#''a considerably low dose of a very low-risk drug once a week is not some crazy out of control behavior.

[numberone-wifeguy]

05/07/24

[juniperpublishers-toxicology]

Transdermal Methimazole for Feline Hyperthyroidism

Introduction

Over the past 20 years, the prevalence of feline hyperthyroidism has increased astoundingly [1-3]. It has become the most common endocrine disorder in cats, and the risk worsens with each year of increasing age, being most common in middle to older-aged felines [1]. The disease is primarily characterized by an excessive production and release of the thyroid hormones thyroxine (T4) and triiodothyronine (T3) most commonly due to a functional, benign adenomatous hyperplasia of the thyroid gland. At present, there is not a feline specific thyroid stimulating hormone (TSH) assay test available, therefore unlike human hyperthyroid diagnosis, veterinarians do not commonly depend on a low TSH value for primary hyperthyroid diagnosis. Hyperthyroidism diagnosis in cats is generally based on a high free T4 level and the presence of clinical signs and symptoms. Some of the clinical complications of hyperthyroidism that may be present include emotional lability, hyperactivity, palpitations, tachycardia, and a plethora of other manifestations of the disease (Table 1). Although the exact etiology is unknown, many nutritional and environmental causes are suspected, including canned cat food products containing iodine, soybean, phthalates, polyphenols, and polychlorinated biphenyls [2,4,5].

Regardless of the etiologic origin, medical management of prolonged thyroid hormone elevation is very important. Untreated hyperthyroidism can have many consequences on the cat. Many cats initially present with a change in personality or behavior, often being more easily agitated and mean, as well as with unexplained weight loss, changes in eating habits, accelerated heart rates, and a goiter. Hyperthyroidism, if left untreated, can also have life threatening adverse effects, such as causing hypertension, cardiac tachyarrhythmia, atrial fibrillation, and even death [6,7]. These result from elevated thyroid hormone levels and cause up-regulation of various gene expressions involved in the body’s metabolism, thermogenesis for heat regulation, nerve function, and muscle and bone function [7]. They also function to increase activation of the sympathetic nervous system, which elevates the heart rate, the heart’s force of contraction, and increases cardiac output overall [8,9]. Clearly, both the symptoms of the disease, as well as the enhancement of these biochemical pathways, can pose serious health risks to the feline patient. The longer a cat goes without treatment, the worse their complications become [6,10,11].

Like the management of hyperthyroidism in humans, there are several different treatment options available for cats. The top three recommended therapies include surgical thyroidectomy, radioiodine therapy, and medication treatment. Thyroidectomy and radioiodine treatment can be permanent solutions to the disease. However, limitations such as expense and permanent hypothyroidism prevent these from being practical options for most feline patients [7,11] (Table 2). Medication therapy is often the most practical and accessible way to manage hyperthyroid cats. Methimazole (Tapazole, Felimazole) is the most common and favored agent in the United States [12]. Other alternatives include carbimazole (a prodrug of methimazole marketed only in the UK), iodine-containing agents, iodine dietary restricted food, and homeopathic regimens [6,12-14]. Dietary iodine restriction is another option, however, there is limited supporting data to determine a true benefit.

Although several treatment options are available for hyperthyroid cats, each therapy option has considerable drawbacks to both the client and the feline patient. Oral methimazole has historically been the most accessible and affordable choice. However, gastrointestinal side effects and an unfavorable twice-a-day oral administration schedule often limit its ultimate therapeutic outcomes in the cat. Both negative attributes are avoided with use of the transdermal methimazole gel compound. Due to the limited amount of data available on transdermal methimazole, this review aims to evaluate whether the pluronic lecithin organogel (PLO) compound of methimazole is effective in treating hyperthyroid cats. In addition, it also serves to provide insight on the recommendations for its use.

Methods

A PubMed search was conducted to identify articles in which the safety or efficacy of transdermal methimazole for treatment of feline hyperthyroidism was assessed. Key MeSH search terms included feline hyperthyroidism with a subheading for treatment. In addition, feline hyperthyroidism plus one of the following search terms were searched: treatment, drug-related side effects and adverse drug reactions. A free-text search was also conducted to identify articles not included in the MeSH term search. Metaanalyses, randomized controlled clinical trials, and case reports were included in the review if the primary focus of the article related to the use of oral or transdermal methimazole for feline hyperthyroidism. Studies were excluded if published in languages other than English. In addition, studies highlighting mechanisms of action, studies of pharmacodynamics or pharmacokinetic effects were excluded.

Results

Clinical data on the topic of feline hyperthyroidism treatment is limited. A PubMed search revealed 14 articles with transdermal methimazole and feline hyperthyroidism as a subheading. Of the articles used in this review, there were six that directly assessed the use and efficacy of transdermal methimazole in the treatment of feline hyperthyroidism. Of those six, five were small clinical studies and one was a case report/series.

Evaluation of oral methimazole

Oral methimazole has remained the mainstay of feline hyperthyroidism treatment since the early 1980’s. It reversibly suppresses thyroid hormone levels by inhibiting thyroid peroxidase. It does not inactivate circulating T4 and T3, resulting in a 2 to 4-week delay before serum T4 concentrations begin to normalize [8]. While it accumulates in the thyroid gland, it does not block the release of preformed hormone, nor does it help reduce goiters [8,15]. Oral methimazole has variable bioavailability ranging from 27 to 100% so its efficacy varies from patient to patient [6]. The recommended dose for maximum efficacy is 2.5mg administered twice daily.

In a randomized, unblinded, clinical trial by Trepanier et al. [11], forty methimazole naive cats with newly diagnosed hyperthyroidism were studied to compare the efficacy of one daily dosing of oral methimazole to twice daily dosing. Owners completed a questionnaire of their cat’s baseline behavior status and reported any changes that occurred during the study. The overall efficacy of once daily methimazole was found to be less effective than twice daily dosing. Serum T4 concentrations were considerably higher in cats receiving once daily dosing, and only 54% (13/24) were found to be euthyroid at two weeks, compared to 87% (13/15) euthyroid in the twice daily group [16]. Both treatment groups showed considerable clinical improvement of many complications caused by hyperthyroidism. However, among the initial 40 cats studied, one cat in the once daily dosing group was removed prior to the 2-week point due to considerable gastrointestinal (GI) upset. Of the remaining 38 feline patients, 17 (44%) developed some type of adverse event throughout the four-week duration. Throughout the remainder of the study, 23% (9 cats) reported similar GI upset. Among the 24 cats treated once daily, 42% (10/24) required discontinuation of therapy, in order to resolve oral methimazole induced adverse events. Facial excoriation was reported in six patients, five reported from the once daily dosed group alone. Five of the six total facial excoriation cases reported were from the once daily dosed group. Manifestations of blood dyscrasias and hepatopathy were not significantly reported in either group [16].

Not only were adverse events such as GI upset and facial excoriations, found to be less prevalent in cats dosed twice a day, but also these cats were also more likely to obtain the goal euthyroid state. Cats also show rebound increases in serum T4 concentrations and a return to hyperthyroid state within 24 to 48 hours of methimazole discontinuation [3,16,17]. This likely correlates with the need for twice daily dosing in cats, and further research should be performed to help determine methimazole’s true intrathyroidal residence time in cats. Oral methimazole is not a cure for feline hyperthyroidism, and treatment must be continued indefinitely. With the intolerable GI upset from the oral tablets and the difficulty many owners face administering the medication twice daily to uncooperative cats, the alternative transdermal route of administration poses significant benefits [16].

Transdermal methimazole formulation

Despite the limited clinical studies on transdermal methimazole, some clinicians have achieved a good therapeutic benefit to using this dosage form in cats. Pluronic lecithin organogel is a microemulsion-based gel containing lecithin, isopropyl palmitate, and pluronic acid to effectively deliver both hydrophilic and lipophilic drugs topically across the stratum corneum and may aid in the administration of methimazole [18- 22]. PLO is composed of both an oil phase (lecithin phase) and an aqueous phase (pluronic phase). It includes isopropyl palmitate acts as a solvent and permeation enhancer while lecithin also serves as a permeation enhancer by increasing the fluidity of the stratum corneum, and slightly disorganizing the skin structure to permit substance permeation [23-25]. PLO reversibly turns into a thick gel at body temperature, leading to an increase in dehydration of the aqueous solution, forming a shell-like structure of aggregated micelles [7,24-28]. Methimazole is an ideal drug for transdermal delivery due to its low molecular weight, high lipid solubility, water solubility, low daily dose, and is non-irritating and non-sensitizing to the skin [20,24].

Efficacy of the PLO methimazole

In a small retrospective study examining dispensing records for 16 hyperthyroid cats undergoing transdermal methimazole treatment, the transdermal formulation was effective at reducing serum T4 concentrations in 15 of the 16 cats studied. One cat showed an increase in serum T4 level, but there is no mention or clarification of appropriate application or other possible contributing factors. The only adverse event reported was a single case of increased blood urea nitrogen level, thought to be the unmasking of prior renal disease. This study also demonstrates variability in dosing and administration frequency of the topical, ranging between 5 mg once a day to a twice daily dose of 7.5mg every morning and 5 mg every night. This wide variation between each feline patient, limits our ability to recommend a standard dose or administration frequency, but does indicate the need for patient-specific doses and frequencies in order to effectively reach the euthyroid goal [29].

