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UNAIDS report indicates new HIV infections in Phl have doubled in past 6 years

The Philippines now has the fastest growing HIV epidemic in Asia and the Pacific.

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A UNAIDS report on the global HIV epidemic states that the number of new infections in the Philippines has more than doubled in the past six years from an estimated 4,300 in 2010 to an estimated 10,500 in 2016 (140% increase).  The Philippines has become the country with the fastest growing HIV epidemic in Asia and the Pacific, and has become one of eight countries that account for more than 90% of new HIV infections in the region.

While the country has the fastest growing epidemic in terms of percentage increase, the number of new infections is not as high as several countries in the region which are estimated to have tens of thousands of new infections annually.

“The Philippines has a small window of opportunity to act now and stop a major HIV epidemic from taking hold,” said Eamonn Murphy, director of UNAIDS Regional Support Team for Asia-Pacific. “If HIV programming is re-directed to focus on the people most at risk and where they are located, I’m sure the country can not only return to a stable situation but even end the AIDS epidemic as a public health threat by 2030.”

While the Philippines has controlled the HIV epidemic among female sex workers, the country noted a shift in the epidemic in 2007, and has therefore scaled-up services tailored to other key risk populations since that time. The Philippine data showed that in 2016, 83% of newly reported HIV cases occurred among males who have sex with males (MSM) and transgender women who have sex with males (TGW).  The majority of the new infections are occurring among 15 to 24 year old MSM and TGW.

In 2015, only 35% of 15 to 24 year old MSM and TGW had correct knowledge on HIV transmission and prevention.  Condom use among MSM and TGW has increased from 36% in 2011 to 50% in 2015.  The percentage of MSM and TGW who knew their HIV status by getting tested increased from 5% in 2011 to 16% in 2015; however this still remains low.

The Philippines is said to have retooled its program to expand HIV services for males who have sex with males and transgender women and has opened clinics that cater specifically to their needs in urban areas, where the risk of HIV is higher.  The strategy is to focus on 117 cities where 80% of the new infections have been reported and to open in each such city at least one HIV clinic which has convenient evening hours for working people, and is a one-stop shop that provide prevention, counseling, laboratory work-up, and treatment services. The government has also taken measures towards enabling rapid HIV screening and delivery of test results.

According to the Department of Health, it is currently providing antiretroviral (ARV) medicine for “free” to anyone who tests positive for HIV, as well as other out-patient services to a maximum of P30,000 ($600) a year per person.  Between 2013 and 2015, the government increased funding for the HIV program, and now shoulders 70% of all financing for its response. (As used here, however, “free” is subjective since only those who pay PhilHealth are able to mainly access ARVs – Ed)

There are also local governments that stepped up their efforts by providing resources and implementing innovative HIV prevention services appropriate for their locales. For example, Quezon City opened three sundown clinics which provide rapid HIV testing and counseling for MSM and TGW, as well as HIV treatment.  The city increased its funding for such initiatives since 2012.

“HIV is one of the top health priorities for the government of the Philippines,” said Dr. Paulyn Jean Rosell-Ubial, the Secretary of the Department of Health.  “We (are) determined and committed to halt the increase in the number of cases and start reversing the trend of the epidemic in five years.”

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School bullying prevention programs that involve peers may be harmful to victims

Schools should avoid using strategies that boost peer visibility of victimization (e.g. identifying a victim in a class meeting). In addition, evaluations of bullying prevention programs that look at the school as a whole should be cautious of hidden negative outcomes for individual students who remain victimized.

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School bullying has been identified as harmful to students’ mental health. Many studies have evaluated the effectiveness of bullying prevention programs, finding mixed results in general and no benefits overall for secondary school students. Looking at the specific components of bullying prevention programs helps to explain the complicated pattern: Unlike intensive programs that include parent training, firm disciplinary methods or improved playground supervision, interventions that involve work with peers tend to lead to increases in bullying. A new review explores why encouraging peers to defend victims may actually cause more harm than good.

The analysis was written by a researcher at the QIMR Berghofer Medical Research Institute and the University of Queensland, Brisbane. It appears in Child Development Perspectives, a journal of the Society for Research in Child Development.

