“The University of Michigan recommends the following: there are very bicycle-friendly communities. It is, however, very important that bicyclists (and motorists) understand the rules of the road and how to stay safe while biking in the city. With an abundance of restaurants and shops downtown and various city parks to explore. Did you know that city ordinances require motorists to stop for pedestrians who are at or in crosswalks?  Walk with a friend, use designated sidewalks or paths, cross at designated crosswalks and don’t just look at signs but use your eyes looking both ways also.As we make the switch from warm to hot weather, it’s important to take the time to review tips for staying safe in the heat.  This means wear sunscreen for skin protection, drink plenty of water, limit alcoholic beverages, dress in loose-fitting, lightweight and light-colored clothing, and limit exercise outdoors in extreme heat.Summertime is often paired with grilling outdoors so this means place grills a minimum of 36″ away from your home, deck railings, and out from under eaves and overhanging branches, set up your grill on a flat, stable surface to prevent tipping, operate your grill safely by checking for leaks and opening the lid before lighting, maintain your grill by cleaning and inspecting it regularly and always have a fire extinguisher nearby.  Of course don’t forget the supervision of children and pets in also establishing a safe zone of at least three feet around the grill, where children and pets are not allowed.”

Division of Public Safety and Security University of Michigan –  DPSS (https://news.dpss.umich.edu/2024/06/1391)

“May sound so basic but not always followed so as a reminder to let the public know the best way to prevent HIV is to understand how the virus is transmitted and take steps to reduce your risk. If you’re living with HIV, understanding these practices can help prevent transmission to others.

HIV can’t be transmitted through saliva or skin-to-skin contact, such as hugging or shaking hands. The virus can only be transmitted by exchanging certain bodily fluids, including genital secretions and blood.

As a result, transmission most frequently occurs during condomless sex or shared use of syringes and other drug injection equipment.

Adopting certain harm reduction strategies, including safer sex and safer substance use or better yet no substance use, can help reduce the risk of contracting or transmitting the virus.

Although you have up to 72 hours to begin PEP, the medication is less likely to be effective over time. Additional medication must also be taken consistently and correctly for 28 days.

If you don’t have a primary care doctor or another healthcare professional to reach out to, you may be able to get a prescription for PEP at your local: health department, sexual health clinic, urgent care center or emergency room.

Know approximately 1.2 million people in the United States have HIV, according to HIV.gov. Of those people, 13% do not know they have it.  In 2021, there were 1,086,806 people living with HIV in the U.S. In 2021, 36,126 people were newly diagnosed with HIV.“

healthline (https://www.healthline.com/health/hiv-aids/hiv-prevention/hiv-prevention?utm_source=google&utm_medium=cpc&utm_cmpid=20958361886&utm_adgid=156321296365&utm_adid=688286705703&utm_network=g&utm_device=c&utm_keyword=&utm_adpos=&utm_gclid=EAIaIQobChMI8fKFhNj0hgMV-2BHAR2JDwgDEAMYASAAEgL8BPD_BwE&gad_source=1&gclid=EAIaIQobChMI8fKFhNj0hgMV-2BHAR2JDwgDEAMYASAAEgL8BPD_BwE#takeaway)

Acquired immunodeficiency syndrome (AIDS) is a chronic, potentially life-threatening condition caused by the human immunodeficiency virus (HIV). By damaging your immune system, HIV interferes with your body’s ability to fight infection and disease.

How HIV is transmitted:

HIV is transmitted via the exchange of body fluids—such as pre-ejaculate fluid, semen, vaginal fluid secretions, blood, or breast milk. Within these bodily fluids, HIV is present as both free virus particles and virus within infected immune cells.

The symptoms and when they develop:

Within a month or 2 of contracting HIV, about 40 to 90-percent of those afflicted suffer from flu-like symptoms including the following:

Fever, fatigue, achy muscles, swollen lymph glands, sore throat, headache, skin rash, dry cough, nausea, rapid weight loss, night sweats, frequent yeast infections (for women), cold sores, and eventually, pneumonia.

Symptoms

The symptoms of HIV and AIDS vary, depending on the phase of infection.

Primary infection (Acute HIV)

Some people infected by HIV develop a flu-like illness within two to four weeks after the virus enters the body. This illness, known as primary (acute) HIV infection, may last for a few weeks. Possible signs and symptoms include:

• Fever
• Headache
• Muscle aches and joint pain
• Rash
• Sore throat and painful mouth sores
• Swollen lymph glands, mainly on the neck
• Diarrhea
• Weight loss
• Cough
• Night sweats

These symptoms can be so mild that you might not even notice them. However, the amount of virus in your bloodstream (viral load) is quite high at this time. As a result, the infection spreads more easily during primary infection than during the next stage.

