Introduction

Beginning in their 20s, women should be aware of the benefits and limitations of breast self-exam (BSE) as a screening tool for breast cancer. Women should know how their breasts normally look and feel. It is extremely important to report any new breast changes to a health professional as soon as they are found. Still, finding a breast change does not necessarily mean there is a cancer.

A woman can notice changes by being aware of how her breasts normally look and feel. Feeling her breasts for changes (breast awareness), or by choosing to use a step-by-step approach (with a BSE) also helps. Similarly, using a specific schedule to examine breasts maintains a heightened awareness of normalcy.

If you choose to do BSE, the information below is a step-by-step approach for the exam.

Special considerations

The best time for a woman to examine her breasts is when they are not tender or swollen. Women who examine their breasts should have their technique reviewed during periodic health exams by their health care professional.

Women with breast implants can do BSE, too. It’s helpful to have the surgeon help identify the edges of the implant so that you know what you are feeling. There is some thought that implants push out the breast tissue; this may actually make it easier to examine. Women who are pregnant or breastfeeding can also choose to examine their breasts regularly.

It is acceptable for women to choose not to do BSE or to do BSE once in a while. Women who choose not to do BSE should still be aware of the normal look and feel of their breasts. Not performing BSE makes it especially important to immediately report any changes to your doctor.

How to perform the breast self-exam

Horizontal positioning

• Lie down and place your right arm behind your head. The exam is done while lying down, not standing up. This is because when lying down the breast tissue spreads evenly over the chest wall and is as thin as possible, making it much easier to feel all the breast tissue.
• Use the finger pads of the 3 middle fingers on your left hand to feel for lumps in the right breast. Make overlapping dime-sized circular motions of the finger pads to feel the breast tissue.
• Use 3 different levels of pressure to feel all the breast tissue. Light pressure is needed to feel the tissue closest to the skin; medium pressure to feel a little deeper; and firm pressure to feel the tissue closest to the chest and ribs. It is normal to feel a firm ridge in the lower curve of each breast, but you should tell your doctor if you feel anything else out of the ordinary. If you’re not sure how hard to press, talk with your doctor or nurse. Use each pressure level to feel the breast tissue before moving on to the next spot.

• Move around the breast in an up and down pattern starting at an imaginary line drawn straight down your side from the underarm and moving across the breast to the middle of the chest bone (sternum or breastbone). Be sure to check the entire breast area going down until you feel only ribs and up to the neck or collar bone (clavicle).
• There is some evidence to suggest that the up-and-down pattern (sometimes called the vertical pattern) is the most effective pattern for covering the entire breast, without missing any breast tissue.
• Repeat the exam on your left breast, putting your left arm behind your head and using the finger pads of your right hand to do the exam.

Standing position

• While standing in front of a mirror with your hands pressing firmly down on your hips, look at your breasts for any changes of size, shape, contour, or dimpling, or redness or scaliness of the nipple or breast skin. (The pressing down on the hips position contracts the chest wall muscles and enhances any breast changes.)
• Examine each underarm while sitting up or standing and with your arm only slightly raised so you can easily feel in this area. Raising your arm straight up tightens the tissue in this area and makes it harder to examine.

Summary

This procedure for doing breast self-exam is different from some previous recommendations. These changes represent an extensive review of the medical literature and input from an expert advisory group. There is evidence that this position (lying down), the area felt, pattern of coverage of the breast, and use of different amounts of pressure increase a woman’s ability to find abnormal areas.

I need to acknowledge and thank the multiple sources that continue to compile and disseminate information to the public. These include the Centers for Disease Control and Prevention, the American Cancer Society and the Susan G. Komen Foundation. We highly recommend them should you need additional or more thorough information. I welcome your questions and comments.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Follow us!

Feel free to ask your SMA expert consultant any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The post How to Perform the Breast Self-Exam appeared first on Jeffrey Sterling, MD.

Introduction

How’s your breast cancer awareness? Breast cancer affects so many of us. If it doesn’t affect you or your family as well, I hope it’s not because you haven’t been paying attention. Sadly, one in eight women will be diagnosed with breast cancer in their lifetime. It’s more likely than not that every single one of us has been affected by this, either directly or through a friend or family member.

