Poll shows Kentucky health-care providers often fail to discuss HIV testing with patients

A new poll suggests that most Kentucky health-care providers follow guidelines for discussing HIV screening with their patients, despite the the importance of early treatment to prevent its progression to AIDS.

Although the Centers for Disease Control and Prevention recommends routine HIV screenings for most patients, just 32 percent of Kentucky adults aged 18 to 64 report discussing HIV testing with their medical provider, according to the Kentucky Health Issues Poll.

About 40 percent of Kentucky adults reported they had never been tested for HIV. It’s estimated that 4,500 Kentuckians are living with HIV infection and it is estimated nationally that one in five people who have HIV do not know they do.

“It made headlines earlier this month when a little girl - the second person in history - was cured of HIV. As exciting as this development was, for most people, HIV remains a life-long condition that must be managed through medication to keep it from progressing to AIDS. The CDC’s recommendations are meant to improve the overall population health by detecting HIV so treatment can begin,” said Dr. Susan Zepeda, president and CEO of the Foundation for a Healthy Kentucky, which co-sponsored the poll.

“It appears that Kentucky providers are either not adhering to the routine screening recommendations or not communicating this message clearly to patients,” she said.

The poll, co-sponsored by the Health Foundation of Greater Cincinnati, was taken Sept. 20 through Oct. 14 by the Institute for Policy Research at the University of Cincinnati. A random sample of 1,680 adults throughout Kentucky was interviewed by landline and cell telephones. The poll's margin of error is plus or minus 2.5 percentage points

Do Tattoos Increase Your Risk Of Cancer?

Tattoos have become increasingly popular over the last decade, as more and more people choose to have important symbols or meaningful images or words tattooed on them, but do they increase the risk of health problems, including cancer?

Tattoos and skin cancer

The case for

Tattoos have been linked to an increased risk of infection as a result of breaking the skin, but some health experts believe that they also increase the risk of skin cancer. Dr DJS Tula, a consultant cosmetic surgeon at the BLK Hospital in Delhi, India, said that tattoos can increase the risk of blood-borne infections, including hepatitis B and C and HIV, as well as types of skin cancer including squamous cell, melanoma and carcinoma. Dr Tula added that having a tattoo does not mean that you are going to get skin cancer, but the risk is elevated because of the ink used to create the design.

Dr Tula also added that tattoos should never been done close to moles because they make it difficult for people to spot changes in the appearance of the mole, which are a common symptom of skin cancer.

Studies published in the USA have also prompted an investigation into the chemical make-up of tattoo ink by the US Food and Drug Administration. Studies showed that some of the chemicals, including black ink benzo(a)pyrene, have been found to cause skin cancer during animal testing.

The case against

In contrast, Dr Ariel Ostad, a dermatologist and surgeon from New York, said that skin experts have been researching the impact of tattoos on the skin for several years and there is no evidence to suggest that tattoos increase the risk of skin cancer. Research involving people who have the condition has not uncovered greater prevalence of skin cancer among people with tattoos and there is also no evidence to suggest that having a tattoo after receiving treatment for skin cancer increase the risk of relapse.

Dr Ostad did support Dr Tula's comments about avoiding tattoos close to moles, stating that tattoos can mask the visible changes in the skin, which may prevent skin cancer from being diagnosed early. Early diagnosis increases survival rates significantly. Dr Ostad's advice was to leave a suitable gap around any moles to ensure that any changes are clearly visible and can be identified without any trouble.

Risk factors for skin cancer

The most important risk factor for skin cancer is sun exposure. Research also suggests that people who have fair skin have a higher risk. If you are going outside, apply sun cream (if you have fair skin that burns easily use a high factor), wear a sun hat and avoid the hottest part of the day (between 11am and 3pm). Avoid using sun beds and tanning lamps, as these use powerful UV rays and increase your risk. If you want a healthy golden glow, use self-tanning products.

Caring for tattooed skin

According to the American Academy of Dermatology, newly tattooed skin is very sensitive and you should take extra care when bathing and going out in the sun. It is also important to keep an eye on your skin and to seek medical help if you notice irritation and rashes around the tattoo. The AAD also recommended avoiding moles when choosing a location for the new tattoo and seeing a dermatologist if you notice any changes in the skin around the tattoo.

