He has kindly allowed his email to be shared, offering his own experience of travel in UAE from a HIV positive person’s perspective.

I’ve travelled extensively with ARV’s since being diagnosed as HIV+ nine years ago now. This has included to the US (thrice, with the travel ban in force before Obama got rid of it – I was amused by your correspondent from Chicago talking about his constitutional right).

I’ve also transited Abu Dhabi numerous times as part of my hithering and thithering between Melbourne and London. I’ve never had an issue in any of these places. I know a few guys who have had stopovers and business trips in the UAE without incident, including one HIV+ man who basically lives and works in Abu Dhabi – I’ve never asked how he got/keeps his visa, and I know he divides his time between there and Frankfurt probably partly for that reason).

Anyway, the advice has always been – go, take your meds (but plan with layers of redundancy – some on your person, some in your hand baggage, some in the hold), bring the usual letter saying they’re for a medical condition (without specificity), if asked (and nobody I know has ever heard of that actually happening), say it’s something to do with your blood and your doctor told you to take these pills.

Of late I’ve never bothered to carry the letter/script – never been asked for it or heard of anyone being asked for it, although theoretically I should have it with me.

I think the only real concern is in the event of becoming seriously unwell while in a country like the UAE. Should that ever happen to me, I suspect I’d be getting my medical advice from already-established links like my HIV specialists in London or Melbourne. Most companies that have a lot of staff scattered around the world also have their own resources and processes to deal with staff who become ill (ie. cabin crew who falls ill in Dubai would probably contact Qantas Medical in the first instance. I’d hazard a guess they already know of HIV-friendly medical services in Dubai).

So it’s unlikely you’d ever be in a situation of having to disclose status to a random Dr or hospital. Unless the illness or injury is so sudden and serious that it’s a full-on live-saving emergency, in which case getting deported is the least of one’s worries (and the subject of HIV is less likely to come up anyway – more likely to be accidents or heart attacks etc).

As noted in the letter from the spokes person from Qantas if HIV medications are held discretely and letters to explain their presence do not mention HIV there is a good chance all will be ok.

This said I am a fairly risk adverse traveller. Ultimately it’s up to each individual to review the facts and to make a decision on their own situation.

Perhaps a parallel situation would have been people living with HIV travelling to the USA before the ban was lifted. I have had many friends travel with their medications. Some would replace the pills into vitamin bottles to reduce questions, some would just pack them as they were willing to take the risk.

Ultimately the decision is up to the individual.

Yours in good health.

Dr George

The post Follow Up On Travel To UAE When HIV Positive appeared first on The Healthy Bear.

Recommended by a therapist friend I have to say I am very impressed by this book.

In “No More Mr Nice Guy” Dr Golver, a family therapist, explores the world of unhappy and unsatisfied men who have developed what he calls “nice guy syndrome”.  A fixed believe that men need to be validated and loved before they are able to love themselves.

Naturally this point of view, developed in early childhood, does not help with growth, satisfaction and feelings of happiness. To quote Dr Glover:

Nice Guys are guided by the following three “covert contracts”:

• If I am a good guy, then everyone will love me and like me (and people I desire will desire me).
• If I meet other people’s needs without them having to ask, then they will meet my needs without me having to ask.
• If I do everything right, then I will have a smooth, problem-free life.

Reading this book has been a great kick in the ass. By ignoring my desires, needs and wants I am going to be floating at the whim of whoever I am currently trying to impress or gain respect from. This needy feeling left me feeling angry and frustrated, wondering “I’ve been good to them, so why aren’t they being the same for me?”

Needless to say this book has been an eye opener. It’s clearly had quite an impact by checking out the many positive Amazon reviews:

Every post-Baby Boomer American man should read this book. This is one of those books that really hits the nail on the head so perfectly that it can almost be painful to read. I have read many self-help books, and the beauty of this book is that it perfectly sums up what I’ve learned in a dozen related self-help books, all in one handy, easy-to-read volume. You can realistically even finish the whole book in one day, yet it has more information than many books that are denser and far more voluminous. If you have ever read books such as Healing the Shame That Binds You, this covers much of the same information but also goes far beyond it, as well as touches on the psychodynamics of modern American men, and also has a lot of novel insights. You will at times feel like the author is talking specifically about you if you’re an American man reading this book.

