UCSF helped create a theater workshop for HIV-positive women suffering from PTSD and other forms of trauma. From left to right: theater participant Cassandra Steptoe, UCSF Professor Edward Machtinger & Rhodessa Jones of the theater group Cultural Odyssey. (Photo: UCSF).

This article was originally published on KQED’s State of Health blog.

Scientists know that women who have been traumatized or suffer from post-traumatic stress disorder (PTSD) are more likely to be at risk for HIV.

Now two new studies published in the journal AIDS and Behavior show that HIV-positive women suffer disproportionately high rates of trauma and PTSD. In a vicious circle, the high rates of trauma lead to increased risk of further spreading the illness.

In the first study researchers at U.C. San Francisco and Harvard Medical School looked at nearly 6,000 HIV-positive women. They found HIV-positive women were twice as likely to experience violence from their partner and five times more likely to suffer from PTSD than the national average.

In the second smaller study of 113 HIV-positive women, researchers reported that women experiencing ongoing trauma were about four times more likely both to have unsafe sex and to fail taking antiretroviral medications correctly.

That combination of skipping medication and unsafe sex leads to alarming public health consequences, says lead author Edward Machtinger, who directs UCSF’s Women’s HIV Program. He said if a woman isn’t taking HIV medications properly, she is more infectious.

“And if that person is having unprotected sex with HIV-negative partners,” Machtinger told me, “that is a situation that predisposes further transmission more than any other. The conclusion that we come to is that trauma fuels all aspects of the HIV epidemic among women.”

Machtinger said the key to curbing this epidemic is to address the trauma, not just the illness. “Our hope is that screening for trauma and intervening for trauma becomes a required aspect of the care for all women with HIV, along with blood tests and HIV medication adherence.”

Machtinger says the Women’s HIV Program (WHP) has turned to an innovative approach to intervention–theater. In a unique collaboration between the WHP and the San Francisco group Cultural Odyssey, HIV-positive women go through a year-long workshop. At the end of the year, the women disclose their HIV status publicly in a performance called Dancing with the Clown of Love.

“None were completely out about their diagnosis prior to participating, and now all of them are out publicly – to their families, and friends and entire community,” said Machtinger. “The women who participated described it as transformative.”

Cassandra Steptoe is one of those women. Steptoe was diagnosed with HIV in 1987, a time when she was working as a prostitute to support her own heroin and cocaine addictions, as well as her then-husband’s addiction. She didn’t reveal that she was HIV-positive for almost two decades. Steptoe says she was frequently beaten, both by her husband and her clients.

“At that point I felt that my life was useless,” said Steptoe. “I didn’t have no hope. Because 1987, when I was diagnosed, there was a lot of people dying in the circle of men and women that I would hang around with. They was dying. And so I just waited around, wanting to die and wondering when I was gonna die. But in the process I was still shooting dope, I was still selling my body, I didn’t care about life, period. I lived in a dark world.”

Steptoe lived on the streets for much of the next two decades. Then in 2001 she was sent to a drug treatment center in San Francisco. That’s where she met Machtinger, and was introduced to the HIV-positive women’s theater workshop. In the workshop, HIV-positive women like Steptoe write and perform their traumatic personal stories, under the guidance of Cultural Odyssey’s Rhodessa Jones.

“Rodessa has a way of having us write our feelings about our past out — the dark places that we wouldn’t go into and we wouldn’t talk about,” Steptoe said. “But because of the safety and trust in this group, I was able to go deeper into my past and write about some things that I didn’t tell nobody. And that freed me a lot about my past.”

Steptoe did her first series of live performances in 2010. She said she now takes all her antiretroviral medications, and works with other HIV-positive women in the community to overcome the shame associated with the virus. “There’s no reason to feel shame. It’s not a crime to be HIV-positive–it’s a health condition. And you know what? We not alone. We in this together. Let’s have safe sex. We don’t need to keep spreading it. Let’s be open about this.”

Watch Cassandra Steptoe’s performance about her HIV status.

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Women with migraines are 2.6 times more likely to have colicky babies, according to a new UCSF study. (Flickr: London looks)

I had a 10-hour migraine yesterday. It was terrible (obviously). So I found it rather morosely coincidental when halfway through the day, as I lay on the couch feeling sorry for myself, I checked my email and noticed this press release from the University of California, San Francisco: “Babies’ Colic Linked to Mothers’ Migraines.”

Colic is excessive crying in a baby that isn’t caused by a medical problem. My mother used to get migraines, and I was a colicky baby. I definitely get migraines, so if I have a baby, will she have colic? According to the results of the UCSF study, I’m about two-and-a-half times more likely to have a baby with colic than a woman who doesn’t suffer from migraines. Great. Starting a family one day suddenly seems even more daunting.

“I hope no one will alter their family-planning based on these study results,” laughed lead author and UCSF child neurologist Amy Gelfand over the phone in response to my colicky baby concerns. “Remember that colic is a time-limited phenomenon, babies do grow out of it by three months of age, typically. And if they do go on to develop migraines later in life, we do have effective treatments to help.”

That’s comforting. But why is there a link between colicky babies and migraines?

Read more on KQED’s State of Health blog.

Patricia Davis straightens a client's hair at her salon in Oakland. (Photo: Shuka Kalantari)

Oakland salon owner Patricia Davis leans over her client to get a better angle on the flat iron that’s clamped to her hair. Steam rises up from the woman’s hair and a spinning fan above spreads the steam throughout the room and out the windows. Sometimes, formaldehyde gas, a known carcinogen, is in that steam. And if that product is called “Brazilian Blowout,” then formaldehyde is definitely in there … despite the fact that it says “formaldehyde-free.”

