139 results on '"Fennie, Kristopher P."'
Search Results
102. Genomic Subtraction Followed by Dot Blot Screening of Streptococcus pneumoniae Clinical and Carriage Isolates Identifies Genetic Differences Associated with Strains That Cause Otitis Media
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Pettigrew, Melinda M., primary and Fennie, Kristopher P., additional
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- 2005
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- View/download PDF
103. Electronic monitoring device event modelling on an individual‐subject basis using adaptive Poisson regression
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Knafl, George J., primary, Fennie, Kristopher P., additional, Bova, Carol, additional, Dieckhaus, Kevin, additional, and Williams, Ann B., additional
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- 2004
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104. The Effect of a Community-Based Exercise Intervention on Symptoms and Quality of Life.
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Knobf, M. Tish, Thompson, A. Siobhan, Fennie, Kristopher, and Erdos, Diane
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- 2014
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105. Shadow on My Heart: A Culturally Grounded Concept of HIV Stigma Among Chinese Injection Drug Users.
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Li, Xianhong, Wang, Honghong, He, Guoping, Fennie, Kristopher, and Williams, Ann Bartley
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Although stigma is a significant barrier to HIV prevention and treatment globally, the culture-specific psychosocial processes through which HIV-infected Chinese experience stigma have not been described. This study used grounded theory to explore the social and psychological processes of HIV-related stigma experienced by Chinese injection drug users and proposed a culture-specific concept of stigma. The focus group had six participants, and we conducted 16 individual interviews. The core category emerged as “Double struggle: Returning to normalcy.” Key concepts were dual stigma and family support, while keeping secrets and active drug use were factors influencing the struggle to return to normalcy. Family responsibility played an important role in bringing family members together to cope with HIV. Recommendations for Chinese health care providers include leveraging the traditional Chinese concept of family responsibility to establish a family alliance in response to the dual stigma and providing psychological counseling and education in treatment clinics. [Copyright &y& Elsevier]
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- 2012
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106. Research Corner. Challenges of an Internet-Based Education Intervention in a Randomized Clinical Trial in Critical Care.
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Funk, Marjorie, Rose, Leonie, and Fennie, Kristopher
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The article examines the benefits and challenges of using an Internet-based education intervention in critical care. It cites the education modules for an Internet-based educational intervention for nurses in a randomized clinical trial (RCT) on electrocardiographic monitoring. Particular focus is given to intervention fidelity, along with the prevention of treatment attrition. It notes the problem posed by measurement attrition to an Internet-based RCT.
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- 2010
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107. Effects of nurse-delivered home visits combined with telephone calls on medication adherence and quality of life in HIV-infected heroin users in Hunan of China.
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Honghong Wang, Jun Zhou, Ling Huang, Xianhong Li, Fennie, Kristopher P., and Williams, Ann B.
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AIDS ,PATIENT compliance ,HEROIN abuse ,QUALITY of life ,DRUGS ,HIV-positive persons - Abstract
Aims and objectives. This study aimed to examine the effects of nurse-delivered home visits combined with telephone intervention on medication adherence, and quality of life in HIV-infected heroin users. Background. Drug use is consistently reported as a risk factor for medication non-adherence in HIV-infected people. Design. An experimental, pretests and post-tests, design was used: baseline and at eight months. Methods. A sample of 116 participants was recruited from three antiretroviral treatment sites, and 98 participants completed the study. They were randomly assigned to two groups: 58 in the experimental group and 58 in the control group. The experimental group received nurse-delivered home visits combined with telephone intervention over eight months, while the control group only received routine care. The questionnaire of Community Programs for Clinical Research on AIDS (CPCRA) Antiretroviral Medication Self-Report was used to assess levels of adherence, while quality of life and depression were evaluated using Chinese versions of World Health Organization Quality of Life Instrument – Abbreviated version (WHOQOL-BREF) and Self-rating Depression Scale, respectively. Data were obtained at baseline and eight months. Results. At the end of eight months, participants in the experimental group were more likely to report taking 100% of pills (Fisher’s exact = 14·3, p = 0·0001) and taking pills on time (Fisher’s exact = 18·64, p = 0·0001) than those in the control group. There were significant effects of intervention in physical ( F = 10·47, p = 0·002), psychological ( F = 9·41, p = 0·003), social ( F = 4·09, p = 0·046) and environmental ( F = 4·80, p = 0·031) domains of WHOQOL and depression ( F = 5·58, p = 0·02). Conclusions. Home visits and telephone calls are effective in promoting adherence to antiretroviral treatment and in improving the participants’ quality of life and depressive symptoms in HIV-infected heroin users. Relevance to clinical practice. It is important for nurses to recognise the issues of non-adherence to antiretroviral treatment in heroin users. Besides standard care, nurses should consider conducting home visits and telephone calls to ensure better health outcome of antiretroviral treatment in this population. [ABSTRACT FROM AUTHOR]
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- 2010
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108. Self-Reported Adherence to Antiretroviral Treatment among HIV-Infected People in Central China.
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Honghong Wang, Gouping He, Xianhong Li, Aiyun Yang, Xi Chen, Fennie, Kristopher P., and Williams, Ann Bartley
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ANTIRETROVIRAL agents ,MEDICAL research ,ANTIVIRAL agents ,DRUG abuse ,HIV-positive persons ,AIDS ,TOMOGRAPHY ,PERSONALITY disorders - Abstract
Although the number of patients receiving antiretroviral (ARV) therapy in Central China is expanding, little is known about their medication adherence. The purpose of this study was to: (1) describe adherence prevalence among patients receiving free ARV in south central China; (2) identify factors associated with adherence; (3) compare 3 self-report measures of adherence in this population. A cross-sectional survey was conducted at seven free treatment sites in Hunan, Hubei, and Anhui Provinces. Adherence measures included direct questioning regarding the number of doses taken in the 7 days prior to interview, the Community Programs for Clinical Research on AIDS (CPCRA) Adherence Self-Report questionnaire, and a 7-day visual analogue scale. Subjects comprised all patients returning for monthly ARV follow-up at each site between April and July 2006. Among the 308 subjects, 244 (79%) lived in the countryside. One hundred seventy (55%) had been on ARV over 1 year. No regimen included a protease inhibitor. Two hundred forty-four (80%) reported taking more than 90% of prescribed doses in the previous 7 days. Sixty-four (20%) subjects reported missing at least 1 dose in that period. The three measures of self-reported adherence were highly correlated. On multivariate analysis, current heroin use (odds ratio [OR] = 2.5; 95% confidence interval [CI] 1,6, p = 0.05) and nonuse of reminders such as cell phone alarms, wall charts, or TV programs (OR 6; 95% CI 3, 11; p = 0.001) were associated with 90% or less adherence. Adherence to ARV in Central China is similar to elsewhere in the world. The 20% of subjects who reported taking 90% or fewer doses are of concern in view of the potential for non-nucleoside reverse transcriptase inhibitor resistance and lack of protease inhibitor back-up regimens. Substance abuse treatment will be an essential element of successful AIDS treatment in China. Prospective studies are needed to evaluate the efficacy of reminder devices to improve adherence in this population and to describe the prevalence and incidence of ARV resistance. [ABSTRACT FROM AUTHOR]
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- 2008
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109. Obesity and immune cell counts in women.
