Search Results: Doctor

You are browsing the search results for doctor

Undoing the STIgma: Normalizing the discourse surrounding STIs

Share

April is STD/STI Awareness Month.

By

Let’s talk about sex. It’s fun, it’s natural.

Now, considering that April is STD/STI Awareness Month, let’s take it one step further and talk about sexually transmitted diseases and infections, or STDs/STIs.

They’re not so fun and not “natural,” per se, but they can and do happen to many people. In fact, according to the American Sexual Health Association, or ASHA, “one in two sexually active persons will contract an STD/STI by age 25” and “more than half of all people will have an STD/STI at some point in their lifetime.”

Yet for the most part, society hasn’t entirely accepted the reality of STIs. Instead, mainstream conversations about STIs rely on seeing them as punchline. This quote from “The Hangover” is a good example: “Remember what happens in Vegas stays in Vegas. Except for herpes. That shit’ll come back with you.”

If STIs aren’t portrayed as comical, then they’re seen as shameful.

“Some people believe that having an STI is horrible and people who have them are bad,” explained John Baldwin, UC Santa Barbara sociology professor and co-author of “Discovering Human Sexuality.”

In other words, there is a stigma associated with STIs.

“It’s not a death sentence.”

– Reyna Perez

Reyna Perez, the clinic lead for UC Berkeley’s Sexual Health Education Program, or SHEP, defined STI stigma as “shame with oneself (about) having an STI or amongst other people.”

“(They think) they’re ‘dirty’ or (use similarly) negative terms,” Perez said.

She went on to explain that campus students often think contracting an STI is the end of their sex lives and lives in general. But this is not true.

“It’s not a death sentence,” Perez said. “Most of them are curable or at least treatable.”

Despite the prevalence of STIs, people don’t know much about them. This lack of understanding reinforces the misconceptions surrounding them.

To help resolve this issue of ignorance, Baldwin first shed light on the difference between STDs and STIs.

“STD is the common language that a lot of people use and (the Centers for Disease Control and Prevention, or the CDC) uses because it communicates with large numbers of people, but medical doctors sometimes like to use ‘STI,’ ” Baldwin explained.

According to Baldwin, the term “STI” is more inclusive because it also considers people who don’t have symptoms but are infected and could infect others.

It’s true: People can be asymptomatic and transmit STIs to their partners.

“Large numbers of Americans have HIV and no symptoms and have sex with lots of others and infect others,” Baldwin said.

Additionally, sexual intercourse isn’t the only method by which STIs can be transmitted, a fact that more people should be aware of. There are many ways in which STIs can be spread, but they often go unnoticed.

According to Perez, “(People) don’t realize how you can contract them and there’s a gap in knowledge.”

Perez said STIs can be transmitted through oral sex or, in rare instances, fingering, which many people are unaware of. She also pointed out that HIV can be spread through non-sexual bodily fluids such as blood and breastmilk.

STIs can also be transmitted by something as simple as skin contact — Elizabeth Wells, lead and co-facilitator of the Sex 101 DeCal, said genital warts and herpes can be spread this way.

Even when it comes to sexual intercourse, the way by which most people believe STIs are spread, people don’t always take preventative measures.

“It’s not like everyone is consistently using condoms or barrier methods,” Perez said.

Another notable fact is that some STIs aren’t even viewed as STIs at all. For instance, cold sores on the mouth region are a form of herpes.

“They don’t realize it until someone brings it up to them,” Perez said. “Once you attach the title of ‘STI,’ suddenly it becomes something to be ashamed of. But it shouldn’t be that way.”

When the facts are laid out like this, it becomes apparent that there’s no reason to make STIs something to feel ashamed about. Many people contract them at some point, and although there are preventative measures such as condoms and other barrier methods, there are many possible avenues through which people can get them.

“Shit happens,” Wells said. “Who are we as individuals and society and people who are sex positive to vilify people that made decisions in the heat of the moment, or it just happens (that) the condom breaks?”

