Health and Medical News and Resources

General interest items edited by Janice Flahiff

Study finds online hookup sites increase HIV rates in sometimes-surprising ways

Study finds online hookup sites increase HIV rates in sometimes-surprising ways.

From the 29 May 2015 University of Maryland news release

COLLEGE PARK, Md. – The introduction of Craigslist led to an increase in HIV-infection cases of 13.5 percent in Florida over a four-year period, according to a new study conducted at the University of Maryland’s Robert H. Smith of Business. The estimated medical costs for those patients will amount to $710 million over the course of their lives.

Online hookup sites have made it easier for people to have casual sex—and also easier to transmit sexually transmitted diseases.  The new study measured the magnitude of the effect of one platform on HIV-infection rates in one state, and offered a detailed look at the varying effects on subpopulations by race, gender and socio-economic status. Looking at the period 2002 to 2006, it found that Craigslist led to an additional 1,149 Floridians contracting HIV.

The study “underscores the need for broader communication and dissemination of the risks posed by the type of online matching platforms studied here,” noted Ritu Agarwal, a professor at the University of Maryland’s Robert H. Smith School of Business and founding director of the Center for Health Information and Decision Systems (CHIDS), and Brad N. Greenwood, a 2013 Smith Ph.D. and assistant professor at Temple University’s Fox School of Business.

The study also found that the new HIV cases came disproportionately from one racial-ethnic group, African Americans, who accounted for some 63 percent of the new cases. “That is a bit of paradox,” says Agarwal, “because research suggests that the African American community is one which uses the Internet the least, even though the gap is narrowing.”

Greenwood described African Americans as suffering the effects of a “double digital divide.” He said, “Not only have studies shown there is lower utilization of the Internet for welfare-enhancing activities, but now there’s evidence of utilization for negative activities as well.”

There was also an increase in new HIV cases among Latinos and Caucasians—although only intermittently statistically significant and not statistically different from each other. The lack of difference between Latinos and Caucasians was notable, as Latinos have a higher baseline rate of HIV infection. One explanation could be that fewer Latinos may have sought treatment. Or Florida’s Latino community, which is especially large and well-off, may not be reflective of national trends.

Another counterintuitive result was that more cases came from non-Medicaid patients, the wealthier patients, than from the population covered by the government program.  That was the case even though the base rate of HIV infection is higher among lower-income citizens. “It could be the case that higher-income people face a higher social penalty for engaging in casual, quasi-anonymous sex, and that the freedom of internet anonymity changes their behavior more than it does for the less wealthy,” Agarwal suggested. “Or it could be a byproduct of substantially better internet access.” (Together with the finding for African Americans, that would suggest that degree of internet access affects different sub-populations in different ways).

HIV-prevention efforts tend to focus on the highest-risk populations, such as the economically disadvantaged, but public-health officials should be aware than online platforms may be “changing the game,” says Agarwal.

Perhaps most surprising of all, given the relatively high rates of infection among bi- and homosexual men, there was not a statistically significant difference in HIV-infection-rate increases across men and women.

It could be the case that homosexual men with HIV who used Craigslist were more likely to practice safe sex than infected heterosexuals, the authors speculated. Or matching platforms may lead to more homosexual activity by men who do not identify publically as homosexuals, who then spread the virus to their female partners. The question demands more research, the authors said.

Agarwal and Greenwood were careful to note that they weren’t making a statement about the overall value of Craigslist. Nevertheless, the study offers a reminder of the downside of connectivity. “While there is a general belief that connectivity is good on average, unfortunately ‘on average’ means that some people are going to benefit more and others are going to lose more,” Agarwal says.  “We need to better understand both the beneficial as well as the punitive effects of the Internet on individual and public health.”

July 20, 2015 Posted by | Consumer Health, Health News Items, Medical and Health Research News | , , , , , | Leave a comment

[Press release] Can social media help stop the spread of HIV?

Pinmap of Tweets Related to HIV

Caption: This is a map showing the origins of tweets related to HIV.

