Survey: Mental health stigmas are shifting

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April 25th, 2016

Mental health has a long-standing public perception problem, but the stigma appears to be shifting, at least in the United States, a new survey reveals. Results from a national online survey on mental health, anxiety and suicide indicate that 90% of Americans value mental and physical health equally.

“Progress is being made in how American adults view mental health, and the important role it plays in our everyday lives. People see connection between mental health and overall well-being, our ability to function at work and at home and how we view the world around us,” said Dr. Christine Moutier, chief medical officer of the American Foundation for Suicide Prevention.
The foundation commissioned a Harris Poll with the Anxiety and Depression Association of America and the National Action Alliance for Suicide Prevention to gauge public opinion on mental health, anxiety and suicide awareness.
In August, the Mental Health and Suicide Survey was emailed to a random sampling of individuals age 18 and older who live in the United States.
Despite recognizing a link between mental health and overall well-being, the majority of survey participants view access to mental health care inaccessible and costly. 150115175106-mental-health-exlarge-169

How Americans view mental health conditions

Although most people surveyed identified life circumstances, depression, post-traumatic stress disorder and bipolar disorder as risk factors for suicide, more than half — 53% — did not know that people with anxiety disorders are also at risk for suicide, the survey found.
“The findings provide key insights into how Americans view mental health conditions, life circumstances, barriers for seeking help and their understanding of the risk factors for suicide,” said Dr. Doryn Chervin, executive secretary of the National Action Alliance for Suicide Prevention.
Though psychiatrists say women are more likely than men to have suicidal thoughts, the survey indicates that women are also more likely than men to receive mental health treatment and more likely to report experiencing anxiety and depressive disorders.
Men, the survey reveals, are less likely to report anxiety and depressive disorders and more likely than women to report substance-related conditions.
Between 1999 and 2013, nationwide suicide rates have increased 19.9%, according to the Centers for Disease Control and Prevention. “Men are four times more likely than women to die from suicide and rates are especially higher for middle-aged, white, non-Hispanic men 35 to 65 years old,” said Dr. Alex Crosby, branch chief with the CDC’s Division of Violence Prevention.
Despite the statistics, nearly all survey respondents — 94% — think suicide is sometimes or often preventable.
“Effectively diagnosing and treating both anxiety disorders and depression, especially when they co-occur, are critical pathways to intervening and reducing the suicide crisis,” said Dr. Mark Pollack, president of the Anxiety and Depression Association of America.

Seeking care seen as a sign of strength

The survey also revealed that people ages 18 to 24 are becoming more comfortable with seeking medical help and are more likely to consider it a sign of strength to see a medical health professional, compared with older people.
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“There are many steps people can take to help if they know someone who is suicidal,” Moutier said. “Reach out to mental health providers, call the National Suicide Prevention Lifeline – 1-800-273-TALK (8255) — and make sure the person is not alone until they can get help.
“Talking helps saves lives.”
While psychiatrists affiliated and not affiliated with the survey acknowledge the steady shift in people wanting to understand mental health better, many say more research needs to be done because a stigma still lingers.
“It’s a great step forward to see a public increase in awareness on mental health issues, but there are still limitations when it comes to gaining access to care,” said Dr. Ranna Parekh, director of the Division of Diversity and Health Equity at the American Psychiatric Association , which was not affiliated with the survey.
“There needs to be an increase in the number of trained mental health professionals, proper facilities and first-response support across the nation in order to treat all the patients who need the special care.”

New Test Can Detect Infertility Genes

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April 25th, 2016

Around 15% of couples have difficulty conceiving. 50% of the time the problem lies with the man. In many cases, faulty genes are the root cause of the problem. But up until recently, there was no way of knowing what these genetic issues were. Cornell University researchers have now come up with a way to detect mutations in genes affecting fertility. Their findings were published in the Proceedings of the National Academy of Sciences. Common genetic variations are known as single nucleotide polymorphisms (SNPs). Every SNP affects a specific nucleotide or building block of DNA. Researchers say patients struggling with infertility can have their DNA sequenced. If doctors can figure out which SNP is defective, they can provide a genetic diagnosis. This may someday lead to intervention on the genetic level. Fertility specialists could simply detect faulty SNP’s and repair or replace them.

shutterstock_290143400To locate the SNP causing the problem today, the genomes of healthy people are placed side-by-side with those having fertility problems, to locate where differences occur. But this method has been ineffective so far. There are too many genes responsible for fertilization, and the process is too complex. John Schimenti the director of the Center for Vertebrate Genomics along with Priti Singh, a postdoctoral fellow in Schimeti’s department, came up with this new method. These researchers used laboratory mice. They looked at a database of all known mice genes responsible for infertility. These have been arrived upon through testing which is not possible in humans. Then these genes were compared to genetic variation within the human genome. They found SNPs associated within four different genes that are thought to cause fertility problems in our species. Then these SNPs were tested in mice. Through this practice, researchers are beginning to identify those SNPs that cause human infertility. Though this genetic testing is not available yet, couples trying for six months to a year without conceiving should consult a physician. Both partners should be tested. Men should see an urologist or fertility specialist.

