Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-9 (of 9 Records) |
Query Trace: Becasen JS[original query] |
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Safety of longer-term doxycycline use: A systematic review and meta-analysis with implications for bacterial STI chemoprophylaxis
Chan PA , Le Brazidec DL , Becasen JS , Martin H , Kapadia J , Reno H , Bachmann L , Barbee LA . Sex Transm Dis 2023 50 (11) 701-712 BACKGROUND: Sexually transmitted infections (STIs) such as syphilis, gonorrhea, and chlamydia have significantly increased over the past decade in the United States. Doxycycline as chemoprophylaxis (i.e., post-exposure prophylaxis [PEP]) offers promise for addressing bacterial STIs. The goal of the current study was to evaluate the safety of longer-term doxycycline use (defined as eight or more weeks) in the context of potential use as STI chemoprophylaxis through a systematic literature review and meta-analysis. METHODS: This review used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines to search MEDLINE/PubMed for clinical studies published from August 2003 through January 2023 that reported on adverse events with doxycycline use with a focus on side-effects and metabolic effects of long-term use. RESULTS: A total of 67 studies were included in the systematic review. Overall, studies on longer-term doxycycline use reported 0% to over 50% adverse events ranging from mild to severe. Most common adverse events included gastrointestinal symptoms (i.e., nausea, vomiting, and abdominal pain), dermatologic (i.e., rash), and neurological (i.e., headache and dizziness) symptoms. Discontinuation of doxycycline due to adverse events was relatively uncommon in most studies. A meta-analysis of placebo controlled clinical trials (N = 18) revealed gastrointestinal and dermatological adverse events were more likely to occur in the doxycycline group. CONCLUSION: Longer-term (8+ weeks) doxycycline use is generally safe and may be associated with minor side-effects. Further research is needed on the potential metabolic impact of longer-term doxycycline use. |
HIV care outcomes among transgender persons with HIV infection in the United States: a systematic review and meta-analysis, 2006-2021
Becasen JS , Morris JD , Denard CL , Mullins MM , Kota KK , Higa DH . AIDS 2021 36 (2) 305-315 OBJECTIVES: HIV prevalence is an estimated 14% among transgender women (TW) and 3% among transgender men (TM). HIV care is vital for viral suppression but is hindered by transphobia and HIV stigma. We assessed HIV care outcomes among transgender persons (TG) with HIV in the United States. DESIGN: Systematic review and meta-analysis of peer-reviewed journal articles. METHODS: We searched multiple electronic databases and CDC's HIV Prevention Research Synthesis database for 2006-September 2018. Eligible reports were US-based studies that included TG and reported HIV care outcomes. Random-effects models were used to calculate HIV care outcome rates. The protocol is registered with PROSPERO (CRD42018079564). RESULTS: Few studies reported outcomes for TM; therefore, only TW meta-analysis results are reported. Twenty-one studies were identified having low-to-medium risk-of-bias scores. Among TW with HIV, 82% had ever received HIV care; 72% were receiving care, and 83% of those were retained in HIV care. Sixty-two percent were currently virally suppressed. Among those receiving HIV care or antiretroviral therapy (ART), 67% were virally suppressed at last test. Sixty-five percent were linked to HIV care ≤3 months after diagnosis. Seventy-one percent had ever been prescribed ART. Approximately 66% were taking ART, and 66% were ART-adherent. Only 56% were currently adherent the previous year. CONCLUSIONS: HIV care outcomes for TW were not ideal, and research gaps exists for TM. High heterogeneity was observed; therefore, caution should be taken interpreting the findings. Integrating transgender-specific health needs are needed to improve outcomes of transgender persons across the HIV care continuum. |
Sexual-risk and STI-testing behaviors of a national sample of non-students, two-year, and four-year college students
