24 results on '"Carneiro PB"'
Search Results
2. GENE EDITING OF FIBROBLAST-LIKE SYNOVIOCYTES FROM MUCOPOLYSACCHARIDOSIS TYPE I MICE WITH THE CRISPR-CAS9 SYSTEM
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Santos, HS, primary, Vera, LNP, additional, Rodrigues, G, additional, Farinon, M, additional, Carneiro, PB, additional, Giugliani, R, additional, Matte, U, additional, Teixeira, HF, additional, Schuh, RS, additional, and Baldo, G, additional
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- 2021
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3. PrEP Use in a US National Sample of Trans Men and Other Transmasculine People Who Have Sex With Men: A Longitudinal Analysis.
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Carneiro PB, Radix AE, Golub S, Grosskopf N, and Grov C
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- Humans, Male, United States epidemiology, Adult, Longitudinal Studies, Young Adult, Homosexuality, Male statistics & numerical data, Prospective Studies, Middle Aged, Female, Adolescent, Pre-Exposure Prophylaxis statistics & numerical data, HIV Infections prevention & control, HIV Infections epidemiology, Transgender Persons statistics & numerical data, Anti-HIV Agents therapeutic use
- Abstract
Introduction: Efforts to improve pre-exposure prophylaxis (PrEP) uptake among gay men, transgender women, and Black cisgender women are evident across the United States, responding to epidemiologic data showing a disproportionate HIV burden in these communities. However, transgender men and other transmasculine people who have sex with men (TMSM)-those assigned female at birth who identify otherwise and have sex with cisgender men-are often excluded from these statistics. This community has unique vulnerabilities and prevention needs. National HIV prevention and planning has yet to include transgender men as a group with increased vulnerability to HIV seroconversion. This study follows a cohort of TMSM to characterize PrEP use longitudinally., Methods: Using data from a prospective US national cohort of TMSM not on PrEP, we analyzed annual PrEP uptake, discontinuation, and other HIV prevention measures over 24 months. We also used generalized estimating equations modeling to assess demographic, healthcare access, gender-affirming, and behavioral factors associated with PrEP uptake over time., Results: Our cohort of 196 TMSM was demographic and regionally diverse. 29% of our sample reported uptake of PrEP in 24 months, with about one-third of users discontinuing within 1 year. Health insurance, having had lower surgery, used post-exposure prophylaxis, or recently having a sexually transmitted infection were associated with increased odds of PrEP use., Conclusion: We found low uptake of PrEP and high discontinuation rates in a US national sample of TMSM over 24 months, despite significant need for HIV prevention. It is vital to increase efforts and investments to support this neglected community., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2024
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4. Depth drive shifts in the fish and benthic assemblages of the South American Reef System.
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Costa RJ, de Macedo Carneiro PB, Feitosa CV, de Sousa Barroso H, da Silva MVC, Giarrizzo T, Salani S, Gastão FGC, Garcia TM, Tavares TCL, Smith TB, and Soares MO
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- Animals, Biodiversity, South America, Anthozoa physiology, Ecosystem, Seaweed physiology, Seaweed growth & development, Porifera physiology, Porifera classification, Coral Reefs, Fishes physiology
- Abstract
The low-latitude habitats of the South American reef system have a high endemism and represent important stepping-stones due to the connectivity with Amazon and Caribbean reefs. We provide the first seabed mapping, and analyze the benthic cover and fish assemblages of these extreme reefs. Fleshy macroalgae (2-66% of cover), algal turfs (0-47%), and sponges (3-25%) are the dominant benthic groups. The main reef builders are crustose coralline algae (2-23%) and only four coral species (0 to 18%), mainly the weedy Siderastrea stellata. Cluster analysis distinguished two groups. The first group includes the shallowest reefs (~ 17 m deep) where fleshy macroalgae are abundant together with higher siltation on the reefs (~ 31% covered by sediments). The second group, by contrast, includes the deeper reefs (22.5-27 m), which have much higher algal turf cover, and the lowest sediment cover (4%). The deeper reefs also have the highest cover of corals (18%) and sponges (25%). We recorded a total of 63 fish species, with the deep reefs being the richest. Analysis indicated that the composition of the benthos was considerably more homogeneous across the study area than the composition of fish assemblages, which had a higher turnover of species among reefs. Moreover, we identified the depth of the reef as a variable structuring the benthic assemblages. The fish assemblage is influenced, in turn, by the benthos. Overall, the seabed mapping revealed the existence of a single reef system with high spatial heterogeneity. Our results provide new insights into the structure of these extreme reefs that have evolved under the influence of sediment resuspension, moderate turbidity, and are warmer than other West Atlantic reefs located at middle- and high-latitudes., Competing Interests: Declarations. Competing interests: The author declare no competing interests., (© 2024. The Author(s).)
