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Purpose: In this study, we aimed to assess the clinical characteristics, reasons for referral, and outcomes of patients with brain metastases (BM) referred to the supportive care center. Methods: Equal numbers of patients with melanoma, breast cancer, and lung cancer with (N = 90) and without (N = 90) BM were retrospectively identified from the supportive care database for study. Descriptive statistics were used to analyze demographic, disease, and clinical data. Kaplan Meier method was used to evaluate survival outcomes. Results: While physical symptom management was the most common reason for referral to supportive care for both patients with and without BM, patients with BM had significantly lower pain scores on ESAS at time of referral (p = 0.002). They had greater interaction with acute care in the last weeks of life, with higher rates of ICU admission, emergency room visits, and hospitalizations after initial supportive care (SC) visit. The median survival time from referral to Supportive Care Center (SCC) was 0.90 years (95% CI 0.73, 1.40) for the brain metastasis group and 1.29 years (95% CI 0.91, 2.29) for the group without BM. Conclusions: Patients with BM have shorter survival and greater interaction with acute care in the last weeks of life. This population also has distinct symptom burdens from patients without BM. Strategies to optimize integration of SC for patients with BM warrant ongoing study. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused havoc in the health sector. Inflammatory cytokines play an important role in the disease condition. Existing evidence has provided certain insights into the repurposing of the drugs. This meta-analysis and systematic review aimed to explore the efficacy of the administration of interferon beta-1b (IFN β-1b) and standard care versus only standard care as the therapeutic agent for managing COVID-19 patients who are severely ill. The search was conducted in the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Scopus, and Google Scholar, which were published during the period January 1, 2020, to February 16, 2023. All the included three studies were independently assessed for eligibility. The modified data extraction form of Cochrane were used. The quality of the three included studies was assessed using the Cochrane risk of bias tool. GradePro software was used to summarize the quality grading of the primary outcome measures. The time taken for clinical improvement was (MD: - 3.28 days; 95% CI: - 5.65, - 0.91; P value = 0.007) when treated with IFN β-1b. The duration of hospital stays (MD: - 2.43 days; 95% CI: - 4.45, - 0.30; P value = 0.03), and need for intensive care unit (ICU) admission (RR: 0.71; 95% CI: 0.52, 0.97; P value = 0.03) was statistically significant. Interferon beta-1b is proven to reduce the duration of hospital stay, and the improved clinical status may become a cornerstone of COVID-19 treatment. [ABSTRACT FROM AUTHOR]

Black men who have sex with men (BMSM) are disproportionately incarcerated in the United States. Incarceration is a barrier to health equity and may be a risk factor for experiences of interpersonal violence. However, the effect of incarceration on experienced violence among BMSM is understudied. We examined associations between recent incarceration on subsequent experiences of race- or sexuality-based violence, intimate partner violence, or community violence. We analyzed data from the HPTN 061 study. Analysis includes data on 1,169 BMSM recruited from 6 U.S. cities who were present at baseline as well as 6- and 12-month followup interview. We tested if self-reported incarceration between baseline and 6 months was associated with self-reported outcomes between 6 and 12 months using logistic regression with inverse probability of treatment weighting and multiple imputation methods. Experienced outcomes included violence due to race or sexuality, intimate partner violence and aggression, and community violence (i.e., gang violence, robbery, shooting). Approximately 14% reported incarceration between baseline and 6 months and 90% reported experiencing violence between 6 and 12 months. In adjusted analyses, incarceration was associated with subsequent race- or sexuality-based violence [aOR (adjusted odds ratio) range: 1.25-1.41, 95% CI (confidence interval) range: 1.00-1.74], experiences of physical abuse and aggression from intimate partners (aOR: 2.35; 95% CI: 1.50, 3.70) and community violence (OR 1.82; 95% CI: 1.23, 2.72). Recent incarceration experience increased risk of exposure to future violence in this population. Mixed methods research examining mediating paths between and downstream effects of incarceration and violence on the wellbeing and health of BMSM is needed. We implore researchers to study violence and incarceration among BMSM. Practitione should implement strategies such as trauma-informed interventions, and policies strengthening the social and economic support needs of Black populations. [ABSTRACT FROM AUTHOR]

