Search for tag: "transmitted"

Interviewer: Misconceptions and misunderstandings about HIV AIDS up next on The Scope.

Announcer: Health tips, medical news, research and more for a happier healthier life, from University of Utah Health Sciences, this is The Scope.

Interviewer: So we're here with Dr. Adam Spivak. He is an assistant professor in the School of Medicine and a specialist in HIV. What we're talking about today is some of the misconceptions. Even in 2016 we've learned so much about the virus and what it means, but some of these misconceptions still are out there. So, let's go ahead and cover some of these. What about transmission? Like, can you get HIV from kissing another person or touching them or sitting on a toilet seat or some of those old kind of . . .

Dr. Spivak: HIV is transmitted primarily sexually, and it can also be transmitted through blood. It cannot be transmitted through saliva, through casual contact, sharing a toilet seat in a public bathroom, sharing food with someone who is HIV infected. None of these are at all put anybody at risk.

Interviewer: But those stigmas did exist once, right? Because they must've come from somewhere.

Dr. Spivak: Oh absolutely, absolutely, and of course in the early days when AIDS was first described in the early 1980s we didn't actually even know what caused it. It took two years. It was not until 1983 that a novel retrovirus, HIV, was discovered as the cause of AIDS. So you can imagine a disease that was causing such severe illness and deaths and you don't know what causes it. We didn't even know entirely that it was an infection for those first few years that a lot of stigma, a lot of stories circulate, and certainly those are powerful and have a way to persist.

Interviewer: One of the other misconceptions at least historically that might still kind of linger on today is you just see some of these old news clippings or these old photographs and things like that where people are referring to HIV and AIDS as a gay disease, as a gay cancer or something like that. We're starting to find out that that's not true.

Dr. Spivak: Yeah, no, no, no. Worldwide HIV is transmitted sexually actually through heterosexual sex as the predominant form of HIV transmission. In the early days again populations that seemed to be hardest hit were gay men, men who have sex with men, injection drug users, sex workers, and interestingly enough people of Haitian descent. But again, that has persisted along with the recognition of the early spread of AIDS among gay men as this population to be shunned. Of course when we're talking about the 1980s we're talking about a group that was very much discriminated against that felt very marginalized. Unfortunately a new disease, a lethal disease, a disease of unknown origin that seemed to be spreading like wildfire had the effect of amplifying a lot of those frankly prejudices that were already present in society.

Interviewer: What about HIV positive women who might be worried about whether or not they can ever have kids or be pregnant? What are some of the misconceptions about that?

Dr. Spivak: One of the real highlights, one of the bright spots with regard to prevention of HIV transmission is mother to child transmission. What we have learned through a number of really well done studies and now many years of clinical practice is that pregnant women with HIV who are started on anti-retroviral therapy on the treatment for HIV really do not pass on HIV to their infants. We know that even a single dose of the medicines given at the time of delivery can reduce transmission from mother to child. It appears as best we understand it that HIV transmits at the time of delivery. Even just a dose or two doses of the medicine at that time is a very powerful preventative. We go a few steps further than that and get mom fully treated, and in those circumstances transmission from mother to child is almost unheard of in the United States and Europe where we do this on a regular basis today, so a real bright spot in terms of HIV prevention.

Interviewer: What about some of the ideas and maybe stigmas that the disease is a death sentence, that if you catch it your life's over?

Dr. Spivak: When AIDS was first described in the 1980s up until the mid-1990s, we did not have reliable treatment and this often was a cause of death in folks that were otherwise young and healthy and in the prime of their lives. The stigma, the stereotype, the concept that HIV AIDS is a death sentence certainly has its roots in truth. However, it's 2016. Starting in the mid-1990s as we've discussed, 1995, '96, the introduction of what we call combination anti-retroviral therapy, new drugs hit the market. It's still what we use today. These are fabulous treatments for HIV. Our patients are living long healthy lives. They have to take the medicines every day.

Untreated absolutely it is devastating to the immune system. It leads to what we call opportunistic infections and ultimately to death. We saw that very graphically in the first decade and a half of this illness. However, what we see today with patients that are able to come in to our clinic, get access to care, take their medicines on a regular basis is that they are leading long, healthy, productive lives and are doing fabulously well.

Interviewer: What's one of the top things that you would suggest for people to have done on this World AIDS Day?

Dr. Spivak: Oh absolutely I think the most important thing that people can do is get tested. I say that because the vast majority of the United States population has never had an HIV test. Now most people may not be actively at risk for HIV which is to say they're not practicing unsafe sex, they may not be injecting drugs, but we do know and there've been a number of studies that have shown that there are quite a number of people living today who have HIV who are not diagnosed. That's a tragedy on a number of fronts. We've talked about the ability to get these folks treated. It ultimately will affect their health. They're also at great risk of spreading the disease.

So, I think the test we have for HIV is one of the best diagnostic tests in modern medicine. It's incredibly accurate. A negative test in the setting of someone who's not at risk for HIV is very reassuring. It sits on their medical chart and they never need to get tested again. We're trying to get most people from zero to one to get tested. Of course the few folks who may have been at risk in the past or still practicing high risk behaviors with regard to HIV, and we're able to identify them and diagnose them with HIV, we're really going to be able to not only help them but help potentially partners help them from spreading the disease.