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- 2024
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5. Characterizing Event-Driven PrEP Use and Investigating its Association with Experiences of PrEP-Related Barriers Among a US National Sample of PrEP Users.
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Carneiro PB, Golub S, Radix AE, Grosskopf N, and Grov C
- Abstract
After a decade of implementation in the US, PrEP uptake remains underutilized by communities that would greatly benefit from it. Event-Driven (ED) PrEP is a potential avenue to increase uptake, however very little is known about its use in the US. We analyzed data derived from Together 5000, an internet-based U.S. national cohort of Sexual and Gender Minority (SGM) individuals aged 16-49 years and at risk for HIV. First, we looked at predictors of ED PrEP use using a framework based on current US-based PrEP implementation-related variables. Then, we explored whether experiencing certain types of barriers were associated with choice of ED PrEP over daily PrEP using logistic regression analysis. Our findings showed that variables related to education and sexual behaviors were associated with ED PrEP choice, while experiencing barriers to daily PrEP had no effect. We found a gradient effect with education, where individuals who reported having some college had 3 times the odds of taking ED PrEP, those reporting a bachelor's degree had 3.25 times the odds, and those with graduate school education had 7.56 times the odds of choosing ED PrEP compared to those with a high school diploma or less. Individuals who reported having 2 or more hours of lead time for sex had 3.35 times the odds of using ED PrEP (aOR = 3.35, 95% CI 2.23-5.47). Participants who reported having an STI within the last 6 months had 60% lower odds of using ED PrEP (aOR = 0.4, 95% CI 0.2-0.72). The use of ED PrEP is a promising pathway for expanding PrEP due to its success and protection levels. Our studies indicated that educational background and behavior influence PrEP choice. Ensuring PrEP candidates and users have access to information about new PrEP types may increase uptake and support implementation efforts., Competing Interests: Declarations Conflict of Interest The authors have no conflicts to report., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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6. Building Capacity of Community Health Centers to Improve the Provision of Postpartum Care Services Through Data-Driven Health Information Technology and Innovation.
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Romero L, Du Mond J, Carneiro PB, Uy R, Osika J, Wallander Gemkow J, Yang TY, Whitt M, Overholser A, Karasu S, Curtis K, and Skapik J
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- Humans, Female, United States, Pregnancy, Electronic Health Records, Centers for Disease Control and Prevention, U.S., Perinatal Care standards, Perinatal Care organization & administration, Quality Improvement, Community Health Centers organization & administration, Postnatal Care standards, Postnatal Care organization & administration, Medical Informatics, Capacity Building
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Maternal morbidity and mortality remain significant challenges in the United States, with substantial burden during the postpartum period. The Centers for Disease Control and Prevention, in partnership with the National Association of Community Health Centers, began an initiative to build capacity in Federally Qualified Health Centers to (1) improve the infrastructure for perinatal care measures and (2) use perinatal care measures to identify and address gaps in postpartum care. Two partner health center-controlled networks implemented strategies to integrate evidence-based recommendations into the clinic workflow and used data-driven health information technology (HIT) systems to improve data standardization for quality improvement of postpartum care services. Ten measures were created to capture recommended care and services. To support measure capture, a data cleaning algorithm was created to prioritize defining pregnancy episodes and delivery dates and address data inconsistencies. Quality improvement activities targeted postpartum care delivery tailored to patients and care teams. Data limitations, including inconsistencies in electronic health record documentation and data extraction practices, underscored the complexity of integrating HIT solutions into postpartum care workflows. Despite challenges, the project demonstrated continuous quality improvement to support data quality for perinatal care measures. Future solutions emphasize the need for standardized data elements, collaborative care team engagement, and iterative HIT implementation strategies to enhance perinatal care quality. Our findings highlight the potential of HIT-driven interventions to improve postpartum care within health centers, with a focus on the importance of addressing data interoperability and documentation challenges to optimize and monitor initiatives to improve postpartum health outcomes.
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- 2024
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7. Missed Opportunity or Cause for Concern? Methamphetamine Use Is Associated With Greater Interest in Event-Driven PrEP Among Sexual Minority Men.
