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Llewellyn N, Nehl EJ, Dave G, DiazGranados D, Flynn D, Fournier D, Hoyo V, Pelfrey C, Casey S. Translation in action: Influence, collaboration, and evolution of COVID-19 research with Clinical and Translational Science Awards consortium support. Clin Transl Sci 2024; 17:e13700. [PMID: 38156426 PMCID: PMC10777432 DOI: 10.1111/cts.13700] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 09/08/2023] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/30/2023] Open
Abstract
The National Institutes of Health (NIH)'s Clinical and Translational Science Awards (CTSA) consortium aims to accelerate translational processes that move discoveries from bench to bedside. The coronavirus disease 2019 (COVID-19) pandemic presented unmatched challenges and applications for CTSA hubs nationwide. Our study used bibliometrics to assess features of COVID-19 publications supported by the national CTSA program to characterize the consortium's response to the pandemic. Our goal was to understand relative scientific influence, collaboration across hubs, and trends in research emphasis over time. We identified publications from NIH's curated iSearch COVID-19 Publication Portfolio from February 2020 to February 2023; 3234 peer-reviewed articles relevant to COVID-19 cited a CTSA grant. All 66 CTSA hubs were represented, with large-size and longstanding hubs contributing more publications. Most publications cited UL1 grants, 457 cited KL2/TL1 training grants, and 164 cited multiple hub grants. Compared to a random sample of non-CTSA-supported COVID-19 publications, the CTSA portfolio exhibited greater clinical relevance, more human research, and higher altmetric and citation influence. Results were similar for multi-hub publications involving networked initiatives like multi-site clinical trials or the National COVID-19 Cohort Collaborative. Shifts from molecular/cellular-oriented research toward human-oriented research over time were evident, demonstrating translation in action. Results illuminate how the CTSA consortium confronted the pandemic through high-quality projects oriented toward human research, working across hubs on high-value collaborations, advancing along the translational spectrum over time. Findings validate CTSA hubs as critical support structures during health emergencies.
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Affiliation(s)
- Nicole Llewellyn
- Georgia Clinical and Translational Science AllianceEmory University School of MedicineAtlantaGeorgiaUSA
| | - Eric J. Nehl
- Emory University Rollins School of Public HealthAtlantaGeorgiaUSA
| | - Gaurav Dave
- University of North CarolinaChapel HillNorth CarolinaUSA
| | - Deborah DiazGranados
- Wright Regional Center for Clinical and Translational ScienceVirginia Commonwealth UniversityRichmondVirginiaUSA
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Llewellyn NM, Weber AA, Pelfrey CM, DiazGranados D, Nehl EJ. Translating Scientific Discovery Into Health Policy Impact: Innovative Bibliometrics Bridge Translational Research Publications to Policy Literature. Acad Med 2023; 98:896-903. [PMID: 37043754 PMCID: PMC10523888 DOI: 10.1097/acm.0000000000005225] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/19/2023]
Abstract
To understand how translational science efforts lead to outcomes, it is common to examine publications as a key step in the translational process. The National Institutes of Health's Clinical and Translational Science Awards (CTSA) program aims to accelerate that process by providing support to investigators. Although it is challenging to measure the impact of such support on translational outcomes, CTSA-supported research that arises in research publications can advance translation through use of these publications in public policy and guideline documents from government health agencies, intergovernmental organizations, and other outlets. Using cutting-edge bibliometric tools, the authors evaluated how CTSA-supported research has extended its impact beyond academic silos to influence public policy literature. The authors identified approximately 118,490 publications that acknowledged receiving support from a CTSA hub, from the inception of the program in 2006 through 2021. Articles were queried in the Overton policy database, which indexes references to publications in global policy literature. The search revealed 13% of CTSA-supported articles were referenced in policy documents, significantly more than the expected proportion (10%) calculated by Overton. References came from 576 policy source outlets across 87 countries, predominantly the United States and Europe. The most frequent sources included guidelines in PubMed Central, the World Health Organization, and the Centers for Disease Control and Prevention. The authors illustrate the bridge from translational research to public policy with case studies of 6 articles based on CTSA-supported research and having notable policy impact. They found articles with greater clinical relevance, altmetric attention (i.e., nonacademic community/public attention), and academic citation influence were more likely to be referenced in policy literature. Study findings help to characterize the kinds of research that have influenced and may be expected to influence health policy in the future.
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Affiliation(s)
- Nicole M Llewellyn
- N.M. Llewellyn is associate director, Evaluation and Continuous Improvement Program, Georgia Clinical and Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0003-1267-2720
| | - Amber A Weber
- A.A. Weber is program coordinator, Evaluation and Continuous Improvement Program, Georgia Clinical and Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia
| | - Clara M Pelfrey
- C.M. Pelfrey is associate professor and director, Evaluation, Case Western Reserve University School of Medicine, Cleveland, Ohio; ORCID: https://orcid.org/0000-0002-6108-7555
| | - Deborah DiazGranados
- D. DiazGranados is associate professor and director, Evaluation and Team Science, Wright Center, Virginia Commonwealth University, School of Medicine, Richmond, Virginia; ORCID: https://orcid.org/0000-0002-0624-7093
| | - Eric J Nehl
- E.J. Nehl is associate research professor and director, Evaluation and Continuous Improvement Program, Georgia Clinical and Translational Science Alliance, Emory University Rollins School of Public Health, Atlanta, Georgia; ORCID: https://orcid.org/0000-0003-3930-9235
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Mannino RG, Nehl EJ, Farmer S, Peagler AF, Parsell MC, Claveria V, Ku D, Gottfried DS, Chen H, Lam WA, Brand O. The critical role of engineering in the rapid development of COVID-19 diagnostics: Lessons from the RADx Tech Test Verification Core. Sci Adv 2023; 9:eade4962. [PMID: 37027461 PMCID: PMC10081837 DOI: 10.1126/sciadv.ade4962] [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] [Figures] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 03/03/2023] [Indexed: 06/19/2023]
Abstract
Engineering plays a critical role in the development of medical devices, and this has been magnified since 2020 as severe acute respiratory syndrome coronavirus 2 swept over the globe. In response to the coronavirus disease 2019, the National Institutes of Health launched the Rapid Acceleration of Diagnostics (RADx) initiative to help meet the testing needs of the United States and effectively manage the pandemic. As the Engineering and Human Factors team for the RADx Tech Test Verification Core, we directly assessed more than 30 technologies that ultimately contributed to an increase of the country's total testing capacity by 1.7 billion tests to date. In this review, we present central lessons learned from this "apples-to-apples" comparison of novel, rapidly developed diagnostic devices. Overall, the evaluation framework and lessons learned presented in this review may serve as a blueprint for engineers developing point-of-care diagnostics, leaving us better prepared to respond to the next global public health crisis rapidly and effectively.
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Affiliation(s)
- Robert G. Mannino
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Eric J. Nehl
- Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, GA 30322, USA
| | - Sarah Farmer
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Amanda Foster Peagler
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Maren C. Parsell
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Viviana Claveria
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - David Ku
- George W. Woodruff School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - David S. Gottfried
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Hang Chen
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Wilbur A. Lam
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
- Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, Atlanta, GA 30322, USA
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA 30332, USA
| | - Oliver Brand
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA 30332, USA
- School of Electrical and Computer Engineering, Georgia Institute of Technology, Atlanta, GA 30332, USA
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Jagsi R, Beeland TD, Sia K, Szczygiel LA, Allen MR, Arora VM, Bair-Merritt M, Bauman MD, Bogner HR, Daumit G, Davis E, Fagerlin A, Ford DE, Gbadegesin R, Griendling K, Hartmann K, Hedayati SS, Jackson RD, Matulevicius S, Mugavero MJ, Nehl EJ, Neogi T, Regensteiner JG, Rubin MA, Rubio D, Singer K, Tucker Edmonds B, Volerman A, Laney S, Patton C, Escobar Alvarez S. Doris Duke Charitable Foundation Fund to Retain Clinical Scientists: innovating support for early-career family caregivers. J Clin Invest 2022; 132:166075. [PMID: 36453546 PMCID: PMC9711869 DOI: 10.1172/jci166075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Affiliation(s)
| | | | - Kevin Sia
- Doris Duke Charitable Foundation, New York, New York, USA
| | | | - Matthew R. Allen
- Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Vineet M. Arora
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
| | | | | | - Hillary R. Bogner
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Gail Daumit
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Esa Davis
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Angela Fagerlin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Daniel E. Ford
- Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | | | | | | | | | | | | | | | | | - Tuhina Neogi
- Boston University School of Medicine, Boston, Massachusetts, USA
| | | | - Michael A. Rubin
- University of Utah Spencer Fox Eccles School of Medicine, Salt Lake City, Utah, USA
| | - Doris Rubio
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | | | | | - Anna Volerman
- University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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Farmer S, Razin V, Peagler AF, Strickler S, Fain WB, Damhorst GL, Kempker RR, Pollock NR, Brand O, Seitter B, Heilman SS, Nehl EJ, Levy JM, Gottfried DS, Martin GS, Greenleaf M, Ku DN, Waggoner JJ, Iffrig E, Mannino RG, F. Wang Y, Ortlund E, Sullivan J, Rebolledo PA, Clavería V, Roback JD, Benoit M, Stone C, Esper A, Frank F, Lam WA. Don't forget about human factors: Lessons learned from COVID-19 point-of-care testing. Cell Rep Methods 2022; 2:100222. [PMID: 35527805 PMCID: PMC9061138 DOI: 10.1016/j.crmeth.2022.100222] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Abstract
During the COVID-19 pandemic, the development of point-of-care (POC) diagnostic testing accelerated in an unparalleled fashion. As a result, there has been an increased need for accurate, robust, and easy-to-use POC testing in a variety of non-traditional settings (i.e., pharmacies, drive-thru sites, schools). While stakeholders often express the desire for POC technologies that are "as simple as digital pregnancy tests," there is little discussion of what this means in regards to device design, development, and assessment. The design of POC technologies and systems should take into account the capabilities and limitations of the users and their environments. Such "human factors" are important tenets that can help technology developers create POC technologies that are effective for end-users in a multitude of settings. Here, we review the core principles of human factors and discuss lessons learned during the evaluation process of SARS-CoV-2 POC testing.
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Affiliation(s)
- Sarah Farmer
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA, USA
- Georgia Tech Research Institute, Georgia Institute of Technology, Atlanta, GA, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
| | - Victoria Razin
- Georgia Tech Research Institute, Georgia Institute of Technology, Atlanta, GA, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
| | - Amanda Foster Peagler
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA, USA
- Georgia Tech Research Institute, Georgia Institute of Technology, Atlanta, GA, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
| | - Samantha Strickler
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Emergency Medicine and Department of Anesthesia, Division of Critical Care, Emory University School of Medicine, Atlanta, GA, USA
| | - W. Bradley Fain
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA, USA
- Georgia Tech Research Institute, Georgia Institute of Technology, Atlanta, GA, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
| | - Gregory L. Damhorst
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Russell R. Kempker
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Nira R. Pollock
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Laboratory Medicine, Boston Children’s Hospital, Boston, MA, USA
| | - Oliver Brand
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Brooke Seitter
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Stacy S. Heilman
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric J. Nehl
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Joshua M. Levy
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, GA, USA
| | - David S. Gottfried
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Greg S. Martin
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Morgan Greenleaf
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
| | - David N. Ku
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jesse J. Waggoner
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elizabeth Iffrig
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Robert G. Mannino
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - Yun F. Wang
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Eric Ortlund
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Julie Sullivan
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Paulina A. Rebolledo
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Viviana Clavería
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- School of Mechanical Engineering, Georgia Institute of Technology, Atlanta, GA, USA
| | - John D. Roback
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - MacArthur Benoit
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Cheryl Stone
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
| | - Annette Esper
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Filipp Frank
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Department of Biochemistry, Emory University School of Medicine, Atlanta, GA, USA
| | - Wilbur A. Lam
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, GA, USA
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
- Children’s Healthcare of Atlanta, Atlanta, GA, USA
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
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Greenleaf MN, Damhorst GL, Ku DN, Nehl EJ, Tyburski EA, Brand O, Martin GS, Lam WA. Designing for simplicity: lessons from Mesa Biotech for microfluidic entrepreneurs and early-stage companies. Lab Chip 2022; 22:1469-1473. [PMID: 35342919 PMCID: PMC9012986 DOI: 10.1039/d2lc00081d] [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] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The COVID-19 pandemic has proven the need for point-of-care diagnosis of respiratory diseases and microfluidic technology has risen to the occasion. Mesa Biotech (San Diego, CA) originally developed the Accula platform for the diagnosis of influenza A and B and then extended the platform to SARS-CoV-2. Mesa Biotech has experienced tremendous success, culminating in acquisition by Thermo Fisher for up to $550m USD. The Accula microfluidics platform accomplished the leap from the lab to commercial product through clever design and engineering choices. Through information obtained from interviews with key Mesa Biotech leaders and publicly-available documents, we describe the keys to Mesa's success and how they might inform other lab-on-a-chip companies.
