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Woodworth KR, Newton SM, Tannis A, Reynolds MR, Olsen EO, Sizemore L, Wingate H, Orkis L, Reynolds B, Longcore N, Thomas N, Kim SY, Panagiotakopoulos L, Wester C, Delman DM, Gilboa SM, Tong VT. Birth Outcomes Among People with Hepatitis C in Pregnancy - Three U.S. States, 2018-2021. Matern Child Health J 2024; 28:979-983. [PMID: 38416334 PMCID: PMC11060891 DOI: 10.1007/s10995-024-03917-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
INTRODUCTION There are limited and conflicting data regarding the impact of hepatitis C in pregnancy on adverse birth outcomes. METHODS Using the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET), a large surveillance cohort, we describe birth outcomes among a cohort of people with HCV in pregnancy in total and by reported substance use. RESULTS Among 1418 infants, 89% were born to people with reported substance use during pregnancy. The proportion born preterm was 20%, 13% were small-for-gestational age and 34% of term infants required intensive care. CONCLUSIONS Assessments of recent changes to recommendations for HCV screening in pregnancy should evaluate the impact on maternal access to care for both HCV treatment as well as comorbidities such as substance use disorder which may contribute to adverse birth outcomes.
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Affiliation(s)
- Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA.
| | - Suzanne M Newton
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Ayzsa Tannis
- Eagle Global Scientific, LLC, San Antonio, TX, USA
| | - Megan R Reynolds
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Emily O Olsen
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Lauren Orkis
- Pennsylvania Department of Health, Pittsburgh, PA, USA
| | | | | | - Nadia Thomas
- New York State Department of Health, Albany, NY, USA
| | - Shin Y Kim
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Lakshmi Panagiotakopoulos
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carolyn Wester
- Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Dana Meaney Delman
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suzanne M Gilboa
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Van T Tong
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Tannis A, Miele K, Carlson JM, O'Callaghan KP, Woodworth KR, Anderson B, Praag A, Pulliam K, Coppola N, Willabus T, Mbotha D, Abetew D, Currenti S, Longcore ND, Akosa A, Meaney-Delman D, Tong VT, Gilboa SM, Olsen EO. Syphilis Treatment Among People Who Are Pregnant in Six U.S. States, 2018-2021. Obstet Gynecol 2024:00006250-990000000-01059. [PMID: 38626449 DOI: 10.1097/aog.0000000000005586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 03/07/2024] [Indexed: 04/18/2024]
Abstract
OBJECTIVE To describe syphilis treatment status and prenatal care among people with syphilis during pregnancy to identify missed opportunities for preventing congenital syphilis. METHODS Six jurisdictions that participated in SET-NET (Surveillance for Emerging Threats to Pregnant People and Infants Network) conducted enhanced surveillance among people with syphilis during pregnancy based on case investigations, medical records, and linkage of laboratory data with vital records. Unadjusted risk ratios (RRs) were used to compare demographic and clinical characteristics by syphilis stage (primary, secondary, or early latent vs late latent or unknown) and treatment status during pregnancy (adequate per the Centers for Disease Control and Prevention's "Sexually Transmitted Infections Treatment Guidelines, 2021" vs inadequate or not treated) and by prenatal care (timely: at least 30 days before pregnancy outcome; nontimely: less than 30 days before pregnancy outcome; and no prenatal care). RESULTS As of September 15, 2023, of 1,476 people with syphilis during pregnancy, 855 (57.9%) were adequately treated and 621 (42.1%) were inadequately treated or not treated. Eighty-two percent of the cohort received timely prenatal care. Although those with nontimely or no prenatal care were more likely to receive inadequate or no treatment (RR 2.50, 95% CI, 2.17-2.88 and RR 2.73, 95% CI, 2.47-3.02, respectively), 32.1% of those with timely prenatal care were inadequately or not treated. Those with reported substance use or a history of homelessness were nearly twice as likely to receive inadequate or no treatment (RR 2.04, 95% CI, 1.82-2.28 and RR 1.83, 95% CI, 1.58-2.13, respectively). CONCLUSION In this surveillance cohort, people without timely prenatal care had the highest risk for syphilis treatment inadequacy; however, almost a third of people who received timely prenatal care were not adequately treated. These findings underscore gaps in syphilis screening and treatment for pregnant people, especially those experiencing substance use and homelessness, and the need for systems-based interventions, such as treatment outside of traditional prenatal care settings.
