1
|
Phillips V, Quest TE, Higgins M, Marconi VC, Balthazar MS, Holstad M. A Cost-Effective Analysis of Motivational Interviewing with Palliative Care Versus Usual Care: Results from the Living Well Project. AIDS Behav 2023; 27:1259-1268. [PMID: 36334215 PMCID: PMC10832615 DOI: 10.1007/s10461-022-03862-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/12/2022] [Indexed: 11/08/2022]
Abstract
Little is known about the impact of early palliative care (EPC) combined with motivational interviewing (MI) for persons living with AIDS (PWA). We compared the cost and quality-adjusted life-years (QALYs) of EPC + MI (n = 61) versus usual care (UC) (n = 60) for patients with AIDS, not on antiretroviral medications, enrolled into the Living Well Project trial. Data on clinic, emergency department, and hospital visits were collected through self-report and billing records. Risk-adjusted average annual health care costs were estimated using a generalized linear model with a gamma log-link function. QALYs were calculated using the SF-12v2. Cost-effectiveness was defined as cost per QALY gained. Estimated intervention costs were $165 per participant. EPC + MI reduced costs by 33% (AOR = 0.67; CI 95%: 0.15, 0.93). QALYs did not differ between groups. Results suggest EPC + MI for PWA is cost-saving and maintains quality of life compared to UC due to reduced hospital and ED costs.
Collapse
Affiliation(s)
- Victoria Phillips
- Department of Health Policy and Management, Rollins School of Public Health of Emory University, Atlanta, Georgia.
- Rollins School of Public Health of Emory University, 1518 Clifton Road, Room 614, 30322, Atlanta, GA, USA.
| | - Tammie E Quest
- Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Melinda Higgins
- Office of Research, Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| | - Vincent C Marconi
- Department of Infectious Disease, Emory University School of Medicine, Atlanta, Georgia
| | - Monique S Balthazar
- Georgia State University Byrdine F. Lewis College of Nursing and Health Professions, Atlanta, Georgia
| | - Marcia Holstad
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
| |
Collapse
|
2
|
Sao SS, Minja L, Vissoci JRN, Watt MH. The Development and Psychometric Evaluation of the HIV Stigmatizing Attitudes Scale (HSAS) in Tanzania. AIDS Behav 2022; 26:1530-1543. [PMID: 34731405 PMCID: PMC8564599 DOI: 10.1007/s10461-021-03506-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/13/2021] [Indexed: 12/02/2022]
Abstract
HIV stigmatizing attitudes are embedded in social context, making it important to develop culturally specific tools for accurate measurement. The goal of this study was to develop and evaluate the psychometric properties of the HIV Stigmatizing Attitudes Scale (HSAS) in Moshi, Tanzania. Items were adapted based on a scale developed by Visser et al. which was one of the first to measure HIV stigmatizing attitudes in the general population (i.e., people not living with HIV). Items were translated into Swahili and modified with iterative feedback. The HSAS was administered to participants (N = 1494) in an HIV stigma reduction intervention study at two antenatal care clinics in Moshi, Tanzania. The HSAS was found to have strong domain coherence and high reliability based on Cronbach’s alpha, Omega 6 coefficient values, and the composite reliability coefficient, and high validity based on content-oriented evidence, relations to other variables, and response process. Factor analysis revealed a two-factor structure (Moral Judgment and Interpersonal Distancing), consistent with the original Visser scale. The HSAS provides a robust way to measure HIV stigma in the Tanzanian context and can be culturally adapted to other settings.
Collapse
Affiliation(s)
- Saumya S Sao
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA.
| | - Linda Minja
- Kilimanjaro Clinical Research Institute, Moshi, Tanzania
| | - João Ricardo N Vissoci
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
- Department of Surgery, Duke Division of Emergency Medicine, Durham, NC, USA
| | - Melissa H Watt
- Duke Global Health Institute, Duke University, 310 Trent Drive, Durham, NC, 27710, USA
- Department of Population Health Sciences, University of Utah, Salt Lake City, UT, USA
| |
Collapse
|
3
|
Blatyta PF, Kelly S, Goncalez TT, Carneiro-Proietti AB, Salomon T, Miranda C, Sabino E, Preiss L, Maximo C, Loureiro P, Custer B, de Almeida-Neto C. Characterization of HIV risks in a Brazilian sickle cell disease population. BMC Public Health 2020; 20:1606. [PMID: 33097032 PMCID: PMC7585195 DOI: 10.1186/s12889-020-09702-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Accepted: 10/14/2020] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A low prevalence of HIV in sickle cell disease (SCD) patients has been reported in the literature though mechanisms for this are not understood. METHODS HIV risk behaviors were compared between SCD cases and non-SCD controls using a self-administered audio computer-assisted self-interview. SCD cases were recruited from a multi-center SCD cohort established in Brazil; controls were recruited from SCD social contacts. Categorical variables were analyzed using Chi-Square or Fisher exact test. Continuous variables were compared using the Mann-Whitney U test. RESULTS There were 152 SCD cases and 154 age/location matched controls enrolled at three participating Brazilian centers during 2016-17. No significant differences in number of sexual partners (lifetime or previous 12 months), male-to-male sex partners or intravenous drug use were observed. Cases received more transfusions, surgeries, and acupuncture treatment. CONCLUSIONS Besides the risk of transfusion-transmitted HIV, which is now exceedingly rare, SCD and non-SCD participants demonstrated similar HIV risk behaviors. Causes other than risk behaviors such as factors inherent to SCD pathophysiology may explain the reported low prevalence of HIV in SCD.
Collapse
Affiliation(s)
- P F Blatyta
- Hospital Moysés Deutsch, São Paulo, SP, Brazil.
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil.
