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207. HIV testing, care referral and linkage to care intervals affect time to engagement in care for newly diagnosed HIV-infected adolescents in fifteen adolescent medicine clinics in the United States

Author

Philbin, Morgan M., Tanner, Amanda E., DuVal, Anna, Ellen, Jonathan M., Xu, Jiahong, Kapogiannis, Bill, Bethel, Jim, and Fortenberry, J. Dennis

Subjects
Male, Health Services Needs and Demand, Adolescent, HIV Infections, Professional-Patient Relations, Continuity of Patient Care, Patient Acceptance of Health Care, Ambulatory Care Facilities, Article, Health Services Accessibility, United States, Young Adult, Adolescent Medicine, Adolescent Health Services, Humans, Female, Delivery of Health Care, Referral and Consultation
Abstract

To examine how the time from HIV testing to care referral and from referral to care linkage influenced time to care engagement for newly diagnosed HIV-infected adolescents.We evaluated the Care Initiative, a care linkage and engagement program for HIV-infected adolescents in 15 US clinics. We analyzed client-level factors, provider type, and intervals from HIV testing to care referral and from referral to care linkage as predictors of care engagement. Engagement was defined as a second HIV-related medical visit within 16 weeks of initial HIV-related medical visit (linkage).At 32 months, 2143 youth had been referred. Of these, 866 were linked to care through the Care Initiative within 42 days and thus eligible for study inclusion. Of the linked youth, 90.8% were ultimately engaged in care. Time from HIV testing to referral (eg, ≤7 days versus365 days) was associated with engagement [adjusted odds ratio = 2.91; 95% confidence interval (CI): 1.43 to 5.94] and shorter time to engagement (adjusted hazard ratio = 1.41; 95% CI: 1.11 to 1.79). Individuals with shorter care referral to linkage intervals (eg, ≤7 days versus 22-42 days) engaged in care faster (adjusted hazard ratio = 2.90; 95% CI: 2.34 to 3.60) and more successfully (adjusted odds ratio = 2.01; 95% CI: 1.04 to 3.89).These data address a critical piece of the care continuum and can offer suggestions of where and with whom to intervene to best achieve the care engagement goals outlined in the US National HIV/AIDS Strategy. These results may also inform programs and policies that set concrete milestones and strategies for optimal care linkage timing for newly diagnosed adolescents.

Published
2016

208. BUILDING AN ACADEMIC PEDIATRIC HEALTH SYSTEM AS THE WORLD CONTINUES TO TURN: A CASE STUDY

Author

ELLEN, JONATHAN M.

Subjects
Academic Medical Centers, Baltimore, Florida, Humans, Articles, Precision Medicine, Hospitals, Pediatric, Pediatrics
Abstract

In 2011, All Children's Hospital (ACH) joined the Johns Hopkins Health System (JHHS) and in so doing became a member of Johns Hopkins Medicine (JHM). The value proposition for the joining of ACH and JHHS/JHM was to transform ACH into an academic pediatric health system. This case study of the transformation provides evidence for the usefulness of a precision medicine framework to organize investments in programs and practices that further the tripartite mission of academic medical centers and may increase the value of the care they deliver.

Published
2016

209. A Tailored Approach to Launch Community Coalitions Focused on Achieving Structural Changes: Lessons Learned From a HIV Prevention Mobilization Study

Author

Chutuape, Kate S, Willard, Nancy, Walker, Bendu C, Boyer, Cherrie B, Ellen, Jonathan, and Adolescent Medicine Trials Network for HIVAIDS Interventions

Subjects
coalition building, Prevention, HIV prevention, TheoryofComputation_GENERAL, HIV Infections, Health Care Coalitions, Community Health Planning, Adolescent Medicine Trials Network for HIVAIDS Interventions, Cohort Studies, Leadership, Infectious Diseases, Good Health and Well Being, Socioeconomic Factors, structural change, community mobilization, Public Health and Health Services, HIV/AIDS, Humans, adolescents, Public Health, Cooperative Behavior, Program Development
Abstract

Public health HIV prevention efforts have begun to focus on addressing social and structural factors contributing to HIV risk, such as unstable housing, unemployment, and access to health care. With a limited body of evidence-based structural interventions for HIV, communities tasked with developing structural changes need a defined process to clarify their purpose and goals. This article describes the adaptations made to a coalition development model with the purpose of improving the start-up phase for a second group of coalitions. Modifications focused on preparing coalitions to more efficiently apply structural change concepts to their strategic planning activities, create more objectives that met study goals, and enhance coalition procedures such as building distributed coalition leadership to better support the mobilization process. We report on primary modifications to the process, findings for the coalitions, and recommendations for public health practitioners who are seeking to start a similar coalition.

