HIV THERAPY ONLINE COURSE

Here is a link to an online course about HIV (presented by GeneEd, a company which writes online training courses for life-science professionals). The course is very well presented and is actually quite easy to understand; I think that most people would actually enjoy it, especially if they are "visual learners". The slides are animated yet not cluttered or confusing, and the course is easy to follow.

Learning topics include:

• What is HIV? (HIV viral structure, HIV viral life cycle)
  
• How Does HIV Affect the Body? (HIV and the Immune system)

In order to understand what effects HIV has on the body, it is important to understand the virus itself- what makes HIV unique and what gives it the ability to integrate itself into the immune system. In order to understand how the antiretroviral medications used to treat HIV actually work, it is essential to first understand how the virus replicates and infects the CD4+ (T-cells) lymphocytes. This course provides an easy-to-understand base for that knowledge.

ACCESS THE COURSE HERE

HIV STIGMA - THE WORLD'S IGNORANCE

As we approach World AIDS Day (12/1/08), I was disheartened to read an article that appeared in a several UK newspapers announcing that a top Catholic school in the UK, which taught former British Prime Minister Tony Blair's children, has cancelled its plans to raise money for a leading AIDS charity. The school's internationally famous choir (the London Oratory School Schola) is one of the country's leading choirs and is a highly sought-after commercial choir; they have performed on soundtracks for Harry Potter and The Lord of the Rings.

The concert was planned by the school to raise money for World AIDS Day. The nominated charity to receive the proceeds was the Terrence Higgins Trust, which is Britain's foremost charity for people living with HIV. This was changed abruptly by the headmaster of the school after a group of the students' parents protested strongly, saying that they "disagreed with the proceeds of the charity benefit going to an organization whose aims and practices conflicted with the teachings and viewpoint of the Catholic church". The headmaster of the school announced that it would be inappropriate for the school to financially support a charity with proceeds from the concert because he did "not feel that the Terrence Higgins Trust was an organization whose philosophy, aims, and practices support Christian values".

A spokesperson for the Terrence Higgins Trust said that they were surprised and disappointed by the decision... I feel that this abrupt decision was very unfair to the Terrence Higgins Trust. This event was being planned for several months, and volunteers at the Terrence Higgins Trust had already spent countless hours working on and promoting the event after it had been designated by the school as the recipient for the proceeds. Raising money for HIV/AIDS is extremely challenging, and cancelling the event less than 1 month before World AIDS day was very inappropriate.

As for the school's opinions that a benefit to support those who are infected with and affected by HIV and AIDS does not support Christian values and teachings- I feel that this is the most "Un-Christian" decision that could have been made. Christian values are supposed to be about love and tolerance, and this is anything but that. I am angered, outraged, and disheartened that Christianity can so selectively determine who deserves to be helped. this decision is certainly not Christian; it is pure evil and full of hatred.

As World AIDS Day approaches, the headmaster of the London Oratory School, the parents of the students who protested the concert, and the so-called Christian leaders who made the decision should take a close look at the HIV/AIDS epidemic. The worldwide statistics are alarming. In the UK alone there are an estimated 88,267 people living with HIV/AIDS. The annual number of newly diagnosed infections in the UK is approximately 8,000, and that number is increasing rapidly, especially among heterosexuals.

HIV affects all of humanity: male, female, single, married, all races and social classes, heterosexual, gay, lesbian, bisexual, transgendered, young, old, educated, professional, unemployed...

HIV and AIDS does not discriminate- so what right does the Catholic church have to discriminate? The leaders of the church should all be ashamed of themselves. This horrible disease can affect anyone. I wonder how the church officials or the parents of the school's children will feel when this disease enter their lives... and we can be sure that it will, eventually.

WHAT IS HIV?

I frequently hear people using the acronyms "HIV" and "AIDS" interchangeably. I wanted to clarify this issue, as it is important to have an accurate understanding of the basics so that you can participate in the fight against this disease by educating others about it.

