Supporters of the initiatives say these new services allow students to get good information about sex anonymously. But there are also those who oppose these initiatives, writes Hoffman.

…proponents of abstinence-based sexual education argue that these digital services presume that sexual activity among teenagers is the norm, and do not spend enough time on alternatives.

“They are only focusing on the risk-reduction model,” said Valerie Huber, executive director of the National Abstinence Education Association, which hopes to kick off its online service for teenagers next year.

Those who run digital programs say they simply want teens to have accurate information, to help them make good decisions. Even though popular culture is saturated with sex, facts and advice can be hard to find.

To learn more:

• Read Hoffman’s article Sex Education Gets Directly to Youths, via Text.

Some of the services discussed:

• ICYC – In Case You’re Curious

• Chicago’s The Sex-Ed Loop

• California’s The Hookup.

• SexEtc: www.sexetc.org

• National Abstinence Education Association: www.abstinenceassociation.org

It is projected that 1 in 50 Latinos will become infected with HIV in their lifetime, yet fewer than half of Latinos in the U.S. have been tested for the virus.

Among Latino men about 80 percent of infections occur among gay and bisexual men, with the largest number of new infections among gay and bisexual men under the age of 30, according the U.S. Centers for Disease Control and Prevention (CDC).

Of these, 1 in 5 are unaware they carry the virus, the CDC says.

In King County there are more  750 Latinos who have HIV or AIDS. Of these, Public Health – Seattle & King Count officials say, 40 percent received a late diagnosis, meaning they were diagnosed with a immunodeficiency due to the infection shortly after their first positive HIV test result.

Many of these individuals could have been infected for years, unknowingly infecting others and missing the chance for early treatment.

“HIV medications work best when started early,” says said Dr. Matthew Golden, Director of Public Health’s HIV/STD Program. “The earlier we catch infection, the sooner people can get medication that will keep them healthy. And they can consistently use condoms to keep their partners from getting infected.”

In King County, HIV has a disproportionate impact on the Latino community, which makes up 6 percent of the population but 13% of people recently diagnoses with the infection.

To raise awareness in the Latino community Public Health – Seattle & King County and Seattle’s Latino LGBT organization Entre Hermanos have teamed up to launch a new campaign called, All Together: The Latino HIV Testing Campaign, or Todos Juntos: Campaña Latina para la Prueba del VIH.

As part of the initiative the campaign has released a new video, directed by local filmmaker Drew Emery, that features a broad cross-section of Latino and Latina community members speaking about the importance of routine HIV testing.

The CDC recommends that all adolescents and adults age 13 to 64 be tested for HIV, that people in high-risk groups to be tested at least yearly, and that HIV testing be part of standard prenatal and pregnancy testing.

A number of programs provide low-cost options to pay for HIV testing and treatment for people have HIV or AIDS.

Some of local testing locations with Spanish speaking staff include:

• Consejo
• Sea Mar
• Entre Hermanos
• Gay City
• Public Health clinics

• Go to Public Health’s HIV/STD Program website for more information about these clinics or SabiaUD.org for information in Spanish.

• Or, to find confidential testing resources near you, visit hivtest.org, a fully English-Spanish bilingual site.

In the 1990s, the infection, which is caused by the bacteria Treponema pallidum, had almost been eliminated among gay and bisexual men in the county, but cases have soared recently, nearly doubling from 2009 to 2010, to 289 cases, and this year the number of cases is on track to double yet again.

Number of cases of early syphilis in King County, WA, by year and sexual orientation, 1994-2010

Gay and bisexual men–men who have sex with men or MSM– account for 90 percent of the new cases, according to Public Health – Seattle & King County, the campaign’s sponsor.

The new campaign, called “Syphilis is Back”, emphasizes that syphilis is easy to catch — but also easy to treat.

Syphilis is usually spread when a person comes into contact with syphilis sore, called a chancre, during vaginal, oral and anal sex. Because these sores can be hidden from view, it is often impossible to tell if a sex partner is infected.

In addition, the symptoms of syphilis can be easy to miss. The first symptom is a chancre, a raised, painless sore, which usually goes away in a few weeks.

Treponema pallidum -- CDC Photo

But even though the sore has gone, the infection persists and with time can have devastating effects on the heart, brain and other organs. Untreated infection in pregnant women can also have devastating effects on the fetus.

However, early infections can be easily treated with a single antibiotic injection.

The new campaign encourages sexually active gay and bisexual men to get tested for syphilis regularly and if they have any symptoms of the infection to be tested right away.

To learn more about the campaign, the signs and symptoms of syphilis, and local testing sites:

• Visit the campaign’s website: www.syphilisrising.com.

• Read the U.S. Centers for Disease Control and Prevention’s fact sheet: Syphilis & MSM (Men Who Have Sex With Men).

• Go to Public Health – Seattle & King County Sexually Transmitted Diseases webpage which has additional information about STDs and information about testing sites.

Palliative care or euthanasia?

Some physicians will heavily sedate dying patients to ease their suffering even though the medications they use may speed their patients’ deaths, a controversial practice called “terminal sedation”, writes reporter Anemoa Hartocollis in an excellent article today’s issue of the New York Times.

Hartocollis writes:

Doctors who perform it say it is based on carefully thought-out ethical principles in which the goal is never to end someone’s life, but only to make the patient more comfortable.

But the possibility that the process might speed death has some experts contending that the practice is, in the words of one much-debated paper, a form of “slow euthanasia,” and that doctors who say otherwise are fooling themselves and their patients.

To learn more:

• Read Hartocollis’ article Hard Choice for a Comfortable Death: Sedation.

UW physician and researcher Dr. Walter Stamm dies

Chlamydia

In an obituary this week, veteran New York Times health reporter Dr. Lawrence Altman recounted the accomplishments and contributions of Dr. Walter Stamm, a UW physician and scientist “whose research spared many women from infertility and helped prevent, control and treat certain common infectious diseases.”

Altman writes:

Among his accomplishments, Dr. Stamm clarified the role of a bacterium, chlamydia trachomatis, in causing pelvic inflammatory disease that often leads to infertility among women . . . “Countless women owe their fertility to Walt Stamm and his colleagues in Seattle,” said Dr. Martin J. Blaser, an infectious disease expert who is chairman of the department of medicine at New York University and who succeeded Dr. Stamm as president of the Infectious Diseases Society of America.

To learn more:

• Read Altman’s article Walter Stamm Dies at 64; Helped Curb Chlamydia

PHOTO CREDIT: Dr. E. Arum, Dr. N. Jacobs/CDC

The high cost of end-of-life care

New York Times reporter Reed Abelson profiles Ronald Reagan U.C.L.A Medical Center, which, he writes, “has earned a reputation as a place where doctors will go to virtually any length and expense to try to save a patient’s life.”

As a result, according to one research group, Medicare pays about $50,000 to the hospital during the last six months of a patient’s life, spending weeks in the hospital under specialists’ care, compared to $25,000 at the Mayo Clinic in Rochester, Minnesota, where doctors care is closely coordinated and are “slow to bring in specialists and aim to avoid expensive treatments that offer little or no benefit to a patient,” he writes.

But are the U.C.L.A wrong to treat their patients so aggressively?

Do the statistics obscure the lives they save?

To learn more:

• Read Abelson’s article: Weighing Medical Costs of End-of-Life Care.

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