18 results on '"David D. Celentano"'
Search Results
2. Awareness of and willingness to use pre-exposure prophylaxis (PrEP) among people who inject drugs and men who have sex with men in India: Results from a multi-city cross-sectional survey
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Allison M. McFall, M. Suresh Kumar, Aylur K. Srikrishnan, Sunil S. Solomon, Shruti H. Mehta, Suniti Solomon, David D. Celentano, Gregory M. Lucas, and Ashwin Belludi
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RNA viruses ,Male ,Health Knowledge, Attitudes, Practice ,Cross-sectional study ,Epidemiology ,Human immunodeficiency virus (HIV) ,Social Sciences ,HIV Infections ,medicine.disease_cause ,Logistic regression ,Pathology and Laboratory Medicine ,Men who have sex with men ,Geographical Locations ,Pre-exposure prophylaxis ,Sexual and Gender Minorities ,Immunodeficiency Viruses ,Surveys and Questionnaires ,Medicine and Health Sciences ,Public and Occupational Health ,Hiv transmission ,Substance Abuse, Intravenous ,Multidisciplinary ,Geography ,Organic Compounds ,Awareness ,Chemistry ,Sexual Partners ,Medical Microbiology ,HIV epidemiology ,Viral Pathogens ,Viruses ,Physical Sciences ,Medicine ,Female ,Pathogens ,Research Article ,Adult ,Asia ,Anti-HIV Agents ,Science ,Men WHO Have Sex with Men ,India ,Human Geography ,Microbiology ,Injection drug use ,Urban Geography ,Young Adult ,Environmental health ,Retroviruses ,medicine ,Humans ,Cities ,Homosexuality, Male ,Microbial Pathogens ,business.industry ,Prophylaxis ,Illicit Drugs ,Lentivirus ,Organic Chemistry ,Organisms ,Chemical Compounds ,Biology and Life Sciences ,HIV ,Willingness to use ,Cross-Sectional Studies ,Medical Risk Factors ,Alcohols ,People and Places ,Earth Sciences ,Pre-Exposure Prophylaxis ,Population Groupings ,Preventive Medicine ,business ,Sexuality Groupings - Abstract
Introduction Pre-exposure prophylaxis (PrEP) is effective in reducing HIV transmission among key populations. In India, where PrEP is not currently part of the national HIV program, little is known about PrEP awareness, willingness to use PrEP, and barriers to uptake among people who inject drugs (PWID) and men who have sex with men (MSM). Methods We used respondent-driven sampling to accrue PWID and MSM in 22 sites from August 2016 to May 2017. Participants were asked about awareness of PrEP, willingness to use PrEP (following a brief description) and reasons why they might not be willing to use PrEP. Participants were also queried on preferences for PrEP delivery modality (oral vs. injectable). Multi-level logistic regression models were used to determine participant correlates of willingness to use PrEP. Estimates were weighted for the sampling method. Results A total of 10,538 PWID and 8,621 MSM who self-reported being HIV-negative were included in the analysis. Only 6.1% (95% confidence interval [CI]: 5.9, 6.3) of PWID and 8.0% of MSM (95% CI: 7.7, 8.4) were aware of PrEP. However, willingness to use PrEP was substantially higher in both groups: 52.4% of PWID and 67.6% of MSM. Participants commonly cited a perceived low risk for acquiring HIV infection, being perceived by others as being HIV-positive, and side effects as reasons why they would be unwilling to use PrEP. Among PWID, sharing needles and hazardous alcohol use were associated with increased willingness to use PrEP. Among MSM, having a main male partner and injection drug use were associated with increased willingness to use PrEP. Preference for daily oral or monthly injectable PrEP was similar among MSM (39.6%% vs. 41.7%,), while PWID were more likely to prefer oral to injectable administration routes (56.3% vs. 31.1%). Conclusions As India plans to roll-out of PrEP in the public sector, our multi-city survey of PWID and MSM highlights the need for key population-focused education campaigns about PrEP and self-assessment of risk.