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Carneiro PB, Carrico A, Golub S, Radix AE, Grosskopf N, Ewart LD, Dilworth S, Doblecki-Lewis S, and Grov C
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- Humans, Male, Adult, Anti-HIV Agents, Middle Aged, Amphetamine-Related Disorders epidemiology, Amphetamine-Related Disorders psychology, Young Adult, Homosexuality, Male statistics & numerical data, Homosexuality, Male psychology, Patient Acceptance of Health Care statistics & numerical data, Patient Acceptance of Health Care psychology, Transgender Persons statistics & numerical data, Transgender Persons psychology, Adolescent, Methamphetamine administration & dosage, HIV Infections prevention & control, Sexual and Gender Minorities statistics & numerical data, Sexual and Gender Minorities psychology, Pre-Exposure Prophylaxis methods, Health Knowledge, Attitudes, Practice
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Our study assessed the association between methamphetamine (i.e., crystal meth, CM) use and awareness and interest in event-driven (ED) PrEP among HIV-negative and those with unknown serostatus cisgender males and transgender people. We performed log-binomial regression analysis to predict awareness (i.e., having heard of ED PrEP) and being interested in ED PrEP. We found that participants who recently used CM were less likely to know of ED PrEP (aPR = 0.83, 95% CI [0.69, 0.99]) but more interested in ED PrEP (aPR = 1.12, 95% CI [1.01, 1.30]), after accounting for demographic and HIV-related behaviors. Opportunities to expand PrEP uptake and improve adherence among individuals who report CM use are essential to impact the HIV epidemic significantly. Continued research on the needs and best practices to work with this community is needed to ensure a successful rollout and implementation of ED PrEP.
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- 2024
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8. Correction: PrEP Uptake and Methamphetamine Use Patterns in a 4-Year U.S. National Prospective Cohort Study of Sexual and Gender Minority People, 2017-2022.
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Guo Y, Westmoreland DA, D'Angelo AB, Mirzayi C, Dearolf M, Ray M, Carneiro PB, Pantalone DW, Carrico AW, Patel VV, Golub SA, Hirshfield S, Hoover DR, Nash D, and Grov C
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- 2024
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9. PrEP Uptake and Methamphetamine Use Patterns in a 4-Year U.S. National Prospective Cohort Study of Sexual and Gender Minority People, 2017-2022.
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Guo Y, Westmoreland DA, D'Angelo AB, Mirzayi C, Dearolf M, Ray M, Carneiro PB, Pantalone DW, Carrico AW, Patel VV, Golub SA, Hirshfield S, Hoover DR, Nash D, and Grov C
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- Humans, Male, Adult, Prospective Studies, United States epidemiology, Female, Anti-HIV Agents therapeutic use, Amphetamine-Related Disorders epidemiology, Amphetamine-Related Disorders ethnology, Homosexuality, Male statistics & numerical data, Homosexuality, Male psychology, Homosexuality, Male ethnology, Risk Factors, Young Adult, Middle Aged, Methamphetamine administration & dosage, HIV Infections prevention & control, HIV Infections epidemiology, Sexual and Gender Minorities statistics & numerical data, Pre-Exposure Prophylaxis statistics & numerical data
- Abstract
Methamphetamine use is on the rise among sexual and gender minority people who have sex with men (SGMSM), escalating their HIV risk. Despite pre-exposure prophylaxis (PrEP) being an effective biomedical HIV prevention tool, its uptake in relation to methamphetamine use patterns in SGMSM has not been studied. In a U.S. cohort study from 2017 to 2022, 6,253 HIV-negative SGMSM indicated for but not using PrEP were followed for four years. Methamphetamine use was categorized (i.e., newly initiated, persistently used, never used, used but quit), and PrEP uptake assessed using generalized estimating equation (GEE), adjusted for attrition. Participants had a median age of 29, with 51.9% White, 11.1% Black, 24.5% Latinx, and 12.5% other races/ethnicities. Over the four years, PrEP use increased from 16.3 to 27.2%. GEE models identified risk factors including housing instability and food insecurity. In contrast, older age, health insurance, clinical indications, and prior PrEP use increased uptake. Notably, Latinx participants were more likely to use PrEP than Whites. Regarding methamphetamine use, those who newly initiated it were more likely to use PrEP compared to non-users. However, those who quit methamphetamine and those who persistently used it had PrEP usage rates comparable to those of non-users. Though PrEP uptake increased, it remained low in SGMSM. Methamphetamine use was associated with PrEP uptake. Healthcare providers should assess methamphetamine use for harm reduction. Prioritizing younger, uninsured SGMSM and addressing basic needs can enhance PrEP uptake and reduce HIV vulnerabilities., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2024
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10. PrEP Discontinuation In A US National Cohort Of Sexual And Gender Minority Populations, 2017-22.
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Guo Y, Westmoreland DA, D'Angelo A, Mirzayi C, Dearolf M, Carneiro PB, Ray M, Pantalone DW, Carrico AW, Patel VV, Golub SA, Hirshfield S, Hoover D, Nash D, and Grov C
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- Humans, Cohort Studies, Minority Groups, Cognition, Sexual Behavior, Sexual and Gender Minorities
- Abstract
In the US, sexual and gender minority populations are disproportionately affected by HIV. Pre-exposure prophylaxis (PrEP) is a key prevention method, but its effectiveness relies on consistent usage. Our four-year national cohort study explored PrEP discontinuation among sexual and gender minority people who initiated PrEP. We found a high annual rate of discontinuation (35-40 percent) after PrEP initiation. Multivariable analysis with 6,410 person-years identified housing instability and prior history of PrEP discontinuation as predictors of discontinuation. Conversely, older age, clinical indication for PrEP, and having health insurance were associated with ongoing PrEP use. To promote sustained PrEP use, strategies should focus on supporting those at high risk for discontinuation, such as younger people, those without stable housing or health insurance, and prior PrEP discontinuers.