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Affiliation(s)
- Ayzsa Tannis
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, and the Division of STD Prevention, National Center for HIV, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, and the Georgia Department of Public Health, Atlanta, Georgia; Eagle Global Scientific, LLC, San Antonio, Texas; Lukos LLC, Tampa, Florida; the Arizona Department of Health Services and Maricopa County Public Health, Phoenix, Arizona; the New Jersey Department of Health, Trenton, New Jersey; the Washington State Department of Health, Bellevue, Washington; and the New York State Department of Health, Albany, New York
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Clopper BR, Zhou Y, Tannis A, Staat MA, Rice M, Boom JA, Sahni LC, Selvarangan R, Harrison CJ, Halasa NB, Stewart LS, Weinberg GA, Szilagyi PG, Klein EJ, Englund JA, Rha B, Lively JY, Ortega-Sanchez IR, McMorrow ML, Moline HL. Medical Costs of RSV-associated Hospitalizations and Emergency Department Visits in Children Aged <5 years: Observational Findings from the New Vaccine Surveillance Network (NVSN), 2016-2019. J Pediatr 2024:114045. [PMID: 38561048 DOI: 10.1016/j.jpeds.2024.114045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 03/13/2024] [Accepted: 03/26/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE To assess medical costs of hospitalizations and emergency department (ED) care associated with respiratory syncytial virus (RSV) disease in children enrolled in the New Vaccine Surveillance Network. STUDY DESIGN We used accounting and prospective surveillance data from six pediatric health systems to assess direct medical costs from laboratory-confirmed RSV-associated hospitalizations (n=2,007) and ED visits (n=1,267) from 2016 through 2019 among children aged <5 years. We grouped costs into categories relevant to clinical care and administrative billing practices. We examined RSV-associated medical costs by care setting using descriptive and bivariate analyses. We assessed associations between known RSV risk factors and hospitalization costs and length of stay (LOS) using chi-square tests of association. RESULTS The median cost was $7,100 (IQR: $4,006-$13,355) per hospitalized child and $503 (IQR: $387-$930) per ED visit. Eighty percent (n=2,628) of our final sample were children aged <2 years. Fewer weeks' gestational age (GA) was associated with higher median costs in hospitalized children [p<0.001, ≥37 weeks' GA: $6,840 ($3,905-$12,450); 29-36 weeks' GA: $7,721 ($4,362-$15,274); <29 w weeks' GA: $9,131 ($4,518-$19,924)]. Full-term infants accounted for 70% of the total expenditures in our sample. Almost three quarters of the healthcare dollars spent originated in children under 12 months of age; the primary age group targeted by recommended RSV prophylactics. CONCLUSIONS Reducing the cost burden for RSV-associated medical care in young children will require prevention of RSV in all young children, not just high-risk infants. Newly available maternal vaccine and immunoprophylaxis products could substantially reduce RSV-associated medical costs.
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Affiliation(s)
- Benjamin R Clopper
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia.
| | - Yingtao Zhou
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Ayzsa Tannis
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Mary Allen Staat
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Marilyn Rice
- Department of Pediatrics, University of Cincinnati, Division of Infectious Diseases, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Julie A Boom
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | - Leila C Sahni
- Texas Children's Hospital, Baylor College of Medicine, Houston, Texas
| | | | | | | | | | - Geoffrey A Weinberg
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | - Peter G Szilagyi
- Department of Pediatrics, University of Rochester School of Medicine and Dentistry, Rochester, New York
| | | | | | - Brian Rha
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
| | - Joana Y Lively
- Division of Viral Diseases, National Center for Immunization and Respiratory Diseases, CDC, Atlanta, Georgia
| | - Ismael R Ortega-Sanchez
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia
| | - Meredith L McMorrow
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; U.S. Public Health Service, Rockville, Maryland
| | - Heidi L Moline
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, U.S. Centers for Disease Control and Prevention (CDC), Atlanta, Georgia; U.S. Public Health Service, Rockville, Maryland
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Sancken CL, Tannis A, Amouzou SA, Burkel V, Carlson JM, Newton S, Gilboa SM, Gonzalez M, Valencia D, Tong VT, Ospina M. Zika virus prevention behaviors and knowledge among male partners of pregnant people and lack of condom use as a prevention behavior from the Zika en Embarazadas y Niños (ZEN) prospective cohort study, Colombia. BMC Res Notes 2024; 17:87. [PMID: 38515162 PMCID: PMC10956169 DOI: 10.1186/s13104-024-06702-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 01/23/2024] [Indexed: 03/23/2024] Open
Abstract
OBJECTIVE Zika virus (ZIKV) infection in pregnancy can cause brain and eye abnormalities and neurodevelopmental sequelae. In the absence of medical countermeasures, behavioral interventions were recommended to prevent mosquito bites and sexual transmission of ZIKV. This report uses data from the Zika en Embarazadas y Niños (ZEN) prospective cohort study in Colombia to describe the knowledge, attitudes, and behaviors (KAB) related to ZIKV prevention in male partners compared to those of their pregnant partners at study enrollment during February 2017-2018. RESULTS Most male partners reported wearing protective clothing such as long pants (97.6%) and long sleeves (72.8%), as well as covering ankles and feet (89.1%) to prevent ZIKV infection. When comparing the preventive behavior of condom use between male and pregnant partners, 26 pairs (10.0%) both responded that they performed the behavior. Overall, 25.1% of male partners and 18.9% of pregnant people reported any condom use during the three months before enrolling in ZEN. When comparing other preventive behaviors between male and pregnant partners, the behavior which was most frequently reported by both partners was wearing long pants (85.4%), and the least frequently reported by both partners was using condoms after finding out about a partner's pregnancy (3.4%).
