Florida Agenda

By San Knew, MSW

Those of you who read this column regularly may tend to be surprised by what you learn. I like to think this is done with a combination of statistical science and wit (if I say so myself). But occasionally I find myself challenged to find the balance between tasteful humor and knowledge. This is one of those times. With that in mind, you may prefer to enjoy your morning coffee and bagel before reading on.

We are talking about yeast infections here, so get set. Most of us think that yeast infections (Candida) are primarily a female problem. It may surprise you, however, to learn that men can also contract or develop yeast infections. Penile, anal and yes, oral, are all types of yeast infections in men. Most commonly, penile yeast infections among men are transmitted sexually,normally after sex with a carrier female, which makes it surprising that yeast infections are not considered a sexually transmitted disease (STD).

Men who engage in vaginal sex with an infected female partner can pass the infection to anyone (male or female). This is one means of the spread of the infection (anally and orally). The rate of infection is higher among uncircumcised men since the foreskin can trap in moisture. General symptoms of penile infection are identified as itching (similar to jock itch), burning during sex and urination, soreness, and redness

of the tip of the penis. Some men may also experience a white, clumpydischarge (not to be mistaken for semen).

Anal infection symptoms are usually isolated to itchiness and redness. Men who also engage in unprotected anal sex (even with an uninfected partner) may develop an infection. This can occur when bacteria in feces comes into contact with the penis, (another reason to avoid that “not so fresh” feeling).

Oral infection (thrush) is usually recognized by white patches covering the inside of the mouth. Patches may be on the insides of the cheeks, tongue, roof of the mouth, and lips and gums as it spreads. Partners performing oral sex on uncircumcised men are at greater risk, again due an increased likelihood of trapped bacteria.

Additional means of infection among men include the prolonged use of antibiotics and men with compromised immune systems. Antibiotics do not discriminate between bad and good bacteria, thus creating an ideal environment for the infection to cultivate. In addition, diabetic individuals are also likely to develop yeast infections due to high levels of sugar in the body – specifically in urine.

Fortunately, prevention and treatment for all these types of yeast infections are fairly simple. Your own personal hygiene is always a good place to start. Also, try being mindful to wash any areas of the body that can trap moisture (foreskin) and remember to completely dry these areas. Severe cases in partners can be identified easily, especially if you are taking the time to playfully “inspect.” Usually treatment includes a week-long regimen of topical cream and abstinence, the latter perhaps being the most difficult of the two.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com or
www.facebook.com/samknew

By San Knew

Life at times can seem to be a numbers game. We budget our time, money and even our health by the numbers. In a way, numbers can act as a system of checks and balances for us – which may explain why they become such an intricate part of lives. I’ve noticed just how much this column comes to rely on numbers. Here is a compellation of a few given over the last year. If any of them spark further, or renew, your interest – feel free to visit the online archives of “Who Knew?” on www.FloridaAgenda.com.

The Female Condom – Changing the rules of the game

“In a report that summarized a study done on 100 men who have sex with men using the female condom, negative experiences included difficulty inserting (33%), irritation (17%), bunching up (12%), unpleasant texture (10%), and noise (9%). Breakage was reported 3 times in 334 episodes of use.”

“Oral” Hygiene
“The Center for Disease Control and Prevention (CDC) reported a case study in Chicago linking 13.7% of syphilis cases being contracted orally.”
“But be aware that most mouthwashes have an alcohol level of 6.6% to 26.9% that could be almost four times as much as a bottle of beer or a glass of wine.”

Male on Male Sexual Assault
“An estimated 12% of case victims are in the age range of 25 and older.”

A Bed’s Tale – What’s on the sheets may be as important as what happens between them.

“What you’re missing might put you in danger of becoming one of the three hundred million plus people in the world that contract ‘Sarcoptes Scabiei Var. Hominis’ or what’s more commonly referred to as ‘scabies.’”

Sex – It’s Not All Bad
“The publication attributes somewhere between 120 to 235 calories for kissing, approximately 8 calories for undressing and an actual orgasm can burn as many as 100 calories.”
“So there you have it, no mention of the 19 million new sexually transmitted infections (STI) reported each year, nor the $14.7 billion spent on STI related healthcare costs.”

