Banning Same-sex Marriage Has Psychological Toll

Fascinating stuff from Shankar Vadantam at NPR:

As the country awaits two important Supreme Court decisions involving state laws on same-sex marriage, a small but consistent body of research suggests that laws that ban gay marriage — or approve it — can affect the mental health of gay, lesbian and bisexual Americans. When several states passed laws to prohibit same-sex marriage, for example, the mental health of gay residents seemed to suffer, while stress-related disorders dropped in at least one state after gay marriage was legalized.

Here’s the research trail:

Beginning around 2004, several states banned gay marriage. Just before that series of bans, the National Institutes of Health happened to conduct a massive survey of 43,093 Americans. The questions elicited detailed information about respondents’ mental health. (To validate what people reported about themselves, psychiatrists also interviewed samples of the people in the survey, and their medical diagnoses closely matched the findings of the survey.)

Soon after the wave of state bans on gay marriage, in 2004 and 2005, the NIMH conducted a second round of interviews, managing to reach 34,653 of the original respondents. (That’s a high rate compared with most polls and surveys.)

Mark Hatzenbuehler, a psychologist at Columbia University who studies the health effects of social policies, analyzed the data gathered before and after the bans to determine how the mental health of people who identified themselves as gay, lesbian or bisexual had changed in those states.

Hatzenbuehler and his colleagues Katie McLaughlin, Katherine Keyes and Deborah Hasin published their analysis in 2010 in the American Journal of Public Health.

“Lesbian, gay and bisexual individuals who lived in the states that banned same-sex marriage experienced a significant increase in psychiatric disorders,” Hatzenbuehler says.

“There was a 37 percent increase in mood disorders,” he says, “a 42 percent increase in alcohol-use disorders, and — I think really strikingly — a 248 percent increase in generalized anxiety disorders.”

To put those numbers in perspective, although Hatzenbuehler did find more than a doubling in the rate of anxiety disorders in states that eventually banned gay marriage, in absolute numbers he found that anxiety disorders went from being reported among 2.7 percent to 9.4 percent of gay, lesbian and bisexual people.

The million-dollar question is whether the laws, and the debates around them, were responsible for the change in mental health. To help answer that question, Hatzenbuehler and his colleagues looked at comparable groups and experiences.

“We showed the psychiatric disorders did not increase in lesbian, gay and bisexual populations in states that didn’t debate and vote on same-sex marriages,” Hatzenbuehler says. “There were also no increases — or much smaller increases — among heterosexuals living in the states that passed same-sex marriage bans.”

Hatzenbuehler has also found, in a study conducted in Massachusetts, that gay men experienced fewer stress-related disorders after that state permitted gay marriage.

In a study tracking the health of 1,211 gay men in Massachusetts, Hatzenbuehler found that the men visited doctors less often and had lower health treatment costs after Massachusetts legalized same-sex marriage. When the researchers examined the diagnostic codes doctors were giving the men, they saw a decrease in disorders that have been linked to stress, such as hypertension, depression and adjustment disorders.

Hatzenbuehler says he thinks stress associated with gay-marriage debates was the “X factor.” He says the quantitative data is backed by what gays, lesbians and bisexuals told the surveyors. “They reported multiple stressors during that period,” Hatzenbuehler says. “They reported seeing negative media portrayals, anti-gay graffiti. They talked about experiencing a loss of safety and really feeling like these amendments and these policies were really treating them as second-class citizens.”

Today, about three-dozen states ban gay marriage and about a dozen have passed laws thatapprove it. Some states have laws that permit civil unions but ban gay marriage.

It’s unclear how or whether the upcoming Supreme Court decisions involving the constitutionality of same-sex marriage will affect the mental and physical health of gays and lesbians nationally.

It’s likely that many gay, lesbian and bisexual people would see an upholding of same-sex marriage bans as an example of prejudice. But it’s also possible the debate around the Supreme Court decisions could have different effects on gays than a local debate involving friends and neighbors.

Hatzenbuehler says his larger point is really that policymakers, judicial leaders and ordinary citizens need to remember that social policies are also health policies.

 

Presidential Proclamation for World AIDS Day 2012

WORLD AIDS DAY, 2012

– – – – – – –

BY THE PRESIDENT OF THE UNITED STATES OF AMERICA

A PROCLAMATION

On World AIDS Day, more than 30 years after the first cases of this tragic illness were reported, we join the global community once more in standing with the millions of people who live with HIV/AIDS worldwide. We also recommit to preventing the spread of this disease, fighting the stigma associated with infection, and ending this pandemic once and for all.

