The HIV pandemic has historically been thought of as either concentrated in specific populations—such as gay men, injection drug–users, sex workers—or generalized across the entire population in sub-Saharan Africa and the Caribbean. But as more and better epidemiological data has become available, the evidence is clear: men who have sex with men (MSM), regardless of whether or not they identify as gay, also are at the core of those generalized epidemics.

MSM in developing countries are 19 times more likely to be infected with HIV than the general population, according to a 2007 literature review.

Even in Africa, at the heart of the pandemic, in Malawi, 21 percent of MSM are infected with the virus compared with 11 percent of the general population, whereas Zambia’s rates are 33 percent versus 15 percent, respectively, says Chris Beyrer, director of the Johns Hopkins Center of Public Health and Human Rights.

“The argument that gay and bisexual men are a trivial sideshow in the global fight against AIDS is wrong,” he told the Global Forum on MSM and HIV, an advocacy network that met this summer prior to the International AIDS Conference in Vienna, Austria.

That epidemiologic evidence has largely have been ignored by most nations’ plans for HIV prevention and care. Cultural values—machismo, homophobia and religion have overridden the data and dominated policy decisions in many places; most recently in the news are Uganda and Malawi.

Some 85 countries still criminalize sexual activity between adults, and eight, including Nigeria and several Islamic countries, impose the death penalty for homosexual acts. Uganda has been embroiled much of the past year in a debate about whether or not to write such a death penalty into their statutes, with evangelical Christians, both local and in the U.S., fanning the flames.

A recent survey of 303 MSM in Kampala, Uganda, found that 37 percent had been physically abused at some point in their lives, 37 percent had been blackmailed and 26 percent had been forced to have sex, according to Joseph Baker, a researcher with the U.S. Centers for Diseases Control and Prevention (CDC).

Even more troubling, members of this group were five times more likely to be infected with HIV. The overall HIV prevalence was 4.5 percent in adult males in Kampala, 13.7 percent among those participating in the survey and 22.4 percent among those who had experienced violence.

“We have a situation where laws and their arbitrary, inappropriate enforcement are increasing risk and vulnerability—thereby imposing barriers to effective HIV responses for those most vulnerable and the general population,” says Jeffrey O’Malley, director of the United Nations Development Programme (UNDP) HIV Group.

Joint United Nations Programme on HIV/AIDS (UNAIDS) Executive Director Michel Sidibe says discrimination against MSM is a human rights issue and unacceptable. But his message seems to be compartmentalized, reserved for preaching to the choir of those working with MSM; his speech to the Global Forum is absent from the UNAIDS Web site.

The recent International AIDS Conference reinforced the trend: Just 2 percent of presentations focused on gay and bisexual men, according to George Ayala, executive officer of the Global Forum.

This trend toward scientific omission has reinforced local social stigma and violence directed against this minority. The results are an amplification of new infections that might otherwise have been reined in, and a continued expansion of the pandemic.

Source Photo: Web MD

Unless it says “light” on the label, that frosty beer you drink may increase the risk of developing psoriasis, a painful skin disease that afflicts more than 7 million Americans, new research indicates.

That’s apparently true for women, at least, according to a study now online that will be published in the December print issue of the journal Archives of Dermatology.

Researchers from Brigham and Women’s Hospital and Harvard Medical School in Boston examined data from 82,869 women who in 1991 were between the ages of 27 and 44.

Beer and Psoriasis
The women, participants in a research program called the Nurses Health Study II, described the amounts and types of alcohol they drank on questionnaires every two years, and also reported whether they had been diagnosed with psoriasis.

Among the findings:

1,150 cases of psoriasis developed, of which 1,069 were used for analysis.
Light beer, red and white wine, and liquor were not associated with psoriasis risk.
The risk of psoriasis was 72% greater among women who had an average of 2.3 drinks per week or more, compared to nurses who abstained from alcohol.
The risk of psoriasis was 2.3 times higher for women who drank five or more beers per week than nurses who didn’t drink beer.
Non-Light Beer
“Non-light beer was the only alcoholic beverage that increased the risk for psoriasis, suggesting that certain non-alcoholic components of beer, which are not found in wine or liquor, may play an important role in new-onset psoriasis,” the authors write in the study. “One of these components may be the starch source used in making beer.”

