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Lucas JA, Marino M, Datta R, Chan BL, Heintzman JD. Ethnicity, Language, and HIV Screening in Older Adult Safety-Net Patients. Am J Prev Med 2023; 65:112-116. [PMID: 36754743 PMCID: PMC10293068 DOI: 10.1016/j.amepre.2023.01.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 01/10/2023] [Accepted: 01/12/2023] [Indexed: 02/09/2023]
Abstract
INTRODUCTION HIV screening should occur for all adults at least once by age 65 years. Older adults have low screening rates. Latinos, with historically low screening rates, have worse HIV outcomes than non-Hispanic White patients. Electronic health record data from a multistate network of community health centers were used to examine whether there are differences in HIV screening for Latino (English and Spanish preferring) and non-Hispanic White older adults. METHODS Data were from the Accelerating Data Value Across a National Community Health Center Network Clinical Research Network of PCORnet from 21 states in 2012-2021 among an open cohort of patients aged 50-65 years. Relative odds of ever having received HIV screening comparing Latinos with non-Hispanic Whites using generalized estimating equation logistic regression modeling were calculated, adjusting for relevant patient-level covariates. Analyses were conducted in 2022. RESULTS Among 251,645 patients, the covariate-adjusted odds of ever receiving HIV screening were 18% higher for English-preferring Latino patients (OR=1.18, 95% CI=1.11, 1.25) and 32% higher for Spanish-preferring Latinos than for non-Hispanic Whites (OR=1.32, 95% CI=1.24, 1.42). CONCLUSIONS Latinos seen in community health centers, regardless of language spoken, are more likely to be screened at least once for HIV than non-Hispanic Whites. This increased screening may be due at least in part to the community health center setting, a setting known to mitigate disparities, as well as due to participation efforts by community health centers in public health campaigns. Future research can prioritize understanding the cause of this relative advantage.
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Affiliation(s)
- Jennifer A Lucas
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon.
| | - Miguel Marino
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | - Roopradha Datta
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon
| | - Brian L Chan
- OCHIN, Inc., Portland, Oregon; Department of Medicine, Oregon Health & Science University, Portland, Oregon
| | - John D Heintzman
- Department of Family Medicine, Oregon Health & Science University, Portland, Oregon; OCHIN, Inc., Portland, Oregon
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2
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Jones J, McKenzie-White J, Saxton R, Grieb SM, Nonyane B, Graham C, Cano A, Johnson S, Childs L, Greenbaum A, Flynn C, Pearlowitz M, Celano S, Chang LW, Page KR. Leveraging mHealth and Patient Supporters for African Americans' and Latinxs' Engagement in HIV Care (LEAN): Protocol for a Randomized, Controlled, Effectiveness-Implementation Trial. JMIR Res Protoc 2023; 12:e42691. [PMID: 36787165 PMCID: PMC9975915 DOI: 10.2196/42691] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 11/02/2022] [Accepted: 11/18/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Despite substantial investments in ending the HIV epidemic, disparities in HIV care persist, and there is an urgent need to evaluate novel and scalable approaches to improving HIV care engagement and viral suppression in real-world settings. OBJECTIVE This paper aims to describe a study protocol for a pragmatic type II hybrid effectiveness-implementation randomized controlled trial comparing existing standard of care clinic HIV linkage, adherence, and retention (LAR) protocols to a mobile health (mHealth)-enhanced linkage, adherence, and retention (mLAR) intervention. METHODS The study will enroll 450 participants from clinics in Baltimore City. Eligibility criteria include being ≥18 years of age, having a new HIV diagnosis or being HIV-positive and out of care, or being HIV-positive and deemed by clinic staff as someone who could benefit from linkage and retention services. Participants randomized to the intervention receive mHealth-supported patient navigation for 12 months. Participants in the control group receive the referring clinic's standard of care patient support. The primary outcome is HIV virologic suppression at 12 months. A subset of participants will be interviewed at 12 months to learn about their HIV care experiences and, for those in the intervention arm, their experiences with the mLAR intervention. This protocol was developed in collaboration with the Baltimore City Health Department (BCHD) and the Maryland Department of Health (MDH) and with input from a community advisory board. RESULTS Enrollment began on February 25, 2020. As of August 11, 2022, 411 of the 450 target participants had been enrolled. CONCLUSIONS Pragmatic implementation science trials designed with input from key stakeholders, including health departments and community members, can help evaluate the evidence for mHealth interventions to reduce HIV health disparities. TRIAL REGISTRATION ClinicalTrials.gov NCT03934437; https://clinicaltrials.gov/ct2/show/NCT03934437. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/42691.