Renfro KJ , Haderxhanaj L , Coor A , Eastman-Mueller H , Oswalt S , Kachur R , Habel MA , Becasen JS , Dittus PJ . J Am Coll Health 2020 70 (2) 1-8 Objective: To determine whether sexual-risk and STI-testing behaviors differ by college student status.Participants: Sexually experienced 17- to 25-year-olds from a 2013 nationally representative panel survey that evaluated the "Get Yourself Tested" campaign. Non-students (n = 628), 2-yr (n = 319), and 4-yr college students (n = 587) were surveyed.Methods: Bivariate analyses and multiple logistic regression were used.Results: Students were less likely than non-students to have had an early sexual debut and to have not used condoms in their most recent relationship. 4-yr students were less likely than non-students to have had multiple sexual partners. 2-yr students were less likely than non-students to have not used contraception in their most recent relationship.Conclusions: 2-yr and 4-yr college students were less likely than non-students to engage in sexual-risk behaviors. Given potentially greater risk for STI acquisition among non-students, identification and implementation of strategies to increase sexual health education and services among this population is needed. |
Estimating the prevalence of HIV and sexual behaviors among the US transgender population: A systematic review and meta-analysis, 2006-2017
Becasen JS , Denard CL , Mullins MM , Higa DH , Sipe TA . Am J Public Health 2018 109 (1) e1-e8 BACKGROUND: Transgender women (transwomen) in the United States have been shown to have high HIV risk with Black and Hispanic transwomen being particularly vulnerable. Growing research on transgender men (transmen) also shows increased HIV risk and burden, although not as much is known for this transgender population. OBJECTIVES: This systematic review estimates the prevalence of self-reported and laboratory-confirmed HIV infection, reported sexual and injection behaviors, and contextual factors associated with HIV risk of transgender persons living in the United States. SEARCH METHODS: We searched the HIV Prevention Research Synthesis database and MEDLINE, EMBASE, PsycINFO, CINAHL, and Sociological Abstracts databases from January 2006 to March 2017 and January 2006 to May 2017, respectively. Additional hand searches were conducted in December 2017 to obtain studies not found in the literature searches. SELECTION CRITERIA: Eligible reports were published US-based studies that included transgender persons and reported HIV status. DATA COLLECTION AND ANALYSIS: Data were double-coded and quality assessed. We used random-effects models employing the DerSimonian-Laird method to calculate overall prevalence of HIV infection, risk behaviors, and contextual factors for transwomen, transmen, and race/ethnicity subgroups. MAIN RESULTS: We reviewed 88 studies, the majority of which were cross-sectional surveys. Overall laboratory-confirmed estimated prevalence of HIV infection was 9.2% (95% confidence interval [CI] = 6.0%, 13.7%; kappa = 24). Among transwomen and transmen, HIV infection prevalence estimates were 14.1% (95% CI = 8.7%, 22.2%; kappa = 13) and 3.2% (95% CI = 1.4%, 7.1%; kappa = 8), respectively. Self-reported HIV infection was 16.1% (95% CI = 12.0%, 21.2%; kappa = 44), 21.0% (95% CI = 15.9%, 27.2%; kappa = 30), and 1.2% (95% CI = 0.4%, 3.1%; kappa = 7) for overall, transwomen, and transmen, respectively. HIV infection estimates were highest among Blacks (44.2%; 95% CI = 23.2%, 67.5%; kappa = 4). Overall, participation in sex work was 31.0% (95% CI = 23.9%, 39.0%; kappa = 39). Transwomen (37.9%; 95% CI = 29.0%, 47.7%; kappa = 29) reported higher participation in sex work than transmen (13.1%; 95% CI = 6.6%, 24.3%; kappa = 10; P = .001). Most outcomes indicated high heterogeneity in the overall and subgroup analyses. CONCLUSIONS: The availability of more data allowed us to calculate estimates separately for transwomen and transmen. HIV prevalence estimates for US transwomen were lower than previous estimates, but estimates for HIV prevalence and participation in sex work were higher when compared with transmen. Evidence gaps remain for transmen and the syndemic relationship of HIV, risky behaviors, and contextual factors specific to the transgender experience. Public Health Implications. This study highlights gender disparities for HIV and risky sexual behavior, as well as evidence gaps that exist for transmen. Tailored programs and services for the transgender population need to be developed to encourage use of and access to HIV prevention services. (Am J Public Health. Published online ahead of print November 29, 2018: e1-e8. doi:10.2105/AJPH.2018.304727). |
