Advice for those Newly Diagnosed with HIV

The impact of an HIV diagnosis can feel overwhelming. Some feel as though their life is ending. Luckily, with advanced therapies, living with HIV isn’t a death sentence like it used to be. In fact, those living with HIV can live relatively normal lives for years and even decades after first becoming infected. In addition, there is a large community of those living with HIV and plenty of available resources to get information, proper care, and support.

Here is some advice for those newly diagnosed with HIV:

First, take a deep breath. Now is the time to reach out for the support of friends, family, your partner, and those around you who care about you.
It’s important to start forming a strong relationship with your primary care doctor. Get all the blood tests and run whatever other tests your physician suggests. Luckily there are anti-viral drugs, known as a cocktail, that can bring your viral load down to undetectable levels.
You may have to change your lifestyle, incorporating more healthful practices such as eating right, getting more sleep, and exercising. Make sure you stick with it. This is your health we are talking about. t give up.
Get informed. There are lots of resources out there, including in your area. It can feel really scary, so get as much information and support as you need. If you are having trouble finding those who understand where you are coming from, find a support group in your area.
Remember that HIV is only an aspect of who you are. Don’t let it define you. Remember to take part in all the other aspects of your life such as your job/career, passions, hobbies, love, life, friendships and more.
HIV may get in the way some times and some people get overwhelmed by the fear and sadness. It’s important to allow yourself to grieve and work through all of the emotions. It really is a life changing event, but if you learn to manage it as just an aspect of your multi-faceted and fulfilling life than it becomes not such a big deal anymore. This isn’t a terminal diagnosis. You don’t have to die of HIV anymore. It takes work and effort. So you have to realize that this is going to change your life in some pretty significant ways.
If you have been rejected by your family, make your own new support group of friends. Support from those who understand and care about you is so important in this trying time. Developing and maintaining a positive attitude is really important.

Life doesn’t end at diagnosis. It’s just the beginning for some tremendous changes in your life. Don’t feel as though this is only an experience for you to learn from. Volunteer in organizations, donate to HIV/AIDS research, go to rallies and inform youth and peers of your struggles and how they can avoid contracting HIV. Remember that you aren’t dying of HIV. You are learning to live with it.

LGBTI Youth & Sexual Health

The CDC defines sexual health as “…a state of physical, emotional, mental and social well-being in relation to sexuality.”

Researchs show that people who identify as LGBTI tend to report lower satisfaction rates in regards to sexual health. In large part this is due to a lack of discussion about LGBTI relationships and sexuality. While many people get such information on dating, relationships, and sexuality during their developmental years from parents, teachers, and other community establishments, LGBTI youth generally get their information online. This can be a great resource, but it can also be full of misleading or inaccurate information.

It is important for LGBTI youth to have access to sexual health resources. A significant factor in establishing sexual health is for both partners to feel safe and satisfied in their relations. Exploring questions pertaining to sexuality and safe practices with adults will help develop self-confidence and eliminate some fears.

Unfortunately, research continues to show that Lesbian, Gay, and Bisexual youth are at an increased risk for being victims of violence, bullying, and suicidal thoughts. It is understandable then that youth who live under constant fear and harassment also encounter greater difficulty in maintaining sexual health within their personal relationships.

In addition to discussing such issues individually, communities can support youth by facilitating open discussions and youth organizations. Creating a safe place for youth to explore questions, raise concerns, and meet with people who share similar thoughts and feelings can go a long way in supporting LGBTI sexual health well into adulthood.

Needless to say, having open and honest conversations about sexuality within the LGBTI community is instrumental to achieving sexual health. The first step in achieving sexual health is to discuss concerns with a healthcare practitioner. Research also shows that people LGBTI youth and adults visit healthcare practitioners less frequently – reach out to a professional today and make an appointment.

Sexual Safety During Pregnancy Possible For Lesbians Too

Worrying about the safety of sexual activity is not something limited to heterosexual couples. Many lesbian couples worry, too. Thankfully, there’s generally no reason to avoid intimacy when you’re expecting. However, there may be certain activities your doctor will advise you to avoid if you are considered a high-risk pregnancy.

