250 results on '"Skaathun, Britt"'
Search Results
2. HIV-1 transmission dynamics among people who inject drugs on the US/Mexico border during the COVID-19 pandemic: a prosepective cohort study
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Skaathun, Britt, Strathdee, Steffanie A, Shrader, Cho-Hee, Nacht, Carrie L, Borquez, Annick, Artamonova, Irina, Harvey-Vera, Alicia, Vera, Carlos F, Rangel, Gudelia, Ignacio, Caroline, Woodworth, Brendon, Chaillon, Antoine, and Vasylyeva, Tetyana I
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Biomedical and Clinical Sciences ,Clinical Sciences ,Infectious Diseases ,Social Determinants of Health ,Behavioral and Social Science ,Clinical Research ,Drug Abuse (NIDA only) ,HIV/AIDS ,Health Disparities ,Substance Misuse ,Women's Health ,Coronaviruses ,Sexually Transmitted Infections ,Emerging Infectious Diseases ,Prevention ,Infection ,Good Health and Well Being ,HIV ,Cross-border transmission ,Tijuana ,Phylodynamics ,People who inject drugs - Abstract
BackgroundWe examined HIV prevalence and transmission dynamics among people who inject drugs in the U.S./Mexico border region during the COVID-19 pandemic.MethodsPeople who inject drugs aged ≥18 years from 3 groups were recruited: people who inject drugs who live in San Diego (SD) and engaged in cross-border drug use in Tijuana, Mexico (SD CBDUs), and people who inject drugs in SD and Tijuana (TJ) who did not engage in cross-border drug use (NCBDUs). We computed HIV prevalence at baseline and bivariate incidence-density rates (IR) at 18-month follow-up. Bayesian phylogenetic analysis was used to identify local transmission clusters, estimate their age, and effective reproductive number (Re) over time within the clusters.FindingsAt baseline (n = 612), 26% of participants were female, 9% engaged in sex work, and HIV prevalence was 8% (4% SD CBDU, 4% SD NCBDU, 16% TJ NCBDU). Nine HIV seroconversions occurred over 18 months, IR: 1.357 per 100 person-years (95% CI: 0.470, 2.243); 7 in TJ NCBDU and 2 in SD CBDU. Out of 16 identified phylogenetic clusters, 9 (56%) had sequences from both the U.S. and Mexico (mixed-country). The age of three youngest mixed-country dyads (2018-2021) overlapped with the COVID-related US-Mexico border closure in 2020. One large mixed-country cluster (N = 15) continued to grow during the border closure (Re = 4.8, 95% Highest Posterior Density (HPD) 1.5-9.1) with 47% engaging in sex work.InterpretationAmidst the COVID-19 pandemic and the border closure, cross-border HIV clusters grew. Efforts to end the HIV epidemic in the U.S. should take into account cross-border HIV-1 transmission from Tijuana. Mobile harm reduction services and coordination with municipal HIV programs to initiate anti-retroviral therapy and pre-exposure prophylaxisis are needed to reduce transmission.FundingThis research was supported by the James B. Pendleton Charitable Trust and the San Diego Center for AIDS Research.
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- 2024
3. Leveraging social networks for identification of people with HIV who are virally unsuppressed
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Cummins, Breschine, Johnson, Kara, Schneider, John A, Del Vecchio, Natascha, Moshiri, Niema, Wertheim, Joel O, Goyal, Ravi, and Skaathun, Britt
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,HIV/AIDS ,Clinical Research ,Infection ,Male ,Humans ,HIV Infections ,Sexual Partners ,Sexual and Gender Minorities ,Social Networking ,Contact Tracing ,contact tracing ,engagement ,HIV ,people with HIV ,recruitment ,social networks ,Biological Sciences ,Medical and Health Sciences ,Psychology and Cognitive Sciences ,Virology ,Biomedical and clinical sciences ,Health sciences - Abstract
ObjectivesThis study investigates primary peer-referral engagement (PRE) strategies to assess which strategy results in engaging higher numbers of people with HIV (PWH) who are virally unsuppressed.DesignWe develop a modeling study that simulates an HIV epidemic (transmission, disease progression, and viral evolution) over 6 years using an agent-based model followed by simulating PRE strategies. We investigate two PRE strategies where referrals are based on social network strategies (SNS) or sexual partner contact tracing (SPCT).MethodsWe parameterize, calibrate, and validate our study using data from Chicago on Black sexual minority men to assess these strategies for a population with high incidence and prevalence of HIV. For each strategy, we calculate the number of PWH recruited who are undiagnosed or out-of-care (OoC) and the number of direct or indirect transmissions.ResultsSNS and SPCT identified 256.5 [95% confidence interval (CI) 234-279] and 15 (95% CI 7-27) PWH, respectively. Of these, SNS identified 159 (95% CI 142-177) PWH OoC and 32 (95% CI 21-43) PWH undiagnosed compared with 9 (95% CI 3-18) and 2 (95% CI 0-5) for SPCT. SNS identified 15.5 (95% CI 6-25) and 7.5 (95% CI 2-11) indirect and direct transmission pairs, whereas SPCT identified 6 (95% CI 0-8) and 5 (95% CI 0-8), respectively.ConclusionWith no testing constraints, SNS is the more effective strategy to identify undiagnosed and OoC PWH. Neither strategy is successful at identifying sufficient indirect or direct transmission pairs to investigate transmission networks.
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- 2024
4. Study protocol: Project 2VIDA! SARS-CoV-2 vaccine intervention delivery for adults in Southern California.
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Skaathun, Britt, Salgin, Linda, Muñoz, Fatima, Talavera, Gregory, Smith, David, Stockman, Jamila, OBryan, Sophie, Ramirez, Daniel, James-Price, Cynthia, and Servin, Argentina
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African American ,COVID-19 ,Latino (Hispanic) ,community-based participatory research ,vaccine hesitancy ,Adult ,Humans ,California ,COVID-19 ,COVID-19 Vaccines ,United States ,Clinical Trial Protocols as Topic - Abstract
BACKGROUND: To date, the United States (US) leads the world in the number of infections and deaths due to the Coronavirus Disease 2019 (COVID-19). Racial and ethnic disparities in COVID-19 morbidity and mortality are staggering. Age-adjusted data show that AA and Latino individuals have had higher rates of death over most of the pandemic and during surges. Project 2VIDA! is community-based participatory research (CBPR) that was developed to address individual, social, and contextual factors related to access and acceptance of the COVID-19 vaccine among African American and Latino communities in Southern California. This paper describes the study protocol and overarching objectives. METHODS AND DESIGN: Project 2VIDA! is a multilevel intervention that builds on the principals of CBPR and is designed to increase uptake of the COVID-19 vaccine among African American and Latino individuals (≥16 years and older) in San Diego County. The intervention was developed with a working group comprised of representatives from community and academia and centers on targeted COVID-19 individual awareness and education, linkage to medical and supportive services, COVID-19 community outreach and health promotion and offering the COVID-19 vaccine through community pop-up clinics. DISCUSSION: Findings from 2VIDA! will provide data on the impact, feasibility, and acceptability of the intervention which are all crucial for the adaptation, refinement, and improvement of vaccine outreach interventions for COVID-19 and other vaccine preventable infectious diseases that severely impact African American and Latino communities. CLINICAL TRIAL REGISTRATION: https://clinicaltrials.gov/ct2/show/NCT05022472?term=Project+2VIDA&draw=2&rank=1, NCT05022472.
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- 2024
5. Willingness to use and distribute HIV self-testing kits among people who inject drugs in the San Diego–Tijuana border region
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Pines, Heather A, Eger, William H, Skaathun, Britt, Vera, Carlos F, Harvey-Vera, Alicia, Rangel, Gudelia, Strathdee, Steffanie A, and Bazzi, Angela R
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Public Health ,Health Sciences ,Behavioral and Social Science ,HIV/AIDS ,Substance Misuse ,Drug Abuse (NIDA only) ,Infectious Diseases ,Good Health and Well Being ,Humans ,Self-Testing ,Substance Abuse ,Intravenous ,HIV Infections ,Drug Users ,Surveys and Questionnaires ,HIV self-testing ,Secondary distribution ,Social networks ,People who inject drugs ,HIV prevention ,Public Health and Health Services ,Substance Abuse ,Health services and systems ,Public health - Abstract
BackgroundHIV self-testing (HIVST) could increase HIV testing access among people who inject drugs (PWID), and secondary distribution (i.e., peer-delivery) of HIVST kits in PWID social networks could further expand coverage. We assessed willingness to use and distribute HIVST kits among PWID in the San Diego-Tijuana border region.MethodsFrom 2020 to 2021, HIV-negative PWID in San Diego, USA, and Tijuana, Mexico, completed surveys and provided data on individual (N = 539) and social network (N = 366) characteristics. We used modified Poisson regression to examine the effects of individual and social network characteristics on willingness to use and distribute HIVST kits.ResultsMost participants were willing to use (81%) and distribute (81%) HIVST kits. At the individual level, prior HIV testing was positively associated with willingness to use (adjusted prevalence ratio [aPR] = 1.24, 95% confidence interval [CI] 1.10-1.40) and distribute (aPR = 1.27, 95% CI 1.12-1.43) HIVST kits, while perceiving oneself to be at higher HIV risk than others was negatively associated with willingness to use HIVST kits (aPR = 0.83, 95% CI 0.74-0.93). At the network level, willingness to distribute HIVST kits was positively associated with network size (aPR = 1.04 per member, 95% CI 1.01-1.08) and greater proportions of one's network encouraging them to use drugs (aPR = 1.29, 95% CI 1.16-1.44) and having a history of homelessness (aPR = 1.51, 95% CI 1.31-1.74) or detention/arrest (aPR = 1.57, 95% CI 1.36-1.82), and negatively associated with a greater proportion of one's network including "very close" persons (aPR = 0.80, 95% CI 0.69-0.94).ConclusionsWe found high potential for HIVST kits and their secondary distribution to increase HIV testing among PWID who face the greatest barriers to facility-based testing.
