1
|
Kosumi E, Kosumi M, Spasovski M. Attitude and practice on Human Papillomavirus, Human Papillomavirus Vaccine and associated factors among population in the Republic of Kosova. Arch Public Health 2022. [DOI: 10.3889/aph.2022.6067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Аpproximately 50–80% of sexually active women are exposed to at least one HPV variant during their lifetime. Based on the 2015 annual report of the National Institute of Public Health of Kosova, 68 new cases of cervical cancer were detected. The aim of the study was to investigate the attitude and practice regarding Human Papillomavirus (HPV) infections and the Human Papillomavirus vaccine in the population of the Republic of Kosova. Material and methods: A cross-sectional survey was conducted to assess the knowledge concerning HPV infections among the population aged 18 to 35+ years. The study was conducted during the period of time June 2021 –to August 2021. The sample included 500 participants. The questionnaire was anonymous, and participants were free to end their participation any time, without completing the questionnaire. Results: Regarding the claim "The HPV vaccine is safe", more than half of the respondents, respectively58.6% declare that they do not know, 33.4% of the respondents agree, 6.0% gave an incorrect answer / disagree, and 2.0% did not answer. The percentage difference between the unknown and correct answers is statistically significant for p<0.05. Conclusion: This study found out that the attitude towards the HPV vaccine among people of the Republic of Kosova is low to moderate. HPV vaccines should be included in the national immunization programs, since there is not still established national vaccination program for HPV vaccination.
Collapse
|
2
|
Lee HY, Luo Y, Neese J, Daniel C, Hahm HC. The Role of English Proficiency in HPV and HPV Vaccine Awareness: A Cross-Sectional Study Across Race/Ethnicity. Asian Pac J Cancer Prev 2021; 22:349-357. [PMID: 33639647 PMCID: PMC8190360 DOI: 10.31557/apjcp.2021.22.2.349] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Indexed: 11/25/2022] Open
Abstract
Objective: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and associated with over 90% of cervical cancer cases. The present study aimed to examine levels of HPV and HPV vaccine awareness and associated factors, particularly English proficiency, across various racial/ethnic groups. Methods: Two cross-sectional datasets, 2017 and 2018 Health Information National Trends Survey (HINTs), were analyzed for the current study. Binary logistic regression analyses were conducted. Findings: Non-Hispanic Whites had the highest levels while non-Hispanic Asians had the lowest levels of awareness regarding HPV and the HPV vaccine. English proficiency was significantly associated with increased HPV awareness among all groups except non-Hispanic Asian, and was significantly associated with greater HPV vaccine awareness in all groups. Discussion: In order to promote health equity across race/ethnicity, language barriers among minorities should be addressed when implementing health education on HPV and the HPV vaccine.
Collapse
Affiliation(s)
- Hee Yun Lee
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Yan Luo
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Jessica Neese
- School of Social Work, The University of Alabama, Tuscaloosa, AL, USA
| | - Casey Daniel
- USA Mitchell Cancer Institute, University of South Alabama, Mobile, AL, USA
| | | |
Collapse
|
3
|
Lama Y, Hu D, Jamison A, Quinn SC, Broniatowski DA. Characterizing Trends in Human Papillomavirus Vaccine Discourse on Reddit (2007-2015): An Observational Study. JMIR Public Health Surveill 2019; 5:e12480. [PMID: 30916662 PMCID: PMC6533775 DOI: 10.2196/12480] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 01/08/2019] [Accepted: 01/18/2019] [Indexed: 01/01/2023] Open
Abstract
Background Despite the introduction of the human papillomavirus (HPV) vaccination as a preventive measure in 2006 for cervical and other cancers, uptake rates remain suboptimal, resulting in preventable cancer mortality. Social media, widely used for information seeking, can influence users’ knowledge and attitudes regarding HPV vaccination. Little is known regarding attitudes related to HPV vaccination on Reddit (a popular news aggregation site and online community), particularly related to cancer risk and sexual activity. Examining HPV vaccine–related messages on Reddit may provide insight into how HPV discussions are characterized on forums online and influence decision making related to