Monday, January 25, 2010
Tik Abuse
We published a very informative presentation on slideshare regarding the use and effects of TIK. please click on the link below to view the presentation.
HIV/AIDS It won't happen to ....Famous last words....
It won’t happen to me… FAMOUS LAST WORDS
HIV / AIDS in the Gay Male Community
I hope that some of you out there saw yourselves or friends in the sexy summer edition’s article on body obsessions. It is a rising reality guys.
Well it’s this time of year again being faced with the realities of our times. It had come to my attention that gay men especially are so naïve about the whole HIV / AIDS issue it is actually scary. Yes I can see those queens going: “Oh, not another thing on moffies and HIV”. I know, I know, I know, but I think it’s time to leave the knitty gritty detail behind and focus on what is actual and applicable to the gay male scene currently.
The year 2006 marked the 25th anniversary of the first reported cases of HIV / AIDS. It was initially diagnosed in the
People ask me what about blow jobs, kissing, rimming, anal sex… Well the sad thing is that there is no real hardcore (pardon the pun) evidence on transmission percentages. Some statistics will be released later in the article.
What is the difference between HIV and AIDS and what is all this CD4 talk
CD4 cells are a specific line of white blood cells (the soldiers that protect us against infection) that are attacked and lowered over time by HIV.
Table 1 : Ranges of Number of CD4 Cells:
| Normal CD4 Count | > 500 – 1000 x 106 / L |
| HIV | > 200 x 106 / L |
| AIDS | <>6 / L |
When the CD4 count lowers the risk of infections are on the up rise. Common opportunistic infections are as follows:
· Oral or Oesophageal thrush / Candida
· Pneumonia (Bacterial / TB / PCP)
· Meningitis (Viral / Bacterial / Fungal)
· Shingles (“gordelroos”)
· Oral Herpes (“koorsblare”)
· Sepsis
Other symptoms and signs that accompany HIV infection are loss of appetite, loss of weight (the so called “slow puncturing”) and generalised lymph glands (lumps underneath the chin, in neck, under armpits, middle inner side of arms, groin etc).
To give you some perspective for the South African gay and straight population
I was at a World Aids Day event on the 1st of December 2006 and the premier of the Western Cape, Ebrahim Rasool, quoted that 24 000 HIV positive patients are on ARVs (Anti Retro Viral Drugs) in the Western Cape. This statistic excludes those diagnosed but with CD4 counts > 200 x 106 / L. I worked as a community service doctor at Khayelitsha Site B CHC (Community Health Care Centre) from July to December 2006. There, 3000 - 4000 HIV positive patients are treated with ARVs, this is costing the government around R750 000 per month (between R250 - R350 per patient per month) just at one clinic.
The reality is then that 6 – 8 % of HIV positive people on ARVs in the
HIV is all around guys and girls and we can’t ignore it because of our own ignorance and thinking that it won’t happen to me.
What increases susceptibility to HIV infection and put homosexual males more at risk
1 Biological Risk Factors
Anal Intercourse does increase an individual’s risk. Both vaginal and anal / rectal epithelium cells have receptors that easily bind to HIV. HIV receptive cells have been identified in the mouth, vagina, foreskin, urethra and rectum. Although vaginal intercourse have been shown to be an efficient route for transmission, rectal tissue is much more vulnerable to tearing during intercourse and the large surface area of the rectum and colon provides more opportunity for HIV penetration and infection. For these reasons, unprotected anal intercourse is believed to be at least 10 times more risky than unprotected vaginal intercourse for acquiring HIV.
Stage of infection influences HIV infection and transmission.
Late stage / AIDS (Acquired Immunodeficiency Syndrome)
· CD4 <>6 / L (LOW CD4 Count)
· In brief the lower the CD4 count the higher the viral load (viral amount in bloodstream).
Primary infection / “Window” Period
· Occurs during the period between first exposure to HIV and the appearance of antibodies against HIV in the bloodstream (AKA Seroconversion).
· Seroconversion happens around 3 weeks to a month after exposure.
· Reason is that viral loads are higher at the time of seroconversion and thus a peak in the transmissibility of HIV soon after a person is infected.
