School of Public Health 
Scarletter
December, 2018
Scarlet Musings
Dear Readers,

Last week, the Rutgers School of Public Heath commemorated the 30 th World AIDS Day with its second annual community forum. At the forum, A ssistant Commissioner for the Division of HIV, STD, and TB Services at the New Jersey Department of Health, Christopher Menschner, announced Governor Murphy’s initiative to end new HIV infections in New Jersey by 2025. As noted in the statement, the Rutgers School of Public Health will partner with the New Jersey Department of Health and other organizations to end this epidemic. Such efforts are in line with the UNAIDS 90-90-90 initiative and the plan adopted by New York to end the AIDS epidemic.

We are proud to be playing such a critical role in this effort to combat this disease, which continues to be fueled by stigma and misinformation.

The forum’s topic this year was “HIV and Aging,” and was headlined by some of the nation’s leading HIV/AIDS researchers and advocates. So too, POZ Magazine recently honored the top 100 people living with HIV who are 50 and over. One of those honored by POZ was our own Dean’s Advisory Council Member, Bruce Richman, who is the founding Director of the Prevention Access Campaign and the U=U movement. Through our own work at the Center for Health identity Behavior & Prevention Studies (CHIBPS) and in our own personal lives, we both have come to know many remarkable individuals who are older adults living and thriving with HIV.

In the United States and globally, the population of people living with HIV/AIDS (PLWHA) continues to age. According to the U.S. Centers for Disease Control and Prevention (CDC), nearly half of PLWHA in the United States are over the age of 50, a proportion expected to rise to 70% by the year 2020. As older individuals enter the later stages of their lives, health challenges naturally emerge—but for older PLWHA, the aging process may be complicated by additional physical and mental health burdens and social conditions which perpetuate stigma towards both aging and HIV. In addition to health-related conditions, older PLWHA may also have fragile social networks, ongoing trauma associated with HIV/AIDS, and increased experiences of stigma, confusion, and uncertainty about what the future may hold and for these who are also members of the LGBT population or the African American population social conditions are worsened by experiences of discrimination that permeate the lives of both sexual and racial minorities in the United States, particularly under the hateful leadership of Donald Trump.

Despite these myriad challenges and experiences, it is imperative that we also recognize that older PLWHA have not only survived but thrived. For those diagnosed in the first decade of AIDS, the prospects of aging with HIV were an unlikely reality. Yet after nearly 4 decades and some 700,000 deaths in our country a small proportion of those diagnosed in the epoch of little hope carry on. And many have thrived.

This generation of warriors have come to be known by some as the AIDS Generation and Long Term Survivors (albeit the first generation of survivors given there is no cure in sight), many of whom were activists in the early days of AIDS fighting for their lives through organizations such as ACT-UP and nowadays have fashioned a new set of initiatives including Let’s Kick ASS ( AIDS Survivors Syndrome) to bring light to their present day realities. These brave individuals who are unsung historical figures have demonstrated grit, fortitude, and determination, which has empowered many of them to adapt to different situations and confront these challenges head-on. Above all, they are resilient.

Resilience is the ability to bounce back from difficult experiences and in the context of the AIDS Generation, resilience can take on many manifestations:
  • It is the experience of attending weekly ACT UP meetings in the 80’s and 90’s despite the shrinking number of attendees because other activists and community members were dying of AIDS-related complications.
  • It is the emotional process of burying a friend/loved one on Tuesday and going back to work on Wednesday.
  • It is occupying the FDA headquarters to demand approval of and access to medications proven to be effective in managing HIV/AIDS.
  • It is the ability to navigate various medical, housing, and economic assistance programs to ensure access to life-saving services.
  • It is the self-discipline and commitment to taking multiple pills—sometimes more than once a day to ensure viral suppression and management of other co-morbid health conditions.
  • It is the process of documenting and sharing stories of survival while navigating the complex realities of living with HIV/AIDS throughout multiple decades of life.

Ultimately for many of the older PLWHA resilience is about going on with one’s life without any assurance that there will be a future. It is as one told us about “being one step ahead of HIV,” and it is a about determination when the odds are stacked against you.

The first gen of older PLWHA who have lived with the virus for decades have been through many of the aforementioned experiences, and thus are the very definition of resilient. While their resilience does not shield them from these stressors all-together, it empowers them to manage and push through the hard days while also celebrating the good ones.
Whether they are still involved in ACT UP, run non-profits or support groups for other PLWHA, are happily married, or are enjoying a well-deserved retirement, members of this community have thrived despite the sometimes-harsh realities they have faced.

