Tag Archives: drug use

Fighting HIV, one dirty needle at a time

The doctor on a mission met the homeless heroin addict who lived under a tree last year at Jackson Health System’s special immunology clinic when both men were struggling to overcome the odds. Jose De Lemos, infected with HIV and hepatitis C from a shared needle, had gone without treatment for almost a year.

He’d dropped 80 pounds, suffered from night sweats and a rash on his leg and chest. Even walking hurt.

He was in no mood for conversation with a well-meaning doc.

But Hansel Tookes, a University of Miami doctor with a degree in public health and a calling to public service, isn’t the kind of doctor who is easily put off. He talked to De Lemos anyway. Sent him to dermatology, started him on meds for HIV and hepatitis C, worked to find him a bed in rehab, and talked — about his own uphill battle to create a syringe exchange program in South Florida, the kind of program that might have prevented De Lemos’ infection.

A public health advocate in Miami, where new HIV infection rates consistently top the state and national charts, Tookes had been struggling for years to get a bill passed in the Florida Legislature to create a program in Miami-Dade County to help end that terrible distinction.

In that time, he had gone from medical student to doctor. Testified before legislative committees over and over. And learned just how hard he would have to fight to get what he considered a very modest proposal to save lives and improve public health through a conservative, Republican-dominated Legislature.

For De Lemos, his doctor’s commitment to the cause — an unpopular one, at that — was a revelation: “I’m hard-headed. And he’s persistent. He’s like, ‘If you get clean, you can talk about this. You’ll be great . You can help me.’ I admire him because he went through a lot but he kept going.”

Tookes recalled a different moment with his patient: “He started crying because he said he didn’t know people cared.”

For the next eight months, as De Lemos kicked heroin, endured a skin condition that caused blisters across his entire torso and finally saw his sky-high viral count drop, Tookes started seeing hope, too. His proposal, which had been stalled for years, started gaining traction. The nationwide heroin epidemic had changed the dialogue about blood-borne diseases. De Lemos’ appointments with Tookes now usually included an update on the needle exchange bill in Tallahassee. Sometimes, when there was a big vote, Tookes played video recordings of the committee meetings on his phone for De Lemos to see.

“The reception in the ER isn’t great. I had to prop the door open,” Tookes said, with a laugh. “But we watched.”

In March, a full five years after Tookes published a study in a medical journal when he was still a student that documented the harsh reality of illicit needle use in Miami, Gov. Rick Scott signed the Miami-Dade Infectious Disease Elimination Act, making Miami-Dade’s program the first legal needle exchange in the American South.

The victory didn’t mean his fight was over. Legislators weren’t unanimous when they approved the bill, and the IDEA act reflects that: It creates a five-year test program, only in Miami-Dade and without any public financing. Tookes and UM, which will run the program, must raise all the money for the program privately, through grants and donations. Tookes — doctor, public health advocate and needle exchange crusader — must now also become a fundraiser.

He’s undaunted. His determination has carried him this far, and he is already envisioning the rest.

“When I flew back to Miami after the bill had passed, I looked at the city as we were landing at MIA and I thought, what we just did is going to change the health of tens of thousands of people,” Tookes said. “And that was an amazing feeling. And that’s an amazing truth. And that’s where we are.”

 

Advanced HIV cases

Tookes, a 35-year-old internist, took on the against-the-odds fight for a needle exchange because he felt he had to. Too many people were coming through the doors of Miami-Dade’s public health system like De Lemos, with advanced cases of HIV in an era when the virus that causes AIDS is generally treated as a disease you live with, not one that kills you. Injection drug overdoses were rising, too.

The doctor knew getting people into treatment earlier could make a huge difference in their lives and reduce infections of others. (“I’m trained to look for public health solutions,” he said.) A needle exchange was a step toward that goal. Florida had never allowed a needle exchange program before. But why couldn’t that change?

