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The Centers for Disease Control and Prevention's (CDC) expanded testing initiative (ETI) aims to bolster HIV testing among populations disproportionately affected by the HIV epidemic by providing additional funding to health departments serving these communities. ETI prioritizes testing in clinical settings; therefore, we examined the relationship between state-level ETI participation and past-year HIV testing among a racially/ethnically diverse sample of adult respondents to the 2012 Behavioral Risk Factor Surveillance System who accessed health services within the 12 months prior to being interviewed. Controlling for individual- and state-level characteristics in a multilevel logistic regression model, ETI participation was independently and positively associated with past-year testing, but this association varied by race/ethnicity. Hispanics had higher odds (adjusted odds ratio [AOR]: 1.49; 95% CI: 1.11-2.02) and American Indian/Alaska Natives had lower odds (AOR: 0.66; 95% CI: 0.43-0.99) of testing if they resided in states with (vs. without) ETI participation. State-level ETI participation did not significantly alter past-year testing among other racial/ethnic groups. Prioritizing public health resources in states most affected by HIV can improve testing patterns, but other mechanisms likely influence which racial/ethnic groups undergo testing.

ObjectiveThis study examined temporal trends in HIV testing among U.S. older adults (50-64 years of age) before and after the release of CDC's routine HIV testing recommendations in 2006.MethodsThe sample (n=872,797; 51.4% female) comprised 2003-2010 Behavioral Risk Factor Surveillance System respondents in the oldest categories to which the recommendations apply: 50-54 years (34.5%, n=301,519), 55-59 years (34.1%, n=297,865), and 60-64 years (31.3%, n=273,413). We calculated (1) four-year pooled prevalences of past-year HIV testing before and after 2006, when the recommendations were released; and (2) annual prevalences of HIV testing overall and by age category from 2003-2010. Using weighted, multivariable logistic regression analyses, we examined binary (pre- vs. post-recommendations) and annual changes in testing, controlling for covariates. We stratified the data by recent doctor visits, examined racial/ethnic differences, and tested for linear and quadratic temporal trends.ResultsOverall and within age categories, the pooled prevalence of past-year HIV testing decreased following release of the recommendations (p

BackgroundAlthough routine human immune deficiency virus (HIV) testing during health care visits is recommended for most adults, many older adults (i.e., ages 50-64 years) do not receive it. This study identified factors associated with HIV testing in the past 12 months (i.e., recent HIV testing) among US adults in the 3 categories of older adulthood (50-54, 55-59, and 60-64 years) for which routine HIV testing is recommended.MethodThis was a cross-sectional analysis of data from US older adult respondents to the 2010 Behavioral Risk Factor Surveillance System. We calculated prevalence (proportions) of HIV testing by age category and race/ethnicity. Using multiple logistic regression, we identified predisposing, enabling, and need factors associated with recent HIV testing within and across age categories, by race/ethnicity and controlling for covariates.ResultsHIV testing prevalence was low (

As a basis for theories of psychopathology, clinical psychology and related disciplines need sound taxonomies that are generalizable across diverse populations. To test the generalizability of a statistically derived 8-syndrome taxonomic model for youth psychopathology, confirmatory factor analyses (CFAs) were performed on the Youth Self-Report (T. M. Achenbach & L. A. Rescorla, 2001) completed by 30,243 youths 11-18 years old from 23 societies. The 8-syndrome taxonomic model met criteria for good fit to the data from each society. This was consistent with findings for the parent-completed Child Behavior Checklist (Achenbach & Rescorla, 2001) and the teacher-completed Teacher's Report Form (Achenbach & Rescorla, 2001) from many societies. Separate CFAs by gender and age group supported the 8-syndrome model for boys and girls and for younger and older youths within individual societies. The findings provide initial support for the taxonomic generalizability of the 8-syndrome model across very diverse societies, both genders, and 2 age groups.

There is a growing need for multicultural collaboration in child mental health services, training, and research. To facilitate such collaboration, this study tested the 8-syndrome structure of the Child Behavior Checklist (CBCL) in 30 societies. Parents' CBCL ratings of 58,051 6- to 18-year-olds were subjected to confirmatory factor analyses, which were conducted separately for each society. Societies represented Asia; Africa; Australia; the Caribbean; Eastern, Western, Southern, and Northern Europe; the Middle East; and North America. Fit indices strongly supported the correlated 8-syndrome structure in each of 30 societies. The results support use of the syndromes in diverse societies.

