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HIV INFECTION RATE AND RISKY BEHAVIOR DECLINE AMONG INJECTION DRUG USERS IN BALTIMORE

Kenrad Nelson, MD, professor of epidemiology; Mahboobeh Safaeian, senior program analyst, epidemiology; Steffanie A. Strathdee, PhD, associate professor of epidemiology; David D. Celentano, MHS ’75, ScD ’77, professor of epidemiology; and David Vlahov, PhD, adjunct professor of epidemiology
October 1, 2002, issue of the American Journal of Epidemiology

Injection drug users (IDUs) in Baltimore have decreased their risky behavior, as well as their chances of contracting HIV, according to a study by Dr. Nelson and colleagues in the Department of Epidemiology. The findings show that the incidence of HIV infection among IDUs declined 12 percent per year during the decade-long study period.

In addition, the researchers found IDUs decreased needle sharing and attended shooting galleries less frequently during the study period, and those IDUs who attained higher degrees of education, were older, and were women were less likely to contract HIV. The researchers say these variables were associated with increased social support and resources to help avoid or reduce high-risk behavior.

“These trends reflect, in part, the response to a concerted public health effort to prevent HIV infection among drug users and the response to the risk of acquiring HIV by drug-using populations,” said Dr. Nelson.

PAIN RELIEVERS MAY PREVENT ALZHEIMER’S DISEASE

Peter P. Zandi, PhD ’01, assistant professor of mental hygiene; James C. Anthony, PhD, professor of mental hygiene; Kathleen M. Hayden, MA, graduate studentin mental hygiene; Lawrence Mayer, MD, PhD, adjunct professor of mental hygiene
September 2002 issue of Neurology

Long-term use of aspirin and other non-steroidal anti-inflammatory drugs could prevent Alzheimer’s disease if taken before symptoms of dementia occur, according to a study conducted by researchers from the School’s Department of Mental Hygiene.

For the study, the researchers followed 3,000 adults over age 65 for three years and monitored their use of aspirin, ibuprofen, naproxen, and other anti-inflammatory drugs. The findings show that people who took aspirin or other anti-inflammatory drugs for more than two years before the study began were 55 percent less likely to develop Alzheimer's than those who did not. They also found that longer use of non-steroidal pain relievers among the study participants was associated with greater protection from the disease.

Dr. Zandi explains that the beneficial effects of taking non-steroidal anti-inflammatory drugs in preventing Alzheimer’s accumulate over a long period of time
and are not apparent until years later.

PATIENT RACE IS A DETERMINANT IN RECEIVING CORONARY ANGIOGRAPHY REFERRAL

Thomas A. LaVeist, PhD, associate professor of health policy and management
August 2002 issue of Health Services Research

A study by Dr. LaVeist and colleagues at St. Agnes Healthcare and Bon Secours Baltimore Health System revealed that patient race is a determining factor in receiving a referral for coronary angiography. However, they found once patients receive a referral, there is no significant difference in receiving the procedure when comparing white and African-American patients.

Coronary angiography is a diagnostic procedure that uses a catheter to inject an image-enhancing substance near the patient’s heart. The procedure helps identify the functioning of the heart’s blood vessels and is a precursor to life-saving open heart surgery.

The study found that African-American patients were 71 percent as likely as white patients to obtain a referral for coronary angiography and 63 percent as likely to receive the procedure. White patients were more likely to be privately insured and less likely to have Medicare, Medicaid, or be uninsured. Analysis shows that patients who have private health insurance are more likely than uninsured patients to receive a referral.

FEMALE PHYSICIANS MORE EMOTIONALLY FOCUSED AND “PATIENT CENTERED” WHEN COMMUNICATING WITH PATIENTS

Debra L. Roter, DrPH, professor of health policy and management, and Yutaka Aoki,
MS, MPH, ME, graduate student in environmental health sciences
August 14, 2002, issue of the Journal of the American Medical Association (JAMA)

Female primary care physicians spend more time with their patients and engage in more positive, social, and emotionally focused talk than their male colleagues, according to a study by Dr. Roter and her colleagues at Northeastern University. Their conclusions are based on a systematic review of previous studies involving physician communication.

“Our review found that female physicians more often engage in communication that we would consider patient-centered and which broadly relates to the larger life context of the patient’s conditions. They do this by addressing psychosocial issues through questioning and counseling, and more emotional and positive talk,” said Dr. Roter. “Doctors are supposed to be considered doctors first, but we know that men and women communicate differently. The results are consistent with what we would expect in everyday life,” she added.

The researchers noted that the findings did not hold true for obstetrics and gynecology, where male doctors spent more time with patients and demonstrated higher levels of emotionally focused talk compared to female physicians. They added that few studies looked beyond primary care physicians and that additional research is needed to determine gender-related practices among subspecialty physicians. None of the studies reviewed linked communication skills to clinical outcomes.