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Family Health and Relationships Newsletter
October 1, 2012
In this Issue
• Improved HIV Care Boosts Life Expectancy at Clinic, Study Found
• Simple Test Might Predict Whether Some Pregnancies Succeed
• Can Facebook Prolong Post-Breakup Pain?
• Bride's Wedding Jitters May Forecast Stormy Marriage

Improved HIV Care Boosts Life Expectancy at Clinic, Study Found

Analysis showed how multifaceted treatment can improve health and extend survival

FRIDAY, Sept. 28 (HealthDay News) -- Treatment advances, a multifaceted treatment approach and federal funding helped improve care and outcomes for all HIV patients at an inner-city clinic in Baltimore, including those often hit hardest by the disease, researchers report.

The 15-year (1995 to 2010) analysis of patients at the clinic serving primarily poor, black patients with high rates of injection drug use showed what state-of-the-art HIV care can achieve with appropriate support, according to the study published online Sept. 28 in the journal Clinical Infectious Diseases.

"Contemporary HIV care can markedly improve the health of persons living with HIV regardless of their gender, race, risk group or socioeconomic status," study author Dr. Richard Moore, of Johns Hopkins University in Baltimore, said in a journal news release.

Health care challenges for HIV patients include lack of access to treatment, failure to stay in care and poor adherence to treatment guidelines. With funding from the federal government's Ryan White Program, the clinic in this study was able to provide care for patients who might otherwise have slipped through the cracks, the study authors pointed out in the news release.

The Ryan White Program, created in 1990, provides services for people with HIV/AIDS who can't afford care.

The Baltimore clinic offers multiple levels of care and support to address HIV patients' complex needs, including primary care, substance abuse and mental health care, and supportive care such as case management, nutrition, emergency services and transportation.

As a result of the multilevel care offered at the clinic and advances in antiretroviral drugs, HIV patients at the clinic now have a life expectancy of 73 years, the study authors found. This life expectancy was the same across all demographic and behavioral risk groups.

But the researchers noted that the results included only those patients who were "engaged in care" -- in other words, those who showed up for lab testing and follow-up appointments.

"Getting people living with HIV engaged in care is critical to their well-being," Moore said.

More information

The U.S. National Institute of Allergy and Infectious Diseases has more about HIV treatment.

Simple Test Might Predict Whether Some Pregnancies Succeed

Study supports checking progesterone levels in women with early pain, bleeding

FRIDAY, Sept. 28 (HealthDay News) -- Measuring progesterone levels in women with pain or bleeding during early pregnancy may help determine whether or not the pregnancy is viable, a new study says.

A viable pregnancy means that there is a reasonable expectation that it will result in a live birth. Progesterone is a hormone that plays a key role in pregnancy.

About one-third of women experience vaginal bleeding or pain in early pregnancy. Ultrasound is used to determine pregnancy viability but this test can sometimes be inconclusive, the authors of the new study pointed out.

Along with Dutch colleagues, researchers at the University of Birmingham in England analyzed the findings of 26 studies involving more than 9,400 pregnant women. Seven of the studies included women with pain or bleeding and an inconclusive ultrasound result, and 19 studies included women with pain or bleeding and no ultrasound.

The analysis showed that a single low progesterone measurement for women with pain or bleeding in early pregnancy can differentiate between a viable and non-viable pregnancy when an ultrasound result was inconclusive.

The progesterone test was less accurate in predicting pregnancy viability in women with pain or bleeding who did not have an ultrasound, according to a university news release.

The study was published online Sept. 28 in BMJ.

Low progesterone levels may occur in some viable pregnancies and the progesterone test should be used with another test to increase its diagnostic accuracy, the researchers concluded.

Because the new study was an observational review of prior studies, it did not conclusively prove that the progesterone test is a viable option for expectant mothers.

More information

The March of Dimes has more about vaginal bleeding during pregnancy  External Links Disclaimer Logo.

Can Facebook Prolong Post-Breakup Pain?

Those who 'stalk' their ex electronically show more longing, less personal growth, study says

TUESDAY, Sept. 25 (HealthDay News) -- Although Facebook can help loving couples feel connected 24/7, there's a downside to all that connectedness when the relationship sours, a new study contends.

Using Facebook to track an ex may seriously impede the brokenhearted's ability to heal and move on, said study author Tara Marshall, of the psychology department at Brunel University's School of Social Sciences in Uxbridge, England.

"People who engaged in Facebook surveillance of their ex-partner, [meaning] people who more frequently looked at their ex-partner's Facebook page and friends list, reported delayed emotional recovery after a breakup compared to people who engaged in less surveillance," Marshall said.

"They reported greater current distress over the breakup, more negative feelings toward the ex-partner, such as jealousy and hostility, more sexual desire and longing for the ex-partner, and less personal growth," she said.

