Sexually Transmitted diseases

[b747 flightboy]

Just filling out this years medical declaration. What's the reasoning behind
"have you ever had a an STI?"

Anyone able to elaborate?

[Mac the Knife]

"Are you going to infect our hosties?" :E

Stupid question. I'd suspect the sanity of any applicant answering "Yes" (maybe that's why they ask it?)

:ok:

[Martin1234]

I think that on my last JAR renewal it said something in the line of a serious STD such as syfillis.

On a South African medical there's the question "have you been tested for HIV". However, the result needs not to be disclosed. So why ask in the first place? A medical should not be used as a poll.

[Thary79]

Sexually transmitted infections are really common in the general population, and judging by the number of patients I saw while practising near Stanstead a lot more common in airline staff. (Probably due to increase in general risky behaviour in airline staff - including flying) They are also making a BIG comeback, where I am practising now the number of new diagnoses of Syphillis and HIV is sky rocketing (interestingly, a budget airline has recently started up at the local airport).

They don't just affect your genitals they also affect other systems; for example,
1, Syphillis - used to be the most common cause of insanity before the invention of Penicillin,
2, HIV - can present with practically any disease possible and probably some that you didn't know existed.
3, Gonnorrhoea - leads to infections at other places like lungs and joints etc

The list goes on.. and on..
My advice as always...
Don't be silly, protect your willy!!

See www.gpnotebook.com (http://www.gpnotebook.com) if you want to know more, or use google images to see what the nasties look like :yuk:

[Mac the Knife]

Normally I hate the spelling police, but I'd really have thought that a hospital doctor ought be able to spell both syphilis and gonorrhea (or gonorrhoea), particularly if he/she is giving advice about it!

"...used to be the most common cause of insanity before the invention of Penicillin."

While I don't dispute that GPI was a lot commoner pre-Salvarsan I doubt whether it was the commonest cause of insanity.

"By 1877, for example, the superintendent of an asylum for men in New York reported that in his institution this disorder accounted for more than twelve percent of the admissions and more than two percent of the deaths."

And from the 1844 Lunacy Report:
"Cases of General Paralysis
In 213 admissions into Hanwcll Asylum - 32
In 120 admissions into Surrey Asylum - 16
In 619 admissions into Lancaster Asylum - 13"

"Gonnorrhoea[sic] - leads to infections at other places like lungs and joints etc"

While gonococcal arthritis and pharyngitis does occur, I'm not so sure about lung involvement.

:ok:

[Thary79]

Everyone knows doctors can't spell, thats why they make sure you can't read their writing!
As with regards to SyphiLis I would be more inclined to go with current expert opinion as many cases were misdiagnosed at the time.
With regards to goNorrhoea causing pneumonia, rare but can happen I will be more than happy to email the reference for a case report.

[Spain_pilot]

Just out of curiosity... I know in the medical paperwork for Class 1 medical they ask about these diseases, but would they actually be detected as well in the blood analysis done in the Class 1? My point is, if they are so common but you have no real reason to suspect you might not find out until a lot later.

[Thary79]

My understanding is that the blood tests are very specific, and are not those carried out routinely when you have your medical.

[Mikeyb59]

Hi all

As a result of this and another thread I have a question for those who may know.

When faced with the question "Have you ever had an AIDS test" I am unsure of what to answer.

As a long time blood/platelet doner I have routinely been tested for HIV, Hepatitus etc etc. But never have I had a specific test for any of the above.

When faced with the above question I have always answered no.

Any opinions?

[obgraham]

Seems to me, Mikey, that "you" have not had an AIDS test, since there isn't a report anywhere with your name and its result. However "Your blood" has.

I've often recommended to people who want a test but don't want a record, to simply go donate blood. If they invite you back, you're good to go!

[Mac the Knife]

Everyone knows doctors can't spell, thats why they make sure you can't read their writing! As with regards to SyphiLis I would be more inclined to go with current expert opinion as many cases were misdiagnosed at the time. With regards to goNorrhoea causing pneumonia, rare but can happen I will be more than happy to email the reference for a case report.

Only some doctors can't spell.

As regards syphilis, I'm sure neurosyphilis WAS underdiagnosed, but the majority of patients with neurosyphilis WOULD have shown other signs of infection such as gummata. These manifestations were not unknown to practitioners at the time who were not complete idiots.

Going from some 12% to at least 51% argues for a massive underdiagnosis for which there is little evidence. Mild endemic and venereal treponematosis may have existed in Europe before the early 16th century but it is undisputable that the great syphilis epidemic started at that time.

Prior to this, there is no evidence that insanity was any less common - for example, it was certainly common enough for Hieronymous Bosch to have painted "The Extraction of the Stone of Madness" around 1475. The Middle Ages in particular, was suffused with madness and accounts of insanity (see - http://www.bmj.com/cgi/content/full/311/7021/1708 ) - there is no evidence for a drastic increase after 1498.

If your "current expert opinion" states that "syphillis used to be the most common cause of insanity before the invention of Penicillin", there is little to support this.

I have no doubt that case reports of gonococcal pneumonia exist (there are case reports of almost anything) but to present it on a par with gonoccal arthritis (which is itself not that common) while failing to mention the common non-genital sites such as the rectum, oropharynx and conjunctiva is misleading at best.

[Natalie_Asfour]

Sexually transmitted infections are really common in the general population, and judging by the number of patients I saw while practising near Stanstead a lot more common in airline staff. (Probably due to increase in general risky behaviour in airline staff - including flying) They are also making a BIG comeback, where I am practising now the number of new diagnoses of Syphillis and HIV is sky rocketing (interestingly, a budget airline has recently started up at the local airport).

