Alcohol, Drugs and New Year’s eve!

We spend every New Year’s eve with hopes of better everything in the new year. In the social whirl of partying with friends, acquaintances and strangers, we inevitably get caught up in the celebratory spirit. Just as counting down to the last second of the old year is considered a necessary accompaniment to ringing in the new year, so is consumption of alcohol. Whether it’s beer, wine, whiskey or cognac, it certainly has the ability to help you relax. Too much of it and it may even make you do things you normally wouldn’t! Like going home with strangers. Having sex without protection. Injecting drugs. Sharing needles. Putting yourself at risk of HIV and other infections.

Did you know that in 2017, Florida had the highest number of new HIV diagnoses in the country?

  • 4 of the 10 metropolitan areas with the highest rates of new HIV infection per 100,000 are in Florida:
    • Miami is at # 1
    • Fort Lauderdale is at # 2
    • Orlando is at # 6
    • Jacksonville is at #9
  • Truvada is an FDA approved drug for use in HIV negative adults and adolescents who have an HIV-positive sexual partner or injection-drug-using partner.
    • However, it is meant to be used in conjunction with safe sex practices.
      • Truvada when used consistently reduces the risk of HIV transmission among injection drug users by more than 70%.
      • When combined with safe sex practices, Truvada reduces risk of sexually transmitted HIV by more than 90%.
    • However, research has shown higher rates of condomless sex AND sexually transmitted infections (STIs) such as gonorrhea, chlamydia and/or syphilis in people who use Truvada.

STDs refer to sexually transmitted diseases. An updated term is STIs (short for sexually transmitted infections).

Truvada targets HIV, but not the bacteria that cause gonorrhea, chlamydia and syphilis.

  • STIs, including HIV, may not always have symptoms that alert you to get medical help.
    • These infected individuals are nevertheless contagious and of course at risk of serious complications, unless treated.
  • In addition to HIV and the bacterial STIs mentioned above, there is also a risk of sexual and/or blood-borne transmission of viruses such as Zika, HPV, genital Herpes, and Hepatitis A, B and C.

No one would willingly choose any of these infections.

The same mindset that does not engage in preventive behaviors, may be more disinclined to see a medical provider for checkups, resulting in life changing consequences.

  • For instance, HPV (human papillomavirus) if undiagnosed and consequently untreated, can cause cancer of the cervix, anus, penis, throat etc., all of which can lead to death if not treated in a timely manner.
  • Genital herpes in women of childbearing age can have negative consequences for the baby if the pregnant woman has an active infection while she is in labor.
    • Even otherwise healthy babies are born with a still developing and therefore, immature immune system.
    • When exposed to Herpes virus, newborn babies may develop neonatal Herpes, an infection that spreads all over the body and can be devastating to the newborn.
  • Hepatitis B virus can cause chronic infections in 2 – 6% of infected adults.
    • Unless cured with specific antiviral drugs, these infected adults can be a source of infection to others.
      • Hepatitis B virus causes chronic infections in about 90% of infected infants and 25 – 50% of children one to five years of age.
    • Antiviral drugs only cure about 50% of treated patients and that too after many years of treatment.
  • Even Hepatitis A virus, which ordinarily causes mild illness, can cause death and severe illness lasting many months.

With the advent of the drug Sovaldi, the cure rate for Hepatitis C has exceeded 90%.

  • However, one pill costs about a thousand dollars in the United States, and the treatment regimen is eight weeks or more!
    • There are about 3.7 million chronically infected Hepatitis C patients in the country.
      • The high cost of Sovaldi makes treatment of all of these chronically infected patients non affordable for our healthcare system.
  • What is the downside to not getting rid of chronic Hepatitis B and C infections?
    • Progression to liver cancer, liver failure and ultimately death.

And of course, most of us now know about microcephaly, the sad and unfortunate defect in the baby born to a Zika virus infected pregnant woman. At the time of this writing, we no longer see local transmission of Zika virus in the United States. However, individuals who travel to places at risk of Zika, can get infected abroad, and upon return, can sexually transfer the virus to others.

These returning travelers should engage in preventive measures such as:

  • preventing mosquito bites for 3 weeks
    • if infected abroad, the returning traveler can carry Zika virus in the bloodstream
      • a biting mosquito can pick up Zika virus from this person and transfer it to the next person it bites
  • Zika virus stays in semen for months after infection.
    • This male can pass Zika virus to others, during unprotected sex.
    • Infected males?
      • Practice safe sex for 3 months.
    • Infected females?
      • Practice safe sex for 2 months.

Like I said before, no one will willingly choose any of these infections! This New Year’s eve, let’s say No to infections as we ring in the new year. This New Year’s eve, let’s be responsible and avoid unsafe choices that could very well incur a lifelong infection.

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