Who Should get Tested for HIV?

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The only way for someone to know if they are infected with HIV is to get tested. The CDC recommends everyone age 13 to 64 get tested for HIV at least once in their lifetime as part of routine health care. People who participate in high-risk activities should get tested more often.

High-risk activities include:

  • Men having sex with men
  • Having sex with a partner who is HIV positive without using a condom or taking Pre-Exposure Prophylaxis (PrEP)
  • Multiple sexual partners in the last year
  • Having sex with someone who participates in the high-risk activities above or, you don’t know their sexual history
  • Exchanging sex for drugs or money
  • Sharing needles, syringes, or other drug injection equipment

Other risk factors that require testing more often:

  • Previously diagnosed with, or treated for, another sexually transmitted infection, hepatitis, or tuberculosis

It’s recommended that high-risk individuals get tested once a year. Intravenous drug users should get tested every six months. Women who are pregnant and haven’t been tested previously should also talk with their healthcare provider about getting tested for HIV. Infected pregnant women can reduce the risk of passing the virus on to their child to as little as 1% with proper treatment.

How do you test for HIV?

NOAH offers HIV testing as part of routine blood work as well as rapid testing which only requires a simple finger poke and produces results in as little as 30 minutes.

How much does it cost?

HIV testing at NOAH is free but does require an appointment with a medical provider. As preventative care, this appointment is typically covered in full by most insurance carriers.

Maricopa County is an HIV Hot Spot

A federal program launched in 2020 “Ending the HIV Epidemic” identified 50 jurisdictions and seven states accounting for more than half of all new HIV diagnoses in the United States. Maricopa County is on the list of HIV “Hot Spots” with new infection rates per 100K people ranking higher than the state and national average. Allocating additional government funds to geographical areas like Maricopa County improves access to HIV testing, treatment and prevention with the goal to reduce new infections by 75% in five years (2025) and by 90% in ten years (2030).

Now more than ever, people living with HIV can lead long healthy lives with proper treatment. The earlier the virus is detected, the sooner treatment can begin. For more details on HIV treatment and prevention, check out our blog post “What if You Test Positive for HIV?” or schedule an appointment with your NOAH provider.

What if You Test Positive for HIV?

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Learning you’ve tested positive for HIV might feel like the end of the world, especially if you weren’t expecting it. It’s normal to feel mad, scared, sad, or even numb at first and you’ll likely experience a wave of these emotions as the reality of your diagnosis begins to set in.

NOAH’s HIV navigation team will contact you immediately if you have a positive HIV diagnosis. Our highly skilled team will help you process and understand your results, help you schedule an initial appointment with an HIV specialty clinic, and connect you with financial assistance if needed.

Treatment

HIV treatment with prescription medication should begin as soon as possible. The goal of this medicine is to reduce the amount of HIV in your blood, often referred to as your “viral load”. The lower your viral load, the lower your chances are of transmitting the virus to others and/or contracting life-threatening infections or cancers.

Research has shown that patients with HIV can obtain an undetectable viral load in six months or less as long as they continue treatment as prescribed. It’s important to note, every patient is different, and results may vary.

HIV is Not a Death Sentence

Though there is no cure for HIV, taking your medicine can keep you undetectable. According to the CDC, in the early years of the epidemic, HIV positive individuals usually only had one or two years to live. Over the past 40 years, HIV treatment has come a long way and enabled patients to live long, healthy lives. The single most important thing you can do to prolong your life and the lives of others is to get tested.

Resources for Support

It’s a good idea to enlist a few support channels to help you cope with your diagnosis and live your best life with HIV. NOAH offers in-person and virtual individual counseling services and your HIV care provider will likely have referrals or recommendations. There are also hundreds of online resources; try Stop HIV Together and Positive Spin; both backed by the CDC, or Maricopa County’s Positively You.

For more information on HIV testing, read our blog article “Who Should get Tested for HIV?” or schedule an appointment with your NOAH provider.

Common Myths About HIV

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MYTH #1: I can get HIV by being around people who are HIV positive.

HIV cannot be spread through casual contact. The virus can only be transmitted through certain body fluids including: blood, semen, rectal fluid, vaginal secretion, and breast milk. HIV is not spread through saliva, sweat, tears, or even mosquito bites. Here’s a detailed list from the CDC on how HIV can and cannot be transmitted.

MYTH #2: Only gay men can get HIV.

Although the infection rates are more prominent in gay and bisexual men. Anyone, regardless of age, gender, ethnicity, or sexual orientation can become infected with HIV.

For new HIV positive cases reported from 2015 to 2019, male to male sexual contact accounted for 69% and male to female sexual contact made up for 23% of diagnoses.

