Ryan White: What You Need to Know

Next Tuesday, August 18th, marks a momentous milestone in the world of HIV--the 25th anniversary of the Ryan White Comprehensive AIDS Resources Emergency (CARE) Act. The Ryan White CARE Act has undergone five legislative reauthorizations (1996, 2000, 2006, 2009, and 2013) and is now known as the Ryan White HIV/AIDS Program (RW Program). 

Ryan White HIV/AIDS Program (RW Program)

The Ryan White CARE Act was passed by Congress in 1990 in response to the growing number of new HIV diagnoses, more people progressing to AIDS, and a vast majority of people living with HIV/AIDS (PLWHA) were uninsured or not adequately insured facing insurmountable medical costs. 

The RW Program by its 'Parts'

Part A funds may be used to provide continuum of care (medical and psychosocial support services) for people living with HIV. Core medical and support services are limited to:

• Outpatient and ambulatory medical care
• AIDS drug assistance program
• AIDS pharmaceutical assistance
• Oral health
• Early intervention services
• Health insurance premium and cost-sharing assistance for low-income individuals
• Medical nutrition therapy
• Hospice Services
• Home and community-based health services
• Mental health services
• Substance abuse outpatient care
• Home health care
• Medical case management, including treatment adherence services

To discover agencies in Las Vegas offering services funded by RW Part A

Part B funds core medical services and support services. Support services that are needed for people with HIV/AIDS to achieve their medical outcomes include respite care for caregivers of people with HIV/AIDS, outreach services, medical transportation, linguistic services, and referrals for health care and support services.

Core medical services include:

• Outpatient and ambulatory health services
• ADAP
• AIDS pharmaceutical assistance
• Early intervention services
• Health insurance premium and cost-sharing health services
• Mental Health
• Outpatient substance abuse care
• Medical Case Management
• HIV Treatment adherence services

To learn more about RW Part B and the above services in Las Vegas

Part C funds cover the following:

• Primary care providers
• Lab, x-ray, and other diagnostic tests
• Medical and dental equipment and supplies
• Patient education in conjunction with medical care
• Transportation for clinical care providers to provide care 
• Other HIV/AIDS-related clinical and diagnostic services and periodic medical evaluations of people with HIV/AIDS
• HIV post-test counseling

Sadly, I speak with many people living with HIV or not that have no recollection of who Ryan White is or is simply known as that kid with AIDS from the 80s. In 1984, at the age of 13, Ryan White was diagnosed with AIDS. At the time, Ryan was living with his mother, Jeanne, in a small blue-collar Indiana town, Kokomo, where they were instantly met with fear, prejudice, discrimination, and hate. He experienced instant stigma due to little to no HIV/AIDS-specific education. Ryan was barred from school in Kokomo and local parents only perpetuated the stigma by keeping their kids out of school until he was removed. Finally, the energy in their town became so toxic that the family moved to a more accepting town.

Ryan was diagnosed in that first wave of AIDS and died, at the age of 18, in 1990, just months before Congress passed the Ryan White CARE Act. Ryan White became a voice for AIDS but should be remembered as a young man who was more than a voice for AIDS and as the son of his mother Jeanne, who is an amazing HIV activist in her own right! Read about Ryan in her own words here. 

On a personal note, I remember Ryan White and the intense fear of the time. In 1984, I was 10 years old and had recently moved from California to Wabash, Indiana, which is a small town less than an hour from Kokomo and Ryan White. The stigma and ignorance was so rampant that my classmates and I were introduced to AIDS because the fear of the disease spreading to surrounding schools was real. Ryan was my introduction to the world of AIDS, the power of stigma, and the need for education. To learn more about Ryan, visit http://www.ryanwhite.com.

Bryan Heitz

Risk Reduction Specialist

Did You Know? - Co-Occurring Disorders

Co-Occurring Disorders (the presence of both a substance abuse condition and a mental health condition at the same time) affect approximately 8.9 million individuals in the United States (around 3% of the population), and sadly, only around 7.4% of those individuals receive treatment for both conditions, while over 55% receive no treatment at all.

