The holiday season can be a time of joy, but it can also bring added stress, anxiety, and depression, especially for those in the LGBT+ community. These months can feel isolating for individuals who may not have supportive families or those struggling with mental health issues.

  How are You Feeling?

If you're feeling down, it's essential to reach out for help. Mental health screenings for depression and anxiety can be done quickly in your provider’s office. Symptoms such as persistent sadness, lack of interest in activities, fatigue, or anxiety may indicate that it’s time to talk to someone.

  Treatment Options:

There are various treatment options available:

• Counseling/Therapy: Cognitive Behavioral Therapy (CBT), talk therapy, and other forms of counseling can help manage symptoms of depression and anxiety.
• Medication: For some, medications such as antidepressants or anti-anxiety medications may be necessary. Work with your healthcare provider to find a treatment that’s right for you.

  Managing Seasonal Affective Disorder (SAD):

Seasonal Affective Disorder (SAD) is a form of depression that occurs during the winter months when there’s less sunlight. Symptoms include low energy, sleeping too much, and feeling hopeless. Treatment options include light therapy, vitamin D supplements, and regular physical activity.

 Remember, mental health is just as important as physical health. Reach out to your provider if you're struggling this holiday season.

October is Breast Cancer Awareness Month, a time to promote the importance of breast cancer screenings and early detection, especially within the LGBT+ community. While breast cancer predominantly affects cisgender women, it's essential for everyone, including transgender patients, to be vigilant about their breast health.

  Breast Cancer Screenings for Trans Patients:

• For Trans Women: Trans women who have undergone hormone therapy with estrogen for at least five years may be at an increased risk for breast cancer. Regular mammograms may be recommended starting at age 50 or sooner, depending on your healthcare provider’s advice.
• For Trans Men: Trans men who have not had top surgery, or who retain some breast tissue after surgery, should still consider regular breast cancer screenings. Mammograms may be necessary based on your remaining breast tissue and personal risk factors.

  Mammograms and Self-Exams:

• Mammograms: These are one of the most effective early detection tools. It’s recommended that people between the ages of 50 and 74 undergo a mammogram every two years, but your provider may recommend starting earlier depending on your risk.
• Self-Exams: Monthly self-exams are a great way to stay aware of any changes in breast tissue. Look for lumps, skin changes, or nipple discharge, and report any concerns to your healthcare provider right away.

  Support for Patients Undergoing Breast Cancer Treatment:

If you're diagnosed with breast cancer, remember that you're not alone. Support groups, counseling, and patient advocacy services are available to help you through treatment, whether it's surgery, chemotherapy, or radiation.

 Remember, early detection saves lives. Schedule your screening today!

Smoking disproportionately affects the LGBT+ community, and individuals living with HIV are at even higher risk for smoking-related illnesses. It’s time to take control of your health and quit smoking.

Smoking in the LGBT+ Community:

According to the CDC, approximately 20.6% of LGBT+ adults smoke , compared to 14.9% of heterosexual adults. This disparity may be due to stress, stigma, and targeted marketing by the tobacco industry toward the LGBT+ community.

  Take Control of Your Health:

During your next visit, talk to your healthcare provider about smoking cessation. Providers can screen for tobacco use and provide resources such as:

• Behavioral Counseling: Therapy or support groups to help you stay on track.
• Nicotine Replacement Therapy (NRT): Products like nicotine patches or gum.
• Prescription Medications: Medications such as varenicline (Chantix) and bupropion (Zyban) can help reduce cravings and ease withdrawal symptoms.

  Resources for Support:

There are numerous resources available to help you quit:

• Quitlines: Free phone-based services like 1-800-QUIT-NOW.
• Online Support: Websites like smokefree.gov offer tailored support for the LGBT+ community.
• Apps: There are many apps available to help track progress and provide motivation.

 

Quitting smoking is one of the best things you can do for your health, especially if you’re living with HIV. Reach out for support today—your future self will thank you!

As fall approaches, it's essential to stay updated on recommended vaccinations to protect yourself and your community. For those in the LGBT+ community and individuals living with HIV, certain immunizations are especially important.

Herpes simplex virus (HSV) is a common viral infection that affects millions of people worldwide. Often misunderstood and stigmatized, HSV comes in two main forms: HSV-1 and HSV-2. In this blog, we'll explore the differences between the two types, how they are transmitted, their symptoms, treatment options, and debunk some common misconceptions.

What is Herpes Simplex Virus?

Herpes simplex virus is a contagious virus that can infect various parts of the body, typically causing cold sores (HSV-1) or genital herpes (HSV-2). Both types of HSV can also cause sores or blisters in other areas, such as the mouth, lips, or genitals.

