September 1st, 2009 by Happy Hospitalist in Uncategorized
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There appears to be some controversy brewing. The New York Times is reporting that the CDC may recommend just that in an effort to protect the boys against HIV as they become sexually active:
The topic is a delicate one that has already generated controversy, even though a formal draft of the proposed recommendations, due out from the Centers for Disease Control and Prevention by the end of the year, has yet to be released.
The American Academy of Pediatrics is currently neutral. As a result, many state Medicaid programs do not pay for the procedure. But it sounds like that may be changing, with a policy indicating circumcision has health benefits beyond HIV prevention.
Hundreds of commenters wrote into the New York Times today to complain about “child abuse” and “genital mutilation” and one “religious sect’s agenda of control” (i.e. Jews).
I don’t see what the big deal is. Everyone seems to be piercing and tattooing their bodies these days. What’s wrong with a little circumcision?
Perhaps you could mandate the same kind of prevention that schools do with their vaccination requirements. What do you think? Should all boys be circumcised?
*This blog post was originally published at A Happy Hospitalist*
July 14th, 2009 by Nancy Brown, Ph.D. in Better Health Network
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In 2006 the Centers for Disease Control and Prevention (CDC) estimated that 1.1 million people were living with HIV, 4.4% of whom were 13 to 24 years old, and 48% of those youth are unaware they are infected. Using the Youth Risk Behavioral Survey (YRBS) data from 2007, the CDC estimated that about 12.9% of high school students had been tested for HIV.
The good news is that the highest risk teens were the ones getting tested more often, but only 22% of the highest risk teens had been tested.
To decrease the number of undiagnosed HIV infections among adolescents and promote HIV prevention, the CDC recommends that healthcare providers offer HIV screening as part of routine medical care for all people ages 13 to 64. People at high risk should be tested every year, including:
- Injection drug users;
- Anyone who exchanges sex for money or drugs;
- Sex partners of people with HIV;
- Men who have sex with men;
- Heterosexual people who have more than one partner since their most recent HIV test; and
- Anyone who gets a sexually transmitted disease.
High schools can support that effort by including information about HIV testing in the health curricula. People familiar with the benefits and process of the testing and counseling are more likely to be tested.
For teens, I usually suggest they go to anonymous testing sites in their community to be testing, so that the test is not including in their medical record. The anonymity also gives them a little extra courage. The trick is that they cannot lose their test number for the two weeks they wait for results.
This post, HIV Screening Should Be Offered As Part Of Routine Medical Care, Even For Teens, was originally published on
Healthine.com by Nancy Brown, Ph.D..
July 8th, 2009 by Nancy Brown, Ph.D. in Better Health Network
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Just a friendly reminder to parents that dating does not equal sex. I cannot tell you how many teens have shared with me that the first lecture they got from their parents when they started dating was about sexually transmitted infections, including HIV and unwanted pregnancy. Their reactions were “what?”
When young teens start dating it is because they have found themselves twitterpated (which is apparently not a real word), and attracted to someone. Chances are good it is more of an emotional attraction than a sexual one, and one that will wax and wane, usually end with tears, but not kill them.
It is easy to understand why parents panic and worry about sexuality and the risks associated with that sexuality – we live in an extremely over-sexualized culture that can make us believe that everyone is having sex – which is not true. Please remember that only half of teens start being sexual before they are 18, but most fall in love at least once before leaving high school.
Dating is about learning how to be in a relationship, and you will be doing your children a great service if you talk with them about relationships, not sex. It is a good idea to make the difference really clear for them, and make your expectations very clear, too! If you expect your teen to not become sexual, tell them that, and why. Ask them to tell you what there limits and expectations about relationships and sex are. Here are some topic suggestions:
- What do they think dating includes?
- What does sexual pressure look and feel like?
- How would your child resist sexual pressure?
- How long do they think people should date before the topic of sex even comes up?
- How will they know if someone is the “one?”
- What would have to happen before they did think about sexual behavior?
If the possibility exists that they will be sexual, then, you can have the conversation about sex – but not if they tell you they will not be swayed and are not interested – you have to trust them.
Many teens are afraid of dating or choose not to date because a partner may expect sex, so they find a friend or pseudo partner to attend events with and protect them from having to resist sexual pressure – which is a great strategy, but keeps them from trying on relationships.
Oh the conversations that we might have … keep talking and make sure they know you are open to talking – even about things that make you squirm.
