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Bunting SR, Hunt B, Boshara A, Jacobs J, Johnson AK, Hazra A, Glick N. Examining the Correlation Between PrEP Use and Black:White Disparities in HIV Incidence in the Ending the HIV Epidemic Priority Jurisdictions. J Gen Intern Med 2023; 38:382-389. [PMID: 35678988 PMCID: PMC9905374 DOI: 10.1007/s11606-022-07687-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 05/25/2022] [Indexed: 10/18/2022]
Abstract
INTRODUCTION HIV incidence remains high in the U.S. as do disparities in new HIV diagnosis between White and Black populations and access to preventive therapies like pre-exposure prophylaxis (PrEP). The federal Ending the HIV Epidemic (EHE) initiative was developed to prioritize resources to 50 jurisdictions with high HIV incidence. METHODS We conducted secondary analyses of data (2013-2019) from the CDC, Census Bureau, and AIDSVu to evaluate the correlation between PrEP use, HIV incidence, and HIV incidence disparities. We compared the PrEP-to-need ratio (PnR) with the ratio of Black and White HIV incidence rates in 46 EHE counties. Subsequent analyses were performed for the seven states that contained multiple EHE counties. RESULTS These 46 counties represented 25.9% of the U.S. population in 2019. HIV incidence ranged from 10.5 in Sacramento County, CA, to 59.6 in Fulton County, GA (per 100,000). HIV incidence disparity ranged from 1.5 in Orleans Parish, LA, to 12.1 in Montgomery County, MD. PnR ranged from 26.8 in New York County, NY, to 1.46 in Shelby County, TN. Change in HIV incidence disparities and percent change in PnR were not significantly correlated (ρ = 0.06, p = 0.69). Change in overall HIV incidence was significantly correlated with increase in PnR (ρ = -0.42, p = 0.004). CONCLUSIONS PrEP has the potential to significantly decrease HIV incidence; however, this benefit has not been conferred equally. Within EHE priority counties, we found significant HIV incidence disparities between White and Black populations. PrEP has decreased overall HIV incidence, but does not appear to have decreased HIV incidence disparity.
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Affiliation(s)
- Samuel R Bunting
- Department of Psychiatry and Behavioral Neuroscience, The University of Chicago Medicine, Chicago, IL, USA.
| | - Bijou Hunt
- Sinai Infectious Disease Center, Sinai Health System, Chicago, IL, USA
- Sinai Urban Health Institute, Sinai Health System, Chicago, IL, USA
| | - Arianna Boshara
- Sinai Infectious Disease Center, Sinai Health System, Chicago, IL, USA
- Sinai Urban Health Institute, Sinai Health System, Chicago, IL, USA
| | - Jacquelyn Jacobs
- Sinai Urban Health Institute, Sinai Health System, Chicago, IL, USA
| | - Amy K Johnson
- Sinai Urban Health Institute, Sinai Health System, Chicago, IL, USA
- Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
- Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
| | - Aniruddha Hazra
- Section of Infectious Diseases and Global Health, Department of Medicine, The University of Chicago Medicine, Chicago, IL, USA
| | - Nancy Glick
- Sinai Infectious Disease Center, Sinai Health System, Chicago, IL, USA
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2
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Groene EA, Boraas CM, Smith MK, Lofgren SM, Rothenberger MK, Enns EA. Evaluation of Strategies to Improve Uptake of Expedited Partner Therapy for Chlamydia trachomatis Treatment in Minnesota: A Decision Analytic Model. MDM Policy Pract 2023; 8:23814683221150446. [PMID: 36714792 PMCID: PMC9880578 DOI: 10.1177/23814683221150446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2022] [Accepted: 12/18/2022] [Indexed: 01/24/2023] Open
Abstract
Background. Despite the established effectiveness of expedited partner therapy (EPT) in partner treatment of bacterial sexually transmitted infections (STI), the practice is underutilized. Objective. To estimate the relative effectiveness of strategies to increase EPT uptake (numbers of partners treated for chlamydia). Methods. We developed a care cascade model of cumulative probabilities to estimate the number of partners treated under strategies to increase EPT uptake in Minnesota. The care cascade model used data from clinical trials, population-based studies, and Minnesota chlamydia surveillance as well as in-depth interviews of health providers who regularly treat STI patients and a statewide survey of health providers across Minnesota. Results. Several strategies could improve EPT uptake among providers, including facilitating treatment payment (additional 1,932 partners treated) and implementing electronic health record reminders (additional 1,755 partners treated). Addressing concerns about liability would have the greatest effect, resulting in 2,187 additional partners treated. Conclusions. Providers expressed openness to offering EPT under several scenarios, which reflect differences in knowledge about EPT, its legality, and potential risks to patients. While addressing concerns about provider liability would have the greatest effect on number of partners treated, provider education and procedural changes could make a substantial impact. Highlights Addressing provider concerns about expedited partner therapy (EPT) legality and its potential risks would result in the most partners treated for chlamydia.EPT alerts and electronic EPT prescriptions may also streamline partner treatment.Provider education about the legality of EPT and its potential risks and training in counseling patients on EPT could also increase uptake.
