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1. HIV screening in the dental setting in New York State.

Author

Rakkoo Chung, Shu-Yin John Leung, Stephen N Abel, Michael N Hatton, Yanfang Ren, Jeffrey Seiver, Carol Sloane, Howard Lavigne, Travis O'Donnell, and Laura O'Shea

Subjects
Medicine, Science
Abstract

While primary care providers in New York State (NYS) are mandated to offer all patients a HIV test, still many NYS residents miss the HIV screening opportunity. To fill the gap, and as the CDC recommends, this study aimed to examine the feasibility of implementing HIV screening in dental setting, identify patient characteristics associated with acceptance of HIV rapid testing, and discuss best practices of HIV screening in dental setting. New York State Department of Health (NYSDOH) collaborated with the Northeast/Caribbean AIDS Education and Training Center (NECA AETC) and three dental schools in New York State to offer free HIV screening tests as a component of routine dental care between February 2016 and March 2018. Ten clinics in upstate New York and Long Island participated in the study. HIV screening was performed using the OraQuick™ In-Home HIV Test. 14,887 dental patients were offered HIV screening tests; 9,057 (60.8%) were screened; and one patient (0.011%) was confirmed HIV positive and linked to medical care. Of all dental patients, 33% had never been screened for HIV; and 56% had not had a primary care visit or had not been offered an HIV screening test by primary care providers in the previous 12 months. Multi-level generalized linear modeling analysis indicated that test acceptance was significantly associated with patient's age, race/ethnicity, gender, country of origin, primary payer (or insurance), past primary care visits, past HIV testing experiences, and the poverty level of patient's community. HIV screening is well accepted by dental patients and can be effectively integrated into routine dental care. HIV screening in the dental setting can be a good option for first-time testers, those who have not seen a primary care provider in the last 12 months, and those who have not been offered HIV screening at their last primary care visit.

Published
2020
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2. Models for Pooled Time-Series Cross-Section Data

Author

Lawrence E Raffalovich and Rakkoo Chung

Subjects
Pooled cross-section time-series, CSTS models, completely pooled model, fixed effects models, multilevel/hierarchical linear models, homicide rate, Political science (General), JA1-92, Social Sciences
Abstract

Several models are available for the analysis of pooled time-series cross-section (TSCS) data, defined as “repeated observations on fixed units” (Beck and Katz 1995). In this paper, we run the following models: (1) a completely pooled model, (2) fixed effects models, and (3) multi-level/hierarchical linear models. To illustrate these models, we use a Generalized Least Squares (GLS) estimator with cross-section weights and panel-corrected standard errors (with EViews 8) on the cross-national homicide trends data of forty countries from 1950 to 2005, which we source from published research (Messner et al. 2011). We describe and discuss the similarities and differences between the models, and what information each can contribute to help answer substantive research questions. We conclude with a discussion of how the models we present may help to mitigate validity threats inherent in pooled time-series cross-section data analysis.

Published
2015

3. Reducing Disparities: A Virtual Quality Improvement Collaborative Resulted in Better Health Outcomes for 4 Target Populations Disproportionately Affected by HIV

Author

Rakkoo Chung, James M. Tesoriero, Clemens Steinbock, Shu-Yin John Leung, Jennifer E Lee, and Charles Kolesar

Subjects
Male, Quality management, Adolescent, Population, MEDLINE, Human immunodeficiency virus (HIV), HIV Infections, Context (language use), medicine.disease_cause, Men who have sex with men, Sexual and Gender Minorities, Acquired immunodeficiency syndrome (AIDS), Outcome Assessment, Health Care, Humans, Medicine, Homosexuality, Male, education, education.field_of_study, business.industry, Health Policy, Public Health, Environmental and Occupational Health, medicine.disease, Quality Improvement, United States, Health equity, Female, business, Demography
Abstract