 In a randomized clinical trial conducted by Sartor et al, 47 newly diagnosed hyperthyroid cats were used to investigate whether PLO formulated transdermal methimazole was safe and efficacious in controlling feline hyperthyroidism. At two weeks of treatment, more cats in the oral methimazole group had serum T4 concentrations within the reference range (14 of 16 [88%], p=0.035). By week four, there was no difference between the oral and transdermal methimazole. The PLO transdermal methimazole group took longer to reduce serum T4 concentrations to the acceptable reference range, however, it was as effective as oral administration in producing euthyroidism by the fourth week of treatment [30]. Fewer GI adverse events were reported with the transdermal formulation (1/27 vs 4/17 in the oral group). The reduction of GI upset deems consideration as it is often the cause of discontinuation of oral methimazole [30,31].

Lecuyer et al evaluated the efficacy of transdermal methimazole in 13 newly diagnosed hyperthyroid cats. The feline patients received 5mg methimazole concentrated in PLO, applied to the inner ear twice daily. In addition to reaching the euthyroid state, all 10 cats that completed the study also showed improved clinical signs related to hyperthyroidism consistent with other previously reported studies [16,32-33]. No GI adverse events were reported, and investigators concluded that PLO transdermal methimazole is a safe and effective alternative to oral methimazole [6].

Duration of t4 suppression

A study by Boretti et al. [33] evaluated the duration of serum T4 suppression among newly diagnosed hyperthyroid cats treated with once daily transdermal methimazole versus twice daily dosing. Twenty cats were treated with the PLO-based methimazole formulation dosed either 2.5mg every 12 hours (10 cats, group 1) or 5mg every 24 hours (10 cats, group 2). Serum T4 concentrations were measured one and three weeks after initiation of therapy, immediately before and every two hours after gel application for up to 10 hours. Cats were limited to a maximum of five blood samplings in one day [33]. A sustained suppression of T4 concentration for at least 24 hours was seen following gel application and there was no significant difference in change in serum T4 concentration immediately before or any time after gel administration in either group. As also discussed in Lecuyer’s study [6], further research is needed concerning the duration of intra thyroid methimazole accumulation [6,33,34]. Among the twice daily dosing group, reductions were required in three cats, and a dose increase was required in one patient. Of the once daily dosing group, two cats required a decrease in dose, and one cat required an increased dose, after three weeks of treatment as a result of sustained hyperthyroid levels [33]. Investigators concluded that once daily application of the PLO methimazole compound can effectively reduce serum T4 concentrations in most hyperthyroid cats. Once a day dosing is most convenient for the owner, and thus promotes better compliance [33]. The compounding of this preparation allows for changes in dose or frequency and allows for the individualization of therapy.  

PLO vs. novel lipophilic base

In a 12-week prospective study by Hill et al, a novel lipophilic formulation of methimazole was investigated. The study included 45 cats newly diagnosed with untreated, naturally occurring hyperthyroidism [12]. The study used a novel lipophilic formulation prepared with methimazole, “carrier compounds” (propylene glycol, polyethylene glycol 4000, dimethyl formamide, and cyclodextrin), and several penetration enhancers, chosen from fatty acids, terpenes, pyrrolidones, a short chain alcohol, glycol ethers, acetins, and triglycerides. The formulation was determined to be stable for 12 months after preparation, by the International Cooperation on Harmonization of Technical Requirements for Registration of Veterinary Products. Cats were treated with a starting dose of either oral carbimazole (5mg twice a day) or the novel transdermal methimazole formulation (10mg, or 0.1mL applied to the inner ear once a day). Both the once daily novel transdermal methimazole and twice daily oral carbimazole were effective in the treatment of feline hyperthyroidism in cats with compliant owners. All owners were satisfied with the improved clinical symptoms.

 The novel lipophilic transdermal formulation had several advantages over the oral carbimazole, as the transdermal medication was tolerated better, and caused no gastrointestinal side effects in the cats. Owners reported that administering tablets to their cats was a challenge, and 35% admitted to missing doses or cats spitting out the medication [12]. Unlike the rare occurrences of pruritus reported with the PLO formulation of methimazole, no adverse events of pruritus or erythema of the inner ear were reported [6,12]. The study suggests that since methimazole is a lipophilic drug, a lipophilic vehicle might more suitable than the PLO base.

Although this study clearly highlights the effectiveness of once a day use of this novel lipophilic formulation, it would have been more appropriate to study it in comparison with the PLO methimazole formulated topical. The novel lipophilic formulation appears to be less irritating to the skin among cats than the PLO. However, this has not been shown clinically significant in any study, and thus does not provide enough evidence to recommend one transdermal formulation over the other [6,12,33]. Further evaluation and study are needed to compare the costs, efficacy, stability, accessibility, and adverse event rates between the PLO and novel lipophilic formulations of methimazole.

Discussion

Transdermal drug delivery is an appealing route of administration for veterinary medicine, especially for clients with uncooperative pets. PLO used for methimazole is recognized as a viable transdermal delivery tool because of its enhanced drug transport capabilities. It can effectively deliver both hydrophilic and lipophilic drugs. Transdermal methimazole circumvents the liver’s first pass metabolism, potentially allowing a lower drug dose for an equal effect while also avoiding the intolerable GI upset often caused by oral drugs leading to discontinuation. Following chronic daily application of PLO formulated methimazole to the inner ear of cats with hyperthyroidism, successful resolution of clinical signs and lower T4 levels have been noted [6,18,30,31,33].

Although ultimately effective, delayed onset of action was noted and transdermal methimazole takes longer to achieve therapeutic serum T4 concentrations compared to oral methimazole activity. Oral administration may be more suitable in cats with very severe hyperthyroidism, requiring rapid reduction of thyroid hormone levels. Repeated dosing with the PLO formulation can lead to exfoliation of the inner ear, mild inflammation, and may cause a depot of drug in the skin [30,35]. As the PLO works to compromise the skin barrier over time, more drug is absorbed. Therefore, maximum effectiveness is not seen immediately, but most feline patients will reach a euthyroid level by week 4 of treatment. Transdermal methimazole can be deemed noninferior to the widely approved oral formulation.

Oral methimazole has only been proven effective if dosed twice a day in cats [16]. Once daily dosing of transdermal methimazole was successful, however, the need for twice daily dosing was recognized early in treatment. Once daily dosing presents an obvious advantage as it is most convenient for the owner and aids in promoting good compliance. Near perfect compliance is imperative when treating hyperthyroidism, because serum T4 concentrations can return to their hyperthyroid level within 48 hours after the last dose. Another unique advantage of the transdermal formulation is that it can be compounded into any dosage concentration needed.

In the past, transdermal methimazole was recommended only for short-term use in cases of oral methimazole induced GI upset or an uncooperative cat. Oral methimazole was indirectly favored due to the cost, variable stability, and unknown pharmacokinetic information of the transdermal form. However, more recent studies have suggested extended effectiveness with long-term use of the transdermal methimazole. Also, upon diagnosis of hyperthyroidism, most cats are near the end of the life and shortterm treatment is usually enough in resolving the hyperthyroid illness until the cat expires due to other unrelated diseases. Although the transdermal formulation is more expensive, it is still a more reasonable cost compared to the expense of thyroidectomy and radioactive therapy. Cat owners reported missing oral doses or cats spitting tablets, thus the transdermal gel may be worth the extra cost in order to manage the disease. Clients at large reported satisfaction with the compounded medicine, with only a few reports of precipitation of the gel [6].

Conclusion

Transdermal use of PLO compounded methimazole is an effective therapy for lowering serum T4 concentrations in cats. It is safe, posing fewer adverse effects than the oral formulation. It can be effectively used to treat feline hyperthyroidism through individualized dosing and frequency of administration. Owners should rotate ears each application and remove any residue with a damp cotton ball prior to the next application. Cats tolerate it very well, and it is favored by owners for its convenience and resolved GI upset events. Frequent monitoring of the cat’s liver function tests, BUN, creatinine, CBC, platelet count, and serum T4 concentration is recommended. Very little data exists regarding its pharmacokinetic properties and formulation stability, and the significance of the information available is limited by the small sample sizes studied.

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[julianlucas95]

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[annieboltonworld]

Postmenopausal Osteoporosis | JuJuniper Puniper Publishers

Juniper Publishers-Open Access Journal of Case Studies

Authored by Vikram Khanna

Abstract

Osteoporosis is a condition with a very high prevalence and its spreading at a rapid pace which is in tandem with the increase in the life expectancy of the general population. With the change in the eating habits the patients are not getting adequate nutrition for the wellbeing of the bones. With the advancements in the field of bone mineral density measurement it may now be possible for early detection and rapid treatment which may lead to the better outcome for the patient and may prove less detrimental for the society as well.