HSV-1: Oral Herpes

HSV-1 is primarily associated with oral herpes, characterized by cold sores or fever blisters around the mouth and lips. However, HSV-1 can also cause genital herpes through oral-genital contact. Transmission can occur through kissing, sharing utensils, or coming into contact with saliva of an infected person.

HSV-2: Genital Herpes

HSV-2 is primarily responsible for genital herpes, characterized by sores or blisters in the genital or anal area. Transmission usually occurs through sexual contact with an infected individual, including vaginal, anal, or oral sex. However, it's important to note that HSV-2 can also cause oral herpes through oral-genital contact.

Symptoms

Both HSV-1 and HSV-2 infections can be asymptomatic, meaning individuals may not experience any symptoms. However, when symptoms do occur, they typically include:

• Pain, itching, or tingling around the affected area
• Small red bumps or blisters that may break open and form painful sores
• Flu-like symptoms such as fever, headache, and swollen lymph nodes

Treatment and Management

While there is no cure for herpes, antiviral medications can help reduce the severity and frequency of outbreaks, as well as alleviate symptoms. These medications, such as acyclovir, famciclovir, and valacyclovir, are most effective when taken at the first sign of an outbreak or as suppressive therapy for individuals with recurrent infections.

In addition to medication, practicing safe sex, using condoms or dental dams during sexual activity, and avoiding sexual contact during outbreaks can help reduce the risk of transmitting HSV to sexual partners.

Debunking Myths

Despite its prevalence, herpes simplex virus is often shrouded in misconceptions and stigma. Here are some common myths debunked:

• Myth: Only promiscuous individuals get herpes. Fact: HSV can affect anyone who comes into contact with the virus, regardless of their sexual behavior.
• Myth: You can only get herpes from sexual contact. Fact: HSV can be transmitted through skin-to-skin contact, including kissing or sharing personal items.
• Myth: Herpes is always symptomatic. Fact: Many people with HSV may not experience any symptoms or have mild symptoms that go unnoticed.

Conclusion

Herpes simplex virus is a common viral infection that affects millions of people worldwide. While it can cause discomfort and inconvenience, it's essential to understand that herpes is manageable with proper treatment and precautions. By dispelling myths, promoting education, and fostering open conversations, we can reduce stigma and support individuals affected by HSV in leading healthy and fulfilling lives.

In recent years, the conversation around sexual health and the prevention of sexually transmitted infections (STIs) has gained significant attention. Among the various strategies available, Post-Exposure Prophylaxis (PEP) has emerged as a crucial tool in reducing the risk of STI transmission. In this blog, we'll delve into the use of Doxycycline PEP (Doxy PEP), exploring what it is, how it works, and its implications for sexual health.

What is Doxy PEP?
Doxycycline PEP, often referred to as "Doxy PEP," is a form of prophylactic treatment used to reduce the risk of acquiring certain STIs after potential exposure. Potential exposures would include condomless sex: meaning oral, anal or vaginal/front hole sex.
It is sort of like the “morning after pill” for STIs. It involves taking a course of antibiotics, specifically doxycycline, within 24 to 72 hours following unprotected sexual contact or other high-risk sexual activities. Taken as directed Doxy PEP can reduce the risk of getting syphilis and chlamydia by approximately two-thirds. Doxy PEP may not be effective against gonorrhea, as about 25% of gonorrhea in the United States has significant resistance to doxycycline. Safer sex practices remain the best way to reduce risk against STIs.

How Does Doxy PEP Work?
Doxycycline is a broad-spectrum antibiotic. When taken as PEP, doxycycline works by targeting and inhibiting the growth of bacteria that may have been transmitted during sexual contact, thereby reducing the likelihood of infection.

How is Doxy PEP Administered?
Doxy PEP is typically administered as a short-term course of oral antibiotics (200 mg), taken once within 24 to no later than 72 hours after a risky sexual contact. You can take another 200 mg dose if you have unprotected sex again within the next 24 hours. It's essential to follow the prescribed dosage and duration of treatment as instructed by a healthcare provider to maximize effectiveness and minimize the risk of antibiotic resistance.

Considerations and Side Effects
While Doxy PEP can be an effective tool in preventing STI transmission, it's not without its considerations and potential side effects. Some important points to keep in mind include:

Effectiveness: While Doxy PEP can reduce the risk of certain STIs, it may not provide complete protection and should not be viewed as a substitute for other preventive measures, such as condom use and regular STI testing. It does not protect against MPOX (monkey pox), HIV or other viral infections, such as genital herpes.