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- 2024
6. Association between where men who have sex with men (MSM) meet sexual partners and chlamydia/gonorrhoea infection before and during the COVID-19 pandemic in San Diego, California
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King, Colin MB, Garfein, Richard S, Bazzi, Angela R, Little, Susan J, and Skaathun, Britt
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Public Health ,Biomedical and Clinical Sciences ,Clinical Sciences ,Health Sciences ,HIV/AIDS ,Prevention ,Sexually Transmitted Infections ,Infectious Diseases ,Clinical Research ,Behavioral and Social Science ,Infection ,Good Health and Well Being ,Male ,Humans ,Adolescent ,Adult ,Gonorrhea ,Sexual Partners ,Homosexuality ,Male ,Sexual Behavior ,Cross-Sectional Studies ,Pandemics ,Neisseria gonorrhoeae ,Sexual and Gender Minorities ,COVID-19 ,Chlamydia Infections ,Chlamydia trachomatis ,California ,Prevalence ,Chalmydia trachomatis ,gonorrhea ,sexual and gender minorities ,Medical Microbiology ,Public Health and Health Services ,Clinical sciences ,Public health - Abstract
BackgroundMeeting sex partners online is associated with increased risk of acquiring sexually transmitted infections. We examined whether different venues where men who have sex with men (MSM) meet sex partners was associated with prevalent Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) infection, and whether prevalence increased during (vs before) the COVID-19 pandemic.MethodsWe conducted a cross-sectional analysis of data from San Diego's 'Good To Go' sexual health clinic from two enrolment periods: (1) March-September 2019 (pre-COVID-19) and (2) March-September 2021 (during COVID-19). Participants completed self-administered intake assessments. This analysis included males aged ≥18 years self-reporting sex with males within 3 months before enrolment. Participants were categorised as (1) meeting new sex partners in-person only (eg, bars, clubs), (2) meeting new sex partners online (eg, applications, websites) or (3) having sex only with existing partners. We used multivariable logistic regression, adjusting for year, age, race, ethnicity, number of sex partners, pre-exposure prophylaxis use and drug use to examine whether venue or enrolment period were associated with CT/NG infection (either vs none).ResultsAmong 2546 participants, mean age was 35.5 (range: 18-79) years, 27.9% were non-white and 37.0% were Hispanic. Overall, CT/NG prevalence was 14.8% and was higher during COVID-19 vs pre-COVID-19 (17.0% vs 13.3%). Participants met sex partners online (56.9%), in-person (16.9%) or only had existing partners (26.2%) in the past 3 months. Compared with having only existing sex partners, meeting partners online was associated with higher CT/NG prevalence (adjusted OR (aOR) 2.32; 95% CI 1.51 to 3.65), while meeting partners in-person was not associated with CT/NG prevalence (aOR 1.59; 95% CI 0.87 to 2.89). Enrolment during COVID-19 was associated with higher CT/NG prevalence compared with pre-COVID-19 (aOR 1.42; 95% CI 1.13 to 1.79).ConclusionsCT/NG prevalence appeared to increase among MSM during COVID-19, and meeting sex partners online was associated with higher prevalence.
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- 2023
7. Phylodynamics and migration data help describe HIV transmission dynamics in internally displaced people who inject drugs in Ukraine
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Kovalenko, Ganna, Yakovleva, Anna, Smyrnov, Pavlo, Redlinger, Matthew, Tymets, Olga, Korobchuk, Anna, Kolodiazieva, Anna, Podolina, Anna, Cherniavska, Svitlana, Skaathun, Britt, Smith, Laramie R, Strathdee, Steffanie A, Wertheim, Joel O, Friedman, Samuel R, Bortz, Eric, Goodfellow, Ian, Meredith, Luke, and Vasylyeva, Tetyana I
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Medical Microbiology ,Biomedical and Clinical Sciences ,Infectious Diseases ,Behavioral and Social Science ,Prevention ,HIV/AIDS ,Infection ,Good Health and Well Being ,HIV ,displacement ,people who inject drugs ,Ukraine ,phylodynamics - Abstract
Internally displaced persons are often excluded from HIV molecular epidemiology surveillance due to structural, behavioral, and social barriers in access to treatment. We test a field-based molecular epidemiology framework to study HIV transmission dynamics in a hard-to-reach and highly stigmatized group, internally displaced people who inject drugs (IDPWIDs). We inform the framework by Nanopore generated HIV pol sequences and IDPWID migration history. In June-September 2020, we recruited 164 IDPWID in Odesa, Ukraine, and obtained 34 HIV sequences from HIV-infected participants. We aligned them to publicly available sequences (N = 359) from Odesa and IDPWID regions of origin and identified 7 phylogenetic clusters with at least 1 IDPWID. Using times to the most recent common ancestors of the identified clusters and times of IDPWID relocation to Odesa, we infer potential post-displacement transmission window when infections likely to happen to be between 10 and 21 months, not exceeding 4 years. Phylogeographic analysis of the sequence data shows that local people in Odesa disproportionally transmit HIV to the IDPWID community. Rapid transmissions post-displacement in the IDPWID community might be associated with slow progression along the HIV continuum of care: only 63% of IDPWID were aware of their status, 40% of those were in antiviral treatment, and 43% of those were virally suppressed. Such HIV molecular epidemiology investigations are feasible in transient and hard-to-reach communities and can help indicate best times for HIV preventive interventions. Our findings highlight the need to rapidly integrate Ukrainian IDPWID into prevention and treatment services following the dramatic escalation of the war in 2022.
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- 2023
8. Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis
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Shrader, Cho-Hee, Borquez, Annick, Vasylyeva, Tetyana I, Chaillon, Antoine, Artamanova, Irina, Harvey-Vera, Alicia, Vera, Carlos F, Rangel, Gudelia, Strathdee, Steffanie A, and Skaathun, Britt
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Public Health ,Health Sciences ,Drug Abuse (NIDA only) ,Substance Misuse ,Infectious Diseases ,Clinical Research ,HIV/AIDS ,Behavioral and Social Science ,Prevention ,Prevention of disease and conditions ,and promotion of well-being ,3.1 Primary prevention interventions to modify behaviours or promote wellbeing ,Good Health and Well Being ,Humans ,Substance Abuse ,Intravenous ,HIV Infections ,Drug Users ,Harm Reduction ,COVID-19 ,Substance-Related Disorders ,Risk-Taking ,Drug users ,HIV infections ,Latent class analysis ,Social Networks ,Mexico ,Public Health and Health Services ,Social Work ,Public health - Abstract
The COVID-19 related U.S.-Mexico border-crossing restrictions disrupted social networks and HIV harm reduction services among people who inject drugs (PWID) in San Diego and Tijuana. We assessed associations of descriptive network norms on PWID's HIV vulnerability during this period. Between 10/2020 and 10/2021, 399 PWID completed a behavioral and egocentric questionnaire. We used Latent Profile Analysis to categorize PWID into network norm risk profiles based on proportions of their network (n = 924 drug use alters) who injected drugs and engaged in cross-border drug use (CBDU), among other vulnerabilities. We used logistic and linear regressions to assess network profile associations with individual-level index of HIV vulnerability and harm reduction behaviors. Fit indices specified a 4-latent profile solution of descriptive network risk norms: lower (n = 178), moderate with (n = 34) and without (n = 94) CBDU and obtainment, and higher (n = 93). Participants in higher risk profiles reported more HIV vulnerability behaviors and fewer harm reduction behaviors. PWID's gradient of HIV risk was associated with network norms, warranting intervention on high-vulnerability networks when services are limited.