Breast Cancer is Different

All cancer is devastating, but something about breast cancer is different. We’ve found the way to eradicate certain cancers and have made remarkable progress on others. Aside from the hereditary component, breast cancer seems so…random, so dehumanizing and so debilitating to so many.

Unlike so many of the things I address as an emergency physician, breast cancer isn’t like trauma, STDs and many other conditions, where one is often directly suffering the consequences of their behavior. It is vital that you appreciate the need and value for early detection to give yourself the best possible chance for the best possible outcomes. I’ll be discussing all these considerations in detail throughout the week.

Breast Cancer Awareness

I appreciate the sentiment behind a National Breast Cancer Awareness Month, but if I could offer you anything on this, it would be a plea to be ‘aware’ every month, and use this month as a (re)commitment to take basic steps that will reduce your risk, a charge to maintain steps for early evaluation and a prod to point you toward prompt treatment if and when needed.

In fact, those three areas will be the topics of my next few posts. In the meantime, please share this or other information about breast cancer with any and all females in your life. I also hope you choose to engage your family, friends and others in conversations geared to improving breast cancer awareness. Odds are many of them have been or will be affected by breast cancer.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

The post October is Breast Cancer Awareness Month appeared first on Jeffrey Sterling, MD.

Introduction

Remember: You are not to blame, and you need not face domestic violence alone.

How would you escape eminent domestic violent abuse?. This is the third post in a Straight, No Chaser series on domestic violence. The first post focused on the scope of domestic violence. The second post focused on risk factors and identifying whether your situation places you at risk.

There has been a lot of recent attention in the news on domestic violence and debates about responses and responsibility. Hence, this post aims to refocus attention on where it needs to be. Better conversations on domestic violence start with getting the abused individual safely out of harm’s way.

When it comes to domestic violence, it is the immediate danger that can make it difficult for you to figure out the safest next move. Thus, it becomes important to know in advance the how and where of your escape plan.

Escaping Imminent Domestic Violence Abuse

If you are in a crisis situation, first make sure you and any other family members (e.g., children, parents) are safe. Leave the scene immediately. Find safe haven wherever it exists, such as an emergency shelter or the home of a friend or family member. You can find a shelter by calling (800) 799-SAFE. Call the police if you think you can’t leave home safely or if you want to bring charges against your abuser. If possible, take house keys, money and important papers with you. The staff members at emergency shelters can help you file for a court order of protection.

Be advised: Do not use drugs or alcohol at this time, because you need to be alert in a crisis. Even while you do what you feel you must do, be aware that use of weapons (even in a life-saving defense) will likely complicate and confuse matters.

If you can, just in  case, plan your escape. Establish escape routes and a safe haven. Secure important documents.

Where Do I Go If I’m Mentally or Physically Hurt?

Talk to a physician or get to an emergency department. We are prepared to check you for any life-threatening consequences to your abuse, treat any medical issue, provide mental health support and make referrals. Should you find an emergency shelter, counseling and support groups are available for you and your children. 

Dealing With Your Abuser

Your primary focus should be on finding help for yourself and escaping the danger.

• First of all, call the police if you believe that you are in danger.
• Also, call the National Domestic Violence Hotline 1-800-799-SAFE (7233), your state domestic violence coalition and/or a local domestic violence agency. Furthermore, seek out and speak with a family law advocate at your local crisis center. He or she can help you press charges against the perpetrator, file a temporary restraining order and advise you on how to seek a permanent restraining order.
• Don’t keep your circumstances hidden. Discuss them with a physician, nurse, therapist, friend, family member or spiritual advisor when you first believe yourself to be in a dangerous environment. Be careful to avoid advice that attempts to place you back in harm’s way or to do anything that is not best for you or your family. Don’t let someone talk you into doing something that isn’t right for you.
• Document any attempts at contact by the perpetrator. Save any new messages (especially threatening ones).
• Keep photographs that show any injuries you received. You will need this should you pursue legal action (e.g., press charges or file a restraining order).
• While it’s best to avoid the abuser completely, if you must meet to exchange documents or personal effects, do it in broad daylight where plenty of people are around, particularly those you know. Due to safety concerns, it is preferable to have someone else make those exchanges, if possible.