HIV is an acronym for human immunodeficiency virus, which is the virus that has been proven to cause HIV disease and AIDS. A person who is HIV positive has HIV disease, which means that they have been infected with HIV. They may or may not have any symptoms of the disease, and they may or may not have AIDS. HIV positive and HIV disease simply means that you have antibodies to the virus or that you have had detectable HIV replication in your blood.

AIDS is an acronym for acquired immunodeficiency syndrome, which is an advanced stage of HIV disease. If you have been diagnosed with AIDS, then you are definitely HIV positive. Certain laboratory markers and the presence of certain symptoms or opportunistic infections put an HIV positive person into the AIDS category (these will be discussed in a later post).

The classification of AIDS has a certain stigma attached to it (above and beyond that which is already associated with having HIV), especially among the HIV positive population itself.Progression of HIV disease to AIDS often makes a person feel as if their health status is rapidly deteriorating, and this can be very distressing for some patients. Everybody who has AIDS also has HIV disease, however not everybody who has HIV disease has AIDS.

As we approach World AIDS Day (December 1, 2007), let's remember to be sensitive to the emotional needs of those who are infected with and affected by HIV/AIDS.

HOW LONG DOES THC (MARIJUANA) STAY IN THE BODY?

Marijuana is the most commonly used and tested for illicit drug in the United States. There is no simple and accurate answer to the question "how long does THC stay in the body?". THC can remain in the body and its metabolites can be detected by many drug tests from 3 to 90 days after it is ingested orally or smoked. Many factors go into determining how long drug toxins will remain in a person's body; these factors vary from person to person and include the analytical method used to detect the drug, your overall health, your body weight and body fat percentage, your metabolic rate, your fluid intake, the type of drug used, and the degree of exposure to the drug toxin.

THC (delta-9-tetrahydrocannabinol) is one of nearly 400 chemicals found in a cannabis (marijuana) plant; it is the particular chemical that accounts for most of marijuana's mind-altering (psychoactive) or so-called pleasurable effects. The strength of the drug (marijuana) and the degree of mind-altering effects obtained after smoking the drug is determined by the amount of THC it contains, and this varies from plant to plant.

In order to answer the question "how long does THC stay in the body?", you have to first understand how the drug is absorbed into the body and how it is metabolized by the body. The THC in marijuana enters the bloodstream within minutes of being smoked (within 30 minutes to 2 hours if ingested orally) and is then rapidly absorbed and stored in fatty body tissue, including the brain, liver, bladder, and kidneys. The fact that THC is fat soluble is the reason why THC is able to remain in the body and be detected for a relatively long period of time when compared to other controlled substances. Once it is stored in the fatty tissues of various organs, THC is slowly released and metabolized by the body. The metabolites (byproducts of the drug after it has run its course throughout the body) of THC are then excreted and cleared from the body; these metabolites of THC (specifically 9-carboxy-THC) are detectable for a much longer period of time than THC is, and this is the reason why most drug toxicology tests look for the metablolites of THC rather than the THC itself.

As pointed out earlier, marijuana's effects on the body and the speed at which it leaves the body (the detection time) is dependent on many variables, but especially on the strength or potency of the marijuana (the amount of THC contained in the plant). It has been estimated that marijuana can have a half-life (the amount of time that it takes for half of the total amount of drug taken to be eliminated from the body) ranging from 1-15 days; therefore it can be expected that the drug will remain detectable in the body for 2-30 days. Since marijuana is an illegal drug, not a pharmaceutical product regulated by the FDA, it is impossible to predict the potency of the drug or what the half life of a particular plant will be. The detection time is also influenced by the amount of exposure you have to the drug. If you inhale second-hand marijuana smoke, there may be detectable metabolites in your body for several days. If you smoke it occasionally, it will usually remain in your system for up to 10 days. If you smoke it on a regular basis it will stay in your system for up to 45 days. THC has a cumulative effect, so if you smoke marijuana heavily on a daily basis, it can stay in the body for up to 90 days. This is because THC is stored in the fat cells in the body's major organs, including the brain, the liver, the bladder, and the kidneys. Once the THC is stored, it is slowly broken down to it's active metabolites (the detectable traces of THC), which can be picked up on a drug test.