Context Although viral suppression rates have recently increased among people with HIV, specific populations still experience disparities in health outcomes, a priority in the national response to end the HIV epidemic. Purpose The end+disparities ECHO Collaborative, a quality improvement initiative among HIV providers in the United States from June 2018 to December 2019, created virtual communities of practice to measurably increase viral suppression rates in populations disproportionately affected by HIV: men who have sex with men of color, Black/African American and Latina women, youth aged 13 to 24 years, and transgender people. Methods Participating Ryan White HIV/AIDS Program-funded providers prioritized their improvement efforts to focus on one target population and joined virtual affinity sessions with other providers focused on that population for guidance by subject matter experts and exchanges with peer providers. During 9 submission cycles, providers reported their viral suppression data for the preceding 12 months. Main outcome measures The principal outcome measures were changes in viral suppression rates among 4 target populations and changes in viral suppression gaps compared with the rest of HIV-infected patients served by the same agency. Results A total of 90 providers were included in the data analyses with an average of 110 775 reported patients, out of which 19 442 represented the targeted populations. The average viral suppression rates for agency-selected populations increased from 79.2% to 82.3% (a 3.9% increase), while the remaining caseload increased at a lower rate from 84.9% to 86.1% (a 1.4% increase). The viral suppression gap was reduced from 5.7% to 3.8%, a 33.5% reduction. Improvements were found across all target populations. Conclusions The collaborative demonstrated improved health outcomes and reductions in HIV-related health disparities, moving toward ending the HIV epidemic. The model of utilizing low-cost videoconferencing technologies to create virtual communities of learning is well suited to mitigate other disease-related disparities, nationally and abroad.

Published
2021
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4. A Peek Into the Future: How a Pandemic Resulted in the Creation of Models to Predict the Impact on Sexually Transmitted Infection(s) in New York State (Excluding New York City)

Author

Rachel Hart-Malloy, Yingchao Yuan, Rakkoo Chung, Deepa T Rajulu, Manjiri Joshi, and Wilson Miranda

Subjects
Microbiology (medical), Coronavirus disease 2019 (COVID-19), Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Gonorrhea, New York, Sexually Transmitted Diseases, Dermatology, 03 medical and health sciences, 0302 clinical medicine, Pandemic, Humans, Medicine, Program planning, Syphilis, 030212 general & internal medicine, Pandemics, Early syphilis, Reproductive health, The Real World of STD Prevention, 030505 public health, business.industry, Incidence, Incidence (epidemiology), Public Health, Environmental and Occupational Health, COVID-19, Models, Theoretical, medicine.disease, Infectious Diseases, 0305 other medical science, business, Demography
Abstract

Decreases in reported sexually transmitted infections were observed during the initial COVID-19 peak in New York State. Differences in predicted and reported sexually transmitted infections suggest high rebound morbidity, affecting public health service delivery., During the initial height of COVID-19 in New York State excluding New York City in March 2020, reports of sexually transmitted infections declined. Prediction models developed to estimate the incidence of early syphilis and gonorrhea during the COVID-19 pandemic were used to study impact on STI diagnoses/reporting and inform sexual health program planning.

Published
2021
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5. Combating Stigma Through HIV Self-Testing: New York State's HIV Home Test Giveaway Program for Sexual Minorities

Author

Susan M Flavin, Zoe Edelstein, Yingchao Yuan, Megan C Johnson, Shu-Yin J Leung, and Rakkoo Chung

Subjects
Male, medicine.medical_specialty, men who have sex with men, Stigma (botany), HIV Infections, Context (language use), Men who have sex with men, HIV Testing, Sexual and Gender Minorities, 03 medical and health sciences, 0302 clinical medicine, in-home HIV test, Acquired immunodeficiency syndrome (AIDS), Transgender, medicine, Humans, Social media, 030212 general & internal medicine, Home test, Homosexuality, Male, 030505 public health, human immunodeficiency virus, business.industry, Health Policy, Public Health, Environmental and Occupational Health, HIV, virus diseases, Research Reports, HIV self-test, medicine.disease, Test (assessment), Family medicine, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, New York City, 0305 other medical science, business
Abstract

