Pediatric Meltdown

Welcome to Pediatric Meltdown, the podcast dedicated to exploring the complexities and challenges of pediatric care. Today, host Dr. Lia Gaggino and guest speaker Dr. Marian Earls tackle the concepts of mental health competencies and integrated behavioral health. As pediatricians, it is crucial to have a multifaceted understanding of mental health and offer the necessary support to children in need. From debunking myths surrounding SSRIs to advocating for policy and payment support, Lia and Marian offer valuable insights into the integration of mental health into pediatric practice. By incorporating evidence-based therapies and working collaboratively with mental health specialists, pediatricians can effectively address mild to moderate mental health issues within their scope of practice. Pediatricians, with their long-standing relationships with families, have a unique opportunity to identify and address these issues early on. Together, we can break down the barriers and stigma surrounding mental health, ultimately improving outcomes and nurturing the emotional well-being of our future generation.        

[03:18 -19:09] Overcoming Barriers and Promoting Mental Health

• Helping pediatricians understand the tools they already have
• Recognizing activities that promote mental health, such as reading with children
• Understanding the role of psychiatrists in co-management
• Discussing the panic and misconceptions regarding mental health assessment

[19:10 - 25:21]  Collaboration and Advocacy for Improved Mental Health Services  

• Advocacy efforts by AAP at the national level to promote integrated mental health care
• Need for engaged Chapters to build relationships with Medicaid programs and private payers
• Recognition of the significant benefits of integrated care, including reduced stigma, improved access, and better outcomes
• Ability to expand capacity and reserve referrals for children with more complex needs through effective management and collaboration with schools and community mental health services

[25:22 - 33:29]  Overcoming Barriers and Promoting Mental Health

• Helping pediatricians understand the tools they already have
• Recognizing activities that promote mental health, such as reading with children
• Understanding the role of psychiatrists in co-management
• Discussing the panic and misconceptions regarding mental health assessment

[33:30 - 46:29] AAP Resources for Mental Health Support 

• Podcasts on psychopharm with experts discussing anxiety meds, SSRIs, and aggression
• Understanding and managing medications for children on psychotropic drugs
• Guidelines and resources for managing ADHD and depression
• AAP's endorsement of Glad PC for identifying and managing depression in kids

[46:30 - 51:19]  Closing segment Takeaway

Links to resources mentioned on the show

AAP Mental Health Initiatives:  https://www.aap.org/en/patient-care/mental-health-initiatives/

AAP Mental Health Practice Readiness Inventory:  https://downloads.aap.org/AAP/PDF/PracticeReadinessInventory.pdf?_ga=2.52822312.1802788953.1685034173-313239514.1676996324

Hunter and Goodie Integrated Behavioral Health in Primary Care:

https://302.buzz/PM-WhatAreYourThoughts

Youth mental health is a pressing issue that often goes untreated, but in this episode of Pediatric Meltdown, Dr. Lia Gaggino and Dr. Rich Dopp shed light on effective strategies for addressing this challenge. Dr. Dopp's expertise in treating adolescents with depressive disorders shines through as he discusses the use of SSRIs and the significance of understanding family history. The episode also highlights the importance of gathering information from multiple sources and utilizing various measures and questionnaires to assess depression in younger children. From recognizing the benefits of exercise in improving mood to discussing the importance of tailored treatment plans, they provide valuable insights for both healthcare professionals and caregivers. With practical advice and a personalized approach, this episode equips listeners with valuable insights to navigate the complexities of youth mental health.