Yet the stigma surrounding STIs persists, largely because of the long societal tradition of suppressing discussions surrounding sex as a whole.

Baldwin expressed his belief that the stigma stems from the Judeo-Christian tradition. Judeo-Christian culture has been a prominent force that has shaped society’s views for hundreds of years. It frowns upon sexual activity, and looking down on STIs — perceived to be spread through sexual means alone — is part and parcel of that general disapproval.

“Society doesn’t evolve very fast in terms of thinking that I think you still see that mindset permeating today,” Wells said. “(STI stigma) is rooted in this idea that we’re not going to be talking about sex.”

Delving even deeper into the issue of STI stigma shows that it is further problematic because it is linked to racism.

According to a 2015 report by the CDC, STIs are more prevalent among certain racial or ethnic minorities than they are among white people. Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.

“It’s largely an issue of access, and you’re seeing a lack of comprehensive sexual education in those areas,” Wells said.

To vilify someone for getting an STI when they don’t even have the resources to know how to prevent them is to vilify them for not having access to sexual health resources. It is to vilify them for structural inequalities in access to education — inequalities which they did not ask for and cannot control.

“Being part of a racial or ethnic minority group also entails a plethora of issues that make it generally more difficult to find and receive appropriate sexual health services.”

Not only is it problematic to treat STIs as a taboo subject when this attitude stems from sexually repressive and prejudiced notions, but STI stigma also is harmful because it inhibits people from seeking medical treatment.

“If someone has an STI, we shouldn’t stigmatize them,” Baldwin explained. “We should try to help them get the best medicine and treatment.”

STI stigma also causes “intense emotional distress,” according to Perez.

“It’s so difficult to start support groups at the Tang Center because there’s stigma,” Perez said.

Considering all these facts and issues, the obvious final question is, “How do we get rid of the stigma surrounding STIs?”

One key component is awareness.

Awareness that people with STIs can and do lead normal lives helps. Modern science has allowed for medication that can either cure or treat STIs.

“It’s a world changer,” Perez said.

When engaging in sexual activity during an outbreak, there is also world of possibilities.

“There are creative ways to have sex while having an outbreak,” Perez explained.

She expanded upon this statement to say that, for instance, partners could use strap-on dildos when the involved parties are having a herpes recurrence.

“I believe that we are moving away from the preceding era of ignorance and successfully moving to have more scientific knowledge of STIs and their treatment so that more people are, in fact, getting good care,” Baldwin said. “Our society is moving in the right direction.”

“The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.”

To promote awareness, according to Perez, the Tang Center and SHEP offer programs for people who are curious to find out more about STIs as well as for people who have already been diagnosed with an STI who desire health coaching and/or emotional and mental support.

Awareness includes being conscious of preventative measures.

“Just being aware of sexual health resources (is) also really important,” Wells said. “A lot of people don’t know about it because it’s not talked about, because sex isn’t talked about.”

Wells explained that, for instance, people can take pre-exposure prophylaxis, or PrEP, before having sex with someone who has HIV or AIDS. This will lower the chance that the partner without HIV/AIDS will also get the infection. Similarly, taking post-exposure prophylaxis, or PEP, after sex with someone who has HIV/AIDS will help prevent transmission of the disease.

Although STIs aren’t the end of the world, if left undiagnosed or untreated, they can become serious health risks. The need for action if you are diagnosed with an STI is further reason to destigmatize STIs –– so people can recognize the symptoms and be unafraid to seek help.

According to Wells, on the last Friday of every month, the Tang Center offers free STI tests that take approximately 20 minutes. She clarified that there is, however, a six-month period after the initial infection in which the tests might not detect its presence.

Another key factor to destigmatizing STIs is simply talking about them. To emphasize this point, Wells quoted a SHEP saying: “Communication is lubrication.”

In other words, people need to start talking about STIs so that it will become acceptable to talk about them as well as to prevent them.

