Last data update: May 20, 2024. (Total: 46824 publications since 2009)
Records 1-15 (of 15 Records) |
Query Trace: Johnson WD [original query] |
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Inequities along the human immunodeficiency virus (HIV) pre-exposure prophylaxis services continuum for black women in the United States, 2015-2020
Townes A , Tanner MR , Yu L , Johnson WD , Zhu W , Iqbal K , Dominguez KL , Henny KD , Drezner K , Schumacher C , Bickham J , Elopre L , Edelstein ZR , Hoover KW . Obstet Gynecol 2023 OBJECTIVE: To estimate the number of women who received human immunodeficiency virus (HIV) and sexually transmitted infection (STI) testing and HIV pre-exposure prophylaxis (PrEP) services by race and ethnicity in seven THRIVE (Targeted Highly Effective Interventions to Reverse the HIV Epidemic)-funded jurisdictions and to estimate associations of age and syphilis and gonorrhea diagnoses with receipt of HIV PrEP services. METHODS: We analyzed data collected from 2015 to 2020 in Birmingham, Alabama; Baltimore City, Maryland; Washington, DC, New Orleans, Louisiana; Brooklyn, New York; Philadelphia, Pennsylvania; and Hampton Roads, Virginia. We compared Black women and women of additional racial and ethnic groups by age, HIV status at enrollment, receipt of STI testing and test positivity, and steps in the PrEP continuum (screened, eligible, referred, linked, and prescribed). We also examined the association of age, syphilis, or gonorrhea with the following steps in the PrEP continuum: screened, referred, linked, and prescribed. RESULTS: Black women made up 69.2% (8,758/12,647) of women served in THRIVE. Compared with non-Black women, Black women were more likely to have a positive test result for syphilis (3.3% vs 2.1%), gonorrhea (4.9% vs 3.5%), chlamydia (5.1% vs 1.9%), or more than one STI (1.4% vs 0.3%). Among women with negative HIV test results or unknown HIV status, Black women were more likely to be screened for PrEP eligibility (88.4% vs 64.9%). Among Black women, the proportion screened for PrEP was higher among those diagnosed with syphilis (97.3%) or gonorrhea (100%) than among those without an STI (88.1% and 87.8%, respectively). Among 219 Black women who presented with syphilis, only 10 (4.6%) were prescribed PrEP; among 407 with gonorrhea, only 11 (2.7%) were prescribed PrEP. CONCLUSION: Although most Black women seeking services received STI testing, the proportion of Black women who were eligible for PrEP and prescribed PrEP was low. To achieve national HIV-prevention goals, it is imperative that Black women have access to PrEP information and services. |
Expanding data to care programs to improve HIV care continuum among men who have sex with men and transgender persons: Key processes and outcomes from project pride, 2015-2019
Mulatu MS , Carter JWJr , Flores SA , Benton S , Galindo CA , Johnson WD , Wilkes AL , Mbaka CK , Prather C . Public Health Rep 2022 138 (1) 333549211058175 OBJECTIVES: During 2015-2019, five local and state health department jurisdictions implemented Data to Care (D2C) programs supported by Project PrIDE (Pre-exposure prophylaxis, Implementation, Data to Care, and Evaluation) to improve linkage or reengagement in HIV medical care among persons with HIV (PWH) who had gaps in care, particularly among men who have sex with men (MSM) and transgender persons. We describe findings from the cross-jurisdiction evaluation of the project. METHODS: We conducted a qualitative analysis of the final progress reports submitted by PrIDE jurisdictions to the Centers for Disease Control and Prevention to identify key D2C activities implemented and challenges encountered. We also conducted descriptive analysis on aggregate quantitative data to summarize key D2C program outcomes. RESULTS: PrIDE jurisdictions implemented multiple activities to build their D2C capacity, identify PWH who were not in care or virally suppressed, provide linkage/reengagement services, and monitor outcomes. Overall, 11 463 PWH were selected for follow-up, 45% of whom were MSM or transgender persons. Investigations were completed for 8935 (77.9%) PWH. Only 2323 (26.0%) PWH were confirmed not in care or virally suppressed; 1194 (51.4%) were subsequently linked/reengaged in care; among those, 679 (56.9%) were virally suppressed at last test. PrIDE jurisdictions identified data-related (eg, incomplete or delayed laboratory results), program capacity (eg, insufficient staff), and social and structural (eg, unstable housing) challenges that affected their D2C implementation. CONCLUSIONS: PrIDE jurisdictions successfully enhanced their D2C capacity, reached priority populations who were not in care or virally suppressed, and improved their engagement in care and health outcomes. Data-related and non-data-related challenges limited the efficiency of D2C programs. Findings can help inform other D2C programs and contribute to national HIV prevention goals. |
