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© Niyazz via Canva.com Every patient, regardless of how they may identify, greatly benefits from preventive healthcare and early detection. Members of the LGBTQIA+ community face unique considerations when it comes to their health, and a proactive approach to preventive screenings and vaccines is important in order to address their individual health needs.  Dr. Karen Thiele, Family Medicine Physician with University Health and Assistant Professor of Family and Community Medicine at the University of Nevada, Reno School of Medicine, breaks down key steps that LGBTQIA+ patients should take to safeguard their health.  PrEP and PEP  Pre-exposure prophylaxis (PrEP) is a strategy to prevent human immunodeficiency virus (HIV) infection. It is an important measure for those who are HIV-negative but may be at risk of contracting it. The highest risk sexual practice is receptive anal intercourse, due to the relative fragility of rectal tissue. This medication can stop HIV from spreading in the body and help patients maintain their HIV-negative status. PrEP is available in both pill form, which is taken every day, and injection form, of which the first two injections are initiated one month after another while all other injections are initiated every two months.  Post-exposure prophylaxis (PEP) is an antiretroviral drug regimen taken after potential HIV exposure to prevent an HIV-negative individual from converting to HIV-positive status. PEP is only for emergency situations and must be started within 72 hours of exposure – sooner is always better than later – and must be taken for 28 days.  PrEP and PEP are available in many ways, including visiting your primary care provider (PCP) or an urgent care location.   HPV Immunization  All genders and identities can protect themselves against human papillomavirus (HPV), a sexually transmitted infection (STI) that can lead to the risk of cervical, mouth, head, neck, throat, anal, vaginal, penile and vulvar cancers. HPV is so common that nearly all sexually active people, regardless of sexual orientation and practices, will be exposed at some point in their lifetime.  The HPV vaccine (common brands include Gardasil and Cervarix) is a safe and effective method to prevent HPV, according to the Centers for Disease Control and Prevention (CDC). This vaccine protects against infections that can lead to HPV-related cancers and precancers, as well as genital warts. While patients should start receiving the vaccine at 9 years old years old, unvaccinated adults up to the age of 45 can also receive the vaccine through their PCP – better late than never!  STI Testing  Sexually-transmitted infections form from bacteria, viruses or parasites that can be transmitted by person-to-person sexual contact through semen, vaginal, blood and other bodily fluids. According to the U.S. Department of Health and Human Services, there are more than 20 million estimated new STI cases across the nation each year.   Luckily, most STIs are preventable. Annual STI testing for HIV, gonorrhea, chlamydia and syphilis is important to stay on top of your sexual health. Because these STIs may sometimes have no symptoms, screening is recommended regularly and with any change in sexual partners. Depending on the specific condition, tests for these infections include urine, swab and blood tests. Speak with your primary care provider on a screening schedule that works best for you.  Prostate Exams  Prostate exams look for early signs of prostate cancer in patients who still have a prostate. The CDC recommends those who are at least 55 years old get regular prostate screenings; however, for patients with a family history of prostate cancer, screenings may be recommended as early as 45 years old.  These exams are done via two common methods – a prostate specific antigen (PSA) blood test and a digital rectal examination (DRE). Your provider can help you determine your risk and when you should start getting screened.  Pap Tests and Pelvic Exams  Patients of all genders who have a cervix, uterus, vagina and/or ovaries will benefit from regular pelvic exams and Pap screenings. A pelvic exam consists of a provider looking inside the vagina and at the cervix for anything unusual. A Pap test, also known as a Pap smear, involves your provider using a small, soft swab to collect cervical cells to check for early signs of cancer.  Generally speaking, people with these organs should have a Pap test every three years starting at age 21 through the age of 30. After age 30, patients should receive a Pap test with HPV co-testing every five years until age 65. These recommendations are changing based on new research, so it is important to have a conversation with your PCP about the current guidelines so you can make an informed choice about what schedule you should follow. A gynecologist or your primary care provider can counsel you and perform these screenings.  Mammograms and Breast Exams  People with breast tissue, especially dense breast tissue, are at risk for breast cancer, and regular breast screenings are your best line of defense. At-home breast self-exams are the first step – you will want to check your breasts for any lumps, changes, fluid leaks, irregular tissue thickening or anything else that feels unusual.  The Breast Cancer Risk Assessment tool, provided by the National Cancer Institute, is a good place to start to identify your risk. Talk with your primary care provider about the risks and benefits of starting screening at age 40 so you can make an informed decision about when to start. If you have any family history of breast or ovarian cancer, your PCP will offer you genetic testing for BRCA 1 and 2 mutations. Nevadans over the age of 18 can also get BRCA genetic test for free by enrolling in the Healthy Nevada Project.  Mammograms are important screening tools, but for a significant portion of people with breast tissue, density of the breast tissue may make mammograms less helpful in detecting cancer. Your primary care provider can help you decide what additional imaging (such as breast ultrasound) might be best for you.

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Winter is a season that is loved by many. It is the time of year when families get to enjoy outdoor activities such as snow and ice-skating and indoor activities such as cooking or playing board games with family. But because the temperature outside is a little more frightful, it can make us need to think a little more creatively about what activities the kids in our lives might enjoy. We have you covered, here are 10 ways to keep children entertained and enriched even when the weather is not sunny Reno, we all know and love. 1. Ice Skating Enjoy the family fun of gliding and twirling around at The Ice Rink at Grand Sierra Resort or check out Reno Ice. Both ice rinks offer public skating sessions for all ages. 2. Movies Watching movies has always been a great activity. Check your local listings to find a theater convenient to your location. 3. Snow Play The Winter is a time that many people use to take advantage of all the snow and ice our area has to offer. People enjoy snowball fights and rolling downhills. It is a great time for kids to have fun in the snow with their friends. 4. Scrap-Booking Being crafty is a great way for the whole family to have fun. Scrapbooking can be done with most of the supplies lying around the house. 5. Write Letters to Our Troops Operation Gratitude sends letters from civilians thanking troops, veterans, and first responders for their service. Recipients say these letters, notes, and drawings are the most cherished items they receive all year. Check out Operation Gratitude for a downloadable guide on how to write a letter to a service member. 6. Nevada Museum of Art Channel your inner Picasso and have fun exploring your artistic side in this monthly HandsONatHome, a family fun experience with different projects and ideas inspired by the collection. Plan your visit. 7. Homemade Activities Create homemade playdough using a handful of ingredients in your pantry. It takes about 10 minutes to make and is sure to get their creativeness flowing. Here is an easy recipe to follow. 8. Cooking Cooking can be fun, especially when you can involve the kids. Pick a recipe that is fun and easy to make and pull the kids in for some help in the kitchen. 9. Discover The Discovery Museum The museum has over 10 permanent exhibitions and a calendar full of activities that families can explore throughout the year. Let's Discover!  10. Who’s Got Talent? This is an activity with so many possibilities, and it's great for all ages, including grown-ups. If you are working, the kids might put together a show and perform for you later. Or the whole family could show off their talents to visiting guests. Click here for ideas.

Read More About 10 Winter Activities to Explore with Your Family