His grandmother, Gracie Wyche, had set the bar high in his family. She was a pioneering black nurse in Miami who started out in the then-segregated wards of Jackson Memorial and eventually became a head nurse, concentrating on a mysterious illness in the 1980s that later became known as AIDS. Tookes became even more interested in public service during his undergraduate work at Yale University and a stint as an investigator for Project Aware, an HIV testing/counseling clinical trial at UM. He got a public health degree at UM, and then his medical degree.

Now a third-year resident who does his research through UM’s division of infectious diseases at the Miller School of Medicine, Tookes said his grandmother’s work set him on this path. “She inspired me,” he said. “There’s just a long history of service on both sides of the family.”

The HIV numbers drove him, too. In 2014, the Miami-Fort Lauderdale region ranked No. 1 in the nation by the U.S. Centers for Disease Control and Prevention for the rate of new HIV infections in areas with more than 1 million people. That year, Miami-Dade County had 1,324 new HIV cases, the CDC said, while Broward had 836 cases. Statewide, in 2014, the Florida Department of Health said 110,000 people were diagnosed and living with HIV. People are still dying of the virus: In the United States, 6,955 people died from HIV and AIDS in 2013, according to the CDC.

Tookes saw the toll up close, in the examining room. A man in his 40s who had sex with men, no body fat and pneumocystis pneumonia, a disease often associated with AIDS _ who didn’t know he’d probably had HIV for years. An impoverished woman from Liberty City with a debilitating bacterial infection from a severely compromised immune system, who had never before been tested for HIV. Or a young man diagnosed with HIV a few months ago who revealed to Tookes during a clinic visit that he uses intravenous methamphetamine.

“Everything with this issue _ all of the advocacy that we did for this policy _ was to fix an issue that we were seeing in everyday clinical practice . I think as physicians, we had a duty to intervene,” Tookes said. “We knew there was something we could do for these people to help them from getting so sick, and so we decided to fight for it.”

He faced deep suspicion about the idea going back to the just-say-no 1980s. Although needle exchange programs have become increasingly common even in GOP-controlled states _ Indiana’s governor and now Republican vice presidential candidate Mike Pence changed his position last year after an outbreak of HIV and hepatitis C _ Florida remained a holdout. Some lawmakers continued to believe that giving addicts clean needles amounted to government-endorsed drug use.

Starting in 2012, Tookes — backed by a coalition including the Florida Medical Association, the Florida Hospital Association and the Miami-Dade State Attorney’s Office — tried to make headway with lawmakers. When he hit the wall of opposition, he didn’t give up. He didn’t get disillusioned or cynical. He tried again. And again. In the legislative sessions of 2013, ‘14, ‘15.

Then 2016 came along. The heroin epidemic created a whole new conversation around the issue of injection-drug use.

State Sen. Oscar Braynon, a Miami Gardens Democrat, sponsored the syringe exchange bill — over and over — because of the high rates of HIV and hepatitis C in his district. He said he saw opposition flag after Florida shut down its “pill mills” starting in 2011, sending opioid users to the needle.

“The first thing people hear is that you’re trying to empower drug users to use drugs,” Braynon said. “But the narrative changed over time … What started to happen is that drug use picked up. First it was people in the ‘hood. But now it’s some of the wealthier people.”

And so the Legislature’s attitude changed. Injection drug use — and the blood-borne diseases that can go with it — were no longer just “a Miami problem,” Tookes said.

“In the context of a nationwide heroin epidemic and in the context of what I believe were many more constituents across the state going to see their senators and representatives and telling them that this was something that was ravaging their communities, we had a lot more of a sympathetic ear from the Legislature this year,” he said.

A needle exchange program won’t fix Miami-Dade’s problem with HIV and hepatitis C. But Tookes says it will help. And though a small percentage of HIV infections can be traced directly to needle use and the biggest risk factor is still sex, reducing the number of shared needles reduces the community’s risk overall. People who share needles don’t always tell their sexual partners that they are at risk.

