New film warns: Hepatitis-B common among Asian Americans

New film warns: Hepatitis-B common among Asian Americans

Be About It by Christopher Wong screened on May 11 at University of Hawaii John A. Burns School of Medicine, followed by a panel discussion.

Wong described his own lack of awareness of the disease and its prevalence before making the film: “The funny thing was that I was not aware of the disease myself. I didn’t know that it even had to do with the liver; that’s how uninformed I was. So when I started to dig deeper I was really shocked by the fact that over 50 percent of the cases are people of Asian descent. That really made me interested.”

Be About It is the story of two Asian fathers, their families and their reality of living with hepatitis-B, a potentially deadly disease that affects approximately one million Asian Americans.
Hep B, caused by the hepatitis B virus, can result in serious liver problems before symptoms become noticeable and is frequently referred to as a “silent killer.” Up to two million people are infected in the U.S., and as many as two out of three Asian Americans living with it aren’t aware they have it. Often stigmatized and misunderstood, hep B is the most common cause of liver cancer among Asian Americans.

Hep B is caused by a virus that is transmitted via blood and other bodily fluids. Hep B can be managed, and the disease can be prevented – but if left untreated, the complications of hep B can potentially be life threatening.

As Asian immigrants are projected to be the largest immigrant population in the country over the next 40 years, the need to call attention to this so-called “silent” disease is more critical than ever. The good news is that hep B can easily be detected with a quick and simple blood test. Everyone should talk to their doctor about getting tested – especially if you are of Asian descent.
If you test negative for hep B, there is a safe and effective vaccine that can prevent hep B, and it is widely available in the United States. If you test positive for hep B, talk to your doctor about whether treatment would be appropriate for you. Regular screenings to monitor the health of your liver are very important, and there are treatments that may potentially lower the amount of virus and decrease the risk of further damage to the liver – some are just one pill a day.
So on Hepatitis Testing Day on May 19, join millions of Asians here in the United States and around the globe and get tested for hepatitis B.
Visit for information about chronic hepatitis B, and to learn about the documentary film short BE ABOUT IT, sponsored by Gilead Sciences, which chronicles the lives of two Asian Americans, Alan and AJ, as they battle chronic hepatitis B, and how their families cope with the impact of this potentially life-threatening disease. The film aims to educate, inspire and ultimately dispel myths about hepatitis B. BE ABOUT IT is subtitled in Chinese, Korean, Vietnamese and Japanese, and community screening kits are now available.

Why I stealth: 'Because it feels better with no condom on'


When Hack put stealthing on the radio earlier this month, Brendan* was listening in - now he had a name for what he had been regularly doing with sexual partners, without their knowledge.

Stealthing is where one partner removes a condom during sex without the consent or knowledge of the other. A study from Yale Law School found it's been happening more often - part of a disturbing trend of gender-motivated sexual violence.

Since that story, we've been contacted by readers and listeners with their own stories of manipulation and deceit - of being stealthed.


Brendan thought this was bullshit.

"I've only just heard about stealthing now and I think it's a ridiculous claim," he said.

He agreed to an interview with Hack host Tom Tilley to explain why he stealths "most of the time" and isn't phased by the risk of unplanned pregnancy or STIs.

Is it sexual assault? Yes, according to the president of The Law Society of New South Wales, Pauline Wright. "Removing a condom after there's been a prior agreement that a condom is going to be used, basically undoes that agreement. Because there is no consent," she said. 

It's almost impossible to verify Brendan's story, though we have verified his identity. This is what he says he's done.

Listen to the interview at 5.30 on Hack. Here's the full transcript:

Tom: Why do you do it?

Brendan: Because it feels better with no condom on.

Shouldn't you negotiate that before sex?

I should, but if I have no reason to wear a condom then I don't really see the problem.

What about the risk of transmitting an STI or getting a person pregnant?

