Targeting social media may increase HIV testing among gay men

Two men kiss as they sit in a riverside park in New York, May 9, 2012.

Reuters/Lucas Jackson

(Reuters Health) – Promoting HIV testing on some of the same social media sites that men who have sex with men and transgender people use to meet friends and sex partners can raise testing rates in these communities, according to results of a U.S. trial.

“Our results are surprising because we were not sure that men and transgender persons would readily accept HIV testing information within the social media and social networking sites that some of them use,” said lead author Scott D. Rhodes of Wake Forest School of Medicine in Winston-Salem, North Carolina. “But we learned that after trust was built, they were eager for information about HIV testing and guidance about how to access testing services.”

We assume that people are knowledgeable about HIV and how to get tested, but that’s not the case, he told Reuters Health by email.

The researchers used the intervention in two online communities and posted in another two forums without the intervention for comparison. The communities, including Adam4Adam, BlackGayChat, Craigslist and Gay.com, are designed for users to meet up in person, so the researchers targeted geographic locations 200 to 330 miles apart to prevent user overlap.

Within each online outlet, a health educator created a public profile and posted triggers about the importance of HIV testing, his availability to help and information on where testing services were available. The profiles were accessible to anyone and the health educator would engage with users who instant-messaged him.

On Craigslist, the educator posted HIV testing information and triggers every three to four hours from 9 a.m. to 5 p.m. Monday through Friday in 2013 and 2014.

The researchers offered site users $10 to complete an assessment, including information on drug and alcohol use, age, race, sexual orientation, HIV status and testing history over the previous year.

More than 1,000 users completed the assessment and most declined the $10 compensation. On average users were 40 years old, almost all reported sex with at least one man and one-third reported sex with at least one woman over the last year.

At the beginning of the year, about 35 percent of users in each group reported having been tested for HIV over the previous 12 months. After the intervention was complete, 64 percent of those in the intervention communities said they had been tested for HIV in the previous year compared to 40 percent of those in the control groups, as reported in Clinical Infectious Diseases.

“Gay and bisexual men as well as transgender women are disproportionally impacted by HIV (that is, by virtue of being a gay or bisexual man, or transgender woman, you are more likely to come in contact with HIV), and thus it is important to ensure frequent HIV testing and linkage to treatment,” said Christian Grov of the CUNY Graduate School of Public Health and Health Policy in New York City, who was not part of the new study.

These groups did respond to the social media intervention, Rhodes said.

“HIV testing is important for anyone who is sexually active, and the CDC recommends that all individuals get tested at least once in their lifetimes and those with risk factors get tested more frequently,” he said.

The intervention was easy to implement, only requiring one health professional and access to the Internet, so it could be widely implemented within social media by health departments and clinics and other organizations working to prevent HIV, he said.

“However, in addition to the health educator’s training, the health educator was skilled in building relationships with social media users, maintaining boundaries, being patient, having a sense of humor, and being comfortable networking with other organizations as well, particularly those offering HIV testing,” he said.

The users in this study were older and mostly white, noted Dr. Lisa Hightow-Weidman of the University of North Carolina at Chapel Hill School of Medicine, who was not part of the new study.

“Interventions to increase testing should be designed to reach younger men who have sex with men, particularly MSM of color as they are the group most impacted by the HIV epidemic in the U.S.,” she said by email.

SOURCE: bit.ly/1VTuWPY Clinical Infectious Disease, online March 14, 2016.

Targeting social media may increase HIV testing among gay men

Health Disparities in the United States: Social Class, Race, Ethnicity, and Health

Outstanding Academic Title, Choice magazine

The health care system in the United States has been called the best in the world. Yet wide health disparities persist between different social groups, and many Americans suffer from poorer health than people in other developed countries. Donald A. Barr’s Health Disparities in the United States explores how socioeconomic status, race, and ethnicity interact with socioeconomic inequality to create and perpetuate these health disparities. Examining the significance of this gulf for the medical community, cultural subsets, and society at large, Barr offers potential policy- and physician-based solutions for reducing health inequity in the long term.

This popular course book, which has been fully updated, now incorporates significant new material, including a chapter on the profound effects of inequality on child development, behavioral choices, and adult health status. An essential text for courses in public health, health policy, and sociology, the second edition analyzes the complex web of social forces that influence health outcomes in the United States. This book is a vital teaching tool and a comprehensive reference for social science and medical professionals.

Click Here For More Information

Health Disparities in the United States: Social Class, Race, Ethnicity, and Health

Eating fermented foods may reduce social anxiety

It’s no secret that fermented foods like kimchi, pickles and sauerkraut are good for you. Filled with probiotics, fermented foods have been found to improve digestive health, and may even be useful in treating issues like high blood pressure, anxiety and eczema.