Drug tests can detect active drugs as well as their metabolites. Drug testing can be done by analyzing blood, urine, hair follicles, and even saliva. As can be seen from the preceding information, the answer to the original question of "How long does THC stay in the body?" is extremely complicated, as there is not a simple formula or calculation for a time limit between when the drug is ingested and when it will no longer be detectable. There is much human variation as well as variation between different types and species of cannabis plants. To complicate matters even more, there are tests that look for a much smaller cut-off amount of the drug; some tests detect up to 50ng/ml, whereas other tests are more sensitive and will detect a smaller, trace amount.

There are numerous websites that offer home cleansing remedies that claim to rid the metabolites of THC from your body, and others that offer home testing kits. None of these, however, have been proven to be effective; in fact the general opinion is that these sites are a huge scam. Increasing your metabolism through vigorous physical exercise may theoretically remove traces of drugs from your body. Others say that flushing your system with a lot of extra water will increase the elimination of THC. This all sounds ridiculous, if you consider that the THC is bound to the fat cells in the body. Water is not going to flush the THC out of the fat; it's only usefulness may be to help the kidneys to eliminate the metabolites of the THC through the urine.

The best way to be sure to pass a drug test is to not use drugs. The purpose of this article is not to discuss or debate the dangers of drug use, however I feel that I would be remiss if I did not mention that marijuana, although deemed to be harmless by many, is an illegal drug and its use has consequences in our society. Regardless of how much one may feel that it should be legalized, the fact of the matter is that it is not. I will even go so far as to support the argument that other things (such as cigarettes) are equally as harmful and should also be illegal, however that is not the way things are, and as members of a civilized society we need to live by the laws. We don't get to pick and choose which ones to obey because we agree with them. In addition to the legalities, consider once again that THC contains over 400 chemicals, many of which have proven to be carcinogenic. In most cases marijuana is smoked, which causes damage to the lungs such as chronic bronchitis, emphysema, and lung cancer. THC is stored in the fat in various organs; it has been shown to contribute to bladder cancer, just as cigarettes are. In an era where society's focus is on health and wellness, where we are concerned about e-coli poisoning in our food and about vaccinations for infectious diseases, it just makes no sense to inhale over 400 toxic chemicals directly into the lungs, does it?

DOES ONLINE HEALTH IMFORMATION HELP THE PROVIDER-PATIENT RELATIONSHIP?

As a healthcare provider and a prescriber, I can say that overall I appreciate a well-informed patient who is actively involved in his or her health care. The fact that someone takes the time and makes the effort to try to learn about their health conditions or about preventive and wellness initiatives means that they have an interest in their health and that they will be willing to make an effort towards their own wellness. This can only make my job easier. I like to think of a patient-provider relationship as a partnership, not as a dictatorship. I can bark out all the orders I want and can write endless prescriptions, however a patient will not follow my directions unless they buy into and believe in what I am saying. I think that my job is to accurately and competently assess a patient, order the correct diagnostic tests and interventions, and then decide together with the patient about what the treatment plan will be. Of course I present the most current, up-to-date, evidence-based treatment options, but I will always discuss alternative treatments if a patient brings them up and will always take the time to listen to a patient if he or she has ideas gained from internet or other research. Afterall, the patient knows his or her body even better than I do.

As for direct to consumer pharmaceutical advertising: there have been many times when a patient has been unable to accurately describe symptoms to me or another provider, and then has gone home and heard a pharmaceutical advertisement describing a certain condition. As if a light bulb is turned on, the patient will say "that is exactly what I feel" or "that is what I have". When that information is again relayed to me, I find it to be very helpful. Oftentimes providers are not able to illicit the correct information from patients, either because we ask the wrong questions or we don't take the time to listen. The reverse side of this, of course, is that in some cases we have to be explaining to people why they don't have a certain condition or why they don't need a certain drug.

