Courage, cowardice and men's health (prostate)

Every now and again Blakka Ellis makes us think as a nation with very good articles pity like his counter part Leighton Levy is limited to the Star News tabloid and ought to have a better platform for them to be seen, no blogs or independent sites are around for both gentlemen at this time, have a read of his take on prostate examination. Who can forget his piece on homo-social behaviours in Jamaica?

with Blakka Ellis

I was sitting in a defenceless position and feeling completely vulnerable. I was nervously gripping the handles of the chair with stiff and sweating hands, as I anxiously arched my back and stiffened my neck in anticipation of mind-shattering physical hurt.

I closed my eyes momentarily in an attempt to zone out and mentally prepare for the horror, and when I opened my eyes again I saw him moving towards me holding a massive and threatening weapon with a long, sharp and shiny point. I wanted to scream, but my ever-present pride reminded me that I'm an adult male and screaming would not be cool. So I recoiled and whispered a soft prayer.

 

periodontal probe

The above description is rather dramatic, isn't it? And it sounds like somebody in a hostage situation involving torture, right? Well it was nothing of the sort. That was actually just me getting some much needed dental attention earlier this week.

The threatening looking 'weapon' was really a harmless little thing called a periodontal probe and when I was about to leap out of my skin, I was gently advised to relax because the dentist done use the thing already, and not only am I still alive, I didn't really feel any pain. But fear is a hell of a thing.

Yes friends, recent moments spent in dentists' chairs have reminded me how fearful I am of doctors generally and dentists especially. Clinics and hospitals are fearsome places. Every piece of equipment seems threatening, and little needle looks like a potential source of excruciating pain. No matter how convincingly I argue with myself, or how badly I curse myself or how gently I try to coax myself, it takes great effort to drag myself to the doctor even for a simple routine check-up. Is that a typical 'man thing'? I don't know.

Anecdotal evidence does seem to suggest that men commonly resist dealing with health issues. And the most common explanation seems to be the suggestion that we're so big, tough and macho, and we strongly internalise a sense of masculine invincibility that prevents us from accepting that we're also susceptible to illnesses. Well, I could pretend that that's my situation but I'll just openly admit the truth: I'm just scared. I'm scared of being probed, poked and prodded. I am afraid of being inspected and injected. And I'm fearful of finding out that I may be sicker than I think I am. Yeah, I know that it's not really manly to admit it, but this man is just afraid!

 

Peter Griffin from that infamous Family Guy episode where he was due for a prostate exam and ended up suing the doctor for sexual abuse 

prostate exam

Someone once told me that fear usually walks hand-in-hand with ignorance, so I've tried to clothe myself with the armour of knowledge. But still, fear persists. I know for example, that fear is the biggest reason preventing me from getting that prostate examination that all men my age should be getting. I also know that whether driven by fear, ignorance or cultural expectations, Caribbean men seem to be giving less than adequate attention to issues relating to our health.

Right now, my father is dealing with some serious health concerns, and it seems almost difficult, nigh impossible, for him to even just admit that he's feeling pain. What pain? He is a man, and maybe he has bought into the idea expressed in the lyrics of the Mighty Diamonds' 1976 hit called Have Mercy. You know the line? It says "Man was made to suffer and women were made to feel the pain".

So Caribbean men, are we courageously suffering or cowardly avoiding our vulnerability? What will it take to make us deal more honestly with our health and wellness reality?

box-mi-back@hotmail.com.

*photos added 

LGBT History Month: Allies – Posthumous Recognition ’11 Part II

See part one on GLBTQJA Wordpress HERE

An ally, friend to the community, consummate party animal, brother in law of sorts and fierce friend, Steve was taken from us and from the pain after undergoing a series of illnesses. One of those persons who assisted many homeless persons in his private capacity, shut outs, ostracised and displaced males and females, he himself went through his own period of torment and displacement, it seems only persons like us who go through the issues or displacement teetering on homeless really develop a heart and extend a hand in the informal type of crisis intervention. A volunteer for a short while with AIDS organizations and was a regular fixture at the once bi-weekly GLABCOM, Gay Lesbian Bisexual community meetings formally held on second and fourth Tuesdays of each month with the fifth month being a games night. His two sisters still are in some sort or remorse even after I mentioned my intention to highlight him in this year's LGBT history post-humous category.


He passed away in 2010. We hope his soul is resting in peace 

Diva Diva Diva the one and only Mi'Que transgender representative in this years remembrance was taken from us tragically this year after an altercation with her spouse went haywire. I only got to know her well over the past two years with her regular appearances at formerly club heavens in St. Ann. She too in some way assisted financially with the now defunct Safe House project and travelled extensively, judging by the two photos I chose out of literally hundreds her sense of style was impeccable and unique.

RIP Mi'Que   

Garfield aka Biggy first came to my attention one faithful Saturday night in 1999 when he wanted a place to stay as he was roaming the streets in Kingston NOT HOMELESS but an avid cruiser and a damned good one too, he too like many others now who are stable went through horrible family and community rejection, he frequented a certain HIV/AIDS organization as well and also attended the GLABCOM Gay Lesbian Bisexual meetings too. We never lost touch since and was referred to at one point as my "daughter" Jovial, conservative at times, overly self concious, loved dancemusic and was a voguer in the days of the popular gay club Entourage in Kingston. He too helped some of the less fortunate until a nasty incident where he was robbed hardened him but in turn as he ailed by complications from diabetes melitus and kidney disease as he was about to commence dialysis the very week after being discharged from hospital he never made it. Some say it was stubbornness that did it as he was told to rest and not to party but he couldn't tame the wild beast within him. He was laid to rest at a popular burial site with all the funeral rights accorded and well attended. 


RIP Garfield aka Biggy


Unsung heroes and names often forgotten when they leave us, let us reflect.


Peace and tolerance


H

Latin America and the Caribbean makes MDG strides

LATIN America and the Caribbean has made strides towards achieving the Millennium Development Goals (MDGs), but there is still much work to be done before the 2015 target date.

The MDGs are a list of eight development objectives to which the international community agreed in 2000. They are:
•Eradicate extreme poverty and hunger
•Achieve universal primary education
•Promote gender equality and empower women
•Reduce child mortality
•Improve maternal health
•Combat HIV/AIDS, malaria and other diseases
•Ensure environmental sustainability
•Develop a global partnership for development

According to the MDGs Report 2011 which was published on Thursday, the region has made some progress in the first six goals, but is lagging in others.
The proportion of people in the region whose income is less than $1 a day moved from 29 per cent in 1990 to 26 per cent in 2005. The target is to halve, between 1990 and 2015, the proportion so defined.
“Robust growth in the first half of the decade reduced the number of people in developing countries living on less than $1.25 a day from about 1.8 billion in 1990 to 1.4 billion in 2005. At the same time, the corresponding poverty rate dropped from 46 per cent to 27 per cent,” the report said.