Toxic Relationships: Bug Chasers and Gift Givers
“Though the compilation of these two groups is a very small subset of the population, they have developed a culture of their own, including ‘conversation parties.’ This is one means in which HIV+ men and those looking to be infected can meet.”

“Save the Tatas “– Male Breast Cancer
“The mild growth does put men at a 1 in 1000 chance of developing one of the five types of breast cancers.”

“Gay and bisexual men are 17% more likely to develop anal cancer.”

Three letters that can change your life – and they’re not what you think. HPV (human papillomavirus)
“For gay and bisexual men, it can be a secret killer.

There are 6.2 millions cases in the US each year and over one hundred strains of the virus, forty of which are transmitted sexually.”

The Doctor Is In, But Are You Out?
“New York’s Center for Disease Control (CDC) released a study showing that 4 in 10 gay men were not out to their doctor.”

Those Crazy Gays…
“For example, one study showed 83 % of transgender people had considered suicide, and 54 % had actually attempted it.”

Talking Dirty: How to Negotiate Safe Sex
“Needless to say, our inhibitions and judgment are impaired with either drugs or alcohol. Studies report that 60% of STDs are transmitted when the partners are under the influence.”

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com or www.facebook.com/samknew

By SAM KNEW, MSW

Of all the things we do to stay healthy, one of the most overlooked preventatives in keeping the doctor away is right under our nose. How often you smile could have a direct impact on your biological and mental well-being. It may be surprising to you that when you smile, even a fake smile, you release endorphins. Endorphins are the transmitters in the brain that reduce pain, and feelings of anger and sadness. This chain reaction in mood has a serious biological benefit: increasing ones immune system, specifically in individuals with compromised immune systems.

Among our best natural defenses are little known lymphocyte (white blood) cells referred to as Natural Killer (NK) cells. These cells, in short, are the meanest, toughest little guys (or ladies) that can effectively destroy most viruses, including HIV and some types of cancers. Various studies even show that individuals with compromised immune systems and large amounts of NK cells systems have been able to postpone the use of medication treatment. And FYI: your mood makes all the difference in the number of NK cells you have. A Harvard study showed individuals with “good coping skills” and a positive outlook tended to produce three times as many active NK cells than those who were identified in a high-stress group.

One aspect that experts are quick to point out is that an individual who frequently functions in high stress keeps their immune system working over time. In effect, your body is busy coping with an increased heart rate, slowed adrenaline, digestion issues and loss of blood flow to major muscle groups. This fright or flight response (the body’s perception of threat or danger) can even have  long term effects, such as hair loss, obesity, diabetes, depression, tooth and gum disease, ulcers and (as it usually comes down to in this column) sexual dysfunction.

Sex and stress are definitely linked. Not only does stress contribute to a low sex drive physiologically, under stress the body releases cortisol, a hormone which inhibits other hormones such as testosterone – the principal male sex hormone. It is also responsible for healthy body development, such as retention of protein and tissue mass, which are especially vital to individuals with compromised immune systems. The good news is that it seems to work the other way around as well. Sex can  be a great stress reliever. Researchers found a correlation between sex and stimulated cell growth in the hippocampus of the brain. That’s the part of the brain primarily associated with long-term memory. In addition, a healthy sex drive can result in decreased blood pressure, and an increase of antibodies and endorphins, which can increase those NK cells. Not to mention, if done right – it should put that smile back on your face.

Sam Knew, MSW is an educator

By Sam Knew, MSW

If you’ve glanced at your television set recently, you’ve probably noticed the networks’ obsession with other people’s obsessions. From over-eaters to hoarding to counting steps – we have witnessed people obsessed with it all – including sex. Don’t worry, this isn’t going to be one of those Tiger Woods pieces. This is a different type of sexual obsession – the fear of contracting STDs (sexually transmitted diseases).  It’s probably fair to say that most of us spend the better part of lives avoiding diseases in general, but these individuals live in a perpetual state of fear, isolation and usually in silence of their obsessive-compulsive disorders (OCD).