“Many school bullying prevention programs encourage and train peer bystanders (helpers) to get actively involved in assisting with possible instances of bullying,” said Karyn L. Healy, research officer from QIMR Berghofer Medical Research Institute, who authored the analysis. “Although this approach is very common and well-intentioned, there is no evidence that it helps victims. Encouraging peers to actively defend victims of bullying may actually produce adverse outcomes for victims.”

Most research on the effectiveness of bullying prevention programs assumes that each program affects bullying and victimization in a simple and unified way. But many programs combine a range of different strategies and participants, which are likely to produce differential effects.

Healy identified several mechanisms through which bystander interventions that involve peer defense of the victim could increase victimization and distress of victims: 1) by disempowering victims, 2) by reinforcing or provoking bullying, or 3) by eroding broader support for victims by the peer group.

Schools should avoid using strategies that boost peer visibility of victimization (e.g. identifying a victim in a class meeting).

“Having lots of peers involved makes the situation more public, which can be damaging to the social reputation of victims,” said Healy. “Having a trained bystander step in also prevents the victim from handling a situation themselves and may make them look weak in the eyes of the bully. Training students to intervene in bullying also has the potential of leading to overuse of peer defense strategies because of benefits to helpers, such as making helpers feel they have higher status or increasing helpers’ feelings of belonging in school.”

Recent evidence suggests that even when programs are successful in reducing bullying, they may still be harmful to the individual students who are victimized the most. “This could potentially be the case for any program that aims to reduce overall bullying without taking into account the impacts on victims,” explains Healy.

To lessen the risk to vulnerable students, Healy suggests that schools be wary of bullying prevention programs that lack evidence of effectiveness for reducing bullying and victimization. Schools should avoid using strategies that boost peer visibility of victimization (e.g. identifying a victim in a class meeting). In addition, evaluations of bullying prevention programs that look at the school as a whole should be cautious of hidden negative outcomes for individual students who remain victimized.

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Suicidal ideation lower among young trans women who had supportive mothers

A study found that the odds of suicidal ideation were lower among young transgender women (YTW) who had mothers who were supportive of their transgender identity.

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Family support matters.

A study found that the odds of suicidal ideation were lower among young transgender women (YTW) who had mothers who were supportive of their transgender identity.

The study – “Maternal Support Is Protective Against Suicidal Ideation Among a Diverse Cohort of Young Transgender Women” by Harry Jin, William Goedel, Adedotun Ogunbajo, Katie Biello, Don Operario, Lisa Kuhns, Sari L. Reisner, Robert Garofalo, and Matthew J. Mimiaga – appeared in LGBT Health.

For this study, the researchers wanted to assess if YTW with parents who are supportive of their transgender identity had lower odds of having suicidal ideation compared with YTW with unsupportive parents. This study analyzed baseline findings from a diverse sample of 297 sexually active, YTW 16–29 years of age who were enrolled in Project LifeSkills, a randomized controlled HIV prevention intervention efficacy trial in Chicago and Boston, between 2012 and 2015. Bivariate and multivariable logistic regression were used to assess if parental support was associated with a decreased odds of suicidal ideation.

The study found that nearly one-fifth (18.9%) of YTW reported suicidal ideation at baseline. In the adjusted multivariable model, YTW with supportive mothers had 0.37 (95% confidence interval = 0.15–0.90) times the odds of having suicidal ideation compared with YTW with unsupportive mothers.

This study found that the “odds of suicidal ideation were lower among YTW who had mothers who were supportive of their transgender identity.”

The researchers suggest that parent-focused interventions to improve the relationships between YTW and their parents may lower the odds of YTW having suicidal ideation.

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Bisexual adults less likely to enjoy health benefits of education

Education has long been linked to health – the more schooling people have, the healthier they are likely to be. But a study found that the health benefits of a good education are less evident among well-educated bisexual adults.

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Education has long been linked to health – the more schooling people have, the healthier they are likely to be. But a new study from Rice University sociologists found that the health benefits of a good education are less evident among well-educated bisexual adults.