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- 2024
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11. Changes in Cost and Insurance Challenges to Cover PrEP Between 2019 and 2021.
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D'Angelo AB, Mirzayi C, Carneiro PB, and Grov C
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- Male, Humans, United States, Homosexuality, Male, Cohort Studies, Sexual Behavior, HIV Infections drug therapy, HIV Infections prevention & control, Sexual and Gender Minorities, Pre-Exposure Prophylaxis
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Introduction: Pre-Exposure Prophylaxis (PrEP) use continues lag estimated need among gay and bisexual men in the United States. Studies report that challenges paying for PrEP may undermine continued use. Our study aimed to measure these challenges over time., Methods: Data were taken from a US national cohort study of cisgender gay and bisexual men and transgender individuals aged 16-49 years. We analyzed data from PrEP-using participants between 2019 and 2021 and observed cost-related and insurance-related challenges participants experienced while on PrEP across time points. We report McNemar and Cochrane Q test statistics to compare differences between groups by year(s)., Results: In 2019, 16.5% (n = 828/5013) of participants were on PrEP; by 2020, 21% (n = 995/4727) were on PrEP, and by 2021, 24.5% (n = 1133/4617) were on PrEP. The proportion of those experiencing challenges paying for PrEP care decreased significantly across time points for clinical appointments, laboratory work, and prescriptions. Those experiencing insurance and copay approval issues did not change significantly. Although not statistically significant, the only proportion that increased over time was those reporting PrEP-related insurance approval issues. In a post hoc analysis, we found that those reporting PrEP use in the past year who were not currently on PrEP were significantly more likely to report experiencing most PrEP challenges, when compared with current PrEP users., Discussion: We found significant reductions in insurance and cost-related challenges between 2019 and 2021. However, those who discontinued PrEP within the past year reported greater challenges paying for PrEP, suggesting that cost and insurance issues may undermine PrEP persistence., Competing Interests: The authors report no conflicts of interest., (Copyright © 2023 Wolters Kluwer Health, Inc. All rights reserved.)
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- 2023
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12. Transgender Individuals and Digital Health.
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Radix AE, Bond K, Carneiro PB, and Restar A
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- Female, Humans, Male, Gender Identity, Health Services Accessibility, Social Stigma, Transgender Persons, HIV Infections epidemiology, HIV Infections prevention & control
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Purpose of Review: The goal of this review is to assess the use of digital technologies to promote the health and well-being of transgender and gender diverse (TGD) people., Recent Findings: TGD individuals experience numerous health disparities, including low uptake of HIV prevention strategies, such as pre-exposure prophylaxis, increased HIV incidence, and suboptimal HIV-related outcomes. These health disparities are the result of widespread intersectional stigma on the basis of gender identity, gender expression, socioeconomic class, race, and ethnicity, which negatively impact access to general medical and transgender-specific health care. TGD individuals often delay or avoid essential medical services due to fear of discrimination. Clinicians frequently lack training, competence, and skills in transgender medicine, further exacerbating the health disparities faced by TGD people. Digital technologies have been used to improve research and clinical care for TGD populations through various modalities; telemedicine, telehealth and mHealth. Digital health technologies, including HIT-enabled clinical decision support, telehealth, telemedicine, and mHealth, offer innovative ways to improve health care access, improve quality of care, and reduce health disparities for TGD populations, including and beyond HIV outcomes, through enhanced care delivery, clinician education, and enhancing social support networks., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
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- 2022
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13. What Predicts a Clinical Discussion About PrEP? Results From Analysis of a U.S. National Cohort of HIV-Vulnerable Sexual and Gender Minorities.
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Carneiro PB, Frye V, Mirzayi C, Patel V, Lounsbury D, Huang TT, Sabounchi N, and Grov C
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- Humans, Sexual Behavior, Anti-HIV Agents therapeutic use, HIV Infections prevention & control, Pre-Exposure Prophylaxis methods, Sexual and Gender Minorities
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HIV-outcome inequities remain prevalent in the U.S. Medical providers (MPs) are gatekeepers of PrEP, and understanding the dynamics of PrEP assessments is of major interest for public health. We analyzed data from Together 5000, an internet-based U.S. national cohort of sexual and gender minority (SGM) individuals aged 16-49 years and at risk for HIV. Among those eligible for PrEP uptake (n = 6264), we modeled predictors of discussing PrEP with an MP. A third (31%) of participants had spoken to a MP about PrEP. Among those who spoke to a MP, 45% suggested they would initiate PrEP; this outcome was more common among participants older than 24. With a persistent stagnant uptake nationwide, new opportunities to influence PrEP uptake must be explored. An attractive less targeted space is the medical office, specifically ways to support an initial and continued discussion about PrEP between MPs and their patients.
