled with my decision to become an AIDS educator and go around to middle schools teaching younger kids about the virus, didn’t convince me to get tested.  


I persisted in my stubbornness another seven years, through a few broken condoms with my college boyfriend, and later a broken heart that led me to perform oral sex on a couple of random dates against my better judgment. Had a slept with a ton of men? Hardly. But I wasn’t a virgin, I knew the risks involved, and yet I convinced myself that AIDS was so horrific it was better not to know. That stuck until I met Daniel. He’d grown up in a “ghetto” part of Miami where many of his friends had become parents in high school, and, as someone who had worked hard to better his situation and attend Columbia University, had a totally different mindset about STIs/STDs. I remember his eyes widening when I told him I’d never been tested. “That’s impossible!” he insisted, musing about the time he’d visited the hospital to get treated for burn and they’d unexpectedly offered him an AIDS test. It was true: these days you almost had to make an effort not to get tested, especially if you live in a big city like New York where free clinics and STI/STD testing centers abound.

Go and Get Tested!
Image by Aloha Angelo Cavalli/Corbis cc


Daniel refused to sleep with me until I got tested. Unlike the men in my past, with him I couldn’t sweet-talk my way out of it. As our romance blossomed, I found myself tormented by thoughts of sickly AIDS patients, of the possibility that I’d contracted the virus and had been living in ignorance. That one slip of paper could spell out my face—positive or negative—terrified me. But I needed to face reality, and give this new relationship a fighting chance, so I agreed to go.


A few days later on one of those perfect fall mornings Daniel and I decided to play hookie from work and mosey on down the Chelsea STI/STD clinic. The enormous concrete box of a building with its peeling gray walls looked like the place one might receive bad news, but I hid my anxiety.

After filling out paperwork, we sat in a waiting room for a good twenty minutes, maybe forty. My fears mounted as the time ticked on and I kept looking into Daniel’s rugged, open face for support; he squeezed my hand. My name was called first. I could feel my stomach somersaulting as I inched down the hallway to the testing room. When the nurse started taking blood, I completely lost it, recounting through tears all the potential times I could’ve contracted HIV, making her promise (which she wasn’t even permitted to do) that I was clean. Thankfully, the wait to receive that slip of paper wasn’t as long as I’d expected -10 minutes max. My results had me jumping up and down, smothering Daniel in hugs, and on my own little high that lasted well into the following day. Even if I never truly thought I had HIV it was important—no, crucial—to know for sure.
Do you want to share your STI/STD testing experience in the city?
www.thethump.com

Tuesday, June 4, 2013

No more Cunnilingus after what happened to Michael Douglas


Michael Douglas, 2012 by David Shankbone
CC Michael Douglas, 2012 by David Shankbone
When America heard from Michael Douglas on Monday, June 3rd that his throat cancer may have been caused by the human papillomavirus (HPV) through cunnilingus (oral sex performed on a woman), many readers must have shuddered. Some by the thought of contracting oral cancer through performing oral sex and others by the thought of not receiving it anymore. After all, in a study quoted by the Kaja Sex blog (2013), coitus made women orgasm only 25% during their sexual escapades with their partners, “but oral sex brought them to climax practically every time”

So lets us look beyond the CNN article, go a bit deeper into what is causing these cases cancer, the strain of the virus behind it, how many cases there are each year and how you can reduce the risk of transmission. 

So what is this human papillomavirus?

To understand the meaning of a term, I like to take it apart: 'Human' is pretty clear so is 'virus'. But what about this Papilloma? Actually we have two words combined here: papilla stems is a Latin word and means “nipple/swelling” and the Greek suffix -oma in medical context indicates a morbid (i.e. unhealthy) growth/tumor. So the name itself means ‘a virus that causes unhealthy growth of nipple/swellings with humans’.


It received that name because the virus was first classified in 1956 to cause skin warts. However since then over 40 different types have been found and they infect various parts of the body from cervix, anus, general pubic skin area, feet to even inside our throat. In most cases our immune system fights these infections and no symptoms develop. However, in some cases cancerous cells can develop over time (usually many years). The strains HPV16 and HPV18 have been identified to be the main cause of cervical and anal cancer. 
These numbers look high and in fact, as we already covered in our trust article, HPV is the most prevalent sexually transmitted infection in the United States. In fact, it is so common, that nearly all of sexually active individuals will get HPV at one point in their lives

Now, let us compare some numbers from general HPV infection down to HPV-induced throat cancer cases to get a better picture:

Another disadvantage when it comes to oral HPV is being a Man. Men are found to be both generally more infected with oral HPV and also suffer around 4 times more cases of HPV induced throat cancer than women. The exact reasons for this imbalance are still unclear. Some speculate that hormonal differences in women might help protect them from the virus. Others deem that oral sex on women for some reason causes a greater likelihood of transmission. I also asked a question HealthTap and Dr. Jeff M. Livingston responded that ' the current thought is that the vagina harbors HPV more frequently therefore so men performing oral sex are at higher risk'.

