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Xavier Hall CD, Ryan D, Hayford C, Morgan E, Tabidze I, D’Aquila R, Mustanski B. Syphilis Prevalence, Incidence, and Demographic Differences in a Longitudinal Study of Young Sexual and Gender Minority Adults Assigned Male at Birth. J Infect Dis 2024; 229:232-236. [PMID: 37816091 PMCID: PMC10786243 DOI: 10.1093/infdis/jiad256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/05/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND Syphilis rates in the United States have increased. Few studies have examined syphilis incidence and prevalence prospectively among young sexual and gender minorities (YSGM). METHODS This study of YSGM assigned male at birth comes from a Chicago-based prospective cohort at 2 visits 6 months apart (N = 882). Syphilis cases were identified through serologic test results and self-reported history. RESULTS In this sample, 25.1% had a lifetime prevalence, and 3.3% were incident cases with a crude incidence rate of 6.76 per 100 person-years. CONCLUSIONS Lifetime syphilis and incidence are high in this sample of YSGM relative to general population samples.
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Affiliation(s)
- Casey D Xavier Hall
- Center of Population Sciences for Health Equity, College of Nursing, Florida State University, Tallahassee, Florida
- Department of Medical Social Sciences, Feinberg School of Medicine
| | - Daniel Ryan
- Institute for Sexual and Gender Minority Health and Wellbeing
| | - Christina Hayford
- Institute for Sexual and Gender Minority Health and Wellbeing
- Third Coast Center for AIDS Research, Northwestern University, Chicago, Illinois
| | - Ethan Morgan
- College of Nursing, Ohio State University, Columbus, Ohio
| | - Irina Tabidze
- Chicago Department of Public Health, Chicago, Illinois
| | - Richard D’Aquila
- Department of Medicine (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Brian Mustanski
- Department of Medical Social Sciences, Feinberg School of Medicine
- Institute for Sexual and Gender Minority Health and Wellbeing
- Department of Medicine (Infectious Diseases), Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
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Xavier Hall CD, Feinstein BA, Rusie L, Phillips Ii G, Beach LB. Race and Sexual Identity Differences in PrEP Continuum Outcomes Among Latino Men in a Large Chicago Area Healthcare Network. AIDS Behav 2022; 26:1943-1955. [PMID: 34993667 PMCID: PMC8736294 DOI: 10.1007/s10461-021-03544-x] [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] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/22/2021] [Indexed: 01/08/2023]
Abstract
U.S. HIV incidence is threefold higher among Latino individuals than non-Latino Whites. Pre-exposure prophylaxis (PrEP) uptake remains low among Latino men. Most HIV studies view Latino communities as a monolithic group, ignoring racial and sexual diversity. This analysis examines PrEP-related outcomes including eligibility, first prescription, and second prescription across race and sexual identity in a sample of Latino cisgender men (n = 8271) who sought services from a healthcare network in Chicago in 2012-2019. Logistic regression was used to calculate adjusted odds ratios. Latino-only participants had lower odds of PrEP eligibility and first prescription compared to White-Latino participants. No other significant differences by race were detected. While bisexual participants had equivalent odds of PrEP eligibility, they had lower odds of first PrEP prescription compared to gay participants. Heterosexual participants also had lower odds of PrEP eligibility and initiation. Future research should address unique factors shaping PrEP-related outcomes among diverse Latino populations.
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Affiliation(s)
- Casey D Xavier Hall
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA.