The relationship between tattoos and skin cancer is unclear. Some experts believe that tattoo ink can increase one’s risk of the condition but then others say that there is no link Further research in this area is being carried out and new evidence may become available in the coming months or years to either refute or support the claim that tattoos increase the risk of cancer.

By Richard Keane

Kentucky Parent Survey: We could do a lot better on school meals, we're very much in favor of more health education

Fewer than 10 percent of Kentucky
parents report that their child has ever
walked or biked to school.

When asked, only about one in four Kentucky parents describe the meals served at their child's schools or day care centers as being nutritious. Fewer than 10 percent report that their child have ever walked or biked to school. And an overwhelming majority want information about sexually transmitted infections, human anatomy, abstinence education, birth control methods and condom use taught in Kentucky's high schools.

These are just a few of the surprising results from the first Kentucky Parent Survey conducted by the Foundation for a Health Kentucky, a random telephone survey of 1,006 parents of children under 18. The survey assessed the views of parents, step-parents, grandparents, foster parents and other legal guardians of children in Kentucky. The term "school" was used broadly in the survey as included (2 percent of total surveyed), as well those in pre-school and day care. The study took on nutrition, physical activity and health education.

Eighty-eight percent of parents reported that it was "very important" that meals at schools meet a minimum standard for nutritional value. Only about 1 in 4 parents currently thought their schools were meeting that standard. Only 11 percent are concerned that their younger children are getting too many "celebration-related" treats at their school.

While parents in the state reported that a little more than half (52 percent) of school-age children took physical education classes, that class was not a daily occurrence but met between one and four times a week. Only about 1 in 3 students took a daily course in P.E. That leaves 14 percent without a planned daily class during the school year.

On the topic of health education, parents reported that half of school-age children in the state took health classes, but again not daily. According to the FHK, "The Kentucky Parent Survey included a series of questions about dating relationships and sexual health to determine support for covering those topics...
At the middle school level, more than 8 in 10 parents would favor teaching communication skills (99 percent), human anatomy (91 percent), abstinence education (85 percent), and information about HIV and sexually transmitted infections (84 percent). At the high school level, more than 8 in 10 would favor teaching communication skills (99 percent), information about HIV and sexually transmitted infections (97 percent), human anatomy (97 percent), abstinence education (94 percent), birth control methods (87 percent), and condom use (84 percent)."

Future reports in the FHV series will address access to safe and effective health care for children, children's health behaviors and family routines and the places where parents turn for information on raising healthy kids.

Sexting Risky For Teen Sexual Behavior

If your adolescent is sexting, they may be already sexually active and engaging in risky behavior, a new study suggests.

Researchers are trying to better understand if young people are at greater risk for HIV or other sexually transmitted diseases because they are sending sexually explicit photos or text messages via cell phones.

"Sexting" is not an alternative to "real world" sexual behavior among adolescents, according to a new study published Monday in the journal Pediatrics.

"The same teens who are engaging in digital sex risk taking through sexting are also the same teens that are engaging in sex risk with their bodies in terms of being sexually active and not using condoms," said lead study author Eric Rice, an assistant professor at the University of Southern California's School of Social Work in Los Angeles.

A 2009 report from the Pew Research Center found that some teens "view sexting as a safer alternative to real life sexual activity."

While the term "sexting" may also include messages also sent over the Internet, this particular study looked solely at cell phone text messages and images. It was conducted via questionnaire in the Los Angeles Unified School District. Researchers surveyed 1,839 students ages 12 to 18 at random. Most were Latino or African-American. Three-quarters of those surveyed had cell phones.

"Even though a minority of teens sext we only found 15% but that 15% are much riskier with their physical sexual behaviors as well as their digital sexual behaviors," says Rice.

He add that teens who reported sexting were seven times more likely to be sexually active than their peers who did not sext.

The data suggests there are norms about sexting, according to Rice, meaning teens are starting to think that sexting is a normal part of their behaviors. More than half of the teens surveyed reported that they had a friend who sexted.

