Friday, February 01, 2008

Health & Wellness: Preventing Sexually Transmitted Infection

From the Grace Church Health and Wellness Committee, February 2008

The theme for February is sexually transmitted infection (STI) prevention. This is a mature subject. Discussions here are not intended for children but they may become the impetus for such discussions between parents and their preadolescent, adolescent and young adults.

As Christians we likely believe that the cornerstone principles of STI prevention are abstinence and fidelity. That is, sexual activity should be postponed until after marriage and married couples should be faithful to one another. The strong forces of mutual attraction, however, test and sometime compromise these principles. Years ago, the wide availability of broad spectrum antibiotics usually provided effective treatment to the STIs that sometimes resulted from sexual behavior.

Times have changed! As a society, we wait longer before we get married. Very intimate sexual behaviors, the kinds that were traditionally reserved for adults, are being talked about and practiced by our youth; and, among the array of infections now transmissible through sexual behaviors are some that are all but resistant to the antibiotics that once cured these infections and other infections (Human Immunodeficiency Virus (HIV)) that have no cure. HIV infections will eventually (sometimes taking 10 years or more) result in the development of Acquired Immune Deficiency Syndrome (AIDS). Over time, AIDS compromises the body’s immune system and its ability to fight infections and cancers. While treatments exist, they only delay this deterioration of the body’s immune system and death is usually the final result. Finally, the number and diversity of injection drug users has expanded. These rather radical changes require that we expand our toolbox of STI prevention strategies.

A Matter of Definition – Where once we thought we knew what abstinence meant, it is not so clear anymore. Virginity, once the hallmark of abstinence is now being redefined. Some experts say that in attempt to preserve their technical “virginity,” some young people are foregoing the act of “making love” but engaging in sexual behaviors with partners that are physically intimate and place these youth and young adults at great risk for developing STIs.

Where are the Risks of Being Infected with HIV?

  • Sexual Behaviors: The majority of HIV infections are transmitted while engaging in unprotected sexual behaviors. Transmission of the virus can occur when infected sexual fluids from one partner come into contact with the intimate mucous membranes of another.
  • Infected Blood or Blood Products: Injection drug users and recipients of blood transfusions are at risk. Transfusion recipients are at minimal risk because the vast majority of blood and blood products are checked for HIV.
  • Mother-to-child Transmission: Mothers infected with HIV can infect their child in utero during pregnancy and at childbirth. Medical personnel can significantly reduce the incidence of these infections by a combination of drug treatment, caesarian section deliveries and telling the mother not to breast feed her infant.

Prevention is really the only practical solution to these infections. If your behaviors match even one of the common risks for developing HIV or other STI, get tested. If you are not sexually active and don’t use injection drugs, delay becoming sexually active until you are older and/or married. If you are sexually active and don’t use injection drugs, take steps to PROTECT YOURSELF.

So far, we have noted that sometimes the cornerstone principles of STI prevention: abstinence and fidelity, are not enough. Societal changes include delayed first marriages and youth becoming sexually active at earlier ages. Public health threats as a consequence of risky behaviors include: increasing intravenous drug abuse and infections such as the deadly Human Immunodeficiency Virus (HIV). Those who are sexually active and not married need to take aggressive steps to prevent STIs and stay SAFE.

Safe Sex Practices:

  • Sexual Abstinence remains the safest sex practice. Wikipedia (www/Wikipedia.com), a frequently consulted “online” information source, defines sexual abstinence as “the practice of voluntarily refraining from some or all aspects of sexual activity.” There should be no physical contact of a sexual nature, obviously including but not limited to “making love”.
  • Non-Penetrative Sexual Behaviors (AKA “Outercourse”) such as massage, clothed rubbing of bodies together, non-intimate touching, hugging and kissing, shared sexual fantasies are all safe from risks of becoming infected with an STI.
  • Physical Barriers – The proper and obsessive use of such physical barriers as latex condoms (for men and for women) have proven to be effective in preventing the transmission of sexually transmitted infections.
  • Engaging in Sexual Behavior with only one partner – again, the ideal here is for each member of a couple planning to be sexually active, not to have engaged in intimate sexual behavior with any other person.