Keywords: Osteoporosis; Menopause; BMD

Introduction

Osteoporosis is a silent condition which has been on the rise in the recent times due to the increase in the life expectancy of the patients [1]. This affects the physical, mental as well as socioeconomic condition of the patient. This review article summarizes the important aspects of this condition as well as sheds light on its treatment.

Definition

The working group of WHO in 1994 came up with the definition which was based on T score of the Bone mineral density (BMD) and it said that a T score less than -2.5 can be considered as osteoporosis [2].

Background

The number of patients with osteoporosis is on a rise and it is expected that the no. will soon reach 34 million in USA [3]. Out of which 80% are expected to be women. The incidence of osteoporosis increases exponentially with age and there is a sharp increase in cases following menopause in females. The incidence of osteoporosis is also associated with an increase in the incidence of fractures which also rises following the decrease in the bone mineral density [4].

Pathophysiology of Postmenopausal Osteoporosis

There may be 2 causes of postmenopausal osteoporosis

Low peak bone mass

Increased bone loss, or both Peak bone mass is determined 70%-80% by genetic factors [5-8]. Remaining causative factors for the peak bone mass include factors like nutrition, activity and hormonal interplay.

Once the peak bone mass is achieved, bone regulation takes place by local remodeling which is regulated by RANK, RANKL protein and OPG. RANK or receptor activator of nuclear factor-kb is present in the osteoclasts and causes the increase in their activity. RANKL or the RANK Ligand is synthetized by osteoblasts and it binds with the RANK receptor on the osteoclasts. OPG or Osteoprotegerin is also synthetized by the osteoblasts and prevents the binding of the RANK to the RANK Ligand by itself binding to the RANKL. Hence, the activity of the osteoclasts and in turn the bone remodeling depends upon the interplay between the RANK and the OPG. This interplay is controlled by hormonal and local factors. If the bone remodeling is in balance (osteoblast = osteoclasts) then there is no decrease in the BMD. A change in the balance of remodeling causes the change in the BMD accordingly.

In postmenopausal females, there are hormonal changes which cause an increase in the RANKL which causes increase in the osteoclastic activity and hence, shifts the bone remodeling towards a bone resorbing balance which leads to osteoporosis.

It has been noted that the bone loss is maximum 3-5 years before menopause and also 3-5 years after menopause. These points towards the indirect as well as the direct causes of bone loss leading to osteoporosis. This bone loss is faster than the average bone loss seen in the senile osteoporosis seen in males. There is also research going on which suggests the change in the micro architecture of bone with the advent of osteoporosis. However, this research and the quantification of these changes are still in experimental stages and not available for commercial use [9]. Factors which accelerate bone loss are included in Table 1. Also, factors which increase the risk of falling and fractures are included in Table 2.

Clinical Features of Postmenopausal Osteoporosis

These include:

Low Bone mass: measured by BMD

Fracture: Single most important manifestation of postmenopausal osteoporosis.

Lifestyle and Non pharmacologic Measures for Bone Health

Goals of this therapy include:

Optimizing skeletal development to increase the peak bone mass

Prevent secondary bone loss

Preserve the skeletal structural integrity

Prevent fractures

Following diets should be taken into consideration:

Good general Nutrition: A balanced diet is necessary for the development of a good peak bone mass. The peak bone mass also depends upon the protein intake as well as the activity level of the patient [10-12].

Calcium: The recommended dose of daily requirement of calcium in various situations is given in Table 3. Some points to be taken into consideration are that calcium is absorbed better with food and calcium citrate gives the least amount of GI side effects as compared to other calcium compounds.

Vitamin D: It is important to assess serum Vitamin D in all individuals suffering from osteoporosis. Vitamin D is found in food stuff like fish oils, fortified milk, cereals and breads. National Osteoporosis foundation recommends a dose of 800-1000 IU for patients more than 50 years old [13]. However, many experts feel that the dose should be between 1000-2000 IU (Safe upper limit being 4000IU/day) [14]. Currently the normal level is 30-32ng/ml (Upper limit being 60ng/ml) [15]. Even though daily doses are present still it has been seen that the intermittent dose was found to be 3 times more potent [16].

Other dietary supplements: Magnesium doesn’t increase the calcium absorption but decrease the GI side effects [17]. Excessive Vitamin A was harmful for the bones in large doses (more than 100000 IU) [18]. Vitamin K (1mg/ day) has been found to decrease the bone turnover and hence decrease the bone loss [19]. Natural estrogens (isoflavones) were thought to prevent bone loss but there has not been any scientific evidence for the same [20-22].

Alcohol: Excessive alcohol intake causes bone loss [23]. Postmenopausal women should take a maximum of 7 drinks a week.

Caffeine: Postmenopausal osteoporotic women should limit their caffeine intake less than 1-2 servings/day as it decreases the intestinal absorption of calcium [24].

Smoking: It is associated with osteoporotic fractures. Patients who give up smoking are at a lesser risk than those who are active smokers [25].

Exercise: Regular light exercises (30-40 mins) everyday increases the muscle strength and it has been seen that it also causes the bone strength to increase [26,27]. However patients with severe osteoporosis should avoid heavy exercises like lifting weights or excessive pushing or pulling.

Prevention of risk factors for Post-menopausal osteoporosis

Spine Imaging: to rule out any fractures

BMD: measured either at the spine or the neck of femur. It can be used to assess the probability of fracture in the next 10 years in a patient using the FRAX tool. However, this modality is still expensive and the benefit to the society is still not confirmed. Lists of indications have been summarized in Table 4.

Treatment of Osteoporosis

Candidates requiring treatment for osteoporosis include [28]:

Drugs approved for postmenopausal osteoporosis have been listed along with their dosage in Table 5 and their possible effects on fracture risk reduction have been mentioned in Table 6. Concomitant use of anti-osteoporotic drugs was thought to reduce the fracture risk better than using a single drug [29]. However, further studies have led to the non-recommendation of this practice [30]. The sequential use of drugs, first the anabolic group followed by the anti resorptive drugs has been found to be beneficial for patients [31].

BMD in progression of the treatment

BMD may be used for the prognosis and the follow-up of the treatment of osteoporosis. The treatment is said to have failed if there is substantial fall in the BMD or any fracture occurrence.

Operative treatment for osteoporosis

Most commonly occurring fractures are the vertebral fractures and there has always been a difference of opinion regarding the management of the same. Vertebroplasty though decreases the pain instantly but doesn’t increase the vertebral height to normal whereas, Kyphoplasty increases the vertebral height along with the reduction in the pain but is expensive [32- 36]. The surgeon should be careful in the fixation of the other fractures by using locking plates and HA coated implants to provide a stable fixation.

Conclusion

The incidence of postmenopausal osteoporosis is on the rise and one should be careful in the management and suitable pharmacotherapy should be given which is tailor made for each and every patient.

For more Open Access Journals in Juniper Publishers please click on: https://juniperpublishers.business.site/ For more articles in Open Access Journal of Case Studies please click on:  To know more about Open Access Journals Publishers To read more…Fulltext please click on: https://juniperpublishers.com/jojcs/JOJCS.MS.ID.555570.php

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TDI Decompression Procedures Courses

The primary expertise I had with a pinched nerve, I used to be in my twenties and had no concept the place it got here from. It felt like somebody had run me via with a dagger in my higher chest, and I used to be absolutely dying. I went to the clinic they usually took a chest x-ray. I anticipated them to return again and inform me I had a significant progress in my lung and solely a matter of weeks until I died. On the time I damage so dangerous, it will have been a superb supply. TDI Decompression Procedures Courses

Properly, the outcomes have been nadda, zip, zero. No progress, no dagger and no holes in something. The physician defined to me that I had most likely "pinched a nerve" between my ribs. For the lifetime of me it made no sense in any respect, as a result of I couldn't recall doing something that may have induced it.

I anticipated him to place me within the hospital and prescribe heavy doses of Morphine. What I acquired was, "go residence, take an aspirin, and in a number of weeks you'll really feel higher". I needed to throw apples at him, however adopted his recommendation and in a number of lengthy weeks felt my regular self as soon as extra.

It was a number of years later, nonetheless in my twenties that I injured my again. I took a working soar at an enormous air cushion off the patio deck and missed it clear. Landed proper on my tail bone and as soon as once more thought I used to be dying. With a number of extra bottles of beer, the ache handed in a pair hours and I used to be sore for a number of days after. Nonetheless.

Read More

Since that day I've had again issues. At first it was each couple of years I'd throw my again out and be laid up for a number of days. However, as I grew older, the episodes turned extra frequent, and lasted longer. Lastly, it wasn't a matter of lasting longer, however one in every of eternally.