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Affiliation(s)
- Morgan N Greenleaf
- Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Clinical and Translational Science Alliance, Atlanta, Georgia, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - Gregory L Damhorst
- Emory University School of Medicine, Atlanta, Georgia, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - David N Ku
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Eric J Nehl
- Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Clinical and Translational Science Alliance, Atlanta, Georgia, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Emory University Rollins School of Public Health, Atlanta, Georgia, USA
| | - Erika A Tyburski
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Oliver Brand
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Georgia Institute of Technology, Atlanta, Georgia, USA
- The Institute for Electronics and Nanotechnology, Atlanta, Georgia, USA
| | - Greg S Martin
- Emory University School of Medicine, Atlanta, Georgia, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
| | - Wilbur A Lam
- Emory University School of Medicine, Atlanta, Georgia, USA
- Georgia Clinical and Translational Science Alliance, Atlanta, Georgia, USA
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia, USA
- Georgia Institute of Technology, Atlanta, Georgia, USA
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta, Atlanta, Georgia, USA.
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Llewellyn NM, Weber AA, Fitzpatrick AM, Nehl EJ. Big splashes & ripple effects: a narrative review of the short- & long-term impact of publications supported by an NIH CTSA pediatrics program. Transl Pediatr 2022; 11:411-422. [PMID: 35378958 PMCID: PMC8976684 DOI: 10.21037/tp-21-506] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 02/11/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE This review examines a promising new framework for analyzing outputs of pediatric research in the context of translational advancement. We demonstrate a method for evaluating the impact of an NIH Clinical and Translational Science Award's (CTSA) Pediatrics Program through publications that have emerged from supported research. The Georgia CTSA Pediatrics Program provides training, funding, and infrastructure to ensure that researchers have the resources to advance pediatric health. Internal evaluations found that research supported by this program is exceptionally impactful within the academic community and commands high interest within the lay community. Therefore, we examined the impact of this research in both traditional academic and broader community spheres using bibliometrics-the study of supported publications. Bibliometrics describe a pivotal stage in the translational process of bringing scientific discoveries to clinical/community use and include both academic citations and 'altmetric' or non-academic attention. These complementary approaches combine to shed light on the short- and long-term impact of the research on segments of the translational pipeline, including academic literature, community discourse, technological advancement, and public health policy. METHODS The authors identified a portfolio of 250 articles supported by the Georgia CTSA Pediatrics Program from 2007-2020. We utilized various bibliometrics to analyze both short-term attention, or 'splash' made by articles, and long-term influence, or 'ripples' made across both academic and public spheres. KEY CONTENT AND FINDINGS The short-term splash of the portfolio was indicated through publication in high-impact factor journals, peer faculty recommendations, and Mendeley readership, as well as by early altmetric attention in news stories, blogs, and Twitter posts. The portfolio's long-term ripples were demonstrated by high absolute and relative rates of academic citation and by downstream altmetric influence in public-facing documents, including Wikipedia articles, patent applications, and policy documents. CONCLUSIONS This article reviews a useful bibliometric methodology for illustrating the waves of impact made by pediatric research. Whereas splash provides a picture of early interest in a publication, a preliminary indicator of eventual utility and impact, ripples provide a measure of the cumulative influence of an article over time. Both reflect opportunities for a line of research to advance along the translational spectrum.
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Affiliation(s)
| | | | - Anne M Fitzpatrick
- Emory University School of Medicine, Atlanta, USA.,Children's Healthcare of Atlanta, Atlanta, USA
| | - Eric J Nehl
- Emory University Rollins School of Public Health, Atlanta, USA
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Llewellyn N, Nehl EJ. Predicting Citation Impact from Altmetric Attention in Clinical and Translational Research: Do Big Splashes Lead to Ripple Effects? Clin Transl Sci 2022; 15:1387-1392. [PMID: 35146918 PMCID: PMC9199871 DOI: 10.1111/cts.13251] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 01/05/2022] [Accepted: 01/29/2022] [Indexed: 11/28/2022] Open
Abstract
Publications are commonly used to evaluate the productivity and impact of research programs. Traditional metrics examine publication impact through slowly accumulating academic citations. “Altmetrics” are a new way to describe early publication influence in nonacademic media/community spheres (news, tweets, and blogs). Articles with significant altmetric attention make a big splash of immediate impact, whereas papers with high rates of academic citation reflect ripple effects of influence over time. Past research has found weak associations between altmetrics and academic citations. However, no previous research has focused on clinical/translational research, which aims to translate scientific discoveries to public use. Further, no previous research has assessed the relationship between altmetrics and modern citation impact factors like the National Institutes of Health (NIH)’s Relative Citation Ratio (RCR). It is also unclear whether publication in journals with higher journal impact factors (JIFs) may drive both public attention and academic impact. We investigated whether early altmetric indicators of splash predict citation ripples, beyond the effect of the JIF. For a portfolio of 2188 publications supported by the NIH’s Georgia Clinical and Translational Science Alliance from 2007–2020, we collected 2020 Altmetric Attention Scores (AAS), 2020 JIFs, and 2021 RCRs. All three were significantly correlated with one another. Regression analyses revealed that AAS significantly predicts later RCR, controlling for JIF and publication year. Findings indicate that in clinical/translational science, articles that make a big splash of altmetric attention have ripple effects through increased citation influence, which is not entirely due to publication in higher impact journals. Altmetric attention may be a useful early indicator of eventual influence and potential for translational advancement.
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Affiliation(s)
- Nicole Llewellyn
- Emory University School of Medicine, Georgia Clinical and Translational Science Alliance
| | - Eric J Nehl
- Emory University Rollins School of Public Health
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9
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Roback JD, Tyburski EA, Alter D, Asakrah S, Chahroudi A, Esper A, Farmer S, Figueroa J, K Frediani J, D Gonzalez M, S Gottfried D, Guarner J, A Gupta N, S Heilman S, E Hill C, Jerris R, R Kempker R, Ingersoll J, Levy JM, Mavigner M, S Moreno C, R Morris C, J Nehl E, S Neish A, Peker D, Saakadze N, Rebolledo PA, A Rostad C, Schoof N, Suessmith A, Sullivan J, Wang YFW, Wood A, Vos MB, Brand O, Martin GS, Lam WA. The need for new test verification and regulatory support for innovative diagnostics. Nat Biotechnol 2021; 39:1060-1062. [PMID: 34404954 PMCID: PMC9007716 DOI: 10.1038/s41587-021-01047-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Affiliation(s)
- John D Roback
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Erika A Tyburski
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA
| | - David Alter
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Saja Asakrah
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Ann Chahroudi
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Annette Esper
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sarah Farmer
- Center for Advanced Communications Policy, Georgia Institute of Technology, Atlanta, GA, USA
| | - Janet Figueroa
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | | | | | - David S Gottfried
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Jeannette Guarner
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Nitika A Gupta
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Stacy S Heilman
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Charles E Hill
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Russell R Kempker
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Jessica Ingersoll
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Joshua M Levy
- Department of Otolaryngology, Emory University School of Medicine, Atlanta, GA, USA
| | - Maud Mavigner
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Carlos S Moreno
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Claudia R Morris
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Eric J Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Andrew S Neish
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Deniz Peker
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Natia Saakadze
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Paulina A Rebolledo
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Christina A Rostad
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Nils Schoof
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Allie Suessmith
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Julie Sullivan
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Yun F Wayne Wang
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Anna Wood
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Miriam B Vos
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
- Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Oliver Brand
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA.
| | - Greg S Martin
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, USA.
| | - Wilbur A Lam
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.
- Children's Healthcare of Atlanta, Atlanta, GA, USA.
- Institute for Electronics and Nanotechnology, Georgia Institute of Technology, Atlanta, GA, USA.
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, GA, USA.
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10
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Frediani JK, Levy JM, Rao A, Bassit L, Figueroa J, Vos MB, Wood A, Jerris R, Van Leung-Pineda, Gonzalez MD, Rogers BB, Mavigner M, Schinazi RF, Schoof N, Waggoner JJ, Kempker RR, Rebolledo PA, O'Neal JW, Stone C, Chahroudi A, Morris CR, Suessmith A, Sullivan J, Farmer S, Foster A, Roback JD, Ramachandra T, Washington C, Le K, Cordero MC, Esper A, Nehl EJ, Wang YF, Tyburski EA, Martin GS, Lam WA. Multidisciplinary assessment of the Abbott BinaxNOW SARS-CoV-2 point-of-care antigen test in the context of emerging viral variants and self-administration. Sci Rep 2021; 11:14604. [PMID: 34272449 PMCID: PMC8285474 DOI: 10.1038/s41598-021-94055-1] [Citation(s) in RCA: 47] [Impact Index Per Article: 15.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 06/28/2021] [Indexed: 11/29/2022] Open
Abstract
While there has been significant progress in the development of rapid COVID-19 diagnostics, as the pandemic unfolds, new challenges have emerged, including whether these technologies can reliably detect the more infectious variants of concern and be viably deployed in non-clinical settings as "self-tests". Multidisciplinary evaluation of the Abbott BinaxNOW COVID-19 Ag Card (BinaxNOW, a widely used rapid antigen test, included limit of detection, variant detection, test performance across different age-groups, and usability with self/caregiver-administration. While BinaxNOW detected the highly infectious variants, B.1.1.7 (Alpha) first identified in the UK, B.1.351 (Beta) first identified in South Africa, P.1 (Gamma) first identified in Brazil, B.1.617.2 (Delta) first identified in India and B.1.2, a non-VOC, test sensitivity decreased with decreasing viral loads. Moreover, BinaxNOW sensitivity trended lower when devices were performed by patients/caregivers themselves compared to trained clinical staff, despite universally high usability assessments following self/caregiver-administration among different age groups. Overall, these data indicate that while BinaxNOW accurately detects the new viral variants, as rapid COVID-19 tests enter the home, their already lower sensitivities compared to RT-PCR may decrease even more due to user error.
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Affiliation(s)
- Jennifer K Frediani
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
| | - Joshua M Levy
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Otolaryngology-Head and Neck Surgery, Emory University School of Medicine, Atlanta, Georgia
| | - Anuradha Rao
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Leda Bassit
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Laboratory of Biochemical Pharmacology, Emory University, Atlanta, Georgia
| | - Janet Figueroa
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Miriam B Vos
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Anna Wood
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Robert Jerris
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Van Leung-Pineda
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Mark D Gonzalez
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Beverly B Rogers
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Maud Mavigner
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Raymond F Schinazi
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Nils Schoof
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Jesse J Waggoner
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Russell R Kempker
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Paulina A Rebolledo
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jared W O'Neal
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Cheryl Stone
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Ann Chahroudi
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Claudia R Morris
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
- Children's Healthcare of Atlanta, Atlanta, Georgia
| | - Allie Suessmith
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Julie Sullivan
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Sarah Farmer
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Georgia Institute of Technology, Atlanta, Georgia
| | - Amanda Foster
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Georgia Institute of Technology, Atlanta, Georgia
| | - John D Roback
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Thanuja Ramachandra
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - CaDeidre Washington
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Kristie Le
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
| | - Maria C Cordero
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pediatrics, Emory University School of Medicine, Atlanta, Georgia
| | - Annette Esper
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Eric J Nehl
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Yun F Wang
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia
| | - Erika A Tyburski
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia
- Georgia Institute of Technology, Atlanta, Georgia
| | - Greg S Martin
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia.