Announcer: Thescoperadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at Thescoperadio.com.

Dr. Jones: Both sexting and Internet safety are increasing concerns for parents of adolescents. I'm Dr. Kyle Bradford Jones, a Family Physician at the University of Utah. We'll find out why, coming up next on The Scope.

Announcer: Medical News and Research, from the University Utah Physicians and Specialists you can use for a happier and healthier life. You're listening to The Scope.

Dr. Jones: Every year, the CS Mott Children's Hospital at the University of Michigan in Ann Arbor performs a poll of adults on the biggest concerns they have for children in the United States. The results of the survey this year showed that there are two topics that increased in rankings much more than any other: sexting and Internet safety. So what is sexting? This is basically sending any sexually explicit messages, which may or may not include sexually related photos, over text or over the Internet. So you can see how this adds a new element to the sexual experience for adolescents.

Now, there have been multiple studies that have looked at this. From a public health perspective, it's estimated from 7-31% of adolescents engage in sexting. But many of the studies have found multiple negatives from this. First of all, adolescents are more likely to engage in riskier sexual behaviors if they participate in sexting. This means more partners, more unprotected sex, which leads to more sexually transmitted infections and unwanted teen pregnancies. It also decreases the age at which they become sexually active, which can then worsen the other risky behaviors that we just mentioned.

Another negative about sexting is that it increases the likelihood of an adolescent using both legal and illegal substances, such as alcohol, drugs, etc. There is also the increased likelihood that adolescents will have low self-esteem and this contributes to emotional confusion in relationships, not only in the short term but can set them up for that for the rest of their lives. There's also the risk that any explicit pictures or messages can make it online in a public forum if a relationship goes poorly.

Now, sexting goes right along with Internet safety, which has many of the same concerns. So a lot of this concern over Internet safety has to do with inappropriate relationships, whether sexual or otherwise. Adolescents then spend too much time on other things on the computer, which can lead to poor socialization and even an increase in obesity.

A few things to watch for in your adolescent. Maybe lots of computer use in a private place, such as their bedroom and when you go to talk to them or check in on them, they might be trying to hide something. Another thing is poor social relationships with friends. So that they mainly have connections with Internet acquaintances they may be more willing to share personal info with. Another thing is obsessions with certain celebrities that may provide a poor example of sexuality and what is considered normal and so that is one thing to keep an eye on, on whom their role models are.

So in summary, sexting and Internet safety are increasing worries for parents and have many public health consequences. The best ways to get help and to get around this are to talk with your children about this so they understand your concerns and know that they can come to you when needed.

Announcer: TheScopeRadio.com is University of Utah Health Sciences Radio. If you like what you heard, be sure to get our latest content by following us on Facebook. Just click on the Facebook icon at TheScopeRadio.com.

Announcer: Medical news and research from University of Utah physicians and specialists you can use for a happier and healthier life. You're listening to The Scope.

Interviewer: I think one of the concerns that people have in America now that the first case of Ebola is here in the United States is that we're going to have a situation similar to that of Africa. Dr. Sankar Swaminathan is the Chief of the Infectious Disease Division at the University of Utah and an infectious disease specialist.

Tell me why we shouldn't expect the same thing happening in the United States as, related to Ebola, as we've seen happen in Africa.

Dr. Swaminathan: The situation is dramatically different here in the United States from West Africa. With regards to transmission, there are two places where transmission has occurred, in the community and in the health care setting. The health care setting in West Africa is about as different from the health care setting in the United States as one could imagine. There are mud floors, no gloves, no running water in many places. So we have the capability here to protect our health care workers and our other patients from spread in the hospital. And that does make a huge difference. There has really been no such transmission in Western hospitals, even when cases have been brought here of other viral hemorrhagic fevers as well.

The transmission in the community occurs because of a variety of reasons. But a lot of it has to do with resources, a lack of trust in officials and in the health care system so that people are afraid to seek care. People even chase away workers when people have come to help. This leads to increased transmission in the homes where people don't have the facilities to deal with it. So that's very, very different. So we're not going to have unchecked spread in homes or in hospitals in this country.

The second is the transmission is really not as easy as people seem to think. Many of these studies that have to do with varieties of transmission have been done in a laboratory. But when you've actually looked at outbreaks of Ebola, even people who lived in a home with someone who died of Ebola did not get the infection unless they were directly in physical contact with the patient, or cleaning up their blood, or vomit, or other bodily fluids.

It's all relative risk. And as long as we have good public health facilities, which we do in this country, it should and will be possible to isolate, identify contacts, isolate those contacts and limit the infection so that one person cannot spread the infection to more than another person.

Now while one can't rule out a secondary case, it's very, very unlikely. Given what we know, from all the evidence that we have as to how it's transmitted, as to how long the virus can live on surfaces, as to how infectious people are, it's very unlikely that we would have the kind of transmission that's occurring in West Africa today.

Announcer: We're your daily dose of science, conversation, medicine. This is The Scope, University of Utah Health Sciences Radio.