After You’ve Escaped

You need to remain detached from your former situation as much as possible and implement changes in your life. Consider these following tips:

• Establish a new routine because someone looking for you will search places you’ve frequented in the past.
• Maintain an escape plan in your new location. It may seem counterintuitive, but avoid a route that takes you through areas with potential weapons – your attacker may end up with them instead of you.
• Change your mobile or home phone number immediately after you’ve escaped the situation.

Being subjected to repeated domestic violence can extract a devastating psychological toll. Although many domestic violence survivors do not need mental health treatment, and many symptoms resolve once they and their children are safe and have support, for others, treatment is a major component of their plan for safety and recovery.

Again, the National Domestic Violence Hotline 1-800-799-SAFE (7233). You should definitely memorize it, but I hope you never have to use it. Unfortunately, the odds reveal that many of you probably will.

I hope you have found the information in this series helpful. Be safe!

Follow us!

Feel free to ask your SMA expert consultant any questions you may have on this topic. Take the #72HoursChallenge, and join the community. Also, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive discounted pricing with bundled orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The post Domestic Violence Abuse – How to Get Out of an Abusive Situation appeared first on Jeffrey Sterling, MD.

Introduction

Lower your risks of domestic violence. Today we point to knowledge as the key to preventing potential life-threatening episodes in the household. This is the second in a Straight, No Chaser series on domestic violence. The previous post focused on the scope of domestic violence. Another post will focus on actions to take if you find yourself in a relationship in which domestic violence occurs.

Considerations reflecting risks of domestic violence

Certain environments or conditions may increase your risk of becoming a victim of domestic violence. Here are certain considerations that suggest you may be at risk:

• Certainly drugs and alcohol can exacerbate an already volatile situation.
• Also, be aware that pregnancy is a particularly sensitive time emotionally. During this time, abuse may start or increase.
• Finally, women with fewer resources or greater perceived vulnerability are at even greater risk for domestic violence and lifetime abuse. Unfortunately, this is especially true for girls, those experiencing physical or psychiatric disabilities and those living below the poverty line.

Sadly, children have several risks of domestic violence. Often, they are at risk even if they do not initially witness it directly. To protect them and yourself, evaluate your mate or others in a position to exert control over you. Abusers are masterful at isolating, manipulating, intimidating and controlling those they abuse. Abusers don’t always attack with a frontal assault. Abuse may begin slowly and progress. You may accommodate certain demands in an effort to “keep the peace” in your relationship and then find yourself beyond an easy retreat from a once generous and loving person who is now intimidating and threatening.

The insidious nature of abuse must be reemphasized. What may seem, at first, to be an isolated incident complicated by theoretically understandable factors may grow into a way of life with seemingly small events triggering abuse. Your abuser may change from an individual showing regret and remorse to someone who seems repulsed by your existence, blaming your every action (or inaction or anticipated action) for the abuse that follows.

Conditions suggesting increased risks of abuse

The following conditions and circumstances have been associated with propensities for abuse. Don’t consider these as absolute predictors as much as risk factors about which you should be aware.

• Whirlwind romance
• Abnormal desire to be with you all the time
• Tracking what you’re doing and who you’re with
• Jealousy at any perceived attention to or from others
• Attempting to isolate you in the guise of loving behavior, including going to lengths to convince you that your friends and family don’t adequately care for you (e.g., “You don’t need to work or go to school” or “We only need each other”)
• Hypersensitivity to perceived slights
• Quick to blame you or others for the abuse
• Pressuring you into doing things you aren’t comfortable with (e.g., “If you really love me, you’ll do this for me”)

Do you have risks of domestic violence? Ask yourself these questions.