I really don't want to get them pregnant so I definitely wouldn't be leaving a trace. As for STIs, I don't want to get them but I would run the risk.

But you're making them take the risk?

Yeah I am. But I'm confident I get checked regularly. I'm pretty safe in saying I'm clean when I'm clean.

So every time you've stealthed someone you've been tested between that occasion and the last sexual partner you've had

Definitely not.

So there is a risk?

Yes there is but there's a risk crossing the road and we all do that.

So you really don't care? It's all about the pleasure?

Of course I care. But I can still look at it from the point of view where I'm pretty sure [about my sexual health], and where I'm pretty sure ... then I'm happy to do it.

How many times would have stealthed someone?

Most of the time. If I'm asked to put one on - which isn't as often as you might think. People are pretty chilled with doing it bareback.

And therefore chilled about their sexual health?

I guess so. I'm not a dirty-looking guy.

So what does that mean? You have less chance of having an STI?

I think so. 

Have you ever been busted stealthing someone?

Yeah. I've been asked to put a condom on before and normally I will.

So you put one on and then take it off without them knowing. How long into having sex before you sneak it off?

I don't know. Pull it out, take it off, put it back in. Everyone's happy.

Most of the time do they notice or not notice?

Not notice.

Have they ever got angry at you?

No-one's ever angry but if someone asks me to put it back on I'll put it back on for sure. That's fair.

So no-one has ever said 'how dare you do that to me, I don't know if you're going to give me an STI and get me pregnant'?

No. No-one's ever said that.

So what's the usual reaction?

'Do you mind - it's safer'. Something to that effect.

But you made an agreement to wear a condom and then you breach that without the person knowing.

I don't know. I don't think I really make an agreement. I just put one on and if nothing is said I take it off. I don't think it's breaking the law.

But if that person has asked you to put on a condom, they're having sex with you on the understanding that's what's going on.

I'd be more worried about getting an STI than getting someone pull a lawyer on me for fraud when I'm having sex and I take a condom off.

Well, both could happen.

Well, I'll take those chances.

Is this a view held by most of your mates?

Yeah I'd say so.

*Name has been changed.



'Poor man's methadone': Imodium is a potentially fatal high

A popular drug that promises rapid relief from diarrhea is worrying doctors and emergency room staff because of the dangerous high it gives opioid abusers.

The over-the-counter medication Imodium, whose main ingredient, loperamide, is an opioid, is cheap and easy to buy at a drugstore. It's available in bulk at Walmart and Costco.

"Drug users, opioid seekers, they are desperate," says Nardine Nakhla, a lecturer at the faculty of pharmacy at the University of Toronto.

"They need this medication to help with the withdrawal, or to achieve that euphoric state. So they disregard the warning and still use the drug if it means they get their fix."

Imodium is safe when taken as directed. The maximum recommended daily dose is 16 milligrams, or eight tablets.

"It's been likened to a poor man's methadone", says Dr. David Juurlink, a drug safety researcher at Sunnybrook Hospital. "At high doses, it will cause effects like methadone or oxycontin. The problem is the doses you need to achieve that is really, really dangerous."

Juurlink says its not uncommon for drug abusers to take up to 200 tablets a day to get high.

"It can cause your heart to stop. It's the sort of thing people can do for weeks or months at a time, with no symptoms at all, then suddenly they just drop dead," says Juurlink.

He says people abusing this drug will put a few hundred pills in a blender, make a smoothie and drink it. "That's especially dangerous because you absorb the drug very quickly."

At Vancouver's St. Paul's Hospital, Dr. Chris DeWitt calls an Imodium overdose a "double whammy."

"It can cause slow breathing or even stopping breathing, similar to other opioids. But it can also cause direct effects on the heart."

On web forums, drug abusers have been talking about the "lope cocktail" for several years. One writes that Imodium may be his "new best friend." Another says his loperamide high "almost killed me a couple times with crazy pressure in my head."