“Education and health: The joint role of gender and sexual identity” examines health among straight, bisexual, gay and lesbian adults with various educational backgrounds. Authors Zhe Zhang, a postdoctoral research fellow at Rice, Bridget Gorman, a professor of sociology at Rice, and Alexa Solazzo, a postdoctoral research fellow at the Harvard University T.H. Chan School of Public Health, were particularly interested in bisexual adults, since they may experience distinctive health vulnerabilities.

The researchers found that while having at least a bachelor’s degree was linked to better health among bisexual adults, they received less benefit than heterosexual and gay or lesbian adults with similar education. This effect was especially true for bisexual women.

“The health benefits of education are well established – so much so that anything we do to promote and improve public education should really be viewed as health policy,” Gorman said. “It’s that impactful on health and well-being. That our analysis showed less health benefit associated with education among bisexual adults compared to heterosexual, gay and lesbian adults is concerning.”

While the researchers could not pinpoint the exact cause, they theorized the problem might be social stigma and additional anxiety among women due to gender discrimination, Zhang said.

“Discrimination of any kind can take a heavy toll on health,” Zhang said. “While we cannot say with certainty that is what is happening in this study, it’s a very real possibility.”

The authors based their study on data from the Behavioral Risk Factor Surveillance System, which included a sample of more than 1.2 million adults living in 44 U.S. states and territories from 2011-2017. They hope the study will raise awareness of the issue and help health professionals provide better care.

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Same-gender couples interact better than heterosexual couples

In terms of the quality of interactions with their partners, the study found same-gendered relationships had better-quality interactions than found in different-gendered relationships.

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Same-gender couples have higher-quality interactions with one another than heterosexual couples.

This is according to a new UC Riverside study that also holds that couples with two men have the smallest social networks.

Researcher Megan Robbins says the recent study is the first to compare same- and different-sex couples’ social networks and daily interactions with one another.

Past research shows that same-gender couples enjoy strengths including appreciation of individual differences, positive emotions, and effective communication. But research hasn’t compared the quality of their daily interactions – inside and outside the couple dynamic – to those of heterosexual couples. 

“The comparison is important because there is so much research linking the quality of romantic relationships and other social ties to health and well-being, yet it is unclear if this applies similarly or differently to people in same-gender romantic relationships because they have been historically excluded from past research,” said Robbins, who is an associate professor of psychology at UCR. Reasons for potential differences include the stigma sexual minorities face, and also their resilience.

For the study, Robbins and her team recruited same-gender and different-gender couples throughout Southern California. The couples had to be in a married or “married-like” committed relationship; living together for at least a year; and have no physical or mental health conditions that impeded their daily functioning.

Among those who applied to be in the study, 78 couples were found to be eligible, 77 of which provided enough data to be used. Twenty-four of the couples were woman-woman; 20 were man-man, and 33 were man-woman.

Participants met with the researchers on two separate Fridays, a month apart, completing surveys. They received text or email prompts several times in the days following the in-person meetings. In the text/email prompts, participants were asked whether they had an interaction with their partner, a family member, or a friend in the past 10 minutes, then asked to rate the quality of the social interaction using a five-point scale – one being unpleasant; three, neutral; five, pleasant.

In terms of social networks, the study found couples in man-man relationships had smaller social networks than woman-woman and man-woman couples. On the other end of the results spectrum, women in relationships with men were most likely to have the largest social networks.

Robbins said the finding is consistent with previous research showing men with men experience the least acceptance among family members.

“We hypothesized that one model for how the social life of people in same-gender couples might differ from those in different-gender couples was a honing model, where people in same-gender couples reduce their social networks down to only those people who are supportive. We found some support for this by learning that the men with men had the smallest social networks in our sample.,” Robbins said.

The quality of interactions with families was reported to be greatest by same-gender couples. There was no difference for interaction quality with friends.

In terms of the quality of interactions with their partners, the study found same-gendered relationships had better-quality interactions than found in different-gendered relationships.

Robbins said that may be due to greater similarity between partners when they share a gender identity, and greater equality within the couple, compared to people in different-sex couples.

“When male and female partners interact, they may do so from a culturally imposed frame wherein men and women are considered ‘opposites,’ which creates more potential for tension in interactions,” Robbins wrote in the paper, titled Social Compensation and Honing Frameworks, and published in the Journal of Social and Personal Relationships.