• Are you ever afraid of your partner?
• Has your partner ever hurt or threatened to hurt you physically or someone you care about?
• Does your partner ever force you to engage in sexual activities that make you uncomfortable?
• Do you constantly worry about your partner’s moods and change your behavior to deal with them?
• Does your partner try to control where you go, what you do and who you see?
• Does your partner constantly accuse you of having affairs?
• Have you stopped seeing family or friends to avoid your partner’s jealousy or anger?
• Does your partner control your finances?
• Has he/she threatened to kill him/herself if you leave?
• Does your partner claim his/her temper is out of control due to alcohol, drugs or because he/she had an abusive childhood?

If you answered yes to some or all of these questions, you could already be at risk for or suffering abuse.

It’s personal. The risks of domestic violence are real indicators of danger. We understand, and we can help. Please … contact us if you’re in need of support. Our expert crisis counselors are here for you, 24/7. 1-844-SMA-TALK or www.SterlingMedicalAdvice.com. You don’t have to “endure with dignity.”

Follow us!

Feel free to ask your SMA expert consultant any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

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The post Identifying Risks of Domestic Violence appeared first on Jeffrey Sterling, MD.

Introduction

October is Domestic Violence Awareness Month, although it doesn’t take a break during other months. Are you concerned about domestic violence? Probably, you should be. You are not alone. Domestic violence (DV) occurs in every culture and society. Also, it occurs in all age groups and in men and women. DV occurs in all races, income levels and religions. Likewise, it occurs in heterosexual and homosexual relationships. Furthermore, it is estimated that one in four women and one in nine men will be victims of DV at some point in their lives. That’s right. As a result, many (if not most) emergency rooms now screen every single woman for domestic violence. Therefore, you need to know the signs of danger and what you can do to get help.

This is the first in a three-part series on domestic violence. This post will focus on the scope of DV. Another post will focus on identifying risk factors. Finally, the third will focus on actions to take if you find yourself in a relationship in which it occurs.

A simple definition of domestic violence

Domestic violence is the abuse that one person with control in a household inflicts on another. Perpetrators can include parents or other caregivers, siblings, spouses or intimate partners. DV reveals itself in several forms, including sexual (e.g., rape), physical (e.g., biting, hitting, kicking) and mental abuse (e.g., constant criticisms or threats, limiting ability to lead otherwise normal lives). These forms tend to center around abnormal control of an aspect of another’s life. Even more, the level of mental control is such that victims of DV often internalize the activity as normal. They also assign fault to themselves and/or accept responsibility for the abuse.

Domestic violence is a crime in all 50 states of the U.S.

First of all, it is a crime.

Above all, victims do not cause abuse and are not responsible for it.

Domestic violence and mental health

Domestic violence has consistent adverse effects on mental health.

• Children suffering from domestic violence often display developmental delays and aggressive behavior. Also, they have difficulty performing in school and tend to have low self-esteem. Furthermore, they are at greater risk for being diagnosed with a psychiatric disorder.
• Domestic violence increases the diagnoses of anxiety disorder, depression, panic attacks and post-traumatic stress disorder. It is also associated with an increase in substance abuse.
• DV increases the incidence of psychotic episodes, suicide attempts and homelessness. It’s presence also slows recovery from those suffering from other mental illness.
• DV increases the risk of retaliatory violence against the perpetrators.

Please … contact us if you’re in need of support. Our expert crisis counselors are here for you, 24/7. 1-844-SMA-TALK or www.SterlingMedicalAdvice.com. You don’t have to “endure with dignity.”

Follow us!

Feel free to ask your SMA expert consultant any questions you may have on this topic. Take the #72HoursChallenge, and join the community. As a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Please share our page with your friends on WordPress! Like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

Copyright © 2018 · Sterling Initiatives, LLC · Powered by WordPress

The post Focus on Domestic Violence appeared first on Jeffrey Sterling, MD.

Introduction

This blog focuses on the conversation physicians have with patients newly diagnosed with HIV. It is the seventh and final blog in the series on HIV and AIDS.

• To read a discussion of HIV being eliminated from the body, click here.
• For an explanation of what HIV and AIDS are, click here.
• For an explanation how HIV and AIDS are contracted, click here.
• To learn about signs and symptoms of HIV and AIDS, click here.
• For an explanation of the risk of contracting HIV from specific acts of sexual intercourse, click here.
• Also, for an explanation of the risk of contracting HIV from specific acts of sexual intercourse, click here.

