WEBVTT - How Outrageous Could Private Equity Be in 2024?

0:00:02.440 --> 0:00:06.760
<v Speaker 1>Bloomberg Audio Studios, Podcasts, radio News.

0:00:07.120 --> 0:00:10.440
<v Speaker 2>You're listening to Bloomberg Business Week with Carol Messer and

0:00:10.520 --> 0:00:12.920
<v Speaker 2>Tim Stenebek on Bloomberg Radio.

0:00:13.160 --> 0:00:14.840
<v Speaker 1>One of the things that we did notice was Apollo

0:00:14.920 --> 0:00:17.919
<v Speaker 1>Global Management Shares Trading hire today. This is after the

0:00:17.960 --> 0:00:21.279
<v Speaker 1>company posted record annual earnings beat Wall Street estimates as

0:00:21.360 --> 0:00:24.759
<v Speaker 1>higher interest rates powered growth at the credit focused alternative

0:00:24.800 --> 0:00:25.560
<v Speaker 1>asset manager.

0:00:25.640 --> 0:00:27.639
<v Speaker 3>Apollo, though, took a more muted tone than some of

0:00:27.680 --> 0:00:31.320
<v Speaker 3>its peers on the prospect for private equity exits. Principal

0:00:31.320 --> 0:00:34.440
<v Speaker 3>investing income from selling private equity assets will fall below

0:00:34.479 --> 0:00:36.680
<v Speaker 3>the multi year average target of one dollar per share

0:00:36.680 --> 0:00:40.280
<v Speaker 3>in twenty twenty four. That's according to CFO Martin Kelly,

0:00:40.360 --> 0:00:41.800
<v Speaker 3>who said that on the earnings.

0:00:41.479 --> 0:00:43.479
<v Speaker 1>Call, all right, one company we wanted to zoom at

0:00:43.520 --> 0:00:45.479
<v Speaker 1>though for an updead in all things private equity, and

0:00:45.520 --> 0:00:48.199
<v Speaker 1>for that return to Antoindrie, founder and chairman of Tiago.

0:00:48.479 --> 0:00:51.120
<v Speaker 1>It's a placement agent best known for assisting private equity

0:00:51.159 --> 0:00:54.480
<v Speaker 1>firms with fundraising, and since nineteen ninety two, the company

0:00:54.480 --> 0:00:57.120
<v Speaker 1>has raised and advised clients and more than fifty billion

0:00:57.160 --> 0:01:00.160
<v Speaker 1>dollars in capital. We're getting that from its website, but

0:01:00.360 --> 0:01:02.680
<v Speaker 1>we've got the man here in studio here in our

0:01:02.680 --> 0:01:07.040
<v Speaker 1>Bloomberg Interactive Broker studio, Antwine. Nice to have you here.

0:01:07.240 --> 0:01:07.800
<v Speaker 4>How are you?

0:01:07.880 --> 0:01:10.160
<v Speaker 1>Let's start big and broad though. How does the environment

0:01:10.200 --> 0:01:11.880
<v Speaker 1>look this year when it comes to private equity?

0:01:12.680 --> 0:01:16.360
<v Speaker 4>It's we are going back to reality. Right after Q

0:01:17.120 --> 0:01:21.759
<v Speaker 4>zero interest rates, etcetera, etcetera, We're going back to flight

0:01:21.800 --> 0:01:26.200
<v Speaker 4>to quality. Mostly it's obviously tougher out there. It's tougher

0:01:26.240 --> 0:01:30.240
<v Speaker 4>for exits, as you've been saying. It's also tougher on

0:01:30.280 --> 0:01:34.400
<v Speaker 4>the investment side because credit is lacking. So we are,

0:01:34.560 --> 0:01:38.920
<v Speaker 4>I think, going to what I was what private equity

0:01:38.959 --> 0:01:42.280
<v Speaker 4>was in the early nineties, right, adding value to businesses

0:01:42.600 --> 0:01:43.680
<v Speaker 4>and being smart about.

0:01:43.560 --> 0:01:46.479
<v Speaker 1>Investing discrete discretionary of course.

0:01:46.800 --> 0:01:52.480
<v Speaker 3>Yeah, So does private equity thrive in an environment like that?

0:01:54.080 --> 0:01:57.200
<v Speaker 4>Not all of it. Some of it was just you know,

0:01:57.320 --> 0:02:00.240
<v Speaker 4>riding the wave, I guess. And these guys are in

0:02:00.280 --> 0:02:04.520
<v Speaker 4>trouble because things are now tougher for those who know

0:02:04.600 --> 0:02:09.000
<v Speaker 4>their way within the difficult environments. It's obviously great times.