Facebook, the world's biggest social-networking site, has more than 900 million users, Marshall noted. Prior research has indicated that one-third of them use the site to monitor the activities of ex-partners.

Such continued "friendship" enables former lovers to keep tabs on each other via status updates, wall posts and photos. And depending on an individual's privacy settings, even an "unfriended" ex may be able to glean information from public posts and the pages of mutual friends.

For the study, published online Sept. 4 in the journal Cyberpsychology, Behavior and Social Networking, Marshall enlisted more than 450 Facebook users to complete an online survey designed to assess their emotional state and Facebook usage patterns post-breakup.

Most were woman, and 87 percent were American. Nearly two-thirds were in college, and one-third had completed high school. Although nearly half were single when surveyed, all had experienced at least one breakup with a romantic partner who also had a Facebook account at the time.

Based on their responses, Marshall determined that engaging in Facebook surveillance of an ex seemed to delay the rejected person's emotional growth and recovery in ways that offline contact didn't.

In sum, the greater the Facebook spying, the greater the heartbreak, she said.

But other experts aren't convinced of that.

Eli Finkel, associate professor of social psychology at Northwestern University in Evanston, Ill., said these findings shouldn't drive anyone to hit the "delete" button just yet.

"The author wants to say that jumping on Facebook makes a person fresh from a breakup more distressed, but this research really doesn't prove that," he said. "What seems more plausible to me is that people who are already especially distressed by a breakup might become obsessive and stalker-ish, and therefore go and try to find out about their ex partner on Facebook."

"Or it may be that it becomes a vicious cycle, with distress first driving an ex to Facebook, and then what they find on Facebook makes them more distressed," Finkel added.

It's possible that what Facebook has done is not change the motivation to stalk an ex "but facilitated the ease with which we can do so," he said. "But really, there's nothing in this work that proves or disproves any of that."

Jeffrey Hall, assistant professor of communications at the University of Kansas, in Lawrence, agrees.

"I don't think this study establishes that logging on to Facebook is a more problematic interpersonal process than what people often did before Facebook when they were in post-breakup distress, which was to seek out information from friends and friends of friends," he said.

"While Facebook might be a unique mechanism for surveilling somebody, this doesn't show that our motivations to go there for information are Facebook-specific, or that once there, you become more distressed than you already were," Hall said.

More information

For more on social networking, visit the Harvard Business School  External Links Disclaimer Logo.

Bride's Wedding Jitters May Forecast Stormy Marriage

Women hesitant to marry have much higher rate of divorce, study finds

SATURDAY, Sept. 22 (HealthDay News) -- Women having second thoughts about getting married should trust their instincts, according to new research.

Psychologists from the University of California, Los Angeles found that women's uncertainty before marriage is a predictor for divorce and marital dissatisfaction in years to come.

"People think everybody has premarital doubts and you don't have to worry about them. We found they are common but not benign," study lead author Justin Lavner, a doctoral candidate in psychology, said in a university news release. "You know yourself, your partner and your relationship better than anybody else does. If you're feeling nervous about it, pay attention to that. It's worth exploring what you're nervous about."

For the study, published online in the Journal of Family Psychology, the psychologists surveyed nearly 250 couples a few months after they got married. The husbands were an average age of 27 when they got married; the wives' average age was 25. Follow-up surveys were conducted every six months for four years.

At their first interview, 47 percent of the husbands and 38 percent of the wives admitted to having doubts about getting married. The researchers noted, however, the women's reservations were a better predictor of trouble to come in the marriage.

The study revealed that 19 percent of the women who said they had doubts about getting married were divorced four years later, compared with 8 percent of those who did not have doubts. Meanwhile, 14 percent of the husbands who reported marriage doubts were divorced four years later, compared with 9 percent who said they did not have worries about getting married.

The researchers noted doubt was a big predictor of marital discord regardless of other factors, such as whether the couple lived together before they were married, how difficult their engagement was or whether they came from divorced families.

The study revealed that 36 percent of couples had no doubts about marriage beforehand. Of these couples, 6 percent got divorced within four years. In marriages where only the husband had doubts, 10 percent got divorced. When only the wife had doubts, the divorce rate jumped to 18 percent. Doubts on both their parts was linked to a 20 percent divorce rate.

"Newlywed wives who had doubts about getting married before their wedding were two-and-a-half times more likely to divorce four years later than wives without these doubts," Lavner said. "Among couples still married after four years, husbands and wives with doubts were significantly less satisfied with their marriage than those without doubts. What this tells us is that when women have doubts before their wedding, these should not be lightly dismissed."

Don't assume that love is enough to overpower your concerns, he added. "There's no evidence that problems in a marriage just go away and get better. If anything, problems are more likely to escalate," he said.

The study authors said that couples having doubts before marriage should talk about their concerns and try to work through them before they walk down the aisle.

More information

The U.S. National Institutes of Health provides more information on divorce.

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