Despite these declines, current trends suggest that the momentum of growth in the developing world remains strong enough to sustain the progress needed to reach the global poverty-reduction target. Based on recently updated projections from the World Bank, the overall poverty rate is still expected to fall below 15 per cent by 2015, indicating that the Millennium Development Goal target can be met.”
The report found that nearly a quarter of children under age five in the developing world remain undernourished, but the proportion of those residing in Latin America and the Caribbean who were underweight in 2009 was four per cent, compared to 10 per cent in 1990.
On the subject of education, Sub-Saharan Africa was found to have the best record for improvement in primary school enrolment. For the 2008/2009 school year, he Caribbean region had a 95 per cent enrolment rate at the primary level, as against 93 per cent ten years prior.
Youth literacy in the region also improved, moving from 92 per cent in 1990 to 97 in 2009.

“Worldwide, the literacy rate of youth (aged 15 to 24) increased from 83 per cent to 89 per cent between 1990 and 2009. Southern Asia and Northern Africa chalked up the most progress, with increases of 20 and 19 percentage points, respectively. Sub-Saharan Africa showed significant improvement as well — a rise of seven percentage points. Still, it remains the region with the lowest youth literacy rate (72 per cent in 2009). In spite of overall progress, 127 million young people lacked basic reading and writing skills in 2009. Nearly 90 per cent of all illiterate youth live in just two regions: Southern Asia (65 million) and sub-Saharan Africa (47 million),” the report said.
On the subject of gender equality, the gender parity index for gross enrolment ratio in primary, secondary and tertiary level institutions for the years 1998/1999 and 2008/2009 was 97 for both sexes; 107 for girls and 108 boys; and 117 for girls and 126 for boys, respectively.

“Wide gaps remain in women’s access to paid work in at least half of all regions,” the document said. “Worldwide, the share of women in non-agricultural paid employment increased from 35 per cent in 1990 to almost 40 per cent in 2009. Progress has slowed in recent years, however, due to the financial and economic crisis of 2008-2009.”
As for the of seats held by women in single or lower houses of national parliaments, the region improved, moving from 15 per cent in 2000 to 23 per cent this year, 2011.
“Representation by women in parliament is at an all-time high, but falls shamefully short of parity.”
Latin American and the Caribbean has also made some progress in addressing the under five mortality rate. The figure per 1,000 live births in 1990 was 52, compared to 23 in 2009.
The maternal mortality rate has also reflected some decline, moving from 320 deaths per 100,000 live births in 1990, to 230 in 2000 and 170 in 2008.
However, the report said gains made in the Caribbean to reduce adolescent pregnancies during the 1990s have stalled. The number of births per 1,000 women aged 15-19 moved from 81 in 1990 to 77 in 2000, then to 69 in 2008.
This might be related to contraceptive use in the region, where, according to the report, there is a high unmet need for the commodity and inadequate family planning. The proportion of women who have an unmet need for family planning among women aged 15-49 who are married or in a union, has barely budged over the years, coming in at 19.5 per cent in 1990, 20.4 per cent in 2000 and 20.2 per cent in 2008.

New HIV infections are in general decline, led by sub-Saharan Africa. In Latin America and the Caribbean the number of new HIV infections per year per 100 people aged 15-49, was 0.09 per cent in 2001 compared to 0.08 per cent in 2009.
Treatment for HIV and AIDS has expanded quickly in the region, jumping to 38 per cent 2009, from five per cent in 2004. However, it was not good enough to meet the 2010 target for universal access.
The world is likely to surpass the drinking water target, the 2011 report said, “though more than one in 10 people may still be without access in 2015. In Latin America and the Caribbean, the proportion of the population using piped water on premises was 72 per cent in 1990 and 84 per cent in 2008. The proportion using improved sources in the same years was 13 per cent and nine per cent; while 15 per cent used unimproved sources in 1990 compared to seven per cent in 2008.

“The world is far from meeting the sanitation target. In fact, at the current rate of progress, it will take until 2049 to provide 77 per cent of the global population with flush toilets and other forms of improved sanitation. Almost half the population of developing regions and some 2.6 billion people globally were not using an improved form of sanitation in 2008,” the document said, pointing out that over 2.6 billion people still lack flush toilets and other forms of improved sanitation.
Regarding national debt, the region’s external debt service payments as a proportion of export revenues was drastically reduced from 21.8 per cent in 2000 to 6.8 in 2008 and moved marginally upward in 2009 to 7.2 per cent.

And in spite of the economic downturn global greenhouse gas emissions continue to climb. The region accounted for 1.7 billion metric tonnes of carbon dioxide emissions in 2008, up from 1 billion metric tonnes in 1990.
The MDGs are measured through 21 targets and 60 official indicators.

ENDS

However the same paper published

UN says Carib, Latin America not on target to meet MDGs

Read more:

also see the MDG flowchart to the left bottom of this blog

Soy: the gender bender?

According to an article in the Jamaica Observer by All Woman Writer Nadine Wilson:

SOY has been recommended as the power food of the 21st century and is the preferred choice for the more health conscious individuals who consider it the perfect alternative to animal protein.

But increasing research has suggested a hidden dark side to soy-based products, which when excessively consumed might wreak hormonal havoc on men.
Because soy is a rich source of phytoestrogen isoflavones, which are similar to the female hormone oestrogen, some research suggests that men can experience gender-bending symptoms by incorporating too much soy in their diet.
Research on whether soy is good or bad is for the most part inclusive. So while some doctors encourage their clients to limit their consumption of soy-based products, those who support a more vegetarian way of life have recommended a diet rich in tofu and soy beverages.

Nutrition consultant and general practitioner Dr André McDonald was very cautious about declaring the effects of soy on the body, given the inclusiveness of studies about the beans, but he did concur that it contained a compound that was similar to oestrogen.

"It can stimulate certain organs as if it was oestrogen stimulating them," he said.
He said a number of his patients have raised concerns about the use of soy in their diet, but he personally doesn't believe it can cause many changes to the body "unless they are taking it in high concentrations".

The doctor points out that oestrogen is also present in chicken and some fruits have the same compound as soy. Because of this, he cautions people not to be too quick in ruling out soy completely from their diet.
"Unfortunately, it is not something that we can just rule on. We have to be very careful," he said.
Apart from the feminising of men, soy has been blamed for a low sperm count in men and the promotion of kidney stone formation. Some doctors also believe that soy contains toxins and therefore leads to thyroid problems.

On the flip side, soy has been touted as one of the best remedies for women going through menopause. It is one of the primary ingredients in infant formulas around the world and some even suggest it helps with weight loss and prevents cancer. Multi-million dollar co-operations have developed a variety of supplements from soy and the fitness industry has created shakes and powders to help people power through their fitness routine.

The effects of soy both good and bad are still controversial, and do not appear to see any resolution in the near future. Still, some experts suggest that individuals consume soy in its unprocessed form instead of after it has undergone genetic modification.

