Updated fact sheets, Kaiser Family Foundation: The fact sheets provide information about the impact of HIV/AIDS on blacks, Latinos and women in the U.S. Each fact sheet includes data about trends and current cases, as well as population-specific information on HIV transmission patterns and access to care (Kaiser Family Foundation release, 5/12).

• Although Black Americans represent only 12% of the U.S. population, they account for half of AIDS cases diagnosed in 2006. Blacks also account for a disproportionate share of HIV/AIDS diagnoses in states/areas with confidential name-based HIV reporting.
• The AIDS case rate per 100,000 among Black adults/adolescents was more than 9 times that of whites in 2006. The AIDS case rate for Black men (82.9) was the highest of any group, followed by Black women (40.4). By comparison, the rate among white men was 11.2.
• HIV-related deaths and HIV death rates are highest among Blacks. Blacks accounted for 56% of deaths due to HIV in 20043 and their survival time after an AIDS diagnosis is lower on average than it is for most other racial/ethnic groups.1 In 2004, Black men had the highest HIV death rate per 100,000 men aged 25–44 at 39.9; it was 5.5 for white men. The HIV death rate among Black women aged 25–44 was 23.1 compared to 1.3 for white women.
• HIV was the 4th leading cause of death for Black men and 3rd for Black women, aged 25–44, in 2004, ranking higher than for their respective counterparts in any other racial/ethnic group.

2008 Fact Sheets

Blacks & HIV/AIDS
http://www.kff.org/hivaids/upload/6089_05.pdf

Latinos & HIV/AIDS
http://www.kff.org/hivaids/upload/6007_05.pdf

Women & HIV/AIDS
http://www.kff.org/hivaids/upload/6007_05.pdf

Source
Kaiser Daily HIV/AIDS Report - Tuesday, May 13, 2008
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=52095

http://posornot.com/

Kaiser Daily HIV/AIDS Report

mtvU, MTV's college network, and the Kaiser Family Foundation, in partnership with POZ Magazine, on Wednesday unveiled "Pos or Not," an online game that aims to confront HIV/AIDS stereotypes and overcome obstacles that prevent people from talking openly about the disease, Reuters reports (Reuters, 4/30). In the game, which also seeks to break down barriers that keep people from getting tested for HIV and using protection, players must decide whether a profiled participant is HIV-positive or negative based on a photo and a few personal details. HIV-positive participants share when they first learned their HIV status, and HIV-negative participants talk about how they have been affected by the disease. The game also provides information about HIV prevention, as well as local HIV and sexually transmitted infection resources from CDC (Kaiser Family Foundation release, 4/30).

The "Pos or Not" campaign, which was inspired by a nationwide competition asking college students to create a web-based game on the topic, is supported by several celebrities, including Wyclef Jean, Fall Out Boy, Will.i.am, Alyssa Milano, Say Anything, Perez Hilton, Angels & Airwaves, Atmosphere, The Spill Canvas, 30 Seconds to Mars, Aesop Rock, Motion City Soundtrack, All Time Low and Rise Against (Reuters, 4/30). Representatives from mtvU and the Kaiser Family Foundation will be presenting "Pos or Not" at the fourth annual Games for Health Conference on May 8-9 in Baltimore (Kaiser Family Foundation release, 4/30).

Source
Kaiser Daily HIV/AIDS Report - Thursday, May 1, 2008
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=51856

"In the United States, more than 65 million people are currently living with an incurable STD. An additional 15 million people become infected each year."
—Center for Disease Control

* It is important to note that this is not just a case of medical science diagnosing what has existed all along. These are NEW diseases, caused by sexual activity with multiple partners. Viruses continue to mutate and multiply, all the while becoming more resistant to treatment.

Statistics

* 1 in 5 Americans has been infected with an STD (American Social Health Association).

* The fastest growing population contracting AIDS is women. In 1985, 7% of AIDS cases reported were women. That percentage increased to 14% in 1992, and to 23% in 1999 (AIDS.ORG).

* Sexually active adolescent girls have the highest risk of cervical infections because the ectropion, or delicate tissue that surrounds a young woman's cervix, is not fully formed until she is 18 years old. It is, therefore, very vulnerable to blood borne infections (Alan Gutmacher Institute, 1994).

* Approximately 2/3 of all people who acquire STDs are under 25 (American Social Health Association).

* PID or Pelvic Inflammatory Disease is the most rapidly increasing cause of infertility in the United States. Researchers have estimated that a sexually active 15-year-old has a 1 in 8 chance of developing PID. By the age of 24, the probability decreases to 1 in 80 (The Medical Institute).

* In the United States, more than 65 million people are currently living with an incurable STD. An additional 15 million people become infected each year (ibid).

* In 1999, reports indicated that strains of Human Papilloma Virus (HPV) were present in 99% of samples tested for cervical cancer. It is estimated that 75% of sexually active Americans are or have previously been infected with HPV (The Medical Institute).

* While almost all STDs can be treated to relieve pain or minimize symptoms, there is no cure for viral STDs, including Human Papilloma Virus (HPV), Human Immunodeficiency Virus (HIV), and Herpes (ibid).

The Most Common Sexually Transmitted Diseases

There are over 30 common STDs.
http://www.carenetabq.org/stdchart.html

Prevention

Abstaining from sex is the only way to be 100 percent confident of avoiding STD infection. Prevention through avoiding exposure is the best strategy for controlling the spread of sexually transmitted diseases. Proper use of condoms with each act of sexual intercourse can reduce, but not eliminate, risk of STDs.
(Center for Disease Control and Prevention)

Condoms provide the best (though not complete) protection against HIV and Gonorrhea. They are less effective protecting against Herpes type 2 and Chlamydia. Condoms provide little protection against bacterial vaginosis and HPV (the most common STD).
(Cates, W. Jr & Stone, K.M. (1992, March/April). Family Planning, Sexually Transmitted Diseases and Contraceptive Choice: A Literature Update- Part I. Family Planning Perspectives, 24(2), 75-84)

Condoms must be used consistently and correctly each time to protect against infection.