Expanding PrEP services for men who have sex with men and transgender persons through health department programs: Key processes and outcomes from Project PrIDE, 2015-2019
Mulatu MS , Carter JWJr , Flores SA , Benton S , Galindo CA , Johnson WD , Wilkes AL , Prather C . Public Health Rep 2022 138 (1) 333549211058173 OBJECTIVE: Pre-exposure prophylaxis (PrEP) Implementation, Data to Care, and Evaluation (PrIDE) was a demonstration project implemented by 12 state and local health departments during 2015-2019 to expand PrEP services for men who have sex with men (MSM) and transgender persons at risk for HIV infection. We describe findings from the cross-jurisdictional evaluation of the project. METHODS: We analyzed work plans, annual progress reports, and aggregate quantitative program data submitted by funded health departments (n = 12) to identify key activities implemented and summarize key project outcomes. RESULTS: PrIDE jurisdictions implemented multiple health equity-focused activities to expand PrEP services to priority populations, including building program capacity, conducting knowledge and awareness campaigns, providing PrEP support services, and addressing barriers to PrEP use. Overall, PrIDE jurisdictions identified 44 813 persons with PrEP indications. Of these, 74.8% (n = 33 500) were referred and 33.1% (n = 14 821) were linked to PrEP providers, and 25.3% (n = 11 356) were prescribed PrEP. Most persons prescribed PrEP were MSM or transgender persons (87.9%) and persons from racial and ethnic minority groups (65.6%). However, among persons with PrEP indications, non-Hispanic Black/African American persons (14.9% of 18 782) were less likely than non-Hispanic White persons (31.0% of 11 633) to be prescribed PrEP (z = -33.57; P < .001). CONCLUSIONS: PrIDE jurisdictions successfully expanded PrEP services for MSM, transgender persons, and racial and ethnic minority groups by implementing health equity-focused activities that addressed barriers to PrEP services. However, PrEP prescription was generally low, with significant disparities by demographic characteristics. Additional targeted interventions are needed to expand PrEP services, achieve equity in PrEP use, and contribute to ending the HIV epidemic in the United States. |
Human immunodeficiency virus prevention for people who use drugs: Overview of reviews and the ICOS of PICOS
Johnson WD , Rivadeneira N , Adegbite AH , Neumann MS , Mullins MM , Rooks-Peck C , Wichser ME , McDonald CM , Higa DH , Sipe TA . J Infect Dis 2020 222 S278-s300 BACKGROUND: This article summarizes the results from systematic reviews of human immunodeficiency virus (HIV) prevention interventions for people who use drugs (PWUD). We performed an overview of reviews, meta-analysis, meta-epidemiology, and PROSPERO Registration CRD42017070117. METHODS: We conducted a comprehensive systematic literature search using the Centers for Disease Control and Prevention HIV/AIDS Prevention Research Synthesis Project database to identify quantitative systematic reviews of HIV public heath interventions with PWUD published during 2002-2017. We recombined results of US studies across reviews to quantify effects on HIV infections, continuum of HIV care, sexual risk, and 5 drug-related outcomes (sharing injection equipment, injection frequency, opioid use, general drug use, and participation in drug treatment). We conducted summary meta-analyses separately for reviews of randomized controlled trials (RCTs) and quasi-experiments. We stratified effects by 5 intervention types: behavioral-psychosocial (BPS), syringe service programs (SSP), opioid agonist therapy (OAT), financial and scheduling incentives (FSI), and case management (CM). RESULTS: We identified 16 eligible reviews including >140 US studies with >55 000 participants. Summary effects among US studies