At this time, I've two ruptured discs, disc degeneration, stenosis and mobility points in consequence. Through the years, I've tried every little thing to maintain me off of the working desk. Till not too long ago the one factor that gave me any aid to talk of was ache drugs and anti inflammatories. These after all risk they signs and never the basis downside, however again surgical procedure is the very last thing anybody ought to attempt. The explanation I say that's the alarming charge of failed again surgical procedures and the poor definition of profitable ones. When the docs can solely give you a 50/50 probability of enchancment, and that enchancment is probably not substantial, it's important to cease and suppose. What if it will get worse?

For thirty years I've prevented going to a Chiropractor. Maybe it was silly on my half, however I at all times considered Chiropractor's a charlatans. Then, two years in the past, I used to be in an vehicle accident which added to my again issues. As a result of my auto insurance coverage would pay for the Chiropractor (my common medical will not) I did some analysis and determined to attempt Decompression Remedy. On paper, in concept, it regarded promising.

The primary Chiropractor I went to used a machine known as the "Evolution DT". The process was easy sufficient. After I arrived on the workplace, they'd first align my again utilizing regular Chiropractic methods. Then they'd have me sit in a chair and apply a moist warmth pack to my decrease again for about 10 minutes to loosen me up.

The Evolution desk is a more moderen mannequin of decompression desk. Consider it as a "cut up" mattress that strikes. The decrease half goes South and the higher half stays fastened. For decrease lumbar decompression, they've what quantities to a chest strap to carry you right down to the desk after which a hip or pelvis belt that's wrapped round your waist, simply above the hip bones. This belt is what is going to pull your decrease torso to the South.

The desk has a built-in laptop which is about, for the quantity of pull or rigidity and the session time. The preliminary settings are primarily based upon your weight after which steadily enhance with every remedy till the strain equals half of your physique weight. The machine goes via a collection of making use of rigidity after which releasing it. As I recall it's about 60 seconds on after which 30 seconds off. This creates a unfavorable vacuum within the discs serving to to tug fluids into the disc to revitalize it.

The session lasts about 20 minutes after which they have you ever sit in a chair once more and apply a chilly pack this time to cut back any swelling that the stretching could have induced for about 10 minutes.

I had good outcomes with the Evolution for the primary 4 or 5 therapies. However then, as a result of I'm on the overweight aspect of chubby, the strain turned an excessive amount of and the hip (pelvis) belt would slip from my hips. No matter how laborious they tried to tie me right down to the machine, the fashion of the belt prevented it from getting a superb grip on my hips. After six periods, I began searching for a distinct machine. I knew the decompression was working as a result of there was an virtually rapid enchancment in my mobility. Much less ache.

I discovered the DRX9000 on the Web and checked out dozens of opinions. The best way it attaches to your hips is with what's extra like a girdle than a belt. The DRX9000 is the most recent by way of innovation in Decompression tables. The general process nonetheless stays about the identical. They align, apply warmth, you spend about 25 minutes on the desk after which they put a chilly pack on you.

The key variations within the two machines is the best way your decrease torso is held in place, the truth that you get into the machine standing up and it lays you down, and final however not least, they will change the angle that your decrease torso is pulled at. This final characteristic permits them to be extra particular in directing which vertebra they deal with. They alter the angle of the strap hooked up to the machine and belt hooked up to your hips. In my case, the ruptured discs are L4 & L5. The primary ten therapies I had have been directed at L4, the following ten at L5.

The primary ten therapies I had have been very efficient. My vary of movement with out ache elevated. The gap I might stroll earlier than I needed to sit down doubled. My general ache degree decreased by at the least 50%. After ten therapies I used to be feeling higher than I had in a number of years.

After they adjusted the settings on the machine to tug on L5, I didn't enhance any additional. I feel I'd have been higher off to have these 10 therapies centered on the L4 vertebra.

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After 20 periods I used to be impressed with the advance. Ideas of giving in to surgical procedure had diminished and I used to be getting round significantly better. I completed these therapies about 18 months in the past and though the advantages have slowly light, I am nonetheless in higher form than I used to be earlier than I had them.

The fee is what retains me from doing one other collection of therapies. With out insurance coverage to pay for it, you're looking at round $three,000 for 20 visits.

Two months in the past, I got here throughout an article for a product known as Spinal Stretch. Developed by a Chiropractor for his sufferers to make use of at residence, it really works on the identical fundamental ideas of the Decompression Tables. In comparison with the tables it's low tech. You could have a strap you both maintain by closing a door on it, or attaching it to a hook you might have screwed into the ground or baseboard. You then connect a belt round your hips, lie down on the ground and tighten it with a ratchet sort gadget thus making use of rigidity to your spinal column.

Though it would not apply as a lot rigidity, and doesn't cycle between on and off so far as the strain goes, it does create aid.

I've discovered that utilizing it twice a day for 30 minutes has improved my again issues considerably. I've to be very cautious on how I connect it to my hips due to the girth I carry, however by hooking the belt onto my common belt I get sufficient of a grip to get the job performed. I would add, that you simply use this machine whereas laying on carpeting. When you tighten it to a lot, you slip ahead. I've not tried it whereas laying on one thing you possibly can't slide on, however have given it thought to extend the strain.

In closing, you probably have decrease again issues, I am a agency believer within the DRX9000 having the ability that will help you. And, if you cannot afford the $3000 for the therapies, store round, you may discover a Chiropractor that's prepared to do it for much less. If not, make investments the $100 or so within the Spinal Stretch, it is going to be the perfect $100 you might have spent this 12 months.

Related Topics:

Advanced EANx Diver Courses Advanced Recreational Trimix Diver

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PrEP for HIV: A Pill to Prevent AIDS?

The post PrEP for HIV: A Pill to Prevent AIDS? was first published to: Know My Status STD Check Blog

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

 PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

 Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

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Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

 Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

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PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

 To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

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PrEP for HIV: A Pill to Prevent AIDS?

The post PrEP for HIV: A Pill to Prevent AIDS? was first published to: Know My Status STD Check Blog

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

 PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

 Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

Secure and Confidential STD testing services

The fastest results possbile - available in 1 to 2 days

GET TESTED TODAY

Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

 Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

Secure and Confidential STD testing services

The fastest results possbile - available in 1 to 2 days

GET TESTED TODAY

PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

 To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

from Know My Status- STD Test https://ift.tt/2VWaq6r via IFTTT

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PrEP for HIV: A Pill to Prevent AIDS?

The post PrEP for HIV: A Pill to Prevent AIDS? was first published to: Know My Status STD Check Blog

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

 PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

 Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

Secure and Confidential STD testing services

The fastest results possbile - available in 1 to 2 days

GET TESTED TODAY

Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

 Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

Secure and Confidential STD testing services

The fastest results possbile - available in 1 to 2 days

GET TESTED TODAY

PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

 To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

from Know My Status- STD Test https://ift.tt/2VWaq6r via IFTTT

[hivknowledgeorg]

PrEP for HIV: A Pill to Prevent AIDS?

PrEP for HIV: A Pill to Prevent AIDS?

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

  PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

  Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

Secure and Confidential STD testing services

The fastest results possbile – available in 1 to 2 days

GET TESTED TODAY

Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

  Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

Secure and Confidential STD testing services

The fastest results possbile – available in 1 to 2 days

GET TESTED TODAY

PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

  To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

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PrEP for HIV: A Pill to Prevent AIDS?

PrEP for HIV: A Pill to Prevent AIDS?

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

  PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

  Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

Secure and Confidential STD testing services

The fastest results possbile – available in 1 to 2 days

GET TESTED TODAY

Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

  Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

Secure and Confidential STD testing services

The fastest results possbile – available in 1 to 2 days

GET TESTED TODAY

PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

  To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

from knowmystatus.life https://ift.tt/2BfSjP7 via IFTTT

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PrEP for HIV: A Pill to Prevent AIDS?

PrEP for HIV: A Pill to Prevent AIDS?

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

  PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

  Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

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Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

  Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

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PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

  To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

from knowmystatus.life https://ift.tt/2BfSjP7 via IFTTT

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Common Complications in Pregnancy

CoCo… Milk tea? Regis Center? UPTC? Nope! CoCo stands for Common Complications during pregnancy and or during the actual delivery of the baby. Taking into consideration the context of the Philippines, wherein most rural areas don’t have equitable access to good quality health care, antibiotics and medicine may not be as readily available as opposed to the ones in the city. Since pregnancy is something that a lot of women go through, the prevention aspect of these common complications must be given priority especially in the rural areas of the country. Some of these common complications will further be explained in the next parts. More than that, this blog will give the symptoms that come with these complications so that you, the reader, may associate these with the corresponding complication. Additionally, certain methods of prevention will be proposed. Yay! Happy Reading ! :)

Miscarriage

A miscarriage, often caused by natural occurrences, is a pregnancy loss that occurs before 20 weeks of pregnancy. After 20 weeks, it is considered a stillbirth already. A rough estimation of 15% of known pregnancies end in a miscarriage. Most women blame themselves when they have a miscarriage. However, it is extremely important to remember that it is not their fault. It could be because of chronic illnesses, chromosomal problems or hormone imbalance. This complication is difficult to prevent because it is caused by natural occurrences. Additionally, there is no straightforward or outright prevention for it. However, there are risk factors that can be taken into consideration.