Barley May Be Culprit
The researchers write that beer is one of the few non-distilled alcoholic drinks that uses a starch source for fermentation, and commonly, it’s barley.

Barley and other starches contain gluten, a substance that some people with psoriasis are very sensitive to, the researchers say.

The researchers say that the association between alcohol consumption and increased risk of new cases of psoriasis, or of the condition worsening, has been suspected for a long time.

“Women with a high risk of psoriasis may consider avoiding higher intake of non-light beer,” the authors say. “We suggest conducting further investigations into the potential mechanisms of non-light beer inducing new-onset psoriasis.”

Source: WEB MD

The number of females infected with the HIV/Aids virus in T&T has now surpassed the number of men living with the dreaded disease. Technical Director of the National Aids Coordinating Committee (NACC), Carol-Ann Senah, made the disclosure in an interview with the Sunday Guardian last week in the wake of the gruesome killing of Dianne Williams and her ten year old son, Shaquille Morgan. Dianne, reportedly infected with the virus, was killed by a man she sheltered at her home. She was said to be seen asking for handouts in San Fernando.

Senah, responding to questions on how women like Williams who are infected with HIV/Aids end up in such circumstances, said over the last three years the number of female cases shot up. “Up until 2007, the number of males outstripped the females,” Senah began. “At the end of 2006, the male to female ratio for new HIV positive cases stood at 51 to 49 but at the end of 2008 females accounted for 694 new positive cases while the males accounted for 609 new cases.”

Worse, the majority of new HIV positive cases among females occurred in the 20-24 age group while the largest number of new HIV positive cases among males were found in the 45 to 49 age group.” Senah said more research is needed to determine whether this reflects the fact that more females are coming forward for testing or is indicative of an increase in the incidence of HIV among females. Unprotected sex. Outlining some reasons for the increase in HIV/Aids among young females, Senah said the biggest challenge is unprotected sex.

“Our research tells us that the percentage of persons who use condoms consistently and correctly are still under 25 per cent. “People still have unprotected sex despite all the warnings. Men feel asking them to use a condom kills the romance. “Some womenalso can’t ask their partners to use a condom because it can result in violence and abuse.”

Senah said prostitutes said some of their clients do not want to use condoms and promise to pay more. The prostitutes agree for the money. A worse reason Senah said, is transactional sex. “A lack of economic power forces women to submit to the man’s demands not to use a condom. These are realities for women. “The woman is not a prostitute but engages in sexual relations to get money for rent, clothes and so on. “She will have a personal boyfriend but have others for money.

She will have different phones for these different men. “And this is not just happening in the lower income bracket but research has shown that it is becoming more frequent at a more middle income level,” Senah said. “Some may be university students. Some may be younger women dating older men for money Refusal to use a condom coupled with multi-partnering increase the risk of getting HIV/Aids. “We’re a multi-partnering society where people will have more than one partner.” Serial monogamy is another lifestyle that can contribute to an increase in HIV/AIDs, Senah said.
She said women’s economic status may lead them to have children with more than one partner. “Serial monogamy is definitely a phenomenon in our society. You may see a woman with three children who have three different fathers.” Rape can also lead to HIV infection, Senah said. She said women who are raped can be saved from HIV infection, however, through the use of anti-retrovirals. “These are given out in the Accident and Emergency Unit at the hospitals.” Incest and sexual abuse of female children has also been linked to HIV infection later in life, Senah said.
Education continues

Despite the refusal to heed their warnings, the NACC continues its HIV/Aids education campaign. “The message we send to young people is to delay sexual intercourse. Children are not physically ready to have children.” The NACC has an ABCDE message. “A is for abstinence until marriage, B for being faithful, C is for using condoms consistently and correctly, D is do the test and E, educate yourself,” Senah said. She said the NACC works with the Education Ministry and non-governmental organisations. UNAids also provide funding to target young men and women. Senah said males need to be educated on how to respect females. “They need to understand that when a woman says no, she means no.” There are also programmes to help women increase their literacy level. “If you educate yourself, you are more empowered and have more negotiating skills,” she noted. Senah said women with the HIV/Aids virus can be in a more unfortunate situation than men who get the disease, like Williams, who was dismembered. The issue of stigma and discrimination affect women more negatively.” Senah said the UN Population Fund provides female condoms free of charge which the NACC tries to distribute at health fairs. “We get mixed responses from women. Our women are still not in charge, economically and emotionally,” she observed.