Fortunately, there is good news: the stigma toward co-occurring disorders (and mental health conditions, in general) is lessening and education is increasing.

This article presents the account of a woman who has suffered from co-occurring disorders (COD), and her thoughts about her experiences and the overall climate/attitudes toward COD in our country.

Community Counseling Center offers services for individuals with co-occurring disorders, and we are here for you. If you, or someone you know, is in need of help, please reach out to us Monday-Friday, 8am - 8pm by calling (702)369-8700 and one of our caring staff members will assist you in beginning or continuing your road to recovery.

-ASM

Did You Know?

July 28th is

 

 

For more information about the types of Hepatitis, how it is transmitted, who is at risk, symptoms, vaccinations and more, please visit the CDC website.

 

Need tested? Visit one of our community partners during their regular testing hours:

 

The Center

Southern Nevada Health District

 

 

-ASM

 

 

 

 

 

 

Serodiscordant Relationships: What You Need To Know

Viral Suppression, Risk, and Serodiscordant Relationships: Should Serodiscordant couples practice safer sex practices? What's the real-life risk of HIV transmission? 

Remember seroconversion from your HIV 101: the physiological conversion from being HIV negative to becoming HIV positive. HIV statuses are reported in terms of positive and negative. Thus, Serodiscordant couples, also referred to as Magnetic Relationships, are those couples where one partner is HIV – and the other partner is HIV +.

As we enter the fourth generation of HIV, we are surviving the disease and living longer lives than those in previous generations. Along with this amazing gift of survival, HIV positive men and women are faced with a myriad of new issues including mixed-status dating and relationships, creating a number of Serodiscordant couples. Serodiscordant couples are presented with a unique set of circumstances to circumvent in order to have an open relationship and a healthy, safe sex life. 

In a 2013 article, John Sovec discusses how Serodiscordant couples are faced with more anxiety and fear than many relationships due to the fear of unintentional HIV transmission: often both the positive partner fears transmitting HIV and the negative partner fears becoming infected. Other challenges include worries regarding HIV care if the positive partner becomes sick, finding psychosocial support for both partners (more services available for the negative partner in a Serodiscordant relationship are needed), and issues of disclosure (who do you tell that your partner is positive?) to name a few. Creating an open dialogue is crucial for any healthy long-lasting relationship; however, it may be more crucial for Serodiscordant couples due to the health risks involved in keeping secrets and lack of communication. "These worries can create a barrier to true intimacy and leave each partner feeling unfulfilled. This is a time when each partner must risk talking about his or her needs, what forms of sexual contact feel safest, likes and dislikes, and how the couple can find ways to keep their sex life active and intriguing."

Are safer sex practices necessary in a Serodiscordant relationship if the HIV positive partner is in treatment, seen regularly by a doctor, and is undetectable? 

 Serodiscordant couples persist with a silent goal in mind: to keep the HIV negative partner negative and to keep the HIV positive partner healthy and undetectable. The goal of becoming undetectable, or viral suppression, is two-fold. One, viral suppression is key in HIV positive people to maintain a healthy CD-4 count, an undetectable HIV viral load, and long-term survival. Second, viral suppression is integral to HIV Prevention due to the fact that having an undetectable viral load carries a low to no risk of HIV transmission depending upon the research. 

Research conducted and reported upon over the last several years regarding Serodiscordant couples and HIV transmission, when the HIV positive partner is undetectable, cumulatively suggest that the real life transmission of HIV between mixed-status partners is extremely low to none. Most recently, the PARTNER study (a study on HIV transmission among Serodiscordant couples where viral suppression is reached in the HIV positive partner) reported on their findings after the first 2-year mark (the full report will be expected in 2017 after the final phase of the study is complete). The findings are remarkable and may offer astounding news about preventing HIV transmission with or without condom use. The unique thing about this study in regard to many earlier studies is that both heterosexual and homosexual couples and sex are included in this study: data from over one thousand mixed-status couples and thirty thousand sexual encounters were collected. Two years into the study, not one instance of HIV has been transmitted regardless of condom use, regardless of whether the couples engaged in anal or vaginal sex. The study also reports that the maximum chance of HIV transmission during viral suppression is 1% for anal sex (insertive or receptive) and 4% for anal sex with ejaculation (with a receptive negative partner). "When asked what the study tells us about the chance of someone with an undetectable viral load transmitting HIV, presenter Alison Rodger said: Our best estimate is it's zero." 