This study compared parents' ratings of behavioral and emotional problems on the "Child Behavior Checklist" (Achenbach, 1991; Achenbach & Rescorla, 2001) for general population samples of children ages 6 to 16 from 31 societies (N = 55,508). Effect sizes for society ranged from 0.03 to 0.14. Effect sizes for gender were less than or equal to 0.01, with girls generally scoring higher on Internalizing problems and boys generally scoring higher on Externalizing problems. Effect sizes for age were less than or equal to 0.01 and varied across types of problems. Total Problems scores for 19 of 31 societies were within 1 "SD" of the overall mean of 22.5. Bisociety correlations for mean item scores averaged 0.74. The findings indicate that parents' reports of children's problems were similar in many ways across highly diverse societies. Nonetheless, effect sizes for society were larger than those for gender and age, indicating the need to take account of multicultural variations in parents' reports of children's problems.

Objective: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. Methods: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. Results: PrIDE jurisdictions implemented multiple health equity–focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP (z = −33.57; P <.001). Conclusions: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity–focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States. [ABSTRACT FROM AUTHOR]

Objectives: During 2015-2019, five local and state health department jurisdictions implemented Data to Care (D2C) programs supported by Project PrIDE (Pre-exposure prophylaxis, Implementation, Data to Care, and Evaluation) to improve linkage or reengagement in HIV medical care among persons with HIV (PWH) who had gaps in care, particularly among men who have sex with men (MSM) and transgender persons. We describe findings from the cross-jurisdiction evaluation of the project. Methods: We conducted a qualitative analysis of the final progress reports submitted by PrIDE jurisdictions to the Centers for Disease Control and Prevention to identify key D2C activities implemented and challenges encountered. We also conducted descriptive analysis on aggregate quantitative data to summarize key D2C program outcomes. Results: PrIDE jurisdictions implemented multiple activities to build their D2C capacity, identify PWH who were not in care or virally suppressed, provide linkage/reengagement services, and monitor outcomes. Overall, 11 463 PWH were selected for follow-up, 45% of whom were MSM or transgender persons. Investigations were completed for 8935 (77.9%) PWH. Only 2323 (26.0%) PWH were confirmed not in care or virally suppressed; 1194 (51.4%) were subsequently linked/reengaged in care; among those, 679 (56.9%) were virally suppressed at last test. PrIDE jurisdictions identified data-related (eg, incomplete or delayed laboratory results), program capacity (eg, insufficient staff), and social and structural (eg, unstable housing) challenges that affected their D2C implementation. Conclusions: PrIDE jurisdictions successfully enhanced their D2C capacity, reached priority populations who were not in care or virally suppressed, and improved their engagement in care and health outcomes. Data-related and non–data-related challenges limited the efficiency of D2C programs. Findings can help inform other D2C programs and contribute to national HIV prevention goals. [ABSTRACT FROM AUTHOR]

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.jsat.2008.11.005 Byline: Deena J. Chisolm (a)(b), Mesfin S. Mulatu (d), Jorielle R. Brown (c) Keywords: Adolescence; Substance use; Mental health; Disparities Abstract: This study examines disparities in co-occurring mental health and substance use problems by race/ethnicity to inform the development of culturally appropriate treatment approaches. Using pooled clinical data collected with the Global Assessment of Individual Needs, we identified racial/ethnic and other factors associated with co-occurring internalizing problems, externalizing problems, and the combination thereof in adolescents in federally funded treatment facilities. Results show that after controlling for demographic and socioenvironmental factors, African Americans, Hispanics, and mixed-race adolescents were more likely than Whites to have co-occurring internalizing problems. African Americans and Native Americans were less likely than Whites to have externalizing problems and to have combined internalizing and externalizing problems. Presence of co-occurring problems was also associated with victimization, homelessness, and family substance abuse. These results indicate that co-occurring mental health problems vary by race/ethnicity, and therefore, refined approaches are needed for culturally appropriate care of patients. Author Affiliation: (a) Center for Innovation in Pediatric Practice, The Research Institute at Nationwide Children's Hospital, Columbus, OH 43205, USA (b) Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43205, USA (c) Center for Substance Abuse Treatment, Substance Abuse and Mental Health Services Administration, Rockville, MD 20857, USA (d) The MayaTech Corporation, Silver Spring, MD 20910, USA Article History: Received 17 April 2008; Revised 1 October 2008; Accepted 25 November 2008

