Last data update: May 06, 2024. (Total: 46732 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Mackellar DA[original query] |
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Enrollment in HIV care two years after HIV diagnosis in the kingdom of Swaziland: An evaluation of a national program of new linkage procedures
MacKellar DA , Williams D , Storer N , Okello V , Azih C , Drummond J , Nuwagaba-Biribonwoha H , Preko P , Morgan RL , Dlamini M , Byrd J , Agolory S , Baughman AL , McNairy ML , Sahabo R , Ehrenkranz P . PLoS One 2016 11 (2) e0150086 To improve early enrollment in HIV care, the Swaziland Ministry of Health implemented new linkage procedures for persons HIV diagnosed during the Soka Uncobe male circumcision campaign (SOKA, 2011-2012) and the Swaziland HIV Incidence Measurement Survey (SHIMS, 2011). Abstraction of clinical records and telephone interviews of a retrospective cohort of HIV-diagnosed SOKA and SHIMS clients were conducted in 2013-2014 to evaluate compliance with new linkage procedures and enrollment in HIV care at 92 facilities throughout Swaziland. Of 1,105 clients evaluated, within 3, 12, and 24 months of diagnosis, an estimated 14.0%, 24.3%, and 37.0% enrolled in HIV care, respectively, after adjusting for lost to follow-up and non-response. Kaplan-Meier functions indicated lower enrollment probability among clients 14-24 (P = 0.0001) and 25-29 (P = 0.001) years of age compared with clients >35 years of age. At 69 facilities to which clients were referred for HIV care, compliance with new linkage procedures was low: referral forms were located for less than half (46.8%) of the clients, and few (9.6%) were recorded in the appointment register or called either before (0.3%) or after (4.9%) their appointment. Of over one thousand clients newly HIV diagnosed in Swaziland in 2011 and 2012, few received linkage services in accordance with national procedures and most had not enrolled in HIV care two years after their diagnosis. Our findings are a call to action to improve linkage services and early enrollment in HIV care in Swaziland. |
Seroprevalence and correlates of hepatitis A among HIV-negative American men who have sex with men
Bialek SR , Barry V , Bell BP , Valleroy LA , Behel S , Mackellar DA , Secura G , Thiede H , McFarland W , Ford WL , Bingham TA , Shehan DA , Celentano DD . Sex Health 2011 8 (3) 343-8 BACKGROUND: Hepatitis A outbreaks are well documented among men who have sex with men (MSM). This analysis examines characteristics associated with hepatitis A virus (HAV) infection among a large group of young adult MSM from five USA cities. METHODS: The Young Men's Survey was a cross-sectional prevalence study of HIV infection and related behavioural risk factors among MSM aged 15-29 years during 1994-2000. Serum specimens from HIV-negative participants were retrospectively tested for antibodies to HAV (anti-HAV). Data were stratified by ethnicity and analysed with logistic regression. RESULTS: Overall anti-HAV prevalence was 18.4% among the 2708 participants, and varied by ethnicity from 6.9 to 45.3% and was highest among Hispanic and Asian men (P < 0.001). Prevalence increased with age across all racial/ethnic groups. Among white men, anti-HAV positivity was associated with having 20 or more lifetime male sex partners for those aged 15-22 years (adjusted odds ratio (AOR)=2.1, 95% confidence interval (CI)=1.0-4.1) and ever having had unprotected anal sex for those aged 23-29 years (AOR=2.4, 95% CI=1.2-4.5). CONCLUSIONS: Factors associated with a history of HAV infection among MSM in non-outbreak settings are probably similar to those among non-MSM. MSM are still at risk for HAV infection as a result of outbreaks occurring in MSM communities. Additional studies of hepatitis A vaccination coverage are needed to determine if strategies to vaccinate MSM are adequate. |
HIV/AIDS complacency and HIV infection among young men who have sex with men, and the race-specific influence of underlying HAART beliefs
