21 results on '"Cook, Robert L."'
Search Results
2. Antiretroviral Therapy Concealment Behaviors and their Association with Antiretroviral Therapy Adherence among People with HIV: Findings from the Florida Cohort Study
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Fisk-Hoffman, Rebecca J., Parisi, Christina E., Siuluta, Nanyangwe, Ding, Delaney D., Widmeyer, Maya, Somboonwit, Charurut, and Cook, Robert L.
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- 2024
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3. Depression and Anxiety Symptoms and Treatment Utilization, and Associated HIV Outcomes among Adults with HIV in Rural Florida
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Manavalan, Preeti, Li, Yancheng, Mills, Jon C., Kwara, Awewura, Zhou, Zhi, Ritter, Alaina S., Spencer, Emma, Pence, Brian W., and Cook, Robert L.
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- 2024
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4. Impulsivity and linkage to HIV Care among People living with HIV in St. Petersburg, Russia
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Dey, Arnab K, Ennis, Nicole, Cheng, Debbie M, Blokhina, Elena, Raj, Anita, Quinn, Emily, Bendiks, Sally, Palfai, Tibor, Dunne, Eugene M, Cook, Robert L, Krupitsky, Evgeny, and Samet, Jeffrey H
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Public Health ,Health Sciences ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Infectious Diseases ,Health and social care services research ,8.1 Organisation and delivery of services ,Infection ,Good Health and Well Being ,Adult ,Male ,Humans ,Female ,Substance Abuse ,Intravenous ,HIV Infections ,CD4 Lymphocyte Count ,Impulsive Behavior ,Substance-Related Disorders ,Russia ,Impulsivity ,HIV ,PWID ,Public Health and Health Services ,Social Work ,Public health - Abstract
This study evaluated the association between impulsivity and linkage to HIV care among Russians living with HIV recruited from an inpatient narcology hospital. Linking Infectious and Narcology Care (LINC) study participants who completed the Barratt Impulsiveness Scale (BIS) were included in these analyses. The primary independent variable was impulsivity score which was categorized as high impulsivity (BIS score > 71) vs. low impulsivity (BIS score
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- 2022
5. Identifying the best measures of alcohol consumption to predict future HIV viral suppression trajectories
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Richards, Veronica L., Leeman, Robert F., Wang, Yan, Cook, Christa, Prins, Cindy, Ennis, Nicole, Spencer, Emma C., and Cook, Robert L.
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- 2022
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6. Changes in Mental Health Among People with HIV During the COVID-19 Pandemic: Qualitative and Quantitative Perspectives
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Parisi, Christina E., Varma, Deepthi S., Wang, Yan, Vaddiparti, Krishna, Ibañez, Gladys E., Cruz, Liset, and Cook, Robert L.
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- 2022
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7. Subjective Cognitive Complaints: Predictors and Health Outcomes in People Living with HIV
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Bryant, Vaughn E., Fieo, Robert A., Fiore, Andrew J., Richards, Veronica L., Porges, Eric C., Williams, Renessa, Lu, Huiyin, Zhou, Zhi, and Cook, Robert L.
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- 2022
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8. Reduced Working Memory is Associated with Heavier Alcohol Consumption History, Role Impairment and Executive Function Difficulties
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Bryant, Vaughn E., Britton, Mark K., Gullett, Joseph M., Porges, Eric C., Woods, Adam J., Cook, Robert L., Williamson, John, Ennis, Nicole, Bryant, Kendall J., Bradley, Carolyn, and Cohen, Ronald A.
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- 2021
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9. Defining the optimal cut-point of self-reported ART adherence to achieve viral suppression in the era of contemporary HIV therapy: a cross-sectional study
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O’Halloran Leach, Emma, Lu, Huiyin, Caballero, Joshua, Thomas, Jennifer E., Spencer, Emma C., and Cook, Robert L.
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- 2021
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10. Spatial and temporal analysis of HIV clinical outcomes in Florida reveals counties with persistent racial and ethnic disparities during 2012-2019.