vaccination. Objective We observed how the HPV vaccine is characterized on Reddit over time and by user gender. Specifically, this study aimed to determine (1) if Reddit messages are more related to cancer risks or sexual behavior and (2) what other HPV vaccine–related discussion topics appear on Reddit. Methods We gathered all public Reddit comments from January 2007 to September 2015. We manually annotated 400 messages to generate keywords and identify salient themes. We then measured the similarity between each comment and lists of keywords associated with sexual behavior and cancer risk using Latent Semantic Analysis (LSA). Next, we used Latent Dirichlet Allocation (LDA) to characterize remaining topics within the Reddit data. Results We analyzed 22,729 messages containing the strings hpv or human papillomavirus and vaccin. LSA findings show that HPV vaccine discussions are significantly more related to cancer compared with sexual behavior from 2008 to 2015 (P<.001). We did not find a significant difference between genders in discussions of cancer and sexual activity (P>.05). LDA analyses demonstrated that although topics related to cancer risk and sexual activity were both frequently discussed (16.1% and 14.5% of word tokens, respectively), the majority of online discussions featured other topics. The most frequently discussed topic was politics associated with the vaccine (17.2%). Other topics included HPV disease and/or immunity (13.5%), the HPV vaccine schedule (11.5%), HPV vaccine side effects (9.7%), hyperlinks to outside sources (9.1%), and the risks and benefit of HPV vaccination (8.5%). Conclusions Reddit discourse on HPV vaccine encompasses a broad range of topics among men and women, with HPV political debates and cancer risk making up the plurality of the discussion. Our findings demonstrated that women and men both discussed HPV, highlighting that Reddit users do not perceive HPV as an issue that only pertains to women. Given the increasing use of social media as a source of health information, these results can inform the development of targeted online health communication strategies to promote HPV vaccination to young adult users of Reddit. Analyzing online discussions on Reddit can inform health communication efforts by identifying relevant, important HPV-related topics among online communities.
Collapse
Affiliation(s)
- Yuki Lama
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States
| | - Dian Hu
- George Washington University, Department of Engineering Management and Systems Engineering, Washington, DC, United States
| | - Amelia Jamison
- Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, United States
| | - Sandra Crouse Quinn
- Department of Family Science, School of Public Health, University of Maryland, College Park, MD, United States.,Maryland Center for Health Equity, School of Public Health, University of Maryland, College Park, MD, United States
| | - David A Broniatowski
- George Washington University, Department of Engineering Management and Systems Engineering, Washington, DC, United States
| |
Collapse
|
4
|
Gilkey MB, McRee AL. Provider communication about HPV vaccination: A systematic review. Hum Vaccin Immunother 2016; 12:1454-68. [PMID: 26838681 PMCID: PMC4964733 DOI: 10.1080/21645515.2015.1129090] [Citation(s) in RCA: 212] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2015] [Revised: 11/19/2015] [Accepted: 12/03/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Improving HPV vaccination coverage in the US will require healthcare providers to recommend the vaccine more effectively. To inform quality improvement efforts, we systematically reviewed studies of provider communication about HPV vaccination. METHODS We searched MEDLINE, CINAHL, EMBASE, and POPLINE in August 2015 to identify studies of provider communication about HPV vaccination. RESULTS We identified 101 qualitative and quantitative studies. Providers less often recommended HPV vaccine if they were uncomfortable discussing sex, perceived parents as hesitant, or believed patients to be low risk. Patients less often received recommendations if they were younger, male, or from racial/ethnic minorities. Despite parents' preference for unambiguous recommendations, providers often sent mixed messages by failing to endorse HPV vaccine strongly, differentiating it from other vaccines, and presenting it as an "optional" vaccine that could be delayed. CONCLUSION Interventions are needed to help providers deliver effective recommendations in the complex communication environment surrounding HPV vaccination.