In three years, we will head into the fourth decade of the epidemic. While we have come far in combatting this insidious virus and know substantially more than we did in 1981, there is still a long way to go in bringing an end to AIDS in our country and around the world. We need to use the tools at our disposal and battle the stigma that continues to fuel the re-emergence of this disease.

We must call upon the skills, knowledge, and life experiences of older PLWHA who are paving the way for a new generation of survivors to learn and grow from past experiences with the hope of adapting new processes to successfully age with HIV/AIDS. We need to work with them to adapt our biomedical, behavioral and policy tools to bring an end to the epidemic so that no one has to grow old with this disease. And in doing so we will celebrate and honor those who are aging with HIV/AIDS and remind society that they continue to be highly relevant, dynamic, vibrant, and above all, a resilient part of our population.

As we commemorate World AIDS Day let us also honor the memories of the 35 million who have died from AIDS, some of those individuals whom we have known and loved.


Perry N. Halkitis PhD, MS MPH
Dean and Professor, Rutgers School of Public Health

&

Kristen D. Krause MPH
Manager, CHIBPS
PhD Candidate, Rutgers School of Public Health
"Keeping the Public in Public Health"
Ending HIV Infection by 2025
The  Rutgers School of Public Health has proudly partnered with with the New Jersey Department of Health to end the HIV epidemic in New Jersey by 2025. As a first step toward ending the epidemic, the New Jersey Department of Health is joining the Rutgers School of Public Health and more than 780 organizations across the nation to support the  Undetectable = Untransmittable (U=U) campaign.
"The Department is proud to collaborate with the Rutgers School of Public Health to spread awareness about the U=U science and will encourage stakeholders and other state agencies to help us promote this campaign,” said Dr. Shereef Elnahal,Commissioner, New Jersey Department of Health.
HIV & Aging
Rutgers School of Public Health and the Rutgers School of Nursing hosted their second annual World AIDS Day Commemoration Community Forum on November 30, 2018 in Newark, NJ. This year’s topic was HIV & Aging and the program explored the complex social, medical, and psychological needs of the aging HIV-positive population and examined models of strength and resilience that define them.
Opening Remarks
Perry N. Halkitis, PhD, MS, MPH, Rutgers School of Public Health Dean, and Suzanne Willard, PhD , Associate Dean for Global Health at the Rutgers School of Nursing, welcome participants. Patricia Fitzgerald-Bocarsly, PhD, Provost, Newark for Rutgers Biomedical and Health Sciences, tenured professor and vice-chair for research, Department of Pathology, Immunology and Laboratory Medicine at New Jersey Medical School, provides opening remarks on HIV/AIDS research and advances over the past 30+ years.
Keynote: HIV & Aging - Where are We Now?
Jesse Milan, Jr. JD , President & CEO of AIDS United, a national organization focused on ending the HIV epidemic in the U.S., provides the keynote address.
Panel: Psychological Well-being - Challenges and Resilience
Mark Brennan-Ing, PhD , Senior Research Scientist at the Brookdale Center for Healthy Aging at Hunter College, moderates a panel on psychological well-being for those living and aging with HIV and AIDS, with:
  • Paul Duberstein, PhD, Chair, Department of Health Behavior, Society, and Policy, Rutgers School of Public Health
  • Monica Rivera Mindt, PhD, President of the Hispanic Neuropsychological Society (HNS), Professor of Psychology, Fordham University
  • Kristen D. Krause, MPH, Manager, CHIBPS, PhD Candidate, Rutgers School of Public Health
Panel: Healthcare Delivery & Service Utilization Addressing the Complex Needs of Older PLWHA  
Peter Oates, RN, MSN . Director of Health Care Services, François-Xavier Bagnoud Center, Rutgers School of Nursing, moderates a panel on healthcare delivery and services for older people living with HIV/AIDS (PLWHA), with:
  • Jeffrey Kwong DNP, MPH, Professor and Associate Dean of the Division of Advanced Nursing Practice, Rutgers School of Nursing
  • Gary Paul Wright, Executive Director and co-founder, African American Office of Gay Concerns
Closing Remarks
Christopher Menschner, MSW, MA , Assistant Commissioner for the Division of HIV, STD, and TB Services, New Jersey Department of Health, provides closing remarks.
The Rutgers School of Public Health would like to recognize and thank our partners at Gilead, Rutgers Biomedical Health Sciences, and conference participants for a successful and meaningful event.
Research
Phthalates Exposure Linked to Speech Delay
Pamela Valera, PhD, MSW, assistant professor of urban public health and social and behavioral health sciences, has co-authored a study examining the impact of negative media portrayals of black men on police violence and behavior. The study found that negative media portrayals do in fact impact how police treat black men in the United States.
Paradigm for Managing HIV-Related Pain in Older Adults
Perry N. Halkitis, PhD, MS, MPH , Dean and Director of the Center for Health Identity Behavior & Prevention Studies, along with colleagues, examine the relationship between socioeconomic status and depression in gay, bisexual, and other young men who have sex with men (YMSM), in latest study. They found that YMSM reported substantial financial hardship and those who were more gay-identified had fewer material resources. Fewer material resources and internalized homophobia were both associated with higher odds of depression.
Injuries and Costs Associated with Young Workers in Career-Technical-Vocational Education
Derek Shendell, DEnv, MPH, associate professor of environmental and occupational health, along with colleagues, has conducted a study that suggests there are more career-technical-vocational education (CTE) injuries among school districts with lower per pupil spending (PPS) than among school districts with higher PPS over a long time period.
Community Health and New Jersey Ports
Researchers team up with Bayonne, Elizabeth, and Newark community members to provide scientific evidence that heavy truck traffic impacted a neighborhood’s air quality and compromised health.
For decades, heavy diesel trucks taking cargo from container ships at the Port Newark-Elizabeth Marine Terminal used a residential street in Elizabeth to avoid the tolls between Exits 13 and 13A on the New Jersey Turnpike. The trucks also routinely idled on the street awaiting their next load. Their route along the narrow, two-lane First Street took them past many homes, two schools, a child care center and an athletic field, prompting concern that the community’s rising rates of asthma were connected to the diesel exhaust.