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- 2022
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14. Demographic, clinical guideline criteria, Medicaid expansion and state of residency: a multilevel analysis of PrEP use on a large US sample.
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Carneiro PB, Mirzayi C, Jones S, Rendina J, and Grov C
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- Demography, Homosexuality, Male, Humans, Male, Medicaid, Multilevel Analysis, United States, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections epidemiology, HIV Infections prevention & control, Internship and Residency, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
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Objective: To explore the association of clinical guideline-related variables, demographics and Medicaid expansion on pre-exposure prophylaxis (PrEP) uptake in one of the largest US sample of men who have sex with men(MSM) and transgender and gender non-binary (TGNB) people ever analysed., Methods: We cross-sectionally analysed predictors of current PrEP use using demographic and HIV risk-related variables (level-1), as well as state-level variables (level-2) (ie, Medicaid expansion status). We further explored the role state of residence plays in PrEP uptake disparities across the USA., Results: We found that the odds of PrEP use were significantly greater in older age, white, cisgender men. Moreover, individuals who reported recent post-exposure prophylaxis use, a recent sexually transmitted infection diagnosis and recent drug use were significantly more likely to report PrEP use. Finally, we found that the median odds of PrEP use between similar individuals from different states were 1.40 for the ones living in the Medicaid expansion states, compared with those not living in Medicaid expansion states. State of residence did not play a significant role in explaining PrEP disparities overall., Conclusion: Our analysis showed that PrEP use is less common in communities standing to benefit the most from it-young MSM and TGNB of colour. However, individuals meeting federal guidelines for PrEP were significantly more likely to use PrEP. Though we found a positive association between living in Medicaid expansion states and PrEP use; that variable, as well as one's state of residency, were not suitable to explain variations in PrEP use in the US., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
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- 2022
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15. Building capacity of community health centers to overcome data challenges with the development of an agile COVID-19 public health registry: a multistate quality improvement effort.
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Romero L, Carneiro PB, Riley C, Clark H, Uy R, Park M, Mawokomatanda T, Bombard JM, Hinckley A, and Skapik J
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- COVID-19 Testing, Capacity Building, Community Health Centers, Humans, Public Health, Quality Improvement, Registries, SARS-CoV-2, COVID-19
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Objective: During the coronavirus disease 2019 (COVID-19) pandemic, federally qualified health centers rapidly mobilized to provide SARS-CoV-2 testing, COVID-19 care, and vaccination to populations at increased risk for COVID-19 morbidity and mortality. We describe the development of a reusable public health data analytics system for reuse of clinical data to evaluate the health burden, disparities, and impact of COVID-19 on populations served by health centers., Materials and Methods: The Multistate Data Strategy engaged project partners to assess public health readiness and COVID-19 data challenges. An infrastructure for data capture and sharing procedures between health centers and public health agencies was developed to support existing capabilities and data capacities to respond to the pandemic., Results: Between August 2020 and March 2021, project partners evaluated their data capture and sharing capabilities and reported challenges and preliminary data. Major interoperability challenges included poorly aligned federal, state, and local reporting requirements, lack of unique patient identifiers, lack of access to pharmacy, claims and laboratory data, missing data, and proprietary data standards and extraction methods., Discussion: Efforts to access and align project partners' existing health systems data infrastructure in the context of the pandemic highlighted complex interoperability challenges. These challenges remain significant barriers to real-time data analytics and efforts to improve health outcomes and mitigate inequities through data-driven responses., Conclusion: The reusable public health data analytics system created in the Multistate Data Strategy can be adapted and scaled for other health center networks to facilitate data aggregation and dashboards for public health, organizational planning, and quality improvement and can inform local, state, and national COVID-19 response efforts., (Published by Oxford University Press on behalf of the American Medical Informatics Association 2021. This work is written by US Government employees and is in the public domain in the US.)
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- 2021
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16. Getting Clear About Rectal Douching Among Men Who Have Sex With Men.