The conversation on the day you get diagnosed with HIV

I’ve had many occasions to tell a patient they were HIV(+). Over the last 20 years of my doing so, that message has changed. It used to be a death sentence. Now, we are discussing a chronic disease that will need to be battled for a lifetime. That said, the responses still haven’t changed much. There are different conversations. Those for whom the diagnosis is a complete surprise (such as those who would have received it from a blood transfusion) tend to be quite emotional. Those who suspect they’ve been infected (e.g. through IV drug use or risky sexual practices) are often quite remorseful.

In general, the responses are much like they were for an earlier generation being told they’d contracted “The Big C (Cancer).”

A typical scenario

• As I walk into the room, the patient is already in complete shock. It’s as if they’re thinking about the error of their ways and simultaneously not thinking at all.
• The moment requires finesse. It’s easy to blow in and out of a room and drop this bomb of news; after all, it’s a busy emergency room. However, this is important. This is a moment when someone’s life will irreparably change. It will either be the first day of the rest of their life or the beginning of the end of their life.
• Patients tend to want this information in private, although to a physician, this is a big red flag. This isn’t private information. Everyone in his or her life immediately became affected. Furthermore, it’s important to start lining up one’s support from the very beginning. I want the patient to have loved ones around to hear this information if they will consent.
• “I need you to pay attention. Stay with me.” I tell patients this regardless of the outcome. The fact that this information is being provided in an ER instead of a primary care physician’s office is important. It usually means behavior modification begins immediately, regardless of the verdict.
• Let’s get this out-of-the-way, because that’s what he or she wants to know. “You’re HIV(+).” Again: “I need you to pay attention, and stay with me.”

Topics to consider and discuss

We will discuss different topics.

• What it means to be HIV(+).
• What it means to have AIDS.
• How the rest of one’s life is going to look with and without treatment.
• What this will mean to one’s family, friends and other loved ones.
• How to give the patient the best opportunity for success.

The conversation can be devastating or empowering. You may find this surprising, but a significant number of patients take this news as a rallying cry. In the same way a smoker is suddenly able to stop smoking cold turkey on the day of a heart attack, newly HIV(+) patients find the strength to stop IV drug abuse and alter other high risk activities.

Here’s a bit of a disclaimer. It’s really not all about friends/family support. Efforts to inform and protect friends and family begin immediately. These are the very people who immediately become at risk once a significant other becomes HIV(+). They deserve to know they are at risk. In many ways it’s easiest to inform them from the very beginning. It’s certainly in their best interest to know as soon as possible.

Back to you and your diagnosis: you may have noticed I haven’t given you much time to breathe or grieve. You will have plenty of time for you to experience denial, anger, bargaining, depression and acceptance after you leave the emergency room. In real-time, the virus is here. The need for risk management begins immediately. Unfortunately, it is likely this wasn’t being handled previously. The most important purpose of your visit wasn’t the launching of your grieving process but the mobilization of resources to treat you and protect others.

Summary

A final point: you really don’t want to go through this. Seeing the utter despair, fear and depression indicates that life at best will be very challenging to live. The steps to minimize your risks are so straightforward. It’s agonizing to see those newly diagnosed mentally retracing their steps. They know that wearing condoms, not being promiscuous or not engaging in needle use was within their control. Make better choices on the front end. After all, you probably wouldn’t knowingly step in front of a moving truck.

You really want to get tested.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

The post The Day You Get Diagnosed With HIV appeared first on Jeffrey Sterling, MD.

Introduction – HIV and STD risks

The post HIV and STD Risks From Sexual Activities Other Than Intercourse appeared first on Jeffrey Sterling, MD.

Introduction – HIV and STD risks

This blog focuses on your HIV and STD risks from specific acts of sexual intercourse. It is the fifth blog in an ongoing series on HIV and AIDS.

• To read a discussion of HIV being eliminated from the body, click here.
• For an explanation of what HIV and AIDS are, click here.
• For an explanation how HIV and AIDS are contracted, click here.
• To learn about signs and symptoms of HIV and AIDS, click here.