Background: Incarceration is linked to risk of sexually transmitted infection (STI) postrelease among women. There has been little examination of incarceration's association with related sexual and reproductive outcomes such as pelvic inflammatory disease (PID) and pregnancy loss, or the role of STI in this relationship and whether these relationships differ between Black and White women. Methods: Using data from the National Longitudinal Study of Adolescent to Adult Health, we examined cross-sectional associations between incarceration (Wave IV; 2007–2008; ages 24–34) and history of STI and PID (n = 5,968), and longitudinal associations between incarceration and later pregnancy loss in mid-adulthood (Wave V; 2016–2018; ages 34–43) among women who had ever been pregnant (n = 2,353); we estimated racial differences. Using causal mediation, we explored whether STI mediated associations with pregnancy loss. Results: Incarceration was associated with a history of STI (White adjusted prevalence ratio [APR]: 1.54, 95% confidence interval [CI] 1.14–2.06; Black APR: 1.26, 95% CI 1.02–1.56); the association between incarceration and PID was null among White women (APR: 0.99, 95% CI 0.47–2.09) and elevated among Black women (APR: 2.82, 95% CI 1.36–5.83). Prior incarceration did not appear associated with pregnancy loss among White women (APR: 1.01, 95% CI 0.70–1.45), but was associated among Black women (APR: 1.38, 95% CI: 0.97–1.97), with STI appearing to partially mediate. Conclusions: Pregnancy loss may be elevated among Black women who have been incarcerated, and incarceration-related increases in STI may account for some of this association. [ABSTRACT FROM AUTHOR]

Reports conflict on how HIV infection influences the clinical course of COVID-19. The New York City (NYC) public hospital system provides care for over 14,000 people with HIV, was central in responding to the COVID-19 pandemic, and is therefore in a unique position to evaluate the intersection of these concurrent infections. Retrospective chart review of patients presenting to NYC Health and Hospitals (NYC H+H) diagnosed with COVID-19 infection from March 1, 2020, through April 28, 2020, compared people living with HIV (PLWH) and a propensity-matched (PM) control group of patients without HIV to evaluate associations between HIV status and COVID-19 outcomes. Two hundred thirty-four PLWH presented for COVID-19 testing and 110 (47%) were diagnosed with COVID-19. Among 17,413 patients with COVID-19 and without HIV, 1:n nearest neighbor propensity score matching identified 194 patients matched on age, sex, race, and any comorbidity. In the sample with COVID-19 (N = 304), PLWH (9.1%) had lower rates of mortality than controls [19.1%; PM odds ratio (PM-OR): 0.41, 95% confidence interval (CI): 0.19–0.86]. Among hospitalized COVID-19 patients (N = 179), HIV infection was associated with lower rates of mechanical ventilation (PM-OR: 0.31, 95% CI: 0.11–0.84) and mortality (PM-OR: 0.40, 95% CI: 0. 17–0.95). In the extended pandemic period through April 2021, aggregate data by HIV status suggested elevated hospitalization and mortality rates in PLWH versus people without HIV. These results suggest that the direct biological impacts of the HIV virus do not negatively influence COVID-19-related outcomes when controlling for comorbidity and demographic variables. [ABSTRACT FROM AUTHOR]

Background Evidence suggests that individuals with history of substance use disorder (SUD) are at increased risk of COVID-19, but little is known about relationships between SUDs, overdose and COVID-19 severity and mortality. This study investigated risks of severe COVID-19 among patients with SUDs. Methods We conducted a retrospective review of data from a hospital system in New York City. Patient records from 1 January to 26 October 2020 were included. We assessed positive COVID-19 tests, hospitalizations, intensive care unit (ICU) admissions and death. Descriptive statistics and bivariable analyses compared the prevalence of COVID-19 by baseline characteristics. Logistic regression estimated unadjusted and sex-, age-, race- and comorbidity-adjusted odds ratios (AORs) for associations between SUD history, overdose history and outcomes. Results Of patients tested for COVID-19 (n  = 188 653), 2.7% (n  = 5107) had any history of SUD. Associations with hospitalization [AORs (95% confidence interval)] ranged from 1.78 (0.85–3.74) for cocaine use disorder (COUD) to 6.68 (4.33–10.33) for alcohol use disorder. Associations with ICU admission ranged from 0.57 (0.17–1.93) for COUD to 5.00 (3.02–8.30) for overdose. Associations with death ranged from 0.64 (0.14–2.84) for COUD to 3.03 (1.70–5.43) for overdose. Discussion Patients with histories of SUD and drug overdose may be at elevated risk of adverse COVID-19 outcomes. [ABSTRACT FROM AUTHOR]

