Newly divorced middle aged women are more vulnerable to contract HIV and other sexually transmitted diseases, according to Christopher Coleman, PhD, RN, associate professor at the University of Pennsylvania School of Nursing, because they tend to let their guard down with new sexual partners and avoid using protection since they are unafraid of getting pregnant. Additionally, as aging occurs, physiological changes due to menopause such as the thinning of vaginal walls make it more susceptible for a woman to contract a virus. Medications that would be used to treat an STD or HIV become hard for a woman to tolerate because an aging body metabolizes medications differently.
"There is a knowledge gap with women knowing what the physiological changes associated with menopause are," said Dr. Coleman.
"There is very little research on this subject and society and the government don't talk about it, but these high risk sexual behaviors need to be addressed because the rate of HIV positive middle aged women is increasing."
The great paradox of global health efforts is that regions of the world most plagued by poverty, poor infrastructure and rampant disease are often the most difficult to support. Now, scientists have demonstrated that confronting several diseases at once can make the most of thinly-stretched donor dollars and national health care budgets, to help to save lives. A new analysis published this week in the open-access journal PLoS ONE (Feb. 3, 2012) (Link to the paper will be posted when it is available from the journal PLOS One online) focused on a combined public health campaign in Western Province, Kenya led by the Swiss-based company Vestergaard Frandsen, the Kenyan Ministry of Health and the U.S. Centers for Disease Control and Prevention (CDC). The analysis looked at the cost effectiveness of simultaneously confronting the problems of HIV/AIDS, malaria, and diarrhea caused by waterborne pathogens. The researchers used the results of the campaign to build an analysis of the impact such efforts could have if carried out more broadly. The analysis found that for every 1,000 people reached through such campaigns, some $16,015 in health care costs would be avoided and more than 16 lives would be saved. As a result, local populations would gain hundreds of years of healthy life. The cost would be $32 per person, but averted health care costs would be greater, leading to the net savings.
"That's a very attractive deal," said James G. Kahn, MD, MPH, a professor of health policy, epidemiology and global health at the University of California, San Francisco (UCSF), who is the senior author on the PLoS ONE study and led the economic aspect of the research.
"This kind of a campaign is an excellent use of global health dollars." Health care workers distributed
"CarePacks" at 37 locations in Kenya over seven days in 2008. These packs contained insecticide-treated bed nets to reduce the spread of malaria, water filters for preventing diarrheal diseases, and condoms.
Some 47,000 people ultimately received the packs, which also contained educational information as incentive for local residents to participate in a voluntary HIV testing and counseling program. By combining efforts to reduce the burdens of malaria, diarrhea, and HIV/AIDS, the program efficiently stretched the impact of its funds, Kahn said, which is important in areas where per capita health expenditures may amount to little more than a few dollars a year. Combining these public health efforts into one program also saved a great deal of time, he added.