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4. Exposure to a Patient-Centered, Web-Based Intervention for Managing Cancer Symptom and Quality of Life Issues: Impact on Symptom Distress

Author

Berry, Donna L, Blonquist, Traci M, Patel, Rupa A, Halpenny, Barbara, and McReynolds, Justin

Subjects
Computer applications to medicine. Medical informatics, R858-859.7, Public aspects of medicine, RA1-1270
Abstract

BackgroundEffective eHealth interventions can benefit a large number of patients with content intended to support self-care and management of both chronic and acute conditions. Even though usage statistics are easily logged in most eHealth interventions, usage or exposure has rarely been reported in trials, let alone studied in relationship to effectiveness. ObjectiveThe intent of the study was to evaluate use of a fully automated, Web-based program, the Electronic Self Report Assessment-Cancer (ESRA-C), and how delivery and total use of the intervention may have affected cancer symptom distress. MethodsPatients at two cancer centers used ESRA-C to self-report symptom and quality of life (SxQOL) issues during therapy. Participants were randomized to ESRA-C assessment only (control) or the ESRA-C intervention delivered via the Internet to patients’ homes or to a tablet at the clinic. The intervention enabled participants to self-monitor SxQOL and receive self-care education and customized coaching on how to report concerns to clinicians. Overall and voluntary intervention use were defined as having ≥2 exposures, and one non-prompted exposure to the intervention, respectively. Factors associated with intervention use were explored with Fisher’s exact test. Propensity score matching was used to select a sample of control participants similar to intervention participants who used the intervention. Analysis of covariance (ANCOVA) was used to compare change in Symptom Distress Scale (SDS-15) scores from pre-treatment to end-of-study by groups in the matched sample. ResultsRadiation oncology participants used the intervention, overall and voluntarily, more than medical oncology and transplant participants. Participants who were working and had more than a high school education voluntarily used the intervention more. The SDS-15 score was reduced by an estimated 1.53 points (P=.01) in the intervention group users compared to the matched control group. ConclusionsThe intended effects of a Web-based, patient-centered intervention on cancer symptom distress were modified by intervention use frequency. Clinical and personal demographics influenced voluntary use. Trial RegistrationClinicaltrials.gov NCT00852852; http://clinicaltrials.gov/ct2/show/NCT00852852 (Archived by WebCite at http://www.webcitation.org/6YwAfwWl7).

Published
2015
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9. Pre-Exposure Prophylaxis Discontinuation During the COVID-19 Pandemic Among Men Who Have Sex with Men in a Multi-Site Clinical Cohort in the United States

Author

Goedel, William C., Rogers, Brooke G., Li, Yu, Nunn, Amy S., Patel, Rupa R., Marshall, Brandon D.L., Mena, Leandro A., Ward, Lori M., Brock, J. Benjamin, Napoleon, Siena, Zanowicki-Marr, Alexandra, Curoe, Kate, Underwood, Ashley, Johnson, Catrell J., Lockwood, Khadijra R., and Chan, Philip A.

Published
2022
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14. Grossesse de substitution durant la pandemie de COVID-19

Author

Haynes, Venus, Hunter, Tru, Ceruti, Justyn, Bowley, Clare, and Patel, Rupa

Subjects
Surrogate motherhood -- Cases -- Health aspects, Company legal issue, Health
Abstract

En 2019, Venus, une femme vivant au Canada avec son enfant, a decide d'etre mere porteuse pour permettre a Justyn et Tru, un couple gai etabli aux Etats-Unis, d'avoir un [...]

Published
2022
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18. Secure Transmission of Password Using Speech Watermarking

Author

Patel, Rupa, Shrawankar, Urmila, and Thakare, V. M

Subjects
Computer Science - Multimedia, Computer Science - Cryptography and Security
Abstract

Internet is one of the most valuable resources for information communication and retrievals. Most multimedia signals today are in digital formats. The digital data can be duplicated and edited with great ease which has led to a need for data integrity and protection of digital data. The security requirements such as integrity or data authentication can be met by implementing security measures using digital watermarking techniques. In this paper a blind speech watermarking algorithm that embeds the watermark signal data in the musical (sequence) host signal by using frequency masking is used. A different logarithmic approach is proposed. In this regard a logarithmic function is first applied to watermark data. Then the transformed signal is embedded to the converted version of host signal which is obtained by applying Fast Fourier transform method. Finally using inverse Fast Fourier Transform and antilogarithmic function watermark signal is retrieved., Comment: Pages: 4 Figures: 7, International Journal of Computer Science and Technology (IJCST) Vol.2, Issue 3, September 2011