MYTH #3: It’s OK to have unprotected sex if both partners have HIV.

Unprotected sex between two people that have each been diagnosed with HIV is still risky.

HIV comes in different forms or variants and those variants can be transmitted between partners even if one or both partners is already infected with HIV. Different types of the virus may not react to medication in the same way or can cause other problems with treatment. Types of HIV are also known to change over time, so even if one partner infected the other, their variants could be different. The risk of transmission can be reduced to zero if both partners use medication to reduce and maintain the amount of HIV in the blood to very low levels. This is also referred to as maintaining an undetectable viral load.

MYTH #4: Birth control prevents HIV.

HIV can be spread through any unprotected sex. Most forms of birth control only prevent pregnancy. The best single way to prevent both HIV and pregnancy during sexual intercourse is by using a condom. However, using a combination of prevention methods like Pre-Exposure Prophylaxis (PrEP) for HIV and one of a wide-range of birth control methods provides even better protection.

MYTH #5: You can tell someone has HIV by how they look.

It’s normal for people with HIV to not look or feel sick. In fact, the CDC reports one in seven people who are infected with HIV don’t even know it. The only way to know if a person has HIV is for them to get tested and share their positive results.

MYTH #6: HIV is curable.

At this time there is no cure for HIV. Medicine can help people who have the virus live long, healthy lives. Treatment can even reduce one’s viral load to an undetectable (and untransmittable) level.

If you have questions about HIV testing, prevention, or treatment, talk to your NOAH provider.

NEWS: NOAH Receives $4.1 Million for New Scottsdale Health Center

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NOAH is pleased to announce that they will receive $4.1 million in funding from the Arizona Alliance for Community Health Centers (AACHC) to support the development of NOAH’s new comprehensive Cholla Health Center in south Scottsdale.

The new 30,000 sq. ft. Cholla Health Center will be located at 8705 E. McDowell Road, in Scottsdale, just off the Loop 101. This new center will consolidate three NOAH health centers in Scottsdale into one, much larger, more comprehensive facility.

The grant was provided to NOAH through Maricopa County Department of Public Health with funds allocated to AACHC. These funds are specifically designated to support programs and services to help people, families, and businesses recover from the effects of the pandemic. The projects selected for grant awards, including NOAH, will help prepare Maricopa County to meet current and future public health crises, as well as daily health care needs.

“This grant both supports a much-needed health center for this community and furthers our mission to provide healthcare services to all,” said NOAH CEO Wendy Armendariz. “NOAH has a long-standing presence in this community so growth here, especially during a great time of need, is an important step for our organization.”

The new Cholla Health Center will combine NOAH services, providers, and staff members from three existing facilities: NOAH Heuser Family Medicine, Heuser Dental Clinic, and the former Cholla Health Center in north Scottsdale. NOAH’s new location will serve 16,000 patients annually from Scottsdale, east Phoenix, Tempe, Mesa and the surrounding areas with integrated care including medical, counseling, psychiatry, dental, on-site laboratory, nutrition, and community resources all under one roof. The NOAH Cholla Health Center is set to open in late 2022. New and existing patients are welcome at this or any of the other NOAH locations in Maricopa County. NOAH accepts all patients with either private and public insurance including AHCCCS/Medicaid, patients who are uninsured or underinsured, and offers health insurance enrollment support, Sliding Fee Scale (SFS), and self-pay discounts. To schedule an appointment or for more information, call 480-882-4545 or click here.

Women’s Health Week #3 – Contraception & Birth Control

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week is May 8 -14 and this year NOAH is highlighting three health issues that women should be familiar with and discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Contraception & Birth Control

Nearly 65% of all women between age 15 and 49 in the U.S. use some form of birth control. But the reasons why are more than pregnancy prevention. Learn more about the types and uses for contraception from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

Why use birth control?

Birth control reduces the chances of an unintended pregnancy when used correctly. But beyond that, many individuals use hormonal birth control to help regulate menstrual cycles, prevent ovarian cysts, regulate hormones, and reduce menstrual pain, Acne, and excessive body hair growth.

What are different contraception options?