Published
2015

216. World Congress Integrative Medicine & Health 2017: part two

Author

Ee, Carolyn, primary, Thuraisingam, Sharmala, additional, Pirotta, Marie, additional, French, Simon, additional, Xue, Charlie, additional, Teede, Helena, additional, Kristoffersen, Agnete E., additional, Sirois, Fuschia, additional, Stub, Trine, additional, Engler, Jennifer, additional, Joos, Stefanie, additional, Güthlin, Corina, additional, Felenda, Jennifer, additional, Beckmann, Christiane, additional, Stintzing, Florian, additional, Evans, Roni, additional, Bronfort, Gert, additional, Keefe, Daniel, additional, Taberko, Anna, additional, Hanson, Linda, additional, Haley, Alex, additional, Ma, Haiwei, additional, Jolton, Joseph, additional, Yarosh, Lana, additional, Keefe, Francis, additional, Nam, Jung, additional, Ojala, Liwanag, additional, Kreitzer, Mary J., additional, Fink, Careen, additional, Kraft, Karin, additional, Flower, Andrew, additional, Lewith, George, additional, Harman, Kim, additional, Stuart, Beth, additional, Bishop, Felicity L., additional, Frawley, Jane, additional, Füleki, Lilla, additional, Kiss, Eva, additional, Vancsik, Tamas, additional, Krenacs, Tibor, additional, Funabashi, Martha, additional, Pohlman, Katherine A., additional, Mior, Silvano, additional, Thiel, Haymo, additional, Hill, Michael D., additional, Cassidy, David J., additional, Westaway, Michael, additional, Yager, Jerome, additional, Hurwitz, Eric, additional, Kawchuk, Gregory N., additional, O’Beirne, Maeve, additional, Vohra, Sunita, additional, Gaboury, Isabelle, additional, Morin, Chantal, additional, Gaertner, Katharina, additional, Torchetti, Loredana, additional, Frei-Erb, Martin, additional, Kundi, Michael, additional, Frass, Michael, additional, Gallo, Eugenia, additional, Maggini, Valentina, additional, Comite, Mattia, additional, Sofi, Francesco, additional, Baccetti, Sonia, additional, Vannacci, Alfredo, additional, Di Stefano, Mariella, additional, Monechi, Maria V., additional, Gori, Luigi, additional, Rossi, Elio, additional, Firenzuoli, Fabio, additional, Mediati, Rocco D., additional, Ballerini, Giovanna, additional, Gardiner, Paula, additional, Lestoquoy, Anna S., additional, Negash, Lily, additional, Stillman, Sarah, additional, Shah, Prachi, additional, Liebschutz, Jane, additional, Adelstein, Pamela, additional, Farrell-Riley, Christine, additional, Brackup, Ivy, additional, Penti, Brian, additional, Saper, Robert, additional, Sampedro, Isabel Giralt, additional, Carvajal, Gilda, additional, Gleiss, Andreas, additional, Gross, Marie M., additional, Brendlin, Dorothea, additional, Röttger, Jonas, additional, Stritter, Wiebke, additional, Seifert, Georg, additional, Grzanna, Noelle, additional, Stange, Rainer, additional, Guendling, Peter W., additional, Gu, Wen, additional, Lu, Yan, additional, Wang, Jie, additional, Zhang, Chengcheng, additional, Bai, Hua, additional, He, Yuxi, additional, Zhang, Xiaoxu, additional, Zhang, Zhengju, additional, Wang, Dali, additional, Meng, Fengxian, additional, Hagel, Alexander, additional, Albrecht, Heinz, additional, Vollbracht, Claudia, additional, Dauth, Wolfgang, additional, Hagel, Wolfgang, additional, Vitali, Francesco, additional, Ganzleben, Ingo, additional, Schultis, Hans, additional, Konturek, Peter, additional, Stein, Jürgen, additional, Neurath, Markus, additional, Raithel, Martin, additional, Krick, Bianka, additional, Haller, Heidemarie, additional, Klose, Petra, additional, Dobos, Gustav, additional, Kümmel, Sherko, additional, Cramer, Holger, additional, Saha, Felix J., additional, Kowoll, Anna, additional, Ebner, Barbara, additional, Berger, Bettina, additional, Choi, Kyung-Eun, additional, He, Lisha, additional, Wang, Han, additional, He, X., additional, Gu, C., additional, Zhang, Y., additional, Zhao, Linhua, additional, Tong, Xiaolin, additional, He, Xinhui, additional, Gu, Chengjuan, additional, Zhang, Ying, additional, Ho, Robin S. T., additional, Chung, Vincent C. H., additional, Wu, Xinyin, additional, Wong, Charlene H. L., additional, Wu, Justin C. Y., additional, Wong, Samuel Y. S., additional, Lau, Alexander Y. L., additional, Sit, Regina W. S., additional, Wong, Wendy, additional, Holmes, Michelle, additional, Bishop, Felicity, additional, Calman, Lynn, additional, Newell, Dave, additional, Field, Jonathan, additional, Htut, Win L., additional, Han, Dongwoon, additional, Choi, Da I., additional, Choi, Soo J., additional, Kim, Ha Y., additional, Hwang, Jung H., additional, Huang, Ching W., additional, Jang, Bo H., additional, Chen, Fang P., additional, Ko, Seong G., additional, Huang, Wenjing, additional, Jin, De, additional, Lian, Fengmei, additional, Jang, Soobin, additional, Kim, Kyeong H., additional, Lee, Eun K., additional, Sun, Seung H., additional, Go, Ho Y., additional, Ko, Youme, additional, Park, Sunju, additional, Shin, Yong C., additional, Janik, Hubert, additional, Greiffenhagen, Natalie, additional, Bolte, Jürgen, additional, Jaworski, Mariusz, additional, Adamus, Miroslawa, additional, Dobrzynska, Aleksandra, additional, Jeitler, Michael, additional, Jaspers, Jessica, additional, von Scheidt, Christel, additional, Koch, Barbara, additional, Michalsen, Andreas, additional, Steckhan, Nico, additional, Kessler, Christian, additional, Huang, Wen-jing, additional, Pang, Bing, additional, Lian, Feng-Mei, additional, Jong, Miek, additional, Baars, Erik, additional, Glockmann, Anja, additional, Hamre, Harald, additional, Kainuma, Mosaburo, additional, Murakami, Aya, additional, Kubota, Toshio, additional, Kobayashi, Daisuke, additional, Sumoto, Yasuhiro, additional, Furusyo, Norihiro, additional, Ando, Shin-Ichi, additional, Shimazoe, Takao, additional, Kelber, Olaf, additional, Verjee, S., additional, Gorgus, Eva, additional, Schrenk, Dieter, additional, Kemper, Kathi, additional, Hill, Ellie, additional, Rao, Nisha, additional, Gascon, Gregg, additional, Mahan, John, additional, Kienle, Gunver, additional, Dietrich, Jörg, additional, Schmoor, Claudia, additional, Huber, Roman, additional, Kim, Weon H., additional, Ahmed, Mansoor, additional, He, Luzhu, additional, Hwang, Jung Hye, additional, Meggyeshazi, Nora, additional, Kovago, Csaba, additional, Klaus, Anne K., additional, Zerm, Roland, additional, Pranga, Danilo, additional, Ostermann, Thomas, additional, Reif, Marcus, additional, von Laue, Hans Broder, additional, Brinkhaus, Benno, additional, Kröz, Matthias, additional, Recchia, Daniela Rodrigues, additional, von Laue, Hans B., additional, Klein-Laansma, Christien T., additional, Jong, Mats, additional, von Hagens, Cornelia, additional, Jansen, Jean P., additional, van Wietmarschen, Herman, additional, Jong, Miek C., additional, Sun, Seung-Ho, additional, Go, Ho-Yeon, additional, Jeon, Chan-Yong, additional, Song, Yun-Kyung, additional, Ko, Seong-Gyu, additional, Koch, Anna K., additional, Rabsilber, Sybille, additional, Lauche, Romy, additional, Langhorst, Jost, additional, Trifunovic-Koenig, Milena, additional, Koster, Evi, additional, Delnoij, Diana, additional, Kroll, Lena, additional, Weiss, Kathrin, additional, Kubo, Ai, additional, Hendlish, Sarah, additional, Altschuler, Andrea, additional, Connolly, Nancy, additional, Avins, Andy, additional, Wardle, Jon, additional, Lee, David, additional, Sibbritt, David, additional, Adams, Jon, additional, Park, Crystal, additional, Mishra, Gita, additional, Lechner, Johann, additional, Lee, Inseon, additional, Chae, Younbyoung, additional, Lee, Jisu, additional, Cho, Seung