Last data update: May 06, 2024. (Total: 46732 publications since 2009)
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Query Trace: Johnson Jones M[original query] |
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Vital signs: Missed opportunities for preventing congenital syphilis - United States, 2022
McDonald R , O'Callaghan K , Torrone E , Barbee L , Grey J , Jackson D , Woodworth K , Olsen E , Ludovic J , Mayes N , Chen S , Wingard R , Johnson Jones M , Drame F , Bachmann L , Romaguera R , Mena L . MMWR Morb Mortal Wkly Rep 2023 72 (46) 1269-1274 INTRODUCTION: Congenital syphilis cases in the United States increased 755% during 2012-2021. Syphilis during pregnancy can lead to stillbirth, miscarriage, infant death, and maternal and infant morbidity; these outcomes can be prevented through appropriate screening and treatment. METHODS: A cascading framework was used to identify and classify missed opportunities to prevent congenital syphilis among cases reported to CDC in 2022 through the National Notifiable Diseases Surveillance System. Data on testing and treatment during pregnancy and clinical manifestations present in the newborn were used to identify missed opportunities to prevent congenital syphilis. RESULTS: In 2022, a total of 3,761 cases of congenital syphilis in the United States were reported to CDC, including 231 (6%) stillbirths and 51 (1%) infant deaths. Lack of timely testing and adequate treatment during pregnancy contributed to 88% of cases of congenital syphilis. Testing and treatment gaps were present in the majority of cases across all races, ethnicities, and U.S. Census Bureau regions. CONCLUSIONS AND IMPLICATIONS FOR PUBLIC HEALTH PRACTICE: Addressing missed opportunities for prevention, primarily timely testing and appropriate treatment of syphilis during pregnancy, is important for reversing congenital syphilis trends in the United States. Implementing tailored strategies addressing missed opportunities at the local and national levels could substantially reduce congenital syphilis. |
The congenital syphilis prevention cascade: Reimagining a missed prevention opportunities framework for effective intervention
O'Callaghan KP , Johnson Jones ML , Mcdonald R , Jackson DA , Grey JA , Kreisel KM , Torrone E . Sex Transm Dis 2023 51 (1) 8-10 Congenital syphilis (CS) rates have risen in the U.S. since 2013. Prevention of CS requires testing and treatment of pregnant and pregnancy-capable persons at high risk for syphilis. We developed a CS Prevention Cascade to assess how effectively testing and treatment interventions reached pregnant persons with a CS outcome. |
Pre-exposure prophylaxis use and detected sexually transmitted infections among men who have sex with men in the United States - National HIV Behavioral Surveillance, 5 US Cities, 2017
Chapin-Bardales J , Johnson Jones ML , Kirkcaldy RD , Bernstein KT , Paz-Bailey G , Phillips C , Papp JR , Raymond HF , Opoku J , Braunstein SL , Spencer EC , Khuwaja S , Wejnert C . J Acquir Immune Defic Syndr 2020 85 (4) 430-435 BACKGROUND: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) may be at high risk for bacterial sexually transmitted infections (STIs). We examined the prevalence of extragenital gonorrhea and chlamydia by PrEP status among a multisite sample of US MSM. METHODS: MSM aged ≥18 years were recruited through venue-based sampling to participate in the 2017 National HIV Behavioral Surveillance. In 5 cities (San Francisco, Washington DC, New York City, Miami, and Houston), participants completed a questionnaire, HIV testing, and pharyngeal and rectal STI specimen self-collection. We measured prevalence of pharyngeal and rectal gonorrhea and chlamydia among self-reported non-HIV-positive MSM who reported using or not using PrEP in the previous 12 months. RESULTS: Overall, 29.6% (481/1627) of non-HIV-positive MSM reported PrEP use in the past year. MSM who reported PrEP use were more likely to have any STI (ie, extragenital gonorrhea and/or chlamydia) than MSM not on PrEP [14.6% vs. 12.0%, adjusted prevalence