Knowing the stats, finding help

Despite the perception, suicide rate is usually down during the holidays. But the statistics are still alarming

One of the biggest myths about suicide apparently is that people are more likely to kill themselves during the Christmas holidays. That’s what I had always thought. But now I know I was misinformed about that and much more related to suicide.

It turns out the month of December actually has the lowest number of suicides during the year, and spring and fall months have the highest incidence, according to the Centers for Disease Control and Prevention. It is speculated that people who might be suicidal think less about killing themselves during the holidays because increased social activity distracts them from their thoughts.

The federal agency recently released the results of its study of suicidal thoughts and behavior in adults for the years 2008-09. The report, which reveals that someone kills him or herself every 15 minutes in the U.S., provides some interesting statistics about suicidal thought. It is the first report to present such data state by state.

One of the more interesting findings of the study is that suicidal thought and behavior vary widely from state to state. About 2.2 million adults — representing 1 percent of the nation’s adult population — acknowledged making plans in the study year to commit suicide, ranging from 0.01 percent of that number living in Georgia to 2.8 percent in Rhode Island.

David-Webb

David Webb The Rare Reporter

About 1 million adults reported attempting suicide, ranging from 0.01 percent in Delaware and Georgia to 1.5 percent in Rhode Island.

The report’s researchers concluded that adults in the Midwest and West were more likely to think about suicide than those in the Northeast and South. Adults in the Midwest were more likely to make plans to commit suicide than those in the South, but suicide attempts did not vary by the four regions.

The variance among the states’ statistics is peculiar, but suicide statistics in general seem to be perplexing. As in the case of loved ones who are often left wondering why victims killed themselves, researchers must try to make sense of the data the victims’ deaths leave behind.

The American Foundation for Suicide Prevention reports that four men commit suicide for every woman who kills herself, as was reflected in the 2008 statistics when 28,450 men succeeded in killing themselves compared to 7,585 women.

Yet women reportedly attempt suicide three times as often as men.

By age, suicide is the sixth leading cause of death for children 5-to-14 years old, and it is the third leading cause of death for people 15-to-24 years old. Rates of suicide among adult men rise with advancing age, and men 65 and older are seven times more likely than women to commit suicide.
Women are most likely to commit suicide between the ages of 45 and 54, and then again after age 75.

By ethnic groups and race, the highest rates are seen among Native Americans, Alaskan-Americans and Anglos. The lowest rates are seen among Latinos and African-Americans who commit suicide at rates of less than half of what is seen in the other groups.

People diagnosed with AIDS are 20 times more likely to commit suicide, according to the foundation.

Among LGBT people the reports of suicide attempts are significantly higher in comparison to straight people in similar socio-economic and age groups, according to the report “Talking About Suicide and LGBT Populations.” The report published by the 2011 Movement Advancement Project notes that statistical information about suicides among LGBT people is scarce.

Indeed, most of the statistics about suicidal behavior and suicide seem to create more questions than they facilitate understanding, but researchers have identified certain constants.

People who kill themselves are most likely to use a firearm in the process; their deaths are likely to occur after they have made an average of 11 previous suicide attempts; they might suffer from major depression; they may abuse alcohol and other drugs, and they could be victims of bullying, physical abuse or sexual abuse.

There are preventive measures that can be taken if someone is in crisis and at risk of suicide, and it is a good idea to be prepared for such an event. The strongest indicator of a suicide risk is a previous attempt or ongoing expressions of intense distress and despair. Those people must never be left alone, and they should immediately be afforded mental health treatment.

Psychotherapy has helped people who are at risk of suicide survive, and alcohol and drug abuse treatment can succeed in saving lives that seemed destined for destruction.

And even though it turns out the holidays are not a time when people are most at risk for planning or attempting suicide, the myth has created an opportunity to raise awareness about a preventable tragedy for both the potential victims and their loved ones.

After all, there often are no second chances when it comes to a risk of suicide.

David Webb is a veteran journalist who has covered LGBT issues for the mainstream and alternative media for three decades. Contact him at davidwaynewebb@yahoo.com or at http://facebook.com/TheRareReporter.

This article appeared in the Dallas Voice print edition December 9, 2011.

—  Kevin Thomas

Knowledge is power

Dr.-Sam-Ho-photo

Dr. Sam Ho

A generation of young people have never known a world without AIDS, but their complacency means new infections continue

People who weren’t yet born when AIDS first emerged are today most at risk for becoming HIV positive — an alarming development that underscores how essential awareness is, especially as we approach World AIDS Day, Dec. 1.

