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+TALK: DR. ANU

This is a transcript of Karl’s conversation with Dr. Anu about Monkeypox, HIV, Meningitis, and more.

KARL
We’re talking monkey pox with Dr. Anu up next.

Welcome to Plus Talk on Plus Life, where we’re all about turning positive into a plus. And today we’re talking to our favorite doctor, she’s Plus Life’s chief medical advisor, Dr. Anu Seshadri. Good to see you, doc.

ANU
Good to see you again, Karl.

KARL
I’ve got a list of questions, lots of topics. So I want to dive straight in, monkeypox. We’re hearing a lot about it. You are talking a lot about it. How dangerous is it?

ANU
Let’s put it into perspective, that’s what I’ve been saying. We’ve had over 530 million cases of COVID 19 and this is about 3000 cases, right? Of monkeypox. There’s been over millions of deaths for COVID 19, barely any for monkeypox. And so I don’t think that we need to be very, very worried. I think we need to be just vigilant. That’s all.

KARL
Okay, so we are hearing reports though, especially outta San Francisco and New York, we’ve just come out of pride month. A lot of LGBTQ plus people are worried, there’ve been a lot of parties and it seems that some of these monkeypox, “outbreaks” have been linked to some of these pride parties. And again, the press is spinning it that this is a gay thing. I feel a little dejavu to HIV. Should members of the LGBTQI plus community be extra concerned?

ANU
I don’t think they need to be extra concerned. It’s sad, correct? I mean, I think that it, this is where the stigma arises. It’s not against, this virus doesn’t pick and choose who it wants to affect. It doesn’t affect the LGBTQ community and that’s what it does. It’s just spread by close contact. So, if you’re around people and in an area where this outbreak has, outbreaks have occurred and it in parties or social settings, yes, you’re more than likely to be exposed and more than likely to be affected or infected because of that. It’s not because of how you identify yourself. It’s because of just who you contact and who you’re in contact with. Does that make sense?

KARL
Totally. And as I said, we’ve just come out of a pride month and it’s been the first time in years that people have been able to come out and celebrate together. So, okay. What about the vaccine? Because we, again, New York has rolled out vaccine clinics and San Francisco has and then we hear about the vaccines running out. Should we proactively be going out and getting this vaccine?

ANU
I think it depends on your lifestyle. So again, if you’re in an area that there is an outbreak and you are potentially exposed or going to potentially be in an area or at a party, for example, where there is going to be exposure. Yes, I think that you can try and find a vaccine. Is it absolutely needed? No, because this virus and the illness is more than likely self limited. I mean, yes, it takes two to four weeks to get over this virus and this viral infection, but you don’t really need the vaccine. It’s just that we’re containing it. There’s antivirals that are treating this that can be used to treat this virus too.

KARL
Now, if I think I’ve been exposed, what do I do?

ANU
Go to your doctor to get-

KARL
Simple enough.

ANU
That’s why we’re, that’s why we’re here. So go to your nearest healthcare facility, talk about being exposed and then seek advice and be evaluated and go accordingly.

KARL
Well, I hear it sort of starts like a pimple, so like, is that what I should be looking for? Like if I have been, let’s say I’ve been at one of these parties or I’ve been in close contact with some people and something pops up, is it a pimple or is it cause for panic?

ANU
Yeah, so the most cases start off as flu like symptoms. So you’re gonna have a fever, feel fatigue, muscle ache, lymph nodes being enlarged. And then it’s usually after you get a fever that the rash starts and it’s usually on the face and then spreads downward, but there are cases where the rash starts first. Regardless, if you feel concerned about monkeypox or that you’re potentially exposed, come and see us as physicians. That’s what we’re here for.

KARL
Okay, and last question on monkeypox. What about those of us like myself living with HIV? Should we take extra precaution? Should we be a little extra concerned, because of our HIV infection, even if we’ve got it under control, we’re undetectable and healthy?

ANU
Great question, Karl. What we’ve seen thus far, is those that have HIV and you’re well controlled on your antivirals, your immune system is robust. There’ absolutely no concern for your health, if you do get infected with monkeypox. There’s more reports as far as, that we have to see if your immune system is not great and your CD4 count is less than 200. Just like with other viruses or bacterial infections, you’re at risk for getting more sick. That’s what we’ve seen, but absolutely, like we haven’t had any reported deaths thus far.

KARL
All right. Switching from monkeypox to meningitis. Now I remember a few years ago, this was a big one, especially in the gay community here in Los Angeles. We were all standing in line to get vaccinated. Where, I hear there’s an up tip again. So for those of us living with HIV, what is your recommendation when it comes to meningitis and getting a, you know, a vaccine?