ratio (aPR) = 1.5, 95% confidence interval (CI) : 1.1 to 2.0], reflecting differences in rectal chlamydia prevalence (8.7% vs. 6.0%, aPR = 1.6, 95% CI: 1.1 to 2.4). PrEP use was not associated with pharyngeal chlamydia, pharyngeal gonorrhea, or rectal gonorrhea. CONCLUSIONS: The prevalence of extragenital STI was high for both MSM on PrEP and those not on PrEP in the past year. MSM on PrEP were more likely to have rectal chlamydia but not pharyngeal STIs or rectal gonorrhea. Our findings support regular STI testing at exposed anatomic sites as recommended for sexually active MSM, including those on PrEP. |
Effectiveness of 1, 2, AND 3 human papillomavirus vaccine doses against HPV-16/18 positive high-grade cervical lesions
Johnson Jones ML , Gargano JW , Powell M , Park IU , Niccolai LM , Bennett NM , Griffin MR , Querec T , Unger ER , Markowitz LE . Am J Epidemiol 2019 189 (4) 265-276 Before 2016, human papillomavirus (HPV) vaccination was recommended in a three-dose schedule; however, many vaccine-eligible U.S. females received <3 doses, providing an opportunity to evaluate real-world vaccine effectiveness (VE) of 1, 2, and 3 doses. We analyzed data on cervical intraepithelial neoplasia grades 2-3 and adenocarcinoma in situ (CIN2+) from the HPV Vaccine Impact Monitoring Project (HPV-IMPACT), 2008-2014. Archived tissue from CIN2+ lesions was tested for 37 HPV types. Women were classified by number of doses received >/=24 months before CIN2+ detection. Using a test-negative design, VE was estimated as 1-adjusted odds ratio from a logistic regression model that compared vaccination history for women whose lesions tested positive for HPV-16/18 (vaccine-type cases) with all other CIN2+ (controls). Among 3,300 women with CIN2+, typing results, and vaccine history available, 1,561 (47%) were HPV-16/18 positive, 136 received (4%) 1 dose, 108 (3%) 2 doses, and 325 (10%) 3 doses. Adjusted odds ratios for vaccination with 1, 2, and 3 doses were 0.53 (95% confidence interval: 0.37, 0.76; VE=47%), 0.45 (95% confidence interval: 0.30, 0.69; VE=55%), and 0.26 (95% confidence interval 0.20, 0.35; VE=74%). We found significant VE against vaccine-type CIN2+ after 3 doses of HPV vaccine and lower but significant VE with 1 or 2 doses. |
Self-reported history of chlamydia or gonorrhea testing among heterosexual women at high risk of HIV infection, National HIV Behavioral Surveillance, 2013
Johnson Jones ML , Kirkcaldy RD , An Q , Gorwitz R , Bernstein K , Paz-Bailey G . Sex Transm Dis 2019 46 (9) 608-616 BACKGROUND: The US Preventive Services Task Force recommends annual chlamydia and gonorrhea screening for sexually active women <25 and >/=25 years old with associated risk factors. We sought to determine self-reported chlamydia and gonorrhea testing and diagnosis rates in the past 12 months in a community-based sample of heterosexual women at high risk of HIV infection. METHODS: We used National HIV Behavioral Surveillance data from 2013 when surveillance was conducted in heterosexual adults with low social economic status. Our analysis was restricted to 18- to 44-year-old women who answered questions regarding chlamydia/gonorrhea testing and diagnosis in the previous 12 months. We calculated the percentage reporting testing and diagnosis. Poisson regressions with generalized estimating equations clustered on recruitment chain were used to assess factors associated with testing and diagnosis. RESULTS: Among 18- to 24-year-old women (n = 1017), 61.0% self-reported chlamydia testing and 57.6% gonorrhea testing in the past 12 months. Among 25- to 44-year-old women (n = 2322), 49.0% and 47.0% reported chlamydia and gonorrhea testing, respectively. Among the subset of 25- to 44-year-old women who met screening criteria, 51.2% reported chlamydia testing. Having seen a medical provider and HIV testing (past 12 months) were associated with chlamydia/gonorrhea testing in both age groups. Self-reported chlamydia (18-24 years, 21.4%; 25-44 years, 12.2%) and gonorrhea diagnoses (18-24 years, 8.4%; 25-44 years, 6.6%) were common. CONCLUSIONS: A substantial number of eligible women may not have been screened for chlamydia/gonorrhea. Renewed efforts to facilitate screening may prevent sequelae and support disease control activities. |
