Newswise — The articles below will be published online April 14, 2011, at 4 p.m. (ET) 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 June 2011 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.
(1) U.S. men who have sex with men have escalated risk of HIV-related mortality
A new study from the American Journal of Public Health reports that men who have sex with men (MSM) in the United States are at greater risk than heterosexual men to die from HIV-related causes. However, mortality risk from non-HIV related causes, including suicide, was not higher among MSM.
Researchers investigated associations between minority sexual orientation and mortality among U.S. men. They used data from a cohort of 5,574 men aged 17 to 59 years, first interviewed in the National Health and Nutrition Examination Survey III, and then tracked for mortality status up to 18 years later. Men were classified into three groups, including: (1) men who have sex with men (2) only female sexual partners, and (3) no sexual partners. Researchers then compared the groups for all-cause mortality, HIV-related mortality, suicide-related mortality, and non-HIV related mortality. They found that MSM experienced greater all-cause mortality compared to heterosexual men. Approximately 13 percent of MSM died from HIV-related causes in contrast to 0.1 percent of men who reported only female partners. Mortality risk from non-HIV related causes, including suicide, was not found to be greater among MSM.
“As we approach the 30th anniversary of the identification of AIDS and its terrible impact on the lives of MSM, we can only celebrate momentarily the gains in the reduction of mortality in this population attributable to the introduction of highly active antiretroviral treatment,” said the study’s authors.
[From: “Sexual Orientation and Mortality Among U.S. Men Aged 17 to 59 Years: Results from the National Health and Nutrition Examination Survey III.” Contact: Susan Cochran, PhD, UCLA School of Public Health, Los Angeles, [email protected]]. (2) Access to mental health drugs among vulnerable populations living with HIV is affected by state-level factors
The relative size of a state’s federal Ryan White HIV/AIDS Program allocation, a state’s political orientation and its concentration of psychiatrists influence the time-to-adoption of psychotropic drugs on state AIDS Drug Assistance Program formularies, claims a new study recently released in the American Journal of Public Health.
Researchers explored state-level factors associated with the adoption of medications to treat mental health conditions on state formularies for the AIDS Drug Assistance Program. They interviewed 22 state and national program experts and indentified 7 state-level factors, including: case burden, federal dollar-per-case Ryan White allocation size, political orientation, state wealth, passage of a mental health parity law, number of psychiatrists per population and size of the mental health budget. They then tested whether the factors were associated with faster adoption of psychotropic drugs from 1997 to 2008.
Of the identified factors, they found that the relative size of a state’s federal Ryan White allocation, the political orientation of a state and its concentration of psychiatrists to be significantly associated with the time of a state’s formulary adopted mental health drugs for HIV-infected individuals.
The study’s authors suggest, “There is substantial heterogeneity across the states in formulary adoption of drugs to treat mental illness. Understanding what factors contribute to variation in adoption is vital given the importance of treating mental health conditions as a component of comprehensive HIV care.”
[From: “The Adoption of Mental Health Drugs on State AIDS Drug Assistance Program Formularies.” Contact: Erika G. Martin, Rockefeller College of Public Affairs & Policy, University at Albany and Nelson E. Rockefeller Institute of Government, Albany, N.Y., [email protected]].
(3) Substance-abusing women offenders benefit from community-based aftercare program once leaving prison
A new national study based out of Canada published in the American Journal of Public Health finds that aftercare is a critical component of a woman’s support system and prediction of success rates among women offenders with substance abuse problems after she leaves prison.
Researchers evaluated the effectiveness of the Community Relapse Prevention and Maintenance program, which was developed by Correctional Service Canada to better meet the needs of women offenders with drug problems. Based on a national sample of women offenders released from one to six federal institutions across Canada from 1998-2007, researchers analyzed the association between exposure and non-exposure to CRPM. They found that women who were not exposed to CRPM were 10 times more likely to return to custody 52 weeks after release from prison, with more than one-third returning to prison within the first six months.
“Strategies that improve access to community aftercare are imperative for improving the life chances and health of these women,” suggest the study’s authors. “The conclusions from this study, although based on women offenders in Canada, are applicable to women prisoners in other countries and support the World Health Organization-United Nations Office on Drugs and Crime assertion that imprisoned women require continuity of care for their health and substance abuse needs.”
[From: “Community-Based Aftercare and Return to Custody in a National Sample of Substance-Abusing Women Offenders.” Contact: Sherri Doherty, Correctional Service Canada, Prince Edward Island, Canada, [email protected]].
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