Health News Blog provides coverage of current health news.

Health care workers are at risk through contact with potentially infected patients and their body fluids. Other people are sometimes also inadvertently exposed to body fluids or needle-stick injuries. The risk of infection in this way depends on how much virus is present in the fluid or on the object (is the infected person encountered late or early in the infection, or during the middle period?) and how long the object has sat around after being used. It also depends on what type of injury a person sustains (was it a small scratch or a deep wound that went into the muscle?). A person who is stuck with a needle containing blood from an infected person runs about a 0.3 percent risk of becoming infected with HIV

Wearing gloves when coming into contact with potentially infected body fluids decreases the likelihood of becoming infected. Wearing two sets of gloves (a practice referred to as double gloving) decreases the risk from a needle-stick injury by about 50 percent compared to using just one set of gloves. This risk is reduced even further with the use of antiviral drugs immediately after exposure (see the section on treatment).

There is no evidence of transmission from infected health care workers to their patients, except for the widely publicized incident of an infected dentist who was found to have infected five of his patients during the 1980s. Exactly how this transmission occurred is not clear. A study of 15,000 patients of 32 infected physicians found that none of them had been infected by their providers.

Drug users who share injection drug works have a high risk of becoming infected with HIV In “shooting galleries,” where persons often share injection drug equipment and may exchange sex for drugs, one study found that a large percentage of the equipment was contaminated with HIV Using household bleach to sterilize the equipment for at least five minutes (and washing it with water afterwards) may decrease the risk of infection but does not eliminate it. The use of sterile needles, sometimes available through a needle exchange program, decreases the risk of HIV infection through injection drug use.

*307\213\8*

Gonorrhea is transmitted through sexual contact with a person who is infected, whether or not the infected person has symptoms. The throat, genital area, and rectal area can become infected. Gonorrhea is very easy to transmit through sexual contact. A man who has unprotected genital sex with an infected woman has a 20-30 percent chance of becoming infected. A woman who has unprotected genital sex with an infected man has a 60-80 percent chance of becoming infected.

Gonorrhea is also easily transmitted through anal intercourse, and the rates of transmission for oral sex are similarly high, especially for a man or woman performing oral sex on a man who has gonorrhea. Similarly, if a man or woman has gonorrhea in the throat and performs oral sex on a man, the man receiving oral sex has a high risk of becoming infected in the urethra. However, a man or woman with gonorrhea in the throat performing oral sex on a woman has a lower risk of transmitting gonorrhea to the woman, because the area of the gonorrheal infection (the throat) is not contacted during oral sex with a woman. If the woman who was receiving oral sex from the man or woman had gonorrhea in the genital area, there would be a low risk of transmission as well, because the throat would not come into contact with the genitals or cervix.

Transmission does not occur through inanimate objects, such as towels or toilet seats. Condoms, if they are used consistently and correctly and do not break or leak, will prevent transmission of gonorrhea. Other barrier methods, such as diaphragms and cervical caps, may help prevent transmission to women, but they are not as effective as condoms in preventing infection. Nonoxynol-9 has antibacterial and antiviral properties in addition to being a spermicide, and therefore it may help prevent transmission of gonorrhea, especially if used with a condom.

*217\213\8*

Depending on the study consulted, between 2 and 10 percent of the general population of men in the United States have sex with other men. They may be homosexual (have sex only with other men) or bisexual (have sex with both men and women). Some men may see themselves as heterosexual (have sex only with women) but occasionally have sex with male partners as well. As have lesbian women, men who have sex with other men have often had to evolve as sexual beings in an environment that has told them that what they are doing is wrong or immoral. That social pressure—along with the HIV epidemic, which in the United States and Europe initially hit the homosexual population the hardest—has made life difficult for many gay men in the last two decades.

Many men who have sex with other men have felt marginalized because of prejudice and excluded from traditional health care settings because of homophobia or the unvoiced assumption on the part of their health care providers that they are heterosexual. Health care providers do, unfortunately, sometimes bring their own prejudices into the work setting. Many health care providers do not receive education about STDs, let alone sensitivity training in dealing with sexual minority groups. This is not an excuse, but rather an unfortunate reality— one that is changing slowly.

For issues of sexual health, men who have sex with other men may choose to seek health care providers other than their regular providers, with whom they may feel uncomfortable being open about their sexuality. Clinics that provide health care primarily to men in same-sex relationships have come into existence since the 1980s for just this reason. Some men may feel more comfortable seeking sexual health care in county or city STD clinics, or in other settings where anonymity can be guaranteed. It is important for any person, irrespective of sexual orientation, to have a relationship with a nonjudgmental health care provider with whom he or she feels comfortable discussing these issues.

*126\213\8*

However, in every state in the United States, when a person is diagnosed with gonorrhea, syphilis, acquired immunodeficiency syndrome (AIDS), or chlamydia, this fact must be reported to the state or local health department. This information is important in helping to develop programs in that area to help stop the spread of these infections. The health department will also assist those who have been diagnosed with these infections in contacting partners to be treated. This partner notification is done anonymously: The health department contacts partners and tells them “Someone you have been intimate with has been diagnosed with an STD, and you should be tested and treated, too.” The name of the person diagnosed with the infection is not revealed, and this information is not released to any other individuals or organizations, such as insurance companies. This is a very important way to help make sure that people get treated. The laws governing the reporting of STDs, including HIV, vary from state to state. Talk with your health care provider about the requirements for your state.

A final thought: Health care providers should not try to impose their own beliefs about sexuality Usually the first thing that happens when you visit a health care provider is that he or she takes a medical history by asking a lot of questions about your health, your behavior (for instance, “Do you smoke?“), and your family’s health. When you are seeking advice about sexual health, some of the questions you will be asked may seem embarrassing. It may seem that a health care provider is prying, but that is usually not the case. These questions help the health care provider assess or religion on patients. To be effective, the health care environment must be supportive and nonjudgmental. If it is not, you would be well advised to find another health care provider.

*52\213\8*

The vagina is a muscular canal that is visible when the labia minora are spread open. From the time of birth, a membrane of tissue called the hymen covers the opening of the vagina; this membrane is usually torn with first sexual intercourse, though it can be torn before. The vagina is usually only 3-4 in. in length, but it can expand during childbirth and slightly during sexual intercourse in women who are past the age of puberty. There are normally bacteria in the vagina, the most common type being Lactobacillus. Some common infections of the vagina (which will be discussed in detail later in the book) are fungal (yeast) infections, bacterial vaginosis, and trichomonas infections. The vagina should not hurt or itch normally. A clear, odorless discharge from the vagina is normal for some women, especially during ovulation (the production of an egg from the ovaries), which occurs in the middle of the menstrual cycle. The cells of the vagina are shed constantly. This process, and the vaginal secretions that are normally produced, keep the vagina clean. Douching is not necessary.

Women whose mothers took the medication diethylstilbestrol (DES) during pregnancy in the 1960s have a higher risk for an unusual cancer of the vagina called vaginal adenocarcinoma. It is important to tell your health care provider if you fall into this category, since special tests must be done during your yearly Pap smear to screen for this type of cancer.

*7\213\8*