Does this mean that those of us in Serodiscordant relationships can toss out the condoms? Not necessarily; however, this is extremely optimistic and viral suppression may be one of our greatest weapons in the arsenal to contain HIV and move closer to the goal of an AIDS-free generation. It is imperative to remember that open and honest communication regarding condoms, unprotected sex, and risk associated with various sexual acts, etc. is necessary for Serodiscordant couples to make their own decisions based on facts and personal decisions. Ultimately, it is up to the individuals within the couple and centers on the HIV positive partner's adherence history and viral load.

Personally, my partner and I have been together for nearly 8 years. We began dating less than a year following my HIV diagnosis. To this day my partner is HIV negative. I become livid when it is assumed that he is HIV positive simply because I am and we are in a relationship. I do not become upset out of shame or fear, but because of the ignorance in that assumption: it is impossible for two mixed-status individuals to have a healthy, 'normal' long-term sexual relationship without both ending up HIV positive. Yet, this assumption is partly to blame for why we see young gay men seek out HIV infection; why some HIV – allow themselves to seroconvert (become HIV +); and why PrEP is being peddled to Serodiscordant couples. 

Hopefully research will continue to support the findings of low to no risk of HIV infection with ART therapy & viral suppression and HIV concerns will no longer be a part of the equation for love and healthy relationships. 

For further reading: 

Should HIV Serodiscordant Couples Always Take Preventative Measures? Experts Debate

Undetectable Viral Load Essentially Eliminates HIV Transmission Risk in Straight Couples 


Bryan C. Heitz
Risk Reduction Specialist
Community Counseling Center  

Did You Know?

16 Damaging Myths About Depression You Need To Stop Believing

(Source: Buzzfeed.com)

1. MYTH: Depression = sadness.

"Ugh, I'm so depressed," said pretty much everyone at some point or another. And even though most people don't mean it literally, a lot of people still think of depression as an exaggerated form of sadness. And it's not. "The range of human experience includes feeling sad -- but the experience of depression, feeling extreme sadness, hopelessness or helplessness is not a healthy range of human emotion," psychologist and author of "Living with Depression," Deborah Serani, Psy.D., tells BuzzFeed Life. 

2. MYTH: You can "snap out of it." 

Many people believe depression is a personality trait, characteristic, or mindset, says Serani. "They think it's a behavior that can be changed with tough love like 'just snap out of it,' or with helpful remarks like 'take a walk and you'll feel better.'" If only it were that easy. You can snap out of it no easier than you can snap out of the flu.

3. MYTH: Depression is caused by a chemical imbalance in the brain.

Sure, this is a step up from believing that your depression is a mindset you can snap out of, but pinpointing low serotonin levels as the main cause is still incorrect. "Depression arises from an interplay of genetics, biology, environment, social experiences, and learned behaviors," says Serani. "Understanding how your own unique biology and the biography of your life influence each other will help you understand how depression touches your life -- and how to treat it successfully." 

4. MYTH: Depression feels the same for everyone.

Depression exists on a spectrum of intensity and can vary from mild to profound, and everything in between. "Depression is not a one-size-fits-all," says Serani. Resist the urge to compare your experience to someone else's or judge when someone's depression manifests in a way you're not familiar with. 

5. MYTH: Depression comes in one form.

When you talk and think about depression, chances are you're thinking about major depression--but while major depression is common, affecting nearly 7 percent of US adults a year, it's not the only type of depressive disorder. 

