New research from the University of Pittsburgh Graduate School of Health indicates an association with the frequency of binge-drinking and LGBTQ-affirmative schools. They found that both heterosexual and gay/lesbian students report less binge alcohol consumption when the environment they live in have a high proportion of schools with programs that support LGBTQ youth.
Researchers analyzed students’ drinking behavior with data collected from the Youth Risk Behavior Survey and the team determined each school’s overall climate toward LGBTQ students using the School Health Profile survey. Environments were considered more affirmative if they had higher proportions of schools that have gay-straight alliances, encourage LGBTQ-related professional development workshops, and provide inclusive sexual health curricula, in addition to other programs or policies that provide supportive and accepting environments for LGBTQ students.
According to lead author Mr. Robert W.S. Coulter, a doctoral student in Graduate School of Public Health’s Department of Behavioral and Community Health Sciences, “Schools that are more affirming of LGBTQ students may be less stressful environments or foster healthy emotional resilience for all students, thereby making them less likely to turn to alcohol as a coping mechanism.”
The University of Florida Health Science Center Libraries will host an exhibit in the library the National Library of Medicine entitled, “Surviving and Thriving: AIDS, Politics, and Culture” from May 20 – July 10, 2016. The exhibit takes its name from the title of a book written in 1987 that focused on living with AIDS. The exhibit focuses on the experiences of people with AIDS who were critical in the political and medical fight against AIDS. The library is located in the Communicore Building on the University of Florida campus.
Several events have been planned around this exhibit, including a presentation at the Alachua County Library District Headquarters Branch, 401 E. University Ave., in Gainesville, Fl. (In early June, Date TBA), by Dr. Tess Jones of the University of Colorado at Denver.
In 2011, Maryland increased its state alcohol taxes. Since then, gonorrhea rates have shown a 24% decrease.
UF Health researchers used data from the National Notifiable Disease Surveillance System for 102 months before the tax increase and 18 months after. They compared the trends in sexually transmitted diseases to three different groups of other states –ones with similar alcohol sales methods with no tax increase, ones with similar trends in STDs, and Rhode Island to account for regional effects.
“If policymakers are looking for methods to protect young people from harmful STIs, they should consider raising alcohol taxes, which have decreased remarkably over the years due to inflation,” said Stephanie Staras, Ph.D., MSPH, an assistant professor in the UF College of Medicine’s department of health outcomes and policy and the study’s lead researcher.
Prior studies have shown that increases in alcohol taxes decrease alcohol consumption this consequently reduces risky sexual behavior. In 2014, the rate of infection from gonorrhea, chlamydia and syphilis increased substantially nationwide, and young people accounted for nearly two-thirds of the cases of gonorrhea and chlamydia. This UF Health study is one of the first to quantify the effect of alcohol taxes on the rate of sexually transmitted infections.
Read the full article by Elizabeth Hillaker Downsfrom The Posthere.
On Wednesday, March 23, 2016 Columbia’s Mailman School of Public Health will host Ambassador Deborah L. Birx, MD, U.S. Global AIDS Coordinator and Special Representative for Global Health Diplomacy as part of the school’s March Grand Rounds event. Dr. Birx will speak on Global Health, HIV, and Health Systems.
Ambassador Birx oversees the implementation of the U.S. President’s Emergency Plan for AIDS Relief (PEPFAR), as well as all U.S. Government engagement with the Global Fund to Fight AIDS, Tuberculosis and Malaria. Throughout her career, Dr. Birx has focused on HIV/AIDS immunology, vaccine research, and global health. Read more about Dr. Birx here.
The lecture is open to the public and also broadcast live online. Participate using #FuturePublicHealth on Twitter. For more information on this talk and others, visit: Grand Rounds 2015-16.
Left to right: Robert L. Cook, MD, MPH, Taj Azarian, PhD, Xingdi Hu, PhD
This month, Professor Robert L. Cook, MD, MPH received word from recent epidemiology graduate Xingdi Hu, PhD that a manuscript on which they collaborated, with Dr. Hu as lead author, had been accepted for publication. The paper, entitled “Utilization of alcohol treatment among HIV-positive women with hazardous drinking,” will be published by the Journal of Substance Abuse Treatment. In addition to the manuscript reflecting productive associations between epidemiology students and their research mentors, this publication marks Dr. Cook’s 100th peer-reviewed paper accepted for publication. Earlier this year Dr. Cook’s 90th such publication was in collaboration with lead author and recent epidemiology graduate Taj Azarian, PhD. These two mentees, along with yet another recent grad Wajiha Akhtar-Khaleel, PhD, published five collaborative papers with Dr. Cook in the past year.
On Friday, February 19, Dr. Cook gave a seminar with updates on the results of the Florida Cohort entitled, “Does Alcohol and Marijuana Use Correlate with HIV Treatment Engagement and Viral Supression for Persons Living with HIV in Florida?”
Alcohol and marijuana use are common in people living with HIV (PLWH), but it is challenging to identify a “cutpoint” for harmful use. The relationship to the outcomes may vary depending on the mechanism (behavioral or biological). Dr. Cook concluded that there is a need to demonstrate an ability to improve HIV outcomes with substance use intervention.
Left to right: Dr. Robert Cook, Ms. Marvene Edwards, Ms. Gay Koehler-Sides
On Thursday, Febraury 18, 2016, we welcomed Marvene Edwards and Gay Koehler-Sides, M.P.H., C.P.H. as they joined us for our biweekly SHARC meeting.