| | - S Kelly
- Vitalant Research Institute, San Francisco, CA, USA
| | - T T Goncalez
- Vitalant Research Institute, San Francisco, CA, USA
| | | | - T Salomon
- Fundação Hemominas, Belo Horizonte, MG, Brazil
| | - C Miranda
- Fundação Hemominas, Belo Horizonte, MG, Brazil
| | - E Sabino
- Instituto de Medicina Tropical da FMUSP, São Paulo, SP, Brazil
| | - L Preiss
- Research Triangle Institute, International, Rockville, MD, USA
| | - C Maximo
- Hemorio, Rio de Janeiro, RJ, Brazil
| | - P Loureiro
- Fundação Hemope and Universidade de Pernambuco, Recife, PE, Brazil
| | - B Custer
- Vitalant Research Institute, San Francisco, CA, USA
| | - C de Almeida-Neto
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Fundação Pró-Sangue de São Paulo, São Paulo, SP, Brazil
| |
Collapse
|
4
|
Belisário AR, Blatyta PF, Vivanco D, Oliveira CDL, Carneiro-Proietti AB, Sabino EC, de Almeida-Neto C, Loureiro P, Máximo C, de Oliveira Garcia Mateos S, Flor-Park MV, de Oliveira Werneck Rodrigues D, Afonso Mota R, Gonçalez TT, Hoffmann TJ, Kelly S, Custer B. Association of HIV infection with clinical and laboratory characteristics of sickle cell disease. BMC Infect Dis 2020; 20:638. [PMID: 32854639 PMCID: PMC7457248 DOI: 10.1186/s12879-020-05366-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 08/19/2020] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Sickle cell disease (SCD) is a multisystem disorder characterized by a wide spectrum of clinical manifestations and severity. Studies investigating potential effects of co-morbid human immunodeficiency virus (HIV) and SCD have produced conflicting results, and additional investigations are needed to elucidate whether the interaction between the two disease states might impact both HIV and SCD clinical outcomes. The association of HIV infection with clinical and laboratory characteristics of patients with SCD was assessed. METHODS This nested case-control study included individuals with SCD with HIV treated at six Brazilian SCD centers. Clinical and laboratory data were abstracted from medical records. HIV positive participants were compared to age, gender, center, and SCD genotype matched HIV negative participants (ratio 1:4). Individual clinical outcomes as well as a composite outcome of any SCD complication and a composite outcome of any HIV-related complication were compared between the two groups. RESULTS Fifteen HIV positive participants were included, 12 (80%) alive and 3 (20%) deceased. Most of the HIV positive patients had HbSS (60%; n = 9), 53% (n = 8) were female, and mean age was 30 ± 13 years. The frequency of individual SCD complications of acute chest syndrome/pneumonia, sepsis/bacteremia, pyelonephritis, ischemic stroke, hemorrhagic stroke, abnormal transcranial Doppler (TCD), and pulmonary hypertension was higher in HIV positive participants when compared to HIV negative, although analyzed individually none were statistically significant. HIV positive participants had significantly higher risk of any SCD complication and of a composite HIV-related complication compared to the HIV negative group (HR = 4.6; 95%CI 1.1-19.6; P = 0.04 and HR = 7.7; 95%CI 1.5-40.2; P = 0.02, respectively). There was a non-significant trend towards higher risk of any infections in participants with HIV positive (HR = 3.5; 95%CI 0.92-13.4; P = 0.07). Laboratory parameters levels were not significantly different in individuals with and without HIV. CONCLUSIONS In summary, our study in SCD patients shows that those with HIV have an increased risk of any SCD complication and HIV-related complications, as well as a suggestive but not significantly increased risk of infections.
Collapse
Affiliation(s)
- André Rolim Belisário
- Fundação Hemominas, Alameda Ezequiel Dias, 321, Belo Horizonte, Minas Gerais, 30130-110, Brazil.
| | - Paula F Blatyta
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Diana Vivanco
- University of California, San Francisco (UCSF), San Francisco, CA, USA
| | | | | | - Ester Cerdeira Sabino
- Faculdade de Medicina (FMUSP) and Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Cesar de Almeida-Neto
- Disciplina de Ciências Médicas, Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brazil
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, SP, Brazil
| | - Paula Loureiro
- Fundação Hemope, Recife, Pernambuco, Brazil
- Universidade de Pernambuco, Recife, Pernambuco, Brazil
| | | | - Sheila de Oliveira Garcia Mateos
- Faculdade de Medicina (FMUSP) and Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
- Fundação Hemorio, Rio de Janeiro, Brazil
| | - Miriam V Flor-Park
- ITACI, Unidade de Onco-hematologia, Instituto da Criança, HCFMUSP, São Paulo, Brazil
| | | | - Rosimere Afonso Mota
- Fundação Hemominas, Alameda Ezequiel Dias, 321, Belo Horizonte, Minas Gerais, 30130-110, Brazil
| | | | - Thomas J Hoffmann
- University of California, San Francisco (UCSF), San Francisco, CA, USA
| | - Shannon Kelly
- Vitalant Research Institute, San Francisco, USA
- UCSF Benioff Children's Hospital Oakland, Oakland, USA
| | - Brian Custer
- University of California, San Francisco (UCSF), San Francisco, CA, USA
- Vitalant Research Institute, San Francisco, USA
| |
Collapse
|
5
|
Cutts JC, Quinn B, Seed CR, Kotsiou G, Pearson R, Scott N, Wilson DP, Harrod ME, Maher L, Caris S, Thompson AJ, Farrell M, Pink J, Hellard ME. A Systematic Review of Interventions Used to Increase Blood Donor Compliance with Deferral Criteria. Transfus Med Hemother 2020; 48:118-129. [PMID: 33976612 DOI: 10.1159/000509027] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/28/2020] [Indexed: 11/19/2022] Open
Abstract
Background and Objectives Pre-donation screening of potential blood donors is critical for ensuring the safety of the donor blood supply, and donor deferral as a result of risk factors is practised worldwide. This systematic review was conducted in the context of an expert review convened by the Australian Red Cross Lifeblood in 2013 to consider Lifeblood's injecting drug use (IDU)-related policies and aimed to identify studies assessing interventions to improve compliance with deferral criteria in blood donation settings. Materials and Methods MEDLINE/PubMed, OVID Medline, OVID Embase, LILACS, and the Cochrane Library (CENTRAL and DARE) databases were searched for studies conducted within blood donation settings that examined interventions to increase blood donor compliance with deferral criteria. Observational and experimental studies from all geographical areas were considered. Results Ten studies were identified that tested at least one intervention to improve blood donor compliance with deferral criteria, including computerized interviews or questionnaires, direct and indirect oral questioning, educational materials, and a combination of a tickbox questionnaire and a personal donor interview. High-quality evidence from a single study was provided for the effectiveness of a computerized interview in improving detection of HIV risk behaviour. Low-quality evidence for the effectiveness of computerized interviews was provided by 3 additional studies. Two studies reported a moderate effect of direct questioning in increasing donor deferral, but the quality of the evidence was low. Conclusion This review identified several interventions to improve donor compliance that have been tested in blood donation settings and provided evidence for the effectiveness of computerized interviews in improving detection of risk factors.
Collapse
Affiliation(s)
| | - Brendan Quinn
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Clive R Seed
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - George Kotsiou
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Ruth Pearson
- Burnet Institute, Melbourne, Victoria, Australia
| | - Nick Scott
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | | | - Mary Ellen Harrod
- NSW Users and AIDS Association, Surry Hills, New South Wales, Australia
| | - Lisa Maher
- Burnet Institute, Melbourne, Victoria, Australia.,Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
| | - Sharon Caris
- Haemophilia Foundation Australia, Malvern East, Victoria, Australia
| | - Alex J Thompson
- Department of Gastroenterology, St Vincent's Hospital and the University of Melbourne, Melbourne, Victoria, Australia
| | - Michael Farrell
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Joanne Pink
- Australian Red Cross Lifeblood, Melbourne, Victoria, Australia
| | - Margaret E Hellard
- Burnet Institute, Melbourne, Victoria, Australia.,Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Department of Infectious Diseases, The Alfred Hospital, Melbourne, Victoria, Australia.,Doherty Institute and School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
6
|
Jones R, Hoover DR. Reduction in a high-risk sex script among young urban women in the Love, Sex, & Choices web video HIV prevention intervention study. Res Nurs Health 2018; 41:535-543. [PMID: 30281811 DOI: 10.1002/nur.21912] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Accepted: 09/08/2018] [Indexed: 11/07/2022]
Abstract
For women, the high-risk sex script of condomless sex to maintain relationships with men is concerning, particularly in regard to heterosexual HIV acquisition. This secondary analysis of data from a clinical trial evaluated the effect of a 12-episode, web-based video series intervention, entitled Love, Sex, and Choices, versus a text message control on lowering the high-risk sex script. The sample comprised 238 predominately urban Black women, ages 18-29, having HIV sex risk behavior. Data were collected at baseline and 6 months post-intervention. The Sex Script Video Response score was used to measure a high-risk sex script. HIV sex risk behavior was measured by Vaginal Equivalent Episodes with high-risk partners. At baseline, lower education, younger age at first sexual intercourse, and alcohol/non-injection drug use before sex were positively associated with a high-risk sex script. At baseline, as the high-risk sex script increased by one log unit, sex risk behavior increased by 0.47 log units (p < 0.001), equivalent to a 60% increase in the geometric mean of sex risk behavior. ANCOVA analysis indicated that from baseline to 6-months post intervention, lowering the high-risk sex script by one unit was associated with an additional reduction of 0.26 units in sex risk behavior. Compared to the text messages, the LSC video series was associated with a 27% greater reduction in the geometric mean of the sex script (p = 0.03). Further investigation into the effect of lowering sex scripts to reduce sex risk behavior is recommended.