Special Underwear Safeguards Male Fertility

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March 16th, 2016

What underwear you wear can affect your fertility. Most men know that when they are trying to conceive with their partner, they should avoid anything that makes the testicles warmer. Sperm is produced at a lower temperature than the body naturally resides, which is why they hang away from the body and adjust themselves according to the ambient temperature. That means when trying to conceive, one should wear boxers over briefs, avoid hot baths, Jacuzzi’s, the steam room, and the sauna. One place men often fail to consider is their cell phone. How does radiation emitted from a smart phone affect male fertility? This issue has been debated for some time in the medical community. One 2014 University of Exeter study found a link between electromagnetic radiation and a low sperm count. But it was not definitive. Most experts say not to leave your phone in your pocket for long periods of time, just in case. Instead, when you are working or at rest place it on a table, or other hard surface some distance away from you, so as to limit the amount of radiation exposure, particularly the sex organs. The same goes for your tablet or laptop. Work at a table or place a hard surface between you and your lap.

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If this doesn’t sound appealing, hit the internet and buy yourself some new drawers. A line of special male undergarments to safeguard male fertility is now available for purchase. It is called Wireless Armour underwear. Sir Richard Branson called them “underpants for superheroes.” The manufacturer says this underwear line protects the male sex organs from the kind of radiation emitted from laptops, tablets, or cell phones. A pure silver mesh has been woven into each pair, making them 99.9% effective against such radiation. British scientist Joseph Perkin invented them. Perkin said he became increasingly aware over the years that his personal electronic devices were exposing him to more and more radiation. With his background in physics, he went to work devising a simple solution. Radiation exposure is not the only possible cause of male infertility. Many things may cause it. Couples who haven’t conceived after six months to a year of unprotected sex should each seek out a physician. The man should check his wardrobe, but also with an urologist.

My boyfriend’s erectile issues are affecting my confidence

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March 14th, 2016

Q. Sometimes my boyfriend and I have great sex — but occasionally he struggles to get enough of an erection for penetrative sex.

I find it difficult because it affects my confidence, and of course his. What could the reason be?

A. The cause could be psychological, or it could be an indication of an underlying health problem. Either way, your boyfriend needs to see a doctor.

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Sexual health does not exist in a realm of its own. It is integral to, and an important marker of, everyone’s general health.

In men, erectile difficulties are associated with a host of serious conditions, such as diabetes, hypertension, cardiovascular disease, peripheral vascular disease and other neurologic and endocrine disorders.

Before you get too anxious, however, I should add that the bulk of research into erectile dysfunction (ED) has been carried out on men over 50 and these conditions also tend to be more common in older men, so there is uncertainty about what is cause and what is effect.

Because erectile function declines with age, when younger men go to a GP with erectile difficulties there is a tendency to presume that the problem is psychological.

However, younger men with ED should always be screened for underlying health problems — a recent study confirmed that in men under 40 ED may be the first clinical sign of the thickening and hardening of the walls of the arteries, which is a precursor to heart disease.

One of the most important clues about the nature of a man’s ED is whether or not he can achieve a rigid erection during manual masturbation.

If your boyfriend can sustain a firm erection during solo sex but he fails when you try to have sex with each other, his problem may relate to stress, anxiety or depression.

If, however, he can’t sustain a firm erection during masturbation and he doesn’t experience nocturnal penile tumescence, the problem is more likely to be related to a health condition.

Psychological ED can often be traced to difficult life events, such as job loss, bereavement, or relationship problems, but it can also be triggered by stressful sexual events.

All men, no matter what their age, experience the occasional uncooperative erection. Hangovers, for example, make it more difficult to get an erection and because hangovers also increase anxiety, they can set up a nasty feedback loop where a failed erection causes performance anxiety, which, in turn, inhibits erection.

Whatever the cause of your boyfriend’s problem, the one thing you need to know is that it is not a reflection of how attracted he is to you.

Try not to take it personally and do your best to encourage him to get a diagnosis as soon as possible. It is very difficult for young men to process the implications of ED, so your support will be hugely important.

Although this might seem like an insurmountable hurdle now, couples who have to deal with sexual difficulties often find that being forced to talk openly to each other about sex establishes much more open and honest lines of communication, and this improves their overall satisfaction within the relationship.

The good news is that there is an ever-increasing range of treatments available to treat ED, so with the right medical or psychological help, he should be able to resolve the problem.

In the meantime, focus on sustaining intimacy in any way you can.

Stepping It Up For Women’s HIV Prevention

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March 14th, 2016

By Shayna Buhler, Senior Program Officer, Interagency Coalition on AIDS and Development (ICAD)

When it comes to HIV, there’s a long way to go to Step it up For Gender Parity by 2030, but progress is being made on several fronts. Key to addressing HIV among women and the gender inequities that fuel the epidemic among them, is the search for new prevention options that make sense in women’s lives and give them the power to make decisions about their own sexual and reproductive health, including HIV prevention. Women continue to be at disproportionately high risk of HIV infection and AIDS is the leading cause of death worldwide for women of reproductive age.