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- 2021
3. Diversity of the hepatitis C virus NS5B gene during HIV co-infection
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Caroline C. King, Ling Kong, Kenneth H. Mayer, Tshegofatso Ngwaga, John E. Tavis, Jason T. Blackard, Robyn S. Klein, Jack D. Sobel, Cassandra Schoborg, David D. Celentano, Denise J. Jamieson, Derrick H. Lin, and Lynn E. Taylor
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0301 basic medicine ,RNA viruses ,Sofosbuvir ,Epidemiology ,Hepacivirus ,Viral Nonstructural Proteins ,medicine.disease_cause ,Cohort Studies ,chemistry.chemical_compound ,Database and Informatics Methods ,0302 clinical medicine ,Medical Conditions ,Immunodeficiency Viruses ,2-Naphthylamine ,Genotype ,Public and Occupational Health ,Phylogeny ,Pathology and laboratory medicine ,Sulfonamides ,Multidisciplinary ,Dasabuvir ,Coinfection ,Hepatitis C virus ,virus diseases ,Medical microbiology ,Hepatitis C ,Vaccination and Immunization ,Infectious Diseases ,HIV epidemiology ,Viruses ,Medicine ,RNA, Viral ,030211 gastroenterology & hepatology ,Female ,Pathogens ,Sequence Analysis ,medicine.drug ,Research Article ,Adult ,Bioinformatics ,Science ,Immunology ,Antiretroviral Therapy ,Nucleotide Sequencing ,Human leukocyte antigen ,Viral quasispecies ,Biology ,Research and Analysis Methods ,Antiviral Agents ,Microbiology ,03 medical and health sciences ,Antiviral Therapy ,Amino Acid Sequence Analysis ,Virology ,Drug Resistance, Viral ,Retroviruses ,medicine ,Humans ,Amino Acid Sequence ,Uracil ,Molecular Biology Techniques ,Sequencing Techniques ,NS5B ,Molecular Biology ,Medicine and health sciences ,AIDS-Related Opportunistic Infections ,Biology and life sciences ,Flaviviruses ,Ribavirin ,Lentivirus ,Organisms ,Viral pathogens ,Genetic Variation ,HIV ,RNA-Dependent RNA Polymerase ,digestive system diseases ,Hepatitis viruses ,Viral Replication ,CD4 Lymphocyte Count ,Microbial pathogens ,030104 developmental biology ,chemistry ,Co-Infections ,Preventive Medicine - Abstract
Viral diversity is an important feature of hepatitis C virus (HCV) infection and an important predictor of disease progression and treatment response. HIV/HCV co-infection is associated with enhanced HCV replication, increased fibrosis, and the development of liver disease. HIV also increases quasispecies diversity of HCV structural genes, although limited data are available regarding the impact of HIV on non-structural genes of HCV, particularly in the absence of direct-acting therapies. The genetic diversity and presence of drug resistance mutations within the RNA-dependent RNA polymerase (NS5B) gene were examined in 3 groups of women with HCV genotype 1a infection, including those with HCV mono-infection, antiretroviral (ART)-naive women with HIV/HCV co-infection and CD4 cell count
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- 2020
4. Rising role of prescription drugs as a portal to injection drug use and associated mortality in Baltimore, Maryland
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Gregory D. Kirk, David L. Thomas, David D. Celentano, Javier A. Cepeda, Shruti H. Mehta, and Jacquie Astemborski
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Male ,Social Sciences ,030508 substance abuse ,Heroin ,Cohort Studies ,Drug Abuse ,0302 clinical medicine ,Medicine and Health Sciences ,Psychology ,030212 general & internal medicine ,Substance Abuse, Intravenous ,Analgesics ,education.field_of_study ,Multidisciplinary ,Pharmaceutics ,Mortality rate ,Drugs ,Middle Aged ,Recreational drug use ,3. Good health ,Analgesics, Opioid ,Substance abuse ,Behavioral Pharmacology ,Research Design ,Polysubstance dependence ,Medicine ,Female ,0305 other medical science ,Research Article ,Cohort study ,medicine.drug ,Adult ,Prescription Drugs ,Drug Research and Development ,Drug Synthesis ,Death Rates ,Science ,Population ,Research and Analysis Methods ,Injections ,03 medical and health sciences ,Population Metrics ,Recreational Drug Use ,medicine ,Humans ,Pain Management ,Medical prescription ,education ,Pharmacology ,Behavior ,Population Biology ,Illicit Drugs ,Pharmaceutical Processing Technology ,business.industry ,Biology and Life Sciences ,medicine.disease ,Opioids ,Baltimore ,business ,Demography - Abstract
Introduction Prescription drug abuse is a major public health problem in rural and suburban areas of the United States, however its emergence in large urban settings with endemic injection drug use remains understudied. We examined temporal trends in injection drug use initiation and mortality among people who inject drugs (PWID) in Baltimore, Maryland. Methods Data were derived from the baseline assessment of PWID enrolled in a community-based cohort study with longitudinal follow-up for mortality assessment. PWID were recruited from 2005–2008 (N = 1,008) and 2015–2018 (N = 737). We compared characteristics by birth cohort (before/after 1980) and type of drug initiated (prescription opioids, prescription non-opioids, non-injection illicit drugs, or injection drugs). We calculated standardized mortality ratios (SMR) using the US general population as the reference. Results PWID born after 1980 were more likely to initiate drug use with prescription opioids and non-opioids and had higher levels of polysubstance prior to injection initiation, compared to individuals born before 1980. Overall mortality was high: 2.59 per 100 person-years (95% CI: 2.27–2.95 per 100 person-years). Compared to the US population, the highest SMRs were observed among participants between 40–44 years of age, with especially high mortality among women in this age group (SMR:29.89, 95% CI: 15.24–44.54). Conclusions Mirroring national trends, the profile of PWID in Baltimore has changed with increased prescription drug abuse and high levels of polysubstance use among younger PWID. Interventions need to reach those using prescription drugs early after initiation of use in order to reduce transition to injecting. Urgent attention is warranted to address premature mortality, particularly among middle-aged and female PWID.
