He said, “AIDS and HIV Are FAKE Diseases Created By the Condom Industry To Sell Their Merchandise To The Unknowing Public.”

“Wise Words” by Jaden Smith …

Screenshot (6)

Believe it or not, this is actually a thing: HIV denialism. Reading these denialists’ blogs/ listening to them online just gives me the heebie-jeebies considering how devastating the effects of HIV  have actually been for patients who contract the virus. In addition,with new medical developments and decreased mortality rates, a new complacency has set in with condom use. Unfortunately, a lot of young adults seem to think it is “uncool” to use condoms or that it is a sign of “having something” when a partner advocates for condom use or the excuse of the weakest of all personalities, in my opinion, – it shows “lack of trust”. Besides the various significant social and mental health impacts of this disease, it costs approximately one million Canadian dollars to treat one patient through a life time of the disease, according to HIV Edmonton. Yet, 15605 people shared this apparently “ground breaking epiphany” by the then 14 year old Jaden Smith , 7351 people thought it was something they should recognize as one of their favorite tweets. Incredible!

*Sigh*

Let’s do a Risk Vs. Benefit analysis of Jaden’s “theory” just for shits and giggles.

Risk if you believe HIV is not real and you use male condoms anyway: You wasted <$2; may reduce sensation (perhaps last a little longer), interrupt foreplay in order to place the condom on penis properly AND make those awful Condom Manufacturers rich.

Benefit if you believe HIV is not real and you used male condoms anyway: You reduce your risk of: unplanned pregnancy, Gonorrhea,  Chlamydia, **Hepatitis B,  Lymphogranuloma Venereum, Trichomoniasis, *Herpes, *Syphilis, *Human Papilloma Virus, *Cervical Cancer, *Genital Warts. You may prevent premature ejaculation (in some men). You may reduce your risks for spontaneous abortions and infertility in the long run.

Don’t know about you, but it seems to me that the Benefits by far outweigh the Risk of being conned by those Condom Manufacturers.

My hope is that the kid was just being sarcastic..or thought he was just being a hilarious 14 year old… that being said.

…I’m seizing my Pharmacist Counselling Moment of Glory Here to Share Some #CondomPoints!

#POINT : HIV is real, as ~ 34,000,000 people living with HIV can attest to this point.

#POINT: We can get to Zero infections by sharing sound knowledge and actively participating in harm reduction efforts (BC has nearly eliminated cases of AIDS).

#POINT: When used consistently and correctly, there is evidence that, male condoms reduces unplanned pregnancy and reduces risk in both men and women of gonorrhea, chlamydia, trichomoniasis, syphilis, herpes, HIV and HPV.

#POINTCondom use does not undermine sexual risk reduction efforts by causing high-risk sexual activity or increasing the frequency of high risk behaviour – evidence from a systematic review of 174  sexual risk intervention studies.

#POINTThere is good evidence that when one partner in a couple has HIV and the other does not, consistent condom use reduces the risk of acquiring the infection by 80 to 95%

#POINT: Different sexual behavior & even positions may affect your risk of contracting a Sexually Transmitted Infections (STI) — More on this topic in upcoming post.

#POINT: STIs, if left undiagnosed could lead to infertility.

#POINT: Whipped cream, a Massage and your Tan might ruin your condoms… oil based products reduce latex condom integrity. Some topical medications, baby oil, suntan oils, vaseline, edible oils, massage oils etc are on this list.

#POINTCondoms are most effective when used with every act – Anal, Vaginal and Oral.

#POINT: New condoms should be used for prolonged sex; and for different types of sex within a single session (for example change after anal sex, before vaginal…)

#POINTThe condom should be used during the entire sexual act. That means, you shouldn’t put it on after genital contact or remove it prior to ejaculation… from beginning of genital contact to after ejaculation.

#POINTNot all condoms are created equal. Natural membrane condoms are made from lamb intestines, contain small pores and should not be recommended for STI protection.

#POINT:  CRAP happens! 2% of the time during vaginal intercourse (rates vary widely across studies and are a little higher during anal); the condom may slip &/or break….
A Back Up Plan? … have several more condoms available, gently wash your genitals with soap and water, though this practice has not been very well studied, washing may reduce your risk of acquiring an STI,  insert an applicator full of spermicide vaginally (to help prevent pregnancy). Note to Girls – Do Not Douche….it does more  harm than good.

#POINTIt is possible to contract an infection during foreplay and non-penetrative sex. A condom placed on the penis before any genital contact greatly reduces risks of infections

#POINTSome infections are transmitted primarily through skin surfaces like herpes, syphilis, chancroid and HPV when the condom completely covers the entire infected area, transmission risks are reduced as well….if the infected area is not covered by the condom then transmission is more likely.

