Condom Homework Increases Compliance, Comfort and Consistency

A new and successful strategy for combating the spread of sexually transmitted diseases such as HIV was revealed today at the American Public Health Association’s annual meeting in Boston.

The idea is based upon the decades old premise that practice makes perfect!.

In the study entitled “A novel, self-guided, home-based intervention to improve condom use among young men who have sex with men.  The men were given a “ditty bag” full of eight different types of condoms and five different types of  lubricants, taught how to apply the condoms correctly, and then assigned homework. The men were expected to try out at least six condoms solo, paying particular attention to their own pleasure and which condoms they liked best.

The purpose of this study was to test of feasibility and efficacy of this intervention and to promote positive condom attitudes and to reduce risk behaviors.

30 volunteer subjects were recruited from a Midwestern University and its surrounding community. A pre-test questionnaire was administered.  A post-test questionnaire was given at Day 15 and an additional follow-up questionnaire at Day 45.

It’s such a simple idea, but nobody has every structured an approach like this,” said William L. Yarber, professor in the Indiana University School of Public-Health. “These are pilot studies. But even with small samples, the results are really good. Men become more motivated to use condoms; they use them more correctly and consistently. They also appreciate learning that there are different condoms available.”

A pilot study, published in the Journal of Men’s Health in 2011, focused on heterosexual men. The new study, focuses on young men who have sex with men, or MSM.  It will be published in the Journal of American College Health, MSM aged 18 – 29 are diagnosed with HIV more than any other group, according to the Centers for Disease Control and Prevention. In fact, half of all new HIV infections in the U.S. are among MSM between the ages of 13 and 24 years. College-aged MSM are more likely than older MSM and men who only have sex with women to be infected with HIV.

“This is an important group of men to reach,” says  Roberta Emetu, who coordinated the research project.  “The men who experienced this intervention became better in their condom use. They not only used them more often but used them correctly. We saw an increase in motivation to use them.”

When pre-test and post-test responses were compared, significant post-intervention improvements were found for beliefs and application of condoms, self-efficacy, condom attitude, motivation to use condoms, and consistency of condom use for insertive penile-anal intercourse.

Yarber and his colleagues have documented for more than 10 years how merely wearing a condom is not enough to provide effective protection against STDs and unwanted pregnancies. Condoms need to be used correctly, yet fit-and-feel issues can result in erection difficulty, loss of sensation, removal of condoms before the intercourse episode ends, and other problems that can interfere with their correct use.

These findings suggest that this intervention could be applicable to college-aged MSM, and could be a great resource or model for other public health condom interventions.

Stopping Herpes From Going Viral

On Wednesday SRxA’s Word on Health reported on a link between memory loss and cognitive decline and the herpes virus.  Today, we bring a glimmer of hope to the 65% – 90% of people worldwide affected with either type 1 or Type 2 herpes simplex virus.

In the US alone, it’s estimated that nearly 60 percent of U.S. men and women between the ages of 14 and 49 carry the HSV-1 virus, while >16.2% are infected with herpes simplex virus type 2 (HSV-2).

HSV-2 is a lifelong and incurable infection that can cause recurrent and painful genital sores and can make those infected with the virus two-to-three times more likely to acquire HIV.

Now, according to a study just published in the Journal of the Federation of American Societies for Experimental Biology (FASEB), researchers from Albert Einstein College of Medicine of Yeshiva University have discovered a novel strategy for preventing, treating or suppressing herpes virus infections.

“We’ve essentially identified the molecular “key” that herpes viruses use to penetrate cell membranes and infect cells of the human body,” said Betsy Herold, MD of The Children’s Hospital at Montefiore.

Dr. Herold and her colleagues had previously shown that infection by the herpes viruses depends on calcium released within the cells. In this study, they found that calcium release occurs because the viruses activate a critical cell-signaling molecule called Akt [also known as Protein Kinase B (PKB) ] at the cell membrane.

As part of their investigation of Akt’s role in herpes infections, the researchers took laboratory cultures of human cell and mixed them for 15 minutes with four different drugs known to inhibit Akt. The cells were then exposed for one hour to herpes simplex virus 2.

The drugs tested were:

• MK-2206 – an experimental drug being studied as adjunct therapy for cancer
• Akt Inhibitor VIII
• Miltefosine, a drug licensed for treatment of leishmaniasis and other protozoal infections
• Perifosine, an experimental agent in phase 3 clinical trials for treatment of several cancers

All four of the drugs significantly inhibited HSV infection in each of the cell types.  Miltefosine was the most potent and reduced viral plaques by 90% in all cell types.

By contrast, cells not pre-treated with the Akt inhibitors were readily infected on exposure to the virus.

“For people infected with herpes, the drug acyclovir helps prevent herpes outbreaks from recurring and lowers the risk of transmitting the infection to others,” said Dr. Herold. “But some people have herpes infections that don’t respond to acyclovir, and unfortunately there is no effective vaccine. So new approaches for suppressing and treating herpes infections are badly needed, and our findings indicate that inhibiting Akt should be a useful therapeutic strategy to pursue.”

OMG! Smartphone Sex Risk for Teens

Teenagers and their phones!  As any parent or indeed observer of human life knows, the mobile phone has become the most important adolescent accessory.  Texting has even taken over from talking as their preferred form of communication. 72% of all teens and 88% of teen cell phone users text-message at least once a day.