More Info
New male and female HIV positive cases at the end of 2008 Females- 694 or 48.53 per cent. Most of these cases were in the 20 to 24 age group. Males 609 or 42.59 per cent. Most are in the 45 to 49 age group. Total number of new HIV positive cases at the end of September 2009 20,255 Number of Aids cases 6,208 Deaths- 3,845

Source: Guardian

According to reports emanating from Jamaica on Tuesday, that island’s Ministry of Health is spending millions to prevent a dengue outbreak. The Jamaica Gleaner reported that the ministry has been fogging, clearing breeding sites and carrying out public education programmes in some 300 communities nationwide.

In Trinidad and Tobago, where as at last Friday there had been three confirmed deaths as a result of dengue haemorrhagic fever, the chief medical officer said there was no need for alarm; figures had not yet reached epidemic proportions. However, spraying to keep down the multiplication of the vector carrying the disease had been heightened in areas of the island where the majority of cases were reported and the Ministry of Health has hired more staff for its vector control unit, reports said.

Dengue Fever Infestion

In the case of Guyana, Minister of Health Dr Leslie Ramsammy said while the country was facing the threat of a dengue outbreak there was no need to panic as the health sector was well equipped to deal with any such crisis. He said citizens needed to be careful and to keep their surroundings clean. He added that dengue and other tropical diseases – the result of climate change – would likely increase and cause major problems in the future. There was no indication as to what, if any, additional steps the ministry planned to take to mitigate the risk of a dengue epidemic.

Apart from the difference in the number of people affected in Jamaica, T&T and Guyana and the variance in responses, it should be noted that Jamaica has a population of 2.6 million; T&T 1.3 million and Guyana 763,437 – these figures were as at 2008 according to the World Bank’s World Development Indicators. Aside from having the highest number of dengue cases and the smallest population of the three countries, it should also be noted that Guyana is the only country with an ongoing garbage crisis in its capital and the only one with major drainage issues – ideal conditions for the breeding of the Aedes species of mosquito which spreads dengue. Even though the local Ministry of Health does not want to spread panic unnecessarily, surely it could be, ought to be doing more than it is at the moment.

It is a well-known fact that dengue is not just a problem in Guyana; its incidence has risen the world over in the last decade. Because of its proximity to the Caribbean, Florida has also seen a marked increase in dengue cases this year, and has put systems in place to mitigate its spread. Although the Aedes mosquito, which is also responsible for the spread of yellow fever, is found in the tropics and sub-tropics, dengue fever, because of global travel, has been found in places like Antarctica. The World Health Organisation has had a global alert in place for the disease since the 1950s. It notes that as many as 100 million people worldwide are infected with dengue or dengue haemorrhagic fever every year and since there are no vaccines to prevent it, the most effective preventative measure was to avoid being bitten by mosquitoes. In other words, regardless of how effective a country’s health sector may be at dealing with the virus it is advisable not to contract it in the first place.

This is at odds with what appears to be the local health sector’s laid back attitude to the risk. Dengue has now become an annual occurrence with the rainy season, but that’s not to say that it should be shrugged off like so many other things in this country. Sadly, it would appear that the epidemic that should be feared in Guyana is apathy. It has already manifested in the Local Government Ministry’s approach to the garbage crisis and seems to be spreading across sectors.

The company issued the voluntary recall of the supplement after it learned from the Food and Drug Administration that lab analysis found it contained Sulfoaildenafil, an analogue of Sildenafil, an FDA-approved drug used as treatment for male erectile dysfunction, according to the Health Department’s release.

The active drug ingredient is not listed on the dietary supplement, and the undeclared ingredient may pose a threat to consumers because the interaction with some prescription drugs may lower blood pressure to dangerous levels, according to the FDA.

