We offer a lot more than just run of the mill primary care at Pacific Oaks Medical Group. We have everything! Including a massage gun that I’m sure will bedazzled in just a few short weeks. Schedule your Osteopathic Treatment with me or Dr. Tellez (also here) and get your campy health on ❤️
150 N Robertson Blvd Suite 300 Beverly Hills 90211 310-652-2562
Safe Sex
What is safe sex to you? Do you use a condom every single time that you engage in sex? What does the word “sex” even mean to you?
Sorry to be the bearer of bad news, but if you think that you have been having 100% safe sex and you are not using a condom when you engage in oral sex, you are indeed putting yourself at risk for STI’s (sexually transmitted infections). This includes cunnilingus (ie eating out a female), and analingus (licking another persons anus or ‘rimming’). Any and ALL sexual activity, EVEN with a condom or dental dam is inherently risky. The point of this post is to not make you a celibate nun, but have some facts spelled out for you in plain English.
More importantly, every single sexually transmitted infection can be transmitted through oral sex. Yes, that means HIV, Hepatitis A, B, C, Syphilis, Gonorrhea, Chlamydia, and Herpes Simplex, and HPV. While you can rest slightly easier that the rate of transmission via oral sex is much lower, you need to understand that your risk is not zero.
It has been reported that the rate of persons under 30 with positive STI screenings is now 50%. Yes, ONE out of every TWO people will have an STI before the age of 30. Many people are attributing the rise in syphilis, chlamydia, and gonorrhea to the widespread use and adoption of PrEP (Truvada, or Pre-Exposure Prophylaxis), because it has increased the overall percentage of reported “condomless” sex acts. However, it must be noted that we are seeing a rise in diagnosed STI’s is because younger persons are in fact going to see their health care providers for more frequent testing as well. Also, studies have shown that most people lie about using condoms anyway.
I will talk about PrEP in another post, but the incidence of HIV has actually dropped almost 20 percent over the past 2 years even though other STI’s have increased. In short, PrEP works so stop being a sexual Nazi.
Any time that you engage in a sexual act (any act involving another persons genitals and yourself) that you need to do your due diligence and get yourself tested. It is your responsibility to get tested at least annually (yearly), if not more frequently when you are having sex with multiple partners. In particular, for men who have sex with men, the rates of gonorrhea and chlamydia are missed 30-40% of the time unless your provider neglects to perform an oral and rectal swab. This is also irrespective of the fact if you are a strict “top” and also if you are not performing any penetrative sex acts. In short, if you put a dick in it or near it, you bettah swab that shit.
And while I will never encourage anyone to have condomless sex based on scientific facts, life is about choices and making choices based on these facts. It has been statistically proven that people who use condoms more often than those who do not, have reportedly less instances of STI’s across the board. That being said, even when condoms are used correctly 100% of the time, they do not eliminate the wearers risk of contracting and STI. The only way to avoid getting an STI is to not have sex at all, and this is not living. Would you judge someone for walking around outside buying groceries and contracting a community acquired pneumonia? Doubtful. So we need to work on de-stigmatizing STI’s and encouraging everyone to get tested.
That being said, you should most often times not run out and get tested the next day immediately after engaging in a new sexual act as oftentimes even if you have contracted a new STI, the test will likely come back negative since it has had no time to incubate.
Chlamydia
24 hours to 5 days after new sexual act
Gonorrhea
2-6 days after a new sexual act
Syphilis
3-6 weeks after a new sexual act
HPV
Can take months
HIV
At least 9 days with most modern testing
STD CHECK offers a full list of when to get tested if you are worried about certain STI’s.
The point of this post is not meant to scare you, but to empower you to take charge of your sexual life. Get tested. Most of these infections are treatable, and are definitely no longer death sentences. People with HIV are living long, productive and healthy lives on ART; also fun fact no one that has reached undetectable viral loads has ever passed HIV on to another sexual partner even when they did not use condoms or PrEP. People with Hepatitis C now have a cure thanks to new antiretroviral treatments as well . So go out there, HAVE SEX, get tested, and be vocal about your status with all of your partners and make it a normal part of the conversation. Silence equals death, and we are so over that.