Let’s be clear that we’re explicitly discussing the types of sexual behaviors that will lead to transmitting HIV and other sexually transmitted infections (STIs). Over the next two days, we will run the gamut of sexual behavior and its implications.

What we hope to accomplish here is to identify those activities that place you at significant risk for contracting HIV and other sexually transmitted infections  (STIs). The take-home message is you really should identify your partner’s health status before you begin sexual activity.

Sexual activity terminology

Today we will focus on four types of sexual activity and discuss the risks of each. Let’s start with some terminology.

• Receptive sex risks speak to risks to the receiver.
• Insertive sex risks speak to risks to the giver.
• Bottoming is a way of describing receptive anal sex.
• Topping is a way of describing insertive anal sex.

Now, let’s review.

Receptive Vaginal Sex

• Vaginal sex without a condom is a high-risk behavior for HIV infection.
• HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
• If you currently have an STI or vaginal infection, your risk for contracting/transmitting HIV is increased because your tissue will be inflamed. This has nothing to do with the presence or absence of symptoms.
• Female condoms protect HIV infection if used correctly. However, the risk still exists for any area exposed and infected (in the presence of an open sore or bleeding, for example).
• Barrier birth control methods (such as diaphragms, IUDs and cervical caps) DO NOT protect against STIs or HIV infection. If infected semen or sperm contacts inflamed or otherwise injured vaginal tissue, the risk of transmission/contraction is present.
• Birth control pills do not protect against HIV or other STIs.

Insertive Vaginal Sex

• HIV is transmitted from men to women much more easily than from women to men during vaginal sex, but the risks are significant for both.
• Condom use is a critical means of protection against STIs that are present without obvious symptoms. Use condoms with a water-based lubricant every time you have insertive vaginal sex to prevent STIs, including HIV.

Receptive Anal Sex (Bottoming)

• Bottoming without a condom provides the highest risk for contracting HIV, more so than any other sexual behavior.
• HIV has been identified in pre-ejaculatory semen. “Pulling out” prior to ejaculation may not decrease your risk.
• Rectal douching before anal sex can increase your HIV risk. Douching irritates the rectal tissue and can make you more receptive to contracting HIV. Soap and water in a non-abrasive manner are adequate means of cleanliness.
• If bottoming, you will best minimize the risk of transmitting HIV and other STIs by always using a water-based lubricant with a latex, polyurethane, or polyisoprene condom. This will help to minimize irritation to the rectum during sex and subsequent transmission.

Insertive Anal Sex (Topping)

• Topping without a condom is a high-risk behavior for transmission of HIV and other STIs. An infection may be present. If small sores, scratches or tears are also present, they would provide a ready path of entry and transmission of HIV.
• Similarly, those same lesions in your partners rectum could harbor infected cells in blood, feces or other fluid, which, when contacted, could infect you through your penis.

Check back for the next post in this series on HIV/AIDS. It will focus on HIV and STD risks from sexual activities other than intercourse.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.

The post HIV and STD Risks From Specific Acts of Sexual Intercourse appeared first on Jeffrey Sterling, MD.

Introduction

This is the fourth blog in an ongoing series on HIV and AIDS and focuses on symptoms of HIV and AIDS.

• To read a discussion of HIV being eliminated from the body, click here.
• For an explanation of what HIV and AIDS are, click here.
• For an explanation how HIV and AIDS are contracted, click here.

The National Institutes of Health has a nice method of categorizing HIV signs and symptoms, which I’ll replicate here. There are several take home messages, and I’ll use the pictures to communicate them.

HIV Positive Without Symptoms

Many people who are HIV-positive do not have symptoms of HIV infection, and symptoms only evolve as their condition deteriorates toward AIDS (Acquired Immunodeficiency Syndrome). Sometimes people living with HIV go through periods of being sick and then feel fine.

