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Hogben M, Dittus PJ, Leichliter JS, Aral SO. Social and behavioural research prospects for sexually transmissible infection prevention in the era of advances in biomedical approaches. Sex Health 2021; 17:103-113. [PMID: 32119815 DOI: 10.1071/sh19105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Accepted: 10/31/2019] [Indexed: 12/20/2022]
Abstract
In the past two decades, major advances in biomedical intervention approaches to prevent HIV and many sexually transmissible infections (STIs) have shown great promise. However, challenges to prevention remain in the area of achieving population-level impact for biomedical prevention approaches. In this paper we address what social and behavioural research approaches can contribute beyond well-known behaviour change and counselling interventions. We organise work into five areas. Adherence and disinhibition research is primarily into individual-level constructs pertaining to maximising intervention effectiveness. Coverage research represents a population-level construct germane to maximising efficient prioritisation for prevention. Research covering social determinants, a second population-level construct, contributes to both prioritisation and effectiveness. Finally, disparities and social inequities need to be incorporated into prevention, given the pervasive and persistent disparities found in rates of HIV and STIs and in their antecedents.
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Affiliation(s)
- Matthew Hogben
- Division of STD Prevention, Centers for Disease Control and Prevention, Mail Stop US12-2, Atlanta, GA 30333, USA; and Corresponding author.
| | - Patricia J Dittus
- Division of STD Prevention, Centers for Disease Control and Prevention, Mail Stop US12-2, Atlanta, GA 30333, USA
| | - Jami S Leichliter
- Division of STD Prevention, Centers for Disease Control and Prevention, Mail Stop US12-2, Atlanta, GA 30333, USA
| | - Sevgi O Aral
- Division of STD Prevention, Centers for Disease Control and Prevention, Mail Stop US12-2, Atlanta, GA 30333, USA
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Friedman EE, Dean HD, Duffus WA. Incorporation of Social Determinants of Health in the Peer-Reviewed Literature: A Systematic Review of Articles Authored by the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. Public Health Rep 2018; 133:392-412. [PMID: 29874147 DOI: 10.1177/0033354918774788] [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: 12/12/2022] Open
Abstract
OBJECTIVES Social determinants of health (SDHs) are the complex, structural, and societal factors that are responsible for most health inequities. Since 2003, the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP) has researched how SDHs place communities at risk for communicable diseases and poor adolescent health. We described the frequency and types of SDHs discussed in articles authored by NCHHSTP. METHODS We used the MEDLINE/PubMed search engine to systematically review the frequency and type of SDHs that appeared in peer-reviewed publications available in PubMed from January 1, 2009, through December 31, 2014, with a NCHHSTP affiliation. We chose search terms to identify articles with a focus on the following SDH categories: income and employment, housing and homelessness, education and schooling, stigma or discrimination, social or community context, health and health care, and neighborhood or built environment. We classified articles based on the depth of topic coverage as "substantial" (ie, one of ≤3 foci of the article) or "minimal" (ie, one of ≥4 foci of the article). RESULTS Of 862 articles authored by NCHHSTP, 366 (42%) addressed the SDH factors of interest. Some articles addressed >1 SDH factor (366 articles appeared 568 times across the 7 categories examined), and we examined them for each category that they addressed. Most articles that addressed SDHs (449/568 articles; 79%) had a minimal SDH focus. SDH categories that were most represented in the literature were health and health care (190/568 articles; 33%) and education and schooling (118/568 articles; 21%). CONCLUSIONS This assessment serves as a baseline measurement of inclusion of SDH topics from NCHHSTP authors in the literature and creates a methodology that can be used in future assessments of this topic.