[00:33 -14:52] The Rising Prevalence of Depression in Children and Adolescents

• The increasing incidence of major depressive episodes among youth
• The potential underestimation of depression rates in certain situations  
• The lack of access to treatment for the majority of affected youth
• The impact of social media, sleep deprivation, traumatic experiences, and negative political climates on depression rates

[14:53 - 26:17]  The Importance of Sleep for Mood  

• Sleep as a vital factor for mood regulation
• Lack of sleep as a symptom of depression
• Sleep disturbance and its impact on mental health  
• Strategies to support better sleep: removing electronic devices, reducing overhead lights, guided meditation, and breathing exercises

[26:18 - 43:30]  Tailoring Therapy to Meet Individual Needs

• Identifying goals is an important first step in tailoring therapy to meet individual needs
• Social skills and problem solving exercises can lead to early gains in functioning  
• Therapy can be tailored to an individual's interests and hobbies
• Changes in functioning can be easier to identify and foster than changes in feelings when treating depression

[43:31 - 56:11]  Benefits and Effectiveness of SSRIs 

• Proven efficacy in treating depression and reducing symptoms
• Effective in reducing anxiety symptoms in some individuals
• Can help regulate sleep patterns and improve sleep quality
• May enhance cognitive function and improve concentration 

[56:12 - 01:02:25]  Closing segment Takeaway

Links to resources mentioned on the show

AAP Guidelines for Adolescent Depression Glad PC 1 https://publications.aap.org/pediatrics/article/141/3/e20174081/37626/Guidelines-for-Adolescent-Depression-in-Primary?autologincheck=redirected

AAP Guidelines for Adolescent Depression Glad PC 2. https://publications.aap.org/pediatrics/article/120/5/e1313/71096/Guidelines-for-Adolescent-Depression-in-Primary

AACAP Facts for Families – Depression

https://302.buzz/PM-WhatAreYourThoughts

This episode of "Pediatric Meltdown" features an insightful conversation with Doctor Sandy Chung, the 2023 president of the American Academy of Pediatrics. Dr. Chung joins host Dr. Lia Gaggino to discuss the importance of investing in children's mental health. The AAP is a national organization that represents over 67,000 pediatricians and aims to promote the health and well-being of children. Dr. Sandy Chung's advocacy work through VMAP and AAP has been instrumental in shaping the discourse on children's mental health and providing access to mental health care. While policymakers need to understand the need for long-term investment in children's mental health, it is also the responsibility of every individual to prioritize mental health and create supportive environments for young people. Let us all work towards prioritizing the mental health of children and building a brighter future for coming generations.

[00:33 -18:39] Being the First Chinese American President of the AAP

• Overcoming barriers and inspiring change
• Importance of breaking stereotypes and categories  
• Encouraging individuals to pursue leadership roles
• Finding the right group of like-minded professionals

[18:40 - 27:11]  Making Mental Health Care Sustainable and Accessible  

• Implementing group therapy appointments, integrated behavioral health, brief interventions, and collaborative care to make mental health care more accessible and affordable
• The AAP is actively working on making mental health care a top child health priority and advocating for sustainable funding and support
• AAP aims to raise awareness about the value of pediatricians in early mental health intervention and promote the importance of prevention and resilience-building in children.  
•  It is crucial for individuals, government, employers, and society as a whole to prioritize and support mental health care to ensure healthy and productive adult outcomes.

[27:12 - 35:13]  Challenges in Addressing Mental Health in Healthcare

• Lack of awareness and understanding of the importance of mental health in healthcare
• The need for momentum and improvement in addressing mental health  
• The broader conversation of investing in children's well-being
• Short-term perspective in healthcare financing and the need for a long-term investment approach

[35:14 - 41:19]  Embracing Opportunities and Making a Difference in Pediatric Practice 

• Letting go of future worries: Embracing the uncertainty of life and career progression
• Seizing opportunities: The power of taking chances and making a positive impact
• Making a difference, big or small: Recognizing the potential to create change in everyday practice
• Preventing future hardships: Harnessing the experiences of pediatric care to improve outcomes for children and families 

[41:20 - 46:17]  Closing Segment Takeaway

Links to resources mentioned on the show

National Network of Child Psychiatry Access Programs – find one near you!