In the U.S, the number of calls to poison centres have doubled between 2010 and 2015. Several people have died of loperamide overdoses. The alarming trend prompted the Food and Drug Administration to issue a safety alert last year warning that higher than recommended doses of Imodium can cause serious heart problems that can lead to death.

The Ontario Poison Centre reports only a "couple of cases" of Imodium poisoning, but its medical director, Dr. Margaret Thompson, can't say whether those involved an overdose or a death because of patient confidentiality.

Juurlink says the small number of cases doesn't tell the whole story.

"We are starting to see more and more people coming to hospital or just dying suddenly at home courtesy of this drug that most of us perceive as pretty innocuous."

A soon to be released review co-authored by Juurlink warns Canada's emergency room physicians to watch for increasing misuse and abuse of loperamide, with patients suffering from "loperamide-induced cardiac toxicity."

It's a challenge for doctors because the go-to antidote Naloxone works to reverse an opiod overdose but can't fix heart problems caused by this medication. Juurlink says doctors sometimes have to resort to "Hail Mary therapies."

Affected people have "grossly abnormal" electrocardiograms, he says. "When a person has that sort of ECG, we don't have a magic drug that we can just give to reverse it."

Imodium is widely available and cheap in drugstores and grocery stores. (Kas Roussy/CBC)

Health Canada says it's aware of health warnings for Imodium in the U.S. The agency says it has conducted a preliminary review of the issue and has not found evidence of a similar problem here, but it will monitor the safety of the drug.

In a Toronto drugstore, Nakhla says she believes more needs to be done to prevent Imodium abuse.

"I think pharmacists need to be adequately monitoring patients who are coming in requesting this type of medication," she said. "They need to think about further restricting the sale of this by placing it behind the counter where they will be in contact with the individual who will be purchasing it."

Juurlink agreed.

"If you couldn't just walk in a drugstore and for $20 walk out with enough of the tablets to get high and possibly kill you, I think that would be a good thing," he said.

By Kas Roussy, CBC News

DOH says 6M Filipinos ‘walking time bombs’

About 12 million Filipinos are hypertensive and half of them are “walking time bombs” who could succumb to a heart attack or stroke because they are unaware of their condition. To raise greater awareness of hypertension, the Department of Health (DOH) on Thursday launched a monthlong campaign to screen Filipinos for abnormal high blood pressure.
Called the May Measurement Month 2017 (MMM17), the campaign aims to screen at least 1.7 million Filipinos for hypertension as part of a global screening effort targeting 25 million people, the DOH said.
“Some of these unsuspecting hypertensive individuals are extremely at risk and can be considered ‘walking time bombs’ because anytime they can figuratively ‘explode’ to develop complications like massive stroke, heart attack, heart failure and kidney failure,” said Health Secretary Paulyn Ubial.
“Health awareness offers tremendous advantages,” she added, referring to screening to detect the illness.
Premature death
Hypertension is a primary contributor to premature death in the country, with 200,000 deaths every year due directly or indirectly to high blood pressure, according to the DOH.
A department report said hypertension was the third leading cause of morbidity in 2014, behind topnotcher acute respiratory infection and pneumonia.
Ubial said screening would be a cost-effective way to identify at-risk individuals early enough to reduce their healthcare costs, increase their productivity and prevent a rise in the overall disease rates.
She urged Filipinos to support the campaign by getting screened this month for hypertension and other noncommunicable diseases like diabetes at local health centers, rural health units or hospitals.
Health workers would need to take a person’s blood pressure several times to establish whether that individual has hypertension. Those diagnosed with hypertension would be encouraged to enroll in the DOH Hypertension and Diabetes Registry and Club for regular checkups and maintenance medicines.
Healthy lifestyle
“We advise the public to know their blood pressure and adopt a healthy lifestyle because your health is in your hands,” Ubial said.
She suggested regular exercise, a diet that is low in fat, sugar, salt and high in fiber, and avoiding tobacco and alcohol consumption to lower the risk of hypertension.
The screening project is a DOH initiative in cooperation with the International Society of Hypertension and the World Hypertension League, the Philippine Society of Hypertension and the Philippine Heart Association.
The DOH chose Manila as the pilot site for MMM17 because of Mayor Joseph Estrada’s focused health-care programs and policies, including the citywide smoking ban and free maintenance medicines for the city’s senior citizens.