Collapse
Affiliation(s)
- Rachel Jones
- Bouvé College of Health Sciences, School of Nursing, Northeastern University, Boston, Massachusetts
| | - Donald R Hoover
- Department of Statistics and Biostatistics, Rutgers University, New Brunswick, New Jersey
| |
Collapse
|
7
|
Andu E, Wagenaar BH, Kemp CG, Nevin PE, Simoni JM, Andrasik M, Cohn SE, French AL, Rao D. Risk and protective factors of posttraumatic stress disorder among African American women living with HIV. AIDS Care 2018; 30:1393-1399. [PMID: 29695184 DOI: 10.1080/09540121.2018.1466981] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
We sought to examine risk and protective factors for Posttraumatic Stress Disorder (PTSD) among African American women living with HIV. This is a cross-sectional analysis of baseline data from a randomized trial of an HIV stigma reduction intervention. We examined data from two-hundred and thirty-nine African American women living with HIV. We examined whether age, marital status, level of education, internalized HIV-related stigma, and social support as potential protective and risk factors for PTSD symptoms using logistic regression. We analyzed bi-variate associations between each variable and PTSD symptoms, and constructed a multivariate logistic regression model adjusting for all variables. We found 67% reported clinically significant PTSD symptoms at baseline. Our results suggest that age, education, and internalized stigma were found to be associated with PTSD symptoms (p < 0.001), with older age and more education as protective factors and stigma as a risk factor for PTSD. Therefore, understanding this relationship may help improve assessment and treatment through evidence- based and trauma-informed strategies.
Collapse
Affiliation(s)
- Eaden Andu
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Brad H Wagenaar
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Chris G Kemp
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Paul E Nevin
- a Department of Global Health , University of Washington , Seattle , WA , USA
| | - Jane M Simoni
- b Department of Psychology , University of Washington , Seattle , WA , USA
| | | | - Susan E Cohn
- d Department of Infectious Diseases , Northwestern University , Chicago , IL , USA
| | | | - Deepa Rao
- f Department of Global Health/Department of Psychiatry and Behavioral Sciences , University of Washington , Seattle , WA , USA
| |
Collapse
|
8
|
Belaunzarán-Zamudio PF, Mosqueda-Gomez JL, Macias-Hernandez A, Sierra-Madero JG, Ahmed S, Beyrer C. Risk factors for prevalent hepatitis C virus-infection among inmates in a state prison system in Mexico. PLoS One 2017; 12:e0179931. [PMID: 28654650 PMCID: PMC5487058 DOI: 10.1371/journal.pone.0179931] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2016] [Accepted: 06/06/2017] [Indexed: 11/18/2022] Open
Abstract
Objectives To estimate the prevalence of HCV-infection and identify associated factors among inmates in the State Prison System of Guanajuato in Mexico (Sep-2011 to Feb-2012). Methods Cross-sectional, observational study in 10 prisons in the State of Guanajuato in Mexico (2011–2012). We offered HCV-testing and applied audio computer-assisted self-interviews to all adults imprisoned in the State Prison System. We used a complex survey analysis to estimate the distribution of variables and its corresponding 95% confidence intervals, taking into consideration the expected cluster effect by common characteristics within prisons. Inverse probability weights were applied to correct potential biased estimates arising from non-participation in accrual activities and non-response rates. We fitted multivariate logistic regression models to identify risk-behaviors associated to HCV-infection. Results We included data of 2,519 participating inmates. Prevalence of HCV-infection was 4.9 (95%CI = 3.6–5.9). Most HCV-infected inmates were male (99%). Before being incarcerated, inmates with HCV-infection were more frequently tattooed, used and injected drugs more frequently, and were more likely to share materials for injecting, when compared with those non-infected. During incarceration, HCV-infected inmates got tattoos and used drugs more often than non-infected, including injecting-drugs and sharing materials. Injecting-drug use (OR = 7.6, 95%CI, 2.5–23.4), sharing materials for injecting-drugs (OR = 19.6, 95%CI, 4.7–81.7) and being tattooed at least once before incarceration (OR = 2.1, 95%CI, 1.1–3.9), but not during incarceration, were independently associated to HCV-infection. Conclusions The prevalence of HCV-infection among inmates in the State of Guanajuato in Mexico is considerably higher than in the general population. The most important risk factors for HCV in this inmate population were injecting-drugs and sharing materials for injections before incarceration. High-risk behaviors during imprisonment are very high particularly among those already infected. HCV diagnostic and treatment services, and harm-reduction programs for incarcerated injecting-drug users in Mexico should be integrated to control the HCV epidemic in Mexico.