I do feel at times that while the book is correct to implore men to have stronger boundaries, it does go a little bit easy on the harpies that are in some of these men’s lives. Sure these men have awful boundaries, but that doesn’t justify how some of these women acted. A minor complaint though, and the good far outweighs the bad.

I know it’s cliche to say a book is life changing, but man this new perspective is very liberating. Despite having worked in psychiatry for many years this book has highlighted my own feelings of “needing to please to get what I want”.

While the book uses many heterosexual analogies, this book is very relevant for gay men, perhaps even more important as gay men are often raised with a sense of “not being quite right”.

Anyways I have to say I have been very impressed with this book. It’s an easy read with good quality, actionable information. I recommend you check it out at Amazon here:

No More Mr. Nice Guy

Have you read this book? I’d love to hear your thoughts.

Dr George

The post No More Mr Nice Guy appeared first on The Healthy Bear.

By “problems” I of course mean the potential arrest and deportation of HIV positive citizens within UAE.

08 April 2013
Senator Nick Xenophon
Senator for South Australia
Level 2, 31 Ebenezer Place Adelaide
South Australia
5000

Dear Senator,

Thank you for your correspondence of 26 March 2013 regarding HIV positive visitors to Dubai.

As we discussed when we met recently, our partnership with Emirates is a critical element in returning Qantas International to profitability and ensuring a sustainable future for the business.

Moving our international hub from Singapore to Dubai is a significant step in the process and as with any new port this can raise queries about cultural norms and local legal practices. We have been working with our staff on cultural training and other activity to make this process as smooth as possible. In the early days of our services to Dubai the feedback from cabin crew has been extremely favourable.

As we discussed, we have particularly been working with the FAAA and interested community groups so that concerns from HIV positive visitors to the United Arab Emirates (UAE) are addressed.

The UAE requires screening for HIV status for work visas or permanent residency applications. Such information is also required in emigrating to Australia among other countries. There is no need for crew or visitors to Dubai to provide any information about their HIV status.

In relation to HIV positive crew or passengers we have confirmed that antiretroviral medicines are permitted to be brought into the UAE. We have also advised that in bringing medicines into the UAE (or other foreign jurisdictions) it is advisable to carry a prescription and letter from a doctor to support the carriage of that medicine.

I am advised that it is not our recommendation to crew that this letter should not disclose the visitor’s HIV status. Rather this letter need not disclose this information because the process relates to Customs (i.e. importing medicine into a foreign country) rather than for a medical purpose.

Qantas Medical Services has questioned multiple carriers who have been operating to and from the UAE for many years and there is no evidence of HIV positive crew suffering any adverse events.

For these reasons it is not necessary to limit flying for HIV positive crew into
Dubai.

Thank you again for writing to me.

OLIVIA WIRTH
Group Executive
Government and Corporate Affairs

As discussed in my previous post about HIV positive travellers in UAE, the concerns of arrest and deportation are very real and raise many question about customs and the importation of medicines to treat HIV. Falling sick while travelling in the UAE could also put a traveller in danger if they disclose their HIV status to medical staff . As noted at the USA Consular Affairs website:

U.S. citizens have been detained and deported for testing positive for HIV or hepatitis.

This is again confirmed in a Khaleej Times report that further states HIV and other communicable diseases are mandated to be reported to health regulators.

The notification of key communicable diseases like HIV/Aids, hepatitis B, TB and syphilis is mandated as per the health regulations in the UAE. Federal laws here stipulate that expatriates infected with these diseases, except syphilis, must be deported.

It is clear that persons looking to work, immigrate or stay in UAE longer then 3 months are required to have a HIV test after arrival and that a positive result for HIV, Hep B or C will have their visa’s rejected.