Many women around the world are placed in situations where they are often unable to negotiate with their partners to be faithful or to use condoms. Stepping it up for gender parity requires that women have access to a range of HIV prevention options, including those that they can use without partner involvement if they choose. Recent advances in oral pre-exposure prophylaxis have contributed to an expanding set of options, and two weeks ago, the results of two vaginal microbicide trials were released, taking us one momentous step forward along this path.

Microbicides are biomedical products being developed to protect healthy people from becoming infected with HIV during sex. Both the Ring Study, led by the International Partnership for Microbicides (IPM), and ASPIRE, led by the US national Institutes of Health -funded Microbicide Trials Network (MTN) demonstrated that a monthly vaginal ring containing the anti-retroviral drug dapivarine worked to safely reduce the risk of HIV infection among the women who wore them. This was the first time that two studies have confirmed that a vaginal microbicide can safely offer protection against HIV. Participants from this and other trials, their communities, prevention advocates and researchers have been working and waiting for this moment for a long time.

The results of the two trials were positive but not overwhelmingly so. The trial showed that compared to the placebo, the monthly dapivarine ring reduced the risk of HIV infection by 31 percent and 27 percent respectively. Much more will be learned as the data continues to be analyzed but a couple of things seem clear. One, the ring works much better when it is used consistently. It works best when it is kept in for the full 30 days and then replaced with a new ring. This is not surprising. We have learned of the importance of consistent use with oral pre-exposure prophylaxis and from previous microbicide trials.

We know this to be true for condoms as well– if they aren’t used consistently and correctly, they just don’t work as well. We also know that the women in the trial removed a ring that to their knowledge may have contained either dapivarine or a placebo, and that dapivarine may or may not work to prevent HIV infection. They were being reminded of these uncertainties at every clinic visit. In Open Label Extension studies that will follow, in which participants from both placebo and dapivarine arms of the trial can participate and access the monthly dapivarine ring (without being blinded), we will be able to get a much clearer picture of how consistently women might use a product that they know contains a drug that has been proven to work.

The studies also indicate that the dapivarine ring showed higher efficacy among women over the age of 21 and showed little to no protection in women ages 18 to 21. More research and analysis will help us to understand whether this is due to different levels of consistency in usage, or due to some other factor such as biological difference.

Young women desperately need more prevention options–globally, they face excessively high rates of HV infection, and may have less power than older women to negotiate the terms of their sexual relationships. But women aged 22 to 26 also have extremely high rates of HIV infection and we cannot underestimate the value of expanding prevention options for this age group.

We have only to look at the example of birth control to be reminded that as women’s lives change, so too will their decisions around sexual and reproductive health. A woman can go through several different birth control options throughout the reproductive life cycle, depending on what she has access to, her lifestyle, the level of risk she is willing to take on, her changing preferences and her biology.

There is no product that will be right for all women, and this highlights the necessity of developing a range of accessible options and to working with young women to figure out what they can and will use as HIV prevention, and of ensuring that young women have access to all prevention options, even if they won’t all choose to use them.

In September 2015, world leaders adopted the 2030 Agenda for Sustainable Development, which includes a set of 17 goals interlinked to end poverty, fight inequality and injustice, and tackle climate change by 2030. Preventing new HIV infections among women through an expanded range of prevention options has the potential to have an incredible impact on the Sustainable Development Goals, from addressing food security, advancing gender equity, building healthier communities — all contributing to economic growth.

Increasing the number of women who are living without HIV, and who have control over their sexual and reproductive health and rights, can face fewer challenges in going to school or work, caring for their children, giving birth to HIV negative children, and facing fewer strains on resources, which is a critical step towards gender equality.

Developing and providing women with access to and knowledge about tools to make decisions about their sexual and reproductive health, possibly with and possibly without negotiation with their partners, is an incredible step towards gender equality. This International Women’s Day, the recent trial results are cause for celebration and call for the redoubling of advocacy efforts to ensure that safe and effective products make it to the hands of the women who need them and that research and development continue to increase the number of options available to all women to prevent HIV infection.


Shayna Buhler
 is a Senior Program Officer with the Interagency Coalition on AIDS and Development (ICAD). ICAD provides leadership in the response of Canadian international development organizations and Canadian HIV organizations in reducing the impact of the global HIV and AIDS epidemic.

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This blog is part of an International Women’s Day series produced by theInteragency Coalition on AIDS and Development (ICAD) in recognition of International Women’s Day 2016 (March 8). The series runs during the week of March 7, 2016 and will feature a selection of blogs written by our member and partner organizations who will share their broad range. Each provides their perspective and their insight on what must be done to achieve UN Women’s campaign of “Planet 50-50 by 2030: Step It Up for Gender Equality” as we embark on the race to meet our 2030 Goals for Sustainable Development.

Disclaimer: The views and opinions expressed in this blog series are those of the authors and do not necessarily reflect those of ICAD.