H., additional, Choi, Yujin, additional, Lee, Jee Y., additional, Ryu, Han S., additional, Yoon, Sung S., additional, Oh, Hye K., additional, Hyun, Lyun K., additional, Kim, Jin O., additional, Yoon, Seong W., additional, Lee, Ju-Yeon, additional, Shin, Sang-Hoon, additional, Jang, Min, additional, Müller, Indra, additional, Park, So-Hyun Janson, additional, Laird, Lance, additional, Mitchell, Suzanne, additional, Li, Xiaofei, additional, Wang, Yunhui, additional, Zhen, Jianhua, additional, Yu, He, additional, Liu, Tiegang, additional, Gu, Xiaohong, additional, Liu, Hui, additional, Ma, Weiguo, additional, Shang, Xuezheng, additional, Bai, Yu, additional, Liu, Wei, additional, Rooney, Collin, additional, Smith, Amos, additional, Lopes, Shirlene, additional, Demarzo, Marcelo, additional, do Patrocínio Nunes, Maria, additional, Lorenz, Peter, additional, Gründemann, Carsten, additional, Heinrich, Miriam, additional, Garcia-Käufer, Manuel, additional, Grunewald, Franziska, additional, Messerschmidt, Silke, additional, Herrick, Anja, additional, Gruber, Kim, additional, Knödler, Matthias, additional, Steinborn, Carmen, additional, Lu, Taoying, additional, Wang, Lixin, additional, Wu, Darong, additional, Luberto, Christina M, additional, Hall, Daniel L., additional, Chad-Friedman, Emma, additional, Lechner, Suzanne, additional, Park, Elyse R., additional, Luberto, Christina M., additional, Park, Elyse, additional, Goodman, Janice, additional, Luer, Sonja, additional, Heri, Matthias, additional, von Ammon, Klaus, additional, Landini, Ida, additional, Lapucci, Andrea, additional, Nobili, Stefania, additional, Mini, Enrico, additional, McDermott, Clare, additional, Richards, Selwyn, additional, Cox, Diane, additional, Frossell, Sarah, additional, Leydon, Geraldine, additional, Eyles, Caroline, additional, Raphael, Hilly, additional, Rogers, Rachael, additional, Selby, Michelle, additional, Adler, Charlotte, additional, Allam, Jo, additional, Bu, Xiangwei, additional, Zhang, Honghong, additional, Zhang, Jianpeng, additional, Mikolasek, Michael, additional, Berg, Jonas, additional, Witt, Claudia, additional, Barth, Jürgen, additional, Miskulin, Ivan, additional, Lalic, Zdenka, additional, Miskulin, Maja, additional, Dumic, Albina, additional, Sebo, Damir, additional, Vcev, Aleksandar, additional, Mohammed, Nasr A. A., additional, Choi, Soo Jeung, additional, Im, Hyea Bin, additional, Mukherjee, Anwesha, additional, Kandhare, Amit, additional, Bodhankar, Subhash, additional, Thakurdesai, Prasad, additional, Munk, Niki, additional, Evans, Erica, additional, Froman, Amanda, additional, Kline, Matthew, additional, Bair, Matthew J., additional, Musial, Frauke, additional, Alræk, Terje, additional, Hamre, Harald J., additional, Björkman, Lars, additional, Fønnebø, Vinjar M., additional, Lian, Feng-mei, additional, Ni, Qing, additional, Tong, Xiao-lin, additional, Li, Xin-long, additional, Liu, Wen-ke, additional, Feng, Shuo, additional, Zhao, Xi-yan, additional, Zheng, Yu-jiao, additional, Zhao, Xue-min, additional, Lin, Yi-qun, additional, Zhao, Tian-yu, additional, Zhao, Xi-Yan, additional, Phd, Hui Che, additional, Zhang, Chen, additional, Liu, Feng, additional, Zhao, Lin-hua, additional, Ye, Ru, additional, Gu, Cheng-juan, additional, Peng, Wenbo, additional, De Carvalho, Diana, additional, El-Bayoumi, Mohamed, additional, Haig, Bob, additional, Kelly, Kimbalin, additional, Wade, Darrell J., additional, Portalupi, Emanuela, additional, Gobo, Giampietro, additional, Bellavita, Luigi, additional, Guglielmetti, Chiara, additional, Raak, Christa, additional, Teuber, Myriam, additional, Molsberger, Friedrich, additional, von Rath, Ulrich, additional, Reichelt, Ulrike, additional, Schwanebeck, Uta, additional, Zeil, Sabine, additional, Vogelberg, Christian, additional, Veintimilla, Dolores Rodríguez, additional, Mery, Guerrero Tapia, additional, Villavicencio, Marisol Maldonado, additional, Moran, Sandra Herrera, additional, Sachse, Christian, additional, Gündlin, Peter W, additional, Sahebkarkhorasani, Monirsadat, additional, Azizi, Hoda, additional, Schumann, Dania, additional, Sundberg, Tobias, additional, Leach, Matthew J., additional, Seca, Susana, additional, Greten, Henry, additional, Selliah, Sugir, additional, Shakya, Anu, additional, Kim, Ha Yun, additional, Im, Hyea B., additional, Sherbakova, Anna, additional, Ulrich-Merzenich, Gudrun, additional, Abdel-Aziz, Heba, additional, Sibinga, Erica, additional, Webb, Lindsey, additional, Ellen, Jonathan, additional, Skrautvol, Kari, additional, Nåden, Dagfinn, additional, Song, Rhayun, additional, Grabowska, Weronika, additional, Osypiuk, Kamila, additional, Diaz, Gloria V., additional, Bonato, Paolo, additional, Park, Moonkyoung, additional, Hausdorff, Jeffrey, additional, Fox, Michael, additional, Sudarsky, Lewis R., additional, Tarsy, Daniel, additional, Novakowski, James, additional, Macklin, Eric A., additional, Wayne, Peter M., additional, Hwang, Inok, additional, Ahn, Sukhee, additional, Lee, Myung-Ah, additional, Sohn, Min K., additional, Sorokin, Oleg, additional, Heydeck, Dagmar, additional, Borchert, Astrid, additional, Hohmann, Christoph-Daniel, additional, Kühn, Harmut, additional, Kirschbaum, Clemens, additional, Stalder, Tobias, additional, Stöckigt, Barbara, additional, Teut, Michael, additional, Suhr, Ralf, additional, Sulmann, Daniela, additional, Streeter, Chris, additional, Gerbarg, Patrica, additional, Silveri, Marisa, additional, Brown, Richard, additional, Jensen, John, additional, Rutert, Britta, additional, Eggert, Angelika, additional, Längler, Alfred, additional, Holmberg, Christine, additional, Sun, Jin, additional, Deng, Xin, additional, Li, Wen-Yuan, additional, Wen, Bin, additional, Robinson, Nicola, additional, Liu, Jian-Ping, additional, Sung, Hyun K., additional, Yang, Narae, additional, Shin, Seon M., additional, Jung, Hee, additional, Kim, Young J., additional, Jung, Woo S., additional, Park, Tae Y., additional, Suzuki, Kiyoshi, additional, Ito, Toshinori, additional, Uchida, Seiya, additional, Kamohara, Seika, additional, Ono, Naoya, additional, Takamura, Mitsuyuki, additional, Yokochi, Ayumu, additional, Maruyama, Kazuo, additional, Tapia, Patricio, additional, Thabaut, Katarzyna, additional, Thronicke, Anja, additional, Steele, Megan, additional, Matthes, Harald, additional, Herbstreit, Cornelia, additional, Schad, Friedemann, additional, Tian, Jiaxing, additional, Yang, Libo, additional, Tian, Tian, additional, Zhang, Hewei, additional, Tian, Xia, additional, Wang, CongCong, additional, Chai, Qian Yun, additional, Zhang, Lijuan, additional, Xia, Ruyu, additional, Huang, Na, additional, Fei, Yutong, additional, Liu, Jianpin, additional, Trent, Natalie, additional, Miraglia, Mindy, additional, Dusek, Jeffrey, additional, Pasalis, Edi, additional, Khalsa, Sat