Collapse
Affiliation(s)
- Pablo F. Belaunzarán-Zamudio
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- División de Investigación de la Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
- * E-mail:
| | - Juan L. Mosqueda-Gomez
- Departamento de Microbiología, Universidad de Guanajuato, León, Guanajuato, Mexico
- Centro Ambulatorio para la Prevención y Atención en SIDA e Infecciones de Transmisión Sexual (CAPASITS), León, Guanajuato, Mexico
| | - Alejando Macias-Hernandez
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubiran, Mexico City, Mexico
- Departamento de Microbiología, Universidad de Guanajuato, León, Guanajuato, Mexico
| | - Juan G. Sierra-Madero
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutricion Salvador Zubiran, Mexico City, Mexico
| | - Saifuddin Ahmed
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| | - Chris Beyrer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
- Johns Hopkins Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States of America
| |
Collapse
|
9
|
Belaunzaran-Zamudio PF, Mosqueda-Gomez JL, Macias-Hernandez A, Rodríguez-Ramírez S, Sierra-Madero J, Beyrer C. Burden of HIV, Syphilis, and Hepatitis B and C Among Inmates in a Prison State System in Mexico. AIDS Res Hum Retroviruses 2017; 33:524-533. [PMID: 28094553 DOI: 10.1089/aid.2016.0271] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We studied the prevalence of HIV, syphilis, hepatitis B virus (HBV), and hepatitis C virus (HCV) infection and associated risk behaviors in the prison state system of Guanajuato, Mexico between September 2011 and February 2012. Blood samples were drawn from adult inmates in all State prisons who agreed to participate in this cross-sectional study. Data on risk behaviors were collected by using self-administered questionnaires. The prevalence of HIV, syphilis, HBV, and HCV infection was 0.6% [95% confidence interval (CI) = 0.2-1.1], 0.7% (95% CI = 0.4-1.0), 0.4 (95% CI = 0.04-0.74), and 4.8 (95% CI = 3.6-5.9), respectively. Female inmates had a higher prevalence of HIV (1.5% vs. 0.6%, p = .05), whereas male inmates had a higher prevalence of HCV (1% vs. 5%, p = .008). Twenty percent (n = 443, 95% CI = 15-26) of the participants were tattooed during incarceration, and most of them were tattooed with recycled materials. Around 60% (57%, 95% CI = 49-65) used drugs before incarceration, and 9.2% (n = 205) used injected drugs. During incarceration, 30% (95% CI = 23-39) used drugs and 43 continued injecting (20% of users). Consistent condom use was low among men before incarcerations but decreased by half during incarceration. The highest consistent condom use before incarceration was among men who have sex with men (MSM) (17.7%, 95% CI = 14-22), but it decreased (9%, 95% CI = 3-14) during incarceration. The prevalence of HIV, HBV, HCV, and syphilis in these inmates is higher than that of the local adult population. Most inmates had sex in prison, but few used condoms consistently. Access to condoms is apparently harder for MSM. Interventions to increase condom use, reduce use of shared or recycled materials for tattooing and injecting drugs, and treatment for drug abuse are needed.
Collapse
Affiliation(s)
- Pablo F. Belaunzaran-Zamudio
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Departamento de Infectología, Instituto Nacional de Ciencias Médicas y Nutrición “Salvador Zubiran,” Mexico City, Mexico
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Juan L. Mosqueda-Gomez
- Departamento de Microbiología de la Universidad de Guanajuato en León Guanajuato, León, Guanajuato, Mexico
- Centro Ambulatorio para la Prevención y Atención en SIDA e Infecciones de Transmisión Sexual de León, León, Guanajuato, Mexico
| | - Alejando Macias-Hernandez
- Departamento de Microbiología de la Universidad de Guanajuato en León Guanajuato, León, Guanajuato, Mexico
| | - Sonia Rodríguez-Ramírez
- Departamento de Microbiología de la Universidad de Guanajuato en León Guanajuato, León, Guanajuato, Mexico
| | - Juan Sierra-Madero
- División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Chris Beyrer
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Johns Hopkins Center for Public Health & Human Rights, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| |
Collapse
|
10
|
Dallas RH, Loew MM, Wilkins ML, Sun Y, Tang L, Porter JS, Gaur AH. Body Image and Risk Behaviors in Youth with HIV. AIDS Patient Care STDS 2017; 31:176-181. [PMID: 28332857 DOI: 10.1089/apc.2016.0259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Body image concerns are common among people living with HIV. Among adults with HIV, body image concerns have been shown to be related to risky sexual behaviors; little research has been conducted among youth living with HIV (YLWH). The current study examined the predictors, including body image, of sexual risk behaviors among YLWH. Adolescents from a single clinic (n = 143; age range, 16-24 years; 69% male; 95% African American) completed a computerized self-report survey to assess demographic, behavioral, and body image domains. Demographic and clinical data were abstracted from the medical record. Logistic regression analyses assessed associations between risk factors and risky sexual behaviors. Results indicated that YLWH who reported less favorable body image perceptions (p = 0.04) and more sexual partners (p = 0.05) were less likely to use condoms during their last sexual encounter. YLWH with six or more sexual partners were more likely to use drugs or alcohol during their last sexual encounter (p = 0.03). A belief that their HIV medications changed their body physically (p = 0.05), history of HIV-related complications (p = 0.03), an undetectable viral load at their most recent clinical laboratory draw (p = 0.01), and having a high school diploma or equivalent (p = 0.001) were independently associated with disclosure of participant's HIV status to a romantic/sexual partner. Findings suggest that body image perceptions may influence risky sexual behavior in YLWH. Further study is warranted to understand and intervene upon this relationship to improve individual and public health outcomes.
Collapse
Affiliation(s)
- Ronald H. Dallas
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Megan M. Loew
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Megan L. Wilkins
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Yilun Sun
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Li Tang
- Department of Biostatistics, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jerlym S. Porter
- Department of Psychology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Aditya H. Gaur
- Department of Infectious Diseases, St. Jude Children's Research Hospital, Memphis, Tennessee
| |
Collapse
|
11
|
Rao D, Molina Y, Lambert N, Cohn SE. Assessing Stigma among African Americans Living with HIV. STIGMA AND HEALTH 2016; 1:146-155. [PMID: 27761520 PMCID: PMC5067075 DOI: 10.1037/sah0000027] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
PURPOSE In the present study, we validated a culturally adapted stigma scale designed to assess stigma among African Americans living with HIV. METHODS We collected data on the scale using an audio computer assisted self-interview (ACASI) format. We validated the scale with a sample of 62 African American participants living with HIV. RESULTS Findings demonstrated that stigma can be measured succinctly and effectively in a 14-item scale with two subscales measuring enacted and internalized stigma. DISCUSSION We identified many advantages to using the scale, which demonstrated good psychometric properties when used with an audio computer assisted self-interview format and with an African American sample. We recommend this scale's use in both clinical practice and research study of HIV-stigma reduction interventions with African American populations.
Collapse
Affiliation(s)
- Deepa Rao
- Department of Global Health, University of Washington, Seattle Washington
| | - Yamile Molina
- Health Services Department, University of Washington, Seattle, Washington
| | - Nina Lambert
- Division of Infectious Diseases, Department of Medicine, Northwestern University, Chicago, Illinois
| | - Susan E Cohn
- Division of Infectious Diseases, Department of Medicine, Northwestern University, Chicago, Illinois
| |
Collapse
|
12
|
Abstract
Emerging research in adults with HIV suggests negative body image may be found at a higher rate in this group. To date, few studies have examined body image in adolescents living with HIV. This exploratory study aimed to characterize body image perceptions among youth living with HIV. Adolescents (n = 143; age range 16-24 years; 69 % male) completed an Audio Computer Assisted Self-Interview Questionnaire that assessed body image, psychosocial, medical and sociodemographic information. Medical history and physical functioning information were abstracted from medical records. Results showed normative global body image on the Multidimensional Body Self-Relations Questionnaire-Appearance Scales. Some subscale elevations were observed; including decreased interest in self-care and appearance, as well as concerns with individual body areas. Overall, youth reported preference for own body shape on the Figure Rating Scale; however, 41 % of youth classified as "overweight" per CDC body mass index reported contentment with current body size. Further, 47 % of youth classified as "normal" weight desired to have larger body size. Youth identified as men who have sex with men most often reported desiring larger body size. Implications for clinical care are discussed.