A needle exchange also brings the hard-core, drug-injecting population into the public health system to be tested and treated. That reduces the risk to everyone else and cuts costs of treating their illnesses.

This is not just theory. In Washington, D.C., the number of new HIV infections dropped from an average of 19 a month to six a month after a needle exchange program was introduced in 2008, according to a study released last year by George Washington University’s public health school. The reduction in cases saved taxpayers an estimated $45.6 million, using CDC estimates that the average lifetime of care for AIDS patients costs about $380,000.

Miami-Dade stands to save money, too, if addicts stop reusing needles. A study co-authored last year by Tookes showed that the cost of treating patients who had bacterial infections as a result of dirty needles ran about $11.4 million a year at taxpayer-funded Jackson Memorial Hospital.

For Tookes, all of these public health arguments start with what he learned on the streets of Miami interviewing intravenous drug users when he was still a medical student at UM. The study he published in 2011 showed that drug users in Miami were 34 times more likely to dispose of their needles in public than drug users in San Francisco, which has had a needle exchange program since 1988.

Tookes still sees the bits and pieces of drug equipment in bushes and along streets, even in upscale places like Brickell Avenue, lined with highrise condos and financial companies from all over the world.

“I still have syringe radar,” he said. “I spot them everywhere.”

 

Street needles

A few miles away from the Jackson clinics where Tookes works, in the shadow of the Metrorail station in Miami’s Overtown neighborhood, Carlos Franco is handing out his precious stash of clean needles to addicts once again.

Franco, 67, says he began his underground one-man operation more than two decades ago after he was horrified to see his girlfriend share needles with other drug users. He buys the sterile syringes, 100 to a box, at his own expense when he has the money, from the North American Syringe Exchange Network.

Franco is instantly recognizable to many in the neighborhood, where orange caps from syringes are sprinkled in vacant, overgrown lots and along sidewalks and under bushes.

“φOye!” yells one man, hailing Franco from a block away.

The operation is quick, Franco reaching into his backpack and handing over several packs of needles. The man, identified only as Flaco _ “Skinny,” in Spanish _ nods his thanks, looks both ways and disappears behind a metal gate next to a house across the street.

Around the corner, near the Interstate 95 overpass, Franco points out the improvised “cookers” that litter the shrubbery, bottoms of soda cans fashioned to heat up drugs. As he’s talking, a blond, thin guy in a T-shirt and jeans walks up poking a toe into the shrubbery.

Franco pulls the box from his backpack. “You need this?”

The man nods, his face now eager. Franco hands him a packet of syringes. Sean says he is 41, from New Jersey, a construction worker when he can find work. He is a heroin addict.

Sean has hepatitis C, something he shrugs off. “If you’re on the streets, it’s sort of required,” he says, with a short laugh that reveals a few missing teeth.

He walks away. A moment later, only half-hidden by a metal fence, he hunches over his arm.

“What really bothers me,” Franco says, “is when the numbers on the side of the syringe are worn off because it’s been used so much. That, and when they use a needle so dull it looks like a nail going into the skin _ it can’t get through.”

Franco knows his needle distribution is both illegal and dangerous, but he’s not sure if he’ll give it up when the official needle exchange program is running. He supports the idea of a legal program but worries about the people who might be too afraid to try it.

“I’ll wait and see,” he says. “A lot of people on the streets know me. I’m not sure if they will go to an official program. The cops might harass the program.”

‘People are still dying’

No one knows exactly why Miami-Dade’s HIV infection rate remains higher than other metropolitan areas, even as medicines are better than ever, statewide rates have declined and mother-to-child transmissions _ AIDS babies _ are rare.

Public health officials rattle off a variety of contributing factors: Thirty-five years into this epidemic, younger people think of HIV as a treatable, chronic disease. Drugs like Truvada, which can prevent HIV infection if taken as a precaution, have added to that perception. HIV is largely an urban disease. Immigration brings people to Florida from places without much access to healthcare or health education. Miami is an international party town, and the highest risk for HIV is unprotected sex, especially for men having sex with men. Testing and medication in South Florida can be difficult to find.

