Tag: North Carolina

Current Climate of HIV Disparity in NC: Part 1

For many people, the term AIDS is no longer representative of the state of HIV; with current treatment options, no individual’s manifestation of HIV should reach the level of AIDS. However, more work needs to be done to prevent the spread of HIV, specifically with a goal of protecting men in the gay community. In the US, men who have sex with men continue to carry the burden of prevalence of individuals living with HIV and rates of new diagnoses. This issue is exacerbated in the South and among black men who have sex with men. Pre-exposure prophylaxis for HIV (PrEP) represents an opportunity to drastically reduce the number of new HIV diagnoses; however, individuals must be able to gain access to this preventative treatment.

Evidence of Disparity

On November 12, 2012, more than five years ago, David Duran wrote an article for the Huffington Post, titled “Truvada Whores?” Duran argued that pre-exposure prophylaxis for HIV (PrEP) allows gay men (and other men who have sex with men) to engage in unsafe sex while taking a pill, rather than encouraging them to partake in safer-sex practices, by which I assume he means the use of a barrier method like a condom.1 In the past five years, little has changed in the way that people think about stigma and PrEP. Even within gay publications and HIV-centered advocacy groups, people continue to write about the “Truvada Whore.”2,3 The use of this term is strongly connected to stigma related to the use of PrEP, which is pervasive even within the medical community4,5 Stigma is exasperated when coupled with the implicit racial bias of providers that causes them to assume that black men who have sex with men engage in riskier sex6 As a result, there is stigma from within the gay community that assumes men who take PrEP are riskier or more likely to have HIV, from outside of the gay community that assumes they’re sluts or whores, and also specifically from the medical community, which assumes that prescribing PrEP will increase risk behaviors, leading to more HIV infections.

 

References

Works Cited

  1. Duran, D. Truvada Whores? Huffinton Post. 2012. https://www.huffingtonpost.com/david-duran/truvada-whores_b_2113588.html
  2. Addison, V. Larry Kramer, Truvada Whores and the Angry Divide Between Two Generations. HIVEqual. n.d. http://www.hivequal.org/homepage/larry-kramer-truvada-whores-and-the-angry-divide-between-two-generations
  3. Logo. Revisiting “Truvada Whore” Three Years Later. NewNowNext. 2016. http://www.newnownext.com/revisiting-truvada-whore-three-years-later/02/2016/
  4. Emory University Rollins School of Public Health. North Carolina. AIDSVu. n.d. https://aidsvu.org/state/north-carolina/
  5. Calabrese SK, Underhill K. How Stigma Surrounding the Use of HIV Preexposure Prophylaxis Undermines Prevention and Pleasure: A Call to Destigmatize “Truvada Whores”. American journal of public health. 2015;105(10):1960-1964.
  6. Calabrese SK, Earnshaw VA, Underhill K, Hansen NB, Dovidio JF. The Impact of Patient Race on Clinical Decisions Related to Prescribing HIV Pre-Exposure Prophylaxis (PrEP): Assumptions About Sexual Risk Compensation and Implications for Access. AIDS and behavior. 2014;18(2):226-240.
  7. Rosenberg ES, Grey JA, Sanchez TH, Sullivan PS. Rates of Prevalent HIV Infection, Prevalent Diagnoses, and New Diagnoses Among Men Who Have Sex With Men in US States, Metropolitan Statistical Areas, and Counties, 2012-2013. JMIR Public Health Surveill. 2016;2(1):e22.
  8. Britz JJ. To Know or not to Know: A Moral Reflection on Information Poverty. Journal of Information Science. 2004;30(3):192-204.

 

STOP Act: Implementation and Effects on the Opioid Epidemic in North Carolina

The rise of the opioid epidemic nationwide has led to an increase of attention from both media and policy makers. Here in North Carolina, a recently passed policy is the Strengthen Opioid Misuse Prevention, or STOP Act, which aims to reduce the amount of Opioids prescribed a one approach to tackle the epidemic. The STOP Act was signed into law by Governor Roy Cooper on June 29, 2017, and since then its four stage implementation has been put into effect, which will continue until 2020.

The first step of implementation occurred almost immediately after the law’s passage, on July 1st 2017, requiring Physician Assistants (PAs) and Nurse Practitioners (NPs) to personally consult with a supervising physician. This applied to Pas and NPs at facilities that primarily engage in treating pain, and the prescription will, or is expected to, last longer than 30 days. Additionally, PAs and NPs have to consult with a supervising physician every 90 days for patients for are continuously prescribed opioids.  Providers are also required to provide information on the disposal of controlled substances, both written and orally, when a patient concludes a course of treatment. The second aspect, implemented on September 1st, 2017, requires that pharmacies report targeted prescriptions to the North Carolina Controlled Substance Reporting System within a day of the prescription is dispensed.