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Womack, Julie, Tien, Phyllis C., Feldman, Joseph, Shin, Ja Hyun, Fennie, Kristopher, Anastos, Kathryn, Cohen, Mardge H., Bacon, Melanie C., and Minkoff, Howard
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OBESITY in women ,IMMUNOLOGIC diseases ,BODY mass index ,MULTIVARIATE analysis - Abstract
Abstract: Obesity is common in women and is associated with a number of adverse health outcomes including cardiovascular disease, infectious diseases, and cancer. We explore the relationship between obesity and immune cell counts in women in a longitudinal study of 322 women from 1999 through 2003 enrolled as HIV-negative comparators in the Women''s Interagency HIV Study. Body mass index (BMI, kg/m
2 ) was categorized as normal weight (BMI 18.5-24.9), overweight (BMI 25-29.9), obese (BMI 30-34.9), and morbidly obese (BMI ≥35). CD4 and CD8 counts and percents and total lymphocyte and white blood cell (WBC) counts were measured annually using standardized techniques. A mixed model repeated measures analysis was performed using an autoregressive correlation matrix. At the index visit, 61% of women were African American; mean age was 35 years, and median BMI was 29 kg/m2 . Immunologic parameters were in the reference range (median CD4 count, 995 cells/mm3 ; CD8 count, 488 cells/mm3 ; total lymphocyte count, 206 cells/mm3 ; median WBC, 6 × 103 cells/mm3 ). In multivariate analyses, being overweight, obese, or morbidly obese were independently associated with higher CD4, total lymphocyte, and WBC counts than being normal weight; morbid obesity was associated with a higher CD8 count. The strongest associations between body weight and immune cell counts were demonstrated in the morbidly obese. Increasing body weight is associated with higher CD4, CD8, total lymphocyte, and WBC counts in women. Investigation into the impact of obesity on immune function and long-term adverse outcomes is needed. [Copyright &y& Elsevier]- Published
- 2007
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110. Adherence to Antiretroviral Medication Among HIV-Positive Patients in Thailand.
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Limkulpong Maneesrigwongul, Wantana, Tulathong, Somchit, Fennie, Kristopher P., and Williams, Ann B.
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- 2006
111. Reconstructing a Health System and a Profession Priorities of Iraqi Nurses in the Kurdish Region.
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Squires, Allison, Sindi, Ali, and Fennie, Kristopher
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SURVEYS ,NURSES ,NURSING ,MEDICAL personnel - Abstract
The article cites a study which evaluates nurses' priorities for health system reconstruction and professional development in Iraq. A survey of 744 Iraqi nurses was conducted, with the research process managed through the Internet. Seven definite priorities emerged along with essential differences in priorities related to years of experience, age, specialty of nursing practice, and many others.
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- 2006
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112. Knowledge, Attitudes, Behaviors, and Perceptions of Risk Related to HIV/AIDS among Chinese University Students in Hunan, China.
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Jin Huang, Bova, Carol, Fennie, Kristopher P., Rogers, Angela, and Williams, Ann B.
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HIV infection transmission ,COLLEGE students ,HIV infections ,AIDS ,LENTIVIRUS diseases - Abstract
The purpose of this paper is to describe HIV/AIDS knowledge, attitudes, and perceptions and identify personal risk behaviors among undergraduate students in China. A descriptive, cross-sectional survey of 1326 students between ages 17 through 28 was conducted in 2002. Results indicated that students held considerable misconceptions about HIV transmission by casual contact and needle sharing as well as stigmatizing attitudes about injection drug use, homosexuality and HIV-positive women who bear children. Results indicated that 14% of Chinese university students are sexually active and risk behaviors tended to increase with age. Additionally, 24% of the students considered themselves to be at moderate to very high risk of contracting HIV and 40% of sexually active students never used condoms. Therefore, it is important to design HIV prevention strategies that target university students in China. [ABSTRACT FROM AUTHOR]
- Published
- 2005
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113. Nurses with Sensory Disabilities: Their Perceptions and Characteristics
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Neal‐Boylan, Leslie, Fennie, Kristopher, and Baldauf‐Wagner, Sara
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A survey design was used to explore the perceptions and characteristics of registered nurses (RNs) with sensory disabilities and their risk for leaving their jobs. An earlier study found that nurses with disabilities are leaving nursing and that employers do not appear to support these nurses. Work instability and the mismatch between a nurse's perceptions of his or her ability and the demands of their work increase risk for job retention problems. This study's convenience sample of U.S. RNs had hearing, vision, or communication disabilities. Participants completed a demographic form, three U.S. Census questions, and the Nurse‐Work Instability Survey. Hospital nurses were three times more likely to be at risk for retention problems. Nurses with hearing disabilities were frustrated at work. Hearing difficulties increased with years spent working as a nurse. Many nurses with sensory disabilities have left nursing. Early intervention may prevent work instability and increase retention, and rehabilitation nurses are ideally positioned to lead early intervention programs.
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- 2011
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114. Variation in the Presence of Neuraminidase Genes among Streptococcus pneumoniaeIsolates with Identical Sequence Types
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Pettigrew, Melinda M., Fennie, Kristopher P., York, Matthew P., Daniels, Janeen, and Ghaffar, Faryal
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ABSTRACTStreptococcus pneumoniaefrequently colonizes the upper respiratory tract of young children and is an important cause of otitis media and invasive disease. Carriage is more common than disease, yet the genetic factors that predispose a given clone for disease are not known. The relationship between capsule type, genetic background, and virulence is complex, and important questions remain regarding how pneumococcal clones differ in their ability to cause disease. Pneumococcal neuraminidase cleaves sialic acid-containing substrates and is thought to be important for pneumococcal virulence. We describe the distribution of multilocus sequence types (ST), capsule type, and neuraminidase genes among 342 carriage, middle ear, blood, and cerebrospinal fluid (CSF) pneumococcal strains from young children. We found 149 STs among our S. pneumoniaeisolates. nanAwas present in all strains, while nanBand nanCwere present in 96% and 51% of isolates, respectively. The distribution of nanCvaried among the strain collections from different tissue sources (P= 0.03). The prevalence of nanCwas 1.41 (95% confidence interval, 1.11, 1.79) times higher among CSF isolates than among carriage isolates. We identified isolates of the same ST that differed in the presence of nanBand nanC. These studies demonstrate that virulence determinants, other than capsule loci, vary among strains of identical ST. Our studies suggest that the presence of nanCmay be important for tissue-specific virulence. Studies that both incorporate MLST and take into account additional virulence determinants will provide a greater understanding of the pneumococcal virulence potential.
