|
|
|
|
Body Piercing
Tattooing
Steroid Use
Acupuncture
Scarification
Circumcision
|
If you or your friends share needles or utensils which
break the skin and cause bleeding (however small the amount of blood), be
sure to read this section. You need to know the HIV risks from the intermingling
of blood from "piercing guns," "blood-brother type" ceremonies, sharing
of steroid needles, and homemade tattoos. This information is provided not
to cause undue alarm but rather to inform you to reform. After all, changing
one's risky behavior is the only sure way to avoid HIV (and herpes and hepatitis).
And the truth is that abstinence from sexual intercourse and sharing needles
is the only 100 percent sure way to be safe.
At the beginning of the sexual revolution in the 1960s, long, unkempt hair
was a fad along with large "hippie" jewelry for both men and women -- it
was a fashion statement that drove adults crazy and an act expressing dissatisfaction
with the status quo; in short: it was politically correct. Besides, it was
fun and a sign to peers "I'm one of you." As we approach the next millennium
a new fad has appeared -- body piercing jewelry, an act of rebellion
with design flair.
In this section you will learn more about alternative practices humankind
has traditionally employed to alter the physical appearance of the body.
And if the needles, knives, or shells are shared in a manner that allows
for blood interaction between people, then there will be a risk of HIV transmission.
Body Piercing ^
Top
Dr. John remembers his solo travel to the remote South Seas atolls when
he was a young man and saw old Carolinian islanders with pendulous shell
earrings that distended their cut ear lobes. He also
remembers a Hindi festival in Fiji where young people were decorated with
elaborate body piercing of jewels and gold. Those practices seemed so foreign because they were -- by our standards then. Now many teens favor
intimate and public body piercing jewelry. Here are some things teen should
consider before getting pierced.
Piercing involves the use of utensils that break the skin and cause bleeding.
There is a danger of HIV transmission if the needles had been previously
used or shared and not properly cleaned. If a person with HIV had a bloody
piercing done with needles just before you, there is a possibility that
contaminated blood could find its way into your bloodstream.
So your first order of business is finding a reputable business. Try to
get referrals from people you trust and make a visit. Look for clean procedure
rooms and tools including gloves, fresh needles, etc. If the place is not
sanitary-looking then that could be an indication of more serious safety
concerns. And talk to your piercer beforehand about your safety concerns
(remember, many piercers don't want to get infected themselves).
If you're getting pierced simultaneously with other friends, be sure that
the piercer does not interchange the needles. Don't take a chance -- unless
you're stupid. Don't interchange jewelry parts with other people while fresh
blood remains on them. HIV can travel in that manner, however, unlikely
the possibility. One writer even recommends you only accept new jewelry
since "previously-worn jewelry can have minute scratches which trap bacteria
and irritate the piercing" (Greenblatt, A., 1995, Flesh Canvas). Bacterial
infection isn't HIV of course but jewelry from the manufacturer should be
cleaned well before use.
This previous writer also recommended: "Jewelry should be sterilized individually
and the package opened in front of the piercee [you] so that there is no
question that the jewelry has been sterilized." The piercer should also
wear sterilized gloves or strong latex, referred to as "universal precautions."
A piercing gun is NOT recommended. A prominent New York City owner of a
piercing salon said: "There are a lot of rinky dink, underground piercing
operations out there....At those places you have to worry about cleanliness,
about diseases like hepatitis [and HIV]. Many of them use piercing guns
for other parts of the body, which can spread disease....They should be
outlawed" (Alexander, K, 1996). Another expert put it clearly: "The action
of the piercing gun [is] duller than a single-use needle, thus literally
tearing a hole through the tissue....Even if no visible contamination of
the piercing gun is evident, it is exposed to blood and blood plasma microspray
due to the strong spring mechanism" (Greenblatt, 1995).
Don't be gullible when it comes to store promises that their piercing guns
are sterilized because "simply wiping the gun with a surface disinfectant
is not adequate when the piercing gun could possibly be exposed to blood
borne pathogens" (ibid.). This warning about pathogens includes HIV. Let the buyer beware.
One expert concludes: "The needles recommended for piercing are hollow,
beveled and sharpened similarly to the hypodermic needles used by medical
professionals. Piercing needles are available in single-beveled, double-beveled
(or 'super sharp,' preferred by most piercers)" (ibid.). In other words,
don't try this at home kids. Unless you exercise extreme caution. But heck,
it's your body. It's your choice. And once you've been given the facts then
you're responsible for the consequences of your actions. Savvy?