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Affiliation(s)
- Eleanor E Friedman
- 1 Association of Schools and Programs of Public Health/CDC Public Health Fellowship Program, Atlanta, GA, USA.,2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA.,3 Chicago Center for HIV Elimination and University of Chicago Department of Medicine, Chicago, IL, USA
| | - Hazel D Dean
- 4 Office of the Director, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Wayne A Duffus
- 2 Office of Health Equity, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
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FUREGATO M, CHEN Y, MOHAMMED H, MERCER CH, SAVAGE EJ, HUGHES G. Examining the role of socioeconomic deprivation in ethnic differences in sexually transmitted infection diagnosis rates in England: evidence from surveillance data. Epidemiol Infect 2016; 144:3253-3262. [PMID: 27511704 PMCID: PMC9150192 DOI: 10.1017/s0950268816001679] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2016] [Revised: 06/14/2016] [Accepted: 07/10/2016] [Indexed: 11/07/2022] Open
Abstract
Differences by ethnic group in STI diagnosis rates have long been recognized in England. We investigated whether these may be explained by ethnic disparities in socioeconomic deprivation (SED). Data on all diagnoses made in sexual health clinics in England in 2013 were obtained from the mandatory STI surveillance system. Poisson regression was used to calculate incidence rate ratios (IRRs) of STIs, by ethnicity, with and without adjustment for index of multiple deprivation (IMD) a measure of area-level deprivation. Unadjusted IRRs (95% confidence intervals) were highest for gonorrhoea [8·18 (7·77-8·61) and 5·76 (5·28-6·29)] and genital herpes [4·24 (3·99-4·51) and 3·58 (3·23-3·98)] for people of black Caribbean and non-Caribbean/non-African black ethnicity and IRRs were highest for syphilis [8·76 (7·97-9·63)] and genital warts [2·23 (2·17-2·29)] for people of non-British/non-Irish white ethnicity compared to white British ethnicity. After adjustment for IMD, IRRs for gonorrhoea [5·76 (5·47-6·07)] and genital herpes [3·73 (3·50-3·97)] declined but remained highest for black Caribbeans and IRRs for syphilis [7·35 (6·68-8·09)] and genital warts [2·10 (2·04-2·16)] declined but remained highest for non-British/non-Irish white compared to white British. In England, ethnic disparities in STI diagnosis rates are partially explained by SED, but behavioural and contextual factors likely contribute. Clinic and community-based interventions should involve social peer networks to ensure they are targeted and culturally sensitive.
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Affiliation(s)
- M. FUREGATO
- National Infection Service, Public Health England, London, UK
| | - Y. CHEN
- Centre for Sexual Health and HIV Research, University College London, London, UK
| | - H. MOHAMMED
- National Infection Service, Public Health England, London, UK
| | - C. H. MERCER
- Centre for Sexual Health and HIV Research, University College London, London, UK
| | - E. J. SAVAGE
- National Infection Service, Public Health England, London, UK
| | - G. HUGHES
- National Infection Service, Public Health England, London, UK
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Chen Y, Zeng Y, Luo F, Yuan Z. A New Algorithm to Optimize Maximal Information Coefficient. PLoS One 2016; 11:e0157567. [PMID: 27333001 PMCID: PMC4917098 DOI: 10.1371/journal.pone.0157567] [Citation(s) in RCA: 16] [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: 02/25/2016] [Accepted: 06/01/2016] [Indexed: 11/25/2022] Open
Abstract
The maximal information coefficient (MIC) captures dependences between paired variables, including both functional and non-functional relationships. In this paper, we develop a new method, ChiMIC, to calculate the MIC values. The ChiMIC algorithm uses the chi-square test to terminate grid optimization and then removes the restriction of maximal grid size limitation of original ApproxMaxMI algorithm. Computational experiments show that ChiMIC algorithm can maintain same MIC values for noiseless functional relationships, but gives much smaller MIC values for independent variables. For noise functional relationship, the ChiMIC algorithm can reach the optimal partition much faster. Furthermore, the MCN values based on MIC calculated by ChiMIC can capture the complexity of functional relationships in a better way, and the statistical powers of MIC calculated by ChiMIC are higher than those calculated by ApproxMaxMI. Moreover, the computational costs of ChiMIC are much less than those of ApproxMaxMI. We apply the MIC values tofeature selection and obtain better classification accuracy using features selected by the MIC values from ChiMIC.