Pregnant lesbians may find the topic of sex to be a touchy subject. During pregnancy some women experience heightened senses and an increased libido, while others lack sexual desire completely. Some have partners who are afraid of injuring the baby and, as a result, put any sexual feelings on the back burner. It’s important to keep in mind, though, that most pregnant women want to be intimate and many want to participate in sexual activity.

Even if genital sex is not desired, there are other ways to go about creating intimacy such as massage, kissing, and touching. The majority of types of lesbian sexual activity, including light penetration, is safe for most pregnant women. However, it’s important to stay away from certain activities such as rough S&M, deep thrusting, or fisting. Do not continue any sexual activity that triggers any discomfort. Avoiding sex toys such as vibrators, dildos and strap-ons are suggested since there’s difficulty in knowing where they’re touching exactly.

During pregnancy, it’s important to take time for yourselves. Otherwise, you’ll find that you won’t naturally have that emotional energy. Take time to get together with friends and family. This is especially important if you’re a single pregnant woman, finding that you’re isolated from most of the lesbian community during this time. Perhaps you’ll even find it worth considering to give yourself a spa day.

And, if you are in a partnership, include your loved one for the spa day. You needn’t even visit a spa. Stay home, give each other massages, have a special dinner together, and even a gigantic dessert. Why not? At least once in awhile.

This is not an easy time for couples, in general, but it can still have more ups than downs. You can both keep your relationship fresh, especially when remembering that you’re going to have to take it more slowly than usual. You might have actual sex less, but find that you’ll become more intimate with your partner in ways that you never imagined.

Cervical Cancer Risk for Lesbians

The risk factors for developing cervical cancer are the same for all women regardless of gender identity and sexual orientation (LGBT Health Education .org). That said, bisexual women and lesbians are ten times less likely to get tested for cervical cancer.

Regular screenings, however, have been shown to be the best way to catch it early when treatment options and outcomes are the best. Lesbians are less likely to get preventative healthcare out of all women and lesbians and bisexuals are less likely to have health insurance that heterosexual women. Originally, cervical cancer was the most deadly form of cancer for women. Today, with early screening, it is one of the most preventable.

Since we know now that bisexual and lesbian women are the least likely to be screened, an outreach program is underway to get cervical cancer under control, and these two groups have been designated as priority populations. In addition, black women suffer the highest mortality rates from cervical cancer, while the highest age-adjusted rates are suffered by Hispanic women. Survival rate from cervical cancer within the first five years of being diagnosed is 67.9%, but if it is found early on, the survival rate is 90.7%. That’s why it’s so important to reach out to these populations and motivate them to get regular screenings.

Smoking, immunosuppression often related to HIV, and human papilloma virus (HPV) infection are major risk factors for cervical cancer. Many in the LGBT community such as lesbian women, bisexual women and transgender men who still have a cervix have higher chances of having or developing these other conditions, and so have an increased risk of developing cervical cancer. What makes matters worse, since they are much less likely to be insured, they are less likely to seek out preventative care.

Obesity is another risk factor which is also higher among lesbians. Not as much data is available on bisexual women, though some studies show that they may have lower insurance rates and higher smoking rates, making them also more susceptible. One study found that 2.2% of bisexual women develop cervical cancer as opposed to 1.3% of heterosexual women. Hispanic and black bisexual and lesbian women should be particularly targeted for an outreach program.

Although we are seeing more and more types of studies being done concerning LGBT health, more still has to be done. We see that race and age data is often collected while sexual orientation data often slips through the cracks of the healthcare system. There has been a pivot recently. LGBT health is becoming more of a priority in communities across the country and certainly on the national front. We should see this data being collected more and issues such as this coming to the forefront, as well as policies and procedures to better address the health disparities suffered by the LGBT community.

Cervical Cancer Risk for Lesbians and WSW
Dr. M. Mirza, LGBT Health Wellness – 2015

Gay Black Men’s Pressure to Conform Leads to Higher HIV Risk

Familial and cultural pressure to conform to expected masculine behaviors leads gay black men to engage in riskier behavior, therefore increasing their risk of contracting HIV. This is according to a report out of the John’s Hopkins Children’s Center and published in Science Daily. This community of men feel distress and social isolation, according to the report, which may contribute to their decision to take part in such behaviors. The “compensatory” behavior according to researchers leads to riskier behavior and contributes to the higher infection rate among gay black men.