Visitors of UAE intending to stay less then 90 days do not have required medical examinations for entry visas. HIVTravel.org further says:

There are no health checks at the border, no health certificates must be presented on entry. Short term stays are therefore possible, however not free of risk. It is not allowed to import antiretroviral medication for personal use.

The list of medicines strictly regulated for import into the UAE is a 47 page document with restrictions on cold and flu tablets, strong analgesics, contraceptive devices and almost all psychiatric medications. To bring these medications into the UAE you require a script that has been authenticated by local diplomatic affairs and then approved by the UAE consulate.

One group of medications conspicuously left ouf of this list of restricted medications are HIV treatments.

This is a significant concern as it has been made very clear that HIV infection = deportation however HIV medicines have been left off the restricted medication list.

While I would like to be able to believe Olivia Wirth’s letter that assures safe travel for HIV positive people I can’t help but think this is a very grey area with the response of the UAE government yet to be fully clarified.

Ms Wirth’s comment about “not needing to mention” HIV status on travel documents leaves me uncomfortable for patients that may carry medicines only ever prescribed for the treatment of HIV.

Could this “omission” be considered deception and lead to further issues?

Currently this is very murky waters and despite Qantas’ cheery outlook I would advise very careful planning before heading to the UAE for a holiday or even a brief stop on the way to or from further destinations.

For those merely transitting Dubai airport there should be few issues however if there is need for overnight stay at a hotel could problems arise?

I would recommend proceeding with very well researched caution.

Yours in good health.

Dr George

The post Qantas Responds To Concerns For HIV Positive Staff & Tourists Travelling To UAE appeared first on The Healthy Bear.

From the ACON website:

Gay and other men who have sex with men (GMSM) travelling to New York City (NYC) should vaccinate against invasive meningococcal disease or IMD (neisseria meingitidis) prior to leaving Australia, following an extended outbreak of the disease among NYC gay men.

While meningococcal bacteria, found in secretions from the nose and throat, is not easily shared, it is reported that “prolonged and extended exposure” can increase risk. Deep kissing is one way meningococcal can spread,  however sharing drinks, food or cigarettes are not considered risky.

Symptoms of meningitis can come on rapidly with the most common symptoms being fever, headache and neck stiffness. Other symptoms can include nausea, vomiting, rash, sensitivity to light and confusion.

Meningococcal disease is very serious. If you or a loved one are not feeling well it’s important to seek medical help quickly. If a house mate, partner or close contact has been diagnosed with meningococcal meningitis their close contacts will require treatment to avoid further illness.

The Australian Society of HIV Medicine (ASHM) has recommended all gay men travelling to NYC be vaccinated.

If you are currently planning a trip to NYC be sure to print this out and share with your doctor. A meningococcal vaccination may save you from significant illness.

Your in good health,

Dr George

The post NYC Meningococcal Meningitis Warning Released For Gay Travellers appeared first on The Healthy Bear.

Lipoatrophy is a problem where normal fat layers in the face, legs and butt shrink or disappear, leading to changes to the body that can be very distressing.

The loss of fat can be most notable in the face as it can lead to an appearance of sunken cheeks. The loss of body fat can also be associated with accumulation of fat in other parts of the body, in particular between the shoulders and also the belly.

While it’s not known the exact cause of these changes, there is evidence that a couple of the HIV medications, in particular stavudine and zidovudine, may be the cause. There are also a handful of reports of increased fat loss with people treated with efavirenz.

What Are The Signs Of Lipoatrophy?

By far the best way to avoid lipoatrophy is to avoid medications that have been associated with the changes. If you notice any changes in the contours of your face it’s important to discuss this with your HIV specialist early.

For many people these changes can creep up slowly. A couple of great tips recommended at Poz Magazine include:

Facial Lipoatrophy

• Be sure to check your smile on a regular basis. By comparing recent photos with older pics you  may notice a loss of skin or volume over the apple of your cheeks or deepening of grooves on the side of the nose.  These distinctive changes can be early signs of lipoatrophy.
• If you notice your jeans are getting loose around the butt or at the tops of your legs this can be another early sign of fat loss. As the fat layers get thinner the veins on the legs can also become more prominent.
• If are noticing a bit of a “dowager hump”, “Crixavan belly” or the formation of “man boobs” this can be another indicator of early fat redistribution.