From 2006 to 2009, the Centers for Disease Control and Prevention reported that the HIV incidence rate for Americans between 13 and 29 years old increased by about 21 percent. In fact, most of the new HIV infections reported in this country involve people under 30.

Americans under 30 have never known a world without AIDS. At the same time, they’ve never really known a time when effective treatment for HIV and AIDS wasn’t available. This hasn’t always been the case. As this disease turns 30, we need to ensure that people — especially younger people — remain aware of AIDS and how to prevent it.

AIDS awareness is one of the biggest challenges we face when trying to prevent it. After 30 years of addressing what was once considered one of America’s most pressing health problems, AIDS is no longer front page news. But on this World AIDS Day, let’s not forget that about 56,000 Americans become infected with HIV each year, according to the CDC, and that more than 14,000 Americans with AIDS die each year.

Thanks to more effective and more available treatments, more Americans who have HIV and AIDS are able to live. The CDC estimates this number at more than 1 million nationwide. Regularly testing people most at risk for HIV — and then providing antiretroviral drugs for HIV/AIDS patients — dramatically reduces the number of new infections.

Preventing HIV is not complicated. If you’re sexually active, get tested. Don’t use IV drugs or share needles. Abstain or practice safer sex.

With preventive care, patients and their health care providers can fight and manage this disease and slow its spread. But we can’t allow today’s more effective treatments to make us complacent or ambivalent, or to lessen our resolve to find a cure.

To learn more or to find a place near you to get tested, visit ActAgainstAIDS.org.

Dr. Sam Ho, M.D., is the chief medical officer for UnitedHealthcare.

This article appeared in the Dallas Voice print edition November 25, 2011.

—  Kevin Thomas

With AIDS funding at risk, Boehner triples budget to defend DOMA

Today I got an “action alert” email from AIDS United and AIDS Interfaith Network, urging me to call my senators and representatives today and urge them to vote against any legislation that would create drastic cuts in federal funds for “essential programs” for people with HIV/AIDS.

House Speaker John Boehner

The email noted that a special congressional committee is working right now on a plan to reduce the deficit, and that cuts to programs like Medicaid, Medicare, Ryan White CARE Act, food stamp programs and unemployment benefits could be on the chopping block. “Cutting these programs will make things worse, not better. People will be hurt and access to life-saving HIV care will be lost,” the email said.

I found the email in the inbox about the same time I found an email from the National Minority AIDS Council pointing out that less than a week after the House Appropriations Committee proposed slashing funding for the Centers for Disease Control and Prevention‘s National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention by $32.7 million, and cutting the Prevention and Public Health Fund by an amazing $1 billion, Republican Speaker of the House John Boehner has tripled the House’s budget for defending the Defense of Marriage Act, legislation that prevents the federal government from recognizing same-sex marriages, even though performed in jurisdictions that do legally recognize them.

Back in March, Boehner decided that the House of Representatives, under Republican control, would hire a law firm to defend DOMA in court, originally budgeting President Obama had announced in February that he was instructing the Justice Department to no longer defend the law in court, because at least part of DOMA — the part which denies legal federal recognition and benefits to same-sex couples who have been married in jurisdictions with gay marriage is legally recognized — is unconstitutional under the Full Faith and Credit Clause of the U.S. Constitution.

That decision came after federal district judges had declared DOMA unconstitutional in two separate lawsuits.

It’s bad enough that Boehner and the Republicans in the House feel the need to spend up to $750,000, as per the initial agreement, to hire someone to defend such an unjust law in the first place. Doing so while at the same time threatening to force the country to default on its debts instead raising the debt ceiling was unconscionable. And now, as thebudget crunch continues and Tea Party Republicans continue to complain about the country’s debt and refuse to consider revenue increases, Boehner and his merry band have decided to up the limit they will pay Kircher to defend DOMA to $1.5 million.

Daniel C. Montoya, deputy executive director of the National Minority AIDS Council, said: “I urge Speaker Boehner to reconsider his decision. 56,000 Americans are infected with HIV each year. More than half of those were among gay and bisexual men. Spending taxpayer money to delegitimize relationships that have been shown to promote healthier lifestyles is antithetical to American values, contrary to the conservative belief in limited government and detrimental to public health. In this time of fiscal and economic strife, certainly the Speaker and his colleagues can find better ways to spend this money.”

Montoya also suggested that Boehner’s decision raises “serious questions about his purported commitment to fiscal responsibility.” Yeah, ya think? If you agree and want to express your opinion to your representatives in Congress, you can call, toll free, 1-888-907- 1485.