People with diabetes, high blood pressure, high cholesterol, or heart disease often take prescription drugs, and the FDA said erectile dysfunction is a common problem in men with these conditions and that they may seek these products to enhance sexual performance.

“We urge consumers who may have purchased Vialipro to discontinue its use,” V.I. Health Commissioner Julia Sheen said in the prepared release. “The product will be refunded by the company.”

For more information on receive a refund call (866) 607-0338 Monday through Friday from 9 a.m. to 5 p.m.

Distributors meanwhile are advised to stop selling Vialipro and to also contact the company for instructions.

Sheen said Tuesday that it was the second time in three months that the V.I. Health Department has issued a warning to consumers about dietary supplements containing an unapproved drug.

In April, Environmental Health staff pulled VIM-25, a single-dose purple pill, off store shelves after the department learned from the FDA that it contained Tadalafil, the active ingredient in the FDA approved drug Cialis, which is commonly prescribed for the treatment of erectile dysfunction.

Health Department epidemiologist Eugene Tull said in the release that Health will conduct routine visits to stores to ensure that owners are adhering to the notice to cease such sales.

Source: VI News

Why do many people think they have a food allergy when they don’t?

Experts say it’s because people don’t understand what really constitutes a food allergy and they often misuse the term.

“Unfortunately, the term ‘allergy’ is sometimes used by the public or health care providers to describe any unpleasant experience patients have with eating food, including ‘feeling bad,’” says Marc Riedl, MD, MS. He worked on the study in The Journal of the American Medical Association and is an assistant professor of medicine at the University of California at Los Angeles David Geffen School of Medicine.

Linking ‘food allergy’ with ‘feeling bad’ causes confusion, and can lead to people cutting out certain foods thinking they’re allergic to them, when instead they may be missing out on delicious foods or risking nutritional deficiencies.

The National Institute of Allergy and Infectious Diseases, which funded the study, is working on guidelines to correct of the confusion over the diagnosis and management of food allergies. The new guidelines are expected to be released later this year.
Myth: I’m allergic to foods that don’t agree with me.

Not necessarily. A food allergy is a very specific immune system response involving either the immunoglobulin E (IgE) antibody or T-cells. Both are immune system cells that react to a particular food protein, such as milk protein.

An IgE reaction occurs within minutes to an hour or so of either smelling, touching, or ingesting a particular food. The presence of the food triggers the immune system to over-react and interpret the food as harmful. Histamine is released, causing symptoms that range from mild to severe, including hives, itching, trouble breathing, wheezing, and anaphylaxis.

About 30,000 Americans per year go to the emergency room due to severe allergic reactions to food, and as many as 200 die every year from food allergies, according to the Food Allergy and Anaphylaxis Network.

A non-IgE immune system reaction can occur within three to four hours of ingestion and can often be mistaken for food insensitivity or food poisoning, explains Wesley Burks, MD, division chief of pediatric allergy and immunology at Duke University Medical Center in Durham, N.C.

“The biggest misunderstanding is that there are different types of food allergies, they’re reproducible, the reactions are the same,” Burks says. “You’re can’t eat cheese, feel sick, and claim a food allergy, but then turn around and enjoy ice cream and feel OK. With a true food allergy, the trigger does not change and the trigger will always set off the same immune system response.”

Reviewed by Gary D. Vogin, MD

A lot of people don’t take the risks of high cholesterol very seriously. After all, one out of five people have high cholesterol. A staggering 50% of Americans have levels above the suggested limit. Could something so common really be a serious health risk?

Unfortunately, yes. Cholesterol is a direct contributor to cardiovascular disease, which can lead to strokes and heart attacks.

“Despite all of the amazing medicines and treatments we have, cardiovascular disease is still the number one cause of death and illness in our society,” says Laurence S. Sperling, MD, director of preventive cardiology at the Emory University School of Medicine, Atlanta, Ga.

The World Health Organization estimates that almost 20% of all strokes and over 50% of all heart attacks can be linked to high cholesterol.