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Rich, Shannan N, Liu, Yiyang, Fisk-Hoffman, Rebecca, Zheng, Yi, Hu, Hui, Spencer, Emma E, Cook, Robert L, and Prosperi, Mattia
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RACIAL inequality ,TREATMENT effectiveness ,HIV ,IMMUNOSUPPRESSION ,BLACK people ,RACE - Abstract
Background: Racial/ethnic disparities in the HIV care continuum have been well documented in the US, with especially striking inequalities in viral suppression rates between White and Black persons with HIV (PWH). The South is considered an epicenter of the HIV epidemic in the US, with the largest population of PWH living in Florida. It is unclear whether any disparities in viral suppression or immune reconstitution—a clinical outcome highly correlated with overall prognosis—have changed over time or are homogenous geographically. In this analysis, we 1) investigate longitudinal trends in viral suppression and immune reconstitution among PWH in Florida, 2) examine the impact of socio-ecological factors on the association between race/ethnicity and clinical outcomes, 3) explore spatial and temporal variations in disparities in clinical outcomes. Methods: Data were obtained from the Florida Department of Health for 42,369 PWH enrolled in the Ryan White program during 2008-2020. We linked the data to county-level socio-ecological variables available from County Health Rankings. GEE models were fit to assess the effect of race/ethnicity on immune reconstitution and viral suppression longitudinally. Poisson Bayesian hierarchical models were fit to analyze geographic variations in racial/ethnic disparities while adjusting for socio-ecological factors. Results: Proportions of PWH who experienced viral suppression and immune reconstitution rose by 60% and 45%, respectively, from 2008-2020. Odds of immune reconstitution and viral suppression were significantly higher among White [odds ratio =2.34, 95% credible interval=2.14-2.56; 1.95 (1.85-2.05)], and Hispanic [1.70 (1.54-1.87); 2.18(2.07-2.31)] PWH, compared with Black PWH. These findings remained unchanged after accounting for socio-ecological factors. Rural and urban counties in north-central Florida saw the largest racial/ethnic disparities. Conclusions: There is persistent, spatially heterogeneous, racial/ethnic disparity in HIV clinical outcomes in Florida. This disparity could not be explained by socio-ecological factors, suggesting that further research on modifiable factors that can improve HIV outcomes among Black and Hispanic PWH in Florida is needed. [ABSTRACT FROM AUTHOR]
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- 2024
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11. Assessing HIV-related stigma in the clinical setting: are providers in Florida interested?
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Fisk-Hoffman, Rebecca J., Woody, Aislinn, Prosperi, Mattia, Cook, Robert L., Cook, Christa, and Vaddiparti, Krishna
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MEDICAL personnel ,RESEARCH funding ,HIV infections ,BODY image ,DESCRIPTIVE statistics ,THEMATIC analysis ,PATIENT-centered care ,ATTITUDES of medical personnel ,DATA analysis software ,SOCIAL stigma ,PSYCHOSOCIAL factors ,DISCLOSURE ,SELF-perception - Abstract
HIV-related stigma is a key contributor to poor HIV-related health outcomes. The purpose of this study is to explore implementing a stigma measure into routine HIV care focusing on the 10-item Medical Monitoring Project measure as a proposed measure. Healthcare providers engaged in HIV-related care in Florida were recruited. Participants completed an interview about their perceptions of measures to assess stigma during clinical care. The analysis followed a directed content approach. Fifteen participants completed the interviews (87% female, 47% non-Hispanic White, case manager 40%). Most providers thought that talking about stigma would be helpful (89%). Three major themes emerged from the analysis: acceptability, subscales of interest, and utility. In acceptability, participants mentioned that assessing stigma could encourage patient-centered care and serve as a conversation starter, but some mentioned not having enough time. Participants thought that the disclosure concerns and negative self-image subscales were most relevant. Some worried they would not have resources for patients or that some issues were beyond their influence. Participants were generally supportive of routinely addressing HIV-related stigma in clinical care, but were concerned that resources, especially to address concerns about disclosure and negative self-image, were not available. [ABSTRACT FROM AUTHOR]
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- 2024
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12. The association of depression and anxiety symptoms to three different types of activities of daily living in persons with and without HIV.
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Bryant, Vaughn E., Shortell, Destin D., DeFelice, Jason S., Huxhold, Ashley, Cook, Robert L., Porges, Eric C., and Cohen, Ronald A.
