Last data update: Nov 04, 2024. (Total: 48056 publications since 2009)
Records 1-4 (of 4 Records) |
Query Trace: Philpott DC[original query] |
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Barriers and facilitators to HIV service access among Hispanic/Latino gay, bisexual, and other men who have sex with men in metropolitan Atlanta-a qualitative analysis
Hassan R , Saldana CS , Garlow EW , Gutierrez M , Hershow RB , Elimam D , Adame JF , Andía JF , Padilla M , Gonzalez Jimenez N , Freeman D , Johnson EN , Reed K , Holland DP , Orozco H , Pedraza G , Hayes C , Philpott DC , Curran KG , Wortley P , Agnew-Brune C , Gettings JR . J Urban Health 2023 100 (6) 1193-1201 Hispanic/Latino persons are disproportionately impacted by HIV in the US, and HIV diagnoses among Hispanic/Latino men in Georgia have increased over the past decade, particularly in metropolitan Atlanta. In 2022, the Georgia Department of Public Health detected five clusters of rapid HIV transmission centered among Hispanic/Latino gay, bisexual, and other men who have sex with men (HLMSM) in metropolitan Atlanta. We conducted in-depth interviews with 65 service providers and 29 HLMSM to identify barriers and facilitators to HIV service access for HLMSM. Interviews were audio recorded, transcribed, and translated, if needed. Initial data analyses were conducted rapidly in the field to inform public health actions. We then conducted additional analyses including line-by-line coding of the interview transcripts using a thematic analytic approach. We identified four main themes. First, inequity in language access was a predominant barrier. Second, multiple social and structural barriers existed. Third, HLMSM encountered intersectional stigma. Finally, the HLMSM community is characterized by its diversity, and there is not a one-size-fits-all approach to providing appropriate care to this population. The collection of qualitative data during an HIV cluster investigation allowed us to quickly identity barriers experienced by HLMSM when accessing HIV and other medical care, to optimize public health response and action. Well-designed program evaluation and implementation research may help elucidate specific strategies and tools to reduce health disparities, ensure equitable service access for HLMSM, and reduce HIV transmission in this population. |
Low CD4 count or being out of care increases the risk for Mpox hospitalization among people with HIV and Mpox
Philpott DC , Bonacci RA , Weidle PJ , Curran KG , Brooks JT , Khalil G , Feldpausch A , Pavlick J , Wortley P , O'Shea JG . Clin Infect Dis 2023 HIV-associated immunosuppression may increase risk of hospitalization with mpox. Among persons diagnosed with mpox in the state of Georgia, we characterized the association between hospitalization with mpox and HIV status. People with HIV and CD4 < 350 cells/mm3 or who were not engaged in HIV care had increased risk of hospitalization. |
Public Health Response to Clusters of Rapid HIV Transmission Among Hispanic or Latino Gay, Bisexual, and Other Men Who Have Sex with Men - Metropolitan Atlanta, Georgia, 2021-2022.
Saldana C , Philpott DC , Mauck DE , Hershow RB , Garlow E , Gettings J , Freeman D , France AM , Johnson EN , Ajmal A , Elimam D , Reed K , Sulka A , Adame JF , Andía JF , Gutierrez M , Padilla M , Jimenez NG , Hayes C , McClung RP , Cantos VD , Holland DP , Scott JY , Oster AM , Curran KG , Hassan R , Wortley P . MMWR Morb Mortal Wkly Rep 2023 72 (10) 261-264 During February 2021-June 2022, the Georgia Department of Public Health (GDPH) detected five clusters of rapid HIV transmission concentrated among Hispanic or Latino (Hispanic) gay, bisexual, and other men who have sex with men (MSM) in metropolitan Atlanta. The clusters were detected through routine analysis of HIV-1 nucleotide sequence data obtained through public health surveillance (1,2). Beginning in spring 2021, GDPH partnered with health districts with jurisdiction in four metropolitan Atlanta counties (Cobb, DeKalb, Fulton, and Gwinnett) and CDC to investigate factors contributing to HIV spread, epidemiologic characteristics, and transmission patterns. Activities included review of surveillance and partner services interview data,(†) medical chart reviews, and qualitative interviews with service providers and Hispanic MSM community members. By June 2022, these clusters included 75 persons, including 56% who identified as Hispanic, 96% who reported male sex at birth, 81% who reported male-to-male sexual contact, and 84% of whom resided in the four metropolitan Atlanta counties. Qualitative interviews identified barriers to accessing HIV prevention and care services, including language barriers, immigration- and deportation-related concerns, and cultural norms regarding sexuality-related stigma. GDPH and the health districts expanded coordination, initiated culturally concordant HIV prevention marketing and educational activities, developed partnerships with organizations serving Hispanic communities to enhance outreach and services, and obtained funding for a bilingual patient navigation program with academic partners to provide staff members to help persons overcome barriers and understand the health care system. HIV molecular cluster detection can identify rapid HIV transmission among sexual networks involving ethnic and sexual minority groups, draw attention to the needs of affected populations, and advance health equity through tailored responses that address those needs. |
Use of mid-upper arm circumference to screen for thinness among sub-Saharan African male detainees
Philpott DC , Belchior-Bellino V , Ververs M . Public Health Nutr 2021 24 (15) 1-24 OBJECTIVE: Body mass index (BMI) is a time-intensive measurement to assess nutritional status. Mid-upper arm circumference (MUAC) has been studied as a proxy for BMI in adults, but there is no consensus on its optimal use. DESIGN: We calculated sensitivity, specificity, and area under receiver operating characteristic curve (AUROCC) of MUAC for BMI <18.5, <17, and <16 kg/m2. We designed a system using two MUAC cutoffs, with a healthy (non-thin) "green" group, a "yellow" group requiring BMI measurement, and a "red" group who could proceed directly to treatment for thinness. SETTING: We retrospectively analyzed monitoring data collected by the International Committee of the Red Cross in places of detention. PARTICIPANTS: 11,917 male detainees in eight African countries. RESULTS: MUAC had excellent discriminatory ability with AUROCC: 0.87, 0.90, and 0.92 for BMI<18.5, BMI<17, and BMI<16 kg/m2, respectively. An upper cutoff of MUAC 25.5 cm to exclude healthy detainees would result in 64% fewer detainees requiring BMI screening and had sensitivity 77% (95%CI 69.4,84.7) and specificity 79.6 (95%CI: 72.6,86.5) for BMI<18.5 kg/m2. A lower cutoff of MUAC<21.0 cm had sensitivity 25.4% (95%CI: 11.7,39.1) and specificity 99.0% (97.9,100.0) for BMI<16 kg/m2. An additional 50kg weight requirement improved specificity to 99.6% (95%CI: 99.0,100.0%) with similar sensitivity. CONCLUSIONS: A MUAC cutoff of 25.5 cm, above which detainees are classified as healthy and below receive further screening would result in significant time savings. A cutoff of <21.0 cm and weight <50 kg can identify some detainees with BMI <16 kg/m2 who require immediate treatment. |
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