HIV Awareness: Progress and Challenges

Authors: Lauren Richey, MD, MPH, FIDSA and Sadie Beckett, MPH

Scientists and researchers have shown through multiple studies that when people living with HIV take their medicines as prescribed and as a result have no detectable virus in their blood on blood tests that they cannot transmit HIV to their sexual partners.

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This knowledge allows people living with HIV to lead full, unrestricted lives that allows them to safely have sex without condoms.  This also allows both men and women living with HIV to have children without the concern of transmitting the infection to their child.

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HIV still remains an important health issue in 2018. While HIV is easy to test for with a simple blood test, many people do not routinely get tested, either because they do not access healthcare or because their provider does not offer them testing.

In 2016, according to the Louisiana Office of Public Health, Louisiana had the third highest HIV diagnosis rate in the United States, with the New Orleans region being the region in Louisiana with the highest diagnosis rate.

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Diagnosis is important because once diagnosed, people will know whether or not they have HIV.  If they learn that they are living with HIV they can access lifesaving medications that improve their health and help them to achieve viral suppression.  When they achieve viral suppression, the virus is then undetectable in their blood and therefore can no longer be transmitted to partners

 University Medical Center New Orleans offers testing in the Infectious Disease Center (Clinic building, Zone C). There is also routine HIV testing in our Emergency Department. So if a medical condition or any risk of exposure to HIV brings you to the ED, you can get tested.

To find other testing centers near you, you can enter your zip code into: gettested.cdc.gov. Other places include your primary medical doctor, OB/GYN , or at a community testing event.

HIV and Stigma

One of the greatest challenges for many people living with aids is still the stigma that goes along with the disease.

The Merriam-Webster definition of stigma is “an identifying mark or characteristic.” In the case of HIV and stigma, HIV is the identifying characteristic, and it reduces a person from being whole and usual to tainted and discounted. The effects of HIV stigma on people living with HIV can be deadly.

People living with HIV are less likely to attend their medical appointments, less likely to be adherent to their medication regimens, and are more likely to suffer from mental health conditions.

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HIV stigma historically stems from a fear of the unknown. It began in the early 1980s when there were numerous cases of rare cancers, pneumonia and deaths of our patients. No one knew how HIV was transmitted which led to transmission myths creating a negative connotation of the infection.

Some of the more “popular” stigmatizing phrases were (and still are) that it is a “gay man’s disease” or HIV is only associated with sex workers and drug users. Anyone who is sexually active is at risk for contracting HIV. It is important to get tested and practice safe sex.

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In 2018, we now have over 40 medications that are used to treat HIV.   We now know that if people living with aids begin their antiretroviral therapy (ART) shortly after their diagnosis they substantially reduce the risk of their partners contracting HIV- indicating the need to start ART as soon as possible.

It is very important for individuals to receive accurate information so that HIV transmission can be prevented or effectively treated if someone is infected.  Without HIV stigma, more people would get into care and stay in care; the rate of HIV infections would decrease; there would be a substantial decrease in AIDS cases; there would be full participation in HIV testing and, most importantly, everyone would know their status.

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HIV and Stigma Discussion

On December 5, join us for a talk on HIV basics, the history of HIV and stigma and what we can do to end stigma. The talks will be at 7 a.m. and 3 p.m. in the UMC Conference Center, located on the first floor of the hospital, 2000 Canal Street. Refreshments will be served.

Lauren Richey, MD, MPH, FIDSA, is an Infectious Disease Specialist and LSU Health Sciences Center Associate Professor of Medicine.

Sadie Beckett, MPH, is a Clinical Educator in the UMC Infectious Disease Center/HIV Outpatient Clinic.

Recipe: Seaside Shrimp and Sausage Gumbo

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Gumbo is a New Orleans holiday favorite. Try this reduced-fat, reduced-salt version, which uses turkey sausage, fresh shrimp and all the flavors your family will savor.