Supplemental Digital Content is Available in the Text., Context: Gay, bisexual, and men who have sex with men (MSM) are disproportionately affected by the HIV/AIDS epidemic more than any other group. In New York State (NYS) outside of New York City (NYC), MSM accounted for 57% of new HIV/AIDS diagnoses in 2017. HIV/AIDS home testing initiatives have been effective at getting priority populations tested for HIV. Objectives: The NYS Department of Health (NYSDOH) administered the HIV Home Test Giveaway (HHTG) program through social media and mobile applications popular among the priority populations to (1) promote HIV screening among gay and bisexual men, MSM, transgender (TG), and gender queer/gender nonconforming (GNC) individuals who have sex with men, and (2) identify individuals with undiagnosed HIV infection. Design/Setting: The NYSDOH recruited participants from NYS (excluding NYC) through social media campaigns between November 2016 and January 2018. Interested individuals were directed to an online eligibility survey. Eligible participants received a coupon via e-mail for a free HIV self-test (HIVST) kit through the manufacturer's Web site. Eligible participants received a $20 to $25 Amazon online gift card if they completed a voluntary online follow-up survey regarding their test results, experiences with the HHTG, and HIV/AIDS risk behaviors. Participants were also able to request assistance from the NYSDOH with further testing and various prevention and supportive services. Participants: In total, 6190 individuals participated and 3197 (52%) were eligible and received a coupon. Of the eligible, 2022 (63%) redeemed coupons for HIVST. Results: Among eligible participants, 976 (31%) reported having never been tested for HIV. On the follow-up survey, 922 (29%) participants reported having used the HIVST kit for themselves; 203 (22%) were first-time testers; and 7 (0.8%) tested HIV reactive. Of the follow-up survey participants, 761 (59%) requested assistance with various services. Conclusions: Media campaigns were effective in promoting HIV testing among priority populations and reaching individuals who have never been tested for HIV.

Published
2020
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6. Cumulative incidence and diagnosis of SARS-CoV-2 infection in New York

Author

Tomoko Udo, Danielle Greene, David R. Holtgrave, Dina Hoefer, Brad Hutton, Shu Yin John Leung, Linda M. Styer, Rakkoo Chung, Meredith A. Barranco, Elizabeth M. Rosenthal, Howard A. Zucker, Jessica Kumar, Monica M. Parker, Eli S. Rosenberg, Johanne E. Morne, and James M. Tesoriero

Subjects
Adult, Male, medicine.medical_specialty, Adolescent, Epidemiology, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Pneumonia, Viral, Population, New York, Ethnic group, infectious diseases, 01 natural sciences, Article, epidemics, Herd immunity, 03 medical and health sciences, Young Adult, 0302 clinical medicine, COVID-19 Testing, Seroepidemiologic Studies, Humans, Medicine, Seroprevalence, Cumulative incidence, 030212 general & internal medicine, 0101 mathematics, education, Pandemics, education.field_of_study, seroprevalence, Clinical Laboratory Techniques, business.industry, Incidence (epidemiology), Incidence, Public health, 010102 general mathematics, COVID-19, Middle Aged, Confidence interval, Coronavirus, surveillance, Female, Coronavirus Infections, business, Contact tracing, Demography
Abstract

ImportanceNew York State (NYS) is an epicenter of the United States’ COVID-19 epidemic. Reliable estimates of cumulative incidence of SARS-CoV-2 infection in the population are critical to tracking the extent of transmission and informing policies, but US data are lacking, in part because societal closure complicates study conduct.ObjectiveTo estimate the cumulative incidence of SARS-CoV-2 infection and percent of infections diagnosed in New York State, overall and by region, age, sex, and race and ethnicity.DesignStatewide cross-sectional seroprevalence study, conducted April 19-28, 2020.SettingGrocery stores (n=99) located in 26 counties throughout NYS, which were essential businesses that remained open during a period of societal closure and attract a heterogenous clientele.ParticipantsConvenience sample of patrons ≥18 years and residing in New York State, recruited consecutively upon entering stores and via an in-store flyer.ExposuresRegion (New York City, Westchester/Rockland, Long Island, Rest of New York State), age, sex, race and ethnicity.Main OutcomesPrimary outcome: cumulative incidence of SARS-CoV-2 infection, based on dry-blood spot (DBS) SARS-CoV-2 antibody reactivity; secondary outcome: percent of infections diagnosed.ResultsAmong 15,101 adults with suitable DBS specimens, 1,887 (12.5%) were reactive using a validated SARS-CoV-2 IgG microsphere immunoassay (sensitivity 87.9%, specificity 99.75%). Following post-stratification weighting on region, sex, age, and race and ethnicity and adjustment for assay characteristics, estimated cumulative incidence through March 29 was 14.0% (95% CI: 13.3-14.7%), corresponding to 2,139,300 (95% CI: 2,035,800-2,242,800) infection-experienced adults. Cumulative incidence was higher among Hispanic/Latino (29.2%, 95% CI: 27.2-31.2%), non-Hispanic black/African American (20.2% 95% CI, 18.1-22.3%), and non-Hispanic Asian (12.4%, 95% CI: 9.4-15.4%) adults than non-Hispanic white adults (8.1%, 95% CI: 7.4-8.7%, pConclusions and RelevanceOver 2 million adults were infected through late March 2020, with substantial variations by subpopulations. As this remains below herd immunity thresholds, monitoring, testing, and contact tracing remain essential public health strategies.