I am also happy to announce that I have set up an alliance between the Hudson Pride LGBT Center in Jersey City NJ to have them send their clients to our clinic for HIV Testing/Treatment/Prevention, STI testing/treatment, as well as all necessary preventative health screenings. I am extremely excited for this partnership, and I hope that it helps to educate ourselves as doctors as well as the community.
Well I certainly fell off of the face of the earth in regards to this website. I had intended to do at least biweekly blog posts related to LGBT health, but I’m sure it is no surprise that a little more than 6 months into my life as an attending that the entire world decided to fall apart. I do hope you are doing well, all things considered. If you feel like you are on a roller-coaster of emotions staring at a track that is headed into a brick wall, then yes you too are living in 2020.
While I can say that I was trained in infection control and safety measures, I was not adequately prepared emotionally/psychologically to handle what this pandemic has thrown at me. How do you explain to people that they need to isolate themselves from those that they love? How do you not internalize that? How can insurance companies still be denying insulin and blood thinners during a global pandemic? Healthcare disparities have only been amplified, and the “have nots” are quite literally being killed at an exponential rate. If there has ever been a case for universal health care, this health care crisis has certainly highlighted the necessity for free and ample access to basic health care that most Americans simply do not have.
Something that has helped me immensely during these anxiety provoking times has been writing. I have never been a “writer” per se, but I found it very therapeutic to reflect on my life in its totality so that I could try and make some sense of the mess that 2020 has been so far. 180 pages later, I have an autobiographical memoir of my “Mostly Horizontal Gay Life”. Maybe it will be published, maybe it will be a Vlog series where I have guests read it and react to it with me, or maybe it will just sit in my google doc indefinitely…who knows. But it sure helped me organize my thoughts around my own life…the good, the bad, and the truly ugly. But looking back it has mostly been hilarious and full of great experiences. I also recommend paint-by-number custom photos!
As of late, I have felt disconnected from everything, much like most of my patients and friends. I am so thankful for my job because when I’m at work I mean something…I offer utility, guidance, knowledge, support, and I can purposefully affect people’s lives. There are tangible gains to the advice or knowledge that I can give people but every day that this pandemic and now civil unrest goes on I feel less and less connected to myself and to everyone around me. I push the limits of my own reality to remind myself that I am indeed alive but I am ultimately scared just like everyone else. I went sky-diving on a whim, and it did not even get my heart beat above 80 beats per minute. It was actually the most relaxed I have felt in months…jumping out of a fucking plane. How that makes any sense is beyond explanation. I have always been an adrenaline junkie, but not getting a rise out of being 10,000 feet in the air is insane. I do hope you are also doing things to keep you happy and healthy as well. Like skydiving.
Netflix released a docuseries called “Lenox Hill” that does the most beautiful job at showing what medical care is like from both the physcians side as well as the patients in New York City. Somehow they were allowed to film during the pandemic, and during one of the last scenes you see the most put together, stoic, unbotherable ER doctor COMPLETELY break down in her car when she returns to her empty home; she is too high risk to be around her husband and child and is distancing herself to make sure they do not become ill and die. To put this in context, one of the first scenes in the series, pre-pandemic, is her lancing an anal abscess, chatting about unprotected sex and the need to “get clean” so this kid can get his life together. She reminds me so much of myself… well, minus the husband and kids, but I like to think that I can keep my shit held together during awkward and hard moments. They started playing this song which sent me into a spiral for the next hour:
Wave-Beck
I move away from this place
In the form of a disturbance
And enter into the world
Like some tiny distortion
If i surrender
And I don’t fight this wave
I won’t go under
I’ll only get carried away
Wave
Wave
Wave
Isolation
Isolation
Isolation
Isolation
What is real? What is truth? What is love? Why do we do the things that we do? Why do I still want a cheesy gordita crunch even though I know it will give me diarrhea? I feel like I am an insignificant dot on a slightly larger insignificant dot hurling around through space inside of that marble on the neck of the cat in the Men in Black. What are we working so hard for? In the words of Big Ang… why should I save another cent because I could just drop dead tomorrow.