www.nncpap.org/map

Other episodes you may like:

https://302.buzz/LinkToAllEpisodes

112 Schizophrenia: Recognizing the Early Symptoms

  96 AAP Blueprint for Youth Suicide Prevention: A Roadmap

  91 Youth Mental Health...

https://302.buzz/PM-WhatAreYourThoughts

Unless you’ve been a victim of Healthcare Disparity and systemic racism, you may not be aware that such a thing exists, and that’s exactly why this episode of “Pediatric Meltdown” is especially important for you to hear. Host Dr. Lia Gaggino and her guest Dr. Terri Major-Kincade, discuss the structural barriers that exist in hospitals and Dr. Terri will give some practical advice on being empathetic and listening to patients' concerns. From Dr. Terri’s expertise in racial health disparities to Dr. Lia's wisdom in pediatric mental health, this episode represents a step towards understanding and addressing the root causes of these issues. It's clear that change is required to overcome the challenges in our healthcare system and provide equitable care for all. You’ll also hear about some creative ideas, everything from an Uber delivering breast milk to converting a convenience store into a Farmer’s Market.  It’s solutions like these that tell us conversations around this issue must continue and more voices need to be heard to create the momentum required for change. We must recognize that health disparities are not only a moral issue but also an economic one that affects our entire society. By working together towards an overall change, we can create an equitable healthcare system that benefits everyone, regardless of their gender, race or socioeconomic status.

[00:33 -21:44] Disparities in Infant Mortality Rates

• Infant mortality rates in certain zip codes in New York City for black infants were higher than some third world countries.
• Black women with a college degree are still two times more likely to have an adverse birth outcome compared to white women with a GED in the United States  
• Poverty and lack of prenatal care are not the only factors contributing to these disparities
• SES status (socioeconomic status) does not protect black women from experiencing adverse birth outcomes
• The way in which the healthcare system intersects with black women is a contributing factor to disparate care.

[21:45 - 37:29] Impact of Stress on Pregnancy and Childbirth  

• Women who experience chronic stress have an increased likelihood of preterm birth
• Chronic stress can lead to remodeling of the cervix and womb, causing challenges during pregnancy
• Stress during pregnancy can also increase the risk of hypertension in children  
• Normalizing the act of asking for help and saying no can help break the cycle of stress
• Chronic stress can also impact telomeres and shorten them, potentially leading to health issues

[37:30 - 50:26]  Supporting a Grieving Family

• Offer condolences and express your willingness to help
• Listen actively and without judgment
• Use the child's name and ask about their memory  
• Maintain eye contact. Let them know that you hear them, you see them
• Respect the family's wishes and boundaries, and avoid offering unsolicited advice or opinions

[50:27 - 57:21] Vision for a Better Future

• A future where conversations about race, color, and culture are unnecessary, but diversity is celebrated
• Emphasizing cultural humility can help us see people's humanity rather than their circumstances
• Allocating more resources to preventive health and normalizing mental health services can lead to significant improvements
• Partnering with communities and addressing social determinants of health can help reduce health disparities
• Recognizing our own biases and being open to learning and growth can lead to positive change for...

https://302.buzz/PM-WhatAreYourThoughts

The adverse effects of racism in healthcare have increasingly become a topic of discussion among medical professionals worldwide. In this episode of the Pediatric Meltdown, host, Dr. Lia Gaggino, is joined by Dr. Joseph Wright, Chief Health Equity Officer of the University of Maryland Medical System, to discuss the role of race consciousness in addressing systemic and structural inequities in healthcare delivery.  Dr. Wright talks about how we can no longer ignore the impact of racism on child development, which can have long-term consequences for their health and well-being. It is the responsibility of pediatricians to advocate for a society that values diversity and promotes equity, and to continue learning about the science of resilience and epigenetic impacts of racism. We must push ourselves to confront and address systemic racism in our healthcare systems, and work towards a future where all children have equal opportunities for health and success. The path towards healing and transformation begins with acknowledging the truth of our past, and taking action to create a better future. If we commit ourselves to this work, together, we can create a brighter and healthier future for all children.        