Credit: Sean Young

Usage Restrictions: Credit required.
[Sean Young, Center for Digital Behavior at the University of California,
http://www.uclahealth.org/main.cfm?id=2341, scroll down for short bio]

 

From the 30 October 2014 UCLA press release

In addition to providing other potential benefits to public health, all of those tweets and Facebook posts could help curb the spread of HIV.

Although public health researchers have focused early applications of social media on reliably monitoring the spread of diseases such as the flu, Sean Young of the Center for Digital Behavior at the University of California, Los Angeles, writes in an October 29th article in the Cell Press journal Trends in Microbiology of a future in which social media might predict and even change biomedical outcomes.

“We know that mining social media will have huge potential benefits for many areas of medicine in the future, but we’re still in the early stages of testing how powerful these technologies will be,” Young said.

With the right tools in place, he says, social media offers a rich source of psychological and health-related data generated in an environment in which people are often willing to share freely.

His recent work on Behavioral Insights on Big Data (BIBD) for HIV offers the tantalizing possibility that insights gleaned from social media could be used to help governments, public health departments, hospitals, and caretakers monitor people’s health behaviors “to know where, when, and how we might be able to prevent HIV transmission.”

Young details a social-media-based intervention in which African American and Latino men who have sex with men shared a tremendous amount of personal information through social media, including when or whether they had ‘come out,’ as well as experiences of homelessness and stigmatization. What’s more, they found that people who discussed HIV prevention topics on social media were more than twice as likely to later request an HIV test.

In the context of HIV prevention, tweets have also been shown to identify people who are currently or soon to engage in sexual- or drug-related risk behaviors. Those tweets can be mapped to particular locations and related to actual HIV trends.

What’s needed now is the updated infrastructure and sophisticated toolkits to handle all of those data, Young said, noting that there are about 500 million communications sent every day on Twitter alone. He and a team of University of California computer scientists are working to meet that challenge now.

Although privacy concerns about such uses of social media shouldn’t be ignored, Young says there is evidence that people have already begun to accept such uses of social media, even by corporations looking to boost profits.

“Since people are already getting used to the fact that corporations are doing this, we should at least support public health researchers in using these same methods to try and improve our health and well being,” he said. “We’re already seeing increased support from patients and public health departments.”

November 4, 2014 Posted by | Medical and Health Research News, Public Health | , , , , , , , , | Leave a comment

U.S. Launches Interactive HIV/AIDS Database on Census.gov

 

AIDS 2012 logo

 

From the July 23 2012 US Census press release

The U.S. Census Bureau today launched aninteractive global resource on the prevalence of HIV infection and AIDS cases and deaths. The database was developed in 1987 and now holds 149,000 statistics, an increase of approximately 10,800 new estimates in the last year, making it the most complete of its kind in the world. The launch comes as thousands of people worldwide meet in Washington, D.C., for the International AIDS Conference this week.

The resource is maintained by the Census Bureau with funding from the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR) through the United States Agency for International Development (USAID).

U.S. Global AIDS Coordinator Ambassador Eric Goosby, head of PEPFAR, said on the launch, “This release of the HIV/AIDS database will expand global access to data that are critical to understanding the epidemic. This information is invaluable for the evidence-based response PEPFAR is championing.”

Census Bureau Director Robert Groves said “This database provides the people who need it with quality statistics — supporting the life-saving efforts of our partners at PEPFAR and USAID and the doctors, nurses and public health officials working to reach the end of AIDS.”

The tool is a library of statistics from more than 12,000 articles in international scientific and medical journals, individual countries’ annual HIV/AIDS surveillance reports, and papers and posters presented at international conferences.

The menu-driven access tool permits users to search for statistical information in countries and territories across the world, as well as by subpopulation, geographic subarea (such as urban and rural), age, sex and year (back to 1960).

Statistics for the United States are available separately from the Centers for Disease Control and Prevention.