Persistent depressive disorder (PDD)--aka dysthymia--is a low-grade chronic form of depression with many of the same symptoms, including low energy, apathy, and stress. Postpartum depression and seasonal affective disorder fall under this umbrella. Depression is also a large part of bipolar disorder, where mood cycles from severe or mild highs to severe lows. 

6. MYTH: Depression is all in your head. 

This phrase should be nixed from your vocabulary, tbh. It minimizes the illness, says Serani, and implies not only that a person is creating depression through their thoughts, but also that their symptoms are only emotional. "Depression is an illness that touches the mind and the body. It corrodes how you think and feel, as well as wrangling your body in seriously negative ways," she says. 

In fact, research shows that depression has a biological effect on the body. It can slow down brain function, create muscle fatigue, lower the immune system, and decrease heart function.

7. MYTH: It's a women's disease.

Yes, women are nearly twice as likely to have depression as men, but that doesn't mean men are safe from depression. In fact, men are often made to suffer in a unique brand of silence, masking their illness in other issues like substance abuse, risky behaviors, and overworking themselves at the office thanks to damaging expectations of masculinity that discourage showing "weakness" and emotion.

8. MYTH: You can always tell when someone is depressed.

We know -- depression is often depicted by black and white images of sad young white women clutching their heads or looking out windows... which, no. Just like depression feels differently to everyone who suffers from it, it never looks the same, either. Not to mention that many people choose to mask what they're going through because of the stigma that surrounds mental illness. This campaign shows what depression really looks like. 

9. MYTH: Your depressed partner will eventually get better if you love them enough. 

It's a nice thought--but one that belittles the serious mental condition that your partner is dealing with. Depression doesn't go away because life is good, so if you date someone with depression, don't expect that to change just because you give them a fairytale ending. 

That said, there are things you can do to help your partner. "Helping your loved one keep appointments, stay in therapy, take medication, refill prescriptions, avoid toxic situations and people, helping to create a supportive warm environment, and making sure healthy eating and sleeping occur are very important ways your love can heal," says Serani. 

10. MYTH: Depression is cured by antidepressants. 

It'd be great if taking antidepressants worked the same way as popping some DayQuil for a cold, but that's unfortunately not the case. The treatment of depression (note: not the cure) involves many moving parts, only one of which may be antidepressants. Some people--maybe even as many as one in four--were worse off on antidepressants than nothing at all. 

11. MYTH: You have to be on antidepressants for the rest of your life.

Nope--a depression diagnosis is not synonymous with a life-long script. Antidepressants can be used for short-term treatment, as part of a long-term regimen, or not at all. Just as depression has no one set list of symptoms, treatment isn't one-size-fit-all, either. Many prefer therapy or a combination of both. 

12. MYTH: How you deal with depression is a sign of mental strength or weakness.

Depression is what Serani calls an "invisible illness," making it easy for people who haven't experienced it to think it can be overcome with hard work and mental strength. This misconception can be super damaging, because it can discourage someone from seeking treatment and perpetuate the idea that those who are suffering, take medication, or see a therapist are weak. 

"Like cancer, heart disease or diabetes, depression is not an illness that can be brushed aside, ignored or willed away. It is a life-threatening illness that is serious, but treatable," says Serani. 

13. MYTH: You need a reason to be depressed.

Painful incidents can absolutely trigger situational depression, but tragic life events like the death of a loved one, divorce, or trauma are enough to make anyone feel sadness, emptiness, and many other symptoms associated with depression. Clinical depression, on the other hand, occurs without a specific trigger setting it into motion, says Serani. 

14. MYTH: You can be too young to be depressed. 

Actually, rates of childhood and adolescent depressive disorders rival those of adults, with 10 to 15 percent of children and teens suffering at any given time. Even as many as one out of 40 babies can have depression and four percent of preschoolers. 

