Action Phase Podcast Episode 15

Jen Chapman headshotJen Chapman, the nerd behind the Public Health Nerd Club, tells me how the allure of “having great stories” enticed her into public health. From going door-to-door informing people that their partner had contracted an STD to researching HIV medication adherence in Botswana, Jen is passionate about public health. Action Phase is on iTunes! Subscribe so you never miss an episode. Please rate the show in order to help other people find it. As always, you can stream it here, too.

Action Phase Podcast Episode 8

Boone_photoAntonio Boone is the Program Assistant at Sexuality with Education and Truth (SWEAT), where he works with young men who have sex with men and are HIV+. We talk about shade-free zones, HIV stigma, and how participating in a program gives you a unique perspective on working for that program. Also, Action Phase is now on iTunes! Now you can subscribe and download episodes so you can listen to them any time. If you like the show, please rate it–ratings will help other people find it.

As always, you can listen to it right here as well.

Action Phase Podcast Episode 6

lorelei_photoLorelei Shingledecker from Philadelphia FIGHT is passionate about helping people improve their lives. We talk about the work she does with the HIV/AIDS community as well as her upcoming photography show featuring immigrants and the music of their childhoods. You can download the episode by going here and saving the page.  Or make your life simpler and listen to it right here, right now.

Happy Thanksgiving!

Introducing Action Phase Podcast

Whelp, I convinced myself. Today I'm releasing the inaugural episode of my new project, Action Phase Podcast. Learn more about it here.

In Episode 1, I talk with Briana Morgan from the Office of HIV Planning Philadelphia. Going to a liberal arts college gave her  one marketable skill, taking minutes at meetings--and now she's doing all kinds of awesome internet and coding things to help make HIV data available to the public.

You can download the episode by going here and saving the page as an mp3.

Or you can listen to it right here!

Friday Five: Non-fatal illness, Medicare, gay blood donors, e-cigarettes, infographic

Each Friday, I use five sentences to summarize and comment on five important, interesting, or just plain amusing health stories from the week. Q: What’s the most prevalent form of non-fatal illness in the world? A: Mental illness and substance abuse disorders. That’s right—mental and emotional issues such as depression, anxiety, drug abuse, and schizophrenia account for 22.8% of all non-fatal illnesses. This isn’t just in the US, but across 187 countries and 30 years. It’s time to stop pretending these disorders don’t exist. The authors of the study presenting these findings say it best: In view of the magnitude of their contribution, improvement in population health is only possible if countries make the prevention and treatment of mental and substance use disorders a public health priority.

Doctors still take Medicare beneficiaries Rumor has it that in light of the Affordable Care Act’s changes to Medicare reimbursement, doctors are fleeing the system and leaving seniors without medical care. But a report from the Department of Health and Human Services showed that in 2012, 90.7% of doctors accepted new Medicare patients, compared to 87.9% in 2005. Furthermore, more doctors are accepting new Medicare patients than are accepting those with private insurance. If you have Medicare, nearly all doctors will accept you. ACA myth debunked.  

Banned4Life wants the FDA to allow gay blood donors Men who have sex with men cannot donate blood. The FDA reasons that because gay men comprise 2% of the US population but in 2010 accounted for 66% of all new HIV infections, and because HIV goes through an “undetectable” period just after initial infection, keeping gay men out of the donor pool maintains the safety of the blood supply. The newly formed Banned4Life group seeks to change this policy. Banned4Life is urging the FDA to consider sexual behaviors, rather than sexual preference or orientation, when deciding who cannot donate blood. Life-threatening illnesses, gay rights, and government regulations can rile up lots of people, and I hope the FDA looks carefully at its policy and is transparent about the decision it makes.  

E-Cigarettes are getting popular among teens Combining two of their favorite things, rebellion and new technology, teens are adopting the newest form of nicotine on the market, electronic cigarettes (or e-cigarettes). Nearly 10% of high schoolers have tried them, doubling the rate from 2011 and far exceeding the 6% of adult smokers who have given e-cigarettes a puff or two. This finding from the CDC raises some interesting questions: are e-cigarettes safer than regular ones? Are the anti-smoking campaigns aimed at teens intended to be anti-cigarette or anti-addiction? Hypothetically, if e-cigarettes carry no risk of disease, would it be okay for teens to use them? Will indoor smoking bans apply to e-cigarettes? These will be crucial questions to address as e-cigarettes gain popularity.

Just how imperfect is US health care, anyway? This colorful, informative, and slightly dizzying infographic from the MPH program at George Washington University shows us how not-so-well our health care stacks up to the rest of the world. Interesting points to consider:

  • 79% of Americans use some kind of contraceptive, one of the only times we’re mostly ahead of the pack, trailing only Russia, the UK, and Canada.
  • Ghana, Algeria, Mexico, and many more countries have higher measles vaccination rates among one year olds.
  • There is 1/3 of a general practitioner for every 1000 Americans, while there is just over two specialists for every 1000 people (87.5% of practicing doctors are specialists).

US vs World Infographic

The HIV Breakthrough, Prenatal Care, and Hope for the Future

On Sunday, news quickly spread that a young child in Mississippi had been cured of HIV. As a newborn, the child tested positive for HIV and the specialist, Dr. Hanna Gay, administered a high dosage of drugs within hours of the child’s birth. After continuing on antiretrovirals for about a year, the child and mother stopped treatment. When they resurfaced months later, the mother stated she had continued the child’s treatment. Surprisingly, the child’s HIV test came back negative. A series of increasingly sensitive tests showed the virus was undetectable. This discovery could overhaul the way mother-to-child (also known as perinatal) transmission is treated. If the results are reproducible, the drug dosage and combination has the potential to stop the 300,000 cases of HIV in newborns reported annually worldwide. What’s unique about this case is that the mother received no prenatal care prior to entering the hospital in labor. Generally, pregnant women with HIV require special treatment considerations in order to prevent mother-to-child transmission. Doctors and expectant mothers weigh the costs and benefits of continuing treatment, keeping in mind that transmission does not usually occur until late in pregnancy or during delivery. This mother and child enjoyed none of the protections of drug treatment until after the birth of the child—and yet they are the center of one of the most promising HIV breakthroughs.

About 25% of infants born to mothers who do not take AZT and other drugs during pregnancy will be infected with HIV. But if the mother undergoes treatment while pregnant, only 2% of newborns will be test positive. Now, with the possibility of mega doses of drugs after birth reducing infection rates even more, we may be working toward eliminating mother-to-child transmission altogether.

Prenatal care is crucial. But in Mississippi, where the child was born, the Kaiser Family Foundation reports that women of color who give birth in the state are far less likely to receive prenatal care until late in their pregnancy or until they go into labor.

Lack of care until late in pregnancy or lack of prenatal care altogether is highest in American Indian (27.8%) and black mothers (22.8%), followed by Hispanic (23.0%) and Asian mothers (14.1%). Compared to the 9.1% of white women who go without care until their child is close to full-term, the inequity is disheartening. And the numbers are not unique to Mississippi. These prenatal care patterns are consistent with the patterns of the country at large. Paired with the CDC’s findings that black women have the highest rate of mother-to-child infection (9.9 per 100,000 births), ethnic and racial disparities in prenatal care matter.

This possible turning point in treatment means that even if an expectant HIV-positive mother receives no prenatal care and gives birth to an HIV-positive child, the child may have a fighting chance to live HIV free. We know that ethnic and racial minority women do not receive prenatal care at the same rates as white women. This potential new treatment option gives hope that HIV-positive women who do not receive prenatal care—women who are disproportionately from ethnic and racial minority groups—may be able see their children live HIV-free.