Published
2013

19. Security Issues In Speech Watermarking for Information Transmission

Author

Patel, Rupa and Shrawankar, Urmila

Subjects
Computer Science - Multimedia, Computer Science - Cryptography and Security
Abstract

The secure transmission of speech information is a significant issue faced by many security professionals and individuals. By applying voice-encryption technique any kind of encrypted sensitive speech data such as password can be transmitted. But this has the serious disadvantage that by means of cryptanalysis attack encrypted data can be compromised. Increasing the strength of encryption/decryption results in an associated increased in the cost. Additional techniques like stenography and digital watermarking can be used to conceal information in an undetectable way in audio data. However this watermarked audio data has to be send through unreliable media and an eavesdropper might get hold of secret message and can also determine the identity of a speaker who is sending the information since human voice contains information based on its characteristics such as frequency, pitch, and energy. This paper proposes Normalized Speech Watermarking technique. Speech signal is normalized to hide the identity of the speaker who is sending the information and then speech watermarking technique is applied on this normalized signal that contains the message (password) so that what information is transmitted should not be unauthorizedly revealed., Comment: Pages: 10 Figures: 5, Conference Procedings, AMOC 2011, Advances in Modeling, Optimization and Computing

Published
2013

21. 1547. Integrating Long-acting Injectable Cabotegravir for PrEP into Standard of Care for Cisgender Women, Transgender Women, Transgender Men, and Men Who Have Sex with Men: Results from the PILLAR & EBONI Studies

Author

Valenti, William M, primary, Phoenix, John, additional, Patel, Rupa R, additional, Tims-Cook, Zandraetta, additional, Pilgrim, Nanlesta, additional, Haley, Amber, additional, Sutton, Kenneth, additional, Gaudion, Alison, additional, Merrill, Deanna, additional, Urbaityte, Rimgaile, additional, Li, Bo, additional, Andrae, David, additional, Bonner, Courtney, additional, Herbst, Abigail, additional, Chowdhury, Dhuly, additional, Garges, Harmony, additional, and Czarnogorski, Maggie, additional

Published
2023
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26. PrEP Persistence Support and Monitoring in Areas of High HIV Burden in the Midwestern United States

Author

McNulty, Moira C., primary, Kerman, Jared, additional, Devlin, Samantha A., additional, Pyra, Maria, additional, Rusie, Laura, additional, Curoe, Kate, additional, Thompson, Liz, additional, Mason, Joseph A., additional, Friedman, Eleanor E., additional, Uvin, A. Ziggy, additional, Brown, C Hendricks, additional, Schneider, John, additional, and Patel, Rupa, additional

Published
2023
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27. Comparative Analysis of Hyperparameter Tuned Convolutional Neural Networks for classification of Diabetic Retinopathy

Author

Patel , Rupa and Chaware, Anita

Subjects
Hyperparameters tuning, Diabetic Retinopathy, Machine learning
Abstract

Diabetic Retinopathy (DR) is one of the leading cause for loss of vision among diabetic patients. Early detection and treatment of disease can prevent serious complications. Deep learning in medical image analysis is very effective. One of the important aspects in building efficient machine learning algorithm is to choose the right combination of hyper parameters. To understand the sensitivity of hyper parameter, hyperparameter tuning is applied to ten deep convolutional neural network (DCNN). Thefundus images from Kaggle diabetic retinopathy dataset is pre-processed and resized to 224 x 224x3. Depending upon the severity of disease dataset images belongs to one of the class (0, 1, 2, 3, 4) so performance of all the ten networks are evaluated class wise. Experimental results reveal that Vgg16 outperformed InceptionV3, Xception, ResNet50, DenseNet121, Densenet169 and DenseNet201. MobileNetv2 outperformed other two light weight models MobileNetv1 and NASNetMobile. Training accuracy for vgg16 is 92%, validation accuracy is 85%, sensitivity is 84%, specificity is 96% and f1 score is 0.84. For MobileNetv2 training accuracy is 98%, validation accuracy is 81%, sensitivity is 81%, specificity is 94% and f1 score is 0.81. Training of Vgg16 and MobileNetv2 is carried out using Adam optimizer with learning rate of 0.001 and 0.00002 respectively, dropout 0.5, batch size is set to 32 and no. of Epoch to 40 and 20 respectively. While comparing the proposed work with previously related similar work it is found that our approach yields better results. This work contributes towards the improvement of the image classification techniques.