Gay and bisexual black men attributed to 4,800 new HIV cases in 2010, more than two times that of other male groups, says the CDC. Thirty five young, male participants took part in this study, recently published in the American Journal of Public Health. Openly gay and bisexual men took part in this study, as did young men who have sexual relations with men but don’t self-identify as gay or bi-sexual, also known as MSM. Adolescent medicine expert at the John’s Hopkins Children’s Center and the study’s lead author, Errol Fields, M.D., Ph.D., said of this study, “HIV risk is the sum total of many factors, but social and family stress is a well-known driver of all types of risk-taking behaviors, and our findings clearly support the notion this also holds true when it comes to HIV risk.”

There is a very traditional view of masculinity with strong anti-gay sentiment in the community where the participants grew up. These participants needed to prove their masculinity, hide homosexuality, and conform to social pressures. This makes them far less likely to take part in monogamous relationships and more likely to take part in unprotected sex. Black gay men also sought affirmation through sex which they weren’t getting from a close loved one in their life. Some also said that having unprotected sex showed trust and love for one’s partner. Since the community they were from expected them to act aggressive and free of any feminine behaviors, they were forced to either conform or be ostracized. Drug use, drinking, fighting and other such risky behavior was taken part in so as to prove their masculinity and fit in.

According to Dr. Fields, “The findings of our study reveal a clear clash between internal sexual identity and external expectations at a critical developmental stage,” As a result, “This clash creates loneliness and low self-esteem and appears to drive these boys and men to risky behaviors, sexual and otherwise.” These young men were also constantly worried that they would be found out. If they were found out they would lose their friends and family, so they needed their secret to be safe. “It’s a true catch-22 for these youngsters,” said Fields. “On one hand, they are dealing with the chronic anxiety of hiding their homosexuality, but on the other they face the prospect of becoming social pariahs if they come out as gay or bisexual.”

Dr. M. Mirza – 2014
lgbt health wellness .com

Health Concerns Faced By Bisexuals

Bisexuality is often misunderstood or not taken seriously. Discrimination exists within the LGBT community and from heterosexuals. A bisexual person might be viewed as someone who can’t make up their mind about their true sexuality or as someone who is promiscuous, having little or no sexual boundaries. More than half of the 3.5 percent of adults in the U.S. who identify as lesbian, gay or bisexual are, in fact, bisexual. They face unique health concerns that deserve our attention.

Some health concerns faced by bisexuals:

Substance abuse – According to research, bisexual women have higher rates of drug use than heterosexual women and close to or possibly higher rates than lesbians. The differences between bisexual and gay men have not been clear in studies.
Alcohol use – Bisexual women have reported higher rates of alcohol use, abuse and alcohol related problems compared to lesbians and heterosexual women.
Sexual health – Bisexual women have reported riskier behavior with sex, compared to heterosexual and lesbian women. Part of this risk comes from the highest rate reported of combining substance/alcohol use and sexual activity. Bisexual men who have sex with men have an increased risk of HIV infection.
Tobacco use – Bisexual women smoke at higher rates than heterosexual women, but about the same as lesbians. Less is known about bisexual men’s smoking habits.
Cancer – Bisexual women have reported higher rates of cancer. Some risk factors are: not having given birth (also relevant to a higher rate of lesbians), or being more likely to give birth after age 30, and alcohol consumption. Also, bisexual women receive mammograms and pap tests at the lowest rates. Men or women who receive anal sex are at a higher risk for anal cancer because of an increased rate of HPV infection.
Nutrition/fitness/weight – Bisexual and lesbian women have higher rates of obesity than heterosexual women and more bisexual women are underweight than heterosexual women or lesbians, which would indicate they might be more likely to struggle with healthy eating. Attempts to achieve perfect bodies, due to pressure, have left some gay and bisexual men with adverse health consequences. They might compulsively exercise, use steroids or develop eating disorders due to a poor body image.
Heart disease – Higher rates of heart disease have been reported by bisexual women compared to heterosexual women.
Depression/anxiety – Bisexual men and women have reported higher levels of anxiety and depression than heterosexuals and sometimes higher than gay men and lesbians. The issues are likely to be more severe for those who lack social support and those who are unable or unwilling to disclose their sexuality.
Social support/emotional well-being – Bisexual women have reported the lowest levels of social support. Bisexual men and women have the lowest emotional well-being of any sexual orientation group.
Self-harm/suicide attempts – Bisexual women and men have reported higher levels of suicide attempts, self-harm and suicidal thoughts than heterosexuals and higher than gay men and lesbians in some studies.