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Affiliation(s)
- Emily A. Groene
- Emily A. Groene, Division of Epidemiology
and Community Health, University of Minnesota School of Public Health, 1300
South 2nd Street, Suite 300, Minneapolis, MN 55454, USA;
()
| | - Christy M. Boraas
- Department of Obstetrics, Gynecology and
Women’s Health, University of Minnesota Medical School, Minneapolis, MN,
USA
| | - M. Kumi Smith
- Division of Epidemiology and Community Health,
University of Minnesota School of Public Health, Minneapolis, MN, USA
| | - Sarah M. Lofgren
- Division of Infectious Diseases and
International Medicine, University of Minnesota Medical School, Minneapolis,
MN, USA
| | - Meghan K. Rothenberger
- Division of Infectious Diseases and
International Medicine, University of Minnesota Medical School, Minneapolis,
MN, USA
| | - Eva A. Enns
- Division of Health Policy and Management,
University of Minnesota School of Public Health, Minneapolis, MN, USA
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3
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Almeida MCD, Cordeiro AMR, Cunha-Oliveira A, Barros DMS, Santos DGSM, Lima TS, Valentim RAM. Syphilis response policies and their assessments: A scoping review. Front Public Health 2022; 10:1002245. [PMID: 36187663 PMCID: PMC9523564 DOI: 10.3389/fpubh.2022.1002245] [Citation(s) in RCA: 1] [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: 07/24/2022] [Accepted: 08/30/2022] [Indexed: 01/27/2023] Open
Abstract
Syphilis is one of the most common sexually transmitted infections (STIs) worldwide and has shown a rising trend in recent years, according to a report published by the World Health Organization (WHO) in 2021. Given this problem, the present study aims to develop a scoping review of what has been done in the world after the publication of the global strategy for the elimination of STIs, with a specific focus on syphilis. Thus, we searched for papers on health policies in response to syphilis in Pubmed, Scopus, ScienceDirect, and EBSCO by CINAHL, as well as in official documents from international health organizations. The period from January 1, 2016, to August 14, 2022 was considered. Our search returned 880 papers addressing "Syphilis," "Health Policy," and "Health Policies" combined. Twenty-three papers fulfilled the inclusion and exclusion criteria according to two research questions set out for this scoping review. Our findings suggest that Brazil and Peru presented the greatest adequacy of the strategies provided by WHO in 2016 and the Pan American Health Organization (PAHO) in 2017, aiming tothe goals set out in the UN's 2030 Agenda for sustainable development. Among the studies found, six countries (Cuba, Thailand, Belarus, Armenia, Moldova, and Puerto Rico) reported the elimination of mother-to-child transmission (MTCT) of syphilis, but the most recent data are from 2016. Furthermore, it is essential to mention that no country has been found that has presented a comprehensive response to syphilis, noting the control or elimination of the disease in all key populations. Thus, it is necessary to constantly monitor national policies based on in-depth studies on the quality of the response, the challenges, and the national, regional, and global perspectives for the control of the disease until 2030, the year in which the SDGs will be reviewed. Systematic review registration https://osf.io/x9er5/?view_only=0cc0062222ec45dcb2f4d41484d285b6, identifier: 10.17605/OSF.IO/X9ER5.