Risk Factors:

Drug use

Smoking

Excess drinking

Listeria (bacteria that may be present in undercooked meats, raw eggs, and unpasteurized dairy products)

Maternal trauma (ex. car accident)

Certain medication

Advanced maternal age (over 35)

Infections such as Lyme disease or Fifth disease

If a miscarriage does occur, here are some symptoms for guidance. The most common symptom is spotting. Spotting, however, does not necessarily mean that a miscarriage has definitely occurred. It is very common in early pregnancies, but it should not be considered normal. It is very crucial to inform the doctor immediately for any indications of spotting.

Symptoms:

Spotting

Mild to severe cramps

Pain in your back or abdomen

Nausea or vomiting

White-pink mucus

Unfortunately, once a miscarriage has occurred, there is nothing that can be done to halt it. Furthermore, it is important to visit the doctor immediately.

What happens during a miscarriage varies from woman to woman. Some may experience heavy bleeding and cramping as a response of the body to remove the contents of the uterus. Some do not experience any symptoms at all, so doctors give patients drugs to stimulate a response from the body.

For couples who would like to get pregnant after an unfortunate miscarriage, it is advisable to ask their doctor or midwife the best possible time they could try again.  

Preeclampsia and Eclampsia

Preeclampsia is a pregnancy complication related to high-blood. It causes a sudden spike in the blood pressure of pregnant women that can reach 140/90 mmHg or higher.  It often occurs after 20 weeks of pregnancy. Eclampsia is a more severe form. It causes pregnant women to have seizures or coma.  The causes of these are unknown. However, factors such as insufficient blood flow to the placenta can be part of the development.

Pregnant women with preeclampsia are at a risk for stroke, organ damage/ failure, and pregnancy loss. If it further develops to eclampsia, the pregnant woman may experience seizures that may lead to death or coma.

Risk Factors:

History of preeclampsia

Chronic hypertension

First pregnancy

New Paternity

Age

Race

Obesity

Multiple pregnancy

Interval between pregnancies

History of certain conditions

In vitro fertilization

Symptoms:

Preeclampsia can develop without showing any symptoms. It is important for pregnant women to regularly check and monitor their blood pressure. Other symptoms may include:

Kidney problems/ Excess protein in urine/ decreased urine output

Severe headaches

Upper abdominal pain, commonly under the ribs

Nausea/ vomiting

Decline in vision

Decreased platelet levels in blood Impaired liver function

Shortness of breath caused by fluid in the lungs

Treatment:

For Preeclampsia

If pregnancy is 37 weeks or later, fetus will be delivered to be able to treat preeclampsia and avoid further complications. If pregnancy is less than 37 weeks, it is the mother’s choice to let the fetus develop further, depending on the severity of the condition. The pregnant woman can also be given corticosteroids to speed up the development of the lungs of the baby before delivery.

If preeclampsia is mild, bed rest will be advised to help the flow of blood to the placenta. The condition of the pregnant woman will be further monitored and she will be given tests to observe the development of preeclampsia.

To prevent a seizure, Anticonvulsant medicine (magnesium sulfate) will be administered. If severe cases, pregnant women will be advised to be confined to be able to monitor her and her baby’s condition

For Eclampsia

To treat active seizures or prevent future seizures, magnesium sulfate can be given to the mother. This has effects on the cardiovascular and neurological system of the mother.  For high blood pressure, antihypertensive medicine can be given.

Prevention:

There is still no clear strategy to to prevent preeclampsia. But there are studies showing the correlation of vitamin D deficiency and preeclampsia. The risk of preeclampsia can be reduce by taking low-dose aspirin or calcium supplements. Before taking any medication or supplements, it is best to consult with a doctor.

Infections

During pregnancy, many different types of infections can occur, whether it be STIs or Sexually Transmitted Infections or simply just inborn infections. The sad part is that, these infections can actually occur while the pregnancy is ongoing or during the actual delivery of the baby. These infections can lead to long lasting effects with the health of the baby and plausibly, to the mother as well. Thankfully, these simple/chronic infections can easily be prevented if proper precaution is taken into consideration before, during and after pregnancy. Infections are usually caused by bacteria or viruses which can affect both the baby and/or the mother during pregnancy.

Risk Factors:

Miscarriages (whether early on or late into the pregnancy)

Ectopic Pregnancy (when implanting of the embryo happens outside the uterus)

Pre term babies

Babies with low weight

Defects such as blindness, deafness, and deformities

Newborn/Maternal deaths

Some concrete examples of infections that one may get during pregnancy are, Chicken Pox, wherein the baby could contract the congenital varicella syndrome, and German Measles, which can cause miscarriages. Of course, these conditions can be avoided simply by communicating with one’s own physician and taking vaccines for such infections. Vaccines are very important in the public health aspect because vaccines are able to prevent these infections/diseases on a population level especially if administered properly.

Symptoms:

Swelling, Redness, Itchiness around the genital area

Odd odor in the genital area

Thin, grey colored discharge

Pain during urinating

Pain in the abdomen area

Fever and other common symptoms to sickness

To combat such infections, it is important to always consult with your doctor and be informed with these symptoms such that when the infection strikes, one would know what it could possibly be.

Although antibiotics are readily available for these infections, prevention of these illnesses should be given priority. With that being said, prevention can concretely be done through proper and safe Vaccination or Booster Shots through your doctor or nearest health center/hospital.

Sources:

https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/complications

https://www.parents.com/pregnancy/complications/miscarriage/miscarriage-causes-signs-and-what-to-expect/

https://www.nichd.nih.gov/health/topics/preeclampsia

https://www.mayoclinic.org/diseases-conditions/preeclampsia/symptoms-causes/syc-20355745

https://www.medicalnewstoday.com/articles/322210.php

https://www.nichd.nih.gov/health/topics/pregnancy/conditioninfo/infections

https://www.rappler.com/move-ph/ispeak/93101-challenges-maternal-health-ph

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PrEP for HIV: A Pill to Prevent AIDS?

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body. Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

  PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

  Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

  Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEp and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then from Meet Positives SM Feed 3 https://ift.tt/2LkXhxZ via IFTTT

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Anti-Obesity powder: Cetilistat powder vs Orlistat powder

Anti-Obesity powder: Cetilistat powder vs Orlistat powder

  1. Cetilistat powder     2. Orlistat powder     3. Cetilistat Dosage      4. Orlistat Dosage     5. Cetilistat powder review     6. Orlistat powder review 7. Cetilistat side effects     8. Orlistat side effects     9. Cetilistat powder Better Tolerated Than Orlistat powder     10. Buy Anti-Obesity powder online     Anti-Obesity powder supplier--AASraw     Anti-Obesity powder from AASraw

  1. Cetilistat powder

Cetilistat powder is an inhibitor of pancreatic lipase, an enzyme that breaks down triglycerides in the intestine. Without this enzyme, triglycerides from the diet are prevented from being hydrolyzed into absorbable free fatty acids and are left to be excreted undigested. This drug, while similar to the currently FDA-approved drug orlistat powder, may have a more tolerable side-effect profile due to a different molecular structure. A phase 2 trial studied 612 obese, diabetic subjects with a BMI of 28 to 45 kg/m2 over a 12-week treatment period. Cetilistat 80 and 120 mg promoted significant weight loss compared with placebo (3.85 kg and 4.32 kg vs. 2.86 kg, respectively). Cetilistat-induced weight loss was similar to the weight loss achieved with orlistat powder (3.78 kg). Cetilistat powder was well tolerated and showed fewer discontinuations due to adverse events than in the placebo and orlistat groups. Given that discontinuation in the orlistat powder group was significantly worse than in the 120 mg cetilistat powder and placebo groups, and was entirely due to gastrointestinal adverse events, cetilistat powder may become a preferred lipase inhibitor for achieving weight loss . Phase 3 trials of cetilistat powder are currently in progress in Japan.

2. Orlistat powder

Orlistat powder is a potent and reversible gastrointestinal lipase inhibitor preventing dietary fat absorption by 30% by inhibiting pancreatic and gastric lipase. Orlistat powder was approved in 1998 and is currently the only available drug for the long-term management of obesity. The prescribed dose is 120 mg capsule 3 times daily, and a half dose (60 mg) is available over-the-counter in some countries, including the U.S. The efficacy of orlistat powder for weight loss has been reported in several RCTs for the long-term management of obesity (approximately 4 years). In meta-analyses of 12 and 15 trials, the mean difference in weight loss due to orlistat was -2.59 kg (95% CI, -3.46 to -1.74 kg) at 6 months and -2.9 kg (-3.2 to -2.5 kg) at 12 months, which was more than the placebo. The beneficial effect on body weight is sufficient to improve several cardiometabolic parameters, including waist circumference, blood pressure, blood glucose levels, and lipid profiles. In a meta-analysis which included 15 studies of approximately 10,995 participants who were treated with orlistat powder or placebo for at least 6 to 12 months, treatment with orlistat powder was associated with a significant decrease in total cholesterol after adjustment for weight loss, which indicates orlistat powder is a useful adjunctive tool for improving cardiovascular risk factor profiles in obese patients. Orlistat powder also reduced the incidence of type 2 diabetes from 9.0% to 6.2% (HR, 0.63; 95% CI, 0.46 to 0.86) in a longer 4-year trial.