Clinical latent infection (Chronic HIV)

In this stage of infection, HIV is still present in the body and in white blood cells. However, many people may not have any symptoms or infections during this time.

This stage can last for many years if you’re not receiving antiretroviral therapy (ART). Some people develop more severe disease much sooner.

Symptomatic HIV infection

As the virus continues to multiply and destroy your immune cells — the cells in your body that help fight off germs — you may develop mild infections or chronic signs and symptoms such as:

• Fever
• Fatigue
• Swollen lymph nodes — often one of the first signs of HIV infection
• Diarrhea
• Weight loss
• Oral yeast infection (thrush)
• Shingles (herpes zoster)
• Pneumonia

Progression to AIDS

Thanks to better antiviral treatments, most people with HIV in the U.S. today don’t develop AIDS. Untreated, HIV typically turns into AIDS in about 8 to 10 years.

When AIDS occurs, your immune system has been severely damaged. You’ll be more likely to develop opportunistic infections or opportunistic cancers — diseases that wouldn’t usually cause illness in a person with a healthy immune system.

The signs and symptoms of some of these infections may include:

• Sweats
• Chills
• Recurring fever
• Chronic diarrhea
• Swollen lymph glands
• Persistent white spots or unusual lesions on your tongue or in your mouth
• Persistent, unexplained fatigue
• Weakness
• Weight loss
• Skin rashes or bumps

When to see a doctor

If you think you may have been infected with HIV or are at risk of contracting the virus, see a doctor as soon as possible.

So what is the answer to prevent this from happening by doing a few things:

-In safe sex from the front (through the vagina) or back (through the rectum-buttock); no matter what sex preference you are.

-When you use various sex partners get checked every 6 months to a year and have sex safely.

-The + HIV pt or now AIDS pt be compliant with the medications and RX the M.D. gives you if you chose not to do so previously.

Unfortunately like many who chose to do unsafe sex in getting this or worse than that those who got the disease by getting it through someone else when they didn’t have it is a shame.  Other ways of transmitting HIV/AIDS or getting it is by getting a blood transfusions (which is rare) but seen more frequently than transfusions would be sharing needle sticks, or even sex partners who didn’t tell their sex partner they had it, which it the worst someone could do to someone else. There are the those who got this disease innocently with not doing unsafe sex but for that percentage it is much lower than those who caused this disease  to spread unsafe sex or sharing needles with others who had the HIV/AIDS which caused the amount to go up higher in the USA and all over for being foolish. To all the people in the world let’s deal with this disease safely for yourselves and others around you. Let us all make a safer world for this is one small way which is greater than you may think.

HIV is a sexually transmitted infection (STI). It can also be spread by contact with infected blood or from mother to child during pregnancy, childbirth or breast-feeding. Without medication, it may take years before HIV weakens your immune system to the point that you have AIDS.

There’s no cure for HIV/AIDS, but medications can dramatically slow the progression of the disease. These drugs have reduced AIDS deaths in many developed nations. Luckily, many individuals who are diagnosed early can live a long, productive life with HIV thanks to a combination of highly active anti-retroviral drug therapy, which prevents to progression to AIDS.

“National HIV Testing Day (NHTD) encourages HIV testing as a critical tool to help end the HIV epidemic in the United States. Observed annually on June 27, the 2024 NHTD theme is Level Up Your Self-Love: Check Your Status, emphasizing self-compassion, self-respect, and self-love in honoring health needs by getting an HIV test. When someone knows their HIV status, they can choose options to stay healthy.

According to the Centers for Disease Control and Prevention (CDC), in 2022, an estimated 1.2 million people in the United States had HIV, but 13 percent of people with HIV did not know their HIV status. HIV testing is the pathway to engage people in care and help them stay healthy, regardless of the test result. People who have a positive HIV test can start antiretroviral therapy (ART) to stay healthy. People who have a negative HIV test can learn how to access HIV prevention options like pre-exposure prophylaxis (PrEP). CDC recommends that everyone aged 13–64 get tested for HIV at least once as part of routine health care. People with certain risk factors—such as having sex with someone who has HIV, sharing needles or drug injection equipment, or being treated for another sexually transmitted infection (STI)—should be tested for HIV at least once per year.”