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- 2019
5. Gender Differences in Factors Related to HIV Risk Behaviors among People Who Inject Drugs in North-East India
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Canjeevaram K. Vasudevan, Gregory M. Lucas, David D. Celentano, Santhanam Anand, Suresh Kumar, Bushra Sabri, Sunil S. Solomon, Aylur K. Srikrishnan, Allison M. McFall, and Shruti H. Mehta
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Male ,RNA viruses ,Cross-sectional study ,Human immunodeficiency virus (HIV) ,lcsh:Medicine ,030508 substance abuse ,Social Sciences ,HIV Infections ,medicine.disease_cause ,Logistic regression ,Pathology and Laboratory Medicine ,Geographical Locations ,0302 clinical medicine ,5. Gender equality ,Immunodeficiency Viruses ,Sociology ,Medicine and Health Sciences ,Medicine ,Psychology ,Needle Sharing ,Drug Interactions ,030212 general & internal medicine ,lcsh:Science ,10. No inequality ,Substance Abuse, Intravenous ,Depression (differential diagnoses) ,Multidisciplinary ,Schools ,3. Good health ,Medical Microbiology ,Viral Pathogens ,Viruses ,Female ,Pathogens ,0305 other medical science ,Research Article ,Adult ,Asia ,Sexual Behavior ,HIV prevention ,Stigma (botany) ,India ,Hiv risk ,Microbiology ,Interpersonal Relationships ,Education ,03 medical and health sciences ,Interpersonal relationship ,Risk-Taking ,Sex Factors ,Retroviruses ,Humans ,Microbial Pathogens ,Needle sharing ,Preventive medicine ,Pharmacology ,Behavior ,business.industry ,lcsh:R ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,Cross-Sectional Studies ,Public and occupational health ,Collective Human Behavior ,People and Places ,lcsh:Q ,Human Sexual Behavior ,business ,Demography - Abstract
People who inject drugs (PWID) in India are at high risk for HIV, with women being at elevated risk. Using a socio-ecological framework, this study assessed whether factors associated with HIV transmission risk behaviors differed across men and women PWID. Data for this cross-sectional study were collected from 6449 PWID in 7 cities in Northeast India. Men (n = 5653) and women (n = 796) PWID were recruited using respondent-driven sampling (RDS). We assessed sex differences in two recent HIV transmission risk behaviors: multiple sex partners and needle/syringe sharing. We used multi-level logistic regression models, which incorporated sampling weights and random intercepts for city, to assess factors associated with these HIV risks, separately among men and women. The prevalence of HIV was significantly higher among women than men (53% vs 18.4%, p
- Published
- 2016
6. The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam
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Tran Viet Ha, Vu Minh Quan, Carl A. Latkin, Wendy W. Davis, Bryan Lau, Nguyen Le Minh, Carla E. Zelaya, Constantine Frangakis, Teerada Sripaipan, Vivian F. Go, Thi Tran Mo, and David D. Celentano
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0301 basic medicine ,Male ,RNA viruses ,Pediatrics ,Medical Doctors ,Thai People ,Health Care Providers ,Psychological intervention ,HIV Infections ,Pathology and Laboratory Medicine ,0302 clinical medicine ,Immunodeficiency Viruses ,Medicine and Health Sciences ,Ethnicities ,Public and Occupational Health ,030212 general & internal medicine ,Prospective cohort study ,education.field_of_study ,Multidisciplinary ,Pharmaceutics ,Incidence ,HIV diagnosis and management ,Middle Aged ,Vaccination and Immunization ,3. Good health ,Professions ,Anti-Retroviral Agents ,Vietnam ,Family planning ,Medical Microbiology ,Viral Pathogens ,Viruses ,Medicine ,Pathogens ,Cohort study ,Research Article ,Adult ,medicine.medical_specialty ,Substance-Related Disorders ,Science ,Population ,Immunology ,HIV prevention ,Antiretroviral Therapy ,Microbiology ,03 medical and health sciences ,Antiviral Therapy ,Drug Therapy ,Physicians ,Retroviruses ,medicine ,Humans ,education ,Microbial Pathogens ,Preventive healthcare ,business.industry ,Lentivirus ,Organisms ,Biology and Life Sciences ,HIV ,030112 virology ,Confidence interval ,Diagnostic medicine ,Health Care ,Sexual abuse ,People and Places ,HIV-1 ,Population Groupings ,Preventive Medicine ,business ,Follow-Up Studies - Abstract
BackgroundIn Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART.MethodsWe investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013.FindingsBy 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6-50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5-56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together.ConclusionsMarginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in combination with community-focused stigma reduction, when being referred and attempting to initiate urgently needed ART.