  Among Korean obese patients receiving orlistat powder for 24 weeks, the mean weight change from baseline was -2.8 kg. Treatment with orlistat powder also improved several metabolic parameters. There were significant improvements of glycemic control (HbA1c, -0.87%; P<0.01), fasting insulin, total cholesterol, LDL-C (P<0.001), waist circumference (-5.48±0.54 cm, P<0.001), systolic blood pressure and diastolic blood pressure (P=0.000), without serious side effects.

  The most common side effects of orlistat powder are gastrointestinal and include diarrhea, fecal incontinence, oily spotting, flatulence, bloating, and dyspepsia. As a result of the adverse effects, orlistat powder may not be well tolerated. However, the side effects tend to occur early and can be reduced as patients learn how to avoid fat-rich diets.

  Recently, serious liver injury has been reported over the past 10 years. Between 1999 and 2008, the U.S. FDA received 32 reports of severe liver injury, including 6 cases of liver failure in patients using orlistat powder, which prompted the U.S. FDA to undertake a review of orlistat's treatment safety. The review identified a total of 13 cases of severe liver injury, reported between April 1999 and August 2009 out of an estimated 40 million people worldwide who had used Xenical or Alli. The U.S. FDA advised healthcare professionals to continue prescription of orlistat powder in August 2009, because severe liver injury was rare. However, a review in May 2010 led to a label revision and the addition of a warning of severe liver injury to educate the public regarding the signs and symptoms of liver injury.

  3. Cetilistat Dosage 

Cetislim (Cetilistat) powder is provided as 60mg strength capsules for administration orally. The medicine is taken with meals to ensure that it can work while the food is being digested, so that the absorption of fat from the diet can be effectively reduced. Your physician will advise you on how much medicine to take with each dose, as well as the required daily dosage. It is very important that you adhere to these instructions. Do not take more than your physician tells you to take.

  Cetislim capsules are offered in 60 mg strength. The dose is to take one capsule with each meal. Don’t skip meals and don’t take more of the medication than prescribed. Taking cetilisat with food can help to block the fat from what you eat from being absorbed into the body. Make sure you work with your doctor to ensure the right foods are eaten and you are taking this medication as you should.

4. Orlistat Dosage

Orlistat powder was oral used as a capsule and a nonprescription capsule.The recommended dosage of Orlistat powder is one 120-mg (a capsule )one time, three times a day . Take orlistat powder during a meal or up to 1 hour after a meal. If a meal is missed or does not have fat, you may skip your dose. Follow the directions on your prescription label or the package label carefully, and ask your doctor or pharmacist to explain any part you do not understand. Take orlistat powder exactly as directed. Do not take more or less of it or take it more often than prescribed by your doctor or stated on the package.

  ★ When You Take Raw Orlistat Powder:

• divide the amount of daily fat, carbohydrates, and protein.

• While you are taking weight loss orlistat, you should avoid foods that with more than 30% fat.

• When eating meat, poultry (chicken) or fish, eat only 2 or 3 ounces (55 or 85 grams)  for a serving, lean cuts of meat is ok. with more grains, fruits, and vegetables. Replace whole-milk products with nonfat or 1% milk and reduced- or low-fat dairy items.

• Take a daily multivitamin that contains vitamins A, D, E, K, and beta-carotene

  Orlistat blocks your body's absorption of some fat-soluble vitamins and beta carotene. Therefore, when you use orlistat you should take a daily multivitamin that contains vitamins A, D, E, K, and beta-carotene. Read the label to find a multivitamin product that contains these vitamins. Take the multivitamin once a day, 2 hours before or 2 hours after taking orlistat, or take the multivitamin at bedtime.

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  ★ After You Use It:

Keep this medication in the container, tightly closed, Where out of reach of children. The expiry date of Orlistat usually are 2 years,you'd better store it at room temperature and away from excess heat, moisture (not in the bathroom), and light. The best way to dispose of your medication is through a medicine take-back program instead of flushing this medication down the toilet.

  ★ Cycle Of Orlistat Powder

  Orlistat powder should be taken every day to be effective. Weight loss normally starts within 2 weeks and continues for 6 to 12 months on Orlistat fat loss. Orlistat powder will then help you to maintain this new lower weight and help to prevent weight being regained.

The improvement in risk factors (such as reduction in high blood pressure, normalising blood sugar levels and lowering cholesterol levels) is usually observed within 1 month of starting therapy and has been maintained during the course of Orlistat treatment.

5. Cetilistat powder review

Cetilistat powder is an inhibitor of pancreatic lipase, an enzyme that breaks down triglycerides in the intestine. Without this enzyme, triglycerides from the diet are prevented from being hydrolyzed into absorbable free fatty acids and are left to be excreted undigested. This drug, while similar to the currently FDA-approved drug orlistat powder, may have a more tolerable side-effect profile due to a different molecular structure. A phase 2 trial studied 612 obese, diabetic subjects with a BMI of 28 to 45 kg/m2 over a 12-week treatment period. Cetilistat 80 and 120 mg promoted significant weight loss compared with placebo (3.85 kg and 4.32 kg vs. 2.86 kg, respectively). Cetilistat-induced weight loss was similar to the weight loss achieved with orlistat powder (3.78 kg). Cetilistat powder was well tolerated and showed fewer discontinuations due to adverse events than in the placebo and orlistat powder groups. Given that discontinuation in the orlistat powder group was significantly worse than in the 120 mg cetilistat and placebo groups, and was entirely due to gastrointestinal adverse events, cetilistat may become a preferred lipase inhibitor for achieving weight loss . Phase 3 trials of cetilistat powder are currently in progress in Japan.

  6. Orlistat powder review

When considering Orlistat powder there needs to be a careful consideration of possible side effects, clinical studies, and what people have to say about it. The FDA has sent a warning letter of possible serious kidney damage caused by Orlistat powder. There’s also many possible side effects, and many customers did mention they experienced effects. Also, clinical studies have shown it to be only effective for up to 6 pounds of weight loss in one year. This is nowhere the amount needed for there to be noticeable results. Still, many custoemrs failed to see any change in weight.

  There’s the 2016 best diet pill called Sletrokor which was rated as this way due to its all natural ingredients, potent weight loss, and customer approval rate. Many users mention it is safe and effective for helping with weight loss. It’s also shown to be good for appetite reduction, increasing metabolism, helping improve mood, and several other benefits. You can find out about this diet pill by clicking here.

  Sletrokor is also backed by a full 30 day money back guarantee. If for any reason you want to schedule a return, you can do so with no questions asked. Click here to find out more about Sletrokor.

  7. Cetilistat side effects

The most commonly reported cetilistat side effects are oily stools, diarrhea, fecal incontinence, frequent bowel movements, and flatulence. In particular,in obese diabetic patients the levels of glycosylated hemoglobin (HbA1c) were also significatively reduced. Cetilistat powder showed mild to moderate adverse events, predominantly of gastrointestinal nature (steatorrhea), with an incidence lower than orlistat powder.

  8. Orlistat side effects

Many of the side effects associated with Orlistat powder are digestive symptoms, probably due to the non-absorption of fats. The most commonly occurring side effect is a change in bowel moments, which often occurs during the first couple of weeks of taking the supplement. Side effects may go away, but it is possible for it to continue for a person’s entire duration on the medication.

  Possible Side Effects

• Reduced absorption of fat-soluble vitamins like A, D, E, and K

• Severe lower back pain

• Vomiting

• Kidney issues

• Ankle swelling

• Shortness of breath

• Fatigue

• Oily, smelly stools

• Increased bowel movements, loose stools, inability to control bowels

  Frequency of Side Effects

The FDA has also published information as to the frequency of certain side effects. In the first year of taking prescription strength Orlistat powder:

• 26.6% of users reported oily spotting.

• 23.9% reported gas with discharge.

• 22.1% experienced urgent bowel movements.

• 20% had fatty or oily stools.

• 10.8% had an increased number of bowel movements.

• 7.7% suffered fecal incontinence.

For 8.8% of Orlistat users, side effects were serious enough for them to discontinue use. In addition to mild or moderate Orlistat side effects, more severe side effects may occur. Users who experience any more severe side effects should discontinue use and contact their doctor.

9. Cetilistat powder Better Tolerated Than Orlistat powder

BUDAPEST, HUNGARY -- April 24, 2007 -- Cetilistat powder, a novel gastrointestinal lipase inhibitor, appears to be as effective in the management of obesity and its comorbidities as another lipase inhibitor, orlistat powder, while demonstrating better tolerability, according to two phase 2 randomised, double-blind, placebo-controlled, 12-week studies.

  "Lipase inhibition has proven efficacy in obese patients and in obese patients with diabetes," said Peter Kopelman, dean, faculty of health, University of East Anglia, Norwich, United Kingdom, who presented the two studies on behalf of the Cetilistat powder European Study Group here at the 15th European Congress on Obesity (ECO).