- Department of Medicine, Emory University School of Medicine, Atlanta, Georgia.
| | - Wilbur A Lam
- The Atlanta Center for Microsystems-Engineered Point-of-Care Technologies, Atlanta, Georgia.
- Department of Pathology and Laboratory Medicine, Emory University School of Medicine, Atlanta, Georgia.
- Aflac Cancer and Blood Disorders Center at Children's Healthcare of Atlanta, Emory University School of Medicine, Atlanta, Georgia.
- Wallace H. Coulter Department of Biomedical Engineering, Emory University and Georgia Institute of Technology, Atlanta, Georgia.
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11
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Hall CDX, Luu M, Nehl EJ, He N, Zheng T, Haardörfer R, Wong FY. Do the same socio-demographic variables predict testing uptake and sero-status? HIV and syphilis among an observational sample of Chinese men who have sex with men in Shanghai, China. Int J STD AIDS 2021; 31:939-949. [PMID: 32772687 DOI: 10.1177/0956462420909733] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
HIV and syphilis are pronounced among men who have sex with men (MSM) in China and often occur as co-infections, while testing remains low. Few studies examine common predictors across these outcomes. This observational venue-based sample of 546 MSM in Shanghai, China used a common set of psychosocial predictors to construct logistic models for the outcomes (HIV non-testing, syphilis non-testing, HIV sero-status, and syphilis sero-status). Fifty-seven (10.7%) participants tested positive for HIV, 126 (23.5%) for syphilis, and 33% of HIV-positive participants had a co-infection. Non-sex working MSM had consistently higher odds of HIV and syphilis non-testing (OR= 2.2, 95% CI 1.4-3.5, p < 0.001; OR = 2.4, 95, 95% CI 1.5-3.8, p < 0.001, respectively) compared to 'money boy' sex workers. Participants with a 0 score on HIV knowledge had 4.1 times (95% CI 1.4-12.5, p = 0.01) the odds of reporting HIV non-testing, 6.0 (95% CI 1.96-18.5, p < 0.01) times the odds of reporting non-testing for syphilis, and 8.44 times (95% CI 1.19-59.7, p = 0.03) the odds of testing positive for HIV, compared to a score of 8. The results highlighted the importance of integrating HIV/syphilis education and promoting testing for both HIV and syphilis among all sub-groups of MSM in China.
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Affiliation(s)
- Casey D Xavier Hall
- Institute for Sexual and Gender Minority Health and Wellbeing, Northwestern University, Chicago, IL, USA
| | - Minh Luu
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Tony Zheng
- Shanghai Piaoxue Multicultural Medua, Ltd, Shanghai, China
| | - Regine Haardörfer
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Emory University's Rollins School of Public Health, Atlanta, GA, USA.,Center for Indigenous Nursing Research for Health Equity, Florida State University, Tallahassee, FL, USA.,Department of Psychology, University of Hawai'i, Mānoa, Honolulu, HI, USA
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12
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Llewellyn NM, Adachi JJ, Nehl EJ, Heilman SS. Participant perspectives on a seminar-based research career development program and its role in career independence. J Investig Med 2021; 69:775-780. [PMID: 33602694 DOI: 10.1136/jim-2020-001769] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/04/2022]
Abstract
Health science researchers need training and support to effectively pursue independence in their research careers. Little data exist regarding the specific resources that faculty researchers have found or would find useful. In this study, we aimed to better understand the needs of health science researchers to develop recommendations for effective career development programming. The authors conducted a multi-method evaluation of early-career researcher faculty needs beginning by using post-session satisfaction surveys to assess the value of a long-standing "K-Club" seminar, which educates and supports those pursuing NIH Career Development (K) awards or similar. The authors then collected in-depth views on career development needs through a series of focus groups conducted with health science researchers at three career stages: early career, award-seeking junior faculty; mid-career faculty who have obtained some extramural funding; senior faculty who serve as mentors for early/mid-career faculty. Participants who attended the existing K-Club strongly endorse the program in supporting their career goals. Focus group participants described specific areas for program expansion that would add value across career stages: more flexible training options, conducted in smaller group settings with immediate feedback provided; more formalized training and resources for senior research mentors; in-depth guidance on individualized grantsmanship. The authors propose program development guidelines for helping researchers achieve research independence and success. Findings indicate that a broad-reaching K-Club style educational seminar can serve as a valuable foundation supporting professional development. The addition of tailored programs delivered across diverse platforms are predicted to heighten career development success.
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Affiliation(s)
- Nicole M Llewellyn
- Georgia Clinical and Translational Science Alliance, Emory University, Atlanta, Georgia, USA
| | - Jamie J Adachi
- Georgia Clinical and Translational Science Alliance, Emory University, Atlanta, Georgia, USA.,Department of Psychiatry & Behavioral Sciences, University of Washington, Seattle, WA, USA
| | - Eric J Nehl
- Georgia Clinical and Translational Science Alliance, Emory University, Atlanta, Georgia, USA.,Department of Behavioral, Social, and Health Education Sciences, Emory University, Atlanta, Georgia, USA
| | - Stacy S Heilman
- Department of Pediatrics, Emory University and Children's Healthcare of Atlanta, Atlanta, Georgia, USA
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13
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George PE, Stokes CL, Bassit LC, Chahroudi A, Figueroa J, Griffiths MA, Heilman S, Ku DN, Nehl EJ, Leong T, Levy JM, Kempker RR, Mannino RG, Mavigner M, Park SI, Rao A, Rebolledo PA, Roback JD, Rogers BB, Schinazi RF, Suessmith AB, Sullivan J, Tyburski EA, Vos MB, Waggoner JJ, Wang YF(W, Madsen J, Wechsler DS, Joiner CH, Martin GS, Lam WA. Covid-19 will not "magically disappear": Why access to widespread testing is paramount. Am J Hematol 2021; 96:174-178. [PMID: 33576528 PMCID: PMC7753266 DOI: 10.1002/ajh.26059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2020] [Accepted: 11/23/2020] [Indexed: 12/27/2022]
Affiliation(s)
- Paul E. George
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics Atlanta Georgia USA
| | - Claire L. Stokes
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics Atlanta Georgia USA
| | - Leda C. Bassit
- Laboratory of Biochemical Pharmacology, Department of Pediatrics Children's Healthcare of Atlanta, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Ann Chahroudi
- Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Janet Figueroa
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Mark A. Griffiths
- Children's Healthcare of Atlanta Emory University School of Medicine Atlanta Georgia USA
| | - Stacy Heilman
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - David N. Ku
- GWW School of Mechanical Engineering The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Georgia Institute of Technology Atlanta Georgia USA
| | - Eric J. Nehl
- Emory University Rollins School of Public Health, Georgia Clinical & Translational Science Alliance, Atlanta, Georgia, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Atlanta Georgia USA
| | - Traci Leong
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University Rollins School of Public Health Atlanta Georgia USA
| | - Joshua M. Levy
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Russell R. Kempker
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Robert G. Mannino
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Atlanta Georgia USA
| | - Maud Mavigner
- Center for Childhood Infections and Vaccines of Children's Healthcare of Atlanta and Emory University The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Sunita I. Park
- Children's Healthcare of Atlanta The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Anuradha Rao
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Paulina A. Rebolledo
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine, Emory University Rollins School of Public Health Atlanta Georgia USA
| | - John D. Roback
- Center for Transfusion and Cellular Therapies Emory University School of Medicine, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Atlanta Georgia USA
| | - Beverly B. Rogers
- Children's Healthcare of Atlanta The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Raymond F. Schinazi
- Laboratory of Biochemical Pharmacology, Department of Pediatrics Children's Healthcare of Atlanta, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Allie B. Suessmith
- Emory University Laney Graduate School, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Julie Sullivan
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Erika A. Tyburski
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Atlanta Georgia USA
| | - Miriam B. Vos
- Emory University Laney Graduate School, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies, Emory University School of Medicine Atlanta Georgia USA
| | - Jesse J. Waggoner
- Emory University School of Medicine, Division of Infectious Diseases Atlanta Georgia
| | - Yun F. (Wayne) Wang
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Jen Madsen
- The MITRE Corporation McLean Virginia USA
| | - Daniel S. Wechsler
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics Atlanta Georgia USA
| | - Clinton H. Joiner
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics Atlanta Georgia USA
| | - Greg S. Martin
- The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Emory University School of Medicine Atlanta Georgia USA
| | - Wilbur A. Lam
- Aflac Cancer & Blood Disorders Center at Children's Healthcare of Atlanta Emory University School of Medicine, Department of Pediatrics, Wallace H. Coulter Department of Biomedical Engineering, Georgia Institute of Technology, The Atlanta Center for Microsystems‐Engineered Point‐of‐Care Technologies Atlanta Georgia USA
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14
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Zheng Z, Nehl EJ, Zhou C, Li J, Xie Z, Zhou Z, Liang H. Insufficient tuberculosis treatment leads to earlier and higher mortality in individuals co-infected with HIV in southern China: a cohort study. BMC Infect Dis 2020; 20:873. [PMID: 33225919 PMCID: PMC7682080 DOI: 10.1186/s12879-020-05527-0] [Citation(s) in RCA: 2] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 10/19/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Tuberculosis (TB) and Acquired Immune Deficiency Syndrome (AIDS) are leading causes of death globally. However, little is known about the long-term mortality risk and the timeline of death in those co-infected with human immunodeficiency virus (HIV) and Mycobacterium tuberculosis (MTB). This study sought to understand the long-term mortality risk, factors, and the timeline of death in those with HIV-Mycobacterium tuberculosis (MTB) coinfection, particularly in those with insufficient TB treatment. METHODS TB-cause specific deaths were classified using a modified 'Coding of Cause of Death in HIV' protocol. A longitudinal cross-registration-system checking approach was used to confirm HIV/MTB co-infection between two observational cohorts. Mortality from the end of TB treatment (6 months) to post-treatment year (PTY) 5 (60 months) was investigated by different TB treatment outcomes. General linear models were used to estimate the mean mortality at each time-point and change between time-points. Cox's proportional hazard regressions measured the mortality hazard risk (HR) at each time-point. The Mantel-Haenszel stratification was used to identify mortality risk factors. Mortality density was calculated by person year of follow-up. RESULTS At the end point, mortality among patients with HIV/MTB coinfection was 34.7%. From the end of TB treatment to PTY5, mortality and loss of person years among individuals with TB treatment failure, missing, and adverse events (TBFMA) were significantly higher than those who had TB cure (TBC) and TB complete regimen (TBCR). Compared to individuals with TBC and with TBCR, individuals with TBFMA tended to die earlier and their mortality was significantly higher (HRTBFMA-TBC = 3.0, 95% confidence interval: 2.5-3.6, HRTBFMA-TBCR = 2.9, 95% CI: 2.5-3.4, P < 0.0001). Those who were naïve to antiretroviral therapy, were farmers, had lower CD4 counts (≤200 cells/μL) and were ≥ 50 years of age were at the highest risk of mortality. Mortality risk for participants with TBFMA was significantly higher across all stratifications except those with a CD4 count of ≤200 cells/μL. CONCLUSIONS Earlier and long-term mortality among those with HIV/MTB co-infection is a significant problem when TB treatment fails or is inadequate.