 

July 24, 2012 Posted by | Health Statistics | , , , , , | Leave a comment

How the Global War on Drugs Drives HIV and AIDS

Global Commission Calls for Drug Decriminalization and Expansion of Proven, Cost-Effective Solutions to Reduce HIV/AIDS – Including Sterile Syringe Access, Safer Injection Facilities, and Prescription Heroin Programs

 

From the 29 June 2012 article at Time.com

The war on drugs is driving much of the global AIDS pandemic, increasing new infections among injection-drug users in the U.S. and elsewhere, according to a new report from the Global Commission on Drug Policy...

(A PDF of the report may be found here***)

bout one-third of all new infections outside of sub-Sarahan Africa occur in injection-drug users.

Since the 1990s, effective public-health strategies to curb HIV transmission in drug users have led to drops in new infections in most countries. But over the same time period, seven countries have seen a 25% increase in new infections. Not coincidentally, five of these countries — mainly in Eastern Europe and Central Asia — employ aggressive drug war strategies, such as arresting and incarcerating users for drug or needle possession…

…These tactics have been shown to be ineffective not only for controlling drug use, but also for reining in the spread of HIV. Why? Because the fear of recrimination prevents drug users from seeking clean needles — a major risk factor for HIV infection. In the U.S. as well, areas with the highest infection rates are those that have the most aggressive drug policies, the report shows. The solution is straightforward, if drastic; it requires a complete overhaul of current drug policy: drug users need treatment, not imprisonment, and drug possession needs to be decriminalized, the authors argue.

 

***

The Commission’s recommendations are summarized here. They include:

– Push national governments to halt the practice of arresting and imprisoning people who use drugs but do no harm to others.

–  Measure drug policy success by indicators that have real meaning in communities, such as reduced rates of transmission of HIV and other infectious diseases, fewer overdose deaths, reduced drug market violence, fewer individuals incarcerated and lowered rates of problematic substance use.

– Respond to the fact that HIV risk behavior resulting from repressive drug control policies and under-funding of evidence-based approaches is the main issue driving the HIV epidemic in many regions of the world.

– Act urgently: The war on drugs has failed, and millions of new HIV infections and AIDS deaths can be averted if action is taken now.

How the drug war fuels the HIV pandemic:

– Fear of arrest drives persons who use drugs underground, away from HIV testing and HIV prevention services and into high-risk environments.

– Restrictions on provision of sterile syringes to drug users result in increased syringe sharing.

– Prohibitions or restrictions on opioid substitution therapy and other evidence-based treatment result in untreated addiction and avoidable HIV risk behavior.

– Deficient conditions and lack of HIV prevention measures in prison lead to HIV outbreaks among incarcerated drug users.

– Disruptions of HIV antiretroviral therapy result in elevated HIV viral load and subsequent HIV transmission and increased antiretroviral resistance.

– Limited public funds are wasted on harmful and ineffective drug law enforcement efforts instead of being invested in proven HIV prevention strategies.

June 29, 2012 Posted by | Public Health | , , , , , , , , | Leave a comment

Increasing Condom Use, Reducing Sexually Transmitted Infections Through Behavioral Interventions

From the 19 December 2011 Medical News Today article

Behavioral interventions aimed at reducing sexual risk behaviors, such as unprotected sex, are effective at both promoting condom use and reducing sexually transmitted infections (STIs) long after the initial intervention, according to a new report in the Journal of Acquired Immune Deficiency Syndromes. …

…Researchers found that behavioral interventions – which included HIV education, motivation and skills-based training aimed at negotiating safer sex behaviors – were successful at improving condom use and reducing incident STIs, including HIV, for up to four years. This meta-analysis is believed to be the first to examine the incidence of HIV in a wide range of at-risk populations.

Scott-Sheldon says that while it may seem intuitive that behavioral changes, such as increased condom use, will result in fewer STIs, previous studies have been unable to support that assertion.

“The association between behavioral and biological outcomes is complex, since transmission of STIs depends on a number of factors, including partner type, characteristics, and perceptions of partner safety,” she says. “Examining both outcomes, and factors associated with sexual risk behaviors, should be important in determining the efficacy of behavioral interventions.” …

Read the entire news article here

December 19, 2011 Posted by | Medical and Health Research News | , , , , , , | Leave a comment

Missed Opportunity To Transform Global HIV/AIDS Fight Reported By Tropical Disease Experts

 

Map of Africa coloured according to the percen...