NB ARVs (Anti Retro Viral Drugs) is associated with a 50 % reduction in the sexual transmission of HIV and slows the progression of the disease and thus have an effect on the stage of infection. Important to remember that ARVs does not cure HIV / AIDS but “freezes” the virus, thus lowering viral load and increasing the CD4 count. This in turn improves the immune system and quality of life.
The presence of other STDs (Sexually Transmitted Diseases) facilitates HIV acquisition.
Genital ulceration (Syphilis, Genital Herpes, Chancroid etc)
Increases relative risk for HIV infection by 1.5 – 7 times (especially Genital Herpes).
Genital discharges (Gonorrhoea, Chlamydia, Trichomonas etc)
Increases relative risk for HIV infection by 60 – 360 %.
NB It is important to mention at this stage that if you contracted an STD it is of utmost importance to also get yourself tested for HIV. Hopefully to exclude HIV infection. It is also vital to realize that Hepatitis B Infection (presenting with jaundice) is 80 times more infective than HIV and is part of the STD spectrum of disease.
Male circumcision has a protective effect against HIV infection because the presence of foreskin indicates more receptors for HIV binding sites. The prevalence of HIV infection is 1.7 – 8 times higher in men with foreskins than in circumcised men (so there you go those guys who are into cut cocks…).
2 Behavioural Risk Factors
Specific sexual acts increase the risk of HIV infection.
Unprotected Receptive Anal Intercourse > Unprotected Insertive Anal Intercourse > Oral Sex
Table 2 : Estimated per act risk for acquisition of HIV by exposure route
| Exposure Route (Without Protection) | Risk / 10 000 Exposures From An Infective Source | Percentage (%): |
| Kissing | None | 0 % |
| Giving Oral Sex | 1 | 0.01 % |
| Receiving Oral Sex | 0.5 | 0.005 % |
| Passive Anal Intercourse (Bottom) | 50 | 0.5 % |
| Active Anal Intercourse (Top) | 6.5 | 0.065 % |
| Needle Pricks / Sharing Needles | 30 – 67 | 0.3 – 0.67 % |
| Blood Transfusion | 9000 | 90 % |
| Penile-Vaginal Intercourse | 5 – 10 | 0.05 – 0.1 % |
Multiple sexual partners / Steam rooms / Sex clubs
Inconsistent condom usage
Lack of knowledge and ignorance about HIV and its risks
Negative attitudes towards safer sex
Drugs (especially TIK / Crystal [Methamphetamines] and Poppers) and alcohol use leads to lowered sexual inhibition and increased likelihood of unsafe sex
Depression
Young gay males especially with a history of sexual abuse
The Internet (personal advertisements and chat rooms like Gaydar, Mambaonline etc). Studies have found that gay men who use the internet as a means to find sex partners are more likely than other men to report an STD and are more likely to engage in risky sexual behaviour.
3 Socio-Cultural Risk Factors
Experience and perceptions of homosexual stigma and discrimination
Homophobia
Racism
Internalized oppression and denial of ones sexuality
Drug and alcohol usage
Poverty / Unemployment / Lack of Health Care Access. In
Optimism about the availability en efficacy of HIV therapies (ARVs) has been associated with sexual risk behaviour especially in younger gay males. This reduces the individuals concerns about becoming infected and rationalises unsafe sexual practices.
HIV Prevention Interventions and the future
There are 3 main areas of prevention of transmission and infection:
1 Behavioural Interventions
· Encouraging condom usage
· Encouraging safe sex rituals
2 Early detection and treatment of STDs
3 Biomedical approaches (THE FUTURE)
· Pre-exposure prophylaxis (PrEP)
· Rectal Topical Micro biocides (Non-Oxynol 9 Formulations etc) and Douching
· Vaccines
NB However, the introduction of vaccines could intensify the epidemic if risky sexual behaviour increases as a result of the perception that vaccines give total protection from HIV infection.
How do I test for HIV?
· Tests for presence of HIV antibodies in the bloodstream
· Will test negative in the “Window” period before seroconversion
· Individuals become HIV antibody positive around 3 weeks to a month after exposure.