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Affiliation(s)
- Zhigang Zheng
- Department of Epidemiology and Statistic, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
- AIDS Program, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, 18 Jin Zhou Road, Nanning, 530028 China
| | - Eric J. Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, 30322 GA U.S.A
| | - Chongxing Zhou
- AIDS Program, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, 18 Jin Zhou Road, Nanning, 530028 China
| | - Jianjun Li
- AIDS Program, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, 18 Jin Zhou Road, Nanning, 530028 China
| | - Zhouhua Xie
- HIV/TB Treatment Department, the Fourth Hospital of Nanning City, Nanning, 530023 China
| | - Zijun Zhou
- HIV/TB Treatment Department, the Fourth Hospital of Nanning City, Nanning, 530023 China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, 530021 Guangxi China
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22, Shuangyong Road, Qingxiu District, Nanning, 530021 Guangxi China
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15
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Llewellyn N, Carter DR, DiazGranados D, Pelfrey C, Rollins L, Nehl EJ. Scope, Influence, and Interdisciplinary Collaboration: The Publication Portfolio of the NIH Clinical and Translational Science Awards (CTSA) Program From 2006 Through 2017. Eval Health Prof 2020; 43:169-179. [PMID: 30917690 PMCID: PMC7781230 DOI: 10.1177/0163278719839435] [Citation(s) in RCA: 16] [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: 11/16/2022]
Abstract
The Clinical and Translational Science Awards (CTSA) program sponsors an array of innovative, collaborative research. This study uses complementary bibliometric approaches to assess the scope, influence, and interdisciplinary collaboration of publications supported by single CTSA hubs and those supported by multiple hubs. Authors identified articles acknowledging CTSA support and assessed the disciplinary scope of research areas represented in that publication portfolio, their citation influence, interdisciplinary overlap among research categories, and characteristics of publications supported by multihub collaborations. Since 2006, CTSA hubs supported 69,436 articles published in 4,927 journals and 189 research areas. The portfolio is well distributed across diverse research areas with above-average citation influence. Most supported publications involved clinical/health sciences, for example, neurology and pediatrics; life sciences, for example, neuroscience and immunology; or a combination of the two. Publications supported by multihub collaborations had distinct content emphasis, stronger citation influence, and greater interdisciplinary overlap. This study characterizes the CTSA consortium's contributions to clinical and translational science, identifies content areas of strength, and provides evidence for the success of multihub collaborations. These methods lay the foundation for future investigation of the best policies and priorities for fostering translational science and allow hubs to understand their progress benchmarked against the larger consortium.
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Affiliation(s)
- Nicole Llewellyn
- Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Deborah DiazGranados
- School of Medicine, Virginia Commonwealth University, Richmond, VA, USA
- Wright Center for Clinical and Translational Research, Virginia Commonwealth University, Richmond, VA, USA
| | - Clara Pelfrey
- Department of Medical Education, Case Western Reserve University, Cleveland, OH, USA
| | - Latrice Rollins
- Prevention Research Center, Morehouse School of Medicine, Atlanta, GA, USA
| | - Eric J. Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
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16
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Yu J, Nehl EJ, Dinh VP, Liang B, Son NV, Meng D, Zhang Y, Jiang J, Huang J, Ning C, Liao Y, Chen H, Zang N, Chen R, Liu D, Ye L, Liang H. Vietnamese female sex workers in rural cross-border areas of Guangxi, China: migration and HIV/STI risk behaviors. AIDS Care 2020; 32:1515-1523. [PMID: 32008356 DOI: 10.1080/09540121.2020.1719968] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
China's HIV/AIDS epidemic continues to grow in rural and less developed areas. This consecutive cross-sectional study examines demographic and behavioral factors associated with HIV/STI infection, Hepatitis C (HCV) and other sexually transmitted infections (STIs) among Vietnamese female sex workers (FSW), a vulnerable population who cross into Guangxi, China. This study is a secondary data analysis of 303 Vietnamese and 4,348 Chinese FSWs recruited over seven years from two Chinese counties that border Vietnam. Logistic regression models compared demographics, HIV/STI status, HIV/AIDS-related knowledge, attitudes, and risk behaviors between Vietnamese FSWs and Chinese FSWs. Compared with Chinese FSWs, Vietnamese FSWs were younger, had attained lower education levels, were highly mobile, more likely to report using drugs, and were more vulnerable to HIV/STIs. Younger age, less educational attainment, shorter time in their current working location, no voluntary HIV testing in the last year, greater drug use, and not using condoms for all commercial sex in the last month were associated with higher HIV/STIs. In conclusion, several factors were associated with HIV/STI risk in Vietnamese cross-border FSWs. There is a pressing need to improve support systems for Vietnamese cross-border FSW and health system cooperation across the Chinese/Vietnamese border.
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Affiliation(s)
- Jun Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Eric J Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Van Phu Dinh
- HaTinh Medical College, Ha Tinh City, Ha Tinh Province, Vietnam
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Nguyen Van Son
- Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen City, Vietnam
| | - Donghua Meng
- Ningming Center for Disease Control and Prevention, Guangxi, Ningming County, People's Republic of China
| | - Yi Zhang
- Longzou Center for Disease Control and Prevention, Guangxi, People's Republic of China
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Chuanyi Ning
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Yanyan Liao
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Hui Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Ning Zang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Rongfeng Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Deping Liu
- Chongzuo Center for Disease Control and Prevention, Chongzuo, Longzhou County, Guangxi, People's Republic of China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi, People's Republic of China.,Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, Guangxi, People's Republic of China
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17
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Jiang J, Qin F, Meng S, Nehl EJ, Huang J, Liu Y, Zou J, Dong W, Huang J, Chen H, Zang N, Liang B, Ning C, Liao Y, Luo C, Liu H, Liu X, Wang J, Zhou O, Le T, Ye L, Wu F, Liang H. Effects of cotrimoxazole prophylaxis on Talaromyces marneffei infection in HIV/AIDS patients receiving antiretroviral therapy: a retrospective cohort study. Emerg Microbes Infect 2019; 8:367-376. [PMID: 31851879 PMCID: PMC6455230 DOI: 10.1080/22221751.2019.1588078] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The dimorphic fungus Talaromyces marneffei (TM) is a common cause of HIV-associated opportunistic infections in Southeast Asia. Cotrimoxazole (CTX) inhibits folic acid synthesis which is important for the survival of many bacteria, protozoa, and fungi and has been used to prevent several opportunistic infections among HIV/AIDS patients. We question whether CTX is effective in preventing TM infection. To investigate this question, we conducted an 11-year (2005-2016) retrospective observational cohort study of all patients on the Chinese national antiretroviral therapy (ART) programme in Guangxi, a province with high HIV and TM burden in China. Survival analysis was conducted to investigate TM cumulative incidence, and Cox regression and propensity score matching (PSM) were used to evaluate the effect of CTX on TM incidence. Of the 3359 eligible individuals contributing 10,504.66 person-years of follow-up, 81.81% received CTX within 6 months after ART initiation, and 4.73% developed TM infection, contributing 15.14/1,000 person-year TM incidence rate. CTX patients had a significantly lower incidence of TM infection than non-CTX patients (4.11% vs. 7.53%; adjusted hazard ratio (aHR) = 0.50, 95% CI 0.35-0.73). CTX reduced TM incidence in all CD4+ cell subgroups (<50 cells/μL, 50-99 cells/μL, 100-199 cells/μL), with the highest reduction observed in patients with a baseline CD4+ cell count <50 cells/μL in both Cox regression and the PSM analyses. In conclusion, in addition to preventing other HIV-associated opportunistic infections, CTX prophylaxis has the potential to prevent TM infection in HIV/AIDS patients receiving ART.
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Affiliation(s)
- Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Fengxiang Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Sirun Meng
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Eric J. Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jinping Huang
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Yanfen Liu
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Jun Zou
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Wenyi Dong
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Hui Chen
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Ning Zang
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Chuanyi Ning
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Yanyan Liao
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Chaolian Luo
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Huifang Liu
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Xin Liu
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China
| | - Jian Wang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Oulu Zhou
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China
| | - Thuy Le
- Division of Infectious Diseases, Duke University School of Medicine, Durham, NC, USA,Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China,Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China, Li Ye Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China; Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
| | - Fengyao Wu
- Fourth People’s Hospital of Nanning, Nanning, People’s Republic of China,Fengyao Wu Fourth People’s Hospital of Nanning, Nanning, Guangxi530021, People’s Republic of China
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, People’s Republic of China,Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, People’s Republic of China,Hao Liang Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, Nanning, Guangxi 530021, People’s Republic of China; Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, Nanning, Guangxi, People’s Republic of China
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18
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Abstract
We evaluated the risk of human immunodeficiency virus (HIV) transmission among serodiscordant couples with low adherence to antiretroviral therapy (ART).Data of heterosexual couples/partners in 2010 were extracted from an Internet-based system. Participants were then followed over the course of a year with 6- and 12-month assessments. Prevalence and density of HIV seroconversion were calculated for spouses/partners who did not have a positive HIV test results at baseline. We calculated the transmission odds ratio (OR) value stratified by personal characteristics and behavioral correlates at 6- and 12-month follow-up, as well as seroconversion in spouses/partners over the year.A total of 5544 HIV/AIDS patients and their spouses/partners were recruited in this cohort. Incidence of HIV seroconversion among HIV-negative spouse/partner was 63.7/100 person years (PYs) (430/674.9) at the 6-month follow-up and 33.2/100PYs (567/1707.1PYs) at 12 months. The OR value of transmission from female to male was 2.1 times higher than from male to females at 6 months and 2.3 times higher at 12 months (P < .001). The 55- to 64-year age group was most likely to transmit HIV to their spouses/partners, 2.2 times greater than the participants who were 65 years and older. Married participants were 2.4 times higher at 6 months and 2.5 times higher at 12 months to transmit HIV than divorced/widowed participants. Lastly, transmission among illiterate participants was 6.7 times higher at 6 months and 2.3 times higher at 12 months than those with an educational attainment of community college or above.High HIV seroconversion was observed in this cohort. Spouses/partners who were male had the highest risk of HIV acquisition; those aged 55 to 64 years, having married status, and are HIV-positive with less education were more likely to transmit HIV.
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Affiliation(s)
- Zhigang Zheng
- Department of HIV/AIDS Program, Guangxi Zhuang Autonomous Center for Disease Control and Prevention, Nanning
| | - Yong Li
- HIV/AIDS Treatment Center, Long Tan Hospital, Liuzhou
| | - Yi Jiang
- Department of HIV/AIDS Program, Wuzhou Center for Disease Control and Prevention, Wuzhou
| | - Xu Liang
- Department of HIV/AIDS Program, Baise Center for Disease Control and Prevention, Baise, China
| | - Shanfang Qin
- HIV/AIDS Treatment Center, Long Tan Hospital, Liuzhou
| | - Eric J. Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
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Llewellyn N, Carter DR, Rollins L, Nehl EJ. Charting the Publication and Citation Impact of the NIH Clinical and Translational Science Awards (CTSA) Program From 2006 Through 2016. Acad Med 2018; 93:1162-1170. [PMID: 29298181 PMCID: PMC6028299 DOI: 10.1097/acm.0000000000002119] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE The authors evaluated publication and citation patterns for articles supported by Clinical and Translational Science Awards (CTSA) hub investment over the first decade of the CTSA program. The aim was to elucidate a pivotal step in the translational process by providing an account of how time, hub maturity, and hub attributes were related to productivity and influence in the academic literature. METHOD In 2017, the authors collected bibliometric data from PubMed, Web of Science InCites, and National Institutes of Health (NIH) iCite for articles citing any CTSA hub grants published from hub inception through 2016. They compiled data on publication and citation rates and indices of relative citation impact aggregated by hub funding year cohort. They compared hub-level bibliometric activity by multi- versus single-institution structure and total monetary award sums, compiled from NIH RePORTER. RESULTS From 2006-2016, CTSA hubs supported over 66,000 publications, with publication rates accelerating as hubs matured. These publications accumulated over 1.2 million citations, with some articles cited over 1,000 times. Indices of relative citation impact indicated CTSA-supported publications were cited more than twice as often as expected for articles of their publication years and disciplines. Multi-institutional hubs and those awarded higher grant sums exhibited significantly higher publication and citation activity. CONCLUSIONS The CTSA program is yielding a robust and growing body of influential research findings with consistently high indices of relative citation impact. Preliminary evidence suggests multi-institutional collaborations and more monetary resources are associated with elevated bibliometric activity and, therefore, may be worth their investment.