Collapse
Affiliation(s)
- Melissa B. Gilkey
- Department of Population Medicine, Harvard Medical School & Harvard Pilgrim Health Care Institute, Boston, MA
| | | |
Collapse
|
5
|
Romaguera J, Caballero-Varona D, Tortolero-Luna G, Marrero E, Suárez E, Pérez CM, Muñoz C, Palefsky J, Ortiz AP. Factors Associated with HPV Vaccine Awareness in a Population-Based Sample of Hispanic Women in Puerto Rico. J Racial Ethn Health Disparities 2016; 3:281-90. [PMID: 27271069 PMCID: PMC5839125 DOI: 10.1007/s40615-015-0144-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Revised: 05/21/2015] [Accepted: 06/17/2015] [Indexed: 02/07/2023]
Abstract
OBJECTIVES The objective of this study was to investigate the factors associated with HPV awareness among women aged 16 to 64 years, among underserved minority Hispanic women living in Puerto Rico. METHODS A population-based, cross-sectional sample of 566 women, ages 16 to 64 years, living in the San Juan metropolitan area were surveyed regarding sexual behavior, HPV knowledge, and HPV vaccine uptake. Data was analyzed using descriptive statistics and multivariate logistic regression. RESULTS Overall, 64.8 % of the women in the sample had heard about the HPV vaccine. Among those in the recommended catch-up vaccination age range (16-26 years, n = 86), 4.7 % had received at least one dose of the HPV vaccine. Of those aware of the availability of the HPV vaccine, most had learned about it through the media, whereas, only 39.6 % had learned about it from a physician. Multivariate logistic regression analysis showed that HPV awareness (OR 8.6; 95 % CI 5.0-14.8) and having had an abnormal Pap smear (OR 2.0; 95 % CI 1.2-3.4) were associated with HPV vaccine awareness (p < 0.05). CONCLUSION HPV vaccine awareness among Hispanic women in the San Juan metropolitan area of Puerto Rico continues to be low. Strong recommendations from physicians and participation in HPV vaccine educational efforts are essential if the rate of HPV vaccination is to increase in the targeted population. Compared to the USA, and to their US Hispanic counterparts, a health disparity with regard to HPV vaccine awareness and coverage is evident in Puerto Rico; targeted action to deal with this disparity is urgently needed.
Collapse
Affiliation(s)
- J Romaguera
- Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico.
| | | | - G Tortolero-Luna
- Department of Obstetrics and Gynecology, School of Medicine, University of Puerto Rico, San Juan, Puerto Rico
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
| | - E Marrero
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - E Suárez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - C M Pérez
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - C Muñoz
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| | - J Palefsky
- University of California, San Francisco, CA, USA
| | - A P Ortiz
- University of Puerto Rico Comprehensive Cancer Center, San Juan, Puerto Rico
- Department of Biostatistics and Epidemiology, Graduate School of Public Health, University of Puerto Rico, San Juan, Puerto Rico
| |
Collapse
|
6
|
Kepka D, Ding Q, Bodson J, Warner EL, Mooney K. Latino Parents' Awareness and Receipt of the HPV Vaccine for Sons and Daughters in a State with Low Three-Dose Completion. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2015; 30:808-12. [PMID: 25572463 DOI: 10.1007/s13187-014-0781-0] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Latinos suffer a disproportionate burden of human papillomavirus (HPV)-preventable cancers, yet uptake and completion of the HPV vaccine among Latinos is below recommendations. Reasons for low HPV vaccine uptake among Latinos in Utah are unknown. We surveyed Latino parents of HPV vaccine age-eligible adolescents (N=118). Univariable analyses identified sociodemographic characteristics associated with HPV vaccine awareness, interest, and uptake for daughter(s) and/or son(s) using chi-square tests or Fisher's exact tests. More parents who had lived in the USA for 15 years or more had vaccinated their daughter (43.6 vs. 32.5%, p=0.035) compared to those living in the USA for shorter time periods. Parents born in Mexico reported their son had not received the HPV vaccine (74.6 vs. 58.3%, p=0.049) more than those born elsewhere. Parents with Mexican birthplace and ancestry reported not knowing about the HPV vaccine as the main barrier to vaccinating daughters (47.1 vs. 5.9%, p=0.002 for both) and sons (birthplace 38.3 vs. 10.3%, p=0.007; ancestry 37.1 vs. 11.1%, p=0.013) compared to those born or descending elsewhere. Non-acculturated parents with a son were more likely to report not knowing about the HPV vaccine as the main barrier to vaccine receipt (47.6 vs. 12.5%, p<0.001). Our results focus on Latinos in an understudied region and complement prior research in other regions. This study may have implications for designing culturally tailored interventions to improve uptake of the HPV vaccine among the growing population of Latinos in Utah, and other states in the Intermountain West.
