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Zorilla RA, Shikuma CM. A Literature Review on the Adherence to Screening Guidelines for Latent Tuberculosis Infection Among Persons Living With HIV. HAWAI'I JOURNAL OF HEALTH & SOCIAL WELFARE 2023; 82:289-295. [PMID: 38093759 PMCID: PMC10713737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Abstract
Human immunodeficiency virus (HIV) infection increases the risk of reactivation of latent tuberculosis infection (LTBI). Although antiretroviral therapy decreases the progression of LTBI to tuberculosis disease (TBD), persons living with HIV (PLHIV) still have higher risk of TBD compared to the general population. LTBI screening is recommended for all newly diagnosed PLHIV to prevent TBD. However, several studies from low TBD incidence countries have reported sub-optimal implementation of these guidelines. This review aims to assess published studies on adherence to LTBI screening among PLHIV by identifying factors and determinants that affect the implementation of LTBI screening among PLHIV in low TBD incidence countries. Electronic databases were used to search for articles describing the adherence to LTBI screening guidelines. Fourteen studies were included in the final review. Ten studies assessed the frequency of PLHIV getting LTBI screening, and 4 studies assessed the compliance of health care providers in implementing the guidelines. PLHIV who were screened for LTBI ranged from 22.4% to 85%, of which 0.8% to 25.6% had positive results. Only 20% to 57.4% of surveyed physicians implemented the guidelines. Country of birth was an independent predictor of receiving LTBI screening. LTBI screening guidelines are inconsistently performed resulting in missed opportunities for TBD prevention. A comprehensive screening policy involving testing all PLHIV may be the best approach, rather than a targeted approach testing foreign-born individuals only. This will minimize missing domestic cases that can worsen disparity in HIV and tuberculosis infection among minority groups, including Asians, Native Hawaiians, and Pacific Islanders.
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Affiliation(s)
| | - Cecilia M. Shikuma
- John A. Burns School of Medicine, University of Hawai‘i at Mānoa, Honolulu, HI
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Kang Y, Kang S, Gibson D, Rodriguez AM, Prochaska J, Kaul S. Disparities in utilization of preventive health services among Asian young adults in the United States. Prev Med 2023; 175:107670. [PMID: 37586609 DOI: 10.1016/j.ypmed.2023.107670] [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] [Received: 02/27/2023] [Revised: 07/07/2023] [Accepted: 08/13/2023] [Indexed: 08/18/2023]
Abstract
Despite the favorable health impacts of preventive services use, young adults remain at a higher risk of not using these services compared with older adults. This study seeks to identify barriers to receiving recommended preventive services among Asian young adults compared to other racial/ethnic young adults. Using 2016-2018 National Health Interview Survey data, this study examined barriers to recommended preventive services among non-Hispanic (NH) Asian young adults aged 18-39 years compared with other racial/ethnic groups in the United States (Total = 25,430; NH Asians = 6.3%). General prevention included fasting blood sugar, cholesterol, blood pressure, and Human Immunodeficiency Virus checkups. We documented information on vaccinations for influenza, pneumonia, tetanus, hepatitis A/B, and female-specific preventive care measures. NH Asian young adults reported blood pressure checkups less often than NH Whites (72.88% vs. 79.92%, p < 0.001). NH Asian young adults were also less likely to report HIV testing than all other racial/ethnic groups (p < 0.001). After controlling for covariates, NH Whites (odds ratio [OR] = 2.00, 95% confidence interval [CI] = 1.60, 2.50), NH Blacks (OR = 1.55, 95% CI = 1.18, 2.02), and other races (OR = 2.40, 95% CI = 1.60, 3.58) were more likely to receive any preventive services than NH Asians. Among those receiving any preventive services, there were no differences between NH Asians and all other racial/ethnic groups in whether they reported receiving relatively more preventive services. Our findings demonstrate that the rates of certain recommended preventive services use were lower among NH Asian young adults. Targeted public health strategies are needed to increase the use of preventive healthcare for racial/ethnic minority young adults.
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Affiliation(s)
- Yejin Kang
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - SuJin Kang
- Institute of Health and Environment, Graduate School of Public Health, Seoul National University, Building 221, 1 Gwanak-ro, Gwanak-gu, Seoul 08826, Republic of Korea
| | - Derrick Gibson
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - Ana M Rodriguez
- Department of Obstetrics and Gynecology, University of Texas Medical Branch, 301 University Blvd Fl 3., Galveston, TX 77555, USA.
| | - John Prochaska
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA.
