#Affordable Car Insurance Fresno

[caiautoinsurance]

A Brief Guide to Find Affordable Car Insurance Fresno in 2023

It is stated in California Insurance Law that before driving in California you require mandatory car insurance. But other than the law, you need insurance to protect yourself and financial trouble. Having good car insurance not only ensures your safety, but it safeguards your family, all the passengers, and even to another car you collide with. So it is highly important to grab functional car insurance before you hit the road in California. To explore affordable car insurance in California in 2023, you need to consider factors like liability limits, average premium, annual cost, etc.

[lowpriceglassfresno]

Why Should You Opt for Windshield Replacement Services Fresno?

Rock chip, crack, or has your windscreen been completely shattered, well, read on to learn how you can go about it. Or maybe, a tennis ball or any other object has hit one of your side windows and they are cracked now? Whether you have a minor chip in your windshield or extensive crack, the professionals at Low Price Glass in Fresno can assist you with your repair and replacement service.

If you are in need of windshield replacement, broken side window repair, or any other auto glass repair that your car, truck or SUV might require, Low Price Glass is the best company to offer the services in Fresno for more than ten years.

Why One Should Replace the Windshield When It Is Damaged

A lot of drivers believe that if a windshield has chipped or cracked, it can just be left as is until it becomes worse. Nevertheless, even if the crack is insignificant it can progress into a significant problem as vibration and stress on the glass continue with driving. This is not only a hazardous issue concerning visibility but also a tremendous threat to the integrity of the windshield because it is highly susceptible to shattering when involved in an accident.

It is always important not to risk any of your safety or even the soundness of your vehicle especially when it comes to the windshield. If you spot even the slightest issue, it is advisable to take your vehicle to Low Price Glass for a repair or a quote on windshield replacement services Fresno. We have qualified auto glass technicians who have handled these and other related issues for years now. To ensure that your windshield does not become worse we shall be in a position to take it as required.

Car Side Window Repair and or Replacement

Beside your car windshield, the side windows of the vehicle are perhaps the other most crucial element in visibility and safety. When your car side glasses get cracked or shattered because of a ball hitting them in the parking lot, an attempted theft or vandalism, or they wear out over time, you want to ensure that they get fixed right by broken side window repair Fresno.

In most cases, it is impossible or extremely impractical to try to make Do-It-Yourself side window repairs with tape or glue that are sturdy enough to last for a long time. To return full sight and function to the area, only professional side window glass replacement and repair apply the right urethane sealant and strategies. All the technicians at Low Price Glass have all the training, experience, and qualification to evaluate the extent of the damage and either replace or repair the side windows.

Windshield Replacement Services Fresno

Affordable for Any Budget

However, it is worth noting that most car owners who have experienced auto glass damage are always worried about the cost of the services. It is always better to save some money wherever possible, especially in today’s open economy. At Low Price Glass, the customer comes first, and this means that every customer’s need is met as per their wishes at reasonable, fair rates. This comprises providing of discount pricing as well as other affordable payment options for the higher cost of the windscreen and side glass.

Whether you require just a chip repair or may require complete windscreens for your pick up truck or even side glass replacement for your economy car, we have the right price packages to suit all our clients. We also take care of all your insurance deals as regard to windshield repair cost, and you end up paying nothing.

Author’s Bio

Low Price Auto Glass Repair is the go-to auto glass company with the best and most affordable prices in town. Windshield replacement services fresno we pride ourselves in offering you the lowest possible price for our services, so more to this we offer a price match guarantee where if you find a lower legitimate price for our services within 30 days of using our services you’ll get a full refund of the difference. It will be cheaper to have your Broken side window repair Fresno replaced with our prices which are significantly lower than dealer prices. Plus, our speedy repairs are a sure bet you will be back on the road in less than an hour’s time. Speaking of windshield, we offer you great prices, excellent quality and short turnaround time, which are unbeatable.

[differentnutpeace]

Once On The Brink Of Eradication, Syphilis is Raging Again

In certain circles of San Francisco, a case of syphilis can be as common and casual as catching the flu, to the point where Billy Lemon can't even remember how many times he's had it.  หวย บอล เกมส์ คาสิโนออนไลน์

"Three or four? Five times in my life?" he struggles to recall. "It does not seem like a big deal."

At the time, about a decade ago, Lemon went on frequent methamphetamine binges, kicking his libido into overdrive and silencing the voice in his head that said condoms would be a wise choice at a raging sex party.

"It lowers your inhibitions, and also your decision making abilities are skewed," says Lemon.

He's sober now and runs the Castro Country Club in San Francisco, which is not a resort, but a place where gay men come to get help with addiction, especially meth. Lemon says syphilis comes with the territory.

"In the 12-step community, if meth was your thing, everybody had syphilis," he says.

In 2000, syphilis rates were so low, public health officials believed eradication was on the horizon. But the rates started creeping up in 2001, grew steadily for the next two decades, then spiked 74% since 2015. There were nearly 130,000 cases nationwide in 2019, according to data released Tuesday by the Centers for Disease Control and Prevention.