Source:
CareNet Pregnancy Center of Albuquerque, http://www.carenetabq.org/stds.shtml

Only about half of the girls in the study acknowledged having sex. Some teens define sex as only intercourse, yet other types of intimate behavior including oral sex can spread some diseases. Among those who admitted having sex, the rate was even more disturbing — 40 percent had an STD. “Those numbers are certainly alarming,” said sex education expert Nora Gelperin, who works with a teen-written Web site called sexetc.org. “Sexuality is still a very taboo subject in our society,” she said. “Teens tell us that they can’t make decisions in the dark and that adults aren’t properly preparing them to make responsible decisions.”

Cecile Richards, president of Planned Parenthood Federation of America, said the study shows that “the national policy of promoting abstinence-only programs is a $1.5 billion failure, and teenage girls are paying the real price.” Similar claims were made last year when the government announced the teen birth rate rose between 2005 and 2006, the first increase in 15 years. The overall STD rate among the 838 girls in the study was 26 percent, which translates to more than 3 million girls nationwide, the CDC said.

The study by CDC researcher Dr. Sara Forhan is an analysis of nationally representative data on 838 girls aged 14 to 19 who took part in a 2003-04 government health survey. Teens were tested for four infections: human papillomavirus, or HPV, which can cause cervical cancer and affected 18 percent of girls studied; chlamydia, which affected 4 percent; trichomoniasis, 2.5 percent; and genital herpes, 2 percent. Dr. John Douglas, director of the CDC’s division of STD prevention, said the results are the first to examine the combined national prevalence of common sexually transmitted diseases among adolescent girls. He said the data likely reflect current prevalence rates. HPV can cause genital warts but often has no symptoms. A vaccine targeting several HPV strains recently became available, but Douglas said it likely has not yet had much impact on HPV prevalence rates in teen girls.

Chlamydia can cause an abnormal discharge and painful urination, but often has no symptoms. Signs of trichomoniasis are similar, and both diseases can be treated with antibiotics. Genital herpes can cause blisters but also is often symptomless. It can’t be cured but medicine can help. The CDC recommends annual chlamydia screening for all sexually active women under age 25. It also recommends the three-dose HPV vaccine for girls aged 11-12 years, and catch-up shots for females aged 13 to 26. The CDC’s Dr. Kevin Fenton said that given the potential complications from STDs, “screening, vaccination and other prevention strategies for sexually active women are among our highest public health priorities.” Douglas said screening tests are underused in part because many teens don’t think they’re at risk, but also, some doctors mistakenly think: “Sexually transmitted diseases don’t happen to the kinds of patients I see.”

Teens need to hear the dual message that STDs can be prevented by abstinence and condoms — and hear them often, said Dr. Ellen Kruger, an obstetrician-gynecologist at Ochsner Medical Center in New Orleans. “You’ve got to hammer at them,” with appropriate information at each stage of teen development to make sure it sinks in, she said. She said there are a lot of myths out there, too — many sexually active teens think the withdrawal method will protect them, or that douching with Coca-Cola will kill STD germs. Dr. Margaret Blythe, an adolescent medicine specialist at Indiana University School of Medicine, said some doctors hesitate to discuss STDs with teen patients or offer screening because of confidentiality concerns, knowing parents would have to be told of the results. Blythe, who heads an American Academy of Pediatrics committee on adolescence, noted that the academy supports confidential teen screening.

Source:
1 in 4 teen girls has at least one STD
Virus that causes cervical cancer most common, government study finds
The Associated Press
updated 12:32 p.m. ET, Tues., March. 11, 2008

GET EDUCATED. GET TESTED. GET INVOLVED. GET TREATED.

Favorite Quote
"Let the choices you make today be choices you can live with tomorrow."

It's imperative that you know your status and GET TESTED TODAY!!

Even though African Americans represent only 13 percent of the U.S. population, look at the statistics:
* 49 percent of all new cases of HIV/AIDS in 2005.
* AIDS is now the leading cause of death for African American women ages 25 to 34.
* It is the second leading cause of death for African American men ages 35 to 44.
* Most African American women (74 percent) living with HIV/AIDS in 2005 were infected through heterosexual contact.
* Almost half (48 percent) of all African American men living with HIV/AIDS in 2005 are men who have had sex with men.
* Another 23 percent of men were infected through injection drug use.
* Blacks with AIDS often don’t live as long as people of other races and ethnic groups with AIDS.

If you do not know if you are infected with HIV, you could be spreading it to others. If you are HIV-positive, you must take steps to prevent passing your HIV infection to another person. If you find out that you have HIV, it does not mean that you are going to get sick and die. While there is no cure for HIV, new drugs are available that can help you stay healthy and decrease the amount of HIV virus in your body. The HIV test detects whether or not you have been exposed to the HIV virus. There are several different kinds of tests: blood tests, urine tests, and an oral (mouth) test. Only a very small amount of blood is needed for the blood tests. HIV tests can take a few days to 2 weeks for results, or with rapid HIV tests you can get results in about 20 minutes.

