Important Findings on HIV Meds, Condom Use Among Drug Users, Barriers to Breast Cancer Screening in new Journal of Urban Health

NEW YORK CITY, March 20 - Research examining an array of urban health topics???including adherence to HIV medication after Sept. 11, barriers to breast cancer screening among certain Latina groups, and condom use among African-American drug users???can be found in the current issue of the Journal of Urban Health, published quarterly by The New York Academy of Medicine. Studies investigate a host of compelling issues, including:

Adherence to HIV medication after Sept. 11:
The Sept. 11 terrorist attacks caused significantly more HIV-positive men in New York City to miss doses of their antiretroviral medications, according to a study led by Perry N. Halkitis, Ph.D., Assistant Professor and Interim Chair of New York University???s Department of Applied Psychology. Even in the most stable of times, adhering to the HIV medication regimen is difficult, Halkitis said. Add a traumatic situation like Sept. 11 into the mix, and it???s a recipe for non-compliance.

Halkitis??? is among the first studies to examine the effects of sudden and/or ongoing psychological trauma on HIV medication adherence. He examined data from Project PILLS, a longitudinal study of HIV medication adherence behaviors among men in the five boroughs who have sex with men (MSM). His study involved 68 men who had been interviewed for Project PILLS prior to Sept. 11 and then again between Sept. 24 and Oct. 24, 2001. The men showed a decline in rate of medication adherence from 90.5% before the terrorist attacks, to 81.9% afterward. These drops in adherence remained, even when controlling for race/ethnicity, income, educational levels and sexual orientation. ???Because mutation rates for HIV are high when antiretroviral medications are not consistently taken, these findings should alert clinicians and mental health providers to carefully monitor patients who suffer sudden trauma,??? said Halkitis, who is also Co-Director of NYU???s Center for HIV Educational Studies and Training.

Barriers to Breast Cancer Screening for Low-Income Mexican and Dominican Women in New York City:
Fear, shame and a lack of information are among the barriers that keep inner-city Mexican and Dominican women from seeking breast cancer screening, according to a new study led by Samantha Garbers, MPA, Research Associate with the Medical and Health Research Association of New York City. Garbers and colleagues interviewed 298 low-income Mexican and Dominican women ages 40 and over who live in medically underserved New York City communities. The screening barriers that they most commonly cited were: not taking care of oneself, or ???descuido,??? (52.3%); lack of information (49.3%); and, fear (44.6%). Even women with access to health care may avoid screening because of these personal barriers.

The study demonstrates that increasing Latinas??? access to screening services may not be enough to ensure that the women get screened for breast cancer. ???Programs targeting Latina populations similar to those in this study need to directly address fears and misconceptions, including an emphasis on taking care of one???s health and the health benefits of early detection,??? Garbers said. ???Outreach campaigns should be designed in collaboration with community members to ensure that cultural factors ??? such as feelings of fear or embarrassment??? are addressed.??? Breast cancer is the most common cancer and the leading cause of cancer death for Latina women in New York City.

Intention to Use Condoms Among Three Groups of Low-Income, Urban African Americans:
Cocaine-users, Noncocaine Drug Users, and Non-Drug Users: African-Americans who use cocaine are at higher risk for contracting HIV and sexually transmitted diseases (STDs) than those who use other drugs or are drug-free, according to research led by Levi Ross of the University of Alabama at Birmingham School of Public Health. That is because they are much less likely to use condoms, researchers found.

Ross and colleagues studied a sample of 737 low-income, African-Americans in four Birmingham neighborhoods with a high prevalence of drug use. Each person interviewed was asked to provide information on a number of HIV risk factors, including condom use. Cocaine users were significantly less likely to protect themselves and their main sexual partners by using condoms and limiting other sexual risk behaviors, even though they accurately perceived their elevated risk for STDs and HIV. ???Compared to both drug users who do not use cocaine and non-drug users, cocaine users were significantly more likely to report having traded sex for money, having traded sex for drugs, and having a history of STDs,??? Ross said. Cocaine users also reported consuming more alcohol in the past month than users of other drugs, and had less intention to use condoms with their main sex partners in the future. ???These findings are important to public health and medical professionals who may not realize that behaviors of cocaine users put them at even greater risk for STDs and HIV than users of cocaine, marijuana, and alcohol,??? Ross said.

The Journal of Urban Health is published quarterly by The New York Academy of Medicine. The Academy is a non-profit institution founded in 1847 that is dedicated to enhancing the health of the public through research, education and advocacy, with a particular focus on urban populations, especially the disadvantaged.

Posted on March 20, 2003

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