| | - Sapna Kaul
- School of Public and Population Health, University of Texas Medical Branch, 301 University Blvd., Galveston, TX 77555, USA
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Martin EG, Ansari B, Hart-Malloy R, Smith DK, Delaney KP, Gift TL, Berruti AA, Trigg M, Rosenberg ES. Racial and ethnic disparities in HIV diagnoses among heterosexually active persons in the United States nationally and by state, 2018. PLoS One 2021; 16:e0257583. [PMID: 34543322 PMCID: PMC8451999 DOI: 10.1371/journal.pone.0257583] [Citation(s) in RCA: 6] [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: 04/18/2021] [Accepted: 09/03/2021] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Despite declining HIV infection rates, persistent racial and ethnic disparities remain. Appropriate calculations of diagnosis rates by HIV transmission category, race and ethnicity, and geography are needed to monitor progress towards reducing systematic disparities in health outcomes. We estimated the number of heterosexually active adults (HAAs) by sex and state to calculate appropriate HIV diagnosis rates and disparity measures within subnational regions. METHODS The analysis included all HIV diagnoses attributed to heterosexual transmission in 2018 in the United States, in 50 states and the District of Columbia. Logistic regression models estimated the probability of past-year heterosexual activity among adults in three national health surveys, by sex, age group, race and ethnicity, education category, and marital status. Model-based probabilities were applied to estimated counts of HAAs by state, which were synthesized through meta-analysis. HIV diagnoses were overlaid to calculate racial- and ethnic-specific rates, rate differences (RDs), and rate ratios (RRs) among HAAs by sex and state. RESULTS Nationally, HAA women have a two-fold higher HIV diagnosis rate than HAA men (rate per 100,000 HAAs, women: 6.57; men: 3.09). Compared to White non-Hispanic HAAs, Black HAAs have a 20-fold higher HIV diagnosis rate (RR, men: 21.28, women: 19.55; RD, men: 15.40, women: 31.78) and Hispanic HAAs have a 4-fold higher HIV diagnosis rate (RR, men: 4.68, RD, women: 4.15; RD, men: 2.79, RD, women: 5.39). Disparities were ubiquitous across regions, with >75% of states in each region having Black-to-White RR ≥10. CONCLUSION The racial and ethnic disparities across regions suggests a system-wide failure particularly with respect to preventing HIV among Black and Hispanic women. Pervasive disparities emphasize the role for coordinated federal responses such as the current Ending the HIV Epidemic (EHE) initiative.
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Affiliation(s)
- Erika G. Martin
- Department of Public Administration and Policy, Rockefeller College of Public Affairs and Policy, University at Albany, Albany, New York, United States of America
- Center for Collaborative HIV Research in Practice and Policy, School of Public Health, University at Albany, Albany, New York, United States of America
| | - Bahareh Ansari
- Department of Information Science, College of Emergency Preparedness, Homeland Security and Cybersecurity, University at Albany, Albany, New York, United States of America
| | - Rachel Hart-Malloy
- Center for Collaborative HIV Research in Practice and Policy, School of Public Health, University at Albany, Albany, New York, United States of America
- New York State Department of Health, Office of Sexual Health and Epidemiology, AIDS Institute, Albany, New York, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York, United States of America
| | - Dawn K. Smith
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Kevin P. Delaney
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Thomas L. Gift
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Andrés A. Berruti
- Division of HIV/AIDS Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Monica Trigg
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Eli S. Rosenberg
- Center for Collaborative HIV Research in Practice and Policy, School of Public Health, University at Albany, Albany, New York, United States of America
- Department of Epidemiology and Biostatistics, School of Public Health, University at Albany, Albany, New York, United States of America
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Li F, McCormick TJ, Katz AR, Whiticar PM, Wasserman GM. Patient and provider characteristics associated with retention in HIV medical care and viral suppression among in care patients in Hawaii. Int J STD AIDS 2021; 32:919-926. [PMID: 33908838 DOI: 10.1177/09564624211002403] [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: 11/16/2022]
Abstract
The percentages of retention in care and viral suppression among persons living with HIV (PLWH) in the United States from 2015 to 2018 were far below the 2020 national goals. This study aims to examine disparities in retention in care and viral suppression. The study population included PLWH diagnosed through 2016, residing in Hawaii at year-end 2016 and 2017, and who were in care in 2017 defined as having ≥1 CD4/viral load tests in 2017. Care providers were categorized as "very frequent" (≥50 patients), "frequent" (25-49 patients), "occasional" (10-24 patients), and "infrequent" (<10 patients). Among the 1752 patients included, 28.0% were not retained in care in 2017 (i.e., <2 CD4/VL tests performed at least 3 months apart), of whom 89.2% had only a single viral load test. Patients receiving care from the "infrequent" group of providers were less likely to be retained in care (adjusted odds ratio (aOR) = 0.48; 95% CI = 0.33, 0.69) or virally suppressed (aOR = 0.39; 95% CI = 0.24, 0.63), than patients receiving care from the "very frequent" group of providers. Percentages of three-year (2016-2018) in care and viral suppression were lowest among patients receiving care from "infrequent" care providers. Patients <45 years old were less likely to be retained in care (aOR = 0.53; 95% CI = 0.41, 0.68) or be virally suppressed (aOR = 0.59; 95% CI = 0.40, 0.86) than those 45 years or older. Patients of multiple races were less likely to be virally suppressed than whites (aOR = 0.38, 95% CI = 0.23, 0.64). Establishing a long-term relationship with an experienced HIV provider appears beneficial to achieve sustainable viral suppression and provision of uninterrupted HIV medical care.
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Affiliation(s)
- Fenfang Li
- Communicable Disease and Public Health Nursing Division, 11147Hawaii State Department of Health, Honolulu, HI, USA
| | - Timothy J McCormick
- Harm Reduction Services Branch, Communicable Disease and Public Health Nursing Division, 11147Hawaii State Department of Health, Honolulu, HI, USA
| | - Alan R Katz
- Office of Public Health Studies, Myron B. Thompson School of Social Work, 3939University of Hawaii, Honolulu, HI, USA
| | - Peter M Whiticar
- Harm Reduction Services Branch, Communicable Disease and Public Health Nursing Division, 11147Hawaii State Department of Health, Honolulu, HI, USA
| | - Glenn M Wasserman
- Communicable Disease and Public Health Nursing Division, 11147Hawaii State Department of Health, Honolulu, HI, USA
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