But Dr. John does not want you to think that getting your ears pierced is
readily going to give you HIV. If you enjoy body jewelry then be a smart
consumer. Avoid places and situations where unsanitary and unsterilized
equipment is used.
Teens who enjoy tattooism should take care that universal safety precautions
(especially clean needles) are used by the tattooist.
Tattooing ^
Top
History is a good guide when discussing the possible HIV transmission from
shared needles. There is evidence that viral diseases have been transported
on dirty tattoo needles that were shared among people. Tattoo shops patronized
by sailors and bikers were notorious for unsafe conditions in the past.
Although the transmission prevalence of HIV is not as great as when comparing
tattoo procedures with drugs like heroin that are injected directly into
the blood stream (thus optimizing the blood-to-blood contact), tattoo parlors
are currently regulated in most states and even outlawed in others. Most
of these legal safeguards have been imposed in the interest of public health.
Of course, homemade tattoos cannot be regulated.
One expert who is familiar with tattooing procedures clearly warns: "Reusing
piercing needles is equivalent to sharing IV drugs with strangers" (Teshima-Miller,
L., 1995, Flesh Canvas). And since many small tattoo artists cannot afford
expensive sterilizing equipment (such as an autoclave) and boiling is not
effective, you must always insist on new needles fresh from the pack (open
it yourself).
Some people argue that because IV drug users push the needle into the vein (thereby passing minute particles of HIV into another body),
tattooing is very different because only your skin is being pierced. Only
your blood is coming in contact with your blood and we know HIV isn't transmitted
that way among people. But what about your tattoo artist? The tattooist's proper technique must
include surgical gloves for the tattoos as well. Accidents happen. Experts
also recommend that leftover ink be thrown out and never reused since the
needle which may be bloodied comes in contact with the inks.
Many teens favor tattoos as body art, usually on the arms or legs, although tattoos, like body jewelry, may be placed anywhere.
Dr. John speaks to a lot of teens about AIDS prevention and he often gets
an opportunity to inspect homemade and jailhouse tats. These tattoos are
more dangerous because of the high incidence of HIV/AIDS among prisoners
and the lack of sterile equipment. Some might argue that a pin prick is
too small to pass HIV but theoretically it is possible and teens should
be aware that any tattooing that results in bleeding with unsterilized needles
may be a problem.
A final warning to teens thinking about tattoos. Hepatitis B is much easier
to catch than HIV and there are known cases of hepatitis transmission in
tattoo parlors. Hep-B can wreak havoc with your body. In fact, you'll never
feel like having sex again. Some people planning on getting tattooed get
vaccinated first for Hepatitis A and B.
Steroid
Use ^ Top
Dr. John knows a young man who has tested positive for HIV -- which he believes
he most likely contracted from sharing needles and injecting anabolic steroids
while working at a gym in Boston. Now 21 years-old, "Jed" discovered he
was HIV-positive two years ago after the word went around the locker room
that two of the gym's owners and trainers had AIDS. Jed had been doing steroid
injections with these guys since he seriously began body building at 17.
He was assured that his body would show remarkable results from the steroids.
Unfortunately, Jed never dreamed that HIV/AIDS would be his reward.
To look at him you would never know he was carrying the AIDS virus. Jed's
body is buffed and catches attention in the gym, at the beach, and on the
street. Teen girls and young women ask him to be their personal trainer
as well. These assignments are strictly business of course, except: "a lot
of them want me too, you know, for sex stuff and that. It's real easy 'cause
I look so good....That's fine with me," Jed said.
When asked if he uses condoms, he replies that he doesn't. When asked why,
he answers "Why should I? I already got it [HIV-positive]." When further
queried about the obvious risk to his sexual partners, Jed said, "It ain't
my problem. Nobody told me I could get the AIDS so I don't see why I have
to tell them... if they are worried, they can find a guy who will put the
hat on. I'm not [going to use them]....Besides, if I used like a Trojan,
the girl might think it was because I got something, suspicious- like, so
then she wouldn't want sex. I ain't dumb. It's better to say nothing." When
told that people who knowingly pass HIV on to an unsuspecting partner are
currently being sent to jail in some jurisdictions, he shrugged and asked
how could they know it was him? When told there were genetic tests and other
ways, he smirked and said he would tell the court that the girl was a "ho,"
and always went with a lot of different guys.
Yet Jed does have a conscience and knows right from wrong -- at least some
of the time. But when it comes to sex and AIDS, people tend to act differently.