B., additional, Trifunovic-König, Milena, additional, Koch, Anna, additional, Uebelacker, Lisa, additional, Tremont, Geoffrey, additional, Gillette, Lee, additional, Epstein-Lubow, Gary, additional, Strong, David, additional, Abrantes, Ana, additional, Tyrka, Audrey, additional, Tran, Tanya, additional, Gaudiano, Brandon, additional, Miller, Ivan, additional, Ullmann, Gerhild, additional, Li, Yuhua, additional, Vaidya, Sujata, additional, Marathe, Vinod, additional, Vale, Ana C., additional, Motta, Jacquelyne, additional, Donadão, Fabíola, additional, Valente, Angela C., additional, Valente, Luana C. Carvalho, additional, Ghelman, Ricardo, additional, Vesovic, Dusan, additional, Jevdic, Dragan, additional, Jevdic, Aleksandar, additional, Jevdic, Katarina, additional, Djacic, Mihael, additional, Letic, Dragica, additional, Bozic, Drago, additional, Markovic, Marija, additional, Dunjic, Slobodan, additional, Ruscuklic, Gordana, additional, Baksa, Dezire, additional, Vrca, Kenan, additional, Vincent, Ann, additional, Wahner-Roedler, Dietlind, additional, Whipple, Mary, additional, Vogelius, Maria M., additional, Friesecke, Iris, additional, Gündling, Peter W., additional, Mahapatra, Saswati, additional, Hynes, Rebecca, additional, Van Rooy, Kimberly, additional, Looker, Sherry, additional, Ghosh, Aditya, additional, Bauer, Brent, additional, Cutshall, Susanne, additional, Walach, Harald, additional, Flores, Ana Borges, additional, Ofner, Michael, additional, Kastner, Andreas, additional, Schwarzl, Gerhard, additional, Schwameder, Hermann, additional, Alexander, Nathalie, additional, Strutzenberger, Gerda, additional, Bu, Xianwei, additional, Zhang, Jianping, additional, Wang, Shang, additional, Shi, Jinfeng, additional, Hao, Yu, additional, Wu, Jun, additional, Qiu, Zeji, additional, Wang, Yuh-Hai, additional, Lou, Chi-Jung, additional, Watts, Sam, additional, Wayne, Peter, additional, Vergara-Diaz, Gloria, additional, Gow, Brian, additional, Miranda, Jose, additional, Sudarsky, Lewis, additional, Macklin, Eric, additional, Wode, Kathrin, additional, Bergqvist, Jenny, additional, Bernhardsson, Britt-Marie, additional, Nordberg, Johanna Hök, additional, Sharp, Lena, additional, Henriksson, Roger, additional, Woo, Yeonju, additional, Hyun, Min K., additional, Wu, Hao, additional, Wang, Tian-Fang, additional, Zhao, Yan, additional, Wei, Yu, additional, Tian, Lei, additional, He, Lei, additional, Wang, Xue, additional, Wu, Ruohan, additional, Han, Mei, additional, Caldwell, Patrina H. Y., additional, Liu, Shigang, additional, Zhang, Jing, additional, Liu, Jianping, additional, Chai, Qianyun, additional, Guo, Zhongning, additional, Wang, Congcong, additional, Liu, Zhijun, additional, Li, Xun, additional, Yang, I. J., additional, Lincha, V. Ruberio, additional, Ahn, S. H., additional, Lee, D. U., additional, Shin, H. M., additional, Yang, Lu, additional, Yang, N., additional, Sung, H., additional, Shin, S. M., additional, Go, H. Y., additional, Jung, H., additional, Kim, Y., additional, Park, T. Y., additional, Yap, Angela, additional, Kwan, Yu H., additional, Tan, Chuen S., additional, Ibrahim, Syed, additional, Ang, Seng B., additional, Yayi, Alfred, additional, Yoo, Jeong E., additional, Yoo, Ho R., additional, Jang, Sae B., additional, Lee, Hye L., additional, Youssef, Ala’a, additional, Ezzat, Shahira, additional, Motaal, Amira Abdel, additional, El-Askary, Hesham, additional, Yu, Xiaotong, additional, Cui, Yashan, additional, Yun, Younghee, additional, Ahn, Jin-Hyang, additional, Jang, Bo-Hyung, additional, Kim, Kyu-Seok, additional, Choi, Inhwa, additional, Glinz, Augustina, additional, ten Brink, Fadime, additional, Büssing, Arnd, additional, Gutenbrunner, Christoph, additional, Helbrecht, Bert, additional, Fang, Tiesheng, additional, Meng, Fengxion, additional, Shen, Zhiming, additional, Zhang, Ruixin, additional, Wu, Fan, additional, Li, Ming, additional, Xuan, Xinyun, additional, Shen, Xueyong, additional, Ren, Ke, additional, Berman, Brian, additional, Zheng, Zian, additional, Wan, Yuxiang, additional, Ma, Xueyan, additional, Dong, Fei, additional, Zick, Suzie, additional, Harris, Richard, additional, Bae, Go E., additional, Kwon, Jung N., additional, Lee, Hye Y., additional, Nam, Jong K., additional, Lee, Sang D., additional, Lee, Dong H., additional, Han, Ji Y., additional, Yun, Young J., additional, Lee, Ji H., additional, Park, Hye L., additional, Park, Seong H., additional, Bocci, Chiara, additional, Ivaldi, Giovanni B., additional, Vietti, Ilaria, additional, Meaglia, Ilaria, additional, Guffi, Marta, additional, Ruggiero, Rubina, additional, Gualea, Marita, additional, Longa, Emanuela, additional, Bonucci, Massimo, additional, Croke, Sarah, additional, Rodriguez, Lourdes Diaz, additional, Caracuel-Martínez, Juan C., additional, Fajardo-Rodríguez, Manuel F., additional, Ariza-García, Angélica, additional, la Fuente, Francisca García-De, additional, Arroyo-Morales, Manuel, additional, Estrems, Maria S., additional, Gómez, Vicente G., additional, Sabater, Mónica Valero, additional, Ferreri, Rosaria, additional, Bernardini, Simonetta, additional, Pulcri, Roberto, additional, Cracolici, Franco, additional, Rinaldi, Massimo, additional, Porciani, Claudio, additional, Fisher, Peter, additional, Hughes, John, additional, Mendoza, Ariadna, additional, MacPherson, Hugh, additional, Filshie, Jacqueline, additional, Di Francesco, Antonia, additional, Bernardini, Alberto, additional, Messe, Monica, additional, Primitivo, Vincenzo, additional, Iasella, Piera A., additional, Taminato, Monica, additional, Alcantara, Jaqueline Do Carmo, additional, De Oliveira, Katia R., additional, Rodrigues, Debora C. De Azevedo, additional, Mumme, Juliana R. Campana, additional, Sunakozawa, Olga K. Matsumoto, additional, Filho, Vicente Odone, additional, Goldenberg, Joshua, additional, Day, Andrew, additional, Sasagawa, Masa, additional, Ward, Lesley, additional, Cooley, Kieran, additional, Gunnarsdottir, Thora, additional, Hjaltadottir, Ingibjorg, additional, Hajimonfarednejad, Mahdie, additional, Hannan, Nicole, additional, Hellsing, Rut, additional, Andermo, Susanne, additional, Arman, Maria, additional, von Hörsten, Iris, additional, Torrielo, Patricia Vásquez, additional, Vilaró, Carmen L. Andrade, additional, Cabrera, Francisco Cerda, additional, Hui, Henny, additional, Ziea, Eric, additional, Tsui, Dora, additional, Hsieh, Joyce, additional, Lam, Christine, additional, Chan, Edith, additional, Jensen, Mark P., additional, Battalio, Samuel L., additional, Chan, Joy, additional, Edwards, Karlyn A., additional, Gertz, Kevin J., additional, Day, Melissa A., additional, Sherlin, Leslie H., additional, Ehde, Dawn M., additional, Jang, Bo-Hyoung, additional, Börner, Anja, additional, Lee, Jihong, additional, Lee, Boram, additional, Chang, Gyu T., additional, Menassa, Alejandra, additional, Motoo, Yoshiharu, additional, Müller, Jürgen, additional, Rabini, Sabine, additional, Vinson, Bettina, additional, Storr, Martin, additional, Niemeijer, Martin, additional, Hoekman, Joop, additional, Ruijssenaaars, Wied, additional, Njoku, Faith C., additional, Norheim, Arne J., additional, Okumus, Filiz, additional, and Oncu-Celik, Halime, additional