Also, HIV has fallen out of the headlines for the most part, added AIDS Healthcare Foundation’s advocacy and legislative affairs manager Jason King.

“People are still dying. But you don’t get the press coverage … So it’s not at the forefront of people’s minds.”

Stigma is part of the problem, too. If you can’t admit you have HIV, your sexual partners are probably at higher risk.

“It’s not a death sentence like before but the stigma still exists,” said King, who is HIV positive. “And then they have to be conscientious about disclosing it to their next partner and they fear rejection.”

That’s definitely true in Miami-Dade, said Dr. Cheryl Holder, a general internist who works at Jessie Trice Community Health Center and is an associate professor at Florida International University.

Holder says stigma, especially in the African-American community, is one of the toughest issues she combats when she sees patients with HIV.

“We’re seeing changes in communities, but it’s still labeled as wrong and there’s something wrong with you … I still have patients who hide their medicine.”

Walking out of the health center at the end of a day not long ago, she saw one of her patients, a young man in a hoodie, waiting for a ride from a family member. “If it weren’t for his diagnosis, I would have waited with him for his family. But as I walked by, he didn’t look at me and I didn’t look at him. And that’s when I know it’s stigma. He couldn’t just pull me over and say, this is my doctor. We need to normalize healthcare so I don’t have to walk past my patient and not meet his mom.”

 

Raising money

In some ways, Tookes’ work starts again now. Though Congress lifted a ban on federal funding for needle exchanges late last year, no federal money can be used on needles themselves. And Florida’s bill specifies that no public money can be used for the program.

That leaves Tookes, working with UM, raising it all — about $500,000 a year. And the pressure is on: Other counties in Florida are watching to see how well the program works.

“This pilot program is going to make a big dent in the infection rate in Miami. All eyes are on us. We have to make this a success.”

He has raised $100,000 from private donors locally — including Joy Fishman, the widow of the inventor of Narcan, the “save shot” for people who are overdosing — and another $100,000 from the MAC AIDS Fund.

Nancy Mahon, global executive director of the fund, said that syringe exchanges are key to fighting HIV/AIDS. “Needle exchange programs like this halt new infections, period. There is still work to do, but providing sterile syringes and supportive services to IV drug users is a solid step in order to begin saving lives.”

Miami-Dade’s health department is joining the effort.

“Definitely, we will be helping in any way we can,” administrator Lillian Rivera said. “We can’t buy the syringes, but we definitely will be providing wrap-around services. As the patients come in, we will be ensuring that they will be tested for HIV and hepatitis … All of the services that we have will be available to the patients that come through the door.”

The IDEA Exchange, which will be run through UM, comes too late to prevent De Lemos’ infections. But it’ll help others as the 35-year war on the epidemic continues _ as many as 2,000 in the first year, Tookes said. A project manager will start work in August, and other staff members are next. The AIDS Healthcare Foundation is donating the HIV and hepatitis C test kits with the agreement that those identified with one of the diseases will be linked with medical care. Tookes is hoping that other groups will follow.

And De Lemos — at 53, homeless no longer — will do his part, inspired by the fight of his doctor to pass the law. His viral load is so low it’s considered undetectable, and he is looking at life with new eyes. Service is part of his personal plan now. “I really want to be a part of this needle exchange program. If he can do that, I can do anything.”

Tookes says he will measure success with each HIV test, each syringe handed out.

“This has been a long journey … It’s a very exciting time for Miami. We’re going to save a lot of lives. We’re going to save a lot of money. We’re going to give people a lot of clean needles. We’re going to provide HIV tests. We’re going to get people into treatment … We’re going to change the world.”

 

Published via the AP member exchange.

Mayor wants nation’s first supervised heroin injection facility

The mayor of Ithaca, New York, wants his city in upstate New York to host the nation’s first supervised injection facility, enabling heroin users to shoot illegal drugs into their bodies under the care of a nurse without getting arrested by police.