But fear not for me, my 5 readers of this blog! If this mess has taught me anything, you need to refocus your energies locally and close to you…which I had not been doing, pretty much ever. I have always been trying to expand my world outside of the confines of my actual tangible world. However, the past 6 months have forced me to make friendships that I know will last the rest of my life…locally! Finally friends that are not a 6 hour flight away. What a remarkable idear!
Trauma pours gasoline on your problems, lights the match, and eats a bucket of popcorn while you scramble to learn how to put the fire out. I was lucky enough to have a group of people here who braved seeing me in real life very early in this pandemic for which I owe them my life. Be thankful for what you do have, and stop focusing on what you don’t have.
Love those around you who deserve your time and energy. Love yourself. Be forgiving to yourself and others for figuring out how to operate in this weird new world. Be kind. Cry when you need to. Exercise. Eat well, but also indulge from time to time. Life is all about balance and mitigated risk…and just like you look both ways before you cross the street you have to figure out a way to navigate this world without being totally isolated. Humans are innately social creatures and we crave true human interaction that is irreplaceable with a Zoom call. Find your circle of trust. Community is more important now than ever before.
Gratitude not attitude my friends.
Also VOTE!
What other topics do you all want me to broach? ❤
Peace and love
Hey all!
I’ve been quite MIA on here during residency. For those of you that are familiar with medical training in the USA, I’m sure you can understand that I barely had time to clean my laundry during residency let alone maintain a website. While it had been my wish to update this website at least twice a month with new medical updates and tidbits, I fell off the wagon quite early. However, I am back online with more vigor than ever! I joined a practice in Los Angeles focused primarily in LGBTQ Care and would like to share a bit about the practice.
Pacific Oaks was one of the first medical practices that began widely testing their patients for HIV, and has consistently been part of clinical research in HIV treatment, prevention, and eventually a cure. They have been a beacon of hope for the LGBTQ community since the 1980’s and I am incredibly proud to be part of this practice.
Pacific Oaks is a multi-specialty private practice located in Beverly Hills on 150 N Robertson Blvd Suite 300. We offer in house Neurology, Podiatry, Urology, and Pain Management. We also offer in house X-Ray, Dexa Scanning, and Ultrasound services including Stress and Stress Echo.
Life in LA has been a big change from the one that I was living in Jersey City and NYC. The weather is perfect every day, and I finally do not live in an apartment that should be condemned. I also live in the heart of the gayborhood and have a 10 minute BIKE RIDE to work every day. I am loving it so far!
Is there anything in particular you all would like to see on here? Videos? Lemme know!
Dr. Jack
I was fortunate enough to be the key-note speaker at World AIDS day in Jersey City December 1st 2017. I am attaching the speech I gave here for those who were not able to attend. Hopefully some pictures will be posted online in the near future that I will add 🙂
I would like to first thank all of you for inviting me here today to speak at an event that has so much personal meaning to me. For those of you who do not know me, I am Jack O’Brien, a second year family medicine resident at Bayonne Medical Center which is part of CarePoint Health. I grew up in a small town of a little over four thousand people near Syracuse New York, so giving a speech here right next to the epicenter of the entire world, New York City, is quite surreal and I will need to pinch myself right now.
I will be a little bit corny, but first like to give a shout-out to my parents, Judy and John O’Brien, for which none of this would be possible without them. Until I was 18 and left for college, they used to spend over two and a half hours a day driving me to gymnastics, and were also the driving force of me coming out of the closet. I was lucky enough to have a family who supported and loved me being for being a gay man since the age of 14 and because of that loving and supportive environment, I am fortunate enough to be standing in front of you today giving this speech.