Published
2017
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219. Social Support and HIV-Status Disclosure to Friends and Family: Implications for HIV-Positive Youth

Author

Lee, Sonia, Yamazaki, Michiyo, Harris, D. Robert, Harper, Gary W., and Ellen, Jonathan

Subjects
Adult, Male, Young Adult, Self Disclosure, Adolescent, Health Status, HIV Seropositivity, Quality of Life, Humans, Social Support, Female, Child, Article
Abstract

The fear of negative reactions from friends and family members affects many human immunodeficiency virus (HIV)-positive adolescents' decisions regarding disclosure of their HIV status. The complex relationships and interplay among social support, fear of stigma, and disclosure of HIV status need to be better understood among youth living with HIV (YLHIV).Social support from friends and family members and HIV status disclosure were examined among 402 youth, aged 12-24 years, living with HIV.In separate analyses, (1) HIV-positive youth who reported more than one close friend and (2) HIV-positive youth who reported that friends and family members continued to socialize with them after disclosure of their HIV diagnosis, had higher levels of perceived social support overall (both p.05). Furthermore, perceived social support did not differ significantly between those participants for whom no family member knew their HIV status and those for whom at least one family member knew their status (p = .13). Race/ethnicity, sexual orientation, education level, and current living situation were not associated with family's knowledge of the participants' HIV infection status (p.07).This investigation adds important information concerning YLHIV, whose early disclosure experiences may influence their resilience and future coping mechanisms regarding experienced stigma, and thus influence the length of time they conceal their HIV status, their decision to disclose their status, and potentially their decisions regarding treatment. Interventions and support systems to assist YLHIV with disclosure, as well as medical care, may improve their overall quality of life.

Published
2015

220. Rethinking Urban Female Adolescents’ Safety Net: The Role of Family, Peers, and Sexual Partners in Social Support

Author

Robinson, Camille A., Trent, Maria, Ellen, Jonathan M., and Matson, Pamela A.

Abstract

Purpose: To examine how interpersonal factors are associated with family, peer, and partner social support among urban female adolescents in sexual relationships.Design: Secondary data analysis of cross-sectional data.Setting: Two urban health clinics and community sites in Baltimore, Maryland.Participants: One hundred sixteen female adolescents (ages 16-19) with 131 heterosexual relationships from the Perceived Risk of Sexually Transmitted Diseases cohort.Measures: Interpersonal factors included parental monitoring, friend–partner connectedness, and feelings of intimacy for partner. Social support was measured using the Multidimensional Scale of Perceived Social Support with family, peer, and partner subdomains.Analysis: Multivariable linear regression models using baseline data and accounting for clustering of partners.Results: Adolescents perceived high levels of family, peer, and partner support, with the greatest coming from partners (range: 1-5; family mean: 4.0 [95% confidence interval, CI: 3.83-4.18]; peer mean: 4.2 [95% CI: 4.05-4.33]; partner mean: 4.5 [95% CI: 4.36-4.60]). Parental monitoring and friend–partner connectedness were significantly associated with greater family (b= 0.11, standard error [SE] = 0.03, P= 0.001; b= 0.15, SE = 0.06, P= .02) and peer support (b= 0.06, SE = 0.02, P= .01; b= 0.29, SE = 0.07, P< .001). Feelings of intimacy for partner was significantly associated with greater partner support (b= 0.08, SE = 0.03, P= .02).Conclusion: Feeling connected to one’s social network and having a connected network is an important contribution to social support for urban female adolescents in sexual relationships. Future research targeting interpersonal factors is warranted, as it may result in increased social support and promote positive sexual health behaviors in an urban female adolescent population.

Published
2020
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221. The Longitudinal Association between Perceived Powerlessness and Sexual Risk Behaviors among Urban Youth: Mediating and Moderating Effects.

