Last data update: Sep 23, 2024. (Total: 47723 publications since 2009)
Records 1-13 (of 13 Records) |
Query Trace: Bradley ELP [original query] |
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In vitro testing of Trichomonas vaginalis drug susceptibility: evaluation of minimal lethal concentrations for metronidazole and tinidazole that correspond with treatment failure
Augostini P , Bradley ELP , Raphael BH , Secor WE . Sex Transm Dis 2023 50 (6) 370-373 BACKGROUND: The only drugs approved by the U.S. Food and Drug Administration for oral treatment of trichomoniasis belong to the 5-nitroimidazole group. Most individuals infected with Trichomonas vaginalis can be cured with a standard treatment of metronidazole or tinidazole, but it is estimated that more than 159,000 people fail treatment each year. Although a minimal lethal concentration (MLC) corresponding to treatment failure has been reported for metronidazole, the MLC for tinidazole associated with treatment failure has not been determined. We conducted a study using T. vaginalis isolates from women with reported treatment success or failure to determine these values. METHODS: We measured MLCs of 47 isolates obtained from women who had failed metronidazole treatment, 33 isolates from women who had failed tinidazole treatment, and 48 isolates from women successfully cured with metronidazole. The cutoff was calculated as the 95th percentile of MLCs of susceptible isolates for each drug. RESULTS: Our data confirmed the MLC previously associated with metronidazole treatment failure is ≥50 μg/ml and identified the MLC associated with tinidazole treatment failure as ≥6.3 μg/ml. For metronidazole, the agreement between laboratory result and treatment outcome was 93.7%, for tinidazole this agreement was 88.9%. CONCLUSIONS: The T. vaginalis susceptibility assay is useful for determining whether 5-nitroimidazole treatment failure in persons with trichomoniasis can be attributed to drug resistance. These results are useful for establishing interpretive guidance of test results and MLC levels can help guide appropriate patient treatment. |
Exploring changes in racial/ethnic disparities of HIV diagnosis rates under the "Ending the HIV Epidemic: A Plan for America" initiative
McCree DH , Chesson H , Bradley ELP , Williams A , Gant Z , Geter A . Public Health Rep 2020 135 (5) 685-690 OBJECTIVES: Racial/ethnic disparities in HIV diagnosis rates remain despite the availability of effective treatment and prevention tools in the United States. In 2019, President Trump announced the "Ending the HIV Epidemic: A Plan for America" (EHE) initiative to reduce new HIV infections in the United States at least 75% by 2025 and at least 90% by 2030. The objective of this study was to show the potential effect of the EHE initiative on racial/ethnic disparities in HIV diagnosis rates at the national level. METHODS: We used 2017 HIV diagnoses data from the Centers for Disease Control and Prevention National HIV Surveillance System. We developed a counterfactual scenario to determine changes in racial/ethnic disparities if the 2017 HIV diagnosis rates were reduced by 75% in the geographic regions targeted by the EHE initiative. We used 4 measures to calculate results: rate ratio, population-attributable proportion (PAP), Gini coefficient, and Index of Disparity. RESULTS: The relative measures of racial/ethnic disparity decreased by 9%-21% in the EHE scenario compared with the 2017 HIV diagnoses data. The largest decrease was in the Hispanic/Latino:white rate ratio (-20.6%) and in the black:white rate ratio (-18.2%). The PAP measure decreased by 11.5%. The absolute versions of the Index of Disparity (unweighted and weighted) were approximately 50% lower in the EHE scenario than in the 2017 HIV diagnoses data. CONCLUSIONS: EHE efforts could reduce but will not eliminate racial/ethnic disparities in HIV diagnosis rates. Efforts to address racial/ethnic disparities should continue, and innovative approaches, specifically those that focus on social and structural factors, should be developed and implemented for populations that are disproportionately affected by HIV in the United States. |
Social and structural factors associated with sustained viral suppression among heterosexual black men with diagnosed HIV in the United States, 2015-2017
McCree DH , Beer L , Fugerson AG , Tie Y , Bradley ELP . AIDS Behav 2020 24 (8) 2451-2460 This paper describes sociodemographic, sexual risk behavior, and clinical care factors associated with sustained viral suppression (SVS) among heterosexual Black men with diagnosed HIV in the US. Sample was 968 men, 2015-2017 cycles of Medical Monitoring Project. We used prevalence ratios and a multivariable logistic regression model to identify independent predictors of SVS. About 9% of sexually active men had sex that carries a risk of HIV transmission. Nearly 2/3 lived at or below the poverty level, 13% were under or uninsured, 1/4 experienced food insecurity and 15% reported recent homelessness. About 26% were not engaged in HIV care, 8% not currently taking antiretroviral therapy (ART) and 59% had SVS. Among men taking ART, care engagement and adherence were the only significant independent predictors of SVS. Efforts to increase VS should focus on increasing ART use, care engagement, and ART adherence, and include strategies that address the social and structural factors that influence them. |