ENDS

However some other experts say soy is excellent for prostate health according to the Doctor Yourself website "Soy products appear to have a special benefit against prostate cancer. Japanese men have especially low death rates from prostate cancer, even thought they get the disease as often as American men do. The Japanese eat a lot of tofu, tempeh, miso, soy milk and other soy foods. Even animals fed a lot of soybeans have far less prostate cancer than others. There are at least two specific substances in soybeans that seem to help fight cancer: genistein and isoflavinoids. These natural chemicals are especially effective against the hormone-dependent cancers, which includes prostate cancer. (Soybean products may lower prostate cancer, Lancaster Intelligencer-Journal, January 12, 1994)

Peace and tolerance

H

It is a myth that homosexuals have lower levels of testosterone says Dr. Heather Little-White

Heather Little-White, PhD, nutritionist and health expert

You may be wondering what is responsible for the sex drive in men. It is the wonder hormone testosterone, commonly referred to as the 'male hormone', as it rightly should be called. Testosterone and its biological effects are often oversimplified in an effort to explain social behaviour. It is well established that the males of the animal species develop and maintain aggressive and sexual gender-specific behaviour as a result of testosterone.

Functions

What are the functions of testosterone in males? Primarily, testosterone transforms the features of the body of a young boy in to that of a man. As such:

His voice deepens

Pubic hair grows

A beard develops

Shoulders get broad

Muscles develop

Sex drive is stimulated

He becomes aggressive, competitive and dominant.

It is in the testicles that testosterone is manufactured and as soon as adolescents start to pack in that 'stuff', physical changes are observed and the 'youth' starts to feel like a man. If testicles are castrated in the human male, there will be a noticeable difference in his sex drive. The process of sex-drive reduction will be slow and uneven according to researchers. Castration is proposed as a radical punishment for sex offenders but there are others who believe that a raging sex drive can be controlled by other methods. One that is commonly used for male sex offenders is giving them Depo-Provera, a synthetic female hormone which shuts down the production of testosterone and so controls the sex drive.

Erection

Although testosterone is considered a powerful hormone, there are limits to its capabilities. Contrary to what is believed, testosterone has little to do with a man's ability to get an erection. It may stimulate desire and his sexual fantasies but it has little to do with performance. A classic example is little boys with low testosterone levels, many of whom get erections quite often.

Men who suffer from erectile dysfunction and loss of libido are led to believe that this is as a result of a decline in testosterone levels as men age. Some men are given testosterone shots or pills but this practice in the absence of low testosterone is a disservice to men. According to Dr Richard Burger, professor of urology at the University of Washington, this practice of shots and pills actually shuts off its own production of testosterone. Testosterone injections given over a period makes it difficult for the body to recover and start producing its own supply again.

Prostate cancer

Further, giving testosterone to men with erection problems may be dangerous. Testosterone stimulates the growth of prostate tumours, so injections and pills place older men at risk for prostate cancer. It should be stressed, though, that testosterone does not cause prostate cancer but stimulates the growth of a pre-existing tumour. The only time that testosterone injections are encouraged is when a man's testosterone levels are very low as in the case of hypogonadism which is an under-functioning of the testes resulting in erection problems.

Women also benefit from the power of testosterone which also boosts their sex drive. In almost every other species, sex drive is only fuelled by female hormones which give them an interest in sex only at the time they are ovulating. The sex drive in male and female humans is driven by testosterone. Men have far more circulating testosterone compared to women which makes them more responsive to seductions.

Menopause

Women produce hormones in their ovaries but most of it comes from the adrenals which fuel women's sex drive into their later years even after menopause. When women complain of a lack of interest at menopause, they may be given replacement testosterone. When older women receive hormone replacement therapy, testosterone is combined with other hormones to boost libido and their sense of well-being. Testosterone is converted in the body to oestrogen, and it is thus possible that testosterone could compound the carcinogenic effects of oestrogen on the breast and the uterus.

There is very little data about the safety and long-term effects of testosterone supplementation in women. In a few instances, testosterone may trigger masculinity in women with features such as facial hair, deepening of the voice and weight gain through the bulking up of muscles. Side effects of testosterone supplementation can include rages or anger, voice deepening, acne, facial hair, weight gain and liver disease.

Homosexuality

It is a myth that homosexuals have lower levels of the male hormone when compared to heterosexuals. There is no research to support this argument as when homosexuals are given massive doses of testosterone their sexual preference does not change. All that may happen is that the homosexual may get a temporary boost in libido.

Testosterone is an amazing hormone but it should not be seen as a panacea to sex problems or as a love potion. It stimulates the sexual urges and plays a significant role in defining gender.

Rhesus monkeys resistant to HIV with special TRIM5 protein

Known as TRIM5, the protein prevents the HI virus from multiplying once it has entered the cell. Researchers from the universities of Geneva and Zurich have now discovered the protein's mechanism, as they report in Nature. This also opens up new prospects for fighting HIV in humans.
Unlike people, certain monkey species, such as rhesus or night monkeys, are resistant to HIV thanks to TRIM5, a cellular protein: In the case of an HIV infection, the protein intercepts the virus as soon as it enters the cell and prevents it from multiplying. We have known about TRIM5 for over six years. However, the mechanism TRIM5 uses to prevent the HI virus from multiplying was still largely unknown.

The majority of the key aspects of TRIM5's defense mechanism against HIV was discovered by the Swiss research teams of Prof. Jeremy Luban, University of Geneva, and Prof. Markus Grütter, University of Zurich, in collaboration with teams from the USA and France. They demonstrated that TRIM5 immediately triggers an immune response if infected with HIV. Consequently, TRIM5 is an HIV sensor in the innate immune system. Unlike the adaptive immune system, which only develops when confronted with a pathogen, the innate immune system is already able to eliminate pathogens as soon as it comes into contact with them.
The HI virus, which penetrates the cell during an infection, has a shell, the components of which are arranged in a lattice, similar to the pattern on a soccer ball. TRIM5 recognizes this lattice structure and specifically attaches itself to it. This stimulates the protein to produce signal molecules known as polyubiquitin chains in the cell. These chains immediately trigger an anti-viral reaction. The "alerted" cell can then start eliminating cells infected with HIV by releasing messenger substances (cytokines).

Humans also have a TRIM5 protein, but it is less effective in fending off HIV. However, the findings in resistant monkeys have opened up new possibilities and ways of fighting HIV in humans. 33 million people are currently infected with HIV worldwide; two million die of AIDS each year. And with 2.7 million people becoming infected every year, HIV remains a major problem.

Markus Grütter
gruetter@bioc.uzh.ch
41-446-355-580

ENDS

Human cells have some natural defenses called “restriction factors” that protect cells against infection by viruses.

Lassoing HIV to the cell

Tetherin is a molecular “lasso” that “tethers” new baby viruses to a cell as they try to escape.

In this figure, taken from Stuart and colleagues in the journal Nature, we see a bunch of HIV virus particles (the little black circles) all clumped around a cell.
This doesn’t normally happen with HIV. Usually new baby viruses bud out of cells and move along to infect new ones.
What’s causing this clumping?