Collapse
Affiliation(s)
- Deanna Kepka
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Qian Ding
- Study Design and Biostatistics Center, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Julia Bodson
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| | - Echo L Warner
- College of Nursing, University of Utah, Salt Lake City, UT, USA.
| | - Kathi Mooney
- College of Nursing, University of Utah, Salt Lake City, UT, USA
- Cancer Control and Population Sciences Department, Huntsman Cancer Institute, 2000 Circle of Hope, Salt Lake City, UT, 84112, USA
| |
Collapse
|
7
|
Yanikkerem E, Koker G. Knowledge, attitudes, practices and barriers towards HPV vaccination among nurses in Turkey: a longitudinal study. Asian Pac J Cancer Prev 2015; 15:7693-702. [PMID: 25292048 DOI: 10.7314/apjcp.2014.15.18.7693] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Human papilloma virus (HPV) occurs in women of all age groups, and causes cervical, anal, vaginal, vulvar, penile and oropharyngeal cancers. The aim of the study was to discover what nurses know about HPV infection, testing and vaccination and to determine vaccine practice of their daughters and perceived barriers. MATERIALS AND METHODS This cross-sectional and prospective study was carried out nurses who have worked in a hospital between January and June 2014. Pre-test and post-test were used to evaluate the nurses' knowledge about HPV infection, testing and vaccination. This study was performed with nurses who had girls between 9 and 26 years of age for evaluating the behavior of vaccination after three months of education. RESULTS The mean of pre-test and post-test scores about HPV infection, which included 22 items, were 8.2±5.6 and 19.2±1.5, respectively. Before education the HPV testing knowledge score was remarkably poor (1.9±1.7 over 5), after education it increased to 4.8±0.5. The mean HPV vaccine knowledge score were 3.7±2.7 (pre-test) 7.3±0.8 (post-test) on a 0-8 scale. The difference between mean total pre-test (13.9±9.1) and post-test (31.3±1.9) scores was statistically significant (p<0.001). After three months of education, only two of the nurses' daughters were vaccinated. The main reason was noted by nurses were not willing to be vaccinated was cost, doubts about safety and efficacy related to the vaccine. About one-third of nurses declared that they would receive the vaccine for their daughter later. CONCLUSIONS Nurses have a crucial role in the prevention, treatment, increasing public awareness and care for population. The education of the nurses about HPV infection, test and vaccination will play an important part decreasing cancer mortality and morbidity.
Collapse
Affiliation(s)
- Emre Yanikkerem
- Department of Obstetrics and Gynaecology Nursing, School of Health, Celal Bayar University, Manisa, Turkey E-mail :
| | | |
Collapse
|
8
|
Dempsey AF, Brewer SE, Pyrzanowski J, Sevick C, O’leary ST. Acceptability of human papillomavirus vaccines among women older than 26 years. Vaccine 2015; 33:1556-61. [DOI: 10.1016/j.vaccine.2015.02.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2014] [Revised: 02/05/2015] [Accepted: 02/06/2015] [Indexed: 01/16/2023]
|
9
|
Bermedo-Carrasco S, Feng CX, Peña-Sánchez JN, Lepnurm R. Predictors of having heard about human papillomavirus vaccination: Critical aspects for cervical cancer prevention among Colombian women. GACETA SANITARIA 2014; 29:112-7. [PMID: 25444387 DOI: 10.1016/j.gaceta.2014.09.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 09/10/2014] [Accepted: 09/16/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVES To determine whether the probability of having heard about human papillomavirus (HPV) vaccination differs by socio-demographic characteristics among Colombian women; and whether the effect of predictors of having heard about HPV vaccination varies by educational levels and rural/urban area of residence. METHODS Data of 53,521 women aged 13-49 years were drawn from the 2010 Colombian National Demographic and Health Survey. Women were asked about aspects of their health and their socio-demographic characteristics. A logistic regression model was used to identify factors associated with having heard about HPV vaccination. Educational level and rural/urban area of residence of the women were tested as modifier effects of predictors. RESULTS 26.8% of the women had heard about HPV vaccination. The odds of having heard about HPV vaccination were lower among women: in low wealth quintiles, without health insurance, with subsidized health insurance, and those who had children (p<0.001). Although women in older age groups and with better education had higher probabilities of having heard about HPV vaccination, differences in these probabilities by age group were more evident among educated women compared to non-educated ones. Probability gaps between non-educated and highly educated women were wider in the Eastern region. Living in rural areas decreased the probability of having heard about HPV vaccination, although narrower rural/urban gaps were observed in the Atlantic and Amazon-Orinoquía regions. CONCLUSIONS Almost three quarters of the Colombian women had not heard about HPV vaccination, with variations by socio-demographic characteristics. Women in disadvantaged groups were less likely to have heard about HPV vaccination.
