Preventing HIV and Maintaining Your Sexual Health

Today, there are many options to prevent HIV, enjoy an active sex life, and maintain your sexual health.

“Being informed and seeing your health care provider regularly is your best defense against most sexually transmitted infections (STIs), including HIV,” says Todd Estabrook, MD, a primary care physician with Mount Sinai Doctors.

Todd Estabrook, MD

In this Q&A, Dr. Estabrook, who is also Assistant Professor of Family Medicine and Community Health at the Icahn School of Medicine at Mount Sinai, outlines the options for preventing HIV and best practices for sexual health.

What are the best ways to prevent HIV?

There are two effective ways to prevent HIV: PrEP (pre-exposure prophylaxis) and using condoms. Open communication with your partners about sexual health is also vital. Discussing STI status, testing history, and prevention methods can help build trust and ensure that everyone involved is taking steps to stay healthy. Sexual health is an essential part of your overall health, so getting regular screenings and maintaining open communication are key to enjoying a healthy sex life while minimizing risks.

What is PrEP?

PrEP, or pre-exposure prophylaxis, includes several options of prescription medications that are used to reduce the risk of contracting HIV before an exposure. It’s a powerful tool in our fight against the HIV epidemic. For those at higher risk, such as individuals with partners living with HIV or those who engage in sex without consistent condom use, PrEP can be a game changer. Studies have shown that when taken as prescribed, PrEP can reduce the risk of contracting HIV by about 99 percent. It’s an incredibly effective measure that empowers you to take control of your sexual health. However, it does not prevent other sexually transmitted infections such as herpes, gonorrhea, chlamydia, and syphilis. PrEP is available as a daily pill or as a long-acting injection.

What is DoxyPEP?

DoxyPEP, or doxycycline post-exposure prophylaxis, is another powerful prevention strategy. DoxyPEP involves taking a one-time dose the antibiotic doxycycline after potential exposure to sexually transmitted infections. Studies show that DoxyPEP can reduce the incidence of certain bacterial STIs: gonorrhea, chlamydia, and syphilis. While it’s not a replacement for other prevention methods, it can be an additional tool to reduce STI rates.

Why is it important to use condoms?

While PrEP and DoxyPEP are highly effective against HIV and certain bacterial STIs respectively, they do not protect against all sexually transmitted infections. This is where safe sex practices come into play. Using condoms consistently and correctly is one of the best ways to protect yourself and your partners from a wide range of STIs. Condoms are easily accessible, affordable, and when used properly, are very effective.

Why is it important to get screened regularly?

Regular STI screenings are crucial. Many STIs can be asymptomatic, meaning you might not know you have one. Regular testing allows for early detection and treatment, which helps you and prevents the spread to partners.

Using these precautions, you can enjoy a healthy sex life while minimizing risks. Your health care provider is an important resource in maintaining your sexual health—so don’t hesitate to reach out to them if you have any questions.

How to Help Kids When Their Parents Are Facing a Cancer Diagnosis

When a parent is facing a cancer diagnosis, children need support too. In fact, research has shown that when a parent is diagnosed with cancer, one of their primary concerns is the well being of their children.

Mount Sinai’s Child Life and Creative Arts Therapy team works with children who have a significant caregiver diagnosed with cancer. The team creates safe, supportive spaces where children can process complex emotions, ask questions, and build healthy coping skills, according to Katherine Parker, MA, ATR-BC, LCAT, Creative Arts Therapy Coordinator.

Families are guided with age-appropriate, therapeutic tools—using creativity, play, and conversation to help children understand and navigate illness with confidence and care. These offerings include developmentally appropriate education, as well as bedside and playroom activities designed to make medical experiences feel less overwhelming.

Katherine Parker, MA, ATR-BC, LCAT

“From everyday challenges to life-changing diagnoses, these services support children and families across many medical situations—and are there year-round, including during the holidays, when care and connection matter most,” she says.

The top two concerns that parents often have are how to have conversations about cancer in a way that children will understand and also how their children are coping over time, says Ms. Parker. “I work with children age six through 24 who have questions about the cancer diagnosis and treatment, I provide developmentally appropriate resources, including videos, books, and I also incorporate play and art materials and helping to normalize the hospital environment and help children develop sustainable coping skills,” she says.