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HEALTH self-care ,CROSS-sectional method ,RESEARCH funding ,CENTER for Epidemiologic Studies Depression Scale ,FUNCTIONAL assessment ,QUESTIONNAIRES ,ANXIETY ,DESCRIPTIVE statistics ,HIV infections ,PSYCHOLOGY of HIV-positive persons ,SOCIAL skills ,MENTAL depression - Abstract
Mood disorders are highly prevalent in people living with HIV (PLWH) and represent a potential contributor to functional impairment in activities of daily living. We aimed to determine if (1) Anxiety and depression symptoms were independently associated with impairments in basic self-care, role functioning, and social functioning and (2) PLWH differentially experienced impairments due to mood symptoms compared to those without HIV. Data for this study were obtained from 150 individuals (87 PLWH, 61% male, mean age
= 44) via a cross-sectional study on alcohol and HIV-associated brain dysfunction. The Beck Anxiety Inventory (BAI) and the Center for Epidemiologic Studies Depression Scale (CES-D) were used to assess anxiety and depressive symptoms. Higher anxiety symptoms were associated with role functioning impairment, while higher depressive and anxiety symptoms were each associated with social functioning impairment. As depressive symptoms increased, PLWH were 3x more likely to have impairments in role functioning compared to those without HIV. HIV status did not interact with mood symptoms to affect basic self-care or social functioning. Overall, mood symptoms are associated with different types of functional impairment, and improved management of mood symptoms could lead to improved role and social functioning. [ABSTRACT FROM AUTHOR] - Published
- 2024
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13. Does treating pain with alcohol affect drinking reduction among women with HIV enrolled in a clinical trial of naltrexone?
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Parisi, Christina E., Gracy, Hannah R., Bush, Nicholas J., Cook, Robert L., Wang, Yan, and Chichetto, Natalie
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NALTREXONE ,PAIN ,CLINICAL trials ,ANALYSIS of variance ,MULTIVARIATE analysis ,OPIOID receptors ,T-test (Statistics) ,ALCOHOL drinking ,RESEARCH funding ,CHI-squared test ,DESCRIPTIVE statistics ,HIV ,PAIN management ,LONGITUDINAL method - Abstract
Background: Many women living with HIV (WLWH) experience pain. Alcohol use with the intent to treat pain could lead to hazardous drinking and difficulty in reducing drinking. Naltrexone acts on opioid receptors important for pain regulation and is an approved treatment for alcohol use disorder. In this secondary analysis of a randomized double‐blind placebo‐controlled naltrexone clinical trial, the goals were to (1) compare alcohol reduction between women who drank to treat pain and those who did not and (2) examine differences in alcohol reduction by both drinking intention and treatment arm. Methods: Women living with HIV (N = 194, mean age 48.3 years, 83% non‐Hispanic Black, 11% Hispanic) with hazardous drinking (>7 drinks/week) were randomized to receive daily treatment with naltrexone 50 mg or placebo for 4 months. Study visits occurred at baseline and 2, 4, and 7 months (posttreatment). The number of drinks/week was measured using the Timeline Follow Back. Use of alcohol to treat pain was self‐reported. Participants were categorized as using alcohol to treat pain or not and in the naltrexone or placebo group. Chi‐square, t‐test, MANOVA, and sequential mixed effects models were used to determine group differences in demographic factors, mean/drinks per week, and percent change in mean drinks/week at baseline and each follow‐up visit. Results: There was a consistent decrease in drinking throughout the study. There was not a significant difference in mean drinks/week at any point in the study between women who used alcohol to treat pain and those who did not. When considering treatment arm, at 2 months only those who did not use alcohol to treat pain in the naltrexone group had a significantly lower mean drinks/week than the other groups (p = 0.007); all groups had similar decreases in drinking from 4 months onward. Conclusion: In the naltrexone group, WLWH who drank to treat pain reduced their alcohol consumption more slowly than WLWH who did not drink to treat pain. Replication of these findings would suggest that alcohol treatment guidelines should address pain as a factor in drinking outcomes. [ABSTRACT FROM AUTHOR]
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- 2023
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14. Changes in frequency of cannabis use among people with HIV during the COVID-19 pandemic: a multi-methods study to explore the underlying reasons for change.
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Parisi, Christina E., Wang, Yan, Varma, Deepthi S., Vaddiparti, Krishna, Ibañez, Gladys E., Cruz Carrillo, Liset, and Cook, Robert L.
