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If you know someone who has Hepatitis C what could one do to prevent getting infected?

You can't get Hepatitis C by casual content.  In other words, you can't get it by hugging, kissing, shaking hands or sitting next to to infected people. However, you shouldn't have unprotected (unsafe) sex with them.  - - - Although if you are in a long-term monogamous relationship with someone who is infected, the chance of your getting it without protection is still very low (about one third persent per year).  Also, you should not share personal items with them that could draw blood like razors/razor blades and tooth brushes.  There is no risk from sharing drinking glasses.

How can Hepatitis C be prevented among injection drug users (IDUs)?

Injection drug use is a risk factor in 60% of the new HCV infections in the U.S. IDUs are encouraged to:

*  Always use a new syringe for each injection.

*  If a new syringe is not available, bleach syinges carefully. In practice, bleach may not effectively kill HCV.  Research shows that IDUs did not leave bleach in their syringes long enough to kill HIV. The same may be true for HCV.  Only use bleach if you must inject drugs before you get a new syringe.

*  Don't share or reuse cookers, water, surfaces you prepare your shot on , cotton, or even tourniquests, (belts, ties). - Since bleach may not effectively kill HCV, try not to share any equipment.

What is the correct method for bleaching syringes?

Step 1:  Rinse.  Fill the syringe with clean water by pulling back on the plunger.  Shake the syringe and squirt the water out. Repeat twice with new water.

Step 2:  Bleach.  Fill the syringe with full strength bleach  and shake.  Leave for thirty seconds, use a watch with a second-hand to be sure.  Squirt the bleach out through the syringe.  Repeat the bleaching two more times, each for thirty seconds.

Step 3:   Rinse.  Rinse the syringe three more times with clean water.  Keep rinse water apart from water used to prepare drugs.  Clean your cooker/spoon with bleach as well if you are if you re-using somebody else's  cooker.    - - - NEVER pound somebody else's cotton/rinse somebody else's cotton or dip into somone else's water supply. There is no way to clean cotton or water.  

How can Hepatitis C be prevented among non-injectors? 

Limit unprotected sex. Make every effort to use a latex condom every time.  Although HCV is not easily transmitted sexually, it is believed 10-20%  of new infections have occured because of sexual intercourse with an infected partner.

What other precautions can IDUs take?

IDUs should be tested for HCV because there is a good chance that they are already HCV- infected .  If they test positive, they should seek medical care, take steps to keep healthy, and prevent transmitting HCV to others.

It is recommended that IDUs be vaccinated against Hepatitis A and Hepatitis B.  The Hepatitis A and Hepatitis B viruses can  damage the liver .  Getting vaccinated against HAV and HBV will protect your liver from these dieases.

How can HCV -infected people stay healthy?  

See a healthcare provider.  Do not take any medications, including over- the- counter and herbal medications  before consulting with your heathcare provider.It is best to see a physician knoweledgeable in the treatment of liver diseases or have your healthcare provider consult with one who is knowledgeable.

Be aware that  alcohol can be toxic to your liver.
Patients with Hepatitis C are more sensitive to
the toxic effects of alcohol. -
Drinking as few
as 1-2 drinks per day,  can damage the liver,
allowing Hepatitis C to progress faster.

 Oh!  No! Not my alcohol!

Get vaccinated.  Check with a healthcare provider about getting vaccinated against the Hepatitis A and Hepatitis B viruses to protect from other liver damage.

Consider entering a drug treatment program (if addicted to alcohol or other drugs).  Reducing the amount and toxicity of the substances that enter the body will help keep the liver as strong as possible.

Attend a risk reduction program to get help reducing alcohol and drug intake.  Not only do risk reduction programs offer free syringes, but they also can recommend  ways to reduce drug toxicity or to better manage drug abuse. - -  Many programs offer stress-reducing therapies such as acupuncture and Reiki that may reduce drug cravings.

Eat healthy foods, get exercise, get rest and relax. - - Taking care of the body will help to strenghten the liver and prevent Hepatitis C from progressing.

Get support.  Most people with Hepatitis C have no symptoms, -  but others feel very fatigued or depressed.  Having Hepatitis C can be scary and overwhelming .  Mentoring and support groups may help a person make life-altering decisions.  

 Get your support with us.  We are here for you. If you
 find yourselves depressed, scared or you feel simply
 overwhelmed - we are here twenty-four hours, - every
 day of the year to answer your questions, to give you
 support and calm your fears. You will find the contact
 information located at the end of the page.         

How can HCV-infected people protect others from the disease?

The same measures that can be taken to prevent being infected with HCV can also be taken to protect others.

*  Do not share syringes, surfaces, cookers, water, ties, etc.
*  Do not let anybody else inject you or inject anybody else.  If you do, use latex gloves
   as a barrier. 
*  Do not donate blood, body organs, other tissue, or sperm.
*  Be sure to cover cuts and sores on the skin.
*  Use latex condoms and tell -partners you are HCV-positive.
*  Do not share razors, toothbrushes, or other personal items that may have blood on 
    them.
*  Do  not share straws used to sniff cocaine.