Published
2020
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7. HIV Screening in the Dental Chair

Author

Michael N. Hatton, Rakkoo Chung, Shu-Yin John Leung, Laura O’Shea, Howard Lavigne, Jeffrey Seiver, Yan-Fang Ren, Travis O’Donnell, Carol Sloane, and Stephen N. Abel

Subjects
medicine.medical_specialty, business.industry, Family medicine, Medicine, Radiology, Nuclear Medicine and imaging, Dentistry (miscellaneous), Surgery, Dental chair, HIV screening, Oral Surgery, business, Pathology and Forensic Medicine
Published
2018
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8. Models for Pooled Cross-Section Time-Series Data.

Author

Raffalovich, Lawrence E. and Rakkoo Chung

Abstract

Several models are available for the analysis of pooled cross-section time-series (CSTS) data, defined as "repeated observations on fixed units" (Beck and Katz 1995). In this paper, we run the following models: (1) a completely pooled model, (2) fixed effects models, and (3) multilevel/ hierarchical linear models. To illustrate these models, we use a Generalized Least Squares (GLS) estimator with cross-section weights (with EViews 8) on the cross-national homicide trends data of 40 countries from 1950 to 2005, which we borrow from published research (Messner et al. 2011). We then describe and discuss those models, their similarities and differences, and what information each can contribute to help answer substantive research questions. We conclude with a discussion of how the models we present may help to mitigate validity threats inherent in pooled cross-section time-series data analysis. [ABSTRACT FROM AUTHOR]

Published
2015

9. Global and Local: Elites and the Dynamics of Nominal Democratization in South Korea and Nigeria.

Author

Rakkoo Chung

Abstract

Many democracy scholars note the paradox of contemporary democracy, in that the third wave of democratization (roughly between 1975 and 2000) witnessed two seemingly incompatible trends, an increase in the quantity and a decrease in the quality of global democracy. Previous theories of democratization cannot explain, and did not predict, the massive emergence of low-quality democracies. To fill this gap, I define nominal democratization as the transition of a nondemocratic regime to a low-quality democracy, and develop theories of nominal democratization through the comparative historical analysis of South Korea and Nigeria. Employing the elite conflict theory, I investigate when, why, how and by whom nominal democratization occurred in response to the pressures from various domestic and international actors, as well as under the particular structural and institutional settings. I demonstrate the ways in which domestic elites and world powers (notably, the U.S. and the U.K.) contributed to producing such nominal democratizations in South Korea and Nigeria. [ABSTRACT FROM AUTHOR]

Published
2013

10. Spuriousness of Gender Paradox in Job Satisfaction: Using General Social Survey (GSS) 2002.

Author

Rakkoo Chung

Subjects
WOMEN'S employment, JOB satisfaction, EMPLOYEE participation in management, SEX discrimination, SOCIAL surveys
Abstract

This paper examines the paradox: why women's job satisfaction is not lower than men's in spite of their objectively poorer rewards. Many previous studies have reported that women tend to value intrinsic features of work while men value extrinsic features. However, this research proposes that the gender difference in job satisfaction, which is referred to as a paradox, is spurious when family responsibility variables are controlled. Its main argument is that those who feel responsibility for the financial support of their family tend to more value extrinsic rewards. This propensity is framed by gender, simply because there are more men among those who feel such responsibility. The General Social Survey (GSS) 2002 supports this point. This research contributes to the field of study of job satisfaction in two ways. First, it proposes two family responsibility variables. They are important to explain the relationship between the pay level and job satisfaction. But they have not been taken into account in the previous studies. Second, this paper gives an alternative explanation that does not lean onto gender bias. The prevalent notion that women like intrinsic rewards while men like extrinsic rewards does not capture the reality but perpetuates gender bias. [ABSTRACT FROM AUTHOR]

Published
2008

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