The most recent aspect of the STOP Act was implemented on January 1st, 2018, and limits the amount of opioids prescribed for acute pain. Practitioners are not able to prescribe more than five days’ worth of any Schedule II or III Opioid or Narcotic, with an exception to things like pain after surgery, where the prescription cannot for longer than seven days. The final part of the law will be implemented on January 1st, 2020, and will require practitioners to electronically prescribed targeted controlled substances, with a few exceptions.

While it is still unclear what impact the law will have on overdose deaths in the state, it appears that the State government is attempting to address this issue. While more resources could be devoted to mental health services, naloxone access and syringe exchanges, and more programs geared toward injecting drug users rather than only those who use prescription drugs, it’s commendable that a joint effort was reached to combat this ongoing epidemic.

 

Sources:

New! Summary of NC’s new opioids law, the STOP Act: North Carolina Medical Board – https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/notice/new-summary-of-ncs-new-opioids-law-the-stop-act

FAQs: The STOP Act of 2017: North Carolina Medical Board – https://www.ncmedboard.org/resources-information/professional-resources/publications/forum-newsletter/article/faqs-the-stop-act-of-2017

STOP Act Provision Takes Effect Jan. 1, Will Limit Opioid Prescriptions: NC Governor Roy Cooper – https://governor.nc.gov/news/stop-act-provision-takes-effect-jan-1-will-limit-opioid-prescriptions

STOP Act Bill Summary: North Carolina Medical Board – https://www.ncmedboard.org/images/uploads/article_images/The_STOP_Act_summary-OnLetterhead.pdf

 

Childhood Hunger – An Issue Worth Tackling

For my last post of National Nutrition Month ® (though it likely won’t be my last post about food and nutrition), I’m highlighting a couple of great organizations in my area (Chapel Hill, NC) that I’ve had the opportunity to collaborate or volunteer with. Both organizations tackle the daunting challenge of ameliorating childhood hunger, specifically in our own North Carolina, where more than 1 in 4 children struggle with hunger.

The NC chapter of the national No Kid Hungry campaign is a public-private partnership to end childhood hungry in the state by connecting kids (and schools) to federal food and nutrition programs. Examples of these programs include the School Breakfast Program, the School Lunch Program, and summer meals programs. They hope to improve access to healthy meals for children and families who need them, strengthen the infrastructure of communities and systems, and improve knowledge about the available programs. One effort that I’m more familiar with is their campaign to get schools on boards with “alternative” breakfast models to increase participation in school breakfast. Although all schools may offer breakfast programs, those who are eligible in free and reduced price meals may not participate due to stigma and other barriers. Alternative models, such as breakfast in the classroom or grab-n-go style carts on the way to class, can help increase access to meals.

While meals in school are one great way to tackle this issue, it’s often that kids who are eligible for free and reduced meals at school often come from families who seriously struggle with food insecurity every day, including those weekends when kids are not in school to receive meals. Many communities have “weekend backpack” models in place to help kids get through the weekend with healthy food. TABLE NC is a small organization in Carrboro, NC that does just that. Kids who are referred to TABLE by school coordinators or school social workers can have their parents sign up to get bags delivered before the weekend right to their home or afterschool center.

To learn more about these fantastic programs, check out their websites and see how you can get involved if this is an issue you’d like to help find a solution to.

 

Photo credit: Saad Akhtar via Flickr.com 

Fried fish is tasty, but possibly fatal for Southerners

Fried fish and french fries

Researchers have correlated higher consumption of fried fish with higher rates of fatal strokes in the "stroke belt" states of the South. Photo credit: http://pdphoto.org/

A study published in the journal Neurology points to a higher rate of fatal strokes in eight southern states: North Carolina, South Carolina, Georgia, Alabama, Mississippi, Tennessee, Arkansas, and Louisiana. Scientists are labeling these states, where coincidentally fried fish is eaten more often than non-fried fish, the “stroke belt.”

The news gets worse if you live in the coastal plain region of North Carolina, South Carolina, or Georgia, which the scientists are now calling the “stroke buckle” for the even higher incidence of fatal strokes in that three-state region.

Additionally, the survey found African-Americans were more likely to eat two or more servings of fried fish per week than were their white neighbors.

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