were significant and favorable for 4 of 5 outcomes measured under RCT (eg, reduced opioid use; odds ratio [OR] = 0.70, confidence interval [CI] = 0.56-0.89) and all 6 outcomes under quasi-experiments (eg, reduced HIV infection [OR = 0.42, CI = 0.27-0.63]; favorable continuum of HIV care [OR = 0.68, CI = 0.53-0.88]). Each intervention type showed effectiveness on 1-6 outcomes. Heterogeneity was moderate to none for RCT but moderate to high for quasi-experiments. CONCLUSIONS: Behavioral-psychosocial, SSP, OAT, FSI, and CM interventions are effective in reducing risk of HIV and sequelae of injection and other drug use, and they have a continuing role in addressing the opioid crisis and Ending the HIV Epidemic. |
Growth in proportion and disparities of HIV PrEP use among key populations identified in the United States national goals: systematic review & meta-analysis of published surveys
Kamitani E , Johnson WD , Wichser ME , Adegbite AH , Mullins MM , Sipe TA . J Acquir Immune Defic Syndr 2020 84 (4) 379-386 BACKGROUD: PrEP use among populations most vulnerable to HIV as identified in national HIV prevention goals is not fully known. This systematic review assessed trends of lifetime self-reported PrEP use and disparities among key populations. METHODS: We used CDC HIV/AIDS Prevention Research Synthesis cumulative database of electronic and manual searches in MEDLINE, CINAHL, EMBASE, and PsycINFO from 2000-2019 to identify English-language primary studies reporting PrEP use. Two reviewers independently screened citations, extracted data, and assessed risk of bias with modified Newcastle-Ottawa Scale. We estimated pooled proportions and crude/adjusted odds ratios (OR). RESULTS: We identified 95 eligible studies including 95,854 US-based survey respondents. A few studies (6.3%) focused on people who inject drugs (PWID). In 2015-2017, men who have sex with men (MSM) had highest proportion of individuals who used PrEP over their lifetime (13.9%[95%CI:8.8-21.1],k[number of surveys]=49) followed by Hispanic/Latinos (11.5[7.1-18.1],12), transgender women (11.2[5.8-20.6],5), and blacks (9.9[8.3-11.8],18). Odds of PrEP use increased by 34%/year (OR=1.34/year[95%CI:1.09-1.64]) and significantly increased over time among MSM (1.53/year[1.21-1.93]) and blacks (1.44[1.13-1.83]). People in the Southern US (9.9[4.7-19.7],8) and youth (7.3[4.7-11.2],8) had lower rates and did not demonstrate growth (0.94[0.29-3.18];0.82[0.43-1.55]). Odds of reporting lifetime PrEP use was twice (2.07[1.27-3.38]) as great among MSM than non-MSM. CONCLUSIONS: Proportions of PrEP use in published surveys have been growing, but remain low for people in the Southern US and youth, and understudied in PWID. Limitations include few studies in certain years while strengths include large number of respondents. Culturally-tailored approaches targeting vulnerable populations are essential to increase PrEP use to reduce disparities in HIV acquisition. |
Effect of a community-level HIV prevention intervention on psychosocial determinants of HIV risk behaviors among young black men who have sex with men (YBMSM)
Eke AN , Johnson WD , O'Leary A , Rebchook GM , Huebner DM , Peterson JL , Kegeles SM . AIDS Behav 2019 23 (9) 2361-2374 In contrast to intervention studies that assess psychosocial factors only as mediators or moderators of HIV risk, the present study assessed the effects of an Mpowerment-based community-level intervention on psychosocial determinants (e.g., depressive symptoms, sexual stigma) of HIV risk behavior among young black MSM. Approximately 330 respondents were surveyed annually for 4 years in each of two sites. General linear models examined change across time between the intervention and comparison communities, and participation effects in the intervention site. Social diffusion (spreading information within networks) of safer sex messages (p < 0.01) and comfort with being gay (p < 0.05) increased with time in intervention versus control. Cross-sectionally, intervention participants responded more favorably (p < 0.05) on social diffusion and depressive symptoms, but less favorably (p < 0.01) on sex in difficult situations and attitudes toward condom use. Findings suggest a need to address broader health issues of MSM as well as sexual risk. |
Increasing prevalence of self-reported HIV pre-exposure prophylaxis (PrEP) use in published surveys - a systematic review and meta-analysis