I don't feel that the abundance of information available on the Internet, on TV or in magazines gives patients too much control over their own treatments. As I've said, it can be a great help to have a patient walk in armed with some insight into their problems. It is then up to the provider to use good, sound professional judgment and to make all treatment decisions based on evidence obtained from current research studies and standards of practice, and to use that data to explain to the patient why a particular treatment may or may not be best for them. Patients want to get well or to stay well; they do not want to walk into the office and "get their own way". I feel that if a patient is insistent about a particular treatment which I don't agree with then I owe it to them to consider it and to present the facts and reasons why it is not the best course of action for them. I don't see that abundant health information is going to be harmful unless providers become so lazy and unethical that they stop communicating with their patients and just "give in" whenever a patient requests a certain drug. Although the provider-patient relationship should be a partnership, the provider is the one with the medical education and the professional licenses to treat and to prescribe, and the ethical duties involved in that must not be forgotten. Providers have a responsibility first to "do no harm" to their patients. This means taking the time to make the right decisions with the patient, not for him; it also means not becoming complacent and letting the patient call the shots and "get his way" because it is easier to do it that way. Practicing medicine is still going to be work; it's just that now we're dealing with a more informed patient population than before.

SEX, SEXUALITY, SEXUAL HEALTH, AND SEXUAL RIGHTS

Most, if not all, adults desire a healthy, happy, and rewarding sex life. Sexual health is a state of well-being as we enjoy and experience our sexuality physically, emotionally, psychologically, spiritually, socially, and culturally.

SEX refers to the biological characteristics (reproductive organs and their functions) that differentiate human beings as being either male or female. In broader terms and in general use in many settings, SEX is often used to refer to "sexual activity".

SEXUALITY is a central part of being human. It involves your attitudes towards sex and intimacy, your sexual desires, and your ability to fulfill your desires. Sexuality encompasses the concepts of sex, gender identities and roles, sexual orientation and preference, intimacy, pleasure, eroticism, and reproduction. Sexual satisfaction is important and necessary for both men and women.
Our sexuality determines how we feel about the following things:
* Our body and how it works
* Our biological sex and gender (biological, social, and legal status as male or
female
* Our gender identity (feelings about our gender)
* Gender roles
* Our sexual orientation (straight, gay, or bisexual)
* Our values about life, love, and the people in our lives
* Eroticism, Intimacy, and Pleasure
* Reproduction

Sexuality is experienced and expressed in thoughts, fantasies, desires, beliefs, attitudes, values, behavior, roles, and relationships. The experience and expression of sexuality is influenced by the interaction of physical, emotional, psychological, social, economic, political, cultural, ethical, moral, legal, religious, and spiritual factors.

SEXUAL HEALTH is not merely the absence of disease or dysfunction; it is a state of well-being related to our sexuality. It encompasses physical, emotional, psychological, spiritual, societal, and cultural aspects of sexuality. In order to make healthy and responsible choices about sex, you need to continuously seek out accurate and reliable information about sex and sexuality. Learning about issues related to the concepts of sexuality will make you more likely to feel good about yourself, allowing you to make the healthiest and the best possible choices for yourself, your sexual partner(s), and your future. Sexual health is best exemplified by voluntary and responsible sexual expressions and acts that enrich both you as an individual and your social life. You need to respect yourself and other people and take good care of your body in order to maintain good sexual health. For sexual health to be attained and maintained, the sexual rights of all persons must be respected, protected and fulfilled.

Sexual health is influenced by personal sexual attitudes, beliefs, and behaviors, as well as societal attitudes and beliefs (the "norm"), biological risk (diseases), and genetic predisposition to disease. Sexual health encompasses the problems of HIV and AIDS, Hepatitis, sexually transmitted diseases (STD), infertility and cancer resulting from STD, unplanned pregnancy, abortion, and sexual dysfunction. Sexual health is also influenced by mental health, acute and chronic illness and disease, disability, violence, and the abuse of drugs and alcohol.

Sexual health includes the ability to enjoy and control sexual and reproductive behavior in accordance with one's own personal beliefs as well as within social ethics. Sexual health means that a person is free of fear, shame, guilt, false beliefs, and other psychological and emotional factors that interfere with sexual response, sexual relations, sexual pleasure, and reproductive functions.