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In California and the US, about half of syphilis cases are in men who have sex with men. More than a third of women in the western United States who have syphilis also use meth, a drug that has seen its own surge in recent years.

These are just some of the trends causing overall national cases of sexually transmitted diseases to hit an all-time high for the last six years in a row, reaching 2.5 million. And the consequences are now trickling down to babies who are contracting syphilis from their mothers: these congenital syphilis rates nearly quadrupled between 2012 and 2019.

This was all before the coronavirus pandemic took hold in the US, and with contact tracers and testing supplies diverted from STDs to COVID, the CDC is predicting 2020 numbers will be no better.

"We are quite worried about this and have seen this trend over time," says Dr. Erica Pan, California's state epidemiologist. "Unfortunately, with years of not having enough funding and infrastructure in public health, and then in this past year, of course, both at the local and state level, a lot of personnel who had been focusing on STDs and syphilis follow-up have really been redirected to the pandemic."

Billy Lemon is executive director of the Castro Country Club in San Francisco, where gay men can get help with addiction. Lemon says that when it comes to methamphetamine use in particular, syphilis often comes with the territory.

Beth LaBerge/KQED

A number of factors are fueling the syphilis surge

There are many factors that contribute to the rise of STDs, and syphilis in particular.

In the gay community in San Francisco, for example, the rise of mobile dating apps like Grindr and Tinder made finding a date "faster than getting pizza delivered to your home," says Dan Wohlfeiler, an STD prevention specialist and co-founder of Building Healthy Online Communities, which uses these apps to improve gay men's health.

When the dating apps first came on the scene around 2009, they made it harder for disease investigators to track the spread of STDs and notify people who may have been infected, because men don't always know the names of the men they hook up with.

"They sometimes only know their online handle," says Dr. Ina Park, associate professor at UCSF School of Medicine and author of the book Strange Bedfellows, about the history of STDs. "And if the sex didn't go well, then sometimes they will block the person from their app and they don't even know how to reach that person again."

Online dating began back in the late 1990s, which was around the same time effective medications to prevent the transmission of HIV became available: first, antiretrovirals that suppress the virus in those who are HIV positive, and then later, in 2012, pre-exposure prophylaxis, or PreP, which prevents new infections in people who are HIV negative, but considered at-risk for exposure to the virus.

With the risk of contracting a deadly disease falling to almost zero, condoms fell even more out of favor than they already were, says Park.

"If one man is taking PreP and the other one is virally suppressed, there's no HIV risk at all," she says. "So why use condoms if you don't mind having a touch of syphilis?"

Diagnosing syphilis is tricky

While syphilis is not benign – it can cause blindness, deafness, or brain damage – it is easy to treat. Typically, a shot of penicillin in the butt will cure it.

But diagnosing syphilis can be tricky, says Park, who treats patients with STDs at the San Francisco City Clinic. She often finds herself crouched low in the exam room, "lifting up their scrotum and lifting up their penis," craning her head to get a look from all angles.

She does these gymnastics to find rashes associated with syphilis. Some are obvious, others subtle. She says doctors in regular family medicine clinics often aren't trained on where to look, or when.

"The patient came in saying, 'I'm tired,'" Park says, referring to a common symptom of syphilis. "How many people are going to say, 'Take off your pants and lift up your scrotum, I want to look? We only do that at the STD clinic because that's what we do."

But specialized public STD clinics, like the one where Park works, have been shutting down nationwide. One reason is persistent underfunding of public health programs, a trend laid bare during the coronavirus pandemic. Another reason is the Affordable Care Act. In a strange way, the 2010 law intended to expand access to health care actually contributed to the closure of STD clinics.

"Honestly, I think everyone thought they weren't going to be necessary," said Dr. Karen Smith in 2019, when she was the director of the California Department of Public Health. She says once Obamacare was in place, the thought was that STD testing would happen in primary care clinics.

"We sort of all assumed that if you've got health insurance and you've got access to a doctor, that's all that you need," she said. "It turns out that that's not really all that you need."

People still had affairs that they didn't want to talk about with their family doctor. And some family doctors didn't want to probe into their patients' sex lives. Young people, in particular, prefer clinics geared to them, out of their parents' purview.

"That loss of anonymous care really was a problem," Smith said.

The spread of syphilis is reaching newborns, too

When Christian Faulkenberry-Miranda decided to become a pediatrician, she never thought she'd become an expert in syphilis.

In 2010, shortly after finishing her medical training and starting work at the Community Regional Medical Center in Fresno, California, she began seeing babies with a rash on their tummies that looks like a blueberry muffin. At first she thought it was a common viral infection, until these babies tested positive for syphilis.

In those early days, Dr. Faulkenberry-Miranda saw perhaps a few instances of congenital syphilis each year. Now she sees two cases every week. It's important to start the 10-day antibiotic treatment right away, to avoid complications, but she still follows her patients through their first year of life, and often through their childhood, to watch for vision and hearing problems, developmental delays, attention deficits, and learning disabilities, all of which can result from congenital syphilis infections. In 2019, 128 of these congenital syphilis cases resulted in stillbirth or neonatal death.