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Affiliation(s)
- Joyce Jones
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | | | - Ronald Saxton
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Suzanne M Grieb
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Bareng Nonyane
- Bloomberg School of Public Health, Johns Hopkins, Baltimore, MD, United States
| | - Cadeesha Graham
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Anthony Cano
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Sheridan Johnson
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
- Baltimore City Health Department, Baltimore, MD, United States
| | - Lanisha Childs
- Baltimore City Health Department, Baltimore, MD, United States
| | - Adena Greenbaum
- Baltimore City Health Department, Baltimore, MD, United States
| | - Colin Flynn
- Maryland Department of Health, Baltimore, MD, United States
| | | | - Shivaun Celano
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Larry W Chang
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
| | - Kathleen R Page
- School of Medicine, Johns Hopkins, Baltimore, MD, United States
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3
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Yuan S, Jiang SC, Zhang ZW, Fu YF, Yang XY, Li ZL, Hu J. How and when does monkeypox (mpox) transmit: Implications for prevention and treatments. Front Pharmacol 2023; 13:1109928. [PMID: 36686676 PMCID: PMC9849587 DOI: 10.3389/fphar.2022.1109928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Accepted: 12/23/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Shu Yuan
- College of Resources, Sichuan Agricultural University, Chengdu, China,*Correspondence: Shu Yuan,
| | - Si-Cong Jiang
- Haisco Pharmaceutical Group Comp., Ltd., Chengdu, China
| | - Zhong-Wei Zhang
- College of Resources, Sichuan Agricultural University, Chengdu, China
| | - Yu-Fan Fu
- College of Resources, Sichuan Agricultural University, Chengdu, China
| | - Xin-Yue Yang
- College of Resources, Sichuan Agricultural University, Chengdu, China
| | - Zi-Lin Li
- Department of Cardiovascular Surgery, Xijing Hospital, Medical University of the Air Force, Xi’an, China
| | - Jing Hu
- School of Medicine, Northwest University, Xi’an, China
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Gonzalez Rodriguez H, Barrington C, McCallister KN, Guy J, Hightow-Weidman L, Hurt CB, McNeil CJ, Sena AC. Perceptions, experiences, and preferences for partner services among Black and Latino men who have sex with men and transwomen in North Carolina. ETHNICITY & HEALTH 2022; 27:1241-1255. [PMID: 33734826 PMCID: PMC8448793 DOI: 10.1080/13557858.2021.1899137] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/01/2021] [Indexed: 06/12/2023]
Abstract
OBJECTIVES In the United States, sexually transmitted infections (STIs) disproportionately affect men who have sex with men (MSM) and transwomen of color. Partner services can prevent STI transmission by facilitating testing and treatment for partners of individuals diagnosed with an STI. Understanding client perspectives towards partner services is critical to their acceptance and uptake. This study examined perceptions, experiences, and preferences for partner services among Black and Latino MSM and transwomen in North Carolina. DESIGN We conducted seven audio-recorded focus groups in English (n = 5) and Spanish (n = 2). The audio was transcribed verbatim and we inductively analyzed data using field notes, systematic coding, and thematic comparison. RESULTS Black MSM reported the most exposure and experiences with partner services, and most perceived partner services negatively. Feeling supported and having flexibility characterized positive experiences with partner services among Black MSM; feeling judged or harassed characterized negative experiences. Black transwomen had less exposure to partner services and had a mix of positive reactions to the approach, along with concerns about client confidentiality. Most Latino participants were unaware of partner services and expressed openness to their potential. All participants preferred self-notifying and wanted flexible, discreet, supportive partner services with linkages to other wellness resources. CONCLUSION Building off positive partner services experiences and responding to client preferences can enhance trust, acceptability, and service use.
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Affiliation(s)
- Humberto Gonzalez Rodriguez
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Katherine Nicole McCallister
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Jalila Guy
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Lisa Hightow-Weidman
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Christopher Browning Hurt
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Candice Joy McNeil
- Department of Medicine, Section on Infectious Diseases, Wake Forest University Health Sciences, Winston-Salem, NC, USA
| | - Arlene Carmela Sena
- Institute for Global Health & Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Galvan FH, Liu H, Brooks RA, Chen YT, Mendoza Lepe R. Using social and sexual networking mobile applications to promote HIV testing, medical care and prevention services among Latino men who have sex with men in Los Angeles County, California, USA. PLoS One 2022; 17:e0268406. [PMID: 35560041 PMCID: PMC9106153 DOI: 10.1371/journal.pone.0268406] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 04/28/2022] [Indexed: 11/18/2022] Open
Abstract
HIV disproportionately affects Latinos versus Whites, with Latinos having higher rates of HIV. Additionally, many HIV-positive Latinos are unaware of their infection. Proyecto Protégete, an HIV prevention intervention developed for Latino men who have sex with men (MSM), used social and sexual networking mobile applications (apps) to recruit individuals for HIV testing and linkage to medical care and prevention services. This study occurred in Los Angeles County, California, USA from December 18, 2015 to April 22, 2017. The study’s primary aim was to assess Proyecto Protégete‘s ability to successfully recruit Latino MSM involved in high-risk sexual activities. A secondary aim was to evaluate its capacity to promote HIV testing and linkage to HIV medical care and prevention services among this population by comparing it to two programs with similar samples. Comparisons using Fisher’s Exact Test were conducted between Proyecto Protégete and the HIV testing program of the agency in which Proyecto Protégete was located and the County-funded HIV testing programs to compare the samples’ rates of HIV-positive Latino MSM identified through HIV testing and linked to HIV medical care and prevention services. Participants were recruited through seven apps. In Proyecto Protégete, 9,573 individuals completed the screener, 4,657 were eligible, and 359 (7.7% of those eligible) enrolled. Among those enrolled, 79% reported anal sex without a condom in the previous twelve months; 51% reported anal sex under the influence of alcohol. The HIV positivity rates were as follows: Proyecto Protégete, 1.71%; the agency, 1.25% (p = .293, compared to Proyecto Protégete); and the County, 1.09% (p = .172, compared to Proyecto Protégete). The rates of those confirmed as new HIV-positives and linked to medical care within 30 days were as follows: Proyecto Protégete, 71.4%; the agency, 81.5% (p = .450, compared to Proyecto Protégete); and the County, 77.3% (p = .503, compared to Proyecto Protégete). Proyecto Protégete had a higher rate of linked referrals to prevention services than the agency’s testing program (19.5% versus 8.3%, p < .001). Proyecto Protégete experienced successes in some areas but not in others. Future research should build on Proyecto Protégete’s experiences to promote HIV-related services among Latino MSM.