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COVID-19 pandemic ,HIV-positive persons ,COMPLICATED grief ,MENTAL depression ,THEMATIC analysis ,AFRICAN Americans - Abstract
Background: People with HIV (PWH) report higher rates of cannabis use than the general population. It is unclear how cannabis use among PWH has been impacted by the COVID-19 pandemic and the implications for the health and wellbeing of PWH. Objectives: To describe changes in frequency of cannabis use among a sample of PWH during the pandemic, reasons for those changes, and implications of the findings. Methods: The data are cross-sectional and come from questions asked in a follow-up phone survey administered to a prospective cohort of PWH in Florida between May 2020 and March 2021. Participants who used cannabis were asked about changes in their frequency of cannabis use in a quantitative survey and reasons for changes in a qualitative open-ended question. Qualitative data were analyzed using thematic analysis. Results: Among 227 PWH (mean age 50, 50% men, 69% Black/African American, 14% Hispanic/Latino), 13% decreased frequency of cannabis, 11% increased frequency, and 76% reported no change. The most common reasons for increasing frequency of cannabis use were reducing anxiety/stress, trying to relax, coping with grief or reducing symptoms of depression, and reducing boredom during the pandemic. Supply or access issues, health concerns, and having already wanted to reduce cannabis use were common reasons for decreased frequency. Conclusion: Nearly 25% of the sample changed their cannabis use frequency during the pandemic. These findings shed light on the behaviors and motivations of PWH who use cannabis and can inform clinical practice and interventions during public health emergencies and beyond. [ABSTRACT FROM AUTHOR]
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- 2023
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15. Does the Relationship Between HIV Stigma Subtypes and Viral Suppression Differ by Age?: A Stratified Analysis of Data from the Florida Medical Monitoring Project.
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Williams, Renessa S., Zhou, Zhi, Cook, Christa, Lucero, Robert, Spencer, Emma C., and Cook, Robert L.
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PUBLIC health surveillance ,CONFIDENCE intervals ,AGE distribution ,VIRAL load ,SOCIAL stigma ,DESCRIPTIVE statistics ,RESEARCH funding ,ODDS ratio ,HIV - Abstract
HIV-related stigma is recognized as a top barrier to achieve viral suppression in the United States, but data describing who is most affected by HIV stigma is limited. The study sought to (1) identify the relationships between HIV-related stigma and unsuppressed viral load and (2) examine whether the association between HIV stigma subtypes and unsuppressed viral load differ by age group (i.e., 18–34, 35–49, and 50+ years-old) using surveillance data from the Florida Medical Monitoring Project (n = 1195). Most participants were 50+ years-old (55%), male (71%), and Black (51%). Enacted stigma was significantly associated with unsuppressed viral loads among the 18–34-year-old age group (OR 1.68, CI 1.09–2.60). After adjusting for potential confounders, only enacted stigma was independently associated with unsuppressed viral load in the 18–34-year-old age group. Results highlight the need for targeted interventions to reduce enacted stigma among younger persons with HIV to achieve viral suppression. [ABSTRACT FROM AUTHOR]
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- 2023
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16. Sociodemographic and clinical factors associated with transdermal alcohol concentration from the SCRAM biosensor among persons living with and without HIV.
