Vampire Brothel

Unlicensed Medi-Spa is Source of 3 New HIV Cases

I admit I didn’t watch (or listen to as only audio is released) the Supreme Court oral arguments in the case that could save countless women’s lives by forcing hospitals in states with strict abortion laws to provide the procedure in emergency situations. Or put another way—because I have to believe that providers in these states want to offer care—protecting doctors and hospitals who provide emergency abortions from overzealous prosecutors. 

I didn’t listen because anything short of all of the men on the court saying in unison, “We’re so sorry, we respect women so much and never meant for anyone’s life to be put in jeopardy, please tell us what we can do to make this right,” was guaranteed to raise my blood pressure.

For anyone else who didn’t listen, that didn’t happen.

The women on the court, including Trump-appointee Amy Coney Barrett, seemed to go after the lawyer representing Idaho on issues related to women’s health and letting women die, but the men were not so moved. Instead, they seemed more concerned about state’s rights and whether a women could feign mental illness to get a late-term abortion in an emergency room.

Wow, they really do hate us ladies, don’t they?

Instead of listening to this, I watched TV. As I mention below, we’re rewatching Buffy with the 13-year-old and just got to the musical episode. It’s even better than I’d remembered. We started The Gentlemen with the older one, and I caught up on The Crown on my own making it through the royal divorce.

We also checked out Elsbeth which brings back a quirky character from The Good Wife in a new role as monitor of the NYPD. In her first case, she out-investigates the police and calls foul play on a case they’re willing to believe was a suicide.

What gave it away, you ask? The victim’s diaphragm. Elsbeth found it’s storage case empty in the bathroom medicine cabinet meaning the victim was wearing it. No one puts their diaphragm in, she argues, if they’re planning suicide. We can poke holes in that theory (just don’t poke holes in the diaphragm), but the thing that got me is that no one uses a diaphragm anymore.

No one.

In fact, so few women use it, it’s not mentioned in the 2017-2019 National Survey of Family Growth at all. It was still there in the early 2000s when about 8% of all women who’d used contraception had ever used one. Now it’s not mentioned at all. Not even in the charts at the back of the report. I suppose it’s included in the footnote that says, “In this table, women are classified roughly according to the one most effective contraceptive method they are using. Additional methods women may be using are not shown here.” Natural family planning made it into the chart even though only 0.3% of women using contraception said it was their current method. Does that mean that even fewer were using diaphragms? 

Elsbeth Tascioni might be clever, but her writers needed to come up with another clue that’s more realistic for a modern college student. Perhaps the victim had taken today’s pill or picked up a refill for three more months of the vaginal ring. I realize that these make for an even less convincing it-must-be-murder theory, but at least they show a basic understanding of college kids. (See the last story for more on what young people are using for contraception, post-Dobbs. Spoiler alert: it involves snipping things.)

Vampire Facials Confirmed as Cause of At Least 3 HIV Infections

I’ve never read an Anne Rice novel or watched any of the Twilight movies (though I do know that they were basically an abstinence-until-marriage allegory written by a Mormon mom). Nonetheless, I am a vampire expert because of Buffy the Vampire Slayer, which we’re working our way through with the younger one. The series teaches us that high school is hell (or at least built on top of it) and sassy teen girls will save the world (multiple times).

I know that vampires can’t come into your home without an invitation, are scared of crosses, get burned by sunlight, and turn to dust when staked anywhere near the heart (a conceit that comes from the series’ low special effects budget). Most people who are bitten die instantly, but thanks to the vampire brothel episode, I know that you can let them nibble with no long-term side effects. If, however, you turn around and drink their blood, you too become a creature of the night.

None of this explains why platelet-rich plasma micro-needling became known as vampire facials. Nobody sucks anybody’s blood. Instead, some of your own blood is removed (from your arm not your neck, and with a needle not fangs). The platelets are then separated out from the rest of the blood and injected back into your face with tiny needles. Internet ads and celebrities (or at least Kardashians) promise it will plump up your skin, make you look younger, and fill in fine lines or acne scars.

There is, however, no evidence that this works according to the American Academy of Dermatology. The procedure, which hasn’t been approved by the FDA as a skin rejuvenator, was developed for bone grafting and osteoarthritis, but those things are not done at pseudo medical establishments with names like VIP Spa.

The Albuquerque, NM spa of that name has now been confirmed as the source of at least three HIV transmissions according to the CDC. The first case was a middle-aged woman who tested positive for HIV in 2018. She had no other risk factors: no history of injectable drug use, no blood transfusions, and no recent sexual contact with someone with HIV. She did tell public health investigators that she’d gotten a vampire facial at VIP Spa. 

This prompted a joint investigation by the CDC and the New Mexico Department of Health. What they found was blood-handling precautions that were worse than those at the vampire brothel. There was equipment containing blood on the kitchen counter; unlabeled vials of blood next to food in the fridge; and unwrapped, potentially already used needles in drawers, on counters, and in the trash.  

What they didn’t find was worse. The spa did not appear to have an autoclave, which is a steam sterilizer needed for cleaning equipment between clients.

It’s actually not easy to get HIV.  While some STIs are transmitted from skin-to-skin and some viruses (as we all know from Covid) are transmitted via respiratory droplets in the air, HIV requires direct contact with blood, semen, or other bodily fluids. Moreover, intact skin can provide a barrier to HIV, and the virus only remains infectious outside of the body for a couple of hours. People cannot get HIV from casual contact such as touching door handles, using the same toilet seat, or sharing food.

People can, however, get HIV from contaminated needles. In fact, it’s one of the most efficient ways to transmit the virus. We know this from intravenous drug users and health care providers who are accidently stuck while treating HIV-positive patients. (PEP or Post-Exposure Prophylaxis can help these providers prevent infection.)

