Navajo Nation confronts HIV and AIDS

Five years ago, the man Elsie Smith loved told her calmly from his hospital bed that it was time for him to go. He died with a hushed goodbye and a squeeze of her hand. Smith herself had been feeling ill for a while. Her bones ached and she vomited often. She soon mourned him from her own hospital bed. A doctor explained to the Navajo woman that her lover had died of AIDS. It was important that they check her blood, he said. She agreed. Two days later, the doctor told her that she had HIV. Her tired mind became flustered with questions, but she asked only one. "What is HIV?"

Smith learned of her diagnosis at the Indian Medical Center in Gallup, where Western medicine and traditional healing converge to treat members of the Navajo Nation and where a ceremonial hogan — or sacred structure — sits on hospital grounds. It is where Jerry Archuleta and Emerson Scott, partners who are both HIV-positive, go for their monthly checkup and where Danny Morris nearly died from AIDS before receiving care from both doctors and medicine men.

The hospital has become a leading force in the effort to quell a rise of HIV transmission among Navajo, a troubling development at a time when HIV infections are holding steady or declining in other groups across the country. Most of the infections are occurring in the Navajo Nation, a vast expanse in the Four Corners region where poverty, poor education, alcohol abuse and the hardships of reservation life cultivate an environment in which the virus can spread.

Larry Foster, the Navajo Nation's sexually transmitted disease coordinator, said health professionals had encountered resistance when giving presentations on the disease. "They didn't want to listen because they thought we were bringing a curse, bringing death into their communities," Foster said. "Nobody cares until they have seen an AIDS death in their family." In sheer numbers, the amount of infections is small among the 173,600 people who live in the Navajo Nation. The Indian Medical Center and its clinics scattered across the reservation log about 35 new cases a year. But that's about three times the number recorded a decade ago.

Read more on the Los Angeles Times website.

Racial Respect and Racial Socialization as Protective Factors for African American Male Youth

African American adolescents must negotiate the transition to adulthood in a society that makes the achievement of positive cultural identity and self-respect difficult. Frequently, young men turn to violence in an attempt to achieve respect in their communities. This study published in the Journal of Black Psychology explores factors that predict the use of violence among African American male youth. Adolescents from 14 through 18 years of age who completed a written survey in group settings in Oregon included 100 youth who were detained in the juvenile justice system and 100 who were members of a community youth development program. A history of witnessing violence strongly predicted the intensity of violent behavior of study youth; however, endorsing positive attitudes toward racial respect significantly moderated the effects of chronic exposure to violence. Additionally, racial socialization was negatively correlated to violence intensity and was marginally significant in moderating the effects of witnessing violence. Implications for practice with male African American youth are highlighted.

Read the abstract of the study. Read the full study (pdf).

Epidemic: Responding to America’s Prescription Drug Abuse Crisis

A new report from the White House titled Epidemic: Responding to America’s Prescription Drug Abuse Crisis discusses prescription drug abuse in the United States. Prescription drug abuse is the Nation’s fastest-growing drug problem. While there has been a marked decrease in the use of some illegal drugs like cocaine, data from the National Survey on Drug Use and Health (NSDUH) show that nearly one-third of people aged 12 and over who used drugs for the first time in 2009 began by using a prescription drug non-medically. The same survey found that over 70 percent of people who abused prescription pain relievers got them from friends or relatives, while approximately 5 percent got them from a drug dealer or from the Internet. Additionally, the latest Monitoring the Future study—the Nation’s largest survey of drug use among young people—showed that prescription drugs are the second most-abused category of drugs after marijuana. In our military, illicit drug use increased from 5 percent to 12 percent among active duty service members over a three-year period from 2005 to 2008, primarily attributed to prescription drug abuse.

Some other data highlights from the report include:

• Death rates from prescription painkillers are three times higher among non-Hispanic whites than for African-Americans and Hispanic whites.
• Death rates among Alaskan Natives and American Indians are about the same as they are for non-Hispanic whites.
• The highest death rates are among people between ages 35 and 54 years.
• Some 830,652 years of “potential life” before the age of 65 were lost in one year because of prescription painkiller overdoses.
• Overdoses from prescription painkillers destroy a similar number of years of potential life lost as road accidents, and significantly more than homicide.
• According to 2008 data, death rates from prescription medication overdoses range from a low of 5.5. per 100,000 individuals in Nebraska to 27 per 100,000 in New Mexico.
• An estimated 1 in every 12 people aged at least 12 years use prescription painkillers recreationally in Oklahoma, the highest rate in the U.S. Nebraska has the lowest rate at 1 in every 30 people.
• Sales of prescription painkillers per head in Florida (highest state) are three times higher than Illinois (lowest state). The higher the sales per person the higher that state's drug overdose death rate tends to be.