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA.
| | - Brian A Feinstein
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | | | - Gregory Phillips Ii
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
| | - Lauren B Beach
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, 625 N Michigan Ave, Suite 1400, Chicago, IL, 60611, USA
- Northwestern University Institute for Sexual and Gender Minority Health and Wellbeing, Chicago, IL, USA
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Simons LM, Lorenzo-Redondo R, Gibson M, Kinch SL, Vandervaart JP, Reiser NL, Eren M, Lux E, McNally EM, Tambur AR, Vaughan DE, Bachta KER, Demonbreun AR, Satchell KJF, Achenbach CJ, Ozer EA, Ison MG, Hultquist JF. Assessment of Virological Contributions to COVID-19 Outcomes in a Longitudinal Cohort of Hospitalized Adults. Open Forum Infect Dis 2022; 9:ofac027. [PMID: 35198645 PMCID: PMC8860154 DOI: 10.1093/ofid/ofac027] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Accepted: 01/24/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND While several demographic and clinical correlates of coronavirus disease 2019 (COVID-19) outcome have been identified, their relationship to virological and immunological parameters remains poorly defined. METHODS To address this, we performed longitudinal collection of nasopharyngeal swabs and blood samples from a cohort of 58 hospitalized adults with COVID-19. Samples were assessed for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral load, viral genotype, viral diversity, and antibody titer. Demographic and clinical information, including patient blood tests and several composite measures of disease severity, was extracted from electronic health records. RESULTS Several factors, including male sex, higher age, higher body mass index, higher 4C Mortality score, and elevated lactate dehydrogenase levels, were associated with intensive care unit admission. Of all measured parameters, only the retrospectively calculated median Deterioration Index score was significantly associated with death. While quantitative polymerase chain reaction cycle threshold (Ct) values and genotype of SARS-CoV-2 were not significantly associated with outcome, Ct value did correlate positively with C-reactive protein levels and negatively with D-dimer, lymphocyte count, and antibody titer. Intrahost viral genetic diversity remained constant through the disease course and resulted in changes in viral genotype in some participants. CONCLUSIONS Ultimately, these results suggest that worse outcomes are driven by immune dysfunction rather than by viral load and that SARS-CoV-2 evolution in hospital settings is relatively constant over time.
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Affiliation(s)
- Lacy M Simons
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Pathogen Genomics and Microbial Evolution, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Ramon Lorenzo-Redondo
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Pathogen Genomics and Microbial Evolution, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Meg Gibson
- Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Sarah L Kinch
- Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Jacob P Vandervaart
- Department of Microbiology-Immunology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Nina L Reiser
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Mesut Eren
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Elizabeth Lux
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Elizabeth M McNally
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Biochemistry and Molecular Genetics, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Anat R Tambur
- Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Douglas E Vaughan
- Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Kelly E R Bachta
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Alexis R Demonbreun
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Department of Pharmacology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Karla J F Satchell
- Center for Genetic Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Structural Genomics of Infectious Diseases, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Chad J Achenbach
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Global Communicable and Emerging Infectious Diseases, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Egon A Ozer
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Pathogen Genomics and Microbial Evolution, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Michael G Ison
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Division of Organ Transplantation, Department of Surgery, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
| | - Judd F Hultquist
- Division of Infectious Diseases, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
- Center for Pathogen Genomics and Microbial Evolution, Institute for Global Health, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
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Bassett SM, Brody LR, Jack DC, Weber KM, Cohen MH, Clark TM, Dale SK, Moskowitz JT. Feasibility and Acceptability of a Program to Promote Positive Affect, Well-Being and Gender Empowerment in Black Women Living with HIV. AIDS Behav 2021; 25:1737-1750. [PMID: 33389322 PMCID: PMC7778488 DOI: 10.1007/s10461-020-03103-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/11/2020] [Indexed: 12/28/2022]
Abstract
While programs and interventions intended to increase positive affect among people living with HIV (PLWH) and other chronic diseases have been associated with improved health outcomes, including decreased depression, programs have not been tailored specifically for Black women. We tailored a program designed to increase positive affect and to decrease depressive symptoms in PLWH to a group format for Black WLWH. We also added skills to increase gender empowerment. We then tested the acceptability and feasibility of this program with 8 Black WLWH. The program was acceptable and relatively feasible, as assessed by women’s participation and feedback about program clarity and helpfulness, which women rated above 9 on a 10-point scale. A few women suggested that optimal delivery point for some skills taught would be shortly after HIV diagnosis. A proof-of-concept program intended to bolster positive emotions and gender empowerment and decrease depression can be tailored for Black WLWH and is relatively feasible and acceptable. A randomized controlled trial is needed to assess the preliminary efficacy of this program on positive affect, depression, and other health outcomes for WLWH.
