Last data update: Jan 27, 2025. (Total: 48650 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Banez Ocfemia MC[original query] |
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Characteristics and care outcomes among persons living with perinatally acquired HIV infection in the United States, 2015
Gray KM , Banez Ocfemia MC , Wang X , Li J , Nesheim SR . J Acquir Immune Defic Syndr 2019 82 (1) 17-23 BACKGROUND: Medical advancements have improved the survival of persons with perinatally acquired HIV infection (PHIV). We describe persons living with diagnosed PHIV and assess receipt of HIV care, retention in care, and viral suppression. METHODS: Data reported to the National HIV Surveillance System (NHSS) through December 2017 were used to characterize persons living with diagnosed PHIV by year-end 2015 in the United States and 6 dependent areas. NHSS data from 40 jurisdictions with complete laboratory reporting were used to assess receipt of HIV care (>/=1 CD4 or viral load during 2015), retention in HIV care (>/=2 CD4 or viral load tests >/=3 months apart during 2015) and viral suppression (<200 copies/mL during 2015) among persons with PHIV diagnosed by year-end 2014 and alive at year-end 2015. RESULTS: By year-end 2015, 11,747 persons were living with PHIV and half were aged 18-25 years. Of 9,562 persons with HIV diagnosed by year-end 2014 and living with PHIV at year-end 2015 in the 40 jurisdictions, 75.4% received any care, 61.1% were retained in care, and 49.0% achieved viral suppression. Persons </=17 years of age had a significantly higher prevalence of being retained in care (PR=1.2, 95%CI=1.2-1.3) and virally suppressed (PR=1.4, 95%CI=1.3-1.5) than persons aged 18-25 years. CONCLUSIONS: Efforts to improve care outcomes among persons with PHIV are needed. Enhanced collaboration between pediatric and adult medical providers may ensure continuity of care during the transition from adolescence to adulthood. |
Transmission patterns in a low HIV-morbidity state - Wisconsin, 2014-2017
Grande KM , Schumann CL , Banez Ocfemia MC , Vergeront JM , Wertheim JO , Oster AM . MMWR Morb Mortal Wkly Rep 2019 68 (6) 149-152 Public health interviews (i.e., partner services), during which persons with diagnosed human immunodeficiency virus (HIV) infection name their sexual or needle-sharing partners (named partners), are used to identify HIV transmission networks to guide and prioritize HIV prevention activities. HIV sequence data, generated from provider-ordered drug resistance testing, can be used to understand characteristics of molecular clusters, a group of sequences for which each sequence is highly similar (linked) to all other sequences, and assess whether named partners are plausible HIV transmission partners. Although molecular data in higher HIV-morbidity states have been analyzed (1-3), few analyses exist for lower morbidity states (4), such as Wisconsin, which reported 4.6 HIV diagnoses per 100,000 persons aged >/=13 years in 2016 (5). The Wisconsin Division of Public Health (DPH) analyzed HIV sequence data generated from provider-ordered drug resistance testing and collected through routine HIV surveillance to identify molecular clusters and describe demographic and transmission risk characteristics among pairs of persons whose sequences were highly genetically similar (i.e., molecular linkages). In addition, overlap between partner linkages identified during public health interviews and molecular linkages was assessed. Overall, characteristics of molecular clusters in Wisconsin mirrored those from states with more HIV diagnoses, particularly in that most molecular linkages were observed among persons of the same race (78.2% of non-Hispanic blacks [blacks] linked to other blacks), the same transmission risk (90.2% of men who have sex with men [MSM] linked to other MSM), and the same age group (59.2% of persons aged 20-29 years linked to other persons aged 20-29 years). Among named partner linkages identified during interviews in which both persons also had a reported sequence, overlap of named partner and molecular linkages was moderate: 33.8% of named partners were plausible transmission partners according to available molecular data. Analysis of HIV sequence data is a useful tool for characterizing transmission patterns not immediately apparent using traditional public health interview data, even in a state with lower HIV morbidity. Prevention recommendations generated from national data (e.g., targeting preexposure prophylaxis for HIV-negative persons at high risk and implementing measures to maintain viral suppression among persons with HIV infection) also are relevant in a lower HIV-morbidity state. |
Identifying Clusters of Recent and Rapid HIV Transmission Through Analysis of Molecular Surveillance Data.