Kamitani E , Wichser ME , Adegbite AH , Mullins MM , Johnson WD , Crouch PC , Sipe TA . AIDS 2018 32 (17) 2633-2635 When combining results from all published surveys, about one in nine global study participants (10.7%) reported ever using PrEP by 2017, a significant increase since U.S. FDA approval in 2012 (OR = 1.6/year, p < 0.00001). Moreover, nearly one in six US-based study participants (17.3%) and nearly one in four MSM who met the CDC's PrEP indications (24.5%) reported ever using PrEP by 2016. The odds of reporting PrEP use are approximately doubling each year (OR = 1.8/year, p < 0.00001; OR = 2.0/year, p < 0.00001). |
Per-partner condom effectiveness for men who have receptive sex with HIV-positive men
Johnson WD , O'Leary A , Flores SA . AIDS 2018 32 (11) 1499-1505 OBJECTIVE: Few studies have examined condom effectiveness for HIV prevention among men who have sex with men (MSM). We estimated condom effectiveness per partner in four cohorts of MSM during 1993-2003 (JumpStart, Vaccine Preparedness Study, VAX004 and Project Explore). METHODS: We used logistic regression to estimate the increase in odds of new HIV infection per HIV-positive partner for condom-protected receptive anal intercourse (PRAI; partners with whom condoms were always used) and condomless (unprotected) receptive anal intercourse (URAI; partners with whom condoms were sometimes or never used). To estimate condom effectiveness for preventing HIV transmission we applied the concept of excess odds, the odds ratio minus 1. The condom failure rate was estimated as the excess odds per PRAI partner divided by the excess odds per URAI partner. Condom effectiveness was then 1 minus the failure rate. RESULTS: The excess odds of HIV infection per HIV-positive partner were 83% for URAI and 7% for PRAI. The resulting failure rate (9%) indicated per-partner condom effectiveness of 91% (95% confidence interval 69-101). CONCLUSION: The increase in odds of new HIV infection per HIV-positive partner for RAI was reduced by 91% for each partner with whom condoms were always used. |
Perceptions of HIV self-testing among men who have sex with men in the United States: A qualitative analysis
Freeman AE , Sullivan P , Higa D , Sharma A , MacGowan R , Hirshfield S , Greene GJ , Gravens L , Chavez P , McNaghten AD , Johnson WD , Mustanski B . AIDS Educ Prev 2018 30 (1) 47-62 HIV testing is the gateway into both prevention and treatment services. It is important to understand how men who have sex with men (MSM) perceive HIV self-tests. We conducted focus groups and individual interviews to collect feedback on two HIV self-tests, and on a dried blood spot (DBS) specimen collection kit. Perceptions and attitudes around HIV self-testing (HIVST), and willingness to distribute HIV self-tests to others were assessed. MSM reported HIVST to be complementary to facility-based testing, and liked this approach because it offers privacy and convenience, does not require counseling, and could lead to linkage to care. However, they also had concerns around the accuracy of HIV self-tests, their cost, and receiving a positive test result without immediate access to follow-up services. Despite these issues, they perceived HIVST as a positive addition to their HIV prevention toolbox. |
Structural interventions in HIV prevention: A taxonomy and descriptive systematic review
Sipe TA , Barham TL , Johnson WD , Joseph HA , Tungol-Ashmon ML , O'Leary A . AIDS Behav 2017 21 (12) 3366-3430 One of the four national HIV prevention goals is to incorporate combinations of effective, evidence-based approaches to prevent HIV infection. In fields of public health, techniques that alter environment and affect choice options are effective. Structural approaches may be effective in preventing HIV infection. Existing frameworks for structural interventions were lacking in breadth and/or depth. We conducted a systematic review and searched CDC's HIV/AIDS Prevention Research Synthesis Project's database for relevant interventions during 1988-2013. We used an iterative process to develop the taxonomy. We identified 213 structural interventions: Access (65%), Policy/Procedure (32%), Mass Media (29%), Physical Structure (27%), Capacity Building (24%), Community Mobilization (9%), and Social Determinants of Health (8%). Forty percent targeted high-risk populations (e.g., people who inject drugs [12%]). This paper describes a comprehensive, well-defined taxonomy of structural interventions with 7 categories and 20 subcategories. The taxonomy accommodated all interventions identified. |