Where Can I Get Tested?
Free and confidential or anonymous HIV tests are available. To find an HIV testing site near you, visit www.hivtest.org. Or, call: 1-800-CDC-INFO (1-800-232-4636), TTY: 1-888-232-6348

What Else Can I Do?
You have the power to help stop the spread of HIV.
* Be safe. The best way to prevent HIV is to abstain from having sex. If you do have sex, use a new latex condom every time. Do not share needles or syringes.
* Talk about it. Talk about sex and HIV with your partners. Find out when they were last tested for HIV and what their status was. Be clear that you will be having safer sex…or none at all.
* Talk to your doctor. If you are sexually active, you should get tested for HIV at least once. Do not assume your doctor will ask you to be tested for HIV.
* Spread the word. Thousands of African Americans are getting HIV each year. Set an example by getting tested and spreading the word that others should do the same.

Source:
NATIONAL HIV TESTING MOBILIZATION CAMPAIGN
U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES
http://www.hhs.gov/aidsawarenessdays/factsheets/docs/05-1221afams.pdf

More Resources:
http://www.cdc.gov/HIV/topics/AA/resources/reports/pdf/heightenedresponse.pdf
http://www.cdc.gov/HIV/topics/AA/index.htm
http://www.blackaidsday.org/pubs_reports/NASTAD2007monograph.pdf
http://www.hhs.gov/aidsawarenessdays/factsheets/docs/aa_fact_sheet.pdf
http://www.blackaidsday.org/pubs_reports/ATurningPoint.pdf

"The HIV/AIDS pandemic presents political, economic, public health, social and scientific challenges to nations worldwide. HIV/AIDS cases have been reported in all regions of the world, but most people living with the disease reside in low- and middle-income countries. The past few years have brought greater international attention to HIV/AIDS and funding for the disease, but the need is much greater. If more is not done to fight the HIV/AIDS pandemic, it is on course to be one of the worst in history, with millions more people estimated to become infected by the end of this decade.

State of the Pandemic
As of the end of 2007, 33.2 million people were estimated to be living with HIV/AIDS worldwide, according to the latest data from the Joint United Nations Programme on HIV/AIDS (UNAIDS) and the World Health Organization (WHO).* The estimates indicate that the global HIV/AIDS prevalence rate (the percent of people living with the disease) has leveled off, although the number of people living with the disease continues to increase. An estimated 2.5 million people became newly infected with HIV in 2007, and more than two million people died of AIDS-related causes in 2007. Women comprise half (50%) of adults estimated to be living with HIV/AIDS worldwide. Young people under the age of 25 are estimated to account for half of all new HIV infections worldwide.

There is no single AIDS epidemic worldwide. Instead, many regions and countries are experiencing diverse epidemics, some of which remain in their early stages. Sub-Saharan Africa is the most-affected region in the world as measured by HIV/AIDS prevalence rates, followed by the Caribbean. There also is concern about the epidemic in parts of Eastern Europe and Asia.

Access to needed services remains low overall and uneven around the world. Although access to antiretroviral (ARV) treatment has increased fivefold since December 2003 in low- and middle-income countries, only 28% of people living with HIV/AIDS in need of ARVs were estimated to be receiving treatment as of December 2006. This represents 2.0 million of the estimated 7.1 million people in need of antiretroviral treatment in these countries. Access to prevention services also is low, with fewer than one in five people at risk of HIV infection estimated to have access in low and middle-income countries.

Worldwide, financial resources for addressing HIV/AIDS in low- and middle-income countries have increased notably over time, but a significant resource gap remains. UNAIDS estimates that spending on HIV/AIDS rose from US$300 million in 1996 to US$8.3 billion in 2005, and is projected to reach US$10 billion in 2007. However, current spending falls far short of what is needed to respond to the epidemic. Sustaining and increasing current efforts to meet the need remain significant challenges in the fight against HIV/AIDS."

WORLD AIDS DAY RESOURCES

KAISER DAILY HIV/AIDS REPORT: Nov 30, 2007
Global Health Advocates Warn Against Complacency in Fighting HIV/AIDS Pandemic Ahead of World AIDS Day
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=49131

Fact Sheet: The Global HIV/AIDS Epidemic
November 2007
http://www.kff.org/hivaids/upload/3030-103.pdf

2007 AIDS epidemic update
http://www.unaids.org/en/HIV_data/2007EpiUpdate/default.asp

Facts at a Glance
GlobalHealthReporting.org
http://www.globalhealthreporting.org/diseaseinfo.asp?id=23

Rap It Up's It's Your (Sex) Life: Your Guide to Safe and Responsible Sex
An informative booklet on preventing unintended pregnancies, HIV and AIDS and other STDs. This brochure was produced by the Henry J. Kaiser Family Foundation as a project of the Foundation and BET.
http://www.kff.org/youthhivstds/upload/BET_RapItUp_Booklet_05.pdf

Health e-Letter
Kalpana Jain, a Kaiser International Health Journalism Fellow, edits this monthly newsletter about HIV/AIDS and other public health issues in India with contributions from journalists from India and around the world.
http://www.kff.org/mediafellows/upload/fellow102007oth.pdf

*Nearly half of all respondents believed most people with HIV are receiving treatment; in fact, 2006 data show only one patient in five is being treated.

*Almost half of respondents said they felt uncomfortable walking next to someone with HIV; 52 percent would not want to live in the same house as a patient; and 79 percent said they would not want to date someone with the virus.

*HIV is spreading, in part, because women are uncomfortable discussing safe sex practices with their partners, said 73 percent of respondents.

"When people believe the disease is not fatal and that there is a cure, that's because we haven't educated them well," said Dr. Marsha Martin, director of HIV/AIDS programs in the office of the mayor of Oakland, Calif.