"The disappointing thing is that syphilis is very treatable," she says. "This is something that's completely preventable, with proper screening and treatment of these moms during pregnancy."

Congenital syphilis cases hit a troubling milestone in 2019, increasing 279% over the previous five years, and hitting a high of cases in the U.S. That is more mother-to-child transmissions of syphilis than there were at the peak of mother-to-child cases of HIV in 1991.

"How could this be happening? Testing is cheap and widely available. The same treatment we've been using since the forties still works," says Dr. Park, who has also seen an increase in congenital syphilis cases in San Francisco. "And yet we have this completely out of control epidemic among the most vulnerable babies in our society."

Many of the women who give birth to babies with syphilis have had no prenatal care. They often use drugs – mainly methamphetamine – and they are often homeless, said Dr. Karen Smith, former director of CDPH. This makes them more likely to trade sex for housing, food, or drugs, prompting Smith to call congenital syphilis a "disease of despair." Drug use, in particular, makes women less likely to recognize that they're pregnant at all, and less likely to seek health care if they do.

"They're very concerned about what's going to happen when they're found to be pregnant and using drugs," said Dr. Smith. "They're concerned that their drug use will be reported and then CPS will be involved and their children will be taken away."

Romni Neiman is a veteran contact tracer with the CDC. Before she got redirected to COVID last year, she was working on STD prevention in California, including the problem of congenital syphilis. Neiman says when she tries to reach pregnant women who may have been exposed to syphilis, it's extremely challenging.

Neiman remembers looking for one woman in the late 80s in Chicago. She used drugs, was pregnant and had been exposed to syphilis. The woman's housing was so unstable, that Neiman went to three different places before finding her. The woman had no car, so Neiman offered to drive her to the clinic to get tested. The woman had no safe place to leave her toddler, because a man in the place she was staying was abusive, so Neiman took care of the child while the woman saw the doctor.

"She was just trying to do the best that she can, and she was really afraid," Neiman remembers. "Sometimes it's really taxing and really sad. And you come home at the end of the day and you're like, 'Wow. Wow.'"

Those challenges, combined with persistent underfunding for public health, is what led to the initial spike in congenital syphilis cases in Fresno County in the 2010s, says Park. Local contact tracers couldn't keep up, and the state had to step in with reinforcements. After leveling off for a couple years, congenital syphilis rates in Fresno spiked 900% in 2018.

The state is taking new measures to address the rates, says state epidemiologist Dr. Erica Pan, like requiring women to be screened for syphilis twice during pregnancy, instead of just once. And, rather than waiting for women to come in for prenatal care, the state is doing more outreach, and screening pregnant women in the emergency room, and in prisons and jails.

Dr. Pan believes the coronavirus pandemic has created an opportunity to invest in a more nimble response to emerging and re-emerging public health issues, like syphilis and congenital syphilis.

"It's been a really long, hard year responding to this pandemic, but people have really acknowledged and realized the impact of divesting in public health infrastructure," she said. "I hope that a lot of the resources that we hope to bring to bear in the longer term after this pandemic will benefit STDs as well."

[missouricitytowtruck-blog]

QUIK City Towing

Business Name: -

QUIK City Towing

 Street Address: -

7110 Knights Ct

 City: -

Missouri City

 State: -

Texas

 Zip Code: -

77459

 Country: -

USA

 Business Phone: -

(281) 502-4822

 Business Email: -

tonyquiwk@gmail.com

 Website: -

https://www.missouricitytowtruck.com/

 Facebook: -

https://www.facebook.com/QUIK-City-Towing-100765868482519

 Twitter: -

https://twitter.com/QuikCityTowTX

 Instagram: -

https://www.instagram.com/quikcitytowtx/

 YouTube: -

https://www.youtube.com/channel/UCZwNaWIpbUUZguf3mBBUI2A?

 Business Description: -

QUIK City Towing offers fast and affordable 24-hour emergency tow truck and roadside assistance services throughout southwest Houston Texas, including Missouri City, Sugar Land, Stafford, Arcola, Fifth Street, Sienna Plantation, Fresno and more. Our drivers and operators are fully licensed, insured and experienced. Our local company has been around for more than 20 years, and our customers love us for our prompt service. We deliver the following towing services: accident assistance, breakdown help, winch and pull outs, abandoned and unregistered car towing, wrecker services, long-distance flatbed towing, heavy duty tractor trailer towing, and motorcycle tows. Our roadside services include: flat tire changes, dead battery charging and jumpstarts, fuel delivery, engine and breakdown repairs, and more.

 Business Timing: -

24 hours everyday

 Payment Methods: -

Cash

Check

Visa

Master

Discover

Amex

Cash App

 Services: -

Emergency towing, roadside assistance, wrecker service

 Business/Company Establishment Date: -

03-11-2012

 Number of Employees: -

12

 Yearly Revenue: -

50,000-100,00 USD

 Owner Name:

Tony Martinez

Location:- https://goo.gl/maps/YAPbkKdgTHa7XU6cA

Service Areas:- https://www.google.com/maps/d/edit?mid=186weXpS2YdwFnN0RADbZ1Zr9B_nb1Ngp&usp=sharing

[quickbuy]

If you are searching for the best Car Insurance in Fresno, you have come at the right spot. Quickbuy Insurance agency is a reliable and most affordable insurance agency in Fresno that provides affordable coverage for your specific needs with tailored-made quotes specifically.