Unhealthy alcohol use, smoking, and depressive symptoms are risk factors for cardiovascular disease (CVD). Little is known about their co-occurrence – termed a syndemic, defined as the synergistic effect of two or more conditions—on CVD risk in people with HIV (PWH). We used data from 5621 CVD-free participants (51% PWH) in the Veteran's Aging Cohort Study-8, a prospective, observational study of veterans followed from 2002 to 2014 to assess the association between this syndemic and incident CVD by HIV status. Diagnostic codes identified cases of CVD (acute myocardial infarction, stroke, heart failure, peripheral artery disease, and coronary revascularization). Validated measures of alcohol use, smoking, and depressive symptoms were used. Baseline number of syndemic conditions was categorized (0, 1, ≥ 2 conditions). Multivariable Cox Proportional Hazards regressions estimated risk of the syndemic (≥ 2 conditions) on incident CVD by HIV-status. There were 1149 cases of incident CVD (52% PWH) during the follow-up (median 10.1 years). Of the total sample, 64% met our syndemic definition. The syndemic was associated with greater risk for incident CVD among PWH (Hazard Ratio [HR] 1.87 [1.47–2.38], p < 0.001) and HIV-negative veterans (HR 1.70 [1.35–2.13], p < 0.001), compared to HIV-negative with zero conditions. Among those with the syndemic, CVD risk was not statistically significantly higher among PWH vs. HIV-negative (HR 1.10 [0.89, 1.37], p =.38). Given the high prevalence of this syndemic combined with excess risk of CVD, these findings support linked-screening and treatment efforts. [ABSTRACT FROM AUTHOR]

Introduction: Emergency department (ED) patients have higher than average levels of food insecurity. We examined the association between multiple measures of food insecurity and frequent ED use in a random sample of ED patients. Methods: We completed survey questionnaires with randomly sampled adult patients from an urban public hospital ED (n = 2,312). We assessed food insecurity using four questions from the United States Department of Agriculture Household Food Security Survey. The primary independent variable was any food insecurity, defined as an affirmative response to any of the four items. Frequent ED use was defined as self-report of ≥4 ED visits in the past year. We examined the relationship between patient food insecurity and frequent ED use using bivariate and multivariable analyses and examined possible mediation by anxiety/depression and overall health status. Results: One-third (30.9%) of study participants reported frequent ED use, and half (50.8%) reported any food insecurity. Prevalence of food insecurity was higher among frequent vs. nonfrequent ED users, 62.8% vs 45.4% (P <0.001). After controlling for potential confounders, food insecurity remained significantly associated with frequent ED use (adjusted odds ratio 1.48, 95% confidence interval, 1.20-1.83). This observed association was partially attenuated when anxiety/depression and overall health status were added to models. Conclusion: The high observed prevalence of food insecurity suggests that efforts to improve care of ED patients should assess and address this need. Further research is needed to assess whether addressing food insecurity may play an important role in efforts to reduce frequent ED use for some patients. [ABSTRACT FROM AUTHOR]

Black men who have sex with men (BMSM) have disproportionate HIV/STI acquisition risk. Incarceration may increase exposure to violence and exacerbate psychosocial vulnerabilities, including internalized homophobia, which are associated with HIV/STI acquisition risk. Using data from HIV Prevention Trials Network 061 (N = 1553), we estimated adjusted prevalence ratios (APR) and 95% confidence intervals (CIs) for associations between lifetime burden of incarceration and HIV/STI risk outcomes. We measured associations between incarceration and HIV/STI risk outcomes with hypothesized mediators of recent violence victimization and internalized homophobia. Compared to those never incarcerated, those with 3–9 or ≥ 10 incarcerations had approximately 10% higher prevalence of multiple partnerships. Incarceration burden was associated with selling sex (1–2 incarcerations: APR: 1.52, 95% CI 1.14–2.03; 3–9: APR: 1.77, 95% CI 1.35–2.33; ≥ 10: APR: 1.85, 95% CI 1.37–2.51) and buying sex (≥ 10 incarcerations APR: 1.80, 95% CI 1.18–2.75). Compared to never incarcerated, 1–2 incarcerations appeared to be associated with current chlamydia (APR: 1.47, 95% CI 0.98–2.20) and 3–9 incarcerations appeared to be associated with current syphilis (APR: 1.46, 95% CI 0.92–2.30). Incarceration was independently associated with violence, which in turn was a correlate of transactional sex. Longitudinal research is warranted to clarify the role of incarceration in violence and HIV/STI risk in this population. [ABSTRACT FROM AUTHOR]