[00:33 -15:26] Racial Disparity and Inequities

• Racial disparities and inequities are deeply embedded in society and history
•  Historical events like the murder of Emmett Till and church bombings highlight the violence against black people  
• The sacrifice of children in pivotal events in the civil rights era should not be forgotten
• Tackling racial disparities and inequities requires collective effort and ongoing momentum

[15:27- 29:16]  The Impact of Adversity on Child Development  

• Personal experiences can have a significant impact on a child's development and shape their worldview
• Exposure to adverse experiences, such as racism and discrimination, can shape a child's worldview and impact their health outcomes
• Stressors can sow the seeds for chronic diseases in children who experience adversity  
•  Understanding the impact of exposure to racism and adverse experiences is crucial for child health professionals in promoting the well-being of children

[29:17-38:57]  Factors affecting childhood development

• A safe and secure community also plays a significant role in children's well-being
• Small details such as self-care products that work for ethnic hair can also impact a child's perception of inclusivity and acceptance
• Words, both big and small, can have powerful effects on a child's growth and development
• Acknowledging and addressing racial disparities in healthcare can make a significant difference in child health outcomes

[38:58- 51:07]  The significance of challenging systemic inequities in healthcare 

•  The healthcare system benefits some groups while ignoring others, impacting the health of vulnerable children.
•  All children deserve to be healthy, and efforts should be made to ensure that those who have been left out are not forgotten.
•  It is necessary to challenge structural and systemic inequities to create a level playing field for all.
• Addressing healthcare disparities requires a race-conscious approach that acknowledges the role of race and racism in differential experiences.

[51:08 - 55:46]  Closing segment Takeaway

Links to resources mentioned on the show

https://302.buzz/PM-WhatAreYourThoughts

Despite ongoing efforts to combat the opioid crisis, there has been a steady increase in the number of individuals struggling with substance use disorder. This trend has left healthcare providers and parents searching for effective ways to address the problem. In this episode of Pediatric Meltdown, Dr. Lia Gaggino and Dr. Deepa Camenga delve into the impact of the opioid epidemic on children and teenagers. They also discuss strategies for screening, identifying, and treating substance use disorder in pediatric patients. One of the primary challenges faced by clinicians is maintaining confidentiality. It is crucial to ensure that teenagers feel heard and respected, as this is instrumental in building trust and facilitating necessary treatment. Simultaneously, parents play a vital role in initiating open conversations with their children about substance use and addiction. By proactively managing addiction at an early stage, teenagers can lead healthy and fulfilling lives, thereby avoiding the long-term consequences associated with addiction. If you know anyone who might be battling with this issue, please share this very important episode.        

[00:33 -14:14] Opioid Use Disorders in the US

• Approximately 2.7 million people in the US have an opioid use disorder
• The numbers of teens and young adults with opioid use disorder are smaller but may be underestimated  
• The age of first use of opioids has risen from adolescence to just above 18 years old
• The AAP recommends validated screeners for substance use such as the S2BI, B-STAD, and CRAS

[14:15 - 27:24]  Strategies for Supporting Youth with Substance Use  

• Build a trusting relationship with the youth
• Use open-ended questions to encourage conversation
• Listen actively and reflectively to what the youth is saying  
• Avoid using judgmental language or tone

[27:25 - 38:59]  Confidentiality in Adolescent Substance Use

• Gray area in breaking confidentiality for substance use
• Breaking confidentiality for fentanyl and heroin use is necessary  
• Clinical judgment needed for vaping and cannabis use
• Be prepared for uncomfortable conversations with parents about breaking confidentiality

[39:00 - 48:06]  Resources for Treating Substance Use in Teens 

• Child psychiatry access programs are expanding across the US
• Family medicine providers can be valuable resources for treatment referrals
• The Provider's Clinical Support System offers resources on medications for opioid use disorder
• The AAP provides buprenorphine trainings and echoes for pediatric clinicians 

[48:07 - 55:45]  Closing segment Takeaway

You can reach Dr. Deepa Camenga

www.linkedin.com/in/Deepa-Camenga. 