Positive Transitions (POST): evaluation of an HIV prevention intervention for HIV-positive persons releasing from correctional facilities
MacGowan RJ , Lifshay J , Mizuno Y , Johnson WD , McCormick L , Zack B . AIDS Behav 2014 19 (6) 1061-9 People with HIV who are released from custody frequently do not maintain the viral suppression and other health benefits achieved while incarcerated. This study was conducted to provide preliminary evidence of efficacy of an intervention to reduce HIV risk behaviors and increase use of HIV medical services following release from custody. People with HIV were recruited from San Francisco County jails, San Quentin State Prison and the California Medical Facility (Vacaville, CA), and randomly assigned to the "standard of care" or POST intervention. POST consisted of 4 sessions pre-release and 2 sessions post-release, focusing on HIV prevention and access to care. Behavioral data were obtained for the 3 months before incarceration and 3 months after release. Although POST participants reported a statistically significant increase in receiving health care at HIV clinics (62.5-84.4 %), there were no significant differences between the POST and control participants with respect to any primary outcomes. |
Comparison of strategies to increase HIV testing among African-American gay, bisexual, and other men who have sex with men in Washington, DC
Baytop C , Royal S , Hubbard McCree D , Simmons R , Tregerman R , Robinson C , Johnson WD , McLaughlin M , Price C . AIDS Care 2014 26 (5) 608-12 This paper presents results from a study conducted to compare the relative effectiveness of three strategies - alternate venue testing (AVT), the social network strategy (SNS), and partner counseling and referral services (PCRS; standard care) - for reaching and motivating previously undiagnosed, African-American men who have sex with men (AA MSM) to be tested for HIV. Data were collected between June 2008 and February 2010 at a gay-identified, community-based organization (CBO) serving AA MSM in Washington, DC. Men were eligible to participate if they were 18-64 years old, self-identified as black or African-American, were biologically male, and self-reported oral or anal sex with a man in the past six months. Fisher's exact test of independence was used to assess differences in demographics, testing history, HIV status and sexual behaviors across the three strategies. The final sample included 470 men who met all eligibility requirements. There were no statistically significant differences in HIV positivity rates across the three strategies. However, relative to standard care, the SNS, and (to a lesser degree) the AVT strategies were more successful in recruiting men that had never been tested. Additionally, the results indicate that each strategy recruited different subgroups of men. Specifically, heterosexually identified men and men who reported engaging in unprotected sex were most likely to be recruited via SNS. Bisexually identified men and older men were most likely to be recruited via AVT or SNS, while standard care tended to reach greater proportions of young men and homosexually identified men. These findings suggest that a combination of strategies may be the best approach for engaging African-American MSM in HIV testing. |
Sisters Empowered, Sisters Aware: three strategies to recruit African American women for HIV testing
Gaiter JL , Johnson WD , Taylor E , Thadiparthi S , Duncan-Alexander T , Lemon C , Turner A , Hickman D , Brown D , Aponte E , Kimbrough L , Prather C . AIDS Educ Prev 2013 25 (3) 190-202 African American women account for 66% of new HIV infections among U.S. women, and many are not aware of their status. The authors compared three strategies (targeted outreach, alternate venues, and social networks) to recruit African American women for HIV testing in Houston, New York City, Baltimore, and Dayton. A quasi-experimental design (N = 4,942) was used to compare HIV-positivity rates and to identify risk factors for previously undiagnosed infection. A total of 2.1% of the women were newly diagnosed with HIV. The proportion newly identified as HIV-positive did not differ significantly among the three strategies (2.4% for social networks, 1.7% for both targeted outreach and alternate venues). However, the social networks strategy recruited women with greater risk behaviors and other characteristics associated with newly identified HIV infection and thus may be effective at reaching some high-risk women before they become infected. A combination of recruitment strategies may be warranted to reach various subgroups of African American women at risk for HIV. |