In a recent settlement agreement with the California Attorney General, GIB, the company that makes the popular Brazilian Blowout hair straightening treatment, will drop the claim that they’re formaldehyde-free. They also have to add a caution label to their product.

“California laws protect consumers and workers and give them fair notice about the health risks associated with the products they use,” said Attorney General Harris. “This settlement requires the company to disclose any hazard so that Californians can make more informed decisions.”

But salon owner Davis says the controversy is overblown. “I think it’s much ado about nothing,” she says as she continues flat-ironing her client’s hair.

Read more on KQED’s State of Health blog.

A Burmese family rest in a temporary camp on the Thai/Burma border. (Rusty Stewart: Flickr)

Some Burmese refugee children heading to the U.S. have toxic levels of lead in the blood, according to a study released this week in the journal Pediatrics. Researchers at the Center for Disease Control and Prevention measured lead levels in Burmese children living in Thai refugee camps. They found that children under age two were at highest risk. Fifteen percent of them had lead poisoning, as did five percent of all children. That compares to less than one percent of all children in the U.S. [PDF] But Burmese refugee children who resettle in Oakland may not be very safe against lead exposure, once they arrive here.

Joan Jeung, a pediatrician who works with Burmese refugees at Asian Health Services in Oakland, was quick to identify the problem. “Moving from a low-income area and conditions of political oppression in Burma, to low-income areas here in the United States where environmental lead levels area still high, I think the quickest link to find is poverty.”

Read more on KQED’s State of Health blog.

Post Traumatic Stress Disorder is a major issue for female soldiers returning from the wars in Iraq and Afghanistan. (Chris Hondros: Getty Images)

The number of women in the military has doubled in the past decade. According to the Pentagon, about 10 percent of the 2.2 million troops who served in Iraq and Afghanistan have been women.

These women are more likely to be in the line of fire than those serving in previous wars — and that means they’re also at a higher risk of having depression, Post-Traumatic Stress Disorder (PTSD) and other mental health problems. Researchers at the University of California San Francisco and the San Francisco VA Medical Center (SFVAMC) wanted to see if gender played a role in mental health outcomes after soldiers were exposed to combat-related trauma. In a recent study, researchers looked at 7,251 veteran responses to different kinds of combat exposure: witnessing killing, sexual trauma, killing in war, and injury. They found that PTSD rates are the same among male and female vets of the Afghanistan and Iraq wars, with about 18 percent of both groups screening positive for the disorder.

Read more on KQED’s State of Health blog.

(Courtesy: Kaiser Family Foundation)

The video, “La Reforma Del Cuidado De La Salud Llega al Público,” is narrated by Isabel Gómez-Bassols, a psychologist and host of the show “Doctora Isabel, el Angel de la Radio.” While Latinos account for 16 percent of the U.S. population, here in California, they make up 38 percent of the population — and about one-third of them don’t have health insurance.

Read more on KQED’s State of Health blog.

Occasional marijuana use isn't bad for the lungs, according to a UCSF study. (Chuck Grimmett: Flickr)

Smoking an occasional marijuana joint isn’t bad for your lungs. In fact, lighting up once in a while may increase lung function, according to researchers at University of California, San Francisco.

The UCSF study, released today, looked at the pulmonary functions of 5,000 men and women over a 20 year period. It found that those who smoked marijuana for up to seven “joint-years” had a slight increase in lung capacity. What the heck is a “joint-year”? It’s defined as an average of one joint a day for seven years, or about one a week for 49 years.

But that doesn’t mean that marijuana smokers have the lung capacity of “The Thing” in Fantasic Four. The change in lung capacity doesn’t have much of a functional impact, according lead author and UCSF professor Mark Pletcher. “The amount of lung volume that is extra in marijuana smokers at that level versus non-marijuana smokers is very small.”

Read more on KQED’s State of Health blog.

Over 130,000 Vietnamese people relocated to Santa Clara County since the end of the Vietnam War. (Photo: Monica M. DaveyAFP/Getty Images)

The first wave of Vietnamese refugees came to the San Jose area in the 1980s, after the fall of Saigon. Now San Jose has the largest Vietnamese population of any city in the country. Santa Clara County is also second largest of any county in the U.S., after Orange County.

Today, Santa Clara released its first-ever Vietnamese health assessment to get a better understanding of this growing population’s health needs.

Health Officer Martin Fenstersheib says Santa Clara County didn’t have a good understanding of what the health needs of its Vietnamese community were prior to this report.

“We had a great interest in doing this because we tend to lump all of our statistics together, especially in the Asian, Pacific Island community. So things are reported that way also.”

Read more on KQED’s State of Health blog.

It looks like they did a pretty good job. The number of registered nurses nationwide skyrocketed in the past decade, according to a study released in today’s Health Affairs. Recent grads aged 23-26 increased by 62 percent. There hasn’t been a spike in nursing grads like this in the U.S. since the 1970s.

And it’s no different in California. Nursing school enrollments have doubled in the past decade, says Joanne Spetz, a nursing professor at UCSF and co-author of a UCSF report looking at California’s nursing forecast. The report shows that in the past five years, the number of California nursing graduates has doubled. Spetz says that’s because California also made huge efforts to recruit nursing students, like implementing accelerated degree programs.

Read the rest on KQED’s State of Health blog.