In some cases, these individuals have worried themselves sick about getting sick. This obsession of contracting an STD, such as HIV, can be classified under the “chicken or egg” syndrome. In a society of bill boards, TV campaigns and marches across most any major street pleading us to get tested and be protected – it’s no wonder so many suffer from this form of OCD, scaring ourselves sexless.

On the surface this may seem like a good thing. People holding out on sexual encounters, afraid of contracting an STD. But some mental health professionals point out this paralyzing and compulsive behavior can lead to more serious problems. Individuals suffering from the “fear of contamination” have an irrational fear of being contaminated by germs, dirt, pathogens, or anything unsanitary. This fear often causes the people to take on compulsive behaviors. Behaviors such as hand washing, taking multiple showers a day, washing and rewashing clothing and other repetitive ritual actions.
The emotional and physical toll of this type of paranoia can set off a chain reaction of issues. These can include stress related illnesses, such as loss of appetite, ulcers, depression and sleep depravation. In addition, this fear makes it extremely challenging to pursue mature, healthy relationships – even with one’s own family and friends, much less romantically. The obsession can even take on a life of it’s own, for example some individuals compelled to be tested compulsively for STDs, even daily, disbelieving negative results.

Oddly enough, individuals who are HIV+ (or have another type of weakened immune system disorder) may develop a similar form of OCD. These individuals may develop social phobias (a fear of being criticized by others). Their fears may also lead to anxiety disorders, with symptoms including: discomfort or pain in the chest, dizziness, nausea, cold or hot flashes, difficulty breathing and physical tremors. These phobias can lead to individuals becoming so paralyzed and ashamed of their condition they may avoid seeking treatment, and develop dangerous coping skills. For example, a study identified HIV+ gay and bi-sexual men, who also suffer from forms of OCD, at an increased risk of developing a substance use disorder (SUD), specifically with methamphetamine (meth).  Meth is also known to develop impotence in users.

Treatment of these disorders can come in many forms, depending on the multiple sub-disorders one develops. In some cases, several forms of behavioral therapy, including exposure therapy – where clients are asked to confront their fears are used. In extreme cases, psychosurgery may be considered. Less invasive treatments include the use of medication (usually in conjunction with therapy). Sufferers could also benefit from support groups and relaxation techniques such as yoga and meditation – and maybe a little less TV.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com or
www.facebook.com/samknew

Sam Knew

There’s a pretty good argument why baseball is one of American’s many favorite pastimes. It could be because of its humble beginnings in our backyards, the excitement of the seventh inning stretch, or even the body hugging uniforms. But honestly, what’s not to love? Balls, men and team showers. With paralleling references like that, it’s no wonder that sex is usually described in baseball terms.

I’m pretty sure I know where “first base” begins and what’s considered a “home run,” but what falls in between varies on each of our own moral compasses, including oral sex. And just like the game, a good game plan can make all the difference–especially to your health.

The risk of contracting sexually transmitted diseases (STD) orally varies depending on the disease itself. The most common oral STDs include herpes, gonorrhea, syphilis, chlamydia, and HPV. The rate of contracting HIV orally is debated among experts; however, most conclude that the risks are low. Health conditions of both “players” are key factors. Open sores, compromised immune systems and viral load are all contributing factors.

Interesting enough, we have some naturally built-in defense systems to help protect us from transmitting and contracting diseases orally. Large sugar-protein  molecules in saliva (glycoprotein) help prevent diseases from being transmitted. Our mouth also has a protective (yet fragile) membrane that safeguards us. In addition, gastric acids in our stomach kill most bacteria and viruses. Again however, a person’s health condition is a contributing factor, including such diseases as oral, throat and stomach ulcers. Now, when was the last time you checked for that?

That being said, there are risk-reducing precautions one can keep in mind. Of course there’s good ‘ole abstinence (at least long enough to get to know your partner), followed by testing. “Suiting up” for the “big game” is another option; this includes using a barrier method, such as a condom. Some complain of a lack of sensation, and others of the taste. However, condoms come in an assortment of textures and flavors for just those reasons. For our extreme, more trusting (or daring) players, who choose to go at it commando (unprotected), you can reduce your risk by limiting your exposure to bodily fluids (such as semen).