AIDS and HIV were something that immediately surfaced during our early conversations about me being gay. The first thing after my mother told me after assuring me that she would always love me and that it would be no problem that I was gay, was immediately followed by “Oh my god I’m so scared that you are going to die of AIDS”. My parents are not terrible people, so just hear me out for a second.
As a 14-year-old, newly out homosexual, in a town of only 4-thousand people, the concept of AIDS, HIV, or any sexually transmitted infection for that matter seemed quite foreign and intangible. I had only heard of HIV or AIDS in an abstract concept in books…I didn’t even know any gay people myself other than people I had met online, let alone someone with HIV or AIDS…and It wasn’t even until my health class at the age of 17 condoms were even spoken about…and even then they were only spoken about in terms of pregnancy prevention (how hetero-normative). Given those facts, I was quite confused as to why they were so scared for my life.
Putting that into perspective, year I came out was 2003; and during that year according to the CDC there were 68-thousand new cases of people who contracted HIV. I’m happy to say that the 2014 statistics report that number is almost cut in half, with only 37-Thousand new cases of HIV diagnosed in the United States. Even more importantly, those who had the diagnosis of AIDS in 2014 was 14-Thousand of all cases of all persons living with HIV, whereas in 2003 the number was almost three times as high, at 39-Thousand. The only thing that my parents knew of HIV or AIDS was that you eventually died from it, and this is why they were unsurprisingly scared for my life.
I am so happy to be able to be a doctor in the year 2017 and be able to tell my patients that their HIV will not kill them any more than a meteor striking them from the sky will. Since the advent of antiretrovirals, almost all new cases of HIV can be halted to the replication levels of becoming “undetectable”. Being undetectable is the treatment goal for all newly diagnosed patients with HIV. Being undetecable means that you will be incapable of spreading the virus to new partners. You heard me right, I did not stutter, INCAPABLE, meaning IMPOSSIBLE to give the virus to another human being. This was unheard of in the 1990’s, but it is becoming the new normal diagnosis given to those who are living with HIV. And for those who are living with an HIV diagnosis, it has truly revolutionized how they live their day-to-day lives. Someone who receives an HIV diagnosis today now has the same life expectancy as someone without the virus.
Within the past few years, the adoption and widespread use of PrEP, or pre-exposure prophylaxis, amongst those who are most at risk, is now aiding in another barrier against those who are negative with staying negative. I would like to proudly before all of you state that I am taking PrEP myself, and I firmly believe that it is the key to making the USA AIDS Free. PrEP has been shown to be more effective than condom use in preventing HIV and eventually AIDS. It is safe, effective, and well tolerated. To state it simply, PrEP+Condoms works.
Promising research is on the way for pre-exposure prophylaxis as well that should hopefully be rolling out and become FDA approved within the next few years. Firstly, and excitingly for patients who are often forgetful, is an injectable that can be given every 8-12 weeks and in preliminary studies has been just as effective as taking PrEP daily. Furthermore, studies are underway where at risk individuals will take a “super dose” of PrEP before high risk activities, and two days after these activities, similar to emergency contraception. These two possibilities are exciting and will with hopefully lead to better compliance with the use of PrEP which seem to be one of the main issues for its efficacy.
Another barrier is cost.
It is my goal as a primary care provider, to get all of those who are at risk, on this medication. Our family medicine clinic at Christ Hospital, is proudly partnered with Hudson Pride Connections, who is sending us their at risk clients in order to have physicians who will provide them with affordable HIV Testing/Treatment/Prevention as well as being a resource for all of their primary care needs.
I work tirelessly every day to educate other physicians and healthcare providers about how to be more sensitive, understanding, and knowledgeable about this patient population. Having HIV means nothing more than having any other contagious disease such as strep throat, and I work every day to destigmatize and demystify HIV and AIDS for anyone I happen to interact with.
I am here to say that the help is here if you need it, you just have to reach out and get it. If you do not have insurance, or are undocumented, our hospital can help you take charge of your health. The majority of the patients seen in our clinic are persons who do not have the means or legal status to have healthcare in the united states, nor the means to pay for it. Healthcare is a human right, and I am dedicated to treating everyone equally regardless of their socioeconomic status, gender identity, sexual orientation, race or religion.