968 new HIV-AIDS cases in March, highest in a month since 1984 – DOH

MANILA — March was a record month for reported new cases of the human immunodeficiency virus (HIV) with 968, the highest number recorded in a month since 1984, the Department of Health (DOH) said Wednesday.
Based on the HIV/AIDS Registry of the Philippines, the latest figure was 32 percent higher compared to 735 recorded cases in the same period in 2016.
This meant that an average of 30 cases were being reported everyday in March.

HIV is a virus that attacks the immune system, the body’s natural defense system. Over time it leads to acquired immunodeficiency syndrome (AIDS).
Of the 968 new cases, 108 had developed into full-blown AIDS.
There were 27 deaths from HIV/AIDS in March.
The regions with the highest number of cases reported in March were the National Capital Region with 309 cases (32 percent); Calabarzon, 135 cases (14 percent); Central Luzon, with 107 (11 percent); Central Visayas, 76 cases (8 percent); and Davao region, 52 cases (5 percent).
Sexual contact remains to be the main mode of transmission with 942, most of which are from the male-having-sex-with-male (MSM) population with 820.
Homosexual contact had the highest number with 560, followed by the bisexual contact with 260, while heterosexual contact led to 122 cases.
Injecting drug use accounted for 22 new cases, while the remaining four cases involved mother-to-child transmission.
A total of 59 overseas Filipino workers (OFWs) were also found to have acquired HIV/AIDS, all of whom were infected through sexual contact.

The latest figures brought to 2,661 the total number of HIV cases reported in the country from January to March this year, which included 292 AIDS cases, and 155 deaths.
Since 1984, a total of 42,283 HIV cases, including 3,957 AIDS cases, and 2,124 deaths, have been recorded in the Philippines. SFM