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Grov C, Westmoreland D, Carneiro PB, Bauermeister JA, and Carrico AW
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- Homosexuality, Male, Humans, Male, Sexual Behavior, Therapeutic Irrigation, HIV Infections epidemiology, Sexual and Gender Minorities
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Receptive anal sex is the primary means through which HIV is transmitted among men who have sex with men (MSM). Recently, researchers have begun investigating the role that rectal douching may play in amplifying risk for transmission. Yet, there is limited research on the frequency with which MSM douche, the products they use, and how this may vary across sociodemographic characteristics. A U.S. national sample of 4745 MSM completed an online survey that assessed their douching behavior, demographic characteristics, sexual behavior, and their anal sexual positioning (i.e., top, bottom, versatile). Nearly two-thirds (65.8%) had engaged in rectal douching in the last three months. Among those who douched, water was commonly reported (84.2%) and 20.1% reported using commercial enemas (e.g., Fleet), as well as water and soap (15.0%)-numbers exceed 100% as some participants reported more than one. Men who douched reported significantly more receptive and insertive condomless anal sex acts in the prior 3 months. One-in-ten men reported rectal bleeding after douching. Compared to HIV-negative participants who had not taken PrEP, participants had higher odds of reporting douching in the past 3 months if they were HIV-negative and currently on PrEP (AOR = 1.82), HIV-negative and previously used PrEP (AOR = 1.58), and HIV-positive (AOR = 1.83). Douching was common in this sample. Given that douching could amplify risk for HIV transmission, healthcare providers should discuss douching safety with their patients, with a focus on harm reduction (e.g., reduce risk of bleeding, as opposed to abstinence from douching)., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.)
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- 2021
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17. Predictors of Event-Driven Regimen Choice in Current PrEP Users and Sexual Behavior Characteristics of MSM Receiving Sexual Health Services in New York City.
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Carneiro PB, Rincon C, and Golub S
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- Homosexuality, Male, Humans, Male, New York City, Sexual Behavior, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections prevention & control, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
- Abstract
While daily PrEP is undeniably effective, broad-based adoption remains low. Non-daily PrEP modalities, like event-driven PrEP (ED PrEP), offer an efficient way to deliver PrEP's protection to priority populations. We carried out an at-home survey with patients receiving sexual health services in a LGBTQ-clinic in New York (n = 147). Participants answered questions on ED PrEP awareness and preferences, sexual behavior, and sexual preparatory practices. Only 50% of our sample were aware of ED PrEP, about 30% met eligibility for ED PrEP, and 35% chose ED PrEP as a good HIV prevention option for them. In a robust Poisson model (n = 128), endorsement of ED PrEP as a good prevention choice was significantly more common in participants who were uninsured, preferred taking PrEP only when needed, and those who had concerns about side-effects. Furthermore, participants reported many sexual behaviors patterns and preparatory practices compatible with use of ED PrEP.
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- 2021
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18. Why Are Patients Switching from Tenofovir Disoproxil Fumarate/Emtricitabine (Truvada) to Tenofovir Alafenamide/Emtricitabine (Descovy) for Pre-Exposure Prophylaxis?
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D'Angelo AB, Westmoreland DA, Carneiro PB, Johnson J, and Grov C
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- Adenine analogs & derivatives, Alanine, Cohort Studies, Emtricitabine therapeutic use, Emtricitabine, Tenofovir Disoproxil Fumarate Drug Combination therapeutic use, Humans, Male, Tenofovir analogs & derivatives, Tenofovir therapeutic use, Anti-HIV Agents therapeutic use, HIV Infections drug therapy, HIV Infections prevention & control, Pre-Exposure Prophylaxis
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Safety differences between tenofovir alafenamide/emtricitabine (TAF) and tenofovir disoproxil fumarate/emtricitabine (TDF/FTC)-formulated pre-exposure prophylaxis (PrEP) appear to have little clinical significance for most PrEP users. Furthermore, generic TDF-formulated PrEP is projected to decrease the price of PrEP. Thus, efforts to shift PrEP users to TAF-formulated PrEP should be considered in light of their potential to undermine efforts to scale-up PrEP nationally. Data are taken from Together 5,000, a US national cohort study predominantly composed of cisgender gay and bisexual men. In 2019-2020, 5034 participants completed their 24-month assessment, which measured whether participants were switching from TDF (Truvada) to TAF (Descovy) for PrEP, and why. Of those reporting PrEP-use ( n = 1009), 277 reported using Descovy for PrEP, and 223 provided a reason for switching to Descovy. A content analysis was used to code participant's reasons for switching. Over half (56%) of participants reported that their doctor recommended switching to Descovy. Without mentioning a provider recommendation, 32% of participants reported that perceived improved safety of Descovy, compared with Truvada, motivated their decision to change their prescription. Other factors cited included the smaller size of the pill and "newness" of Descovy. Further, several participants mentioned negative advertising about Truvada as rationale for switching. Although scientific consensus supports the safety of both TDF/FTC and TAF, our results suggest that current messaging through physicians and other sources have emphasized superior safety of TAF-implying that TDF/FTC may not be safe in the long term. Efforts to shift users onto TAF may undermine public perception of TDF-formulated PrEP.