US regional changes in racial/ethnic disparities in HIV diagnoses among women in the United States, 2012 and 2017
McCree DH , Chesson H , Bradley ELP , Lima A , Fugerson AG . AIDS Behav 2019 24 (4) 1118-1123 Racial/ethnic and geographic disparities in HIV diagnosis rates exist among women in the United States. Black/African American women are disproportionately affected; rates are highest in the South and Northeast. Monitoring progress towards eliminating disparities in HIV diagnosis rates among women is a national HIV prevention goal. To illustrate the performance of different measures of disparities, we compared 2012 and 2017 HIV diagnosis rates among adult and adolescent females by race/ethnicity and geographic region. We used HIV surveillance data for diagnoses and five absolute and three relative measures of disparity. The absolute disparity decreased in each region; the relative disparity decreased with the exception of one measure in the Northeast and South. Despite progress, disparities in HIV diagnosis rates among women remain. Appropriate strategies to measure progress and contextualize findings are needed. |
Successfully recruiting black and Hispanic/Latino adolescents for sexually transmitted infection and HIV prevention research
Bradley ELP , Lanier Y , Ukuku Miller AM , Brawner BM , Sutton MY . J Racial Ethn Health Disparities 2019 7 (1) 36-44 Disparities in rates of sexually transmitted infections (STIs) and HIV between Black/African American and Hispanic/Latino adolescents and their white counterparts are well documented. Researchers may encounter notable challenges recruiting Black/African American and Hispanic/Latino adolescents for sexual risk reduction studies. In this article, we present information to assist with planning, implementing, and evaluating recruitment and retention strategies. We also provide practical examples of challenges and solutions from three STI/HIV epidemiologic or prevention intervention studies with different study purposes and populations. Researchers can use this information to aid proposal development, create or refine a recruitment/retention protocol before implementation, and troubleshoot challenges during implementation. |
Psychological and social determinants of health, antiretroviral therapy (ART) adherence, and viral suppression among HIV-positive black women in care
Bradley ELP , Frazier EL , Carree T , Hubbard McCree D , Sutton MY . AIDS Care 2019 31 (8) 1-10 Black women are disproportionately affected by HIV, accounting for 61% of women diagnosed in 2016. Black women with HIV are less likely to be adherent to antiretroviral therapy (ART) and virally suppressed compared to women of other racial/ethnic groups. We analyzed 2013-2014 data from 1703 black women patients in the Centers for Disease Control and Prevention's Medical Monitoring Project to examine whether select psychological and social determinants of health (SDH) factors were associated with ART adherence and viral suppression. We calculated weighted estimates and used multivariable logistic regression with adjusted prevalence ratios (aPR) and 95% confidence intervals (CI) to examine correlates of ART adherence and viral suppression. Women who had not been incarcerated in the past 12 months (aPR = 1.24; CI: 1.04-1.48) and had not experienced discrimination in a health care setting since their HIV diagnosis (aPR = 1.06; 1.00-1.11) were slightly more likely to be adherent to ART. Women who lived above the federal poverty level were more likely to be virally suppressed during the past 12 months (aPR = 1.09; CI: 1.01-1.18). More research is warranted to identify the best strategies to create health care settings that encourage black women's HIV care engagement, and to address other key SDH and/or psychological factors. |
Disparities in incidence of human immunodeficiency virus infection among black and white women - United States, 2010-2016