SEXUAL RIGHTS include the right of all humans to pursue a safe, satisfying, and pleasurable sex life with the partner of their choice, free of coercion, discrimination, and violence. All humans should have these basic sexual rights; however, as evidenced by the continued oppression of women, arranged marriages, and the practice of genital mutilation of females in order to negate sexual pleasure which are still occurring in many areas of the world, these rights are being violated.

All humans should have the right to the highest possible standard of sexual health, which includes access to sexual and reproductive healthcare services. They should be able to seek, receive, and talk about information related to sexuality without punishment or discrimination. They should be able to decide whether they want to be sexually active or not and to choose their sexual partner(s). Sexual relations should be mutually consensual, and sexual as well as marriage partners should be an individual choice. Women should have the right to decide whether or not, and when, to have children. A human being should expect that sexual partners will respect their bodily integrity and refrain from mutilation and violence.

In order for sexual rights to be upheld, a legal regulatory system where the sexual rights of all humans are upheld is required. There also must be an integrated system of healthcare and community professionals who can address sexual health and rights at the individual, family, community, and health system levels and provide appropriate interventions and referrals. The responsible exercise of human rights requires that all persons respect the rights of others.

HOW TO KEEP HIV AT BAY

Intensive prevention and education initiatives are the best way to keep HIV/AIDS "at bay". The problem with global efforts to prevent new HIV infections is that the education initiatives must be adaptable to the beliefs and customs of each individual culture and group of people; what works in one part of the world will be useless in another. A "canned approach" such as handing out free condoms to people will not work.

Condoms will only prevent disease if people use them. People will only use the condoms if they truly understand and believe that sexual contact without the protection of a condom will spread the HIV virus. In some parts of the world, people remain ignorant to the facts of science and refuse to believe that AIDS is caused by a virus. Many myths persist as to the cause of AIDS, and until these are dispelled we will continue to see an increase in the number of new infections worldwide. Education and prevention messages must be culturally based and individualized. In the under-developed parts of the world HIV/AIDS is growing at an alarming rate. Much needs to be done as far as prevention work goes, in addition to finding a way to fund the cost of treatment for those who do become infected.

Even in the developed world, where we have the benefits of advanced science, medical technology, and effective medical treatment, we still have a lot of work to do. People continue to engage in risky sexual behavior, and there are new infections diagnosed every day. There are many who have treatment available and who choose, for whatever reason, not to adhere to the treatment. There are know that they have the virus and yet they continue to engage in high-risk behavior.

Human behavior is a very complex phenomenon, and the study of human behavior and effecting changes in behavior is complicated by different cultures and belief systems. It is so easy for one to simply say that the best way to keep HIV/AIDS at bay is to use a condom. That is true; using a condom correctly with every single act of intimacy outside of a monogamous relationship with a known HIV negative partner is, in fact, the best way to prevent the transmission of HIV and other STD's. Anyone who understands HIV disease will adamantly support this fact. However, we need to take it a step further and begin to consider how we are going to get everyone worldwide to buy into this. Until we do, there will be no slowing of this horrible epidemic. You can lead a horse to water, but you cannot make him drink, just as you can hand out condoms but you cannot make people use them. We need to think outside of the box and start individualizing our prevention efforts worldwide.

HIV AND AIDS IN HIGH SCHOOL STUDENTS

HIV and AIDS are very frightening to most people; public education is the key to ending most of the fear and stigma surrounding the disease. Once people understand how the disease is and is not spread, there will be less fear of those who are infected. HIV, the virus that causes AIDS, is transmitted from one person to another only through infected body fluids such as blood, semen, vaginal fluids, and breast milk. HIV is not spread through tears, by coughing, sharing straws, cups, or eating utensils, kissing, hugging, sitting next to someone who is infected or even through slow dancing with someone who is infected. Healthy children of all ages can attend the same schools as those who are HIV infected. No special precautions need to be taken other than that an HIV positive child should not play contact sports, such as football, hockey, or wrestling, where injury and bleeding are likely.