Published
2023

38. Factors associated with suboptimal retention in HIV pre-exposure prophylaxis care among men who have sex with men

Author

Rogers, Brooke G., primary, Sosnowy, Collette, additional, Chan, Philip A., additional, Patel, Rupa R., additional, Mena, Leandro A., additional, Arnold, Trisha, additional, Gomillia, Courtney, additional, Zanowick-Marr, Alexandra, additional, Curoe, Kate, additional, Underwood, Ashley, additional, Villalobos, Jesus, additional, Chu, Christina, additional, Galipeau, Drew, additional, Montgomery, Madeline, additional, and Nunn, Amy S., additional

Published
2022
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39. Pre-exposure Prophylaxis Discontinuation During the COVID-19 Pandemic Among Men Who Have Sex With Men in a Multisite Clinical Cohort in the United States

Author

Goedel, William C., primary, Rogers, Brooke G., additional, Li, Yu, additional, Nunn, Amy S., additional, Patel, Rupa R., additional, Marshall, Brandon D. L., additional, Mena, Leandro A., additional, Ward, Lori M., additional, Brock, J. Benjamin, additional, Napoleon, Siena, additional, Zanowick-Marr, Alexandra, additional, Curoe, Kate, additional, Underwood, Ashley, additional, Johnson, Catrell J., additional, Lockwood, Khadijra R., additional, and Chan, Philip A., additional

Published
2022
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42. List of Contributors