Childhood abuse and homelessness are independently associated with substance use. Though childhood abuse and homelessness are strongly correlated, research on the joint effect of exposure to both traumatic life events on substance use is limited. Objective: To estimate independent and joint effects of childhood abuse and homelessness on substance use risk during emerging adulthood and adulthood. Methods: Using the National Longitudinal Study of Adolescent to Adult Health (N = 12,288), we measured associations between exposure to physical or sexual abuse in childhood, homelessness in childhood or emerging adulthood, or exposure to both traumas and outcomes of binge drinking, marijuana use, cocaine use, methamphetamine use, and prescription opioid misuse during emerging adulthood (Wave III, ages 18–26 years) and adulthood (Wave IV, ages 24–32 years). Results: In adjusted analyses, exposure to childhood abuse alone, homelessness alone, and both childhood abuse and homelessness were significant correlates of most substance use indicators in emerging adulthood. Those jointly exposed to childhood abuse and homelessness had disproportionate risk of substance use, particularly use of cocaine (adjusted odds ratio (AOR)=4.25, 95% confidence interval (CI): 2.70, 6.71) and methamphetamine (AOR = 6.59, 95% CI: 3.87, 11.21). The independent and combined effects of abuse and homelessness generally persisted into adulthood though associations tended to weaken. Conclusions/Importance: Those with exposure to abuse, homelessness, and both adverse outcomes constitute a high-risk population for substance use. Addressing abuse and homelessness should be a component of preventing drug risk for screening, treatment, and prevention efforts. [ABSTRACT FROM AUTHOR]

Background: We aimed to investigate the impact of reducing drinking in patients with unhealthy alcohol use on improvement of chronic pain interference, substance use, and psychiatric symptoms. Methods: We analyzed longitudinal data from 2003 to 2015 in the Veterans Aging Cohort Study, a prospective, multisite observational study of US veterans, by emulating a hypothetical randomized trial (a target trial). Alcohol use was assessed using the Alcohol Use Disorders Identification Test (AUDIT) questionnaire, and outcome conditions were assessed via validated survey items. Individuals were followed from the first time their AUDIT score was ≥ 8 (baseline), a threshold consistent with unhealthy alcohol use. We compared individuals who reduced drinking (AUDIT < 8) at the next follow‐up visit with individuals who did not (AUDIT ≥ 8). We fit separate logistic regression models to estimate odds ratios for improvement of each condition 2 years postbaseline among individuals who had that condition at baseline: moderate or severe pain interference symptoms, tobacco smoking, cannabis use, cocaine use, depressive symptoms, and anxiety symptoms. Inverse probability weighting was used to account for potential selection bias and confounding. Results: Adjusted 2‐year odds ratios (95% confidence intervals) for associations between reducing drinking and improvement or resolution of each condition were as follows: 1.49 (0.91, 2.42) for pain interference symptoms, 1.57 (0.93, 2.63) for tobacco smoking, 1.65 (0.92, 2.95) for cannabis use, 1.83 (1.03, 3.27) for cocaine use, 1.11 (0.64, 1.92) for depressive symptoms, and 1.33 (0.80, 2.22) for anxiety symptoms. Conclusions: We found some evidence for improvement of pain interference symptoms and substance use after reducing drinking among US veterans with unhealthy alcohol use, but confidence intervals were wide. [ABSTRACT FROM AUTHOR]