An online randomized controlled trial evaluating HIV prevention digital media interventions for men who have sex with men
Hirshfield S , Chiasson MA , Joseph H , Scheinmann R , Johnson WD , Remien RH , Shaw FS , Emmons R , Yu G , Margolis AD . PLoS One 2012 7 (10) e46252 BACKGROUND: As HIV infection continues unabated, there is a need for effective interventions targeting at-risk men who have sex with men (MSM). Engaging MSM online where they meet sexual partners is critical for HIV prevention efforts. METHODS: A randomized controlled trial (RCT) conducted online among U.S. MSM recruited from several gay sexual networking websites assessed the impact of 2 HIV prevention videos and an HIV prevention webpage compared to a control condition for the study outcomes HIV testing, serostatus disclosure, and unprotected anal intercourse (UAI) at 60-day follow-up. Video conditions were pooled due to reduced power from low retention (53%, n = 1,631). No participant incentives were provided. PRINCIPAL FINDINGS: Follow-up was completed by 1,631 (53%) of 3,092 eligible men. In the 60 days after the intervention, men in the pooled video condition were significantly more likely than men in the control to report full serostatus disclosure ('asked and told') with their last sexual partner (OR 1.32, 95% CI 1.01-1.74). Comparing baseline to follow-up, HIV-negative men in the pooled video (OR 0.70, 95% CI 0.54-0.91) and webpage condition (OR 0.43, 95% CI 0.25-0.72) significantly reduced UAI at follow-up. HIV-positive men in the pooled video condition significantly reduced UAI (OR 0.38, 95% CI 0.20-0.67) and serodiscordant UAI (OR 0.53, 95% CI 0.28-0.96) at follow-up. CONCLUSIONS/SIGNIFICANCE: Findings from this online RCT of MSM recruited from sexual networking websites suggest that a low cost, brief digital media intervention designed to engage critical thinking can increase HIV disclosure to sexual partners and decrease sexual risk. Effective, brief HIV prevention interventions featuring digital media that are made widely available may serve as a complementary part of an overall behavioral and biomedical strategy for reducing sexual risk by addressing the specific needs and circumstances of the target population, and by changing individual knowledge, motivations, and community norms. TRIAL REGISTRATION: ClinicalTrials.gov NCT00649701. |
Efficacy of an HIV/STI prevention intervention for black men who have sex with men: findings from the Many Men, Many Voices (3MV) project
Wilton L , Herbst JH , Coury-Doniger P , Painter TM , English G , Alvarez ME , Scahill M , Roberson MA , Lucas B , Johnson WD , Carey JW . AIDS Behav 2009 13 (3) 532-44 Black men who have sex with men (MSM) in the United States experience disproportionately high rates of HIV and other sexually transmitted infections (STIs); however, the number of evidence-based interventions for Black MSM is limited. This study evaluated the efficacy of Many Men, Many Voices (3MV), a small-group HIV/STI prevention intervention developed by Black MSM-serving community-based organizations and a university-based HIV/STI prevention and training program. The study sample included 338 Black MSM of HIV-negative or unknown HIV serostatus residing in New York city. Participants were randomly assigned to the 3MV intervention condition (n = 164) or wait-list comparison condition (n = 174). Relative to comparison participants, 3MV participants reported significantly greater reductions in any unprotected anal intercourse with casual male partners; a trend for consistent condom use during receptive anal intercourse with casual male partners; and significantly greater reductions in the number of male sex partners and greater increases in HIV testing. This study is the first randomized trial to demonstrate the efficacy of an HIV/STI prevention intervention for Black MSM. |
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