Author

Abrahamian, Fredrick M., primary, Aldape, Michael J., additional, Aldasoro, Edelweiss, additional, Allen, Upton D., additional, Al-Sum, Hythem, additional, Anadkat, Milan J., additional, Anders, Katherine, additional, Angelakis, Emmanouil, additional, Angus, Brian John, additional, Antoniadou, Anastasia, additional, Arena, Fabio, additional, Arends, Joop E., additional, Arribas, Jose R., additional, Artenstein, Andrew W., additional, Atherton, John C., additional, Aucott, John N., additional, Aw, Tar-Ching, additional, Babcock, Hilary M., additional, Bailey, Robin, additional, Bailey, Thomas C., additional, Banks, Adam Z., additional, Barillo, David J., additional, Barrette, Ernie-Paul, additional, Bauer, Martijn P., additional, Bayston, Roger, additional, Beard, C. Ben, additional, Beardsley, Justin, additional, Beeching, Nick J., additional, Bégué, Rodolfo E., additional, Beldi, Guido, additional, Benson, Constance A., additional, Berbari, Elie F., additional, Berenger, Jean-Michel, additional, Berger, Christoph, additional, Bernardino, Jose I., additional, Bille, Jacques, additional, Billioux, Alexander C., additional, Bitnun, Ari, additional, Blair, Iain, additional, Blanche, Stéphane, additional, Bleck, Thomas P., additional, Bleeker-Rovers, Chantal P., additional, Bleijenberg, Gijs, additional, Bloch, Karen C., additional, Blum, Johannes, additional, Blumberg, Emily A., additional, Bonomo, Robert A., additional, Bonten, Marc J.M., additional, Bourayou, Rafik, additional, Bouza, Emilio, additional, Brandt, K. Ashley, additional, Bretelle, Florence, additional, Brisse, Sylvain, additional, Britton, Warwick J., additional, Brook, Itzhak, additional, Brouwer, Matthijs C., additional, Browne, Sarah K., additional, Bryant, Amy E., additional, Bühler, Silja, additional, Bulger, Eileen M., additional, Buller, R. Mark L., additional, Burke, Leah A., additional, Burri, Christian, additional, Butler, Marcus W., additional, Calandra, Thierry, additional, Calfee, David P., additional, Calvo-Cano, Antonia, additional, Cameron, D. William, additional, Carcillo, Joseph A., additional, Carson, Gail, additional, Chambers, Stephen T., additional, Charrel, Remi N., additional, Nguyen, Vinh Chau Van, additional, Chevaliez, Stéphane, additional, Chiller, Tom M., additional, Christaki, Eirini, additional, Chung, Kevin K., additional, Clifford, David B., additional, Clumeck, Nathan, additional, Cohen, Jonathan, additional, Collinge, John, additional, Conlon, Christopher P., additional, Conrad, Curdin, additional, Cooke, Fiona J., additional, Cope, Jennifer Rittenhouse, additional, Corey, G. Ralph, additional, Cross, John H., additional, Cunha, Burke A., additional, Cunha, Cheston B., additional, D'Journo, Benoit, additional, Daikos, George L., additional, Daniels, Johannes M.A., additional, Davidson, Robert N., additional, Day, Nicholas P.J., additional, De Cock, Kevin M., additional, de Silva, Thushan I., additional, de Vries, Henry J.C., additional, de Wit, Stéphane, additional, Delaloye, Julie, additional, Denning, David W., additional, Dennis, David T., additional, Dhanireddy, Shireesha, additional, Dielubanza, Elodi J., additional, Diemert, David J., additional, Doganay, Mehmet, additional, Doherty, Tom, additional, Dolecek, Christiane, additional, Dondorp, Arjen M., additional, Douglas, Abby, additional, Drancourt, Michel, additional, Dubourg, Grégory, additional, Dudley, Michael N., additional, Durand, Guillaume, additional, Eckhardt, Benjamin J., additional, Efstratiou, Androulla, additional, Ekkelenkamp, Miquel B., additional, Eranki, Ambika, additional, Erdem, Hakan, additional, Escota, Gerome V., additional, Evans, Heather L., additional, Eziefula, Alice Chijioke, additional, Fenollar, Florence, additional, Fenwick, Alan, additional, Fierer, Joshua, additional, Finch, Roger G., additional, Fleckenstein, James M., additional, Forstner, Christina, additional, Foschi, Federico, additional, Fournier, Pierre-Edouard, additional, French, Martyn A., additional, Gage, Kenneth L., additional, Garcia, Lynne S., additional, Gascon, Joaquim, additional, Gastañaduy, Arturo S., additional, Gautret, Philippe, additional, Geisler, William M., additional, Ghanem, Khalil G., additional, Giani, Tommaso, additional, Giannella, Maddalena, additional, Gilliam, Bruce L., additional, Gilliet, Michel, additional, Glaser, Carol