They don't just affect your genitals they also affect other systems; for example,
1, Syphillis - used to be the most common cause of insanity before the invention of Penicillin,
2, HIV - can present with practically any disease possible and probably some that you didn't know existed.
3, Gonnorrhoea - leads to infections at other places like lungs and joints etc

The list goes on.. and on..
My advice as always...
Don't be silly, protect your willy!!

See www.gpnotebook.com (http://www.gpnotebook.com) if you want to know more, or use google images to see what the nasties look like :yuk:

Could you please provide at least an approximate figure of how many per cent of flying staff are HIV positive?

My thread about HIV was closed, and after having 3 HIV tests I still think about it every day. I will have another test, but I would like to at least approximately estimate how big my risk of being exposed to HIV was. Even though "my" pilot was German

[Flyin'Dutch']

Could you please provide at least an approximate figure of how many per cent of flying staff are HIV positive?

My thread about HIV was closed, and after having 3 HIV tests I still think about it every day. I will have another test, but I would like to at least approximately estimate how big my risk of being exposed to HIV was. Even though "my" pilot was German

I have no figures and am sure neither has Thary. I suspect they are very small. However that does not mean that people should not protect themselves!

If you are worried you need to go and talk to your healthcare professional. They can counsel you on your particular set of circumstances and what would be the most appropriate way to proceed.

Bulletin Boards are good for learning general principles but very bad for trying to work out what you should do in your particular case. So do go back to your healthcare professional.

I've often recommended to people who want a test but don't want a record, to simply go donate blood. If they invite you back, you're good to go!

Very poor advice.

If you think you may be at risk of a STD you are better advised to go and see someone in an STI/GUM clinic. Not only can they discuss with you exactly what you should be tested for and when but it also ensures that people who are at risk do not donate blood.

It takes some time for the tests to become positive our local clinic advises a 6 week wait before doing an HIV test for that reason.

STI/GUM clinics/clinicians are by law required to uphold confidentiality so without your consent nothing will get disclosed.

HIV testing is now a lot less controversial than it was 10 years ago when everyone needed extensive counselling and signing of consent forms before you could do the test. Most people who have applied for any serious lifeinsurance will have been tested. Pregnant ladies are now routinely tested too.

The question on the application forms for lots of things have therefore now been changed from 'have you ever had an HIV test' to 'have you ever tested positive for HIV/AIDS'

JAR medicals do not test for HIV/AIDS as far as I am aware. Only full blood count to make sure not anaemic and cholesterol.

Sexual transmitted diseases are definitely on the increase but I think that Thary is a bit careless in linking that to airline travel or employment.

Agree with Mac that few doctors have spelling problems; true we can not write legibly!

Mac, am impressed with your medical historic knowledge or google skills!

:}

PS Thary, what sort of medicine do you practise?

[Natalie_Asfour]

I have already had 3 HIV tests, it was more than 6 weeks after the sex, the result every time was negative, but I might do another one, and I owreally would like to estimate how much the risk is, so when I go, I know how many percent at least approximately the risk was

[Natalie_Asfour]

I have already been to my health care professionals, 3 HIV tests negative. Before I go back I would like at least approximate estimation of how big my risk was. Sorry for dubble post

[Mac the Knife]

"I have already been to my health care professionals, 3 HIV tests negative. Before I go back I would like at least approximate estimation of how big my risk was."

I have already quoted you a ballpark estimation of your risk on the other thread.

"The baseline answer is that for a single act of unprotected vaginal sex with an HIV+ve male the rate of female seroconversion (infection) is around 1:1000"

You have already had 3 negative tests, one of them very recent. The chances of you seroconverting now must be very small - <1:10,000

And your pilot (nationality irrelevant) may well not have been HIV+ve at all.

I think you are becoming phobic now. I suggest that you make an appointment with a specialist in HIV/AIDS.

[obgraham]

Though Dutchy didn't agree with my advice to Mikey, specific to his question, I do agree with Dutchy's advice. If you feel you're at risk, get tested. On this side of the pond, counselling is a required part of the testing.

So Natalie, you did that. Now don't be obsessing about it. There really is no answer to the question you asked, since I'm sure statistics on such a small subgroup as you refer to are not kept. Time to move on. And be careful.

[Flyin'Dutch']

I have already had 3 HIV tests, it was more than 6 weeks after the sex, the result every time was negative, but I might do another one, and I owreally would like to estimate how much the risk is, so when I go, I know how many percent at least approximately the risk was

If you were in the 6 week window between having unprotected sex and a test it would be interesting to know whether that sexual partner had HIV/AIDS or came from a high risk group.

That way you could estimate what your infection risk might be.

Ultimately what matters is whether you have got infected or not.

If you have had the appropriate test at the appropriate time and it was done properly by appropriate professionals and the test is negative then it does not relevant whether the sexual partner was positive or not.

You're not and that is what matters!

I don't know what the circumstances were but make sure you use condoms in the future if you not did so already and some suggest to use 2 condoms at a time to get a double layer.

[unstable load]

Hi all

When faced with the question "Have you ever had an AIDS test" I am unsure of what to answer.

I live in South Africa and have had an HIV test every few years as a requirement of having life insurance in that country.

Having said that, if I answered no to that question and the person reading the answers was half awake, I could find myself in a lifetime of trouble for the answer as it would technically be a lie!

[captplaystation]

Flyin Dutch, I see you recommend the "Irish" method , Oi wear two " to be sure to be sure", incidentally, on which part of your body are you expected to wear the second one . . . . . ?