Art Therapy is helpful for exploring hard emotions, creative expression, and sometimes families even work on projects together to help with communication and bonding. “A cancer diagnosis can bring on many challenging changes for families. For caregivers, I’ve seen immense amount of relief when they hear that there’s a role dedicated to supporting their children,” she says. “For children, I’ve seen them really engage in a safe space where they can talk about and process difficult thoughts and feelings.”

She adds, “I find so much purpose in helping families find meaning. When families are able to connect through moments of joy or creating new traditions together, I feel really honored to be a part of their journey.”

What Are the Benefits of the New GLP-1 Weight Loss Pills?

GLP-1 weight loss medications, which includes Wegovy®, Ozempic®, and Zepbound®, are powerful drugs that help people who are obese or overweight to lose weight.

Obesity is a chronic condition that affects about 40 percent of people in the United States, according to the U.S. Centers for Disease Control and Prevention. Until recently, the medication was only available in a weekly injection. But in December 2025, the U.S. Food and Drug Administration approved an oral version of Wegovy.

In this Q&A, Jennifer Lauren Abrams, DO, explains some of the advantages of the pill over the injections, as well as how to switch from the injection to the pill and other questions you should ask your doctor. Dr. Abrams, an endocrinologist, is part of Mount Sinai Doctors-Brooklyn Heights.

Can you tell me about the new GLP-1 weight loss pills?

This new weight loss pill is an oral form of semaglutide, the same medication that is approved for weight loss in the injectable version of Wegovy. Semaglutide is part of a class of drugs known as GLP-1 receptor agonists because they mimic the action of a hormone called GLP-1, which targets the area of the brain that slows digestion and processes hunger. In injection or pill form, semaglutide decreases your appetite overall and makes you feel full sooner, so you eat less. The pills offer an easier and more convenient option that is highly effective, in combination with a healthy diet and regular exercise.

Jennifer Lauren Abrams, DO. Click here to make an appointment

Are the pills as effective as the shots?

Yes. A study published in The New England Journal of Medicine showed that patients who received semaglutide pills at the maximum dose had an average weight loss of 13.6 percent from where they started. The clinical trial for the injectable semaglutide showed an average weight loss of 14.9 percent. There is no clinical trial that compares oral and injectable semaglutide , but a separate study looked at the indirect correlation between the two. It showed that the two medications have comparable effects on weight.

What are the advantages of a pill vs. a shot?

The main advantage of the pill is that you can get the benefits of semaglutide without having to take an injection. Many patients either cannot or do not want to use needles. The pills are more convenient—and just as effective. Semaglutide is approved to treat weight loss in patients with obesity or overweight with a weight-related condition such as high blood pressure, and for cardiovascular disease in patients with obesity or overweight; it is not approved to treat diabetes.

Are there any side effects of the pill?

The side effects are the same for the pill and the shot. They are usually minor: headache, nausea, diarrhea, vomiting, constipation, stomach pain, and fatigue. Most people only have side effects for a few days after starting the medication or increasing the dose. If you eat slowly and have smaller meals, you may reduce your risk for side effects. More serious side effects of the drug are very rare. If you have side effects, talk to your health care provider because they may be able to make adjustments.

Can the drug lead to muscle loss?

Both the oral and the injectable semaglutide help with weight loss. The medication does not target fat specifically, so you may experience some muscle loss. For that reason, it is important to do strength training while on the drug, after checking with your doctor to make sure it is safe for you to do so.

How do you get started?

You can only get the semaglutide pill with a doctor’s prescription. You take the pill once a day with water, after fasting. Then do not eat, drink, or take other medications for a half hour. You should not take Wegovy if you are pregnant or planning to become pregnant.

If you are taking the pill, do you have fewer doctor appointments?

The follow-up is usually similar, but you should ask your doctor.

Does the pill dose ramp up as the shot does?

Yes. With both injections and pills, you start at the lowest dose and increase it every 30 days until you reach the highest level you can tolerate. At that point, the drug has the greatest effect on weight loss. But the doses are not the same because the body absorbs the injectable and oral medications differently. The maximum dose for the injection is 2.4 milligrams, and the maximum dose for the pill is 25 milligrams.