Whether we like it or not, we are ALL living with HIV, even if we are not actually infected with the virus. It is up to each and every one of us to adapt our lifestyle to prevent the spread of the infection and to teach our children and others important safety measures. All children should be taught not to touch blood without gloves under any circumstances, no matter who is bleeding. Safe sex education needs to start in elementary school and reinforced over and over and over again. Everyone should be taught about the importance of condom use with each and every intimate encounter, from start to finish. Children and teenagers need to realize that they cannot tell by looking at someone if they are HIV positive; someone may look healthy and be the most popular athlete at the school and turn out to have HIV.

We need to be more worried about the HIV status of those strangers whom teenagers are meeting and forming intimate relationships with rather than the people who are known to be HIV positive. Knowing someone's HIV status is actually better than not knowing and assuming that a potential sexual partner is HIV negative because they "don't look sick".

Sure, HIV and AIDS are frightening; so is cancer. The difference is that, for the most part, HIV and AIDS are preventable. Public education and sex education are the keys that will keep this epidemic from spreading further. Ignorance and ignoring the facts will spell disaster. A good place for people to begin learning about HIV and AIDS is http://www.thebody.com

DO NOT SHARE YOUR TOOTHBRUSH

Not sharing toothbrushes, even with close family members, is an essential concept for health, wellness, and overall good hygiene, irregardless of whether someone has HIV/AIDS, Hepatitis B or Hepatitis C or some other blood-borne illness. Most people are turned off at the mention of someone using their toothbrush, even a spouse; the toothbrush is a very "personal" item, not meant to be shared.

Many bacteria and viruses are present in the mouth; these germs are transferred to the toothbrush and then have a nice moist place to multiply. For this reason it is recommended that the toothbrush be replaced after someone is treated for strep throat or some other serious throat infection. If a person has an outbreak of oral herpes, it would be prudent to change the toothbrush once the active lesions are healed, just as it is recommended by the CDC to change the toothbrush when it is visibly soiled with blood and at least once each month, no matter what.

It must be emphasized that transmission of HIV or Hepatitis from a toothbrush is a very improbable event; there needs to be visible blood on the brush in order to transmit the viruses (they are not transmitted in plain saliva or oral secretions). If there were visible blood on the brush, I would think that even one who had considered picking up another's toothbrush would be turned off...

WE ARE ALL AFFECTED BY HIV - WHAT YOU CAN DO TO FIGHT HIV & AIDS

EVERYONE SHOULD GET TESTED AND KNOW THEIR HIV STATUS

Many people feel that if they are infected with HIV they would rather not know. Others will not take a test because they are afraid that they could not handle the results. No matter what the results of your HIV test are, remember that knowledge is power. Some very important facts about the fight against HIV & AIDS are:

• If you test HIV negative, you will be educated about how the virus is transmitted and about the lifestyle changes that you can make immediately in order to protect yourself from becoming infected with HIV or another sexually transmitted disease.
• It you test HIV positive, you can begin to receive specialized HIV treatment immediately; treatment of HIV early in the disease will help you to stay healthy longer and may delay the progression to AIDS and the onset of some of the more serious complications of HIV disease. It is very important that you receive regular care from a provider who specializes in the treatment of HIV & AIDS. To find a provider in your area, go to www.directory.poz.com
• If you test positive, you will be given information about where to go for medical care, financial and case management services, and emotional support.
  
• If you are HIV postive you can take extra precautions to prevent the spread of HIV to your loved ones and sexual partners.
• If you are a woman and are pregnant or plan to become pregnant, you need to know your HIV status. If you are HIV positive, there are medications that are safe for you and your unborn baby that can help to prevent your baby from becoming infected.

Anyone who has unprotected oral, vaginal, or anal sex or who shares needles is at risk of becoming infected with HIV. You owe it to yourself and to others to take an HIV test and to learn what we can do to prevent the spread of the virus. To learn more about where to go for a test in your area, how the test is done, how and when you will receive results, and about confidentiality and anonymity, go to http://www.hivtest.org

If your healthcare provider does not suggest an HIV test, ask for one; ask your sexual partners to get tested, also.

Respect yourself by protecting yourself. Pledge to use a condom/ask your partner to use a condom with each and every intimate sexual act. We all have the power to fight HIV & AIDS. Let's use that power and stand up and fight this disease!