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- 2023
9. Cocirculation and replacement of SARS-CoV-2 variants in crowded settings and marginalized populations along the US-Mexico border
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Chaillon, Antoine, Bojorquez, Ietza, Sepúlveda, Jaime, Harvey-Vera, Alicia Yolanda, Rangel, M Gudelia, Skaathun, Britt, Mehta, Sanjay R, Ignacio, Caroline, Porrachia, Magali, Smith, Davey M, and Strathdee, Steffanie A
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Health Services and Systems ,Public Health ,Health Sciences ,Biodefense ,Vaccine Related ,Prevention ,Infectious Diseases ,Lung ,Emerging Infectious Diseases ,Good Health and Well Being ,Humans ,SARS-CoV-2 ,Substance Abuse ,Intravenous ,Mexico ,Drug Users ,COVID-19 ,lineages ,recombination ,genetic ,drug users ,emigrants and immigrants ,Public Health and Health Services ,Health services and systems ,Public health - Abstract
ObjectiveTo interrogate the circulating SARS-CoV-2 lin-eages and recombinant variants in persons living in migrant shelters and persons who inject drugs (PWID).Materials and methodsWe combined data from two studies with marginalized populations (migrants in shelters and persons who inject drugs) in Tijuana, Mexico. SARS-CoV-2 variants were identified on nasal swabs specimens and compared to publicly available genomes sampled in Mexico and California.ResultsAll but 2 of the 10 lineages identified were predomi-nantly detected in North and Central America. Discrepan-cies between migrants and PWID can be explained by the temporal emergence and short time span of most of these lineages in the region.ConclusionThe results illustrate the temporo-spatial structure for SARS-CoV-2 lineage dispersal and the potential co-circulation of multiple lineages in high-risk populations with close social contacts. These conditions create the potential for recombination to take place in the California-Baja California border.
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- 2023
10. Latent Profile Patterns of Network-Level Norms and Associations with Individual-Level Sexual Behaviors: The N2 Cohort Study in Chicago
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Shrader, Cho-Hee, Duncan, Dustin T., Chen, Yen-Tyng, Driver, Redd, Russell, Jonathan, Moody, Raymond L., Knox, Justin, Skaathun, Britt, Durrell, Mainza, Hanson, Hillary, Eavou, Rebecca, Goedel, William C., and Schneider, John A.
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- 2023
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11. Differences in characteristics and interactions with close contacts among PWID in the San Diego Border Region before and during the COVID-19 pandemic
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Marquez, Lara K, Martin, Natasha K, Strathdee, Steffanie A, and Skaathun, Britt
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- 2024
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12. Interplay Between Geography and HIV Transmission Clusters in Los Angeles County
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Skaathun, Britt, Ragonnet-Cronin, Manon, Poortinga, Kathleen, Sheng, Zhijuan, Hu, Yunyin W, and Wertheim, Joel O
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Biomedical and Clinical Sciences ,Clinical Sciences ,Sexually Transmitted Infections ,Clinical Research ,Prevention ,HIV/AIDS ,Genetics ,Health Disparities ,Infectious Diseases ,2.2 Factors relating to the physical environment ,Infection ,Good Health and Well Being ,cluster analysis ,HIV infections ,transmission ,molecular epidemiology ,HIV infections/transmission ,Clinical sciences ,Medical microbiology - Abstract
BackgroundClusters of HIV diagnoses in time and space and clusters of genetically linked cases can both serve as alerts for directing prevention and treatment activities. We assessed the interplay between geography and transmission across the Los Angeles County (LAC) HIV genetic transmission network.MethodsDeidentified surveillance data reported for 8186 people with HIV residing in LAC from 2010 through 2016 were used to construct a transmission network using HIV-TRACE. We explored geographic assortativity, the tendency for people to link within the same geographic region; concordant time-space pairs, the proportion of genetically linked pairs from the same geographic region and diagnosis year; and Jaccard coefficient, the overlap between geographical and genetic clusters.ResultsGeography was assortative in the genetic transmission network but less so than either race/ethnicity or transmission risk. Only 18% of individuals were diagnosed in the same year and location as a genetically linked partner. Jaccard analysis revealed that cis-men and younger age at diagnosis had more overlap between genetic clusters and geography; the inverse association was observed for trans-women and Blacks/African Americans.ConclusionsWithin an urban setting with endemic HIV, genetic clustering may serve as a better indicator than time-space clustering to understand HIV transmission patterns and guide public health action.
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- 2021
13. Leveraging social networks for identification of people living with HIV who are virally unsuppressed
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Cummins, Breschine, Johnson, Kara, Schneider, John A., Del Vecchio, Natascha, Moshiri, Niema, Wertheim, Joel O., Goyal, Ravi, and Skaathun, Britt
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- 2023
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14. What is needed to achieve HCV microelimination among HIV-infected populations in Andalusia, Spain: a modeling analysis
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Skaathun, Britt, Borquez, Annick, Rivero-Juarez, Antonio, Mehta, Sanjay R, Tellez, Francisco, Castaño-Carracedo, Manuel, Merino, Dolores, Palacios, Rosario, Macías, Juan, Rivero, Antonio, and Martin, Natasha K
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Biomedical and Clinical Sciences ,Clinical Sciences ,Digestive Diseases ,Substance Misuse ,Hepatitis ,Liver Disease ,Drug Abuse (NIDA only) ,Hepatitis - C ,Prevention ,Behavioral and Social Science ,Sexual and Gender Minorities (SGM/LGBT*) ,Chronic Liver Disease and Cirrhosis ,Emerging Infectious Diseases ,HIV/AIDS ,Infectious Diseases ,6.1 Pharmaceuticals ,Evaluation of treatments and therapeutic interventions ,Infection ,Good Health and Well Being ,Antiviral Agents ,Cohort Studies ,Coinfection ,HIV Infections ,Hepatitis C ,Homosexuality ,Male ,Humans ,Male ,Models ,Theoretical ,Prevalence ,Prospective Studies ,Spain ,Substance-Related Disorders ,Sustained Virologic Response ,Hepatitis C virus ,Microelimination ,HIV ,Direct-acting antivirals ,Microbiology ,Medical Microbiology ,Clinical sciences ,Medical microbiology ,Public health - Abstract
BackgroundScale-up of hepatitis C virus (HCV) treatment for HIV/HCV coinfected individuals is occurring in Spain, the vast majority (> 85%) with a reported history of injecting drug use and a smaller population of co-infected men who have sex with men (MSM). We assess impact of recent treatment scale-up to people living with HIV (PLWH) and implications for achieving the WHO HCV incidence elimination target (80% reduction 2015-2030) among PLWH and overall in Andalusia, Spain, using dynamic modeling.MethodsA dynamic transmission model of HCV/HIV coinfection was developed. The model was stratified by people who inject drugs (PWID) and MSM. The PWID component included dynamic HCV transmission from the HCV-monoinfected population. The model was calibrated to Andalusia based on published data and the HERACLES cohort (prospective cohort of HIV/HCV coinfected individuals representing > 99% coinfected individuals in care in Andalusia). From HERACLES, we incorporated HCV treatment among diagnosed PLWH of 10.5%/year from 2004 to 2014, and DAAs at 33%/year from 2015 with 94.8% SVR. We project the impact of current and scaled-up HCV treatment for PLWH on HCV prevalence and incidence among PLWH and overall.ResultsCurrent treatment rates among PLWH (scaled-up since 2015) could substantially reduce the number of diagnosed coinfected individuals (mean 76% relative reduction from 2015 to 2030), but have little impact on new diagnosed coinfections (12% relative reduction). However, DAA scale-up to PWLH in 2015 would have minimal future impact on new diagnosed coinfections (mean 9% relative decrease from 2015 to 2030). Similarly, new cases of HCV would only reduce by a mean relative 29% among all PWID and MSM due to ongoing infection/reinfection. Diagnosing/treating all PLWH annually from 2020 would increase the number of new HCV infections among PWLH by 28% and reduce the number of new HCV infections by 39% among the broader population by 2030.ConclusionTargeted scale-up of HCV treatment to PLWH can dramatically reduce prevalence among this group but will likely have little impact on the annual number of newly diagnosed HIV/HCV coinfections. HCV microelimination efforts among PWLH in Andalusia and settings where a large proportion of PLWH have a history of injecting drug use will require scaled-up HCV diagnosis and treatment among PLWH and the broader population at risk.
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- 2020
15. The role of drug treatment and recovery services: an opportunity to address injection initiation assistance in Tijuana, Mexico
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Meyers, Stephanie A, Rafful, Claudia, Jain, Sonia, Sun, Xiaoying, Skaathun, Britt, Guise, Andrew, Gonzalez-Zuñiga, Patricia, Strathdee, Steffanie A, Werb, Dan, and Mittal, Maria Luisa
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Health Services and Systems ,Health Sciences ,Drug Abuse (NIDA only) ,Behavioral and Social Science ,HIV/AIDS ,Prevention ,Emerging Infectious Diseases ,Substance Misuse ,Clinical Research ,Infectious Diseases ,Health Services ,Good Health and Well Being ,Female ,Health Services Accessibility ,Humans ,Interviews as Topic ,Male ,Mexico ,Opiate Substitution Treatment ,Qualitative Research ,Social Stigma ,Substance Abuse ,Intravenous ,Medication assisted treatment ,Methadone ,Residential drug treatment ,Injection drug use ,Harm reduction ,Tijuana ,Injection initiation ,Tijuana ,Mexico ,Psychology ,Substance Abuse ,Public health ,Clinical and health psychology - Abstract
BackgroundIn the U.S. and Canada, people who inject drugs' (PWID) enrollment in medication-assisted treatment (MAT) has been associated with a reduced likelihood that they will assist others in injection initiation events. We aimed to qualitatively explore PWID's experiences with MAT and other drug treatment and related recovery services in Tijuana Mexico, a resource-limited setting disproportionately impacted by injection drug use.MethodsPReventing Injecting by Modifying Existing Responses (PRIMER) seeks to assess socio-structural factors associated with PWID provision of injection initiation assistance. This analysis drew on qualitative data from Proyecto El Cuete (ECIV), a Tijuana-based PRIMER-linked cohort study. In-depth qualitative interviews were conducted with a subset of study participants to further explore experiences with MAT and other drug treatment services. Qualitative thematic analyses examined experiences with these services, including MAT enrollment, and related experiences with injection initiation assistance provision.ResultsAt PRIMER baseline, 607(81.1%) out of 748 participants reported recent daily IDU, 41(5.5%) reported recent injection initiation assistance, 92(12.3%) reported any recent drug treatment or recovery service access, and 21(2.8%) reported recent MAT enrollment (i.e., methadone). Qualitative analysis (n = 21; female = 8) revealed that, overall, abstinence-based recovery services did not meet participants' recovery goals, with substance use-related social connections in these contexts potentially shaping injection initiation assistance. Themes also highlighted individual-level (i.e., ambivalence and MAT-related stigma) and structural-level (i.e., cost and availability) barriers to MAT enrollment.ConclusionTijuana's abstinence-based drug treatment and recovery services were viewed as unable to meet participants' recovery-related goals, which could be limiting the potential benefits of these services. Drug treatment and recovery services, including MAT, need to be modified to improve accessibility and benefits, like preventing transitions into drug injecting, for PWID.
