This morning I was invited to do a presentation for Grand Rounds at one of the local community hospitals. Grand Rounds are weekly educational sessions funded by medical staff for all hospital staff and includes doctors, nurses, pharmacists, physiotherapists, etc. I was pleased to see it was a full house. I usually have to warm up the crowd (call it foreplay, if you will); it makes everyone just a bit more comfortable about a taboo subject. The subject this time around was HIV which is a chronic condition and no longer the death sentence it once was.
What is HIV?
HIV is the Human Immunodeficiency Virus, the virus that causes AIDS which is Acquired Immunodeficiency Syndrome or the late stage of HIV infection. The immune system weakens and a person may get serious illnesses as a result. If a person is HIV infected or has HIV disease, it means that they have HIV in their body and can transmit the virus to others.
HIV/AIDS is a global crisis and young people are the most vulnerable group. Girls are at 2-4 times greater risk due to the surface area of the vagina and labia. Also, semen contains a higher concentration of the virus when a person is infected with HIV compared with HIV positive female sexual secretions. The presence of an STI (Sexually Transmitted Infection) increases the risk of HIV transmission. The highest STI rate is in girls aged 15-19 years old.
It is important that health care professionals, especially family doctors develop a good rapport with their young patients to help them develop the necessary skills to:
- Make healthy decisions;
- Know what healthy and unhealthy relationships are; and
- Help to de-stigmatize HIV and AIDS
Doctors and nurses and members of the health care team are trusted professionals and that is why it is important that they impart sex education on their young patients or they will learn the information from someone else and it may not be accurate. A child’s own parents may not be comfortable talking about sex and fail to speak to their children about it at a young age. Many are surprised when they find their child viewing porn and realize their children are sexual beings. Newsflash: We all are!
Transmission Facts
It is vital that kids know HIV is not transmitted by:
- Casual contact (hand shaking, touching, hugging)
- Sneezing
- Tears, saliva or sweat
- Sharing drinking glasses (although this is poor hygiene and other diseases may be transmitted)
- Public washrooms, drinking fountains, swimming pools/hot tubs
- Pets
- Sharing razors
HIV is transmitted through vaginal, anal and/or oral sex without the use of a condom with a person who has HIV or a person whose HIV status is unknown. HIV is also spread through sharing needles, syringes or works (spoons, cotton, bottle caps that have been used by a person with HIV to shoot drugs including vitamins, insulin and/or steroids). Sharing needles for tattooing or piercing is also risky.
Teach Teens to Practice Safe Sex
What is most important is that teens know that it’s all sex… vaginal, oral and anal. Abstinence is a choice and is the only sure fire way to prevent HIV and STIs. Teens need to know to practice safe sex and use a condom. Also, alcohol and drugs fuel poor decision making and increases risk because it is harder to say no, especially as peer pressure increases.
Adolescence may be a challenging time for most kids as they navigate this developmental stage. Armed with accurate information, health care professionals gain confidence in discussing the subject of sex. I refer to the Plissit Model when I discuss sex with my patients and I also suggest a few good openers such as:
- Many students speak to me about…
- Hey, I saw this article about HIV and teens…
An important question: teens who have had at-risk sex may ask when they should be tested for HIV. It takes three months for antibodies to develop; you will want to advise them to avoid risky behaviour while waiting to be tested.
It may be helpful to learn a bit of #teenspeak in your efforts to treat your teenage patients. Learn their language and use it with them, but not too much. Be mad (cool). Make it turnt (fun). Hashtag everything. Ask them if they are killing it (doing amazing things like succeeding in school or sports). Teens hook up these days and have friends with benefits; “friends for cut” is lingo for having sex. TBT? Nope, not Throwback Thursday. It means what a great time we had getting wasted at that party last week. Mupload that ish (post that selfie)…#Hashtagwhatever, the list goes on…