Trends in high-grade cervical lesions and cervical cancer screening in 5 states, 2008-2015
Gargano JW , Park IU , Griffin MR , Niccolai LM , Powell M , Bennett NM , Johnson Jones ML , Whitney E , Pemmaraju M , Brackney M , Abdullah N , Scahill M , Dahl RM , Cleveland AA , Unger ER , Markowitz LE . Clin Infect Dis 2019 68 (8) 1282-1291 BACKGROUND: We describe changes in rates of cervical intraepithelial neoplasia grades 2, 3 and adenocarcinoma in situ (CIN2+) during a period of human papillomavirus (HPV) vaccine uptake and changing cervical cancer screening recommendations. METHODS: We conducted population-based laboratory surveillance for CIN2+ in catchment areas in 5 states, 2008-2015. We calculated age-specific CIN2+ rates per 100000 women by age groups. We estimated incidence rate ratios (IRR) of CIN2+ for 2-year periods among all women and among screened women to evaluate changes over time. RESULTS: A total of 16572 CIN2+ cases were reported. Among women aged 18-20 and 21-24 years, CIN2+ rates declined in all sites, whereas in women aged 25-29, 30-34, and 35-39 years, trends differed across sites. The percent of women screened annually declined in all sites and age groups. Compared to 2008-2009, rates among screened women were significantly lower for all 3 periods in women aged 18-20 years (2010-2011: IRR 0.82, 95% confidence interval [CI] 0.67-0.99; 2012-2013: IRR 0.63, 95% CI 0.47-0.85; 2014-2015: IRR 0.44, 95% CI 0.28-0.68) and lower for the latter 2 time periods in women aged 21-24 years (2012-2013: IRR 0.86, 95% CI 0.79-0.94; 2014-2015: IRR 0.61, 95% CI 0.55-0.67). CONCLUSIONS: From 2008-2015, both CIN2+ rates and cervical cancer screening declined in women aged 18-24 years. The significant decreases in CIN2+ rates among screened women aged 18-24 years are consistent with a population-level impact of HPV vaccination. |
Cervical adenocarcinoma in situ: Human papillomavirus types and incidence trends in five states, 2008-2015
Cleveland AA , Gargano JW , Park IU , Griffin MR , Niccolai LM , Powell M , Bennett NM , Saadeh K , Pemmaraju M , Higgins K , Ehlers S , Scahill M , Johnson Jones ML , Querec T , Markowitz LE , Unger ER . Int J Cancer 2019 146 (3) 810-818 Primary prevention through the use of human papillomavirus (HPV) vaccination is expected to impact both cervical intraepithelial neoplasia (CIN) and adenocarcinoma in situ (AIS). While CIN is well described, less is known about the epidemiology of AIS, a rare cervical precancer. We identified AIS and CIN grade 3 (CIN3) cases through population-based surveillance, and analyzed data on HPV types and incidence trends overall, and among women screened for cervical cancer. From 2008-2015, 470 AIS and 6,587 CIN3 cases were identified. The median age of women with AIS was older than those with CIN3 (35 vs 31 years; p<0.01). HPV16 was the most frequently detected type in both AIS and CIN3 (57% in AIS; 58% in CIN3), whereas HPV18 was the second most common type in AIS and less common in CIN3 (38% vs. 5%; p<0.01). AIS lesions were more likely than CIN3 lesions to be positive for high-risk types targeted by the bivalent and quadrivalent vaccines (HPV16/18, 92% vs. 63%; p<0.01), and nonavalent vaccine (HPV16/18/31/33/45/52/58, 95% vs. 87%; p<0.01). AIS incidence rates decreased significantly in the 21-24 year age group (annual percent change [APC] overall: -22.1%, 95% CI: -33.9 to -8.2; APC among screened: -16.1%, 95% CI: -28.8 to -1.2), but did not decrease significantly in any older age group. This report on the largest number of genotyped AIS cases to date suggests an important opportunity for vaccine prevention of AIS, and is the first to document a decline in AIS incidence rates among young women during the vaccine era. This article is protected by copyright. All rights reserved. |
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