  The first study investigated the use of cetilistat powder in 372 obese patients with a body mass index (BMI) > 30, in centres throughout Europe. All patients received intensive dietetic counselling throughout the study and consumed a prescribed diet that was calculated to be approximately 500 kcals below their weight-maintaining diet. In addition, patients were given 60, 120, or 240 mg of cetilistat powder, or placebo, at mealtimes, three times daily. Significant weight loss was achieved in all treatment groups at 12 weeks, with a 3.5-kg reduction in weight achieved with 120 mg cetilistat powder three times daily versus placebo (P <.05).

  "Cetilistat powder was effective in inducing weight loss in 12 weeks of study," Dr. Kopelman said in a presentation on April 23rd. "In addition, there were significant reductions in waist circumference." In the second study presented by Dr. Kopelman, the researchers enrolled 612 obese subjects with type 2 diabetes, who were taking metformin. Many of the patients were also on statins, and about a third were also taking antihypertensive medication.

  As in the previous study, patients received a hypocaloric diet and one of three different doses of cetilistat powder (40, 80, or 120 mg), or placebo. In addition, a fourth study group was randomised to 120 mg of orlistat  powder 3 times daily. Dr. Kopelman said that significant weight reductions were achieved in all treatment groups, with approximately 35% of subjects on the highest cetilistat powder dose achieving a weight loss of about 5% of their initial body weight or more. In addition, there were statistically significant reductions in glycosilated haemoglobin (HbA1c) over 12 weeks. Although the efficacy data were comparable between cetilistat powder and orlistat powder, considerable differences emerged between these two drugs regarding their tolerability profiles, according to Dr. Kopelman.

  Overall, patients treated with orlistat powder had nearly twice as many serious adverse events -- primarily gastrointestinal -- leading to treatment discontinuation than in the cetilistat powder group. The rate of severe adverse events leading to discontinuation was comparable between the placebo group and those receiving cetilistat powder. On the basis of these results, Dr. Kopelman concluded that cetilistat powder has a favourable tolerability profile, and it is safe and efficacious in the management of obesity and its comorbidities.

10. Buy Anti-Obesity powder online

  Anti-Obesity powder supplier--AASraw

You can also buy Anti-Obesity powder online,however, make sure that the purchase is done from a reliable source and Anti-Obesity powder powder supplier. The illegal versions of this drug are highly unsafe and can be very dangerous for your health. You can also ask your doctor or the health provider to recommend you a reliable source, so that you could buy Anti-Obesity powder online now.

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CAS.NO Dosage Brand Name

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PrEP for HIV: A Pill to Prevent AIDS?

PrEP for HIV: A Pill to Prevent AIDS? was first published to: knowmystatus.life

PrEP for HIV: A Pill to Prevent AIDS?

Remember high school health class when Coach So-and-so (don’t pretend that your health teacher wasn’t a coach) talked about HIV? Coach Whats-his-face said that HIV was incurable, and once you got it, there was nothing you could do to get rid of it. Coach also said that the only way to prevent HIV was by using condoms or staying abstinent.

While HIV may still be incurable, there have been leaps and bounds in the scientific community to help prevent HIV. Enter: PrEP.

PrEP is a daily pill taken to prevent HIV from developing, should the virus ever enter your body.Maybe you’ve never heard of it. Maybe you have heard of it, but you never took the time to look into it. Or maybe you’ve heard of PrEP, but just don’t know if it’s right for you. Regardless of which category you fall under, with PrEP’s prevention rate of HIV being higher than condoms’ prevention rate, information about PrEP should definitely be in your sexual health repertoire.

So, in order to keep PrEP in your sexual wellness toolbox of information, we need to cover PrEP’s Basics (What PrEP is, How It Works, How Effective It is), Who PrEP is for (People in Monogamous Relationships, People with Risky Behaviors, and People in Certain Demographics), and other PrEP Considerations (Side Effects, Who Should not Take PrEP, and PrEP in Regards to Other Implications). By the end of this post, you’ll be completely prepped for PrEP!

 PrEP Basics

Before we get into some of the more nitty-gritty details of PrEP, we need to understand the basics of it. This includes what PrEP is, how it works, and its effectiveness.

What is PrEP?

Definition

PrEP stands for Pre-Exposure Prophylaxis, but let’s break down what that means:

Prophylaxis is a preventative action taken to prevent disease. This is mainly done by specific means (taking specific drugs), or done against a specific disease (HIV in this case). Pre-Exposure is before being exposed to the disease

Pre-Exposure Prophylaxis for HIV is when someone who hasn’t been exposed to HIV takes drugs to prevent the disease.

PrEP is taken as a defense to prepare the body in case it ever encounters the disease. The only form of PrEP for HIV currently available is a combination of two HIV medications: tenofovir and emtricitabine. It’s sold under the name “Truvada.”

PrEP History

Scientists have been working on a medication to prevent HIV since the 1980s. Then, in 2012, there was a breakthrough: Truvada was approved by the FDA for over-the-counter sale! Right now it is the only medication that is FDA-approved for pre-exposure prophylaxis. That’s why the term “PrEP” is currently synonymous with “Truvada.”

Potential alternatives to  Truvada are currently in trials, but so far none have proven effective in preventing HIV, nor are they FDA-approved. Before 2012, there weren’t any drugs to prevent HIV contraction, but there were drugs to help after exposure to the virus.

PrEP vs PEP

PEP or “Post-Exposure Prophylaxis” is an emergency HIV treatment for people who were recently exposed to HIV. PEP was around before PrEP and is still on the market. It is most used by healthcare workers after they believe they’ve been exposed to the HIV virus. PEP has a much higher drug concentration than PrEP because it needs to block HIV after it’s begun to take hold in the body. It must be taken within 72 hours of exposure to HIV, and the treatment must be continued for a month.

Think of it like birth control pills: Birth control pills are taken daily and emit a small dose of hormones to help prevent pregnancy. If a woman isn’t on birth control pills, and she’s exposed herself to getting pregnant, she’ll need to take a morning-after pill. The morning-after pill is a much higher concentration of birth control hormones because it needs to work immediately to block the pregnancy from happening. PrEP is like birth control pills, and PEP is like the morning after pill. In both cases, pre-exposure prevention is easier on the system than post-exposure prevention.

How Does it Work?

PrEP is an NRTI

As stated before, PrEP is a combination of two drugs: tenofovir and emtricitabine. These two drugs work in very specific ways, but before we can explain how they work, we need to look at how HIV works.

HIV binds to the cell and releases its RNA and enzymes into the cell. HIV then uses Reverse Transcriptase to change its RNA into DNA. Once HIV has DNA, it inserts itself into the cell’s DNA. HIV uses the DNA to make long chains of HIV proteins. It then assembles into new HIV. The new HIV then buds out of the cell.

“Antiretrovirals” is a generic term for drugs used to block a retrovirus (like HIV) from replicating. One class of antiretrovirals is Nucleoside Reverse Transcriptase Inhibitors (NRTIs). These antiretrovirals inhibit Reverse Transcriptase from converting HIV RNA into DNA.

Since the NRTI blocks the HIV RNA from turning into DNA, HIV can’t enter the cell’s nucleus nor can it combine with the cell’s DNA. It blocks HIV from having the ability to take over a cell and replicate within it.

Is PrEP a Vaccine?

Scientists are continuing to work on a vaccine for HIV, but PrEP is an antiretroviral, not a vaccine. Though both of them prevent disease, antiretrovirals and vaccines are two different things.

Antiretrovirals help stop viruses from replicating in the system if they become introduced into the body.

Vaccines introduce a weakened version of a virus into the body. This is done to create a reaction in the immune system called antibodies. Antibodies are produced to fight off the weakened virus. After the antibodies have fought off the weakened version of the virus, the body will be able to quickly make them again should it ever be exposed to a full-strength version of the virus.

How do You Take it?

PrEP is an oral pill that should be taken daily in order for it to be effective. There is no set amount of time to continue taking PrEP; a person must decide for him or herself how long they should take the medicine. A good rule of thumb is to take PrEP for as long as you believe to be putting yourself at risk of contracting HIV. PrEP is only FDA-approved when it is taken daily, and studies that show the effectiveness of PrEP were based on daily dosing. PrEP can be taken with or without food, and it’s recommended to be taken at the same time every day.

What is Its Effectiveness?

How Long Before It Is Effective?

Scientists aren’t sure about how long PrEP must be taken before it becomes fully effective. Some studies suggest that if you take PrEP every day, it reaches its maximum effectiveness in the blood at 20 days, in the rectal tissue at about 7 days, and in the vaginal tissues at about 20 days.

How Effective Is It?

If taken every day for at least 20 days, PrEP is 92% – 99% effective in reducing the risk of contracting HIV. It’s most effective if the drug levels in your body are consistently high. That’s why every day dosing is recommended.