The longer you’re exposed, the greater your risk. One option is to move the “finish line.” Preferably somewhere where fluids are less likely to enter your bloodstream. However, you still run the risk of exposure with “pre-game” anticipation. Lastly, in the conventional wisdom and words of Stanford University, “swallow or spit, just don’t let it sit.” No matter how you play it, it’s cle ar you need

a solid game plan ahead of time. This can make the difference between a perfect season and overtime at your doctor’s office.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By Sam Knew

So if revenge is a dish best served cold, at what temperature do you forgive? As a rule of thumb, allowing yourself some cooling off time is always best, but what happens when the heat of your emotions never seems to cool? Forgiveness is definitely one of those things that is easier said than done. For multiple reasons, holding on to the pain that others in our lives have caused us is easier than taking the emotional and challenging steps towards releasing it. This appears to be even more true for men. Studies find that men generally have a more difficult time forgiving. The consequences include higher risk of heart disease, increased blood pressure, and depression. The increased risk of holding these grudges seem like common sense to most, so why is it so many people struggle with it?

One reason is how we each define “forgiveness.” For starters, forgiveness is not about the people in our lives who have hurt us. Forgiveness is a gift we give ourselves, and by accepting that truth, we may find ourselves more willing to take on the challenge. As with most challenges, when the choice to overcome them comes from within (versus an outside source, such as a family member, friend or a counselor), the effort put out is usually greater. Additionally, this self-determining action can make the process more beneficial than the actual outcome, which once again emphasizes the true beneficiary of forgiveness. But making up our minds to let go of the past is just the start of this journey. The next step is to implement our decision.

In some cases, individuals are fortunate enough to have the opportunity to confront their past in-person. In these cases, it’s important to remember to address your own feelings and thoughts about the situation. Using “I” statements is a great way of doing this, such as, “I really felt betrayed when you…” For many, this may prove the most difficult task. Individuals may feel foolish and u n c o m f o r t a b l e exposing their emotions. But the pay off (regardless of the outcome) is worth it. In cases that have created serious selfdoubt within oneself, individuals can see themselves as a victim. This form of self-expression allows a person to take control of a situation and allows victims to transform themselves into survivors. Survivors see the world differently from victims.

They have a sense of control and empowerment that victims do not.

In other cases, confronting individuals from your past may not always be an option. These individuals may have to find forgiveness on a more emotional and/or spiritual level. One technique is to change your inner dialog, that is, the things you tell yourself. For instance, remind yourself that forgiveness is not about forgetting or condoning past actions. More importantly, remind yourself what forgiveness is: it’s simply accepting that the past cannot be changed. This is true even when you, yourself, are the person that you have to forgive. Not allowing yourself to be trapped by the “would ‘ya, should ‘ya, could ‘ya” mindset is key. Maya Angelou, one of today’s great poets, best-selling author and activist, may have said it best, “I did then what I knew how to do. Now that I know better, I do better.”

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By SAM KNEW, MSW

Long before tangled bed sheets, before the first kiss, before cocktails or a promising “hello,” there’s a cosmic element that draws two people together – one that may not require any words at all. But who knew it may be what you aren’t saying that’s costing you your health – and maybe your life? In the heat of passion, it isn’t always easy to ask your partner about their sexual history or health status. And the end result can be one of the 12 million new sexually transmitted infections (STI) reported each year.

Oddly enough, in an era where condoms are passed out in schools and shopping centers and sex is used to sell everything from bottled water to dental plans, it’s a wonder that so many of us have trouble talking about sex. But for those who enjoy a little verbal foreplay, choosing your words carefully can make the issues of protection a non-issue. By incorporating the mention of condoms and other types of barriers into your “flirt dialog,” you can set a precedent that tells your partner what’s expected.