"A lot of young people think that their friends are sexting, and if you think that your friends are sexting, you're much more likely to sext yourself," he said 17 times more likely, according to study.

"I think that the implications are that teens who are sexting may be at greater risk for sexually transmitted diseases because the teens who sext are about 1.5 times more likely to not use condoms when they're having sex," in addition to increasing the risk of teen pregnancy, Rice says.

This study was conducted in only one urban area; the authors realize that some of the results may not accurately represent rural areas. In addition, recent nationwide research found much lower rates of sexting.

However, Rice said this information can be valuable for parents.

"We [parents, clinicians, educators] should be talking about sexting and the fact that it's part of the risky sex behaviors and it's not just something that exists in a virtual space, so to speak," he said.

"Talking about sexting might be easier for [parents] than talking about sex and it could lead into a larger conversation about sex."

By Georgiann Caruso, CNN

More breakthroughs lately in fight against HIV/AIDS

It has been an inspiring season of breakthroughs in the fight to prevent the spread of HIV and AIDS. Earlier this week, the Food and Drug Administration approved the pill Truvada, "a preventive measure for healthy people who are at high risk of acquiring HIV through sexual activity, such as those who have HIV-infected partners," reports Matthew Perrone for The Associated Press.

Just two weeks ago, the agency also approved the first over-the-counter HIV test that can be used at home. "I think the combination of self-testing and a medicine that you can take at home to prevent infection could mean a whole new approach to HIV prevention that is a bit more realistic," said Dr. Demetre Daskalakis of New York University's Langone Medical Center.

In the meantime, a research team at the University of Nebraska Medical Center is making progress to develop a weekly or twice-monthly injection that would help manage patients with HIV. The long-acting injection "would be a substantive improvement over daily and sometimes more complex regimen of pills," lead investigator Dr. Howard Gendelman told research-reporting service Newswise.

"We actually followed the process exactly as we would with a person — and it worked," he said. "This is all very exciting. Although there are clear pitfalls ahead and the medicines are not yet ready for human use, the progress is undeniable." (Read more)

FDA approves fast, take-home test that detects HIV

A model demonstrates how to use the OraQuick test, which
detects the presence of HIV in saliva.
AP photo by Chuck Zovko.

Soon, taking an HIV test will be no more complicated than swabbing one's mouth and waiting for the results. The Federal Food and Drug Administration last week approved the OraQuick test, which detects HIV antibodies and gives a result in 20 to 40 minutes. 

Orasure plans to start selling the test in October at local pharmacies and online, reports Matthew Perrone for The Associated Press. It is expected to cost less than $60 but more than the one used by health professionals, which costs $17.50.

About 240,000 of the 1.2 million people who are suspected of carrying the HIV virus don't know they are infected. 

The FDA says the test is not 100 percent accurate, but a trial conducted by Orasure showed it only detected HIV in people who have the virus 92 percent of the time. It was 99.9 accurate ruling out HIV in people not carrying the virus. People who test negative should re-test after three months because it can take time for the HIV antibodies to appear. (Read more)

Pharmacies to offer free HIV tests as part of pilot program; no Ky. locations chosen yet

Getting tested for HIV may soon be as easy as going to the pharmacy to get a flu shot or blood pressure check. Pharmacies in 24 cities and rural communities will offer rapid HIV tests free of charge as part of a $1.2 million program. Testing is already available in Washington, D.C., Oakland, Calif., and an Indian health service clinic in Montana. The remaining 17 locations will soon be chosen by the Centers for Disease Control and Prevention.

The test involves swabbing the inside of a person's mouth and preliminary results take about 20 minutes. Makers of the test say it is accurate 99 percent of the time. "If the test is positive for the AIDS virus, pharmacy employees will refer customers to a local health department or other health care providers for a lab blood test to confirm results, counseling and treatment," The Associated Press reports. "The workers are expected to deliver the news face-to-face and give customers privacy."