#POINT: Next time your partner says condoms reduce the sensation/ are too sterile, remember that condoms come in a variety of shapes, sizes, colors, thickness, with or without lubricants/ spermicides, with or without reservoir-tip or nipple-ends. They can be straight-sided or tapered toward the closed end, textured (ribbed) or smooth, solid-colored/ nearly transparent, and odorless, scented or flavored — Perhaps this comment should simply be taken as a challenge to discover the “sensational” condom…I propose that all sexually active people should own Sex Kits containing one of each…(plus a travel sized kit… latex condoms can probably be carried, for convenience, for up to one month) 😉

#POINT: It is true that the odds of your partner having an STI in Canada are generally low — From the latest reports that I could find in 2010: 277.6 overall cases of Chlamydia per 100,000; 33.4 overall cases Gonorrhea per 100,000; 5.2 overall cases of Syphilis per 100,000; because HIV is not yet curable, I’d share the number of people living with the disease not the number of new cases/ year. In 2011, 71300 were estimated to be living with HIV in Canada plus 17,890 who were potentially unaware of it; meaning, 89280 people were likely carrying the virus out of 34.34 million Canadians that year.

These odds may increase significantly depending on various factors such as age, gender, race/ethnicity, sexual orientation, incarceration, intravenous drug use, number of sexual partners, marital status, residence in an urban area, new sex partner(s), history of prior STI, illicit drug use, contact with sex workers, intimate partner violence.

#POINT: Your knowledge of the low statistical odds, of meeting someone with these infections in Canada, is in fact meaningless to you, because you are not a science experiment, and as such, you are not the statistical average of 35 million people. You do not as a matter of fact know you & your partner’s status at every possible moment. You do not know the exact virulence factor of the bug(s) you may/ may not be exposing yourself to.You do not know how your odds of infection are skewed by the intersection of all the aforementioned factors in your particular case. For example, those odds of having Chlamydia in 2010 could shift from ~ 1 in 360 overall to closer to 1 in 50 if you were a 23 year old female living in Canada at the time.

… On The Twitter Philosopher….

This is the problem with everyone having a platform to share their thoughts, crazy ideas and pseudo-journalistic efforts, people use their influence to spread non-evidence based non-medicine nonsense about very important medical topics. Our patients are inundated with these messages, news and ideas daily. It is for this reason, I think it is crucial that we (actual Health Care Professionals) consider developing the skills required to engage with our patients through these new platforms of communication. A social media presence is becoming more crucial than ever imagined to share good quality messages with our patients. Our social capital as healthcare professionals place us in an ideal position to influence general thoughts and ideas about various topics and hopefully fix damaging content that sometimes end up forming general opinion. I wish there was a forum for our colleges and regulatory bodies to list advisories/ warnings about bogus sources of health information too. Bad information can be as bad for one’s health as administering an inappropriate medication.

There is a distinct dearth of engaging health media. It would be helpful if more critically evaluated evidence based medicine starts getting shared in patient friendly language online.

For now, I have created my tongue in cheek tool tip for my patients who show up at the pharmacy, having self-diagnosed via Oprah/ WebMd/ Dr. Oz. I plan to actually hand this out, the next time someone comes in with some absurd knowledge acquired from the internet or television; I’ll keep you all updated about how my first use of this card goes

Source Checker

…. Back to Jaden …

$2

vs

Reduce your risk (even when already low) for HIV &/or unplanned pregnancy  &/or Gonorrhea &/or Chlamydia  &/or Hepatitis B  &/or Hepatitis C &/or Lymphogranuloma Venereum  &/or  Trichomoniasis &/or *Herpes&/or  *Human Papilloma Virus &/or *Cervical Cancer &/or *Genital Warts &/or Syphilis .

???

It seems to me that if you are upset about condom companies getting rich, then you should buy stocks and get rich with the condom companies too! (May I suggest the Female Health Company Nasdaq: FHCO? They are doing particularly well…)

get tested and…

use the damn condom!

*Even with use of condoms, HPV (which could cause Cervical Cancer & Genital Warts), Herpes and Syphilis may still be contracted depending on what part of the genitals is infected. For the giver of oral sex, a condom may reduce risks of contracting HPV, Herpes & Syphilis as well.

**Hepatitis B is the smallest sexually transmitted pathogen; laboratory studies indicate male condoms are an effective barrier against this too.

I specifically referred only to male condoms in this post, because most of the efficacy data available are related to those more so than female condoms.

 

Sources:
Therapeutic Choices
UptoDate.com
5 years of great education at the University of Alberta.