- Published
- 2006
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115. Genomic Subtraction Followed by Dot Blot Screening of Streptococcus pneumoniaeClinical and Carriage Isolates Identifies Genetic Differences Associated with Strains That Cause Otitis Media
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Pettigrew, Melinda M. and Fennie, Kristopher P.
- Abstract
ABSTRACTStreptococcus pneumoniaestrains are the leading cause of bacterial otitis media, yet little is known about specific bacterial factors important for this disease. We utilized a molecular epidemiological approach involving genomic subtraction of the S. pneumoniaeserogroup 19 middle ear strain 5093 against the laboratory strain R6. Resulting subtraction PCR (sPCR) products were used to screen a panel of 93 middle ear, 90 blood, 35 carriage, and 58 cerebrospinal fluid isolates from young children to identify genes found more frequently among middle ear isolates. Probe P41, similar to a hypothetical protein of Brucella melitensis, occurred among 41% of middle ear isolates and was found 2.8 (95% confidence interval [CI], 1.32 to 6.5), 3.3 (95% CI, 1.9 to 5.7), and 1.8 (95% CI, 1.1 to 3.0) times more frequently among middle ear strains than carriage, blood, or meningitis strains, respectively. sPCR fragment H10, similar to an unknown Streptococcus agalactiaeprotein, was present in 31% of middle ear isolates and occurred 3.6 (95% CI, 1.2 to 11.2), 2.8 (95% CI, 1.5 to 5.4), and 2.6 (95% CI, 1.2 to 5.5) times more often among middle ear isolates than carriage, blood, or meningitis strains, respectively. These studies have identified two genes of potential importance in otitis media virulence. Further studies are warranted to outline the precise role of these genes in otitis media pathogenesis.
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- 2005
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116. Florida Efforts to Address Covid-19 A Model for National Replication
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Merritt, Lisa, Zabriske, Queen Meccasia, Fennie, Kristopher, and Booher, Janice T.
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- 2020
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117. Additional file 1 of Sustained HIV viral suppression among men who have sex with men in the Miami-Dade County Ryan White Program: the effect of demographic, psychosocial, provider and neighborhood factors
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Sheehan, Diana M., Dawit, Rahel, Semiu O. Gbadamosi, Fennie, Kristopher P., Li, Tan, Merhawi Gebrezgi, Brock, Petra, Ladner, Robert A., and Trepka, Mary Jo
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3. Good health - Abstract
Additional file 1. Variables considered for health need and psychosocial indices
118. Additional file 1 of Sustained HIV viral suppression among men who have sex with men in the Miami-Dade County Ryan White Program: the effect of demographic, psychosocial, provider and neighborhood factors
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Sheehan, Diana M., Dawit, Rahel, Semiu O. Gbadamosi, Fennie, Kristopher P., Li, Tan, Merhawi Gebrezgi, Brock, Petra, Ladner, Robert A., and Trepka, Mary Jo
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3. Good health - Abstract
Additional file 1. Variables considered for health need and psychosocial indices
119. Perceived neighborhood social cohesion moderates the relationship between neighborhood structural disadvantage and adolescent depressive symptoms.
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Dawson, Christyl T., Wu, Wensong, Fennie, Kristopher P., Ibañez, Gladys, Cano, Miguel Á., Pettit, Jeremy W., and Trepka, Mary Jo
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SOCIAL cohesion , *SOCIAL perception , *NEIGHBORHOODS , *MULTILEVEL models , *SOCIAL context - Abstract
There is a dearth of research exploring the moderating role of the social environment on neighborhood structural disadvantage and depressive symptoms, particularly among adolescents. Therefore, we examined if adolescent perceptions of neighborhood social cohesion and safety moderated the association between neighborhood structural disadvantage and adolescent depressive symptoms. This cross-sectional study used data from the National Longitudinal Study of Adolescent to Adult Health (Add Health). The study sample consisted of 12,105 adolescents enrolled in 9th-12th grades during the 1994-1995 school year across the United States (U.S.). Mixed effects multilevel modeling was used to determine if adolescent perceptions of neighborhoods moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms. Results showed that perceived neighborhood social cohesion moderated the relationship between neighborhood structural disadvantage and adolescent depressive symptoms (p ≤ 0.001). At higher levels of perceived neighborhood social cohesion, neighborhood structural disadvantage was associated with decreased depressive symptoms. Findings suggest that improving perceived neighborhood social cohesion may decrease adolescent depressive symptoms, particularly in neighborhoods with high disadvantage. This aspect of the neighborhood social environment may serve as a target for structural and other interventions to address the growing burden of depression among adolescents. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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120. Racial Residential Segregation and STI Diagnosis Among Non-Hispanic Blacks, 2006-2010.
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Lutfi, Khaleeq, Trepka, Mary Jo, Fennie, Kristopher P., Ibañez, Gladys, and Gladwin, Hugh
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SEXUALLY transmitted disease diagnosis , *SEXUALLY transmitted disease risk factors , *POPULATION , *HISPANIC Americans , *BLACK people , *RACE , *SOCIOECONOMIC factors , *SURVEYS , *RESEARCH funding , *POVERTY , *DATA analysis software - Abstract
Sexually transmitted infections (STI) disproportionately impact non-Hispanic blacks. Racial residential segregation has been associated with negative socioeconomic outcomes. We sought to examine the association between segregation and STI diagnosis among blacks. The National Survey of Family Growth and US Census served as data sources. Five distinct dimensions represent segregation. The association between STI diagnosis and each segregation dimension was assessed with multilevel logistic regression modeling. 305 (7.4%) blacks reported STI diagnosis during the past 12 months. Depending on the dimension, segregation was a risk factor [dissimilarity aOR 2.41 (95% CI 2.38-2.43)] and a protective factor [isolation aOR 0.90 (95% CI 0.89-0.91)] for STI diagnosis. Findings suggest that STI diagnosis among blacks is associated with segregation. Additional research is needed to identify mechanisms for how segregation affects STI diagnosis and to aid in the development of interventions to decrease STIs. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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121. Abstract 210
- Author
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Funk, Marjorie, Fennie, Kristopher, Stephens, Kimberly, and May, Jeanine
- Abstract
Background & Objective:The PULSE Trial is a 5-year multisite randomized clinical trial to evaluate implementation of American Heart Association Practice Standards for Electrocardiographic Monitoring on nurses' knowledge, quality of care, and patient outcomes. The primary intervention was an online ECG monitoring education program for nurses. A key indicator in assessing patient outcomes is the incidence of myocardial infarction (MI) while on a monitored unit. Determination of MI while in hospital can be challenging, requiring time-consuming medical record review. We propose a method of reducing the number of medical records necessary for review to determine occurrence of an in-hospital MI by using an algorithm that incorporates administrative and laboratory data.
- Published
- 2014
122. Acceptance of Opt-Out HIV Screening in Outpatient Settings in the United States: A Systematic Review and Meta-Analysis.