Background and aims Examination of longitudinal relationships between childhood traumatic experiences and drug use across the life-course at the national level, with control of confounding by other forms of trauma, is needed. We aimed to estimate the prevalence of nine typologies of childhood traumas and the cumulative number experienced, correlation between traumas and associations between individual and cumulative number of traumas with drug use during adolescence, emerging adulthood and adulthood. Design Secondary data analysis using the National Longitudinal Study of Adolescent to Adult Health. Setting United States. Participants A nationally representative sample of individuals in grades 7-12 (aged 11-21 years) during 1994-95, who were re-interviewed during emerging adulthood (2001-02; aged 18-28) and adulthood (2007-08; aged 24-34). The analytical sample comprised 12 288 participants with data at all three waves. Measurements Nine typologies of childhood traumas: neglect; emotional, physical and sexual abuse; parental incarceration and binge drinking; and witnessing, being threatened with and experiencing violence. Indicators of each were summed to measure cumulative dose. Outcomes were marijuana and cocaine use during adolescence, emerging adulthood and adulthood. Findings Approximately half experienced at least one childhood trauma; traumas were not highly correlated. We observed a dose-response relationship between the number of traumas and drug use in adolescence [marijuana, adjusted odds ratio (aOR) one trauma versus none = 1.65, 95% confidence interval (CI) = 1.42, 1.92; two traumas = 2.58, 95% CI = 2.17, 3.06; ≥ four traumas = 6.92, 95% CI = 5.17, 9.26; cocaine, aOR one trauma = 1.87, 95% CI = 1.23, 2.84; two traumas = 2.80, 95% CI = 1.74, 4.51; ≥ four traumas = 9.54, 95% CI = 5.93, 15.38]. Similar dose-response relationships with drug use were observed in emerging adulthood and adulthood. Each individual trauma was associated independently with either marijuana or cocaine use in adolescence, emerging adulthood and/or adulthood. Conclusions Childhood trauma is prevalent in the United States, and individual types as well as the total number experienced are associated significantly with marijuana and cocaine use throughout the life-course. [ABSTRACT FROM AUTHOR]

Background: Research on the association between antisocial personality disorder (ASPD) with comorbid mental disorders and sexually transmitted infection (STI)/HIV risk among inmates is scant despite the high prevalence of psychopathology and of STI/HIV in this population. Methods: We used baseline data from Project DISRUPT, a cohort study conducted among incarcerated African American men (n = 207), to measure associations between ASPD and STI/HIV risk. We also conducted latent class analyses (LCAs) to identify subgroups defined by ASPD with comorbid stress, depression, and borderline personality disorder symptoms and measured associations between latent class membership and STI/HIV risk. Results: Approximately 15% had ASPD and 39% reported depression. Controlling for sociodemographics, stress, and depression, ASPD was independently associated with illicit [AOR = 3.23, 95% confidence interval (CI): 1.18–8.87] and injection drug use (AOR: 5.49, 95% CI: 1.23–24.42) but not with sexual risk. LCAs suggested that those at high risk of ASPD were likely to experience co-morbid mental disorders. ASPD comorbid with these disorders was linked to drug and sex risk. Conclusions: STI/HIV prevention for inmates should incorporate diagnosis and treatment of ASPD and comorbid disorders, and interventions to address ASPD-related factors (e.g., impulsivity) that drive STI/HIV risk. [ABSTRACT FROM AUTHOR]

Child sexual abuse is associated with substance use and sexual risk behaviors during adolescence and adulthood, but no known studies have documented associations across the life course in a nationally representative U.S. sample. We used the National Longitudinal Study of Adolescent to Adult Health to measure associations between child sexual abuse and substance use and sexual risk behaviors during adolescence, young adulthood, and adulthood among males and females (n = 11,820). Approximately 10% of females and 7% of males reported child sexual abuse. Associations with substance use were strongest during adolescence and lessened over time. Increased odds of sexual risk among those with a history of child sexual abuse remained consistent through the life course. Significant gender differences existed for some associations (e.g., adulthood multiple partners: males adjusted odds ratio (AOR) = 1.73, 95%CI:1.18, 2.53; females AOR = 1.11, 95%CI:0.79, 1.56). Trauma-informed prevention interventions should address child sexual abuse among both males and females to prevent substance use and sexual risk behavior throughout the life course. [ABSTRACT FROM PUBLISHER]

