Translator's Note: What goes, This color is my observation in the style: “I've seen or lived this”! I never injected anything but clexane into me.
What is causing deaths among HIV-positive people in San Francisco?
- Mortality Rates Have Not Decreased for People with HIV in San Francisco Since 2013
- Researchers reviewed medical records for causes of death among people with HIV
- A growing fraction of deaths result from non-HIV-related cancers and overdose.
For decades, San Francisco has been hit hard by the HIV pandemic. As a result, it has often been at the forefront of adapting models to provide HIV-related care and treatment. What happens to the HIV pandemic in San Francisco usually happens in other cities in high-income countries, so it's worth paying attention to HIV-related trends in the city.
In 2013, a consortium of organizations and citizens called “Getting to Zero - San Francisco” graduated. Its goals are to significantly reduce HIV-related deaths, new infections, and HIV-related stigma. The city has made a lot of progress since 2013, with 44% reduction in new HIV infections and 25% reduction in HIV-related deaths.
However, scientists at the University of California San Francisco (UCSF) found that “the age-adjusted overall mortality rate did not change between [seropositive people]”Since 2013. They suspect that a large proportion of deaths in the present era have arisen from complications of non-HIV-related cancers and the use of recreational substances.
To better understand the underlying problems of the death of HIV-positive people, UCSF scientists reviewed and compared health and socioeconomic information between July 2016 and May 2017 between the following two groups of people:
- HIV-positive 48 who died
- 108 HIV-Positive People Who Did Not Die
On average, participants who died lived with HIV for 20 years and their CD4 + count before death was 400 cells / mm3. In total, 90% of participants were men and 10% were women.
Results - Causes of Death
The known causes of death were as follows:
- HIV-related diseases - 27% (It's smaller…)
- Non-AIDS Cancer - 15%
- Overdose / Substance Use - 15%
- Cardiovascular Diseases - 10%
- Trauma / Accident - 4%
- Suicide - 4%
- Hepatitis B or C virus-related liver disease - 4%
- Other liver diseases - 4%
- Non-AIDS Infections - 4%
- Chronic obstructive pulmonary disease - 2%
- Kidney Disease - 2%
Compare and contrast
Scientists compared many factors between the two groups of participants and found that the following factors were more likely among people who died:
- Homelessness (a very serious problem that I have known closely and for a longer time than could be said to be “sensible”).
- Injecting drug use in homeless last year,
- Stopping ART last year ("Sing" That's me talking to you)
- Without having a partner or being single.
A closer look
Scientists also conducted a thorough review of “circumstances that may have contributed to death” among participants. They found that the following factors were major contributors:
- Substance use
- Mental ilnesess (depression, for example)
- Homeless people.
Based on their analysis, scientists recommended interventions on the following themes to reduce deaths among HIV-vulnerable people in San Francisco:
- Supporting Housing -
The house model I FACED in the 90 decade made me choose to return to the streets and would yield pages, pages, pages and pages… And I would say I saw the devil in God's house…
Although there is a supportive housing program in the city, scientists have noted that the "housing supply remains very limited." They encouraged future intervention that combined investment in supportive housing with case management.
O Smoking is associated with many injuries, including an increased risk of various cancers. Research has found that smoking rates among HIV-positive people are higher than those among HIV-negative people. Scientists mentioned the need for smoking cessation programs.
Heroin and other opioids
A Street drug injection is associated with a lot of damage. Scientists encourage the availability of treatment programs for people with opioid use disorder. This treatment has been found in other studies to reduce deaths and improve HIV-related outcomes, such as involvement in care, conquest and maintenance of viral suppression.
According to scientists, the use of stimulants (cocaine, methamphetamine) "is increasing" among gay men, bisexuals and other men who have sex with men in San Francisco. They encouraged, after research, the search for effective interventions to treat stimulant use disorder.
Bipolar disorder and schizophrenia
Scientists found that mental illness contributed to the “circumstances of death in more than one third of [participants]”. They said that schizophrenia and bipolar disorder may have made some participants more vulnerable (to suicidal ideation) Substance use, which in turn probably decreased their adherence to ART. They noted that among HIV-negative people with schizophrenia, "death from substance use outweighs suicide by its contribution to excess mortality."
Studies among HIV-negative people have found an increased risk of death in single and unmarried people. "Providing social support services can benefit particularly older people [HIV-positive people] living alone, and they may suffer the consequences of greater susceptibility to geriatric conditions," they said. like falls and cognitive problems without additional support. ”
My father - RIP - lost his life as a result of a succession of "clinical disasters such as his withdrawal from physical therapy" after a fall.
Did he die from the fall? No. But the fall determined the direction of his life based on his way of being, living, seeing life and, I think, his lack of information (he was never interested in the Internet - he said, INTRANSPONIBLE BARRIER) one thing leads to another….
Abandonment of care regarding HIV -Chiquinha - !!!
Scientists said that “retaining [HIV-positive people] on ART” remains a challenge in the US, particularly in populations with severe mental illness, substance use challenges and housing instability, with new strategies needed. Continued investment in re-engagement programs [ART] such as San Francisco's How to Zero navigation program, particularly for people missing or missing primary care appointments, can potentially improve the persistence of ART in this population. "
The present study is imperfect in design; also had a relatively small sample of people. However, scientists have taken steps to minimize the potential to draw biased conclusions when analyzing the data. The results of this study are very important because, as has been noted, issues similar to those in San Francisco are happening in other cities in high-income countries.
For the future
The scientists made the following solution-oriented statement:
“In addition to continued investment in medical interventions, implementation of comprehensive social services of known effectiveness, such as supportive housing, substance use and mental health treatment, and investment in the development of new strategies, it will be necessary to dramatically reduce preventable deaths. ”-
Translated by Claudio Souza from the original in What's causing deaths among HIV-positive people in San Francisco? De Sean R. Hosein
It is convenient to take this text to the people who put in everything a socialist bias that, a good economy in financial resources was the great consequence immediately linked to the treatment with Antiretrovirals. I have this study on Blog, it's about 2001 / 2002 and it's hard to find. There are more than four thousand texts. And it's lemon soda to get some stuff here!
And yes, it is cheaper to treat (it is expensive, as you said), and it would not be wise to murder almost one million people and still spend more on it than if you did not kill them and still be known and remembered by history, like a genocide in the name of God!
Bad publicity for God and, I feel, He is getting tired of it!
Claudio Souza (color is wine)