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Gebrezgi, Merhawi T., Mauck, Daniel E., Sheehan, Diana M., Fennie, Kristopher P., Cyrus, Elena, Degarege, Abraham, and Trepka, Mary Jo
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DIAGNOSIS of HIV infections , *HIV prevention , *HIV infection risk factors , *CINAHL database , *CONFIDENCE intervals , *OUTPATIENT services in hospitals , *MEDICAL care , *MEDICAL screening , *MEDLINE , *META-analysis , *ONLINE information services , *RISK management in business , *SYSTEMATIC reviews - Abstract
Objectives: In the United States, about 15% of persons living with HIV infection do not know they are infected. Opt-out HIV screening aims to normalize HIV testing by performing an HIV test during routine medical care unless the patient declines. The primary objective of this systematic review and meta-analysis was to assess the acceptance of opt-out HIV screening in outpatient settings in the United States. Methods: We searched in PubMed and CINAHL (Cumulative Index to Nursing and Allied Health Literature) for studies published from January 1, 2006, through December 31, 2018, of opt-out HIV screening in outpatient settings. We collected data from selected studies and calculated for each study (1) the percentage of persons who were offered HIV testing, (2) the percentage of persons who accepted the test, and (3) the percentage of new HIV diagnoses among persons tested. We also collected information on the reasons given by patients for opting out. The meta-analysis used a random-effects model to estimate the average percentages of HIV testing offered, HIV testing accepted, and new HIV diagnoses. Results: We initially identified 6986 studies; the final analysis comprised 14 studies. Among the 8 studies that reported the size of the study population eligible for HIV screening, 71.4% (95% confidence interval [CI], 53.9%-89.0%) of the population was offered an HIV test on an opt-out basis. The test was accepted by 58.7% (95% CI, 47.2%-70.2%) of persons offered the test. Among 9 studies that reported data on new HIV diagnoses, 0.18% (95% CI, 0.08%-0.26%) of the persons tested had a new HIV diagnosis. Patients' most frequently cited reasons for refusal of HIV screening were that they perceived a low risk of having HIV or had previously been tested. Conclusions: The rates of offering and accepting an HIV test on an opt-out basis could be improved by addressing health system and patient-related factors. Setting a working target for these rates would be useful for measuring the success of opt-out HIV screening programs. [ABSTRACT FROM AUTHOR]
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- 2019
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123. Role of Country of Birth, Testing Site, and Neighborhood Characteristics on Nonlinkage to HIV Care Among Latinos
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Theophile Niyonsenga, Merhawi T. Gebrezgi, Elena Cyrus, Julie H. Levison, Mary Jo Trepka, Lorene M. Maddox, Kristopher P. Fennie, Chelsea Cosner, Emma C Spencer, Diana M. Sheehan, Sheehan, Diana M, Cosner, Chelsea, Fennie, Kristopher P, Gebrezgi, Merhawi T, Cyrus, Elena, Maddox, Lorene M, Levison, Julie H, Spencer, Emma C, Niyonsenga, Theophile, and Trepka, Mary Jo
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Male ,Hispanics ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,0302 clinical medicine ,Residence Characteristics ,Risk Factors ,Prevalence ,Medicine ,Mass Screening ,030212 general & internal medicine ,human immunodeficiency virus ,Cuba ,Hispanic or Latino ,Continuity of Patient Care ,Middle Aged ,Viral Load ,Case management ,Infectious Diseases ,symbols ,Florida ,Female ,0305 other medical science ,Viral load ,Adult ,animal structures ,Adolescent ,Anti-HIV Agents ,Emigrants and Immigrants ,Hiv testing ,03 medical and health sciences ,symbols.namesake ,Humans ,Country of birth ,Poisson regression ,Latinos ,Healthcare Disparities ,linkage to care ,neighborhood ,Retrospective Studies ,030505 public health ,business.industry ,Puerto Rico ,Public Health, Environmental and Occupational Health ,Retrospective cohort study ,Confidence interval ,United States ,testing site ,Behavioral and Psychosocial Research ,business ,Case Management ,Demography - Abstract
The objective of this study was to estimate disparities in linkage to human immunodeficiency virus (HIV) care among Latinos by country/region of birth, HIV testing site, and neighborhood characteristics. A retrospective study was conducted using Florida HIV surveillance records of Latinos/Hispanics aged 13 diagnosed during 2014-2015. Linkage to HIV care was defined as a laboratory test (HIV viral load or CD4) within 3 months of HIV diagnosis. Multi-level Poisson regression models were used to estimate adjusted prevalence ratios (aPR) for nonlinkage to care. Of 2659 Latinos, 18.8% were not linked to care within 3 months. Compared with Latinos born in mainland United States, those born in Cuba [aPR 0.60, 95% confidence interval (CI) 0.47-0.76] and Puerto Rico (aPR 0.61, 95% CI 0.41-0.90) had a decreased prevalence of nonlinkage. Latinos diagnosed at blood banks (aPR 2.34, 95% CI 1.75-3.12), HIV case management and screening facilities (aPR 1.76, 95% CI 1.46-2.14), and hospitals (aPR 1.42, 95% CI 1.03-1.96) had an increased prevalence of nonlinkage compared with outpatient general, infectious disease, and tuberculosis/sexually transmitted diseases/family planning clinics. Latinos who resided in the lowest (aPR 1.57, 95% CI 1.19-2.07) and third lowest (aPR 1.33, 95% CI 1.01-1.76) quartiles of neighborhood socioeconomic status compared with the highest quartile were at increased prevalence. Latinos who resided in neighborhoods with
- Published
- 2018
124. Racial/Ethnic Disparities in Failure to Initiate HIV Care: Role of HIV Testing Site, Individual Factors, and Neighborhood Factors, Florida, 2014–2015
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Diana M. Sheehan, Mary Jo Trepka, Lorene M. Maddox, Daniel E. Mauck, Kristopher P. Fennie, Spencer Lieb, Theophile Niyonsenga, Trepka, Mary Jo, Sheehan, Diana M, Fennie, Kristopher P, Mauck, Daniel E, Lieb, Spencer, Maddox, Lorene M, and Niyonsenga, Theophile
- Subjects
Adult ,Male ,Adolescent ,poverty ,Population ,Ethnic group ,Individuality ,social determinants ,HIV Infections ,Article ,White People ,03 medical and health sciences ,symbols.namesake ,Young Adult ,0302 clinical medicine ,Acquired immunodeficiency syndrome (AIDS) ,Residence Characteristics ,medicine ,HIV care linkage ,Outpatient clinic ,Humans ,Mass Screening ,030212 general & internal medicine ,Social determinants of health ,Poisson regression ,Healthcare Disparities ,education ,neighborhood ,education.field_of_study ,030505 public health ,business.industry ,HIV testing site ,Public Health, Environmental and Occupational Health ,Hispanic or Latino ,Middle Aged ,Patient Acceptance of Health Care ,medicine.disease ,Confidence interval ,Black or African American ,Socioeconomic Factors ,Donation ,symbols ,Florida ,Female ,0305 other medical science ,business ,Demography - Abstract