The son of an addict who abandoned his family, Ithaca Mayor Svante Myrick is only 28 years old, but knows intimately how destructive drugs can be.

As he worked his way from a homeless shelter into the Ivy League at Cornell University and then became Ithaca’s youngest mayor four years ago, Myrick encountered countless people who never got the help they needed.

“I have watched for 20 years this system that just doesn’t work,” Myrick explained in an Associated Press interview. “We can’t wait anymore for the federal government. We have people shooting up in alleys. In bathroom stalls. And too many of them are dying.”

Describing his proposals to the AP ahead of a formal announcement planned for this week, the mayor said creating a place where addicts can inject heroin safely is a key part of a holistic approach to drug abuse that Ithaca will be rolling out, one that treats addiction more like a public health issue than a problem for the criminal justice system to solve. Nurses or physicians could quickly administer an antidote if a user overdoses, while addicts also could get clean syringes and be directed to treatment and recovery programs, he said.

Myrick expects supervised injection sites to be a hard sell in Albany, let alone in Washington, D.C., but his political sensibilities reflect what polls show is a growing belief among younger Americans that the war on drugs announced in 1971 by President Richard Nixon has failed.

“I think for a lot of people this is going to sound like a weird concept — ‘Aren’t you just encouraging them to use drugs?’” he said. “But I think it’s more possible now than at any time in our history. The opioid epidemic is affecting more people and we know we can’t wait any longer for the federal government to do something.”

Canada, Europe and Australia are already working to reduce overdose deaths with these facilities. In the United States, even the idea of creating a supervised injection site faces significant legal and political challenges. But Myrick sees an opening now in response to huge increases in overdose deaths nationwide. In New York state, overdose deaths involving heroin and other opiates shot from 186 in 2003 to 914 in 2012.

Myrick said he will ask New York’s Health Department to declare the heroin epidemic a state health crisis, which he said would enable his city to proceed without involving the state legislature.

Ithaca officials began looking seriously at alternatives to simply jailing addicts after the city had three fatal overdoses and 13 non-fatal overdoses in a three-week span in 2014. The city of 30,000, which hosts Ithaca College as well as Cornell, is one of New York’s most liberal communities and is a prime candidate for new approaches, Myrick said.

Myrick crafted his plan in collaboration with police and prosecutors, overcoming initially strong opposition from the elected district attorney, Gwen Wilkinson.

“What brought me around was the realization that this wouldn’t make it more likely that people will use drugs,” Wilkinson said. “What it would do is make it less likely that people will die in restaurant bathrooms.”

Police Chief John Barber is not totally convinced. He “firmly” supports other parts of the plan, but said “I am wary of supervised injection sites.”

Spokesmen for the Department of Health and Gov. Andrew Cuomo didn’t respond Monday to the AP’s request for comment. Cuomo has supported needle exchange programs and boosted funding for addiction prevention and treatment, but has yet to take a position on supervised injection.

Some pieces of Ithaca’s plan don’t need state approval, such as the creation of a new city office of drug policy and a youth apprenticeship program to give young people alternatives to drugs. Myrick also wants police to send low-level drug offenders to treatment instead of jail, adopting a strategy used in Seattle.

Canada’s first injection facility, known as “Insite,” opened in Vancouver in 2003. Every day, 800 users visit, and between 10 and 20 of them overdose each week, but no one has ever died there, according to Dr. Patricia Daly, chief medical health officer at Vancouver Coastal Health, which operates it.

“These overdoses are completely reversible,” Daly said. “People die because they inject alone.”

Insite receives most of its funding from government now, but faced significant initial opposition from officials in Ottawa. A 2011 Canadian Supreme Court decision ordered federal officials to stop fighting the facility, noting that it has saved lives “with no discernable negative impact.”