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Richards, Veronica L., Liu, Yiyang, Orr, Jessica, Leeman, Robert F., Barnett, Nancy P., Bryant, Kendall, Cook, Robert L., and Wang, Yan
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LIVER physiology ,BIOSENSORS ,HIV-positive persons ,STATISTICS ,SELF-evaluation ,MULTIVARIATE analysis ,HEALTH status indicators ,ALCOHOLIC intoxication ,SOCIOECONOMIC factors ,ALANINE ,ALCOHOL drinking ,ENZYMES ,REWARD (Psychology) ,DESCRIPTIVE statistics ,BREATH tests ,BODY mass index ,AMINOTRANSFERASES ,ALCOHOLS (Chemical class) ,ASPARTATE aminotransferase ,LONGITUDINAL method ,BEHAVIOR modification - Abstract
Background: Transdermal alcohol biosensors can objectively monitor alcohol use by measuring transdermal alcohol concentration (TAC). However, it is unclear how sociodemographic and clinical factors that influence alcohol metabolism are associated with TAC. The main aim of this study was to examine how sociodemographic factors (sex, age, race/ethnicity) and clinical factors (body mass index, liver enzymes: alanine aminotransferase [ALT] and aspartate transaminase [AST]), alcohol use disorder, and HIV status were associated with TAC while controlling for level of alcohol use. Methods: We analyzed data from a prospective study involving contingency management for alcohol cessation among persons living with and without human immunodeficiency virus (HIV) that used the Secure Continuous Remote Alcohol Monitoring (SCRAM) biosensor. Forty‐three participants (Mage = 56.6 years; 63% male; 58% people living with HIV) yielded 183 SCRAM‐detected drinking days. Two indices derived from SCRAM: peak TAC (reflecting level of intoxication) and TAC area under the curve (TAC‐AUC; reflecting alcohol volume)—were the main outcomes. Self‐reported alcohol use (drinks/drinking day) measured by Timeline Followback was the main predictor. To examine whether factors of interest were associated with TAC, we used individual generalized estimating equations (GEE), followed by a multivariate GEE model to include all significant predictors to examine their associations with TAC beyond the effect of self‐reported alcohol use. Results: Number of drinks per drinking day (B = 0.29, p < 0.01) and elevated AST (B = 0.50, p = 0.01) were significant predictors of peak TAC. Positive HIV status, female sex, elevated AST, and number of drinks per drinking day were positively associated with TAC‐AUC at the bivariate level, whereas only self‐reported alcohol use (B = 0.85, p < 0.0001) and female sex (B = 0.67, p < 0.05) were significant predictors of TAC‐AUC at the multivariate level. Conclusions: HIV status was not independently associated with TAC. Future studies should consider the sex and liver function of the participant when using alcohol biosensors to measure alcohol use. [ABSTRACT FROM AUTHOR]
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- 2021
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17. Association of Syndemic Unhealthy Alcohol Use, Smoking, and Depressive Symptoms on Incident Cardiovascular Disease among Veterans With and Without HIV-Infection.
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Chichetto, Natalie E., Kundu, Suman, Freiberg, Matthew S., Koethe, John R., Butt, Adeel A., Crystal, Stephen, So-Armah, Kaku A., Cook, Robert L., Braithwaite, R. Scott, Justice, Amy C., Fiellin, David A., Khan, Maria, Bryant, Kendall J., Gaither, Julie R., Barve, Shirish S., Crothers, Kristina, Bedimo, Roger J., Warner, Alberta, and Tindle, Hilary A.
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HIV infections ,MULTIVARIATE analysis ,CARDIOVASCULAR diseases ,RETROSPECTIVE studies ,ALCOHOL drinking ,MENTAL depression ,DESCRIPTIVE statistics ,SMOKING ,VETERANS ,LONGITUDINAL method ,PROPORTIONAL hazards models - Abstract
Unhealthy alcohol use, smoking, and depressive symptoms are risk factors for cardiovascular disease (CVD). Little is known about their co-occurrence – termed a syndemic, defined as the synergistic effect of two or more conditions—on CVD risk in people with HIV (PWH). We used data from 5621 CVD-free participants (51% PWH) in the Veteran's Aging Cohort Study-8, a prospective, observational study of veterans followed from 2002 to 2014 to assess the association between this syndemic and incident CVD by HIV status. Diagnostic codes identified cases of CVD (acute myocardial infarction, stroke, heart failure, peripheral artery disease, and coronary revascularization). Validated measures of alcohol use, smoking, and depressive symptoms were used. Baseline number of syndemic conditions was categorized (0, 1, ≥ 2 conditions). Multivariable Cox Proportional Hazards regressions estimated risk of the syndemic (≥ 2 conditions) on incident CVD by HIV-status. There were 1149 cases of incident CVD (52% PWH) during the follow-up (median 10.1 years). Of the total sample, 64% met our syndemic definition. The syndemic was associated with greater risk for incident CVD among PWH (Hazard Ratio [HR] 1.87 [1.47–2.38], p < 0.001) and HIV-negative veterans (HR 1.70 [1.35–2.13], p < 0.001), compared to HIV-negative with zero conditions. Among those with the syndemic, CVD risk was not statistically significantly higher among PWH vs. HIV-negative (HR 1.10 [0.89, 1.37], p =.38). Given the high prevalence of this syndemic combined with excess risk of CVD, these findings support linked-screening and treatment efforts. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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18. Trends in Sexually Transmitted Infections in United States Ambulatory Care Clinics from 2005–2016.