Delayed initiation of human immunodeficiency virus (HIV) care affects disease progression. To determine the role of HIV testing site and neighborhood-and individual-level factors in racial/ethnic disparities in initiation of care, we examined Florida population-based HIV/AIDS surveillance system records. We performed multilevel Poisson regression to calculate adjusted prevalence ratios (APR) for non-initiation of care by race/ethnicity adjusting for HIV testing site type and individual-and neighborhood-level characteristics. Of 8,913 people diagnosed with HIV during 2014-2015 in the final dataset, 18.3% were not in care within three months of diagnosis. The APR for non-initiation of care for non-Hispanic Blacks relative to non-Hispanic Whites was 1.57 (95% confidence interval [CI] 1.38-1.78) and for those tested in plasma/donation centers relative to outpatient clinics was 2.45 (95% CI 2.19-2.74). Testing site and individual variables contribute to racial/ethnic disparities in non-initiation of HIV care. Linkage procedures, particularly at plasma/blood donation centers, warrant improvement. Refereed/Peer-reviewed
- Published
- 2018
125. Sex and Racial/Ethnic Differences in Premature Mortality Due to HIV: Florida, 2000–2009
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Mary Jo Trepka, Lorene M. Maddox, Theophile Niyonsenga, Spencer Lieb, Karma McKelvey, Kristopher P. Fennie, Trepka, Mary Jo, Niyonsenga, Theophile, Fennie, Kristopher P, McKelvey, Karma, Lieb, Spencer, and Maddox, Lorene M
- Subjects
Adult ,Male ,Gerontology ,Ethnic group ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,White People ,Young Adult ,Acquired immunodeficiency syndrome (AIDS) ,Antiretroviral Therapy, Highly Active ,Cause of Death ,Poverty Areas ,Humans ,Medicine ,Minority Health ,Healthcare Disparities ,Sex Distribution ,Young adult ,Cause of death ,Mortality, Premature ,business.industry ,Research ,Public Health, Environmental and Occupational Health ,Hispanic or Latino ,Middle Aged ,medicine.disease ,Confidence interval ,Black or African American ,Early Diagnosis ,Years of potential life lost ,Population Surveillance ,Florida ,Multilevel Analysis ,Female ,Racial/ethnic difference ,business ,Demography - Abstract
Objective. This study aimed to characterize premature mortality among people diagnosed with HIV infection from 2000 to 2009 in Florida, by sex and race/ethnicity, to estimate differences in premature mortality that could be prevented by linkage to HIV care and treatment. Methods. Florida surveillance data for HIV diagnoses (excluding concurrent AIDS diagnoses) were linked with vital records data to ascertain deaths through 2011. Years of potential life lost (YPLL) were obtained from the expected number of remaining years of life at a given age from the U.S. sex-specific period life tables. Results. Among 41,565 people diagnosed with HIV infection during the study period, 5,249 died, and 2,563 (48.8%) deaths were due to HIV/AIDS. Age-standardized YPLL (aYPLL) due to HIV/AIDS per 1,000 person-years was significantly higher for females than males (372.6, 95% confidence interval [CI] 349.8, 396.2 vs. 295.2, 95% CI 278.4, 312.5); for non-Hispanic black (NHB) females than non-Hispanic white (NHW) and Hispanic females (388.2, 95% CI 360.7, 416.9; 294.3, 95% CI 239.8, 354.9; and 295.0, 95% CI 242.9, 352.5, respectively); and for NHB males compared with NHW and Hispanic males (378.7, 95% CI 353.7, 404.7; 210.6, 95% CI 174.3, 250.8; and 240.9, 95% CI 204.8, 280.2, respectively). In multilevel modeling controlling for individual factors, NHB race was associated with YPLL due to HIV/AIDS for women ( p=0.04) and men ( pConclusion. Among people diagnosed with HIV infection, females and NHB people had a disproportionately high premature mortality from HIV/AIDS, suggesting the need for enhanced efforts to improve linkage to and retention in care and medication adherence for these groups.
- Published
- 2015
126. Deaths due to screenable cancers among people living with HIV infection, Florida, 2000-2014
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Mary Jo Trepka, Theophile Niyonsenga, Lorene M. Maddox, Rehab Auf, Diana M. Sheehan, Kristopher P. Fennie, Trepka, Mary Jo, Auf, Rehab, Fennie, Kristopher P, Sheehan, Diana M, Maddox, Lorene M, and Niyonsenga, Theophile
- Subjects
Male ,medicine.medical_specialty ,Epidemiology ,HIV Infections ,Lower risk ,National Death Index ,Article ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Breast cancer ,Pharmacotherapy ,Acquired immunodeficiency syndrome (AIDS) ,Internal medicine ,Neoplasms ,medicine ,Humans ,030212 general & internal medicine ,Lung cancer ,Intensive care medicine ,Early Detection of Cancer ,business.industry ,Mortality rate ,Public Health, Environmental and Occupational Health ,Keywords ,medicine.disease ,Vital Statistics ,030220 oncology & carcinogenesis ,Florida ,Female ,business ,Cohort study - Abstract
Introduction: Because of antiretroviral therapy, people living with HIV infection are surviving longer and are at higher risk for chronic diseases. This study's objective was to assess the magnitude of deaths due to cancers for which there are screening recommendations for people living with HIV in Florida. Methods: Florida Department of Health Enhanced HIV/AIDS Reporting System data were matched with Department of Health Vital Records and the National Death Index to identify deaths and their causes through 2014. The sex-specific and cause-specific mortality rates and indirect standardized mortality ratios (SMRs, using U.S. mortality rates as a standard) were calculated during 2016 for people reported with HIV infection 2000-2014. Results: Despite the competing risk of HIV mortality, among the 25,678 females, there was a higher risk of cervical (SMR=6.32, 95% CI=4.63, 8.44), colorectal (SMR=2.05, 95% CI=1.44, 2.83), liver (SMR=8.96, 95% CI=5.39, 14.03), and lung (SMR=5.82, 95% CI=4.80, 6.96) cancer mortality and lower risk of breast cancer mortality (SMR=0.57, 95% CI=0.42, 0.76). Among 63,493 males, there was a higher risk of liver (SMR=5.50, 95% CI=4.47, 6.70) and lung (4.63, 95% CI=4.11, 5.19) cancer mortality. Among males, the lung cancer SMR significantly declined 2000-2014 (p < 0.05), but was still high in 2012-2014 (SMR=3.59, 95% CI=2.87, 4.43). Conclusions: These results indicate the importance of primary and secondary cancer prevention during primary care for people living with HIV infection. Refereed/Peer-reviewed
- Published
- 2017
127. Sustained HIV viral suppression among men who have sex with men in the Miami-Dade County Ryan White Program: the effect of demographic, psychosocial, provider and neighborhood factors.