Safe Social Practices: If you are thinking about or have already become sexually active, be prepared to:

  • Tell your partner if, when, where and how you want to be touched or don’t want to be touched.
  • Mutually share your sex histories and get tested - insist that your partner get tested for STIs as well then share your results with each other.
  • Get regular physical check-ups, including checks for infections.
  • Insist on always following safe sexual behavior practices.
  • Acknowledge that physical intimacy finds its best expression in stable, committed, loving relationships that include not only sexual behaviors, but also creativity, mutual respect, power sharing, tolerance, forgiveness, problem-solving, mutual sharing and trust.

Should you have concerns or want additional information about the material presented above, please contact your local health care provider, the Public Library, the Centers for Disease Control and Prevention (www.cdc.gov), the Rector, or someone on the Grace Church Health and Wellness Ministry Committee (Chaired by Mrs. Florence Poyer, R.N.)

Prepared by: Walter S. Handy, Ph.D., member, Grace Church Health and Wellness Ministry Committee.

Health & Wellness: Death & Dying

From the Grace Church Health and Wellness Committee, February 2008

Chronic diseases require us to adapt our lifestyles, endure the discomfort and pain associated with the disease and its treatments, and sometimes, consider the likelihood of death. Some health conditions reach the point where a “cure” is no longer possible and death is imminent. In these circumstances, organizations offering Hospice Care can help to assure that maximal quality of life is achieved during the final days and weeks. Your Rector and/or health practitioner are the best sources of information about how to prepare for death.

Coping with Death: Irrespective of our age, the process of dying often involves medical, familial, psychosocial and spiritual as well as financial demands and conflicts. Successfully addressing these demands and conflicts requires active coping strategies that may outpace our personal resources. Hospice represents a continuum of end-of-life care that “provides comfort and support for persons with life-limiting conditions as well as their families. Hospice care aims to make the person comfortable and relieve their symptoms and pain for the entire length of their illness” (www.caringinfo.org).

Effective Pain Management is a critical element of Hospice Care. We have all experienced many types of pain, from the pain of a sprained ankle, achy joints, a headache, an infected tooth or in the lower back. Some psychosocial disorders such as depression, moderate to severe anxiety, and other emotional problems can cause pain or they can make the experience of existing pain worse. While we have learned to cope with most of these kinds of pain with our existing resources, some diseases such as cancers cause pain that exceed our personal abilities to cope. Hospice care is likely to be of benefit here. For example, experts tell us that with proper medical intervention greater than 85% of cancer pain can be controlled. Effective pain management results from the development and application of a pain management treatment plan. Such a plan often involves the combination of treatments and medications and a proven evaluation plan that tells the team what is and what is not effectively controlling the pain. Adjustments can then be made as needed. Cancer patients and health care professionals should work together to develop this plan - the cornerstone of effective pain management.

· Hospice may also make the following types of care available, as needed:

o Emotional and psychosocial support for the patient during the course of dying.

o Specific Prayer – asking God to help you and your team manage the pain and symptoms associated with your disease(s) and prayer for acceptance of conditions you are powerless to change. Requesting the prayer intercession of others for your comfort.

o Marshalling extra familial support by teaching family members critical skills to help them to care for you.

o Providing short-term inpatient care to help you and your family manage pain and symptoms when they overwhelm your ability to manage them at home or if family caregivers need respite.

o Providing grief support and counseling for loved ones.

Should you have concerns or want additional information about the material presented above, please contact your local health care provider, the Rector, or someone on the Grace Church Health and Wellness Ministry Committee (chaired by Mrs. Florence Poyer, R.N.)

Prepared by: Walter S. Handy, Ph.D., member, Grace Church Health and Wellness Ministry Committee