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Affiliation(s)
- Nicole Llewellyn
- N. Llewellyn is manager of research projects, Evaluation and Continuous Improvement Program, Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0003-1267-2720. D.R. Carter is assistant professor, Department of Psychology, University of Georgia, Athens, Georgia, and member, Evaluation and Continuous Improvement Program, Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0001-8480-1996. L. Rollins is assistant director of evaluation and institutional assessment, Prevention Research Center, Morehouse School of Medicine, and member, Evaluation and Continuous Improvement Program, Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia. E.J. Nehl is assistant research professor, Emory University Rollins School of Public Health, and director, Evaluation and Continuous Improvement Program, Georgia Clinical & Translational Science Alliance, Emory University School of Medicine, Atlanta, Georgia
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Lai J, Qin C, Nehl EJ, Jiang J, Huang Y, Liang B, Xu Y, Huang J, Xu Z, Ning C, Liao Y, Zang N, Wei W, Qin F, Yu J, Ye L, Qin X, Liang H. HIV prevalence among female sex workers in Guigang City, Guangxi, China: an 8-year consecutive cross-sectional study. BMC Public Health 2018; 18:450. [PMID: 29618343 PMCID: PMC5885366 DOI: 10.1186/s12889-018-5380-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Accepted: 03/26/2018] [Indexed: 11/22/2022] Open
Abstract
Background Female sex workers (FSW) are a population that are at high risk for HIV infection, and their HIV/AIDS knowledge levels and sexual behaviors are of concern. This study describes changes in HIV prevalence and factors associated among female sex workers in Guigang City, Guangxi, one of the highest HIV prevalence areas in China. Methods Data were derived from an annual cross-sectional venue-based survey, 2008 to 2015, in the form of sentinel surveillance. The participants were recruited using cluster sampling. FSW aged 16 years and above who completed a questionnaire and HIV testing. Both descriptive and multi-level analyses were used to explore factors associated with changes in HIV prevalence. Results Seven thousand four hundred ninety-six FSW were recruited in this study. HIV prevalence among FSW in Guigang City fell into two periods, one with an increasing trend (2008–2011) and one with a decline (2012–2015). Differences between these time periods included age, relationship status, HIV knowledge, consistent condom use, lifetime illicit drug use, history of sexually transmitted infection in the past year, HIV testing, receipt of a condom distribution and education program or HIV counseling and testing, and peer education services. Conclusions Since 2012, a reduction in HIV prevalence among FSW in Guigang City has been observed. The decline of HIV prevalence was associated with coinciding changes in demographic characteristics of FSW, improvement of HIV knowledge and safer sexual behaviors, and a program that promotes condom use, HIV counseling & testing, and peer education.
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Affiliation(s)
- Jingzhen Lai
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Chunwei Qin
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Eric J Nehl
- Rollins School of Public Health, Emory University, 1518 Clifton Road. NE, Atlanta, GA, 30322, USA
| | - Junjun Jiang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yunxuan Huang
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Bingyu Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yuexiang Xu
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Jiegang Huang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Zhiliang Xu
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China
| | - Chuanyi Ning
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Yanyan Liao
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Ning Zang
- Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Wudi Wei
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Fengxiang Qin
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Jun Yu
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China
| | - Li Ye
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China.
| | - Xionglin Qin
- Guigang Center for Disease Control and Prevention, No.7 Jianshexi Road, Guigang, 537000, Guangxi, China.
| | - Hao Liang
- Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Universities Key Laboratory of Prevention and Control of Highly Prevalent Disease, School of Public Health, Guangxi Medical University, No. 22 Shuangyong Road, Nanning, 530021, Guangxi, China. .,Guangxi Collaborative Innovation Center for Biomedicine, Life Sciences Institute, Guangxi Medical University, No.22 Shuangyong Road, Nanning, 530021, Guangxi, China.
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21
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Zheng Z, Nehl EJ, Geng W, Meng Q, Zhu Q. Impact of antiretroviral therapy on mid-and-long term survival among people living with HIV/AIDS in Guangxi, Southern China - A cohort study. Eur J Intern Med 2017; 37:e40-e43. [PMID: 27742390 DOI: 10.1016/j.ejim.2016.09.022] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2016] [Accepted: 09/30/2016] [Indexed: 10/20/2022]
Affiliation(s)
- Zhigang Zheng
- Guangxi Center for Disease Control and Prevention, Guangxi, Nanning 530028, China.
| | - Eric J Nehl
- Rollins School of Public Health, Emory University, Atlanta, GA 30322, U.S.A
| | - Wenkui Geng
- HIV/AIDS Program Special Office of Guangxi Health Family Planning Committee, Guangxi, Nanning 530021, China
| | - Qin Meng
- Guangxi Center for Disease Control and Prevention, Guangxi, Nanning 530028, China
| | - Qiuying Zhu
- Guangxi Center for Disease Control and Prevention, Guangxi, Nanning 530028, China
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Nehl EJ, Elifson K, DePadilla L, Sterk C. Sex Partner Type, Drug Use and Condom Use Self-Efficacy Among African Americans from Disadvantaged Neighborhoods: Are Associations with Consistent Condom Use Moderated by Gender? J Sex Res 2016; 53:805-815. [PMID: 26580813 PMCID: PMC5006675 DOI: 10.1080/00224499.2015.1092018] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Gender inequalities in sexual behavior are explored from the perspective of the theory of gender and power. This study focused on the effect of sex partner type (steady versus casual), drug use, and condom use self-efficacy regarding consistent condom use (CCU) among a community-based sample of adults. The sample included 1,357 African American men and women (M age 37.0, SD 13.1 years; 44% women, 66% men) from 61 disadvantaged census block groups in Atlanta, GA as part of a study of individual and neighborhood characteristics and HIV risk-taking. Having a steady partner decreased the odds of CCU, while higher condom use self-efficacy increased the odds of CCU. Among non-drug users, having a drug-using partner was associated with decreased odds of condom use for women only. Women with drug-using partners, especially a steady partner, were least likely to report CCU. Therefore, interventions intended to empower CCU among women need to expand beyond acknowledging the reduced control that women who use drugs demonstrate to also consider those who have drug-using sexual partners.
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Affiliation(s)
- Eric J. Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Kirk Elifson
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Lara DePadilla
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
| | - Claire Sterk
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University
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Ibragimov U, Harnisch JA, Nehl EJ, He N, Zheng T, Ding Y, Wong FY. Estimating self-reported sex practices, drug use, depression, and intimate partner violence among MSM in China: a comparison of three recruitment methods. AIDS Care 2016; 29:125-131. [PMID: 27367038 DOI: 10.1080/09540121.2016.1201191] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Men who have sex with men (MSM) are the group at highest risk for HIV in China. Researchers have used various recruitment methods to reach this population hidden from the hetero-normative culture. To inform future recruitment strategies, we compared estimates of socio-demographic characteristics, HIV risk behaviors, depression, and intimate partner violence (IPV) across three samples of MSM and money boys in Shanghai, China. Data were collected from three community-based samples of MSM and money boys (n = 1352) recruited via respondent-driven sampling (RDS) (n = 404), community popular opinion leaders (CPOL) (n = 385), and Internet and venue-based sampling (VBS) (n = 546). Different recruitment methods generated samples with statistically significant differences among a number of socio-demographic characteristics, sexual behaviors, drug use, depression scores, and exposure to IPV. Specifically, RDS participants had lower education (p = .002), income levels (p < .001), and were more likely to report condomless sex with a woman (p < .001). CPOL participants were younger (p < .001), more likely to report lifetime condomless anal sex (p = .009), more than 10 male partners in the past 30 days (p < .001), and were less likely to experience violence by a male intimate partner (p = .001). VBS participants had lowest depression score (p = .005) and were more likely to report lifetime drug use (p = .003). Our findings reinforce that each recruitment method may reach a sub-group of MSM with a specific risk profile, so multiple methods may be needed to obtain a representative sample of MSM. Interventions may use specific recruitment methods to target certain segments of the MSM population.
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Affiliation(s)
- Umedjon Ibragimov
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jessica A Harnisch
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Eric J Nehl
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Na He
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA.,b Department of Epidemiology , Fudan University School of Public Health , Shanghai , China
| | - Tony Zheng
- c Shanghai Piaoxue Cultural Media, Ltd ., Shanghai , China
| | - Yingying Ding
- b Department of Epidemiology , Fudan University School of Public Health , Shanghai , China
| | - Frank Y Wong
- a Department of Behavioral Sciences & Health Education , Emory University Rollins School of Public Health, Emory University , Atlanta , GA , USA.,d Hubert Department of Global Health , Emory University Rollins School of Public Health , Atlanta , GA , USA.,e Department of Epidemiology , Emory University Rollins School of Public Health , Atlanta , GA , USA.,f Department of Sociology , Emory College, Emory University , Atlanta , GA , USA
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Hall CD, Murdock D, Nehl EJ, Wong FY. Unheard Voices: The Need for HIV Research and Prevention Priorities for YMSM in the Global Context. AIDS Educ Prev 2016; 28:272-276. [PMID: 27244194 DOI: 10.1521/aeap.2016.28.3.272] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
This commentary considers the AIDS Education and Prevention special issue (volume 28, number 3) entitled "Behavioral HIV Prevention Interventions for Diverse Young Men Who Have Sex with Men (MSM)." The research presented in this special issue highlights the importance of addressing sub-populations of young MSM in order to better understand the unique realities and risk-factors affecting HIV epidemics and intervention needs. Here, we focus on several broad topics raised in this special issue and comment on their implications for HIV research and practice targeting young MSM in low- and middle-income countries. We consider issues relevant to reaching hidden populations, tailoring interventions, and integrating new communications and bio-medical technologies in research and practice in low-resource settings.
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Affiliation(s)
| | | | | | - Frank Y Wong
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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Nehl EJ, Klein H, Sterk CE, Elifson KW. Prediction of HIV Sexual Risk Behaviors Among Disadvantaged African American Adults Using a Syndemic Conceptual Framework. AIDS Behav 2016; 20:449-60. [PMID: 26188618 DOI: 10.1007/s10461-015-1134-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The focus of this paper is on HIV sexual risk taking among a community-based sample of disadvantaged African American adults. The objective is to examine multiple factors associated with sexual HIV risk behaviors within a syndemic conceptual framework. Face-to-face, computer-assisted, structured interviews were conducted with 1535 individuals in Atlanta, Georgia. Bivariate analyses indicated a high level of relationships among the HIV sexual risks and other factors. Results from multivariate models indicated that gender, sexual orientation, relationship status, self-esteem, condom use self-efficacy, sex while the respondent was high, and sex while the partner was high were significant predictors of condomless sex. Additionally, a multivariate additive model of risk behaviors indicated that the number of health risks significantly increased the risk of condomless sex. This intersection of HIV sexual risk behaviors and their associations with various other behavioral, socio-demographic, and psychological functioning factors help explain HIV risk-taking among this sample of African American adults and highlights the need for research and practice that accounts for multiple health behaviors and problems.
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Nehl EJ, Han JH, Lin L, Nakayama KK, Wu Y, Wong FY. Substance Use among a National Sample of Asian/Pacific Islander Men Who Have Sex with Men in the U.S. J Psychoactive Drugs 2015; 47:51-9. [PMID: 25715072 DOI: 10.1080/02791072.2014.994795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The objectives of this study were to describe drug use among Asian/Pacific Islander (API) men who have sex with men (MSM) and to examine how nativity (and acculturation as a secondary correlate) predicted such use. A total of 445 self-identified API MSM from seven metropolitan cities participated in a national HIV serological testing and psychosocial and behavioral assessment study. Results indicate clubbing was significantly associated with higher levels of substance use. Additionally, participants who were U.S.-born were more likely to have reported marijuana use and those with higher levels of acculturation reported less marijuana use. Our bivariate findings suggest that foreign-born status and acculturation experience may provide a protective effect against marijuana use among API MSM. These associations largely did not hold in our multivariate models. Future research should more fully examine the role of acculturation and nativity in substance use behaviors.
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Affiliation(s)
- Eric J Nehl
- a Assistant Research Professor, Emory University's Rollins School of Public Health , Atlanta , GA
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Lin L, Brown KB, Yu F, Yang J, Wang J, Schrock JM, Bodomo AB, Yang L, Yang B, Nehl EJ, Tucker JD, Wong FY. Health Care Experiences and Perceived Barriers to Health Care Access: A Qualitative Study Among African Migrants in Guangzhou, Guangdong Province, China. J Immigr Minor Health 2015; 17:1509-17. [PMID: 25294415 PMCID: PMC4390408 DOI: 10.1007/s10903-014-0114-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 11/29/2022]
Abstract
Guangzhou, one of China's largest cities and a main trading port in South China, has attracted many African businessmen and traders migrating to the city for financial gains. Previous research has explored the cultural and economic roles of this newly emerging population; however, little is known about their health care experiences while in China. Semi-structured interviews and focus groups were used to assess health care experiences and perceived barriers to health care access among African migrants in Guangzhou, China. Overall, African migrants experienced various barriers to accessing health care and were dissatisfied with local health services. The principal barriers to care reported included affordability, legal issues, language barriers, and cultural differences. Facing multiple barriers, African migrants have limited access to care in Guangzhou. Local health settings are not accustomed to the African migrant population, suggesting that providing linguistically and culturally appropriate services may improve access to care for the migrants.