"The results of this survey, coupled with the recent failure of the most promising AIDS vaccine trial, underscore that we are not going to vaccinate or cure our way out of this epidemic," said Nancy Mahon, the MAC AIDS Fund's executive director. "All of us, particularly in the funding community, need to redouble our efforts and resources and focus on basic and effective HIV prevention programs that address gender, age, and race differences in a direct and culturally competent way."

Source:
GLOBAL: "Many People Don't Think AIDS Is Fatal: Survey"
Reuters Health (11.13.07):: Anthony J. Brown, MD

--Forwarded Message Attachment--
PREVENTION-NEWS Digest for Friday, November 16, 2007.
Subject: prevention-news digest: November 16, 2007
From: prevention-news@listmanager.aspensys.com
Date: Sat, 17 Nov 2007 00:00:08 -0500

Sexual Prevention
One of the main ways HIV transmission occurs is through vaginal, anal, and oral sex. Therefore, the best way to prevent being infected with the HIV virus is by practicing abstinence. This means to refrain from having sex. Having sex within a long-term, mutually monogamous relationship with someone who has tested free of HIV is also considered to be safe.

Needle Risk
It is possible to contract HIV by using contaminated needles. Most commonly, this refers to needles and syringes used for intravenous drugs. However, it can also include needles used in tattooing and piercing. For intravenous drug users, the best way to prevent being infected with HIV is to quit using drugs. Failing this, though, you can reduce your risk of infection by:

Never sharing or reusing needles for drug injection. Always safely disposing of your needles or taking them to a needle exchange center. If you are getting a tattoo or a piercing, be sure that the facility you go to only uses new, sterile needles. The facility should also dispose of used needles in a safe and sanitary manner.

Blood Contact
One method of transmitting HIV is through contact with an infected person’s blood. Since the early 1980’s, all blood services and blood banks in North America have utilized rigorous screening procedures to ensure that all the blood they collect and distribute is free of the HIV virus. However, not all countries have the facilities or resources for this type of screening. If you are planning on donating blood, make sure the needles they use are new and sterile. If you are receiving blood, ask about the screening process of the blood being used in the procedure.

Health care workers are also at risk of being infected with HIV through direct contact with an infected person’s blood. People working in a health care setting should take the following precautions to lower their chances of accidental contact and infection:

Wash hands thoroughly with soap and warm water both before and after a procedure. Always use protective barriers (i.e. latex gloves, masks) when you are in direct contact with bodily fluids including blood. If possible, always use new, single-use disposable needles and syringes for all injections. Safely dispose of this injection equipment immediately after use. Promptly disinfect any contaminated equipment that is not disposable after use. If you think you may have come into contact with an infected person’s blood, it is a good idea to go for HIV testing

HIV and Pregnancy
Because it is possible to pass the HIV virus onto your unborn child, it is highly recommended that all pregnant women, regardless of whether they display any HIV symptoms, have an HIV test done during their pregnancy. Pregnant women who are HIV positive should discuss with their health care provider about starting treatment.
Mother-to-child HIV transmission is also possible through breast milk. If you are HIV positive, discuss with your doctor the pros and cons of breastfeeding your child. You may be advised to avoid breastfeeding.

Sex with HIV
In couples where both partners are infected with HIV, there may be a feeling that it is not necessary to use condoms when having sex or to take precautions. You’re both infected with the virus, anyways, right?

Although there is some debate, there is evidence to suggest that it is possible for an individual who is already infected with HIV to be re-infected with a different strain of HIV. This can cause issues with your treatment as you could be infected with an HIV strain that is resistant to certain medications. Aside from the possible risk of re-infection, there is also an increased risk of being infected with some other type of infection, most likely another sexually transmitted disease. This includes herpes, HPV, and Hepatitis B and C. Even if you and your partner are both HIV positive, it is still important to use condoms consistently and properly every time you have sex.

Source: Epigee Women's Health,
http://www.epigee.org/health/hiv_prevention.html

What are the signs and symptoms of trichomoniasis?
Most men with trichomoniasis do not have signs or symptoms; however, some men may temporarily have an irritation inside the penis, mild discharge, or slight burning after urination or ejaculation. Some women have signs or symptoms of infection which include a frothy, yellow-green vaginal discharge with a strong odor. The infection also may cause discomfort during intercourse and urination, as well as irritation and itching of the female genital area. In rare cases, lower abdominal pain can occur. Symptoms usually appear in women within 5 to 28 days of exposure.

What are the complications of trichomoniasis?
The genital inflammation caused by trichomoniasis can increase a woman's susceptibility to HIV infection if she is exposed to the virus. Having trichomoniasis may increase the chance that an HIV-infected woman passes HIV to her sex partner(s).

How does trichomoniasis affect a pregnant woman and her baby?
Pregnant women with trichomoniasis may have babies who are born early or with low birth weight (less than five pounds).

How is trichomoniasis diagnosed?
For both men and women, a health care provider must perform a physical examination and laboratory test to diagnose trichomoniasis. The parasite is harder to detect in men than in women. In women, a pelvic examination can reveal small red ulcerations (sores) on the vaginal wall or cervix.

What is the treatment for trichomoniasis?
Trichomoniasis can usually be cured with the prescription drug, metronidazole, given by mouth in a single dose. The symptoms of trichomoniasis in infected men may disappear within a few weeks without treatment. However, an infected man, even a man who has never had symptoms or whose symptoms have stopped, can continue to infect or re-infect a female partner until he has been treated. Therefore, both partners should be treated at the same time to eliminate the parasite. Persons being treated for trichomoniasis should avoid sex until they and their sex partners complete treatment and have no symptoms. Metronidazole can be used by pregnant women. Having trichomoniasis once does not protect a person from getting it again. Following successful treatment, people can still be susceptible to re-infection.