Now, a new study suggests that young adults who eat fermented foods exhibit fewer signs of social anxiety, linking mental health to the health of one’s gut. The kids who are helped the most? The ones who have a genetic risk for social anxiety disorder.

Professors from the College of William and Mary and the University of Maryland School of Social Work teamed up to create a questionnaire that was given to around 700 students. They were asked about their consumption of fermented foods over the last 30 days. To measure against other healthy habits, researchers also asked about how many fruits and vegetables the students ate as well as about how often they exercised.

“This study shows that young adults who are prone towards anxiety report less social anxiety if they frequently consume fermented foods with probiotics,” said psychology professor Matthew Hilimire. “These initial results highlight the possibility that social anxiety may be alleviated through low-risk nutritional interventions, although further research is needed to determine whether increasing probiotic consumption directly causes a reduction in social anxiety.”

Hilimire explained, “It is likely that the probiotics in the fermented foods are favorably changing the environment in the gut, and changes in the gut in turn influence social anxiety. I think that it is absolutely fascinating that the microorganisms in your gut can influence your mind.”

Fermented foods weren’t the only good medicine found in the answers in the questionnaire. The researchers also found a link between exercise and reduced social anxiety.

This study is just the first in a series of in-depth explorations of the mind-gut connection, says Hilimire.

“Assuming similar findings in the experimental follow-up, what it would suggest is that you could augment more traditional therapies (like medications, psychotherapy or a combination of the two) with fermented foods — dietary changes — and exercise, as well.”

The researchers also want to do further research to see if there is a correlation between eating fermented foods and autism symptoms.

So, what kind of fermented foods should you can add to your diet? Here are three easy ones you can likely find on the shelf at your local supermarket.

Sauerkraut: This ballpark favorite, traditionally used to top hot dogs, hamburgers and reubens, is a good probiotic, contains vitamins C, helps fight ulcers, and has cancer fighting properties.

Research has shown that eating kimchi has been linked to cholesterol reduction, immune system health, colorectal health, digestive assistance, and it can also help the body fight cancer and obesity.

Kombucha: This drink, which has been gaining popularity in the U.S., is fermented tea, meaning it contains probiotics. It’s also a good source of B vitamins.

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Eating fermented foods may reduce social anxiety

How social media is fuelling the worrying rise in eating disorders

The number of teenagers being admitted to hospital with eating disorders has nearly doubled in just three years Photo: Alamy

A quick internet search, a few clicks, and the screen flashes up an image of a young woman, tall, fully made-up – and frighteningly emaciated. Around me I hear take a sharp intake of breath. I was filming a recent episode of the Channel 4 documentary Supersize vs Superskinny, in which we asked a group of parents to look at “thinspiration” websites – so-called because they are dedicated to encouraging young women with eating disorders to maintain their life-threatening illnesses.

Such pro-anorexia and pro-bulimia websites offer tips on how to avoid food (drink ice-cold water or black coffee, chew ice cubes, brush your teeth, go for a run, look at yourself naked and pinch your fat, or clean something dirty until you lose your appetite…). They suggest starting a “Fasting Journal”, and posting online “inspirational” images of your ribcage, shoulder blades or thigh gap. They offer advice on how to hide your eating disorder from your family, even on how to “purge” silently.

Little wonder, then, that the NHS has revealed that the number of teenagers being admitted to hospital with eating disorders has nearly doubled in just three years. The Royal College of Psychiatrists has laid the blame for this unprecedented rise firmly at the door of social media.

^{The number of teenagers being admitted to hospital with eating disorders has nearly doubled in three years (Alamy)}

While some “pro-ana” [pro-anorexia] sites claim to provide a neutral forum for suffers to discuss their problems and support each other in recovery, others brazenly assert that anorexia is a lifestyle choice, not a medical condition – and the individual’s choice not to eat should be respected. (A sample post from a young girl: “I convinced my parents to let me go vegan so now all I eat during dinner is vegetables if I even eat at all Stay f—— strong and skinny! Starve on.”)

• I’m lucky social media was in its infancy when I was anorexic

Looking at the skeletal selfies posted on these websites, and the messages of encouragement accompanying them, the parents in my focus group were visibly upset. As a former sufferer myself, even as someone who used to look that way, I too was shocked. I had never come across such honest discussions of how to starve yourself.

I recently interviewed a 17-year-old girl whose anorexia had been sparked by one of these websites. She showed me a thin red bracelet sent to her “by some guy in America when I joined the pro-ana movement. When the hunger gets too much, when I think I’m going to give in, I touch the bracelet and remind myself it’s stronger to starve.”

^{Emma Woolf, a former sufferer}

Who is running these sites, and what their motivation might be, is anyone’s guess. The very fact that they exist, entirely unregulated, and accessible to any teenage girl (or boy) in the privacy of their bedroom, is a scandal. In July 2013, David Cameron pledged to take action against the “corroding influence” of internet pornography, particularly child sexual abuse.

