Last data update: May 13, 2024. (Total: 46773 publications since 2009)
Records 1-30 (of 32 Records) |
Query Trace: Valentine J[original query] |
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Critical elements of community engagement to address disparities and related social determinants of health: The CDC Community Approaches to Reducing STDs (CARS) initiative
Rhodes SD , Daniel-Ulloa J , Wright SS , Mann-Jackson L , Johnson DB , Hayes NA , Valentine JA . Sex Transm Dis 2021 48 (1) 49-55 BACKGROUND: Community Approaches to Reducing Sexually Transmitted Disease (CARS), a unique initiative of the US Centers for Disease Control and Prevention, promotes the use of community engagement to increase sexually transmitted disease (STD) prevention, screening, and treatment and to address locally prioritized STD-related social determinants of health within communities experiencing STD disparities, including youth, persons of color, and sexual and gender minorities. We sought to identify elements of community engagement as applied within CARS. METHODS AND MATERIALS: Between 2011 and 2018, we collected and analyzed archival and in-depth interview data to identify and explore community engagement across 8 CARS sites. Five to 13 interview participants (mean, 7) at each site were interviewed annually. Participants included project staff and leadership, community members, and representatives from local community organizations (e.g., health departments; lesbian, gay, bisexual, transgender, and queer-serving organizations; faith organizations; businesses; and HIV-service organizations) and universities. Data were analyzed using constant comparison, an approach to grounded theory development. RESULTS: Twelve critical elements of community engagement emerged, including commitment to engagement, partner flexibility, talented and trusted leadership, participation of diverse sectors, establishment of vision and mission, open communication, reducing power differentials, working through conflict, identifying and leveraging resources, and building a shared history. CONCLUSIONS: This study expands the community engagement literature within STD prevention, screening, and treatment by elucidating some of the critical elements of the approach and provides guidance for practitioners, researchers, and their partners as they develop, implement, and evaluate strategies to reduce STD disparities. |
Weathering the storm: Syringe services program laws and human immunodeficiency virus during the COVID-19 pandemic
Jackson H , Dunphy C , Grist MB , Jiang X , Xu L , Guy GP Jr , Salvant-Valentine S . J Acquir Immune Defic Syndr 2023 94 (5) 395-402 BACKGROUND: Syringe services programs (SSPs) are community-based prevention programs that provide a range of harm reduction services to persons who inject drugs. Despite their benefits, SSP laws vary across the United States. Little is known regarding how legislation surrounding SSPs may have influenced HIV transmission over the COVID-19 pandemic, a period in which drug use increased. This study examined associations between state SSP laws and HIV transmission among the Medicaid population before and after the COVID-19 pandemic. METHODS: State-by-month counts of new HIV diagnoses among the Medicaid population were produced using administrative claims data from the Transformed Medicaid Statistical Information System from 2019 to 2020. Data on SSP laws were collected from the Prescription Drug Abuse Policy System. Associations between state SSP laws and HIV transmission before and after the start of the COVID-19 pandemic were evaluated using an event study design, controlling for the implementation of COVID-19 nonpharmaceutical interventions and state and time fixed effects. RESULTS: State laws allowing the operation of SSPs were associated with 0.54 (P = 0.044) to 1.18 (P = 0.001) fewer new monthly HIV diagnoses per 100,000 Medicaid enrollees relative to states without such laws in place during the 9 months after the start of the COVID-19 pandemic. The largest effects manifested for population subgroups disproportionately affected by HIV, such as male and non-Hispanic Black Medicaid enrollees. CONCLUSION: Less restrictive laws on SSPs may have helped mitigate HIV transmission among the Medicaid population throughout the COVID-19 pandemic. Policymakers can consider implementing less restrictive SSP laws to mitigate HIV transmission resulting from future increases in injection drug use. DISCLAIMER: The findings and conclusions in this report are those of the author(s) and do not necessarily represent the official position of the Centers for Disease Control and Prevention. |
The Transformative Role of Authentic Partnership in the Tuskegee Public Health Ethics Program
Valentine JA . J Healthc Sci Humanit 2018 8 (1) 21-29 Partnership is a much-venerated concept and is regularly applied to a broad range of human endeavors, as both a means to an end and the desired end itself. For example, to promote the public's health many programs often rely on partnerships between institutions and communities to implement interventions. Yet despite their generally positive value, partnerships are not without challenges. Unfortunately there are times when a given partnership does not advance a common good, as illustrated by the U.S Public Health Service Syphilis Study at Tuskegee, Alabama (the Syphilis Study), which lasted forty years. However, despite this tragic history, by employing the principles of authentic partnership, the relationships between the federal government, Tuskegee University, and the affected communities are experiencing transformation. By collaboratively working together these partners are able to effectively promote and support ethical public health research and practice. |