15. MYTH: There is nothing you can do yourself to alleviate symptoms of depression.  

While there is nothing more annoying than the assumption that someone can get over depression through exercise, meditation, and other lifestyle changes, research does point favorably toward these being good methods of dealing with depression symptoms. Here are some self-care ideas to get you started. 

16. MYTH: A depression diagnosis means your life is over.

There's no getting around it. Depression is hard. So hard. And sometimes it can take so much out of you that it feels impossible to look forward. But it won't always be that way. "Many people with depression can lead rich and productive lives," says Serani. "With proper treatment, a person with depression can find meaning and success."

Mental Health in Literature

Fiction

1. "A Tale for the Time Being" by Ruth Ozeki
2. "After Birth" by Elisa Albert
3. "The Bell Jar" by Sylvia Plath
4. "The Round House" by Louise Erdrich
5. "Norwegian Wood" by Haruki Murakami
6. "The Things They Carried" by Tim O'Brien
7. "Hausfrau" by Jill Alexander Essbaum
8. "A Gesture Life" by Chang-rae Lee
9. "All The Bright Places" by Jennifer Niven
10. "Nobody Is Ever Missing" by Catherine Lacey
11. "OCD Love Story" by Corey Ann Haydu

Nonfiction

12. "The Glass Castle" by Jeannette Walls
13. "Willow Weep for Me" by Meri Nana-Ama Danquah
14. "Trauma and Recovery" by Judith Lewis Herman
15. "After a While You Just Get Used To It" by Gwendolyn Knapp
16. "Unholy Ghost: Writers on Depression" edited by Nell Casey
17. "Stop Walking on Eggshells" by Paul Mason
18. "Wasted: A Memoir of Anorexia and Bulimia" by Marya Hornbacher
19. "Don't Panic" by R. Reid Wilson, PhD
20. "Just Checking: Scenes From the Life of an Obsessive-Compulsive" by Emily Colas
21. "Lit" by Mary Karr
22. "Irritable Hearts: A PTSD Love Story" by Mac McClelland
23. "Lay My Burden Down: Suicide and the Mental Health Crisis Among African Americans" by Alvin Poussaint and Amy Alexander
24. "Hyperbole and a Half" by Allie Brosh

*This list was published on Buzzfeed on June 9. Click HERE for more information about the books listed.

Introducing: Community Cares!

Did you know that today is the "Worldwide Day of Giving?"

Each month, generous individuals, community partners, and businesses in Southern Nevada give back to Community Counseling Center in many ways, including offering their time, resources, and/or monetary donations.

Giving is simple -- maybe it's a few minutes you might have otherwise spent checking Facebook, or a coffee from Starbucks that you can do without for one day. It might be offering a smile or kind words to someone in need of encouragement, or lending a helping hand to make someone's task go faster. Giving doesn't have to cost any money at all, just a little time and willingness. 

In short, everyone is capable of giving in some capacity. 

With that in mind, Community Counseling Center is delighted to unveil its newest program, "Community Cares," a volunteer-based, staff-led initiative to give back to the community that so abundantly supports us each and every day. 

Throughout the month of June, we will be collecting nonperishable food items that will be donated to East Valley Family Services. Anyone who is able is encouraged to join the CCC staff in participating in this worthy cause. A collection box is located in our main lobby, near the front desk.  We also welcome suggestions for other service projects that "Community Cares" could adopt in future months. 

Let's do some good in the community by giving back. Together, we can make a difference!

-ASM

Did You Know?

 For More Information...

HIV/AIDS Long Term Survivors

 

Today is National HIV/AIDS Long-Term Survivor Awareness Day (NHALTSAD). It is a day to celebrate those who have survived decades of surviving, not just living, with HIV/AIDS. It was on June 5, 1981, that the disease now known as AIDS first appeared in the Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

National HIV/AIDS Long-Term Survivors Awareness Day is held annually on June 5th on the anniversary of the first published report of what came to be known as AIDS.

