Tag: policy

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.

 

The Battle over Sugary Drinks

The New York City Board of Health last Thursday approved a restriction on the sale of soda and other sugary drinks over 16 ounces at restaurants, movie theaters and other venues. (See report by the New York Times). The measure is to take effect on March 12th, 2013.

In the meanwhile, for fear of the long-term erosion of profits and other cities’ following suit, the soft-drink industry is clenching its fist to fight back hard, with actions including a potential lawsuit and an advertising campaign on consumers’ free choice, which already has cost more than one million dollars.

“The evidence strongly supports a relationship between sweet drinks and obesity,” one expert said. A report released by CDC early this year shows that more than one-third of U.S. adults (78 million) were obese in years 2009-2010. Overweight and obesity-related conditions are the second leading cause of preventable death in the United States.

Larger packaging is a strategy for companies to sell more and earn more, but things are often complicated once public interests are concerned. It is a debate over business profits, health outcome, medical costs, freedom of choice and the interests of other stakeholders. If, as the soft drinks companies claim that the restriction limits people’s freedom of choice, one can just imagine how much larger can the packages still be? Is there really no limit on size? Should companies be responsible for people’s lives rather than making money?

The problem is that people would no longer feel surprised when something becomes part of the everyday order. It is always harder to get rid of a bad habit than to prevent it in the first place. In most cases, consumers have little experience with obesity-related diseases and don’t know enough about the consequences. Asking them to make decisions before that seems unfair.

How do you think about the ban on the sale of larger sugary drinks in New York City? Is it a right move?

Let’s go Fido: Nudge your way to health

Get off the couch and get moving.

A recent NYT “Well” blog post by Tara Parker-Pope espouses the benefits of walking the dog;

One study even found that older people are more likely to take regular walks if the walking companion is canine rather than human.

“You need to walk, and so does your dog,” said Rebecca A. Johnson, director of the human-animal interaction research center at the University of Missouri College of Veterinary Medicine. “It’s good for both ends of the leash.”

Is a dog (or any walkable pet – large cat, iguana, you name it) a personal version of the “nudge” public policies promoted by Richard Thaler and Cass Sunstein in their book by the same name?

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Mobilizing the troops: Advocating health funding through communication

Photo by Daniel Borman, From Flickr.

Funding is always an issue for people in the business of communicating health.  Funding is needed to carry out programs, to inform and to educate, but funding related to public health programs is often on the chopping block when tough budget cuts need to be made.

Funding related to teen pregnancy prevention has been one of the areas recently facing cuts, but the National Campaign to Prevent Teen and Unplanned Pregnancy is fighting it, and they are encouraging individuals to stand up and fight for funding as well.

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Feature: Food evironments and the Feds

Food environments matter, and race and socioeconomic status play an important role in determining how likely you are to be able to get to healthy food, let alone eat it. A 2002 study by Manual Franco investigating food environments in Baltimore found that African Americans were disproportionately more likely to live in areas with less access to healthy food than Caucasians. Elizabeth Baker revealed in a 2006 study that there were more fast-food restaurants in low-income neighborhoods than in high-income areas.Carrot

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Sex in the media: What’s a person to do?

A teen boy using the computer

Talking about media use can be beneficial according to the AAP

Sex is prevalent in the media, and the American Academy of Pediatrics has something to say about it. In the September issue of Pediatrics, the American Academy of Pediatrics published a revised policy statement that addresses sexual messages in the media and has some recommendations for parents and pediatricians. The original piece was published in 2001.

New recommendations include:

  • Having pediatricians help parents and teens recognize the importance of the issue by asking two media related questions at visits: How much time do you spend daily with entertainment media? And is there a TV or Internet access in your bedroom?
  • Encouraging parents (and pediatricians) to understand social networking sites and to talk to their kids about them
  • Encouraging parents to use media storylines to discuss sex with their teens
  • Restricting the airing of erectile dysfunction ads to after 10 p.m. because they can confuse young viewers

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