The future of pharmacist-delivered status-neutral HIV prevention and care
Weidle PJ , Brooks JT , Valentine SS , Daskalakis D . Am J Public Health 2023 113 (3) e1-e3 During 2019 in the United States, there were an estimated 1.2 million people with HIV and 34 800 new HIV infections, among which people belonging to minority ethnic and racial groups were disproportionally affected: 41% of new HIV diagnoses were among Black/African American people and 29% were among Hispanic/Latino people.1 In February 2019, the US Department of Health and Human Services launched Ending the HIV Epidemic in the US, a multiagency initiative with four key strategies (Diagnose, Treat, Prevent, and Respond), which when implemented together can end the HIV epidemic in the United States by 2030.2 Pharmacists and community pharmacies are and will continue to be an essential part of the public health and medical infrastructure needed to end the HIV epidemic. Pharmacists are positioned to facilitate linkage to mainstream health care by reaching people from racial and ethnic groups that are disproportionately affected by HIV. Durable pharmacist impact hinges on addressing policy and practice barriers to enable expanded pharmacy-based HIV services.3 We call on leaders in public health, state and local health departments, professional organizations dedicated to addressing the needs of people with HIV, and community-based organizations to increase engagement with pharmacists and pharmacy associations within their jurisdiction. This could be accomplished, in part, by including them on HIV planning boards and utilizing their skills and availability to support a status-neutral approach to HIV services. These actions will not only help end the HIV epidemic in the United States, but will also help address the syndemic of HIV, viral hepatitis, sexually transmitted infections, and substance use disorder. |
It is not just the southeast-geographically pervasive racial disparities in Neisseria gonorrhoeae between non-Hispanic Black and White US women
Rowlinson E , Stenger MR , Valentine JA , Hughes JP , Khosropour CM , Golden MR . Sex Transm Dis 2023 50 (2) 98-103 Spatial analyses of gonorrhea morbidity among women often highlight the Southeastern United States but may not provide information on geographic variation in the magnitude of racial disparities; such maps also focus on geographic space, obscuring underlying population characteristics. We created a series of visualizations depicting both county-level racial disparities in female gonorrhea diagnoses and variations in population size. We calculated county- and region-level race-specific relative rates (RelR) and between-race rate differences (RDs) and rate ratios (RRs) comparing gonorrhea case rates in non-Hispanic Black (NHB) versus non-Hispanic White (NHW) women. We then created proportional symbol maps with color representing counties' RelR/RD/RR category and symbol size representing counties' female population. Gonorrhea rates among NHB women were highest in the Midwest (718.7/100,000) and West (504.8), rates among NHW women were highest in the West (74.1) and Southeast (72.1). The RDs were highest in the Midwest (654.6 excess cases/100,000) and West (430.7), whereas the RRs were highest in the Northeast (12.4) and Midwest (11.2). Nearly all US counties had NHB female rates ≥3× those in NHW women, with NHB women in most highly populated counties experiencing ≥9-fold difference in gonorrhea rates. Racial disparities in gonorrhea were not confined to the Southeast; both relative and absolute disparities were equivalent or larger in magnitude in areas of the Northeast, Midwest, and West. Our findings help counter damaging regional stereotypes, provide evidence to refocus prevention efforts to areas of highest disparities, and suggest a useful template for monitoring racial disparities as an actionable public health metric. | eng |
Telehealth services: Implications for enhancing sexually transmitted infection prevention
Valentine JA , Mena L , Millett G . Sex Transm Dis 2022 49 S36-s40 In the United States, sexually transmitted infections (STIs) are among the most persistent threats to health equity. Increasing access to STI prevention and control services through the provision of Remote Health and Telehealth can improve sexual health outcomes. Telehealth has been shown to increase access to care and even improve health outcomes. The increased flexibility offered by Telehealth services accommodates both patient and provider. Although both Telehealth and Remote Health strategies are important for STI prevention, share common attributes, and, in some circumstances, overlap, this article will focus more specifically on considerations for Telehealth and how it can contribute to increasing health equity by offering an important complement to and, in some cases, substitute for in-person STI services for some populations. Telehealth assists a variety of different populations, including those experiencing STI disparities; however, although the Internet offers a promising resource for many American households and increasing percentages of Americans are using its many resources, not all persons have equal access to the Internet. In addition to tailoring STI programs to accommodate unique patient populations, these programs will likely be faced with adapting services to fit reimbursement and licensing regulations. |