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Affiliation(s)
- Milena C. D. Almeida
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | | | - Aliete Cunha-Oliveira
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
- Health Sciences Research Unit: Nursing (UICISA:E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
| | - Daniele M. S. Barros
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
| | - Diana G. S. M. Santos
- Health Sciences Research Unit: Nursing (UICISA:E), School of Nursing of Coimbra (ESEnfC), Coimbra, Portugal
- Coimbra Hospital, University Center, Coimbra, Portugal
| | - Thaísa S. Lima
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Brazilian Ministry of Health, Brasília, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
- Department of Biomedical Engineering, Federal University of Rio Grande do Norte (UFRN), Natal, Brazil
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Onaisi R, Joseph JP, Castera P, Pontgratz C. Sexual risk behaviour reduction interventions in primary care in Organization of Economic Cooperation and Development countries. A systematic review. Fam Pract 2022; 39:762-770. [PMID: 34668006 DOI: 10.1093/fampra/cmab131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Sexually transmitted infections are a major public health issue, both in France and worldwide. Primary healthcare professionals play a key role in sexual health and prevention, but few take on this subject. Prevention strategies are diverse, thus risk reduction strategies focussing on behavioural changes are still needed. PURPOSE We conducted a systematic review to analyse risk reduction interventions focussing on behavioural change in OECD countries in primary healthcare settings to help develop a prevention tool easy to apply in primary care. METHODS We searched for English- or French-language controlled trials in PubMed, Cochrane Library, Scopus, PsycINFO, PsycArticle, PBSC, SocINDEX, Google Scholar, and CAIRN, supplemented with the bibliographies of previous systematic reviews. Thirty controlled, randomized, or nonrandomized trials were included in the systematic review. We did not conduct any meta-analysis due to the diversity of populations, outcomes and study designs. RESULTS There are efficient interventions in primary healthcare settings for reducing sexual risk behaviours and/or incident STI. Their efficiency seems to grow with the length and intensity of the intervention. Most interventions target only young, high-risk patients, and their long-term impact is uncertain. Most included studies had an overall risk of bias estimated as high or with some concerns. CONCLUSIONS Some tools could be used in primary care, with possible efficiency though results are difficult to generalize, and value should be assessed in daily practice. Future research should also focus on older population given the epidemiological evolutions, but also lower-risk population to target all patients seen in primary care settings.
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Affiliation(s)
- Racha Onaisi
- Department of General Practice, University of Bordeaux, Bordeaux, France
| | - Jean-Philippe Joseph
- Department of General Practice, University of Bordeaux, Bordeaux, France.,CIC 1401-EC (Clinical Epidemiology), Bordeaux, France.,Inserm U1219, Univ. Bordeaux, Bordeaux, France
| | - Philippe Castera
- Department of General Practice, University of Bordeaux, Bordeaux, France
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Benjamins MR, Saiyed N, Bunting S, Lorenz P, Hunt B, Glick N, Silva A. HIV mortality across the 30 largest U.S. cities: assessing overall trends and racial inequities. AIDS Care 2021; 34:916-925. [PMID: 34125639 DOI: 10.1080/09540121.2021.1939849] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
BACKGROUND Despite decreases in overall HIV mortality in the U.S., large racial inequities persist. Most previous analyses of HIV mortality and mortality inequities have utilized national- or state-level data. METHODS Using vital statistics mortality data and American Community Survey population estimates, we calculated HIV mortality rates and Black:White HIV mortality rate ratios (RR) for the 30 most populous U.S. cities at two time points, 2010-2014 (T1) and 2015-2019 (T2). RESULTS Almost all cities (28) had HIV mortality rates higher than the national rate at both time points. At T2, HIV mortality rates ranged from 0.8 per 100,000 (San Jose, CA) to 15.2 per 100,000 (Baltimore, MD). Across cities, Black people were approximately 2-8 times more likely to die from HIV compared to White people at both time points. Over the decade, these racial disparities decreased at the national level (T1: RR = 11.0, T2: RR = 9.8), and in one city (Charlotte, NC). DISCUSSION We identified large geographic and racial inequities in HIV mortality in U.S. urban areas. These city-specific data may motivate change in cities and can help guide city leaders and other health advocates as they implement, test, and support policies and programming to decrease HIV mortality.