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- 2016
7. GB Virus C (GBV-C) Infection in Hepatitis C Virus (HCV) Seropositive Women with or at Risk for HIV Infection
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Caroline C. King, Jeffrey A. Welge, Kenneth H. Mayer, Gang Ma, Robert S. Klein, Jason T. Blackard, Jack D. Sobel, Lytt I. Gardner, David D. Celentano, Denise J. Jamieson, and Lynn E. Taylor
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medicine.medical_specialty ,Viral Diseases ,Epidemiology ,Hepatitis C virus ,lcsh:Medicine ,GB virus C ,HIV Infections ,Hepacivirus ,medicine.disease_cause ,Virus ,Internal medicine ,Genotype ,Medicine ,Humans ,Prospective Studies ,lcsh:Science ,Medicine and health sciences ,Multidisciplinary ,biology ,business.industry ,Coinfection ,Incidence (epidemiology) ,lcsh:R ,Age Factors ,Hepatitis C ,Flaviviridae Infections ,medicine.disease ,biology.organism_classification ,CD4 Lymphocyte Count ,Infectious Diseases ,HIV epidemiology ,Immunology ,HIV-1 ,RNA, Viral ,lcsh:Q ,Female ,business ,5' Untranslated Regions ,Viral load ,Research Article - Abstract
Background GB virus C (GBV-C) may have a beneficial impact on HIV disease progression; however, the epidemiologic characteristics of this virus are not well characterized. Behavioral factors and gender may lead to differential rates of GBV-C infection; yet, studies have rarely addressed GBV-C infections in women or racial/ethnic minorities. Therefore, we evaluated GBV-C RNA prevalence and genotype distribution in a large prospective study of high-risk women in the US. Results 438 hepatitis C virus (HCV) seropositive women, including 306 HIV-infected and 132 HIV-uninfected women, from the HIV Epidemiologic Research Study were evaluated for GBV-C RNA. 347 (79.2%) women were GBV-C RNA negative, while 91 (20.8%) were GBV-C RNA positive. GBV-C positive women were younger than GBV-C negative women. Among 306 HIV-infected women, 70 (22.9%) women were HIV/GBV-C co-infected. Among HIV-infected women, the only significant difference between GBV-negative and GBV-positive women was age (mean 38.4 vs. 35.1 years; p
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- 2014
8. Psychosocial Predictors of Non-Adherence and Treatment Failure in a Large Scale Multi-National Trial of Antiretroviral Therapy for HIV: Data from the ACTG A5175/PEARLS Trial
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James Hakim, Matthew J. Mimiaga, Katie B. Biello, Thomas B. Campbell, Anjali A. Joglekar, Steven A. Safren, Ann Walawander, Jocelyn E. Remmert, Laura M. Smeaton, Wadzanai Samaneka, David D. Celentano, Umesh G. Lalloo, Nagalingeswaran Kumarasamy, Mulinda Nyirenda, Javier R. Lama, Aspara Nair, Aadia Rana, Ana Martinez, and Virginia Kayoyo
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Male ,lcsh:Medicine ,HIV Infections ,law.invention ,0302 clinical medicine ,Immunodeficiency Viruses ,Quality of life ,Randomized controlled trial ,law ,Psychology ,Medicine ,Public and Occupational Health ,030212 general & internal medicine ,lcsh:Science ,Multidisciplinary ,Reverse-transcriptase inhibitor ,Pharmaceutics ,Middle Aged ,Vaccination and Immunization ,3. Good health ,Treatment Outcome ,Anti-Retroviral Agents ,Medical Microbiology ,Viral Pathogens ,Infectious diseases ,Female ,0305 other medical science ,Psychosocial ,Research Article ,medicine.drug ,Adult ,medicine.medical_specialty ,Drug Adherence ,Immunology ,Antiretroviral Therapy ,Context (language use) ,Viral diseases ,Microbiology ,03 medical and health sciences ,Pharmacotherapy ,Drug Therapy ,Internal medicine ,Humans ,Microbial Pathogens ,Medicine and health sciences ,Pharmacology ,Psychological and Psychosocial Issues ,030505 public health ,business.industry ,lcsh:R ,Biology and Life Sciences ,HIV ,Social Support ,Models, Theoretical ,Health Care ,Clinical trial ,Regimen ,Quality of Life ,Patient Compliance ,lcsh:Q ,business - Abstract
Background PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS. Methods Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. “Life-Steps” adherence counseling was provided. Results In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p
- Published
- 2014
9. Estimation of HIV Incidence in a Large, Community-Based, Randomized Clinical Trial: NIMH Project Accept (HIV Prevention Trials Network 043)
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Craig Chin, Michal Kulich, Glenda Gray, Stephen F. Morin, Agnès Fiamma, Michel W. Alexandre, Deb Bassuk, Estelle Piwowar-Manning, Greg Szekeres, David D. Celentano, Susan H. Eshleman, John Hackett, Suwat Chariyalertsak, Priscilla Swanson, Caroline E. Mullis, Mark A. Marzinke, Thomas J. Coates, Linda Richter, Deborah Donnell, William Clarke, Oliver Laeyendecker, Michael D. Sweat, and Alfred Chingono