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Sheehan, Diana M, Dawit, Rahel, Gbadamosi, Semiu O, Fennie, Kristopher P, Li, Tan, Gebrezgi, Merhawi, Brock, Petra, Ladner, Robert A, and Trepka, Mary Jo
- Abstract
Background: HIV viral suppression is associated with health benefits for people living with HIV and a decreased risk of HIV transmission to others. The objective was to identify demographic, psychosocial, provider and neighborhood factors associated with sustained viral suppression among gay, bisexual, and other men who have sex with men.Methods: Data from adult men who have sex with men (MSM) enrolled in the Miami-Dade County Ryan White Program (RWP) before 2017 were used. Sustained viral suppression was defined as having an HIV viral load < 200 copies/ml in all viral load tests in 2017. Three-level (individual, medical case management site, and neighborhood) cross-classified mixed-effect models were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI) for sustained viral suppression.Results: Of 3386 MSM, 90.8% were racial/ethnic minorities, and 84.4% achieved sustained viral suppression. The odds of achieving sustained viral suppression was lower for 18-24 and 25-34 year-old MSM compared with 35-49 year-old MSM, and for non-Latino Black MSM compared with White MSM. Those not enrolled in the Affordable Care Act, and those with current AIDS symptoms and a history of AIDS had lower odds of achieving sustained viral suppression. Psychosocial factors significantly associated with lower odds of sustained viral suppression included drug/alcohol use, mental health symptoms, homelessness, and transportation to appointment needs. Individuals with an HIV physician who serves a larger volume of RWP clients had greater odds of sustained viral suppression. Neighborhood factors were not associated with sustained viral suppression.Conclusion: Despite access to treatment, age and racial disparities in sustained viral suppression exist among MSM living with HIV. Addressing substance use, mental health, and social services' needs may improve the ability of MSM to sustain viral suppression long-term. Furthermore, physician characteristics may be associated with HIV outcomes and should be explored further. [ABSTRACT FROM AUTHOR]- Published
- 2020
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128. Completeness of HIV reporting on death certificates for Floridians reported with HIV infection, 2000-2011
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Theophile Niyonsenga, Kristopher P. Fennie, Lorene M. Maddox, Spencer Lieb, Mary Jo Trepka, Diana M. Sheehan, Trepka, Mary Jo, Sheehan, Diana M, Fennie, Kristopher P, Niyonsenga, Theophile, Lieb, Spencer, and Maddox, Lorene M
- Subjects
Adult ,Pediatrics ,medicine.medical_specialty ,Health (social science) ,Social Psychology ,Adolescent ,AIDS-Related Opportunistic Infections ,Underlying cause of death ,Human immunodeficiency virus (HIV) ,HIV Infections ,medicine.disease_cause ,World health ,Article ,Death Certificates ,Cohort Studies ,03 medical and health sciences ,cause of death ,Young Adult ,0302 clinical medicine ,Cause of Death ,medicine ,Humans ,030212 general & internal medicine ,vital statistics ,Young adult ,Cause of death ,Aged ,030505 public health ,business.industry ,Public Health, Environmental and Occupational Health ,HIV ,virus diseases ,Middle Aged ,mortality ,Population Surveillance ,Immunology ,Florida ,Female ,Death certificate ,0305 other medical science ,business ,Cohort study - Abstract
Human immunodeficiency virus (HIV) mortality is used as a key measure to monitor the impact of HIV throughout the world. It is important that HIV be correctly recorded on death certificates so that the burden of HIV mortality can be tracked accurately. The objective of this study was to determine the extent of failure to correctly report HIV on death certificates and examine patterns of incompleteness by demographic factors. Causes of death on death certificates of people infected with HIV reported to the Florida HIV surveillance system 2000–2011 were analyzed to determine the proportion without mention of HIV who had an underlying cause of death suggestive of HIV based on World Health Organization recommendations. Of the 11,989 deaths, 8089 (67.5%) had an HIV code (B20–B24, R75) as any of the causes of death, 3091 (25.8%) had no mention of HIV and the underlying cause was not suggestive of HIV, and 809 (6.7%) had no mention of HIV but the underlying cause was suggestive of HIV. Therefore, 9.1% (809/8898) of probable HIV-related deaths had no mention of HIV on the death certificate. Dying within 1 month of HIV diagnosis was the factor most strongly associated with no mention of HIV when the underlying cause was suggestive of HIV on the death certificate. The results suggest that HIV mortality using only vital records may underestimate actual HIV mortality by approximately 9%. Efforts to reduce incompleteness of reporting of HIV on death certificates could improve HIV-related mortality estimates. Refereed/Peer-reviewed
- Published
- 2015
129. Using Causal Bayesian Networks to Assess the Role of Patient-Centered Care and Psychosocial Factors on Durable HIV Viral Suppression.
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Trepka MJ, Gong Z, Ward MK, Fennie KP, Sheehan DM, Jean-Gilles M, Devieux J, Ibañez GE, Gwanzura T, Nawfal ES, Gray A, Beach MC, Ladner R, and Yoo C
- Subjects
- Humans, Female, Male, Retrospective Studies, Adult, Middle Aged, Florida epidemiology, Anti-HIV Agents therapeutic use, Patient-Centered Care, HIV Infections psychology, HIV Infections drug therapy, Bayes Theorem, Viral Load
- Abstract
We assessed the role of patient-centered care on durable viral suppression (i.e., all viral load test results < 200 copies per ml during 2019) by conducting a retrospective cohort study of clients medically case managed by the Miami-Dade County Ryan White Program (RWP). Summary measures of patient-centered care practices of RWP-affiliated providers were obtained from a survey of 1352 clients. Bayesian network models analyzed the complex relationship between psychosocial and patient-centered care factors. Of 5037 clients, 4135 (82.1%) had durable viral suppression. Household income was the factor most strongly associated with durable viral suppression. Further, mean healthcare relationship score and mean "provider knows patient as a person" score were both associated with durable viral suppression. Healthcare relationship score moderated the association between low household income and lack of durable viral suppression. Although patient-centered care supports patient HIV care success, wrap around support is also needed for people with unmet psychosocial needs., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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130. Acceptability and Feasibility of a Tai Chi/Qigong Intervention for Older People Living With HIV.
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Ibañez GE, Ahmed S, Hu N, Larkey L, Fennie KP, Lembo M, and Huertas L
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- Humans, Aged, Middle Aged, Feasibility Studies, Quality of Life, Tai Ji, Qigong, HIV Infections prevention & control, Meditation
- Abstract
Tai chi/qigong (TCQ) is a low impact, meditative movement with breathwork that may benefit people with HIV (PWH) over 50 years old. This study is a feasibility clinical trial of a remote TCQ intervention for older PWH. Participants (n = 48) were recruited via clinic sites and social media and randomized to a TCQ, sham qigong, or wait-list control group. The 12-week intervention included fourteen 45-60-minute sessions. Acceptability (satisfaction, attitudes, practice, attendance) and feasibility (retention rate, adverse events, remote delivery) data were surveyed. Overall retention rate was 72.9%, but 81.2% for the TCQ group. Most TCQ participants attended at least 10 sessions (62.5%) and were practicing TCQ after 2 weeks (72.7%). Over 92% of TCQ participants reported satisfaction and positive attitudes and preferred remote versus in person delivery (63.6%). Two mild intervention related adverse events occurred. Findings suggest that a remote TCQ intervention is acceptable, feasible, and safe among older PWH., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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131. Gay Neighborhoods: Can They Be Identified in a Systematic Way Using Latent Class Analysis?