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Affiliation(s)
- Maureen R Benjamins
- Sinai Urban Health Institute, Chicago, IL, USA.,Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Samuel Bunting
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Peter Lorenz
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Bijou Hunt
- Sinai Urban Health Institute, Chicago, IL, USA
| | | | - Abigail Silva
- Loyola University Parkinson School of Health Sciences and Public Health, Maywood, IL, USA
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6
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Thompson K, Cramer R, LaPollo AB, Hubbard SH, Chesson HW, Leichliter JS. Using Mixed Methods and Multidisciplinary Research to Strengthen Policy Assessments Focusing on Populations at High Risk for Sexually Transmitted Diseases. Public Health Rep 2020; 135:32S-37S. [PMID: 32735194 DOI: 10.1177/0033354920931832] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Kelly Thompson
- 6548 Research & Evaluation Group, Public Health Management Corporation, Philadelphia, PA, USA
| | - Ryan Cramer
- 1242 Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Archana Bodas LaPollo
- 6548 Research & Evaluation Group, Public Health Management Corporation, Philadelphia, PA, USA
| | | | - Harrell W Chesson
- 1242 Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Jami S Leichliter
- 1242 Division of STD Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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7
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Ibragimov U, Beane S, Friedman SR, Komro K, Adimora AA, Edwards JK, Williams LD, Tempalski B, Livingston MD, Stall RD, Wingood GM, Cooper HLF. States with higher minimum wages have lower STI rates among women: Results of an ecological study of 66 US metropolitan areas, 2003-2015. PLoS One 2019; 14:e0223579. [PMID: 31596890 PMCID: PMC6785113 DOI: 10.1371/journal.pone.0223579] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 09/24/2019] [Indexed: 11/19/2022] Open
Abstract
Prior research has found that places and people that are more economically disadvantaged have higher rates and risks, respectively, of sexually transmitted infections (STIs). Economic disadvantages at the level of places and people, however, are themselves influenced by economic policies. To enhance the policy relevance of STI research, we explore, for the first time, the relationship between state-level minimum wage policies and STI rates among women in a cohort of 66 large metropolitan statistical areas (MSAs) in the US spanning 2003-2015. Our annual state-level minimum wage measure was adjusted for inflation and cost of living. STI outcomes (rates of primary and secondary syphilis, gonorrhea and chlamydia per 100,000 women) were obtained from the CDC. We used multivariable hierarchical linear models to test the hypothesis that higher minimum wages would be associated with lower STI rates. We preliminarily explored possible socioeconomic mediators of the minimum wage/STI relationship (e.g., MSA-level rates of poverty, employment, and incarceration). We found that a $1 increase in the price-adjusted minimum wage over time was associated with a 19.7% decrease in syphilis rates among women and with an 8.5% drop in gonorrhea rates among women. The association between minimum wage and chlamydia rates did not meet our cutpoint for substantive significance. Preliminary mediation analyses suggest that MSA-level employment among women may mediate the relationship between minimum wage and gonorrhea. Consistent with an emerging body of research on minimum wage and health, our findings suggest that increasing the minimum wage may have a protective effect on STI rates among women. If other studies support this finding, public health strategies to reduce STIs among women should include advocating for a higher minimum wage.
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Affiliation(s)
- Umedjon Ibragimov
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
- * E-mail:
| | - Stephanie Beane
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Samuel R. Friedman
- National Development and Research Institutes Inc, New York, NY, United States of America
| | - Kelli Komro
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Adaora A. Adimora
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
- Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Jessie K. Edwards
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Leslie D. Williams
- Division of Community Health Sciences, University of Illinois at Chicago School of Public Health, Chicago, IL, United States of America
| | - Barbara Tempalski
- National Development and Research Institutes Inc, New York, NY, United States of America
| | - Melvin D. Livingston
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Ronald D. Stall
- Department of Behavioral and Community Health Sciences and Department of Infectious Diseases and Microbiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, United States of America
| | - Gina M. Wingood
- Department of Sociomedical Sciences, Columbia University, New York, NY, United States of America
| | - Hannah L. F. Cooper
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
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Jin H, Marshall BD, Raifman J, Montgomery M, Maynard MA, Chan PA. Changes in Patient Visits After the Implementation of Insurance Billing at a Sexually Transmitted Diseases Clinic in a Medicaid Expansion State. Sex Transm Dis 2019; 46:502-506. [PMID: 31295216 PMCID: PMC6636341 DOI: 10.1097/olq.0000000000001014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Medicaid expansion has led to unique opportunities for sexually transmitted disease (STD) clinics to improve the sustainability of services by billing insurance. We evaluated changes in patient visits after the implementation of insurance billing at a STD clinic in a Medicaid expansion state. METHODS The Rhode Island STD Clinic offered HIV/STD screening services at no cost to patients until October 2016, when insurance billing was implemented. Care for uninsured patients was still provided for free. We compared the clinic visits in the preinsurance period with the postinsurance period using t-tests, Poisson regressions, and a logistic regression. RESULTS A total of 5560 patients were seen during the preinsurance (n = 2555) and postinsurance (n = 3005) periods. Compared with the preinsurance period, the postinsurance period had a significantly higher average number of patient visits/month (212.9 vs. 250.4, P = 0.0016), including among patients who were black (36.8 vs. 50.3, P = 0.0029), Hispanic/Latino (50.8 vs. 65.8, P = 0.0018), and insured (106.3 vs. 130.1, P = 0.0025). The growth rate of uninsured (+0.10 vs. +4.11, P = 0.0026) and new patients (-4.28 vs. +1.07, P = 0.0007) also increased between the two periods. New patients whose first visit was before the billing change had greater odds (adjusted odds ratio, 2.68, 95% confidence interval, 2.09-3.44; P < 0.0001) of returning compared with new patients whose first visit was after the billing change. CONCLUSIONS Implementation of insurance billing at a publicly funded STD clinic, with free services provided to uninsured individuals, was associated with a modest increase in patient visits and a decline in patients returning for second visits.