Mapping nurse practitioners' scope of practice laws: A resource for evaluating pre-exposure prophylaxis prescriptions
Salvant Valentine S , Carnes N , Caldwell J , Gelaude D , Taylor R . Health Equity 2022 6 (1) 27-31 Context: Reducing the number of new HIV infections will require addressing barriers to HIV pre-exposure prophylaxis (PrEP) access and uptake. Nurse practitioners (NPs) may help increase PrEP access and uptake. State scope of practice laws determines NPs' ability to work independently and their authority to prescribe PrEP, a legend nonscheduled medication. Methods: This analysis applied legal epidemiology methods to analyze the laws of the 50 states and the District of Columbia that govern NPs' scope of practice as they may apply to prescribing legend nonscheduled medications. These laws were extracted from Westlaw Next between April and June 2019. Results: As of June 8, 2019, 17 states had laws that allowed NPs to both practice independently and prescribe legend nonscheduled drugs without restriction. Conclusion: The role that state scope of practice laws plays in potentially limiting NPs' ability to prescribe PrEP should be considered. Increasing PrEP access and uptake is essential in reaching national HIV prevention goals. This analysis can inform further studies and polices on barriers to PrEP access and uptake. |
Reducing homelessness among persons with HIV: An ecological case study in Delaware
Courtenay-Quirk C , Mizuno Y , Roland KB , Salvant Valentine S , Taylor RD , Zhang J . J HIV AIDS Soc Serv 2021 21 (1) 1-15 Among persons with HIV (PWH), homelessness is associated with poorer health. From 2009 to 2014, national HIV prevention goals included a reduction in homelessness among PWH. We sought to examine social ecological factors associated with homelessness among PWH at a sub-national level during that period. National data identified Delaware as the only jurisdiction where homelessness among PWH declined from 2009 to 2014. We analyzed population-level indicators and conducted telephone interviews with 6 key stakeholders to further examine this trend. Overall homelessness, household poverty, and median housing price were associated with homelessness among PWH in Delaware. Key stakeholders highlighted centralized services as program strengths, and pointed to common challenges, e.g., long wait lists, limited availability of units, and complex procedures. In addition to broader social and economic factors, coordinated program strategies may improve housing outcomes for PWH. Monitoring trends at sub-national levels can help identify successful approaches as well as ongoing challenges. © This work was authored as part of the Contributor’s official duties as an Employee of the United States Government and is therefore a work of the United States Government. In accordance with 17 USC. 105, no copyright protection is available for such works under US Law. |
Program-Level Strategies for Addressing Sexually Transmitted Disease Disparities: Overcoming Critical Determinants That Impede Sexual Health
Wright SS , Johnson DB , Bernstein KT , Valentine JA . Sex Transm Dis 2021 48 (12) e174-e177 The Centers for Disease Control and Prevention (CDC) continues to report stark increases in sexually transmitted disease (STD) rates, as many STD programs continue to strategize regarding how to address persistent STD disparities among racial and ethnic minorities.1,2 Sexually transmitted disease disparities are complex and driven by systemic issues, including social determinants such as racism, poverty, inadequate health care access, educational inequalities, and environmental threats.2,3 Many STD prevention efforts focus on individual-level risk factors and individual-level interventions; however, moving more upstream to address social determinants that shape the foundations of society and affect STD disparities is critical.4–6 It is key that STD programs address STD disparities to move the needle in reducing disparities seen among racial and ethnic minority populations who are most impacted by STDs, particularly for HIV, gonorrhea, chlamydia, and syphilis.7 |
Improving sexual health in U.S. rural communities: Reducing the impact of stigma
Valentine JA , Delgado LF , Haderxhanaj LT , Hogben M . AIDS Behav 2021 26 1-10 Sexually transmitted infections (STI), including HIV, are among the most reported diseases in the U.S. and represent some of America's most significant health disparities. The growing scarcity of health care services in rural settings limits STI prevention and treatment for rural Americans. Local health departments are the primary source for STI care in rural communities; however, these providers experience two main challenges, also known as a double disparity: (1) inadequate capacity and (2) poor health in rural populations. Moreover, in rural communities the interaction of rural status and key determinants of health increase STI disparities. These key determinants can include structural, behavioral, and interpersonal factors, one of which is stigma. Engaging the expertise and involvement of affected community members in decisions regarding the needs, barriers, and opportunities for better sexual health is an asset and offers a gateway to sustainable, successful, and non-stigmatizing STI prevention programs. |
Emergence and rapid transmission of SARS-CoV-2 B.1.1.7 in the United States.