Sadly, these very people who are most at risk for new HIV diagnoses are the patients we most often treat. Young black or latino men who have sex with men, who are lower-income, between the ages of 18-28, are the most at risk for contracting HIV. It is my goal as a primary care provider to ensure that these patients have proper prevention of diseases that are indeed preventable, which now includes HIV. However, the key to staying HIV and AIDS free is right here, right in my hands. Let’s make America AIDS free, one pill at a time.
And then I took my PrEP in front of the whole crowd 🙂
Pictures to follow!
Domestic Abuse in Gay Relationships
This is not just a subjective problem that I am seeing; domestic abuse is an increasingly important topic to broach with your patients and for yourself if you are suffering from any form of abuse (emotional, physical, financial, or stalking).
For any providers that are reading this, please make it a point to address safety in your patients household on all visits. Simply asking “How is it going at home?” is enough to get the conversation started. It is your job as a healthcare professional to help your patients in any way possible, especially when it comes to domestic violence and abuse.
According to the CDC:
That means that one out of every four gay men are raped or assaulted by an intimate partner, and almost two out of every four gay men have experienced some other form of sexual violence. More importantly, it is twice as common in the LGTBQ population as compared to the heterosexual population.
Even worse, these are reported statistics. This means that there are far more instances of abuse that are unreported due to victims fearing backlash from the perpetrator and even the repercussions of speaking out against their attackers from people in their community. Men are two times as likely to NOT report a form of abuse as compared to women.
Often times men are written off as being impervious to sexual assault, and this is frankly just as preposterous as telling a female rape victim that her outfit was too salacious as she was simply “asking for it”. Rape, sexual assault, and domestic partner violence can happen to anyone. I myself am a survivor of these acts and I am here to help support you all through this journey.
The first hurdle in overcoming abuse is first admitting that there has been abuse of any kind. Your doctor is a great place to start! We have at our fingertips resources such as therapists, psychiatrists, outreach groups, and housing shelters to help you start your journey to acceptance with what has happened to you.
Most importantly, if you are in a dangerous situation you need to get out of it. If you feel that you are not safe at home, you need to tell someone so that they can help you place yourself into a safer environment. This is most often the hardest step, as there could be joint housing, finances, and even children that make you feel like you are unable to separate yourself from the situation. Do not let these obstacles stop you from protecting yourself.
As a survivor myself, I know that it personally it took more than one friend telling me that the abuse I suffered was unacceptable until I finally decided to end my abusive relationship. Every single person is entitled and worthy of a relationship where they feel safe.
If you are financially unable to afford housing, or house with a friend or loved one here is a link to for Hudson County shelters. Most of them are only available for women or children of abuse, but there are many that are accessible for men as well.
800.656.HOPE (4673) National Abuse Hotline Available 24/7
1 (800) 572-SAFE (7233) NJ Abuse Hotline Available 24/7
24/7 access online at www.online.rainn.org
In the famous words of Senator Maxine Waters: RECLAIM YOUR TIME.
Now that intern year has officially ended and I’m settling into my second year of residency, I thought that I would start a blog to help promote who I am, how I have gotten here, and just generally how to be happy! I hope to be posting weekly to biweekly to keep everyone up to date on new medical advances and just general life advice from my perspective. I hope that this blog shows that you do not need to be perfect in order to achieve a happy, balanced, and successful life.
A little bit about me:
Born September 8th 1989 in Syracuse NY to two wonderful parents, Judy and John O’Brien
Ex-Junior Olympic Level 10 Gymnast; still active flipper!
Binghamton University Spanish and Psychology Alumni 2010
Fluent in both Castilian Spanish and Brazilian Portuguese
NYIT-COM Alumni 2016
Bayonne Medical Center Family Medicine Resident PGY-II
Proud and out Gay Man and LGTBQ Advocate, PrEP Counselor and Provider
Follow my journey
Dr. Jack O'Brien 