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- 2020
16. Grindr Users Take More Risks, but Are More Open to Human Immunodeficiency Virus (HIV) Pre-exposure Prophylaxis: Could This Dating App Provide a Platform for HIV Prevention Outreach?
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Hoenigl, Martin, Little, Susan J, Grelotti, David, Skaathun, Britt, Wagner, Gabriel A, Weibel, Nadir, Stockman, Jamila K, and Smith, Davey M
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Biomedical and Clinical Sciences ,Clinical Sciences ,Prevention ,Health Disparities ,Behavioral and Social Science ,Infectious Diseases ,HIV/AIDS ,Sexual and Gender Minorities (SGM/LGBT*) ,Clinical Research ,Sexually Transmitted Infections ,Clinical Trials and Supportive Activities ,Mental Health ,Infection ,Good Health and Well Being ,Cohort Studies ,HIV ,HIV Infections ,Homosexuality ,Male ,Humans ,Male ,Mobile Applications ,Pre-Exposure Prophylaxis ,Sexual and Gender Minorities ,United States ,HIV risk ,dating app ,pre-exposure prophylaxis ,substance use ,risk behavior ,Biological Sciences ,Medical and Health Sciences ,Microbiology ,Clinical sciences - Abstract
BackgroundTechnology has changed the way that men who have sex with men (MSM) seek sex. More than 60% of MSM in the United States use the internet and/or smartphone-based geospatial networking apps to find sex partners. We correlated use of the most popular app (Grindr) with sexual risk and prevention behavior among MSM.MethodsA nested cohort study was conducted between September 2018 and June 2019 among MSM receiving community-based human immunodeficiency virus (HIV) and sexually transmitted infection (STI) screening in central San Diego. During the testing encounter, participants were surveyed for demographics, substance use, risk behavior (previous 3 months), HIV pre-exposure prophylaxis (PrEP) use, and Grindr usage. Participants who tested negative for HIV and who were not on PrEP were offered immediate PrEP.ResultsThe study included 1256 MSM, 1090 of whom (86.8%) were not taking PrEP. Overall, 580 of 1256 (46%) participants indicated that they used Grindr in the previous 7 days. Grindr users reported significantly higher risk behavior (greater number of male partners and condomless sex) and were more likely to test positive for chlamydia or gonorrhea (8.6% vs 4.7% of nonusers; P = .005). Grindr users were also more likely to be on PrEP (18.7% vs 8.7% of nonusers; P < .001) and had fewer newly diagnosed HIV infections (9 vs 26 among nonusers; P = .014). Grindr users were also nearly twice as likely as nonusers to initiate PrEP (24.6% vs 14%; P < .001).ConclusionsGiven the higher risk behavior and greater acceptance of PrEP among MSM who used Grindr, Grindr may provide a useful platform to promote HIV and STI testing and increase PrEP uptake.
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- 2020
17. Socio-Structural and Neighborhood Predictors of Incident Criminal Justice Involvement in a Population-Based Cohort of Young Black MSM and Transgender Women
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Hotton, Anna L, Chen, Yen-Tyng, Schumm, Phil, Khanna, Aditya S, Brewer, Russell, Skaathun, Britt, Issema, Rodal S, Ramani, Santhoshini, Ramachandran, Arthi, Ozik, Jonathan, Fujimoto, Kayo, Harawa, Nina T, and Schneider, John A
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Public Health ,Health Sciences ,HIV/AIDS ,Substance Misuse ,Behavioral and Social Science ,Infectious Diseases ,Prevention ,Clinical Research ,Sexual and Gender Minorities (SGM/LGBT*) ,Infection ,Peace ,Justice and Strong Institutions ,Adolescent ,Adult ,Black or African American ,Chicago ,Cohort Studies ,Crime ,Criminals ,Female ,Forecasting ,HIV Infections ,Homosexuality ,Male ,Humans ,Logistic Models ,Male ,Residence Characteristics ,Risk-Taking ,Socioeconomic Factors ,Transgender Persons ,Young Adult ,HIV ,Criminal justice involvement ,Incarceration ,Health inequities ,Sexual and gender minorities ,Resilience ,Socio-structural factors ,Human Movement and Sports Sciences ,Public Health and Health Services ,Public health - Abstract
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over 18 months of follow-up. Controlling for respondent age, gender and sexual identity, spirituality (aOR 0.56, 95% CI 0.33-0.96), and presence of a mother figure (aOR 0.41, 95% CI 0.19-0.89) were protective against CJI. Economic hardship (financial or residential instability vs. neither aOR 2.23, 95% CI 1.10-4.51), two or more past episodes of CJI vs. none (aOR 2.66, 95% CI 1.40-5.66), and substance use (marijuana use vs. none aOR 2.79, 95% CI 1.23-6.34; other drug use vs. none aOR 4.49, 95% CI 1.66-12.16) were associated with CJI during follow-up. Research to identify and leverage resilience factors that can buffer the effects of socioeconomic marginalization may increase the effectiveness of interventions to address the socio-structural factors that increase the risk for CJI among Black MSM and transgender women. Given the intersection of incarceration, HIV and other STIs, and socio-structural stressors, criminal justice settings are important venues for interventions to reduce health inequities in these populations.
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- 2020
18. Phylodynamics Helps to Evaluate the Impact of an HIV Prevention Intervention
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Vasylyeva, Tetyana I, Zarebski, Alexander, Smyrnov, Pavlo, Williams, Leslie D, Korobchuk, Ania, Liulchuk, Mariia, Zadorozhna, Viktoriia, Nikolopoulos, Georgios, Paraskevis, Dimitrios, Schneider, John, Skaathun, Britt, Hatzakis, Angelos, Pybus, Oliver G, and Friedman, Samuel R
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Microbiology ,Biological Sciences ,HIV/AIDS ,Prevention ,Infectious Diseases ,Infection ,Good Health and Well Being ,HIV Infections ,HIV-1 ,Humans ,Molecular Epidemiology ,Phylogeny ,Viral Load ,pol Gene Products ,Human Immunodeficiency Virus ,HIV ,phylodynamics ,birth-death model ,prevention ,intervention - Abstract
Assessment of the long-term population-level effects of HIV interventions is an ongoing public health challenge. Following the implementation of a Transmission Reduction Intervention Project (TRIP) in Odessa, Ukraine, in 2013-2016, we obtained HIV pol gene sequences and used phylogenetics to identify HIV transmission clusters. We further applied the birth-death skyline model to the sequences from Odessa (n = 275) and Kyiv (n = 92) in order to estimate changes in the epidemic's effective reproductive number (Re) and rate of becoming uninfectious (δ). We identified 12 transmission clusters in Odessa; phylogenetic clustering was correlated with younger age and higher average viral load at the time of sampling. Estimated Re were similar in Odessa and Kyiv before the initiation of TRIP; Re started to decline in 2013 and is now below Re = 1 in Odessa (Re = 0.4, 95%HPD 0.06-0.75), but not in Kyiv (Re = 2.3, 95%HPD 0.2-5.4). Similarly, estimates of δ increased in Odessa after the initiation of TRIP. Given that both cities shared the same HIV prevention programs in 2013-2019, apart from TRIP, the observed changes in transmission parameters are likely attributable to the TRIP intervention. We propose that molecular epidemiology analysis can be used as a post-intervention effectiveness assessment tool.