By: Tina G. Santos - Reporter / @santostinaINQPhilippine Daily Inquirer

Poll shows fewer Pinoy smokers due to higher cigarette prices

High tobacco excise taxes helped cut smoking prevalence among Filipino adults by 5.9 percent in 2015, according to the results of the Global Adult Tobacco Survey (GATS) released Friday.
Dr. Encarnita Blanco-Limpin, Framework Convention on Tobacco Control (FCTC) executive director, said at press briefing that high taxes have been a "great discouragement" to consumers surveyed for the second GATS.
"The price, actually, even in other countries, it has been shown that really tax measure is the most effective measure that we can implement to reduce tobacco use," Limpin said.
"Sa mga mahihirap, if they don't have enough money to spend, then they would rather na they placed the money to the more important needs of the family: food, education, children, yung clothing, instead of buying cigarettes."
Tobacco use dropped from 29.7 percent in 2009, the first time GATS was conducted, to 23.8 percent in 2015.
About 55.5 percent of current (daily and less than daily) smokers attempted to quit smoking in the past 12 months because of the cost of cigarettes, which can run them P678.4 a month, the survey also said.
Of those who smoked in the past 12 months, four percent managed to successfully quit; 76.7 percent planned to or were thinking about quitting; and 56.5 percent who visited a healthcare provider were advised to quit.
Higher taxes, no public smoking
Among the policies that helped reduce tobacco use is the Sin Tax Reform Law of 2012, which restructured the excise tax on alcohol and tobacco products and marked up their retail prices.
"Because of the sin taxes, since it has really provided much impact on how much money will be consumed just to buy for the cigarettes," Health Assistant Secretary Dr. Maria Francia Laxamana said.
The strict implementation of the policy prohibiting smoking in government buildings except for designated smoking areas and public places were also given significant heft.
"Let us not also remove the impact of the efforts on the drive against smoking in public places because we have actually shown in this particular study, in this survey, that there was significant reduction also in exposure to second-hand smoke which means to say that the drive against smoking in public place is also working very well," Limpin stressed.
More investment into counter advertising such as warning labels on cigarette packages, anti-cigarette smoking commercials, and posters also encouraged smokers to quit tobacco.
The number of adults who noticed anti-smoking information on any media is up 83.2 percent; those who noticed posters are up 57.9 percent; and those who heard radio counter commercials go up to 39.1 percent.
While the full effects of cigarette warning labels could not yet be ascertained, as it was only put into full effect in November 2016, 44.6 percent current smokers thought about quitting because of warning labels on cigarette packages.
"The fear factor was there when we showed the messages to the communities, to our areas here in the different regions of the country, even in our airports, seaports, we have a lot of messages there that conveys the fear factor of continuing smoking," Laxamana said.
"It has provided the greatest impact of change in the behavior."
Secondhand smoke, advertising still high
While smoking rates have dropped, a large number of adults remain exposed to secondhand smoke and advertising by the tobacco industry.
Secondhand smoke exposure is greatest at home at 34 percent (39 percent men and 30.3 percent women) and at work at 21.5 percent (26.4 percent men and 16.4 women), the report said.
Bars and nightclubs remain the biggest culprit of secondhand smoke exposure in public at 86.3 percent, followed by public transportation at 37.6 percent, and restaurants at 21.9 percent.
Meanwhile, 58.6 percent of adults noticed sponsorship or promotion of cigarettes, with 44 percent spotting them in stores and 9.6 percent seeing them on clothing or other items with cigarette brand names or logos.
Comprehensive ban should be next
While the reduction has been significant, Limpin said a comprehensive ban in tobacco advertising should be the next step in reducing the public's exposure to tobacco.
"We have to push for maybe a comprehensive ban on tobacco advertising, promotion, and sponsorship because right now, we can still see a lot of advertisement, particularly in the stores and this is clearly shown in the data," Limpin said.
Health Secretary Paulyn Jean Rosell-Ubial said they will also push for plain packaging and banning of "tingi" or selling of individual cigarette sticks to secure 100 percent smoke-free public spaces.
"Right now, it's not total, there is still some advertisement at the point of sale. Also, we're moving for plain packaging of the cigarette or tobacco products. I hope that would also further reduce the consumption of tobacco," Ubial said.
Ubial and World Health Organization Technical Officer Dr. Benjamin Lane are also pushing for a unitary tax instead of the tiered tax system envisioned for tobacco and alcohol to protect Filipinos.
"The WHO does not support a two-tier, we do not think it is a good idea. A single tier tax, as planned by the government of the Philippines, as was supposed to take effect in January of this year, that is the way to go," Lane said.
"It's actually very fair on poor people because it protects them more. It needs to be a single tier in order that people do not substitute away to local, cheaper brands and smoke the same amount or even more; and in order that the people who are poor are given the same level of protection as everybody else," he continued.
Lastly, Limpin campaigned for a national smoking cessation program to give current smokers the means to completely cease their consumption of tobacco.
"From the data we have seen that there is a very high number of smokers who are interested in quitting; many of them started to quit but a majority of them were not able to successfully quit," Limpin said.
"We need to have a more comprehensive smoking cessation program, not just a brief tobacco intervention but we need to really have the intensive smoking cessation program which, I believe, the Department of Health is already going to start with within the year," she continued.
GATS 2015 had a sample size of 13,963 households and had a 95.6 percent household response rate while 11,644 individuals surveyed had a 96.3 percent response rate, amounting to an overall response rate of 92.1 percent.
Persons aged 15 and above were surveyed by the Philippine Statistics Authority in coordination with the DOH. —KBK, GMA News

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