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Unigwe, Ikenna, Yang, Seonkyeong, Song, Hyun Jin, Lo-Ciganic, Wei-Hsuan, Hincapie-Castillo, Juan, Cook, Robert L., and Park, Haesuk
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SEXUALLY transmitted diseases ,OUTPATIENT medical care ,MEDICAL care surveys ,OLDER people ,LOGISTIC regression analysis - Abstract
We examined the prevalence trends of non-human immunodeficiency virus (HIV) sexually transmitted infections (STI) and associated patient characteristics in U.S. ambulatory-care settings from 2005–2016. We conducted a retrospective repeated cross-sectional analysis using data from the National Ambulatory Medical Care Survey (NAMCS) for individuals aged 15–64 with a non-HIV STI-related visit. Data were combined into three periods (2005–2008, 2009–2012, and 2013–2016) to obtain reliable estimates. Logistic regression was used for analysis. A total of 19.5 million weighted, non-HIV STI-related ambulatory visits from 2005–2016 were identified. STI-related visits per 100,000 ambulatory care visits increased significantly over the study period: 206 (95% CI = 153–259), 343 (95% CI = 279–407), and 361 (95% CI = 277–446) in 2005–2008, 2009–2012, and 2013–2016, respectively (P
trend = 0.003). These increases were mainly driven by increases in HPV-related visits (56 to 163 per 100,000 visits) from 2005–2008 to 2009–2012, followed by syphilis- or gonorrhea-related visits (30 to 67 per 100,000 visits) from 2009–2012 to 2013–2016. Higher odds of having STI-related visit were associated with younger age (aged 15–24: aOR = 4.45; 95% CI = 3.19–6.20 and aged 25–44: aOR = 3.59; 95% CI = 2.71–4.77) vs. 45–64-year-olds, Black race (aOR = 2.41; 95% CI = 1.78–3.25) vs. White, and HIV diagnosis (aOR = 10.60; 95% CI = 5.50–20.27) vs. no HIV diagnosis. STI-related office visits increased by over 75% from 2005–2016, and were largely driven by HPV-related STIs and syphilis- or gonorrhea-related STIs. [ABSTRACT FROM AUTHOR]- Published
- 2022
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19. Who wants long-Acting injectable antiretroviral therapy? Treatment preferences among adults with HIV in Florida.
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Fisk-Hoffman, Rebecca J., Liu, Yiyang, Somboonwit, Charurut, Widmeyer, Maya, Canidate, Shantrel, Prosperi, Mattia, and Cook, Robert L.
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ANTIRETROVIRAL agents , *SOCIAL networks , *HIV-positive persons , *INCOME , *LOGISTIC regression analysis - Abstract
Long-acting injectable (LAI) antiretroviral therapy (ART) is available to people with HIV (PWH), but it is unknown which PWH prefer this option. Using the Andersen Behavioral Model this study identifies characteristics of PWH with greater preference for LAI ART. Cross-sectional data from the Florida Cohort, which enrolled adult PWH from community-based clinics included information on predisposing (demographics), enabling (transportation, income), and need (ART adherence <90%) factors. ART preference was assessed via a single question (prefer pills, quarterly LAI, or no preference). Confounder-adjusted multinomial logistic regressions compared those who preferred pills to the other preference options, with covariates identified using directed acyclic graphs. Overall, 314 participants responded (40% non-Hispanic Black, 62% assigned male, 63% aged 50+). Most (63%) preferred the hypothetical LAI, 23% preferred pills, and 14% had no preference. PWH with access to a car (aRRR 1.97 95%CI 1.05–3.71), higher income (aRRR 2.55 95%CI 1.04–6.25), and suboptimal ART adherence (aRRR 7.41 95% CI 1.52–36.23) were more likely to prefer the LAI, while those who reported having no social network were less likely to prefer the LAI (aRRR 0.32 95% CI 0.11–0.88). Overall LAI interest was high, with greater preference associated with enabling and need factors. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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20. Association between cannabis use disorder and greater apathy in adults with HIV.
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Britton, Mark K., DeFelice, Jason, Porges, Eric C., Cohen, Ronald, Li, Yancheng, Wang, Yan, Ibañez, Gladys E., Somboonwit, Charurut, and Cook, Robert L.