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Affiliation(s)
- Frank H. Galvan
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
| | - Honghu Liu
- Division of Public Health & Community Dentistry, School of Dentistry, University of California, Los Angeles, California, United States of America
- Division of General Internal Medicine & Health Services Research, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- Department of Biostatistics, Jonathan and Karin Fielding School of Public Health, University of California, Los Angeles, California, United States of America
| | - Ronald A. Brooks
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
- Department of Family Medicine, David Geffen School of Medicine, University of California, Los Angeles, California, United States of America
- * E-mail:
| | - Ying-Tung Chen
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
| | - Ricardo Mendoza Lepe
- Department of Research and Evaluation, Bienestar Human Services, Inc., Los Angeles, California, United States of America
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Johnson Lyons S, Gant Z, Jin C, Dailey A, Nwangwu-Ike N, Satcher Johnson A. A Census Tract-Level Examination of Differences in Social Determinants of Health Among People With HIV, by Race/Ethnicity and Geography, United States and Puerto Rico, 2017. Public Health Rep 2022; 137:278-290. [PMID: 33629905 PMCID: PMC8900243 DOI: 10.1177/0033354921990373] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/06/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Social and structural factors, referred to as social determinants of health (SDH), create pathways or barriers to equitable sexual health, and information on these factors can provide critical insight into rates of diseases such as HIV. Our objectives were to describe and identify differences, by race/ethnicity and geography, in SDH among adults with HIV. METHODS We conducted an ecological study to explore SDH among people with HIV diagnosed in 2017, by race/ethnicity and geography, at the census-tract level in the United States and Puerto Rico. We defined the least favorable SDH as the following: low income (<$40 000 in median annual household income), low levels of education (≥18% of residents have RESULTS HIV diagnosis rates increased 1.4 to 4.0 times among men and 1.5 to 5.5 times among women as census-tract poverty levels increased, education levels decreased, income decreased, unemployment increased, lack of health insurance increased, and vacant housing increased. Among racial/ethnic groups by region and SDH, we observed higher HIV diagnosis rates per 100 000 population among non-Hispanic Black (49.6) and non-Hispanic White (6.5) adults in the South and among Hispanic/Latino (27.4) adults in the Northeast than in other regions. We observed higher HIV diagnosis rates per 100 000 population among non-Hispanic Black (44.3) and Hispanic/Latino (21.1) adults than among non-Hispanic White (5.1) adults. CONCLUSION Our findings highlight the importance of SDH in HIV infection and support the need for effective, targeted local interventions to specific populations based on HIV diagnoses and prevalence to prevent infection and reduce racial/ethnic disparities.
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Affiliation(s)
- Shacara Johnson Lyons
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Zanetta Gant
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Chan Jin
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
- ICF, Atlanta, GA, USA
| | - André Dailey
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ndidi Nwangwu-Ike
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Anna Satcher Johnson
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Azhar S, Tao X, Jokhakar V, Fisher CB. Barriers and Facilitators to Participation in Long-Acting Injectable PrEP Research Trials for MSM, Transgender Women, and Gender-Nonconforming People of Color. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2021; 33:465-482. [PMID: 34874761 PMCID: PMC10916744 DOI: 10.1521/aeap.2021.33.6.465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
We collected 216 responses from sexually active MSM, transgender women, and gender-nonconforming (GNC) people of color through a web-based survey to understand the facilitators and barriers to research participation in a hypothetical LAI PrEP trial. In adjusted models, these items were found to be significantly associated with research participation likelihood: ever participated in HIV research study; comfort with taking daily pill; comfort with providing urine sample; and concerns over potential side effects of shot. Asian participants were more concerned about others knowing they were being recruited than were Black and Latinx respondents F(2, 216) = 3.98; p < .05. Asian respondents were also less comfortable with being recruited at organizations serving communities of color than Black and Latinx respondents, F(2, 216) = 5.10; p < .05. Cisgender respondents were more comfortable with being recruited by a friend or colleague than were transgender/GNC respondents, F(1, 215) = 4.8; p < .05.
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Ma A, Comstock SE, Oyeside OA. Typologies of Sexual Health Vulnerability Predicting STI Preventive Behaviors Among Latinx Adults in the U.S.: A Latent Class Analysis Approach. J Immigr Minor Health 2021; 24:1288-1299. [PMID: 34655371 DOI: 10.1007/s10903-021-01293-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/10/2021] [Indexed: 11/25/2022]
Abstract
Vulnerability to poor sexual health among U.S. Latinx populations is poorly understood, despite high STI rates. We examined how vulnerability typologies differ in their STI preventive behaviors. Using data from the 2016 National Health Interview Survey, we performed latent class analysis to test the association between sexual health vulnerability and HIV testing, hepatitis testing or vaccination, and HPV vaccination from a subsample of Latinx adults. Three classes emerged: Under-Employed Females with Health Care Access, Slightly Under-Employed Females with Some Health Care Access, and Employed Males without Health Care Access. Slightly Under-Employed Females with Some Health Care Access were associated with lack of HIV testing, hepatitis B and C testing, and HPV vaccination. Employed Males without Health Care Access were associated with lack of HIV testing and HPV vaccination. Sexual health vulnerability may be associated with certain STI preventive behaviors, which can inform and refine sexual health promotion programming.