Collapse
Affiliation(s)
| | - Cindy Xin Feng
- School of Public Health, University of Saskatchewan, Saskatoon, Canada; Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Canada
| | | | - Rein Lepnurm
- School of Public Health, University of Saskatchewan, Saskatoon, Canada
| |
Collapse
|
10
|
Frew PM, Zhang S, Saint-Victor DS, Schade AC, Benedict S, Banan M, Ren X, Omer SB. Influenza vaccination acceptance among diverse pregnant women and its impact on infant immunization. Hum Vaccin Immunother 2013; 9:2591-602. [PMID: 24172064 PMCID: PMC4162045 DOI: 10.4161/hv.26993] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Revised: 10/22/2013] [Accepted: 10/30/2013] [Indexed: 01/07/2023] Open
Abstract
OBJECTIVE We examined pregnant women's likelihood of vaccinating their infants against seasonal influenza via a randomized message framing study. Using Prospect Theory, we tested gain- and loss-frame message effects and demographic and psychosocial correlates of influenza immunization intention. We also explored interactions among pregnant women who viewed "Contagion" to understand cultural influences on message perception. METHODS Pregnant women ages 18-50 participated in a randomized message framing study from September 2011 through May 2012 that included exposure to intervention or control messages, coupled with questionnaire completion. Venue-based sampling was used to recruit racial and ethnic minority female participants at locations throughout Atlanta, Georgia. Bivariate and multivariate analyses were conducted to evaluate key outcomes. RESULTS The study population (n = 261) included many lower income (≤ $20,000/yearly household earnings) pregnant participants (69.2%, n = 171) inclusive of Black/African Americans (88.5%, n = 230), Hispanic/Latinas (7.3%, n = 19), and Other/Multicultural women (4.2%, n = 11). Both gain [OR = 2.13, 90% CI: (1.120, 4.048)] and loss-frame messages [OR = 2.02, 90% CI: (1.083, 3.787)] were significantly associated with infant influenza vaccination intention compared with the control condition. Intention to immunize against influenza during pregnancy had a strong effect on intent to immunize infants [OR = 10.83, 90%CI: (4.923, 23.825)]. Those who had seen the feature film "Contagion" (n = 54, 20.69%) viewed gain- and loss-framed messages as appealing (x (2) = 6.03, p = 0.05), novel (x (2) = 6.24, p = 0.03), and easy to remember (x (2) = 16.33, P = 0.0003). CONCLUSIONS In this population, both gain- and loss-framed messages were positively associated with increased maternal intent to immunize infants against influenza. Message resonance was enhanced among those who saw the film "Contagion." Additionally, history of immunization was strongly associated with infant immunization intention. :
Collapse
Affiliation(s)
- Paula M Frew
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Department of Behavioral Sciences and Health Education; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Siyu Zhang
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Department of Epidemiology; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Diane S Saint-Victor
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Hubert Department of Global Health; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Ashley C Schade
- Division of Allied Health; Emory University School of Medicine; Decatur, GA USA
| | - Samantha Benedict
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Department of Epidemiology; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Maral Banan
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Department of Behavioral Sciences and Health Education; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Xiang Ren
- Division of Infectious Diseases; Department of Medicine; Emory University School of Medicine; Decatur, GA USA
- Department of Epidemiology; Rollins School of Public Health; Emory University; Decatur, GA USA
| | - Saad B Omer
- Hubert Department of Global Health; Rollins School of Public Health; Emory University; Decatur, GA USA
| |
Collapse
|