—  admin

UN urges more funds for early HIV treatment

Report comes on heels of study showing medicines dramatically reduce spread of virus

EDITH M. LEDERER | Associated Press

UNITED NATIONS — The United Nations AIDS agency on Friday urged increased funding for early treatment of people with HIV following a new international study showing it could dramatically reduce the number of new infections through sexual transmission.

UNAIDS Executive Director Michel Sidibe said pushing for early treatment “is at the top of the agenda” following the striking results of an international study overseen by the U.S. National Institutes of Health.

The nine-nation study offered convincing evidence of what scientists have long believed — that HIV medicines don’t just benefit the patient, but may act as a preventive by making those people less infectious. Earlier treatment in the study meant patients were 96 percent less likely to spread the virus to their uninfected partners, according to preliminary results announced last month.

Sidibe told a news conference launching a new report by UNAIDS that early treatment and prevention efforts must also be accompanied by better skills for health workers and sex education for young people.

“Access to treatment will transform the AIDS response in the next decade,” Sidibe said. “Anti-retroviral therapy is a bigger game-changer than ever before — it not only stops people from dying, but also prevents transmission of HIV to women, men and children.”

Sidibe stressed that billions of dollars will be needed to meet the agency’s vision for the future — “zero new HIV infections, zero discrimination and zero AIDS-related deaths.”

The report said “universal access” to drug treatment for those with HIV is achievable.

UNAIDS released the 139-page document ahead of today’s 30th anniversary of the first official report of what would become the HIV epidemic by the U.S. Centers for Disease Control and Prevention. The General Assembly is holding a high-level meeting on AIDS at U.N. headquarters from June 8-10, where 20 world leaders and over 100 ministers are expected.

U.N. Deputy Secretary-General Asha-Rose Migiro said at Friday’s launch that the world is “at a turning point in the AIDS response” and the meeting is an opportunity to “expand HIV services … (and) chart a new path.”

“The goal towards achieving universal access to HIV prevention, treatment, care and support must become a reality by 2015,” she said.

The last decade has seen a nearly 25 percent decline in new HIV infections, a reduction in AIDS-related deaths, and “unprecedented advances” in access to treatment, prevention services and care, the report said.

In India, which has the largest number of people living with HIV in Asia, the rate of new infections fell by more than 50 percent, while in South Africa, which has the largest number of HIV cases in Africa, the rate fell by more than 35 percent, the report said.

But UNAIDS said these achievements are unevenly distributed, exceedingly fragile, and fall short of global targets.

“People in rich countries don’t die from AIDS any more,” former U.S. President Bill Clinton wrote in the report, “but those in poor countries still do — and that’s just not acceptable.”

The report said more than 34 million people were living with HIV at the end of 2010 — including 2.6 million who became newly infected with the virus that causes AIDS in 2009.

It said the proportion of countries conducting systematic surveillance of HIV among high-risk populations increased between 2008 and 2010: from 44 percent to 50 percent for sex workers, and from 30 percent to 36 percent for gay men. An estimated 20 percent of the 15.9 million people who inject drugs worldwide are living with HIV, the report said.

An estimated 6.6 million people in low- and middle-income countries were receiving antiretroviral drug treatment at the end of last year, but about 9 million eligible people in those countries were not, the report said.

According to the report, investment in the response to HIV in low-and middle-income countries rose from US$1.6 billion in 2001 to US$15.9 billion in 2009.

U.N. Secretary-General Ban Ki-moon wrote in the preface that “the number of people becoming infected and dying is decreasing, but the international resources needed to sustain this progress have declined for the first time in 10 years, despite tremendous unmet needs.”

Sidibe said financial challenges are putting “unprecedented downward pressure on funding sources, internally and internationally.” But he said the right approach can spur all countries “to do things better, with maximum value for money.”

The Lancet, a British medical journal, published a proposal developed byFriday a study group set up by UNAIDS which outlines what the group called “a more targeted and strategic approach to investment.”

Implemeting the new investment framework “would avert 12.2 million new HIV infections and 7.4 million deaths from AIDS between 2011 and 2020 compared with continuation of present approaches,” it said,

“The yearly cost of achievement of universal access to HIV prevention, treatment, care, and support by 2015 is estimated at no less than $22 billion,” the Lancet report said, but in the long term the cost of responding to AIDS would be reduced.

—  John Wright

Study: Pill helps gay men avoid HIV infection

Experts call Truvada research ‘a major milestone’ but warn that condoms remain the ‘first line of defense’

MARILYNN MARCHIONE  |  Associated Press

MILWAUKEE — Scientists have an exciting breakthrough in the fight against AIDS. A pill already used to treat HIV infection turns out to be a powerful weapon in protecting healthy gay men from catching the virus, a global study found.