Ms. Edwards is an HIV/AIDS Peer Navigator at the Florida Department of Health in Alachua County. She was diagnosed in 1987 with HIV and is dedicated to tearing down any stigma associated with HIV. Ms. Edwards also leads the Positives Empowering Positives (PEP) club.
Ms. Koehler-Sides is the Area 3/13 HIV/AIDS Program Coordinator at the Florida Department of Health in Alachua County. Ms. Koehler-Sides is dedicated to helping curb the spread of HIV.
We had a round table discussion about the Peer Navigator program in Area 3/13and the different strategies used to connect with people. The program aims support HIV-positive individuals as they enter and stay in care, adhere to treatment protocols, and improve their quality of life. We looked at the number of persons living with HIV (PLWH) that were engaged in stages of the continuum of HIV care. About 84% of those diagnosed with HIV in 2014 had documented HIV-related care within 3 months of diagnosis. About 80% in care had a suppressed viral load in 2014.
Recently, more and more courses are shifting away from being taught exclusively in lecture halls or online and instead, professors are turning to the blended learning model, combining the best aspects of both. Material, including recorded lectures and texts, is put up online and students can review them before class. Meanwhile, in class, students work on assignments, allowing them to maximize their interaction with the professor and obtain as much assistance where needed.
In an article in UF Health’s The POST, two SHARC students, Danielle Sharpe (pictured left) and Eugene Dunne, are featured, offering their take on the change.
The Deep South region has become the epicenter of the US HIV epidemic. Despite having only 28% of the total US population, nine states in the Deep South account for nearly 40% of national HIV diagnoses. This region has the highest HIV diagnosis rates and the highest number of people living with HIV of any US region based on data for 2008-2011. And new research has found that the five-year survival rate for people diagnosed with HIV or AIDS is lower in the Deep South than in the rest of the country.
So why are we seeing higher death rates and lower survival rates among those living with HIV in the Deep South? The reasons are complicated, but poverty, social stigma, lack of health-care infrastructure and more rural geography likely all play a role.
Recent research by the Centers for Disease Control and Prevention (CDC) and the Southern HIV/AIDS Strategy Initiative (SASI) at Duke University Law School in nine states of the Deep South – Alabama, Florida, Georgia, Louisiana, Mississippi and North and South Carolina, Tennessee and Texas – found that people diagnosed with HIV or AIDS in these states are dying at higher rates than those diagnosed in the rest of the country. This is the case even after controlling for regional differences in age, sex, race, and area population size.
CDC/SASI research found that 27% of people diagnosed with AIDS in the Deep South region in 2003-2004 had died within five years of diagnosis. Although five-year survival varied among states in the Deep South, no state had a survival percentage at or above the US average, 77%. In Louisiana, one-third of people diagnosed with AIDS and 19% of those diagnosed with HIV had died within five years of diagnosis.
Researchers also compared the characteristics of those diagnosed with HIV/AIDS in the Deep South region to national averages and found higher percentages of young people (aged 13-24), blacks, females and transmission attributed to heterosexual contact among the region’s individuals diagnosed with HIV. More than one-quarter of people diagnosed with HIV lived outside a large urban area, which is the highest percentage of any US region.
What makes the Deep South different from the rest of the US?
The Deep South has lower levels of income, education and insurance coverage than the rest of the US. Poverty is consistently associated with poorer health so it is not surprising that the Deep
South is experiencing high death rates among those diagnosed with HIV. And none of the Deep South states have accepted federal dollars to expand their Medicaid programs under the Affordable Care Act, leaving thousands of people in the region without health insurance.
Geography also plays a role in the Southern HIV epidemic. Much of the Deep South HIV epidemic is concentrated outside of large urban areas. The CDC/SASI research found that living outside a large urban area at the time of HIV diagnosis significantly predicted greater death rates among people living with HIV in the region.
HIV-related stigma has been found to be higher outside the large urban areas and transportation is a significant barrier to medical care for HIV-positive individuals living outside urban areas since most HIV specialty care is located in urban areas. Without reliable transportation, people miss appointments and may lack access to supportive services such as case management, support groups and legal services.
Thanks to advances in HIV treatment, people who are diagnosed with HIV can have normal life expectancies. But that’s only if they get linked to HIV medical care and remain on treatment, which is a challenge in a region where so many people live outside of urban areas, live in poverty or lack access to health care.
HIV-related stigma has consistently been cited as a driver of the HIV epidemic — especially in the South. In the words of a Deep South focus group participant living with HIV, “HIV doesn’t kill. Stigma kills.”
HIV care providers in the Deep South region tell stories of patients who don’t come to their medical appointments, who won’t participate in support groups, who won’t disclose their HIV status to their closest family members (and the list goes on) because of stigma and a deep fear of how they will be perceived if others discover their status. Stigma also prevents people from getting tested for HIV, which is a critical step in getting the right treatment and in preventing further transmission of the disease.
Overcoming stigma and promoting prevention
The drivers of the Southern HIV epidemic are complicated and to a great extent mirror the causes of poor health outcomes overall in southern states. Creative programs, such as the expansion of telemedicine programs and the co-location of HIV care with other services, such as case management and mental health and substance abuse care, are important to overcome stigma and the lack of transportation and medical care in non-urban areas.
Funding to support anti-stigma interventions, including empowerment initiatives for those living with HIV and educational efforts for churches and community, is critical. Finally, increased prevention funding that is directed at urban and rural areas alike is crucial if we are to stem the new HIV diagnosis rates and lower the death rates in the Deep South.