Washington NL , Gangavarapu K , Zeller M , Bolze A , Cirulli ET , Schiabor Barrett KM , Larsen BB , Anderson C , White S , Cassens T , Jacobs S , Levan G , Nguyen J , Ramirez JM3rd , Rivera-Garcia C , Sandoval E , Wang X , Wong D , Spencer E , Robles-Sikisaka R , Kurzban E , Hughes LD , Deng X , Wang C , Servellita V , Valentine H , De Hoff P , Seaver P , Sathe S , Gietzen K , Sickler B , Antico J , Hoon K , Liu J , Harding A , Bakhtar O , Basler T , Austin B , MacCannell D , Isaksson M , Febbo PG , Becker D , Laurent M , McDonald E , Yeo GW , Knight R , Laurent LC , de Feo E , Worobey M , Chiu CY , Suchard MA , Lu JT , Lee W , Andersen KG . Cell 2021 184 (10) 2587-2594 e7 The highly transmissible B.1.1.7 variant of SARS-CoV-2, first identified in the United Kingdom, has gained a foothold across the world. Using S gene target failure (SGTF) and SARS-CoV-2 genomic sequencing, we investigated the prevalence and dynamics of this variant in the United States (US), tracking it back to its early emergence. We found that, while the fraction of B.1.1.7 varied by state, the variant increased at a logistic rate with a roughly weekly doubling rate and an increased transmission of 40%-50%. We revealed several independent introductions of B.1.1.7 into the US as early as late November 2020, with community transmission spreading it to most states within months. We show that the US is on a similar trajectory as other countries where B.1.1.7 became dominant, requiring immediate and decisive action to minimize COVID-19 morbidity and mortality. |
HIV criminalisation laws and ending the US HIV epidemic
Mermin J , Valentine SS , McCray E . Lancet HIV 2021 8 (1) e4-e6 The USA has initiated plans to reduce HIV incidence by 90% over the next 10 years through the Ending the HIV Epidemic Initiative. To succeed, the nation will need to not only overcome the scientific and programmatic barriers to testing, treatment, and prevention, but also to address the legal obstacles, racial discrimination, economic disadvantage, and homophobia that underpin many of the disparities that are prevalent in the HIV epidemic. These social barriers directly prevent access to services and indirectly impede efforts to change HIV from an exceptional, stigmatised disease to a preventable and treatable infection. One area that continues to cause concern for some people with HIV, activists, and public health officials are HIV criminalisation laws1—legislation passed with the intent of reducing HIV transmission and sanctioning individuals whose behaviour potentially exposed people to HIV. |
Contraceptive use at first sexual intercourse among adolescent and young adult women with disabilities: The role of formal sex education
Namkung EH , Valentine A , Warner L , Mitra M . Contraception 2020 103 (3) 178-184 OBJECTIVES: This study examines receipt of formal sex education as a potential mechanism that may explain the observed associations between disability status and contraceptive use among young women with disabilities. STUDY DESIGN: Using the 2011-17 National Survey of Family Growth, we analyzed data from 2,861 women aged 18 to 24 years, who experienced voluntary first sexual intercourse with a male partner. Women whose first intercourse was involuntary (7% of all women reporting sexual intercourse) were excluded from the analytic sample. Mediation analysis was used to estimate the indirect effect of receipt of formal sex education before first sexual intercourse on the association between disability status and contraceptive use at first intercourse. RESULTS: Compared to nondisabled women, women with cognitive disabilities were less likely to report receipt of instruction in each of six discrete formal sex education topics and received instruction on a fewer number of topics overall (B = -0.286, 95% CI = -0.426 to -0.147), prior to first voluntary intercourse. In turn, the greater number of topics received predicted an increased likelihood of contraceptive use at first voluntary intercourse among these women (B = 0.188, 95% CI = 0.055 to 0.321). No significant association between non-cognitive disabilities and receipt of formal sex education or contraceptive use at first intercourse was observed. CONCLUSIONS: Given the positive association between formal sex education and contraceptive use among young adult women with and without disabilities, ongoing efforts to increase access to formal sex education are needed. Special attention is needed for those women with cognitive disabilities. |
Response to Dr Robert E. Fullilove's Editorial Letter: "Race and Sexually Transmitted Diseases…Again?"