A., additional, Glupczynski, Youri, additional, Gnann, John W., additional, Goldstein, Ellie J.C., additional, Gottstein, Bruno, additional, Gouriet, Frederique, additional, Gravitt, Patti E., additional, Green, Michael D., additional, Green, Stephen T., additional, Groll, Andreas H., additional, Gulick, Roy M., additional, Gupta, Arjun, additional, Habib, Gilbert, additional, Harbarth, Stephan, additional, Harris, Marianne, additional, Hayden, Frederick G., additional, Hetem, David J., additional, Hill, Philip C., additional, Hirschel, Bernard, additional, Hodowanec, Aimee C., additional, Hoffart, Louis, additional, Hoffmann, Christian, additional, Holland, Steven M., additional, Horby, Peter W., additional, Horne, David J., additional, Hraiech, Sami, additional, Hull, Mark W., additional, Huttner, Angela, additional, Ingram, Richard J.M., additional, Islam, Jasmin, additional, Ison, Michael G., additional, James, Scott H., additional, Jenkins, Claire, additional, Jenkins, Stephen G., additional, Jensen, Jørgen Skov, additional, Johnston, Christine, additional, Jones, Theodore B., additional, Jordan, Stephen J., additional, Julian, Kathleen G., additional, Kato, Yasuyuki, additional, Kauffman, Carol A., additional, Kaye, Keith S., additional, Keane, Michael P., additional, Keeney, James, additional, Kelly, Paul, additional, Kent, Stephen J., additional, Kern, Winfried V., additional, Keynan, Yoav, additional, Kim, Andrea A., additional, Koné-Paut, Isabelle, additional, Kosmidis, Chris, additional, Kroes, Aloys C.M., additional, Kroon, Frank P., additional, Ksiazek, Thomas G., additional, Kuhlmann, F. Matthew, additional, Kuijper, Ed J., additional, Kwon, Jennie H., additional, Kyei, George B., additional, Lacombe, Karine, additional, Lagacé-Wiens, Philippe, additional, Lagier, Jean-Christophe, additional, Lamagni, Theresa, additional, Landraud, Luce, additional, Lanternier, Fanny, additional, LaPlante, Kerry L., additional, Lawn, Stephen D., additional, Lawrence, Steven J., additional, Leblebicioglu, Hakan, additional, Lee, Nelson, additional, Leggett, James E., additional, Lehours, Philippe, additional, Levy, Pierre-Yves, additional, Leyh, Rainer G., additional, Lillis, Rebecca A., additional, Limmathurotsakul, Direk, additional, Lin, Jennifer, additional, Lindquist, H.D. Alan, additional, Lipsky, Benjamin A., additional, Liscynesky, Christina, additional, Looney, David, additional, Lortholary, Olivier, additional, Lowy, Franklin D., additional, Luft, Benjamin J., additional, Mackowiak, Philip A., additional, MacPherson, Paul A., additional, Maghraoui-Slim, Valérie, additional, Mallon, Patrick W., additional, Mangino, Julie E., additional, Manuel, Oriol, additional, Marchetti, Oscar, additional, Marks, Kristen M., additional, Marr, Kieren A., additional, Marrazzo, Jeanne, additional, Marschall, Jonas, additional, Martin, David H., additional, Matonti, Frédéric, additional, Matulewicz, Richard S., additional, Mayer, Kenneth H., additional, McCulloh, Russell J., additional, McGready, Rose, additional, Mdodo, Rennatus, additional, Mead, Simon, additional, Mégraud, Francis, additional, Meintjes, Graeme, additional, Metcalf, Sarah C., additional, Michaels, Marian G., additional, Migliori, Giovanni Battista, additional, Miles, Michael A., additional, Miller, Alastair, additional, Mimiaga, Matthew J., additional, Mingeot-Leclercq, Marie-Paule, additional, Misch, Elizabeth Ann, additional, Mitreva, Makedonka, additional, Montaner, Julio S.G., additional, Moore, Caroline B., additional, Muñoz, Patricia, additional, Muñoz, Jose, additional, Murray, Clinton K., additional, Musso, Didier, additional, Mutengo, Mable, additional, Mutizwa, Misha M., additional, Naber, Kurt G., additional, Natarajan, Pavithra, additional, Neme, Santiago, additional, Newton, Paul N., additional, Nichols, Ronald A., additional, Nicolle, Lindsay E., additional, Nosten, François, additional, Notarangelo, Luigi D., additional, Nutman, Thomas B., additional, Nyirjesy, Paul, additional, O'Connell, P. Ronan, additional, Opal, Steven M., additional, Ormerod, L. Peter, additional, Osmon, Douglas R., additional, Pankert, Marie Boulze, additional, Pantaleo, Giuseppe, additional, Papazian, Laurent, additional, Parente, Diane M., additional, Parola, Philippe, additional, Parsaei, Shadi, additional, Pascual, Manuel