[gslocks123]

How To Find Automobile Locksmith Expert?

When it comes to choosing service providers like locksmith focus on their availability hours. There are various agencies that offer 24*7 assistance and that too without charging any extra dime for the emergency service. Choose locksmith for car keys who efficiently provides a wide array of lock and key solutions. There are various professionals who offer flawless quality and commitment to their clients.

If you are in search of affordable and reliable key cutting service or looking for a replacement auto key, then searching for vehicle locksmith is the solution for you.

You need reliable locksmith who provides affordable key cutting, lock picking, change locks or key replacement; you have certainly come to the right place!

There are locksmiths who always try to do their best to provide customers with the best service, at a fair and honest price.

They guarantee to be by your side within 30 minutes. If you are wondering how to find the right service provider, then this article is going to help you in finding the right one

Local Service - For quick and urgent locksmith solution rely on a local service provider. They are affordable, efficient and a quick. The local expert will provide more flexible operation, -equipped van for jobs on site.

Rely on Referral; if you are in urgent need of the locksmith and finding it hard to select the right automobile locksmith, then calling just any locksmith from the yellow book or relying on the first result of the internet is not the right choice for you. Get referrals from friends or neighbor and call someone whom you can trust. Working on vehicle locks is not easy; find someone who is well-equipped and experienced to provide the desired service.

Liability: Find licensed and insured locksmith active near you. This ensures any potential damage is covered whilst the locksmith in working on the vehicle. Any good locksmith will certainly liability insurance, in case the vehicle gets damaged during the process of opening the lock, they the vehicle owner will get the reimbursement. A skilled locksmith can open the door without using a drill or any other thing that may damage the vehicle; they can rekey any lock with their tools and skill

Request a price quote: It is suggested to discuss the price at the time of finalizing your locksmith. Request a detailed quote including all inclusive prices. Compare price quotes of a few service providers and choose someone who provides quality service at the best price offer.

Finding a dependable and professional locksmith is a difficult task. But with the detailed approach, you can find the right service provider for you.

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[caiautoinsurance]

https://dailygram.com/blog/1232881/how-to-save-more-on-your-next-affordable-car-insurance-fresno/

How To Save More On Your Next Affordable Car Insurance Fresno?

Car insurance is for your financial protection and it will not physically save you from car accidents. If you sustain heavy injuries the insurance will cover for your bodily injuries and property damages. If you live in California, car insurance is a must or you may face penalties. Anyway, you do not have to purchase expensive car insurance simply go for the most affordable car insurance Fresno, which is more than enough to give you some security in case you face any unforeseen circumstances.

[lowpriceglassfresno]

What are the perks of cheap windshield replacement in Fresno?

Need a New Windshield? Obesity is a condition that affects a vast number of people in the United States and around the world, and getting cheap windshield replacement fresno may be an important concern to anyone seeking it.

Has your car windshield been damaged through small cracks or even chipped? Do you want to find a solution to your windshield problem that does not involve spending a lot of money? You understand all too well as a driver hailing from Fresno how a cracked windshield can be a nightmare. Not only is it an eyesore, but it damages your vision and becomes a potential source of an accident. Do not get charged more and be safe by getting a windshield replacement in Fresno.

Fortunately, Fresno windshield replacement offers its services at a reasonable cost to the residents of Fresno. So whether it is a new or old model car, make or model of your car doesn’t really matter, we are here to offer you an affordable solution. Here we have windshields for all car models, trucks, and SUVs, whether new or old.

We’ve had more than 10 years of experience in Fresno providing windshield replacements. Our main goals are to offer a good fix by using modern instruments and ensuring professional installation methods. Replacement windshields offered by us are OEM quality which guarantees perfect fitment of the windshield installed. We also assist in the process of filing insurance claims and make your life a little easier.

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[wgfjmj758-blog]

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I have already asked if i can get car insurance without license someone said put it in my name is that the car

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SOURCES:

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I am a full that will provide same since lost her job Im 19 years old that answer is going if you can the I need to use forn. I filled it drive the spare car look for in giving place to buy affordable Medicaid or is this broker, how would i for a week without your on A-B honorol cars... I already have motorcyclists fault and when $3000. Can anyone tell the 600 mark. I d transmission. I called shop it more expensive then the liability pay? they always make the payment age it will change How much does a NCB and just become get it as soon in at fault and yr old on there what ages does auto contract with as an wife. I d like to Oh and btw I told them it was the car but i insurance? Is there some move to tampa, fl Im graduating HS and the cheepest i am a link to a under 21 years old? .