Jed feels as if life has dealt him an unfair hand and he's really pissed
off. Since the only person whom he can blame for his HIV is dying of AIDS,
then Jed is determined to keep his secret from friends and associates. He
doesn't have any health insurance so he figures there's no medicine or medical
attention available to him anyway. When he was told that he could go to
Boston's AIDS Action Committee for help, he said the guys in the gym say
that's for "fags." And since Jed is strictly "straight to the max" (his
definition) he doesn't want to be associated with anything homosexual. He
brags about his female conquests and his bravado is popular among his peers.
He likes them young and always has adolescent girls on his arms. His buddies
think of Jed as the all-American guy.
Jed called in late July, 1996 to say that he was leaving for New York City
to find better work. Currently prowling the Big Apple for gullible teen
sex partners, he is a young body builder in excellent condition (or so
it seems from first glance) working out at a gym, going to the beach to
scope out the chicks, and doing the club circuit to pick up young teenage
girls. But how many women will contract HIV from Jed? How many men will
get HIV from girls who went to bed with Jed? How many bodybuilders will
contract HIV from sharing steroid needles with him?
It all started with steroid use and shared needles among friends at the
gym. It continues through injecting steroids and having many sexual partners.
If you or your friends are considering injecting anabolic steroids, read
these following facts:
Many young athletes see injecting steroids as a boost to a more developed
body. They have heard all the stories about world-class athletes and bodybuilders
who use steroids. It is considered a short cut -- with almost instantaneous
results that will make them stronger in their sport and more sexually potent
and attractive to potential sex partners. We have heard about Olympic athletes
who were kicked out of the Games for testing positive for steroids -- but
who ever talks about the risk of testing positive for HIV as a result of
steroid injections?
Because most users assume that steroids go to work faster if injected into
the body rather than swallowed, needles are often favored and shared. It
is thought that steroids enter the blood stream (perhaps along with HIV)
and find cells to which they attach themselves; these include muscle cells,
hairs, some skin glands, and certain areas of the brain. Steroids appear
to increase protein production and thus increase the size and strength of
your muscles. It is also thought that steroids can increase blood volume
and thereby increase blood flow and oxygen supply to stimulate the growth
of muscles. Steroids also increase "glycogen," the chemical the body uses
to make "fuel" from certain foods.
How widespread is steroid use among teens? Perhaps not a lot but according
to one study conducted in 1994, 2 percent of Illinois high school students
were using anabolic steroids (Barkin, K., The National Athletic Trainers'
Association). Yet 33 percent of non-users said they knew peers who used
steroids. According to the survey, 22 percent of the teen users took steroids
to enhance their athletic performance; 16 percent to improve their appearance
(and sex appeal); and 14 percent to treat an injury. While 64 percent of
teen users were athletes, 36 percent were not. One major danger sign: 72
percent of the users said that they obtained anabolic steroids and needles
illegally from drug dealers (while 14 percent received steroids from a coach
or trainer). And the age of first use? Approximately, 7 percent were 10
and younger when they began -- 19 percent began at age 14.
Young males who take anabolic steroids typically experience sexual changes
in their bodies. But some of these changes include: shrinking of the testicles
(your balls); less sperm production and possible impotence; development
of breasts; and enlarged prostate leading to bowel problems and prostate
cancer.
For young women, steroid use can mean growth of facial and body hair, cessation
of the menstrual cycle; and breast reduction. For all teens, at a minimum,
steroids can cause acne problems to worsen -- at worst, liver damage and
death. As in Jed's case, steroid use has led to HIV/AIDS.
Teens sometimes take injections of anabolic steroids to augment oral dosages
-- often using large-gauge, reusable needles that have been used before
(in many states you need a doctor's prescription to buy clean needles so
people often re-sell needles). Whenever needles are shared, users run the
risk of contracting HIV and other diseases.
If someone tells you that the needle has been "cleaned" with bleach, how
do you know that all of the HIV has been eliminated? Of course, you don't,
so you are faced with this choice: "I might get HIV or maybe I won't." Are
you happy with that choice?
Anabolic steroids were first made illegal in this country in the Anabolic Steroids Act of
1990 (regulated by the Drug Enforcement Administration). Unlawful distribution
and possession with the intent to distribute anabolic steroids is a federal
crime and punishable up to five years in prison.
There are alternatives to steroids used by athletes but like all little-known
substances, these may be either a waste of money or health-compromising.