Signs and Symptoms of Early HIV

As early as two–four weeks after exposure to HIV (but sometimes as far out as three months later), people can experience an acute illness, often described as “the worst flu ever.” This is called acute retrovirus syndrome (ARS) or primary HIV infection. This represents the body’s natural response to HIV infection. During primary HIV infection, there are higher levels of virus circulating in the blood, which means that people can more easily transmit the virus to others.

Symptoms resemble a flu-like syndrome, including fever, chills, nights sweats, muscle aches and fatigue. Other symptoms may include a rash, sore throat, swollen lymph nodes and ulcers in mouth. It is important to state that not everyone gets ARS when they become infected with HIV.

Signs and Symptoms of Chronic or Latent Phase HIV

The post What Are The Symptoms of HIV and AIDS? appeared first on Jeffrey Sterling, MD.

Introduction

Fortunately, this isn’t 1983, but HIV and AIDS are still far too common. Thankfully, we now know how HIV infection is contracted. Yet, HIV and AIDS awareness are still critical. Be knowledgeable to be empowered!

This is the third blog in an ongoing series on HIV and AIDS.

• To read a discussion of HIV being eliminated from the body, click here.
• For an explanation of what HIV and AIDS are, click here.
• For an explanation of the signs and symptoms of HIV and AIDS, click here.

How HIV lives

First, let’s address a simple principle. The HIV virus can live and reproduce in high levels in blood and other body fluids, including breast milk, rectal mucus, semen (and pre-semen) and vaginal fluids. Exposure and transmission of these fluids cause HIV infection. In special circumstances (such as healthcare workers), individuals may become exposed to other areas that may contain high levels of HIV, including amniotic fluid (in pregnancy women), cerebrospinal fluid (from the brain and spinal cord) and synovial fluid (from various joints).

Now please take a moment and look at the lead picture. In addition to those circumstances listed, you should know that fluids such as feces, nasal fluid, saliva, sweat, tears, urine or vomit don’t by themselves contain high enough levels to transmit HIV. Unfortunately, these fluids often mix with infected blood. In these cases, the blood exposure is prompting transmission.

HIV transmission

HIV transmission occurs in specific ways.

• During anal, oral or vaginal sex – You have contact with your partner’s body fluids during sex. When your partner is infected, contact areas are very likely to be high in HIV viral load. These areas include the anus, mouth, penis, vagina or vulva. HIV infection is transmitted through small breaks in these surfaces. One of the reasons HIV infection rates are higher in individuals with herpes and syphilis is because those diseases cause open sores, creating additional opportunities for HIV-infected body fluids to enter the body.
• During pregnancy, childbirth or breastfeeding – Babies have constant contact with their mother’s potentially infected body fluids. Means of transmitting HIV from mother to child include through amniotic fluid, blood and infected breast milk.
• From injection drug use – Injecting drugs puts you in contact with blood. You can directly deliver HIV into your bloodstream with contaminated needles and their contents.
• As a result of occupational exposure – Healthcare workers must be constantly diligent against this method of transmission. Risks of HIV transmission to healthcare workers occur through blood transferred from needle sticks and cuts, and less commonly through contact of infected body fluids splashed into the eyes, mouth or into an open sore or cut.
• From a blood transfusion or organ transplant – Fortunately, this is now very rare. The stringency of screening requirements in the US has been largely successful in regards to this method of transmission. Still, it is possible to transmit HIV through blood transfusions or organ transplants from infected donors.

How you get HIV and AIDS

How does one get AIDS?
AIDS is a progression of HIV into its later stages, after severe damage to the immune system. You don’t “get AIDS” as much as HIV progresses to AIDS in certain circumstances. It seems like not long ago HIV could progress to AIDS in a matter of a few years. Fortunately, with the development of specialized medications in the 1990s, people with HIV are living much longer with HIV before they develop AIDS.

Follow us!

Ask your SMA expert consultant any questions you may have on this topic. Also, take the #72HoursChallenge, and join the community. Additionally, as a thank you, we’re offering you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.jeffreysterlingbooks.com. Another free benefit to our readers is introductory pricing with multiple orders and bundles!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK. Likewise, please share our page with your friends on WordPress! Also like us on Facebook @ SterlingMedicalAdvice.com! Follow us on Twitter at @asksterlingmd.