0:02:10.040 --> 0:02:14.160
<v Speaker 4>They can buy great assets at cheaper prices, they can

0:02:14.240 --> 0:02:18.320
<v Speaker 4>have less competition, and they can think about you know,

0:02:18.360 --> 0:02:19.320
<v Speaker 4>great growth bands.

0:02:19.440 --> 0:02:21.919
<v Speaker 3>How are you thinking about using leverage when it comes

0:02:21.960 --> 0:02:24.680
<v Speaker 3>to buyouts right now, just because interest rates are so

0:02:24.760 --> 0:02:25.560
<v Speaker 3>much higher.

0:02:26.360 --> 0:02:30.359
<v Speaker 4>I think it's it's obviously part of the game, you know, leverage.

0:02:30.400 --> 0:02:32.960
<v Speaker 4>It can leverage, can can make people rich. It can

0:02:33.000 --> 0:02:36.280
<v Speaker 4>also hurt or kill. I think you have to use

0:02:36.320 --> 0:02:40.200
<v Speaker 4>it with a lot of you know, skill, and that's

0:02:40.200 --> 0:02:42.040
<v Speaker 4>what most of these guys are doing right now.

0:02:42.160 --> 0:02:44.040
<v Speaker 1>What do you make of though, kind of it's all

0:02:44.080 --> 0:02:48.200
<v Speaker 1>about private credit right now? Do we continue to see

0:02:48.480 --> 0:02:50.839
<v Speaker 1>I feel like, you know, traditional Wall Street is saying, wait,

0:02:50.880 --> 0:02:53.800
<v Speaker 1>I increasingly want a piece of that. How does that

0:02:53.880 --> 0:02:56.239
<v Speaker 1>impact the market? How does that, you know, impact some

0:02:56.280 --> 0:02:58.240
<v Speaker 1>of the conversations that you're having with the clients you

0:02:58.280 --> 0:02:58.600
<v Speaker 1>deal with.

0:02:58.919 --> 0:03:02.919
<v Speaker 4>Most LPs are indeed interested in credit. That I mean,

0:03:02.919 --> 0:03:05.200
<v Speaker 4>you go to them, they don't really want to know

0:03:05.200 --> 0:03:08.520
<v Speaker 4>about private equity or VC growth, et cetera. They're all

0:03:08.520 --> 0:03:11.400
<v Speaker 4>interested in credit. I guess up to a point, at

0:03:11.440 --> 0:03:15.160
<v Speaker 4>some point there will be probably too much available.

0:03:14.680 --> 0:03:16.239
<v Speaker 1>And money tracing too many things.

0:03:17.160 --> 0:03:19.760
<v Speaker 4>Of course, unlike everything, you know, it's supply and demand.

0:03:19.840 --> 0:03:22.360
<v Speaker 4>And when there's a you know, too much supply and

0:03:22.400 --> 0:03:24.799
<v Speaker 4>not enough demand, you're in. You're in. You're in, You're

0:03:24.840 --> 0:03:25.679
<v Speaker 4>in trouble. Does it.

0:03:25.840 --> 0:03:27.400
<v Speaker 1>When you say trouble, though, does it mean that it

0:03:27.480 --> 0:03:30.680
<v Speaker 1>results in that we see assets being build up in

0:03:30.760 --> 0:03:33.240
<v Speaker 1>terms of valuations, and so there's going to be fallout.

0:03:33.600 --> 0:03:36.080
<v Speaker 4>Yeah, and it's going to mean less less. I mean

0:03:36.120 --> 0:03:38.600
<v Speaker 4>performance is probably going to be hit. I think it's not.

0:03:39.400 --> 0:03:41.960
<v Speaker 4>It's not there yet, right, There's going to be a

0:03:42.000 --> 0:03:45.520
<v Speaker 4>few years where the asset class is going to thrive.

0:03:45.720 --> 0:03:48.000
<v Speaker 4>But at some point, I mean, things go back to

0:03:48.080 --> 0:03:48.400
<v Speaker 4>the mean.

0:03:49.120 --> 0:03:51.800
<v Speaker 3>Hey, we should know for everybody who has not necessarily

0:03:51.880 --> 0:03:54.680
<v Speaker 3>been keeping up, Hulhan Loki is acquiring Triogra. The deal

0:03:54.760 --> 0:03:57.720
<v Speaker 3>is expected to close in the first half of the year.