When do you reach your ideal weight?

With both pill and shot, we expect to see maximum weight loss after about 12 months after you reach your maximum dosage. Studies have found an average maximum weight loss of 14 to 25 percent, with up to 25 percent of people losing 20 percent of their body weight.

If you start out taking the shot, can you switch to the pill?

Yes. The doses are different, but you can switch between the injectable and the pill. If you are interested in making the switch, you should talk to your health care provider.

What do people need to know about insurance and reimbursement?

That can be a little tricky because the medications are so new. Several commercial insurance plans currently cover the pills, but that could change over time. I recommend you check with your insurance to see if your plan covers it.

How long do you take the GLP-1 medications?

You take GLP-1 medications, pill or injection long term. When patients come off the medication, they typically regain the weight they lost. I tell patients that being overweight or obese is a chronic condition, like high blood pressure or diabetes, which requires long-term management. So, just as with those other conditions, your commitment to nutrition, exercise, and in some cases medication, needs to be long-term.

Colorectal Cancer Is Rising Among Younger People. Here’s What We Know.

Colorectal cancer (cancers of the colon and rectum) is now the leading cause of cancer death in the United States for both men and women under the age of 50. In 2018, the American Cancer Society changed their screening recommendation from age 50 to 45 because of the alarming increase in early-onset colorectal cancer (affecting those under 50 years old).

A recent study published in the Journal of the American Medical Association (JAMA) reported that colorectal cancer mortality has risen 1 percent annually since 2005, an increase that has now placed colorectal cancer as the No. 1 cause of cancer mortality in young adults. Experts don’t know why more younger people are getting colorectal cancer, but it’s clear that early-onset colorectal cancer is an important public health issue.

Pascale White, MD, MBA, MS, FACG

In this Q&A, Pascale White, MD, MBA, MS, FACG, Director of Health Equity in Action for Liver and Digestive Diseases (HEALD), and Associate Professor of Medicine (Gastroenterology and Liver Disease), Icahn School of Medicine at Mount Sinai, discusses warning signs younger people should look out for and when to see a doctor.

Why are many people in their 20s and 30s going undiagnosed with colorectal cancer?

Many young people may not have primary care doctors or are ignoring their symptoms. They may go to an urgent care center for strep throat or the flu but may be too embarrassed to discuss symptoms like rectal bleeding and may not be thinking they could have colorectal cancer. Regardless of how old you are, you should never ignore symptoms and should seek medical attention. Having a primary care doctor who could start a timely workup of the symptoms and make a referral to a gastroenterologist is critical to making the diagnosis early. The earlier colorectal cancer is diagnosed, the greater your chances are for survival.

Unfortunately, we are seeing that younger patients are being diagnosed with advanced stage colorectal cancer (stages III and IV). A majority of cases are occurring in the rectum and the distal (left) colon, which can present as rectal bleeding. That is why it is important not to delay seeing the doctor.

What increases my risks as a younger person?

While scientists do not have the exact answers, lifestyle and environmental factors are being investigated. Some studies have linked risk factors for early-onset colorectal cancer to obesity and alcohol intake. Note that these are similar risk factors for older adults too. Other risk factors include having a family history of colorectal cancer or having a hereditary condition like Lynch syndrome; not getting enough physical activity; using tobacco and eating a low-fiber diet high in processed foods.

A Colorectal Cancer Health and Screening Fair will be held at The Mount Sinai Hospital Friday, March 6, from 9 am to 3 pm. Click here to learn more.

Are certain groups more at risk than others?

Early-onset colorectal cancer is increasing in both men and women, but racial disparities exist. Although incidence among non-Hispanic white patients has shown a consistent increase, Black patients still have the highest overall incidence and lowest survival rates.

What type of family history puts me at risk?

The majority of young people who are getting early-onset colorectal cancer don’t have a family history of cancer. That said, any family history of colorectal cancer could be relevant. Knowing first-degree family history (mom/dad/brother/sister) helps your doctor determine if there is a higher risk. However, second-degree family history (aunts/uncles/grandparents/grandchildren/half siblings/nieces and nephews) can help spot potential patterns that might put you at risk. Mount Sinai has genetic counselors that can help identify these patterns.