Links to resources mentioned on the show

--AAP News Article: Fentanyl a rising threat to child health: What pediatricians should know

https://publications.aap.org/aapnews/news/22634/Fentanyl-a-rising-threat-to-child-health-What

--Resources for Parents Partnership to End Addiction drugfree.org

--Provider...

https://302.buzz/PM-WhatAreYourThoughts

Mental health is a crucial aspect of our lives, yet it's often neglected and stigmatized. Dr. Lia Gaggino and her guest, Dr. Carol Chen, will discuss the delicate subject of self-harm and how it pertains to mental health in this episode of Pediatric Meltdown. They examine the numerous causes of young people's self-injury as well as the risk factors and comorbidities that go along with it. You'll learn about Dialectical Behavioral Therapy (DBT), a successful therapy, and how parents can help their kids who engage in self-harming behaviors. For parents, educators, and mental health professionals who want to address self-harm in a helpful and constructive way with advice on coping methods, particularly for adolescents struggling with self-injurious behaviors, this episode will provide significant insights and tools. as technology develops.  However, it's crucial to be knowledgeable about mental health concerns and recognize the symptoms of distress in our loved ones and in ourselves. It is essential to establish a forum for open discussion and greater knowledge of the resources accessible. By addressing the underlying causes of self-harm, we can assist teenagers in developing healthier coping strategies and enhance their general wellbeing. So let's all work together to end the stigma associated with mental health problems, get those who need it some care, and encourage one another as we go through this healing process.

[00:33 -11:15] Blurring the Lines: The Challenge of Identifying Self-Injury Intentions

• Self-injurious behavior is an umbrella term for actions that result in physical injury to oneself, including suicidal and non-suicidal behaviors
• Non-suicidal self-injury specifically refers to behaviors where harm is intentionally caused to one's body for reasons not socially recognized or sanctioned, without the intention of ending one's life  
• Examples of non-suicidal self-injury include cutting, scratching, burning, hair pulling, and punching objects
• It's important to differentiate between suicidal and non-suicidal behaviors for proper risk assessment and intervention, but the distinction can be blurry at times.

[11:16 -20:08]  Understanding the Psychological Underpinnings of Self-Harm  

• Self-injurious behaviors have diverse reasons and psychological functions
• Some teens may self-harm to rebel or seek attention, while others do it out of desperation or depression
• Self-harm is often used as an unhealthy coping mechanism to deal with difficult emotions and to feel in control  
• Some use it to distract themselves or to feel something, as they may feel numb in their daily lives

[20:09 -28:50]  Childhood Trauma and Self-Harm: Understanding the Link and its Implications for Treatment

• Self-injury is associated with mental health disorders like anxiety, depression, eating disorders, substance use disorder, PTSD, and personality disorders
• Childhood trauma, especially sexual abuse, is linked to an increase in cutting behavior  
• Borderline personality disorder includes self-harm as one of its nine criteria
• Teenagers may exhibit borderline personality traits, including cutting, but are not diagnosed with personality disorders due to their developing personalities

[28:51-40:50]  How Medications Can Help Heal Trauma and Unleash Inner Happiness 

• SSRIs can be used to treat anxiety and depression
• Alpha agonists like Guanfacine or Clonidine can be helpful for impulsivity and trauma response
• Naltrexone can be used for repeated self-injurious...

https://302.buzz/PM-WhatAreYourThoughts

Psychological safety is crucial and cannot be undervalued in the continuing and challenging process of addressing physician burnout and prioritizing well-being. Dr. Gaggino's guest, Karen Horneffer-Ginter, PhD, discusses how organizations and institutions can start to acknowledge and deal with the systemic problems causing burnout by creating a space where clinicians can openly express concerns without fear of retaliation or condemnation. Individuals must prioritize their own self-care and wellness in addition to organizational and institutional reforms. Karen Horneffer-Ginter believes It's time to change the way healthcare is perceived and to value the humanity of people who care for others. Yes, burnout is a complex problem that calls for all hands-on deck. And Dr. Lia Gaggino and Karen Horneffer-Ginter will explore the concept of promoting a "safe-place culture" and the concept that clinicians can and should work towards creating an environment where everyone thrives and feels valued.   