In 2010, my Administration released the National HIV/AIDS Strategy, our Nation’s first comprehensive plan to fight the domestic epidemic. The Strategy aims to reduce new infections, increase access to care, reduce health disparities, and achieve a more coordinated national response to HIV/AIDS here in the United States. To meet these goals, we are advancing HIV/AIDS education; connecting stakeholders throughout the public, private, and non-profit sectors; and investing in promising research that can improve clinical outcomes and reduce the risk of transmission. Moving forward, we must continue to focus on populations with the highest HIV disparities — including gay men, and African American and Latino communities — and scale up effective, evidence-based interventions to prevent and treat HIV. We are also implementing the Affordable Care Act, which has expanded access to HIV testing and will ensure that all Americans, including those living with HIV/AIDS, have access to health insurance beginning in 2014.

These actions are bringing us closer to an AIDS-free generation at home and abroad — a goal that, while ambitious, is within sight. Through the President’s Emergency Plan for AIDS Relief (PEPFAR), we are on track to meet the HIV prevention and treatment targets I set last year. We are working with partners at home and abroad to reduce new infections in adults, help people with HIV/AIDS live longer, prevent mother-to-child transmission, and support the global effort to eliminate new infections in children by 2015. And thanks to bipartisan action to lift the entry ban on persons living with HIV, we were proud to welcome leaders from around the world to the 19th International AIDS Conference in Washington, D.C.

Creating an AIDS-free generation is a shared responsibility. It requires commitment from partner countries, coupled with support from donors, civil society, people living with HIV, faith-based organizations, the private sector, foundations, and multilateral institutions. We stand at a tipping point in the fight against HIV/AIDS, and working together, we can realize our historic opportunity to bring that fight to an end.

Today, we reflect on the strides we have taken toward overcoming HIV/AIDS, honor those who have made our progress possible, and keep in our thoughts all those who have known the devastating consequences of this illness. The road toward an AIDS-free generation is long — but as we mark this important observance, let us also remember that if we move forward every day with the same passion, persistence, and drive that has brought us this far, we can reach our goal. We can beat this disease. On World AIDS Day, in memory of those no longer with us and in solidarity with all who carry on the fight, let us pledge to make that vision a reality.

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States do hereby proclaim December 1, 2012, as World AIDS Day. I urge the Governors of the States and the Commonwealth of Puerto Rico, officials of the other territories subject to the jurisdiction of the United States, and the American people to join me in appropriate activities to remember those who have lost their lives to AIDS and to provide support and comfort to those living with this disease.

IN WITNESS WHEREOF, I have hereunto set my hand this twenty-ninth day of November, in the year of our Lord two thousand twelve, and of the Independence of the United States of America the two hundred and thirty-seventh.

BARACK OBAMA

Stem Cells: Killing HIV

From Science Daily:

Human Immunodeficiency Virus (public domain)

Expanding on previous research providing proof-of-principal that human stem cells can be genetically engineered into HIV-fighting cells, a team of UCLA researchers have now demonstrated that these cells can actually attack HIV-infected cells in a living organism.

The study, published April 12 in the journal PLoS Pathogens, demonstrates for the first time that engineering stem cells to form immune cells that target HIV is effective in suppressing the virus in living tissues in an animal model, said lead investigator Scott G. Kitchen, an assistant professor of medicine in the division of hematology and oncology at the David Geffen School of Medicine at UCLA and a member of the UCLA AIDS Institute.

“We believe that this study lays the groundwork for the potential use of this type of an approach in combating HIV infection in infected individuals, in hopes of eradicating the virus from the body,” he said.

Full story here.

ZZZZZZZZ- You Need More Sleep

In my role as a therapist, I hear people complain about lack of sleep inability to fall asleep, fatigue and mental grogginess. It’s simple- we’re not getting enough sleep. Persons with chronic illness- including HIV- are especially susceptible and will benefit greatly from enhanced sleep hygiene.
Below is a helpful infographic Ken found on sleep:

You Need More Sleep
Created by: MedicalBillingAnd CodingCertification.net

Infographic: Climate Change Hoax

Image

Click for story

The Catholic Hierarchy: “Suffer The Little Children.”

Illinois Catholic bishops are taking their ball and going home in the face of federal non-discrimination requirements for foster care and adoption. The New York Times:

Children of the United Kingdom's Children's Mi...

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Roman Catholic bishops in Illinois have shuttered most of the Catholic Charities affiliates in the state rather than comply with a new requirement that says they must consider same-sex couples as potential foster-care and adoptive parents if they want to receive state money. The charities have served for more than 40 years as a major link in the state’s social service network for poor and neglected children.