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LGBTQIA campus centers ‘more important than ever’ during Covid-19, argue scholars

Students’ experiences shifted dramatically as a result of Covid-19, often to the detriment of their health and well-being. For example, many LGBTQIA students returned to unsafe and/or unsupportive homes when they were unable to remain on-campus; the abrupt and unexpected shift into these harmful and traumatic environments has exacerbated the need for additional support services.

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“Essential services” is a phrase that has become commonplace in the era of Covid-19. In a commentary, scholars from Lehigh University and Ohio State University argue that LGBTQIA college and university campus resource centers are essential to the health, well-being and academic achievement of LGBTQIA students since these centers “are uniquely positioned to meet the needs of these students during Covid-19 and, as such, must continue to receive support and funding.”

Why LGBTQ+ Campus Resource Centers are Essential” was published by Psychology of Sexual Orientation and Gender Diversity, a publication of the American Psychological Association, and is authored by Chelsea Gilbert, PhD student in Educational Studies at Ohio State University; Nicole L. Johnson, a faculty member in Counseling Psychology at Lehigh University; Claire Siepser, Master of Education student in Counseling Psychology at Lehigh University; and, Ann E. Fink, a faculty member in the Department of Biological Sciences at Lehigh University.

“LGBTQIA populations are particularly vulnerable to certain stressors and risks at play during the Covid-19 pandemic, particularly if they also belong to other marginalized social groups,” says Fink. “LGBTQIA Campus Centers are essential resources for LGBTQIA students and require adequate funding and institutional support.”

LGBTQIA people and other marginalized genders and sexualities face well-documented health disparities, according to information distributed by the Centers for Disease Control and Prevention (CDC). These disparities have been exacerbated by the pandemic.

The authors specifically cite research which finds significantly higher risk for Covid-19 among the houseless and the fact that LGBTQIA youth have higher rates of houselessness than the general population.

In addition, they write that “for those who do access care for Covid-19-related symptoms, a lack of LGBTQIA-competent providers may increase their vulnerability within healthcare settings.”

College students often experience marginalization and discrimination, according to a 2014 study that found that more than 25% of LGB college students either witnessed or experienced some of form of harassment which correlated with increased reports of anxiety and depression.

The authors call on administrators, faculty and students to undertake efforts to ensure that “institutional leaders and decision-makers understand the gravity of LGBTQIA student needs under Covid-19 and then act to meet those needs.”

“College students’ experiences shifted dramatically as a result of Covid-19, often to the detriment of their health and well-being. For example, many LGBTQIA students returned to unsafe and/or unsupportive homes when they were unable to remain on-campus; the abrupt and unexpected shift into these harmful and traumatic environments has exacerbated the need for additional support services…” they write.

“These are challenging times within higher education, and tough budgetary decisions are being made daily,” says Gilbert, who for five years served as the Director of the Pride Center for Sexual Orientation & Gender Diversity at Lehigh. “It is my hope that decision-makers for these budgets might read our piece and consider the ways that LGBTQIA student services provide invaluable resources to campus communities in light of Covid-19.”

“It is my hope that the individuals who are in charge of making challenging decisions about what is considered essential during times of crisis will read this piece and see the true need for LGBTQIA student services, especially in the midst of a pandemic,” says Johnson.

Adds Siepser: “It is difficult to assess the depth and longevity of the psychological impact of this crisis and thus it is important to continue to support the LGBTQIA students who are being disproportionately affected by Covid-19.”

The authors call on administrators, faculty and students to undertake efforts to ensure that “institutional leaders and decision-makers understand the gravity of LGBTQIA student needs under Covid-19 and then act to meet those needs.”

“Students, faculty, and staff who may not have direct control over these decisions, can use their voices to advocate for such important decisions,” ends Johnson”Take action!”

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Health & Wellness

Experiencing police violence worsens mental health in distinct ways

Simply put, the experience of police violence puts Black, Latino, Indigenous, and sexual minority communities at higher risk of distinct mental health problems, in addition to greater risk of death at the hands of police.