[00:33 -13:55] The Evolving Landscape of Wellness and Well-being in Healthcare

• Recognizing the Neglected Importance of Mental Health in Medicine
• Wellness vs. Well-Being: Exploring the Nuances and Evolving Definitions in Healthcare  
• Adapting Language for Genuine Conversations: Addressing Burnout, Moral Injury, and Beyond
• Personalizing Wellness: Moving Beyond Individual Responsibility and Addressing Organizational Interventions

[13:56- 25:06] Challenges in Maintaining Boundaries and Well-being in Healthcare  

• Healthcare professionals find themselves sacrificing their own well-being, time, and personal needs to attend to the needs of others, going above and beyond their duties.
• A distinction between work and personal life can be facilitated through rituals, similar to Mr. Rogers taking off his jacket and putting on his sweater.
• healthcare providers MUST regularly check in with themselves, assess their own well-being, and acknowledge their vulnerabilities.   
• Healthcare professionals are often in a mindset of providing help rather than seeking it, which can hinder their own self-assessment and well-being.

[25:07 -39:20]  Organizational Interventions and Advocacy for Well-being

• Profit: The need to ensure financial sustainability and keep the lights on in the business of medicine.
• Wellness: healthcare professionals taking care of their own well-being and finding a balance between personal and professional life.  
• Organizational interventions: Call centers, hospitalist services, and neonatal nurse practitioners could address workload and provide support.
• Documentation and electronic health records: Dealing with the challenges and demands associated with electronic records and finding ways to improve efficiency and reduce administrative burdens.

[39:21- 49:53]  The Importance of Self-Care and Support 

• Prioritizing personal needs and seeking professional help when necessary
• Overcoming the stigma of seeking for professional help
• Taking intentional breaks from the work-related responsibilities with apps, family time, alone time, etc.
• Scheduling time for restorative activities and unplugging

[49:54 - 54:36]  Closing segment Takeaway

You can reach Karen Horneffer-Ginter

Linked In:  @Karen Horneffer-Ginter

Links to resources mentioned on the show

From Triple to Quadruple Aim:  

https://302.buzz/PM-WhatAreYourThoughts

If you're a parent, you know that there's nothing quite as challenging as dealing with difficult childhood behaviors. Tantrums, potty training, and biting are just a few of the challenges that parents face on a daily basis. Today, Dr. Lia Gaggino talks with pediatrician Dr. Arthur Lavin and Therapist Susan Glaser who have not only authored several books on parenting But are the hosts of the highly acclaimed podcast Parent Talk that offers practical parenting tips and expert insights on everything from child development to managing conflicts with your kids. The explain how “Potty mastery” a significant milestone in a child's development is and should be approached as a partnership rather than training. With patience and understanding, parents can celebrate their child's achievements and encourage them to reach new milestones. So, whether you're a new parent or an experienced pro, this episode is for anyone looking to become a better parent.         

[00:33 -15:50]Tips for Successful Parenting: Insights from the Parent Talk Podcast

• Designed for parents of children of all ages
• Provides practical strategies to manage conflicts with children
• Offers insights into child development to help parents understand their behavior  
• Focus on “Mastery” vs “Training” 

[15:51- 25:52]  How to Navigate Potty Training: Tips from an Expert  

• Potty mastery can be a toddler task, ideally started around age two
• Parents should set up the environment with potty seats and lots of underwear”
• Start around age two when they have enough language and physical ability?  
• Pullups are not recommended, as they are essentially just diapers without tabs
• Logical consequences reinforce potty training, such as having the child clean up their mess

[25:53- 39:43]  Toddlers and Tantrums: Understanding the Big Bang of Consciousness