· Less expensive (Around R80 - State Hospital Rates)
· Replicates and multiplies HIV DNA
· Can identify HIV even within the “Window” period
· Individuals become HIV DNA positive around day 12 after exposure
· More expensive (Around R400 - State Hospital Rates)
Conclusion
There is a great deal of scientific evidence supporting the effectiveness of HIV prevention interventions for homosexual men. Despite these interventions, recent increases in HIV diagnoses indicate that those prevention efforts have not been scaled up and intensified sufficiently to curb the spread of HIV infection in gay domestic and the gay international population.
Difficulties in collecting accurate data on HIV infection in gay males in
Adequate resources must be dedicated to improving accurate data collection, addressing the socio-cultural issues that contribute to gay male risk sexual behaviour, and implementing evidence-based behavioural, biomedical, and social interventions that address growing rates of HIV infection in multiple settings.
This information was made available with the help of my esteemed colleague Dr Craig Corcoran, a Consultant at the Medical Virology Department at
Wednesday, January 6, 2010
Poppers
Poppers – Genie in a Bottle
“Once u let the genie out of the bottle it’s pretty difficult to put him back”
This is the first in a series of articles I will be writing on recreational drug use. As we all know it is a controversial subject and as we all know as well everyone of use have either used it or knows someone that does. These articles do not promote or condemn the use of drugs - that you may decide for yourself, it merely gives you the facts in order to be informed of what’s out there.
We will be publishing our articles on our facebook group, our blog site as well as other relative news and information sites. You are welcome to submit your questions to us on either facebook or email us on medicape.david@gmail.com
I have had a few freaky calls the last few months from weird and wonderful gay men around
For this article I decided to stay focused and still ponder on gay sex issues by doing some research on poppers.
What is this hype about “poppers”? Well that was where my journey started. I realized that a lot of gay people around
Well boys and girls take a deep breath (pardon the pun!) and pick up those reading glasses.
What Is Poppers?
Facts:
· Also known as Amyl Nitrate and Butyl Nitrate
· Sold in the past as “room deodorizers” / “Incense”
· Chemically related to laughing gas (nitrous oxide) used in anesthetics
· It is a clear, yellow, volatile and inflammable liquid
· Has it’s effect once in transition to its volatile form when inhaled / sniffed
· It is an unstable chemical that decomposes when exposed to light, heat and oxygen
· Usually found in an amber / brown bottle (12mL screw top) for protection against light and oxygen - thus preserving drug integrity
· Must be stored in a cool, dark location (ex fridge) for protection against heat
· Sweet smell when fresh and unpleasant “moldy socks” smell when stale
· Abused because it is readily available and inexpensive
Retail Names:
General poppers brands available in
Rush / Man Scent / Jungle Juice
Others:
Jolt / Locker Room / Jack Hammer / Bullet / Heart-On
Definition of an Inhalant:
An inhalant is a breathable chemical that produces psychoactive (mind-altering) vapors.
History of Amyl Nitrate:
Amyl Nitrate was a prescription item used in patients with angina pectoris (heart pains associated with a heart attack). The ampoule was to be broken which made a snapping / pop sound (hence the nickname “poppers”) and sniffed / inhaled. This then dilated vessels surrounding the heart relieving the pain. Newer nitrates for heart disease are in the form of Isosorbide dinitrate (Isordilâ), a tablet you put under the tongue when someone is experiencing angina / heart attack.
The above leads us to the believe that a bottle of poppers should be kept handy whenever someone is having a heart attack - let them have a sniff…
The ban on amyl quickly became ineffective when an enterprising gay medical student in
What are the feelings, effects and side effects when inhaling / sniffing poppers?
Inhaled nitrates may be the nearest thing to a true aphrodisiac. One sniff leads to an almost immediate effect that lasts a few minutes. Typically, just long enough to facilitate penetration or terminate in ejaculation.
They are:
1 Blood Vessel Dilatation
Body:
® Drop in blood pressure ® Palpitations (Reflex tachycardia)
® Flushed face, neck and chest ® Warm, blushing sensation
® Temporary loss of erection
It's funny that, for a drug so associated with sex, poppers dilate the blood vessels in the penis as well, making erection difficult.