How can trichomoniasis be prevented?
The surest way to avoid transmission of sexually transmitted diseases is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected.
Latex male condoms, when used consistently and correctly, can reduce the risk of transmission of trichomoniasis.
Any genital symptom such as discharge or burning during urination or an unusual sore or rash should be a signal to stop having sex and to consult a health care provider immediately. A person diagnosed with trichomoniasis (or any other STD) should receive treatment and should notify all recent sex partners so that they can see a health care provider and be treated. This reduces the risk that the sex partners will develop complications from trichomoniasis and reduces the risk that the person with trichomoniasis will become re-infected. Sex should be stopped until the person with trichomoniasis and all of his or her recent partners complete treatment for trichomoniasis and have no symptoms.

Where can I get more information?
CDC’s STD Home Page:
http://www.cdc.gov/std/
Trichomoniasis - Topic Page
http://www.cdc.gov/std/trichomonas/default.htm
STD Information/Referrals to STD Clinics
1-800-CDC-INFO (800-232-4636)

Source:
Trichomoniasis - CDC Fact Sheet
http://www.cdc.gov/std/trichomonas/STDFact-Trichomoniasis.htm

How do people get genital herpes?
HSV-1 and HSV-2 can be found in and released from the sores that the viruses cause, but they also are released between outbreaks from skin that does not appear to be broken or to have a sore. Generally, a person can only get HSV-2 infection during sexual contact with someone who has a genital HSV-2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected. HSV-1 can cause genital herpes, but it more commonly causes infections of the mouth and lips, so-called "fever blisters." HSV-1 infection of the genitals can be caused by oral-genital or genital-genital contact with a person who has HSV-1 infection. Genital HSV-1 outbreaks recur less regularly than genital HSV-2 outbreaks.

What are the signs and symptoms of genital herpes?
Most people infected with HSV-2 are not aware of their infection. However, if signs and symptoms occur during the first outbreak, they can be quite pronounced. The first outbreak usually occurs within two weeks after the virus is transmitted, and the sores typically heal within two to four weeks. Other signs and symptoms during the primary episode may include a second crop of sores, and flu-like symptoms, including fever and swollen glands. However, most individuals with HSV-2 infection may never have sores, or they may have very mild signs that they do not even notice or that they mistake for insect bites or another skin condition. Most people diagnosed with a first episode of genital herpes can expect to have several (typically four or five) outbreaks (symptomatic recurrences) within a year. Over time these recurrences usually decrease in frequency.

What are the complications of genital herpes?
Genital herpes can cause recurrent painful genital sores in many adults, and herpes infection can be severe in people with suppressed immune systems. Regardless of severity of symptoms, genital herpes frequently causes psychological distress in people who know they are infected. In addition, genital HSV can cause potentially fatal infections in babies. It is important that women avoid contracting herpes during pregnancy because a first episode during pregnancy causes a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed. Fortunately, infection of a baby from a woman with herpes infection is rare. Herpes may play a role in the spread of HIV, the virus that causes AIDS. Herpes can make people more susceptible to HIV infection, and it can make HIV-infected individuals more infectious.

How is genital herpes diagnosed?
The signs and symptoms associated with HSV-2 can vary greatly. Health care providers can diagnose genital herpes by visual inspection if the outbreak is typical, and by taking a sample from the sore(s) and testing it in a laboratory. HSV infections can be difficult to diagnose between outbreaks. Blood tests, which detect HSV-1 or HSV-2 infection, may be helpful, although the results are not always clear-cut.

Is there a treatment for herpes?
There is no treatment that can cure herpes, but antiviral medications can shorten and prevent outbreaks during the period of time the person takes the medication. In addition, daily suppressive therapy for symptomatic herpes can reduce transmission to partners.

How can herpes be prevented?
The surest way to avoid transmission of sexually transmitted diseases, including genital herpes, is to abstain from sexual contact, or to be in a long-term mutually monogamous relationship with a partner who has been tested and is known to be uninfected. Genital ulcer diseases can occur in both male and female genital areas that are covered or protected by a latex condom, as well as in areas that are not covered. Correct and consistent use of latex condoms can reduce the risk of genital herpes only when the infected area or site of potential exposure is protected. Since a condom may not cover all infected areas, even correct and consistent use of latex condoms cannot guarantee protection from genital herpes.Persons with herpes should abstain from sexual activity with uninfected partners when lesions or other symptoms of herpes are present. It is important to know that even if a person does not have any symptoms he or she can still infect sex partners. Sex partners of infected persons should be advised that they may become infected. Sex partners can seek testing to determine if they are infected with HSV. A positive HSV-2 blood test most likely indicates a genital herpes infection.

Where can I get more information?