PrEP is 92% – 99% effective in reducing the risk of contracting HIV

Missed Doses

If you miss a dose, don’t worry! Just take the pill as soon as you remember. Once PrEP is built up in the system, it’s very forgiving. A single missed dose won’t tremendously alter PrEP’s effectiveness. But if you find that you’re missing multiple doses in a week, or you begin to notice that you’re missing one dose each week, the effectiveness will decrease and PrEP may not be right for you. It should also be noted that PrEP is much more forgiving for anal sex than vaginal sex. Since it only needs 7 days to build up protection in the rectal tissue, compared to the 20 days needed for vaginal tissue, those who miss doses and engage in anal sex are more likely to remain protected than those who miss doses and engage in vaginal sex.

 Who is PrEP for?

The first qualification to be a candidate for PrEP is to prove you’re HIV negative. If you’re unsure about your HIV status and wish to begin taking PrEP, take our HIV test and bring the results to your healthcare provider. Then consider the following questions:

Are You In A Mixed-Status Relationship?

Monogamous Relationship

If you and your partner are in a mutually monogamous relationship, and he or she is HIV-positive, PrEP may be right for you. PrEP will work to keep HIV from replicating within your cells and help you remain HIV-negative. It’s also good to keep in mind that if your HIV-positive partner is managing their HIV well, their HIV viral load may be undetectable. Know that if he or she has had an UVL (Undetectable Viral Load) for over 6 months their HIV is considered untransmissible, and you are at an extremely low risk of contracting HIV. However, if you choose to take PrEP, you’re keeping yourself extra protected, and there’s no such thing as too much protection when it comes to HIV.

Starting a Family

If you are a female, your HIV-positive partner is a male, and you are trying to get pregnant, PrEP is the way to go. It protects you so that neither you nor your unborn fetus will become HIV-positive. PrEP can protect you when trying to conceive, during pregnancy, and while breastfeeding. It’s a great way to allow mixed-status couples to have an HIV-negative baby.

Non-monogamous Relationship

If you and your HIV-positive partner have decided to have an open or a polyamorous relationship, PrEP is a great choice for you and your other partners. It’s always best to disclose your HIV status, your partner’s HIV status, and your PrEP regimen to potential new partners, as well as talk to them about getting on PrEP.

Do You Engage In Risky Behaviors?

Anal or Vaginal Sex Without A Condom

If you engage in anal or vaginal sex with partners whose HIV status is unknown, you’re at substantial risk of contracting HIV. In both vaginal and anal sex, being the receptive partner puts you at the highest risk of obtaining HIV. This also means that being the insertive partner puts you at the highest risk of spreading HIV.

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Sharing Needles/Syringes

If you use needles or syringes for medical purposes, to get high, or for tattoos/piercings, and you’re unsure about the cleanliness of the materials you use, PrEP may be right for you. Sharing dirty needles is a quick way to inject HIV right into your bloodstream; without medicine to stop it, it will begin replicating and taking over your cells.

Sex Workers

If your job involves sexual activity with partners of unknown HIV status, PrEP is for you. It’s necessary to take steps to keep yourself free and clear of all STDs, so consider adding PrEP to your daily regimen to protect yourself and your job security.

Are You A Part of These Demographics?

Studies show that people who are a part of these demographics are at a higher risk of contracting HIV. ***Please note that these factors are based on statistics and do not take into account any specific lifestyle choices***

Sexuality and Race

According to HIV.gov, gay and bisexual men have the highest number of new HIV diagnoses in the United States. This puts them at a higher risk of contracting HIV when having sex with a new male partner. Additionally, blacks and Hispanics are largely affected by HIV more than other racial groups. Finally, transgender women who have sex with men are among the groups at highest risk of HIV infection. If you’re a part of any of these groups, statistically speaking, there is a higher chance of contracting HIV. Of course, whether you get HIV is dependent upon how you live your life and how safe you are.

Location

In 2016 (the most recent data available), California clocked in having the most cases of HIV in the US with 4,961 cases. Florida came in a close second with 4,940, and Texas was third with 4,464. On a county level, Los Angeles County (CA) had the highest number of cases with 1,844, Harris County (TX) had 1,264, and Miami-Diade County (FL) had 1,272.

Location is a risk factor when it comes to HIV contraction. However, it is just a factor. Merely living in a location doesn’t immediately increase your chances of acquiring HIV (just like being gay or being black doesn’t either), but if you live in one of these locations and are dating a lot or dating in a community where HIV rates are high, consider PrEP as a way to protect yourself from the unexpected.

Recent STI

Have you had an STI within the past 6 months? If so, you may be at a higher risk of contracting HIV. Certain STIs, like chlamydia, gonorrhea, and trichomoniasis, can make your body more susceptible to the HIV virus, but, again, this is just a factor. If you don’t engage in risky behaviors, or don’t believe to be putting yourself at risk of contracting HIV, a recent STI is not a reason to get on PrEP. But, if you have had a recent STI and do find yourself in some sticky situations, think about adding PrEP to your daily routine.

 Other PrEP Considerations

So now we know What PrEP is, and Who PrEP is for, and you may be wondering if PrEP is right for you or someone you know. But before you make a decision whether to bring up PrEP at your next night out, check out these considerations:

PrEP Side Effects

Minor Side Effects

The following are common side effects of PrEP:

Nausea

Vomiting

Stomach Pain

Fatigue

Headaches

Dizziness

These side effects typically occur within the first month of beginning PrEP and tend to disappear after a few weeks.

Serious Side Effects

Liver Damage – One of the liver’s jobs is to break down harmful substances and remove waste from the body. This is essential to the body functioning correctly, however, the liver sees PrEP as a toxin. The liver then works with the kidneys and other organs to make the medicines in PrEP safer. This can cause the liver to become overworked and succumb to Hepatotoxicity: the official term for liver damage caused by medications or other chemicals.

Kidney Failure – The kidneys filter blood, then reabsorb useful aspects of it. PrEP is excreted by the kidneys, and it can build up in the kidneys causing damage. It can lead to declines in filtration, reabsorption, as well as major tubal damage. The tubal damage (tubulopathy) can disrupt the body’s pH balance as well as lead to bone density loss.

Lactic Acidosis – Lactic acid is a toxic chemical that’s produced when muscles don’t receive enough oxygen. Lactic acid builds up in the blood, but it gets filtered out by the kidneys. If the kidneys aren’t working well because of PrEP, there can be a buildup of lactic acid in the body (Lactic Acidosis). It can lead to major organ failure and death.

Who Should Not Take PrEP

Hepatitis Sufferers

Hepatitis means inflammation of the liver. Due to the problems that PrEP can cause in the liver (outlined above), if you suffer from Hepatitis or have other pre-existing liver issues, PrEP may not be for you.

Kidney Problems

PrEP has shown a mild to moderate decrease in kidney functioning in health users. However, because of the way that PrEP can build up and cause damage to the kidneys, it’s not advised for those with pre-existing kidney problems.

HIV-Positive

This should go without having to be stated again, but if you are HIV-positive, PrEP is not for you. It is a preventative medication (pre-exposure) for people who have not yet been exposed to the virus.

PrEP and Other Factors

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PrEP and HIV Infection

Truvada works wonders preventing HIV, but what would happen if PrEP didn’t protect you and you became infected with the virus? If you acquire HIV while taking PrEP, stop taking PrEP immediately. PrEP is an antiretroviral that works to stop HIV in the early stage of its life cycle. If HIV progresses past its early stage while you’re on PrEP, the virus can build up an immunity to it and other antiretrovirals, making it hard to manage.

PrEP and Screenings

To be on PrEP, you need to get checked by a healthcare provider every 3 months. This is done to ensure that you have no acquired HIV and that the previously stated complications have not arisen. If you’re unable to get checked this often due to work or transportation constraints, consider alternative options.

PrEP and Other STIs

PrEP only prevents HIV infection; it does not prevent against other STIs. When PrEP became FDA-approved, a concern surfaced that it would encourage more people to have unprotected sex, thus leading to more STIs. Since then, there have been studies to both prove and negate that. In 2014, the CDC showed that syphilis was on the rise, and 83% of those cases were from gay and bisexual men. Experts suggest this increase is due to gay and bisexual men using PrEP and not using condoms. However, a 2017 study showed that chlamydia and gonorrhea rates among gay and bisexual men had declined because PrEP users had to be tested more often. With more regular checkups, there’s more of a chance to catch STDs. But when HIV is the main concern, it’s easy to lose sight of the curable STIs.

 To Sum it All Up…

Now that you understand What PrEP is, Who it’s For, and Other PrEP Considerations, color yourself PrEP-ared. And even though Coach So-and-so from health class was kind of right: HIV is incurable (currently), and once you get it, you’ve got it; science has progressed since the early 2000s, and we now have a way to prevent you from getting it. Think about if PrEP is right for you or your partner(s). Consult your healthcare provider, and don’t forget to bring them the results of your HIV Test. That way before you walk into the office, you’ll be prepped for PrEP.

Medically Reviewed by J. Frank Martin JR., MD on October 1, 2018

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