 

“[NHALTSAD] is a day to celebrate our survival and begin envisioning the future we never imagined. The first decades of our adulthood were overwhelmingly consumed with illness, death and fear. Now it is up to us to ensure that the next decades are the best they can be. The least we can do is afford survivors the respect they have earned and acknowledge them as elders, teachers and leaders.” -- Tez Anderson is the lead organizer of NHALTSAD (2014)

Research was conducted by Dr. George Solomon and Dr. Lydia Temoshok on how the mind and emotions impact the immune system. The purpose of their study was to understand how "long-term survivors" of HIV are different from people who follow the expected course of HIV disease. Through their research they were able to identify eight characteristics among long-term survivors of HIV.

The eight characteristics are:

1. They are realistic and accept their diagnosis and do not take it as a death sentence.
2. They have a fighting spirit and refuse to be helpless/hopeless.
3. They have changed lifestyles.
4. They are assertive and have the ability to get out of stressful and unproductive situations.
5. They are tuned into their own psychological and physical needs -- and they take care of them.
6. They are able to talk openly about their illness.
7. They have a sense of personal responsibility for their health, and look at the treating health care provider as a collaborator.
8. They are altruistically involved with other persons with HIV.

Long term survivors are now experiencing unique and complicated litany of challenges including, but not limited to, effects of stigma/discrimination/prejudice, depression, isolation, long term side effects of HART, compounded health problems due to long term HIV/AIDS infection, loss of friends or family, etc. So, if you have a Long Term Survivor of H/A in your circle of friends or family, reach out and express support in their continued fight and survival! Or, just support by posting on your social media sites and let the world know your support Long Term Survivors and their struggle!

 

Bryan C. Heitz

Risk Reduction Specialist, CCCofSN

Did You Know?

Today is "Say Something Nice Day!!"

So, here are 7 reasons why you should pay a compliment to someone every day...

1) It takes the focus off you.

Anytime you can break the habit of "stinkin' thinkin'" even just for a second, you're shifting your attention from all the things going wrong in our day and putting it on helping make someone else's day a little sunnier. Before long, your compliment to a complete stranger could go viral, and strangers everywhere will be smiling at each other, telling the person they passed on the street something they like about them. Yes, this is indeed a game changer for everyone.

2) Smiling burns calories.

And smiling often leads to laughing, and laughing burns even more calories. 

3) Compliments spark creativity.

Finding something positive to say to someone at least once a day has the power to remove, say, that person's mental block around a big project they've been struggling with and clear the pathways for them to get to the solution. While something this drastic might not happen to each person who receives a compliment from you, you will undoubtedly create a space for them to think differently from that moment on. Small acts of kindness go a long way these days.

4) Kindness doesn't actually kill.

We've all heard the phrase "kill them with kindness." Well, if the fear of killing someone with kindness has prevented you from complimenting a person, I hereby release you from said fear. Kindness could quite possibly kill a bad mood or a bad memory, but it WILL NOT kill you or the person on the other end of the kindness. Don't believe me? Try it! Be nice to someone right now and see what happens. 

5) Sincere compliments build trust. 

Each one of us walking this planet has the desire to be acknowledged. When someone else notices even the slightest thing about another person, it can shout to the person, "Hey! Someone noticed me!!" Your daily compliments to "the shy one" at work whose name no one knows can help her break out of her shyness and, who knows? turn her into the best friend you've ever had. We all need someone in our lives we can trust, and the more we build up others, the more we're also building up ourselves. 

6. What goes around comes around. 

When you give a compliment, you're more than likely going to get one in return. And like we just saw in the previous reason, when someone notices you, you'll feel special, even if it's just for a moment. That moment could be enough to carry you the rest of the day and keep you happy and productive. Your boss might notice the change in your attitude and give you the raise that's been coming to you for the last two years. You'll be happier, your co-workers will be happier, and pretty soon the whole office building is happy. And yet again we have things going and coming around. 

7. Compliments are F.R.E.E.!

Enough said!

Source

Happy Memorial Day!