Collapse
|
13
|
Sun J, Patel F, Kirzner R, Newton-Famous N, Owens C, Welles SL, Chilton M. The Building Wealth and Health Network: methods and baseline characteristics from a randomized controlled trial for families with young children participating in temporary assistance for needy families (TANF). BMC Public Health 2016; 16:583. [PMID: 27421287 PMCID: PMC4947340 DOI: 10.1186/s12889-016-3233-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 06/16/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Families with children under age six participating in the Temporary Assistance for Needy Families Program (TANF) must participate in work-related activities for 20 h per week. However, due to financial hardship, poor health, and exposure to violence and adversity, families may experience great difficulty in reaching self-sufficiency. The purpose of this report is to describe study design and baseline findings of a trauma-informed financial empowerment and peer support intervention meant to mitigate these hardships. METHODS We conducted a randomized controlled trial of a 28-week intervention called Building Wealth and Health Network to improve financial security and maternal and child health among caregivers participating in TANF. Participants, recruited from County Assistance offices in Philadelphia, PA, were randomized into two intervention groups (partial and full) and one control group. Participants completed questionnaires at baseline to assess career readiness, economic hardship, health and wellbeing, exposure to adversity and violence, and interaction with criminal justice systems. RESULTS Baseline characteristics demonstrate that among 103 participants, there were no significant differences by group. Mean age of participants was 25 years, and youngest child was 30 months. The majority of participants were women (94.2 %), never married (83.5 %), unemployed (94.2 %), and without a bank account (66.0 %). Many reported economic hardship (32.0 % very low household food secure, 65.0 % housing insecure, and 31.1 % severe energy insecure), and depression (57.3 %). Exposure to adversity was prevalent, where 38.8 % reported four or more Adverse Childhood Experiences including abuse, neglect and household dysfunction. In terms of community violence, 64.7 % saw a seriously wounded person after an incident of violence, and 27.2 % had seen someone killed. Finally, 14.6 % spent time in an adult correctional institution, and 48.5 % of the fathers of the youngest child spent time in prison. CONCLUSIONS Baseline findings demonstrate that caregivers participating in TANF have suffered significant childhood adversity, adult violence exposure, and poverty-related stressors that can limit workforce success. High prevalence of housing and food insecurity, exposure to adversity, violence and criminal justice systems demands comprehensive programming to support families. Trauma-informed approaches to career readiness such as the Building Wealth and Health Network offer opportunities for potential success in the workforce. TRIAL REGISTRATION This study is retrospectively registered with ClinicalTrials.gov. The Identifier is: NCT02577705 The Registration date is October 13, 2015.
Collapse
Affiliation(s)
- Jing Sun
- />Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, 2213 McElderry St, Room M139, Baltimore, MD 21205 USA
| | - Falguni Patel
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | | | - Nijah Newton-Famous
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Constance Owens
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| | - Seth L. Welles
- />Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, 3215 Market Street, 5th Floor, Room 535, Philadelphia, PA 19104 USA
| | - Mariana Chilton
- />Department of Health Management and Policy, Drexel University Dornsife School of Public Health, 3600 Market Street, 7th Floor, Philadelphia, PA 19104 USA
| |
Collapse
|
14
|
McKay HS, Bream JH, Margolick JB, Martínez-Maza O, Phair JP, Rinaldo CR, Abraham AG, Jacobson LP. Host factors associated with serologic inflammatory markers assessed using multiplex assays. Cytokine 2016; 85:71-9. [PMID: 27295613 DOI: 10.1016/j.cyto.2016.05.016] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2015] [Revised: 05/10/2016] [Accepted: 05/16/2016] [Indexed: 02/06/2023]
Abstract
Chronic systemic inflammation contributes to the development of adverse health conditions, yet the influence of fixed and modifiable risk factors on many serologic biomarkers of inflammation remains largely unknown. Serum concentrations of twenty-three biomarkers, including C-reactive protein (CRP), cytokines (CXCL11, CXCL8, CXCL10, CCL2, CCL13, CCL4, CCL17, CXCL13, IL-10, IL-12p70, IL-6, TNF-α, IL-2, IFN-γ, IL-1β, GM-CSF, BAFF), and soluble immune receptors (sCD14, sIL-2Rα, sCD27, sgp130, sTNF-R2) were measured longitudinally using multiplexed immunometric assays in 250 HIV-uninfected men followed in the Multicenter AIDS Cohort Study (1984-2009). Generalized gamma regression was used to determine the statistical significance of factors associated with each biomarker. After accounting for age, race, and education, and for analysis of multiple biomarkers, higher concentrations of specific individual biomarkers were significantly (P<0.002) associated with hypertension, obesity, hepatitis C infection, stimulant use, and diabetes and lower concentrations with hypercholesterolemia. These associations should be taken into account in epidemiological studies of these biomarkers, and may provide potential targets for disease prevention and treatment.
Collapse
Affiliation(s)
- Heather S McKay
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Jay H Bream
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joseph B Margolick
- W. Harry Feinstone Department of Molecular Microbiology and Immunology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Otoniel Martínez-Maza
- Department of Obstetrics & Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Microbiology, Immunology & Molecular Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Epidemiology, UCLA Fielding School of Public Health, University of California, Los Angeles, CA, USA
| | - John P Phair
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Charles R Rinaldo
- Department of Molecular Virology and Microbiology, University of Pittsburgh School of Medicine, Pittsburgh, CA, USA
| | - Alison G Abraham
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa P Jacobson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
15
|
Windsor LC, Jemal A, Benoit E. Community Wise: paving the way for empowerment in community reentry. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:501-511. [PMID: 24630737 DOI: 10.1016/j.ijlp.2014.02.023.nihms576112] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers.
Collapse
Affiliation(s)
- Liliane Cambraia Windsor
- Rutgers, State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104, USA.
| | - Alexis Jemal
- Rutgers, State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104, USA
| | - Ellen Benoit
- National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
| |
Collapse
|
16
|
Windsor LC, Jemal A, Benoit E. Community Wise: paving the way for empowerment in community reentry. INTERNATIONAL JOURNAL OF LAW AND PSYCHIATRY 2014; 37:501-11. [PMID: 24630737 PMCID: PMC4142095 DOI: 10.1016/j.ijlp.2014.02.023] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
Theoretical approaches traditionally applied in mental health and criminal justice interventions fail to address the historical and structural context that partially explains health disparities. Community Wise was developed to address this gap. It is a 12week group intervention informed by Critical Consciousness Theory and designed to prevent substance abuse, related health risk behaviors, psychological distress, and reoffending among individuals with a history of incarceration and substance abuse. This paper reports findings from the first implementation and pilot evaluation of Community Wise in two community-based organizations. This pre-posttest evaluation pilot-tested Community Wise and used findings to improve the intervention. Twenty-six participants completed a phone and clinical screening, baseline, 6- and 12-week follow-ups, and a focus group at the end of the intervention. Measures assessed participants' demographic information, psychological distress, substance use, criminal offending, HIV risk behaviors, community cohesion, community support, civic engagement, critical consciousness, ethnic identification, group cohesion, client satisfaction, and acquired treatment skills. Research methods were found to be feasible and useful in assessing the intervention. Results indicated that while Community Wise is a promising intervention, several changes need to be made in order to enhance the intervention. Community Wise is a new approach where oppressed individuals join in critical dialogue, tap into existing community resources, and devise, implement and evaluate their own community solutions to structural barriers.