“It shouldn’t be uncomfortable for people because the way I see it, it’s mutual respect within relationships,” Perez explained. “I’m respecting my partner and getting myself tested and taking preventative measures, and my partner should respect me back by also being open to talking about STIs and … getting tested and (taking) those preventative measures as well.”

The way in which the discussion around STIs is being framed is also something to consider. For instance, discerning between STDs and STIs is important. Likewise, it’s crucial not to define people by their STIs.

“We don’t even like to use the word ‘HIV-positive,’ ” Perez said. “We like to use the phrase ‘a person living with HIV’ because they’re a person first before their STI.”

Awareness and communication aimed at undoing the stigma around STIs are imperative for the sake of public health but also for the sake of true sex positivity.

Complete Article HERE!

Share

10 Things You Always Wanted to Ask an HIV-Positive Guy

Share


 

By

I’m a gym homo. I love Neapolitan pizza. I hate scary movies. I have six tattoos. I take cock like a champ. And, I’m HIV-positive.

After living with HIV for four years, I’ve heard the same questions over and over. Sometimes I wish I could present quick, pre-packaged answers — a list of “saved phrases” on my phone — but then I remind myself how desperately I asked questions during that first impossible week after getting my test results.

So today, I’m answering the questions that everyone secretly wants to ask an HIV-positive guy. What would you like to know?

1. Do you know who infected you?

I don’t. Most HIV-positive guys I’ve talked to do not know who infected them.

Few people intend to give someone HIV. There are random crazies, but most guys are just doing what I was doing — fucking around, having fun, and assuming everything is fine. You can give someone HIV without knowing you’re positive.

The virus has to “build up” to a certain point in your body to trigger an HIV test, which means you can test negative and still have transmittable HIV.

There’s an ugly myth that HIV-positive folks recreationally go around infecting others. That’s a lie regurgitated by fearmongering, anti-fact, sex-negative, poz-phobic people. It’s likely that the man who gave it to me did not know he had it. I feel for him, whoever he is, because at some point after playing with me, he got news that no one is ready to hear.

I do not, but don’t take that as an indicator of what most HIV-positive guys do. Many HIV-positive men become more diligent about condom use after seroconverting.

In the age of PrEP, condoms are no longer the only way to protect yourself (or others) from HIV — or the most effective. PrEP — a once-a-day, single-pill regimen that has been proven more effective than regular condom use at preventing HIV transmission — is something I urge all HIV-negative guys to learn about.

I play bare. I accept the risks of catching other STIs and STDs as an unavoidable part of the sex I enjoy. I get a full-range STD check every three months, and sometimes more frequently.

3. How did sex change for you after becoming positive?

Since seroconverting, I have more — and better — sex. Forced to see my body and my sex in a new light, I started exploring fetishes and interests I had never tried. In my early days of being positive, I played every week with a dominant. Today, I’m a skilled, kinky motherfucker.

4. Has anyone ever turned you down because of your status?

Many times. When I was newly positive, those refusals really hurt.

I remember one occasion that was especially painful. I was eating Chinese food with a friend and started crying at the table because several guys that week had turned me down on Grindr.

He let me cry for a few minutes, then said, “HIV is something in your blood. That’s all it is. If they can’t see how sexy you are because of something in your blood, they’re boring, uneducated, and undeserving, and you can do better.” He was right.

5. How old were you when you tested positive?

I was 21. I didn’t eat for a few days. I slept on friends’ sofas and watched movies instead of doing homework. Somehow I continued acing my college classes.

I walked down to the Savannah River every night to watch cargo ships roll through, imagining their exotic ports — Beijing, Mumbai, Singapore, New York — and their cold passage across the Atlantic. I wanted to jump in the black water every night but I knew some drunk tourist would start screaming and someone would save me.

I made it through those months, and I’m glad I did. The best of my life came after becoming positive.