In fact, overdose deaths dropped 35 percent in the surrounding neighborhood after Insite opened its doors at ground zero for Vancouver’s heroin problem, according to research by Brown University epidemiologist Brandon D.L. Marshall.

In the U.S., state and federal laws would put both users and operators of such a facility at risk of arrest.

Even some former addicts say it should stay that way.

“We’re talking about a government-sponsored shooting gallery,” said Mike Gimbel, an addiction expert who served as drug czar in Baltimore County after beating heroin. “It’s misguided. The addict is going to say: this is cool, a place I don’t have to worry about the cops. Why should an addict stop if there are no consequences for their behavior?”

That said, more funding to provide wider access to effective treatment is the only solution, Gimbel said. “We all recognize we’re not going to be able to arrest our way out of this problem.”

Indiana extends emergency needle exchange program to combat HIV outbreak

Indiana Gov. Mike Pence on April 20 extended a needle exchange program in a rural, southern Indiana county to help combat an HIV outbreak, even though he generally opposes such programs.

The ultra-conservative Pence approved a 30-day extension of a March 26 executive order that declared a public health emergency in Scott County, about 30 miles north of Louisville, Kentucky. Pence opposes such programs as part of a statewide anti-drug policy but said the efforts to fight the outbreak must continue.

“While we’ve made progress in identifying and treating those affected by this heartbreaking epidemic, the public health emergency continues and so must our efforts to fight it,” Pence said in a statement on April 20.

Scott County, which has a population of about 23,700, would normally see about five new HIV cases in a typical year. The Indiana State Department of Health officials reported late last week that there are now 120 confirmed HIV cases and 10 preliminary positive cases tied to the county — about one confirmed case for every 200 people living there. The cases have all been linked to needle-sharing among intravenous drug users.

Health officials say they expect the number of cases to increase as more people are tested, putting pressure on Pence and lawmakers to consider more long-term options.

Lawmakers heard testimony this week on a proposal that would legalize needle exchange programs, which allow drug users to turn in used hypodermic needles in return for sterile ones in an effort to contain the spread of diseases.

If passed, the top 23 Indiana counties with the highest rate per population of hepatitis C would be able to establish their own exchange program. Health officials say high rates of hepatitis C are a key indicator of needle sharing and a potential HIV outbreak.

Other counties with lower rates could establish programs pending approval from county officials.

The future of the legislation is uncertain, since Pence has suggested that he would veto a broad-based needle exchange bill.

“I’m convinced law enforcement, public education is the best means to steer people away from drug abuse and drug addiction,” he said during a March news conference.

Opponents of the measure expressed concerns about handing out paraphernalia to drug users, and questioned whether the programs would be effective in rural areas such as Scott County that don’t have adequate testing and health care resources available.

“It’s just too early to tell what’s going to be successful down there,” said David Powell, executive director of the Indiana Prosecuting Attorneys Council. “There’s a huge public health issue here. I get that, but we must also incorporate public safety aspects of this.”

Dr. Beth Meyerson, an assistant professor of public health policy and administration at Indiana University in Bloomington said the spread of disease should be a first priority, and treatment programs and health resources can be established concurrently.

“If someone is drowning, you throw a buoy and that needle exchange is the buoy,” she said. “We want to have a stronger system and we will…ultimately it’s still that life buoy that’s critical for those users at the time.”

Senate Health Committee Chairwoman Patricia Miller, a Republican, said she is normally “not a fan” of needle exchange programs but is open to the proposal given the circumstances.

“Health officials are telling us potentially we’ll see this in other counties so I’m concerned about that,” she said. “We need to address it.”

Miller said she is also considering a provision that would set a two-year expiration date on the programs.

What you ‘like’ on Facebook can be surprisingly revealing

Clicking those friendly blue “like” buttons strewn across the Web may be doing more than marking you as a fan of Coca-Cola or Lady Gaga.

It could out you.

It might reveal how you vote.

It might suggest that you’re an unmarried introvert with a high IQ and a weakness for nicotine.

