Hepatitis C

This is when the sh*t really hits the fan! There is very little good news to report on this front, so buckle up and get ready for this bumpy ride. Once again, most infected are without symptoms and this is another blood born illness. Luckily it is not associated with other bodily fluids, like saliva, semen or sweat as a mode of transmission. This virus is literally taking a high toll on our community as infection rates are on a constant rise due to usage of injectable drugs, including METH (TINA, CRYSTAL, T). Needle sharing with infected partners is one of the most dangerous…and stupid, things you can do. If you choose to continue to inject drugs here are a few tips to keep your liver safe:

NEVER SHARE NEEDLES

FIND A NEEDLE EXCHANGE PROGRAM

BRING YOUR OWN NEEDLES

Ok, now that we are clear on that. HEP C remains in the liver for about 85% of those infected. Read that last sentence again…I’ll wait. HEP C is also the leading cause of liver transplants but the illness usually recurs even after the transplant operation. PLEASE take this virus seriously. A quick note on body modification. Piercings and tattoos account for a large percentage of HEP C infections. At GMJ, where many of us have art work and adornments across our bodies, we believe that your parlor should be as clean, if not more so, than your doctor’s office. Dirty needles are the main cause of this transmission. When choosing a parlor for your first, next or last piece of art, be sure to check for autoclave systems, which clean utensils, artists that use latex gloves and wash their hands between clients, but most of all trust your gut. If the place seems like a dingy hole in the wall that will give you HEP C, you are probably right. ONLY PATRONIZE LICENSED PARLORS, and skip the jail house tattoos. You know who you are.

Fisting

If you flag red, we are now talking to you. If you are HIV positive, or think you or your partner(s) might be, stick around too. The act, or art, or placing one or more fingers up the rectum of another person, sometimes to the extreme, or desired, point of forearm, is called fisting. This activity is not for everyone and only the most skilled, or one who has found someone to train them in this practice, should be participating. This is not a “junior” varsity sport. It is professional level. If this is not your thing, don’t judge, because you have your own sexual activities and fetishes that others look down on too. If this section is too much for you, leave quietly and don’t disturb your neighbor in the process.
Now, for those that remain. For obvious reasons, fisting can be a very dangerous sexual act and must be approached with care and lots and lots of lube and relaxation of the rectal muscles and mind. There are a host of well received publications on this sexual art form which we suggest you look into if you plan to participate but are in need of further guidance.

In the United States and The United Kingdom, higher and higher rates of HEP C infection in gay men due to fisting have been reported each year. This, coupled with HIV rates, makes this a dangerous illness for our community. In the past, unprotected anal sex was considered to be a substantial contributor for transmission on its own, but this has been widely dismissed with study, and linked back to the practice of fisting as a precurser. It, currently, is not believed that the act of fisting alone is the greatest causation, rather the possible “trauma” associated with it and then subsequent sexual activities like unprotected anal sex and rimming.  To be very clear, neither this study nor GMJ is condemning the act of fisting, or those that perform it, rather explaining that proper care, precaution and protection should be utilized if the consenting parties are going to engage in oral or anal sex afterwards.

We get deeper into the danger zone when we factor in METH usage again, which is still a very serious community problem, because this drug not only reduces your inhibitions it also decreases your ability to feel pain, thus limiting your awareness to anal pain, tears and even bleeding. If you are a trained fister, you should already know how to protect yourself and your partners, but if you don’t or are in need of this information, here are some tips.
  • Ask about your partner’s HEP C and HIV status
  • Disclose your HEP C and HIV status
  • Always use latex gloves when fisting
  • Always use condoms during anal sex after fisting
  • Watch for blood during and after a fisting session
  • Use lots and lots of lube, preferably thick and slick brands
  • Be mindful of your partners body, and if he is in pain or relaxed
  • Don’t go too far or too fast
  • If you use METH, be mindful of the amounts and its effects
  • GET TESTED FOR HEP C before fisting/getting fisted!

Prevention

Above, we have already discussed the many ways to prevent HEP A/B/C but for the remedial class, the basics you need to remember are that this is a virus which is transmitted through bodily fluids but most often blood. Using condoms during sexual intercourse is one of, if not the best way to protect yourself. Also, getting vaccinated is a sure fire way to keep from contracting HEP A and B. The vaccine is a THREE (3) SERIES, and you must complete the entire series for it to be truly effective. Sometimes, you may have to repeat the series if it does not take effect, but worse things have happened to you in life. The series is usually done in 1-3 months increments depending on your over all health. The A and B vaccines may even be administered together, so ask you medical provider about this series and make sure you get the entire set. Got it?

Treatment

It is estimated that about 50-80% of those infected with HEP C will become chronic but about 40-80 clear with treatment. Our friends over at AIDSMAP.com have created a great graphic to help you understand how to decide which treatment options are right for you. But, here is some basic information to get you started. The world health community is taking HEP C very seriously and creating new treatments all the time. The main issue is finding the right medication(s) for you and your lifestyle. This includes factoring in your HIV status. Interferon has been the base treatment for HEP C for many years now, but is being outpaced by medications which attack the virus from different points of its life cycle.
Interferon treatments typically last between six(6) months to a year, but some of these new meds work in as little as 12 weeks. The side effects associated with Interferon are pretty bad with many patients not only complaining but stopping treatment. With this in mind, new measures are being put in place to create drugs without it. Some of the questions you will need to consider are:
  • Can you wait until more drugs become available or is there a risk that your liver disease might worsen, and so become more difficult to treat?
  • What is the value to you of being cured of hepatitis C now, rather than waiting? How long are you prepared to wait?
  • How confident are you that newer drugs will be available if your liver disease becomes worse?
  • What do you feel about the possibility that taking hepatitis C treatment now may not cure the infection?
  • Do you feel ready to start a course of interferon-based treatment in the near future.
  • The only known Hep C cure is very costly. Can you, with or without insurance, afford it?
We here at GMJ know that this was a difficult topic to read about and can seem like a scary illness to contract. It is a very powerful virus which can have long lasting effects and even cause death. We want you to take all of the strains of hepatitis as seriously as you would HIV, and heed the information and advice listed above. The best defense is a great offense. Take care of yourself and your partners.

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