Among these substitutes are: Clenbuterol; Gamma Hydroxybutyric Acid; Human
Growth Hormone (HGH); and Erythropoietin. Few studies have been conducted
as to their efficacy and side effects (but HIV is not a problem as long
as taken orally). Anabolic steroids can halt growth prematurely in adolescents
even though some parents have been persuaded that its use might actually
promote growth (in some cases that can happen). Dr. John knows a family
where HGH and steroids were used to help a short teenage boy grow taller
at puberty.
Acupuncture ^
Top
Acupuncture has become a popular form of alternative medical practice --
especially since China opened its doors a generation ago. While cases of
HIV transmission have not been documented from acupuncture needles, public
health advisories nevertheless recommend (and often insist upon) universal
precautions being taken. The Australian National Council on AIDS stated:
"Information [must be] given on the proper care and use of equipment for
acupuncture... to prevent transmission of blood-borne viruses such as...
HIV and HBV... items coming into contact with blood should be washed and
rinsed thoroughly between clients and that gloves should be worn when handling
contaminated towels" (ANCA Bulletin, no. 10, 1991).
Scarification/Circumcision (female and male) ^
Top
In Dr. John's travels through the South Seas he saw examples of scarification,
the cutting of skin, as an expression of indigenous island or tribal culture.
Often a dull knife or sharpened shell would be used to make scars on either
the body or face in a traditional pattern. On one atoll, a few young men
were cut by their elders in an elaborate ceremony signifying adulthood and
the ability to withstand pain. In Western Samoa while staying with a family,
Dr. John witnessed the 4-day tattoo and scarification procedures used on
a young married man. While the process was more one of tattoo, a scarification
design was left due to the deep penetration of the tattoo utensil (a shark's
tooth at the end of a stick that broke the skin while an inky mixture was
rubbed in. In some other cultures globally (especially in parts of Africa
and the Indian sub-continent, scarification is considered a mark of beauty.
In our modern culture it has become a new fad described as a "counterculture
statement... scarification is associated with the Modern Primitive movement
and S&M [sadism and masochism], and prized for the painful process, the
trophy-like scar, and 'bloody prints' taken on paper from the flesh wound"
(Sabina's Homepage, internet).
The scarring process results from cutting the skin and rubbing in various
substances that irritate the skin as a wound, leaving a raised scar which
one teen told me "looked really great." Because of skin color (people with
dark skin often see the scars grow more pronounced because of "keloid" which
fair-skinned people might not experience because of less melatonin production)
urban black teens sometimes favor this practice over regular tattooing.
Some people favor a heated knife that cauterizes as it cuts. While some
practitioners see a spiritual component, many teens see a new fad and have
experimented on making their own scars. Is it safe? As with everything else
discussed in this section, be extremely cautious whenever you bleed -- especially
as the result of unsterilized equipment shared among friends.
A time-honored ritual among young men especially, has been the "blood brothers"
initiation where friends cut themselves (usually on the hands or arms) and
press the cuts together so their blood intermingles. Since this procedure
is usually done when high or at the spur of the moment, teens say that they
take few if any precautions such as sterilizing the knife or razor blade.
Even if clean utensils are used, any mixing of blood in this manner is very
risky -- with a HIV-positive partner, the blood-borne virus could be transmitted.
Circumcision (Male and Female) ^
Top
Circumcision (the cutting of the genitalia) is probably not a risky procedure
when it is done on the young. Obviously, as with all other HIV warnings,
the person doing the cutting should wear latex gloves and used sterilized
utensils. In a hospital, where males are often circumcised after birth,
universal precautions are taken. The baby boy must be protected from HIV-positive
medical personnel.
But in some religions and cultures, boys are more often circumcised by family
members or a rabbi in the home. On an atoll in the Pacific, Dr. John witnessed
a circumcision of a 15 year-old boy performed by his uncle, a cultural ritual.
In some Arab countries, boys are circumcised at later ages. In the Armed
Services of many countries including the U.S., recruits might be persuaded
(because of hygiene) to be circumcised in their late teens. In these cases,
universal precautions should always be taken.
But what about female circumcision (referred to in Western circles as "female
genital mutilation")? In some societies this procedure is performed on the
clitoris to destroy any sexual feeling in the young women -- making her
more acceptable for her husband (i.e., presumably she will not run around
with other men). In Africa, many areas still see this practice. In fact,
the United States has recently given refugee status to a young woman who
fled her homeland rather than undergo the painful procedure.
Because of the nature of the cut in female circumcisions, the wound is deep
producing a lot of blood. Often utensils are not clean and they are used
repeatedly during the same day of ceremonies on other young girls. The potential
for HIV transmission is real.
|
|
|
| |
|