English: Estimated HIV prevalence among young adults (15-49) by country. http://commons.wikimedia.org/wiki/File:Map-of-HIV-Prevalance-in-Africa.png

 

From the 12 December 2011 Medical News Today article 

Global HIV/AIDS prevention and treatment efforts are missing a major opportunity to significantly improve health conditions in poor countries by simply adding low-cost care for the many other chronic and disabling diseases routinely afflicting and often killing these same patients, according to a panel of disease experts who spoke at the annual meeting of the American Society of Tropical Medicine and Hygiene (ASTMH).

“People want better health; they do not understand why we silo diseases,” said Judd Walson, a global health and infectious disease expert at the University of Washington. “If you die from malaria, you don’t care that your HIV was treated. Communities want us to leverage the resources we have to treat and prevent disease as effectively as possible.”

Walson and his colleagues on the panel noted that many victims of HIV/AIDS also typically suffer from one or more of about 17 neglected, but burdensome, tropical diseases often called “diseases of poverty” because they prey on the “bottom billion” – the world’s poorest people. They include ailments such as trachoma, schistosomiasis, lymphatic filariasis, leishmaniasis, Chagas disease and onchocerciasis, all of which are either insect-borne disease, bacterial infections, or caused by parasitic worms.

Despite the illness and deaths attributable to these diseases, proposed US funding for fighting them was only about $155 million in 2011, or about 3 percent of the $5.6 billion invested in HIV/AIDS efforts. Moreover, the programs often exist in isolation from one another with, for example, many programs restricting support only to antiretroviral drugs to treat AIDS.

Yet tropical disease experts note that in places like sub-Saharan Africa, where neglected diseases affect 1.4 billion people, co-infections with HIV are common. And they see mounting evidence that dealing with multiple diseases at the same time and in the same place is more cost-effective and clinically beneficial.

Walson pointed to a program in Western Kenya that focused on a community suspected of having high levels of HIV but whose remote location made it hard to reach to conduct testing. The program promised access to free bed nets and water filters to those residents who came in for a test. In just six days, some 10,000 residents turned out for the free nets and filters. The result: 1181 people were found to be HIV positive and referred to care while thousands of people gained new tools for preventing malaria and water-borne diseases. …….

December 12, 2011 Posted by | Consumer Health, Public Health | , , , | Leave a comment

Only One Quarter of Americans with HIV Have Virus Under Control

English: The Red ribbon is a symbol for solida...

Image via Wikipedia

Only One Quarter of Americans with HIV Have Virus Under Control
http://www.cdc.gov/nchhstp/newsroom/WAD2011PressRelease.html
Nearly 3 out of 4 Americans living with HIV do not have their infection under control, according to a Vital Signs report by the Centers for Disease Control and Prevention.

The Press Release

CDC launches campaign to increase HIV testing so more can access needed care

 

Nearly 3 out of 4 Americans living with HIV do not have their infection under control, according to a Vital Signs report by the Centers for Disease Control and Prevention, released today in advance of World AIDS Day, December 1. The authors say the low percentage is because 1 in 5 people with HIV do not realize they are infected and, of those who are aware, only 51 percent receive ongoing medical care and treatment.

Of the nearly 1.2 million people living with HIV in the United States, only an estimated 28 percent have a suppressed viral load (defined as viral load less than 200 copies of the blood-borne virus per milliliter of blood) – meaning that the virus is under control and at a level that helps keep them healthy and reduces the risk of transmitting the virus to others.

However, of those living with HIV who are in ongoing care and on antiretroviral treatment, 77 percent have suppressed levels of the virus. Effective HIV treatment and care benefit infected individuals by improving their health, and are also important for HIV prevention. Results from a recent study of heterosexual couples from the National Institutes of Health showed that consistently taking antiretroviral therapy, in combination with safer behaviors, can reduce the risk of spreading HIV by approximately 96 percent.