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Affiliation(s)
| | - Ayzsa Tannis
- Eagle Global Scientific, LLC, San Antonio, TX, USA
| | - Sandra A Amouzou
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | | | - Suzanne Newton
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Suzanne M Gilboa
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Diana Valencia
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Van T Tong
- U.S. Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Martha Ospina
- Instituto Nacional de Salud de Colombia, Bogotá, Colombia
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Moline HL, Tannis A, Toepfer AP, Williams JV, Boom JA, Englund JA, Halasa NB, Staat MA, Weinberg GA, Selvarangan R, Michaels MG, Sahni LC, Klein EJ, Stewart LS, Schlaudecker EP, Szilagyi PG, Schuster JE, Goldstein L, Musa S, Piedra PA, Zerr DM, Betters KA, Rohlfs C, Albertin C, Banerjee D, McKeever ER, Kalman C, Clopper BR, McMorrow ML, Dawood FS. Early Estimate of Nirsevimab Effectiveness for Prevention of Respiratory Syncytial Virus-Associated Hospitalization Among Infants Entering Their First Respiratory Syncytial Virus Season - New Vaccine Surveillance Network, October 2023-February 2024. MMWR Morb Mortal Wkly Rep 2024; 73:209-214. [PMID: 38457312 PMCID: PMC10932582 DOI: 10.15585/mmwr.mm7309a4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
Respiratory syncytial virus (RSV) is the leading cause of hospitalization among infants in the United States. In August 2023, CDC's Advisory Committee on Immunization Practices recommended nirsevimab, a long-acting monoclonal antibody, for infants aged <8 months to protect against RSV-associated lower respiratory tract infection during their first RSV season and for children aged 8-19 months at increased risk for severe RSV disease. In phase 3 clinical trials, nirsevimab efficacy against RSV-associated lower respiratory tract infection with hospitalization was 81% (95% CI = 62%-90%) through 150 days after receipt; post-introduction effectiveness has not been assessed in the United States. In this analysis, the New Vaccine Surveillance Network evaluated nirsevimab effectiveness against RSV-associated hospitalization among infants in their first RSV season during October 1, 2023-February 29, 2024. Among 699 infants hospitalized with acute respiratory illness, 59 (8%) received nirsevimab ≥7 days before symptom onset. Nirsevimab effectiveness was 90% (95% CI = 75%-96%) against RSV-associated hospitalization with a median time from receipt to symptom onset of 45 days (IQR = 19-76 days). The number of infants who received nirsevimab was too low to stratify by duration from receipt; however, nirsevimab effectiveness is expected to decrease with increasing time after receipt because of antibody decay. Although nirsevimab uptake and the interval from receipt of nirsevimab were limited in this analysis, this early estimate supports the current nirsevimab recommendation for the prevention of severe RSV disease in infants. Infants should be protected by maternal RSV vaccination or infant receipt of nirsevimab.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - New Vaccine Surveillance Network Product Effectiveness Collaborators
- Coronavirus and Other Respiratory Viruses Division, National Center for Immunization and Respiratory Diseases, CDC; UPMC Children’s Hospital of Pittsburgh, Pittsburgh, Pennsylvania; Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Texas Children’s Hospital, Houston, Texas; Baylor College of Medicine, Houston, Texas; Department of Pediatrics, Seattle Children’s Hospital, Seattle, Washington; Department of Pediatrics, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Infectious Diseases, Cincinnati Children’s Hospital Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Pediatrics, University of Rochester Medical Center and University of Rochester–Golisano Children’s Hospital, Rochester, New York; Department of Pathology and Laboratory Medicine, Children’s Mercy Hospital, Kansas City, Missouri; Department of Pediatrics Children’s Mercy Hospital, Kansas City, Missouri