The bishops have followed colleagues in Washington, D.C., and Massachusetts who had jettisoned their adoption services rather than comply with nondiscrimination laws.

The vilification of LGBT persons by the hierarchy of the Roman Catholic Church is quickly becoming hysterical paranoia. What I find interesting is that it flies in the face of most of the opinions of people in the pews as well as the experience of many of the clergy and bishops themselves. They know gay people, they minister to gay people, and- I know this from personal experience- many of them are gay people.

Yet, this real-life, personal experience has no credibility in the face of freakishly ideological edicts from Rome. It’s absolutely backward. The experience of the people is supposed to form the church, form the hierarchy.

Not to mention the disregard for social and biological science. This is a church that would rather let the little children suffer. It saddens me.

Where’s the love, people?

Read the full story here

Reasonable Evangelicals Disavow “Fundamentalist Rejection Of Reason”

Today’s Op-Ed piece in by Karl Giberson and Randall J Stephens in The NYT is a piece well worth reading.

For many people, “Evangelical Christian” has become code for “Christian, anti-scientist”. The writers of todays column point out that this isn’t necessarily so- or fair. The vocal minority who claim Evangelical Christianity are, in fact, not so. They are Fundamentalists. Excerpt:

Like other evangelicals, we accept the centrality of faith in Jesus Christ and look to the Bible as our sacred book, though we find it hard to recognize our religious tradition in the mainstream evangelical conversation. Evangelicalism at its best seeks a biblically grounded expression of Christianity that is intellectually engaged, humble and forward-looking. In contrast, fundamentalism is literalistic, overconfident and reactionary. (emphasis mine)

Fundamentalism is dangerous. In case you have forgotten, Fundamentalists were the ones who hijacked and piloted planes into the World Trade Center. Of a different religion, yes, but adhering to the same principles. The writers haven’t forgotten, and they are reminding the rest of the world that these few don’t speak for the rest:

Americans have always trusted in God, and even today atheism is little more than a quiet voice on the margins. Faith, working calmly in the lives of Americans from George Washington to Barack Obama, has motivated some of America’s finest moments. But when the faith of so many Americans becomes an occasion to embrace discredited, ridiculous and even dangerous ideas, we must not be afraid to speak out, even if it means criticizing fellow Christians.

Amen.

Shut The (Bleep) Up

We watched a little bit of the VMA’s last night- just until the latest episode of Torchwood reran- and I was amazed at all the bleeps that were happening. It almost made the show unwatchable.

Not because I’m a prude, but because I have a hard time with interrupted continuity. I hate distractions.

Ask anybody who has ever sat next to me in a movie theater- or watched a movie with me in my living room; I hate talking, interruptions or distractions. Ken has learned to sit on the aisle, and, if he doesn’t remember, I remind him to use the restroom before the movie. I don’t like talking or noisy crowds in the theater, either. I paid my good money to watch a movie, not listen to your conversation and commentary. For me, a movie is like a roller coaster- I pay my money, I get in the car and I don’t get out until the ride is over.

And I don’t bring my colicky baby.

But when something is continually interrupted, it starts to concern me. I have a hard time tracking. Maybe it’s advancing age and/or deafness that’s making me less tolerant of distractions, but it seems to be having its own manifestation in politics. Candidates are actively interrupting scientific communication in this country. Blatantly standing up in the middle of the show and making factual inferences with fantastical statements. Distracting people from the reality hiding behind the curtain with a little folksy humor or superstitious nonsense.

And I’m annoyed.

Thank God that I’m not alone. Paul Krugman today has an excellent article about the trending GOP tendency to deny science, knowledge- and maybe, common sense- in favor of the popularly held beliefs of uneducated, superstitious people. My words, not his. These are his:

According to Public Policy Polling, only 21 percent of Republican voters in Iowa believe in global warming (and only 35 percent believe in evolution). Within the G.O.P., willful ignorance has become a litmus test for candidates, one that Mr. Romney is determined to pass at all costs.

So it’s now highly likely that the presidential candidate of one of our two major political parties will either be a man who believes what he wants to believe, even in the teeth of scientific evidence, or a man who pretends to believe whatever he thinks the party’s base wants him to believe.

And the deepening anti-intellectualism of the political right, both within and beyond the G.O.P., extends far beyond the issue of climate change.

Lately, for example, The Wall Street Journal’s editorial page has gone beyond its long-term preference for the economic ideas of “charlatans and cranks” — as one of former President George W. Bush’s chief economic advisers famously put it — to a general denigration of hard thinking about matters economic. Pay no attention to “fancy theories” that conflict with “common sense,” the Journal tells us. Because why should anyone imagine that you need more than gut feelings to analyze things like financial crises and recessions?