Background: In the US, nearly half of sexually transmitted infections (STIs) occur among 15–24-year-olds, and disproportionate rates of infections exist among blacks. Modifiable factors that drive STI transmission from adolescence into young adulthood should be identified, especially among this vulnerable population. Methods: The National Longitudinal Study of Adolescent Health (n = 13 123) was used to examine racial differences in the prevalence of adolescent inhalant use and unadjusted and adjusted longitudinal associations between inhalant use and adulthood STI risk. Results: Adolescent inhalant use was more commonly reported by whites than blacks. Inhalant use was an indicator of adulthood multiple partnerships among all groups except black females and was an especially strong indicator of 10 or more past year partnerships among men (white risk ratio (RR): 3.48, 95% confidence interval (CI): 1.46–8.32; black RR: 4.47, 95% CI: 1.34–14.90). Adolescent inhalant use was also predictive of adulthood STI among white women and black men, with black male inhalant users having more than twice the risk of a biologically-confirmed or self-reported STI in adulthood than non-users (RR: 2.35, 95% CI: 1.29–4.25). Conclusions: White adolescents and, more so, black male adolescents inhalant users experience disproportionate adulthood STI risk and, thus, constitute a priority population for STI prevention. [ABSTRACT FROM PUBLISHER]

Institutional delivery is an important factor associated with reduced maternal mortality rate (MMR). MMR in Haiti is high (350 per 100,000) and institutional delivery is low-just over 25 % of women delivered at a health facility in 2010. There also exists substantial rural-urban disparity in delivery with more hospital deliveries in urban than in rural areas. We aimed to study the prevalence and determinants of institutional delivery in a sample of women of childbearing age in rural Haiti. The study took place in Fond des Blancs and Villa, as part of a baseline assessment undertaken prior to implementation of a maternal, child health, nutrition, and water and sanitation program. From October to November 2011, women 15-49 years old (N = 575) were selected using a cross-sectional two-stage sampling strategy. We used descriptive and multivariate logistic regression analyses to assess the prevalence of and factors associated with institutional delivery. The prevalence of institutional delivery was 45.4 %; a rate higher than the national average of 25 %. In adjusted analyses, correlates of institutional delivery were younger maternal age (25 years and younger) (OR 1.82; CI 1.15, 2.90; P = 0.0112), antenatal care receipt (OR 3.70; CI 1.84, 7.43; P = 0.0003) and those who were poor according to our poverty index score classification (OR 2.04; CI 1.13, 3.69; P = 0.0187). This study shows that increased hospital delivery is likely explained by accessibility to antenatal care. Programs that improve access to antenatal care, with concurrent efforts to address structural inequalities that drive socio-economic deprivation, are likely critical to increasing institutional delivery. [ABSTRACT FROM AUTHOR]

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We used the National Longitudinal Study of Adolescent Health (N = 14,322) to measure associations between non-injection crack-cocaine and injection drug use and sexually transmitted infection including HIV (STI/HIV) risk among young adults in the United States and to identify factors that mediate the relationship between drug use and infection. Respondents were categorized as injection drug users, non-injection crack-cocaine users, or non-users of crack-cocaine or injection drugs. Non-injection crack-cocaine use remained an independent correlate of STI when adjusting for age at first sex and socio-demographic characteristics (adjusted prevalence ratio (APR): 1.64, 95 % confidence interval (CI): 1.16-2.31) and sexual risk behaviors including multiple partnerships and inconsistent condom use. Injection drug use was strongly associated with STI (APR: 2.62, 95 % CI: 1.29-5.33); this association appeared to be mediated by sex with STI-infected partners rather than by sexual risk behaviors. The results underscore the importance of sexual risk reduction among all drug users including IDUs, who face high sexual as well as parenteral transmission risk. [ABSTRACT FROM AUTHOR]