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Epidemiology ,Cross-sectional study ,HIV Infections ,law.invention ,0302 clinical medicine ,Randomized controlled trial ,law ,Prevalence ,Clinical endpoint ,Medicine ,030212 general & internal medicine ,Young adult ,National Institute of Mental Health (U.S.) ,0303 health sciences ,education.field_of_study ,Multidisciplinary ,Applied Mathematics ,Incidence ,Incidence (epidemiology) ,virus diseases ,HIV diagnosis and management ,Viral Load ,Thailand ,3. Good health ,Anti-Retroviral Agents ,HIV epidemiology ,Infectious diseases ,Viral load ,Algorithms ,Research Article ,Adult ,medicine.medical_specialty ,Adolescent ,Science ,Voluntary counseling and testing ,HIV prevention ,Population ,Viral diseases ,Microbiology ,Infectious Disease Epidemiology ,Young Adult ,03 medical and health sciences ,Virology ,Internal medicine ,Humans ,education ,Biology ,Acquired Immunodeficiency Syndrome ,Population Biology ,030306 microbiology ,business.industry ,HIV ,United States ,CD4 Lymphocyte Count ,Viral Disease Diagnosis ,Cross-Sectional Studies ,Computer Science ,Africa ,Immunology ,business ,Mathematics - Abstract
BackgroundNational Institute of Mental Health Project Accept (HIV Prevention Trials Network [HPTN] 043) is a large, Phase III, community-randomized, HIV prevention trial conducted in 48 matched communities in Africa and Thailand. The study intervention included enhanced community-based voluntary counseling and testing. The primary endpoint was HIV incidence, assessed in a single, cross-sectional, post-intervention survey of >50,000 participants.MethodsHIV rapid tests were performed in-country. HIV status was confirmed at a central laboratory in the United States. HIV incidence was estimated using a multi-assay algorithm (MAA) that included the BED capture immunoassay, an avidity assay, CD4 cell count, and HIV viral load.ResultsData from Thailand was not used in the endpoint analysis because HIV prevalence was low. Overall, 7,361 HIV infections were identified (4 acute, 3 early, and 7,354 established infections). Samples from established infections were analyzed using the MAA; 467 MAA positive samples were identified; 29 of those samples were excluded because they contained antiretroviral drugs. HIV prevalence was 16.5% (range at study sites: 5.93% to 30.8%). HIV incidence was 1.60% (range at study sites: 0.78% to 3.90%).ConclusionsIn this community-randomized trial, a MAA was used to estimate HIV incidence in a single, cross-sectional post-intervention survey. Results from this analysis were subsequently used to compare HIV incidence in the control and intervention communities.Trial registrationClinicalTrials.gov NCT00203749.
- Published
- 2013
10. Awareness of and willingness to use pre-exposure prophylaxis (PrEP) among people who inject drugs and men who have sex with men in India: Results from a multi-city cross-sectional survey.
- Author
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Ashwin Belludi, Allison M McFall, Sunil Suhas Solomon, David D Celentano, Shruti H Mehta, A K Srikrishnan, M Suresh Kumar, Suniti Solomon, and Gregory M Lucas
- Subjects
Medicine ,Science - Abstract
IntroductionPre-exposure prophylaxis (PrEP) is effective in reducing HIV transmission among key populations. In India, where PrEP is not currently part of the national HIV program, little is known about PrEP awareness, willingness to use PrEP, and barriers to uptake among people who inject drugs (PWID) and men who have sex with men (MSM).MethodsWe used respondent-driven sampling to accrue PWID and MSM in 22 sites from August 2016 to May 2017. Participants were asked about awareness of PrEP, willingness to use PrEP (following a brief description) and reasons why they might not be willing to use PrEP. Participants were also queried on preferences for PrEP delivery modality (oral vs. injectable). Multi-level logistic regression models were used to determine participant correlates of willingness to use PrEP. Estimates were weighted for the sampling method.ResultsA total of 10,538 PWID and 8,621 MSM who self-reported being HIV-negative were included in the analysis. Only 6.1% (95% confidence interval [CI]: 5.9, 6.3) of PWID and 8.0% of MSM (95% CI: 7.7, 8.4) were aware of PrEP. However, willingness to use PrEP was substantially higher in both groups: 52.4% of PWID and 67.6% of MSM. Participants commonly cited a perceived low risk for acquiring HIV infection, being perceived by others as being HIV-positive, and side effects as reasons why they would be unwilling to use PrEP. Among PWID, sharing needles and hazardous alcohol use were associated with increased willingness to use PrEP. Among MSM, having a main male partner and injection drug use were associated with increased willingness to use PrEP. Preference for daily oral or monthly injectable PrEP was similar among MSM (39.6%% vs. 41.7%,), while PWID were more likely to prefer oral to injectable administration routes (56.3% vs. 31.1%).ConclusionsAs India plans to roll-out of PrEP in the public sector, our multi-city survey of PWID and MSM highlights the need for key population-focused education campaigns about PrEP and self-assessment of risk.
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- 2021
- Full Text
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11. Diversity of the hepatitis C virus NS5B gene during HIV co-infection.
