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Facente SN, Patel S, Hecht J, Wilson E, McFarland W, Page K, Vickerman P, Fraser H, Burk K, Morris MD. Hepatitis C Care Cascades for 3 Populations at High Risk: Low-income Trans Women, Young People Who Inject Drugs, and Men Who Have Sex With Men and Inject Drugs. Clin Infect Dis 2021; 73:e1290-e1295. [PMID: 33768236 PMCID: PMC8442786 DOI: 10.1093/cid/ciab261] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND To achieve elimination of hepatitis C virus (HCV) infection, limited resources can be best allocated through estimation of "care cascades" among groups disproportionately affected. In San Francisco and elsewhere, these groups include young (age ≤ 30 years) people who inject drugs (YPWID), men who have sex with men who inject drugs (MSM-IDU), and low-income trans women. METHODS We developed cross-sectional HCV care cascades for YPWID, MSM-IDU, and trans women using diverse data sources. Population sizes were estimated using an inverse variance-weighted average of estimates from the peer-reviewed literature between 2013 and 2019. Proportions of past/current HCV infection, diagnosed infection, treatment initiation, and evidence of cure (sustained virologic response at 12 weeks posttreatment) were estimated from the literature using data from 7 programs and studies in San Francisco between 2015 and 2020. RESULTS The estimated number of YPWID in San Francisco was 3748; 58.4% had past/current HCV infection, of whom 66.4% were diagnosed with current infection, 9.1% had initiated treatment, and 50% had confirmed cure. The corresponding figures for the 8135 estimated MSM-IDU were: 29.4% with past/current HCV infection, 70.3% diagnosed with current infection, 28.4% initiated treatment, and 38.9% with confirmed cure. For the estimated 951 low-income trans women, 24.8% had past/current HCV infection, 68.9% were diagnosed with current infection, 56.5% initiated treatment, and 75.5% had confirmed cure. CONCLUSIONS In all 3 populations, diagnosis rates were relatively high; however, attention is needed to urgently increase treatment initiation in all groups, with a particular unmet need among YPWID.
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Affiliation(s)
- Shelley N Facente
- School of Public Health, Division of Epidemiology and Biostatistics, University of California Berkeley, Berkeley, California, USA,Facente Consulting, Richmond, California, USA
| | - Sheena Patel
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Jennifer Hecht
- San Francisco AIDS Foundation, San Francisco, California, USA
| | - Erin Wilson
- San Francisco Department of Public Health, San Francisco, California, USA
| | - Willi McFarland
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA,San Francisco Department of Public Health, San Francisco, California, USA
| | - Kimberly Page
- University of New Mexico, Albuquerque, New Mexico, USA
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Hannah Fraser
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Katie Burk
- San Francisco Department of Public Health, San Francisco, California, USA
| | - Meghan D Morris
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, USA,Correspondence: M. D. Morris, 550 16th St, Box 124, San Francisco, CA 94153, USA ()
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Mizuno Y, Purcell DW, Knowlton AR, Wilkinson JD, Gourevitch MN, Knight KR. Syndemic vulnerability, sexual and injection risk behaviors, and HIV continuum of care outcomes in HIV-positive injection drug users. AIDS Behav 2015; 19:684-93. [PMID: 25249392 DOI: 10.1007/s10461-014-0890-0] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Limited investigations have been conducted on syndemics and HIV continuum of care outcomes. Using baseline data from a multi-site, randomized controlled study of HIV-positive injection drug users (n = 1,052), we examined whether psychosocial factors co-occurred, and whether these factors were additively associated with behavioral and HIV continuum of care outcomes. Experiencing one type of psychosocial problem was significantly (p < 0.05) associated with an increased odds of experiencing another type of problem. Persons with 3 or more psychosocial problems were significantly more likely to report sexual and injection risk behaviors and were less likely to be adherent to HIV medications. Persons with 4 or more problems were less likely to be virally suppressed. Reporting any problems was associated with not currently taking HIV medications. Our findings highlight the association of syndemics not only with risk behaviors, but also with outcomes related to the continuum of care for HIV-positive persons.