Objectives. We examined race differences in the longitudinal associations between adolescent alcohol use and adulthood sexually transmitted infection (STI) risk in the United States. Methods. We estimated multivariable logistic regression models using Waves I (1994-1995: adolescence) and III (2001-2002: young adulthood) of the National Longitudinal Study of Adolescent Health (n=10783) to estimate associations and assess differences between Whites and African Americans. Results. In adjusted analyses, adolescent alcohol indicators predicted adulthood inconsistent condom use for both races but were significantly stronger, more consistent predictors of elevated partnership levels for African Americans than Whites. Among African Americans but not Whites, self-reported STI was predicted by adolescent report of any prior use (adjusted odds ratio [AOR]=1.47; 95% confidence interval [CI]=1.00, 2.17) and past-year history of getting drunk (AOR=1.53; 95% CI=1.01, 2.32). Among Whites but not African Americans, biologically confirmed STI was predicted by adolescent report of past-year history of getting drunk (AOR=1.68; 95% CI=1.07, 2.63) and consistent drinking (AOR=1.65; 95% CI=1.03, 2.65). Conclusions. African American and White adolescent drinkers are priority populations for STI prevention. Prevention of adolescent alcohol use may contribute to reductions in adulthood STI risk. [ABSTRACT FROM AUTHOR]

Black men and people belonging to sexual minority groups are disproportionately impacted by criminal legal involvement and sexually transmitted infections (STIs). Traumatic experiences are often associated with later criminal legal involvement, depression symptoms, sexual risk behavior, and STIs. Research on the joint influence of trauma and incarceration on STI risk among racial and/or sexual minority people is limited. This study tested the association between posttraumatic stress disorder (PTSD) symptoms and incarceration on sexual risk behavior and STI among Black sexual minority men (SMM), a population that may be at higher risk for contracting STIs. Using data from the HIV Prevention Trials Network 061 Study, a longitudinal study of adult Black SMM in six U.S. cities (N = 855), we tested associations between past 6-month incarceration and subsequent sexual risk behavior, STI, and depression symptoms, for those with and without preincarceration PTSD symptoms. PTSD symptoms were elevated among participants who reported Hispanic ethnicity, having sex with both men and women, and previous incarceration. Although there were no significant differences between recent incarceration and sexual risk for those with and without PTSD, incarceration was linked to some sexual risk behaviors regardless of PTSD symptoms. Among people with PTSD symptoms, there was a higher prevalence of sexual risk and depression symptoms, regardless of incarceration. These findings suggest a potentially compounding influence of PTSD symptoms and incarceration on sexual risk and infection among Black SMM. Public Significance Statement: The results of this study show that sexual risk and infection may be amplified for Black sexual minority men with posttraumatic stress disorder symptoms and criminal legal involvement. This study highlights the potential importance of further assessment, intervention, and referrals for newly released racial and sexual minority men with trauma histories, to reduce sexually transmitted infections and promote sexual health. [ABSTRACT FROM AUTHOR]

Treatment with methadone and buprenorphine medications for opioid use disorder (MOUD) during incarceration may lead to better community re-entry, but evidence on these relationships have been mixed. We aimed to identify community re-entry patterns and examine the association between in-jail MOUD and a pattern of successful reentry defined by rare occurrence of reincarceration and preventable healthcare utilization. Data came from a retrospective, observational cohort study of 6066 adults with opioid use disorder who were incarcerated in New York City jails and released to the community during 2011–14. An outcome was community re-entry patterns identified by sequence analysis of 3-year post-release reincarceration, emergency department visits, and hospitalizations. An exposure was receipt of in-jail MOUD versus out-of-treatment (42 % vs. 58 %) for the last 3 days before discharge. The study accounted for differences in baseline demographic, clinical, behavioral, housing, and criminal legal characteristics between in-jail MOUD and out-of-treatment groups via propensity score matching. This study identified five re-entry patterns: stability (64 %), hospitalization (23 %), delayed reincarceration (7 %), immediate reincarceration (4 %), and continuous incarceration (2 %). After addressing confounding, 64 % and 57 % followed the stability pattern among MOUD and out-of-treatment groups who were released from jail in 2011, respectively. In 2012–14, the prevalence of following the stability pattern increased year-by-year while a consistently higher prevalence was observed among those with in-jail MOUD. Sequence analysis helped define post-release stability based on health and criminal legal system involvement. Receipt of in-jail MOUD was associated with a marker of successful community re-entry. • Sequence analysis identified five community re-entry patterns. • 64 % of the cohort members followed the stability pattern. • Receipt of in-jail MOUD contributed to a positive outcome of community re-entry. • In-jail MOUD has potential to break a vicious cycle of reincarceration and addiction. [ABSTRACT FROM AUTHOR]