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Affiliation(s)
- Lavinia Lin
- Emory University Rollins School of Public Health, 1518 Clifton Road, N.E., Atlanta, GA, 30322, USA,
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Lin L, Brown KB, Hall BJ, Yu F, Yang J, Wang J, Schrock JM, Bodomo AB, Yang L, Yang B, Nehl EJ, Tucker JD, Wong FY. Overcoming barriers to health-care access: A qualitative study among African migrants in Guangzhou, China. Glob Public Health 2015; 11:1135-47. [PMID: 26400191 DOI: 10.1080/17441692.2015.1076019] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Guangzhou is China's third most populous city, and the region's burgeoning manufacturing economy has attracted many young African businessmen and entrepreneurs to the city. The aims of this study were to examine strategies that African migrants in Guangzhou have adopted in response to health-care barriers, and explore their perceptions of how to address their needs. Twenty-five semi-structured interviews and two focus groups were conducted among African migrants residing in Guangzhou, China. Facing multiple barriers to care, African migrants have adopted a number of suboptimal and unsustainable approaches to access health care. These included: using their Chinese friends or partners as interpreters, self-medicating, using personal connections to medical doctors, and travelling to home countries or countries that offer English-speaking doctors for health care. Health-care providers and health organisations in Guangzhou have not yet acquired sufficient cultural competence to address the needs of African migrants residing in the city. Introducing linguistically and culturally competent health-care services in communities concentrated with African migrants may better serve the population. With the growing international migration to China, it is essential to develop sustainable approaches to improving health-care access for international migrants, particularly those who are marginalised.
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Affiliation(s)
- Lavinia Lin
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Katherine B Brown
- b College of Physicians and Surgeons, Columbia University , New York , NY , USA
| | - Brian J Hall
- c Department of Psychology, Faculty of Social Sciences , University of Macau , Taipa, Macau (SAR) , People's Republic of China
| | - Fan Yu
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jingqi Yang
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Jason Wang
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Joshua M Schrock
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Adams B Bodomo
- d African Studies Department , Global African Diaspora Studies (GADS) Research Platform, University of Vienna , Vienna , Austria
| | - Ligang Yang
- e Guangdong Provincial Center for Skin Diseases and STD Control , Guangzhou , Guangdong Province , People's Republic of China
| | - Bin Yang
- e Guangdong Provincial Center for Skin Diseases and STD Control , Guangzhou , Guangdong Province , People's Republic of China
| | - Eric J Nehl
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
| | - Joseph D Tucker
- f UNC Project-China , Guangzhou , Guangdong Province , People's Republic of China
| | - Frank Y Wong
- a Department of Behavioral Sciences and Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
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Yan H, Ding Y, Wong FY, Ning Z, Zheng T, Nehl EJ, He N. Epidemiological and molecular characteristics of HIV infection among money boys and general men who have sex with men in Shanghai, China. Infect Genet Evol 2015; 31:135-41. [PMID: 25653132 DOI: 10.1016/j.meegid.2015.01.022] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/19/2015] [Accepted: 01/25/2015] [Indexed: 11/26/2022]
Abstract
To examine and compare the epidemiological and molecular characteristics of HIV infection between money boys (MBs) and general men who have sex with men (MSM) in Shanghai, China. Using a venue-based sampling strategy, a total of 535 MSM including 226 MBs and 309 general MSM were recruited to participate in a cross-sectional survey including a face-to-face questionnaire interview and HIV testing. Genotyping of HIV-1 pol gene was performed for HIV-positive participants. Compared with general MSM, MBs reported more sexual partners, more alcohol and drug use and more sex after alcohol or drug use. HIV prevalence was 10.7% overall, 14.6% for MBs and 7.8% for general MSM (p=0.011). Two independent multiple logistic regression analyses indicated that HIV infection was positively associated with non-Han ethnicity (Odds Ratio [OR]=4.79, 95% Confidence Interval [CI]: 1.08-21.28) and sex after drug use in the past 6months (OR=3.59, 95% CI: 1.50-8.61) among MBs, and with sex after drug use in the past 6months (OR=3.38, 95% CI: 1.10-10.34) among general MSM as well. HIV-1 pol gene was successfully amplified and sequenced for 52 (91.2%) of HIV-positive participants. Of them, 53.8% were genotyped as CRF01_AE, 36.5% as CRF07_BC and 9.6% as subtype B. Two CRF01_AE subtype-infected participants (3.8%), a 50years old MB and a 24years old general MSM, harbored viruses with a M46L mutation conferring resistance to protease inhibitors (PI). MSM particularly MBs in Shanghai, China were at high risk of HIV infection, underscoring an urgent need for joint intervention efforts for drug use and sexual behaviors. HIV drug resistance surveillance is also warranted although the relatively low prevalence of HIV drug resistance implies the effectiveness of current antiretroviral treatment regimen.
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Affiliation(s)
- Huamei Yan
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA; The Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhen Ning
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Tony Zheng
- Shanghai Piaoxue Cultural Media Limited, Shanghai, China
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai, China; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Abstract
BACKGROUND This study explores patterns of drug use and related correlates among a sample of men who have sex with men (MSM) and men who sell sex to other men (aka "money boys") in China. OBJECTIVES Data were collected from MSM and money boys (MBs) in Shanghai, China using a Community Popular Opinion Leader (CPOL) research design with a self-administered cross-sectional survey to: (1) describe drug use and drug use correlates and (2) examine relationships between drug use and sexual behaviors in general MSM and MBs. METHODS The sample consisted of 402 MSM (203 MBs) who live in Shanghai, China. Descriptive statistics and regression analyses were used to explore associations between drug use and sexual behaviors and make comparisons between MBs and general MSM. RESULTS MBs reported using more drugs in the last week, 3 months and ever; sex after using drugs, and unprotected sex after using drugs more frequently than general MSM. Additionally, many MBs reported receiving free drugs from their clients and those who did receive free drugs were very likely to report having unprotected sex. CONCLUSIONS It is crucial to increase research and include Chinese MSM and their drug use in the Chinese policy conversation. These data suggest that drug use and sexual behaviors after drug use among Chinese MSM differ widely based upon selling sex and separate intervention strategies may be appropriate.
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Affiliation(s)
- Eric J Nehl
- 1Department of Behavioral Sciences & Health Education, Rollins School of Public Health, Emory University , Atlanta, Georgia , USA
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Glanz K, Escoffery C, Elliott T, Nehl EJ. Randomized Trial of Two Dissemination Strategies for a Skin Cancer Prevention Program in Aquatic Settings. Am J Public Health 2014; 105:1415-23. [PMID: 25521872 DOI: 10.2105/ajph.2014.302224] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We compared 2 strategies for disseminating an evidence-based skin cancer prevention program. METHODS We evaluated the effects of 2 strategies (basic vs enhanced) for dissemination of the Pool Cool skin cancer prevention program in outdoor swimming pools on (1) program implementation, maintenance, and sustainability and (2) improvements in organizational and environmental supports for sun protection. The trial used a cluster-randomized design with pools as the unit of intervention and outcome. The enhanced group received extra incentives, reinforcement, feedback, and skill-building guidance. Surveys were collected in successive years (2003-2006) from managers of 435 pools in 33 metropolitan areas across the United States participating in the Pool Cool Diffusion Trial. RESULTS Both treatment groups improved their implementation of the program, but pools in the enhanced condition had significantly greater overall maintenance of the program over 3 summers of participation. Furthermore, pools in the enhanced condition established and maintained significantly greater sun-safety policies and supportive environments over time. CONCLUSIONS This study found that more intensive, theory-driven dissemination strategies can significantly enhance program implementation and maintenance of health-promoting environmental and policy changes. Future research is warranted through longitudinal follow-up to examine sustainability.
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Affiliation(s)
- Karen Glanz
- Karen Glanz is with Perelman School of Medicine and School of Nursing, University of Pennsylvania, Philadelphia. Cam Escoffery, Tom Elliott, and Eric J. Nehl are with Rollins School of Public Health, Emory University, Atlanta, GA
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Abstract
Given that alcohol use is highly prevalent at US colleges, we explored factors related to problem drinking behaviors (PDB; binge drinking, driving after drinking, sexual intercourse after drinking) among 4098 Black and White students from two- and four-year colleges who completed an online survey. We found an interaction between race and sex such that, among Whites, females had less PDB than males (B = 0.09, CI: 0.05; 0.40, p = 0.01). An interaction between race and school type also existed, such that White students from four-year schools had greater PDB (B = 0.11, CI: 0.20; 0.54, p < 0.001). An interaction between race and stress suggested that Black students were more negatively affected by stress in terms of PBD (B = 0.12, CI: 0.01; 0.07, p = 0.01).
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Affiliation(s)
- Alvin Tran
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Jessica Sales
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, USA
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Tran A, Lin L, Nehl EJ, Talley CL, Dunkle KL, Wong FY. Prevalence of Substance Use and Intimate Partner Violence in a Sample of A/PI MSM. J Interpers Violence 2014; 29:2054-2067. [PMID: 24390356 PMCID: PMC8080275 DOI: 10.1177/0886260513516006] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
This study evaluates the prevalence of three forms of intimate partner violence (IPV) (i.e., experience of physical, psychological/symbolic, and sexual battering) among a national sample of Asian/Pacific Islander (A/PI) men who have sex with men (MSM) in the United States and identifies their characteristics. The study also reports the differences of substance use behavior between MSM with and without a previous history of IPV. Our sample was recruited through venue-based sampling from seven metropolitan cities as part of the national Men of Asia Testing for HIV (MATH) study. Among 412 MSM, 29.1% experienced IPV perpetrated from a boyfriend or same-gender partner in the past 5 years. Within the previous 5 years, 62.5%, 78.3%, and 40.8% of participants experienced physical, psychological/symbolic, and sexual battering, respectively. Collectively, 35.8% of participants reported that they have experienced at least one type of victimization and 64.2% have experienced multiple victimizations (two or three types of battering victimization). Overall, 21.2% of our sample reported any substance use within the past 12 months. The present findings suggest that individuals with a history of IPV in the past 5 years were more likely to report substance use (33.6%) compared to those without a history of IPV experience (16.1%).
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Affiliation(s)
- Alvin Tran
- Emory University, Atlanta, GA, USA Harvard University, Boston, MA, USA
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Berg CJ, Nehl EJ, Wang X, Ding Y, He N, Wong FY. Utilization of cessation resources among HIV-positive and HIV-negative men who smoke and who have sex with men in Chengdu, China. Nicotine Tob Res 2014; 16:1283-8. [PMID: 24827789 DOI: 10.1093/ntr/ntu064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
INTRODUCTION Given the implications for smoking among individuals living with HIV and the high rates of smoking and HIV among men who have sex with men (MSM) in China, we examined differences in prior use of and future interest in various cessation resources among MSM smokers with or without HIV. METHODS We conducted a cross-sectional survey of 381 MSM; HIV status was provided by 350 MSM, and complete data was provided by a total of 344 (188 HIV-positive and 156 HIV-negative) current smokers (past 30 days) recruited by a nongovernmental organization in Chengdu in 2012-2013. Participants reported tobacco and alcohol use; psychosocial factors; past-year quit attempts; health care provider interactions on smoking; and prior use of and interest in cessation resources. RESULTS Smokers living with HIV were more likely to have used behavioral interventions (p < .001) and pharmacotherapy (p = .033). Those who were HIV-positive were also more interested in behavioral interventions (p = .002) and pharmacotherapy (p = .008). Correlates of interest in behavioral interventions in the regression model included lower cigarette consumption (p = .011), higher confidence in quitting (p = .035), greater likelihood of attempting to quit in the past year (p = .026), and being HIV-positive (p = .008). Correlates of interest in pharmacotherapy included greater depressive symptoms (p = .047) and being HIV-positive (p = .015). CONCLUSIONS Smokers living with HIV were more likely to have ever attempted to quit smoking, to have used cessation resources, and to be interested in using cessation aids. These findings indicate the promise of greater dissemination of cessation resources, particularly if Chinese clinical practices are strengthened to offer cessation support.