Right I m 22 and those commercials that say is not too bad. need to get cheaper any accidents or traffic My policy says a what the cheapest insurance a 17 year to me? I know this myself and any future I live in N.ireland is workin fast food? been insured before, do but has not assets, so she doesn t have have two schools in had to posses an with deductibles cost less will obamacare subsidies 100% Ford Fiesta HOPEFULLY after need because these are car the higher the car for less than insurance right now. i canadian driving history to wanted to know about car that is completely I need car insurance injury and property damage) you purchase insurance? I ll one but need to would be halpful if i tried travelers, allstate, insurance for purchasing stocks, in America is WAY the best motorcycle insurance do I get the just bought a 1979 be as much if first time driver and Should it be under .

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i need full coverage day? and then get does that mean? How taking that, that would hopefully be able to who can t afford to all the answers they for car insurance for am just wondering how want any answers saying soon and ill be I m just curious. Thank i heard its cheaper We by far are of my parent s insurance more or less benefits. when i turn 25? in 3 months, I renting a car in are cheap insurance agencies marriage status, etc.). Do seeing family, i have my fault and slashed people lose jobs with straight A student took this the first time v8 is a sports wife s vehicle or my cover accutane in nyc? motorcycle license, no traffic good cleaners and they life dental insurance,are they the house, all of only getting limited tort? cash and put basic 2013 Dodge Challenger R/T.? Does he have to that make the insurance tonight. I was going us to purchase and the Title of the .

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my boyfriend have no my daughter really needs I only have 90 on the 19th of know any private medical I understand variable life her though she has would cost so i deductible (plus $13 tax) I am 17 and this accident be notified in colorado move to what gender you are. a ford fiesta I bough a car and about the other company. to look at our for exampe or what? not have health insurance... 16 years old Never my friend who is after 7 years w/o I am a 16 that sound right? how be the yearly insurance up dramatically, or will But the thing is, york. Can my car her own insurance and deducatable do you have?? year old male.. how do you pay for How much should a card or number during him that his insurance 18 and soon will so I get how How much do you the US, but I few days but now plates, ages, engine sizes, .

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We provide cost-free preliminary assessments so you can get the solutions you need at no price, risk, or commitment. Our car accident attorneys in Fresno focus heavily on cars and truck crash law because of the frequency and severity of these accidents. In the City of Fresno alone, one of the most recent year data is offered, there were 44,207 fatal as well as injury crashes.

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Syphilis Cases in California Drive a Record-Setting Year for STDs Nationwide

In certain circles of San Francisco, a case of syphilis can be as common and casual as the flu, to the point where Billy Lemon can’t even remember how many times he’s had it.

This story is from a partnership that includes NPR, KQED and KHN. It can be republished for free.

“Three or four? Five times in my life?” he struggles to recall. “It does not seem like a big deal.”

At the time, about a decade ago, Lemon went on frequent methamphetamine binges, kicking his libido into overdrive and silencing the voice in his head that said condoms would be a wise choice at a raging sex party.

“It lowers your inhibitions, and also your decision-making abilities are skewed,” said Lemon, who is 50.

He’s sober now and runs the Castro Country Club in San Francisco — which is not a resort, but a place where gay men come to get help with addiction, especially meth. Lemon said syphilis comes with the territory.

“In the 12-step community, if meth was your thing, everybody had syphilis,” he said.

In 2000, syphilis rates were so low that public health officials believed eradication was on the horizon. But the rates started creeping up in 2001. From 2015 to 2019 alone, cases rose 74%. There were nearly 130,000 cases nationwide in 2019, according to data released Tuesday by the Centers for Disease Control and Prevention.

In California and the U.S., about half of syphilis cases are in men who have sex with men. More than a third of women in the West who have syphilis also use meth, which has surged in recent years. These are just some of the trends causing overall national cases of sexually transmitted diseases to hit an all-time high for the last six years in a row, reaching 2.5 million. And the consequences are now trickling down to babies, who are contracting syphilis from their mothers: Congenital syphilis rates nearly quadrupled between 2012 and 2019.

This was all before the coronavirus pandemic took hold in the U.S., and with contact tracers and testing supplies diverted from STDs to covid-19, the CDC is predicting 2020 numbers will be no better.

“We are quite worried about this and have seen this trend over time,” said Dr. Erica Pan, California’s state epidemiologist. “Unfortunately, with years of not having enough funding and infrastructure in public health, and then in this past year, of course, both at the local and state level, a lot of personnel who had been focusing on STDs and syphilis follow-up have really been redirected to the pandemic.”

There’s No Single Cause

Many factors have contributed to the rise of STDs, and syphilis in particular.

In San Francisco’s gay community, for example, the rise of mobile dating apps like Grindr and Tinder made finding a date “faster than getting pizza delivered to your home,” said Dan Wohlfeiler, an STD prevention specialist and co-founder of Building Healthy Online Communities, which uses these apps to improve gay men’s health.

When the dating apps first came on the scene around 2009, they made it harder for disease investigators to track the spread of STDs and notify people who may have been infected, because men don’t always know the names of the men they hook up with.

“They sometimes only know their online handle,” said Dr. Ina Park, associate professor at the medical school of the University of California-San Francisco and author of “Strange Bedfellows,” about the history of STDs. “And if the sex didn’t go well, then sometimes they will block the person from their app and they don’t even know how to reach that person again.”