Serves six; one cup per serving

Ingredients

1½ tablespoons all-purpose flour

Vegetable oil spray

4 ounces reduced-fat smoked turkey sausage, thinly

sliced

3 cups frozen bell pepper stir-fry mix (bell peppers and onions)

14.5-ounce can no-salt-added stewed tomatoes, undrained

1 ¼ cups water

10 ounces frozen sliced okra

1 tablespoon fresh lemon juice (optional)

½  tablespoon sugar

2 medium bay leaves

½ teaspoon dried thyme, crumbled

½ teaspoon red hot-pepper sauce (optional)

¼  cup water

1 cup uncooked rice

8 ounces peeled raw medium shrimp

½ cup snipped fresh parsley

1 tablespoon olive oil (extra virgin preferred)

½ teaspoon salt

Preparation Instructions

Heat a Dutch oven over medium heat. Put flour in Dutch oven and cook for 3 minutes, or until golden, stirring constantly. Pour into a small bowl.

Lightly spray Dutch oven with vegetable oil spray (being,careful not to spray near a gas flame). Increase heat to medium-high. Cook sausage for 3 minutes, or until richly browned, stirring constantly. Transfer to a plate and set aside.

Put bell peppers, tomatoes with liquid, 1 ¼  cups water, okra, lemon juice, sugar, bay leaves, thyme, and hot-pepper sauce in Dutch oven, scraping bottom and sides to dislodge any browned bits. Whisk remaining ¼  cup water into flour. Stir mixture into gumbo. Bring to a boil over medium-high heat. Reduce heat and simmer, covered, for 30 minutes, or until bell peppers are very soft, stirring occasionally.

Meanwhile, prepare rice using package directions, omitting salt and margarine.

Stir shrimp into gumbo. Cook for 5 minutes, or until shrimp are pink on outside and opaque in center. Remove from heat.

Stir in remaining ingredients, including sausage and rice.

Nutrition Information

1 ½ Starch, 3 Vegetable, 1½ Lean Meat

Calories: 233

Total Fat: 3g

  • Saturated Fat: 0.5g;
  • Polyunsaturated Fat: 0.5g
  • Monounsaturated Fat: 2g

Carbohydrates: 38g

Sugar 7g

Fiber 3g

Cholesterol 63mg

Protein 13g

Sodium 437mg

This recipe was a project of the Southern University Dietetic Internship class at UMC. 

Antibiotics Aren’t Always the Answer

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Author: Jennifer Lambert, PharmD, MPA

Did you know?

An estimated 2 million illnesses and 23,000 deaths occur each year in the US due to antibiotic resistant infections.1 Antibiotics are drugs used to treat bacterial infections, not viral infections. Using antibiotics the wrong way can lead to antibiotic-resistant infections that cause illness or death. Therefore, healthcare providers are being more careful when prescribing antibiotics and acknowledging that antibiotic resistance is one of the most urgent threats to the public’s health.

Taking Antibiotics creates resistant bacteria

Antibiotic resistance occurs when bacteria no longer respond to the drugs designed to kill them.  If more and more patients take unnecessary antibiotics, we will soon run out of options to treat the most common bacterial infections.  This is why it is important to only take antibiotics as prescribed by a healthcare professional and to NEVER share your prescription for antibiotics.

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Antibiotics DO NOT work on viruses

Illnesses such as colds and the flu ARE NOT treated by antibiotics.  See the chart below to see which of the most common illnesses typically do not need an antibiotic.

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If I don’t need antibiotics, what can I do to help myself feel better if I have a viral illness? Pain relievers, fever reducers, decongestants, saline nasal spray or drops, warm compresses, liquids, and rest may be the best things to help you feel better. Ask your healthcare provider or pharmacist what symptom relief is best for you.

Help us Celebrate!

Help UMCNO celebrate World Antibiotics Awareness week Nov. 12-18th.

