Mens Health in Primary Care (Current Clinical Practice) 2016

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Mens Health in Primary Care (Current Clinical Practice) 2016

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Current Clinical Practice Series Editor: Neil S Skolnik Joel J. Heidelbaugh Editor Men's Health in Primary Care Current Clinical Practice Series editor Neil S Skolnik More information about this series at http://www.springer.com/series/7633 Joel J Heidelbaugh Editor Men’s Health in Primary Care Editor Joel J Heidelbaugh, MD, FAAFP, FACG Departments of Family Medicine and Urology University of Michigan Medical School Ann Arbor, NY, USA Current Clinical Practice ISBN 978-3-319-26089-1 ISBN 978-3-319-26091-4 DOI 10.1007/978-3-319-26091-4 (eBook) Library of Congress Control Number: 2015960810 Springer Cham Heidelberg New York Dordrecht London © Springer International Publishing Switzerland 2016 This work is subject to copyright All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed The use of general descriptive names, registered names, trademarks, service marks, etc in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use The publisher, the authors and the editors are safe to assume that the advice and information in this book are believed to be true and accurate at the date of publication Neither the publisher nor the authors or the editors give a warranty, express or implied, with respect to the material contained herein or for any errors or omissions that may have been made Printed on acid-free paper Humana Press is a brand of Springer Springer International Publishing AG Switzerland is part of Springer Science+Business Media (www.springer.com) Acknowledgments For my patients, my students and residents, my mentors, and my colleagues For the advancement of men’s health worldwide With deepest gratitude to my coauthors for their inspiration and contributions And to my family for their love and support v Preface What is men’s health? “Guy problems You know, prostate and genital problems They die of heart attacks and strokes mostly Working out at the gym Oh yeah, some cancers too And stupid, risky behaviors Guys like to take chances, and don’t always think about what might happen to them We should know better Yeah, that should just about cover it…” [1] While the above answer is quite superficial in its scope, it should be widely acknowledged that men on the worldwide arena share the common factor that they are at a higher risk of premature death from the majority of adverse health conditions that we would expect to affect men and women equally Ultimately, men’s health as a subgenre of medicine needs to progress beyond a discussion simply reflecting morbidity and mortality statistics, urology, and sexual function concerns, to focus on the circumstances that influence men to either seek or not seek preventive and holistic medical care In the past decade, the field of men’s health has begun to evolve and gain some modest traction, not simply as an answer to “women’s health,” but more formally to recognize, research, and address medical and social issues predicated upon inherent disparities affecting the male gender However, creating a distinct field of “men’s health” is still an admirable goal, one that should be multidisciplinary and should focus on the unique biopsychosocial factors that impact the health of men across the life cycle In reviewing the currently available primary care and specialty-oriented men’s health-affiliated journals and textbooks, I continue to see a growing need for primary care clinicians to have a multidisciplinary and evidence-based reference guide to the diseases and disorders that affect male patients of all ages, with a comparative epidemiologic focus Although the majority of references for this target audience on general pediatric and adult medical problems are considered to be comprehensive and up to date, few are specifically targeted at those diseases and disorders that unequally affect male patients Hopefully, future provisions of men’s health will be supported through such legislature as the Affordable Care Act, which should help to improve many parameters of healthcare outcomes in men vii viii Preface The collection of authors assembled for this textbook represents a cohort of nationally and recognized scholars, clinicians, and researchers, many of whom are the leading experts on their respective topics They have provided current evidencebased reviews and practice recommendations on best practice strategies to approach common clinical concerns and disorders in men’s health I would like to sincerely thank all of the authors who donated their extremely valuable time and energy to believe and participate in this textbook project A very special thanks is given to Patrick Carr and his excellent staff at Springer for their assistance in the production and timely publication of this textbook It is my hope that this textbook spawns a broader interest in recognizing and addressing disparities in men’s health and provides a practical reference for learners and clinicians who care for common disorders in male patients across the globe Best wishes Reference Random male patient interview conducted by editor, when soliciting advice on what to include in a textbook on men’s health, Ypsilanti Health Center, Ypsilanti, Michigan, June 11, 2004 Appears in Heidelbaugh JJ (ed.) Clinical Men’s Health: Evidence in Practice Philadelphia, PA: Saunders/Elsevier, 2008 Ypsilanti, MI Ann Arbor, MI Joel J Heidelbaugh Series Editor Introduction As a practicing primary care physician, I take care of many men who suffer from chronic diseases including hypertension, high cholesterol, diabetes, heart disease, COPD, and BPH I also have noticed that many men first present to the doctor at the insistence of their spouses, an