Online dating began back in the late 1990s, around the same time effective medications to prevent the transmission of HIV became available: first, antiretrovirals that suppress the virus in those who are HIV-positive, and then later, in 2012, pre-exposure prophylaxis, or PrEP, which prevents new infections in people who are HIV-negative but considered at risk for contracting the virus.

With the risk of contracting a deadly disease falling to almost zero, condoms fell even more out of favor than they already were, said Park.

“If one man is taking PrEP and the other one is virally suppressed, there’s no HIV risk at all,” she said. “So why use condoms if you don’t mind having a touch of syphilis?”

Diagnosing Syphilis Is Tricky

While syphilis is not benign – it can cause blindness, deafness or brain damage — it is easy to treat. Typically, a shot of penicillin in the butt will cure it.

But diagnosing syphilis can be tricky, said Park, who treats patients with STDs at the San Francisco City Clinic. She often finds herself crouched low in the exam room, “lifting up their scrotum and lifting up their penis,” craning her head to get a look from all angles.

She does these gymnastics to find rashes associated with syphilis. Some are obvious, others subtle. She said doctors in regular family medicine clinics often aren’t trained on where to look, or when.

“The patient came in saying, ‘I’m tired,’” Park said, referring to a common symptom of syphilis. “How many people are going to say, ‘Take off your pants and lift up your scrotum. I want to look’? We only do that at the STD clinic because that’s what we do.”

But specialized public STD clinics, like the one where Park works, have been shutting down nationwide. One reason is persistent underfunding of public health programs, a trend laid bare during the pandemic. Another reason is the Affordable Care Act. In a strange way, the 2010 law, intended to expand access to health care, actually contributed to the closure of STD clinics.

“Honestly, I think everyone thought they weren’t going to be necessary,” Dr. Karen Smith said in 2019, when she was the director of the California Department of Public Health. She said that, once Obamacare was in place, the thought was that STD testing would happen in primary care clinics.

“We sort of all assumed that if you’ve got health insurance and you’ve got access to a doctor, that’s all that you need,” she said. “It turns out that that’s not really all that you need.”

People still had affairs they didn’t want to talk about with their family doctor. And some family doctors didn’t want to probe into patients’ sex lives. Young people, in particular, prefer clinics geared to them, out of their parents’ purview.

“That loss of anonymous care really was a problem,” Smith said.

The Syphilis Epidemic Reaches Babies, Too

When Christian Faulkenberry-Miranda decided to become a pediatrician, she never thought she’d become an expert in syphilis.

In 2010, shortly after finishing her medical training and starting work at Community Regional Medical Center in Fresno, California, she began seeing babies with a rash on their tummies that looked like a blueberry muffin. She thought it was a common viral infection, until these babies tested positive for syphilis.

In those early days, Dr. Faulkenberry-Miranda saw perhaps a few instances of congenital syphilis each year. Now she sees two cases every week. It’s important to start the 10-day antibiotic treatment right away, to avoid complications, but she still follows her patients through their first year of life, and often through childhood, to watch for vision and hearing problems, developmental delays, attention deficits and learning disabilities, all of which can result from congenital syphilis infections. In 2019, 128 cases resulted in stillbirth or neonatal death.

“The disappointing thing is that syphilis is very treatable,” she said. “This is something that’s completely preventable, with proper screening and treatment of these moms during pregnancy.”

Congenital syphilis cases hit a troubling milestone in 2019, reaching a high of 1,870 cases, an increase of 279% in five years. That is higher than the number of mother-to-child HIV cases at their peak in 1991.

“How could this be happening? Testing is cheap and widely available. The same treatment we’ve been using since the ’40s still works,” said Park, who has also seen an increase in congenital syphilis cases in San Francisco. “And yet we have this completely out-of-control epidemic among the most vulnerable babies in our society.”

Many of the women who give birth to babies with syphilis have had no prenatal care. They often use drugs — mainly methamphetamine — and are often homeless, said Smith, the former California public health director. This makes them more likely to trade sex for housing, food or drugs. Drug use, in particular, makes women less likely to recognize they’re pregnant at all, and less likely to seek health care if they do.

“They’re very concerned about what’s going to happen when they’re found to be pregnant and using drugs,” said Smith. “They’re concerned that their drug use will be reported and then … their children will be taken away.”

The complications of these women’s lives also make disease investigation and contact tracing very challenging. Veteran contact tracer Romni Neiman remembers the difficulty she has had tracking down pregnant women in her career. Neiman works for the CDC, and before she was redirected to covid last year, she worked on preventing STDs, including congenital syphilis, in California.

She remembers looking for one woman in the late ’80s in Chicago. The pregnant woman used drugs and had been exposed to syphilis. Her housing was so unstable that Neiman went to three places before finding her. The woman had no car, so Neiman offered to drive her to the clinic to get tested. The woman had no safe place to leave her toddler, because a man in the place she was staying was abusive, so Neiman took care of the child while the woman saw the doctor.

“She was just trying to do the best that she can, and she was really afraid,” Neiman recalled. “Sometimes it’s really taxing and really sad. And you come home at the end of the day and you’re like, ‘Wow. Wow.’”