Besides oral sex, it is even speculated that oral HPV can be transmitted by kissing or other means as in some studies, patients were diagnosed HPV positive that never had sex or oral sex. 
cc - Delicious Mango by Miro42 via Compfight 

HPV-induced oral cancer cases on the rise

To get a perspective on the trend of these HPV-induced throat cancer cases, I talked to Dr. William Owen in the Davies Medical Center. He has been working with sexual health before HIV was even known and can provide a truly holistic view:

Dr. William Owen, photo from owenmed.com

"It has been said that we are witnessing a rise in diagnoses of oropharygeal cancer attributable to HPV over recent years. This increase is definitely a phenomenon that I've observed over the 3.5 decades that I have been in private medical practice in San Francisco.  

I think that the key to this rise is the latency, that is, the long "incubation period" between the time one is infected with HPV and the time when he or she begins to develop manifestations of cancer. We see this pattern of latency with HPV related anal and cervical cancers as well. "
And on the note that Michael Douglas might have stated that cunnilingus was also the best cure for throat cancer, Dr. Owen crushes our hope for this false remedy but thanks Michael anyway:
"I think that Michael Douglas was being a bit facetious when he was quoted as saying that cunnilingus is the best cure for throat cancer. Although the statement might seem outrageous, time and again we've seen that whenever a star weighs in on some serious disease, people listen. Farah Fawcett did this for anal cancer, Rock Hudson and Elizabeth Taylor for AIDS, Michael Fox for Parkinson's, and the list goes on. The point is that these luminaries raise public awareness about these often neglected medical conditions."

How to reduce risk of transmission of oral HPV

There are a number of options available today to prevent or greatly reduce the risk of an oral HPV transmission:
  • There is a vaccine! Gardasil is available today for men and women under 26 (Cervarix for women). It protects the body against the dangerous HPV types 16 and 18 that are related to various types of cancers, as well as type 6 and 11 which are related to the genital warts. Ideally, the three shots should already be given to children at the age of 9 - way before they become sexually active and are exposed to the virus. So get vaccinated if you are under 26. Unfortunately, way too little Americans are receiving all three shots of the HPV vaccination today.
  • There is a condom for cunnulingus. It is called a dental dam, a 6x6 inch latex sheet that can be placed over the vagina or anus. Check out the Blisstree blog for more information and instructions
  • Keep good oral hygiene and ask your dentist to include cancer screening of the posterior areas of your mouth in your annual dental exam. As with so many conditions, treatment options and success rate will be tremendously higher if the cancer can be detected early. 
  • Reducing Partners: The Mount Sinai Medical Center in New York estimates that men who give oral sex to 6 or more women are 8.6X more likely to contract HPV-induced throat cancer than those men who never had oral sex. 
On the regular oral cancer screenings, Dr. Owen also states:
"The key is to be aware of your body and to see the doctor to check out any suspicious growths, whether in the mouth, on the tongue, or in the neck glands (lymph nodes). That's because the earlier you find these cancers, the more likely it is to treat them successfully. So remember that your dentist can be a powerful ally in helping to diagnose mouth related cancers at an early stage."

To sum it up, a huge part of our society is affected by HPV, many carry the virus orally and 1% even carries the high risk HPV16 strain. However, as Dr. Debby Herbenick concludes in Men’s Health (2011), “most people who give or receive oral sex will not get HPV. And most people who get HPV will not go on to develop cancer”. Again, its our immune system that keeps the virus from developing further in most cases. So keep that immune system up and running and reduce your risk as appropriate. 

Follow up action for you:
Please make a list of your relatives and friends with children. Give them a quick call and ask them or their parents if the HPV Vaccination has been given. Insist that it should be given to boys as well as girls. And as Dr. Owen recommends: "even if they missed that age 9 to 14 timeframe, do motivate them to get vaccinated against HPV as soon thereafter as practicable." 


This will be your good deed for today!


CC - Gardasil vaccine and box by Jan Christian

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