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Affiliation(s)
- S M Bassett
- Medical Social Sciences, Northwestern University, Chicago, IL, USA.
| | - L R Brody
- Psychological & Brain Sciences, Boston University, Boston, MA, USA
| | - D C Jack
- Fairhaven College of Interdisciplinary Studies, Western Washington University, Bellingham, WA, USA
| | - K M Weber
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - M H Cohen
- Department of Medicine, Rush University and Stroger Hospital of Cook County, Chicago, IL, USA
| | - T M Clark
- Cook County Health and Hektoen Institute of Medicine, Chicago, IL, USA
| | - S K Dale
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - J T Moskowitz
- Medical Social Sciences, Northwestern University, Chicago, IL, USA
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Feinstein BA, McConnell E, Dyar C, Mustanski B, Newcomb ME. Minority stress and relationship functioning among young male same-sex couples: An examination of actor-partner interdependence models. J Consult Clin Psychol 2019; 86:416-426. [PMID: 29683699 DOI: 10.1037/ccp0000296] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In different-sex couples, individual and partner stress can both have a negative impact on relationship functioning (actor and partner effects). Gay and bisexual men experience unique stress (sexual minority stress), but few studies have examined the effects of this stress on relationship functioning among young male couples. The current study examined (a) actor and partner effects of general and minority stress (internalized stigma, microaggressions, victimization, and outness) on relationship functioning (relationship quality and negative relationship interactions), (b) interactions between individual and partner stress as predictors of relationship functioning, and (c) dyadic coping and relationship length as moderators of actor and partner effects. METHOD Actor-partner interdependence models were tested using data from 153 young male couples. RESULTS There was strong support for actor effects. Higher general stress and internalized stigma were associated with lower relationship quality, but only for those in longer relationships. Additionally, higher general stress, internalized stigma, and microaggressions, and lower outness, were associated with more negative relationship interactions. There was limited support for partner effects. Having a partner with higher internalized stigma was associated with more negative relationship interactions, but none of the other partner effects were significant. There was no support for individual and partner stress interacting to predict relationship functioning or for dyadic coping as a stress buffer. CONCLUSIONS Findings highlight the influence of one's own experiences of general and minority stress on relationship functioning, but raise questions about how partner stress influences relationship functioning among young male couples. (PsycINFO Database Record
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Affiliation(s)
- Brian A Feinstein
- Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine
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Ridgway JP, Almirol EA, Schmitt J, Schuble T, Schneider JA. Travel Time to Clinic but not Neighborhood Crime Rate is Associated with Retention in Care Among HIV-Positive Patients. AIDS Behav 2018; 22:3003-3008. [PMID: 29600423 PMCID: PMC6076870 DOI: 10.1007/s10461-018-2094-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [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: 10/17/2022]
Abstract
Using geospatial analysis, we examined the relationship of distance between a patient's residence and clinic, travel time to clinic, and neighborhood violent crime rates with retention in care or viral suppression among people living with HIV (PLWH). For HIV-positive patients at a large urban clinic, we measured distance and travel time between home and clinic and violent crime rate within a two block radius of the travel route. Kruskal-Wallis rank sum was used to compare outcomes between groups. Over the observation period, 2008-2016, 219/602 (36%) patients were retained in care. Median distance from clinic was 3.6 (IQR 2.1-5.6) miles versus 3.9 (IQR 2.7-6.1) miles among those retained versus not retained in care, p = 0.06. Median travel time by car was 15.9 (IQR 9.6-22.9) versus 17.1 (IQR 12.0-24.6) minutes for those retained versus not retained, p = 0.04. Violent crime rate along travel route was not associated with retention. There was no significant association between travel time or distance and viral suppression.