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Affiliation(s)
- Harry Jin
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Brandon D.L. Marshall
- Department of Epidemiology, Brown University School of Public Health, Providence, RI
| | - Julia Raifman
- Boston University School of Public Health, Boston, MA
| | - Madeline Montgomery
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
| | | | - Philip A. Chan
- Department of Behavioral and Social Sciences, Brown University School of Public Health, Providence, RI
- Department of Medicine, Brown University, Providence, RI
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Meyerson BE, Davis A, Reno H, Haderxhanaj LT, Sayegh MA, Simmons MK, Multani G, Naeyaert L, Meador A, Stoner BP. Existence, Distribution, and Characteristics of STD Clinics in the United States, 2017. Public Health Rep 2019; 134:371-378. [PMID: 31112071 DOI: 10.1177/0033354919847733] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES Studies of sexually transmitted disease (STD) clinics have been limited by the lack of a national list for representative sampling. We sought to establish the number, type, and distribution of STD clinics and describe selected community characteristics associated with them. METHODS We conducted a 2-phased, multilevel, online search from September 2014 through March 2015 and from May through October 2017 to identify STD clinics in all 50 US states and the District of Columbia. We obtained data on clinic name, address, contact information, and 340B funding status (which requires manufacturers to provide outpatient drugs at reduced prices). We classified clinics by type. We also obtained secondary county-level data to compare rates of chlamydia and HIV, teen births, uninsurance and unemployment, and high school graduation; ratios of primary care physician to population; health care costs; median household income; and percentage of population living in rural areas vs nonrural areas. We used t tests to examine mean differences in characteristics between counties with and without STD clinics. RESULTS We found 4079 STD clinics and classified them into 10 types; 2530 (62.0%) clinics were affiliated with a local health department. Of 3129 counties, 1098 (35.1%) did not have an STD clinic. Twelve states had an STD clinic in every county, and 34 states had ≥1 clinic per 100 000 population. Most STD clinics were located in areas of high chlamydia morbidity and where other surrogate needs were greatest; rural areas were underserved by STD clinics. CONCLUSIONS This list may aid in more comprehensive national studies of clinic services, STD clinic adaptation to external policy changes (eg, in public financing or patient access policy), and long-term clinic survival, with special attention to clinic coverage in rural areas.
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Affiliation(s)
- Beth E Meyerson
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Alissa Davis
- 3 Columbia University School of Social Work, New York, NY, USA
| | - Hilary Reno
- 4 Division of Infectious Disease, Department of Medicine, Washington University in St. Louis, St. Louis, MO, USA
| | - Laura T Haderxhanaj
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - M Aaron Sayegh
- 5 Department of Epidemiology and Biostatistics, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA
| | - Megan K Simmons
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Gurprit Multani
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Lindsey Naeyaert
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Audra Meador
- 1 Department of Applied Health Science, Indiana University School of Public Health-Bloomington, Bloomington, IN, USA.,2 Rural Center for AIDS/STD Prevention, Indiana University, Bloomington, IN, USA
| | - Bradley P Stoner
- 6 Departments of Anthropology and Medicine, Washington University in St. Louis, St. Louis, MO, USA.,7 St. Louis STD/HIV Prevention Training Center, St. Louis, MO, USA
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10
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Xu Y, Chen X, Yu B, Joseph V, Stanton B. The effects of self-efficacy in bifurcating the relationship of perceived benefit and cost with condom use among adolescents: A cusp catastrophe modeling analysis. J Adolesc 2017; 61:31-39. [DOI: 10.1016/j.adolescence.2017.09.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2017] [Revised: 08/11/2017] [Accepted: 09/12/2017] [Indexed: 10/18/2022]
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11