Structural intervention with school nurses increases receipt of sexual health care among male high school students
Dittus PJ , Harper CR , Becasen JS , Donatello RA , Ethier KA . J Adolesc Health 2017 62 (1) 52-58 PURPOSE: Adolescent males are less likely to receive health care and have lower levels of sexual and reproductive health (SRH) knowledge than adolescent females. The purpose of this study was to determine if a school-based structural intervention focused on school nurses increases receipt of condoms and SRH information among male students. METHODS: Interventions to improve student access to sexual and reproductive health care were implemented in six urban high schools with a matched set of comparison schools. Interventions included working with school nurses to improve access to sexual and reproductive health care, including the provision of condoms and information about pregnancy and sexually transmitted disease prevention and services. Intervention effects were assessed through five cross-sectional yearly surveys, and analyses include data from 13,740 male students. RESULTS: Nurses in intervention schools changed their interactions with male students who visited them for services, such that, among those who reported they went to the school nurse for any reason in the previous year, those in intervention schools reported significant increases in receipt of sexual health services over the course of the study compared with students in comparison schools. Further, these results translated into population-level effects. Among all male students surveyed, those in intervention schools were more likely than those in comparison schools to report increases in receipt of sexual health services from school nurses. CONCLUSIONS: With a minimal investment of resources, school nurses can become important sources of SRH information and condoms for male high school students. |
Community colleges: Rethinking STD prevention for the nontraditional college campus
Habel MA , Becasen JS , Kachur R , Eastman-Mueller H , Dittus PJ . Community Coll J Res Pract 2016 4 (11) 747-756 As increased attention and proposed funding are being directed toward community colleges, it is important to consider the sexual and reproductive health care needs of this growing population. Existing data suggest there are significant sexual health needs among this population and often insufficient provision of services. Some community college students are more likely than students at 4-year colleges to test positive for sexually transmitted diseases (STDs). Given resource constraints, creative solutions are required. These may include campus-wide policies addressing STD/HIV (human immunodeficiency virus) prevention, referral systems to connect students to care in the community, and partnerships with local health departments, Federally Qualified Health Centers, or community-based organizations to assist with the provision of services. Colleges have the unique opportunity to provide students with valuable information about sexual health and services. Community colleges, in particular, are uniquely positioned to reach at-risk community members for STD testing and sexual health care who might otherwise be lost to care. More research is needed on the sexual health needs of community college students, especially on factors such as geographic location, how embedded the school is into the community, social norms around sexual health on college campuses, and health services offered. New and innovative ways to promote linkage to care for testing and counseling could offer potential health benefits to this growing at-risk population. |
Parental monitoring and its associations with adolescent sexual risk behavior: a meta-analysis
Dittus PJ , Michael SL , Becasen JS , Gloppen KM , McCarthy K , Guilamo-Ramos V . Pediatrics 2015 136 (6) e1587-99 CONTEXT: Increasingly, health care providers are using approaches targeting parents in an effort to improve adolescent sexual and reproductive health. Research is needed to elucidate areas in which providers can target adolescents and parents effectively. Parental monitoring offers one such opportunity, given consistent protective associations with adolescent sexual risk behavior. However, less is known about which components of monitoring are most effective and most suitable for provider-initiated family-based interventions. OBJECTIVE: We performed a meta-analysis to assess the magnitude of association between parental monitoring