Mind:
® Rush of blood to brain (the “rush” feeling)
® Headaches
® Intensification current positive emotions
® Increasing lust decreasing inhibition, thus encouraging a sense of raw animal sexuality
® Dizziness
® Nausea and vomiting
® Decreased pain perception
2 Muscle Relaxation
Body:
® Making anal intercourse easier (also secondary to the decrease in pain sensation)
3 Other
The blood cells:
® Transient cyanosis (blueness) and paleness. This happens by nitrates changing the structure of red blood cells’ hemoglobin molecules (also known as methemoglobinemia)
Why is Poppers Used in the Sexual Setting:
The three fazes:
1 Foreplay:
Poppers make you less inhibited and more sexual
2 Penetration:
Poppers facilitate penetration by enhanced perception and feeling of both being filled and being grasped; anal penetration becomes easier, probably from a combination of muscular relaxation and decreased pain perception.
3 Orgasm:
When poppers are inhaled shortly before orgasm, the user may experience a sense of exhilaration and acceleration, a freeing of inhibition of movement and vocalization (for the screamers and moaners out there! even for those more inhibited), and perception of orgasm as prolonged, intense and exalted.
How do poppers work?
The nitrate portion of the molecule is what affects you, regardless of what organic molecule (amyl, butyl etc) it's attached to. The effects are the same regardless. It is not physically addictive but mentally. The chemical dissembles in the blood stream too quickly after inhalation to cause physical addiction. It has got similar effects to anesthetics, which act to slow down body functions. At low doses, users may feel slightly stimulated; at higher amounts, they may feel less inhibited, less in control; at high doses, a user can lose consciousness.
Important points and dangers of poppers use?
· The effects of poppers may be increased when used with others drugs like alcohol, ecstasy (“e”) and amphetamines (“Tik”, “Crystal” etc).
· The use of Viagra® with Poppers can be fatal because of dramatic fall in blood pressure.
· Because poppers cause blood vessel dilatation in rectum and anus, it is more likely to bleed. Safe sex should always be practiced.
· People with heart problems should not use poppers, and it's widely agreed that people with suppressed immune systems (for example HIV positive patients) should avoid them as well.
· All forms of poppers are highly flammable; don't use them if you're smoking or have a fireplace or candles nearby.
· The fluid can burn the skin (and mucous membranes of the nose) if you're not careful.
· Nitrates are harmful if swallowed and can be fatal. Statistics show no known deaths from inhalation. It would seem that even heavy inhalation usage has a very wide margin of safety. Ingestion / injection are a different matter and death occurs by methemoglobinemia.
· Tolerance develops if used too often (like with any drug / medicine) and more and more will need to be used to have the same effect. So remember boys, use in moderation!
· It is not illegal to sell poppers but persons must be over the age of 18. In some countries like
Long Term Poppers Use and its Complications:
· Weight loss
· Fatigue
· Electrolyte (salt) imbalance
· Blood abnormalities (suppression of the immune system, anemia etc)
· Repeated sniffing of concentrated vapors over a number of years can cause permanent damage to the nervous system, which means greatly reduced physical and mental capabilities. In addition, long-term sniffing of certain inhalants can damage the liver, kidneys, blood, and bone marrow.
What Happens When Inhalants are used Along with Other Drugs?
As in all drug use, taking more than one drug at a time multiplies the risks. Such drugs are tranquilizers, sleeping pills or alcohol. Using inhalants whilst taking other drugs that slow down the body's functions leads to an increased risk of death from overdose. Loss of consciousness, coma, or death can result.
Safe Sex, HIV, STDs and Poppers (Also Other Drugs)?
Poppers suppress inhibition so be careful. Safe sex is always advised.
The Conclusion:
Poppers can be highly addictive mentally. It enhances the sexual experience and pleasure. People find the drug a welcome stimulant and become so dependent on them that they cannot climax any other way. They who have tried poppers in the past say it takes a lot of self-discipline and self-restraint for them to control how "nice" they made their orgasm feel. Many gay men who use it find they're no longer able to enjoy sex without them. Some can't even jack off without it! The mental effects’ mode of action is not fully known.
For further information type in the word poppers on Google or any internet search engine and you will find more than three million articles to your disposal. It is a fascinating read.
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