Mackellar DA , Hou SI , Whalen CC , Samuelsen K , Valleroy LA , Secura GM , Behel S , Bingham T , Celentano DD , Koblin BA , Lalota M , Shehan D , Thiede H , Torian LV . Sex Transm Dis 2011 38 (8) 755-63 BACKGROUND: Among men who have sex with men (MSM) in the United States, the influence of HIV/AIDS complacency and beliefs about the efficacy of highly active antiretroviral therapy (HAART) on HIV-infection risk is unknown. METHODS: We analyzed data from a 1998-2000 cross-sectional 6-city survey of 1575 MSM aged 23 to 29 years who had never tested for HIV or had last tested HIV-negative to assess these plausible influences overall and by race/ethnicity. FINDINGS: Measured as strong endorsement for reduced HIV/AIDS concern due to HAART, HIV/AIDS complacency was associated with reporting ≥10 male sex partners (odds ratio [OR], 2.94; 95% confidence interval [CI], 2.12-4.07), unprotected anal intercourse with an HIV-positive or HIV-unknown-status male partner (OR, 2.06; 95% CI, 1.51-2.81), and testing HIV-positive (adjusted OR [AOR], 2.35; 95% CI, 1.38-3.98). Strong endorsement of the belief that HAART mitigates HIV/AIDS severity was more prevalent among black (21.8%) and Hispanic (21.3%) than white (9.6%) MSM (P < 0.001), and was more strongly associated with testing HIV-positive among black (AOR, 4.65; 95% CI, 1.97-10.99) and Hispanic (AOR, 4.12; 95% CI, 1.58-10.70) than white (AOR, 1.62; 95% CI, 0.64-4.11) MSM. CONCLUSIONS: Young MSM who are complacent about HIV/AIDS because of HAART may be more likely to engage in risk behavior and acquire HIV. Programs that target HIV/AIDS complacency as a means to reduce HIV incidence among young MSM should consider that both the prevalence of strong HAART-efficacy beliefs and the effects of these beliefs on HIV-infection risk might differ considerably by race/ethnicity. |
Reasons for not HIV testing, testing intentions, and potential use of an over-the-counter rapid HIV test in an internet sample of men who have sex with men who have never tested for HIV
Mackellar DA , Hou SI , Whalen CC , Samuelsen K , Sanchez T , Smith A , Denson D , Lansky A , Sullivan P . Sex Transm Dis 2010 38 (5) 419-28 BACKGROUND: Correlates of main reasons for not HIV testing, HIV testing intentions, and potential use of an over-the-counter rapid HIV test (OTCRT) among men who have sex with men who have never tested for HIV (NTMSM) are unknown. METHODS: We evaluated these correlates among 946 NTMSM from 6 US cities who participated in an internet-based survey in 2007. FINDINGS: Main reasons for not testing were low perceived risk (32.2%), structural barriers (25.1%), and fear of testing positive (18.1%). Low perceived risk was associated with having fewer unprotected anal intercourse (UAI) partners and less frequent use of the internet for HIV information; structural barriers were associated with younger age and more UAI partners; fear of testing positive was associated with black and Hispanic race/ethnicity, more UAI partners, and more frequent use of the internet for HIV information. Strong testing intentions were held by 25.9% of all NTMSM and 14.8% of those who did not test because of low perceived risk. Among NTMSM who were somewhat unlikely, somewhat likely, and very likely to test for HIV, 47.4%, 76.5%, and 85.6% would likely use an OTCRT if it was available, respectively. CONCLUSIONS: Among NTMSM who use the internet, main reasons for not testing for HIV vary considerably by age, race/ethnicity, UAI, and use of the internet for HIV information. To facilitate HIV testing of NTMSM, programs should expand interventions and services tailored to address this variation. If approved, OTCRT might be used by many NTMSM who might not otherwise test for HIV. |
A plausible causal model of HAART-efficacy beliefs, HIV/AIDS complacency, and HIV-acquisition risk behavior among young men who have sex with men