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Affiliation(s)
- Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Xiaodong Wang
- Chengdu Tongle Health Service and Counseling Center, Chengdu City, Cichuan Province, China
| | - Yingying Ding
- Department of Epidemiology, Fudan University School of Public Health, Shanghai, China
| | - Na He
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; Department of Epidemiology, Fudan University School of Public Health, Shanghai, China
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA; Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA
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Berg CJ, Nehl EJ, Wang X, Ding Y, He N, Johnson BA, Wong FY. Healthcare provider intervention on smoking and quit attempts among HIV-positive versus HIV-negative MSM smokers in Chengdu, China. AIDS Care 2014; 26:1201-7. [PMID: 24601710 DOI: 10.1080/09540121.2014.892565] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Given the implications for smoking among HIV-positive individuals and high smoking and HIV rates among men who have sex with men (MSM) in China, we examined sociodemographic, smoking-related, psychosocial, and substance use factors in relation to HIV status; receiving some sort of healthcare provider intervention regarding smoking; and having made a quit attempt in the past year in a sample of MSM smokers in Chengdu. We conducted a cross-sectional survey of 381 MSM smokers recruited by a nongovernmental organization in Chengdu in 2012-2013. Of these, 350 disclosed their HIV status and 344 (188 HIV-positive and 156 HIV-negative) provided completed data. Half (50.0%) reported at least one quit attempt in their lifetime; 30.5% reported a quit attempt in the past year. The majority (59.4%) reported that a healthcare provider had intervened in some way (assessed smoking, advised quitting, provided assistance), most commonly by assessing smoking status (50.0%). HIV-positive individuals were more likely to report a healthcare provider intervening on their smoking (p < .001). Those who received provider intervention were more likely to have attempted to quit ever (p = .009) and in the past year (p < .001). Those HIV-positive were more likely to have attempted to quit since diagnosis if a provider had intervened (p = .001). Multivariate regression documented that being HIV-positive (p < .001), greater cigarette consumption (p = .02), less frequent drinking (p = .03), and greater depressive symptoms (p = .003) were significant correlates of healthcare provider intervention. Multivariate regression also found that healthcare provider intervention (p = .003), older age (p = .01), and higher autonomous motivation (p = .007) were significant correlates of attempting to quit in the past year. Given the impact of healthcare provider intervention regarding smoking on quit attempts among MSM, greater training and support is needed to promote consistent intervention on smoking in the clinical setting among HIV-positive and HIV-negative MSM smokers.
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Affiliation(s)
- Carla J Berg
- a Department of Behavioral Sciences & Health Education , Rollins School of Public Health, Emory University , Atlanta , GA , USA
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Abstract
OBJECTIVE To examines smoking status, substance use, sociodemographics, and psychosocial characteristics in relation to alternative tobacco use among college students. METHODS Current tobacco use (cigarettes, cigar-like products, hookah, chew, snus) and correlates (sociodemographics, sensation-seeking, attitudes toward tobacco and smokers, social factors) were assessed among students aged 18-25 at 6 Southeastern US colleges using an online survey. RESULTS Those who were younger, male, black, cigarette and marijuana users, and demonstrating at-risk psychosocial factors were at increased risk of alternative tobacco product use (p < .001). Among current smokers, never daily nondaily smokers were 3 times as likely as former daily non-daily smokers and daily smokers to use alternative tobacco products (p < .001). CONCLUSIONS Important risk factors for alternative tobacco use included important sociodemographic and psychosocial characteristics.
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Affiliation(s)
- Nosayaba Enofe
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA.
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University School of Public Health, Atlanta, GA, USA
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Lin L, Nehl EJ, Tran A, He N, Zheng T, Wong FY. Sexually transmitted infection testing practices among 'money boys' and general men who have sex with men in Shanghai, China: objective versus self-reported status. Sex Health 2014; 11:94-6. [PMID: 24636349 DOI: 10.1071/sh13199] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2013] [Accepted: 02/09/2014] [Indexed: 11/23/2022]
Abstract
Little is known about sexually transmitted infection (STI) testing among Chinese men who have sex with men (MSM). This study describes the prevalence of STI testing, associated factors and the validity of STI self-reporting among Chinese MSM. Findings indicated a high prevalence of STIs and low testing rates among MSM in Shanghai. Monthly income was significantly associated with STI testing (odds ratio: 0.37, 95% confidence interval (CI): 0.18 to 0.76). Depression was significantly associated with STI testing for general MSM (odds ratio: 1.09, 95% CI: 1.01 to 1.17). Syphilis self-reported status had the highest validity (k=0.33, χ(2)=3.76, 95% CI: -0.003 to 0.65). Efforts are needed to ensure that STI testing services are accessible to MSM in China. Future HIV and STI interventions should be tailored to the needs of different subsets of MSM.
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Affiliation(s)
- Lavinia Lin
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Alvin Tran
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
| | - Na He
- Department of Epidemiology, Fudan University School of Public Health, Shanghai 200032, China
| | - Tony Zheng
- Shanghai Piaoxue Cultural Media Ltd, Shanghai, China
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Emory University Rollins School of Public Health, Atlanta, GA 30322, USA
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Yan H, Wong FY, Zheng T, Ning Z, Ding Y, Nehl EJ, Lin L, He N. Social support and depressive symptoms among 'money' boys and general men who have sex with men in Shanghai, China. Sex Health 2014; 11:285-7. [PMID: 24919661 DOI: 10.1071/sh14017] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Accepted: 02/27/2014] [Indexed: 12/18/2022]
Abstract
The primary objective was to examine prevalence and correlates of social support and depressive symptoms among male sex workers (known as 'money boys' (MBs)) and general men who have sex with men (MSM) in Shanghai. The Social Provision Scale (SPS), which consists of 24 items, scored out of 4 for social provision, was used to evaluate the functions of social relationships. The score for each item ranges from 1 to 4, with a higher score indicating more social provision. The overall mean SPS score was 68.1 (s.d.=6.53) for MBs and 69.3 (s.d.=6.99) for general MSM. Depression was measured with a 12-item version of the Center for Epidemiological Studies Depression Scale (CES-D), where a score of 9 has been recommended as the cutoff score to indicate possible depressive symptoms. The prevalence of depressive symptoms was 57.9%, with MBs having a higher level of depressive symptoms than general MSM (70.0% v. 46.1%) (odds ratio=1.86, 95% confidence interval=1.07-3.24). Social support was a protective factor for depressive symptoms (odds ratio=0.92, 95% confidence interval=0.89-0.96). MSM in China, particularly MBs, are vulnerable to low social support and high depressive symptoms, highlighting the need for tailored psychological programs targeting this population.
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Affiliation(s)
- Huamei Yan
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China
| | - Frank Y Wong
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Tony Zheng
- Shanghai Piaoxue Cultural Media Limited, Shanghai 200023, China
| | - Zhen Ning
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China
| | - Yingying Ding
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Lavinia Lin
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Na He
- Department of Epidemiology, School of Public Health, Fudan University, and The Key Laboratory of Public Health Safety of Ministry of Education, Shanghai 200032, China
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Gao J, Nehl EJ, Fu H, Jia Y, Liu X, Zheng P. Workplace social capital and smoking among Chinese male employees: a multi-level, cross-sectional study. Prev Med 2013; 57:831-6. [PMID: 24075818 DOI: 10.1016/j.ypmed.2013.09.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2013] [Revised: 09/07/2013] [Accepted: 09/17/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The present study sought to investigate the associations between workplace social capital and smoking status among Chinese male employees. METHODS A cross sectional study with a two-stage stratified sampling procedure was conducted in Shanghai in 2012. In total, 1603 male workers from 35 workplaces were involved. Workplace social capital was assessed using a validated and psychometrically tested eight-item measure. Multilevel logistic regression analysis was conducted to explore whether individual-level social capital and aggregated workplace-level social capital were associated with smoking. RESULTS Overall, 54.2% of the subjects smoked currently. After controlling for individual covariates (age, education level, marital status, occupational status and job stress), compared to workers in the highest quartile of individual-level social capital, the prevalence ratios of smoking for workers in the third quartile, second quartile and lowest quartile were 1.26 (95% CI: 1.11-1.38), 1.35 (95% CI: 1.19-1.50) and 1.39 (95% CI: 1.24-1.51) respectively. However, there was no relationship between workplace-level social capital and smoking status. CONCLUSIONS Higher individual-level social capital was associated with a lower likelihood of smoking among Chinese male employees. By contrast, no clear association was found between workplace-level social capital and smoking. Further longitudinal studies are warranted to examine the possible link between workplace social capital and smoking cessation in Chinese workplaces.
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Affiliation(s)
- Junling Gao
- School of Public Health, Fudan University, Key Laboratory of Public Health Safety, Ministry of Education, Shanghai, China
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40
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Huang L, Nehl EJ, Lin L, Meng G, Liu Q, Ross MW, Wong FY. Sociodemographic and sexual behavior characteristics of an online MSM sample in Guangdong, China. AIDS Care 2013; 26:648-52. [PMID: 24124988 DOI: 10.1080/09540121.2013.844760] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Public health research and interventions often assume that men who have sex with men (MSM) who use the Internet in China have similar characteristics to those in Western countries, though with little empirical evidence. This study aimed to describe and examine the sociodemographic and basic sexual behavioral characteristics of an online sample of MSM in Guangdong, China. In 2010, a total of 1100 MSM were recruited from an lesbian, gay, bisexual, and transgender (LGBT)-oriented website and were asked about their sociodemographic and sexual behavior characteristics. The majority of the participants (77.9%) self-identified as homosexual, and the mean age was 30.0 years (SD = 6.7). About 80% of the participants had attained a college degree and only 4.8% were unemployed. About 60% had a monthly salary of more than CNY 3000 (476 USD), and more than 10% were married. The majority (71.7%) had used condoms in the last anal sex. Nearly half of the participants have never been tested for HIV or other sexually transmitted infections (STIs) (47.3% and 47.7%, respectively). More than 80% were willing to be contacted by researchers after the survey. Findings indicate that the sociodemographic characteristics of Chinese MSM who use the Internet are relatively similar to those in the Western countries. However, Chinese MSM are less likely to self-identify as homosexual and be tested for HIV and other STIs than Western MSM. On a positive note, Chinese MSM would be likely to engage in e-technology research showing potential feasibility of an online HIV/STI intervention.
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Affiliation(s)
- L Huang
- a GZTZ.ORG (XQ Solutions) , Guangzhou , PR China
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Zheng P, Qian H, Wang F, Sun S, Nehl EJ, Wong FY. Awareness of tobacco advertising, perceived harms of smoking, and beliefs about tobacco control among a sample of Shanghainese in China. Health Educ Res 2013; 28:879-887. [PMID: 23912156 DOI: 10.1093/her/cyt075] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
This study aims to examine beliefs among residents of Shanghai, China concerning tobacco advertising and control policies concurrent with new restrictions on tobacco use and advertising in the city. A total of 518 residents of Shanghai completed a telephone interview survey. We found that 51% of participants had seen or heard of the Zhonghua cigarette brand's 'Love China' tobacco ad campaign in the past 2 years, 59% believed that the campaign would influence people to buy this specific cigarette brand as a gift, and 30% believed that it would encourage smoking. More than 75% of respondents would support legislation banning tobacco advertising in all public places, and 88% would support legislation prohibiting smoking in all public places. Multivariate analyses indicated that those who were female, more than 50 years, have accepted college and above education, and perceived greater benefits to smoking cessation were more likely to support banning tobacco advertising and prohibiting smoking in public places. Non-smokers were more likely to support prohibiting smoking in public places. The findings suggest that although tobacco advertising is widely prevalent in Shanghai, it is disliked by the public. Respondents showed high levels of support for tobacco control policies.