A., additional, Patel, Rupa, additional, Patrozou, Eleni, additional, Pawlotsky, Jean-Michel, additional, Peacock, Sharon J., additional, Pechère, Jean-Claude, additional, Pelegrin, Ivan, additional, Peters, Barry S., additional, Peters, Edgar J.G., additional, Petersen, Jeannine M., additional, Petersen, Lyle R., additional, Petraitis, Vidmantas, additional, Pham, Luu-Ly, additional, Picado, Albert, additional, Pilatz, Adrian, additional, Pilmis, Benoit, additional, Pinazo, María-Jesús, additional, Pletz, Mathias W., additional, Pogue, Jason M., additional, Polgreen, Evelyn L., additional, Polgreen, Philip M., additional, Posfay-Barbe, Klara M., additional, Powderly, William G., additional, Presti, Rachel, additional, Prod'hom, Guy, additional, Puolakkainen, Mirja, additional, Quinn, Thomas C., additional, Raoult, Didier, additional, Razonable, Raymund R., additional, Read, Robert C., additional, Redfield, Robert R., additional, Rentenaar, Rob J., additional, Reynolds, Steven J., additional, Ribi, Camillo, additional, Richardson, Malcolm D., additional, Ritter, Michele L., additional, Roch, Antoine, additional, Rockstroh, Jürgen Kurt, additional, Rojek, Amanda, additional, Romero, José R., additional, Rooijakkers, Suzan H.M., additional, Rosenbluth, Daniel, additional, Rosenzweig, Sergio D., additional, Rossolini, Gian Maria, additional, Rubinstein, Ethan, additional, Ryan, Greg, additional, Safren, Steven A., additional, Sahasrabuddhe, Vikrant V., additional, Saikku, Pekka A.I., additional, Sajadi, Mohammad M., additional, Salvaggio, Michelle R., additional, Santos, Carlos A.Q., additional, Satlin, Michael J., additional, Schaeffer, Anthony J., additional, Schimmer, Christoph, additional, Schooley, Robert T., additional, Schumacher, Richard F., additional, Sha, Beverly E., additional, Shapiro, Daniel S., additional, Sheehan, Gerard, additional, Shlaes, David M., additional, Shoham, Shmuel, additional, Simmons, Cameron P., additional, Simon, Dennis W., additional, Simon, Matthew S., additional, Simonsen, Kari A., additional, Slack, Mary P.E., additional, Smith, Tyrel T., additional, Sobel, Jack D., additional, Souli, Maria, additional, Sridhar, Shruti, additional, Steckelberg, James M., additional, Stevens, Dennis L., additional, Strah, Heather, additional, Sturm, A. Willem, additional, Sungkanuparph, Somnuek, additional, Tabrizi, Sarah J., additional, Tacconelli, Evelina, additional, Tan, Chen Sabrina, additional, Taplitz, Randy A., additional, Thomas, Guillemette, additional, Thomas, Lora D., additional, Thuny, Franck, additional, Thwaites, Guy, additional, Tissot, Frederic, additional, Tønjum, Tone, additional, Torriani, Francesca J., additional, Toso, Christian, additional, Tulkens, Paul M., additional, Tunkel, Allan R., additional, Turner, Claire E., additional, Ustianowski, Andrew P., additional, van Bambeke, Françoise, additional, van Crevel, Reinout, additional, van de Beek, Diederik, additional, van Delden, Christian, additional, van der Eerden, Menno M., additional, van der Meer, Jos W.M., additional, van der Poll, Tom, additional, van Ingen, Jakko, additional, van Putten, Jos, additional, Vaudaux, Bernard P., additional, Vermund, Sten H., additional, Viscidi, Raphael P., additional, Visvanathan, Kumar, additional, Visvesvara, Govinda S., additional, von Seidlein, Lorenz, additional, Wagenlehner, Florian M.E., additional, Wald, Anna, additional, Walsh, Thomas J., additional, Warhurst, David C., additional, Warnock, David W., additional, Warrell, David A., additional, Warrell, Mary J., additional, Warris, Adilia, additional, Watkins, Richard R., additional, Weatherall, David J., additional, Weber, Rainer, additional, Weidner, Wolfgang, additional, White, Jonathan R., additional, White, Peter J., additional, Whitehorn, James, additional, Whitley, Richard J., additional, Whitty, Christopher J.M., additional, Wiersinga, Willem Joost, additional, Wilcox, Mark H., additional, Williams, Thomas N., additional, Wilson, Cara C., additional, Wilson, Mary Elizabeth, additional, Wisplinghoff, Hilmar, additional, Wood, Robin, additional, Wunderink, Richard G., additional, Wyles, David, additional, Yang, Zhi-Tao, additional, Yoder, Jonathan S., additional, Zaidi, Najam A., additional, Zimmer, Andrea J., additional, Zuckerman, Jane N., additional, and Zumla, Alimuddin, additional