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Tshegofatso Ngwaga, Ling Kong, Derrick Lin, Cassandra Schoborg, Lynn E Taylor, Kenneth H Mayer, Robert S Klein, David D Celentano, Jack D Sobel, Denise J Jamieson, Caroline C King, John E Tavis, and Jason T Blackard
- Subjects
Medicine ,Science - Abstract
Viral diversity is an important feature of hepatitis C virus (HCV) infection and an important predictor of disease progression and treatment response. HIV/HCV co-infection is associated with enhanced HCV replication, increased fibrosis, and the development of liver disease. HIV also increases quasispecies diversity of HCV structural genes, although limited data are available regarding the impact of HIV on non-structural genes of HCV, particularly in the absence of direct-acting therapies. The genetic diversity and presence of drug resistance mutations within the RNA-dependent RNA polymerase (NS5B) gene were examined in 3 groups of women with HCV genotype 1a infection, including those with HCV mono-infection, antiretroviral (ART)-naïve women with HIV/HCV co-infection and CD4 cell count
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- 2020
- Full Text
- View/download PDF
12. Rising role of prescription drugs as a portal to injection drug use and associated mortality in Baltimore, Maryland.
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Javier A Cepeda, Jacquie Astemborski, Gregory D Kirk, David D Celentano, David L Thomas, and Shruti H Mehta
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Medicine ,Science - Abstract
IntroductionPrescription drug abuse is a major public health problem in rural and suburban areas of the United States, however its emergence in large urban settings with endemic injection drug use remains understudied. We examined temporal trends in injection drug use initiation and mortality among people who inject drugs (PWID) in Baltimore, Maryland.MethodsData were derived from the baseline assessment of PWID enrolled in a community-based cohort study with longitudinal follow-up for mortality assessment. PWID were recruited from 2005-2008 (N = 1,008) and 2015-2018 (N = 737). We compared characteristics by birth cohort (before/after 1980) and type of drug initiated (prescription opioids, prescription non-opioids, non-injection illicit drugs, or injection drugs). We calculated standardized mortality ratios (SMR) using the US general population as the reference.ResultsPWID born after 1980 were more likely to initiate drug use with prescription opioids and non-opioids and had higher levels of polysubstance prior to injection initiation, compared to individuals born before 1980. Overall mortality was high: 2.59 per 100 person-years (95% CI: 2.27-2.95 per 100 person-years). Compared to the US population, the highest SMRs were observed among participants between 40-44 years of age, with especially high mortality among women in this age group (SMR:29.89, 95% CI: 15.24-44.54).ConclusionsMirroring national trends, the profile of PWID in Baltimore has changed with increased prescription drug abuse and high levels of polysubstance use among younger PWID. Interventions need to reach those using prescription drugs early after initiation of use in order to reduce transition to injecting. Urgent attention is warranted to address premature mortality, particularly among middle-aged and female PWID.
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- 2019
- Full Text
- View/download PDF
13. Gender Differences in Factors Related to HIV Risk Behaviors among People Who Inject Drugs in North-East India.
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Bushra Sabri, Allison M McFall, Sunil S Solomon, Aylur K Srikrishnan, Canjeevaram K Vasudevan, Santhanam Anand, David D Celentano, Shruti H Mehta, Suresh Kumar, and Gregory M Lucas
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Medicine ,Science - Abstract
People who inject drugs (PWID) in India are at high risk for HIV, with women being at elevated risk. Using a socio-ecological framework, this study assessed whether factors associated with HIV transmission risk behaviors differed across men and women PWID. Data for this cross-sectional study were collected from 6449 PWID in 7 cities in Northeast India. Men (n = 5653) and women (n = 796) PWID were recruited using respondent-driven sampling (RDS). We assessed sex differences in two recent HIV transmission risk behaviors: multiple sex partners and needle/syringe sharing. We used multi-level logistic regression models, which incorporated sampling weights and random intercepts for city, to assess factors associated with these HIV risks, separately among men and women. The prevalence of HIV was significantly higher among women than men (53% vs 18.4%, p
- Published
- 2017
- Full Text
- View/download PDF
14. The Effect of a Multi-Level Intervention on the Initiation of Antiretroviral Therapy (ART) among HIV-Infected Men Who Inject Drugs and Were Diagnosed Late in Thai Nguyen, Vietnam.