Read the complete report (pdf).

Disparities Persist in Depression Diagnosis: Older Black Americans Less Likely to Receive Diagnosis

Racial and cultural factors still affect the diagnosis and treatment of depression in elderly Americans, despite improvements to diagnostic tools and therapies in recent decades, according to a new study published in the American Journal of Public Health. Researchers found that elderly blacks are less likely to be diagnosed, and therefore treated, than whites or Hispanics.

About 6.6 percent of elderly people in the United States have an episode of major depression each year, making it a significant public health issue for older Americans, the Rutgers University researchers pointed out in a university news release. If it's left untreated or undertreated, depression can have a major negative impact on quality of life and can also complicate medical conditions that are common in elderly people, including congestive heart failure, arthritis and diabetes, Ayse Akincigil, an assistant professor in Rutgers' School of Social Work, and colleagues explained.

The investigators analyzed data collected from nearly 34,000 Medicare beneficiaries between 2001 and 2005, and found that rates of depression diagnosis were 6.4 percent for whites, 4.2 percent for blacks, 7.2 percent for Hispanics, and 3.8 percent for other groups. "Efforts are needed to reduce the burden of undetected and untreated depression and to identify the barriers that generate disparities in detection and treatment," the researchers concluded. "Promising approaches include providing universal depression screening and ensuring access to care in low-income and minority neighborhoods," they added.

Read more on the Medline Plus website. Read the abstract of the study.

LGBT Seniors Report Higher Levels of Depression and Binge Drinking than Peers

Senior citizens who identify as LGBT face higher rates of disabilities and physical and mental stress than their heterosexual peers, according to a new study from the University of Washington's School of Social Work. Titled "The Aging and Health Report: Disparities and Resilience among Lesbian, Gay, Bisexual, and Transgender Older Adults," the study has made history as one of the first federally funded reports to examine challenges faced by LGBT seniors.

A multi-state research team led by the School of Social Work's Karen Fredriksen-Goldsen surveyed 2,560 LGBT adults aged 50-95 throughout the United States. Across the board, LGBT seniors reported higher levels of loneliness, depression and binge drinking than heterosexuals in the same age group. Nearly one-half of those interviewed reported a disability, while about one-third said they've experienced depression. Four of every 10 participants have contemplated suicide.

Histories of victimization have created lasting fears for many seniors. The study showed that 80 percent of respondents had been victimized in some way during their lifetimes; this included verbal and physical assault, threats of physical violence or being 'outed,' and damaged property. Additionally, 21 percent of participants said they were denied a job or promotion because of perceived sexual orientation.

When it came to medical care, 21 percent of respondents said they had not disclosed their sexual orientation to doctors for fear of receiving inferior care. And 13 percent reported being turned away from healthcare professionals after coming out. Fredriksen-Goldsen cautioned that hiding one's sexual orientation could lead to severe health problems, including increased risks of breast or prostate cancer, hepatitis and HIV. "If you do not disclose to your doctor," Britta Larson explains, "that means that you're not going to be getting proper medical service. Your doctor's not going to be asking the right questions and doing the right screenings."

There was some positive healthcare news, however. Of those interviewed, 91 percent of LGBT older adults reported participating in wellness activities such as meditation and photography. And 82 percent said they engage in modern physical activities such as brisk walks. "LGBT older adults are resilient and living their lives and building their communities," Fredriksen-Goldsen said.

Fredriksen-Goldsen presented the study's key findings Nov. 9, 2011 during a congressional briefing and urged lawmakers to take note of the growing LGBT senior population, which is expected to double to more than 4 million by 2030. "The higher rates of aging and health disparities among LGBT older adults are a major concern," Fredriksen-Goldsen said. "Prevention and intervention strategies must be developed to address their unique and mounting needs and to effectively respond to the increasing number of older adults in these communities."

 

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