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Mauck DE, Fennie KP, Ibañez GE, Fenkl EA, Sheehan DM, Maddox LM, Spencer EC, and Trepka MJ
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- Homosexuality, Male, Humans, Latent Class Analysis, Male, HIV Infections epidemiology, HIV Infections prevention & control, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
- Abstract
Identifying gay neighborhoods could help in targeting HIV prevention efforts for men who have sex with men. This study's purpose was to identify gay neighborhoods using latent class analysis (LCA). Data at the ZIP code level were drawn from the American Community Survey, website lists of gay bars and neighborhoods, and the Florida Department of Health HIV surveillance system. A two-class model was selected based on fit. About 9% of the ZIP code data was in class two, which was designated as gay neighborhoods. Cohen's kappa coefficient was used to examine agreement between the classification of ZIP codes from LCA and websites. Fair agreement was found (0.2501). Gay neighborhoods could serve as a place to disseminate information about pre-exposure prophylaxis and other methods for HIV prevention. Improved measures, such as the planned question about same-sex spouses for the 2020 US Census, are needed to identify gay neighborhoods in population-level surveys., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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132. Correction to: Gay Neighborhoods: Can They Be Identified in a Systematic Way Using Latent Class Analysis?
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Mauck DE, Fennie KP, Ibañez GE, Fenkl EA, Sheehan DM, Maddox LM, Spencer EC, and Trepka MJ
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- 2022
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133. Symptoms, Stress, and HIV-Related Care Among Older People Living with HIV During the COVID-19 Pandemic, Miami, Florida.
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Algarin AB, Varas-Rodríguez E, Valdivia C, Fennie KP, Larkey L, Hu N, and Ibañez GE
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- Aged, Aged, 80 and over, Betacoronavirus, COVID-19, Coronavirus Infections epidemiology, Female, Florida epidemiology, HIV Infections epidemiology, Humans, Male, Middle Aged, Pandemics, Pneumonia, Viral epidemiology, Psychological Distress, SARS-CoV-2, Anti-HIV Agents therapeutic use, Coronavirus Infections psychology, HIV Infections drug therapy, HIV Infections psychology, Pneumonia, Viral psychology, Stress, Psychological
- Published
- 2020
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134. Quality Of Life And Stigma Among People Living With HIV/AIDS In Iran.
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Ebrahimi Kalan M, Han J, Ben Taleb Z, Fennie KP, Asghari Jafarabadi M, Dastoorpoor M, Hajhashemi N, Naseh M, and Rimaz S
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Background: Stigma against HIV profoundly affects the quality of life (QOL) of people living with HIV/AIDS (PLWHA). We aimed to assess the factors associated with QOL in PLWHA in Iran, specifically HIV-related stigma, sociodemographic and clinical characteristics., Methods: Two hundred PLWHA participated in this cross-sectional study. Data were collected using sociodemographic, stigma, and WHO-QOL-BREF questionnaires. Correlations, ANOVAs, and Student's t -distribution tests were performed as bivariate analyses. We employed stepwise multiple linear regression analysis to explore the main factors associated with QOL domains., Results: Six domains of QOL were negatively correlated with three domains of stigma (p<0.001 for all). Stepwise multiple linear regression revealed that, after adjusting for confounders, lack of healthcare insurance, having no basic knowledge of HIV/AIDs prior to diagnosis, low monthly income of participants and family, and stigma (blaming and distancing, discrimination, and fear) were associated with low mean score of different domains of QOL., Conclusion: Our findings indicated that increasing HIV/AIDS-related stigma decreases QOL in PLWHA in Iran. Attention toward decreasing stigma, improving healthcare plan, and cultivating economic condition should be given high priority to ensure improvement in total QOL and corresponding domains in PLWHA's life., Competing Interests: The authors declare that there are conflicts of interest regarding the publication of this paper., (© 2019 Ebrahimi Kalan et al.)
- Published
- 2019
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135. A Review: Associations Between Attention-deficit/hyperactivity Disorder, Physical Activity, Medication Use, Eating Behaviors and Obesity in Children and Adolescents.
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Quesada D, Ahmed NU, Fennie KP, Gollub EL, and Ibrahimou B
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- Adolescent, Child, Humans, Attention Deficit Disorder with Hyperactivity epidemiology, Exercise, Feeding Behavior psychology, Impulsive Behavior physiology, Pediatric Obesity epidemiology
- Abstract
In the past few years we have become increasingly aware of strong associations between obesity and ADHD. Both conditions are major public health issues, affecting children, adolescents and adults alike., Objective: This review seeks to (1) examine prior research on the association between ADHD and obesity in children and adolescents; (2) discuss mechanisms and consequent behavioral attributes to gain understanding of the path association between ADHD and obesity, (3) review studies examining the role of physical activity, medication, eating behavior and gender on the relationship between ADHD and obesity in children and adolescents., Method: PubMed, CINAHL and PsycINFO databases were used to search for studies whose subjects were children and adolescents, ages 0-17 years and whose publication years were from 2000 to 2016. After screening 31 studies were included in the review., Results: The literature suggests that there is a significant association between ADHD and obesity. Further, the inattentive and impulsive behaviors that characterize ADHD could contribute to dis-regulated eating behaviors and a lack of motivation to engage in physical activity. In addition, it is proposed that medication, gender and physical activity play a role in mediating and moderating the relationship between ADHD and obesity., (Copyright © 2018 Elsevier Inc. All rights reserved.)
- Published
- 2018
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136. Racial/Ethnic Disparities in Failure to Initiate HIV Care: Role of HIV Testing Site, Individual Factors, and Neighborhood Factors, Florida, 2014-2015.