Bradley ELP , Williams AM , Green S , Lima AC , Geter A , Chesson HW , McCree DH . MMWR Morb Mortal Wkly Rep 2019 68 (18) 416-418 Incident human immunodeficiency virus (HIV) infections among adolescent females and women declined during 2010-2016, with the largest decrease (21%) occurring among black women (1). However, in 2016, although black women accounted for 13% of the U.S. female population, 60% of new HIV infections among women were in black women, indicating persisting disparities (1). CDC used the population attributable proportion (PAP) disparity measure to describe the proportional decrease in HIV infection among black and white women combined that would be realized if the group with the higher rate (blacks) had the same rate as did the group with the lower rate (whites) (2). Analyses indicated that an estimated 3,900 of 4,200 (93%) incident HIV infections among black women in 2016 would not have occurred if rates were the same for black and white women. The PAP disparity measure decreased from 0.75 in 2010 to 0.70 in 2016, suggesting that if incidence rates for black women were the same as those for white women, the annual number of incident HIV infections among black and white women would have been 75% lower in 2010 and 70% lower in 2016. Continued efforts are needed to identify and address social and structural determinants associated with HIV-related disparities to eliminate these disparities and decrease HIV incidence among black women. |
Trends in geographic rates of HIV diagnoses among black females in the United States, 2010-2015
Elmore K , Bradley ELP , Lima AC , Khalil GM , Obi-Tabot E , Gant Z , Dean HD , McCree DH . J Womens Health (Larchmt) 2018 28 (3) 410-417 BACKGROUND: HIV diagnoses among females in the United States declined 22% from 2010 to 2015, including a 27% decline in diagnoses among black females. Despite this progress, disparities persist. Black females accounted for 60% of new HIV diagnoses among females in 2015. Geographic disparities also exist. This article describes geographic differences in HIV diagnoses among black females in the United States, from 2010 to 2015. MATERIALS AND METHODS: We examined HIV surveillance data from 2010 to 2015 to determine in which geographic areas decreases or increases in HIV diagnoses occurred. We used data from the National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention's (NCHHSTP) AtlasPlus to calculate percent changes in HIV diagnosis rates by geographic region for black females >/=13 years of age. RESULTS: The number of new HIV diagnoses declined 27% among black females from 2010 to 2015. The highest rates of HIV diagnosis per 100,000 population of black females, from 2010 to 2015, were in the Northeast and the South. In 2015, five of the eight states reporting the highest rates of HIV diagnosis (i.e., the highest quartile) were in the South. CONCLUSIONS: HIV diagnosis rates decreased nationally among black females, but the decreases were not uniform within regions or across the United States. Some states experienced increases, and black females in the South and Northeast remain disproportionately affected. Additional research is needed to ascertain factors associated with the increases to continue progress toward reducing HIV-related disparities among females in the United States. |
Effectively addressing human immunodeficiency virus disparities affecting US black women
Bradley ELP , Geter A , Lima AC , Sutton MY , Hubbard McCree D . Health Equity 2018 2 (1) 329-333 Black women have disproportionately higher rates of human immunodeficiency virus (HIV) infection, and low percentages being linked to care and becoming virally suppressed, compared with women of other races/ethnicities. To date, few evidence-based HIV prevention and care interventions tailored for black women exist. We highlight three essential factors to consider in designing culturally and gender-appropriate studies to address HIV-related disparities affecting black women: (1) social determinants of HIV risk, (2) determinants of equity, and (3) perceptions of black women's sexuality. Synergy between a strong evidence base and developing strong partnerships could accelerate progress toward HIV-related health equity for black women. |
Improving HIV preexposure prophylaxis implementation for women: Summary of key findings from a discussion series with women's HIV prevention experts
Bradley ELP , Hoover KW . Womens Health Issues 2018 29 (1) 3-7 Although diagnoses of human immunodeficiency virus (HIV) infection in women have been decreasing over the past several years, women still comprise nearly 20% of all HIV diagnoses in the United States (Centers for Disease Control and Prevention [CDC], 2017a). The largest proportion of these diagnoses in women have been in Black/African American women (referred to hereafter as Black), who accounted for 61% of new diagnoses in 2016 and were the second most affected subpopulation after men who have sex with men (CDC, 2017a). Several factors can influence women's risk for HIV infection. Women who live in communities or are part of sexual networks with a high prevalence of undiagnosed or untreated HIV and certain sexually transmitted infections are at increased risk of acquiring HIV (Fleming and Wasserheit, 1999, Laumann and Youm, 1999, Morris et al., 2009). Concurrent sexual partnerships, which have been linked to sex ratio imbalances, poverty, and high incarceration rates for Black men, in high prevalence networks can also promote HIV transmission (Adimora et al., 2006, Adimora et al., 2013, Pouget et al., 2010). Additionally, women might not be aware that they are at risk for HIV infection if their male sexual partners do not disclose their HIV status or sexual or drug injection risk behaviors. |