0:03:58.400 --> 0:04:00.280
<v Speaker 3>What does this look like for for your life? What

0:04:00.280 --> 0:04:01.960
<v Speaker 3>does it look like for the business? I mean, this

0:04:02.040 --> 0:04:02.600
<v Speaker 3>is a big deal.

0:04:02.680 --> 0:04:03.520
<v Speaker 1>Do you go on vacations.

0:04:04.840 --> 0:04:07.680
<v Speaker 4>I'm not yet dealing. I'm not yet going on vacation.

0:04:08.040 --> 0:04:10.920
<v Speaker 4>The deal is not closed yet. We are we have

0:04:11.040 --> 0:04:14.280
<v Speaker 4>signed an agreement. We are basically done, except that we're

0:04:14.320 --> 0:04:18.200
<v Speaker 4>waiting for regulatory approvals. So we should be done, as

0:04:18.240 --> 0:04:21.520
<v Speaker 4>you said, in the next month. For the time being,

0:04:21.560 --> 0:04:25.360
<v Speaker 4>we operate as two different businesses. But at some point, yes,

0:04:25.400 --> 0:04:27.520
<v Speaker 4>we will become part of a big machine, which is

0:04:27.560 --> 0:04:31.920
<v Speaker 4>great for us. Lots of new opportunities in this huge market.

0:04:32.200 --> 0:04:33.839
<v Speaker 3>Can you give us some details of the agreement?

0:04:35.240 --> 0:04:40.719
<v Speaker 4>Can I say, no, you want I'm afraid I'm afraid

0:04:40.760 --> 0:04:44.279
<v Speaker 4>this was this is still something we are not talking about.

0:04:44.279 --> 0:04:46.560
<v Speaker 4>Maybe when the deal is done, maybe, I mean that's

0:04:46.600 --> 0:04:49.200
<v Speaker 4>also that's also something they need to agree to.

0:04:49.400 --> 0:04:51.160
<v Speaker 3>Maybe you could tell us what the tie up of

0:04:51.200 --> 0:04:53.400
<v Speaker 3>these two companies means for your business.

0:04:54.800 --> 0:04:57.839
<v Speaker 4>Uh, it means it's really one plus one equals three

0:04:57.960 --> 0:05:03.760
<v Speaker 4>maybe more. Ours strength are their weaknesses. Their weaknesses are

0:05:03.839 --> 0:05:09.560
<v Speaker 4>you know, the opposite. There's I mean geographically and business wise.

0:05:09.960 --> 0:05:13.120
<v Speaker 4>We bring a lot of stuff they don't have. They

0:05:13.160 --> 0:05:16.120
<v Speaker 4>bring a lot of distribution power to us. They have

0:05:16.240 --> 0:05:21.400
<v Speaker 4>thirty five offices, we have five. We're not in Asia

0:05:21.440 --> 0:05:25.480
<v Speaker 4>with Triago, which at some point I guess would have

0:05:25.480 --> 0:05:29.320
<v Speaker 4>become a problem. So we're now much much stronger. I mean,

0:05:29.320 --> 0:05:30.599
<v Speaker 4>we will be much much stronger.

0:05:30.600 --> 0:05:32.680
<v Speaker 1>But there is something to write being bigger, like I

0:05:32.680 --> 0:05:34.720
<v Speaker 1>think at some point, because there is so much competition

0:05:34.800 --> 0:05:36.920
<v Speaker 1>that when you can be a house that offers a

0:05:36.960 --> 0:05:40.400
<v Speaker 1>lot like as you said, there's not a lot of overlap,

0:05:40.600 --> 0:05:43.760
<v Speaker 1>there's power in that, and there's something about increasing your

0:05:43.760 --> 0:05:45.560
<v Speaker 1>presence physically that makes it easier.

0:05:45.600 --> 0:05:49.400
<v Speaker 4>Absolutely, absolutely, I think is this There's going to be

0:05:49.440 --> 0:05:52.919
<v Speaker 4>more consolidation in this space for that same reason you

0:05:53.000 --> 0:05:55.200
<v Speaker 4>want to be a giant or nothing.

0:05:55.400 --> 0:05:57.200
<v Speaker 1>Right, And I'm asuman clients come to you. They want

0:05:57.800 --> 0:05:59.479
<v Speaker 1>a lot of things that they can play with or

0:05:59.520 --> 0:06:02.440
<v Speaker 1>work with. Hey, you have shared with us your ten

0:06:02.480 --> 0:06:05.120
<v Speaker 1>outrageous predictions for private equity in twenty and twenty four.

0:06:05.160 --> 0:06:06.480
<v Speaker 1>What's your most outrageous?