Oster AM , France AM , Panneer N , Banez Ocfemia MC , Campbell E , Dasgupta S , Switzer WM , Wertheim JO , Hernandez AL . J Acquir Immune Defic Syndr 2018 79 (5) 543-550 ![]() ![]() BACKGROUND: Detecting recent and rapid spread of HIV can help prioritize prevention and early treatment for those at highest risk of transmission. HIV genetic sequence data can identify transmission clusters, but previous approaches have not distinguished clusters of recent, rapid transmission. We assessed an analytic approach to identify such clusters in the United States. METHODS: We analyzed 156,553 partial HIV-1 polymerase sequences reported to the National HIV Surveillance System and inferred transmission clusters using two genetic distance thresholds (0.5% and 1.5%) and two time periods for diagnoses (all years and 2013-2015, i.e., recent diagnoses). For rapidly growing clusters (with >/=5 diagnoses during 2015), molecular clock phylogenetic analysis estimated the time to most recent common ancestor for all divergence events within the cluster. Cluster transmission rates were estimated using these phylogenies. RESULTS: A distance threshold of 1.5% identified 103 rapidly growing clusters using all diagnoses and 73 using recent diagnoses; at 0.5%, 15 clusters were identified using all diagnoses and 13 using recent diagnoses. Molecular clock analysis estimated that the 13 clusters identified at 0.5% using recent diagnoses had been diversifying for a median of 4.7 years, compared with 6.5-13.2 years using other approaches. The 13 clusters at 0.5% had a transmission rate of 33/100 person-years, compared with previous national estimates of 4/100 person-years. CONCLUSIONS: Our approach identified clusters with transmission rates 8 times those of previous national estimates. This method can identify groups involved in rapid transmission and help programs effectively direct and prioritize limited public health resources. |
Notes from the field: HIV infection investigation in a rural area - West Virginia, 2017
Evans ME , Labuda SM , Hogan V , Agnew-Brune C , Armstrong J , Periasamy Karuppiah AB , Blankinship D , Buchacz K , Burton K , Cibrik S , Hoffman W , Kirk N , Lee C , McGraw D , Banez Ocfemia MC , Panneer N , Reynolds P , Rose B , Salmon M , Scott M , Thompson A , Wills D , Young SA , Gupta R , Haddy L , Weidle PJ , Mark-Carew M . MMWR Morb Mortal Wkly Rep 2018 67 (8) 257-258 From January to July 2017, the West Virginia Department of Health and Human Resources (WV DHHR) identified 10 cases of human immunodeficiency virus (HIV) infection in three counties where HIV diagnoses typically range from six to 13 annually (1). In these counties, the spread of bloodborne pathogens via injection drug use (IDU) is a major public health concern, and risk reduction programs offering syringe services were not available, although they were available in other counties (2,3). As of July 2017, nine of the 10 persons identified were men who have sex with men (MSM), two of whom had reported a prior history of IDU. Coinfections with syphilis (five patients), hepatitis B virus (three), and hepatitis C virus (HCV) (two) were also documented. By September 2017, the sexual or injection contacts named by persons in the investigation expanded the original assessment area to encompass 15 counties, 14 of which were among the nation’s top 220 counties thought to be particularly vulnerable to rapid spread of HIV and HCV infections via IDU (4). The investigated counties share some characteristics with rural Scott County, Indiana, where an HIV outbreak was linked to IDU in 2015 (5), including a high prevalence of drug overdose deaths, prescription opioid sales, and unemployment. |
Use of blood donor screening data to estimate Zika virus incidence, Puerto Rico, April-August 2016
Chevalier MS , Biggerstaff BJ , Basavaraju SV , Banez Ocfemia MC , Alsina JO , Climent-Peris C , Moseley RR , Chung KW , Rivera-Garcia B , Bello-Pagan M , Pate LL , Galel SA , Williamson P , Kuehnert MJ . Emerg Infect Dis 2017 23 (5) 790-795 Puerto Rico has been heavily impacted by Zika virus, a mosquitoborne flavivirus that emerged in the Americas during 2015. Although most persons with Zika virus show no symptoms, the virus can cause neurologic and other complications, including fetal microcephaly. Local Zika virus transmission in Puerto Rico has been reported since December 2015. To prevent transfusion-associated transmission, local blood collection ceased in March 2016 but resumed in April 2016 after Zika virus screening of blood donations became available. Using data from screening of blood donations collected by the 2 largest blood centers in Puerto Rico during April 3-August 12, 2016, and assuming a 9.9-day duration of viremia, we estimated that 469,321 persons in Puerto Rico were infected during this period, for an estimated cumulative incidence of 12.9%. Results from blood donation screening during arboviral outbreaks can supplement routine clinical and surveillance data for improved targeting of prevention efforts., |
The International Dimension of the U.S. HIV Transmission Network and Onward Transmission of HIV Recently Imported into the United States.