6. What does “undetectable” mean?

“Undetectable” is a term used to describe an HIV-positive person who is diligently taking their meds. In doing so, they suppressed the virus in their body to the point that their viral load is under 200 copies/m — unable to be detected on a standard HIV test (hence, “undetectable”). Put simply: the virus is so low in your body that it’s hard to transmit.

“Hard” is an understatement. The PARTNER study monitored 767 serodiscordant (one positive, one negative) couples, gay and straight, over several years. In 2014, the results showed zero HIV transmissions from an HIV-positive partner with an undetectable viral load to an HIV-negative partner.

Being undetectable means the likelihood of you transmitting HIV is slim to none. It means you’re doing everything scientifically possible to be as healthy as you can be, and you are protecting your partners in the process.

7. Have you had any side effects from the meds?

Yes, but side effects today are mild in comparison to what they were in the past. AZT was hard on the body, but we’re past that. New HIV drugs come out every year. We’re in a medical age where new treatment options, such as body-safe injection regimens, are fastly approaching realities.

On my first medication, I had very vivid dreams and nightmares, an upset stomach for a week or two, and I developed weird fat deposits on my neck and shoulders. I switched meds a year in and couldn’t be happier.

There are options. Talk to your doctor if you have shitty side effects and ask about getting on a different medication.

8. What’s it like to date after becoming HIV-positive?

It’s just like dating for everyone else. There are losers and jerks, and there are excellent, top-quality guys I love. My HIV status has never impeded my dating life.

I’m non-monogamous, polyamorous, and kinky, and I think these characteristics drive away interested guys faster than anything else. My status never comes up. I put my status loud and clear on every profile, and I say it directly before the first date. If you don’t like it, don’t waste my time — I have other men to meet.

9. How do you respond to HIV stigma?

It’s an automatic turn-off. Disinterested. Discard pile.

I have active Grindr and Scruff profiles (and a few others). Each profile reads: “If you’re afraid of my HIV status, block me.”

I’m not interested in someone who, in 2017, walks around terrified of HIV. Learn your shit, guys. Learn about how HIV is prevented. Get on PrEP. Use condoms.

Educate yourself and learn how it’s treated, and what the reality of living with HIV is like today (it’s so mild and easy that I forget about it, TBH).

Yes, you should take necessary steps to prevent HIV. However, you don’t need to live your life in fear or abstain from having sex with people merely because they’re positive. I no longer believe HIV is the worst thing you can catch. Hep C is way worse. Scabies is pretty miserable. And bad strains of the flu kill people.

HIV? It’s one pill (or a couple of pills) a day. Yes, you will have it forever. Yes, you will face stigma for having it. But, the people who stigmatize you are ignorant and out-of-date. Dismiss them.

10. What would you tell someone who just tested positive?

Welcome! You inadvertently joined a club you didn’t ask for, but the membership includes some of the greatest minds in history, so you’re in good company. The virus felled many of the greatest campaigners for LGBTQ rights and freedoms that ever lived. They struggled so that you can get up in the morning, pop your pill, and live a long life.

Those who lived and died paid your initiation fees. They fought, protested, rallied and organized so that you can be here — so that you can stick around and enjoy your fabulous, queer life. Always respect their sacrifice and dedication.

You are loved. You will find love. You will find impossibly good-looking men who want to fuck you (or want you to fuck them) who don’t give a shit about your HIV status. And if it’s in the cards, someday you’ll marry one of those fellas.

You have brothers and sisters who share this quality with you. In the words of Sister Sledge, we are family.

Complete Article HERE!

Share

Men feel sad after sex too, say researchers

Share

Post-coital blues is a real thing

By

While orgasms are (rightly) highly sought after, feeling an unexplainable sadness after sex is something a lot of women experience sometimes. But what many people don’t realise is that the same thing can happen to men.

A group of researchers at Queensland University of Technology suggest that making love can make men occassionally depressed. So depressed in fact, that they suffer something called post-coital dysphoria (PCD).