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Affiliation(s)
- Alice Ma
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA.
| | - Sara E Comstock
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA
| | - Oluwadamilola A Oyeside
- Department of Applied Health, Southern Illinois University Edwardsville, Campus Box 1126, Edwardsville, IL, 62026-1126, USA
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Barrington C, Davis DA, Villa-Torres L, Carcano J, Hightow-Weidman L. Intersectionalities and the HIV continuum of care among gay Latino men living with HIV in North Carolina. ETHNICITY & HEALTH 2021; 26:1098-1113. [PMID: 31109189 DOI: 10.1080/13557858.2019.1620177] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/16/2018] [Accepted: 05/11/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Latino men who have sex with men (MSM) are disproportionately affected by HIV in the US and only half of Latinos diagnosed with HIV are virally suppressed. Little is known about the determinants of HIV care and treatment outcomes among Latinos. We used theories of intersectionality to assess the HIV testing, care and treatment experiences of gay Latino men living with HIV in a new immigrant destination. DESIGN We conducted qualitative in-depth interviews with US and foreign-born gay Latino men living with HIV (n = 14) recruited through referrals from HIV care providers and case managers. We used Maxwell and Miller's theory of qualitative analysis to guide our approach to data analysis, integrating narrative techniques and thematic coding. We used theories of intersectionality - including both intersecting identities and structures - as an interpretive framework to understand participants' outcomes and experiences. RESULTS All participants were engaged in HIV care at the time of the interviews. The mental health burden of diagnosis and managing life with HIV was a salient theme across all interviews. Most participants had experienced interruptions in their care due to both intersecting stigmatized identities (e.g. being gay, Latino, undocumented) and intersecting structures (healthcare, immigration policy, institutionalized homophobia). Undocumented participants directly connected their immigration status to their ability to get work, which then affected their retention in HIV care and treatment adherence. CONCLUSIONS Examining the interplay between identities and structures provides a contextualized understanding of outcomes along the HIV care continuum among gay Latino men that goes beyond behavioral and cultural explanations. There is a need to assess long-term experiences of navigating HIV care and treatment given the intersecting structures of mobility, housing instability, and immigration policy.
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Affiliation(s)
- Clare Barrington
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Dirk A Davis
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Laura Villa-Torres
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
| | - Joaquin Carcano
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
| | - Lisa Hightow-Weidman
- Department of Health Behavior, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, USA
- Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, USA
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Colón-López V, Pérez-Guzmán D, Canario De La Torre MM, Centeno-Alvarado N, Agudelo-Salas IY, Rolón Y, Miranda S, Pabón M, Rodríguez-Lebrón J, Girona Lozada G. Provider-Initiated HIV Testing in Puerto Rico from Data of the National HIV Behavioral Surveillance-Heterosexual Cycle (NHBS-HET) 2016: National Cross-Sectional Survey (Preprint). JMIR Public Health Surveill 2021; 8:e29890. [PMID: 36287600 PMCID: PMC9647451 DOI: 10.2196/29890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 03/21/2022] [Accepted: 08/02/2022] [Indexed: 11/24/2022] Open
Abstract
Background According to the Centers for Disease Control and Prevention and World Health Organization guidelines, all individuals aged 13-64 years should get screened for HIV infection as part of their routine medical examinations. Individuals at high risk should get tested annually. Objective This study aimed to identify the sociodemographic, health care, and sexual behavioral characteristics of provider-initiated HIV testing using data from the Puerto Rico National HIV Behavioral Surveillance 2016 cycle, directed toward heterosexual individuals at increased risk of HIV infection. Methods A sample of 358 eligible participants were recruited through respondent-driven sampling, where sociodemographic characteristics, health care use, and HIV test referral were used to assess a description of the study sample. Pearson chi-square and Fisher tests were used to evaluate proportional differences. Multivariate logistic regression models were performed to determine the association between independent variables and HIV test referral. Adjusted prevalence ratios by sex and age with their 95% CIs were determined using a statistical significance level of .05. Results Despite 67.9% (243/358) of participants showing high-risk sexual behavioral practices and 67.4% (236/350) reporting a low perceived risk of HIV infection among those who visited a health care provider within the last 12 months, 80.7% (289/358) of the study sample did not receive an HIV test referral at a recent medical visit. Multivariate analysis showed that the estimated prevalence of the participants who received an HIV test referral among those who reported being engaged in high-risk sexual behaviors was 41% (adjusted prevalence ratio .59, 95% CI .39-.91; P=.02) lower than the estimated prevalence among those who did not engage in high-risk sexual behavior. Conclusions This sample of Puerto Rican adults reported a significantly lower prevalence of receiving an HIV test referral among heterosexual individuals at increased risk of HIV infection who engaged in high-risk behaviors. This study further emphasizes the need for health care providers to follow recommended guidelines for HIV test referrals in health care settings. Promotion practices in the future should include enhancing referral and access to HIV tests and implementing preventive measures to counteract the HIV epidemic in Puerto Rico.