In an effort to improve a ir quality , Rutgers School of Public Health and  Environmental & Occupational Health Sciences Institute researchers, led by Robert Laumbach, MD, MPH , teamed up with New Jersey community members to ban heavy diesel trucks, carrying  Port  Newark-Elizabeth Marine Terminal cargo, from using and idling on local residential streets.
Perspective: Protecting Youth from Tobacco
Cristine Delnevo, PhD, director, Center for Tobacco Studies at the Rutgers School of Public Health and co-leader, Cancer Prevention and Control Research Program at the Rutgers Cancer Institute of New Jersey, provides perspective on the FDA's recent announcement to revisit policies that restrict access newly to regulated non-combustible tobacco products, electronic nicotine delivery systems, and e-cigarettes.
BAD NEWS: You don't get an extra hour of sleep!
Despite the common misconception, you don’t actually get an extra hour of sleep from changing the clocks back.
Helmut Zarbl, PhD , director of the Rutgers Environmental and Occupational Health Sciences Institute  and chair of the Department of Environmental and Occupational Health, an expert in circadian rhythm and its influence on sleep-wake cycles, hormone release, eating habits and more, explains how daylight savings time affects our health.
Celebrating #FirstGen Students
This November, we highlighted our first-generation college students as part of the Center for First-Generation Student Success ' s National First-Generation College Celebration. B eing a first-generation college student means that you are or were the first in your family to attend college or graduate school. It also represents progress and hope for the future of your family and demonstrates resilience, persistence, and determination.

Meet some of our #FirstGen students and faculty below! 
Jonas Attilus, MD, a Rutgers School of Public Health student pursuing his  MPH  in health systems and policy at the is a first-generation college student and a "legend!"
Mark Robson , PhD , Board of Governors Distinguished Service Professor at the  Rutgers School of Environmental and Biological Sciences  and  Rutgers School of Public Health, was a first-generation student and a "proud New Jersey farmer!"
Qiana Brown, PhD, MSW, MPH, an associate professor of social work and public health was a first-generation student and "sets an example for others!"
Layla Shatursun , a Rutgers School of Public Health articulated degree BS/BA-MPH student, is a first-generation student and "proud!"
APHA 2018 Roundup!
Thank you to all of our fantastic partners in public health, alumni, students, faculty, and staff for another successful American Public Health Association Annual Meeting!

Can't wait to see everyone at APHA 2019 in Philly next year!
Marian Passannante, PhD , associate dean for educational program development and professor of epidemiology was honored with the 2018 Abraham Lilienfeld Award from the Epidemiology Section of the American Public Health Association for pedagogy, at APHA!
L eslie Kantor, PhD, MPH, chair and professor of the Department of Urban-Global Public Health, was honored with the 2018 Carl S. Schultz Lifetime Achievement Award from the Sexual and Reproductive Health Section of American Public Health Association, at APHA!
Season's Greetings
Dean Perry N. Halkitis and the Rutgers School of Pubic Health family wish you a happy, healthy, and harmonious holiday season!
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