Is drinking water sold in vending machines safe for people with HIV?

Early in September the local news media reported that the water sold in vending machines is not as safe as we would like to believe.

According to these reports, as many as 62 percent of the machines which advertised "purified" water contain dissolved solids exceeding state limits and 93 percent contain bacteria levels 163 times greater than typical tap water. The cause is said to be due to a lack of maintenance on the machines.

Los Angeles County supervisor Michael Antonovich has initiated a motion calling for a county study. While the Department of Health Services plans to begin to test the machines located outside grocery stores, Director of the Department of Health Services for Los Angeles County Jonathan Fielding said there is no immediate public health threat.

People with HIV infection would best act on the side of caution. People infected with HIV are 200 to 900 times as susceptible to food- and water-borne pathogens than people who are not infected with HIV. This means that people with HIV should drink water that promises to be safe and avoid water from vending machines.

Safe water is water that has been brought to a rapid boil for one minute, distilled water, or water that has gone through reverse osmosis or a filter meeting the National Sanitation Foundation's Standard 53 for Cyst Reduction. Unless it meets these guidelines, bottled water or water from a vending machine is not guaranteed to be safe.

Your Medicare policy may cover glucose test strips

There has been some confusion about Medicare coverage of blood glucose test strips, lancets and meters whether or not you use insulin to control diabetes. Keep the following in mind when using these benefits:

• The benefits apply to people with either Medicare Part B or Medicare managed care coverage.

• Deductibles and co-pays for your Medicare policy may apply to these benefits.

• In order for Medicare to cover these benefits, a doctor must prescribe blood glucose testing supplies to you and document how often you need to test on the prescription.

• Your Medicare policy may define how many test strips and lancets you are entitled to each month.

Medicare is also to cover diabetes outpatient self-management. Precise rules have not yet been defined and are expected to be published by the Health Care Financing Administration in late fall. Request that your physician prescribe diabetes education from a registered dietitian who is experienced in diabetes and HIV nutrition.

Medicare beneficiaries or family members can find out more information about these benefits by calling a Medicare hotline at (800) 638-6833, the American Diabetes Association at (800) 342-2383 or visiting the ADA web site at http://www.diabetes.org

Using antibacterial soap may be risky for people with HIV

Advertising for antibacterial soaps and cleaning may sound convincing, but remember, it is ultimately a marketing strategy for increasing their sales.

What the ads do not state is that products like antibacterial soaps increase the risk of developing bacteria that will eventually be resistant to those agents and become even stronger. Members of the HIV community understand the seriousness of resistance to an active ingredient -- be it drug or cleanser. It is not a frivolous concern.

Washing with hot soapy water is enough. It will do the job of cleaning counters, utensils, floors, dishes and hands. Soap and water will keep you safe from germs, especially if you put some good ol' elbow grease into it and scrub. It is the mechanical action of water, soap and brushing that really loosens the dirt and bacteria off surfaces and the rinse water carries it away.

The Health & Nutrition Letter of Tufts University (October 1998) suggest ways from overusing antibacterial agents.

• Use regular soap to wash your hands and regular dishwashing liquid for kitchenware.

• Use bleach -- and chlorine-containing cleaners.

• Wash your hands often.

• Use products containing the antibacterial ingredient triclosan only when someone in your household is particularly vulnerable -- for example, when that person just comes from the hospital or is recuperating from an illness or operation.

• Wash fruits and vegetables thoroughly with water and, if applicable, a soft brush.

• Rinse animal foods (poultry, meats, fish) in running water.

• Don't be impressed by household products that are advertised as containing antibacterial agents. There is no evidence that they lower the incidence of infection.

• Don't talk your doctor into giving you an antibiotic for a viral infection.

• Don't stop a course of antibiotic treatment midstream.

• Never share your antibiotics with family and friends.

This article has been reprinted at The Body with the permission of AIDS Project Los Angeles (APLA).