0:06:06.480 --> 0:06:09.000
<v Speaker 4>So I've seen some of them, you know, in the past.

0:06:09.040 --> 0:06:12.599
<v Speaker 4>Some of them did happen, so maybe not so outrageous,

0:06:12.720 --> 0:06:16.560
<v Speaker 4>you know. I guess the most outrageous is probably Carla

0:06:16.600 --> 0:06:20.760
<v Speaker 4>Iken and Nelson Pels buying all the distressed funds out there.

0:06:21.240 --> 0:06:24.480
<v Speaker 4>I think I put the forty billion number in there.

0:06:24.920 --> 0:06:29.719
<v Speaker 4>There will be lots of fallout from funds. There has

0:06:29.760 --> 0:06:34.120
<v Speaker 4>to be some some cleanup, and there aren't many players

0:06:34.120 --> 0:06:37.720
<v Speaker 4>doing that already. So these guys or similar entities could

0:06:37.760 --> 0:06:39.719
<v Speaker 4>probably do a lot in that space.

0:06:40.040 --> 0:06:42.000
<v Speaker 3>Hey, one thing I was really surprised to see on

0:06:42.040 --> 0:06:44.960
<v Speaker 3>your predictions for twenty twenty four was Amazon creating an

0:06:45.000 --> 0:06:48.960
<v Speaker 3>online private equity exchange, this so called category killer. Carol

0:06:49.000 --> 0:06:51.440
<v Speaker 3>and I've spoken about the past couple of years. The

0:06:51.480 --> 0:06:54.680
<v Speaker 3>idea of private equity. You know, private equity providers want

0:06:54.800 --> 0:06:56.840
<v Speaker 3>to access to people's farrow one case. They want to

0:06:56.880 --> 0:06:58.839
<v Speaker 3>make this thing. You know that just not just high

0:06:58.839 --> 0:07:01.120
<v Speaker 3>net worth individuals have acces too. What do you mean

0:07:01.160 --> 0:07:02.120
<v Speaker 3>by Amazon doing this?

0:07:02.640 --> 0:07:06.479
<v Speaker 4>I think the asset class needs fluidity. A few years ago,

0:07:06.600 --> 0:07:10.040
<v Speaker 4>it wasn't really needed because the retail investors were not

0:07:10.200 --> 0:07:12.840
<v Speaker 4>playing in that game. Today it's a complete different story

0:07:13.600 --> 0:07:17.600
<v Speaker 4>and they I think these people especially need to know

0:07:17.720 --> 0:07:19.720
<v Speaker 4>that there's a way out, right.

0:07:20.120 --> 0:07:21.840
<v Speaker 3>But that's one of the reasons why returns have been

0:07:21.880 --> 0:07:25.320
<v Speaker 3>good is because it's you get that high return in

0:07:25.360 --> 0:07:27.600
<v Speaker 3>exchange for locking up your money for you know, ten

0:07:27.640 --> 0:07:28.320
<v Speaker 3>twelve years.

0:07:28.440 --> 0:07:30.880
<v Speaker 4>Yeah, but you can still get a very decent return

0:07:30.960 --> 0:07:32.640
<v Speaker 4>even if you leave the show, you know, in the

0:07:32.720 --> 0:07:36.920
<v Speaker 4>in the in between, right, And that's that's an option,

0:07:37.040 --> 0:07:40.280
<v Speaker 4>it's not. I guess that most people stay where they are,

0:07:40.320 --> 0:07:44.040
<v Speaker 4>and ninety nine percent of the paper, the private equity paper,

0:07:44.160 --> 0:07:48.400
<v Speaker 4>stays where it is. Trades account for roughly one percent.

0:07:49.000 --> 0:07:53.200
<v Speaker 4>My bet is that, especially if such tool exists, you know,

0:07:53.240 --> 0:07:54.560
<v Speaker 4>we may go to five percent.

0:07:54.920 --> 0:07:56.920
<v Speaker 1>Just got about thirty forty seconds left here. I love

0:07:56.920 --> 0:07:59.240
<v Speaker 1>this one though about Michael Jordan, Serena Williams and Blue

0:07:59.240 --> 0:08:03.680
<v Speaker 1>Owl Console Private equity, sports investments, I mean sports private equity. Man,

0:08:03.680 --> 0:08:04.400
<v Speaker 1>it's a love affair.

0:08:04.720 --> 0:08:08.440
<v Speaker 4>Prediction prediction, don't this one could happen.

0:08:09.120 --> 0:08:11.040
<v Speaker 1>Thirty seconds here, This one could happen.