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- 2020
19. Recent HIV Infection among men who have sex with men and transgender women in Tijuana
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Skaathun, Britt, Pines, Heather A, Patterson, Thomas L, Semple, Shirley J, Pekar, Jonathan, Harvey-Vera, Alicia, Rangel, Gudelia, and Mehta, Sanjay R
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Public Health ,Health Sciences ,Substance Misuse ,Sexual and Gender Minorities (SGM/LGBT*) ,Drug Abuse (NIDA only) ,Infectious Diseases ,HIV/AIDS ,Behavioral and Social Science ,Sexually Transmitted Infections ,2.2 Factors relating to the physical environment ,Infection ,Reproductive health and childbirth ,Good Health and Well Being ,Brazil ,Female ,HIV Infections ,Homosexuality ,Male ,Humans ,Male ,Substance-Related Disorders ,Transgender Persons ,HIV Infections ,epidemiology ,Sexual and Gender Minorities ,Disease Transmission ,Infectious ,Public Health and Health Services ,Public health - Abstract
OBJECTIVE To characterize recent HIV infections among newly diagnosed men who have sex with men and transgender women in Tijuana. METHODS Limiting Antigen (LAg)-Avidity testing was performed to detect recent HIV infection within a cohort of newly-diagnosed men who have sex with men and transgender women in Tijuana. Logistic regression was used to determine characteristics associated with recent infection. A partial transmission network was inferred using HIV-1 pol sequences. Tamura-Nei 93 genetic distances were measured between all pairs of sequences, and the network was constructed by inferring putative transmission links (genetic distances ≤ 1.5%). We assessed whether recent infection was associated with clustering within the inferred network. RESULTS Recent infection was detected in 11% (22/194) of newly-diagnosed participants. Out of the participants with sequence data, 60% (9/15) with recent infection clustered compared with 31% (43/139) with chronic infection. Two recent infections belonged to the same cluster. In adjusted analyses, recent infection was associated with years of residence in Tijuana (OR = 1.5; 95%CI 1.01-1.09), cocaine use (past month) (OR = 8.50; 95%CI 1.99-28.17), and ever experiencing sexual abuse (OR = 2.85; 95%CI 1.03-7.85). DISCUSSION A total of 11% of men newly diagnosed with HIV who have sex with men and transgender women in Tijuana were recently infected. The general lack of clustering between participants with recent infection suggests continued onward HIV transmission rather than an outbreak within a particular cluster.
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- 2020
20. HIV-1 transmission dynamics among people who inject drugs on the US/Mexico border during the COVID-19 pandemic: a prosepective cohort study
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Skaathun, Britt, primary, Strathdee, Steffanie A., additional, Shrader, Cho-Hee, additional, Nacht, Carrie L., additional, Borquez, Annick, additional, Artamonova, Irina, additional, Harvey-Vera, Alicia, additional, Vera, Carlos F., additional, Rangel, Gudelia, additional, Ignacio, Caroline, additional, Woodworth, Brendon, additional, Chaillon, Antoine, additional, and Vasylyeva, Tetyana I., additional
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- 2024
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21. 1961. Grindr™ on Screen Activity on iPhones Correlates with HIV Risk and Substance Use in Men Who Have Sex with Men, San Diego
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Hoenigl, Martin, Little, Susan J, Stockman, Jamila K, Skaathun, Britt, Grelotti, David, Weibel, Nadir, and Smith, Davey M
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Sexual and Gender Minorities (SGM/LGBT*) ,Clinical Research ,Prevention ,Behavioral and Social Science ,HIV/AIDS ,Substance Misuse ,Drug Abuse (NIDA only) ,Infection ,Good Health and Well Being - Abstract
Abstract: Background: Technology has changed the way men-who-have-sex-with-men (MSM) seek sex; ≥60% of MSM in the United States use the internet to find sex partners, primarily via Grindr™ which is the most used dating app among MSM. Studies to date have mostly evaluated Grindr™ use as a dichotomous variable and found inconsistent results regarding associations with increased HIV risk behavior. Importantly, Grindr™ “on-screen” activity is monitored by phones and can provide an objective measure of app usage. Here we aimed to assess Grindr™ “on-screen” activity in MSM undergoing community-based HIV and sexually transmitted infection (STI) screening in San Diego, and to correlate activity with sexual risk behavior and substance use. Methods: This nested cohort study was conducted between December 2018 and April 2019 and leveraged our “Good to Go” (AI106039) screening program for participant recruitment. During their testing encounter participants not on HIV PrEP were provided with surveys on demographics, substance use and risk behavior during previous 3 months, and Grindr™ usage. Participants with iPhones were instructed on how to assess Grindr™ on-screen activity (i.e., time on-screen during last 7 days) on their phones (Figure 1). Risk behavior was classified using the validated San Diego Early Test (SDET) Score (Figure 2). Results: Overall 378/784 (48%) MSM participants indicated that they had opened Grindr™ during the previous 7 days. Grindr™ users had higher SDET scores than those not using Grindr™ (median SDET 2, IQR 0–5; mean 2.29) while there was no difference in proportion of substance users (alcohol and marijuana excluded, 21% vs. 17%; P = 0.14). Of 231 MSM who indicated recent Grindr™ use (61%) had iPhones; median on-screen activity during the previous 7 days was 144 minutes (range 1–2,640 minutes). Participants with high Grindr™ utilization (>80th percentile of time on screen corresponding to >480 minutes), had significantly higher SDET scores (median 5 vs. 2; mean 4.02 vs. 3.26; P < 0.001) and a tendency toward a higher proportion of substance users (29% vs. 20%) than those with lower Grindr™ utilization. Conclusion: This study introduces Grindr™ on-screen activity as an objective measure that can help identify MSM at high risk for HIV. Disclosures: All Authors: No reported Disclosures.
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- 2019
22. People with high HIV viral load within risk networks: who are these people and who refers them best?
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Korobchuk, Anna, Davtyan, Hayk, Denisiuk, Olga, Zachariah, Rony, Nikolopoulos, Georgios K, Paraskevis, Dimitrios, Skaathun, Britt, Schneider, John, Vasylyeva, Tetyana I, Williams, Leslie D, Smyrnov, Pavlo, and Friedman, Samuel R
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Biomedical and Clinical Sciences ,Public Health ,Health Sciences ,Clinical Sciences ,Infectious Diseases ,HIV/AIDS ,Prevention ,Pediatric ,Pediatric AIDS ,Infection ,Good Health and Well Being ,Adult ,Cities ,Disease Transmission ,Infectious ,Female ,HIV ,HIV Infections ,Humans ,Male ,Middle Aged ,Risk Assessment ,Sexual Behavior ,Substance Abuse ,Intravenous ,Ukraine ,Viral Load ,Young Adult ,people with high viral load ,PHVL ,risk network ,high viral load ,venues ,Medical Microbiology ,Public Health and Health Services ,Clinical sciences ,Medical microbiology ,Epidemiology - Abstract
IntroductionViral load is one of the most important determinants for HIV transmission. Identification of people with high viral load (PHVL) can be effective in limiting onward HIV transmission. In order to improve the identification of these individuals within risk networks, we determined a) the number of PHVL recruited through risk networks b) their socio-demographic, behavioural and clinical characteristics and c) the characteristics of individuals who referred these PHVL to the study.MethodologyFrom November 2013 to March 2016, in Odessa, Ukraine, Transmission Reduction Intervention Project (TRIP) was implemented to identify people recently infected with HIV within the risk networks of "seeds" and "venues" where they engaged in risk behaviour.ResultsTRIP identified 53 PHVL, of whom 32 (60%) injected drugs; 42 (79%) were unaware of their HIV status; 25 (47%) had more than one sex partner, and only 14 (26%) were using condoms. There were 164 people who referred individuals into the study; 33 of them (20%) referred PHVL. In terms of referrers, those with lower than secondary level of education, not living with a sex partner, and reporting regular condom use were significantly more likely (p < 0.05) to refer PHVL. Most PHVL (38, 72%) and their referrers (27, 82%) were found through venues.ConclusionsIn Odessa city, PHVL are at high risk of transmitting HIV as the majority inject drugs, do not know their HIV status, and have unprotected sex and/or multiple partners. Targeting these individuals for HIV prevention, harm reduction and initiation of antiretroviral treatment (ART) is urgent.
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- 2019
23. Social network approaches to locating people recently infected with HIV in Odessa, Ukraine
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Williams, Leslie D, Korobchuk, Ania, Smyrnov, Pavlo, Sazonova, Yana, Nikolopoulos, Georgios K, Skaathun, Britt, Morgan, Ethan, Schneider, John, Vasylyeva, Tetyana I, Duong, Yen T, Chernyavska, Svitlana, Goncharov, Vitaliy, Kotlik, Ludmila, and Friedman, Samuel R
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Infectious Diseases ,HIV/AIDS ,Infection ,Adult ,Contact Tracing ,Epidemiological Monitoring ,Female ,HIV Infections ,Humans ,Male ,Social Networking ,Ukraine ,HIV ,treatment as prevention ,social network ,intervention ,recent HIV infection ,PWID ,HIV ,PWID ,Public Health and Health Services ,Other Medical and Health Sciences ,Clinical sciences ,Epidemiology ,Public health - Abstract
IntroductionThis paper examines the extent to which an intervention succeeded in locating people who had recently become infected with HIV in the context of the large-scale Ukrainian epidemic. Locating and intervening with people who recently became infected with HIV (people with recent infection, or PwRI) can reduce forward HIV transmission and help PwRI remain healthy.MethodsThe Transmission Reduction Intervention Project (TRIP) recruited recently-infected and longer-term infected seeds in Odessa, Ukraine, in 2013 to 2016, and asked them to help recruit their extended risk network members. The proportions of network members who were PwRI were compared between TRIP arms (i.e. networks of recently-infected seeds vs. networks of longer-term infected seeds) and to the proportion of participants who were PwRI in an RDS-based Integrated Biobehavioral Surveillance of people who inject drugs in 2013.ResultsThe networks of PwRI seeds and those of longer-term infected seeds had similar (2%) proportions who were themselves PwRI. This was higher than the 0.25% proportion in IBBS (OR = 7.80; p = 0.016). The odds ratio among the subset of participants who injected drugs was 11.17 (p = 0.003). Cost comparison analyses using simplified ingredients-based methods found that TRIP spent no more than US $4513 per PwRI located whereas IBBS spent $11,924.ConclusionsFurther research is needed to confirm these results and improve TRIP further, but our findings suggest that interventions that trace the networks of people who test HIV-positive are a cost-effective way to locate PwRI and reduce HIV transmission and should therefore be implemented.