And while they may not all rival world record texter, Fred Lidgren, who sent 566,607 text messages during a one month period, I know several who are not far behind. And for those of you still doing the math, yes that’s a staggering 18,887 texts per day or 787 per hour or 13 texts each minute. LOL!

Not only does smartphone use kill the art of conversation, it has a decidedly most sinister side-effect.  According to new research just presented at the American Public Health Association meeting, smartphone use among teens is associated with an increased likelihood of being solicited for sex and having sex with an internet-met partner.

According to a 2011 survey among almost two thousand Los Angeles high school students, young people with smartphones are one and a half times as likely to report being sexually active, almost two times as likely to have been approached online for sex, and more than twice as likely to engage in sex with an Internet-met partner compared with those who do not access the internet on their cell phones.

Additionally, those being solicited online for sex are also found to be engaging in unprotected sex. Five percent of the participants reported using the Internet to seek sex partners and 17% of the participants reported being approached online for sex by someone they did not know.

“We, parents, health educators, physicians, must recognize that cell phones are yet another new way for adolescents to meet sex partners,” said researcher Hailey Winetrobe, MPH. “Parents and school health professionals should talk to their teens about being safe in meeting people online and in using condoms to prevent sexually transmitted infections and unplanned pregnancies.”

While we’re not suggesting that parents take their teenagers cell phones away, maybe it’s time to put those smartphones to good use and create apps and websites for adolescent-targeted sexual health programs.

What do you think?

Chris Cross – setting the record straight on Columbus Day

In previous years, we have honored explorer Christopher Columbus – on this, his day.  In previous years, we have also enjoyed the federal holiday. Not so, this year.  Today we are working.  And that may explain why this year we’re painting a slightly different picture of the famous Genoa-born son of a wool merchant.

For many years, Christopher Columbus was regarded as one of the great heroes of Western history. He was touted as the New World`s pivotal discoverer who subsequently brought civilization to its backward peoples.  Whatever hardships and cruelties were inflicted upon the natives was generally thought to be insignificant in comparison with the benefits of European science and religion. Yada, yada.  Turns out, Christopher Columbus wasn’t quite that smart.  For one, he sailed in the wrong direction, landed thinking he was in the West Indies, and started calling everyone Indians. And even his most ardent admirers acknowledge that Columbus was self-centered, ruthless, avaricious, and a racist.

During the latter part of the 20th century, a Native American awareness movement developed in the United States and elsewhere, which called Columbus’ legacy into question. To those critics, the year 1492 represented not just a major turning point in world history, but the starting gun for the destruction of native cultures. Exploration was quickly superseded by settlement and exploitation. War, slavery, disease, and death followed in their wake.

Both American and European lives were changed in what is sometimes referred to as the “Columbian Exchange.” Europeans became acquainted with corn, chocolate, potatoes, tomatoes, and various peppers and spices. These imports vastly changed the diet in the Old World. Tobacco also began to exert its impact. Life in the Americas was changed by the importation of chickens, goats, horses, oxen, cattle, donkeys, sheep, coffee, rice, bananas, sugarcane, wheat, and barley.

On a more lethal level, diseases also were apparently exchanged. The Europeans brought a host of infectious maladies unknown in the New World, the most damaging of which was smallpox. Some authorities have suggested that syphilis was contracted by Columbus’ crew members and taken back to Europe. And then there’s the teeny-weeny little detail that Columbus was not in fact the European discoverer of the New World. That feat was accomplished 500 years earlier by the Norse.

Nevertheless, we won’t beat up further on poor old Columbus. After all, he’s not here to defend himself these days.  And, just because we’re not celebrating his special day doesn’t mean we’re bitter (well, not much), nor does it mean that the voyages of Columbus don’t merit a place in history.

To all our readers who are enjoying the Columbus Day holiday – we say enjoy the day. To everyone else, we say – we’re right there with you!  Happy Monday.

Syphilis Sets Sail

SRxA’s Word on Health has heard that history may about to be rewritten.  According to researchers at Emory University, not only did Christopher Columbus discover the New World, he also brought back one of the world’s most feared diseases.

A new review of the origin of syphilis supports the theory that the sexually transmitted disease was carried to Europe aboard Christopher Columbus’ ships.

“Syphilis has been around for 500 years,” says study co-leader Molly Zuckerman, assistant professor at Mississippi State University. “People started debating where it came from shortly afterwards, and they haven’t stopped since.

Although syphilis was one of the first global diseases, understanding where it came from and how it spread may help us combat diseases today. Prior to Columbus’ voyage in 1492, syphilis did not exist in Europe or the Old World.

After analyzing the evidence from 54 reports, the team from Emory found that before Columbus’ historic voyage to the New World, skeletal material lacked the diagnostic characteristics for chronic syphilis, such as small holes in the skull and long bones.

Their appraisal, published in the Yearbook of Physical Anthropology, suggests that someone sailing with Columbus carried Treponema – the bacteria that causes syphilis back to Europe. Treponema can cause other diseases, such as yaws and pinta, that are spread through skin-to-skin or oral contact in tropical climates.

Their theory is that the bacteria mutated into the sexually transmitted form to survive in the cooler and more sanitary conditions of Europe.

“In reality, it appears that venereal syphilis was the byproduct of two different populations meeting and exchanging a pathogen,” Zuckerman said. “It was an adaptive event, the natural selection of a disease, independent of morality or blame.”

That said, we’re still blaming Columbus!