0:08:11.160 --> 0:08:13.960
<v Speaker 4>This one could happen. I don't know about the names,

0:08:14.040 --> 0:08:16.800
<v Speaker 4>I don't know about the people. But there's private equity

0:08:16.840 --> 0:08:20.000
<v Speaker 4>on sports, as you said, is a love affair. And

0:08:20.040 --> 0:08:21.880
<v Speaker 4>there's a lot to be done in the space. And

0:08:21.920 --> 0:08:26.280
<v Speaker 4>it's still pretty you know, it's I mean, there's much

0:08:26.320 --> 0:08:29.080
<v Speaker 4>more to be done compared to other sectors where most

0:08:29.080 --> 0:08:30.840
<v Speaker 4>of the action has been taking place already.

0:08:30.960 --> 0:08:32.839
<v Speaker 1>There's something to you on AI, which I love. AI

0:08:32.960 --> 0:08:36.040
<v Speaker 1>hits turbulence in private equity, back to acquisitions. I love

0:08:36.040 --> 0:08:37.640
<v Speaker 1>that because I feel like, maybe take some of the

0:08:37.679 --> 0:08:38.200
<v Speaker 1>froth out.

0:08:38.240 --> 0:08:42.600
<v Speaker 4>Maybe it's an art not as science and human beings

0:08:42.640 --> 0:08:44.160
<v Speaker 4>are still needed in the space.

0:08:44.320 --> 0:08:46.800
<v Speaker 1>Come back soon, let us know. Thanks are going Antwindry

0:08:46.840 --> 0:08:49.480
<v Speaker 1>and this was fun and interesting and engaging. Founder of

0:08:49.520 --> 0:08:52.360
<v Speaker 1>Triago joining us here at our Bloomberg Interactive Broker Studio.

0:08:52.360 --> 0:08:54.000
<v Speaker 1>I'm Carol Masser along with to the stand of it,

0:08:54.120 --> 0:08:57.920
<v Speaker 1>this is Bloomberg. Well not sure if this has been

0:08:57.920 --> 0:09:00.800
<v Speaker 1>on your radar. But cases of syphilis, which yes, was

0:09:00.920 --> 0:09:06.120
<v Speaker 1>once we're once on its way to being eradicated. Our

0:09:06.160 --> 0:09:08.440
<v Speaker 1>soaring in the US. Numbers are hitting levels not seen

0:09:08.480 --> 0:09:11.360
<v Speaker 1>for seventy years. Is according to the CDC, the Centers

0:09:11.360 --> 0:09:14.040
<v Speaker 1>for Disease Control and Prevention. So think about it. Cyphilis

0:09:14.080 --> 0:09:16.480
<v Speaker 1>at one point was on its way to be knocked

0:09:16.480 --> 0:09:17.120
<v Speaker 1>out completely.

0:09:17.280 --> 0:09:19.520
<v Speaker 3>Well, it's a different time now and it's kind of startling.

0:09:19.520 --> 0:09:21.640
<v Speaker 3>More than two hundred thousand cases were recorded in twenty

0:09:21.720 --> 0:09:24.400
<v Speaker 3>twenty two. The latest figure show that's up seventeen percent

0:09:24.440 --> 0:09:27.560
<v Speaker 3>on the previous year. If left untreated, Carol, the disease

0:09:27.600 --> 0:09:29.439
<v Speaker 3>can cause blindness and even death.

0:09:29.520 --> 0:09:31.000
<v Speaker 1>All right, For more on this, we turn back to

0:09:31.160 --> 0:09:34.080
<v Speaker 1>doctor Ian las Bader, clinical Professor of Medicine at NYU

0:09:34.160 --> 0:09:37.640
<v Speaker 1>Lango Medical Center. He is on Zoom in New York City.

0:09:38.360 --> 0:09:40.240
<v Speaker 1>Great to have you here and great to be talking

0:09:40.280 --> 0:09:42.720
<v Speaker 1>with you, Doctor Les Beater again, I hope you're well.

0:09:44.080 --> 0:09:47.720
<v Speaker 2>Everything is great. Hope all is well with the beautiful

0:09:47.840 --> 0:09:49.439
<v Speaker 2>Carol and handsome Tim.

0:09:49.559 --> 0:09:51.839
<v Speaker 1>Oh well, thank you very much, good very much. You

0:09:51.880 --> 0:09:55.520
<v Speaker 1>will keep coming back after that. No, we're doing well,

0:09:55.679 --> 0:09:57.720
<v Speaker 1>just trying to keep up with kind of the newsflow.