Author

Lim, Sahnah, Powell, Terrinieka W., Xue, Qian-Li, Towe, Vivian L., Taylor, Ralph B., Ellen, Jonathan M., and Sherman, Susan G.

Subjects
POWER (Social sciences), TEENAGERS' sexual behavior, URBAN youth, SELF-perception, RISK-taking behavior in adolescence, UNSAFE sex, BLACK people, CONDOMS, LONGITUDINAL method, MOTIVATION (Psychology), RISK-taking behavior, HUMAN sexuality, WHITE people, PSYCHOSOCIAL factors, SOCIOECONOMIC factors, SEXUAL partners
Abstract

A distal psychosocial factor, perceived powerlessness, has been found to predict various sexual risk behaviors among youth, yet no studies have assessed mediators or moderators in this relationship. Using a demographically diverse, longitudinal sample of urban youth (N = 257), this study assessed whether the need for sexual validation mediates the relationship between perceived powerlessness and sexual risk behaviors and to assess whether this mediated pathway is moderated by socioeconomic status and gender. The mean age of the participants was 21 years old (range: 15–24) and the majority of the sample identified as Black (65%) and female (62%). The results of structural equation modeling showed that the need for sexual validation mediated perceived powerlessness and condomless sex at last sex among Black youth. The need for sexual validation mediated perceived powerlessness and concurrent sexual partnerships among White youth and depended on levels of socioeconomic status. Sexual risk behavior interventions should provide youth with increased opportunities that encourage feelings of validation from other personal achievements in addition to sex while simultaneously addressing the structural conditions that drive young people to feel powerless. [ABSTRACT FROM AUTHOR]

Published
2019
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222. Childbearing Motivations and Desires, Fertility Beliefs, and Contraceptive Use among Urban African-American Adolescents and Young Adults with STI Histories.

Author

Alexander, Kamila A., Perrin, Nancy, Jennings, Jacky M., Ellen, Jonathan, and Trent, Maria

Subjects
YOUNG adults, FERTILITY, TEENAGERS, AGE, CONDOM use
Abstract

This study explored the influence of STI history on childbearing motivations, fertility beliefs, current childbearing desires, and contraception use among urban African-American adolescents and young adults (AYA). Secondary data were from the Neighborhood Influences on Adolescent and Young Adult Health (NIAAH) study, conducted from 2004 to 2007. Sample included 517 AYA ages 15-24 years (male: n = 199, female: n = 318). Linear and logistic regression models examined gender differences in childbearing motivations (CBM) and desires, fertility beliefs, condom, and contraception use. Logistic regression models were constructed to examine age, pregnancy history, and STI fertility knowledge as potential confounders. AYA men (3.29) and AYA women (3.23) had similar CBM mean scores. AYA women had more positive CBM and used condoms less. Condom use was not associated with CBM among AYA men (OR = 0.71, p = 0.069). Low beliefs about fertility (OR = 0.52, p = 0.003) and prior pregnancy (OR = 5.27, p = 0.002) were associated with current childbearing desires among AYA women. AYA men's low fertility beliefs were only associated with current childbearing desires (OR = 0.56, p = 0.044). AYA men reported more contraception use (67.46 vs. 55.04%), especially with no partner pregnancy history (OR = 0.26, p = 0.017). Younger men (15 to 18 years old) reported more contraception or condom use compared to older AYA men (19-25 years old) (OR = 0.40, p = 0.016). Young men reporting a partner's prior pregnancy used fewer condoms or contraception (OR = 0.23, p = 0.028). STI history did not influence CBM in this sample of urban youth. Prior pregnancy experiences and chronological age, however, were important milestones shaping proximal motivations and desires to bear children, beliefs about fertility, and contraception behaviors. [ABSTRACT FROM AUTHOR]

Published
2019
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223. Sexual Partner Characteristics, Relationship Type, and HIV Risk Among a Community Venue–Based Sample of Urban Adolescent and Young Adult Men Who Have Sex With Men.

Author

Boyer, Cherrie B., Greenberg, Lauren, Korelitz, James, Harper, Gary W., Stewart-Campbell, Rachel, Straub, Diane, Sanders, Renata, Reid, Lisa-Henry, Futterman, Donna, Lee, Sonia, and Ellen, Jonathan M.

Subjects
TEENAGERS' sexual behavior, HIV infections, SEXUAL partners, TRANSACTIONAL sex, SEXUALLY transmitted diseases, MEN who have sex with men
Abstract

Few studies have examined sexual partnerships and HIV risk in diverse samples of African American/Black and Hispanic/Latino adolescent and young adult men who have sex with men (YMSM), a group that have a high burden of HIV in the United States. A community–venue recruitment approach was used, which identified significant differences in HIV risk by sexual partner type among 1,215 YMSM. Those with casual partners had a higher number of sexual partners, had more sexually transmitted infections (STIs), were more likely to engage in transactional sex, and to use alcohol, marijuana, or other substances compared with those with main partners only. Among those with female sexual partners, many used condoms "every time" when engaging in vaginal sex with casual partners, but a sizable proportion "never/rarely" used condoms with their main partners. Our findings demonstrate a need for tailored HIV prevention education and counseling with necessary skills regarding consistent and correct condom use with all sexual partnerships. [ABSTRACT FROM AUTHOR]

Published
2019
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224. Structural Effects on HIV Risk Among Youth: A Multi-level Analysis.

Author

Miller, Robin Lin, Strzyzykowski, Trevor, Chiaramonte, Danielle, Acevedo-Polakovich, Ignacio, Spring, Hannah, Lee, Kyung-Sook, Santiago-Rivera, Olga, Boyer, Cherrie B., and Ellen, Jonathan M.

Subjects
HIV infection risk factors, MEDICAL cooperation, POPULATION geography, RACE, RESEARCH, RISK-taking behavior, SEX distribution, SOCIAL stigma, RESIDENTIAL patterns, WELL-being, AT-risk people, ATTITUDES toward AIDS (Disease)
Abstract

We proposed a multilevel model of structural influences on HIV-risky sexual partnerships in a diverse sample of 1793 youth residing in 23 states and the District of Columbia. We examined the influence of concentrated disadvantage, HIV stigma, and sexual and gender minority stigma on engagement in HIV risky sexual partnerships and whether youth’s participation in opportunity structures, anticipation of HIV stigma, and perceptions of their community as youth-supportive settings mediated structural effects. After controlling for age, HIV status, and race, we found structural HIV stigma had deleterious indirect effects on youth’s participation in HIV-risky sexual partnerships. Concentrated disadvantage and structural sexual and gender minority stigma had direct negative effects on youth’s perceptions of their communities as supportive and on their participation in prosocial activity. Support perceptions had direct, protective effects on avoidance of HIV-risky sexual partnerships. Structural stigma undermines youth’s belief that their communities invest in their safety and well-being. [ABSTRACT FROM AUTHOR]

Published
2018
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225. Ecological barriers to HIV service access among young men who have sex with men and high-risk young women from low-resourced urban communities.