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- 2019
24. Cost-effectiveness and budgetary impact of HCV treatment with direct-acting antivirals in India including the risk of reinfection
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Chaillon, Antoine, Mehta, Sanjay R, Hoenigl, Martin, Solomon, Sunil S, Vickerman, Peter, Hickman, Matthew, Skaathun, Britt, and Martin, Natasha K
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Economics ,Applied Economics ,Psychology ,Infectious Diseases ,Clinical Research ,Cost Effectiveness Research ,Comparative Effectiveness Research ,Health Services ,Hepatitis ,Hepatitis - C ,Liver Disease ,Digestive Diseases ,Chronic Liver Disease and Cirrhosis ,Emerging Infectious Diseases ,Infection ,Good Health and Well Being ,Adult ,Antiviral Agents ,Budgets ,Cost-Benefit Analysis ,Female ,Hepatitis C ,Chronic ,Humans ,India ,Male ,Quality-Adjusted Life Years ,Recurrence ,Risk Factors ,General Science & Technology - Abstract
BackgroundHCV direct-acting antivirals (DAAs) are produced in India at low cost. However, concerns surrounding reinfection and budgetary impact limit treatment scale-up in India. We evaluate the cost-effectiveness and budgetary impact of HCV treatment in India, including reinfection.MethodsA closed cohort Markov model of HCV disease progression, treatment, and reinfection was parameterized. We compared treatment by fibrosis stage (F2-F4 or F0-F4) to no treatment from a health care payer perspective. Costs (2017 USD$, based on India-specific data) and health utilities (in quality-adjusted life years, QALYs) were attached to each health state. We assumed DAAs with 90% sustained viral response at $900/treatment and 1%/year reinfection, varied in the sensitivity analysis from 0.1-15%. We deemed the intervention cost-effective if the incremental cost-effectiveness ratio (ICER) fell below India's per capita GDP ($1,709). We assessed the budgetary impact of treating all diagnosed individuals.ResultsHCV treatment for diagnosed F2-F4 individuals was cost-saving (net costs -$2,881 and net QALYs 3.18/person treated; negative ICER) compared to no treatment. HCV treatment remained cost-saving with reinfection rates of 15%/year. Treating all diagnosed individuals was likely cost-effective compared to delay until F2 (mean ICER $1,586/QALY gained, 67% of simulations falling under the $1,709 threshold) with 1%/year reinfection. For all scenarios, annual retesting for reinfection was more cost-effective than the current policy (one-time retest). Treating all diagnosed individuals and reinfections results in net costs of $445-1,334 million over 5 years (
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- 2019
25. Network Research Experiences in New York and Eastern Europe: Lessons for the Southern US in Understanding HIV Transmission Dynamics
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Friedman, Samuel R, Williams, Leslie, Young, April M, Teubl, Jennifer, Paraskevis, Dimitrios, Kostaki, Evangelia, Latkin, Carl, German, Danielle, Mateu-Gelabert, Pedro, Guarino, Honoria, Vasylyeva, Tetyana I, Skaathun, Britt, Schneider, John, Korobchuk, Ania, Smyrnov, Pavlo, and Nikolopoulos, Georgios
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Biomedical and Clinical Sciences ,Clinical Sciences ,Immunology ,HIV/AIDS ,Pediatric ,Pediatric AIDS ,Mental Health ,Behavioral and Social Science ,Prevention ,Infection ,Generic health relevance ,Adult ,Europe ,Eastern ,Female ,HIV ,HIV Infections ,Humans ,Male ,New York ,Opioid-Related Disorders ,Risk ,Risk-Taking ,Social Support ,Social networks ,Risk networks ,Opioid users ,PWUD ,Phylogenetics ,Respondent-driven sampling ,Quasi-networks ,Behaviors ,Medical Microbiology ,Virology ,Clinical sciences - Abstract
PurposeThis paper presents an overview of different kinds of risk and social network methods and the kinds of research questions each can address.Recent findingsIt also reviews what network research has discovered about how network characteristics are associated with HIV and other infections, risk behaviors, preventive behaviors, and care, and discusses some ways in which network-based public health interventions have been conducted. Based on this, risk and social network research and interventions seem both feasible and valuable for addressing the many public health and social problems raised by the widespread use of opioids in the US South.
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- 2018
26. Risk network approaches to locating undiagnosed HIV cases in Odessa, Ukraine
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Smyrnov, Pavlo, Williams, Leslie D, Korobchuk, Ania, Sazonova, Yana, Nikolopoulos, Georgios K, Skaathun, Britt, Morgan, Ethan, Schneider, John, Vasylyeva, Tetyana I, and Friedman, Samuel R
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Biomedical and Clinical Sciences ,Clinical Sciences ,Drug Abuse (NIDA only) ,Infectious Diseases ,Substance Misuse ,Prevention ,HIV/AIDS ,Clinical Research ,Infection ,Good Health and Well Being ,Adult ,Female ,HIV Infections ,Humans ,Male ,Risk Reduction Behavior ,Ukraine ,HIV prevention ,early infection ,risk networks ,social network ,HIV diagnosis ,treatment as prevention ,Public Health and Health Services ,Other Medical and Health Sciences ,Clinical sciences ,Epidemiology ,Public health - Abstract
IntroductionProviding HIV healthcare and Treatment as Prevention both depend on diagnosing HIV cases, preferably soon after initial infection. We hypothesized that tracing risk networks recruits higher proportions of undiagnosed positives than outreach-based testing or respondent-driven sampling (RDS) in Odessa, Ukraine.MethodsThe Transmission Reduction Intervention Project (TRIP) used risk network tracing to recruit sexual and injection networks of recently-infected and longer-term infected (LTs) seeds (2013 to 2016). Integrated Biobehavioural Surveillance (IBBS) (2013) used RDS to recruit people who inject drugs (PWID). Outreach Testing tested PWID for HIV at community outreach sites (2013 to 2016). Proportions of undiagnosed positives among those tested were compared TRIP versus IBBS; TRIP versus Outreach Testing and between TRIP arms. Costs were compared across the projects.ResultsTRIP tested 1252 people (21% women) in seeds' risk networks; IBBS tested 400 (18% women); Outreach Testing 13,936 (31% women). TRIP networks included a higher proportion of undiagnosed positives (14.6%) than IBBS (5.0%) or Outreach Testing (2.4%); odds ratio (OR) 3.25 (95% CI 2.07, 5.12) versus IBBS and 7.03 (CI 5.95, 8.31) versus Outreach Testing respectively. Findings remained significant in analyses stratified by sex and when PWID in TRIP networks were compared with Outreach Testing and IBBS. Within TRIP, recently-infected participants' networks contained higher proportions of undiagnosed positives (16.3%) than LTs' networks (12.2%); OR 1.41 (CI 1.01, 1.95). TRIP located undiagnosed positives less expensively than did RDS or Outreach Testing.ConclusionsTRIP's recruiting techniques, including prioritizing networks of the recently infected, find undiagnosed HIV-positive people efficiently. They should be integrated with standard practice to improve case-finding. Research should test these techniques in other socio-epidemiologic contexts.Clinical trial registryRegistered ClinicalTrials.gov: NCT01827228.
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- 2018
27. Study protocol: Project 2VIDA! SARS-CoV-2 vaccine intervention delivery for adults in Southern California
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Skaathun, Britt, primary, Salgin, Linda, additional, Muñoz, Fatima A., additional, Talavera, Gregory A., additional, Smith, Davey M., additional, Stockman, Jamila K., additional, O’Bryan, Sophie E., additional, Ramirez, Daniel, additional, James-Price, Cynthia, additional, and Servin, Argentina E., additional
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- 2024
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28. A network intervention that locates and intervenes with recently HIV-infected persons: The Transmission Reduction Intervention Project (TRIP).