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During this week and throughout the whole year, we encourage patients and families to help us be Antibiotics Aware by doing the following:

  • Get the facts about antibiotics. Antibiotics do not work on viruses, such as those that cause colds, flu, bronchitis, or runny noses, even if the mucus is thick, yellow, or green. When antibiotics aren’t needed, they won’t help you, and the side effects could still hurt you.
  • Ask your doctor, nurse, or pharmacist about the best way to feel better.
  • While your body fights off a virus, pain relievers, fever reducers, saline nasal spray or drops, warm compresses, liquids, and rest can help you feel better.
  • If you need antibiotics, take them exactly as prescribed. Talk with your doctor if you have any questions about your antibiotics.
  • Talk with your doctor if you develop any side effects, especially severe diarrhea, since that could be a Clostridioides difficile (C. difficile or C. diff) infection, which needs to be treated.
  • Do your best to stay healthy and keep others healthy by cleaning hands, covering coughs, staying home when sick, and getting recommended vaccines, such as the flu vaccine.

Citations:

1 CDC. Antibiotic Resistance Threats in the United States, 2013. 16 September 2013. 32.

The Color Purple: Raising Awareness of Pancreatic Cancer

Author: Jennifer Gnerlich, MD, UMC Surgical Oncologist and Assistant Professor of Clinical Surgery at LSU Health New Orleans

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While pink may be the rage in October, we find ourselves turning to purple in November to support pancreatic cancer awareness. While not a common cancer, the amount of people affected is increasing every year with an expected 55,500 to be diagnosed with pancreatic cancer this year.

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The hardest part about pancreatic cancer is that there is no screening test, no blood work or X-ray to detect this cancer at an early stage. Instead, every person needs to be aware of warning signs that can suggest they might be at risk for having pancreatic cancer. These warning signs include:

  • Skin or the whites of eyes turning yellow
  • Upper belly/stomach pain or back pain that does not get better with medication like ibuprofen or acetaminophen
  • Indigestion or a bad stomach ache that does not get better with antacids
  • Unexplained weight loss when there has been no change in diet or exercise
  • New diagnosis of diabetes late in life

 

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While a person at any age can be diagnosed with pancreatic cancer, most people diagnosed with pancreatic cancer are between the ages of 55 and 85 years old. If you are diagnosed with diabetes late in life and have no other risks factors for it (obesity, eating food high in sugar/carbs), you may want to ask your doctor if you are at risk for pancreatic cancer.

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Along with having no good screening test, there are only two ways to actively prevent the disease. The main one is to stop any tobacco smoking. Through research, we have now learned that smoking is the number one thing a person can do to prevent pancreatic cancer. The second thing is to maintain a normal weight. Obesity is also associated with pancreatic cancer, so make sure to exercise at least 30 minutes a day, 5 days a week. Also, try to eat healthy with normal sized food portions. A good way to cut out sugar in your life is to remove all juice and soda. Try to drink water, tea (unsweetened), or coffee (no cream or sugar).

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To raise support and awareness for pancreatic cancer, the LSU Foundation is sponsoring the first flagship team in Louisiana. PurpleStride takes place on Sunday, November 4th at 8:00am at City Park. Please consider signing up for Team LSU/UMC – Purple Reign. Registration is free with the discount code FLAGSHIP. Click here to register.

The Pancreatic Cancer Action Network (PanCAN) hosts PurpleStride all over the nation, but we are lucky enough to have it in New Orleans this year! Please help us reach our goal by joining the team or donating. Money raised goes for patient support, research, and advocacy in Washington DC. Have your voice heard to wage hope against this disease because we need YOU!

About Dr. Gnerlich

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Dr. Gnerlich is a board-certified surgical oncologist specializing in upper gastrointestinal cancers in the pancreas, bile ducts, liver, stomach, esophagus and retroperitoneal sarcomas. Dr. Gnerlich is excited about bringing new procedures like HIPEC (hyperthermic intraperitoneal chemotherapy) to UMC for patients with certain types of cancer that have spread throughout the abdomen.

To make an appointment with Dr. Gnerlich or one of our cancer specialists, please contact (504)702-3697 or (504) 702-5700.