CDC-INFO
1-800-CDC-INFO (800-232-4636)
TTY: 1-888-232-6348

National Herpes Hotline
(919) 361-8488

National Herpes Resource Center
http://www.ashastd.org/herpes/herpes_overview.cfm

CDC National Prevention Information Network (NPIN)
http://www.cdcnpin.org/scripts/index.asp

Source:
Genital Herpes - CDC Fact Sheet
http://www.cdc.gov/std/Herpes/STDFact-Herpes.htm

Get Tested * Know Your Status * Stay Safe

Sources:
http://hivtest.org/press_files/subindex.cfm

The following links highlight what you need to know about HIV/AIDS:
http://www.cdc.gov/hiv/topics/basic/
http://www.cdc.gov/hiv/resources/brochures/at-risk.htm
http://www.cdc.gov/hiv/resources/brochures/livingwithhiv.htm
http://www.cdc.gov/hiv/resources/qa/transmission.htm
http://aidsinfo.nih.gov/HealthTopics/HealthTopicDetails.aspx?MenuItem=HealthTopics&Search=Off&HealthTopicID=65&ClassID=51"

The risks of HIV infection depend on more than what you do with each other sexually. For example, more important than his CD4 count is his viral load. A high viral load and any STDs on either of you really increases the risk of transmission because both will increase the population of virus and infectable cells. For this reason, an STD checkup may be in order for both of you. Even if he has a low viral load, this only reflects levels of HIV in his blood. Levels in the genital tract where semen is produced can be much higher, particularly if there is an infection such as an STD, which has been shown to increase production of the virus.

You asked about kissing and intercourse specifically, but there are a lot of safe things along a continuum between these two. Pretty much anything you can do with your hands, or "outercourse," is a lot safer than penetration by his penis. Another "outercourse" method, for example, is rubbing his penis between your butt cheeks while you lie flat on your stomach. Using some water-based lube really helps. If having his penis inside you is important, then you need to find some good quality condoms that fit him well. He might have a brand that he likes, otherwise go with a Japanese made condom. I'm not sure whether double bagging is safer than just one condom. Two condoms rubbing together might increase friction and cause them to break. Two condoms may also be more likely to slip off due their greater combined bulk than a single, sheer condom.

Oral sex on you is safe, however if you go down on him there is a risk of transmission. To reduce the risk you can either use a condom or be sure to squeeze out and wipe off any precum and avoid getting cum in your mouth. The risk of oral sex, including deep kissing, really depends on the health of your gums and throat. If you have bleeding gums or a sore throat, then I would avoid kissing and oral sex until these have been resolved. One way to reduce the risk of bleeding gums is to use mouthwash instead of brushing and flossing when you are together because brushing and flossing can cause little scrapes and cuts in the gums.

Source:
How safe is it to have sex with my HIV-positive boyfriend?
Answered by Nicolas Sheon, HIV InSite Prevention Editor
http://hivinsite.ucsf.edu/insite?page=ask-01-01-01

Disclaimer:
LivetoKnow.com is designed for educational purposes only and does not provide medical advice, diagnosis, and/or treament. The information provided throughout our website should not be used for diagnosing or treating a health problem or a disease. It is not a substitute for professional care. The LivetoKnow.com organization suggests seeking the advice of a healthcare professional for personal questions concerning the spread of HIV/AIDS and other sexually transmitted diseases.

Stay informed about safer sex. Safer sex isn't always about wearing a condom. Sometimes it can be as simple as getting regular STD tests or getting vaccinated for Hepatitis A & B. Choose things that you're comfortable adopting. Keep these in mind the next time you meet up for sex.

Know your boundaries. Decide what level of risk you are willing to take. Have an idea of what you're willing and not willing to do sexually before you meet up for sex. This will help you stay in control and out of harm's way.

Keep your head in a good place. If you're too high or drunk to make good decisions, your risk of doing things you might not do otherwise is greatly increased.

Plan ahead. Know your boundaries and safer sex guidelines. Hell, it wouldn't hurt to carry a few condoms and lube with you, even if the possibility of sex seems remote.

What if your sex partner also has HIV? Although re-infection with a drug-resistant or more aggressive disease-causing strain of HIV is still being debated, it is something to be considered when negotiating safer sex between two HIV-positive sex partners.

Negotiate What You're Comfortable With Once You Meet

Ask a few key questions. If you're nervous about having a conversation about sex, ask a few key questions that can help you make a better decision about what you're willing to do sexually. Questions like: "What's your HIV status?" "Have you been tested for STD's lately?" or "What are you into?" can give you just enough information to help you make decisions about what to do and what not to do sexually.

Have a conversation during a low-key moment. Waiting until you're in the sack and getting hot may not be the best time to negotiate sex. You're already doing it! Find a time earlier in the evening before you enter the bedroom to have the conversation.

Communicate using positive language. Negotiating sex can be difficult as it is. When someone gets defensive it can be even more difficult. Respect your partner's decision, whatever it is. And request that they respect yours.

Be clear about what you want. If you just want lots of kissing, caressing, and touching, then make it clear to them up front. You have the right to determine what you're willing to do sexually and have that respected by a partner. If they don't agree, say good-bye.

Follow through. Once the clothes are off and things start getting hot, it's easy to get caught up in the moment. Never assume your partner will follow-through on the agreement. You are always responsible for your own safety.

Be assertive. Sometimes a sex partner may try to convince you to do something you're not comfortable doing. Be assertive but respectful in your response. If you're not comfortable doing it, then don't. Offer another sexual delicacy that you're both comfortable with. If they still insist, get up and leave.

Thank your partner. If they are willing to have a conversation about sex, thank them! If they followed through on what you both discussed, marry them! Negotiating sex can be difficult. If you both worked together to make it happen, then you both deserve a standing ovation.

Source:
http://www.stayinformedsonoma.net/cgi-bin/default.asp?AID=60

NBA players featured in the PSAs include Lamar Odom and Luke Walton of the Los Angeles Lakers; Samuel Dalembert and Kyle Korver of the Philadelphia 76ers; and Richard Jefferson and Marcus Williams of the New Jersey Nets. Hip-Hop legend Doug E. Fresh produced the original music for the PSAs.