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- 2021
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19. Factors Associated with Being PrEP-Naïve Among a U.S. National Cohort of Former-PrEP and PrEP-Naïve Participants Meeting Objective Criteria for PrEP Care.
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Carneiro PB, Westmoreland DA, Patel VV, and Grov C
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- Cohort Studies, Female, Gender Identity, Humans, Male, Pre-Exposure Prophylaxis, Sexual Behavior, HIV Infections prevention & control, Homosexuality, Male
- Abstract
There is an urgent need to increase uptake and persistence in HIV pre-exposure prophylaxis (PrEP) in PrEP-eligible candidates. Little is known about the similarities and differences between groups of PrEP-naïve and former users, an important consideration for future interventions. We explored factors associated with being PrEP-naïve in a U.S. national cohort of naïve and former-PrEP users, all of whom met objective criteria for PrEP care at enrollment. Data were derived from the Together 5000 cohort study, an Internet-based U.S. national cohort of cisgender and trans men and trans women who have sex with men. Participants were recruited via ads on men-for-men geosocial networking apps. All participants were not on PrEP at the time of enrollment. We conducted bivariate analysis to explore differences between the two groups and used multivariable logistic regression to assess factors associated with being PrEP-naïve. Of the 6283 participants, 5383 (85.7%) were PrEP-naïve and 900 (14.3%) were former-PrEP users. There were significant differences between PrEP-naïve and former-PrEP users across multiple demographic variables, in addition to PrEP-related and psychosocial variables. Factors associated with being PrEP-naïve included younger age, sexual identity other than gay/queer, lower perception of candidacy for PrEP care, less willingness to take PrEP, lower access to PrEP care, and individual-level barriers such as health- and provider-related concerns. Programs and policies designed to address uptake and persistence of PrEP should be aware of these differences. Providing care in non-traditional LGBTQ-care settings, home-based PrEP interventions, and provision by healthcare providers other than physicians could improve uptake. Future research should investigate mechanisms that can improve uptake and persistence in communities in need of PrEP.
- Published
- 2021
- Full Text
- View/download PDF
20. Awareness and Acceptability of Undetectable = Untransmittable Among a U.S. National Sample of HIV-Negative Sexual and Gender Minorities.
- Author
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Carneiro PB, Westmoreland DA, Patel VV, and Grov C
- Subjects
- Cohort Studies, Cross-Sectional Studies, Female, Gender Identity, Health Knowledge, Attitudes, Practice, Homosexuality, Male, Humans, Male, Sexual Behavior, Sexual Partners, HIV Infections epidemiology, HIV Infections prevention & control, Pre-Exposure Prophylaxis, Sexual and Gender Minorities
- Abstract
While the "Undetectable = Untransmittable" (U=U) message is widely endorsed, little is known about its breadth and reach. Our study describes socio-demographic characteristics and sexual behaviors associated with having heard of and trusting in U =U in a U.S. national sample of HIV-negative participants. Data were derived from the Together 5,000 cohort study, an internet-based U.S. national cohort of cis men, trans men and trans women who have sex with men. Approximately 6 months after enrollment, participants completed an optional survey included in the present cross-sectional analysis (n = 3286). Measures included socio-demographic and healthcare-related characteristics; questions pertaining to knowledge of and trust in U=U (dependable variable). We used descriptive statistics and multivariable logistic models to identify characteristics associated with these variables and explored patterns in willingness to engage in condomless anal sex (CAS) with regard to trust in U=U. In total, 85.5% of participants reported having heard of U=U. Among those aware of U=U, 42.3% indicated they trusted it, 19.8% did not, and 38.0% were unsure about it. Latinx, Asian, lower income, and Southern participants were less likely to have heard of U=U. Having had a recent clinical discussion about PrEP or being a former-PrEP user were associated with trust in U=U. Willingness to engage in CAS was positively associated with trust in U=U, and varied based on the partner's serostatus, PrEP use and viral load. Although we found high rates of awareness and low levels of distrust, our study indicated that key communities remain unaware and/or skeptical of U=U.
- Published
- 2021
- Full Text
- View/download PDF
21. Recruiting vulnerable populations to participate in HIV prevention research: findings from the Together 5000 cohort study.