What symptoms indicate that younger people should see a doctor?

A majority of younger people who are coming to see the doctor with early-onset colorectal cancer are symptomatic, and the most common symptoms are blood in stool and abdominal pain. Other symptoms include iron deficiency anemia, unintentional weight loss, and a change in bowel habits. Young people need to understand seeing blood in the stool (whether it is bright red blood or black stool) should not be ignored. Bleeding could be caused by something benign like hemorrhoids or something malignant like colorectal cancer. If you experience these symptoms, see a doctor as soon as possible. If colorectal cancer is caught early, your chances of survival are higher.

How can I reduce my risk?

Some things may not be in your complete control. For example, we are investigating whether there are certain environmental exposures that put younger people at risk. That said, there are actions you can take regardless of age that reduce overall risk for colorectal cancer. These include eating a well-balanced diet of high-fiber foods (fruits, vegetables, nuts, legumes, and whole grains); reducing your intake of processed foods, especially processed meat; reducing alcohol intake; getting regular exercise; and monitoring any health conditions you have, such as diabetes and obesity​.

What is a colonoscopy?

colonoscopy is a safe and effective procedure where a doctor uses a camera to examine the lining of the colon and rectum for growths called polyps and/or other abnormalities, including colorectal cancer. During the examination, you are given some sedation to keep you comfortable. If polyps are found, they are removed and sent to a pathologist for evaluation. Some polyps are benign while others could be precancerous. The type of polyps removed will determine when the colonoscopy should be repeated in the future.

Will my insurance cover it?

Insurance companies cover colonoscopies for people who are 45 years and older for screening colonoscopies. A screening colonoscopy is what the procedure is called when it is being done on a patient who has no symptoms. If you are under age 45 but are experiencing symptoms, you would be sent for a diagnostic colonoscopy because the procedure is being done to find the diagnosis that would explain the symptoms. In either case, we encourage patients to communicate with their insurance company prior to procedures to ensure they will cover the cost.

How can I get a colonoscopy if I don’t have insurance?

Call your health provider to see what resources may be available for free or low-cost colonoscopies. They can help navigate patients to centers that accommodate people who do not have insurance.

Why Flu Cases Are High Right Now, and What You Should Do

Every fall and winter, health care professionals remind people to get the flu shot and take basic precautions. But this season it’s even more important, as flu rates are unusually high.

For example, in late December, the New York State Department of Health reported the highest number of flu cases in a single week since these records were kept, beginning in 2004. The flu season typically peaks in December, January, and February.

In this Q&A, Jennifer Duchon, MD, MPH, DrPH, explains why flu rates are high now, and what you should do about it, especially to protect those most vulnerable, including children under age 5, pregnant persons, adults over age 65, and those with chronic illnesses or weak immune systems. Dr. Duchon is Hospital Epidemiologist and Director of Antimicrobial Stewardship at the Mount Sinai Kravis Children’s Hospital and an Associate Professor of Pediatrics at the Icahn School of Medicine at Mount Sinai.

Jennifer Duchon, MD, MPH, DrPH

What symptoms should I look out for?

Common flu symptoms include:

  • Fever or chills
  • Cough and sore throat
  • Runny or stuffy nose
  • Headache and body aches
  • Fatigue or weakness
  • Vomiting or diarrhea

Symptoms tend to come on more suddenly than other viruses like the common cold, and can linger, especially the cough. Symptoms to worry about are trouble breathing or very fast breathing, persistent chest pain, inability to drink or keep down liquids, confusion, or if a fever or symptoms improve and then suddenly worsen.

Why are more people getting sick with the flu right now?

Flu cases are more widespread this season for a couple of important reasons. Each year, the influenza vaccine is developed in advance of the season, using surveillance data and modeling to predict how influenza strains will change and which strains will circulate. This year, after the vaccine was produced, one of the influenza strains developed changes in some of the viral proteins. These changes in the virus’s proteins mean that one strain of flu that is circulating this year is not as well matched to the vaccine as we would like, making the vaccine less effective in preventing the flu.

What are other factors?