Picchetti V , Chesson H , Torrone E , Valentine J . Sex Transm Dis 2020 47 (12) e62 We appreciate Dr Fullilove continuing the work that his father started in the 1940s to bring attention to the limitations of using reported race and Hispanic ethnicity to identify the risk for sexually transmitted diseases (STDs).1 We agree that race and Hispanic ethnicity are social attributes of groups of people, not biological attributes of individuals in those social groups; therefore, the observed disparities in gonorrhea case rates by race and Hispanic ethnicity are unlikely to be caused by biological differences linked to race or Hispanic ethnicity. Those disparities are associated with a range of other social factors, including differential access to quality sexual health care and prevalence of disease in sexual networks. Measuring disparities in STDs can help direct limited prevention resources toward populations at greatest need. However, when reporting disparities in STDs, it is important to ensure that the underlying drivers of observed disparities are identified to avoid stigmatizing the affected groups and to inform the design and implementation of effective interventions to reduce or eliminate disparities. | | We also agree with Dr Fullilove that our investigation of race and Hispanic ethnicity classification strategies will not, in and of itself, reduce disparities; however, our work draws attention to some of the challenges in monitoring trends in observed disparities in rates of reported gonorrhea.2 Because Hispanics may be of any race, our goal was to determine whether important disparities in the rates of reported gonorrhea were being masked when using the current classification of all Hispanics into a single Hispanic ethnicity category. We found that the categorization strategy had a minimal impact on trends in disparities over time; however, the magnitude of the disparity each year was affected by the classification approach. In addition, we found that race and Hispanic ethnicity were missing for approximately 1 in 5 gonorrhea cases. If these data are not missing at random, estimates of disparities will be biased. Metrics used to evaluate interventions to reduce STDs in populations most affected will need to consider these limitations. |
Effect of CDC 2006 Revised HIV Testing Recommendations for Adults, Adolescents, Pregnant Women, and Newborns on state laws, 2018
Salvant Valentine S , Caldwell J , Tailor A . Public Health Rep 2020 135 189s-196s In 2006, the Centers for Disease Control and Prevention updated its recommendations for HIV testing of 4 population groups in health care settings: adults, adolescents, pregnant women, and newborns. Important components of the revised recommendations included opt-out routine HIV screening; eliminating prevention counseling for opt-out routine HIV screening; repeat HIV testing in the third trimester for all women at high risk for acquiring HIV and for women receiving health care in facilities and/or jurisdictions with high HIV burden; testing during labor and delivery for women with undocumented HIV status; and testing the newborn when the mother's HIV status is unknown. To assess the integration of these testing recommendations into state laws and to inform future recommendations, we researched and assessed statutes and regulations that addressed HIV testing in the 4 population groups in all 50 states and the District of Columbia in 2018. We then classified the laws, based on their consistency with the recommendations for each of the 4 population groups. Of 31 states and the District of Columbia that had relevant laws, all addressed at least 1 component of the recommendations. Although no state had laws that incorporated all the recommendations for all the population groups, 5 states (Delaware, Illinois, Louisiana, Maryland, and New Hampshire) had incorporated all the recommendations for adults and adolescents, and 4 states (Connecticut, Nevada, North Carolina, and West Virginia) had incorporated all the recommendations for pregnant women and newborns. |
Performance evaluation of the Aptima HIV-1 RNA Quant assay on the Panther system using the standard and dilution protocols
Rossetti R , Smith T , Luo W , Taussig J , Valentine-Graves M , Sullivan P , Ingersoll JM , Kraft CS , Ethridge S , Wesolowski L , Delaney KP , Owen SM , Johnson JA , Masciotra S . J Clin Virol 2020 129 104479 BACKGROUND: Currently, FDA-approved HIV-1 viral load (VL) assays use venipuncture-derived plasma. The Hologic Panther system uses 0.7mL total volume for the Aptima HIV-1 Quant Assay standard (APT-Quant-std) and dilution (APT-Quant-dil) protocols. However, smaller plasma volumes from fingerstick whole blood (FSB) collected in EDTA-microtainer tubes (MCT) could provide an easier sample collection method for HIV-1 VL testing. OBJECTIVES: To evaluate the performance of the APT-Quant-std compared to the Roche CAP/CTM and Abbott m2000RT VL assays and an alternative APTQuant 1:7 dilution protocol, the latter using 100muL of MCT-derived plasma from FSB. STUDY DESIGN: Linearity was determined using commercial HIV-1 RNA plasma controls. Dilutions ranging 1.56-2.95 log10 copies/mL