But if you’ve been diagnosed with high cholesterol, don’t despair. The good news is that high cholesterol is one risk factor for strokes and heart attacks that you can change. You just need to take action now, before your high cholesterol results in more serious disease.
All About High-Risk Cholesterol Numbers

When it comes to high cholesterol risks, it’s tough to keep the details straight. We might have a vague idea of whether our cholesterol is “good” or “bad,” but we forget the actual numbers by the time we get to the parking lot outside our doctor’s office. So it may be worth reviewing the basics.

Cholesterol is a fat-like substance circulating in your blood. Some of your cholesterol comes from the foods you eat. But the bulk of it is actually made in your own body, specifically in the liver. Cholesterol does have some good uses. It is needed to make some hormones and it is important for the function of our cells. But an excess of it in the bloodstream can lead to trouble.

Cholesterol comes in several different forms, but doctors focus mostly on two: LDL cholesterol and HDL cholesterol.

* LDL is also called “bad cholesterol” — Sperling suggests that you think of the “L” as standing for lousy. LDL cholesterol can clog your arteries, increasing the risk of heart attack and stroke. Most people should aim for a level of less than 100 mg/dL. However, people who already have heart disease may need to aim for under 70 mg/dL.

* HDL is “good cholesterol.” Imagine the “H” stands for healthy, Sperling suggests. This type of cholesterol attaches to bad cholesterol and brings it to the liver, where it’s filtered out of the body. So HDL cholesterol reduces the amount of bad cholesterol in your system. You should aim for 60 mg/dL or higher.
* Triglycerides are not cholesterol but another type of fat floating in your blood. Just as with bad cholesterol, having a high level of triglycerides increases your risk of cardiovascular problems. Aim for a level of less than 150 mg/dL.

So although we all talk about high cholesterol risks, the term is a little misleading. What we really mean is high levels of bad LDL cholesterol and triglycerides and a low level of good HDL cholesterol.

What about total cholesterol, which is the sum of your LDL and HDL? While anything under 200 mg/dL is still considered the target, most experts don’t focus on the number. It doesn’t mean all that much. “Someone can have a total cholesterol of under 200 — which is lower than average for Americans — but still have unhealthy levels of HDL or LDL,” says Sperling.

Whole grains, like popcorn and whole wheat, also contribute dietary fiber and vitamin E. Though avocados have fat, it’s the good-for-you, monounsaturated fat that contributes to healthy blood flow.

On April 17, Powell was among the participants at a seminar sponsored by Baptist Health International Center of Miami and the Caribbean Association of Oncology and Hematology on breast and prostate cancer, which was held at the Hilton Trinidad & Conference Centre.

The afternoon patient forum featured a presentation from Powell on her personal experiences as a Baptist Health patient. She also proffered details to the audience about the Basia Survivor Network (BSN), a regional support group that she founded to educate women about cancer and how to live a healthy lifestyle after contracting the disease.

“I think that the event was well received,” said Powell to The Observer. “It was a good initiative on the part of Baptist Health to improve awareness.

“I always instill in women that there is a cure, and that lifestyle is important and so is educating yourself, as both help you to deal with the diagnosis in a more proactive way. So, that is what I shared with the persons who attended.”

Since dealing with the disease herself, Powell has become a tireless advocate for women diagnosed with, and surviving breast cancer in the Caribbean.

“My objective is to improve the message, that there is a cure, and to improve the type of information being disseminated,” she explained.

Within BSN, both cancer patients and survivors receive much-needed emotional support and are helped to achieve the right attitude and mindset to deal with the challenges, and sometimes perceived stigmas, presented by the disease.

Powell’s impetus to spread her message across the region came from her association with the organization where she received treatment.

“I knew nothing about Baptist Health, prior to my going there,” she said. “I really fell in love with the staff. They helped to change my mindset, and that is what I wanted to do for others in the Caribbean.”

The television show that she hosts is extremely popular in Trinidad, and according to Powell has a large following in the English-speaking Caribbean. Shows are due to begin soon in Jamaica, and have already been running in Barbados.

“I would love to bring the show to St. Kitts if a television station would carry it,” she said.

Clips from The Basia Show can be seen by clicking into the appropriate link at www.basiamagazine.com.

It was on August 10, 2009, that Powell’s life changed forever when she was diagnosed with invasive ductual carcinoma. A long-time volunteer with the Jamaica Cancer Society, she never contemplated being a patient herself.

