Male circumcision: benefits outweigh risks

Male circumcision: benefits outweigh risks

HEALTH

The benefits of male circumcision outweigh the risks, according a long awaited draft of federal guidelines from U.S. health officials released on Tuesday, which indicate that scientific evidence supports recommending the procedure.

The U.S. Centres for Disease Control and Prevention found that medically performed male circumcision could help decrease the risk of contracting HIV and several other sexually transmitted infections (STIs) as well as other health problems.

The recommendation, which includes counselling parents of male newborns on the benefits and risks of the procedure, comes at a time when the rate of male circumcision has been decreasing in the United States.

From 1979 through 2010, the national rate of newborn circumcision declined 10 percent to 58 percent, according to the CDC

The procedure, which has been subject of fierce debate, involves cutting the foreskin around the tip of the penis.

"These recommendations are based on an evaluation of available information on the health risks and benefits associated with high-quality, medically performed male circumcision and were developed to pertain to men and male newborns in the United States," the document said.

Several studies conducted in Africa indicated that circumcision could help reduce the spread of HIV, the virus that causes AIDS.

All uncircumcised adolescent and adult males who engage in heterosexual sex should be informed about the significant, but partial, efficacy of male circumcision in reducing the risk of acquiring HIV and some STIs through heterosexual sex, as well as the potential harms of male circumcision, the draft guidelines said.

The overall risk of adverse events associated with male circumcision is low, with minor bleeding and inflammation cited as the most common complications, according to a CDC fact sheet.

The draft recommendations are subject to a 45-day public comment period and a formal external peer review. Comments provided will be considered before recommendations are finalized, CDC said.

The agency said it developed the draft guidance based on a systematic review of all evidence on the health risks and benefits of circumcision and consultation with experts in HIV prevention and related fields

- Reuters

healthandwealth Pada 19:07 Komentar

Most HIV+ Americans don't have virus under control

Most HIV+ Americans don't have virus under control

HEALTH

Fewer than one-third of Americans living with HIV had the virus under control in 2011, with many either not receiving regular medical care or unaware they carry the virus, a new U.S. study finds.

Combination drug therapies

The U.S. Centres for Disease Control and Prevention study estimates that 70 percent of the 1.2 million Americans living with HIV in 2011 did not have their virus under control, even though combination drug therapies can effectively suppress the virus before it can develop into full-blown Aids.

A combination of indifference and lack of access to medical care appeared to outweigh ignorance as a driving factor in cases of uncontrolled HIV, researchers from the CDC's National Centre for HIV/Aids reported Tuesday.

"For people living with HIV and Aids, it's not enough to know -- you also have to go for health care," said CDC Director Dr. Tom Frieden at a Tuesday news briefing.

"For health care systems, it's not enough to diagnose patients," he added. "You have to take accountability and responsibility for every patient diagnosed in your health center, to provide them with the most sensitive, effective, culturally appropriate care so that they will get onto treatment, stay into treatment, live longer, live healthier, stay out of the hospital and not infect others."

When used consistently, antiretroviral medication can keep HIV controlled at very low levels in the body, allowing people with HIV to live longer, healthier lives, Frieden said.

Clinical guidelines

Viral suppression also reduces the likelihood that patients will transmit HIV to others. Treatment has been shown to reduce sexual transmission of HIV by 96 percent, the CDC said, and U.S. clinical guidelines recommend that everyone diagnosed with HIV receive treatment.

Among the nearly 840,000 people who had not achieved viral suppression, researchers found that:

• 66 percent had been diagnosed but were not engaged in regular HIV care;
• 20 percent did not yet know they were infected;
• 4 percent were getting some care but weren't prescribed antiretroviral treatment;
• 10 percent were prescribed antiretroviral treatment but had not been able to fully suppress their HIV.

The study did not find statistically significant differences in viral suppression by race, ethnicity or gender, which is "encouraging," said Dr. Jonathan Mermin, director of the CDC's National Center for HIV/Aids, Viral Hepatitis, STD and Tuberculosis Prevention.

But researchers did find that young adults are at greater risk of uncontrolled HIV, with only 13 percent of people age 18 to 24 having achieved viral suppression. "More than any other group, our young people are not getting the care they need," said Mermin, also speaking at the news briefing.

Read: Giant condom rolled over a big one

This is largely because young adults are less likely to have been diagnosed with HIV. Only half of those 18 to 24 with HIV have been diagnosed, compared with more than 90 percent of people 45 and older, the report said.

Hard to maintain treatment

"To close the age gap in viral suppression, we will need to expand efforts to reach young adults with HIV testing," Mermin said.

Mermin said that accessing HIV care can be difficult, particularly for people who are impoverished or suffering from substance abuse problems.

But even people of means can find it hard to maintain HIV treatment, Frieden said.

"Taking treatment for an infection that may have no symptoms and that you need to take for life is not easy," he said. "That's why it's so important that services for people living with HIV be sensitive, easy to access and without financial barriers."

The CDC hopes to improve HIV diagnosis and treatment through efforts launched in 2010 as part of the National HIV/Aids Strategy, said Dr. Eugene McCray, director of the CDC's Division of HIV/Aids Prevention, at the news briefing.

McCray said these efforts include innovative partnerships to make HIV testing simple, accessible and routine.

Additional efforts include programs to help health departments identify infected individuals who have fallen out of care. Public awareness campaigns about the importance of HIV testing and ongoing HIV treatment are also key, McCray said.

- Health24

healthandwealth Pada 11:42 Komentar

Three in 10 Americans Have Diabetes and Don’t Know It

Three in 10 Americans Have Diabetes and Don’t Know It

HEALTH

It’s common knowledge that one-third of people living with HIV/AIDS are unaware of their status, but nowdiabetes is following in similar footsteps.