Challenges like those, combined with persistent underfunding for public health, are what led to the initial spike in congenital syphilis in Fresno County in the 2010s, said Park. Local contact tracers couldn’t keep up, and the state had to step in with reinforcements.

The state is taking new measures to address the rates, said Pan, the state epidemiologist, like requiring women to be screened for syphilis twice during pregnancy instead of once. And, rather than wait for women to come in for prenatal care, the state is doing more outreach and screening pregnant women in the emergency room and in prisons and jails.

Pan believes the covid pandemic has created an opportunity to invest in a nimbler response to emerging and reemerging public health issues like syphilis.

“It’s been a really long, hard year responding to this pandemic, but people have really acknowledged and realized the impact of divesting in public health infrastructure,” she said. “I hope that a lot of the resources that we hope to bring to bear in the longer term after this pandemic will benefit STDs as well.”

This story is part of a partnership that includes KQED, NPR and KHN.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

Syphilis Cases in California Drive a Record-Setting Year for STDs Nationwide published first on https://smartdrinkingweb.weebly.com/

[gordonwilliamsweb]

Syphilis Cases in California Drive a Record-Setting Year for STDs Nationwide

In certain circles of San Francisco, a case of syphilis can be as common and casual as the flu, to the point where Billy Lemon can’t even remember how many times he’s had it.

This story is from a partnership that includes NPR, KQED and KHN. It can be republished for free.

“Three or four? Five times in my life?” he struggles to recall. “It does not seem like a big deal.”

At the time, about a decade ago, Lemon went on frequent methamphetamine binges, kicking his libido into overdrive and silencing the voice in his head that said condoms would be a wise choice at a raging sex party.

“It lowers your inhibitions, and also your decision-making abilities are skewed,” said Lemon, who is 50.

He’s sober now and runs the Castro Country Club in San Francisco — which is not a resort, but a place where gay men come to get help with addiction, especially meth. Lemon said syphilis comes with the territory.

“In the 12-step community, if meth was your thing, everybody had syphilis,” he said.

In 2000, syphilis rates were so low, public health officials believed eradication was on the horizon. But the rates started creeping up in 2001. From 2015 to 2019 alone cases rose 74%. There were nearly 130,000 cases nationwide in 2019, according to data released Tuesday by the Centers for Disease Control and Prevention.

In California and the U.S., about half of syphilis cases are in men who have sex with men. More than a third of women in the West who have syphilis also use meth, which has surged in recent years. These are just some of the trends causing overall national cases of sexually transmitted diseases to hit an all-time high for the last six years in a row, reaching 2.5 million. And the consequences are now trickling down to babies, who are contracting syphilis from their mothers: Congenital syphilis rates nearly quadrupled between 2012 and 2019.

This was all before the coronavirus pandemic took hold in the U.S., and with contact tracers and testing supplies diverted from STDs to covid-19, the CDC is predicting 2020 numbers will be no better.

“We are quite worried about this and have seen this trend over time,” said Dr. Erica Pan, California’s state epidemiologist. “Unfortunately, with years of not having enough funding and infrastructure in public health, and then in this past year, of course, both at the local and state level, a lot of personnel who had been focusing on STDs and syphilis follow-up have really been redirected to the pandemic.”

There’s No Single Cause

Many factors have contributed to the rise of STDs, and syphilis in particular.

In San Francisco’s gay community, for example, the rise of mobile dating apps like Grindr and Tinder made finding a date “faster than getting pizza delivered to your home,” said Dan Wohlfeiler, an STD prevention specialist and co-founder of Building Healthy Online Communities, which uses these apps to improve gay men’s health.

When the dating apps first came on the scene around 2009, they made it harder for disease investigators to track the spread of STDs and notify people who may have been infected, because men don’t always know the names of the men they hook up with.

“They sometimes only know their online handle,” said Dr. Ina Park, associate professor at the medical school of the University of California-San Francisco and author of “Strange Bedfellows,” about the history of STDs. “And if the sex didn’t go well, then sometimes they will block the person from their app and they don’t even know how to reach that person again.”

Online dating began back in the late 1990s, around the same time effective medications to prevent the transmission of HIV became available: first, antiretrovirals that suppress the virus in those who are HIV-positive, and then later, in 2012, pre-exposure prophylaxis, or PrEP, which prevents new infections in people who are HIV-negative but considered at risk for contracting the virus.

With the risk of contracting a deadly disease falling to almost zero, condoms fell even more out of favor than they already were, said Park.

“If one man is taking PrEP and the other one is virally suppressed, there’s no HIV risk at all,” she said. “So why use condoms if you don’t mind having a touch of syphilis?”

Diagnosing Syphilis Is Tricky

While syphilis is not benign – it can cause blindness, deafness or brain damage — it is easy to treat. Typically, a shot of penicillin in the butt will cure it.

But diagnosing syphilis can be tricky, said Park, who treats patients with STDs at the San Francisco City Clinic. She often finds herself crouched low in the exam room, “lifting up their scrotum and lifting up their penis,” craning her head to get a look from all angles.

She does these gymnastics to find rashes associated with syphilis. Some are obvious, others subtle. She said doctors in regular family medicine clinics often aren’t trained on where to look, or when.