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Affiliation(s)
- Yuko Mizuno
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, 1600 Clifton Road, NE Mail Stop E37, Atlanta, GA, 30333, USA,
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Houston E, Osborn A, Lyons T, Masvawure T, Raja S. Exploring Perceived Social Support from Peer Facilitators in an HIV Treatment Adherence Intervention for African American Patients: A Content Analysis of Participant Perspectives. JOURNAL OF COMMUNITY & APPLIED SOCIAL PSYCHOLOGY 2015. [DOI: 10.1002/casp.2228] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Eric Houston
- Department of Psychology; Illinois Institute of Technology; 3105 S. Dearborn St. Chicago IL 60616 USA
| | - Amanda Osborn
- Department of Psychology; Illinois Institute of Technology; 3105 S. Dearborn St. Chicago IL 60616 USA
| | - Thomas Lyons
- HIV/AIDS Research and Policy Institute; Chicago State University; 9501 S. King Dr. Chicago IL 60628 USA
| | | | - Sheela Raja
- College of Dentistry; University of Illinois-Chicago; 801 S. Paulina St. Chicago IL 60612 USA
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Eller LS, Bunch EH, Wantland DJ, Portillo CJ, Reynolds NR, Nokes KM, Coleman CL, Kemppainen JK, Kirksey KM, Corless IB, Hamilton MJ, Dole PJ, Nicholas PK, Holzemer WL, Tsai YF. Prevalence, correlates, and self-management of HIV-related depressive symptoms. AIDS Care 2011; 22:1159-70. [PMID: 20824569 DOI: 10.1080/09540121.2010.498860] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Depressive symptoms are highly prevalent yet undertreated in people living with HIV/AIDS (PLHAs). As part of a larger study of symptom self-management (N=1217), this study examined the prevalence, correlates, and characteristics (intensity, distress, and impact) of depressive symptoms, and the self-care strategies used to manage those symptoms in PLHAs in five countries. The proportion of respondents from each country in the total sample reporting depressive symptoms in the past week varied and included Colombia (44%), Norway (66%), Puerto Rico (57%), Taiwan (35%), and the USA (56%). Fifty-four percent (n=655) of the total sample reported experiencing depressive symptoms in the past week, with a mean of 4.1 (SD 2.1) days of depression. Mean depression intensity 5.4 (SD 2.7), distressfulness 5.5 (SD 2.86), and impact 5.5 (SD 3.0) were rated on a 1-10 scale. The mean Center for Epidemiologic Studies Depression Scale score for those reporting depressive symptoms was 27 (SD 11; range 3-58), and varied significantly by country. Respondents identified 19 self-care behaviors for depressive symptoms, which fell into six categories: complementary therapies, talking to others, distraction techniques, physical activity, medications, and denial/avoidant coping. The most frequently used strategies varied by country. In the US sample, 33% of the variance in depressive symptoms was predicted by the combination of education, HIV symptoms, psychological and social support, and perceived consequences of HIV disease.
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Affiliation(s)
- L S Eller
- Rutgers The State University of New Jersey, Newark, USA.
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Results from a randomized controlled trial of a peer-mentoring intervention to reduce HIV transmission and increase access to care and adherence to HIV medications among HIV-seropositive injection drug users. J Acquir Immune Defic Syndr 2008; 46 Suppl 2:S35-47. [PMID: 18089983 DOI: 10.1097/qai.0b013e31815767c4] [Citation(s) in RCA: 100] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND There is a lack of effective behavioral interventions for HIV-positive injection drug users (IDUs). We sought to evaluate the efficacy of an intervention to reduce sexual and injection transmission risk behaviors and to increase utilization of medical care and adherence to HIV medications among this population. METHODS HIV-positive IDUs (n=966) recruited in 4 US cities were randomly assigned to a 10-session peer mentoring intervention or to an 8-session video discussion intervention (control condition). Participants completed audio computer-assisted self-interviews and had their blood drawn to measure CD4 cell count and viral load at baseline and at 3-month (no blood), 6-month, and 12-month follow-ups. RESULTS Overall retention rates for randomized participants were 87%, 83%, and 85% at 3, 6, and 12 months, respectively. Participants in both conditions reported significant reductions from baseline in injection and sexual transmission risk behaviors, but there were no significant differences between conditions. Participants in both conditions reported no change in medical care and adherence, and there were no significant differences between conditions. CONCLUSIONS Both interventions led to decreases in risk behaviors but no changes in medical outcomes. The characteristics of the trial that may have contributed to these results are examined, and directions for future research are identified.
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