Side Effects: Common side effects of doxycycline may include gastrointestinal upset, nausea, and sensitivity to sunlight. Make sure to take doxycycline with plenty of water to reduce the risk of it getting stuck when you swallow and severely irritating the esophagus. Avoid taking doxycycline within 2 hours of foods or medications containing calcium (milk, calcium supplements, antacids or multivitamins). Avoid over-exposure of sun or wear sunscreen with use.

Antibiotic Resistance: Overuse or misuse of antibiotics, including Doxy PEP, can contribute to the development of antibiotic resistance, making it harder to treat bacterial infections in the future. It's crucial to use antibiotics judiciously and only when necessary. Doxy PEP may not be effective against gonorrhea, as about 25% of gonorrhea in the United States has significant resistance to doxycycline. Safer sex practices remain the best way to reduce risk against STIs.

Conclusion
Doxycycline PEP (Doxy PEP) is an important component of comprehensive STI prevention strategies, particularly in situations where there has been a high-risk exposure to certain bacterial STIs. By understanding how Doxy PEP works, its recommended use, and potential considerations, individuals can make informed decisions about their sexual health and well-being. As always, open communication with healthcare providers and adherence to recommended guidelines are key to maximizing the effectiveness of Doxy PEP and promoting overall sexual health.

Sexually transmitted infections (STIs) are a significant health concern for individuals worldwide, and certain populations, such as men who have sex with men (MSM), face specific challenges when it comes to sexual health. MSM are at a higher risk of contracting and transmitting STIs due to various factors. In this blog, we will explore the most common STIs among MSM, risk factors, preventive measures, and the importance of regular testing.

1.     Common STI’s among MSM:

• Human Immunodeficiency Virus (HIV) : HIV is a viral infection that attacks the immune system, leading to AIDS if left untreated. MSM account for a significant portion of new HIV diagnoses globally. Regular testing and the use of pre-exposure prophylaxis (PrEP) can reduce the risk of HIV transmission. HIV is very treatable and those that are on treatment and undetectable cannot transmit the virus. Besides knowing your status, being on PrEP or HIV treatment are the best ways to prevent the spread of HIV.
• Syphilis: Syphilis is a bacterial infection that can affect multiple organs. MSM have seen a surge in syphilis cases, particularly among those engaging in high-risk sexual behaviors. Timely diagnosis and treatment are crucial to prevent complications.
• Gonorrhea and Chlamydia: These bacterial infections can occur in various parts of the body, including the genitals, rectum, and throat. MSM are at an increased risk due to unprotected anal and oral sex. Regular testing, using condoms and silicone lubricants (when engaging in receptive anal sex) can help prevent the spread of these infections.
• Human Papillomavirus (HPV): Most sexually active people have acquired HPV by adulthood. It is contracted by skin-to-skin contact and most commonly detected in the genital, anal, and oral cavity. MSM have increased risk of anal cancer due to HPV related anal cancers. Those that are HIV positive have an even greater risk than those that are HIV negative. Vaccination and screening for high-risk types of HPV should be performed on all MSM after age 30 for those that are HIV positive and over 40 for those that are HIV negative.
• Monkey Pox (MPox): Most recently a variation of the small pox virus has plagued the MSM community. Mpox is transmitted through skin to skin contact and most commonly transmitted in large group events. MSM should be vaccinated to prevent contracting Mpox.

  2.     Risk Factors:

• Condomless Sexual Activity: Engaging in anal or oral sex without the use of barriers, such as condoms or dental dams, significantly increases the risk of STI transmission.
• Multiple Sexual Partners: Having multiple sexual partners can increase the likelihood of encountering STIs. It is crucial to discuss sexual health with partners and use barriers consistently.
• Substance Abuse: Substance use, especially drugs like methamphetamine, can lead to risky sexual behaviors and impair judgment, further increasing the risk of STI transmission. Alcohol should not be discounted as a substance that can reduce inhibitions leading to decisions that can raise the risk of contracting STI’s.