Tetherin! It latches onto these new viruses and keeps them on the cell surface, which prevents them from moving on to infect new cells.
But this doesn’t usually occur in HIV infection. Most new viruses are able to escape the effect of tetherin. In real life, tetherin activity is so bad from HIV’s point of view, that HIV actually has a protein called Vpu that it uses to block tetherin.
The figure from the Stuart paper shows what happened when the experimenters deleted the Vpu gene from HIV and allowed the virus to replicate itself in cells. What happened is that without the action of HIV’s Vpu protein, all the new baby viruses got stuck to the cells and clumped together because of tetherin. Blocking Vpu might even make an attractive target for an antiretroviral drug by allowing tetherin to do its job.

What got me writing this post this week was a new paper that came out about how HIV targets another restriction factor called APOBEC3G, and how it might use that to its advantage.

Mutant-maker

APOBEC3G is another restriction factor that we have in our cells. APOBEC3G (pronounced “ape oh Beck 3G”) has a weird way of messing with HIV.It introduces mutations in the HIV genome by essentially changing the DNA base guanosine (G) into adenosine (A).

It’s actually a bit more complicated than that but the end-result is the same: APOBEC3G changes Gs in HIVs genome to As. Now introducing all these mutations into its genome is bad for HIV because the mutations can mean that its proteins won’t work as well. So yet again, HIV has a protein that counteracts this restriction factor. That protein is called Vif.
APOBEC Advantage

Last year, Fourati and colleagues published a nice paper where they looked at whether antiretroviral therapy could result in changes in Vif, the anti-APOBEC3G protein. Their idea was that HIV might be able to use the mutagenic (mutation introducing) activity of APOBEC3G to its advantage.
We know that mutations in HIV can cause drug resistance, which allows the virus to replicate even in the presence of antiretrovirals. For instance, a single mutation in HIV’s reverse transcriptase gene (a mutation to the amino acid valine at position 184) can allow the virus to replicate in the presence of the antiretroviral drugs lamivudine (3TC) and emtricitabine (FTC).

Fourati and colleagues had the idea that a mutation Vif might slightly reduce its ability to block APOBEC3G. Vif blocks APOBEC3G mostly by targeting it to be degraded by the cell, which reduces the levels of APOBEC3G within the cell.
So, a mutation in Vif could potentially allow a little bit more APOBEC3G to stick around in cells, which could make the build-up of mutations a bit faster, without allowing APOBEC to go crazy and introduce too many mutations. If this actually did happen, you’d expect to find Vif mutations in HIV from patients who are failing therapy due to drug resistance. This is exactly what the Fourati group found.
Specifically, there was a mutation in Vif called K22H (a change at position 22 from the amino acid lysine to a histidine) that was almost 10 times more common in patients who were failing therapy. They then performed experiments where they took HIV with the K22H mutation and grew it in cells. If the mutation decreases Vif’s action against APOBEC, you would expect more of those G to A mutations in the resulting viruses.

More on VIF Mutation here

Should doctors disclose HIV status of patients to partners? discussed at Medical Ethics conference

"I believe that she has a right to know, because it is her life that is at stake," says one practitioner

(discussion was based on heterosexual sex)

NADINE WILSON

Observer reporter

wilsonn@jamaicaobserver.com

MEDICAL doctors were Sunday divided when asked if they should be allowed to disclose the HIV/AIDS status of patients to partners who they were knowingly putting at risk.
The issue was raised by senior consultant in anesthesia at the University Hospital of the West Indies, Mona, and chairman of the Medical Association of Jamaica Ethics Committee Dr Allan Barnett at an Ethics Conference put on by the Jamaica Medical Doctors Association (JMDA) at the Mona Visitor's Lodge. The doctor presented a hypothetical situation involving a patient by the name of John who was HIV positive. Although John was found to be HIV positive, he refused to tell his pregnant partner Sue of his status and asked the doctor not to do so.

Vice-president of the Jamaica Medical Doctors Association, Dr Kenneth Appiah (left) greets president of the Jamaica Hotel and Tourist Association, Wayne Cummings during Sunday’s ethics conference at the University of the West Indies Mona Visitors’ Lodge, while chairman of the Medical Association of Jamaica Ethics Committee, Dr Allan Barnett looks on. (Photo: Bryan Cummings)

Read more: http://www.jamaicaobserver.com/news/Should-doctors-disclose-HIV-status-of-patients-to-partners-_8367124#ixzz1E7LwHVrF

When asked what should be done in this situation, some amongst the large gathering of medical practitioners felt that the doctor in this situation should be allowed to inform the pregnant woman and John's general practitioner about his status, while others disagreed.


Doctors are at present bound by law to keep their patient's information confidential but are expected to report new cases of HIV to the Ministry of Health, which is then expected to activate John's tracing pattern and at some point inform Sue.
But Dr Barnett took issue with this. "The way things work in Jamaica, that is not likely to happen before she gets her baby delivered," he said.
Under the Medical Act of Jamaica, a registered medical practitioner would be deemed guilty of conduct that is disgraceful in a professional respect if he breaches a patient's confidence, but Dr Barnett believes that the disclosure of a patient's HIV/AIDS status to their partner should be an exception to this rule.


"In other jurisdictions such as the UK, there is legislation which permits disclosure in the public interest and ethically and legally Sue must be informed," he said. "What we are supposed to do under those jurisdictions is explain to the patient that 'look I am sorry, I understand your concern, but your partner is at risk and the baby is at risk and you need to tell them and if you are not going to tell them I will tell them, so you have three days in which to do that, after which I am going to come and speak to her and let her know'," he said.


Dr Barnett's call for a change in the law comes amidst concerns raised by the health ministry last week that HIV/AIDS cases in Jamaica were increasing despite various efforts in the past few years to address the issue. In 1999, the number of reported cases stood at 1,436 in comparison to 1,738 in 2009.


"This situation is exacerbated by [a] high incidence of multiple partnerships and low condom usage. Persons continue to engage in risky behaviour and thereby risk their lives and those of their loved ones," Health Minister Rudyard Spencer said in a recent statement.

Despite increased access to anti-retroviral drugs, AIDS claimed the lives of 378 people in Jamaica in 2009. In an effort to increase awareness of the disease, the ministry launched Safer Sex Week last week under the theme "Protect your love, use a glove", which was expected to serve as an urgent reminder for persons to stick to one partner and use a condom whenever they are having sex.


"Men have an average of six sex partners, while women have an average of three...," the minister said in his statement, in reference to data presented in the 2008 Knowledge, Attitude, Behaviour, and Practice Survey.


Given the increase in HIV cases and the high levels of promiscuity, vice-president of the JMDA, Dr Kenneth Appiah also believes that the doctor in John's case should be allowed to inform Sue that he is positive and that her baby is at risk.
"I believe that she has a right to know, because it is her life that is at stake and also the life of her child and we should try as much as possible to find ways and means in being able to not break the confidentiality issue but at the same time be able to ensure that she is not at a disadvantage because of legal ramifications," he said. He added that it was a matter which his group would discuss further.

14 things you didn’t know about his penis

Snapping, smoking and circumcision

IT'S one of his most treasured assets, responsible, many times for that sense of security he has in his manhood. But there are myths, doubts and uncertainties that surround the penis, many promulgated by the men themselves. Here are 14 things you may not have known about it, but should.