If you are noticing any of these signs it’s important to talk with your HIV doctor about looking for alternative treatments that can minimise these side effects.

Can Lipodystrophy Be Treated?

By far the best treatment for lipoatrophy is to avoid it.

If you notice any of these early changes be sure to talk with your doctor straight away. They may be able to change your treatments to be  minimise these effects.

In Australia the facial lipoatrophy is able to be treated with PBS subsidised dermal filler Sculptra™.

People living with HIV are able to receive 10 vials of Sculptra to help restore facial volume to the cheeks. To access this treatment you simply need a referral from your HIV prescriber to a plastic surgeon or other doctor trained in Sculptra’s use.

After the initial treatment there is top up treatments available under the scheme.

If you are suffering or worried about these changes I urge you to speak to your doctor. Lipoatrophy can lead to feelings of isolation and stigmatism, I urge you to be open with your doctor about medication choices, potential side effects and treatment if they occur.

Within the USA there may be the opportunity to have these treatments under health insurance, again be sure to talk to your doctors or your health insurance providers.

Yours in good health.

Dr George

The post What Is Lipoatrophy? appeared first on The Healthy Bear.

Are you suffering with any of the following symptoms of erectile dysfunction:

• erections no longer being as firm
• erections not lasting long enough to satisfy
• not waking in the morning with an erection
• any bending, pain or discomfort with erections

If you have any concerns worries or questions be sure to have a talk with your family doctor. It’s important to eliminate common medical issues that are associated with erectile dysfunction as well as talking about the best erectile dysfunction treatments for you.

Special thanks to Derek Whitney for the great info-graphic.

Yours in good health.

Dr George

PS. Please feel free to click the like button to share with other men who may be embarrassed to talk about this topic.

The post Cool Erectile Dysfunction Info-graphic appeared first on The Healthy Bear.

Guy #2:  No more kids for you two?
Guy #1:  No, she figures we’re both getting too old for a baby.
Guy #2:  How is your boy anyway?  Haven’t seen him in awhile.
Guy #1:  Oh John’s good, pitching this year varsity.
Guy #2:  He’ll definitely have the girls hanging around him now.
Guy #1:  Yeah if he had any time for them.
Guy #2:  Focused on baseball?
Guy #1:  Focused on boys.
Guy #2:  You’re shittin me!
Guy #1:  I kid you not.  Came out to me and Mary Ann bold as daylight last year.
Guy #2:  Well I’ll be damned!  I’m not supposed to know it but I overheard Patrick Junior tell his sister he might be gay not two months ago.
Guy #1:  We all saw that coming though.
Guy #2:  You’re the second person to say that.  How’d everybody see it but me?
Guy #1:  It was just a feelin Pat.  He was always a little soft, ya know?
Guy #2:  I guess you’re right.  But damn Charlie, we both have gay kids.  What do we do now?  Both our sons are gay.
Guy #1:  We don’t do anything.  We let em be gay and if some kid calls em a faggot we go to their house and raise hell with the parents like normal.
Guy #2:  Well I guess John and Lucinda won’t be getting together like we thought awhile ago.
Guy #1:  Guess not.
**long pause**
Guy #2:  Hey Charlie, you thinkin what I’m thinkin?
Guy #1:  I was for about half a second then it got weird and I started thinkin about somethin else instead.

How freaking amazing it that! I could only wish that there were more parents just like these two.

If there was some way I could track down these two dads on a train I would love to give them both a massive hug for being so dam awesome!

I hope this story puts a nice happy spring in your step just like it did for me. Please feel free to share with someone who might appreciate a smile today.

Yours in great health.

Dr George

The post Two Dads On A Train appeared first on The Healthy Bear.