HIVinfo.NIH.gov (https://hivinfo.nih.gov/understanding-hiv/hiv-aids-awareness-days/national-hiv-testing-day)

Where does HIV/AIDS come from for staters?  Here is the history we have learned over the years about this virus:

Well the Aids Institute states “Scientists identified a type of chimpanzee in West Africa as the source of HIV infection in humans. They believe that the chimpanzee version of the immunodeficiency virus (called simian immunodeficiency virus or SIV) most likely was transmitted to humans and mutated into HIV when humans hunted these chimpanzees for meat and came into contact with their infected blood. Over decades, the virus slowly spread across Africa and later into other parts of the world.

The earliest known case of infection with HIV-1 in a human was detected in a blood sample collected in 1959 from a man in Kinshasa, Democratic Republic of the Congo. (How he became infected is not known.) Genetic analysis of this blood sample suggested that HIV-1 may have stemmed from a single virus in the late 1940s or early 1950s.

We know that the virus has existed in the United States since at least the mid- to late 1970s. From 1979–1981 rare types of pneumonia, cancer, and other illnesses were being reported by doctors in Los Angeles and New York among a number of male patients who had sex with other men. These were conditions not usually found in people with healthy immune systems.

In 1982 public health officials began to use the term “acquired immunodeficiency syndrome,” or AIDS, to describe the occurrences of opportunistic infections, Kaposi’s sarcoma (a kind of cancer), and Pneumocystis jirovecii pneumonia in previously healthy people. Formal tracking (surveillance) of AIDS cases began that year in the United States.

What is the actual virus causing AIDS?

In 1983, scientists discovered the virus that causes AIDS. The virus was at first named HTLV-III/LAV (human T-cell lymphotropic virus-type III/lymphadenopathy-associated virus) by an international scientific committee. This name was later changed to HIV (human immunodeficiency virus).

For many years scientists theorized as to the origins of HIV and how it appeared in the human population, most believing that HIV originated in other primates. Then in 1999, an international team of researchers reported that they had discovered the origins of HIV-1, the predominant strain of HIV in the developed world. A subspecies of chimpanzees native to west equatorial Africa had been identified as the original source of the virus. The researchers believe that HIV-1 was introduced into the human population when hunters became exposed to infected blood.”

HIV is a lenti virus which is a subgroup of the retrovirus.

For starters HIV affects the white blood cells (WBCs) in this sense:

We have types of WBC’s and one type is called CD4. That is the cell the HIV binds to when it gets in your blood stream. Another name for them is T-helper cells. CD4 cells are made in the spleen, lymph nodes, and thymus gland, which are part of the lymph or infection-fighting system. CD4 cells move throughout your body, helping to identify and destroy germs such as bacteria and viruses.  Without going into specific medical terminology there is replication of this virus in the DNA and RNA killing out the normal white blood cell type of CD4 and other things like macrophages which are reproduced into CD4 cells with the virus with the body not knowing or able to detect this error in DNA and RNA of the CD4 white blood cells which ending line allows the immunity to go down. Remember the HIV virus binds to the surface of the CD4 cells. The virus entering CD4 cells now allows them to become a part of CD4 replicated cells regarding their make up due to changes made in the DNA and RNA cause the virus has invaded the bloodstream. As CD4 cells multiply to fight infection, they also make more copies of HIV now. Continuing to replicate, leading to a gradual decline of CD4 cells in decreasing that individuals immunity to infection.

The 2 types of HIV:

There are two types of HIV that have been characterized: HIV-1 and HIV-2.

HIV-1 is the virus that was initially discovered and termed both LAV and HTLV-III. It is more virulent, more infective and is the cause of the majority of HIV infections globally. The lower infectivity of HIV-2 compared to HIV-1 implies that fewer of those exposed to HIV-2 will be infected per exposure. Because of its relatively poor capacity for transmission, HIV-2 is largely confined to West Africa.

What is CD4 and how it helps the doctor:

The CD4 count measures the number of CD4 cells in a sample of your blood drawn by a needle from a vein in your arm. Along with other tests, the CD4 count helps tell how strong your immune system is. By knowing this when the blood test is done the CD4 helps the following, for the doctor:

-it indicates the stage of your HIV disease

-it guides the treatment

– it predicts how your disease may progress.