- Subjects
- *
MARIJUANA abuse , *ALCOHOLISM , *APATHY , *ALCOHOL drinking , *ADULTS - Abstract
Apathy is prevalent among people with HIV (PWH) and is associated with poor clinical outcomes. Cannabis use and Cannabis Use Disorder (CUD) are also disproportionately prevalent among PWH. CUD and younger onset of cannabis use may be linked to apathy in the general population; however, patterns of use most strongly associated with apathy have not been firmly established, and it is unclear whether cannabis use is linked to apathy in PWH. We examined associations in 311 adult PWH between Apathy Evaluation Scale-Self (AES-S) scores and CUD history (current/past/no CUD/no cannabis use) and between AES-S scores and age of CUD onset (adolescent-onset/adult-onset). We also examined robustness of associations to adjustment for depressive symptoms (which may overlap with apathy symptoms) and alcohol use. Current CUD was associated with greater AES-S scores relative to cannabis users with no CUD history (β = 2.13, 95 % CI = 0.37–3.90, p = 0.018). Adolescent-onset CUD was not associated with greater apathy relative to adult-onset CUD (β = 0.56, 95 % CI = -2.57 – 3.68, p = 0.7). Associations became nonsignificant after adjustment for depressive symptoms, but not after adjustment for alcohol use. Alcohol use was correlated with apathy (r = 0.19, 95 % CI: 0.076–0.29, p = 0.001). Cannabis Use Disorder and at-risk alcohol use are associated with apathy among PWH; this finding highlights the need for substance use disorder prevention and treatment among PWH. • Cannabis Use Disorder was associated with greater self-reported apathy. • 15 % of participants met cutoffs for clinically-significant apathy, regardless of Cannabis Use Disorder status. • Cannabis Use Disorder was not associated with more frequent cannabis use. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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21. Age-Associated Gut Dysbiosis, Marked by Loss of Butyrogenic Potential, Correlates With Altered Plasma Tryptophan Metabolites in Older People Living With HIV.
- Author
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Ghare, Smita, Singhal, Richa, Bryant, Vaughn, Gautam, Sabina, Tirumala, Chanakya Charan, Srisailam, Praneet Kumar, Reyes-Vega, Andrea, Ghooray, Dushan, McClain, Craig J., Hoffman, Kristi, Petrosino, Joseph, Bryant, Kendall, Govind, Varan, Cohen, Ronald, Cook, Robert L., and Barve, Shirish
- Abstract
Background: Imbalance in tryptophan (TRP) metabolism and its neuroactive metabolites, serotonin and kynurenine (KYN), is a known pathogenic mechanism underlying neurocognitive impairment. Gut microbiota plays an important role in TRP metabolism, and the production of these neuroactive molecules affects neurocognitive function. Although both HIV infection and normal aging independently induce gut dysbiosis and influence TRP metabolism, their interactive effects on compositional/functional changes in gut microbiota and consequent alterations in TRP metabolites remain largely undetermined. Methods: Older people living with HIV infection (PLWH, aged 50–70 years, n = 22) were enrolled in this cross-sectional pilot study. Metagenomic analysis of fecal microbiome using 16S Ribosomal ribonucleic acid gene sequencing and metabolomics analysis of plasma using mass spectrometry with a reverse-phase iquid chromatography tandem mass spectrometry were performed. Statistical analyses included the univariate linear regression and Spearman correlation analyses. Results: Age-associated changes in plasma levels of key neuroactive TRP metabolites, serotonin and KYN, were seen in PLWH. Specifically, we observed age-dependent decreases in serotonin and increases in KYN and KYN-to-TRP ratio, indicative of dysfunctional TRP metabolism. Furthermore, the gut dysbiosis seen in older PLWH is characterized by a reduction of Firmicutes/Bacteroidetes ratio and butyrate-producing microbial families Lachnospiraceae and Lactobacillaceae. Of importance, correspondent with gut dysbiosis, increasing age was significantly associated with decreased plasma butyrate levels, which in turn correlated positively with serotonin and negatively with KYN/TRP ratio. Conclusions: Age-dependent gut microbial dysbiosis distinguished by a decrease in butyrogenic potential is a key pathogenic feature associated with the shift in TRP metabolism from serotonin to KYN in older PLWH. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
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