A new study found that nearly three in 10 Americans are living with Type 2 diabetes and don’t even know it. To make it even worse, when researchers from Emory University really honed in on the data, they found that a whopping two-thirds of these people had seen a doctor more than two times that year and still were not screened for diabetes.

Other findings included:

— Only about 1 in 5 diagnosed diabetics refrained from smoking and had achieved the targets for hemoglobin A1C, blood pressure, and LDL “bad” cholesterol. This speaks to the need for diabetics to take their illness more seriously.

— 75 percent of the people diagnosed with diabetes also had high blood pressure, which can increase risk for certain complications.

Diabetes, which is a chronic disease that affects our blood sugar and ability to regulate our insulin, is not a game: It is the seventh leading cause of death and can lead to amputations, dialysis and blindness. Not to mention not having diabetes under control can be extremely detrimental to your death.

“The reality is, I would be more concerned about diabetes than Ebola,” lead author Dr. Carlos del Rio, chair of the Emory University Department of Global Health told Yahoo News.

So why are doctors letting folks slip through the cracks?

It’s simple. For many people there aren’t that many signs when it comes to diabetes — it’s usually asymptomatic, only showing signs when the disease has really progressed. But really, doctors should know better and routinely test for it, especially when it comes certain risk factors such as a family history, obesity and an unhealthy diet.  

Not to mention, too many folks are uninsured, use the ER for primary health care and may not have a primary health provider who emphasizes on preventive care.

This issue is especially important for African-Americans given that we are disproportionately diagnosed with diabetes. 

An estimated 4.7 million of us suffer from it. Fifteen percent of all African-Americans who are 20 and older have diabetes; 25 percent of African-Americans between the ages of 65 and 74 have diabetes; and 25 percent of African-American women over 55 have diabetes. 

Think you may be at risk for diabetes? Talk to your provider about your risk factors, what you can do to prevent developing diabetes and most important, ask to be screened. You do not want to be one of the eight million who are unaware of their diabetes status. 

healthandwealth Pada 18:15 Komentar

Sex slaves remain traumatised long after freedom

Sex slaves remain traumatised long after freedom

HEALTH

When 13-year-old Hoa was freed last month from a brothel in Guangdong, China, and brought back to Vietnam by her rescuers, her nightmare didn't end.

Traumatised and ill, she first returned to her village in North Vietnam's Nghe An province.

But there she lived in fear of being sold to traffickers again, and she was stigmatised by the local community for her four months in the brothel. She was later moved to a safe shelter in the capital Hanoi.

Like many former sex slaves, Hoa, who did not want to use her real name, suffers memory loss, depression, recurrent nightmares and an inability to concentrate.

Trust issues

She also finds it hard to trust people.

"Her mother loves her, but she doesn't know how to express her love. And it's hard for Hoa to believe her," said Chau Thi Minh Dinh, a psychologist at the Blue Dragon Children's Foundation, which rescued her, moved her to the Hanoi shelter and is helping her find a safe place to live.

There are almost 36 million slaves worldwide, according to the 2014 Global Slavery Index, published by the Walk Free Foundation this week. Many suffer extreme trauma, but there are limited resources to help them.

Thi Minh Dinh is the only psychologist at Blue Dragon, which has rescued 353 children since 2005, and she is one of the few psychologists in Vietnam who can help children like Hoa.

She telephones the most vulnerable every evening.

"At night-time they are scared, they are alone," she said in an interview.

They will need her support for many months to come, she said.

Pulling yourself together

How do the girls pick up the pieces after such a traumatic experience?

"It's better than you might think," said Michael Brosowski, director and founder of the Hanoi-based Blue Dragon Children's Foundation who, with Thi Minh Dinh, was speaking at the Trust Women conference in London on Wednesday.

"I think that young people have a resilience that is often difficult for us adults to understand, and in Vietnamese culture there is a real attitude of pull yourself back together again and get on with it. So those factors mean that the girls that we meet who have been rescued, they do surprisingly well."

Many recover enough to resume their studies, marry, have children and get jobs.

"But I think that underneath the surface there are always scars that remain," he added.

Stigma of counselling

It's not just people forced into sex work who are traumatised. People trafficked into other sectors, including domestic work, factories and the fishing industry also suffer extreme trauma and often suffer high levels of depression, said Cathy Zimmerman, who has researched the mental health of trafficking victims for many years.

"It's generally not a matter of move on, get over it... Generally people will need longer term support," Zimmerman, who works at the London School of Hygiene and Tropical Medicine, said on the sidelines of the Trust Women conference.

Zimmerman quoted a Lithuanian woman who had been trafficked to London: "I feel like they've taken my smile and I can never have it back."

How much care trafficking survivors need depends on what they have been through, their personality, and their situation once they have escaped.

People testifying in court against their traffickers may need more mental health support than "someone who is back in a comfy home with their family earning a nice income," Zimmerman said.

However, counselling is stigmatized in many cultures, and even if people are offered help, "they'll say 'no' because they think it means that they are crazy," Zimmerman said.

There needs to be a greater focus on finding out exactly what kind of assistance victims of trafficking need, she said.

"If you could find something that would work with a population that's as traumatised as this and as diverse as this . . . you could really roll that out to the millions of people who are being trafficked right now," she said.

"It's not just about prosecuting the perpetrators. In the end I think if you gave somebody the choice between regaining their mental health versus prosecuting their perpetrator, I think you know which one they'd choose."

- Health24

healthandwealth Pada 15:35 Komentar