1. Imitating Kartel can break it.

The penis has a tough tissue running around it which gets sturdy when erect. "Any sudden bend can cause it to rupture," urologist at the Winchester Surgical Centre, Dr Leroy Harrison, said. "Erection and aggression can cause it to rupture, which is really a tear," he explained. This penile rupture can occur during vigorous sex or a quick action like someone jumping onto a man's lap. When this occurs, there is a popping noise, followed by excruciating pain. And though it may be humiliating for a man, the condition can only be remedied with treatment from a doctor. If not treated, it can lead to permanent erectile dysfunction (ED).

2. Failure to launch can signal heart disease, diabetes or hypertension.

Like with women, stress and a bad day at work can kill a man's sexual desire, however, if he is always not in the mood and there is no other woman getting his game on then maybe he has a condition that needs medical attention. Not being able to get an erection can be either psyco-genic or non-psycogenic, Dr Harrison explained. Psycogenic reasons are mind-based such as performance anxiety, conscience and guilt, while non-psychogenic is anything that causes a lack of blood flow to the penis. This can include heart disease, diabetes, hypertension and spinal injuries.

3. It can shrink like a wool sweater in a hot water wash.

It is believed that cold weather and cold water cause the penis to shrink while also easing an erection. "A cold shower causes the blood vessels to constrict, which decreases the blood flow to the penis," Dr Harrison explained. Thus the concept that he can take a cold shower in the mornings to get rid of his erection is actually true.

4. Smokers have a harder time rising to the occasion. For decades doctors have been warning against smoking as it clogs the arteries. These include arteries taking blood to the penis, when these arteries become clogged it is harder to get a rush of blood that causes an erection. This means smokers may have a harder time rising to the occasion. Dr Harrison said after a while, a smoker may not be able to perform sexually at all.

5. He gets an erection even while sleeping.

Believe it or not, your man's penis does have a mind of its own, and as some persons like to say, it is the lightest organ on the body — it rises with just a thought! Dr Harrison said there are three ways in which a man can get an erection (1) reflexogenic — handling of the penis, (2) Nocturnal Penile Tumescence — erection while sleeping and (3) psychogenic — through viewing or thinking about something sexual. "A man has two to three erections each night but he is only aware of the one he wakes up with," Dr Harrison said. Erections are sometimes the result of impulses firing from the brain during REM (Rapid Eye Movement) sleep.

6. Circumcision is good for any penis.

While many men do not believe in it, research has shown that there are health benefits to circumcision, such as less urinary tract infections and a decreased risk of contracting HIV.

7. Most men share same-sized penises.

According to studies done, penises typically measure between three and four inches when flaccid and five to six inches when erect. In fact, when aroused, a man who started out on the small side can end up expanding proportionally more than larger males.

8. Most penises curve.

The majority of penises lean slightly to the left or right when rigid. However, there are others that tend to bend up or down drastically, so much so that having sex is almost impossible. This is known as Peyronie's Disease and happens when the penis doesn't expand evenly during a hard-on.

9. Penis size and shape is not hereditary.

While he may have many traits from his dad, penis size, thickness and shape are not a part of it. Penises are actually formed in the utero by natural causes.

10. Average erection is two hours, average discharge time seven minutes.

Men can have an erection lasting up to two hours before it starts fading away on its own, the urologist explained. However, the average time from penetration to the time he ejaculates is seven minutes +/- three. Dr Harrison explained, too, that some men can have an erection lasting up to four hours or more but this is very unsafe. "What you find is that the blood flows in the penis but not out," he said. "So the tissues are not getting enough oxygen, so after awhile it gets very painful." This, he said, means a visit to the doctor who will apply an injection or pull out the excess blood. This can sometimes have serious complications such as no more erections.

11. Orgasm is all in his spine not his brain.

The signal for a man to ejaculate is the result of muscles contractions in the spinal cord and pelvis.

12. 'Tan pon it long' isn't always a good thing.

Though deejays promote it and men boast about it, an erection that simply won't go away isn't a miracle, but a medical emergency. If the blood flow that causes an erection doesn't eventually leave the penis serious complications can result, like blood clots.

13. Men really do get 'blue balls'.

Jamaican men like to talk about getting 'blue-balls' if they do not get the chance to have sex. While they use this as a common excuse, technically it's true. The condition is called prostatic congestion and the achiness in the testicles is caused by 'trapped' blood. This can in fact be relieved by an orgasm, or by massaging the prostate.

14. Drinking alcohol affects his penis.

It has been found that a man's penis will go limp if he drinks too much. Dr Harris said a number of men will in fact feel that they perform better after drinking but this is all due to the mind being manipulated by the alcohol and is in no way true. Men who drink do not perform as well, neither do they stay as long.

— Donna Hussey-Whyte

Sexual Activity Among Jamaica's Men

Gleaner's Health Article

Dr Pauline Williams-Green

The scenario is played out frequently in my medical practice. A man walks into the office; often unwilling to make eye contact and when asked the reason for the visit, states sheepishly, "Doc, I have picked up a leak!" or "It's my back, doctor!" This is the introduction to a consultation on sexually transmitted infections (STIs).

Sexual ignorance

Sexual activity begins at an early age among males in Jamaica. The Ministry of Health reports that the median age for sexual initiation of boys is about 13 years. Early onset of sexual activity, frequent change in partners and multiple partners increase the risks of transmission of infections.

Many young males are ignorant of sex, sexual intimacy, the way females become pregnant, STIs and condom use. A recent study revealed that about one-third of males have had two or more sexual partners in the last year. It is worrying that even males who have some knowledge do not adhere to safe sexual practices.

Agents of STIs

Commonly recognised STIs include gonorrhoea, syphylis and chlamydia. These infections affect primarily the genital parts but may also affect the throat, rectum and anus. Viruses are important causes of STIs such as HIV, hepatitis A, B and C, herpes simplex and human papillomavirus. Parasites such as lice and scabies can also be transmitted during sexual intimacy.

Syphylis causes a sore on the penis which resolves spontaneously. It later reappears as a rash. If untreated, syphylis will cause nerve damage. Chlamydia causes an abnormal discharge from the penis and may cause a chronic infection in the prostate. It is also responsible for infertility among couples. Gonorrhoea is suspected when the man complains of burning when he passes urine or he gets pus from the penis within a few days of sexual intercourse.

The human immunodeficiency virus (HIV) is the causative agent of HIV infection and Acquired Immune Deficiency Syndrome. Human papillomavirus (HPV) causes cervical cancer in females. HPV also causes warts in males and females. Genital herpes causes a recurrent, painful rash for which there is no cure. However medication is available for suppression of the attacks.

Controlling STIs

Fortunately, condom use has increased steadily among males. This is a major weapon in the fight against most sexually transmitted infections. Prevention is the best protection against STIs and is often the only means of controlling their spread. Safe sexual practices, adherence to one sexual partner and condom use will reduce heartaches for both men and women.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.