Hepatitis C is a blood-borne virus.  The blood of an infected person must get into your bloodstream.  Hepatitis C is not spread through casual contact like shaking hands with, hugging, drinking after, or eating off the same plate with an infected person. 


If you inject drugs:

I.  Use safer injection techniques  

     *Use sterile syringes.
     *Use your own new cotton, cooker/spoon clean water and ties.
     *Have a clean surface on your preparation area - open a newspaper and put your 
      supplies on it.

2.   Try to use less risky methods to take your drugs, like taking prescription 
      drugs instead of powder, or snorting and smoking instead of injecting.
     

If You snort drugs: 

1.  Use your own straws when snorting.  Use those little sticky Post-It-style notes
     to make your own straws. All snorters can have their own sticky note-straw,
     and they are easy to carry around, roll up, and throw away.

2.  Be careful of where you place your straws when snorting with a group or 
     snorting around injectors.  Any blood on the injection equipment, or place
     where the straws were laid could contaminate the straws with the Hepatitis        virus.

  If You smoke drugs:

1. Use your own rubber tip on a glass crack pipe to keep your lips from getting     cut.  It can protect your lips from getting burned out on a hot pipe, too. These
    sores can dry out, crack open and bleed - possibly exposing you to or spread-    ing Hepatitis C.  Cut and burnt lips also offer a direct pathway into your blood-
    stream during oral sex.

2.  Keep the mouthpiece of your smoking equipment clean and try not to share.
     If you must share your pipe, wiping the glass mouthpiece with bleach or the       rubber mouthpiece with alcohol may prevent the spread of infections.

3.  Consider quitting drugs.

Reference:  HEP C HANDBOOK  1ST EDITION 
                    Hepatitis C Working Group of Georgia


NOTE:   It ought to be stated here that sharing your snorting utensils is a known transmission route for Hep C, Hep B and HIV.   - - Always use your own snorting equipment and play it safe.

Always cut, chop or screen the coke to a fine powder - use small doses at a time and aim it high up inside the nasal cavity.  - - - Clean you nose without fail after every coke session (not after every toot).   However it is not wise to douch or oil your nose more than every few days and if your using coke more than that - well, your using too much.


Warm salted water is the best douche to use.

1.  Dissolve ¼ teaspoon salt in a cup of warm water.  - - - - Pinch your thumb and forefinger together and pour a little of this solution over them. -  Sniff it in gently so a warm salt spray is spread over the membranes inside your nose.

2.  Commercial nose sprays are pretty rough on nasal passages that are already irritated by cocaine and so should not be used frequently.  - - - This weak saline solution is really all you need.

3. Once your nasal cavity is irrigated, the 2nd step is to lubricate it with vitamin E oil. Use natural vitamin E oil that contains only alpha-tocopherol in an organic medium like safflower oil. Or you can open up a vitamin E capsule with a razor blade. 'Healthaid' has a vitamin E oil (hypoallergenic) that is just right and costs about £6 at your local chemist. - - You can also get Healthaid's Vit E capsules, 60 caps for around £6.  - - If your fingers are large use a Q Tip, or use the tip of your little finger making sure it's clean and not jagged. - - Dab some E oil on the swab or fingertip and very carefully and slowly, stick it up your nose. Gently wiggle it so the oil coats the membranes on all sides. - Repeat the procedure in the same nostril, making sure that you lubricate the entire inner rim of the nostril and the little pocket near the tip of your nose.

4.  Do the same to the other nostril then look in the mirror and smile - - - - you've just started a procedure - - - -  that will help keep your nose and sinuses in better condition.   - - - - Don't worry if your nose starts feeling stuffy again, it's just your mucous membranes beginning to revive.  -The tingling will stop in a little while.

A perforated septum is more often than not caused by clumsy attempts to clean the nose than by cocaine.  --The nose needs time to recover after snorting drugs and like cocaine itself, douching and oiling more than every few days may harm your nose - or worse, your sinuses. If crusting in your nose continues or you start getting nosebleeds - lay off the coke and see your doctor without delay. - - If you notice any malfunction in your system whatsoever - it could be a warning signal of an oncoming illness and should be checked out by a trusted physician.

Reference: Lee,.D. 1981 (first published) Cocaine Handbook:  An Essential reference. USA: What If?


    Answered By:  Mark Katz M.D. Regional HIV/AIDs Coordinator
                             Kaiser Permanente Of Southern California

Sir,
I would like to know:
1) the chance of acquiring HIV while bathing in a bath tub with HIV infected person.
2) the chance of acquiring HIV in public beaches when skin abrasion/open wound is there
3) sanitary pad of an infected lady in swimming pool. 