**Keeping your CD4 count high can reduce complications of HIV disease and extend your life.**

”Recent years have witnessed substantially increased research regarding sex differences in pain. The expansive body of literature in this area clearly suggests that men and women differ in their responses to pain, with increased pain sensitivity and risk for clinical pain commonly being observed among women. Also, differences in responsivity to pharmacological and non-pharmacological pain interventions have been observed; however, these effects are not always consistent and appear dependent on treatment type and characteristics of both the pain and the provider. Although the specific aetiological basis underlying these sex differences is unknown, it seems inevitable that multiple biological and psychosocial processes are contributing factors. For instance, emerging evidence suggests that genotype and endogenous opioid functioning play a causal role in these disparities, and considerable literature implicates sex hormones as factors influencing pain sensitivity. However, the specific modulatory effect of sex hormones on pain among men and women requires further exploration. Psychosocial processes such as pain coping and early-life exposure to stress may also explain sex differences in pain, in addition to stereotypical gender roles that may contribute to differences in pain expression.”

National Library of Medicine – NIH (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3690315/)

The nervous system’s dials for communicating chronic pain to the body work differently in male and female mice, according to a study published today in Nature Neuroscience. If this difference is also found in humans, it could lead to chronic pain treatments that are better tailored to the patient. But the most immediate impact might be in basic research — the earliest stages of work — since right now, the mice being used are almost exclusively male.

Chronic pain affects more than 100 million people in the US, which is more than heart disease, cancer, and diabetes combined. And many pain conditions occur more often in women than in men, according to the FDA. That’s why figuring out how male and female mice deal with pain — and whether they do so differently than humans — is so important. After all, most medical research — including pain research — starts with mice.

In the study, researchers focused on microglia, a type of immune cell that can be found in the brain and the spinal cord. These cells are known to play a role in the “volume knob” for pain, explains Jeffrey Mogil, a pain researcher at McGill University and a co-author of the study. The knob turns way up after an injury. A genetic study done in Mogil’s lab a few years ago had indicated that microglia weren’t as important in the pain circuit of female mice. So, the scientists decided to find out if interfering with the microglia would have the same effect in male and female mice.

Male mice had no pain, whereas female mice did

The researchers used mice that were suffering from a hypersensitivity to pain. The scientists gave them drugs that target the microglial cells in the spinal cord, in the hopes that this would prevent the animals from feeling pain. But only male mice responded to the drugs — the female mice still had an increased sensitivity to pain.

When the researchers repeated these experiments in mice under varying conditions, they saw the same results: male mice had no pain, whereas female mice did. “Whatever the manipulation is, in every case, blocking microglia or some part of the microglial system brings the pain sensitivity back to normal in male mice, and doesn’t do anything in female mice,” Mogil says.

Now looking at the human we see this: There is a growing body of literature that indicates women are more likely than men to be undertreated for their pain.

It appears that gender affects not only pain perception, pain coping, and pain reporting, but also pain-related behaviors, including use of healthcare and the social welfare system. It is also probable that men and women differ systematically in their responses to pain treatments, although further research is needed in this area.

For many common pain conditions, including migraine and tension-type headache, facial pain, and abdominal pain, population-based studies indicate higher prevalence rates in adult women than in adult men.

Despite the difficulties with human laboratory experiments on pain sensitivity, many investigators are willing to draw the inference from these studies that women are, in general, more sensitive to painful stimuli than men, and that this difference is biologically based.

Whatever the pain prevalence differences for men and women, most studies show that women seek healthcare for pain at a higher rate than men:

• • One study indicated that women are more likely to be given sedatives for their pain, while men are more likely to be given pain medication.

  • Faherty and Grier studied the administration of pain medication after abdominal surgery and found (after controlling for weight) that physicians prescribed less pain medication for women than for men ages 55 or older, and that nurses administered less pain medication to women than to men ages 25-54 years.

  • Beyer et al examined pain medication given to children and found that, after surgery, boys received significantly more codeine than girls, and girls were more likely than boys to be given acetaminophen.

  • In a 1994 study of 1,308 outpatients, Cleeland and colleagues found that women with metastatic cancer were significantly more likely than men with the same diagnosis to receive inadequate pain medications.

  • In a study of several hundred AIDS patients, Breitbart and colleagues found that, based on the WHO analgesic ladder guideline, women were significantly more likely than men to receive inadequate analgesic therapy.

  • A study by Weir and colleagues found that women are less likely than men to be referred to a specialty pain clinic, at least upon initial encounters with their physicians.

  • A study reviewing cancer care at seven outpatient clinics in California found that female cancer patients were prescribed half the pain medication as male patients with the same pain intensity scores.