Breast Lumps In Men

Breast lumps in men are uncommon but cause great concern when they do occur. A lump may be found in both breasts but usually occur in only one. Breast swellings are common in newborns because of the high levels of oestrogen received from their mothers before birth.

Lumps also often occur in young men in early adolescence because of the conversion of androgens to oestrogen. This swelling may be tender. It may be of short duration, lasting up to 18 months and, rarely, the lump persists throughout the adolescent's life.

Certain drugs, such as spirolactone, are known to cause increases in the size of the breasts. Men who receive drugs similar to oestrogen for the treatment of prostate cancer will experience growth in the size of the breasts.

Men can also have a breast lump which is cancerous. Fortunately, these cancers are rare. A third of men with breast cancer have family members who had breast cancer. There is also a familial form of breast cancer where both genders are at risk of the breast cancer. Sadly, breast cancers in men are often far advanced because of delays in taking action by both patient and physician.

Cancerous lumps

A rock-hard lump which may be fixed to the chest or cause changes to the overlying skin could be a breast cancer. Any man with a breast lump should visit his doctor for an examination. Most times, the doctor can differentiate between a non-cancerous swelling and a possible cancer.
A definite diagnosis is made using fine-needle aspiration or by removing the lump guided by ultrasound. Men with breast lumps should have a mammogram. As in the case of women, mammograms are 90 per cent effective in determining whether the lump is cancerous. Ultrasound may be used to detect cysts in the breast but these are also rare in men.

Breast self-examination

Men, too, should examine their breasts once monthly. This may be done standing in front of the mirror, lying down or in the shower. Look at both breasts for size, any turning in of the nipples, bulging or dimpling of the skin. With one hand behind your head, use the other hand to press against the breast on the other side. Check the entire breast with your finger pads. Use small circles as you move your fingers up and down the breast.

Breast lumps in men and women require evaluation and should be dealt with as soon as they are discovered. Most of these lumps are not serious but all of them should be evaluated for cancer.

Dr Pauline Williams-Green is a family physician and president of the Caribbean College of Family Physicians; email: yourhealth@gleanerjm.com.

He wants to go back there. Is he gay? (Observer)

By DONNA HUSSEY-WHYTE

All Woman writer

WHILE oral sex is becoming less and less of a taboo practice, anal sex is fast catching on. In fact, a number of women have confessed that their partners are asking that they indulge in the act secretly.

While some women are agreeing to anal sex, others are not only uncomfortable with the act, but feel that their relationship is on the rocks as they wonder if their men either have the tendency to be gay or are bisexuals.

Ann-Marie told All Woman of her personal experience after six years of marriage in which she suspected that her husband was bisexual. This, after he started forcing her into anal sex, even when she refused.
"Every time he wanted to have sex, it would be around there. He didn't seem to get any pleasure out of vaginal sex anymore and even if I told him I didn't want to because it was painful, it never seemed to matter," Ann-Marie said. In fact, to help her cope with the pain, she said her husband would use vaseline to lubricate the area

.
"I started really hating sex and hating him because of it," she said. "He seemed obsessed with anal sex. I saw him with some DVDs and all of them — about eight — all had pictures of naked women with their rears being the main focus. It was an obsession for him."
But to compound the situation, Ann-Marie said her husband refused to take her out alone, and when they did go out, there was always a third party tagging along — a male.

"If we decided to go somewhere, he would stop somewhere and pick up a guy in the community or call someone and tell them he was going X place and ask if he wanted to come. These were normally very young boys and so I could not help but wonder if he was gay."
Numerous conversations with her husband she said, resulted in just as many denials. Three years ago, they separated. To date Ann-Marie said she is convinced her husband is gay. Especially, she said, after discovering over a year ago that he was sharing home with another man in Stony Hill.
"The boundaries between vagina and anus are collapsing fast," sex therapist Sidney McGill said. "I think performing anal sex has to do with moving out of the conventional way of having sex. Couples try to do something different," he said.
However, this is not always the case.

"There are men who have been with men who are not gay," McGill explained. "The thing is not as clear cut as it might sound, because the definition of homosexuality has to do with persistent homosexual ideation. So if the person is not having persistent thought for, or persistent feelings for, or a desire for men, then he is not homosexual."

He explained, too, that there were heterosexual men who have blurred the boundaries between male and female.
"They are heterosexuals, they are having sex with women but they like to try something different every now and then and they have their buddies that they will have sex with. So it's not a bindary thing anymore where it's either you are gay or you are not."
Thirty four year old communications consultant Harold W confessed that anal sex was like breathing to him before he got married nine years ago, yet never once had he thought about being with a man.
"I don't agree that if you have anal sex with a woman you are gay or have homosexual tendencies," he said. "I used to have anal sex with women and I would never go with a man. It's just like kissing. I would kiss my wife but I would never kiss a man. It's the same way I would have anal sex with her but would never touch a man. That's the reality of the situation. It's just a part of my being freaky."

Dr McGill agreed that for some men, anal sex is just another pleasurable act that in no way means the men are gay.
"I don't know if I would want to use the word 'freaky' though. I would say it's trying something new — trying something different," he said. "I know of men who enjoy having anal sex with their wives who are no way gay at all! And I am talking about professionals — medical doctors, lawyers, and people like those," he said.

However, he said there is no surefire way to tell if the man having anal sex with his female partner is among those who sees a thin line between having sex with a man and having sex with a woman.
"There are some men who don't make such a sharp distinction when it comes to who they have sex with. And if they have very good buddies they can masturbate together and they don't see anything wrong with that. And then there are others who would love to try anal sex with their female partners, [but are afraid to because of the stigma]," he said.

"He is afraid he might start questioning his own sexual orientation," McGill said. "This will be even more devastating for him if he does it and likes it."

All in good fun
In many cases, McGill said, couples desire to experiment with new things that they have never tried before like oral sex. If they enjoy this they may move on to bondage sex, dress up sex, drinking alcohol, etc, creative things that might get them both excited.

"He might not even think that he is going to have anal sex with her tonight," Dr McGill said. "They might just be having sex and having such a good time that he starts to go there and she probably will allow him."
Dr McGill says it is as a result of the varied reasons why men will perform anal sex why the label 'bisexual' should be dropped.

"I think we should stop using that word about being bisexual — it's a political word — and I don't think it captures gay, heterosexual or bisexual, because not everyone fits into any of these neat boxes," he said.

Sexual Reproduction for Same Sex Couples?

The Chromosome Chronicles

One of the common arguments against gay marriage goes something like this: marriage is an institution that is meant to support reproduction, and same-sex couples can’t sexually reproduce. Full disclosure: I support gay marriage. However, regardless of my opinion, this entry will help debunk this specific argument. More importantly, I will outline three important discoveries that will one day allow same sex couples to have biological children that are purely made from their genes

The definition of sexual reproduction needs to be clarified here. According to Wikipedia, sexual reproduction passes “a combination of genetic material to offspring, resulting in diversity.” I’m going to clarify: sexual reproduction is when the DNA of the two parental units, through the process of meiosis (formation of a gamete) and the process of fertilization, each contribute to ~50% of the genes of the resulting offspring.