That’s the conclusion of a study published this week in Proceedings of the National Academy of Sciences. Researchers reported analyzing the likes of more than 58,000 U.S. Facebook users to make guesses about their personalities and behavior, and even whether they drank, smoked, or did drugs.

Cambridge University researcher David Stillwell, one of the study’s authors, said the results may come as a surprise.

“Your likes may be saying more about you than you realize,” he said.

Facebook launched its like button in 2009, and the small thumbs-up symbol has since become ubiquitous on the social network and common across the rest of the Web as well. Facebook said last year that roughly 2.7 billion new likes pour out onto the Internet every day – endorsing everything from pop stars to soda pop. That means an ever-expanding pool of data available to marketers, managers, and just about anyone else interested in users’ inner lives, especially those who aren’t careful about their privacy settings.

Stillwell and his colleagues scooped up a bucketful of that data in the way that many advertisers do –through apps. Millions of Facebook users have surveyed their own personal traits using applications including a program called myPersonality. Stillwell, as owner of the app, has received revenue from it, but declined to say how much.

The study zeroed in on the 58,466 U.S. test takers who had also volunteered access to their likes.

When researchers crunched the “like” data and compared their results to answers given in the personality test, patterns emerged in nearly every direction.

The study found that Facebook likes were linked to sexual orientation, gender, age, ethnicity, IQ, religion, politics and product use. The likes also mapped to relationship status, number of Facebook friends, as well as half a dozen different personality traits.

Some likes were more revealing than others. Researchers could guess whether users identified themselves as black or white 95 percent of the time. That success rate dropped to a still impressive 88 percent when trying to guess whether a male user was gay, and to 85 percent when telling Democrats from Republicans.

Identifying drug users was trickier – researchers got that right only 65 percent of the time, a result scientists generally describe as poor. Predicting whether a user was respectively a child of divorce was even dicier. With a 60 percent success rate, researchers were doing just slightly better than random guesses.

The linkages ranged from the self-evident to the surreal.

Men who liked TV song-and-dance sensation “Glee” were more likely to be gay. Men who liked professional wrestling were more likely to be straight. Drinking game aficionados were generally more outgoing than, say, fans of fantasy novelist Terry Pratchett. People who preferred pop diva Jennifer Lopez usually gathered more Facebook friends than those who favored the heavy metal sound of Iron Maiden.

Among the more poignant insights was the apparent preoccupation of children of divorce with relationship issues. For example, those who expressed support for statements such as “Never Apologize For What You Feel It’s Like Saying Sorry For Being Real” or “I’m The Type Of Girl Who Can Be So Hurt But Still Look At You & Smile” were slightly more likely to have seen their parents split before their 21st birthday.

Some of the patterns were difficult to understand: The link between curly fries and high IQ scores was particularly baffling.

Stillwell, designer of the myPersonality app, said revenue from it came from advertising. “I’d prefer not to say how much, but it wasn’t enough to live on,” he said.

Jennifer Golbeck, a University of Maryland computer scientist who wasn’t involved in the study but has done similar work, endorsed its methodology, calling it smart and straightforward and describing its results as “awesome.”

But she warned of what the work showed about privacy on Facebook.

“You may not want people to know your sexual orientation or may not want people to know about your drug use,” she said. “Even if you think you’re keeping your information private, we can learn a lot about you.”

Facebook said the study fell in line with years of research and was not particularly surprising.

“The prediction of personal attributes based on publicly accessible information, such as ZIP codes, choice of profession, or even preferred music, has been explored in the past,” Facebook’s Frederic Wolens said in a written statement.

Wolens said that Facebook users could change the privacy settings on their likes to put them beyond the reach of researchers, advertisers or nearly anyone else. But he declined to say how many users did so.

For the unknown number of users whose preferences are public, Stillwell had this advice: Look before you like.

The like button is “quite a seductive thing,” he said. “It’s all around the Web, it’s all around Facebook. And it’s so easy.”