Now, we don’t know who will win next year’s presidential election. But the odds are that one of these years the world’s greatest nation will find itself ruled by a party that is aggressively anti-science, indeed anti-knowledge. And, in a time of severe challenges — environmental, economic, and more — that’s a terrifying prospect.

And if you want more proof that the GOP is pandering to the uneducated you don’t have to look much farther than Michele Bachmann. Her blind-to-the-facts manner is starting to leak holy water as well:

Speaking to a crowd in Florida over the weekend, Bachmann said the historic earthquake and massive hurricane that rocked the East Coast last week was a message that God is upset with the way politicians in Washington have been doing things. The interview with the St. Petersburg Times…:

She hailed the tea party as being common-sense Americans who understand government shouldn’t spend more than it takes in, know they’re taxed enough already and want government to abide by the Constitution.

I don’t know how much God has to do to get the attention of the politicians. We’ve had an earthquake; we’ve had a hurricane. He said, ‘Are you going to start listening to me here?’Listen to the American people because the American people are roaring right now. They know government is on a morbid obesity diet and we’ve got to rein in the spending.”

Emphasis added. Bachmann’s comments put her closer to Pat Robertson’s take on the week than her most prominent rivals for the Republican nomination.

Part of me wants to yell “Shut the (bleep) up!” The same part of me that was annoyed in the theater during Schindler’s List when that woman with the whimpering and complaining kids (kids around 5, 6 and/or 7 from what I could tell), who kept telling them loudly to sit still, be quiet and stop whining throughout the whole movie- instead of taking them out the door and across the hall to watch Beethoven’s 2nd. In my frustration, I threw a dirty look and a kernel or two of popcorn her way.

It’s how I feel when people, jockeying to be the most powerful person in the world, blatantly disregard science in favor of folksyisms that appease- and get votes. This guy/gal is just like me. They should be president.

Huh? Whatever happened to the drive to be intelligent in our culture? When did it become evil? Haven’t we learned our lesson about folksy presidents from Texas?

I guess not. Just like the lady in the theater didn’t know-or didn’t care- that bringing small children to Schindler’s List would wreck the movie for almost everyone else in the room. But this time, I’m not going to just sit there, fuming. I’m not keeping my mouth shut.

Consider this the opening salvo.

Buttered.

HIV: Treatment is Prevention

Today’s New England Journal of Medicine has an excellent research study on HIV, entitled Preventing HIV-1 Infection with Antiretroviral Therapy.

Scott Hammer,MD, in an editorial for the journal, gives a brief overview of the study:

In this issue of the Journal, Cohen et al. describe the results of the HIV Prevention Trials Network (HPTN) 052 study, which has now provided definitive proof that (as suggested by the findings of previous cohort studies) antiretroviral treatment reduces the rate of sexual transmission of HIV-1.

Did you hear that? Definitive proof.

Early antiretroviral treatment not only significantly lowers the risk of transmitting the virus, it also shows increased health benefits for the HIV infected. The conclusions by the research team in the article:

In conclusion, the biologic plausibility of the use of antiretroviral therapy for the prevention of HIV-1 infection has been carefully examined during the past two decades. The idea of HIV-1 treatment as prevention has garnered tremendous interest and hope and inspired a series of population-level HIV-1 treatment-as-prevention studies that are now in the pilot or planning stages. Such interventions are based on the hypothesis that the use of antiretroviral therapy reliably prevents HIV-1 transmission over an extended period of time. In this trial, we found that early antiretroviral therapy had a clinical benefit for both HIV-1–infected persons and their uninfected sexual partners. These results support the use of antiretroviral treatment as a part of a public health strategy to reduce the spread of HIV-1 infection. (emphasis mine)

This is science at work. Get tested. If you’re HIV-positive, get into care and take your meds. We can slow this thing down.

Money quote from Dr Hammer:

Antiretroviral therapy is by no means perfect and is not the ultimate answer to controlling and ending the HIV epidemic. Adverse events, emergence of drug-resistant viral strains, maintenance of adherence, sustainability, and cost are just some of the concerns. However, this is precisely the wrong time to limit access to antiretroviral therapy in resource-limited settings, since we have the tools in hand to maintain or restore health in infected persons and reduce transmission to their sexual partners.

Yep.
So now that we know, will anything happen?

(PS- the picture above is of my morning pills)

Statins May Benefit Persons with HIV

Persons with HIV often take statins to combat high cholesterol levels caused by taking certain HIV Meds, but a new study suggests statins could benefit HIV+ persons by lowering inflammation and calming the immune system.
It may be a low cost way to lower the damaging effects of HIV in the human body. Read it here.