This post, Teen Dating Does Not Mean They’re Having Sex, was originally published on
Healthine.com by Nancy Brown, Ph.D..
May 12th, 2009 by Nancy Brown, Ph.D. in Better Health Network
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Last year the Centers for Disease Control and Prevention (CDC) announced that there were 40 percent more new HIV infections each year than was previously believed. And yet, a new (2009) survey by the Kaiser Family Foundation has found that Americans, even those in the high risk groups for HIV, are worrying less about HIV/AIDS. How can this be?
The survey suggests that:
- Fewer Americans consider HIV an urgent health problem.
- Only 17 percent of people aged 18-29 (those traditionally the most sexually active) reported that they were personally very concerned about becoming infected with HIV.
- In spite of HIV rates being seven times higher among African Americans, personal concern about HIV has decreased in this population.
- More than half of people aged 18-29 have not been tested for HIV, in spite of the fact that the CDC now recommends HIV testing for all adults.
The survey also found that misinformation and stigma about people living with HIV still exist.
- Although 44 percent of the 2,554 adults surveyed reported that they would be comfortable with a coworker who had HIV, 51 percent would be uncomfortable having their food prepared by someone who was HIV positive.
- One-third of the people surveyed incorrectly believed that HIV could be transmitted by sharing a glass of water; touching a toilet seat; or swimming in a pool with an HIV positive person.
- 18 percent believed there was a cure for HIV and 24 percent believed there was a vaccine available to prevent HIV.
This is scary stuff and suggests that families, parents, schools, and medical professionals have their work cut out for them – more HIV education, please!
This post, Why Aren’t We Worrying About HIV Anymore?, was originally published on
Healthine.com by Nancy Brown, Ph.D..
March 26th, 2009 by Stacy Stryer, M.D. in News, Opinion
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The number of teens giving birth in the United States has increased for the second year in a row, after a decline for 14 consecutive years. According to a reported recently released by the Centers for Disease Control, the birth rate increased from 41.9 births per 1000 teens in 2006 to 42.5 births in 2007. Not only does becoming pregnant and giving birth as a teen increase the risk of serious medical problems for the newborn, including low birth weight and an increased risk of death, but it also makes it more likely that a mom will have many socioeconomic difficulties, including a greater chance she will end up on welfare, not receive a high school degree, and live below the poverty level (which translates to difficulties for newborns as they get older).
Obviously, teens who become pregnant did not use a condom during intercourse, or at least not correctly. Therefore, these teens are also at risk of developing sexually transmitted diseases, such as Chlamydia, gonorrhea, and AIDS. Unfortunately, some of these infections, such as HIV, can pass through the placenta, and infect the unborn fetus. Given the fact that the risk of developing HIV and AIDS in adults is increasing in some areas of the United States, it also makes it more likely that an infected female will become pregnant. A report recently published stated that the rate of HIV is greater than 3% in Washington DC, which is considered an epidemic.
Although researchers don’t know why the number of babies born to teens has increased for the second year in a row, they speculate that increases may be due to increased risk taking, more relaxed and changing attitudes, portraying sex as OK or even a positive experience on TV, increased risk taking by teens, changing attitudes, and having teen role models who become pregnant (Miley Cirus, Jamie Lynn Spears, Bristol Palin).
How are we going to improve these statistics? We must ensure that sex, STDs, teen pregnancy and contraception is not only taught at school but also discussed in our own home – over and over. Our teens must not only learn our values, but also how to keep themselves healthy. It is fine to teach abstinence at home, but parents should also teach about condoms as a way to protect their teens. Often, we are the last to know that they have become sexually active. (Regular communication and discussion with our teens may give us the privilege of finding out sooner!)
It is also important to teach our teens how to deal with a certain situation before it happens, such as what to do when someone of the opposite sex makes an advance. If your child hasn’t been taught what to do in situations such as a teen making a physical advance, friends trying to increase poor behavior via peer pressure, watching drinks carefully , and others, she will probably be more likely to freeze up when such a situation arises and allow it to get out of hand. My rule of them it to talk about these tough subjects about 2 years before your teens may be in such a situation. This gives them time to think about it and formulate a plan of how to say “no” or how to stay safe. We need to see a reversal of the teen birth rate – in order to do this, we need the community, schools and parents all to work toward a common goal of educating and protecting our teens.