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Trepka MJ, Sheehan DM, Fennie KP, Mauck DE, Lieb S, Maddox LM, and Niyonsenga T
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- Adolescent, Adult, Black or African American statistics & numerical data, Female, Florida, HIV Infections therapy, Hispanic or Latino statistics & numerical data, Humans, Individuality, Male, Mass Screening statistics & numerical data, Middle Aged, Patient Acceptance of Health Care statistics & numerical data, Residence Characteristics statistics & numerical data, Socioeconomic Factors, White People statistics & numerical data, Young Adult, Black or African American psychology, HIV Infections ethnology, Healthcare Disparities ethnology, Hispanic or Latino psychology, Patient Acceptance of Health Care ethnology, White People psychology
- Abstract
Delayed initiation of human immunodeficiency virus (HIV) care affects disease progression. To determine the role of HIV testing site and neighborhood- and individual-level factors in racial/ethnic disparities in initiation of care, we examined Florida population-based HIV/AIDS surveillance system records. We performed multilevel Poisson regression to calculate adjusted prevalence ratios (APR) for non-initiation of care by race/ethnicity adjusting for HIV testing site type and individual- and neighborhood-level characteristics. Of 8,913 people diagnosed with HIV during 2014-2015 in the final dataset, 18.3% were not in care within three months of diagnosis. The APR for non-initiation of care for non-Hispanic Blacks relative to non-Hispanic Whites was 1.57 (95% confidence interval [CI] 1.38-1.78) and for those tested in plasma/donation centers relative to outpatient clinics was 2.45 (95% CI 2.19-2.74). Testing site and individual variables contribute to racial/ethnic disparities in non-initiation of HIV care. Linkage procedures, particularly at plasma/blood donation centers, warrant improvement.
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- 2018
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137. Individual and Neighborhood Determinants of Late HIV Diagnosis Among Latinos, Florida, 2007-2011.
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Madhivanan P, Dillon FR, and Maddox LM
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- Adolescent, Adult, Female, Florida epidemiology, Humans, Male, Middle Aged, Odds Ratio, Residence Characteristics, Risk Factors, Sex Factors, Young Adult, Delayed Diagnosis statistics & numerical data, Emigrants and Immigrants statistics & numerical data, HIV Infections diagnosis, HIV Infections ethnology, Hispanic or Latino statistics & numerical data
- Abstract
The objective of this study was to examine individual and neighborhood determinants of late HIV diagnosis by gender and birthplace among Latinos. Florida HIV surveillance data for 2007-2011 were merged with American Community Survey data to estimate the odds of late HIV diagnosis (AIDS within 3 months of HIV diagnosis). Of 5522 HIV-positive Latinos, 26.5 % were diagnosed late. The odds ratio (OR) for late diagnosis was 1.39 times higher for males than females [95 % confidence interval (CI) 1.14-1.69]. Neighborhood-level factors associated with late diagnosis included residing in the 3 highest quartiles of neighborhood unemployment for males. The OR was 1.22 times higher for foreign- than US-born Latinos (95 % CI 1.07-1.40). Among foreign-born, residing in areas in the 2nd and 3rd quartiles of unemployment, in rural areas, and areas with <25 % Hispanic/Latino population were associated with late diagnosis. Population-based HIV testing campaigns may require tailoring to ensure that they effectively reach male Latinos in areas with high unemployment and foreign-born Latinos in rural and predominantly non-Latino areas.
- Published
- 2017
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138. Black-White Latino Racial Disparities in HIV Survival, Florida, 2000-2011.
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Sheehan DM, Trepka MJ, Fennie KP, Prado G, Cano MÁ, and Maddox LM
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- Adolescent, Adult, Aged, Aged, 80 and over, Female, Florida ethnology, Humans, Male, Middle Aged, Proportional Hazards Models, Risk Factors, Rural Population statistics & numerical data, Socioeconomic Factors, Urban Population statistics & numerical data, Young Adult, Black or African American statistics & numerical data, Ethnicity statistics & numerical data, HIV Infections ethnology, HIV Infections mortality, Hispanic or Latino statistics & numerical data, Residence Characteristics, White People statistics & numerical data
- Abstract
This research aimed to estimate Black/White racial disparities in all-cause mortality risk among HIV-positive Latinos. Florida surveillance data for Latinos diagnosed with HIV (2000-2008) were merged with 2007-2011 American Community Survey data. Crude and adjusted hazard ratios (aHR) were calculated using multi-level Cox regression. Of 10,903 HIV-positive Latinos, 8.2% were Black and 91.9% White. Black Latinos were at increased mortality risk compared with White Latinos after controlling for individual and neighborhood factors (aHR 1.40, 95% confidence interval (CI) 1.21-1.62). In stratified analyses, risk factors for Black Latinos included: age ≥60 years compared with ages 13-19 (aHR 4.63, 95% CI 1.32-16.13); US birth compared with foreign birth (aHR 1.56, 95% CI 1.16-2.11); diagnosis of AIDS within three months of HIV diagnosis (aHR 3.53, 95% CI 2.64-4.74); residence in the 3rd (aHR 1.82, 95% CI 1.13-2.94) and 4th highest quartiles (aHR 1.79, 95% CI 1.12-2.86) of neighborhood poverty compared with the lowest quartile; and residence in neighborhood with 25%-49% (aHR 1.59, 95% CI 1.07-2.42) and ≥50% Latinos compared with <25% Latinos (aHR 1.58, 95% CI 1.03-2.42). Significant racial disparities in HIV survival exist among Latinos. Differential access to-and quality of-care and perceived/experienced racial discrimination may be possible explanations.
- Published
- 2015
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139. Adherence to antiretroviral medication among HIV-positive patients in Thailand.
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Maneesriwongul WL, Tulathong S, Fennie KP, and Williams AB
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- Adult, Anti-HIV Agents therapeutic use, Antiretroviral Therapy, Highly Active, Female, HIV Infections epidemiology, Humans, Male, Middle Aged, Odds Ratio, Thailand epidemiology, Viral Load, Anti-HIV Agents administration & dosage, HIV Infections drug therapy, Patient Compliance
- Abstract
Background: The use of antiretroviral (ARV) medications is expanding rapidly in Thailand. The determinants of optimal adherence for HIV-positive patients in Thailand are unknown., Methods: A sample of 149 Thai patients receiving ARV therapy at Bhumrasnaradura Infectious Disease Institute located near Bangkok completed a structured questionnaire and reported medication adherence on a 30 day visual analog scale. HIV RNA test results were abstracted from the medical record., Results: Adherence ranged from 25% to 100%. The median was 100% and the mean was 96%. The majority of subjects (114, 77%) had an HIV RNA =50 copies/mL. An undetectable viral load was associated with adherence >/=95% (odds ratio [OR] = 3.0; 95% confidence interval [CI] 1.3 to 7.1; P = 0.02) and with a lower mean number of months on ARV therapy (22 versus 32 months; P = 0.03). Gender, educational level, method of payment, use of GPO-VIR, and whether or not the patient was on his or her initial ARV regimen were not associated with an undetectable viral load. In the multivariate analysis, only length of time in months was associated with an undetectable viral load. For each additional month, the odds of being undetectable were 0.975. (OR = 0.975; 95% CI 0.954 to .996; P = 0.02)., Conclusions: Adherence was high in this cohort and was associated with HIV-RNA levels. However, these data confirm that adherence is only 1 factor that determines the effectiveness of ARV treatment. Duration of treatment was associated with virologic failure, controlling for adherence.
- Published
- 2006
- Full Text
- View/download PDF
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