Author

Chiaramonte, Danielle, Strzyzykowski, Trevor, Acevedo-Polakovich, Ignacio, Miller, Robin Lin, Boyer, Cherrie B., and Ellen, Jonathan M.

Subjects
HIV prevention, CONTENT analysis, ECOLOGICAL research, EMOTIONS, HEALTH services accessibility, HETEROSEXUALS, INTERVIEWING, RESEARCH methodology, MEDICAL needs assessment, MEDICAL quality control, MEDICAL care use, MEN'S health, METROPOLITAN areas, RESEARCH funding, RISK-taking behavior, SEX education, SOCIAL stigma, WOMEN'S health, HEALTH literacy, DATA analysis software, MEN who have sex with men
Abstract

Using an ecological perspective, we sought to elucidate the perceived barriers preventing HIV service access among two groups of U.S. youth (ages 12–24) disproportionately affected by HIV, men who have sex with men, and high-risk women. We content analyzed interviews with 318 key informants to identify distinct service access barriers. The 29 barriers informants named were organized into six categories (service-seeking demands, stigmas, knowledge and awareness, service quality, powerful opposition, and negative emotions). Findings suggest that barriers impacting access to HIV prevention, testing, and linkage-to-care services are remarkably similar and point to the need for comprehensive approaches to improving youth's access services that address both individual-level barriers and extra-individual barriers simultaneously. Findings can be used to guide future research, programming, and interventions to reduce the disproportionate spread of HIV among U.S. youth. [ABSTRACT FROM AUTHOR]

Published
2018
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228. A Comparison of Network-Based Strategies for Screening At-Risk Hispanic/Latino Adolescents and Young Adults for Undiagnosed Asymptomatic HIV Infection

Author

Kapogiannis, Bill G., Hightow-Weidman, Lisa, Gonin, René, Ellen, Jonathan M., and Febo, Irma

Abstract

Hispanic/Latino adolescents and young adults are disproportionately impacted by the HIV/AIDS epidemic; yet, little is known about the best strategies to increase HIV testing in this group. Network-based approaches are feasible and acceptable means for screening at-risk adults for HIV infection, but it is unknown whether these approaches are appropriate for at-risk young Hispanics/Latinos. Thus, we compared an alternative venue-based testing (AVT) strategy with a social and sexual network referral (SSNIT) strategy.

Published
2014
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234. Cross-sectional survey comparing HIV risk behaviours of adolescent and young adult men who have sex with men only and men who have sex with men and women in the US and Puerto Rico

Author

Ellen, Jonathan M and Ellen, Jonathan M

Abstract

ObjectiveTo examine the HIV risk behaviours of men who have sex with men only (MSMO) and men who have sex with men and women (MSMW), aged 12-24 years, in five US cities and in San Juan, Puerto Rico.MethodsData were collected through four annual cross-sectional anonymous surveys at community venues and included questions about sexual partnerships, sexual practices including condom use and substance use. Demographic and risk profiles were summarised for both groups.ResultsA total of 1198 men were included in this analysis, including 565 MSMO and 633 MSMW. There were statistically significant differences between the two groups for many risk factors examined in multivariable models. MSMW were more likely to identify as bisexual, be in a long-term relationship, have a history of homelessness, have ever used marijuana, have ever been tested for HIV and to have been tested for HIV within the past 6 months. MSMW may be more likely to ever exchange sex for money and ever have a sexually transmitted infection than MSMO.ConclusionsMSMW were more likely to report several markers of socioeconomic vulnerability or behaviours associated with increased risk for HIV than MSMO. MSMW contribute to HIV prevalence in the USA, and better understanding of the risk profile of this group is essential to understand heterosexual HIV transmission. MSMW, particularly those who identify as bisexual or questioning, may feel uncomfortable participating in programmes that are designed for gay-identified men. Therefore, prevention strategies need to target distinct subgroups that compose the population of MSM.

Published
2015

235. Evaluation of the effect of human immunodeficiency virus-related structural interventions: the connect to protect project.

Author

Ellen, Jonathan M and Ellen, Jonathan M

Abstract

ImportanceWith the emphasis on structural-level interventions that target social determinants of human immunodeficiency virus (HIV) transmission to curb the HIV epidemic, there is a need to develop evaluation models that can detect changes in individual factors associated with HIV-related structural changes.ObjectiveTo describe whether structural changes developed and achieved by community coalitions are associated with an effect on individual factors associated with the risk of contracting HIV.Design, setting, and participantsIn this serial cross-sectional survey design, data were collected from 8 cities during 4 rounds of annual surveys from March 13, 2007, through July 29, 2010. Study recruitment took place at venues where the population of focus was known to congregate, such as clubs, bars, community centers, and low-income housing. The convenience sample of at-risk youth (persons aged 12-24 years) included 5337 individuals approached about the survey and 3142 (58.9%) who were screened for eligibility. Of the 2607 eligible participants, 2559 (98.2%) ultimately agreed to participate.InterventionsAchievement of locally identified structural changes that targeted public and private entities (eg, federal agencies, homeless shelters, and school systems) with the goal of fostering changes in policy and practice to ultimately facilitate positive behavioral changes aimed at preventing HIV.Main outcomes and measuresNumber of sexual partners, partner characteristics, condom use, and history of sexually transmitted infections and HIV testing.ResultsExposure to structural changes was not statistically significantly associated with any of the outcome measures, although some results were in the direction of a positive structural change effect (eg, a 10-unit increase in a structural change score had an odds ratio of 0.88 [95% CI, 0.76-1.03; P = .11] for having an older sexual partner and an odds ratio of 0.91 [95% CI, 0.60-1.39; P = .39] for using a condom half the time or les

Published
2015

240. Mindfulness instruction for HIV-infected youth: a randomized controlled trial.

Author

Webb, Lindsey, Perry-Parrish, Carisa, Ellen, Jonathan, and Sibinga, Erica

Subjects
PSYCHOLOGICAL adaptation, COGNITIVE testing, DRUGS, PSYCHOLOGY of HIV-positive persons, PATIENT compliance, PSYCHOLOGICAL stress, STRESS management, VIRAL load, WELL-being, RANDOMIZED controlled trials, CONTROL groups, MINDFULNESS, DESCRIPTIVE statistics, CD4 lymphocyte count
Abstract