observation that is not mine alone While I knew that men have a shorter life expectancy than women, I had not given much thought to the fact that from their first year of life onward, despite many occupational and social advantages when compared to women, men are more likely to die at any given age than their female counterparts I had not thought a lot about the possibility that this increase in mortality may be partly attributable to behavioral choices and the consequent chronic diseases that men suffer from Like a boy who grows up in the forest and never gives much thought that the trees may simultaneously form and obscure the landscape, I had never thought much about social determinant of men’s health I had never given direct attention to the distinct interaction between male expectations, stresses, the behavioral choices that are often a by-product of these stresses and expectations, as well as their relation to chronic disease and mortality It is seldom, after 30 years in the practice of medicine, to be provoked to think anew about a common problem that influences the health of the patients that I take care of each and every day This book provokes such thought and provides data and the commentary which sheds new light on this common issue For this, the authors deserve our thanks and attention Neil Skolnik, MD Professor of Family and Community Medicine Temple University School of Medicine Associate Director Family Medicine Residency Program Abington Memorial Hospital ix 292 J Medder Human Immunodeficiency Virus MSM account for about two-thirds of new HIV cases with % derived from injection drug use The incidence of HIV has increased 12 % from 2008 to 2010 for MSM, especially in adolescent and young adult MSM (22 % increase) MSM make up over one-half of all persons with HIV in the USA, and about one-third not know that they are infected [4] Postexposure Prophylaxis (PEP) An antiretroviral regimen of three drugs (tenofovir, emtricitabine, and raltegravir; alternative regimens are also available) should be started within 72 h after an HIV exposure and continued for 28 days Periodic HIV testing is recommended at 1, 3, and months following the exposure [15] Those with recurrent exposures should consider preexposure prophylaxis (see below) Preexposure Prophylaxis (PrEP) The Centers for Disease Control and Prevention (CDC) [15] and World Health Organization (WHO) [47] recommend that MSM and others whose behaviors place them at a significant risk of getting HIV infection consider the benefits of taking the once-daily antiretroviral combination of tenofovir and emtricitabine If taken daily, PrEP can reduce the risk of infection up to 92 % without significant complications A clinical practice guideline [16] and provider’s supplement [48] for PrEP were issued in 2014 by the US Public Health Service and include criteria for determining HIV risk and a comprehensive program of every 3-month STI/HIV testing, side effect monitoring, and safe sex counseling [15] Criteria for taking PrEP for MSM include all of the following [16]: • • • • Adult man age 18 and older Without acute or established HIV infection Any male sex partners in the past months Not in a monogamous partnership with a recently tested, HIV-negative man And at least one of the following: • Any anal sex without condoms (receptive or insertive) in the past months • Any STI diagnosed or reported in past months • Is in an ongoing sexual relationship with an HIV-positive male partner Insurance companies generally are covering the cost of PrEP with the rationale that preventing HIV infections is cheaper than treating HIV/AIDS The manufacturer (Gilead) also has an online medication assistance program for those without insurance and co-pay assistance for those with insurance Anal Cancer Anal cancer and cervical cancer are caused by the same strains of HPV (see above) Proponents argue for anal Pap screening based on the model for cervical screening and the higher incidence of anal cancer in MSM (20 times) and especially in MSM 15 Caring for Men Who Have Sex with Men 293 with HIV (40 times) [45] However, progression of anal cancer precursors to cancer appears to be much lower than for cervical cancer No definitive evidence exists that screening reduces the incidence of anal cancer and well-designed prospective trials are needed [49] While the CDC states that screening can be considered, the US Preventive Services Task Force does not make any recommendations for screening One common recommendation is for anal Pap screening every years for MSM without HIV; in MSM with HIV, periodicity is based on CD4 counts (biannually if ≥500 and annually if

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  • Acknowledgments

  • Preface

    • Reference

    • Series Editor Introduction

    • Contents

    • Contributors

    • Chapter 1: Men’s Health in 2010s: What Is the Global Challenge?

      • What Is Men’s Health?

      • Are We Improving the Lives of Men?

        • Life Expectancy

        • Mortality, Morbidity, and Leading Causes of Death

        • Why Is Creating/Providing Adequate Men’s Health Such a Challenge?

        • Is the ACA Appropriately Poised to Improve the Preventive Healthcare of Men?

        • Future Directions for Improving Men’s Health

        • Conclusion

        • References

        • Chapter 2: Masculinity in Men’s Health: Barrier or Portal to Healthcare?

          • Masculinity in Men’s Health

            • Conceptualizing and Measuring Masculinity

            • Stress, Masculinity, and Men’s Health Behavior

            • Masculinity Changes over Time

            • Social Determinants of Masculinity and Men’s Health

            • How Do Men Conceptualize Health?

            • Conclusion

            • References

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