Daily doses of Truvada cut the risk of infection by 44 percent when given with condoms, counseling and other prevention services. Men who took their pills most faithfully had even more protection, up to 73 percent.

Researchers had feared the pills might give a false sense of security and make men less likely to use condoms or to limit their partners, but the opposite happened — risky sex declined.

The results are “a major advance” that can help curb the epidemic in gay men, said Dr. Kevin Fenton, AIDS prevention chief at the U.S. Centers for Disease Control and Prevention. But he warned they may not apply to people exposed to HIV through male-female sex, drug use or other ways. Studies in those groups are under way now.

“This is a great day in the fight against AIDS … a major milestone,” said a statment from Mitchell Warren, head of the AIDS Vaccine Advocacy Coalition, a nonprofit group that works on HIV prevention.

Because Truvada is already on the market, the CDC is rushing to develop guidelines for doctors using it for HIV prevention, and urged people to wait until those are ready.

“It’s not time for gay and bisexual men to throw out their condoms,” Fenton said. The pill “should never be seen as a first line of defense against HIV.”

As a practical matter, price could limit use. The pills cost from $5,000 to $14,000 a year in the United States, but only 39 cents a day in some poor countries where they are sold in generic form.

Whether insurers or government health programs should pay for them is one of the tough issues to be sorted out, and cost-effectiveness analyses should help, said Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases.

“This is an exciting finding,” but it “is only one study in one specific study population,” so its impact on others is unknown, Fauci said.

His institute sponsored the study with the Bill & Melinda Gates Foundation. Results were reported at a news conference Tuesday and published online by the New England Journal of Medicine.

It is the third AIDS prevention victory in about a year. In September 2009, scientists announced that a vaccine they are now trying to improve had protected one in 3 people from getting HIV in a study in Thailand. In July, research in South Africa showed that a vaginal gel spiked with an AIDS drug could cut nearly in half a woman’s chances of getting HIV from an infected partner.

Gay and bisexual men account for nearly half of the more than 1 million Americans living with HIV. Worldwide, more than 40 million people have the virus, and 7,500 new infections occur each day. Unlike in the U.S., only 5 to 10 percent of global cases involve sex between men.

“The condom is still the first line of defense,” because it also prevents other sexually spread diseases and unwanted pregnancies, said the study leader, Dr. Robert M. Grant of the Gladstone Institutes, a private foundation affliated with the University of California, San Francisco.

But many men don’t or won’t use condoms all the time, so researchers have been testing other prevention tools.

AIDS drugs already are used to prevent infection in health care workers accidentally exposed to HIV, and in babies whose pregnant mothers are on the medication. Taking these drugs before exposure to the virus may keep it from taking hold, just as taking malaria pills in advance can prevent that disease when someone is bitten by an infected mosquito.

The strategy showed great promise in monkey studies using tenofovir (brand name Viread) and emtricitabine, or FTC (Emtriva), sold in combination as Truvada by California-based Gilead Sciences Inc.

The company donated Truvada for the study, which involved about 2,500 men at high risk of HIV infection in Peru, Ecuador, Brazil, South Africa, Thailand and the United States (San Francisco and Boston). The foreign sites were chosen because of high rates of HIV infection and diverse populations.

More than 40 percent of participants had taken money for sex at least once. At the start of the study, they had 18 partners on average; that dropped to around 6 by the end.

The men were given either Truvada or dummy pills. All had monthly visits to get HIV testing, more pills and counseling. Every six months, they were tested for other sexually spread diseases and treated as needed.

After a median followup of just over a year, there were 64 HIV infections among the 1,248 men on dummy pills, and only 36 among the 1,251 on Truvada.

Among men who took their pills at least half the time, determined through interviews and pill counts, the risk of infection fell by 50 percent. For those who took pills on 90 percent or more days, risk fell 73 percent. Tests of drug levels in the blood confirmed that more consistent pill-taking gave better protection.

The treatment was safe. Side effects were similar in both groups except for nausea, which was more common in the drug group for the first month but not after that. Unintended weight loss also was more common in the drug group, but it occurred in very few. Further study is needed on possible long-term risks.

What’s next?

All participants will get a chance to take Truvada in an 18-month extension of the study. Researchers want to see whether men will take the pill more faithfully if they know it helps, and whether that provides better protection. About 20,000 people are enrolled in other studies testing Truvada or its component drugs around the world.