Now let’s go through some basic stem cell science (read: skip this paragraph if you know the basics). Stem cells are characterized by two abilities: self-renewal and potency. Self-renewal describes their ability to divide indefinitely. Potency refers to the fact that stem cells can “differentiate” into different types of specialized cells. Adult stem cells are generally “multipotent” which means they can differentiate into a few cell types. Embryonic stem cells are “pluripotent” which means they can become any type of cell in the body. This is the reason that embryonic stem cells are so interesting: pluripotency. Pluripotent stem cells are a necessity for same-sex couples to reproduce. Now that we’ve covered some basics, we’ll move on to the three important breakthroughs that will make same sex reproduction possible:

1. Cellular reprogramming: the creation of induced pluripotent stem cells (iPSCs)

One source of pluripotent stem cells is the inner cell mass of a developing embryo – embryonic stem cells. However, a technique known as “cellular reprogramming” allows a pluripotent stem cell to be created from a mature adult skin cell after being treated with a number of transcription factors. These cells have been dubbed “induced pluripotent stem cells” or iPSCs. They are nearly identical to embryonic stem cells. More importantly, they are genetically identical to the person who donated the skin cells. This makes the cells “individualized” pluripotent stem cells. These cells can be used to form any type of tissue in the body.

2. Creation of Oocytes (eggs) from pluripotent stem cells

Pluripotent stem cells can be directed to “differentiate” into any type of cell in the body. It was reported in 2003 that scientists successfully directed mouse pluripotent stem cells to differentiate into mouse oocytes. What this means is that a skin cell can be taken from any person (male included) reprogrammed into an iPSC, and then the iPSC can be differentiated into an egg cell. This is the discovery that can help two men have a child together.

3. Creation of Sperm from pluripotent stem cells

The same exact logic from eggs can be applied to sperm. Scientists have recently demonstrated the ability to form sperm from embryonic stem cells. While the team has warned that this science will not be used for fertility treatment, the creation of sperm still has ramifications beyond infertility research. For the purpose of same-sex reproduction, the creation of sperm in vitro can one day help two women have a child together.

Application of these discoveries towards same-sex reproduction:

These three techniques, once perfected will lead to the ability for male/male and female/female couples to have biological children, children who are a combination of their own genes. The creation of eggs from pluripotent stem cells is important for male/male couples, and the creation of sperm from pluripotent stem cells is important for female/female couples. Below, I will walk step-by-step through the scenarios for male/male and female/female couples.

Sexual Reproduction for Gay Couples:

For a gay couple, one man needs to be designated as the father (the one who donates the sperm), and the other as the mother (the one who donates the egg). The “father” in this case can just donate sperm the normal way…no hardcore science is really involved. The “mother,” however, needs to employ the reprogramming and differentiation techniques discussed above. Specifically, this man needs to donate skin cells. These cells must be reprogrammed into iPSCs, and the iPSCs must then be differentiated into eggs (this process is shown to the right). Once the eggs are created, they can be mixed with the sperm from the “father” to create an embryo from two men.

There are a few things to be aware of. First of all, the “mother” is also responsible for donating the mitochondrial DNA, which means that the man who opts to create the egg will also be donating the mitochondrial DNA. Another issue is that men carry an X and a Y chromosome. This means that there is a 50% chance that any gametes (sperm or egg) created from a man will have a Y chromosome. The egg must not have a Y chromosome because it might result in an embryo with two Y chromosomes, which would not survive. Finally, men still cannot carry children (I’m talking about biological men (XY), despite what you may have heard in the summer of 2008), so the embryos created from the two men will have to be implanted into a surrogate mother to deliver the baby.

Sexual Reproduction for Lesbian Couples:

For lesbian couples, there are fewercaveats to be aware of. Once again, one woman must be the “mother” by donating the egg while the other plays the role of the “father” by donating the sperm. The mother can donate the eggs just as a woman normally does through reproductive endocrinology in an in vitro fertilization setting. The “father” must utilize the reprogramming and differentiation techniques described above to produce the sperm (as summarized in the accompanying picture).

Either member of this couple is capable of carrying the embryo (or embryos). If they opt to both carry embryos at the same time, I would go so far to say that the children can be considered fraternal twins. There is one important caveat that the women must be aware of: they cannot have a son. Women only carry XX chromosomes, and neither of them are capable of donating the Y chromosome necessary for male development. For this reason, lesbian couples are only capable of having biological daughters.

Politics, Ethics, and the Like…

The application of technology towards same-sex reproduction, in my eyes, is an advancement for both gay marriage and science. Scientifically, we are learning more about child development every year, and it will allow us to bring more healthy children into the world. For same-sex couples, the once impossible concept of a biological child is now a real possibility.

While I cannot see any ethical arguments against this type of procedure, I am open to a discussion about how far this may be pushing the envelope. In any case, I am still amazed every time I think about how far we have come with the ability to help people through science.

Source

5,000 more HIV-infected Jamaicans now need life-saving drug

XVIII International AIDS Conference in Vienna Austria

with Ingrid Brown

THE recently revised World Health Organisation (WHO) guidelines requiring HIV-infected persons to be placed on medication at an earlier stage of the disease will require an additional 5,000 more Jamaicans to be placed on the life-saving drug.

Dr Kevin Harvey, head of Jamaica's National HIV programme, told the Observer here in Vienna that the revised guidelines mean that instead of 10,000 there are 15,000 Jamaicans who will now be required to be placed on ARV.
Of this number only 7,000 persons are currently receiving treatment.

"This (new guidelines) means our coverage would drop from 75 per cent to 50 per cent, hence we have moved from nearly achieving universal access to being half-way there," he explained.

Prior to the revised guidelines persons were only placed on the drug when their CD cell count was 200 and below, but they are now required to take the drug when their CD cell count is at 350.

But with the need for persons to be placed on ARVs earlier, there is great disquiet among infected persons that inability to afford good nutrition will render the drug less effective and result in a shorter life span.

Once placed on ARVs, infected persons must take the drug for the rest of their lives.

According to Dr Harvey, the HIV programme provides small grants for income generation as well as small stipend for bus fares and lunch to those most in need and ready-to-use foods for children.

HIV-positive children need between 50 to 100 per cent more calories, compared to HIV-negative children, while adults need up to 30 per cent more calories as the disease progresses.

In light of this, head of the United Nations World Food Programme Martin Bloem is urging Governments, health care providers and other partners to include a good nutrition programme in the treatment of people living with HIV/AIDS in their respective countries.

"There is a growing body of evidence that food, and nutritional support are essential for keeping people living with HIV for longer and for improving the effectiveness of treatment," said Bloem.

"If people don't have access to food it is hard to take antiretroviral drugs and the risk of going off the treatment rises," he told the Observer.

He pointed out that among malnourished patients who start on ARVs the risk of death is two to six times higher, compared to those who are receiving proper nourishment.

Meanwhile, Dr Anthony Fauci of the United States Institute of Allergy and Infectious Disease said HIV needs to be addressed directly but also in the context of various other issues surrounding the disease such as lack of proper nutrition for infected persons.

