September 9: Fetal Alcohol Awareness Day

September 9 is Fetal Alcohol Awareness Day. At 9 a.m. the bells of the St. Augustine Cathedral in downtown Tucson will ring, so we can remember on the ninth hour of the ninth day of the ninth month not to drink alcohol during the nine months of pregnancy.


Fetal alcohol syndrome is entirely preventable.


I became aware of fetal alcohol syndrome the way many parents do — by dealing with a child affected by a mother’s drinking while pregnant. I had to learn about it to parent my son, who had come to me when he was 7 years old, and who, in his teens, had regressed in his emotional and cognitive functioning. I needed to understand the outbursts that resulted in holes punched or kicked in the walls; broken mirrors, broken windows, broken china; stolen jewelry, my winter jacket that I saw walking down the street worn by his friend, who had given money for it; the daily swearing and the inability to understand that his behavior had consequences.

What is fetal alcohol syndrome (FAS)?

Fetal alcohol syndrome is the leading cause of IQ scores below 70 in this country (though most people with FAS have normal intelligence), and is entirely preventable. You have probably seen ads talking about the importance of not drinking during pregnancy. But it is not only women of childbearing age who need to be educated. Doctors, especially ob/gyns and pediatricians, teachers, and social workers — everyone who works with children, in fact — need to learn about the effects of prenatal exposure to alcohol. Also judges, probation officers, and others working in the juvenile and adult criminal justice systems need to be educated; most of them have quite a bit of contact with the victims of fetal alcohol exposure, whether diagnosed or not. Continue reading

STD Awareness: Viral Hepatitis

Hepatitis A virus particles are pictured in this electron micrograph. Image: Betty Partin, CDC

Hepatitis isn’t commonly thought of as a sexually transmitted disease (STD) — for most people, hepatitis conjures images of contaminated food or unsanitary restaurants. But hepatitis should be on the radar of anyone who is sexually active. There are several different viruses that cause hepatitis, and some can be sexually transmitted, including hepatitis A (HAV), hepatitis B (HBV), and, to a lesser extent, hepatitis C (HCV).

While HBV is most efficiently transmitted through blood, it can also easily hitch rides from person to person via sexual fluids. However, we covered HBV in depth last year in observance of World Hepatitis Day. As May is Hepatitis Awareness Month, we’ll turn the spotlight on HAV and HCV for this month’s installment of our STD Awareness series.

Hepatitis A (HAV)

HAV spreads through fecal-oral contact and is more widespread in parts of the world with poor sanitation. It is relatively rare in the United States, although in 2003 there was a hepatitis A outbreak outside of Pittsburgh — the largest in the United States — that was traced to improperly washed raw scallions. All told, there were 650 confirmed illnesses and four deaths. HAV is very resilient and can survive outside a host for long periods of time — other foodstuffs it can contaminate include filter-feeding shellfish, which can concentrate HAV from contaminated seawater in their tissues. When these shellfish are undercooked, they can pack quite a punch as billions of virus particles are released into the unsuspecting diner’s body.


Vaccination against hepatitis A confers lifelong immunity while sparing you from illness caused by a natural infection.


Unfortunately, no matter how well you clean your fresh produce or how long you cook shellfish, certain sexual activities can increase your risk of acquiring HAV. As with intestinal parasites, which can be present in minuscule amounts of fecal matter, so too can virus particles be present in microscopic bits of feces. Oral contact with the anus (“rimming” or anilingus) is the riskiest activity in terms of HAV transmission — oral-genital contact can also do the trick, as can manual contact between the anus and the mouth. While hepatitis A outbreaks have been reported among MSM — men who have sex with men — populations, oral-anal contact is associated with increased risk for HAV infection regardless of sexual orientation. To reduce your risk of sexual HAV transmission, use latex condoms or dental dams during oral activities. HAV can also be transmitted via blood, and hepatitis A outbreaks have been reported among IV drug users. Continue reading

Honoring Life: Arizonans Observe National Native American HIV/AIDS Awareness Day

Tuesday, March 20, 2012, is National Native American HIV/AIDS Awareness Day (NNHAAD). Started in 2007, NNHAAD is focused on promoting HIV education, prevention, and testing among Native Americans, Alaska Natives, and Native Hawaiians. Dr. Yvette Roubideaux, a former professor at the University of Arizona who is now director of Indian Health Service, has called NNHAAD a day to “celebrate our successes and plan how to best continue working in partnership to address HIV and AIDS among Native people.”


On March 16, Arizona State University will observe Native American HIV/AIDS Awareness Day with speakers, information, and free HIV testing.


Although HIV affects every segment of society in the United States, Native Americans and Alaska Natives are disproportionately affected, ranking third, after black and Latina/Latino Americans, in the rate of HIV/AIDS diagnosis. Even as high as it is, the documented rate of diagnosis most likely understates the actual rate of HIV among Native Americans and Alaska Natives. This is due to racial misidentification in collected data and poor data reporting between state and federal agencies and the Indian Health Service (IHS). Further deflating the rate of diagnosis is the concern among people from smaller Native communities about anonymity during testing and confidentiality after diagnosis. Those concerns and the stigma associated with HIV lead to a reluctance to get tested, which delays or precludes diagnosis.

To understand the high rate of HIV, it helps to look at risk factors that uniquely affect Native Americans and Alaska Natives. Dr. Anthony Dekker of the Phoenix Indian Medical Center, interviewed for the newspaper Indian Life, commented that Native American patients “have very high rates of … sexually transmitted diseases … We also know that there is a very high rate of alcohol and [substance abuse] in the American Indian/Alaska Native population. There are many reasons for that, but what happens is that when you take a population that has had high rates of substance abuse and high rates of sexually transmitted diseases, [that population] also has high rates of HIV.” A high rate of substance abuse is associated with a high rate of HIV and other STIs, since impairment can lead to risky sexual behavior, such as poorer negotiation of condom use. Continue reading