Collapse
Affiliation(s)
- Liliane Cambraia Windsor
- Rutgers, State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104, USA.
| | - Alexis Jemal
- Rutgers, State University of New Jersey, School of Social Work, 360 Martin Luther King Jr. Blvd, Hill Hall, Room 401, Newark, NJ 07104, USA
| | - Ellen Benoit
- National Development and Research Institutes, Inc., 71 West 23rd Street, 8th Floor, New York, NY 10010, USA
| |
Collapse
|
17
|
Djawe K, Brown EEJ, Gaul Z, Sutton M. Community-based electronic data collections for HIV prevention research with black/African-American men in the rural, Southern USA. AIDS Care 2014; 26:1309-17. [PMID: 24773187 DOI: 10.1080/09540121.2014.911812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
In Florida, the HIV case rate among black men is five times that of white men; tailored HIV prevention interventions are lacking. Historical concerns regarding trust with public health venues and sharing sensitive information make face-to-face data collection with some rural, southern black men challenging. We evaluated the feasibility and acceptability of using audio computer-assisted self-interviews (ACASIs) by local community-based organization members to collect HIV-related information from black men in rural settings. We used logistic regression to estimate associations between using ACASI and participants' sociodemographic characteristics. Of 636 men approached, 586 (92.0%) participated, 479 (81.7%) never completed a computer survey, and 287 (71%) of those reporting a preference preferred ACASI for future data collections. Increased age, past computer use, and sharing a household with someone were significantly associated with ACASI feasibility and acceptability. Using ACASI with black men in rural settings is feasible for HIV intervention research and disparity-reducing goals.
Collapse
Affiliation(s)
- Kpandja Djawe
- a Division of HIV/AIDS Prevention , Centers for Disease Control and Prevention , Atlanta , GA , USA
| | | | | | | |
Collapse
|
18
|
Color-coded audio computer-assisted self-interviews (C-ACASI) for poorly educated men and women in a semi-rural area of South India: "good, scary and thrilling". AIDS Behav 2013; 17:2260-8. [PMID: 23361948 DOI: 10.1007/s10461-013-0414-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
It is challenging to collect accurate and complete data on sensitive issues such as sexual behaviors. Our objective was to explore experience and perceptions regarding the use of a locally programmed color-coded audio computer-assisted self interview (C-ACASI) system among men and women in a semi-rural setting in south India. We conducted a mixed-methods cross-sectional survey using semi-structured interviews among 89 truck drivers and 101 truck driver wives who had participated earlier in the C-ACASI survey across a predominantly rural district in Tamil Nadu. To assess the color-coded format used, descriptive quantitative analysis was coupled with thematic content analysis of qualitative data. Only 10% of participants had ever used a computer before. Nearly 75% did not report any problem in using C-ACASI. The length of the C-ACASI survey was acceptable to 98% of participants. Overall, 87% of wives and 73% of truck drivers stated that C-ACASI was user-friendly and felt comfortable in responding to the sensitive questions. Nearly all (97%) participants reported that using C-ACASI encouraged them to respond honestly compared to face-to-face personal interviews. Both the drivers and wives expressed that C-ACASI provided confidentiality, privacy, anonymity, and an easy mechanism for responding truthfully to potentially embarrassing questions about their personal sexual relationships. It is feasible and acceptable to use C-ACASI for collecting sensitive data from poorly computer-literate, non-English-speaking, predominantly rural populations of women and men. Our findings support the implementation of effective and culturally sensitive C-ACASI for data collection, albeit with additional validation.
Collapse
|
19
|
Blatyta PF, Custer B, Gonçalez TT, Birch R, Lopes ME, Lopes Ferreira MI, Carneiro Proietti AB, Sabino EC, Page K, de Almeida-Neto C. Undisclosed human immunodeficiency virus risk factors identified through a computer-based questionnaire program among blood donors in Brazil. Transfusion 2013; 53:2734-43. [PMID: 23521083 DOI: 10.1111/trf.12166] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2012] [Revised: 12/10/2012] [Accepted: 12/10/2012] [Indexed: 12/31/2022]
Abstract
BACKGROUND Human immunodeficiency virus (HIV) risk factor screening among blood donors remains a cornerstone for the safety of blood supply and is dependent on prospective donor self-disclosure and an attentive predonation interview. Audio computer-assisted structured interview (ACASI) has been shown to increase self-reporting of risk behaviors. STUDY DESIGN AND METHODS This cross-sectional study was conducted between January 2009 and March 2011 at four Brazilian blood centers to identify the population of HIV-negative eligible blood donors that answered face-to-face interviews without disclosing risks, but subsequently disclosed deferrable risk factors by ACASI. Compared to the donor interview, the ACASI contained expanded content on demographics, sexual behavior, and other HIV risk factors questions. RESULTS A total of 901 HIV-negative blood donors were interviewed. On the ACASI, 13% of donors (n = 120) declared a risk factor that would have resulted in deferral that was not disclosed during the face-to-face assessment. The main risk factors identified were recent unprotected sex with an unknown or irregular partner (49 donors), sex with a person with exposure to blood or fluids (26 donors), multiple sexual partners (19 donors), and male-male sexual behavior (10 donors). Independent factors associated with the disclosure of any risk factor for HIV were age (≥40 years vs. 18-25 years; adjusted odds ratio [AOR], 0.45; 95% confidence interval [CI], 0.23-0.88) and blood center (Hemope vs. Hemominas; AOR, 2.51; 95% CI, 1.42-4.44). CONCLUSION ACASI elicited increased disclosure of HIV risk factors among blood donors. ACASI may be a valuable modality of interview to be introduced in Brazilian blood banks.
Collapse
Affiliation(s)
- Paula Fraiman Blatyta
- Fundação Pró-Sangue Hemocentro de São Paulo, São Paulo, SP, Brazil; Blood Systems Research Institute, San Francisco, California; Westat, Rockville, Maryland; Fundação Hemorio, Rio de Janeiro, RJ, Brazil; Fundação Hemope, Recife, PE, Brazil; Fundação Hemominas, Belo Horizonte, MG, Brazil; Department of Infectious Diseases, Medical School, University of São Paulo, São Paulo, SP, Brazil; University of California at San Francisco, San Francisco, California
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
20
|
Etcheverry MF, Evans JL, Sanchez E, Mendez-Arancibia E, Meroño M, Gatell JM, Page K, Joseph J. Enhanced retention strategies and willingness to participate among hard-to-reach female sex workers in Barcelona for HIV prevention and vaccine trials. Hum Vaccin Immunother 2013; 9:420-9. [PMID: 23291931 PMCID: PMC3859767 DOI: 10.4161/hv.22903] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The potential for implementation of HIV vaccine trials in hard-to-reach female sex workers in an inner city area of Barcelona, Spain was assessed via a study of HIV risk, willingness to participate and the success of retention strategies. In 130 women, serological HIV status, behavioral risk exposures and willingness to participate in future HIV vaccine trials were recorded every six months using a confidential questionnaire. An enhanced retention (ER) strategy was compared with a control retention (CR) strategy comprising the recording of data on appointment cards. HIV seroincidence and retention rates were estimated. Retention rates after 6 and 12 mo of follow-up in the ER group were 76% and 69% respectively compared with 16% and 13% in the CR group. Among the ER group 97% were willing to participate in HIV vaccine trials at baseline and, after 12 mo of follow-up. Willingness was significantly associated with higher HIV risk exposure, and higher education level. Successfully retaining these cohorts over time in settings with a high HIV seroincidence rate is an ongoing challenge that will need to be addressed to ensure participation in future trials. Furthermore, as we have demonstrated, the fact that retaining hard-to-reach populations is difficult should not exclude this target population for HIV vaccine and prevention trials.