If words escape you in the heat of the moment, there are a few options that may make it a little easier to negotiate the terms of engagement. Consider getting creative – using your mouth to slip on a condom can be a sexual turn on and leaves little to be discussed. However, the passion doesn’t always make its way to bedroom, so you may want to consider placing condoms in other areas around the home – or even car for that matter. The female condom, which is gaining more popularity and approval among gay men, is another safe alternative. One advantage is that the sexual recipient (the bottom) can place the device in place hours before hand and not have to interrupt foreplay placing in the device or bother negotiating safe sex practices with their partner.

Of course, like any advice, it’s always easier said than done, and sometimes we can make the conversation even more difficult throwing alcohol and drugs into the mix. Needless to say, our inhibitions and judgment are impaired with either. Studies report that 60% of STDs are transmitted when the partners are under the influence. Not to mention the numerous sexual assaults of women and men which occur while intoxicated.

But for all of the alternatives offered, there’s no substitute for the real thing. Having a direct conversation with your partner can eliminate a lot of dancing around the issue – and can actually make your sexual experience a more pleasant, worry-free one. Starting the conversation doesn’t have to be embarrassing or uncomf

ortable. You could start by offering your own status or preference, like “I’m STD free,” or “I only use condoms”. What you do want to avoid, though, are vague and uncommitted statements like, “I prefer condoms” or “could we use a condom?” This might give your partner the misconception that safe sex is an option – when it clearly isn’t.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By San Knew

Recently, a reader commented that as often as he reads about sexually transmitted diseases and infections, it’s amazing anyone would want to have sex at all. So I thought I would take a moment to share all the wonderful benefits to having a healthy and safe sex life. Aside from the opportunity of sharing an amazing experience with someone, there are other parts of your body that can reap the benefits, as well.

Did you know that an average of 30 minutes of sex could burn up to 85 calories

? But not to worry, for all of you who are taking it slow – you don’t have to go all the way to get all of the benefits. Daily Muscle published its own unofficial finding and broke down the numbers to “the build up”. The publication attributes somewhere between 120 to 235 calories for kissing, approximately 8 calories for undressing and an actual orgasm can burn as many as 100 calories. And not only can these benefits be seen in one’s waistline, but there’s some good things happening inside your body, as well.

CBS News reported that researchers found, “having sex twice or more a week reduced the risk of fatal heart attack by half for men, compared with those who had sex less than once a month”. There are also reports correlating fewer cancer diagnoses among men with high frequency of ejaculation. The Journal of the American Medical Association found that “Frequent ejaculations (21 or more a month) were linked to lower prostate cancer risks in older men, as well, compared with less frequent ejaculations of four to seven monthly.” Wilkes University has also conducted its own study, in which it identified that people who had sex once or twice a week had higher levels of antibodies, which can protect you from getting colds and other infections.

However, as most of us already know, the best benefit of great sex is how it makes us feel. One reason for those good vibrations may be explained by studies showing increased levels of oxytocin during sex. Oxytocin is a chemical produced in the brain, usually associated with “pair bonding” (it’s also referred to as the “love hormone”). These increased levels are associated with a reduced sense of pain and feelings of anxiety and an increased sense of generosity and intimacy. Additionally, CNN shared a study published in Biological Psychology, that found “people who had sex more often tended to have lower diastolic blood pressure.” The study also linked the finding to feelings of decreased stress levels in general for those individuals.

So there you have it, no mention of the 19 million new sexually transmitted infections (STI) reported each year, nor mention of the $14.7 billion spent on STI related healthcare costs; just the benefits of a HEALTHY and SAFE sexual experience, which we should all take advantage of. Did I mention HEALTHY and SAFE?

Condom … check.

Playful body inspections … check.

Names … check.

So, what are you missing that might put you in danger of becoming one of the three hundred million plus people in the world who contract “Sarcoptes Scabiei Var. Hominis,” or what’s more commonly referred to as “scabies”. This infestation of the skin by human itch mites has the possibility of burrowing into the layers of the skin, causing an irritable rash while laying its eggs. And this is one sexually transmitted disease (STD) you can contract even with your clothes on.

Transmission of scabies is primarily through skin-to-skin contact, which is why it is considered an STD. Scabies mites can also be spread through casual contact, such as “dancing, close personal contact, and normal intimate contact between members of a family,” according to Varment Guard, a pest control service. However, scabies can also be contracted via clothes, towels or bed sheets. In addition, individuals with compromised immune systems are at risk of contracting a severe form of scabies called “crusted” or “Norwegian Scabies,” which is more easily transmitted.

