HIV Patients Lose More Years To Smoking Than HIV

Bad news for people with HIV who smoke: you’re losing twice as many years of your life by continuing your habit. And that’s not all. You’re also going to die at three times the rate of non-smokers with HIV….

Smoking

Smoking (Photo credit: Wikipedia)

From Science Daily:

Among HIV patients receiving well-organized care with free access to antiretroviral therapy, those who smoke lose more years of life to smoking than to HIV, according to a Danish study published in Clinical Infectious Diseases and available online. The findings highlight the importance of smoking cessation efforts in the long-term, integrated care of patients infected with HIV.

Marie Helleberg, MD, of Copenhagen University Hospital and colleagues estimated the effect of smoking on mortality, risk of death, and life expectancy, and the number of life years lost to smoking compared to years lost to HIV among nearly 3,000 HIV-infected patients treated in Denmark from 1995 to 2010. They also compared mortality associated with smoking between HIV patients and the country’s background population. Where HIV care is integrated and antiretroviral therapy is available at no cost, “more than 60 percent of deaths among HIV patients are associated with smoking,” rather than HIV, Dr. Helleberg said.

Estimated life expectancy differed significantly based on smoking status. A 35-year-old HIV patient who currently smokes had a life expectancy of 62.6 years, compared to 78.4 years for a nonsmoker infected with HIV. The loss of years of life associated with smoking was twice as high as that associated with HIV among HIV-infected patients. In addition, researchers found the excess mortality of HIV-infected smokers to be three times higher than that of individuals not infected with HIV.

Quitting smoking-along with increased exercise- are the two things people with HIV can do to extend their lives and overall health. I quit over three years ago. And yeah, it’s not easy. But it’s worth it.

So if you need a New Year’s resolution, it’s staring you right in the face. And if you need help, it’s readily available here.

Read the full article at Science Daily 

Identification of LGBT Needs in the Exam Room

A physician performs a routine checkup on a pa...

A physician performs a routine checkup on a patient at the medical clinic. (Photo credit: Wikipedia)

Last time you were in an exam room, did you feel that the attending physician received all the information needed to gain an accurate perspective of your plight? Did you share everything you felt you should, no matter how personal? Did said physician even ask about anything, aside from the usual short list of inquiries we are all too familiar with in that particular setting?

If you are a physician, do you really get the answers you need from your patients? Or perhaps it is just too uncomfortable when talking about sexual health and behaviors. More likely, they do not disclose the details out of discomfort, or even fear.

LGBT persons have shown to have some unique healthcare needs, sometimes experiencing disparities in care. LGBT patients are often uncomfortable or inhibited from talking openly with healthcare providers about sexual orientation, gender identity, and sexual behaviors. Certain sexual behaviors do not automatically define that patient as LGBT, and not all LGBT patients are going to have similar sexual behaviors. Truthfully, it’s not about whether a person is a member of the LGBT community or not. It’s about the individuals choices and behaviors that could be putting their health at risk, as well as the health of others. In order to cover everyone’s needs, patients must speak openly with providers. Providers must delve into the patients behaviors and understand where the risk behavior is at for each patient. I am going to lay out a few examples, ideas, and suggestions for physicians, as well as patients.

In any healthcare position, you will find people from diverse backgrounds and lifestyles. Different interests, tastes, and mindset. The right approach will reassure patients that the provider is knowledgeable, genuine, concerned, confidential and accepting. This enables the patient to open up and discuss the very private matters of sexual behavior, often in this society a ‘taboo’ subject.

Ask the patient to tell a bit about themselves. As the patient, make sure you indulge your sexual partner(s), safe sex practices, and concerns. Some behaviors have an amount of risk attached to them that is often unknown to the patient.  A physician might ask “Do you have any questions or concerns about your sexuality, sexual orientation or sexual desires?”. Use gender-neutral terms and mirror the patient’s terminology to better understand how they identify. For example, asking “do you have a partner or spouse?” “Are you currently in a relationship?” “What do you call your partner?” are all good ways to decide how the patient will identify without offending them with clinical terms which may sound cold and ‘labeled’. From here the in-depth sexual questions begin: “Are you sexually active?” “When you have sex, do you have sex with men, women or both?” “Are you and your partner monogamous?” “How many sexual partners have you had in the past year?” “Do you have vaginal sex, anal sex, or both?”. These and many more are the key to finding out just what unique needs your particular patient might have.

It is important to differentiate between sexual identity and sexual behavior. Providers need to discuss sexual behavior with patients regardless of sexual identity in order to define risk-assessment, ascertaining what activities they engage in and to learn what they are doing to prevent the transmission of disease.

And for the majority of readers, as  patients we have a personal responsibility to find the courage to openly discuss in confidence all of our behaviors and desires with our doctors, nurses, therapists and counselors, etc. This is extremely important. We cannot rely on someone to read our thoughts and know the truth.

Stand up and be proud of yourself. I can almost guarantee that the person treating you has heard it all. And if they haven’t, they will soon enough.