“Everyone assumes what happens in the bedroom is normal but there are a wide range of responses in the period of time immediately following consensual sexual activity, known as the resolution phase,” explains Robert Schweitzer, study author and a professor at QUT.

“For example, some people like to cuddle, others like to be alone and there are others, as we have found in previous research that experience what is described as post-sex blues.”

He noted that most of the time, the period just after sex elicits good feelings. But it’s also pretty common for some individuals to feel melancholy or tearful after the act.

While researchers seem stumped about the true cause of PCD, some suggest post-sex blues could be the result of negative emotions coming to the surface after an orgasm (or lack of one). But Schwitzer is determined to find out for sure. He’s now recruiting participants for a new study which will survey men and women (of all sexual orientations) to explore their experience directly after sex.

“There is anecdotal evidence that postcoital dysphoria is not uncommon in both men and women. If we can better understand what is happening in the bedroom and the prevalence of post-sex blues, we can start looking at causes and possible solutions,” he added.

Complete Article HERE!

Share

It’s not sex that makes you healthier and happier—it’s what you do before and after

Share

by Leah Fessler

People who have sex more frequently report a greater sense of general happiness, according to numerous studies. One even found that having sex once a week, as opposed to monthly, boosts spirits more than earning an extra $50,000 per year.

Yet the sex-happiness association means nothing if we don’t know why it exists. New research published in Personality and Social Psychology Bulletin sheds some light on the matter: Sex itself isn’t what makes us happier, it’s about the snuggles we share before, during, and after.

“We demonstrated that an important reason why sex is associated with well-being is that it promotes the experience of affection with the partner,” says University of Toronto postdoctoral fellow Anik Debrot, the study’s co-author. “Thus, the quality of the bond with the partner is essential to understand the benefits of sex.”

The new research actually comprises four separate studies. In the first two, researchers evaluated the correlation between sex and well-being through cross-sectional surveys of people in romantic relationships. In the first, 335 people (138 men, 197 women) in the US (predominantly married and straight) reported how frequently they have sex and engage in “affectionate touching” (e.g. cuddling, kissing, caressing). They also rated their “life satisfaction” on a one to five scale. The second was similar, but asked 74 couples in San Francisco’s Bay Area to rate their tendency to feel positive emotions such as joy, contentment, pride, amusement, and awe.

Both confirmed that more sexual activity correlates with increased positivity and life satisfaction. However, the association between sex and general happiness was dependent on affectionate touching, meaning that when the researchers accounted for for affectionate touching in their predictive model, the association between sex frequency and life satisfaction was insignificant. These results held steady regardless of participants’ age, relationship duration, and relationship status.

The third and fourth studies took a “Dear diary” approach—participants recorded their emotional state and sexual and affectionate activity on digital devices throughout the day, for several days. The third assessed 106 Swiss couples over ten days, 88% of which were married, and all of which had a child under age eight. It checked in on them six months later. The fourth included 58 Swiss couples, the majority of which were university students.

These daily diary studies showed that on days when people have sex, they experienced more affection and positive emotions immediately after sex, and hours later. “We could also show that sex promotes positive emotions, but that positive emotions do not increase the odds of having sex,” Debrot explains, “This indicates that people seem to feel good because they have sex, but not that they have sex because they feel good.” This finding supports the conclusion that affection—which has been proven to promote psychological and physiological wellbeing outside the sexual realm—is key to coital pleasure.

More, as Debrot explains, previous studies have found that positive talks often occur after sex, that exchanging signs of affection after sex means sexual and relationship satisfaction increases, and that frequent assurance of commitment and love after sex is the best predictor of a good relationship.

Importantly, participants who felt more positive emotions (like joy and optimism) after having sex with their partner in the ten-day study also showed higher relationship satisfaction six months later. This long-term correlation, however, only held true when participants experienced positive emotions after sex, regardless of how frequently they were sexually active.