Among the more than one million people living with HIV/AIDS in the U.S., the CDC estimates one in four does not know they are infected, and globally, the Joint United Nations Program on HIV/AIDS (UNAIDS) estimates that 8 in 10 o f people living with HIV in low or middle income countries do not know they are infected with the virus . Both the CDC and UNAIDS have encouraged more routine testing.

“Through relationships with organizations like the GBC, the NBA, our teams and players are to build on our commitment to raise awareness of HIV/AIDS, here at home and around the world,” said NBA Senior Vice President Kathy Behrens.

"HBO has a long history of using our network in the service of illuminating and elevating the issue of AIDS into our culture," said Richard Plepler, HBO Co-President. "As part of our promise to making a difference, it has been our privilege to commit our resources to this PSA campaign."

“HIV is on the rise in the U.S. as it is around the world. Knowing your status is essential to bringing infection rates down and increasing access to life-saving medications,” said GBC President and CEO Richard Holbrooke. “We are honored to join with member companies NBA and HBO as well as the Kaiser Family Foundation on this important campaign, which builds crucial momentum for GBC’s larger Test America initiative.”

“Having Jamie Foxx, Queen Latifah, and NBA players talking about HIV testing helps to present testing as a more routine part of care, as recommended by the CDC,” said Kaiser President and CEO Drew Altman. “HIV testing provides an opportunity to receive counseling about risks, and early knowledge of HIV status helps link people to care.”

“Increasing the number of people who are aware of their HIV infection is an essential step toward improved HIV treatment and prevention efforts in the U.S. Today nearly 40 percent of individuals diagnosed with HIV are diagnosed within one year of developing AIDS – that’s on average ten years after they become infected. For many, it may be too late to fully benefit from available treatments. At the same time, data suggest that individuals who do not know their HIV status account from between 50 and 70 percent of new sexually transmitted HIV infections in the US. But when people learn they are HIV-infected, research shows that most take steps to protect others from infection” said Kevin A. Fenton, M.D., Ph.D., FFPH, Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention.

The PSAs will be shown in arenas during NBA games throughout the 2007-2008 regular season. MTV and BET have also committed to airing the PSAs in the U.S. as part of their longstanding public education partnerships, thinkHIV and Rap-It-Up respectively. Internationally, the Global Media AIDS Initiative (GMAI) will distribute the PSAs to its more than 100 members in more than 60 countries. The African Broadcast Media Partnership Against HIV/AIDS (ABMP) and the Caribbean Broadcast Media Partnership on HIV/AIDS (CBMP) have also committed to distributing the PSAs to their members media companies to air in their respective regions. The PSAs being distributed by the ABMP and CBMP will refer audiences to local resources.

The partnership will also be featured on June 13 at the GBC’s 2007 Annual Awards for Business Excellence that will honor former President Bill Clinton for his outstanding leadership on HIV/AIDS. The PSAs grew out of a commitment made at the 2006 annual Clinton Global Initiative meeting, held in New York City last fall.

Source: Kaiser Family Foundation, News Release - Wednesday, June 13, 2007

Risk Associated with Specific Sexual Practices

Epidemiologic investigations of HIV transmission provide substantial evidence that some sexual practices are associated with a high risk of HIV transmission, whereas others are not.

Penile-Vaginal Sex
Heterosexual intercourse is presumed to be the most common mode of HIV infection worldwide. Studies of male-to-female and female-to-male transmission provide strong epidemiologic evidence that heterosexual transmission of HIV does occur via penile-vaginal intercourse. Vaginal sex during menstruation may increase the risk of transmission from an infected female to an uninfected male, but probably does not increase the risk of transmission from an infected male to an uninfected female.

The efficiency of heterosexual transmission of HIV and per-act risk of infection are the subjects of debate in the literature. Early studies on heterosexual transmission in Western countries established that male-to-female transmission in the vagina was significantly more likely than female-to-male transmission from the vagina, with estimates in three studies ranging from 1.9, 2.3, and 8.0 times greater efficiency of male-to-female transmission. Per-act infectivity in two studies was found to be low: 0.0005 and 0.0009 for male-to-female transmission, and 0.0003 and 0.0001 for female-to-male transmission. However, studies conducted in developing countries have estimated that per-act transmission probabilities are greater by a factor of 10 for both male-to-female and female-to-male transmission.

Although the greater efficiency of male-to-female versus female-to-male transmission has also been observed in developing countries, a systematic review of the literature found a greatly enhanced efficiency of female-to-male transmission in the high-prevalence epidemics of Asia and sub-Saharan Africa. The ratio of male-to-female summary mean transmission rates in the developing world compared to the rate in Western countries was 2.9, whereas for female-to-male transmission this ratio was 3.41. Women in some developing countries may be more infectious due to higher prevalence of sexually transmitted infections (STIs) and untreated HIV disease; although the authors state that evidence for the relative importance of these factors is unclear. The greater susceptibility of men in developing countries is also difficult explain, and may include a low prevalence of male circumcision, poor genital hygiene, a high prevalence of genital ulcer disease, and a high prevalence of unprotected sex with women having a high probability of being HIV infected.

Penile-Anal Sex
Strong evidence exists that being the receptive partner in unprotected penile-anal intercourse is associated with a high risk of HIV infection. Transmission of HIV to the receptive partner probably occurs as a result of the deposition of HIV-infected semen on traumatized rectal mucosa. More recently, studies have suggested that exposure to infected pre-ejaculate through anal intercourse may also carry a high risk of transmission. Unprotected receptive anal intercourse (URAI) has been consistently described as an independent risk factor for HIV infection among MSM (men who have sex with men). One recent study estimated the per-act risk of HIV infection from URAI with a partner who is HIV-positive at 0.82% (82 in 10,000) and with a partner of unknown serostatus at 0.27% (27 in 10,000).