0:09:57.760 --> 0:10:00.160
<v Speaker 1>Having said that this, you know, speaking of new use

0:10:00.200 --> 0:10:02.920
<v Speaker 1>flow and headlines, you know, we are always interested in

0:10:03.000 --> 0:10:05.720
<v Speaker 1>various health issues. This cut us by surprise, tell us

0:10:05.720 --> 0:10:07.520
<v Speaker 1>about what's going on when it comes to syphilis in

0:10:07.559 --> 0:10:09.199
<v Speaker 1>the cases that are increasing.

0:10:10.600 --> 0:10:15.280
<v Speaker 2>So we really go from macro events, geopolitical events, Powell

0:10:15.440 --> 0:10:19.920
<v Speaker 2>interest rates to the micro, from macro to micro. Syphilis

0:10:19.960 --> 0:10:24.000
<v Speaker 2>has been around for centuries and STDs have been around

0:10:24.040 --> 0:10:28.000
<v Speaker 2>for centuries. Syphilis is a small spiral bacteria called a

0:10:28.080 --> 0:10:33.199
<v Speaker 2>spiral keep really goes through several phases. After an acute infection,

0:10:33.360 --> 0:10:38.720
<v Speaker 2>it goes through a primary and then secondary phases. It

0:10:38.760 --> 0:10:42.000
<v Speaker 2>can become latent where really there are no symptoms. And

0:10:42.040 --> 0:10:45.920
<v Speaker 2>I think that's the biggest issue in those several phases

0:10:46.040 --> 0:10:49.280
<v Speaker 2>after that initial physical contact where there may be an

0:10:49.320 --> 0:10:53.360
<v Speaker 2>ulcer Asrah Shanker, and the rate is going up. We

0:10:53.520 --> 0:10:57.520
<v Speaker 2>have rates of STDs going up two point five million

0:10:57.600 --> 0:11:04.720
<v Speaker 2>cases all told, chlamydia area syphalus, herpes. Now, syphilis can

0:11:04.760 --> 0:11:08.600
<v Speaker 2>be asymptomatic after the initial ulcer, and that's really the

0:11:08.640 --> 0:11:12.120
<v Speaker 2>problem is that we need to screen people better for this.

0:11:13.360 --> 0:11:17.360
<v Speaker 2>It's not just a disease of over fifty five communities

0:11:17.360 --> 0:11:21.280
<v Speaker 2>in Florida. We see this across all groups, in young

0:11:21.320 --> 0:11:26.000
<v Speaker 2>people and gay men, in heterosexuals, so we really have

0:11:26.080 --> 0:11:28.600
<v Speaker 2>to screen for it. A pregnant woman have to be

0:11:28.679 --> 0:11:32.360
<v Speaker 2>screened as well. We're seeing an increase in neonatal syphilis,

0:11:32.520 --> 0:11:36.120
<v Speaker 2>which can be very devastating for development. So it is

0:11:36.280 --> 0:11:39.640
<v Speaker 2>very concerning the number of cases two hundred thousand year

0:11:39.800 --> 0:11:45.559
<v Speaker 2>just of syphilis alone. Easily treatable with antibiotics, bicillin, penicillin

0:11:46.360 --> 0:11:49.760
<v Speaker 2>which is easily available. So the key thing really is

0:11:49.840 --> 0:11:53.680
<v Speaker 2>screening patients, asking people when they come in, ask your doctor,

0:11:54.120 --> 0:11:58.240
<v Speaker 2>can I have an SDD panel says for HIV IT

0:11:58.320 --> 0:12:02.120
<v Speaker 2>tys for a syphilis diarrhea test for hepatitis.

0:12:01.679 --> 0:12:03.719
<v Speaker 3>Doctor Lesbater, I'm surprised to hear you say that it's

0:12:03.760 --> 0:12:07.480
<v Speaker 3>easily treated, because we know it is easily treated based

0:12:07.480 --> 0:12:12.079
<v Speaker 3>on the medications. But aren't these medications historically, at least

0:12:12.080 --> 0:12:13.520
<v Speaker 3>in the last couple of years, haven't they been in

0:12:13.520 --> 0:12:17.400
<v Speaker 3>short supply. I mean I'm talking about penicillin. Then bisillin

0:12:17.480 --> 0:12:18.640
<v Speaker 3>as well has been in shortage.

0:12:18.960 --> 0:12:23.640
<v Speaker 2>By bicillin. Bysilin is a certain form of intramuscular penicillin. Okay,

0:12:23.679 --> 0:12:26.200
<v Speaker 2>Typically you know a big syringe in the butt, which

0:12:26.240 --> 0:12:30.040
<v Speaker 2>may be why people get a little afraid of that. Yes,

0:12:30.080 --> 0:12:34.520
<v Speaker 2>you're exactly right. Recently supplies have been short, that's no reason.