ANU
Yeah. So again, this depends on where there’s outbreak. I don’t think everybody and anybody needs to go and get a vaccine right away. If you’re going to be traveling, for example, I just had a patient in my clinic the other day. If you’re gonna be traveling to Florida, where there is an outbreak and expect to be potentially exposed, then it’s the right thing to do. And it’s a safe thing to do, is go ahead and get vaccinated. That’s my, that’s my advice.

KARL
So how concerned should we be about meningitis? Cause I mean, I’ve read and heard that it can be disastrous and deadly.

ANU
It can be, but then again, you have to take, you have to step back and take a look at the big picture, right? Look at the total number of cases, look at where these outbreaks are occurring. It’s not like COVID 19 where this is spreading like wildfire, it’s in certain pockets. So if you plan to be in those certain pockets and outbreaks and this is where, look at the resources that are given. CDC has a great website to actually talk about where these outbreaks are occurring. And if you plan to travel there or you are there, then that’s where you need to get vaccinated and be more vigilant about it.

KARL
All right. Okay. So again, moving through, we’ve ticked the two Ms off. Shingles, it’s something that happens to us, typically when we get older. I, curious about those of us living with HIV again and whether we should be getting that vaccine at an earlier age, cause I think normally, you sort of recommend the vaccine around 50 ish, right?

ANU
Yes. Yeah.

KARL
So what about someone like me, I’m turning 42 soon. Is it something that I should look at proactively getting while I’m younger and how long does it last?

ANU
Yes, generally, they do recommend it. It’s a two shot series. There’s a new, before, prior to this, the shingles vaccine was called Zoster vax. There’s a new vaccine that’s been out for plenty of years called Shingrix. It’s about 98% effective in preventing shingles. And it’s recommended that you do get vaccinated, if you’re 19 and above with HIV.

KARL
Well, I think I’ve gotta make an appointment and come and see doctor, cause I haven’t had it. How badly can some, again, I guess we’re talking about healthy immune systems and being undetectable, but if I am living with HIV and shingles occurs, am I in a more dangerous position than somebody who hasn’t got HIV that gets shingles?

ANU
No, again, it depends on how robust your immune system is. So if it’s like you Karl and you’re very, very healthy, then you can expect your immune system to be able to handle any virus or bacterial infection, because your immune system is robust enough. And that’s the, that’s the great part about these medications that are out there right now, that makes you equals you possible.

KARL
Well, and I think that’s a nice way to sort of tie it up, you know, to talk about that all the more reason why we should be getting tested. And if we are testing positive, getting on HIV treatment, right?

ANU
Exactly.

KARL
It’s keeping us healthy. Okay, so I’ve saved to the best for last, because no one likes to talk about their bottoms, even the bottoms, but anal pap smears. If I am a gay man and you know, I enjoy, you know, that kind of stuff. What should we be doing about anal pap smears?

ANU
You should be asking your healthcare provider to be conducting an anal pap smear, if you are age 35 and above. So that is what’s recommended, as of right now. So anal pap smears, if you’re age 35 and above.

KARL
And we know right, that people living with HIV, even though we might be on effective treatment, there is, tends to be a higher risk for us to develop cancer in that part of our body, right?

ANU
Right, and the reason for it is because there are other viruses, such as HPV, human papilloma virus. And I want to just correlate that for somebody like me, who’s a woman, even though I may have a great immune system, I could still be infected in my cervical region. My vaginal-

KARL
Your lady parts.

ANU
You know, my your lady parts.

KARL
Your lady parts.

ANU
Yes, my lady parts with HPV that can potential turn into cervical cancer. So, if you do have HPV in your bottom or anal region, that can carry an increased risk for anal cancer. But again, this is a virus that we’re checking for and your body has the capability of getting, fighting it and getting rid of it on its own.

KARL
Yeah, and there are a lot of people who have HPV and you never show any symptoms if you don’t know it, right?

ANU
Yeah, exactly. And there are vaccines for HPV as well.

KARL
Correct. And I think it’s a course of three.

ANU
Yes.

KARL
I’ve had two, so I’m on my way. Dr. Anu, thank you, as always, we’ve gone through quite a list quite quickly, but all important topics, always lovely seeing you, thanks for your time and going through all of this with us.

ANU
Thank you for having me, take care, Karl and stay safe.

KARL
As always. And the point just goes to continue to be made. If you’re living with HIV, all the more reason why it is so important to stay on your anti-retro virals. And if you don’t know your status, even more important to go out and get tested. That’s gonna do it for this episode of Plus Talk. Thanks for watching, we’ll see you next time. Remember you can follow across social media platforms, we are @pluslifemedia and check us out on our website, Pluslifemedia.com. Until next time, see you later, stay safe. Bye.

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