 

http://www.usmemorialday.org

Harvey Milk Day

 

In Remembrance of Harvey Milk

May 22, 1930 - November 27, 1978

Harvey Milk was a visionary civil and human rights leader who became one of the first openly gay elected officials in the United States when he won a seat on the San Francisco Board of Supervisors in 1977. Milk’s unprecedented loud and unapologetic proclamation of his authenticity as an openly gay candidate for public office, and his subsequent election gave never before experienced hope  to Lesbian, Gay, Bisexual, and Transgendered (LGBT) people everywhere at a time when the community was encountering widespread hostility and discrimination. His remarkable career was tragically cut short when he was assassinated nearly a year after taking office.

Source: Milk Foundation

Did You Know?

 

For more information about today's events, please visit the The Gay & Lesbian Community Center of Southern Las Vegas (The Center).

Did You Know?

 

What Does HIV Prevention Really Mean?

 

 

 

HIV prevention is more than basic HIV education (e.g. infectious fluids, transmission routes, risky behaviors, condom use, etc.), it includes Risk Reduction and, the controversial strategy of, Harm Reduction. What does HIV prevention mean, and what is the difference between risk and harm reduction.

***

HIV Prevention focuses on the prevention of new HIV infections with education and risk/harm reduction strategies. HIV transmission occurs through sexual and non-sexual behaviors with varying levels of risk. Sexually, HIV is transmitted through unsafe/unprotected oral, vaginal, anal, or any form of sexual play that involves exposure to HIV infected fluids (blood, semen, vaginal fluids, breast milk, or any bodily fluid that contains HIV-infected blood). Non-sexually, HIV is transmitted through blood-to-blood contact (shared needles used by an HIV-infected individual and, extremely rare, contaminated blood products) and mother-to-child transmission (during pregnancy, delivery, or breastfeeding).

Preventing sexual transmission of HIV involves a number of strategies including safer sex practices, testing, treating STIs, and treatment as prevention. Safer sex practices include limiting the number of sexual partners and unprotected sexual encounters; knowing the risk-level involved in oral, vaginal, and anal sex; and, correct use of condoms from erection to ejaculation. Condom use includes both external (male) and internal (female) condoms (never to be used together), and it is important to note that internal condoms can be used for vaginal sex by women and for anal sex by both women and men.

Regular HIV and STI testing is key in preventing new HIV infections. It was not too long ago that we were advised to get an HIV test once a year. Now, frequency of HIV testing depends upon the quantity of sexual encounters & partners an individual has had; thus, a sexually-active individual not in an honest, monogamous relationship (regardless of age, gender, or sexual identity) should test once every 3 to 6 months.

Treatment as prevention consists of two strategies using antiretroviral therapy (ART) to prevent HIV transmission: PEP and PrEP. PEP, or Post-Exposure Prophylactics, is utilized after an individual has potentially been exposed to HIV in an exposure situation (sexual or non-sexual). PEP is a 4-week daily dose of ART that potentially stops HIV infection and should be started within 72 hours after HIV exposure. PrEP, or Pre-Exposure Prophylactics, is utilized before an individual is potentially exposed to HIV. PrEP is being targeted to at-risk HIV-negative men who have sex with men (MSM). More about this controversial topic shall be addressed in a later blog.

Preventing HIV transmission through blood focuses on screening blood products; reducing the instances of accidental needle sticks in medical settings; and, most importantly, decreasing the sharing of used needles in injection drug use (IDU).

***

 

Risk Reduction is concerned with reducing the actual risk an individual has of acquiring HIV through sexual and non-sexual behaviors. For example, knowing that receptive (bottoming) anal sex (regardless of sexual identity) carries the greatest risk for sexual transmission of HIV, whereas, oral sex (regardless of sexual identity) carries the least risk for sexual transmission of HIV emphasizes risk reduction.

Risk reduction among People living with HIV/AIDS (PLWHA) focuses on treatment and adherence to HART. The goal of HART for PLWHA is to decrease an individual’s viral load (how many copies of HIV replications per ml of blood) as low as possible, hopefully, until it becomes undetectable (also known as viral suppression). This is an example of using Treatment as prevention and risk reduction.