Mackellar DA , Hou SI , Whalen CC , Samuelsen K , Valleroy LA , Secura GM , Behel S , Bingham T , Celentano DD , Koblin BA , Lalota M , Shehan D , Thiede H , Torian LV . AIDS Behav 2010 15 (4) 788-804 Despite considerable research, the causal relationship remains unclear between HIV/AIDS complacency, measured as reduced HIV/AIDS concern because of highly active antiretroviral therapy (HAART), and HIV risk behavior. Understanding the directionality and underpinnings of this relationship is critical for programs that target HIV/AIDS complacency as a means to reduce HIV incidence among men who have sex with men (MSM). This report uses structural equation modeling to evaluate a theory-based, HIV/AIDS complacency model on 1,593 MSM who participated in a venue-based, cross-sectional survey in six U.S. cities, 1998-2000. Demonstrating adequate fit and stability across geographic samples, the model explained 15.0% of the variance in HIV-acquisition behavior among young MSM. Analyses that evaluated alternative models and models stratified by perceived risk for HIV infection suggest that HIV/AIDS complacency increases acquisition behavior by mediating the effects of two underlying HAART-efficacy beliefs. New research is needed to assess model effects on current acquisition risk behavior, and thus help inform prevention programs designed to reduce HIV/AIDS complacency and HIV incidence among young MSM. |
Prevalence of HIV infection and prior HIV testing among young men who have sex with men. The Baltimore young men's survey
Sifakis F , Hylton JB , Flynn C , Solomon L , MacKellar DA , Valleroy LA , Celentano DD . AIDS Behav 2010 14 (4) 904-12 Data are presented from the Baltimore Young Men's Survey, a cross-sectional, venue-based sample survey of risks associated with HIV and report of a prior HIV test, conducted between 1996 and 2000, and enrolling 843 young men who have sex with men (MSM) aged 15-29 years. HIV prevalence was 12.1% overall and racial disparities in HIV prevalence were pronounced (range, 2.9% among non-Hispanic whites to 27.1% among non-Hispanic blacks). Risks independently associated with being HIV-positive were: being between 26 and 29 years of age, being non-Hispanic black or of other/mixed race, having had 20 or more lifetime male sex partners, having been diagnosed with a sexually transmitted disease (STD), and not being currently enrolled in school. The majority of participants (78.9%) reported a prior HIV test. In multivariate analysis, being older, having had five or more lifetime male sex partners, having had anal intercourse with males, reporting an STD diagnosis, and reporting recent unprotected anal sex were associated with report of a prior HIV test. Prevention efforts must address high HIV prevalence among young non-Hispanic black MSM and must make testing and effective counseling for young MSM readily available. |
Evaluation of oral fluid enzyme immunoassay for confirmation of a positive rapid human immunodeficiency virus test result
Wesolowski LG , Sanchez T , MacKellar DA , Branson BM , Ethridge SF , Constantine N , Ketema F , Sullivan PS . Clin Vaccine Immunol 2009 16 (7) 1091-2 The CDC recommends that a reactive rapid human immunodeficiency virus (HIV) test be confirmed with an approved supplemental test; the performance of an intermediate enzyme immunoassay (EIA) is optional. In support of this recommendation, it was found that of 1,431 reactive rapid HIV test results, 2 (0.1%) had false-negative oral fluid Western blot results and both had false-negative EIA results. |
Rapid human immunodeficiency virus (HIV) test quality assurance practices and outcomes among testing sites affiliated with 17 public health departments
Wesolowski LG , Ethridge SF , Martin EG , Cadoff EM , Mackellar DA . J Clin Microbiol 2009 47 (10) 3333-5 Rapid HIV testing is often conducted in non-clinical settings by staff with limited training, so quality assurance (QA) monitoring is critical to ensure accuracy of test results. Rapid tests (n=86,749) were generally conducted according to manufacturer instructions, but ongoing testing competency assessments and on-site QA monitoring were not uniformly conducted. |
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