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Affiliation(s)
- Jessica P Ridgway
- Department of Medicine, University of Chicago, 5841 S Maryland Ave, MC 5065, 60637, Chicago, IL, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Ellen A Almirol
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Jessica Schmitt
- Department of Medicine, University of Chicago, 5841 S Maryland Ave, MC 5065, 60637, Chicago, IL, USA
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
| | - Todd Schuble
- Research Computing Center, University of Chicago, Chicago, IL, USA
| | - John A Schneider
- Department of Medicine, University of Chicago, 5841 S Maryland Ave, MC 5065, 60637, Chicago, IL, USA.
- Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA.
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Bouris A, Jaffe K, Eavou R, Liao C, Kuhns L, Voisin D, Schneider JA. Project nGage: Results of a Randomized Controlled Trial of a Dyadic Network Support Intervention to Retain Young Black Men Who Have Sex With Men in HIV Care. AIDS Behav 2017; 21:3618-3629. [PMID: 29079949 PMCID: PMC5705428 DOI: 10.1007/s10461-017-1954-8] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [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: 12/31/2022]
Abstract
HIV-positive young black MSM (YBMSM) experience poor outcomes along the HIV care continuum, yet few interventions have been developed expressly for YBMSM retention in care. Project nGage was a randomized controlled trial conducted across five Chicago clinics with 98 HIV-positive YBMSM aged 16-29 between 2012 and 2015. The intervention used a social network elicitation approach with index YBMSM (n = 45) to identify and recruit a support confidant (SC) to the study. Each index-SC dyad met with a social worker to improve HIV-care knowledge, activate dyadic social support, and develop a retention in care plan. Each index and SC also received four mini-booster sessions. Control participants (n = 53) received treatment as usual. Surveys and medical records at baseline, 3-, and 12-months post-intervention assessed visit history (3 or more visits over 12 months; primary outcome), and sociodemographic, network, social-psychological, and behavioral factors. At baseline, there were no differences in age (M = 23.8 years), time since diagnosis (M ≤ 2 years), clinic visits in the previous 12 months (M = 4.1), and medication adherence (68.6 ≥ 90% adherence). In multivariate logistic regression analysis, intervention participants were 3.01 times more likely to have had at least 3 provider visits (95% CI 1.0-7.3) than were control participants over 12 months. Project nGage demonstrates preliminary efficacy in improving retention in care among YBMSM. Results suggest that engaging supportive network members may improve key HIV care continuum outcomes.
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Affiliation(s)
- Alida Bouris
- School of Social Service Administration, University of Chicago, Chicago, IL, USA.
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA.
- Third Coast Center for AIDS Research, University of Chicago and Northwestern University, 969 E. 60th St, Chicago, IL, 60637, USA.
| | - Kaitlyn Jaffe
- Department of Sociology, University of British Columbia, Vancouver, BC, Canada
| | - Rebecca Eavou
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - Chuanhong Liao
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
| | - Lisa Kuhns
- Division of Adolescent Medicine, Ann & Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA
- Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Dexter Voisin
- School of Social Service Administration, University of Chicago, Chicago, IL, USA
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Third Coast Center for AIDS Research, University of Chicago and Northwestern University, 969 E. 60th St, Chicago, IL, 60637, USA
| | - John A Schneider
- Department of Medicine, Chicago Center for HIV Elimination, University of Chicago, Chicago, IL, USA
- Third Coast Center for AIDS Research, University of Chicago and Northwestern University, 969 E. 60th St, Chicago, IL, 60637, USA
- Department of Medicine, University of Chicago, Chicago, IL, USA
- Department of Public Health Sciences, University of Chicago, Chicago, IL, USA
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