Collapse
Affiliation(s)
- M Florencia Etcheverry
- AIDS Research Unit; Hospital Clínic/IDIBAPS-HIVACAT; University of Barcelona; Barcelona, Spain
| | | | | | | | | | | | | | | |
Collapse
|
21
|
Marks King R, Vidrine DJ, Danysh HE, Fletcher FE, McCurdy S, Arduino RC, Gritz ER. Factors associated with nonadherence to antiretroviral therapy in HIV-positive smokers. AIDS Patient Care STDS 2012; 26:479-85. [PMID: 22612468 DOI: 10.1089/apc.2012.0070] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Adherence to antiretroviral therapy (ART) has markedly improved HIV disease management, and significantly reduced HIV/AIDS-associated morbidity and mortality. Although recent studies suggest a relationship between smoking and suboptimal adherence to ART, a more in-depth understanding of this relationship is needed. We conducted a secondary analysis using data from a randomized controlled smoking cessation trial to investigate the association of nonadherence to ART with potential demographic, psychosocial (perceived stress and depression), and substance use (nicotine dependence, illicit drug use, and alcohol use) variables among persons living with HIV/AIDS (PLWHA) who smoke. The mean (standard deviation [SD]) age of participants (n=326) was 45.9 years old (SD=7.6). Additionally, the majority were male (72.1%), self-identified as black (76.7%), and reported sexual contact as the mode of HIV acquisition (70%). Unadjusted logistic regression analysis indicated that depression (odds ratio [OR]=1.02; 95% confidence interval [CI]=1.00, 1.04), illicit drug use (OR=2.39; 95% CI=1.51, 3.79) and alcohol use (OR=2.86; 95%CI=1.79, 4.57) were associated with nonadherence. Adjusted logistic regression analysis indicated that nicotine dependence (OR=1.13; 95% CI=1.02, 1.25), illicit drug use (OR=2.10; 95% CI=1.27, 3.49), alcohol use (OR=2.50; 95% CI=1.52, 4.12), and age (OR=1.04; 95% CI=1.00, 1.07) were associated with nonadherence. Nicotine dependence, illicit drug use, and alcohol use are potentially formidable barriers to ART adherence among PLWHA who smoke. Future efforts should investigate the complex relationships among these variables to improve adherence particularly among populations confronted with multifaceted health challenges.
Collapse
Affiliation(s)
- Rachel Marks King
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Damon J. Vidrine
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Heather E. Danysh
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Faith E. Fletcher
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Sheryl McCurdy
- Department of Health Promotion and Behavioral Sciences, University of Texas School of Public Health, Houston, Texas
| | - Roberto C. Arduino
- Department of Internal Medicine/Infectious Diseases, The University of Texas Health Science Center at Houston Medical School, Houston, Texas
| | - Ellen R. Gritz
- Department of Behavioral Science, The University of Texas MD Anderson Cancer Center, Houston, Texas
| |
Collapse
|
22
|
Dolezal C, Marhefka SL, Santamaria EK, Leu CS, Brackis-Cott E, Mellins CA. A comparison of audio computer-assisted self-interviews to face-to-face interviews of sexual behavior among perinatally HIV-exposed youth. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:401-410. [PMID: 21604065 PMCID: PMC3621976 DOI: 10.1007/s10508-011-9769-6] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Revised: 04/16/2011] [Accepted: 04/21/2011] [Indexed: 05/28/2023]
Abstract
Computer-assisted interview methods are increasingly popular in the assessment of sensitive behaviors (e.g., substance abuse and sexual behaviors). It has been suggested that the effect of social desirability is diminished when answering via computer, as compared to an interviewer-administered face-to-face (FTF) interview, although studies exploring this hypothesis among adolescents are rare and yield inconsistent findings. This study compared two interview modes among a sample of urban, ethnic-minority, perinatally HIV-exposed U.S. youth (baseline = 148 HIV+, 126 HIV-, ages 9-16 years; follow-up = 120 HIV+, 110 HIV-, ages 10-19 years). Participants were randomly assigned to receive a sexual behavior interview via either Audio Computer-Assisted Self-Interview (ACASI) or FTF interview. The prevalence of several sexual behaviors and participants' reactions to the interviews were compared. Although higher rates of sexual behaviors were typically reported in the ACASI condition, the differences rarely reached statistical significance, even when limited to demographic subgroups--except for gender. Boys were significantly more likely to report several sexual behaviors in the ACASI condition compared to FTF, whereas among girls no significant differences were found between the two conditions. ACASI-assigned youth rated the interview process as easier and more enjoyable than did FTF-assigned youth, and this was fairly consistent across subgroup analyses as well. We conclude that these more positive reactions to the ACASI interview give that methodology a slight advantage, and boys may disclose more sexual behavior when using computer-assisted interviews.
Collapse
Affiliation(s)
- Curtis Dolezal
- HIV Center for Clinical and Behavioral Studies, Unit 15, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, New York, NY 10032, USA.
| | | | | | | | | | | |
Collapse
|
23
|
Etcheverry MF, de Lazzari E, Fuchs JD, Meroño M, Sierra E, Del Romero J, Evans JL, Mendez-Arancibia E, Jacques C, Rojas D, Segú M, Gatell JM, Joseph J. Pilot study assessing HIV vaccine trial readiness among female sex workers, injection and non-injection drug users, and men who have sex with men in Spain. AIDS Behav 2010; 14:607-17. [PMID: 19037720 DOI: 10.1007/s10461-008-9486-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to assess HIV risk and willingness to participate in HIV vaccine trials in three high risk populations in Spain. Eight hundred and forty-four participants, comprising female sex workers, injection and non-injection drug users (IDUs and NIDUs, respectively), and men who have sex with men were tested for HIV and surveyed for risk and willingness to participate in future preventive HIV vaccine trials. HIV seroprevalence was 3.8% (95% CI: 2-11). HIV infection was associated with transgender identification, IDU in the past year, and sex with an IDU or other drug-using partner. The majority (82%) expressed their willingness to participate in HIV vaccine trials. Substantial sexual and parenteral risk in all groups and concomitant willingness to participate in vaccine trials was found, particularly among women and IDUs. Additional longitudinal cohort studies in Spain are needed to plan future vaccine efficacy trials.