You have options but talk to your PCP or OBGYN about what method is right for you. Here are the different types of birth control available:

  • “The Pill” – A daily pill that combines two hormones: estrogen and progesterone. Failure rate: 7%.
  • Progestin-Only Pill – Like “The Pill” above but only the hormone progesterone. Failure rate: 7%.
  • Implant (Nexplanon) – This is a small rod placed in the arm by your doctor that gives a continuous dose of progestin slowly over 3 years. Low failure rate: 0.1%.
  • IUD (Intrauterine Devices) – These small T-shaped devices are placed in the uterus by your doctor. There are two options:
    • Hormonal: Releases a small hormone dose each day and can last 3 to 6 years. Low failure rate: 0.1% – 0.4%.
    • Copper: Can stay in your uterus for up to 10 years. Low failure rate: 0.8%.
  • Injection/Shot – This is a progestin shot every three months. The biggest side effect of the injection is weight gain. Failure rate: 4%.
  • Patch – The patch placed on a person’s skin releases hormones. A new patch is put on each week for three weeks, with no patch during the fourth week. These can be difficult in hot climates because it doesn’t stick as well. Failure rate: 7%.
  • Vaginal Ring – The ring releases estrogen and progesterone. You wear the ring for three weeks and then remove it on the fourth week. Failure rate: 7%.
  • Other methods:
    • Diaphragm – 16% failure rate
    • Male condom – 18% failure rate
    • Female condom – 21% failure rate
    • Cervical cap – 23% failure rate
    • Sponge – 24% failure rate
    • Fertility based methods (tracking cycle days, basal body temperature) – 26% failure rate
    • Spermicide – 28% failure rate

How to pick the right form of birth control?

Remember that not everyone will respond the same way to every form of birth control. And not everyone has the same reason for needing birth control. Be sure to discuss with your provider any types of current or previous forms of birth control used and any side effects so together you will find the right form of birth control for you!

How Important is it to See a Dermatologist?

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NOAH is focused on providing primary care to our patients, but we often refer patients to specialists for secondary care specific to a medical concern or screening. One of those referrals is for a yearly exam with a doctor who specializes in our bodies’ largest organ – our skin! The Skin Cancer Foundation recommends people of average risk for skin cancer see a dermatologist once a year for a full-body skin exam. The purpose of this exam is to screen for skin cancer by looking for and testing unusual spots on the skin; and to identify and treat any other skin conditions.

What to Expect During Your Annual Exam

  • You’ll likely be asked to change into a hospital gown; removing all of your clothes except for your underwear.
  • The dermatologist will visually scan your entire body for any abnormal spots or skin conditions.
  • Your doctor will even check hard to see places like your scalp, behind your ears, and in-between your toes.
  • Some doctor’s will use a dermatascope to magnify your skin and see through the first few layers.
  • If you are at average risk for skin cancer and don’t have any other skin conditions or concerns, your exam may take as little as ten minutes.

Tips for a Successful Exam

  • It’s a good idea to do a self-exam before your appointment. If you find any suspicious spots, you can point those out to your doctor right away. Also check your genital area for any spots or skin conditions you may want to address.
  • Skip the makeup (or be prepared to remove it) but do keep your normal cleansing/moisturizing routine. It’s best for your doctor to see how your skin normally appears. If there’s excessive dryness, etc. they may recommend a change.
  • Remove nail polish from your fingers and toes, skin cancer can form there too.
  • Wear your hair down or in a loose ponytail so it’s easy for the doctor to examine your scalp; and remove earrings for better visibility behind your ears.

What Happens if you have an Abnormal Spot?

  • If the dermatologist finds anything that looks suspicious, part or all of the spot will be removed and sent to a lab for testing.
  • If the spot is determined to be skin cancer, the doctor will discuss treatment options with you. Treatment can be as simple as removing the entire spot plus a small margin around the edges if it’s caught early.

Do Your Part to Prevent Skin Cancer

  • May is Skin Cancer Awareness Month but skin cancer prevention is important year-round, especially in Arizona.
  • Reduce your exposure to the sun; especially between 10 a.m. and 4 p.m. when UV rays are strongest.
  • Use broad spectrum sunscreen with an SPF of 15 or higher as part of your daily skin care routine.
  • If you are spending time in the sun, try to reduce the amount of skin exposed by wearing long sleeves, a wide-brimmed hat, etc.
  • Be sure to reapply sunscreen throughout the day if you are outside for a long period of time.
  • Check the label on waterproof sunscreen and reapply as directed.
  • Opt for sunless tanner over indoor tanning beds.
  • Check your body monthly and contact your doctor with anything that concerns you. Here’s a handy Body Mole Map from the American Academy of Dermatology Association that guides you through a self-exam, reminds you what to look for, and even provides space to indicate the location and description of abnormal findings.

Women’s Health Week #2 – HPV Vaccine

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 8 – 14, NOAH is highlighting three health issues that women should be familiar with and can discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

HPV Vaccine

Vaccines save lives in many ways, but the HPV vaccine and the virus it prevents is a little different. Two of NOAH’s providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs explain why.

What is the HPV Vaccine?