3.     Preventive Measures:

• Using Condoms: Consistently using condoms or dental dams during anal and oral sex can reduce the risk of STI transmission. Water-based lubricants can also help minimize the chance of condom breakage. Water-based or silicone-based lubricants  are safe to use with all types of condoms. Oil-based lubricants, such as petroleum jelly, lotion, or baby oil, can break down latex, polyurethane, or polyisoprene condoms, leading to failure during intercourse. Spermicide is also safe to use with condoms. It is important to never use two condoms at once.
• Regular Testing: Regular STI testing is essential for early detection and prompt treatment. MSM should consider getting tested every three to six months or as recommended by healthcare professionals. Diversity Family Health recommends getting tested before engaging with a new partner and 7 days after a sexual encounter with every new partner. Diversity Family Health walk-in STI clinic is a convenient way to get regular testing.
•   Vaccinations: Vaccines, such as the HPV vaccine (now available up to age of 45) and the hepatitis A and B vaccines, can provide protection against certain STIs. Consult with a healthcare provider to determine the appropriate vaccinations for your individual needs.
• Pre-Exposure Prophylaxis (PrEP): PrEP is available for the prevention of HIV. Oral PrEP is a pill, when taken daily can prevent HIV. Alternatively, injectable PrEP can be taken on the same day every two months to prevent HIV. Both oral and injectable PrEP when taken as directed have proven to reduce the risk of HIV transmission by 99%.
• Post-Exposure Prophylaxis (PEP): There are two forms of PEP, one for HIV and one for Chlamydia, Gonorrhea, and Syphilis. HIV P EP: When not on PrEP, medication can be taken to prevent getting HIV if the medication is started within 72 hours of exposure. This medication is taken for 28 days and is very effective at preventing HIV infection.  Doxy-PEP: Doxycycline has been proven to prevent chlamydia and syphilis up to 66% when taken, preferably, within 24 hours but no later than 72 hours after a condomless sexual encounter. It can also be effective against gonorrhea, however 25% of gonorrhea in the US is resistant to doxycycline.
• Treatment as Prevention: Those that are positive for HIV can also prevent the spread of HIV by taking their medication as prescribed. If a person’s viral load (the number of HIV virus detected in the blood) are less than 200 they are considered undetectable and they cannot transmit the virus to others. Rarely is HIV transmitted by someone who knows they are HIV positive.

4.     Importance of Communication, Education & Support:

• Open Communication: Honest and open communication with sexual partners is vital for preventing STI’s. Discussing sexual health, STI testing history, and potential risks can help make informed decisions.
• Education and Awareness: Promoting comprehensive sex education and raising awareness about STIs within the MSM community is crucial. Accessible information can empower individuals to make informed choices and seek appropriate healthcare.
• LGBTQ+ Healthcare Providers: Seeking healthcare from LGBTQ+-experienced providers who are knowledgeable about MSM sexual health can ensure better understanding and support. Book your sexual health appointment with Diversity Family Health.

Conclusion: Sexually transmitted infections remain a concern for men who have sex with men, but with knowledge, communication, and preventive measures, the risk can be significantly reduced. Regular testing (knowing your status), implementing prevention strategies, and open dialogue with healthcare providers and sexual partners are crucial steps in maintaining sexual health and well-being. Remember, taking care of your sexual health is an important aspect of leading a fulfilling and healthy life.

Bacterial vaginosis (BV) is a common vaginal infection that affects all people assigned female at birth (AFAB) regardless of sexual orientation. While BV can occur in any AFAB, including lesbians and transgender men. it is important to raise awareness about prevention strategies specifically tailored to this community. In this blog post, we will explore what BV is, its potential causes, and provide practical tips for preventing BV for all people AFAB, including lesbians and transgender men.

Understanding Bacterial Vaginosis (BV): BV is a vaginal infection caused by an imbalance in the natural bacterial flora of the vagina. Normally, the vagina contains a delicate balance of good and bad bacteria. However, when the bad bacteria outnumber the good bacteria, it can lead to symptoms such as unusual vaginal discharge, odor, itching, and discomfort.

Prevention Strategies: Preventing BV involves adopting certain practices and habits that promote a healthy vaginal environment. Here are some key strategies to consider:

1.    Maintain Good Vaginal Hygiene:

• Use mild, unscented soaps and avoid douching, as it disrupts the natural pH balance of the vagina.
• After using the toilet, wipe from front to back to prevent the spread of bacteria from the anus to the vagina.

2.    Sex Practices

• Engaging in informed sexual practices can reduce the risk of BV and other sexually transmitted infections (STIs). For lesbian couples, it is essential to pay attention to hygiene practices before and after sexual activity.
• Consider using barrier methods such as dental dams or gloves during oral-genital or manual-genital contact to reduce the risk of bacterial transfer.

3.    Limit Antibiotic Use

• Overuse of antibiotics can disrupt the vaginal microbiome, potentially leading to an imbalance and increased risk of BV
• Whenever possible, discuss with your healthcare provider alternative treatment options that do not involve antibiotics or explore strategies to minimize their impact on the vaginal flora.