Acceptability of oral rapid HIV testing at dental clinics in communities with high HIV prevalence in South Florida
Bradley ELP , Vidot DC , Gaul Z , Sutton MY , Pereyra M . PLoS One 2018 13 (4) e0196323 BACKGROUND: Expanding HIV screening for populations at risk necessitates testing in nontraditional settings. We assessed HIV testing in dental clinics in South Florida, an urban area with the highest rates of HIV diagnoses in the United States in 2015. AIMS: We explored patients' acceptance of oral HIV rapid tests administered by dental providers and identified reasons for accepting or declining HIV testing. METHODS: During 2014 and 2015, dentists and hygienists at two federally qualified health center (FQHC) dental clinics who serve racial/ethnic minority patient populations in South Florida were trained to administer oral HIV rapid tests as a part of a routine dental visit. Patients presenting for dental services were offered a rapid HIV test and brief survey regarding their demographics, HIV testing history and behaviors. RESULTS: We enrolled 600 patients (median age = 43 years; IQR: 29-56 years), 45% non-Hispanic black and 35% Hispanic/Latino, 83% graduated high school, and 50% unemployed. Most (85%) accepted oral HIV rapid testing (none tested HIV-positive); 14% had never been tested for HIV. The most common reasons for testing were a desire to know HIV status (56%) and free testing (54%). Among 93 (15%) patients who declined testing, 58% were tested recently and 31% felt confident that they were HIV-negative; however, 74 (80%) who declined testing said they would feel comfortable discussing HIV prevention with their dentist. Additionally, 290 of 600 patients (48%) reported condomless vaginal or anal sex in the past 6 months. Further, among 119 patients who had condomless sex with an HIV-positive partner and/or one whose HIV status was unknown, 98 (82%) accepted the oral HIV test. CONCLUSION: Dental clinics may provide expanded opportunities for oral HIV rapid testing and conversations about HIV prevention in high HIV prevalence communities. |
Developing FAITHH: Methods to develop a faith-based HIV stigma-reduction intervention in the rural south
Bradley ELP , Sutton MY , Cooks E , Washington-Ball B , Gaul Z , Gaskins S , Payne-Foster P . Health Promot Pract 2018 19 (5) 1524839917754044 Human immunodeficiency virus (HIV) disproportionately affects Blacks/African Americans, particularly those residing in the southern United States. HIV-related stigma adversely affects strategies to successfully engage people in HIV education, prevention, and care. Interventions targeting stigma reduction are vital as additional tools to move toward improved outcomes with HIV prevention and care, consistent with national goals. Faith institutions in the South have been understudied as partners in HIV stigma-reduction efforts, and some at-risk, Black/African American communities are involved with southern faith institutions. We describe the collaborative effort with rural, southern faith leaders from various denominations to develop and pilot test Project Faith-based Anti-stigma Initiative Towards Healing HIV/AIDS (FAITHH), an HIV stigma-reduction intervention that built on strategies previously used with other nonrural, Black/African American faith communities. The eight-module intervention included educational materials, myth-busting exercises to increase accurate HIV knowledge, role-playing, activities to confront stigma, and opportunities to develop and practice delivering a sermon about HIV that included scripture-based content and guidance. Engaging faith leaders facilitated the successful tailoring of the intervention, and congregation members were willing participants in the research process in support of increased HIV awareness, prevention, and care. |
Testing our FAITHH: HIV stigma and knowledge after a faith-based HIV stigma reduction intervention in the rural south
Payne-Foster P , Bradley ELP , Aduloju-Ajijola N , Yang X , Gaul Z , Parton J , Sutton MY , Gaskins S . AIDS Care 2017 30 (2) 1-8 Eliminating racial/ethnic HIV disparities requires HIV-related stigma reduction. African-American churches have a history of addressing community concerns, including health issues, but may also contribute to stigma. We developed and pilot tested a faith-based, anti-stigma intervention with 12 African-American churches in rural Alabama. We measured HIV-related stigma held by 199 adults who participated in the intervention (individual-level) and their perception of stigma among other congregants (congregational-level). Analyses of pre- and post-assessments using a linear mixed model showed the anti-stigma intervention group reported a significant reduction in individual-level stigma compared with the control group (mean difference: -.70 intervention vs. -.16 control, adjusted p < .05). Findings suggest African-American churches may be poised to aid HIV stigma-reduction efforts. |
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