According to the CDC, there are about 1.1 million Americans who are infected with HIV, but up to 20 percent of them don't know they have it. Since 2006, the CDC has recommended all Americans ages 13 to 64 get tested at least once, but fewer than half of adults under the age of 65 have done so. (Read more)

Check HIV status Pregnant women Advised

A mother living with HIV has advised pregnant women to go for Voluntary Testing and Counselling (VTC) to know their HIV status to help protect their unborn babies against HIV infections.

She said if she had taken advantage of such an opportunity, she would have protected her child from getting infected.

The 32-year-old mother was speaking at a programme on prevention of HIV as part of a behavioural change project, organised by the Technical Support Unit of the Ghana AIDS Commission in the Eastern Region for students of the Victory Vocational Institute in Koforidua.

The programme was aimed at protecting the students against HIV infection.

She said she was a strong woman who never knew her HIV status until she gave birth to her first child about four years ago.

The woman said 10 months after delivery, her baby developed a boil under the armpit and was taken to hospital but after several treatments without success, the medical officer called for HIV test and the baby was found to be HIV positive.

She was also encouraged to take the test which later proved positive.

She encouraged all women to know their HIV status so that they could seek early treatment and protect their children and the future generation from HIV infections.

Ms Golda Asante, Technical Co-ordinator of the Ghana AIDS Commission, in charge of the Eastern Regional branch, advised the students to concentrate on their education and avoid going to town without permission to engage in activities that could expose them to acquiring HIV.

She said the target of the Eastern Regional branch of the commission was to achieve zero infection of HIV and the total elimination of mother-to-child transmissions.

The woman informed the students that they could access VTC on HIV in all government hospitals in the region and those who test positive could be put on the Anti-Retroviral Therapy to sustain them for the rest of their lives.

More Americans dying from hepatitis C than from AIDS

More people are dying in the U.S. from hepatitis C than from AIDS, a new report from the Centers for Disease Control and Prevention says. More than 3.2 million Americans have the hepatitis virus, which can cause chronic infection of the liver and eventually lead to liver failure.

Hepatitis C death rates climbed to almost 5 per 100,000 in 2007, from fewer than 3 per 100,000 in 1999. In the same time period, the HIV-AIDS death rate dropped to slightly more than 4 per 100,000 from more than 6 per 100,000.

"The declines in HIV reflect the accomplishments in building a public health response to the epidemic that improved screening and provided means of access to effective treatment," said Dr. John W. Ward, director of the Division of Viral Hepatitis at the CDC and author of the study. A similar program for hepatitis C would be similarly helpful, he said.

The disease is most commonly spread by exposure to infected blood. Intravenous drug abuse is the most common method of transmission, reports MedicineNet.com.

Ward said there is now a treatment "that was about 70 effective at clearing the virus from the body, but, he said, most infected people are unaware of their condition and do not receive treatment," reports Nicholas Bakalar for The New York Times. (Read more)

Get tested, get treatment, Bluegrass HIV Coalition encourages

Today is World AIDS Day and health advocates are asking Kentuckians to get tested and get treatment.

Hundreds of Kentuckians are diagnosed with AIDS each year, reports Mary Meehan of the Lexington Herald-Leader. Minority populations are hit particularly hard, with black men nearly 10 times more likely to die of AIDS than non-Hispanic white men. Black women are almost 23 more times more likely to die from the infections, compared to non-Hispanic white women.

Though people are still dying, AIDS is not a widely-discussed disease, in part because of its past association with homosexual activity. Mark Johnson, member of the Bluegrass HIV Coalition, said AIDS can be hard for people to talk about.

In addition, the infection is often seen as treatable, in part because of people like Magic Johnson, who has had the infection more than 20 years but is still in good health. What people don't see "is the often expensive regimen of drugs that is needed to keep the worst of the disease at bay, the side effects of those medicines or the ultimate end of what is still an incurable disease," Meehan reports. (Read more)

Dec. 1 is World AIDS Day; 1.2 million Americans are thought to be infected, but only 1 in 5 know it

Friday is World AIDS Day, an opportunity to learn the facts about the virus and show support for people living with it.