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Nikolopoulos, Georgios, Pavlitina, Eirini, Muth, Stephen, Schneider, John, Psichogiou, Mina, Williams, Leslie, Paraskevis, Dimitrios, Sypsa, Vana, Magiorkinis, Gkikas, Smyrnov, Pavlo, Korobchuk, Anya, Skaathun, Britt, Malliori, Melpomeni, Kafetzopoulos, Evangelos, Hatzakis, Angelos, Friedman, Samuel, and Vasylyeva, Tetyana
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Adult ,Female ,Greece ,HIV Infections ,Humans ,Male ,Public Health ,Social Support - Abstract
Early treatment, soon after infection, reduces HIV transmissions and benefits patients. The Transmission Reduction Intervention Project (TRIP) evaluated a network intervention to detect individuals recently infected (in the past 6 months). TRIP was conducted in Greece (2013-2015) and focused on drug injector networks. Based on HIV status, testing history, and the results of an assay to detect recent infections, TRIP classified drug injector Seeds into groups: Recent Seeds (RS), and Control Seeds with Long-term HIV infection (LCS). The network members of RS and LCS were traced for two steps. The analysis included 23 RS, 171 network members of the RS, 19 LCS, and 65 network members of the LCS. The per-seed number of recents detected in the network of RS was 5 times the number in the network of LCS (Ratio RS vs. LCS: 5.23; 95% Confidence Interval (CI): 1.54-27.61). The proportion of recents among HIV positives in the network of RS (27%) was approximately 3 times (Ratio RS vs. LCS: 3.30; 95% CI: 1.04-10.43) that in the network of LCS (8%). Strategic network tracing that starts with recently infected persons could support public health efforts to find and treat people early in their HIV infection.
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- 2016
29. Leveraging social networks for identification of people with HIV who are virally unsuppressed
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Cummins, Breschine, primary, Johnson, Kara, additional, Schneider, John A., additional, Del Vecchio, Natascha, additional, Moshiri, Niema, additional, Wertheim, Joel O., additional, Goyal, Ravi, additional, and Skaathun, Britt, additional
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- 2023
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30. Molecular Analysis of Human Immunodeficiency Virus Type 1 (HIV-1)–Infected Individuals in a Network-Based Intervention (Transmission Reduction Intervention Project) : Phylogenetics Identify HIV-1–Infected Individuals With Social Links
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Kostaki, Evangelia-Georgia, Nikolopoulos, Georgios K., Pavlitina, Eirini, Williams, Leslie, Magiorkinis, Gkikas, Schneider, John, Skaathun, Britt, Morgan, Ethan, Psichogiou, Mina, Daikos, Georgios L., Sypsa, Vana, Smyrnov, Pavlo, Korobchuk, Ania, Malliori, Meni, Hatzakis, Angelos, Friedman, Samuel R., and Paraskevis, Dimitrios
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- 2018
31. Pre-exposure Prophylaxis (PrEP) Awareness and Use Within High HIV Transmission Networks
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Schueler, Kellie, Ferreira, Matthew, Nikolopoulos, Georgios, Skaathun, Britt, Paraskevis, Dimitrios, Hatzakis, Angelos, Friedman, Samuel R., and Schneider, John A.
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- 2019
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32. A Longitudinal Examination of Factors Associated with Network Bridging Among YMSM: Implications for HIV Prevention
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Skaathun, Britt, Voisin, Dexter R., Cornwell, Benjamin, Lauderdale, Diane S., and Schneider, John A.
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- 2019
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33. A Network Intervention to Locate Newly HIV Infected Persons Within MSM Networks in Chicago
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Morgan, Ethan, Skaathun, Britt, Nikolopoulos, Georgios K., Paraskevis, Dimitrios, Williams, Leslie D., Smyrnov, Pavlo, Friedman, Samuel R., and Schneider, John A.
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- 2019
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34. Association between where men who have sex with men (MSM) meet sexual partners and chlamydia/ gonorrhoea infection before and during the COVID- 19 pandemic in San Diego, California.
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King, Colin M. B., Garfein, Richard S., Bazzi, Angela R., Little, Susan J., and Skaathun, Britt
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- 2023
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35. Phylodynamics and migration data help describe HIV transmission dynamics in internally displaced people who inject drugs in Ukraine
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Kovalenko, Ganna, primary, Yakovleva, Anna, additional, Smyrnov, Pavlo, additional, Redlinger, Matthew, additional, Tymets, Olga, additional, Korobchuk, Anna, additional, Kolodiazieva, Anna, additional, Podolina, Anna, additional, Cherniavska, Svitlana, additional, Skaathun, Britt, additional, Smith, Laramie R., additional, Strathdee, Steffanie A., additional, Wertheim, Joel O., additional, Friedman, Samuel R., additional, Bortz, Eric, additional, Goodfellow, Ian, additional, Meredith, Luke, additional, and Vasylyeva, Tetyana I., additional
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- 2022
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36. Prioritization of carceral spending in U.S. cities: Development of the Carceral Resource Index (CRI) and the role of race and income inequality
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Skaathun, Britt, primary, Maviglia, Francesca, additional, Vo, Anh, additional, McBride, Allison, additional, Seymour, Sarah, additional, Mendez, Sebastian, additional, Gonsalves, Gregg, additional, and Beletsky, Leo, additional
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- 2022
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37. 1105. A Matched-Group Comparison of Interventions for COVID-19 During the First and Second Waves of the COVID-19 Pandemic in a County Hospital in Chicago.
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Hernandez Acosta, Ruben A, primary, Corpuz, Carlos, additional, Gonakoti, Sriram, additional, Patel, Palak, additional, Chang, Hillary, additional, Akaho, Elikplim, additional, Skaathun, Britt, additional, Hoffman, Michael, additional, and Rezai, Katayoun, additional
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- 2022
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38. Trends in HIV Risk, Testing, and Treatment among MSM in Chicago 2004–2014: Implications for HIV Elimination Planning
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Morgan, Ethan, Skaathun, Britt, Lancki, Nicola, Jimenez, Antonio D., Ramirez-Valles, Jesus, Bhatia, Ramona, Masiello-Schuette, Stephanie, Benbow, Nanette, Prachand, Nikhil, and Schneider, John A.
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- 2017
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39. Sex Behaviors as Social Cues Motivating Social Venue Patronage Among Young Black Men Who Have Sex with Men
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Young, Lindsay E., Michaels, Stuart, Jonas, Adam, Khanna, Aditya S., Skaathun, Britt, Morgan, Ethan, Schneider, John A., and uConnect Study Team
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- 2017
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40. Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States
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Skaathun, Britt, Pho, Mai T., Pollack, Harold A., Friedman, Samuel R., Mcnulty, Moira C., Friedman, Eleanor E., Schmitt, Jessica, Pitrak, David, and Schneider, John A.
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Minorities -- Health aspects ,HIV testing -- Comparative analysis -- Management -- Economic aspects ,HIV infection -- Statistics -- Diagnosis -- Prevention ,Company business management ,Health - Abstract
: Introduction: Incident HIV infections persist in the United States (U.S.) among marginalized populations. Targeted and cost‐efficient testing strategies can help in reaching HIV elimination. This analysis compares the effectiveness and cost of three HIV testing strategies in a high HIV burden area in the U.S. in identifying new HIV infections. Methods: We performed a cost analysis comparing three HIV testing strategies in Chicago: (1) routine screening (RS) in an inpatient and outpatient setting, (2) modified partner services (MPS) among networks of the recently HIV infected and diagnosed, and (3) a respondent drive sampling (RDS)‐based social network (SN) approach targeting young African‐American men who have sex with men. All occurred at the same academic medical centre during the following times: routine testing, 2011 to 2016; MPS, 2013 to 2016; SN: 2013 to 2014. Costs were in 2016 dollars and included personnel, HIV testing, training, materials, overhead. Outcomes included cost per test, HIV‐positive test and new diagnosis. Sensitivity analyses were performed to assess the impact of population demographics. Results: The RS programme completed 57,308 HIV tests resulting in 360 (0.6%) HIV‐positive tests and 165 new HIV diagnoses (0.28%). The MPS completed 146 HIV tests, resulting in 79 (54%) HIV‐positive tests and eight new HIV diagnoses (5%). The SN strategy completed 508 HIV tests, resulting in 210 (41%) HIV‐positive tests and 37 new HIV diagnoses (7.2%). Labour accounted for the majority of costs in all strategies. The estimated cost per new HIV diagnosis was $16,773 for the RS programme, $61,418 for the MPS programme and $15,683 for the SN testing programme. These costs were reduced for the RS and MPS strategies in sensitivity analyses limiting testing efficacy to the highest prevalence patient populations ($2,841 and $33,233 respectively). Conclusions: The SN strategy yielded the highest proportion of new diagnoses, followed closely by the MPS programme. Both the SN strategy and RS programme were comparable in the cost per new diagnosis. A simultaneous approach that consists of RS in combination with SN testing may be most effective for identifying new HIV infections in settings with heterogeneous epidemics with both high rates of HIV prevalence and HIV testing., INTRODUCTION The United States (U.S.) continues to experience new HIV infections; the number of new HIV diagnoses remains stable at around 40,000 cases per year [1]. U.S. Health and Human [...]