HIV-infected youth experience many stressors, including stress related to their illness, which can negatively impact their mental and physical health. Therefore, there is a significant need to identify potentially effective interventions to improve stress management, coping, and self-regulation. The object of the study was to assess the effect of a mindfulness-based stress reduction (MBSR) program compared to an active control group on psychological symptoms and HIV disease management in youth utilizing a randomized controlled trial. Seventy-two HIV-infected adolescents, ages 14-22 (mean age 18.71 years), were enrolled from two urban clinics and randomized to MBSR or an active control. Data were collected on mindfulness, stress, self-regulation, psychological symptoms, medication adherence, and cognitive flexibility at baseline, post-program, and 3-month follow-up. CD4+ T lymphocyte and HIV viral load (HIV VL) counts were also pulled from medical records. HIV-infected youth in the MBSR group reported higher levels of mindfulness (P = .03), problem-solving coping (P = .03), and life satisfaction (P = .047), and lower aggression (P = .002) than those in the control group at the 3-month follow-up. At post-program, MBSR participants had higher cognitive accuracy when faced with negative emotion stimuli (P = .02). Also, those in the MBSR study arm were more likely to have or maintain reductions in HIV VL at 3-month follow-up than those in the control group (P = .04). In our sample, MBSR instruction proved beneficial for important psychological and HIV-disease outcomes, even when compared with an active control condition. Lower HIV VL levels suggest improved HIV disease control, possibly due to higher levels of HIV medication adherence, which is of great significance in both HIV treatment and prevention. Additional research is needed to explore further the role of MBSR for improving the psychological and physical health of HIV-positive youth. [ABSTRACT FROM AUTHOR]

Published
2018
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241. Youth health outcomes from the Connect-to-Protect coalitions to prevent adolescent HIV infections.

Author

Miller, Robin Lin, Lee, Kyung-Sook, Chiaramonte, Danielle, Santiago-Rivera, Olga J., Acevedo-Polakovich, Ignacio, Boyer, Cherrie B., and Ellen, Jonathan M.

Subjects
HIV prevention, HIV infections -- Social aspects, YOUTH health, DISEASES in teenagers, COALITIONS, URBAN health
Abstract

We assessed the relationships among HIV-related social and behavioral outcomes resulting from an adolescent-focused HIV structural change initiative in eight urban sites operating Connect-to-Protect coalitions. Over a 4-year period, annual cross-sectional panels of adolescents (N = 2248) completed an audio-computer-assisted interview, providing data on satisfaction with their communities as adolescent-supportive environments, internalized HIV stigma, lifetime HIV-testing, lifetime sexual risk-taking and number of sexual partners in the prior year. We used structural equation modeling to estimate hypothesized links between time since coalition mobilization to our social and behavioral outcomes. Over the 4 years, adolescents perceived their communities to become more supportive (p < .05). Positive perceptions of community support were associated with lower lifetime HIV sexual risk (p < .05). The effect of time on risk behavior was mediated by perceptions of community support. Stigma was unchanged over time. Stigma had damaging effects on risk behavior, effects which were also mediated by perceptions of community support. Special efforts are needed to address the deleterious effect of HIV stigma on high-risk urban adolescents. [ABSTRACT FROM AUTHOR]

Published
2018
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243. Are adolescents being screened for sexually transmitted diseases?

Author

Ellen, Jonathan M., Lane, Margo A., McCright, Jacque, Staggers, Barbara, White, D'Juanna, and Rodriquez, Roberto

Subjects
African American teenagers -- Health aspects, Sexually transmitted diseases -- Diagnosis, African American youth -- Health aspects, Health, Diagnosis, Health aspects
Abstract

* Objectives To determine the proportion of sexually experienced African American adolescents who report having been screened for sexually transmitted diseases and to determine the proportion who report having been screened for these diseases among adolescents who have had a preventive primary health care visit in the past 2 years. * Methods A telephone survey of a population-based sample of African American adolescents aged 12 to 17 years residing in a low-income neighborhood in San Francisco with a high prevalence of sexually transmitted diseases. * Results Of the 302 adolescents surveyed, 118 (39.1%) reported a history of sexual intercourse. Of these, 17 (26.2%) of 65 males and 31 (58.5%) of 53 females had been screened for a sexually transmitted disease in the previous 12 months. Twenty (30.8%) of the males and 32 (60.4%) of the females had been screened for a sexually transmitted disease in the previous 24 months. Of the 93 participants who had had a preventive primary care visit since their first episode of sexual intercourse, 14 (26.4%) of the 53 males and 24 (60.0%) of the 40 females had been screened for a sexually transmitted disease in the previous 24 months. * Conclusions Sexually experienced African American adolescents in San Francisco are being screened for sexually transmitted diseases at rates well below those recommended by current clinical guidelines. A low rate of screening was found even in adolescents who had been seen for a preventive primary care visit since they had first had sex. This suggests that the preventive primary care visit is not being used to its full potential as an opportunity to screen and treat adolescents for sexually transmitted diseases. Capitalizing on this opportunity to screen may increase the number of cases of sexually transmitted diseases diagnosed and, thus, decrease rates of these diseases in this population., A study of low-income African American adolescents in San Francisco, California INTRODUCTION A cornerstone of prevention and control of sexually transmitted diseases (STDs) is the early diagnosis and treatment of [...]

Published
2000

246. The Available Pool of Sex Partners and Risk for a Current Sexually Transmitted Infection

Author

Jennings, Jacky M., Taylor, Ralph, Iannacchione, Vince G., Rogers, Susan M., Chung, Shang-en, Huettner, Steven, and Ellen, Jonathan M.

Subjects
Male, Sexually Transmitted Diseases, Bacterial, Adolescent, Chlamydia Infections, Article, Sampling Studies, Gonorrhea, Young Adult, Sexual Partners, Residence Characteristics, Risk Factors, Baltimore, Confidence Intervals, Multilevel Analysis, Odds Ratio, Prevalence, Humans, Female
Abstract

Sexually transmitted infection (STI) transmission models propose that incident STIs are related to exposure to infected sex partners. The objective of this study was to determine whether the prevalence of STIs among the available pool of sex partners in a neighborhood, measured indirectly, is an independent determinant of a current incident STI.The target population comprised 58,299 English-speaking, sexually active 15- to 24-year-olds in 486 census block groups (CBGs) in Baltimore, MD. A sample of 65 CBGs was selected using a stratified, systematic, probability-proportional-to-size strategy and 13,873 households were randomly selected. From 2004 through 2007, research assistants administered an audio computer-assisted interview survey and collected biologic samples for gonorrhea and chlamydia testing.The final sample size included 575 participants from 63 CBGs. Additional data provided gonorrhea prevalence from 2004 through 2005 per 15- to 49-year-old persons per 100,000 per CBG. After adjustment for individual-level STI risk factors in a multilevel probability model, adolescents and young adults living in high (vs. low) prevalence STI areas were 4.73 times (95% confidence interval [CI]: 3.65-6.15) more likely to have a current incident STI.To inform prevention programs, future research should focus on identifying mechanisms through which context causes changes in local sexual networks and their STI prevalence.

Published
2010

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