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The experience of police violence is associated with mental and emotional trauma distinct from that caused by other kinds of violence, creating a public health crisis for communities most affected.

Simply put, the experience of police violence puts Black, Latino, Indigenous, and sexual minority communities at higher risk of distinct mental health problems, in addition to greater risk of death at the hands of police, according to the paper.

The study is authored by a group of researchers at several universities, including UC Riverside, who have been examining the mental health effects of police violence at the population level for several years.

“It’s a public health issue because police violence is not experienced equally in our society but instead has a disproportionate effect on the mental health of racial, ethnic, and sexual minorities,” said Bruce Link, a UC Riverside distinguished professor of sociology and public policy. “The point of our paper is to indicate why the experience of police violence is uniquely stressful and therefore particularly impactful.”

People who have experienced police violence have few options for redress. They must report incidents to the same police departments that abused them in the first place.

Psychologists agree that trauma spurs biological or psychological changes that manifest over time as psychiatric symptoms, particularly when the trauma is sexually or physically violent. Research on stressful life events, especially uncontrollable events, has attempted to provide a broader framework for how stress may affect a person’s usual activities, goals, and values, but until recently this approach has not been applied to police violence.

Link, along with Jordan DeVylder of Fordham University and Lisa Fedina of the University of Michigan, reviewed numerous studies of the effects of police violence on mental health in a paper called “Impact of police violence on mental health: a theoretical framework,” and identified eight factors distinct to police violence.

Police violence is state sanctioned

Unlike most other forms of violence, police violence is embedded in a history of state-enforced practices that permitted cruel, unusual, and dehumanizing punishment of individuals deemed to be from so-called “dangerous classes,” particularly Blacks. Communities of color and LGBTQ communities have been historically subjected to discriminatory laws, such as Jim Crow laws and sodomy laws, which permitted harassment and excessive and fatal force against individuals from these communities.

The police are a pervasive presence

Police are everywhere, especially in low-income communities of color. People who have experienced violent or stressful encounters with police have no way to avoid being around constant reminders of these painful experiences, or the fear of future encounters.

There are limited options for recourse

People who have experienced police violence have few options for redress. They must report incidents to the same police departments that abused them in the first place. Police are authorized to use force in a wide variety of situations and survivors have to prove that the violence was not legitimate. Because they have few options for reporting an incident, for legal recourse, or for advocacy services and referrals to mental health treatment, any mental health symptoms they have may worsen over time.

Police culture deters internal accountability

Violence committed through institutions, rather than interpersonal relationships, is supported by organizational cultures that condone it. Police often maintain a code of silence around violence and therefore often fail to hold each other accountable. This amounts to gaslighting survivors who do report incidents, potentially worsening mental health symptoms.

Police violence alters deeply held beliefs

Many are taught that police protect them and their communities from various dangers and help in emergencies. A single violent encounter can shatter this belief for an individual, but when police violence is the norm, instead of an isolated incident, the community at large loses trust in the police as an institution and, often correctly, comes to regard them as part of the problem.

Racial and economic disparities in exposure

Police violence is disproportionately directed at people of color, especially Blacks and Latinos, potentially leading to diminished feelings of self-worth and value within American society.

Police violence is stigmatizing

Because police are allowed to use force in many situations, survivors of police violence are often blamed for the encounter. Their actions are heavily scrutinized and faulted to justify the officers’ actions, especially by members of groups that benefit from the social order policing upholds. Moreover, many people have friends and relatives who work as police officers, making it feel like a betrayal to report incidents of police violence.

Police are typically armed

Unlike police in many countries, American police carry firearms and police departments have become heavily militarized. Police are given broad latitude to determine when and how to deploy force. Every interaction with police holds the possibility of violence, and for communities subjected to routine overpolicing, this threat brings additional challenges for mental health.

The researchers call for a framework to examine the mental health consequences of police violence that takes into account these points. However, implicit in their analysis are solutions for the public health crisis caused by police violence, such as demilitarizing police, holding police accountable when untoward events occur, ending the overpolicing of communities of color, providing better reporting options and support for survivors of police violence, and policies that build mutual trust between police and the communities they are meant to serve.

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