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Affiliation(s)
- Vivian Colón-López
- Cancer Control and Population Sciences Program, Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
- Evaluation Program, Health Services Administration, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico
| | - Derick Pérez-Guzmán
- Data Analysis and Publication Core, Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | | | - Nadia Centeno-Alvarado
- Data Analysis and Publication Core, Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Ivony Y Agudelo-Salas
- Data Analysis and Publication Core, Comprehensive Cancer Center, University of Puerto Rico, San Juan, Puerto Rico
| | - Yadira Rolón
- HIV/AIDS Surveillance Program, Puerto Rico Health Department, San Juan, Puerto Rico
| | - Sandra Miranda
- HIV/AIDS Surveillance Program, Puerto Rico Health Department, San Juan, Puerto Rico
| | - Maria Pabón
- HIV/AIDS Surveillance Program, Puerto Rico Health Department, San Juan, Puerto Rico
| | | | - Gladys Girona Lozada
- HIV/AIDS Surveillance Program, Puerto Rico Health Department, San Juan, Puerto Rico
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Ramírez-Ortiz D, Sheehan DM, Moore MP, Ibañez GE, Ibrahimou B, De La Rosa M, Cano MÁ. HIV Testing Among Latino Emerging Adults: Examining Associations with Familism Support, Nativity, and Gender. J Immigr Minor Health 2020; 22:1039-1048. [PMID: 32222904 PMCID: PMC7442717 DOI: 10.1007/s10903-020-01000-x] [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] [Indexed: 10/24/2022]
Abstract
Research examining factors associated with low uptake of HIV testing among Latino emerging adults is scarce. Thus, this study examined the association between familism support and lifetime history of HIV testing among Latino emerging adults, and whether nativity status and gender moderated this association. A cross-sectional online survey of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida was conducted and data were analyzed using robust Poisson regression models. Results indicated that 59.9% of participants reported a lifetime history of HIV testing. Higher familism support was associated with a decreased prevalence of lifetime history of HIV testing (aPR = 0.81, 95% CI: 0.68- 0.95). Nativity status moderated the association between familism support and lifetime history of HIV testing, with this negative association, only found among immigrants (aPR = 0.46, 95% CI: 0.28-0.74). Gender did not moderate this association. Familism support plays a role in HIV testing behaviors, and thus should be considered when developing programs to increase HIV testing among Latinos.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Research Center in Minority Institutions, Florida International University, Miami, FL, USA
| | - Melanie Paige Moore
- Institute for Global Health and Infectious Diseases, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
- Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA.
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.
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12
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Özdener-Poyraz AE, Slugocki M, Kalabalik-Hoganson J, Han J. Pre-Exposure Prophylaxis (PrEP) in the Prevention of HIV: Strategies, Target Populations and Upcoming Treatments. HIV AIDS-RESEARCH AND PALLIATIVE CARE 2020; 12:283-293. [PMID: 32801927 PMCID: PMC7395680 DOI: 10.2147/hiv.s216024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/16/2020] [Accepted: 07/09/2020] [Indexed: 12/26/2022]
Abstract
Pre-exposure prophylaxis (PrEP) against HIV infection with tenofovir/emtricitabine is proven to be effective yet uptake of this preventive measure has been difficult due to several barriers such as cost, access, and misinformation. Certain subpopulations are disproportionately affected by this problem. Several methods have been developed to close the gap in care. New antiretroviral treatment strategies are being investigated for safety and efficacy in preventing HIV infection.
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Affiliation(s)
- Ayşe Elif Özdener-Poyraz
- Fairleigh Dickinson University, School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Florham Park, NJ 07932, USA
| | - Malgorzata Slugocki
- Fairleigh Dickinson University, School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Florham Park, NJ 07932, USA
| | - Julie Kalabalik-Hoganson
- Fairleigh Dickinson University, School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Florham Park, NJ 07932, USA
| | - Jayoung Han
- Fairleigh Dickinson University, School of Pharmacy and Health Sciences, Department of Pharmacy Practice, Florham Park, NJ 07932, USA
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13
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Ramírez-Ortiz D, Sheehan DM, Ibañez GE, Ibrahimou B, De La Rosa M, Cano MÁ. Self-efficacy and HIV testing among Latino emerging adults: examining the moderating effects of distress tolerance and sexual risk behaviors. AIDS Care 2020; 32:1556-1564. [PMID: 32131621 DOI: 10.1080/09540121.2020.1736259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Latino emerging adults in the United States are at a high risk of HIV and have a low prevalence of HIV testing. This study examined the association between self-efficacy for HIV testing, distress tolerance and lifetime history of HIV testing, and tested the moderating effect of distress tolerance and sexual risk behaviors on the association between self-efficacy and lifetime history of HIV testing. Data were collected from a cross-sectional sample of 157 Latino emerging adults aged 18-25 using an online survey and were analyzed using hierarchical logistic regression and moderation analyses. We found that 62.8% of those engaging in sexual risk behaviors had ever been tested for HIV. Participants that reported higher levels of self-efficacy (aOR=3.49, 95%CI: 1.78-6.83) were more likely to have ever been tested for HIV in their lifetime. There was a statistically significant three-way interaction among self-efficacy for HIV testing, distress tolerance and sexual risk behaviors (b=2.76, 95%CI: .52, 5.00, p=.016). This interaction suggests that among those that reported any sexual risk behaviors, higher levels of self-efficacy were associated with lifetime history of HIV testing only at higher levels of distress tolerance. Further research is warranted to determine how self-efficacy and distress tolerance work together among high-risk groups to promote HIV testing.