Several investigators found that receptive penile-anal sex is also a risk factor for male-to-female transmission. Others failed to find this association among heterosexual couples. Of the latter studies, however, three had small sample sizes, which may have made a relationship between anal sex and HIV infection impossible to detect. It is probable that unprotected anal sex between heterosexual partners carries a similar per-act risk as it would between MSM, with greater risk incurred by the receptive female partner.

Whether being the inserting partner in unprotected penile-anal sex is an independent risk factor for HIV infection is not well understood. Most early studies did not demonstrate a statistically significant association between this practice and HIV infection among MSM. This was not taken as evidence that the behavior was free of risk. One recent study has estimated the per-act risk of unprotected insertive anal sex with an HIV-positive or unknown status partner at 0.06% (6 in 10,000). This risk, although 4-14 times less than that estimated for URAI, remains considerable. The lack of more complete information on the risk of unprotected insertive anal sex reflects the research community's attention to the riskier activity URAI, rather than any consensus that unprotected anal sex has been determined to be of low risk to the insertive partner.

Rectal Douching and Rectal Fisting
Studies of transmission among MSM have revealed that rectal douching increases the risk of HIV infection. A similar association between fisting (penetration of the anus with the hand) and HIV infection was observed in some studies, but not others. One presumptive mechanism for transmission via these practices is that they disrupt the mucosal barrier of the rectum and thus facilitate entry of HIV into the bloodstream during subsequent exposure to infected body fluids. In a large cohort study of MSM, the investigators devised a composite variable called "rectal trauma," composed of enema usage, receptive fisting, report of blood around the rectum, and evidence of scarring, fissure, or fistula on examination. They found that higher rectal trauma scores correlated with increased risk of HIV infection.

Oral-Penile Sex
Oral-penile contact (fellatio) is not an efficient route of HIV infection. Estimating precise per-act risk is difficult because so few people practice oral sex to the exclusion of other, higher-risk sexual activities. Nonetheless, the risk of infection from oral sex is believed to be extremely low. Early male-to-male transmission studies consistently failed to demonstrate an increased risk of HIV infection associated with the practice of oral-penile sex. A more recent study of MSM confirmed earlier findings, and further estimated that on a population level, the risk of HIV infection among MSM that is attributable to oral sex is extremely low. Most studies of male-to-female and female-to-male transmission also failed to show any increased risk of HIV infection associated with oral-penile sex. A cohort study among heterosexual couples at an STI clinic in Spain found no signs of infection attributable to oral sex, supporting the conclusion that HIV transmission via oral-penile sex between heterosexuals was extremely low.

Oral-penile contact is not completely risk free, however a study of per-contact risk of infection to the receptive partner found that the probability of infection was 0.06% with a known HIV-positive partner and 0.04% with partners of unknown status. Although these are low probabilities, the authors suggest that oral-penile sex may play a larger role in the epidemic among MSM as more men adopt these behaviors as risk reduction measures Several case reports have implicated oral-penile contact as a source of male-to-male transmission. In one study of heterosexual transmission, repeated oral sex was associated with transmission of HIV from men with AIDS to their spouses, although competing risks also showed significant associations in this study. Because so few people practice oral-penile sex to the exclusion of other sexual practices, it is very difficult to recruit and retain subjects for epidemiologic studies of the HIV risk associated with this practice. Only one study was able to do this; another examined monogamous couples whose only unprotected sexual activity was oral sex. No signs of infection were observed in either study. Despite the case reports, the epidemiologic evidence suggests that unprotected oral-penile sex is a low-risk activity.

Oral-genital sex, both oral-penile and oral-vaginal, can transmit STIs other than HIV with varying degrees of efficiency. Receptive oral-penile sex carries the risk of gonorrheal infection for both men and women, and insertive oral-penile sex, although carrying only extremely low, hypothetical risk of HIV infection to the insertive partner, carries a demonstrable risk of urethral gonorrheal infection. Other risks of receptive oral-genital sex include small probabilities of human papillomavirus and hepatitis C transmission. Insertive oral-penile sex is an efficient route for the transmission of herpes simplex virus (HSV). The damage that many STIs cause to mucosa can conceivably increase the likelihood of transmission of HIV through oral sex, although this risk has not been quantified.

Oral-Vaginal Sex
The risk of HIV transmission through oral-vaginal sex (cunnilingus) has received less attention than oral-penile sex. There have been case reports of female-to-male and female-to-female transmission of HIV infection via oral-vaginal sex. One study found an association between oral-vaginal sex and female-to-male transmission of HIV, although competing risks also showed significant associations in this study. As with oral-penile sex, conducting an epidemiologic study that can examine oral-vaginal sex in the absence of competing HIV risk behaviors is difficult, and no such studies have been reported. However, all studies that have controlled for competing risk behaviors have concluded that oral-vaginal sex is extremely low risk.

Oral-Anal Sex
Although oral-anal contact is not an independent risk factor for HIV infection based on data from male-to-male transmission studies, it may be a marker for other high-risk sexual practices. Analysis showed an increased risk of HIV infection associated with oral-anal sex. Oral-anal sex has been shown to be a route of transmission for hepatitis A and B, and parasitic infections such as giardiasis and amebiasis.

Source:
Safer-Sex Methods
HIV InSite Knowledge Base Chapter
December 2003; Content reviewed January 2006
Tim Lane, PhD, MPH, University of California San Francisco
Herminia Palacio, MD, MPH, Harris County Health Department, Houston, Texas
http://hivinsite.ucsf.edu/InSite?page=kb-07-02-02#S3.2X