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Tannis A, Englund JA, Perez A, Harker EJ, Staat MA, Schlaudecker EP, Halasa NB, Stewart LS, Williams JV, Michaels MG, Selvarangan R, Schuster JE, Sahni LC, Boom JA, Weinberg GA, Szilagyi PG, Clopper BR, Zhou Y, McMorrow ML, Klein EJ, Moline HL. SARS-CoV-2 Epidemiology and COVID-19 mRNA Vaccine Effectiveness Among Infants and Children Aged 6 Months-4 Years - New Vaccine Surveillance Network, United States, July 2022-September 2023. MMWR Morb Mortal Wkly Rep 2023; 72:1300-1306. [PMID: 38032834 PMCID: PMC10718202 DOI: 10.15585/mmwr.mm7248a2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/02/2023]
Abstract
SARS-CoV-2 infection in young children is often mild or asymptomatic; however, some children are at risk for severe disease. Data describing the protective effectiveness of COVID-19 mRNA vaccines against COVID-19-associated emergency department (ED) visits and hospitalization in this population are limited. Data from the New Vaccine Surveillance Network, a prospective population-based surveillance system, were used to estimate vaccine effectiveness using a test-negative, case-control design and describe the epidemiology of SARS-CoV-2 in infants and children aged 6 months-4 years during July 1, 2022-September 30, 2023. Among 7,434 children included, 5% received a positive SARS-CoV-2 test result, and 95% received a negative test result; 86% were unvaccinated, 4% had received 1 dose of any vaccine product, and 10% had received ≥2 doses. When compared with receipt of no vaccines among children, receipt of ≥2 COVID-19 mRNA vaccine doses was 40% effective (95% CI = 8%-60%) in preventing ED visits and hospitalization. These findings support existing recommendations for COVID-19 vaccination of young children to reduce COVID-19-associated ED visits and hospitalization.
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Carlson JM, Tannis A, Woodworth KR, Reynolds MR, Shinde N, Anderson B, Hobeheidar K, Praag A, Campbell K, Carpentieri C, Willabus T, Burkhardt E, Torrone E, O’Callaghan KP, Miele K, Meaney-Delman D, Gilboa SM, Olsen EO, Tong VT. Substance Use Among Persons with Syphilis During Pregnancy - Arizona and Georgia, 2018-2021. MMWR Morb Mortal Wkly Rep 2023; 72:63-67. [PMID: 36656787 PMCID: PMC9869742 DOI: 10.15585/mmwr.mm7203a3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Despite universal prenatal syphilis screening recommendations and availability of effective antibiotic treatment, syphilis prevalence during pregnancy and the incidence of congenital syphilis have continued to increase in the United States (1,2). Concurrent increases in methamphetamine, injection drug, and heroin use have been described in women with syphilis (3). CDC used data on births that occurred during January 1, 2018-December 31, 2021, from two states (Arizona and Georgia) that participate in the Surveillance for Emerging Threats to Pregnant People and Infants Network (SET-NET) to describe the prevalence of substance use among pregnant persons with syphilis by congenital syphilis pregnancy outcome (defined as delivery of a stillborn or live-born infant meeting the surveillance case definition for probable or confirmed congenital syphilis). The prevalence of substance use (e.g., tobacco, alcohol, cannabis, illicit use of opioids, and other illicit, nonprescription substances) in persons with a congenital syphilis pregnancy outcome (48.1%) was nearly double that among those with a noncongenital syphilis pregnancy outcome (24.6%). Persons with a congenital syphilis pregnancy outcome were six times as likely to report illicit use of opioids and four times as likely to report using other illicit, nonprescription substances during pregnancy than were persons with a noncongenital syphilis pregnancy outcome. Approximately one half of persons who used substances during pregnancy and had a congenital syphilis pregnancy outcome had late or no prenatal care. Tailored interventions should address barriers and facilitators to accessing screening and treatment for syphilis among persons who use substances. The need for syphilis screening and treatment should be addressed at any health care encounter during pregnancy, especially among persons who use substances.
