Ask The Doctor: MENINGITIS IN GAYS IN SOUTHERN CALIFORNIA

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As of this writing, the LA Times reports 19 cases of meningitis so far in 2016, and more than half are in gay men. It is transmitted by saliva (not through the penis), so sharing a cup or kissing may spread it. These two habits are why we offer it to college students who seem to have outbreaks. The smaller and slower cluster of cases a couple of years ago had more HIV positive gay men. LA and Long Beach Public Health Departments are offering free vaccines to gay and bisexual men. In our Riverside County Public Health HIV clinics we are offering it to those who haven’t had it who socialize with gays. This is the first time I have asked gays if they socialize with other gays, like at a social event, e.g. a pool party (not a meeting or presentation) and only about half say that they do. Of the ones that don’t, I hear that they are very busy at their jobs, don’t have many gay friends, and being outside of LA or San Diego, there aren’t as many convenient opportunities for social events. I haven’t talked about this with any Palm Springs area residents yet since my clinic assignments have been in Riverside and Perris lately, not Indio.  Desert AIDS Project is available in Palm Springs for the same patient mix we have elsewhere.

The vaccine consists of 2 doses, 2 months apart and then a booster every 5 years if needed by what is going on in the community. Contact your health care provider if you desire the vaccine. If you need further help, contact your local County clinic or public health department.

Los Angeles County (213) 974-7284  alert: http://publichealth.lacounty.gov/eprp/Health%20Alerts/LAC%20DPH%20IMD%20VAX%20MSM%20072616.pdf

Long Beach (562) 570-4400. article: http://www.presstelegram.com/health/20160727/long-beach-health-officials-nonprofit-to-hold-vaccine-clinic-in-response-to-meningitis-outbreak

San Diego (619) 692-8501  (760) 740-4000has an informative webpage: http://www.countynewscenter.com/socal-meningococcal-disease-cases-spike-among-gay-men/

Riverside County (800) 720 9553

San Bernardino (888) 818-8988

NEW DRUG TREATS ALL TYPES OF HEPATITIS C

Epclusa® is now approved and it contains a new medication combined with a slightly older one that treats successfully all 6 genotypes of Hepatitis C. This is the first time we have had a medication with such a broad activity.

NEW OBESITY STOMACH SURGERY ADVANCES

  1. There is a surgery that re-forms your stomach like a sleeve instead of a bag. This and the fact that the stomach empties slower cause you to feel full earlier.
  2. Stapling the stomach so that it has a lower volume is another way to weight loss. These first two procedures require anesthesia and surgery. The next is much easier and costs less.
  3. A balloon inserted into the stomach through a thin tube in the nose which detaches also helps with the full feeling. The balloon must be removed in 6 months. Can another then be inserted?

TINY BLOOD AMOUNT IN YOUR STOOL (POOP)?

For those over 50 it is easy to take a card home, smear a tiny amount of stool on it and mail it to the lab. If it comes back positive, you may have a bleeding source from your nose and mouth down to the end of your intestines. This should be checked out. Since colon cancer is the second most common cancer, we usually ask for a colonoscopy to make sure there aren’t any polyps there that can be removed easily. It is better to find the cancer early than let it grow and spread.  A new study showed that the risk of cancer is higher the longer you wait to get the scoping after the test is positive.

FREE HOME HIV TESTS HELP

Since Australia wants to eliminate HIV, they offered free home test kits to those who didn’t get tested often enough or who never were tested before. For the study, they selected men who had had usafe sex with at least 5 partners (very risky) over the last 3 months. With this risk, they should be tested every 3-6 months, so they did it every 3. There was great acceptance and they found some with early infection which saves lives. The men in the self-test group had more than twice the tests; they seemed to add the self-tests to their regular testing strategy at their clinics.

SOME WOMEN CATCH HIV EASIER

In South Africa, a certain bacterium that is common in some women’s vaginas makes it easier for them to catch HIV. If they have a certain other bacteria, that is an STI, causing symptoms then the Tenofovir for PrEP being used to prevent transmission is weaker at preventing HIV transmission.

SHAKING THE HIV BUSHES

The latest study to bring the dormant (sleeping) HIV out of their sanctuaries and expose them to medication had disappointing results. Hopefully they will keep at it and review and improve their plan for the next study.

Be Safe! Wear protection. Keep those questions coming.

Daniel Pearce, D.O., FACOI

Clinical Associate Professor of Medicine, Loma Linda University School of Medicine

Adjunct Professor of Internal Medicine and HIV, Touro University California College of Osteopathic Medicine and Midwestern University Arizona College of Osteopathic Medicine

HIV Specialist, Assistant TB Physician, Riverside County Public Health Department

Hepatitis C Specialist and Researcher, Southern California Liver Centers, Riverside

Researcher, Inland Empire Liver Foundation and Clinical & Translational Research Center

REFERENCES: Medscape®

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