0:12:34.520 --> 0:12:37.520
<v Speaker 2>There are other alternative and oral medications that can be used.

0:12:38.400 --> 0:12:40.960
<v Speaker 2>That's really no reason not to be tested, and for

0:12:41.040 --> 0:12:45.600
<v Speaker 2>physicians there are other options. We also have infectious disease specialists.

0:12:45.640 --> 0:12:48.600
<v Speaker 2>If you get a positive result on a blood test

0:12:48.640 --> 0:12:52.400
<v Speaker 2>and you're not sure, refer to an infectious disease specialist

0:12:53.360 --> 0:12:57.400
<v Speaker 2>so that the patient gets the right treatment. All pregnant women, young,

0:12:57.520 --> 0:13:01.559
<v Speaker 2>sexually active people, but even older people should be tested

0:13:01.559 --> 0:13:05.200
<v Speaker 2>if they're single, if they're sexually active. Really, there's no

0:13:05.280 --> 0:13:08.320
<v Speaker 2>reason not to screen everyone on a regular basis.

0:13:08.520 --> 0:13:11.440
<v Speaker 1>Why wait, so, why are we seeing in increasing cases?

0:13:13.000 --> 0:13:16.240
<v Speaker 2>Well, I think they're a variety of reasons. Certainly, when

0:13:16.240 --> 0:13:19.000
<v Speaker 2>people were let out of the gate after COVID, everyone

0:13:19.160 --> 0:13:24.360
<v Speaker 2>was sheltering in place. In twenty nineteen and twenty, we've

0:13:24.400 --> 0:13:27.760
<v Speaker 2>really seen an explosion people going out. I think we've

0:13:27.840 --> 0:13:31.400
<v Speaker 2>dropped our guard. People are not using condoms or barrier methods.

0:13:32.280 --> 0:13:34.680
<v Speaker 2>I don't think people are really thinking about it, and

0:13:34.760 --> 0:13:38.280
<v Speaker 2>I think sometimes doctors are uncomfortable to say to young

0:13:38.320 --> 0:13:41.760
<v Speaker 2>people are old people, How do you feel about doing

0:13:41.920 --> 0:13:45.240
<v Speaker 2>STD screening? Usually if you bring it up in the office,

0:13:45.280 --> 0:13:47.680
<v Speaker 2>patients will say, sure, it's an extra vial of blood,

0:13:47.720 --> 0:13:50.400
<v Speaker 2>that's fine to do. So I think it's a combination

0:13:50.480 --> 0:13:53.880
<v Speaker 2>of patients not asking and doctor's not asking, and I

0:13:53.920 --> 0:13:57.960
<v Speaker 2>think there's been more contact, and I think Tim, you're right.

0:13:58.040 --> 0:14:01.280
<v Speaker 2>Because of a little less availability, doctors may have been

0:14:01.320 --> 0:14:04.160
<v Speaker 2>reluctant to test for it or treat for it. The

0:14:04.240 --> 0:14:09.000
<v Speaker 2>problem with syphilis is people can be asymptomatic and spread it.

0:14:09.120 --> 0:14:13.040
<v Speaker 2>Unlike anna rhea or chlamydia, where typically you have painful

0:14:13.200 --> 0:14:19.640
<v Speaker 2>urination or a drip. Syphilis after the initial infection, maybe

0:14:19.680 --> 0:14:22.760
<v Speaker 2>asymptomatic patients don't even know they have it. They can

0:14:22.800 --> 0:14:27.080
<v Speaker 2>present non specifically fever, rash on the hands, swollen lumph notes,

0:14:27.360 --> 0:14:29.200
<v Speaker 2>so it can be tricky to diagnose.

0:14:29.440 --> 0:14:32.160
<v Speaker 3>Doctor Lesbater, I'm wondering if sort of this big shift

0:14:32.200 --> 0:14:34.600
<v Speaker 3>has happened in recent years with the way that people

0:14:34.800 --> 0:14:37.560
<v Speaker 3>think about this stuff. You know, when I was growing up,

0:14:37.840 --> 0:14:42.040
<v Speaker 3>HIV was a death sentence for people. And the incredible

0:14:42.080 --> 0:14:46.160
<v Speaker 3>advances that we've seen in treating HIV and making it

0:14:46.200 --> 0:14:51.240
<v Speaker 3>so essentially live people are able to live with HIV

0:14:51.400 --> 0:14:56.120
<v Speaker 3>at this point, very long and healthy lives. I'm wondering

0:14:56.160 --> 0:14:58.520
<v Speaker 3>if we've seen if that is part of a shift

0:14:58.720 --> 0:15:02.479
<v Speaker 3>in terms of how we think about STDs as a society,

0:15:02.560 --> 0:15:05.600
<v Speaker 3>that we're no longer sort of scared straight with this stuff.

