WHEN SEX WORK IS ILLEGAL, MORE HIV IS TRANSMITTED.

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Studies have shown that in countries where selling or buying sex is illegal, sex workers are more likely to face violence, not use condoms and contract HIV, researchers said on Tuesday, calling for prostitution to be decriminalized. The sex takes place in a hurry and in isolated, unsafe places. There is not as much time to negotiate condom use and avoid violence and theft. The HIV and other sexually transmitted diseases transmitted can enter the rest of the population causing individual and public health problems. It is everyone’s problem.

LARGE SURVEY OF TRANSGENDER HIGH SCHOOL STUDENTS
Confirms earlier findings that: Compared with cisgender males and cisgender females, transgender students were more likely to report violence victimization, substance use, and suicide risk, and, although the transgenders were more likely to report some sexual risk behaviors, they were also more likely to be tested for HIV infection. These findings indicate a need for intervention efforts to improve health outcomes among transgender youths.

COMING OFF PAIN PILLS/HEROIN
If someone wants to come off these medications, clonidine pills under medical supervision has been used to lower the withdrawal symptoms. Clonidine blocks some of the shower of hormones that are causing the symptoms.

MARIJUANA SUBSTITUTING FOR HEROIN / OPIATES?
A new opinion piece in JAMA states that it is dangerous to assume this can be done safely. I would rather say “risky” rather than “dangerous” since the evidence is weak and better trials must take place to make this a recommendation. Another weak evidence story: When the marijuana dispensary closed up the street from me years ago, my patients’ pain was poorly controlled and opiates were needed for them to function.

ULTRAPROCESSED FOODS ASSOCIATED WITH HIGHER DEATH RATES.
We already know that these foods are associated with obesity, hypertension, high cholesterol, and cancer. A French study of 44,551 adults showed that diets high in these foods are dangerous: mass-produced, ready-to-eat foods such as packaged snacks, sugary drinks, breads, candies, ready-made meals, and processed meats. Such foods usually contain “empty calories” and have a high caloric content with little nutritional value. They are low in fiber and high in carbohydrates, saturated fats, and salt. Usually, they contain food additives and contaminants that may be harmful to health, including some that may be carcinogenic. The larger proportion of the diet these foods took, the higher the death rate. They were and are unable to do a double-blind placebo controlled trial over many years regarding diet—very few people would agree and follow it. So we’ll have to settle with the evidence that is in: avoid these foods.

ASK YOUR TEEN FRIENDS ABOUT ALCOHOL
Here are the questions, “In the past year, on how many days have you had more than a few sips of beer, wine, or any drink containing alcohol?” Then, “If your friends drink, how many drinks do they usually drink on an occasion?” The higher the numbers as answers, the higher the risk for teen alcoholism, which is very destructive and can lead to a short life of suffering. Do your teen friends a favor and ask them these questions.

METH CAUSING SYPHILIS?
In the 1980s and 1990s the crack cocaine epidemic was associated with a rise in syphilis cases. Likewise, the increase in meth use also seems to be contributing to the current syphilis epidemic. People who use drugs use less condoms, have sex with more people, and have more transactional sex (sex for money, drugs, housing, rides, favors). Condoms decrease the chance of syphilis transmission. Be Safe. Live a healthy lifestyle — it is worth it.

LEAVING HOSPITAL EARLY DOUBLES RISK OF RETURNING
Leaving the hospital before instructed usually means you will be back and may have to start over or be in there even longer. I know that bills need to be paid, pets must be cared for, withdrawal from cigarettes, alcohol, and drugs can be severe while you are bored in the hospital. I have had many patients leave too early, only to have some of them come back worse or dead. Some do fine on the outside. Providers are under pressure to discharge patients early so there is no reason to think we want to keep you in too long.

PrEP USERS HAVING MORE STIs AND HEPATITIS C?
We already know that sexually transmitted infections (STIs) is on the rise in PrEP (HIV prevention pill) users, but now there is an indication that Hepatitis C is on the rise too. Be safe!

ALCOHOL IS WINNING (?)
Hepatitis C was the main reason for liver transplants recently, taking over from alcohol. But with aggressive treatment of Hepatitis C, alcohol is back on top as the main reason for liver transplants. Maybe people are drinking more and finally that habit is finally catching up with them. Many patients with cirrhosis from alcohol or hepatitis die from bleeding before a transplant can happen. The liver makes the chemicals to clot blood, and the spleen in these patients holds onto the platelets—the little cell pieces that plug the bleeding holes.

Keep those questions coming, be safe!

Daniel Pearce, D.O., FACOI, AAHIVMS
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, Borrego Health (Riverside, San Bernardino, San Jacinto)
Member, Coachella Valley Clinical Research Initiative

REFERENCES: Medscape®

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