Published
2017
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44. Projected Effects of Disruptions to Human Immunodeficiency Virus (HIV) Prevention Services During the Coronavirus Disease 2019 Pandemic Among Black/African American Men Who Have Sex With Men in an Ending the HIV Epidemic Priority Jurisdiction

Author

Labs, Jennifer, primary, Nunn, Amy S, additional, Chan, Philip A, additional, Bessey, S, additional, Park, Carolyn J, additional, Marshall, Brandon D L, additional, Patel, Rupa R, additional, Mena, Leandro A, additional, and Goedel, William C, additional

Published
2022
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47. Long-term retention in pre-exposure prophylaxis care among men who have sex with men and transgender women in the United States

Author

Chan, Philip A., Patel, Rupa R., Mena, Leandro, Marshall, Brandon Dl, Rose, Jennifer, Coats, Cassandra Sutten, Montgomery, Madeline C., Tao, Jun, Sosnowy, Collette, Mayer, Kenneth H., and Nunn, Amy

Subjects
Transgender people -- Health aspects, MSM (Men who have sex with men) -- Health aspects, HIV infection -- Risk factors -- Prevention -- Demographic aspects, Health
Abstract

: Introduction: Retention in HIV pre‐exposure prophylaxis (PrEP) care in real‐world settings, outside of controlled trials or demonstration projects, remains poorly understood. Methods: We evaluated retention in PrEP care outcomes among men who have sex with men (MSM) and transgender women prescribed PrEP through March 2017 at three clinical sites in the United States (US): Jackson, Mississippi; Providence, Rhode Island; and St. Louis, Missouri. We determined retention rates by attendance of clinical visits every three months, per US Centers for Disease Control and Prevention (CDC) guidelines, as well as by the timing of patients’ actual clinical visits. Multivariable analyses examined demographic and behavioural factors associated with retention. Results: From 2013 to 2015, 282 MSM and transgender women were prescribed PrEP; 82% attended a follow‐up visit. Based on CDC recommendations, 56% of patients were retained in PrEP care at the first follow‐up visit, having attended a visit three months after initiation. However, 76% had a follow‐up visit within eight months. Thirty‐percent were retained at 12 months by CDC criteria, but 62% were retained when using a 16‐month endpoint. Self‐reported adherence was strongly correlated with retention. In multivariable analyses, younger age was associated with decreased odds of retention at initial follow‐up, and completing college was associated with increased odds of retention at 16 months. Eight participants were newly diagnosed with HIV; six were African American, and seven were under 30 years of age. Conclusions: Measuring retention in PrEP care using three‐month follow‐up intervals may underestimate true retention. Nevertheless, retention in PrEP care is suboptimal in real‐world settings and should be the focus of future interventions., Introduction The HIV epidemic in the United States (US) disproportionately impacts gay, bisexual and other men who have sex with men (MSM), as well as transgender women. MSM have a [...]

Published
2019
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48. Factors associated with suboptimal retention in HIV pre-exposure prophylaxis care among men who have sex with men.

Author

Rogers, Brooke G., Sosnowy, Collette, Chan, Philip A., Patel, Rupa R., Mena, Leandro A., Arnold, Trisha, Gomillia, Courtney, Zanowick-Marr, Alexandra, Curoe, Kate, Underwood, Ashley, Villalobos, Jesus, Chu, Christina, Galipeau, Drew, Montgomery, Madeline, and Nunn, Amy S.

Subjects
HIV prevention, RESEARCH methodology, HUMAN sexuality, INTERVIEWING, MEDICAL care costs, SOCIAL factors, PATIENT-centered care, PRE-exposure prophylaxis, RESEARCH funding, SEX customs, MEN who have sex with men, PATIENT compliance, MISINFORMATION, MEDICAL appointments, TRANSPORTATION
Abstract

Despite the efficacy of HIV pre-exposure prophylaxis (PrEP), retention in care in the United States remains suboptimal. The goal of this study was to explore factors that lead to suboptimal retention in PrEP care for men who have sex with men (MSM) in real-world clinical settings in the United States. Trained interviewers conducted semi-structured interviews with MSM (N = 49) from three clinics who had been engaged in PrEP care in the Midwest (n = 15), South (n = 15), and Northeast (n = 19) geographic regions and had experienced a lapse in PrEP use. Factors that emerged as related to suboptimal retention in PrEP care included structural factors such as transportation and out-of-pocket costs; social factors such as misinformation on media and in personal networks; clinical factors such as frequency and timing of appointments; and behavioral factors such as changes in sexual behavior and low perceived risk for HIV. Participants suggested reducing the out-of-pocket costs of medications and lab visits, having flexible appointment times, culturally responsive services, and comprehensive patient navigation to help retention in care. These findings leveraged real-world experiences and opinions of patients to inform gaps in current services and how to make changes to optimize PrEP care. [ABSTRACT FROM AUTHOR]

Published
2023
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