0:15:06.520 --> 0:15:09.520
<v Speaker 2>You're so right. I think that's exactly the case. I

0:15:09.520 --> 0:15:14.200
<v Speaker 2>think it's off people's radar internationally and globally, there's something

0:15:14.320 --> 0:15:18.680
<v Speaker 2>like seven point five million cases of syphilis. Forget the

0:15:18.760 --> 0:15:22.440
<v Speaker 2>other SDDS, that's just syphilis seven point five million globally,

0:15:23.040 --> 0:15:27.000
<v Speaker 2>So people who travel, people who may have encounters overseas,

0:15:27.320 --> 0:15:29.440
<v Speaker 2>we really need to raise it on the radar. And

0:15:29.480 --> 0:15:33.080
<v Speaker 2>you're right now that HIV rates are coming down and

0:15:33.120 --> 0:15:37.320
<v Speaker 2>it's more treatable, we give patients at risk pre exposure prophylaxis,

0:15:37.360 --> 0:15:41.040
<v Speaker 2>so once a day pill for HIV to reduce their

0:15:41.120 --> 0:15:44.720
<v Speaker 2>ability to transmit it to other people or to acquire it.

0:15:45.360 --> 0:15:47.960
<v Speaker 2>So you're right, I think our guard is down with

0:15:48.000 --> 0:15:53.600
<v Speaker 2>the more traditional STDs because HIV is more manageable these days.

0:15:53.800 --> 0:15:56.160
<v Speaker 2>We really need to raise awareness, and it's good that

0:15:56.200 --> 0:15:57.760
<v Speaker 2>you guys are raising awareness.

0:15:58.000 --> 0:16:01.440
<v Speaker 1>So what would you suggest to individuals listening and thinking, Okay,

0:16:01.960 --> 0:16:03.960
<v Speaker 1>how do I kind of incorporate this into my own

0:16:03.960 --> 0:16:05.760
<v Speaker 1>medical care and make sure I stay on top of this.

0:16:06.640 --> 0:16:09.000
<v Speaker 2>You know, once a year. There's no harm if you're

0:16:09.120 --> 0:16:12.360
<v Speaker 2>sexually active, or more frequently than that, certainly, if you

0:16:12.440 --> 0:16:15.480
<v Speaker 2>engage in high risk behavior. Every time you see the

0:16:15.520 --> 0:16:18.040
<v Speaker 2>doctor a couple of times a year. In addition to

0:16:18.120 --> 0:16:21.880
<v Speaker 2>whatever testing PSA cholesterol, ask to have them put in

0:16:21.920 --> 0:16:28.239
<v Speaker 2>an STD panel which tests for hepatitis, herpes, gonorrhea, chlamydia, syphilis,

0:16:28.440 --> 0:16:31.880
<v Speaker 2>and if any of those are positive, early treatment means

0:16:31.960 --> 0:16:36.680
<v Speaker 2>better treatment, less likely to transmit it to someone else.

0:16:37.000 --> 0:16:40.000
<v Speaker 2>And if you have atypical symptoms a rash or fever,

0:16:40.160 --> 0:16:43.720
<v Speaker 2>swollen lymph nodes raise the possibility, there's no harm in

0:16:43.760 --> 0:16:46.520
<v Speaker 2>doing a blood test, and if they're positive then it's

0:16:46.560 --> 0:16:51.080
<v Speaker 2>eminently treatable, usually earlier on. Later on it's harder to treat.

0:16:51.440 --> 0:16:53.520
<v Speaker 1>All right, Well, some good advice and something to think

0:16:53.520 --> 0:16:55.400
<v Speaker 1>about when we go, you know, in terms of just

0:16:55.440 --> 0:16:57.960
<v Speaker 1>your own healthcare. Hey, listen, Ian, thank you so much.

0:16:58.000 --> 0:17:00.560
<v Speaker 1>Always appreciate getting some time with you, doctor Ian las Bader.

0:17:00.800 --> 0:17:04.200
<v Speaker 1>He's clinical professor of medicine at ny U Landgown Medical Center.

0:17:04.680 --> 0:17:06.600
<v Speaker 1>Joining us on Zoom from New York City,