The HPV vaccine protects against the human papillomavirus (HPV). This is a sexually transmitted infection and is extremely common. Almost everyone will be exposed to HPV at some point in their lives. Typically, if you are exposed, your body will fight off the virus easily. But when that doesn’t happen, HPV can lead to cancer later in life. In fact, HPV is responsible for more than 95% of cervical cancer cases.

The two- or three-part HPV vaccine (depending on your age) is given to preteens and is covered by most insurance, including Medicaid/AHCCS. If you don’t have insurance, you can get the vaccine at no cost at NOAH through Vaccines for Children.

Why is this vaccine so important?

The HPV vaccine provides coverage for nine strains of HPV which are linked to cervical cancer, anal cancers, and mouth cancers. Getting this vaccine protects against HPV and decreases the risk of future cancer. HPV vaccine is essentially a cancer vaccine.

Why does this vaccine start at 11?  

HPV vaccines can start as young as age 9, but according to the American Cancer Society, preteens have the best immune response with this vaccine, and the vaccine works best when given before someone is exposed to the virus. If the vaccines don’t start until age 15, they will need three doses instead of two. Vaccines can be given up to age 26.

Both males and females need the HPV vaccine because it protects you and your partners from getting or passing the virus. It also prevents genital warts and some cancers which both males and females can get.

What if you are 26 years and older?

The vaccine is now approved up to age 45, but it is less effective after age 18. Discuss this with your doctor if you are interested. Most sexually active adults have been exposed to some, but probably not all, strains of HPV. If you haven’t received the vaccine and are over 26, the best way to prevent these types of cancers is regular physicals and screenings with your PCP.

Women’s Health Week – Cervical Cancer

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By Dr. Hadass Fuerst & Dr. Marissa Jacobs

Women’s Health Week kicks off on Mother’s Day every year. This year for Women’s Health Week from May 14 – 20, NOAH is highlighting three health issues that women should be familiar with and should discuss with their provider any time of year.

NOAH recommends that everyone have a primary care provider (PCP) and a medical home. If you don’t have one or both of these, contact NOAH and establish a PCP who is right for you!

Cervical Cancer

Around 12,000 people are diagnosed cervical cancer every year. Understand more about this cancer from two of NOAH’s family medicine providers, Dr. Hadass Fuerst and Dr. Marissa Jacobs.

What is Cervical Cancer and what causes it?

Cervical cancer is a cancer that forms at the lower end of the uterus. Most cervical cancers are caused by Human Papilloma Virus (HPV), the most spread sexually transmitted infection (STI). About 80% of people will be infected with this virus at some point in their lives, and most people’s bodies will naturally fight off the virus. For those who can’t fight it off, HPV can lead to health issues like cervical cancer later in life. That’s why the HPV vaccine is so important. More on that later.

How Can I Lower My Risk of Cervical Cancer?

Yes! First, get regular Pap smears/tests. According to the CDC, millions of women aged 21-65 haven’t had a Pap test in the last five years! Pap tests are covered by private insurance and Medicaid/AHCCCS and are the best way to diagnose any problems. Pap tests save lives.

Second, get the HPV vaccine if possible. It is safe and very effective at reducing the risk of getting HPV-caused cancers later in life.

The CDC estimates that around 93% of cervical cancer cases could be prevented by regular Pap tests and HPV vaccine.

How Often Do I need a Pap Test?

It used to be that Pap tests were recommended every year. With what we know now about HPV and cervical cancer risk factors, that recommendation has changed. The new recommendation for people also being tested for HPV is every three years for people aged 21-29, and every five years for people 30-65.

Who Can Get HPV Vaccines?

Typically, the three-dose HPV vaccine is recommended for males and females around age 11 or 12. We wrote all about the HPV vaccine here!

Monitoring your Teen’s Mental Health

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Pre-teen and teen years are marked by a rollercoaster ride of emotions making them difficult to navigate for students, parents, and educators. Emotional ups and downs are often normal for this age group, but can be a warning sign of a more serious mental health condition, like depression. While it’s one of the most common mental illnesses, depression is a leading risk factor for suicide. In a recent study by the Centers for Disease Control (CDC), 44% of teens surveyed reported two or more weeks of feeling sad or hopeless in the last year and 9% had attempted suicide.

It can be challenging to tell the difference between normal teen behavior and depression. So how do you know when it’s something more serious?