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- 2020
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41. Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis
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Shrader, Cho-Hee, primary, Borquez, Annick, additional, Vasylyeva, Tetyana I., additional, Chaillon, Antoine, additional, Artamanova, Irina, additional, Harvey-Vera, Alicia, additional, Vera, Carlos F., additional, Rangel, Gudelia, additional, Strathdee, Steffanie A., additional, and Skaathun, Britt, additional
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- 2022
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42. Network Viral Load: A Critical Metric for HIV Elimination
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Skaathun, Britt, Khanna, Aditya S., Morgan, Ethan, Friedman, Samuel R., and Schneider, John A.
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- 2018
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43. Are HIV Seroconversions Among Young Men Who Have Sex With Men Associated With Social Network Proximity to Recently or Long-Term HIV-Infected Individuals?
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Morgan, Ethan, Skaathun, Britt, Duvoisin, Rebeccah, Michaels, Stuart, and Schneider, John A.
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- 2018
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44. Marijuana Use as a Sex-Drug is Associated with HIV Risk Among Black MSM and Their Network
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Morgan, Ethan, Skaathun, Britt, Michaels, Stuart, Young, Lindsay, Khanna, Aditya, Friedman, Samuel R., Davis, Billy, Pitrak, David, Schneider, John, and The UConnect Study Team
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- 2016
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45. Association between where men who have sex with men (MSM) meet sexual partners and chlamydia/gonorrhea infection before and during the COVID-19 pandemic in San Diego, CA
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King, Colin Michael Baile, Garfein, Richard S1, Skaathun, Britt, King, Colin Michael Baile, King, Colin Michael Baile, Garfein, Richard S1, Skaathun, Britt, and King, Colin Michael Baile
- Abstract
Meeting sex partners online is associated with increased risk of acquiring sexually transmitted infections (STIs). We examined whether different venues where men who have sex with men (MSM) meet sex partners was associated with prevalent chlamydia and gonorrhea infection, and if prevalence increased during (vs. before) the COVID-19 pandemic.We conducted a cross-sectional analysis of data from the San Diego “Good To Go” (GTG) sexual health clinic from two enrollment periods: (1) 03/2019-09/2019 (pre-COVID-19), and (2) 03/2021-09/2021 (during COVID-19). Participants completed self-administered intake assessments. This analysis included males ≥18 years old self-reporting sex with other males within 3 months before enrollment. Participants were categorized as (1) meeting new sex partners in-person only (e.g. bars, clubs, etc.), (2) meeting new sex partners online (e.g. applications, websites, etc.), or (3) having sex only with existing partners. We used multivariable logistic regression, adjusting for year, age, race, ethnicity, number of sex partners, PrEP use, and drug use to examine whether venue or enrollment period were associated with chlamydia and gonorrhea infection (either vs. no STI). Among 2,546 participants, mean age was 35.5 (range: 18-79); 27.9% were non-white; 37.0% were Hispanic. Overall STI prevalence was 14.8% and was higher (17.8%) during COVID-19 versus pre-COVID-19 (13.3). Participants met sex partners online (56.9%), in-person (16.9%), or only had existing partners (26.2%) in the past 3 months. Compared to having only existing sex partners, meeting partners online was associated with higher STI prevalence (adjusted Odds Ratio [aOR]: 2.32; 95% confidence interval [CI]: 1.51-3.65), while meeting partners in-person was not associated with STI prevalence (aOR: 1.59; CI: 0.87-2.89). Enrollment during COVID-19 was associated with higher STI prevalence compared to pre-COVID-19 (aOR: 1.42; CI: 1.13-1.79). Meeting sex partners online was associated with inc
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- 2022
46. Network-level HIV risk norms are associated with individual-level HIV risk and harm reduction behaviors among people who inject drugs: a latent profile analysis.
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Shrader, Cho-Hee, Shrader, Cho-Hee, Borquez, Annick, Vasylyeva, Tetyana I, Chaillon, Antoine, Artamanova, Irina, Harvey-Vera, Alicia, Vera, Carlos F, Rangel, Gudelia, Strathdee, Steffanie A, Skaathun, Britt, Shrader, Cho-Hee, Shrader, Cho-Hee, Borquez, Annick, Vasylyeva, Tetyana I, Chaillon, Antoine, Artamanova, Irina, Harvey-Vera, Alicia, Vera, Carlos F, Rangel, Gudelia, Strathdee, Steffanie A, and Skaathun, Britt
- Abstract
The COVID-19 related U.S.-Mexico border-crossing restrictions disrupted social networks and HIV harm reduction services among people who inject drugs (PWID) in San Diego and Tijuana. We assessed associations of descriptive network norms on PWID's HIV vulnerability during this period. Between 10/2020 and 10/2021, 399 PWID completed a behavioral and egocentric questionnaire. We used Latent Profile Analysis to categorize PWID into network norm risk profiles based on proportions of their network (n = 924 drug use alters) who injected drugs and engaged in cross-border drug use (CBDU), among other vulnerabilities. We used logistic and linear regressions to assess network profile associations with individual-level index of HIV vulnerability and harm reduction behaviors. Fit indices specified a 4-latent profile solution of descriptive network risk norms: lower (n = 178), moderate with (n = 34) and without (n = 94) CBDU and obtainment, and higher (n = 93). Participants in higher risk profiles reported more HIV vulnerability behaviors and fewer harm reduction behaviors. PWID's gradient of HIV risk was associated with network norms, warranting intervention on high-vulnerability networks when services are limited.
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- 2022
47. Criminal justice involvement history is associated with better HIV care continuum metrics among a population-based sample of young black MSM
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Schneider, John A., Kozloski, Michael, Michaels, Stuart, Skaathun, Britt, Voisin, Dexter, Lancki, Nicola, Morgan, Ethan, Khanna, Aditya, Green, Keith, Coombs, Robert W., Friedman, Samuel R., Laumann, Edward, and Schumm, Phil
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- 2017
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48. Glycemic control is associated with lower odds of mortality and successful extubation in severe COVID-19
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Pescatore, Jay M., primary, Sarmiento, Juan, additional, Hernandez-Acosta, Ruben A., additional, Skaathun, Britt, additional, Quesada-Rodriguez, Nancy, additional, and Rezai, Katayoun, additional
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- 2021
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49. Preexposure Prophylaxis Awareness and Use in a Population-Based Sample of Young Black Men Who Have Sex With Men
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Khanna, Aditya S., Michaels, Stuart, Skaathun, Britt, Morgan, Ethan, Green, Keith, Young, Lindsay, and Schneider, John A.
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- 2016
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50. People with high HIV viral load within risk networks: who are these people and who refers them best?
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Nikolopoulos, Georgios K., Korobchuk, Anna, Davtyan, Hayk, Denisiuk, Olga, Zachariah, Rony, Paraskevis, Dimitrios, Skaathun, Britt, Schneider, John, Vasylyeva, Tetyana I., Williams, Leslie D., Smyrnov, Pavlo, Friedman, Samuel R., Nikolopoulos, Georgios K. [0000-0002-3307-0246], and Paraskevis, Dimitrios [0000-0001-6167-7152]
- Subjects
PHVL ,Adult ,Male ,Multiple Partners ,Sexual Behavior ,HIV Infections ,Microbiology ,Risk Assessment ,Article ,law.invention ,03 medical and health sciences ,Young Adult ,0302 clinical medicine ,Condom ,people with high viral load ,law ,Virology ,Intervention (counseling) ,Disease Transmission, Infectious ,Medicine ,Humans ,030212 general & internal medicine ,venues ,Cities ,Substance Abuse, Intravenous ,030304 developmental biology ,0303 health sciences ,Harm reduction ,Secondary level ,Risk behaviour ,high viral load ,business.industry ,Transmission (medicine) ,HIV ,General Medicine ,Middle Aged ,Viral Load ,3. Good health ,Infectious Diseases ,Parasitology ,Female ,business ,risk network ,Ukraine ,Viral load ,Demography - Abstract
Introduction: Viral load is one of the most important determinants for HIV transmission. Identification of people with high viral load (PHVL) can be effective in limiting onward HIV transmission. In order to improve the identification of these individuals within risk networks, we determined a) the number of PHVL recruited through risk networks b) their socio-demographic, behavioural and clinical characteristics and c) the characteristics of individuals who referred these PHVL to the study. Methodology: From November 2013 to March 2016, in Odessa, Ukraine, Transmission Reduction Intervention Project (TRIP) was implemented to identify people recently infected with HIV within the risk networks of “seeds” and “venues” where they engaged in risk behaviour. Results: TRIP identified 53 PHVL, of whom 32 (60%) injected drugs; 42 (79%) were unaware of their HIV status; 25 (47%) had more than one sex partner, and only 14 (26%) were using condoms. There were 164 people who referred individuals into the study; 33 of them (20%) referred PHVL. In terms of referrers, those with lower than secondary level of education, not living with a sex partner, and reporting regular condom use were significantly more likely (p < 0.05) to refer PHVL. Most PHVL (38, 72%) and their referrers (27, 82%) were found through venues. Conclusions: In Odessa city, PHVL are at high risk of transmitting HIV as the majority inject drugs, do not know their HIV status, and have unprotected sex and/or multiple partners. Targeting these individuals for HIV prevention, harm reduction and initiation of antiretroviral treatment (ART) is urgent.
- Published
- 2019
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