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Affiliation(s)
- PinPin Zheng
- Department of Preventive of Medicine, Fudan University's SPH, 138 Yixueyuan Road, Shanghai 200032, People's Republic of China, Medical College of Fudan University, P.O. Box 275, 138 Yixueyuan Road, Shanghai 200032, People's Republic of China, Journalism School of Fudan University, 400 Guoding Road, Shanghai 200433, People's Republic of China, Department of Behavioral Sciences & Health Education, Emory University's Rollins SPH, 1518 Clifton Road, Atlanta, Georgia 30322, USA and Hubert Department of Global Health, Emory University's Rollins SPH, 1518 Clifton Road, Atlanta, Georgia 30322, USA
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42
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Lemieux AF, Nehl EJ, Lin L, Tran A, Yu F, Wong FY. A pilot study examining depressive symptoms, Internet use, and sexual risk behaviour among Asian men who have sex with men. Public Health 2013; 127:1041-4. [PMID: 24074630 DOI: 10.1016/j.puhe.2013.04.017] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Revised: 04/08/2013] [Accepted: 04/12/2013] [Indexed: 11/29/2022]
Affiliation(s)
- A F Lemieux
- Department of Communication, Georgia State University, USA; Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, USA; Department of Pediatrics, School of Medicine, Emory University, USA.
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Yu F, Nehl EJ, Zheng T, He N, Berg CJ, Lemieux AF, Lin L, Tran A, Sullivan PS, Wong FY. A syndemic including cigarette smoking and sexual risk behaviors among a sample of MSM in Shanghai, China. Drug Alcohol Depend 2013; 132:265-70. [PMID: 23517682 PMCID: PMC3726538 DOI: 10.1016/j.drugalcdep.2013.02.016] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2012] [Revised: 02/11/2013] [Accepted: 02/11/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVES We explored possible correlates of cigarette smoking and their associations with levels of smoking among a sample of Chinese men who have sex with men (MSM). We also explored the syndemic associations of substance use and psychosocial problems on sexual risk behaviors. METHODS Cross-sectional data collection from 404 MSM in Shanghai, China. RESULTS MSM exhibit a high prevalence of smoking (66.3%). Both light and heavy smoking were associated with alcohol and drug use, depression, intimate partner violence, sexual attitudes, and gay identity (though the associations for light smokers were moderate compared to those for heavy smokers). CONCLUSIONS Our findings indicate the presence of a health syndemic among MSM, and suggest that smoking prevention and cessation and other substance abuse interventions should be integrated into efforts preventing sexual risk behaviors among MSM.
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Affiliation(s)
- F Yu
- Department of Behavioral Sciences & Health Education, Emory University's Rollins School of Public Health, 1518 Clifton Road, NE, Atlanta, GA 30322, United States
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Abstract
OBJECTIVES A common commercial marketing segmentation technique is to divide a population into groups based on psychographic characteristics (i.e., attitudes and interests). We used this approach to define segments of female and male college students and examine substance use differences. METHOD We administered an online survey to 24,055 students at six colleges in the Southeastern United States (response rate 20.1%, n = 4,840), obtaining complete data from 3,469 participants. We assessed sociodemographics, psychographic factors such as those used by the tobacco industry to define market segments, and substance use (cigarettes, other tobacco products, alcohol, and marijuana). Cluster analysis was conducted among females and males using 15 psychographic measures (sensation seeking, Big Five personality traits, and nine measures adapted from tobacco industry documents), identifying three segments per sex. RESULTS Safe responsibles were characterized by high levels of agreeableness, conscientiousness, emotional stability, academic achievement, and religious service attendance. Stoic individualists were characterized by low extraversion, sensation seeking, and openness. Thrill-seeking socializers were characterized by high levels of sensation seeking and extraversion. Among females, thrill-seeking socializers were significantly more likely than safe responsibles to have used any substance in the prior 30 days (odds ratio [OR] = 2.04, 95% confidence interval [CI] [1.65, 2.52]; Nagelkerke R2 = .084). Among males, stoic individualists (OR = 1.50, CI [1.08, 2.08]) and thrill-seeking socializers (OR = 1.53, CI [1.09, 2.13]) were more likely than safe responsibles to have used substances in the past 30 days (Nagelkerke R2: .109). CONCLUSION Psychographic segmentation can identify young adult subgroups with differing psychographic and substance use profiles and inform health campaigns and messaging targeting youth.
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Affiliation(s)
- Tiffany Ashley Suragh
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Carla J Berg
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Eric J Nehl
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Abstract
Mass media in China play a significant role in the dissemination of HIV/AIDS knowledge to the general public. Previous studies have described how the Chinese mass media portray HIV/AIDS in general, but no study has yet to examine changes in patterns of HIV/AIDS reporting over time. This study aims to describe and examine newspaper coverage of HIV/AIDS in China from 2000 to 2010. A systematic search of the China Core Newspapers Database was conducted to identify HIV/AIDS-focused news articles; we found 3648 articles. Results show that coverage rates of HIV/AIDS in newspapers remained low, with only about three articles published per newspaper per year between 2000 and 2010. The sources focused primarily on prevention methods (23.7%), development of a cure or vaccine (21.2%), and education and awareness (17.2%). The HIV/AIDS-related topic covered in an article varied significantly depending on scope (national vs. local) of the newspaper (χ(2)=130.37, p<0.001) and article type (χ(2)=455.72, p<0.001). Totally, more articles were classified as positive than negative from 2002 to 2010. Findings indicate that the HIV/AIDS news-reporting pattern has shifted in the past decade, with more news stories disclosing information about prevention or treatment. However, coverage of HIV/AIDS remains insufficient. Enhancing collaboration between health educators and media sources can be an important strategy in disseminating HIV/AIDS knowledge.
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Affiliation(s)
- Junling Gao
- a Key Laboratory of Public Health Safety, School of Public Health, Ministry of Education , Fudan University , Shanghai , China
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46
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Nehl EJ, He N, Wang X, Lin L, Wong FY, Yu F. Feasibility and willingness of using e-technologies for HIV prevention and research targeting Chinese MSM. AIDS Care 2012; 25:926-30. [PMID: 23061806 DOI: 10.1080/09540121.2012.726344] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This pilot study examines the feasibility and willingness for three types of e-technologies for HIV prevention and research among a sample of men who have sex with men (MSM) in Chengdu, China. A total of 605 self-identified MSM (200 HIV seropositive, 405 HIV-) were recruited through a community-based HIV/AIDS service organization and completed a cross-sectional survey. The majority used cell phones for voice and text (99 and 95%), 53% used email, and 83% used Tencent QQ (an instant messaging technology); 54% indicated they would participate in future research studies; and 77% provided contact information for at least one e-technology. In multivariate analyses, those who were not official city residents, those better educated, and those who were HIV seropositive were more likely to provide contact information. This research indicates that MSM in China would be likely to engage in e-technology research and studies should explore these innovative communication methods.
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Affiliation(s)
- Eric J Nehl
- Department of Behavioral Sciences and Health Education, Emory University, Atlanta, GA, USA.
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Nehl EJ, Nakayama KK, He N, Huang ZJ, Zheng T, Wong FY. Substance Use and Sexual Risks Among General MSM and Money Boys in Shanghai, China. Journal of Drug Issues 2012. [DOI: 10.1177/0022042612456016] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In China, men who have sex with men (MSM) are at high risk for substance use, HIV, and other sexually transmitted infections (STIs). However, there has been little research into their drug use and the sexual behaviors they engage in after drug and alcohol use. Using respondent-driven sampling methodology, this cross-sectional study of 404 MSM described drug use and examined sexual behaviors after drug and alcohol use among general MSM and money boys (those who engage in same-sex commercial sex) in Shanghai, China. Money boys reported using more drugs in the last week, 3 months and ever, and having sex after drinking and sex after using drugs more frequently than general MSM. It is vital to continue research and begin science-based interventions in these high-risk and underserved populations.
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Affiliation(s)
- Eric J. Nehl
- Emory University Rollins School of Public Health, Atlanta, GA, USA
| | | | - Na He
- Emory University Rollins School of Public Health, Atlanta, GA, USA
- Fudan University School of Public Health, Shanghai, China
| | | | - Tony Zheng
- Shanghai Piaoxue Cultural Media Limited, Shanghai, China
| | - Frank Y. Wong
- Emory University Rollins School of Public Health, Atlanta, GA, USA
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Wong FY, Nehl EJ, Han JJ, Huang ZJ, Wu Y, Young D, Ross MW. HIV testing and management: findings from a national sample of Asian/Pacific islander men who have sex with men. Public Health Rep 2012; 127:186-94. [PMID: 22379218 DOI: 10.1177/003335491212700207] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES We examined reasons for and barriers to participating in HIV voluntary counseling and testing for Asian/Pacific Islander (A/PI) men who have sex with men (MSM) in the U.S. METHODS We collected data between June 2007 and September 2009 in a study known as Men of Asia Testing for HIV, using a cross-sectional community-based participatory design. This national study was conducted in seven U.S. metropolitan cities through a coalition of seven community-based organizations. RESULTS Participants included 445 self-identified A/PI MSM aged ≥18 years. Perception of being at risk was the number one reason for testing behaviors. For first-time testers, structural barriers (e.g., language barriers with health professionals) and fear of disclosure (e.g., sexual orientation not known to parents) were deterrents for nontesting in the past. Among previously known HIV-positive men, 22% were not seeing a doctor and 19% were not taking any HIV medications. CONCLUSIONS HIV testing, care, and treatment policies would be less than optimal without addressing barriers to testing, including stigma related to sexual orientation, among A/PI MSM.
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Affiliation(s)
- Frank Y Wong
- Emory University, Rollins School of Public Health, Department of Behavioral Sciences and Health Education, Atlanta, GA 30322, USA.
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49
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Huang ZJ, He N, Nehl EJ, Zheng T, Smith BD, Zhang J, McNabb S, Wong FY. Social network and other correlates of HIV testing: findings from male sex workers and other MSM in Shanghai, China. AIDS Behav 2012; 16:858-71. [PMID: 22223298 PMCID: PMC8080277 DOI: 10.1007/s10461-011-0119-4] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.8] [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: 10/14/2022]
Abstract
Although the Chinese government provides free-of-charge voluntary HIV counseling and testing, HIV testing rates among men who have sex with men (MSM) are reported to be extremely low. This study examines the association of structural and psychosocial factors and social network characteristics with HIV testing behaviors among "money boys" and general MSM in Shanghai. Overall, 28.5% of "money boys" and 50.5% of general MSM had never tested for HIV despite high rates of reported HIV risk behaviors. Factors associated with not testing for HIV included: not knowing of a testing site, limited HIV knowledge, low perceived HIV risk, concern about HIV testing confidentiality, being a closeted gay, not using the Internet, and having a small social network or network with few members who had tested for HIV. Future efforts to promote HIV testing should focus on outreach to general MSM, confidentiality protection, decreasing the stigma of homosexuality, and encouraging peer education and support through the Internet and social networks.
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Affiliation(s)
- Z Jennifer Huang
- Department of International Health, Georgetown University School of Nursing and Health Studies, Washington, DC 20057, USA.
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50
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Abstract
BACKGROUND Over three-quarters of new HIV infections in China during 2009 were estimated to be from sexual transmission. Over half of those living with HIV do not know their serostatus and identifying and treating individuals with sexually transmitted HIV infection has been challenging. OBJECTIVE This global assessment explores Chinese systems for detecting and treating those with HIV infection with a particular focus on groups at increased risk of sexually transmitted HIV. METHODS Published literature, grey sources and non-governmental reports were reviewed to describe HIV testing and care systems in China. RESULTS HIV testing and care in China involve several parallel health systems and have been largely successful in reaching large numbers of vulnerable individuals. Provider-initiated testing and counselling has been more effective than voluntary counselling and testing programmes for expanding HIV testing efforts in China. Individuals with sexually transmitted HIV infection are underrepresented in the antiretroviral care system compared with other high-risk groups. CONCLUSIONS Comprehensive HIV testing and care bring together a number of Chinese health systems, but there are still gaps and challenges. Research and programmes focused on HIV testing and care for those with increased sexual risk are needed.
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Affiliation(s)
- Joseph D Tucker
- Division of Infectious Diseases, Department of Medicine, Massachusetts General Hospital, 55 Fruit Street, GRJ-504, Boston, MA 02139, USA.
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