"But we cannot say we will not address AIDS until we address these other problems and vice versa, so we have to address them both," he said.

Asked about placing persons on ARVs earlier than normal given the nutritional challenges, Fauci said malnourished infected persons do badly regardless of what stage they are placed on the life-saving drug.

Meanwhile, he insisted that countries need to also assign large budgets to purchasing ARVs and to ensure that they source cheaper and better drugs.

Lubricant Use May Raise HIV Infection Risk During Unprotected Anal Sex

Lab study found some products have a toxic effect on cells, tissue

(HealthDay News) -- The use of lubricants during unprotected anal intercourse may indirectly raise the risk of HIV transmission in the receptive partner, among both men and women, new research warns.

Click here to find out more!

Concern about the possibility is being raised in the form of two new studies, and revolves around the fact that HIV infection risk rises if other infections are already present in the rectal lining of the receptive partner, the study authors noted.

In that light, indications that some lubricants may contribute to a generally increased risk for sexually transmitted infections, and therefore in turn for HIV, are scheduled for presentation this week in Pittsburgh at the International Microbicides Conference.

Conducted between 2006 and 2008, one study -- which focused on approximately 900 residents in the Baltimore and Los Angeles region -- observed that men and women who use lubricants in general are three times more likely to have some form of a rectal sexually transmitted infection. The finding held regardless of gender, HIV status, condom use, and the number of sex partners the study participants had had in the prior month.

Although no specific lubricants were identified as particularly problematic, most study participants said they used a water-based lubricant (76 percent), while 28 percent used silicon-based products, 17 percent oil-based lubricants, and 6 percent said used a numbing lubricant.

The second study -- led by Charlene Dezzutti of the University of Pittsburgh and the Microbicide Trials Network -- looked at five of the most popular over-the-counter and/or mail-order lubricants, identified as such through a survey of 9,000 men and women living in 100 different countries.

All the lubricants were water-based, except for one silicon-based product.

The research team -- including collaborators from International Rectal Microbicide Advocates (IRMA) -- did not examine the effect of lubricant use during actual sex. However, in laboratory testing, some of the lubricants were found to have a toxic effect on cells and rectal tissue, perhaps as the result of the dissolved salts and sugars the products contained.

PRE and Wet Platinum were found to be the safest lubricants in terms of toxicity, whereas Astroglide and KY Jelly appeared to be the most problematic.

"We know we can't make any conclusions based on this one small study," cautioned IRMA lubricant safety advocate Marc-Andre LeBlanc, in a news release. "Further research is absolutely necessary to understand the potential role of sexual lubricants in HIV transmission. We should be able to provide consumer guidance regarding lubes that are found to be safer than others."

"Some lubes are probably better than others, but we don't know where any of the currently available products fall along the spectrum from good to bad," added IRMA chair Jim Pickett.

"We must ensure that existing lubes don't facilitate HIV transmission," he added. "People have a right to this kind of information, and it's very past due."

Conference organizers pointed out that in the United States, 90 percent of men who have sex with men -- whether self-identified as gay or not -- engage in receptive anal intercourse. Between 10 percent and 35 percent of heterosexual women have done so at least once. And in either instance, condoms are often not used, while lubricants are.

Source

Older men and Andropause or senior slump

Andropause is the equivalent to or mimics the menopause condition that older women have in their years of life. It is basically a steady drop in the male hormone testosterone below the normal levels over time which affects nearly every other thing in the males’ body which can lead to erectile dysfunction, mood swings similar to menopause in women and fat deposits around the mid section of the body which may eventually lead to other lifestyle diseases and problems such as diabetes.

It is also called ADAM – Androgen decline in the aging male,

SHAM – shifting hormones in the aging male and another colloquial name is macho pause.

Symptoms and suggestions

Symptoms include loss of desire for sex as interest in sex falls otherwise known as the senior slump, erectile dysfunction and paranoia due to lack of sexual desire with frustration setting in. Irritability and depression with loss of sleep are spin offs as well due to the problems in their respective relationships. Hot flashes and severe mood swings with more frequency as the problem ages. On an average andropause may set in as the testis shrinks slowly and the adrenal gland that produces testosterone begins a slow decline of production of the hormone thus decreasing the availability in the male body usually in the early to mid fifties in most men, it can be earlier but it progresses as one gets older. It unfortunately a natural process for the testosterone levels in a man to fall but there may be some things one can do to maybe delay or significantly slow this occurrence.

Maintain a healthy lifestyle is one broad way then exercise and nutrition come into play as well. Avoid smoking, proper stress management skills, resting well, lowering or eliminating alcohol intake and eating well are recommended though simplistic as they may sound. Avoid or seek to decrease the physical condition of central obesity or fat around the tummy although our Jamaican culture prides “Big Belly Men” as sugar daddies or a sign of prosperity in life it can be dangerous especially as it relates to andropause. As the belly gets bigger the testosterone levels get lower and the testis get smaller as well. The actual belly fat is a sign that a man is actually producing less testosterone among other ailments and conditions as well.

Back pain is not necessarily a sign of andropause as Jamaicans like to attribute sexual prowess by the conditions of the back there may be other reasons why an older man may have back pain such as heavy object lifting or improper posture while seated and took much weight by the pot belly pulling on the rest of the body. There is no specific diet that promotes testosterone production one has to manage every day diet reducing fat intake, carbohydrates and sugars. A test is available known as a Testosterone Level which can determine the levels of the hormone in the body and possible limited testosterone treatment but not all men qualify for this kind of intervention. If a man has a very large prostate or signs of prostate cancer, heart disease, liver disease then they do not qualify for testosterone treatment. However if one doesn’t have those predisposing factors then there are dosages of testosterone that can be administered by a qualified professional.

Cardiovascular effects
The fall in testosterone levels has a number of negative effects on cardiovascular health it modifies the system, it can accelerate hardening of the blood vessels, the belly fat around the tummy area often time seeps into the bloodstream which speed up the levels of cholesterol which causes impaired circulation to the heart or long term heart disease.
Andropause can speed up the aging process tremendously. The emotional and behavioural changes can lead to violent reactions which paranoia men are usually very unhappy due to erectile dysfunction and with both partners in a heterosexual sense having meno and andropause it can be very confrontational. Services are available through sex therapists and Urologists (specialist who looks at problems of the urinary system) who can determine and recommend ways to resolve the issues, the urologist can test for testosterone levels and prescribe treatment where appropriate.

Bone density issues
Bone density may be affected as well as testosterone is a substance produced in the testis and the adrenals that an effect on several other parts of the body’s function. The hormone with the adrenals helps to build protein and influence the production blood cells in the bone marrow and bone formation so if one testosterone levels begin to fall one can loose bone mass thus affecting cell production which may lead to osteoporosis where the bones themselves become porous making the individual proned to fractures easier than normal.

So fellas begin to adjust your lifestyle as you get older we too have our challenges as we age not only the ladies.

Peace and tolerance

H

more reading on Andropause