All of the situations you describe are considered to be nil risk for acquiring HIV. - -  It is simply not a casually transmitted virus. You essentially need to have needle-sharing or sexual fluid contact with someone with the virus in order to get it. - - The situations you describe essentially all involve the possibility of HIV-positive blood causing infection, but this simply has not been known to happen through water- - - whether it be bathwater or seawater or the ocean.

I only had one sexual partner and he got tested for HIV, it came back negative. My quesiton is, since he was the only person I have been with, do I still need to get tested if his test was negative?  If so, why?

You bring up an interesting question. Given that your partner had been tested at some point for HIV, one might assume he has participated in some behavior risky enough so as to warrant concern. If his test was negative 3-6 months after all such behavior, and you indeed believe what he says, and there was no further unprotected sex or needle sharing subsequent to that, yes, indeed you would not need a test.

Just to play devil's advocate for a moment, let's say his test had been negative one week before you got together. - - - But three days later he participated in high-risk activity and contracted HIV.  -You would have been at risk yourself of acquiring this from him, even with his "negative test."

I'm not saying you need a test after one sexual contact- - - - - and you do not state the specifics of the activity so we do not know if it were high-risk or not. But the real take-home lesson here is that no one can really figure out for you if you have been infected for the virus or not. If you are concerned, and/or if you participated in unprotected sex or needle-sharing, then the official word is that you should be screened to be sure you did not acquire HIV.

Dear doctor,
Maybe this is a very unusual and bizzare question, maybe not, but I did not find answer to it anywhere on the net, so I am comming to you:

It is said that the HIV virus survives in the body fluids, outside the body,  for just several hours (how many I do not know). It is, I suppose, because the fluids dry up and the virus is sensitive to oxygen and it dies. But what if these fluids do not dry up (for example in water or wet environment, or in an ointment)?

I was thinking especially of the ointment, as it stays "wet" quite long. -  Is there any danger from using an ointment, - - in which some amount (maybe little) of these body fluids would be present and would keep its infectiousness?  - - - -As hypothetical as this question is, I would nonetheless be glad if you could answer it.

I have also read that HIV virus can be suspended and reactivated in alcohol.  I have never heard about this before and it seems to me like important informa-tion. So alcohol should not be used to disinfect?

Thank you very much for your time. --J

You certainly bring up questions which are unusual!

I do not know why one would even "suspect" that the virus survives in ointment, - given how ointments are manufactured so as to usually be anti-microbial in nature. How would one ever prove this? Or even more to the point, prove that this could cause HIV infection to be spread? In many health care and institutional settings nowadays, - - antibacterial ointment is dispensed in individual packets, rather than from larger tubes.  - - - -Please consider doing this if it will abate your anxiety.

As for the second issue, there have been voices for years which have denounced alcohol as a disinfectant. - - This runs counter to the way in which HIV has been understood by most scientists and clinicians for years. I think that rather than tell you definitively which is right and which is wrong, I would urge you, if this is an issue for you, to read further, consider the sources, and draw your own conclusions. For me, alcohol as a disinfectant against HIV works just fine!

Hi, I have been having unprotected oral sex with my girlfriend who has recently been diagnosed with HIV. What kind of risk am I at?

Oral sex is generally not as high-risk as intercourse, as the enclosed table will illustrate. The risk is very small.  - - -  - It would be a good idea for you to test now, and again at 3 months, and of course to proceed with some rational decision-making between you and your girlfriend on the parameters of your sexual interaction. Many couples do decide to have oral sex, and "take the risk," as small as it is; others decide not to.

As for intercourse, it would be a good idea to use a condom, always.

My ex- husband has HIV and, I found out this evening, - - - -  that our 16 year old daughter borrowed her father's razor to shave her legs. I immediately went into a panic. I asked her if she had nicked herself at all and she said she hadn't. She has recently found out that her Father is gay, but does not know that he is HIV. Should I get her tested immediately?!?

The likelihood of HIV transmission to your daughter is EXTREMELY low, so low that I would not recommend that she be tested for HIV.  -But I would make sure that razors aren't shared in your household, as other viruses, including hepatitis B and hepatitis C are also potentially transmissible through sharing razors and yes, - even toothbrushes (assuming blood is transported from one person into other person's bloodstream). The good news, HIV-wise, is that HIV is NOT easy to transmit within a household setting. For example, holding hands, sharing a glass or a towel, are NOT dangerous. The main precaution is to avoid person-to-person exposure of blood, semen/vaginal fluids, and stool. Twenty years into the HIV epidemic it remains reassuring that only one case of household transmission has been documented: that involved a woman who aquired HIV from cleaning up diarrhea on a chronic basis without using gloves. So if you and your daughter take basic precautions, you should be fine.

 

Contact Us:  ChangeYourLife@MedicalAssistedTreatment.com

If you need us, send a message to the above address, leaving your name, a number we can reach you at and the best time to call you.  We will call at our expense. If you want to call us, you can reach us at 770-527-9119.                   We are available twenty four hours every day, even on Holidays.

Compiled and Edited :  Deborah Shrira, RPH,CMA           18 February 2006  

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