In the United States, there are 1.2 million people living with the HIV infection, which leads to AIDS. Of those who are infected with the virus in the U.S., only one in five know they have it, the Centers for Disease Control and Prevention report. Each year, about 50,000 Americans become infected. About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009; Kentucky ranks 19th in the country for the number of people who have the HIV infection.

Since the epidemic began, nearly 594,500 people have died with AIDS in the U.S. Between 1981 and 2007, more than 25 million people have died from the virus around the world.

Secretary of State Hillary Rodham Clinton spoke of the epidemic in a Nov. 8 address at the National Institutes of Health. "The fight against AIDS began three decades ago in June 1981. American scientists reported the first evidence of a mysterious new disease," she said. "Thirty years later, we ... know a great deal about the virus itself. We understand how it is spread, how it constantly mutates in the body, how it hides from the immune system. And we have turned this knowledge to our advantage."

Most at risk are gay, bisexual or other men who have sex with men. The CDC estimates that though this population accounts for just 2 percent of the U.S. population, it accounted for 61 percent of all new HIV infections in 2009. But heterosexuals and people who inject drugs can also contract the disease. Heterosexuals account for 27 percent of new cases. Another 9 percent of people who contracted the virus did so by using injected drugs.

Blacks accounted for 44 percent of new HIV infections in 2009, though they only represent 14 percent of the U.S. population. In 2009, the rate of new infection was 6.5 times greater for black men than it was for white men.

People can now be tested for the infection using a saliva sample and have the results in just 15 to 20 minutes. To find an HIV/AIDS prevention and service provider by county, click here.

Monday, June 27 is National HIV Testing Day

Kentuckians are being encouraged to find out their HIV status on Monday, June 27, National HIV Testing Day.

About 1,700 Kentuckians were diagnosed with HIV between Jan. 1, 2005 and Dec. 31, 2009. About 1 in 3 Kentucky adults under the age of 65 have been screened for HIV, the Foundation for a Healthy Kentucky notes. Christian, Hopkins and McLean counties have the highest rate of HIV testing, with 45 percent of adults being tested. Montgomery County has the lowest rate at 24 percent. For more county-specific information, click here.

The earlier that HIV is discovered, the better the treatment works, but early detection is not commonplace in Kentucky. By the time they are tested for HIV, 30 percent of Kentuckians already have full-blown AIDS. Though at one time 100 percent of Kentuckians infected with HIV died within five years, now 82 percent are alive after the same time period.

Kentucky ranks 19th in the country for the number of people who have the HIV infection that leads to AIDS. "Health officials say that at least one new HIV infection is discovered each day in Kentucky," Mary Meehan of Lexington Herald-Leader recently reported. National HIV Testing Day was founded by the National Association of People Living with AIDS in 1995. To find a testing site, click here.

Number of HIV/AIDS cases is increasing in Louisville area

The number of newly diagnosed AIDS and HIV cases in Louisville is increasing even as the fear of the deadly disease wanes. The number of newly diagnosed cases in Jefferson County rose from 80 in 2005 to 107 cases in 2008, The Courier-Journal's Laura Ungar reports. The number of new HIV cases increased from 136 cases to 154 in the same period.

"People think it's a disease of the past. Unfortunately it's very much alive," said Janet Mann, director of program development for AIDS Interfaith Ministries of Kentuckiana.

"People think: All I have to do is take a few pills every day. But it still kills people ... and it affects quality of life," said Bobby Edelen (left, by C-J's Kylene Lloyd). Edelen has lived with the disease that causes AIDS for 21 years. "Every day is not a picnic."

Complacency, drug use and lack of education are causing the numbers to increase, health officials say. But while numbers rise, there is less money to deal with the growing need. HIV/AIDS funding to the Kentucky Department of Public Health dropped from $11 million in 2008 to $9.4 million in 2010.

There is still no cure for HIV/AIDS, but there is medicine that can "keep people somewhat healthy by preventing the virus from reproducing or by blocking it from entering cells," Ungar reports. But people respond to medicine in different ways. "Taking meds for HIV is similar to cancer patients taking chemotherapy. Some are able to take it. Some are deathly sick," Edelen said. (Read more)