Wednesday Wisdom

Meet Our Staff: Marilyn Anderson

Today is the second installment of "Meet Our Staff," as we venture into our Diversity, Health & Wellness Program to introduce you to Marilyn!

Name: MARILYN ANDERSON

What do you do at CCC? 

I am the Diversity, Health and Wellness (DHW) Program Coordinator. I work via a SAMHSA grant and our focus population is minority gay men but we are free to test all individuals for HIV and Hep C. We provide testing and treatment for individuals who may or may not be positive. They include referring for substance use, mental health, psychiatry, etc. We also provide case management services to clients by assisting them with housing, job searches, food, medical insurance, clothing, etc.

How long have you been at CCC?

I started at CCC in January 2013 as a DHW Case Manager. 

Where are you from originally?

I was born in Illinois, but raised in Vegas.

What is your favorite vacation spot?

Berchtesgaden, Germany 

What is your favorite food? 

I have way too many for just one favorite, but some of my tops are sushi, foie gras, ma po tofu, and whole steamed crab with ginger and onion! 

Who is someone you look up to or admire and why?

I'll keep the name a secret, but I admire this person because of who they are inside!

What do you enjoy doing in your spare time?

There are so many fun things to do in my spare time. Having a glass of wine with good friends, watching a movie in bed, vacationing, reading….

What is your favorite place in Las Vegas?

In an airplane above it, watching the lights fade as I fly off to another country!

If you could have any animal as a pet, what would you choose and why?

My little Meg (cat) that I have right now. Why? Because she's awesome!  

What would you choose as a career if you were not in this field?

I'd write novels

What is your favorite thing about working at CCC?

I adore the people I work with… best bunch ever! 

What words of wisdom do you have to share?

"The heart has its reasons which reason knows nothing of." - Pascal 

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  

Wednesday Wisdom

Meet Our Staff: Mark Brana

Community Counseling Center has an amazing staff who works tirelessly every day to change lives for the better, and we'd like you to meet them!

Mark has graciously offered to be our first victim participant. So, without further ado...

 

Name: MARK BRANA

What do you do at CCC? 

I  recently became a Co-Occurring Disorders counselor, so now I will be spending most of my time working out of our Henderson location, but before that, I worked in the Substance Abuse Department. I ran both Stress Impulse/Anger Management groups as well as a Men's Recovery group. I also do individual sessions and have been trained in EMDR. I work with a variety of clients, including clients who have experienced trauma. I enjoy working with my clients and seeing the progress they make. 

How long have you been at CCC?

I started interning at CCC on July 7th, 2013 and was hired as a full-time employee May 1, 2014. 

Where are you from originally?

I grew up in Northern Minnesota, approximately 2 hours from the Canadian Border. Yes, it's cold there. 

What is your favorite vacation spot?

I like to travel to places I have never been, so I can't pick just one place. Although I do have to say I found spending time in Eastern Europe very enjoyable. 

What is your favorite food? 

I have missed very few meals in my lifetime. I enjoy all foods, and often eat Chinese food. My wife does the cooking for the most part. The easier question to answer is what foods don't I like. Beets, I hate beets.

Who is someone you look up to or admire and why?

I look up to anyone taller than me; it's hard to look them directly in the eyes without doing so. I admire my grandfather who passed away in May 2013. I would say I am most like him in my demeanor, sense of humor, and outlook on life. He lived an exemplary life and I can only hope to be half as exemplary as he was.

What do you enjoy doing in your spare time?

Spare time? I have not heard of the concept. Lately, I have spent my spare time changing diapers and trying to figure out how I am going to deal with my daughter when she is 16. I am thinking she won't date until she is 50. I enjoy playing sports and working out. I also enjoy riding my motorcycle and playing guitar. I read, although rarely, when I find something that interests me. 

What is your favorite place in Las Vegas?

Anywhere I go with my wife, friends, or family. I do not particularly enjoy gambling or being on the Strip.

If you could have any animal as a pet, what would you choose and why?

I would have a lion. Why?? See the first part of the 'spare time' question, I think this would help. Otherwise, I would have a dog. I like having dogs because they are loyal and not as snobby as cats. 

What would you choose as a career if you were not in this field?

It's hard to say. At one point in my life, I was going to go into law enforcement. I also thought about being a helicopter pilot, but I'm afraid of heights. This also made being an astronaut a difficulty. I would probably have to say a professional fisherman. Getting paid to fish, how do I get into that?

What is your favorite thing about working at CCC?

I enjoy the people I work with and the freedom to do my job my way. Some agencies are focused on one type of therapy and do not allow clinicians the freedom to be themselves. I think being too narrow-minded and focused on only one approach is detrimental to any agency. Being open and free to explore gives you the most opportunity to help clients.

What words of wisdom do you have to share?

When life is getting you stressed, just take a deep breath and remember: It's just life, no one gets out alive.

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."

Wednesday Wisdom