• The big bang of consciousness occurs between 15-18 months of age when children begin to develop a sense of self-awareness.
• Prior to this development, infants have no sense of self and react only to their immediate surroundings.  
•  The sudden realization of self often leads to toddlers asserting their independence and saying "no" more frequently.
• Tantrums can be a common response to frustration as toddlers learn to navigate their new sense of self and assert their desires
• Parents should focus on providing a safe environment and positive reinforcement rather than punishing or shaming their child during a tantrum

[39:44 - 52:07]  Strategies for Helping Children with Autism and Preschool Biting Behaviors 

• Occupational therapy and sensory-based strategies can help address behavior issues in preschoolers
• Early intervention for children with autism spectrum disorders is crucial
• Biting is a typical behavior among preschoolers, often triggered by inner turmoil rather than an intent to hurt others
• Environment and class size can influence behaviors; lowering class size and having extra teachers can help address biting incidents
• Understanding the root cause of constant biting can help address the behavior. 

[52:08 - 57:35]  Closing segment Takeaway

Links to resources mentioned on the show

Guests Susan Glaser and Dr. Arthur Lavin co-authored two books.; 

Who’s the Boss: Moving Families from Conflict to Collaboration 

https://302.buzz/PM-WhatAreYourThoughts

When you think of HIV, do you breathe a sigh of relief thinking “well, at least we don’t have to deal with THAT anymore”?  Has it completely fallen off your radar as a medical issue that is “under control”? Well, then it’s important that you listen to this episode. Dr. Gaggino talks with Dr. Julia Rosebush and Britt Hodgdon, LCSW. Together they dive into the topic of HIV and trauma recovery. They’ll share insights on how to support individuals living with HIV and overcome stigma, as well as discussing the concept of undetectable equals untransmittable and how it impacts communication and relationships. You’ll also hear about the role of trauma recovery and somatic therapy in destigmatizing HIV and promoting self-perception. This is a powerful conversation on how to thrive with HIV and befriend it.          

[00:33 -18:52] Addressing HIV Stigma

• HIV stigma still exists despite advances in treatment and prevention.
• Stigmatizing attitudes can negatively affect the mental health and well-being of those living with HIV.  
• HIV stigma can lead to discrimination in healthcare and other areas of life.
• Advocacy and education can help decrease HIV stigma and empower those living with the virus.
• Language also plays a role in HIV stigma, and using non-stigmatizing terminology is important in reducing stigma.

[18:53- 33:22]  HIV and Undetectable Viral Load  

• Undetectable viral load means untransmittable HIV to sexual partners
• Years of research have solidified the undetectable equals untransmittable concept.
• Youth should not be afraid of transmitting HIV if they achieve an undetectable viral load.  
• Normalizing conversations about HIV and reducing stigma surrounding the virus
• Encouraging youth to prioritize their sexual health and seek appropriate medical care if needed.

[33:23 -46:07]  Communicating about HIV Status: Language and Approaches for Young People

• Importance of confidentiality and privacy when discussing HIV status
• Strategies for building trust and rapport with young people when discussing HIV. 
• Highlighting the effectiveness of antiretroviral therapy for managing HIV
• Encouraging young people to take ownership of their health and prioritize self-care.
• The role of healthcare professionals in educating and supporting young people living with HIV

[46:08 - 54:38]  Improving Conversations about Sexuality, Identity, and Gender with Young People 

• Professionals need to be fluent in “young-person-speak” to have effective conversations about sexuality, identity, and gender.
• Assumed binaries should be avoided, and young people should be asked to name who they are and how they want to be referred to.
• Centering young people in conversations about their bodies can be a relief for the medical field and benefit young people.
• There is room for growth among professionals in this space.
• Rethinking the way we talk to young people about sexuality, identity, and gender is ultimately necessary for caring for young people and families. 

[54:39 - 1:00:03]  Closing segment Takeaway

You can reach Dr. Julia Rosebush

LinkedIn:  Julia Rosebush, DO, FAAP | LinkedIn 

Hashtags:  #hivprevention #hivawareness #gettingtozero...