Dr. M. Mirza, lgbt health wellness .com – 2015

Understanding Anal Cancer Screenings

It is a rare disease, but anal cancer does exist and deserves our attention.

The cases of anal cancer are a lot more prevalent in gay and bisexual men or, “men who have sex with men” (MSM). Unfortunately, most MSM’s have not been tested or know that any screenings are out there, and do not know much, if anything about anal cancer. Medical professionals are actually divided on whether they should even screen for it and how they would do so. Currently, there isn’t any standardized protocol for anal cancer screening.

Facts about anal cancer:

Anal cancer is diagnosed in approximately two out of every 100,000 people in the general population every year.
MSMs who are HIV negative are 20 times more likely to receive an anal cancer diagnosis (about 40 per 100,000 people)
MSMs who are HIV positive are up to 40 times more likely to receive this diagnosis (about 80 per 100,000 people)
The same strains of Human Papillomavirus (HPV) that cause cervical cancer in women also cause anal cancer
In MSMs, HPV is transmitted through both protected and unprotected anal intercourse and skin-to-skin contact. HPV is very common– approximately 75 percent of all sexually active adults acquire HPV; not all HPV infections lead to cancer.

A number of men don’t have any apparent symptoms of HPV, but possible symptoms include:

Genital warts affecting the anus, penis and/or peritoneum
Abnormal discharge from the anus
Bleeding from the anus and rectum
Itching of the anus; pain or pressure around the anus
A sore or sores that do not heal, around the anus

Since the cervix and anus are similar, biologically, and both are target areas for HPV infection, a pap smear can be used test the anus for pre-cancerous cell changes and cancer. More and more health activists and gay physicians believe this procedure could reduce the incidence of anal cancer as significantly as it has with cervical cancer in women.

It is recommended by them that all MSMs, especially those who are HIV positive, receive testing every 1 to 3 years, depending on their CD4 count and immunology wellbeing. Their recommendation for HIV negative MSMs is for testing every 3 years. Other physicians don’t believe all MSMs need to be tested due to the small number of cases, facility shortages for follow-up procedures, and the cost, pain and fear of looking at small changes in cells (dysplasia). In addition, the number of insurance policies that would cover pap smears for the anus is low.

Even though the AIDS Institute of New York recommends that HIV positive gay men “and others with history of HPV disease” be tested annually, there appears to be little agreement about the importance and practicality of offering all MSM clients this testing.

Dr. M. Mirza, lgbt health wellness .com – 2015

Gay and Bisexual Men and HIV Risk

Should the Education System Feel Responsible?

The discussion of homophobia and the actual risk of HIV to the population is always a heated debate, but it becomes a muddier and more frustrating topic when words like “men who have sex with men” (MSM) and “bisexual” are used—and these words are used frequently in studies conducted by the Center for Disease control on AIDs and HIV. The statistics on diagnoses of HIV in 2010 indicate that gay, bisexual, or MSM men whom comprise about 2% of the population account for about 63% of diagnoses in the United States. But the word “about” is the confusing part. It is not exactly clear how many of these men are straight men that have engaged in homosexual acts, and perhaps one might wonder if these men are admitting to homosexual behavior because they are seeking treatment for HIV. Are we certain these men were included in the estimated 2%? Most new diagnoses of HIV occur in young men between 13-24 years of age… they comprised a jaw-dropping 72% of the gay and bisexual men diagnosed with HIV in 2010. Of these individuals, an incredibly large percent of them are African American male youth from disadvantaged backgrounds. Their reported sexual orientation is not the reason that they have contracted the disease, but rather a lack of sexual education and resources for gay men and youths is to blame.