Although having an undetectable viral load does not mean that HIV is no longer transmittable, it does mean that it is less likely to transmit HIV than an individual without viral suppression. In 2014, the Conference on Retroviruses and Opportunistic Infections stated that researchers “calculated that the average real-world risk reduction as a result of an undetectable viral load would be 95 percent."

 ***

 

Harm Reduction, historically, is concerned with reducing the harms associated with injection drug users (IDU).  The number one non-sexual behavior that carries the most risk for HIV transmission is sharing needles, most commonly, for injection drug use. However, other forms of drug use (smoking, snorting, drinking, etc.) also contribute to the transmission and spread of HIV. Alcohol, marijuana, methamphetamines, and other recreational drugs often impair one’s decision-making skills, decreases inhibitions, and increase the opportunity to engage in sexual or non-sexual risky behaviors that put the individual at risk for HIV transmission and other STIs.

Harm reduction, in terms of reducing non-sexual HIV transmission, should include availability to clean needles and works for IDU. It is more likely that an IDU would use clean needles/works if they are available than an IDU would simply quit injecting drugs.

Harm reduction strategies need to be applied to sexual risks as well. Harm reduction, in terms of sexual HIV transmission, may include getting an individual to move from never using condoms to using condoms for the most risky sexual behaviors (anal and vaginal sex).

***

 

Today we, the diligent community of HIV professional in all areas of the fight, have a myriad of HIV prevention strategies of which we should not take advantage. It is equally important to acknowledge that many of these prevention strategies were not available in the beginning of the aids era more than thirty years ago. Finally, regardless of the prevention, risk reduction, or harm reduction strategy used, one must implement said strategy without judgment, prejudice, or blame.

 

-Bryan Heitz

Risk Reduction Specialist
CCCofSN

It's Never Too Early to be Aware

 

www.samhsa.gov/children

 

Did You Know?

 

 

 

Myth: Mental health problems don't affect me.

 

Fact: Mental health problems are actually very common.

• 1 in 5 American adults have experienced a mental health issue
• 1 in 10 young people experienced a period of major depression
• 1 in 20 Americans lived with a serious mental illness, such as schizophrenia, bipolar disorder, or major depression
• Suicide is the 10th leading cause of death in the United States, accounting for more than 38,000 American lives each year

 

Myth: Children don't experience mental health problems

 

Fact: Even very young children may show early warning signs of mental health concerns. These mental health problems are often clinically diagnosable, and can be a product of the interaction of biological, psychological, and social factors.

 

Half of all mental health disorders show first signs before a person turns 14 years old, and three-quarters of mental health disorders begin before age 24.

 

Unfortunately, less than 20% of children and adolescents with diagnosable mental health problems receive the treatment they need. Early mental health support can help a child before problems interfere with other developmental needs.

 

 

Myth: Personality weakness or character flaws cause mental health problems. People with mental health problems can snap out of it if they try hard enough.

 

Fact: Mental health problems have nothing to do with being lazy or weak and many people need help to get better. Many factors contribute to mental health problems, including:

• Biological factors, such as genes, physical illness, injury, or brain chemistry
• Life experiences, such as trauma or a history of abuse
• Family history of mental health problems

People with mental health problems can get better and many recover completely.

 

 

Myth: I can't do anything for a person with a mental health problem.

 

Fact: Friends and loved ones can make a big difference. Only 38% of adults with diagnosable mental health problems and less than 20% of children and adolescents receive needed treatment. Friends and family can be important influences to help someone get the treatment and services they need by:

• Reaching out and letting them know you are available to help
• Helping them access mental health services
• Learning and sharing the facts about mental health, especially if you hear something that isn't true
• Treating them with respect, just as you would anyone else
• Refusing to define them by their diagnosis or using labels such as "crazy"

 

Source: www.mentalhealth.gov