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Affiliation(s)
- Daisy Ramírez-Ortiz
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Diana M Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida, USA.,Research Center in Minority Institutions, Florida International University, Miami, Florida, USA
| | - Gladys E Ibañez
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Boubakari Ibrahimou
- Department of Biostatistics, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Mario De La Rosa
- Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida, USA.,Department of Social Work, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA
| | - Miguel Ángel Cano
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.,Center for Research on U.S. Latino HIV/AIDS and Drug Abuse, Florida International University, Miami, Florida, USA
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14
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Weitlauf JC, Ortiz A, Kroll-Desrosiers AR, Quiñones Vázquez ME, Cannell B, Hernandez MNB, Brandt C, Mattocks K. Characterization and Comparison of Physical and Mental Health Profiles and Department of Veterans Affairs Health Care Utilization Patterns among Operation Iraqi Freedom/Operation Enduring Freedom Women Veterans in Puerto Rico versus the United States. Womens Health Issues 2020; 30:49-56. [PMID: 31796346 DOI: 10.1016/j.whi.2019.10.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 10/21/2019] [Accepted: 10/22/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Research on the physical and mental health profiles and patterns of health care use among women veterans receiving health care from the Department of Veterans Affairs (VA) on the island of Puerto Rico is lacking. METHODS This cross-sectional study examines differences in physical and mental health conditions, and patterns of VA health care use, between women veterans of the Operation Iraqi Freedom/Operation Enduring Freedom (OIF/OEF) era who were using VA facilities in Puerto Rico (n = 897) and those using U.S.-based VA facilities (n = 117,216) from 2002 to 2015. RESULTS Results of fully adjusted logistic regression models revealed that OIF/OEF women in Puerto Rico had heightened risk for global pain-related disorders (i.e., any pain) (adjusted odds ratio [AOR], 1.45; 95% confidence interval [CI], 1.22-1.71), back pain (AOR, 1.83; 95% CI, 1.56-2.14), diabetes (AOR, 1.42; 95% CI, 1.03-1.95), hyperlipidemia (AOR, 3.34; 95% CI, 2.80-3.98), major depression (AOR, 1.78; 95% CI, 1.53-2.06), and bipolar depression (AOR, 1.66; 95% CI, 1.34-2.04). They also evidenced greater risk for a host of reproductive health conditions and had higher average annual use of VA health care than their U.S. counterparts. CONCLUSIONS OIF/OEF women receiving VA health care in Puerto Rico evidenced a greater burden of physical illness, depression, and heightened use of VA health care services relative to their U.S. counterparts. Providers' increased awareness of the physical and mental health care needs of this population is warranted. Research efforts that help to identify efficient and effective strategies to provide culturally tailored and/or personalized health care for this population could also be useful.
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Affiliation(s)
- Julie C Weitlauf
- Veterans Affairs Palo Alto Health Care System, Center for Innovation to Implementation (CI2I), Menlo Park, California; Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California.
| | - Ana Ortiz
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico & University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - Aimee R Kroll-Desrosiers
- Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts
| | | | - Brad Cannell
- School of Public Health, University of Texas Health Science Center at Houston, Dallas, Dallas, Texas
| | | | - Cynthia Brandt
- Veterans Affairs Connecticut Health Care System, West Haven, Connecticut; Department of Emergency Medicine, Yale University, New Haven, Connecticut
| | - Kristin Mattocks
- Departments of Quantitative Health Sciences, Psychiatry and Family Medicine, University of Massachusetts Medical School, Worcester, Massachusetts; Veterans Affairs Central Western Massachusetts Health Care System, Leeds, Massachusetts
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15
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Guinness RR, Volk JE, Hurley LB, Tobias TT, Marcus JL. Low-Intensity Outreach to Increase Uptake of HIV Preexposure Prophylaxis Among Patients with Sexually Transmitted Infections. AIDS Behav 2019; 23:544-547. [PMID: 30101394 DOI: 10.1007/s10461-018-2245-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
We piloted a low-intensity outreach intervention to increase linkage to PrEP care among HIV-uninfected individuals with rectal sexually transmitted infections or syphilis. We sent a secure email message or letter with information about accessing PrEP. Of those sent an email, 12.4% were linked to PrEP care; linkage differed by race/ethnicity, ranging from 0% of Black individuals to 32% of Hispanic individuals (P = 0.019). No individuals sent letters were linked to PrEP care. A one-time secure email to high-risk patients is feasible to increase linkage to PrEP care. Studies are needed to evaluate scalable interventions to increase PrEP uptake in at-risk populations.