HIV is not a consequence of homosexual behavior, but a consequence of risky sexual behavior (and in some cases drug use). Is that what men who have sex with men are doing, inflating the CDC’s estimates of homosexuals and bisexuals with HIV? Perhaps, but not because MSM are given to more wanton sexual behavior. This term can describe a situation where a man is sexually attracted to another man for any number of reasons but still identifies as straight. He isn’t bisexual because he doesn’t judge himself to be bisexual, and from a positive psychological perspective of identity this is what matters. He may think he is only capable of committing to a woman in a romantic way, or he may not feel equally attracted to both sexes, but either way he is not homophobic and in denial of his identity. In all probability these men have diverse sexual habits because of the broad category of relationships it can describe.

Obviously some high-risk sexual behaviors, particularly those occurring between men under the influence of drugs or alcohol, are being thrown into this category of men who have sex with men. These encounters would probably not meet most standards for “romantic” behaviors between men, and it is horribly unfair that they are counted among the estimates for new diagnoses of HIV in gay and bisexual men. The rampant homophobic attitudes that prevent awareness campaigns and resources from being accessed in some communities would like us to think that all gay men are having random encounters. The bitter irony is that this fear-mongering promotes carelessness, especially in younger people who need to be educated on what exactly “high-risk sexual behavior” is.

It’s an unsavory topic, but teenagers are having sex. The academic world has come a long way in its attitude towards homosexuality recently by including LGBT alliance and awareness groups in schools, but we need to take a more aggressive attitude towards sexual education in schools. Sexual education needs to be taught in every classroom, and the earlier that teens get it the better off they are. The LGBT community is not taking up enough time in classroom discussions of sexuality. The education system cannot tiptoe around topics like “men who have sex with men” and “homosexuality”. There is no end to the number of mistakes a teenager can make without appropriate guidance from the education system. We were all there once… we have to be honest with ourselves. Blaming stupidity and thinking that the actions of wayward teens don’t affect us is our right, but the astoundingly high numbers of new HIV diagnoses portray the denial of these youths by our culture—they are parallel minds that we just won’t accept responsibility for. Rather than scapegoating the underprivileged communities that raise them, efforts to raise LGBT awareness need to expand beyond home. Community effort needs to mean national effort and then global effort. Bridging the gap between LGBT communities and underprivileged communities created by HIV is the key to fighting this epidemic. If there is anything you can do, don’t hesitate.

MSM, Gay, and Bisexual Men and HIV Risk: Should the Education System Feel Responsible?
Dr. M. Mirza – lgbt health wellness .com – 2014

Should You Take PrEP?

When we first learned how to combat the HIV/AIDS epidemic of the 80’s and 90’s, safe sex was the only surefire answer to prevent HIV infection. PrEP or Pre-Exposure Prophylaxis is a new recent development you can take to avoid contracting HIV. It must be taken daily, but it has been proven effective according to the Centers for Disease Control and Prevention (CDC). Remember to continue using condoms; PrEP does nothing for STD’s like chlamydia, syphilis and others diseases on the rise.

Truvada is the brand name of this medication, which combines two anti-retroviral drugs. If not taken daily the chances of contraction rise greatly. When talking to your doctor about PrEP, be honest as to whether you can reliably take this medication every day. Taking it one time before a particular act does not mean it will prevent the spread of HIV.

If you believe you are at risk, follow these guidelines to help ensure you stay HIV free:

If you have a relationship with a partner who is HIV positive, you should ask your doctor about PrEP.
Anyone who is not in a monogamous relationship and is gay or bisexual who has had an STD within the last six months or has unprotected anal sex should take PrEP.
Anyone who has unprotected sex with more than one partner whose HIV status is unknown, those who use intravenous drugs, sex workers or those that have bisexual male partners should use PrEP.
A patient must get a doctor’s prescription before going on PrEP. Those who are prescribed PrEP must have normal kidney function, have a negative HIV test, show no signs or symptoms of HIV and have never had hepatitis B or have taken the vaccination against it.
After receiving a prescription and taking it daily, a patient must have a checkup once every three months for counseling on how they are doing and how well they are adhering to the medication, assessments of side effects, HIV testing, kidney function check and more.
Even though you are on PrEP, no method is 100% effective. One should still continue to get tested for HIV. A Truvada prescription costs between $1,300 to $1,700 for a month’s worth of pills. If you are considering PrEP, check with your insurance company and physician or urologist to see if the medication is covered. To avoid HIV practice safe sex and limit your number of partners. Protect yourself; you are worth it.

Dr M. Mirza
lgbt health wellness .com – 2014