Overall, skepticism about vaccines has increased, resulting in fewer people being vaccinated against the flu. When fewer people are immunized, influenza spreads more easily within communities. Together, these factors contribute not only to a higher number of flu cases, but also to a greater risk of more severe illness, particularly in young children, older adults, and those with underlying medical conditions.

Why is it important to get the flu shot?

Even though the flu vaccine is not a perfect match to the most common strain circulating this year, vaccination is still strongly recommended. This year’s flu vaccine has been shown to reduce the risk of the most serious complications of influenza, including hospitalization, pneumonia, and death—especially in vulnerable populations such as young children, pregnant persons, older adults, and people with underlying medical conditions, such as asthma or heart disease. Children cannot be vaccinated against the flu until they are six months old, so it’s important that the whole household (and caregivers) get vaccinated to protect the most vulnerable members of the family.

What should you do if your family gets the flu?

If someone in your family develops flu symptoms, focus on the basics:

  • Rest and good hydration are essential.
  • Fever-reducing medications such as acetaminophen (Tylenol®) or ibuprofen (Motrin®) can help with aches and fever when used as directed.
  • Antiviral medications such as Tamiflu® and Xofluza® can be prescribed by a health care provider. When started early, these medicines can shorten the duration of illness and reduce the risk of severe complications.

It is also important to limit the spread of the virus. Anyone who is sick should wear a mask. They should stay home from school, work, and activities, at least until symptoms are improving and they have been fever free without the use of fever-reducing medications for more than one day. Within the household, practicing good cough etiquette, frequent handwashing, and cleaning commonly touched surfaces can help protect other family members. Most people can recuperate from the flu on their own. If symptoms are severe, worsening, or if the person is at higher risk for complications, you should contact your doctor.

Strep Throat: What Parents Need to Know About the Infection

If your child has ever had a bad sore throat, it may have been caused by group A streptococcal (Group A Strep) bacteria, otherwise known as strep throat. This is a common type of bacterial infection found in the throat and on the skin that can cause a variety of infections.

These infections are most common in school-aged children because they are in close contact. The infections are very contagious but typically mild, and they can be easily treated. It is rare, but in some case where strep throat goes untreated, kidney and heart disease can develop. This is why early detection and treatment is essential.

Tessa Scripps, MD

In this Q&A, Tessa Scripps, MD, a pediatrician and Assistant Professor at the Icahn School of Medicine at Mount Sinai, explains what causes strep throat, how to recognize the symptoms and treat them, and ways to help prevent the infection and keep it from spreading.

What are some common symptoms and infections caused by this strep infection?

Two of the most common infections are:

  • Strep throat, the most common form, causes a sore throat, fever, swollen lymph nodes, and sometimes white patches on the tonsils.
  • Impetigo, a skin infection, causes crusty skin sores, most often around the nose and mouth of children.

Other infections include:

  • Scarlet fever, which causes a red rash, fever, sore throat, and sometimes a strawberry tongue.
  • Cellulitis, which causes redness, swelling, and skin that is warm to the touch.
  • Necrotizing fasciitis, a rare and serious infection that destroys skin and tissue.
  • Streptococcal toxic shock syndrome (STSS) a rare and life-threatening condition that causes fever, low blood pressure, organ failure, and a rash.

How is strep throat treated?

There is a rapid test for strep throat that can often confirm the diagnosis during a doctor’s visit. Your health care provider may swab your child’s throat to test for strep infection. Amoxicillin (or an alternative antibiotic for those with penicillin allergies) usually gets children back to normal within 24-48 hours. Typically, an antibiotic ointment is used to treat the skin infection. For both infections, children tend to get better in a few days. Early diagnosis and treatment can help prevent complications.

How is the strep infection transmitted?

The strep infection is spread through close contact with an infected person, such as through coughing, sneezing, or sharing drinks or utensils or by contact with infected wounds or objects.

How can I protect my family and prevent strep?

There are some basic measures you can take to prevent strep, including:

  • Overall good hygiene is the best way to protect your family not only from strep but from other infections and illnesses too.
  • Good hand hygiene is essential for preventing the spread of the infection.
  • Cover your nose and mouth when coughing or sneezing.
  • Avoid close contact with sick people.

When should I call the pediatrician?

If your child has a combination of a sore throat, fever, and swollen glands, you should call your pediatrician.