This type of research always required some external imposition, and it’s impossible to determine exactly what about sex makes us happier. But it makes one reality clear: Sex promotes affection, and affection makes us feel good in the immediate, short, and long-term. And while more frequent sex is proven to make us feel better, prescribing participants to have more frequent sex on its own doesn’t help.

So if you’re looking to increase personal or relationship happiness (and a $50k bonus isn’t quite on the table) your best bet may be simple: Be attentive to your partners’ sexual and emotional needs, allow enough space and time for intimacy, and express your attraction and love before, during, after sex.

Complete Article HERE!

Share

Time for a Sexual Revolution In Health Care Treatment

Share

Why is care for sexual health issues considered a luxury when it’s a necessary part of population health?

By Zachary Hafner

When Americans seek care for most common health conditions, there is rarely much question about coverage. Every day, consumers—including those on Medicaid and Medicare—seek care for sore joints, depression, and even acne without worrying about whether or not their insurance will cover their doctor visits and medications. For the most part, coverage for sexual health issues is less straightforward—but why? Is it because sexual health issues are not considered legitimate illnesses? Because the costs are significant? Or is it because raising the topic of sexual health can offend certain personal and organizational values? Whatever the reason, it is time for a change.

It’s hard to deny the human and economic burden of sexually transmitted infections (STIs) on this country. The CDC estimates that 110 million Americans are infected with an STI, resulting in direct medical costs of $16 billion annually. The most common and fastest growing STI in this country is human papillomavirus (HPV), and it is estimated that half of sexually active men and women will get HPV at some point in their lives. In 2006, a vaccine for HPV was introduced and now there are several. CDC guidelines recommend administering a multi-dose series, costing about $250–450, to all boys and girls at age 11 or 12. (Some states require the vaccine for school admission.) It was included in mandatory coverage under the ACA. Since the HPV vaccine was first recommended in 2006 there has been a 64% reduction in vaccine-type HPV infections among teen girls in the United States.

It seems clear that this kind of care for sexual health is necessary for public health and is also part of caring for the whole individual, a central tenet of population health. But what about sexual health care that doesn’t involve infectious disease? Is it still a population health issue if there’s no communicable disease involved?

Let’s take erectile dysfunction (ED) for example. It is nearly as common in men over 40 as HPV is in the general population—more than half of men over 40 experience some level of ED, and more than 23 million American men have been prescribed Viagra. With a significant portion of the population suffering from ED, is it important for payers and providers to consider ED treatment to be essential health care and to cover it accordingly? Medications like Viagra and Cialis are an expensive burden at upwards of $50 per pill. Medicare D does not cover any drugs for ED, but some private insurers do when the medications are deemed medically necessary by a doctor. A handful of states require them to do so, but they are typically listed as Tier 3 medications—nonessential and with the highest co-pays.

Almost 7 million American women have used infertility services. Coverage for infertility diagnosis and treatment is not mandated by the ACA, though 15 states require commercial payers to provide various levels of coverage. The cost of infertility treatments is highly variable depending on the methods used but in vitro fertilization treatments, as one measure, average upward of $12,000 per attempt.

Are treatments for ED and infertility elective or necessary? In an age of consumerism and heightened attention to the whole patient across a broader continuum of care, organizations that support the availability of a broad set of sexual health services to a diverse group of consumers will have a big competitive advantage, but they may face challenges balancing the costs. Health care has advanced in both technical and philosophical ways that allow people to manage their diseases, cure their problems, and overcome limitations. It has also shone light on the significant advantages to considering a diagnosis in the context of the whole individual—their social and emotional health as well as coexisting conditions. Studies have shown, for example, that infertility, ED, and STIs all have a significant relationship with depression and anxiety.

It’s time sexual health was folded in to the broader definition of wellness instead of marginalized as a separate issue. For too many Americans, it’s too big an issue not to address.

Complete Article HERE!

Share