California is being respected for closing some of the vaccine loopholes after the 2015 measles outbreak starting in Disneyland from a traveler. The latest statistics for 2019 by county, the number of measles cases are: Los Angeles-10, Orangel-2, San Diego, Riverside, San Bernardino, and Imperial all-0. (April, 2019)
Those born before 1964 were probably exposed or had measles (like me) and those born after most likely received the vaccination. Remember no vaccine causes immunity in 100% of the patients so if you are concerned, ask your provider for a test for immunity. When we look at large numbers, the risk of measles complications is much higher than the tiny risk from the vaccine. The vaccine protects you and those around you for many years.
PrEP FOR TRANSGENDER FEMALES WEAKER THAN FOR CIS-MALES
We recommend daily Truvada® in males and females, but males can take 2 pills 2-12 hours before sex and 1 daily x2 after (PrEP on demand). If that is more than or about 7 pills a week then it is better to take it daily. E.g. for a monogamous male truck driver who is home once a week then this plan works well with less medication taken. Females have lower levels of Truvada® in the vaginal and rectal secretions so they must take it daily. Now it is found that transgender females on female hormone medication have the same lower levels, so daily for them looks best.
CHEMICALS BAD FOR YOU?
Sunscreens were approved for over-the-counter sale years before the FDA tightened the rules. (remember using tanning lotion or baby oil?) Lately a study measured the levels when sunscreen was applied 4 times a day for a few days, like when you are on a beach vacation. The levels of the chemicals were found in the blood and increased daily. Like vapes, we have no idea whether these chemicals are toxic and what levels are bad. We do know that many have used these chemicals for years and nothing dramatic has been found. But like cigarettes in the 1950s, we didn’t know they were bad. The best advice is to avoid them and not take the risk. Hats, long sleeves, cover up.
YES! THERE IS A SHORTAGE OF ANTIVIRALS IN MEXICO
The government assured the patients that they were consolidating the meds at the government clinics to make sure the patients didn’t run out. Now many patients have run out of meds. HIV advocacy groups have been speaking up.
MEDITERRANEAN DIET PROTECTS FROM DEPRESSION TOO
It is well-known that this diet with moderate protein, olive oil, and many vegetables is associated with a long life, but until now it has not been tested in older people. This group took the diet and it seemed they had less depression than those not on this diet.
HEALTH CARE WORKERS DON’T NEED ANNUAL TB TESTS
The CDC says it is not helpful to have annual TB tests but it is best to do upon hiring and when exposed to a TB patient. About 10 years ago the guideline also dropped for HIV patients to have it upon entry to a clinic and then if TB was suspected as a diagnosis.
RESEARCH SUSPENDED AT A UNIVERSITY
The government takes protection of patients very seriously. Every few years the government stops research at respected institutions when they find fraud, or poor handling of studies which put patient safety at risk. So be reassured that if you enter a study, the staff have many rules to obey to inform you of the risks and keep you safe. This latest university is on the East Coast.
ARE YOU ON A NEW TYPE OF BLOOD THINNER AND HAVE HIV?
If so, there has been studies showing at least one of these is safe with antivirals. The pharmacy and provider should check for drug interactions on their phones/computers.
WEIGHT GAIN MAY PREDICT EARLY DEMENTIA IN HIV
A new study showed that those with HIV and the Metabolic Syndrome (waist >40”, high triglycerides, hypertension, blood sugar high, good cholesterol low) have a higher risk for mental decline. Best to keep the weight off at an early age and look like the men in this magazine! Second best is to change your lifestyle to correct some of these abnormalities.
Another presentation at an obesity conference showed that severe obesity is linked to a 50% increase in early death, 12 times risk of getting diabetes, and 22 times risk of sleep apnea.
ALCOHOL USE ABOVE MINIMAL RISK FOR DECLINE IN HIV PATIENTS
Patients who drink no alcohol or minimal alcohol do well with controlling their HIV, otherwise faster decline in health is more common. As a reminder: the latest news for all people is that mild or moderate alcohol is not good enough for your heart to cancel out the negative effects. Sorry! Now a little coffee is good but more has a negative health effect.
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