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Affiliation(s)
- Yuan Chen
- Hunan Provincial Key Laboratory for Biology and Control of Plant Diseases and Insect Pests, Hunan Agricultural University, Changsha, China
| | - Ying Zeng
- Orient Science &Technology College of Hunan Agricultural University, Changsha, China
| | - Feng Luo
- Hunan Provincial Key Laboratory for Biology and Control of Plant Diseases and Insect Pests, Hunan Agricultural University, Changsha, China
- College of Plant Protection, Hunan Agricultural University, Changsha, China
- School of Computing, Clemson University, Clemson, South Carolina, United States of America
| | - Zheming Yuan
- Hunan Provincial Key Laboratory for Biology and Control of Plant Diseases and Insect Pests, Hunan Agricultural University, Changsha, China
- Hunan Provincial Key Laboratory for Germplasm Innovation and Utilization of Crop, Hunan Agricultural University, Changsha, China
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Xiong M, Lan L, Feng T, Zhao G, Wang F, Hong F, Wu X, Zhang C, Wen L, Liu A, Best JM, Tang W. Analysis of the sex ratio of reported gonorrhoea incidence in Shenzhen, China. BMJ Open 2016; 6:e009629. [PMID: 26975933 PMCID: PMC4800114 DOI: 10.1136/bmjopen-2015-009629] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE To assess the clinical process of gonorrhoea diagnosis and report in China, and to determine the difference of sex ratio between reported incidence based on reporting data and true diagnosis rate based on reference tests of gonorrhoea. SETTING A total of 26 dermatology and sexually transmitted disease (STD) departments, 34 obstetrics-gynaecology clinics and 28 urology outpatient clinics selected from 34 hospitals of Shenzhen regarded as our study sites. PARTICIPANTS A total of 2754 participants were recruited in this study, and 2534 participants completed the questionnaire survey and provided genital tract secretion specimens. There were 1106 male and 1428 female participants. Eligible participants were patients who presented for outpatient STD care at the selected clinics for the first time in October 2012 were at least 18 years old, and were able to give informed consent. OUTCOME MEASURES Untested rate, true-positive rate, false-negative rate and unreported rate of gonorrhoea, as well as reported gonorrhoea incidence sex ratio and true diagnosis sex ratio were calculated and used to describe the results. RESULTS 2534 participants were enrolled in the study. The untested rate of gonorrhoea among females was significantly higher than that among males (female 88.1%, male 68.3%, p=0.001). The male-to-female sex ratios of untested rate, true-positive rate, false-negative rate and unreported rate were 1:1.3, 1.2:1, 1:1.6 and 1:1.4, respectively. The reported gonorrhoea incidence sex ratio of new diagnosed gonorrhoea was 19.8:1 (male vs female: 87/1106 vs 5/1420), while the true diagnosis sex ratio was 2.5:1 (male vs female: 161/1106 vs 84/1420). These data indicate that the sex ratio of reported gonorrhoea incidence has been overestimated by a factor of 7.9 (19.8/2.5). CONCLUSIONS We found the current reported gonorrhoea incidence and sex ratios to be inaccurate due to underestimations of gonorrhoea incidence, especially among women.
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Affiliation(s)
- Mingzhou Xiong
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
- Department of Epidemiology and Health Statistics, Public Health School of Central South University, Changsha, Hunan, China
| | - Lina Lan
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Tiejian Feng
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Guanglu Zhao
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Feng Wang
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Fuchang Hong
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Xiaobing Wu
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Chunlai Zhang
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Lizhang Wen
- STD Prevention and Control Department, Shenzhen Center for Chronic Disease Control, Shenzhen, Guangdong, China
| | - Aizhong Liu
- Department of Epidemiology and Health Statistics, Public Health School of Central South University, Changsha, Hunan, China
| | | | - Weiming Tang
- Project-China, University of North Carolina, Guangzhou, Guangdong, China
- Department of STI Control, Guangdong Provincial Center for Skin Diseases and STIs control, Guangzhou, Guangdong, China
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Neighborhoods at risk: estimating risk of higher Neisseria gonorrhoeae incidence among women at the census tract level. Sex Transm Dis 2015; 41:649-55. [PMID: 25299410 DOI: 10.1097/olq.0000000000000195] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The association between area-based social factors and sexually transmitted diseases has been demonstrated in numerous studies. Such associations have not previously been explored for their potential to quantify likelihood of higher transmission of gonorrhea in small geographic areas. METHODS Aggregate census tract-level sociodemographic factors in 4 domains (demographics, educational attainment, household income, and housing characteristics) were merged with female gonorrhea incidence data from 113 counties in 10 US states. Multivariate models were constructed, and a tract-level composite gonorrhea risk index was calculated. This composite risk index was validated against gonorrhea incidence among women from 2 independent states. RESULTS Seven tract-level factors were found to be most strongly correlated with female gonorrhea incidence: educational attainment, proportion of female headed households, annual household income below US $20,000, proportion of population non-Hispanic black, proportion of housing units currently vacant, proportion of population reporting moving in last year, and proportion of households that are nonfamily units. Composite index was highly correlated with female gonorrhea in the study area and validated with independent data. CONCLUSIONS Social factors predict gonorrhea incidence at the census tract level and identify small areas at risk for higher morbidity. These data may be used by health departments and health care practices to develop geographically based disease prevention and control efforts. This is especially useful because gonorrhea incidence data are not routinely available below the county level in many states.
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Dean HD, Fenton KA. Integrating a social determinants of health approach into public health practice: a five-year perspective of actions implemented by CDC's national center for HIV/AIDS, viral hepatitis, STD, and TB prevention. Public Health Rep 2014; 128 Suppl 3:5-11. [PMID: 24179273 DOI: 10.1177/00333549131286s302] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
- Hazel D Dean
- Centers for Disease Control and Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Atlanta, GA
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