“While we have known that viral suppression can be achieved with proper HIV treatment and care, today’s new Vital Signs data highlight the challenges our country faces in keeping HIV-positive Americans in the care they need to control the virus,” said CDC Director Thomas R. Frieden, M.D., M.P.H. “By improving testing, linkage to care and treatment services, we can help people living with HIV feel better and live longer, and can reduce the spread of HIV dramatically. This is not just an individual responsibility, but a responsibility for families, partners, communities and health care providers.”

Men who have sex with men (MSM), the population most severely affected by HIV in the United States, are least likely to know they are infected and less likely to receive prevention counseling (39 percent, compared with 50 percent of men who have sex with women and women who have sex with men).

Study authors underscore that improvements are needed at each stage in the overall process of treatment and care. That means increasing the number of infected Americans who are tested, linked to care, remain in care, receive prevention counseling and are successfully treated – all to achieve viral suppression.

“Closing the gaps in testing, access to care and treatment will all be essential to slowing the U.S. HIV epidemic,” said Jonathan Mermin, M.D., director of CDC’s Division of HIV/AIDS Prevention. “HIV testing is the most important first step toward breaking the cycle of transmission. Combined with effective prevention services, linkage to care and ongoing effective treatment, testing provides a gateway to the most effective prevention tools at our disposal.”

New campaign encourages black gay and bisexual men to get tested for HIV

To increase HIV testing rates among one of the populations most affected by HIV, black gay and bisexual men, CDC also launched a new national awareness campaign, Testing Makes Us Stronger. CDC collaborated with gay and bisexual community leaders, physicians and other experts to develop the campaign, which strives to raise awareness, improve access and increase the number of black gay and bisexual men who are aware of their HIV status: the first step to care, treatment and prevention services.

Testing Makes Us Stronger encourages men to “stay strong and informed.” The ads depict a diverse range of black gay men, including individuals and couples. The campaign includes national print and online advertising; a dedicated website and Facebook page; promotion at black gay pride events; and outdoor and transit advertising in gay and African-American neighborhoods in six cities where black gay and bisexual men are heavily affected by HIV – Atlanta, Baltimore, Houston, New York City, Oakland, Calif., and Washington, D.C.

“Black gay and bisexual men across the country are already doing many of the right things to protect themselves – but more need to make HIV testing a regular part of their lives,” said Kevin Fenton, M.D., director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD and Tuberculosis Prevention. “Testing Makes Us Stronger was designed by black gay men for black gay men and strives to communicate the power of knowing your HIV status as a first step toward staying healthy.”

Research shows that black gay and bisexual men do not engage in riskier behaviors than other gay men, but are at higher risk for HIV due to the high prevalence of HIV that already exists in many black and gay communities, increasing the likelihood of becoming infected with each sexual encounter.

In addition to increasing testing and ensuring that people with HIV remain in care, CDC scientists stress that proven approaches to risk reduction – such as consistent condom use and reducing the number of sexual partners – among uninfected individuals will also remain critical. In part, because of the substantial amount of HIV transmission that occurs during the early stages of HIV infection, well before diagnosis and treatment can occur.

Testing Makes Us Stronger is the latest campaign of Act Against AIDS, CDC’s umbrella campaign to fight complacency about HIV nationwide. Other Act Against AIDS campaigns include those which focus on African-American women, African-American youth, health care providers and the general public.

More information about the new statistics on viral suppression and Testing Makes Us Stronger is available at www.cdc.gov/nchhstp/newsroom.

CDC works 24/7 saving lives, protecting people from health threats and saving money to have a more secure nation. Whether these threats are chronic or acute, manmade or natural, human error or deliberate attack, global or domestic, CDC is the U.S. health protection agency.

Vital Signs is a CDC report that appears on the first Tuesday of the month as part of the CDC journalMorbidity and Mortality Weekly Report, or MMWR. The report provides the latest data and information on key health indicators, such as cancer prevention, obesity, tobacco use, motor vehicle passenger safety, prescription drug overdose, HIV/AIDS, alcohol use, health care–associated infections, cardiovascular health, teen pregnancy, asthma and food safety.

December 10, 2011 Posted by | Consumer Health, Public Health | , , , | Leave a comment

   

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