A young man sprinkling his lawn and bushes with pesticides wanted to check the contents of the barrel to see how much pesticide remained in it. He raised the cover and lit his lighter; the vapors ignited and engulfed him He jumped from his truck, screaming.

His neighbor came out of her house with a dozen eggs and a bowl yelling: “bring me some more eggs!”

She broke them, separating the whites from the yolks.
The neighbor woman helped her to apply the whites onto the young man’s face.

When the ambulance arrived and the EMTs saw the young man, they asked who had done this. Everyone pointed to the lady in charge.

They congratulated her and said: “You have saved his face.”

I think it’s vital to make it absolutely clear: Do not use egg whites for burns.

Useing egg whites for burns is dangerous for a number of reasons:

• Uncooked eggs are a wonderful medium to grow bacteria. Applying egg whites to burnt, raw, damaged skin can introduce bacteria that will make treating and healing the burn very difficult.
• Egg allergies is quite common. Applying egg whites to broken skin can result in an immediate allergic reaction. There are now more then a hand full of documented deaths from allergic reactions after this treatment.
• Any thing other then cooling the wound and getting emergency medical care is simply delaying treatment and allowing the burn to continue.

 What Is The Best Treatment For Burns?

Immediate and appropriate first aid is vital to reduce the severity of burns. Following these steps can help reduce the chance of significant scarring and damage from a burn.

• First ensure your own safety. You can’t help anyone if you get burnt as well.
• Remove the person from the source of the burn:
  • If there is fire put the fire out.
  • If electrical switch the power off at the mains.
  • If petrol, chemical, or hot water, remove soaked clothing and wash the area with copious amounts of cool water. Never add water if electricity is still live!
• Get emergency medical care immediately.
• Keep cooling the area for at least 20 minutes with water.
• If there is a delay getting to medical care applying cling wrap can help reduce pain.

Burns are a critical injury and require rapid medical care. Don’t ever delay getting help by applying things like egg whites for burns.

Remember: Get away from the source of the burn safely. Cool the burn with lots of cold water for at least 20 minutes. Get medical help fast.

Yours in good health.

Dr George

The post Using Egg Whites For Burns? appeared first on The Healthy Bear.

Most concerning for me was that the author included explicit tips on how to use a particular condom safe lubricant to trick sexual partners and hide their intention to secretly ejaculate inside them.

The reasoning the lube is featured is two fold. Firstly the lube  is reported to looks and smell like semen. The second reason is that the site owner get’s paid by the company to promote the product. Simple checking of the site shows that all links to the lube is via an affiliate tracking link enabling the stealth bareback site to be paid if readers purchase after clicking his link.

In an attempt to direct attention away from the manufacturers of the lube a disclaimer has been placed stating that  the manufacturer does not endorse or even know about how he teaches people to use their product. While on the surface this appears to absolve the company, the author fails to mention that he gets paid  25% of every sale by the company that manufacturers the lube.

Today I have written to the company to highlight how their product has been promoted and I hope they may reconsider the relationship with this site.

Please don’t get me wrong I believe the guys have created a greate product that is sex positive and safe for use with condoms. I would hope that the affiliate activity of this stealth bareback website has simply not been seen and this post may highlight their activity.

I will keep you posted on further developments.

Update:

Less then one hour after publication the lube manufacturer has contacted me letting me know they have made moves to have all references to their product removed from the site. I am glad to see that this product will hopefully no longer be connected with the vile and despicable acts promoted by this stealth bareback site.

Yours in good health.

Dr George

The post Stealth Bareback: Payment For Teaching How To Infect With HIV? appeared first on The Healthy Bear.

The study performed at University of Southern Queensland showed that having a beard can reduce UV ray exposure to around one third of our non beard wearing friends. Of course these results are dependent on the length of the facial hair as well as the position of the sun on the horizon.

While it’s great that our jaws and chins may have the extra protection, don’t forget to put on some sunscreen onto the rest of your face to help reduce the risk of skin cancers. A little bit of protection can go a long way!

Yours in beard loving health.

Dr George

The post Beards Found To Reduce Sun Damage appeared first on The Healthy Bear.