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Woodworth KR, Newton SM, Olsen EO, Tannis A, Sizemore L, Wingate H, Orkis L, Reynolds B, Longcore N, Thomas N, Bocour A, Wills A, Kim SY, Panagiotakopoulos L, Wester C, Delman Meaney D, Gilboa SM, Tong VT. Timing of Positive Hepatitis C Virus Test Results During and 1 Year Before Pregnancy. Obstet Gynecol 2022; 140:997-999. [PMID: 36357975 PMCID: PMC10951865 DOI: 10.1097/aog.0000000000004980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/01/2022] [Indexed: 11/13/2022]
Abstract
The incidence of hepatitis C virus (HCV) infection in reproductive-aged adults quadrupled during the past decade. Hepatitis C can progress to advanced liver disease and be transmitted perinatally. Highly effective curative hepatitis C treatment is available but is not recommended in pregnancy. Using the Surveillance for Emerging Threats to Mothers and Babies Network, we describe timing of positive RNA testing among pregnant people with HCV (HCV RNA detected during or within one year prior to pregnancy). Four US jurisdictions reported 1161 pregnancies during 2018-2021 among people with hepatitis C: 75.9% were multiparous; and 21.4% had their first peri-pregnancy HCV RNA detected prior to pregnancy, indicating potential missed treatment opportunities to improve maternal health and prevent perinatal transmission.
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Affiliation(s)
- Kate R Woodworth
- Division of Birth Defects and Infant Disorders, National Center on Birth Defects and Developmental Disabilities, and the Division of Viral Hepatitis, National Center for HIV, Viral Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia; Eagle Global Scientific, LLC, San Antonio, Texas; the Tennessee Department of Health, Nashville, Tennessee; the Pennsylvania Department of Health, Pittsburgh, Pennsylvania; and the New York State Department of Health, Albany, and the New York City Department of Health and Mental Hygiene, New York, New York
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9
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Craig-Kuhn MC, Schmidt N, Scott G, Gomes G, TatahMentan M, Enaholo O, Guzman S, Tannis A, Hall J, Triggs DR, Kissinger PJ. Changes in Sexual Behavior Related to the COVID-19 Stay-at-Home Orders Among Young Black Men Who Have Sex With Women in New Orleans, LA. Sex Transm Dis 2021; 48:589-594. [PMID: 33872224 PMCID: PMC8596751 DOI: 10.1097/olq.0000000000001444] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND COVID-19 stay-at-home orders enacted in New Orleans, LA on March 16, 2020, may have caused changes in the way young men interacted with sex partners. METHODS An online substudy was conducted (May 21, 2020 to June 9, 2020) among Black men who have sex with women, 18 years and older, and who had previously enrolled in the parent study Check It (May 17, 2017 to March 6, 2020) to assess changes in sexual behavior during the stay-at-home orders. RESULTS Among 111 participants, from enrollment in Check It to during stay-at-home orders, recent vaginal sex declined from 96.4% to 47.8% (P < 0.0001), reports of multiple female sex partners declined from 45.0% to 14.4% (P < 0.0001), and sexual abstinence increased from 3.6% to 38.7% (P < 0.0001). Among those who did have vaginal sex, condomless sex rates did not change between enrollment in Check It and the substudy (64.5% vs 67.9%, P = 0.68). During stay-at-home orders oral sex, virtual sex, and pornography viewing were 40.5%, 42.3%, and 76.6%, respectively. Some (17.1%) acquired a new sex partner during stay-at-home orders, and 44.1% left their home to meet a partner for sex. Only 27.9% had seen information about safe sex during the pandemic. Income was diminished for 62.2% and 23.4% moved away from New Orleans when stay-at-home orders were enacted. CONCLUSIONS Although there was an overall reduction in physical sex, half of participants reported physical sex, with many leaving their home to have sex during stay-at-home orders and many not using condoms. Others adopted sexual abstinence, increased virtual sex, and/or pornography viewing, which may have protected them from both sexually transmitted infections and COVID-19.
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Affiliation(s)
- Megan Clare Craig-Kuhn
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Norine Schmidt
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Glenis Scott
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Gérard Gomes
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Mom TatahMentan
- Environmental Health Sciences Department, Tulane University School of Public Health and Tropical Medicine
| | - Ososese Enaholo
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Stephanie Guzman
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Ayzsa Tannis
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Jacob Hall
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
| | - Daniel R. Triggs
- Health Policy and Management Department, Tulane University School of Public Health and Tropical Medicine
| | - Patricia J. Kissinger
- Epidemiology Department, Tulane University School of Public Health and Tropical Medicine
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