Collapse
Affiliation(s)
- María Florencia Etcheverry
- AIDS Research Unit, Infectious Diseases Department, Hospital Clínic/IDIBAPS, School of Medicine, University of Barcelona, C/ Villarroel, 170, 08036, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
24
|
Estes LJ, Lloyd LE, Teti M, Raja S, Bowleg L, Allgood KL, Glick N. Perceptions of audio computer-assisted self-interviewing (ACASI) among women in an HIV-positive prevention program. PLoS One 2010; 5:e9149. [PMID: 20161771 PMCID: PMC2818842 DOI: 10.1371/journal.pone.0009149] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Accepted: 01/15/2010] [Indexed: 11/18/2022] Open
Abstract
Background Audio Computer-Assisted Self Interviewing (ACASI) has improved the reliability and accuracy of self-reported HIV health and risk behavior data, yet few studies account for how participants experience the data collection process. Methodology/Principal Findings This exploratory qualitative analysis aimed to better understand the experience and implications of using ACASI among HIV-positive women participating in sexual risk reduction interventions in Chicago (n = 12) and Philadelphia (n = 18). Strategies of Grounded Theory were used to explore participants' ACASI experiences. Conclusion/Significance Key themes we identified included themes that could be attributed to the ACASI and other methods of data collection (e.g., paper-based self-administered questionnaire or face-to-face interviews). The key themes were usability; privacy and honesty; socially desirable responses and avoiding judgment; and unintentional discomfort resulting from recalling risky behavior using the ACASI. Despite both positive and negative findings about the ACASI experience, we conclude that ACASI is in general an appropriate method for collecting sensitive data about HIV/AIDS risk behaviors among HIV-positive women because it seemed to ensure privacy in the study population allowing for more honest responses, minimize socially desirable responses, and help participants avoid actual or perceived judgment.
Collapse
Affiliation(s)
- Larissa J Estes
- School of Public Health, University of Texas, Houston, Texas, United States of America.
| | | | | | | | | | | | | |
Collapse
|
25
|
Pallett E, Rentowl P, Hanning C. The brief fatigue inventory: comparison of data collection using a novel audio device with conventional paper questionnaire. J Pain Symptom Manage 2009; 38:390-400. [PMID: 19577421 DOI: 10.1016/j.jpainsymman.2008.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Revised: 10/21/2008] [Accepted: 12/10/2008] [Indexed: 11/28/2022]
Abstract
An Electronic Portable Information Collection audio device (EPIC-Vox) has been developed to deliver questionnaires in spoken word format via headphones. Patients respond by pressing buttons on the device. The aims of this study were to determine limits of agreement between, and test-retest reliability of audio (A) and paper (P) versions of the Brief Fatigue Inventory (BFI). Two hundred sixty outpatients (204 male, mean age 55.7 years) attending a sleep disorders clinic were allocated to four groups using block randomization. All completed the BFI twice, separated by a one-minute distracter task. Half the patients completed paper and audio versions, then an evaluation questionnaire. The remainder completed either paper or audio versions to compare test-retest reliability. BFI global scores were analyzed using Bland-Altman methodology. Agreement between categorical fatigue severity scores was determined using Cohen's kappa. The mean (SD) difference between paper and audio scores was -0.04 (0.48). The limits of agreement (mean difference+/-2SD) were -0.93 to +1.00. Test-retest reliability of the paper BFI showed a mean (SD) difference of 0.17 (0.32) between first and second presentations (limits -0.46 to +0.81). For audio, the mean (SD) difference was 0.17 (0.48) (limits -0.79 to +1.14). For agreement between categorical scores, Cohen's kappa=0.73 for P and A, 0.67 (P at test and retest) and 0.87 (A at test and retest). Evaluation preferences (n=128): 36.7% audio; 18.0% paper; and 45.3% no preference. A total of 99.2% found EPIC-Vox "easy to use." These data demonstrate that the English audio version of the BFI provides an acceptable alternative to the paper questionnaire.
Collapse
Affiliation(s)
- Edward Pallett
- Department of Health Sciences, Division of Anaesthesia, Critical Care and Pain Management, University Hospitals of Leicester NHS Trust, Leicester Royal Infirmary, Leicester, UK.
| | | | | |
Collapse
|
26
|
Designing an audio computer-assisted self-interview (ACASI) system in a multisite trial: a brief report. J Acquir Immune Defic Syndr 2008; 49 Suppl 1:S52-8. [PMID: 18724191 DOI: 10.1097/qai.0b013e318184481a] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To describe the advantages and limitations of an audio computer-assisted self-interview (ACASI) system in a multisite trial with African American couples and to present the steps in designing, testing, and implementing a system. METHODS The ACASI system evolved from a paper and pencil interview that was pilot tested. Based on this initial work, the paper and pencil interview was translated into storyboards that were the basis of the development of ACASI system. Storyboards consisted of 1 page per question and provided the programmers with the test of the question, valid responses, and any instructions that were to be read to the participants. Storyboards were further translated into flow diagrams representing each module of the survey and illustrating the skip patterns used to navigate a participant through the survey. Provisions were also made to insert a face-to-face interview, into the ACASI assessment process, to elicit sexual abuse history data, which typically requires specially trained data collectors with active listening skills to help participants reframe and coordinate times, places and, emotionally difficult memories. RESULTS The ACASI was successfully developed and implemented in the main trial. During an exit interview, respondents indicated that they liked using the ACASI and indicating that they favored it as the method to answer questions. CONCLUSIONS It is feasible to implement an ACASI system in a multisite study in a timely and efficient way.
Collapse
|
27
|
Boily MC, Abu-Raddad L, Desai K, Masse B, Self S, Anderson R. Measuring the public-health impact of candidate HIV vaccines as part of the licensing process. THE LANCET. INFECTIOUS DISEASES 2008; 8:200-7. [PMID: 18291341 DOI: 10.1016/s1473-3099(07)70292-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The full impact of vaccines against infectious diseases is manifest at both the individual and the community levels. We argue that evaluating the community-level impact of HIV vaccine candidates should be an integral part of the licensing process. We describe a framework for the public-health evaluation of an HIV vaccine, which is based on the interactive use of mathematical models and community randomised clinical trials (C-RCTs) following completion of individual-based clinical trials (I-RCTs). Mathematical models of HIV vaccine can be used to take public-health considerations into account during the licensing process and can also help to select promising vaccine candidates for testing in C-RCTs. We also describe community and individual-based measures useful for defining public-health criteria necessary to guide the licensing process. To move forward, it is crucial to reach a consensus on what should constitute adequate public-health criteria. At the very least, a suitable vaccine would provide some individual benefit to vaccinees and not be detrimental to the population at large. In future I-RCTs and C-RCTs, quantifying each protective vaccine characteristic (eg, reductions in susceptibility or viral load) is important if regulators are to evaluate adequately the potential community-level impact of the vaccine across different settings, populations, and conditions of use.
Collapse
Affiliation(s)
- Marie-Claude Boily
- Department of Infectious Diseases, Faculty of Medicine, Imperial College, London, UK.
| | | | | | | | | | | |
Collapse
|