Background: In the United States, HIV rates are disproportionately high among black women, with 78% of cases attributed to heterosexual transmission. This analysis examined HIV testing, high-risk behaviors and condom use consultation for the prevention of sexually transmitted diseases (STD) among a diverse sample of women. Methods: Secondary analyses were conducted using data from the 2004 Behavioral Risk Factor Surveillance System (BRFSS). This dataset included a sample of 43,550 (12% black, 79% white, and 9% Hispanic) women aged 18 to 49 years, living in the United States. Both bivariate and multivariate statistical analyses were conducted. Results: Multivariate logistic regression analyses revealed that ethnic group differences existed for past-year HIV test, high-risk behaviors, and condom use consultation even after we controlled for age, education, income, employment status, and region of residence. Black women were three times more likely than white women to report a past-year HIV test and Hispanic women were 50% more likely than white women and report a past-year HIV test. Women who reported receiving condom use consultations were most likely to be Hispanic, 30 to 34 years old, and residents of the northeast. Conclusions: Initiatives to promote HIV testing appeared to have affected HIV testing behaviors among black women. However, increased HIV testing among black women was not associated with an increased likelihood of condom use counseling by a healthcare professional. More emphasis on HIV counseling is warranted to assist with HIV risk reduction and to complement HIV testing initiatives. doi:10.1300/J013v46n02_05 KEYWORDS. African American women, HIV testing, HIV-risk behaviors, counseling

In this study, the authors compared ratings of behavioral and emotional problems and positive qualities on the Youth Self-Report (T. M. Achenbach & L. A. Rescoda, 2001) by adolescents in general population samples from 24 countries (N = 27,206). For problem scales, country effect sizes (ESs) ranged from 3% to 9%, whereas those for gender and age ranged from less than 1% to 2%. Scores were significantly higher for girls than for boys on Internalizing Problems and significantly higher for boys than for girls on Externalizing Problems. Bicountry correlations for mean problem item scores averaged .69. For Total Problems, 17 of 24 countries scored within one standard deviation of the overall mean of 35.3. In the 19 countries for which parent ratings were also available, the mean of 20.5 for parent ratings was far lower than the self-report mean of 34.0 in the same 19 countries (d = 2.5). Results indicate considerable consistency across 24 countries in adolescents' self-reported problems but less consistency for positive qualities. Keywords: YSR, cross-cultural, self-reported problems, adolescents

Background: Transgender persons are at high risk for HIV infection. Testing is a key component of the national effort to end the HIV epidemic in the United States. Setting: Sixty-one local and state health departments and 150 community-based organizations funded by the Centers for Disease Control and Prevention to conduct HIV testing programs. Methods: We analyzed HIV testing data submitted to the Centers for Disease Control and Prevention by funded health departments and community-based organizations during 2012--2017. Descriptive analysis examined patterns of HIV testing and key outcomes (diagnosis of HIV infection, linkage to HIV medical care, and interview for partner services) among transgender persons. Multi- variate robust Poisson regression was used to assess associations between HIV testing outcomes and demographic characteristics, census region, and test setting. Results: A total of 82,818 HIV tests were provided to transgender persons. Of these, 2280 (2.8%) transgender persons were diagnosed with HIV infection; 1556 (1.9%) received a new and 724 (0.9%) a previous diagnosis with HIV infection. The highest percentage of new HIV diagnosis was found among persons tested in correctional settings (4.6%), non-Hispanic Blacks (3.5%) and transgender women (2.4%). Among newly diagnosed persons, 85.0% were linked to HIV medical care #90 days after diagnosis and 63.5% were interviewed for partner services. Conclusions: HIV positivity was high, and the delivery of partner services was low, among transgender persons. HIV testing outcomes among transgender persons varied significantly by demographic characteristics and test setting. HIV prevention programs that are responsive to the needs of transgender persons may address gender- related disparities in HIV testing outcomes. [ABSTRACT FROM AUTHOR]

The article offers information on HIV partner services data during 2013–2017 related to HIV partner service delivery among transgender women in the U.S. analyzed by Centers for Disease Control and Prevention. Topics include lower percentage of index transgender women interviewed by CDC-funded health departments than for all index; missed opportunities to improve health of transgender women; and 18.6 percent transgender women partner who received a new diagnosis of HIV infection.