Highlights From the Am. Jrl of Public Health: Jan. 2013 Issue

Article ID: 595964

Released: 9-Nov-2012 1:00 PM EST

Source Newsroom: American Public Health Association (APHA)

Newswise — The articles below will be published online Nov. 15, 2012, at 4 p.m. (EST) by the American Journal of Public Health® under “First Look” at http://www.ajph.org/first_look.shmtl, and they are currently scheduled to appear in the January 2013 print issue of the Journal. “First Look” articles have undergone peer review, copyediting and approval by authors but have not yet been printed to paper or posted online by issue. The American Journal of Public Health is published by the American Public Health Association, www.apha.org, and is available at www.ajph.org.

American Journal of Public Health Highlights:

1) Health disparities persist among those with HIV.2) Messages in the media can influence long-term safer sex among teens.3) Felony convictions of concealed handgun licensees differ from felony convictions of non-licensees.1) Health disparities persist among those with HIVNational HIV surveillance system reveals greater health disparities for HIV patients who are younger and black or Hispanic, according to a new study published by the American Journal of Public Health.

Researchers evaluated data collected from adults and adolescents diagnosed with HIV in 13 U.S. jurisdictions. Guided by the goals of the National HIV/AIDS Strategy, they assessed timely linkage to care after diagnosis and the number of patients who were virally suppressed. Both factors evaluated in the study assist in managing health care and preventing future infections for newly diagnosed HIV patients.

Results show that among 4,899 people diagnosed in 2009, 81.7 percent were linked to care within three months of diagnosis with a lower proportion of blacks and Hispanics than whites being linked to care. Among 53,642 people diagnosed through 2008 and living with HIV at the end of 2009 with a viral load test result reported to surveillance, 69.4 percent were virally suppressed. Furthermore, fewer blacks and Hispanics were virally suppressed than whites. Other risk group populations with lower linkage to care and with fewer virally suppressed individuals included persons between the ages of 13 and 24.

“Successful medical management of a person with HIV and the prevention of new infections requires the identification of infection at an early stage of disease, timely linkage to clinical care, prompt initiation of combination antiretroviral therapy when indicated, regular care visits, and adherence to prescribed antiretroviral therapy regimens,” the study’s authors explain.

“The completeness and quality of HIV surveillance data are critical for monitoring progress toward the goals of the National HIV/AIDS Strategy,” the authors of the study conclude.

[From: “Using the HIV Surveillance System to Monitor the National HIV/AIDS Strategy.” Contact: Kristen Mahle Gray, MPH, HIV Incidence and Case Surveillance Branch, Division of HIV/AIDS Prevention, CDC, Atlanta, Ga., blo9@cdc.gov]. 2) Messages in the media can influence long-term safer sex among teensEffective media messages can be important to creating safer habits when it comes to teens and sex, finds a new study published in the American Journal of Public Health. Project iMPPACS, named for the site locations of the project, was designed to determine the impact of mass media messages on the sexual behavior of hetero-sexual African American youth.

The study's participants were 1,657 adolescents between the ages of 14 and 17. A media intervention exposed youth to television and radio messages focused on three themes: reducing the belief that a steady partner is a safe partner, reducing the belief that consistent use of condoms is less pleasurable and reducing the belief that negative outcomes result from partner negotiations about consistent condom use. Researchers then asked participants over the next 36 months about their attitudes toward safer sex as well as their sexual behavior.

Results showed that media messages were effective in influencing teens’ safer sexual behavior with program effects persisting even after the media messages were discontinued. In particular, the messages found to be most effective were those that reduced the belief that a steady partner is a safe partner and that "safer sex partners" can be reliably identified by informal selection rules used by teens.

“Young people (as well as adults) are particularly susceptible to discontinuing condom use after initiating sex with a new partner in as short a period as a few weeks. Nevertheless, even if such partnerships are monogamous, they will not protect one from transmission of STIs if a partner was infected by a previous partner. Project iMPPACS is to our knowledge the first example of a media intervention that attempted to change this problematic practice,” stated the study’s authors.

“Mass media provide an effective way to enhance the durability of interventions carried out on the ground, and they independently change sexual norms and behaviors among youths on their own,” the study’s authors suggest.

[From: “Safer Sex Media Messages and Adolescent Sexual Behavior: 3-Year Follow-Up Results From Project iMPPACS.” Contact: Michael Hennessy, PhD, MPH, Annenberg Public Policy Center, University of Pennsylvania, Philadelphia, Pa., mhennessy@asc.upenn.edu].

3) Felony convictions of concealed handgun licensees differ from felony convictions of non-licensees.Criminal convictions involving concealed handgun licensees in Texas are more likely to involve violations of firearm regulations, threats of gun violence or crimes involving death than are the convictions of non-licensees, according to a new study published in the American Journal of Public Health.

Researchers analyzed criminal convictions data from the Texas Department of Public Safety and focused on nine felony categories. Collectively, concealed handgun licensees were much less likely than non-licensees to be convicted of these crimes. This study, however, did not analyze differences in the rates of criminal convictions in the two populations. It instead, compared the types of crimes for which licensees and non-licensees were convicted.

According to the study, criminal convictions of non-licensees were more likely to be for simple assaults, burglaries and robberies. Alternatively, the study found that a higher proportion of the convictions of concealed handgun licensees were for sexual offenses, weapons offenses, deadly conduct and offenses involving the intentional killing of another person.

“Our findings indicate that the safe hands into which states put concealed handguns may not be as safe as one would hope. Ideally, further research will identify characteristics of those concealed handgun license holders who have some likelihood of engaging in firearm-related crimes and allow policymakers to develop licensure rules that would deny those individuals a license,” the study’s authors concluded.

They also noted that the results implied that opening up new settings (e.g., universities) in which concealed handguns may be carried could result in an increase in gun related crimes in those settings.

[From: “When Concealed Handgun Licensees Break Bad: Criminal Convictions of Concealed Handgun Licensees in Texas, 2001-2009.” Contact: Charles D. Phillips, Texas A&M Health Science Center School of Rural Public Health, College Station, Texas, phillipscd@srph.tamhsc.edu].

The American Journal of Public Health is the monthly journal of the American Public Health Association ® (APHA), the oldest and most diverse organization of public health professionals in the world. APHA is a leading publisher of books and periodicals promoting sound scientific standards, action programs and public policy to enhance health. More information is available at www.apha.org.

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