were prepared to determine the APT-Quant-dil Limit of Quantitation (LOQ) using Probit analysis. Specificity of APT-Quant-std was calculated using 326 HIVnegative samples. To evaluate agreement, 329 plasma specimens were tested with APT-Quant-std, CAP/CTM, and m2000RT. Forty-seven matched venipuncture and MCT-derived plasma specimens were tested with APT-Quant-std and APT-Quant-dil. RESULTS: Among the RNA controls, specificity was 99.69 % for APT-Quant-std. The R2 values were 0.988 (APT-Quant-std/CAP/CTM), 0.980 (APT-Quant-std/ m2000RT), and 0.997 (APT-Quant-std/APT-Quant-dil). The APT-Quant-dil LOQ was estimated at 2.7 log10 copies/mL (500 copies/mL) (95 %CI 2.62-2.87). At 2.3 log10 copies/mL (200 copies/mL), the overall agreement was 91.0 % for APT-Quant-std/CAP/CTM, 85.7 % for APT-Quant-std/m2000RT, and 82.9 % for APT-Quant-std/APT-Quant-dil. Quantified APT-Quant-std results were on average 0.2 log10 copies/mL higher than CAP/CTM and m2000RT and 0.14 log10 copies/mL higher than APT-Quant-dil. CONCLUSION: APT-Quant showed similar performance compared to the CAP/CTM and m2000RT assays and remains sensitive and accurate using the dilution protocol. |
Preexposure prophylaxis for prevention of HIV acquisition among adolescents: Clinical considerations, 2020
Tanner MR , Miele P , Carter W , Valentine SS , Dunville R , Kapogiannis BG , Smith DK . MMWR Recomm Rep 2020 69 (3) 1-12 Preexposure prophylaxis (PrEP) with antiretroviral medication has been proven effective in reducing the risk for acquiring human immunodeficiency virus (HIV). The fixed-dose combination tablet of tenofovir disoproxil fumarate (TDF)/emtricitabine (FTC) was approved by the U.S. Food and Drug Administration (FDA) for use as PrEP for adults in 2012. Since then, recognition has been increasing that adolescents at risk for acquiring HIV can benefit from PrEP. In 2018, FDA approved revised labeling for TDF/FTC that expanded the indication for PrEP to include adolescents weighing at least 77 lb (35 kg) who are at risk for acquiring HIV. In 2019, FDA approved the combination product tenofovir alafenamide (TAF)/FTC as PrEP for adolescents and adults weighing at least 77 lb (35 kg), excluding those at risk for acquiring HIV through receptive vaginal sex. This exclusion is due to the lack of clinical data regarding the efficacy of TAF/FTC in cisgender women.Clinical providers who evaluate adolescents for PrEP use must consider certain topics that are unique to the adolescent population. Important considerations related to adolescents include PrEP safety data, legal issues about consent for clinical care and confidentiality, the therapeutic partnership with adolescents and their parents or guardians, the approach to the adolescent patient's clinical visit, and medication initiation, adherence, and persistence during adolescence. Overall, data support the safety of PrEP for adolescents. PrEP providers should be familiar with the statutes and regulations about the provision of health care to minors in their states. Providers should partner with the adolescent patient for PrEP decisions, recognizing the adolescent's autonomy to the extent allowable by law and including parents in the conversation about PrEP when it is safe and reasonable to do so. A comprehensive approach to adolescent health is recommended, including considering PrEP as one possible component of providing medical care to adolescents who inject drugs or engage in sexual behaviors that place them at risk for acquiring HIV. PrEP adherence declined over time in the studies evaluating PrEP among adolescents, a trend that also has been observed among adult patients. Clinicians should implement strategies to address medication adherence as a routine part of prescribing PrEP; more frequent clinical follow-up is one possible approach.PrEP is an effective HIV prevention tool for protecting adolescents at risk for HIV acquisition. For providers, unique considerations that are part of providing PrEP to adolescents include the possible need for more frequent, supportive interactions to promote medication adherence. Recommendations for PrEP medical management and additional resources for providers are available in the U.S. Public Health Service clinical practice guideline Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2017 Update and the clinical providers' supplement Preexposure Prophylaxis for the Prevention of HIV Infection in the United States - 2017 Update: Clinical Providers' Supplement (https://www.cdc.gov/hiv/clinicians/prevention/prep.html). |
Suspected locally acquired coccidioidomycosis in human, Spokane, Washington, USA
Oltean HN , Springer M , Bowers JR , Barnes R , Reid G , Valentine M , Engelthaler DM , Toda M , McCotter OZ . Emerg Infect Dis 2020 26 (3) 606-609 The full geographic range of coccidioidomycosis is unknown, although it is most likely expanding with environmental change. We report an apparently autochthonous coccidioidomycosis patient from Spokane, Washington, USA, a location to which Coccidioides spp. are not known to be endemic. |
Molecular epidemiology of noroviruses in children under 5 years of age with acute gastroenteritis in Yaoundé, Cameroon.