and adolescent sexual intercourse, condom use, and contraceptive use. DATA SOURCES: We conducted searches of Medline, the Cumulative Index to Nursing and Allied Health Literature, PsycInfo, Cochrane, the Education Resources Information Center, Social Services Abstracts, Sociological Abstracts, Proquest, and Google Scholar. STUDY SELECTION: We selected studies published from 1984 to 2014 that were written in English, included adolescents, and examined relationships between parental monitoring and sexual behavior. DATA EXTRACTION: We extracted effect size data to calculate pooled odds ratios (ORs) by using a mixed-effects model. RESULTS: Higher overall monitoring (pooled OR, 0.74; 95% confidence interval [CI], 0.69-0.80), monitoring knowledge (pooled OR, 0.81; 95% CI, 0.73-0.90), and rule enforcement (pooled OR, 0.67; 95% CI, 0.59-0.75) were associated with delayed sexual intercourse. Higher overall monitoring (pooled OR, 1.12; 95% CI, 1.01-1.24) and monitoring knowledge (pooled OR, 1.14; 95% CI, 1.01-1.31) were associated with greater condom use. Finally, higher overall monitoring was associated with increased contraceptive use (pooled OR, 1.42; 95% CI, 1.09-1.86), as was monitoring knowledge (pooled OR, 2.27; 95% CI, 1.42-3.63). LIMITATIONS: Effect sizes were not uniform across studies, and most studies were cross-sectional. CONCLUSIONS: Provider-initiated family-based interventions focused on parental monitoring represent a novel mechanism for enhancing adolescent sexual and reproductive health. |
A systematic review of sexual health interventions for adults: narrative evidence
Hogben M , Ford J , Becasen JS , Brown KF . J Sex Res 2014 52 (4) 1-26 Recent work has explored the intersection between sexual health (as construed by the World Health Organization and others) and public health domains of action in the United States of America. This article reports the narrative results of a systematic review of sexual health intervention effects on public health-relevant outcomes. To qualify, interventions had to be based on the principles (1) that sexual health is intrinsic to individuals and their overall health and (2) that relationships reflecting sexual health must be positive for all parties concerned. Outcomes were classed in domains: knowledge, attitudes, communication, health care use, sexual behavior, and adverse events. We summarized data from 58 studies (English language, adult populations, 1996-2011) by population (adults, parents, sexual minorities, vulnerable populations) across domains. Interventions were predominantly individual and small-group designs that addressed sexual behaviors (72%) and attitudes/norms (55%). They yielded positive effects in that 98% reported a positive finding in at least one domain; 50% also reported null effects. The most consistently positive effects on behaviors and adverse events were found for sexual minorities, vulnerable populations, and parental communication. Whether via direct action or through partnerships, incorporating principles from existing sexual health definitions in public health efforts may help improve sexual health. |
Sexual health interventions: a meta-analysis
Becasen JS , Ford J , Hogben M . J Sex Res 2014 52 (4) 1-11 In the second of two companion papers, we conducted a meta-analysis of sexual health interventions in three domains. The interventions chosen for the meta-analysis were a subset of studies presented in a narrative review (the first of the two companion papers); these in turn were selected on the basis of fit to principles derived from the World Health Organization (WHO) and other definitions of sexual health. Studies (n = 20) were drawn from Medline and PsycINFO databases (English language, adult populations, 1996-2011) and fell into three domains: knowledge, attitudes, and sexual behaviors. We estimated intervention effects via Hedges' g, using the random-effects approach. Initial estimates revealed a large effect for knowledge, g = 1.32 (95% CI = 0.51-2.14), and smaller effects for attitude change, g = 0.17 (0.11-0.24) and behavior, g = 0.21 (0.13-0.29). After removing outliers to produce more precise estimates, the final effect sizes for knowledge, attitudes, and sexual behavior were, respectively, 0.25 (0.03-0.48), 0.18 (0.12-0.24), and 0.18 (0.11-0.24). Interventions yielded positive effects across populations and in all the domains studied. |
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