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Carla E Zelaya, Nguyen Le Minh, Bryan Lau, Carl A Latkin, Tran Viet Ha, Vu Minh Quan, Thi Tran Mo, Teerada Sripaipan, Wendy W Davis, David D Celentano, Constantine Frangakis, and Vivian F Go
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Medicine ,Science - Abstract
BackgroundIn Vietnam, an estimated 256,000 people are living with HIV, and 58% of HIV-infections reported are among people who inject drugs (PWID). While antiretroviral therapy (ART) is widely available in Vietnam, marginalized hard-to-reach male PWID, demonstrate significantly reduced and delayed access to ART.MethodsWe investigated the effect of a randomized four-arm multi-level intervention trial on ART initiation among male PWID. Our analysis was conducted among a subset of trial participants (n = 136), who were newly diagnosed as HIV-infected, treatment naïve, and eligible for ART (baseline late diagnosis). The trial arms included: 1, standard of care (HIV testing and counseling); 2, structural-level intervention (door-to-door communications and community video screenings); 3, individual-level intervention (counseling plus group support); and 4, individual-level plus structural-level intervention. In a time-to-event analysis, we used a non-parametric approach for competing risks to estimate cumulative incidence function (CIF) for ART initiation (event of interest) by arm and the difference in CIF for each trial arm as compared to Arm 1. Follow-up was conducted at 6, 12, 18 and 24 months. Data collection occurred from 2009 to 2013.FindingsBy 24-months, 61.0% initiated ART, and 30.9% had died prior to ART initiation. In the first 6 months, participants in arm 4 (individual plus community intervention) had a 28% (95% confidence interval (CI): 6-50%) increased probability of initiating ART. Despite increasing coverage of ART in all arms throughout follow-up, participants in arm 4 retained a 31% (95% CI: 5-56%) increased probability of initiating ART. The individual and community components of the intervention were only effective when delivered together.ConclusionsMarginalized, hard-to-reach men, who do not routinely engage in HIV services, and therefore come into care late, may benefit significantly from both individual counseling and group support, in combination with community-focused stigma reduction, when being referred and attempting to initiate urgently needed ART.
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- 2016
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15. Efficacy of a Multi-level Intervention to Reduce Injecting and Sexual Risk Behaviors among HIV-Infected People Who Inject Drugs in Vietnam: A Four-Arm Randomized Controlled Trial.
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Vivian F Go, Constantine Frangakis, Nguyen Le Minh, Carl Latkin, Tran Viet Ha, Tran Thi Mo, Teerada Sripaipan, Wendy W Davis, Carla Zelaya, Pham The Vu, David D Celentano, and Vu Minh Quan
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Medicine ,Science - Abstract
Injecting drug use is a primary driver of HIV epidemics in many countries. People who inject drugs (PWID) and are HIV infected are often doubly stigmatized and many encounter difficulties reducing risk behaviors. Prevention interventions for HIV-infected PWID that provide enhanced support at the individual, family, and community level to facilitate risk-reduction are needed.455 HIV-infected PWID and 355 of their HIV negative injecting network members living in 32 sub-districts in Thai Nguyen Province were enrolled. We conducted a two-stage randomization: First, sub-districts were randomized to either a community video screening and house-to-house visits or standard of care educational pamphlets. Second, within each sub-district, participants were randomized to receive either enhanced individual level post-test counseling and group support sessions or standard of care HIV testing and counseling. This resulted in four arms: 1) standard of care; 2) community level intervention; 3) individual level intervention; and 4) community plus individual intervention. Follow-up was conducted at 6, 12, 18, and 24 months. Primary outcomes were self-reported HIV injecting and sexual risk behaviors. Secondary outcomes included HIV incidence among HIV negative network members.Fewer participants reported sharing injecting equipment and unprotected sex from baseline to 24 months in all arms (77% to 4% and 24% to 5% respectively). There were no significant differences at the 24-month visit among the 4 arms (Wald = 3.40 (3 df); p = 0.33; Wald = 6.73 (3 df); p = 0.08). There were a total of 4 HIV seroconversions over 24 months with no significant difference between intervention and control arms.Understanding the mechanisms through which all arms, particularly the control arm, demonstrated both low risk behaviors and low HIV incidence has important implications for policy and prevention programming.ClinicalTrials.gov NCT01689545.
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- 2015
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16. GB Virus C (GBV-C) Infection in Hepatitis C Virus (HCV) Seropositive Women with or at Risk for HIV Infection.
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Jason T Blackard, Gang Ma, Jeffrey A Welge, Caroline C King, Lynn E Taylor, Kenneth H Mayer, Robert S Klein, David D Celentano, Jack D Sobel, Denise J Jamieson, and Lytt Gardner
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Medicine ,Science - Abstract
BACKGROUND:GB virus C (GBV-C) may have a beneficial impact on HIV disease progression; however, the epidemiologic characteristics of this virus are not well characterized. Behavioral factors and gender may lead to differential rates of GBV-C infection; yet, studies have rarely addressed GBV-C infections in women or racial/ethnic minorities. Therefore, we evaluated GBV-C RNA prevalence and genotype distribution in a large prospective study of high-risk women in the US. RESULTS:438 hepatitis C virus (HCV) seropositive women, including 306 HIV-infected and 132 HIV-uninfected women, from the HIV Epidemiologic Research Study were evaluated for GBV-C RNA. 347 (79.2%) women were GBV-C RNA negative, while 91 (20.8%) were GBV-C RNA positive. GBV-C positive women were younger than GBV-C negative women. Among 306 HIV-infected women, 70 (22.9%) women were HIV/GBV-C co-infected. Among HIV-infected women, the only significant difference between GBV-negative and GBV-positive women was age (mean 38.4 vs. 35.1 years; p
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- 2014
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17. Estimation of HIV incidence in a large, community-based, randomized clinical trial: NIMH project accept (HIV Prevention Trials Network 043).