The Prime Minister promised that children would be protected by the automatic filtering of adult material, that illegal image searches would be blocked, and that sites such as Twitter would be forced to monitor the images posted by their users. If we can do this for pornography, why not for images of emaciated young girls?

Go online yourself, have a look. Every parent and teacher needs to know that “thinspiration” sites are dangerous. They glamorise anorexia, they promote photogenic waif-like models and starvation, and ignore the breadth and misery of eating disorders. Anorexia is not photogenic or glamorous, not from the inside. I was anorexic for more than ten years. When I started at Oxford University aged 19, I weighed around nine stone and was happy, healthy and well-adjusted.

When I left, aged 21, I weighed around five stone. None of the myths around anorexia applied: I did not dislike my body, and never had done. I did not think I looked fat, or wear skimpy clothes, or even look in the mirror much. I had declared war on myself.

^{Some ‘pro-ana’ sites suggest the individual’s choice not to eat should be respected (Rex Features)}

Even if you’re not actively looking for encouragement with an eating disorder, even if you avoid the internet altogether, you can’t avoid the overwhelming message of our age, that weight loss is good, weight gain is bad, that thinner (harder, leaner, greener) is better. We live in a hypervisual age, with most of us – especially the young – confronting thousands of images every day. The focus on women’s bodies is intense, in every magazine, website or TV advert, on every billboard and celebrity shot, and in the conversations of friends, mothers and sisters around us.

The effect can be profound, and yet still eating disorders are misunderstood. They are dismissed as a teenage, female condition (although male eating disorders are on the increase) or misrepresented as faddy dieting, body hang-ups, a phase they’ll “grow out of”. In fact, the opposite is true: eating disorders are highly addictive, and self-starvation becomes involuntary.

Anorexia has the highest mortality rate of all mental illnesses, more deadly than schizophrenia. One in five anorexics will die, either from physical complications or suicide.

In looking at the danger of media influences, we need to recognise the long-term health consequences. With anorexia, these include infertility, amenorrhoea (cessation of periods), loneliness and depression; bulimia can lead to kidney and heart problems as well as electrolyte imbalance. Osteoporosis (low bone density) is an invisible but growing problem among young women who avoid calcium-rich dairy products such as milk and cheese – and up to 90 per cent of anorexics show some degree of bone loss.

Secretly Starving: Inside the world of anorexia blogging

Meanwhile, a form of disordered eating known as orthorexia is becoming increasingly mainstream, fuelled by the mania for healthy eating and our growing anxiety around obesity. Orthorexia is somewhere on the blurred boundary between being health-conscious and a health obsessive.

It is defined as a “fixation with righteous or correct eating” – but what begins as an attempt to improve one’s lifestyle can morph into an unhealthy fixation. It can lead to self loathing, low self-esteem, social isolation and even malnourishment. In their search for the perfectly balanced lifestyle, orthorexics combine restrictive diets with punishing exercise regimes, are fanatical about calorie-counting, green juicing and honing their gym-bodies. Orthorexia thrives in a society in which we’re urged to count calories and “eat clean”, to avoid artificial additives and preservatives, to beware plastic packaging and hidden toxins and, above all, never to get fat.

^{Orthorexia is becoming increasingly mainstream (Getty)}

Disordered eating invariably goes hand in hand with excessive levels of physical activity. When I was at my sickest with anorexia, I would get up at dawn and run five miles a day, no matter how cold or exhausted I felt. But, again, there are those blurred lines. Hardcore workouts have surged in popularity among middle-class women, who go for the burn at their “skinny-bitch collective” classes and then Instagram the results. An 18-year-old student I know says she “feels bad” when she sees the post-workout selfies of her role models Ellie Goulding, Kylie Jenner and Miley Cyrus on Tumblr.

The situation for parents, especially mothers, is complicated. Do you encourage your daughter to exercise regularly, eat her five-a-day and drink her green juice, or will this trigger something more obsessive? Will she pick up on your own dietary habits? Will your body dissatisfaction damage her for life?

Now in my 30s, I have a healthy BMI and am physically “recovered”. But it has taken more than a decade to get to this point: gaining weight was the hardest fight of my life. I wonder if I was in my teens now, desperately trying to beat an eating disorder in today’s febrile online environment, how I would have coped. Goaded or triggered or simply surrounded by these images of super-healthiness, fitness, thinness, other anorexics chewing ice cubes, and my role models existing on wheatgrass shots: would I ever have recovered? I’m not sure.

• Emma Woolf is the author of An Apple a Day and The Ministry of Thin. Her latest book, Letting Go, is published by Summersdale, priced £8.99. To order your copy, call 0844 871 1514 or visit books.telegraph.co.uk

How social media is fuelling the worrying rise in eating disorders