The most common symptom of scabies is itchiness, usually in areas of the body such as the elbow, between the fingers, armpit, breast, nipples, penis and buttocks. The female mites are responsible for burrowing eggs below the skin, creating grayish-white or skin-colored lines on the surface of the skin. The intense skin itching can lead to further infections, allowing bacteria into the skin, possibly causing inflammation of the kidneys and, for a few dozen individuals each year, death.

Unfortunately, individuals can go weeks – even months – before symptoms

develop. However, it is still possible to contract scabies from an infected person who doesn’t display symptoms. A person with crusted (Norwegian) scabies can spread the disease “by brief skin-to-skin contact or by exposure to bedding, clothing, or even furniture that he/she has used,” according to the Center for Disease Control, which is why those infected should seek immediate treatment. Itching may still continue up to three weeks after a topical lotion treatment is applied, which should be simultaneously followed by a laundry list, including bedding, towels and clothes.

So, what should be left on your checklist to avoid this type of STD? Here’s a hint … two words. That’s right, “personal hygiene”. Maintaining personal hygiene is vital and a great indicator of your partner’s health status. Although contraction of scabies is not a reflection of one’s personal hygiene, individuals with good personal hygiene and sanitary living condition are less likely to contract the disease. In addition, infected individuals with good hygiene have less mite infestation, decreasing the rate of transmission to others.

By sam knew, msw

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com

By Sam Knew, msw

We’ve all seen the movie where, after a night of wild lovemaking, they each light up a cigarette and reflect on their hours of sexual bliss (bliss optional). But believe it or not, with each drag you may be committing sexual suicide. Along with smoking there are a number of things men do to decrease or kill their own sex drive. Smoking, by far, may be one of the most common. One issue is all those toxins that build up in your system, which contributes to a lethargic feeling (that feeling of indifference and a loss in interest). This can occur after having just one cigarette.

Smoking can also damage the blood vessels in the penis, which restricts blood flow, in turn lowering the pressure of blood in the penis – making an erection more and more difficult.

But giving up the habit may come at another cost to your libido. Food often becomes a replacement for many who are quitting smoking; usually it is related to an oral fixation (yes, it’s okay to giggle). But the danger of packing on those pounds is another mood killer, especially along the waistline. Fat around the abdomen absorbs testosterone more efficiently than any other fat cells in the body. Testosterone is a steroid hormone and the principle male sex hormone. As it diminishes, so does your sex drive. But the problem doesn’t always originate at or below the waist.

Drugs such crystal meth at first can be a sexual magnifier, releasing 12 times the amount of dopamine (the pleasure chemical) to the brain. Eventually, however, the drug destroys the brain’s pleasure receptors, making it increasingly impossible to experience any type of pleasure. Other less suspecting drugs can have mood alternating effects as well, such as some prostate and HIV medications, antidepressants, blood pressure pills, antipsychotics and even some cholesterol lowering medicines. And, of course, what you’re washing these possible mood killers down with can accelerate the effects on your body. Combining these substances with alcohol can lead to additional – long term, and possible irreversible – damage. Alcohol alone, however, can also lead to sexual impotency. Though a glass or two may make you less inhibited, it also damages the nerves (including those in the penis), which leads to the inability to physically be aroused. Long-term alcohol abuse can make this a permanent effect.

Avoiding most the aforementioned substances may prove to be a challenge for some, especially if they have acted as your social lubricant. Learning to deal with your emotional/social barriers could have a bigger pay off in the end. This includes how we cope with the everyday stressors in our lives. Sex and stress are definitely linked. Not only does stress contribute to a low sex drive physiologically, under stress the body releases cortisol (a hormone) which inhibits other hormones – such as testosterone. The good news is that it seems to work the other way around, as well. Sex can be a great stress reliever – but of course your first move may have to be on yourself.

Sam Knew, MSW is an educator and a local counselor. He can be reached at samknewmsw@gmail.com