  • Males outnumber females two to one in the burn population. This is related to male household and job roles, which increase the risk for burn injury. Furthermore, males more commonly engage in risk-taking behaviors involving chemicals, flammable materials, or electricity.So what do we see so for at this point:

• We feel pain more intensely than men, according to a new study of 11,000 men and women who were patients at the Stanford Hospital and Clinics.

• Researchers analyzed electronic medical records of patients’ reports of pain across a range of different diseases, and found a distinct gender-driven difference in how much discomfort patients say they felt. The study included 47 disorders — from cancer to back conditions and infectious diseases — and more than 161,000 patient-reported pain scores. The patients were all asked by nurses or other health personnel to rate their pain on an 11-point scale, with 0 representing “no pain” and 11 signifying the “worst pain imaginable”.

• Not surprisingly, most responses clustered around either the two extremes of very little pain or extreme pain or the middle score of 5. But overall, women were more likely to indicate higher pain levels than men, says lead author Dr. Atul Butte, chief of systems medicine in the department of pediatrics at Stanford University School of Medicine. And that was true across almost all of the different diseases. “That was the most surprising finding,” says Butte. “We completely wouldn’t have expected such a difference across almost all disorders, where women were reporting a whole pain point higher on the 0-to-10 scale than men.”

• Of course, self-reports can’t account for the fact that people may define tolerable and intolerable pain in vastly different ways, says Butte, but the fact that a gender difference emerged from such a large number of patients suggests that the effect is real.

• What accounts for the gender gap? Hormones may explain some of the difference — studies have shown that estrogen in women can help dampen the activity of pain receptors, helping them to tolerate higher levels of pain. That means, however, that they may become more sensitive to pain during low-estrogen parts of the menstrual cycle.

• There may also be explanations that have nothing to do with biology. Men, for example, may feel compelled by cultural stereotypes to be tough, and therefore report feeling less pain than they really do —especially when asked by the mostly female nursing staff.

Still, even if non-biological factors are influencing how much pain men and women report, Butte says the difference is worth noting. “The reasons may be biological or they may not be, but we should still be aware of the bias that patients have in reporting pain,” he says. He is hoping to continue the research by following up these results with surveys of patients’ ratings after they were treated for pain. That may help doctors to better address the real pain patients may be feeling.

Through the National Library of Medicine in 2022 (https://pubmed.ncbi.nlm.nih.gov/36038207/) They state; “Chronic pain affects 20% of adults and is one of the leading causes of disability worldwide. Women and girls are disproportionally affected by chronic pain. About half of chronic pain conditions are more common in women, with only 20% having a higher prevalence in men. There are also sex and gender differences in acute pain sensitivity. Pain is a subjective experience made up of sensory, cognitive, and emotional components. Consequently, there are multiple dimensions through which sex and gender can influence the pain experience. Historically, most preclinical pain research was conducted exclusively in male animals. However, recent studies that included females have revealed significant sex differences in the physiological mechanisms underlying pain, including sex specific involvement of different genes and proteins as well as distinct interactions between hormones and the immune system that influence the transmission of pain signals. Human neuroimaging has revealed sex and gender differences in the neural circuitry associated with pain, including sex specific brain alterations in chronic pain conditions. Clinical pain research suggests that gender can affect how an individual contextualizes and copes with pain. Gender may also influence the susceptibility to develop chronic pain. Sex and gender biases can impact how pain is perceived and treated clinically. Furthermore, the efficacy and side effects associated with different pain treatments can vary according to sex and gender. Therefore, preclinical and clinical research must include sex and gender analyses to understand basic mechanisms of pain and its relief, and to develop personalized pain treatment.”.

“CDC states the following:

• Sickle cell disease (SCD) is a group of inherited blood disorders. Abnormal hemoglobin is produced.
• Red blood cells become hard and sticky and get stuck in small blood vessels, resulting in pain and other serious complications.
• There are several types of SCD, some more severe than others.
• In the United States, SCD is often found at birth through routine newborn screening.

Sickle cell disease (SCD) affects about 100,000 people in the United States; more than 90% are non-Hispanic Black or African American, and an estimated 3%–9% are Hispanic or Latino.

The estimated life expectancy of those with SCD in the United States is more than 20 years shorter than the average expected.

Many people with SCD unfortunately do not receive the recommended healthcare screenings and treatments.”

Center for Disease Control and Prevention – CDC (https://www.cdc.gov/sickle-cell/data/index.html)