4.    Wear Breathable Underwear and Clothing:

• Wearing breathable cotton underwear and avoiding tight-fitting clothing can help prevent excessive moisture buildup and create an unfavorable environment for bacterial overgrowth.
• Latex and silicone packers can also cause for extra moisture buildup in transgender men. Wicking fabrics to keep the area dry should be between the packer and the body.

5.    Probiotics:

• Probiotics, available as oral supplements or vaginal suppositories, can help restore and maintain a healthy balance of vaginal bacteria. Consider discussing with your healthcare provider to determine the most suitable option for you.

6.    Regular Health Check-ups:

• Routine gynecological exams and screenings are crucial for early detection and treatment of any vaginal infections or abnormalities. Regular visits to your healthcare provider will help ensure your overall vaginal health.

Conclusion: Preventing bacterial vaginosis is important for all people AFAB, including lesbians and transgender men, to maintain optimal vaginal health. By implementing these preventive strategies, you can promote a healthy vaginal environment and reduce the risk of BV. Remember, open communication with healthcare providers and sexual partners, and implementing prevention strategies, are key components of maintaining good vaginal health.

It is vital to emphasize that sexual orientation and gender identity does not determine the risk of developing BV. All people AFAB, regardless of their sexual orientation, can benefit from these preventive measures. Prioritize your well-being and take proactive steps towards promoting vaginal health for a happier and healthier life.

Human papillomavirus (HPV) is one of the most common sexually transmitted infections (STIs) worldwide. While it affects both men and women, certain populations, such as men who have sex with men (MSM) and transgender women (TW), face unique challenges and risks related to HPV transmission and associated health issues. In this blog post, we will delve into the topic of HPV in MSM/TW, exploring its prevalence, transmission, potential health implications, prevention strategies, and the importance of regular screenings.

Understanding HPV: HPV is a group of viruses that can be transmitted through various forms of sexual contact, including penile, vaginal, anal, and oral sex. It is estimated that there are over 200 different types of HPV, out of which approximately 40 types can infect the genital area. These can be further classified as low-risk and high-risk types based on their association with various health conditions.

Prevalence in MSM/TW: Research indicates that MSM/TW are at a higher risk of acquiring HPV compared to heterosexual men. This is primarily due to factors such as the nature of sexual practices involved, including receptive anal sex, which can facilitate the transmission of HPV. Studies have shown that up to 70-90% of HIV-positive MSM are infected with at least one type of HPV. Additionally, the prevalence of anal HPV infection among HIV-negative MSM can range from 20% to 70%, depending on the specific population studied.

Health Implications: While most HPV infections resolve on their own without causing any significant health issues, persistent infection with certain high-risk types can lead to the development of various conditions. In MSM/TW, the most concerning outcome is the increased risk of anal cancer. Studies have shown that the incidence of anal cancer is significantly higher among MSM/TW compared to the general population. Other HPV-related conditions, such as genital warts, oral and throat cancers, can also affect MSM/TW.

Prevention and Screening: Preventing HPV transmission is crucial for MSM/TW to reduce the risk of associated health problems. Here are some key prevention strategies to consider:

1.     Vaccination: The HPV vaccine is available for both males and females, and it is recommended for MSM/TW up to age 45. Vaccination provides protection against the most common high-risk and low-risk types of HPV, reducing the risk of infection and related complications.

2.     Condom Use: Consistent and correct use of condoms during anal sex can help reduce the risk of HPV transmission. However, since HPV can also infect areas not covered by condoms, such as the scrotum or upper thighs, condoms do not provide complete protection.

3.     Regular Screenings: Routine screenings are essential for early detection and treatment of HPV-related conditions. For MSM/TW, this should include regular anal Pap smears and visual inspections conducted by healthcare professionals trained in anal health.

Conclusion: HPV is a prevalent STI among MSM/TW, with significant implications for their health. Understanding the risks, transmission methods, and potential health issues associated with HPV is crucial for MSM/TW to make informed decisions about their sexual health. By adopting preventive measures such as vaccination, using condoms, and regular screenings, MSM/TW can actively reduce their risk of acquiring and transmitting HPV, thereby safeguarding their overall well-being.

Remember, open and honest communication with healthcare providers and sexual partners is paramount to maintaining good sexual health. Stay informed, get vaccinated, and prioritize regular screenings for a healthier future. The providers at Diversity Family Health are skilled in the appropriate prevention and screening for HPV and HPV related anal cancers in MSM/TW. Make an appointment to discuss your sexual health needs at your convenience.