A narrative on the Basia Magazine Web site provides insight into her feelings at that time.

“The best way to describe my state of mind was numb. One minute you are living a normal life and the next you are a cancer patient. That transition can be difficult for many. My predominant recollection of the people around my life who were diagnosed with cancer was prolonged illness or death.”

Once treatment at Baptist Health had commenced, her life’s path had been made clear.

” I had two choices — I could fight the good fight, receive the best medical care and talk to my survivor friends weekly and visit their support groups and keep it all to myself, or I could form a dynamic survivor network that would be equal to theirs and pamper women in my country and in other parts of the Caribbean, while making a difference in the way they handle a cancer diagnosis and the way they fought it,” she related on her site.

BSN participants meet weekly to explore issues affecting their lives. The sessions include complimentary activities such as yoga, reflexology, dance, and lectures from world-class doctors and surgeons from sponsor Baptist Health. The hospital also agreed to fund surgeries for a specific number of women who were not able to afford them, through their association with the Network.

Dr. Deirdre Marshall, a board certified plastic and reconstructive surgeon at South Miami Hospital, part of the Baptist Health South Florida Network, performed Powell’s reconstructive surgery.

“She is a celebrity and a public figure, and used that in a positive way to bring attention to the whole issue,” said Marshell of Powell.. “She had a very positive attitude about it, even when she was receiving treatment.”

Generally, Marshall sees women whose cases are not advanced, and where a good prognosis and outcome from treatment is expected. Given the high detection rates in the United States, it is now rare for her to see advanced cases of breast cancer.

“Most women can get some kind of medical insurance that would cover their getting a mammogram, and getting to a doctor to get examined,” said Marshall. “Also, most people know now that if you do have breast cancer, and it is detected, the disease can be cured, so that they’re not so afraid to keep on top of it.”

According to Marshall, since she began practicing the reconstruction aspect of breast cancer surgery has changed significantly for the better.

“When I first started, we used to just make a mound on the chest, and they never really looked very good,” she said. “Now we try to get results so that the reconstructed breast looks even better than what you started with. We have new types of implants and new ways of moving the tissue around, in addition to other materials that we use to construct a realistic looking breast. We look at it not only as reconstruction, but also as cosmetic surgery.”

Marshall informed that the trend right now is for women, even if they only have cancer in one breast, to opt for removal of both breasts because once cancer is found in one breast the chances getting it in the other increase.

“In general, the chances of getting breast cancer is about 1 in 8, and if you already have cancer in one breast, it is even higher than that,” she said.

“So, most women just remove the second one as a preventative measure. When we reconstruct, they come out looking better because they match. It is better to have the mastectomy on both sides, but some women choose to keep the healthy breast and have surgery done on that, although the result doesn’t produce as good a match.”

Many younger women feel more peace of mind if they just remove all of their breast tissue to minimize the chances of acquiring cancer again, according to Marshall.

“I have never seen a patient regret having surgery done on the second breast,” she said.

A fairly recent innovation in breast cancer surgery involves immediate reconstruction, which begins virtually at the same time as the mastectomy and is advantageous to affected women because they never have to go around without anything in the breast area.
“The additional surgery only adds a few hours to the overall operation time and cuts out the need for one whole operation. For mental and self-esteem reasons, it is better to have both done at the same time,” explained Marshall.

Genetic testing is the latest technology to come along in the field. Medical researchers can now determine if women are carrying a gene that indicates it will be likely, given a possible mutation in their DNA, that they will get breast cancer through heredity factors.

It is only necessary for a woman to spit in a cup, rather than take a blood test, to find out if they are at risk for ovarian or Fallopian tube cancer.

“Some women follow up on a positive test by having reconstruction surgery without even having the disease, as a preventative measure” said Marshall.

“The next step in genetic testing involves looking at the daughters of women who do carry the gene, and figuring out when the best time is to get the tests done for them.”

Dr. Marshall is a graduate of Yale University, Columbia University Academic Institute in Paris, France, as well as the Stanford University School of Medicine. She is the recipient of numerous awards and honors, including the Katherine M. McCormick Foundation Award for Women in Medicine and the Stanford University School of Medicine Research Honors Award.