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Oliver Laeyendecker, Estelle Piwowar-Manning, Agnes Fiamma, Michal Kulich, Deborah Donnell, Deb Bassuk, Caroline E Mullis, Craig Chin, Priscilla Swanson, John Hackett, William Clarke, Mark Marzinke, Greg Szekeres, Glenda Gray, Linda Richter, Michel W Alexandre, Suwat Chariyalertsak, Alfred Chingono, David D Celentano, Stephen F Morin, Michael Sweat, Thomas Coates, and Susan H Eshleman
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Medicine ,Science - Abstract
BackgroundNational Institute of Mental Health Project Accept (HIV Prevention Trials Network [HPTN] 043) is a large, Phase III, community-randomized, HIV prevention trial conducted in 48 matched communities in Africa and Thailand. The study intervention included enhanced community-based voluntary counseling and testing. The primary endpoint was HIV incidence, assessed in a single, cross-sectional, post-intervention survey of >50,000 participants.MethodsHIV rapid tests were performed in-country. HIV status was confirmed at a central laboratory in the United States. HIV incidence was estimated using a multi-assay algorithm (MAA) that included the BED capture immunoassay, an avidity assay, CD4 cell count, and HIV viral load.ResultsData from Thailand was not used in the endpoint analysis because HIV prevalence was low. Overall, 7,361 HIV infections were identified (4 acute, 3 early, and 7,354 established infections). Samples from established infections were analyzed using the MAA; 467 MAA positive samples were identified; 29 of those samples were excluded because they contained antiretroviral drugs. HIV prevalence was 16.5% (range at study sites: 5.93% to 30.8%). HIV incidence was 1.60% (range at study sites: 0.78% to 3.90%).ConclusionsIn this community-randomized trial, a MAA was used to estimate HIV incidence in a single, cross-sectional post-intervention survey. Results from this analysis were subsequently used to compare HIV incidence in the control and intervention communities.Trial registrationClinicalTrials.gov NCT00203749.
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- 2013
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18. Psychosocial predictors of non-adherence and treatment failure in a large scale multi-national trial of antiretroviral therapy for HIV: data from the ACTG A5175/PEARLS trial.
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Safren SA, Biello KB, Smeaton L, Mimiaga MJ, Walawander A, Lama JR, Rana A, Nyirenda M, Kayoyo VM, Samaneka W, Joglekar A, Celentano D, Martinez A, Remmert JE, Nair A, Lalloo UG, Kumarasamy N, Hakim J, and Campbell TB
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- Adult, Anti-Retroviral Agents therapeutic use, Female, Humans, Male, Middle Aged, Models, Theoretical, Psychology, Quality of Life, Social Support, Treatment Outcome, Anti-Retroviral Agents administration & dosage, HIV Infections drug therapy, Patient Compliance psychology
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Background: PEARLS, a large scale trial of antiretroviral therapy (ART) for HIV (n = 1,571, 9 countries, 4 continents), found that a once-daily protease inhibitor (PI) based regimen (ATV+DDI+FTC), but not a once-daily non-nucleoside reverse transcriptase inhibitor/nucleoside reverse transcriptase inhibitor (NNRTI/NRTI) regimen (EFV+FTC/TDF), had inferior efficacy compared to a standard of care twice-daily NNRTI/NRTI regimen (EFV+3TC/ZDV). The present study examined non-adherence in PEARLS., Methods: Outcomes: non-adherence assessed by pill count and by self-report, and time to treatment failure. Longitudinal predictors: regimen, quality of life (general health perceptions = QOL-health, mental health = QOL-mental health), social support, substance use, binge drinking, and sexual behaviors. "Life-Steps" adherence counseling was provided., Results: In both pill-count and self-report multivariable models, both once-a-day regimens had lower levels of non-adherence than the twice-a-day standard of care regimen; although these associations attenuated with time in the self-report model. In both multivariable models, hard-drug use was associated with non-adherence, living in Africa and better QOL-health were associated with less non-adherence. According to pill-count, unprotected sex was associated with non-adherence. According to self-report, soft-drug use was associated with non-adherence and living in Asia was associated with less non-adherence. Both pill-count (HR = 1.55, 95% CI: 1.15, 2.09, p<.01) and self-report (HR = 1.13, 95% CI: 1.08, 1.13, p<.01) non-adherence were significant predictors of treatment failure over 72 weeks. In multivariable models (including pill-count or self-report nonadherence), worse QOL-health, age group (younger), and region were also significant predictors of treatment failure., Conclusion: In the context of a large, multi-national, multi-continent, clinical trial there were variations in adherence over time, with more simplified regimens generally being associated with better adherence. Additionally, variables such as QOL-health, regimen, drug-use, and region play a role. Self-report and pill-count adherence, as well as additional psychosocial variables, such QOL-health, age, and region, were, in turn, associated with treatment failure.
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- 2014
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