This is why anyone who handles blood needs to take universal precautions including wearing gloves, not sharing needles with friends or between patients, sterilizing all equipment carefully, and properly disposing of needles. Universal precautions do not include leaving needles on countertops or sticking blood in the fridge next to the Hazelnut Coffeemate and your coworker’s tuna sandwich.

Not surprisingly, VIP Spa was operating without a license. The spa was shut down after the first HIV case was discovered, and the owner later pled guilty to practicing medicine without a license. He was sentence to 3 ½ years in prison and 4 years of probation.

The NM Department of Health and the CDC offered free HIV testing to anyone who had been a client of the spa as part of its investigation. The CDC identified two additional cases of HIV transmission (one woman diagnosed in 2018 and another in 2023) and found 59 people who may have been exposed to HIV during vampire facials or other cosmetic procedures. Over 200 spa clients were tested with no additional infections, however.

Vampires are bad (except the one who got his soul back, he’s just tortured). Vampire facials aren’t necessarily bad (except for the pain and that whole no proof they work thing), but getting any medical procedure done in a non-medical setting is very bad. If you just have to try this unproven procedure where someone repeatedly sticks your face with needles, gey gezinterhayt*, but go to a real dermatologist.

* A favorite Yiddish phrase of my Bubbie’s. It roughly translates to “go in good health” but is basically the old world version of “you do you.”

More Young People Choose Sterilization Post-Dobbs

A few weeks ago, I went to see Ali Wong. The comedian who opened for her told a joke about vasectomies that I can’t remember, but in it he explained that when you have a vasectomy you still make sperm, they just can’t get out. A woman a few rows behind me and to the left gasped audibly and said, “No way, that can’t be true.” I refrained from turning around to:

1) Check out who’d said that,

b) Confirm that that the comedian was correct, and

iii) Ask exactly what she thought did happen in a vasectomy.

This explanation is for the woman a few rows behind me to the left: A vasectomy is a simple procedure in which the vas deferens are cut and sealed. The vas deferens are two tubes that take the sperm from the testes (where they’re made) into the urethra which runs through the penis to the outside world. Cutting the vas deferens does not stop sperm production, but the sperm can’t get into the semen or out of the body. The sperm die and absorbed by the body. 

To be extra clear for the woman a few rows behind me and to the left: the other components of semen—water, plasma, and mucus—are made by other parts of the reproductive system such as the seminal vesicles, the prostate, and the Cowper’s gland. These are not affected by a vasectomy, so men will still ejaculate as normal post-snip. 

Similarly, female sterilization—which is sometimes referred to as tubal ligation or getting your tubes tied—involves cutting and sealing the fallopian tubes which are the passageways from the ovaries to the uterus. As I have discussed before, some doctors now prefer to remove fallopian tubes entirely instead of tying them because most ovarian cancer starts in the tubes. This procedure is called a salpingectomy, and the seven-year anniversary of mine was just last week.

Most months an egg is released, travels down a fallopian tube into the uterus all by itself, and—when it becomes clear it wasn’t fertilized—comes out as part of menstrual flow. Every once in a while, an egg comes out of an ovary and meets some sperm in the fallopian tube where it is fertilized and then continues on its journey into the uterus and sets up shop for 10 months or so. (Anyone who has carried a pregnancy to term knows that 40 weeks is way closer to 10 months than nine).

After the tubes are tied or removed, eggs will still be released as normal, but they will have no way to get to the uterus. They die off somewhere in the body. Since the ovaries are still functioning as normal and releasing all the same hormones, all other aspects of the person’s menstrual cycle should stay the same.

This information seems extra relevant today because a new study found that the number of vasectomies done on people ages 18 to 30 went up in the months/years after the SCOTUS decision overturning Roe vs. Wade. Researchers looked at medical records for over 113 million people from June 2019 through September 2023. In the months before the Dobbs decision, the vasectomy rate among this age group was already going up by about 1 procedure per 100,000 male patients each month and the tubal ligation rate was going up by almost 3 procedures per 100,000 female patients each month. Right after Dobbs there was a spike of about 27 vasectomies and 58 tubal ligations per 100,000 male and female patients respectively. The surge in vasectomies leveled off but the tubal ligation rate continued to rise by about a little more than 5 procedures per 100,000 women each month.

The study had no way of asking sterilized young people why they decided to go the permanent contraception route, so we can’t confirm that the stories of women not getting the lifesaving care they needed scared the vasa deferentia right out of them. Still, Jacqueline Ellison, an assistant professor in the Department of Health Policy and Management at the Pitt School of Public Health and lead author on this study says the data “… highlight the indirect effects of Dobbs on the reproductive autonomy of young people.”

Dr. Ellison also noted the differences in the patterns between men and women. She told CNN, “It may seem obvious, but it’s important to emphasize that cisgender men may not feel the same sense of urgency to undergo vasectomy because they don’t experience the same consequences of unwanted pregnancy.” Men also don’t have to fear that the Supreme Court’s next step will be taking us back to the days when women needed signed permission slips from their husbands before they were allowed to get their tubes tied.

Choosing a permanent contraception method is not necessarily a bad idea for anyone. These are safe procedures with nearly perfect effectiveness. (I say nearly because I know at least two kids born post-vasectomy.) But they are permanent. People talk about vasectomy reversal but that’s a complicated procedure that often doesn’t work. (Snipping something so small is easy, putting it back together is not.)

Anyone who has any doubts should choose a long-acting reversible contraceptive method like an IUD or implant that also have near-perfect effectiveness rates and can be taken out at any point. Of course, once again, the burden is on women because we don’t yet have any long-acting reversible method for men. (No, wearing special underwear to heat your balls doesn’t count.)