The JED Foundation suggests watching for these warning signs:

  • Significant changes in eating, sleeping, self-care, or socializing habits
  • Sadness and/or withdrawal from social situations, especially if they persist for a while
  • Extreme mood swings or irritability
  • Seeming much more fearful and/or avoiding certain environments, situations, or social interactions altogether (such as school avoidance)
  • Using drugs or alcohol, especially changes in typical patterns of use
  • Difficulty with or neglect of basic self-care, personal hygiene, etc. 
  • Getting in fights or suddenly not getting along with others 
  • Sudden increase in reckless, impulsive, out-of-control behaviors
  • Changes in social media behavior 

Most importantly, trust your gut. If you feel like something’s not right, act on it.

For expert tips on talking with your teen about mental health, check out The JED Foundation’s guide, “What to do if you’re Concerned about your Teen’s Mental Health,” which addresses topics including:

  • Signs that your teen may be struggling
  • Preparing yourself emotionally to have the conversation
  • What to say and do during the conversation
  • What to do if your teen denies a problem or refuses help but you are still concerned
  • How to follow up after the conversation

Understand that sometimes, no matter how hard you try, talking to your teen about their emotions can be difficult, if not impossible. NOAH can help. Our Behavioral Health Counselors are available to talk in-person or via video call and many of them specialize in young adults and/or depression. Schedule an appointment today.

If you feel your teen may be in danger of harming themself or others, go to the nearest emergency room or reach out to any of the crisis resources below:

  • Mercy Maricopa Crisis Line: 602-222-9444 
  • Teen Life Line phone or text: 602-248-TEEN (8336)
  • Veterans Crisis Line: 1-800-273-8255 (press 1)
  • National Suicide Prevention Lifeline: 1-800-273-TALK (8255)
  • National Substance Use and Disorder Issues Referral and Treatment Hotline: 1-800-662-HELP (4357)

Understanding Food Allergies

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Food allergies are getting more attention in recent years – which is a good thing! Around 32 million Americans, including 5.6 million children, are living with a potentially life-threatening food allergy. The more we know about allergies, the better!

Food Allergy vs Food Sensitivity

First things first; food allergies and food sensitivities or intolerances aren’t the same thing. Food allergies are a serious medical condition where your body’s immune system reacts to a specific food protein. It can look like getting a rash or hives, swelling, dizziness, itching, and even anaphylaxis (a serious reaction that can affect breathing and blood pressure read more here).  

If someone thinks they or a family member may have a food allergy, a medical provider should be the one to test and diagnose the allergy.

Food sensitivities or intolerances do not involve the immune system. Things like lactose intolerance, gluten sensitivity, and others are in the digestive system. They can cause serious discomfort like bloating, constipation, cramping, and nausea, but they can’t be fatal. Read more about food sensitivities.

Most Common Food Allergies

People can be allergic to many different kinds of food. Common food allergies are:

  • Peanuts – One of the most common food allergies in children and adults, peanuts – a legume (different from a tree nut) – is usually a lifelong allergy.
  • Milk and Dairy Products – Cow’s milk is the most common allergy in infants and young children, though most outgrow it. It is also one of the most common adult food allergies too.
  • Eggs – A common food allergy for babies and children, many will outgrow it. Some adults remain allergic, and it can be to egg whites, or egg yolks since they contain different proteins.
  • Shellfish – Allergies to this type of seafood, including shrimp, prawns, lobster, and crayfish are typically lifelong, though most people don’t experience a reaction until they are an adult.
  • Soy – Most common in infants and young children, most outgrow a soy allergy. Soy is a legume like peanuts but being allergic to one doesn’t mean someone will be allergic to the other.
  • Wheat – This allergy affects children the most, but many outgrow it by age 10. This is not the same a celiac disease, wheat allergies are to the proteins found in wheat, not gluten.
  • Tree Nuts – Not the same as peanuts, tree nuts include almonds, cashews, walnuts, and more. An allergy to these nuts also includes things like nut butters and oils. Being allergic to one type of tree nut increases the risk of becoming allergic to other tree nuts.

What Next?

If you or a loved one is diagnosed with a food allergy, try not to feel overwhelmed. While it does mean you need to change what you eat, there are many resources and people and groups to support you, including NOAH’s Nutrition Services team.

Make sure you have a proper diagnosis with a medical provider. Discuss with them what the diagnosis means. Will the child outgrow it? What medications should you have? What does a severe reaction look like?

Finally, the most important thing to know is that the best way to prevent an allergic reaction to food is to avoid that food. That is what most doctors recommend along with having an epi-pen on-and always to treat any reaction to food allergies. Even a small amount can cause a reaction, but here are some tips.

There is promising news about a new intensive treatment called “food allergen desensitization” which is available and can resolve the allergy in some cases – though definitely not all cases. If you are interested in learning more about this treatment, ask your medical provider if this is right for you.

To get you started on figuring out your food allergies and staying safe, check out our recipes with different ingredient options.