- Author
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Grov C, Westmoreland DA, Carneiro PB, Stief M, MacCrate C, Mirzayi C, Pantalone DW, Patel VV, and Nash D
- Subjects
- Adolescent, Adult, Cohort Studies, Female, Humans, Male, Mass Screening, Middle Aged, Bisexuality statistics & numerical data, HIV Infections prevention & control, Homosexuality, Male statistics & numerical data, Patient Selection, Vulnerable Populations
- Abstract
Purpose: The aim of the article was to examine factors associated with completing enrollment milestones in the Together 5000 cohort of at-risk men (n = 8661), transmen (n = 53), and transwomen (n = 63) who have sex with men., Methods: Between 2017 and 2018, participants completed an online enrollment survey and were offered opportunities to complete an incentivized secondary online survey as well as self-administered at-home HIV testing (OraSure). We explored factors associated with completing each study component., Results: In total, 8777 individuals completed our enrollment survey, 6166 (70.3%) completed the secondary survey, and 5010 returned the at-home HIV test kit that was mailed to them (81.3% of those mailed a kit). In our multivariable models, those who were White, with more years of education, were more likely to complete study components, although the magnitude of these associations was small. For example, 50.9% of those enrolled, 47.9% of those completing the secondary survey, and 46.8% of those completing HIV testing were persons of color-a statistically significant, but meaningfully insignificant decline., Conclusions: These findings highlight the need for researchers to identify barriers that may prevent persons of color and younger individuals from participating in research studies., (Copyright © 2019 Elsevier Inc. All rights reserved.)
- Published
- 2019
- Full Text
- View/download PDF
22. Increased anthropogenic pressure decreases species richness in tropical intertidal reefs.
- Author
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Portugal AB, Carvalho FL, de Macedo Carneiro PB, Rossi S, and de Oliveira Soares M
- Subjects
- Animals, Anthozoa, Aquatic Organisms growth & development, Fishes, Humans, Aquatic Organisms classification, Biodiversity, Coral Reefs, Environmental Monitoring
- Abstract
Multiple human stressors affect tropical intertidal sandstone reefs, but little is known about their biodiversity and the environmental impacts of these stressors. In the present study, multiple anthropogenic pressures were integrated using the relative environmental pressure index (REPI) and related to benthic community structure across an intertidal gradient in five sandstone reefs in the tropical South Atlantic coast. Greater species richness and diversity were noted in the low intertidal zones. There was a negative relationship between REPI and species richness, suggesting that increasing anthropogenic pressure has decreased benthic richness. The factors associated with the loss of richness were jetties built to control erosion, urban areas, beachfront kiosks and restaurants, fish markets, and storm sewers with illegal sewage connections. Our results highlight the need for better infrastructure planning and rigorous monitoring of coastal urban areas, since the large influence of multiple human pressures in these reefs leads to biodiversity losses., (Copyright © 2016 Elsevier Ltd. All rights reserved.)
- Published
- 2016
- Full Text
- View/download PDF
23. Assessment of DNA damage in goat preantral follicles after vitrification of the ovarian cortex.
- Author
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Faustino LR, Carvalho AA, Silva CM, Rossetto R, Lopes CA, van Tilburg MF, Carneiro PB, Báo SN, Moura AA, Bordignon V, Figueiredo JR, and Rodrigues AP
- Subjects
- Animals, Female, Goats, Ovarian Follicle drug effects, Cryopreservation methods, Cryoprotective Agents pharmacology, DNA Damage drug effects, Ovary drug effects, Tissue Preservation methods, Vitrification
- Abstract
Effective methods for gamete preservation should have low impact on DNA integrity. The present study investigated the effects of vitrification of goat ovarian tissues on the occurrence of DNA fragmentation and DNA double-stand breaks using the terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end-labelling (TUNEL) assay and detection of phosphorylated histone H2AX (γH2AX), respectively. Goat ovaries were collected at a local abattoir and 12 tissue fragments were prepared from each ovarian pair. Tissue fragments were used as fresh control samples or were cultured in vitro, vitrified or vitrified and cultured. Vitrification was performed using the Ovarian Tissue Cryosystem. Fragments from all groups (control and treatments) were processed for histology, transmission electron microscopy, TUNEL assay and immunofluorescence. Compared with fresh control samples, a lower percentage of morphologically normal follicles was detected in the vitrification followed by culture treatment group (P<0.05). Normal follicular ultrastructure was observed in all groups. Immunofluorescence revealed the presence of γH2AX foci in few oocytes and ovarian stromal cells. TUNEL-positive follicles were found in samples without significant differences among groups (P>0.05). In conclusion, the vitrification protocol used in the present study did not increase DNA damage in preantral follicles enclosed in goat ovarian tissues.
- Published
- 2015
- Full Text
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24. Synthesis of novel peptide linkers: simultaneous cyclization and labeling.
- Author
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Dewkar GK, Carneiro PB, and Hartman MC
- Subjects
- Cyclization, Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization, Staining and Labeling, Time Factors, Xylenes chemistry, Peptides chemistry
- Abstract
Synthesis of novel peptide linkers was accomplished by monocarboxylation of 1,3,5-tris(bomomethyl)benzene with a wide variety of carboxylic acids in the presence of diisopropylethylamine. These reagents can be used to simultaneously cyclize and label peptides containing two cysteines. Many labels are compatible with this method including lipids, fluorescent groups, and biotin.
- Published
- 2009
- Full Text
- View/download PDF
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