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16
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The importance of accounting for testing and positivity in surveillance by time and place: an illustration from HIV surveillance in Japan. Epidemiol Infect 2018; 146:2072-2078. [PMID: 30205849 DOI: 10.1017/s0950268818002558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The number of tests performed is an important surveillance indicator. We illustrate this point using HIV surveillance data, focusing on Tokyo and Okinawa, two prefectures with high HIV notification rates in Japan. Restricting to data reported from local public health centres and affiliate centres where testing data are accessible, we assessed HIV surveillance data during 2007-2014, based on the annual HIV notification rate (per 100 000 population), HIV testing rate (per 100 000 population) and proportion testing HIV-positive (positivity). Nationally, testing activity and positivity showed an inverse relationship; in 2008, the testing rate peaked, but positivity was lowest. While notification rates were higher for Tokyo (median = 0.98, range = 0.89-1.33) than Okinawa (median = 0.61, range = 0.42-1.09), Okinawa had slightly higher testing rates (median = 187, range = 158-274) relative to Tokyo (median = 172, range = 163-210). Positivity was substantially lower in Okinawa (median = 0.34%, range = 0.24-0.45%) compared with Tokyo (median = 0.57%, range = 0.46-0.67%). Relative to the national testing rate (median = 85, range = 80-115) and positivity (median = 0.34%, range = 0.28-0.36%), Tokyo had higher positivity, despite more testing. In 2014 in Okinawa, all three indicators increased, providing a strong reason to be concerned as positivity increased despite more testing. Together with other information, accounting for testing and positivity improve interpretation of surveillance data to guide public health assessments.
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17
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Sheehan DM, Cosner C, Fennie KP, Gebrezgi MT, Cyrus E, Maddox LM, Levison JH, Spencer EC, Niyonsenga T, Trepka MJ. Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos. AIDS Patient Care STDS 2018; 32:165-173. [PMID: 29630853 DOI: 10.1089/apc.2018.0021] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
The objective of this study was to estimate disparities in linkage to human immunodeficiency virus (HIV) care among Latinos by country/region of birth, HIV testing site, and neighborhood characteristics. A retrospective study was conducted using Florida HIV surveillance records of Latinos/Hispanics aged ≥13 diagnosed during 2014-2015. Linkage to HIV care was defined as a laboratory test (HIV viral load or CD4) within 3 months of HIV diagnosis. Multi-level Poisson regression models were used to estimate adjusted prevalence ratios (aPR) for nonlinkage to care. Of 2659 Latinos, 18.8% were not linked to care within 3 months. Compared with Latinos born in mainland United States, those born in Cuba [aPR 0.60, 95% confidence interval (CI) 0.47-0.76] and Puerto Rico (aPR 0.61, 95% CI 0.41-0.90) had a decreased prevalence of nonlinkage. Latinos diagnosed at blood banks (aPR 2.34, 95% CI 1.75-3.12), HIV case management and screening facilities (aPR 1.76, 95% CI 1.46-2.14), and hospitals (aPR 1.42, 95% CI 1.03-1.96) had an increased prevalence of nonlinkage compared with outpatient general, infectious disease, and tuberculosis/sexually transmitted diseases/family planning clinics. Latinos who resided in the lowest (aPR 1.57, 95% CI 1.19-2.07) and third lowest (aPR 1.33, 95% CI 1.01-1.76) quartiles of neighborhood socioeconomic status compared with the highest quartile were at increased prevalence. Latinos who resided in neighborhoods with <25% Latinos also had increased prevalence of nonlinkage (aPR 1.23, 95% CI 1.01-1.51). Testing site at diagnosis may be an important determinant of HIV care linkage among Latinos due to neighborhood or individual-level resources that determine location of HIV testing.
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Affiliation(s)
- Diana M. Sheehan
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, Florida
| | - Chelsea Cosner
- Herbert Wertheim College of Medicine, Florida International University, Miami Florida
| | - Kristopher P. Fennie
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Merhawi T. Gebrezgi
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
| | - Elena Cyrus
- Center for Substance Use and HIV/AIDS Research on Latinos in the United States (C-SALUD), Florida International University, Miami, Florida
| | - Lorene M. Maddox
- HIV/AIDS Section, Florida Department of Health, Tallahassee, Florida
| | - Julie H. Levison
- Division of General Internal Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emma C. Spencer
- HIV/AIDS Section, Florida Department of Health, Tallahassee, Florida
| | | | - Mary Jo Trepka
- Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida
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18
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Borre ED, Hyle EP, Paltiel AD, Neilan AM, Sax PE, Freedberg KA, Weinstein MC, Walensky RP. The Clinical and Economic Impact of Attaining National HIV/AIDS Strategy Treatment Targets in the United States. J Infect Dis 2017; 216:798-807. [PMID: 29029344 PMCID: PMC5853503 DOI: 10.1093/infdis/jix349] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 07/21/2017] [Indexed: 11/13/2022] Open
Abstract
Background The US National HIV/AIDS Strategy (NHAS) aims for 72% (90% diagnosed times 80% of those virally suppressed) viral suppression among persons with human immunodeficiency virus (HIV) by 2020. We examined the clinical and economic impact of reaching this target, in the general US population and among black men who have sex with men (MSM), the group with the highest HIV prevalence. Methods Using a mathematical simulation, we project the 5- and 20-year clinical outcomes, costs, and incremental cost-effectiveness ratios for (1) Current Pace of detection, linkage, retention, and virologic suppression and (2) NHAS investments in expanded testing ($24-$74 per test) and adherence ($400 per person-year), calibrated to achieve 72% suppression by 2020. We examined alternative rates of testing, retention, and suppression and the efficacy and cost of adherence interventions. Results Compared with Current Pace over 20 years, NHAS averted 280000 HIV transmissions (80000 in black MSM) and 199000 (45000) deaths and saved 2138000 (453000) years of life, while increasing costs by 23%. The incremental cost-effectiveness ratio for NHAS compared with Current Pace was $68900 per quality-adjusted life-year ($38300 for black MSM) and was most sensitive to antiretroviral therapy costs. Conclusions Reaching NHAS targets would yield substantial clinical benefits and be cost-effective in both the general US and black MSM populations.