Wertheim JO , Oster AM , Hernandez AL , Saduvala N , Banez Ocfemia MC , Hall I . AIDS Res Hum Retroviruses 2016 32 1046-1053 ![]() ![]() The majority of HIV infections in the United States can be traced back to a single introduction in late-1960s or early 1970s. However, it remains unclear whether subsequent introductions of HIV into the United States have given rise to onward transmission. Genetic transmission networks can aid in understanding HIV transmission. We constructed a genetic distance-based transmission network using HIV-1 pol sequences reported to the U.S. National HIV Surveillance System (n=41,539) and all publicly available non-U.S. HIV-1 pol sequences (n=86,215). Of the 13,145 U.S. persons clustered in the network, 457 (3.5%) were genetically linked to a potential transmission partner outside the United States. For internationally connected persons residing in but born outside the United States, 61% had a connection to their country of birth or to another country that shared a language with their country of birth. Bayesian molecular clock phylogenetic analysis indicates that introduced non-subtype B infections have resulted in onward transmission within the United States. |
Young sexual minority males in the United States: sociodemographic characteristics and sexual attraction, identity and behavior
Fasula AM , Oraka E , Jeffries WLth , Carry M , Banez Ocfemia MC , Balaji AB , Rose CE , Jayne PE . Perspect Sex Reprod Health 2016 48 (1) 3-8 CONTEXT: HIV incidence is increasing among 13-24-year-old U.S. men who have sex with men, yet limited research is available to guide HIV prevention efforts for this population. METHODS: National Survey of Family Growth data collected in 2002, in 2006-2010 and in 2011-2013 from 8,068 males aged 15-24 were analyzed to describe the population of U.S. young sexual minority males (i.e., males reporting same-sex attraction, identity or behavior). Correlates of sexual minority classification were assessed in logistic regression models. RESULTS: An estimated 10% of young males, representing a population of 2.1 million, were sexual minorities. Males had an elevated likelihood of being sexual minorities if they were aged 18-19 or 20-24, rather than 15-17 (prevalence ratio, 1.7 for each); belonged to nonblack, non-Hispanic racial or ethnic minority groups (1.6); had no religious affiliation, rather than considering religion very important (1.9); or lived below the federal poverty level (1.3). They had a reduced likelihood of being sexual minorities if they lived in metropolitan areas outside of central cities (0.7). Among young sexual minority males, 44% were 15-19 years old, 29% were poor and 59% resided outside central cities. Forty-seven percent had engaged in same-sex behavior. Of those with data on all measured dimensions of sexuality, 24% reported same-sex attraction, identity and behavior; 22% considered themselves heterosexual, yet had had a male sex partner. CONCLUSION: Future investigations can further explore subpopulations of young sexual minority males and assess sexual trajectories, resilience and HIV risk. |
Using Molecular HIV Surveillance Data to Understand Transmission Between Subpopulations in the United States.
Oster AM , Wertheim JO , Hernandez AL , Banez Ocfemia MC , Saduvala N , Hall HI . J Acquir Immune Defic Syndr 2015 70 (4) 444-51 ![]() BACKGROUND: Studying HIV transmission networks provides insight into the spread of HIV and opportunities for intervention. We identified transmission dynamics among risk groups and racial/ethnic groups in the United States. METHODS: For HIV-1 pol sequences reported to the U.S. National HIV Surveillance System during 2001-2012, we calculated pairwise genetic distance, identified linked pairs of sequences (those with distance ≤1.5%), and examined transmission category and race/ethnicity of these potential transmission partners. RESULTS: Of 40,950 sequences, 12,910 (32%) linked to ≥1 other sequence. Of men who have sex with men (MSM) who linked to ≥1 sequence, 88% were linked to other MSM and only 4% were linked to heterosexual women. Of heterosexual women for whom we identified potential transmission partners, 29% linked to MSM, 21% to heterosexual men, and 12% to persons who inject drugs. Older and black MSM were more likely to be linked to heterosexual women. Assortative mixing was present for all racial/ethnic groups; 81% of blacks/African Americans linked to other blacks. CONCLUSIONS: This analysis is the first use of U.S. surveillance data to infer an HIV transmission network. Our data suggest that HIV infections among heterosexual women predominantly originate from MSM, followed by heterosexual men. Although few MSM were linked to women, suggesting that a minority of MSM are involved in transmission with heterosexual women, these transmissions represent a substantial proportion of HIV acquisitions by heterosexual women. Interventions that reduce transmissions involving MSM are likely to also reduce HIV acquisition among other risk groups. |
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