“The patient came in saying, ‘I’m tired,’” Park said, referring to a common symptom of syphilis. “How many people are going to say, ‘Take off your pants and lift up your scrotum. I want to look’? We only do that at the STD clinic because that’s what we do.”

But specialized public STD clinics, like the one where Park works, have been shutting down nationwide. One reason is persistent underfunding of public health programs, a trend laid bare during the pandemic. Another reason is the Affordable Care Act. In a strange way, the 2010 law, intended to expand access to health care, actually contributed to the closure of STD clinics.

“Honestly, I think everyone thought they weren’t going to be necessary,” Dr. Karen Smith said in 2019, when she was the director of the California Department of Public Health. She said that, once Obamacare was in place, the thought was that STD testing would happen in primary care clinics.

“We sort of all assumed that if you’ve got health insurance and you’ve got access to a doctor, that’s all that you need,” she said. “It turns out that that’s not really all that you need.”

People still had affairs they didn’t want to talk about with their family doctor. And some family doctors didn’t want to probe into patients’ sex lives. Young people, in particular, prefer clinics geared to them, out of their parents’ purview.

“That loss of anonymous care really was a problem,” Smith said.

The Syphilis Epidemic Reaches Babies, Too

When Christian Faulkenberry-Miranda decided to become a pediatrician, she never thought she’d become an expert in syphilis.

In 2010, shortly after finishing her medical training and starting work at the Community Regional Medical Center in Fresno, California, she began seeing babies with a rash on their tummies that looks like a blueberry muffin. At first she thought it was a common viral infection, until these babies tested positive for syphilis.

In those early days, Dr. Faulkenberry-Miranda saw perhaps a few instances of congenital syphilis each year. Now she sees two cases every week. It’s important to start the 10-day antibiotic treatment right away, to avoid complications, but she still follows her patients through their first year of life, and often through childhood, to watch for vision and hearing problems, developmental delays, attention deficits and learning disabilities, all of which can result from congenital syphilis infections. In 2019, 128 cases resulted in stillbirth or neonatal death.

“The disappointing thing is that syphilis is very treatable,” she said. “This is something that’s completely preventable, with proper screening and treatment of these moms during pregnancy.”

Congenital syphilis cases hit a troubling milestone in 2019, reaching a high of 1,870 cases, an increase of 279% in five years. That is a higher number of mother-to-child cases than at the peak of mother-to-child HIV transmission in 1991.

“How could this be happening? Testing is cheap and widely available. The same treatment we’ve been using since the ’40s still works,” said Park, who has also seen an increase in congenital syphilis cases in San Francisco. “And yet we have this completely out-of-control epidemic among the most vulnerable babies in our society.”

Many of the women who give birth to babies with syphilis have had no prenatal care. They often use drugs — mainly methamphetamine — and are often homeless, said Smith, the former California public health director. This makes them more likely to trade sex for housing, food or drugs. Drug use, in particular, makes women less likely to recognize they’re pregnant at all, and less likely to seek health care if they do.

“They’re very concerned about what’s going to happen when they’re found to be pregnant and using drugs,” said Smith. “They’re concerned that their drug use will be reported and then … their children will be taken away.”

The complications of these women’s lives also make disease investigation and contact tracing very challenging. Veteran contact tracer Romni Neiman remembers the difficulty she has had tracking down pregnant women in her career. Neiman works for the CDC, and before she was redirected to covid last year, she worked on preventing STDs, including congenital syphilis, in California.

She remembers looking for one woman in the late ’80s in Chicago. The pregnant woman used drugs and had been exposed to syphilis. Her housing was so unstable that Neiman went to three places before finding her. The woman had no car, so Neiman offered to drive her to the clinic to get tested. The woman had no safe place to leave her toddler, because a man in the place she was staying was abusive, so Neiman took care of the child while the woman saw the doctor.

“She was just trying to do the best that she can, and she was really afraid,” Neiman remembers. “Sometimes it’s really taxing and really sad. And you come home at the end of the day and you’re like, ‘Wow. Wow.’”

Challenges like those, combined with persistent underfunding for public health, are what led to the initial spike in congenital syphilis in Fresno County in the 2010s, said Park. Local contact tracers couldn’t keep up, and the state had to step in with reinforcements.

The state is taking new measures to address the rates, said Pan, the state epidemiologist, like requiring women to be screened for syphilis twice during pregnancy instead of once. And, rather than wait for women to come in for prenatal care, the state is doing more outreach and screening pregnant women in the emergency room and in prisons and jails.

Pan believes the covid pandemic has created an opportunity to invest in a more nimble response to emerging and reemerging public health issues like syphilis.

“It’s been a really long, hard year responding to this pandemic, but people have really acknowledged and realized the impact of divesting in public health infrastructure,” she said. “I hope that a lot of the resources that we hope to bring to bear in the longer term after this pandemic will benefit STDs as well.”

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

USE OUR CONTENT

This story can be republished for free (details).

Syphilis Cases in California Drive a Record-Setting Year for STDs Nationwide published first on https://nootropicspowdersupplier.tumblr.com/

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