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Marotta P. Assessing Spatial Relationships between Race, Inequality, Crime, and Gonorrhea and Chlamydia in the United States. J Urban Health 2017; 94:683-698. [PMID: 28831708 PMCID: PMC5610128 DOI: 10.1007/s11524-017-0179-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Incidence rates of chlamydia and gonorrhea reached unprecedented levels in 2015 and are concentrated in southern counties of the USA. Using incidence data from the Center for Disease Control, Moran's I analyses assessed the data for statistically significant clusters of chlamydia and gonorrhea at the county level in 46 states of the USA. Lagrange multiplier diagnostics justified selection of the spatial Durbin regression model for chlamydia and the spatial error model for gonorrhea. Rates of chlamydia (Moran's I = .37, p < .001) and gonorrhea (Moran's I = .38, p < .001) were highly clustered particularly in the southern region of the USA. Logged percent in poverty (B = .49, p < .001 and B = .48, p < .001) and racial composition of African-Americans (B = .16, p < .001 and B = .40, p < .001); Native Americans (B = .12, p < .001 and B = .20, p < .001); and Asians (B = .14, p < .001 and B = .09, p < .001) were significantly associated with greater rates of chlamydia and gonorrhea, respectively, after accounting for spatial dependence in the data. Logged rates of rates violent crimes were associated with chlamydia (B = .053, p < .001) and gonorrhea (B = .10, p < .001). Logged rates of drug crimes (.052, p < .001) were only associated with chlamydia. Metropolitan census designation was associated with logged rates of chlamydia (B = .12, p < .001) and gonorrhea (B = .24, p < .001). Spatial heterogeneity in the distribution of rates of chlamydia and gonorrhea provide important insights for strategic public health interventions in the USA and inform the allocation of limited resources for the prevention of chlamydia and gonorrhea.
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Abstract
BACKGROUND Partner services have been a mainstay of public health sexually transmitted disease (STD) prevention programs for decades. The principal goals are to interrupt transmission and reduce STD morbidity and sequelae. In this article, we review current literature with the goal of informing STD prevention programs. METHODS We searched the literature for systematic reviews. We found 9 reviews published between 2005 and 2014 (covering 108 studies). The reviews varied by study inclusion criteria (e.g., study methods, geographic location, and infections). We abstracted major conclusions and recommendations from the reviews. RESULTS Conclusions and recommendations were divided into patient referral interventions and provider referral interventions. For patient referral, there was evidence supporting the use of expedited partner therapy and interactive counseling, but not purely didactic instruction. Provider referral through Disease Intervention Specialists was efficacious and particularly well supported for HIV. For other studies, modeling data and testing outcomes showed that partner notification in general reached high-prevalence populations. Reviews also suggested more focus on using technology and population-level implementation strategies. However, partner services may not be the most efficient means to reach infected persons. CONCLUSIONS Partner services programs constitute a large proportion of program STD prevention activities. Value is maximized by balancing a portfolio of patient and provider referral interventions and by blending partner notification interventions with other STD prevention interventions in overall partner services program structure. Sexually transmitted disease prevention needs program-level research and development to generate this portfolio.
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Keen L, Blanden G, Rehmani N. Lifetime marijuana use and sexually transmitted infection history in a sample of Black college students. Addict Behav 2016; 60:203-8. [PMID: 27161534 DOI: 10.1016/j.addbeh.2016.04.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Revised: 03/30/2016] [Accepted: 04/20/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sexually transmitted infections (STIs) and marijuana use are more prevalent in African Americans/Blacks (Blacks) than any other ethnicity in the United States. Given the significant health care costs and deleterious health correlates of using marijuana or contracting a STI, it is imperative to examine their association, especially in the vulnerable and underrepresented group of young adult Blacks. PURPOSE The current study examines the association between lifetime marijuana use on history of STI diagnosis in a sample of Black college students. RESULTS Approximately 81% of the 213 participants were female, with approximately 81% also being 21years of age or younger. Alcohol (88%) led the prevalence of substances ever used, followed by marijuana (75%), and cigarettes (57%). When including demographic and substance use covariates, lifetime marijuana use (AOR=2.51; 95% CIs, 1.01, 6.21) and age (AOR=2.72; 95% CIs, 1.32, 5.64) were associated with history of STI. CONCLUSION These findings will inform intervention and prevention methods used to reduce STI prevalence and marijuana use among Black young adults. Both epidemiological and biological foundations will be discussed.
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