The government also will review all ongoing prevention studies, such as those of vaccines or anti-AIDS gels, and consider whether any people currently assigned to get dummy medicines should now get Truvada since it has proved effective in gay men.

Gilead also will discuss with public health and regulatory agencies the possibility and wisdom of seeking approval to market Truvada for prevention. The company has made no decision on that, said Dr. Howard Jaffe, president of Gilead Foundation, the company’s philanthropic arm. Doctors can prescribe it for this purpose now if patients are willing to pay for it, and some already do.

Some people have speculated that could expose Gilead to new liability concerns, if someone took the pill and then sued if it did not protect against infection.

“The potential for having an intervention like this that has never been broadly available before raises new questions. It is something we would have to discuss internally and externally,” Jaffe said.

Until the CDC’s detailed advice is available, the agency said gay and bisexual men should:

• Use condoms consistently and correctly.

• Get tested to know their HIV status and that of their partners, and get tested and treated for syphilis, gonorrhea and other infections that raise the risk of HIV.

• Get counseling to reduce drug use and risky sex.

• Reduce their number of sexual partners.

—  John Wright

CDC study shows ‘concentrated epidemic’ of HIV in gay, bisexual men

44% of 8,000 men in 21 cities didn’t know they had virus

MIKE STOBBE  |  AP Medical Writer

ATLANTA — One in five sexually active gay and bisexual men has the AIDS virus, and nearly half of those don’t know they are infected, a federal study of 21 U.S. cities shows.

Experts said the findings are similar to earlier research, but the study released Thursday, Sept. 23 is the largest to look at gay and bisexual U.S. men at high risk for HIV. More than 8,000 men were tested and interviewed, and 44 percent of those who had the virus didn’t know they had it.

Overall, less than half of 1 percent of Americans have the AIDS virus, according to a calculation by the Kaiser Family Foundation, a research and policy organization in Washington, D.C.

But gay and bisexual men continue to be infected at much higher rates, said Jennifer Kates, Kaiser’s director of global health and HIV policy.

“We don’t have a generalized epidemic in the United States. We have a concentrated epidemic among certain populations,” she said.

That’s why a new national AIDS strategy, unveiled by the White House in July, is emphasizing more of a government focus on men who have sex with men and others at the highest risk of getting infected, Kates said.

The Centers for Disease Control and Prevention recommends HIV testing at least once a year for all men who have sex with men and are sexually active, but research indicates more than half don’t get tested.

An earlier study in just five cities in 2004-05 found similar results.

The new study, conducted in 2008, included 16 additional cities. Researchers offered free testing to the men, interviewed them and paid around $25 for their participation.

Black men were more likely to have HIV, with 28 percent reportedly infected, compared to 18 percent of Hispanic men and 16 percent of white men.

Black men were also least likely to know they were infected — about 60 percent didn’t know they had HIV — compared 46 percent of Hispanic men and 26 percent of whites.

—  John Wright

Focus on the Family says bullying issue being hijacked to bring homosexuality into schools

Associated Press

DENVER — The conservative Christian group Focus on the Family is accusing national gay advocacy groups of using bullying-prevention initiatives at public schools to introduce the viewpoint that homosexuality is normal.

Focus on the Family education expert Candi Cushman told The Denver Post for its Saturday, Aug. 28 editions that the Christian group supports bullying prevention but that the issue “is being hijacked by activists.”

“We feel more and more that activists are being deceptive in using anti-bullying rhetoric to introduce their viewpoints, while the viewpoint of Christian students and parents are increasingly belittled,” Cushman said. The Colorado Springs-based group said conservative Christians are portrayed as bigots for their opposing viewpoints, while public schools increasingly teach students that homosexuality should be accepted.

The national Gay, Lesbian and Straight Education Network says it wants all students to be treated with respect regardless of sexual orientation, gender identity, religion or race, ability or national origin.

“Bullying is a serious public health crisis in this country, according to no less an authority than the U.S. Department of Health and Human Services,” Eliza Byard, the executive director of GLSEN, told The Denver Post.

The Centers for Disease Control and Prevention said in a 2008 report that about 30 percent of sixth-to- 10th-grade students in the U.S. report being bullied, and Byard said the problem is more common with gay students.

Focus on the Family took aim at a 24-page GLSEN booklet titled, “Just the Facts About Sexual Orientation and Youth.” It will be delivered to public school superintendents around the country, Focus on the Family said.

“The theme: Schools are only allowed to provide one message about homosexuality — that it’s normal and should be embraced,” Focus on the Family said.

Byard said the idea for the booklet came from GLSEN but that it was authored by a coalition of medical, mental-health and education organizations.

—  John Wright