White People Problems? – Anorexia – Ultra-Thin Model Ban

This post is a few months due, but I was too busy to write my thoughts when this was more of a relevant topic. Bear with me.

In April, France joined Israel, Spain and Italy, in banning the use of models with a BMI < 18. Use of underweight models, in France, will come with a chance of up to 6 months in jail and a fine of up to $82,000 (USD). Because France is a major hub of fashion and in fact influences a lot of trends and thoughts about clothing and the female body image, I was thrilled about this ban. In my opinion, the media does play a huge role in body image distortion for many young women; I’d go as far as saying your TV, Radio, magazines, books, websites and newspapers could be some sort of risk factor for developing eating disorders.

There are some deficiencies in broadly applying BMI as a unit of measuring healthy weight. A number of theories exist: BMI may underestimate obesity in metabolically obese normal weight people (often referred to as skinny fat people), or may over estimate obesity in shorter people like with people in lower socio-economic classes or also in people with far east Asian heritage… or my personal favourite, BMI overestimates obesity in some athletes, so that lean Olympian with lots of heavy muscle seems more obese than your neighbourhood couch potato if you assessed by just BMI. These theories and truths aside, I do believe this was a great positive message to send to healthy weight girls that forcing yourself into looking like this>>

anorexic… is in fact not representative of most women

… neither is it fashionable or beautiful.

I actually think this portrayal of ultra-skinny femininity as an ideal, is in  fact a public health concern.

I got to wondering about which women (because this is more prevalently  a women’s issue) might be influenced by the ban. Though Anorexia  nervosa is a rare condition, I wondered, if most Countries implemented this ban, would it have a truly global impact in spreading knowledge about healthy body images?

In case you are unaware, I’ll let you in on a well-known, but often ignored secret … There is some temptation amongst immigrants to label certain diseases and conditions, as a problem only for “developed countries” or western societies or in particular Caucasian people in higher socio-economic classes in developed western societies. Pretty much all mental health conditions and eating disorders happen to fall into this box.

There is even a theory about why Anorexia Nervosa might be just a developed society’s problem:

The age-related obesity hypothesis: posits that the otherwise normal tendency by women to seek a youthful appearance can become maladaptive and lead to anorexia nervosa in environments in which thinness becomes the primary indicator of youth, such as in modern industrialized societies”1

Hmmmmm….An interesting sociological determinant of health….

Truth is in most western societies, there exists an obsession with weight loss, staying skinny and attempting to reach crazily unattainable and unhealthy physical attributes displayed by actors and models. This preoccupation unfortunately gets tied into many young adult’s self-esteem and self-image with concomitant psychological effects. Where I’m from, being curvy, voluptuous even fat was an attractive feature (this fact is changing with increased influence of globalization and spread of western media influence), so it is tempting to assume, no one is anorexic in Nigeria. I found exactly 2 case studies of Nigerians in Nigeria diagnosed with anorexia nervosa, which might indicate gross under diagnosis of the condition or the assumption that it is not an African problem or may be related to the fact that most Nigerians still consider fuller figured women as beautiful. Anorexia Nervosa is definitely not exclusive to Caucasian people in Western developed societies, however an increase of this condition has been associated with urbanization and the spread of media – exposure promoting western ideals of beauty.2-5 So, once again, I’ll say I’m pleased that France, Israel, Spain and Italy are making baby steps in altering this particular risk factor.

I know this is not a highly prevalent condition, but I wonder about ethnic minorities in Canada? Are there equivalent rates of anorexia nervosa amongst our ethnic minorities in Canada as in the general population?

I could not find a solid answer to that question. So, maybe you physicians who get to deal with this more often can share thoughts?

 

  1. Lozano GA (2008). “Obesity and sexually selected anorexia nervosa”.Medical Hypotheses 71 (6): 933–940. doi:1016/j.mehy.2008.07.013.PMID 18760541.
  2. Eating pathology in East African women: the role of media exposure and globalization. Eddy KT, Hennessey M, Thompson-Brenner H, J Nerv Ment Dis. 2007 Mar; 195(3):196-202.
  3. Nasser M. Eating disorders across cultures.  2009;8(9):347–50. doi: 10.1016/j.mppsy.2009.06.009.
  4. Becker AE, et al. Social network media exposure and adolescent eating pathology in Fiji.Br J Psychiatry. 2011;198(1):43–50. doi: 10.1192/bjp.bp.110.078675.
  5. Pavlova B, et al. Trends in hospital admissions for eating disorders in a country undergoing a socio-cultural transition, the Czech Republic 1981–2005.Soc Psychiatry Psychiatr Epidemiol. 2010;45(5):541–50. doi: 10.1007/s00127-009-0092-7.