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Affiliation(s)
- Ethan D Borre
- Medical Practice Evaluation Center
- Division of General Internal Medicine
| | - Emily P Hyle
- Medical Practice Evaluation Center
- Division of Infectious Diseases
| | | | - Anne M Neilan
- Medical Practice Evaluation Center
- Division of Infectious Diseases
- Department of Pediatrics, Massachusetts General Hospital
| | - Paul E Sax
- Division of Infectious Diseases, Brigham and Women’s Hospital
| | - Kenneth A Freedberg
- Medical Practice Evaluation Center
- Division of General Internal Medicine
- Division of Infectious Diseases
- Harvard University Center for AIDS Research, Harvard Medical School
- Department of Epidemiology, Boston University School of Public Health, and
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Milton C Weinstein
- Department of Health Policy and Management, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Rochelle P Walensky
- Medical Practice Evaluation Center
- Division of General Internal Medicine
- Division of Infectious Diseases
- Division of Infectious Diseases, Brigham and Women’s Hospital
- Harvard University Center for AIDS Research, Harvard Medical School
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19
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Page KR, Martinez O, Nieves-Lugo K, Zea MC, Grieb SD, Yamanis TJ, Spear K, Davis WW. Promoting Pre-exposure Prophylaxis to Prevent HIV Infections Among Sexual and Gender Minority Hispanics/Latinxs. AIDS EDUCATION AND PREVENTION : OFFICIAL PUBLICATION OF THE INTERNATIONAL SOCIETY FOR AIDS EDUCATION 2017; 29:389-400. [PMID: 29068715 PMCID: PMC5765546 DOI: 10.1521/aeap.2017.29.5.389] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
Sexual and gender minority Hispanics/Latinxs (henceforth: Latinxs) continue to be disproportionately impacted by HIV/AIDS in the U.S. Pre-exposure prophylaxis (PrEP) is a biomedical prevention approach which holds significant promise for at risk and vulnerable populations. We discuss barriers and facilitators to uptake of PrEP among sexual and gender minority Latinxs living in the U.S. through an ecosocial lens that takes into account structural, community, and individual contexts. The impact of immigration status on PrEP uptake emerges as a major and recurrent theme that must be understood and addressed by HIV prevention programs aiming to promote an inclusive strategy for sexual and gender minority Latinxs living in the U.S.
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Affiliation(s)
- Kathleen R Page
- School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Omar Martinez
- College of Public Health, Temple University, Philadelphia, Pennsylvania
| | - Karen Nieves-Lugo
- Department of Psychology, George Washington University, Washington, D.C
| | - Maria Cecilia Zea
- Department of Psychology, George Washington University, Washington, D.C
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20
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Rebchook G, Keatley J, Contreras R, Perloff J, Molano LF, Reback CJ, Ducheny K, Nemoto T, Lin R, Birnbaum J, Woods T, Xavier J. The Transgender Women of Color Initiative: Implementing and Evaluating Innovative Interventions to Enhance Engagement and Retention in HIV Care. Am J Public Health 2017; 107:224-229. [PMID: 28075641 PMCID: PMC5227951 DOI: 10.2105/ajph.2016.303582] [Citation(s) in RCA: 50] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/16/2016] [Indexed: 11/04/2022]
Abstract
To improve health outcomes among transgender women of color living with HIV, the Health Resources and Services Administration's Special Programs of National Significance program funded the Enhancing Engagement and Retention in Quality HIV Care for Transgender Women of Color Initiative in 2012. Nine demonstration projects in four US urban areas implemented innovative, theory-based interventions specifically targeting transgender women of color in their jurisdictions. An evaluation and technical assistance center was funded to evaluate the outcomes of the access to care interventions, and these findings will yield best practices and lessons learned to improve the care and treatment of transgender women of color living with HIV infection.
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Affiliation(s)
- Gregory Rebchook
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - JoAnne Keatley
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Robert Contreras
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Judy Perloff
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Luis Freddy Molano
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Cathy J Reback
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Kelly Ducheny
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Tooru Nemoto
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Royce Lin
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Jeffrey Birnbaum
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Tiffany Woods
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
| | - Jessica Xavier
- Gregory Rebchook is with the Center for AIDS Prevention Studies, University of California, San Francisco (UCSF). JoAnne Keatley is with the Center of Excellence for Transgender Health, UCSF. Robert Contreras is with BIENESTAR Human Services, Los Angeles, CA. Judith Perloff is with Chicago House & Social Services, Chicago, IL. Luis Freddy Molano is with the Community Healthcare Network, New York, NY. Cathy J. Reback is with the Friends Research Institute, Los Angeles. Kelly Ducheny is with Howard Brown Health, Chicago. Tooru Nemoto is with the Public Health Institute, Oakland, CA. Royce Lin is with the San Francisco Department of Public Health, San Francisco. Jeffrey Birnbaum is with the Downstate Medical Center, State University of New York, Brooklyn. Tiffany Woods is with the Tri-City Health Center, Fremont, CA. Jessica Xavier is with the Health Resources and Services Administration, Rockville, MD
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