Mugyia AE , Ndze VN , Akoachere JTK , Browne H , Boula A , Ndombo PK , Cannon JL , Vinje J , Ndip LM . J Med Virol 2018 91 (5) 738-743 Norovirus is a common cause of acute gastroenteritis (AGE) among children in developing countries. Limited data on the prevalence and genetic variability of norovirus are available in Cameroon, where early childhood mortality due to AGE is common. We tested 902 fecal specimens from children younger than 5 years of age hospitalized with AGE between January 2010 and December 2013. Overall, 76 (8.4%) samples tested positive for norovirus, of which 83% (63/76) were among children < 12 months old. Most of the noroviruses detected were in children infected between July and December of each year. All norovirus-positive specimens were genotyped, with 80% (61/76) being GII.4 (three variants detected). Genotypes GI.2, GI.6, GII.1, GII.2, GII.3, GII.6, GII.16, GII.17, and GII.21 genotypes were also detected. Interestingly, GII.4 Sydney and GII.17 Kawasaki viruses were found as early as 2010, years before their emergence globally. This study suggests norovirus is a significant cause of moderate to severe gastroenteritis among young children in Cameroon. Results are important to highlight appropriate prevention and control strategies for reducing the burden of norovirus disease. This article is protected by copyright. All rights reserved. |
Consistency of state statutes and regulations with Centers for Disease Control and Prevention's 2006 Perinatal HIV Testing Recommendations
Valentine SS , Poulin A . Public Health Rep 2018 133 (5) 601-605 Thanks to assiduous public health efforts, the overall annual rate of perinatal HIV transmission has decreased. In the United States, 44 infants acquired HIV perinatally in 2014, down from 71 in 2012.1 Mother-to-child (perinatal) HIV transmission is preventable2: the risk of perinatal HIV transmission can be reduced to <2% if a woman receives antiretroviral therapy (ART) during pregnancy and avoids breastfeeding and if the infant receives prophylaxis soon after birth.3 If a mother has HIV diagnosed during labor, treatment as late as the intrapartum period can reduce the rate of transmission from 25.5% to 10.0%. However, beginning prophylaxis 3 or more days after birth does not substantially reduce the risk of contracting HIV.4 Thus, identifying HIV infection early, through HIV testing of pregnant women and newborns, can help provide essential and timely linkage to care for mother and child.5 |
Syphilis elimination: Lessons learned again
Valentine JA , Bolan GA . Sex Transm Dis 2018 45 S80-S85 It is estimated that approximately 20 million new sexually transmitted infections (STIs) occur each year in the United States. The federally-funded STD prevention program implemented by CDC is primarily focused on the prevention and control of the three most common bacterial STIs: syphilis, gonorrhea, and chlamydia. A range of factors facilitate the transmission and acquisition of sexually transmitted infections, including syphilis. In 1999 CDC launched the National Campaign to Eliminate Syphilis from the United States. The strategies were familiar to public health in general and to STD control in particular: 1) enhanced surveillance, 2) expanded clinical and laboratory services, 3) enhanced health promotion, 4) strengthened community involvement and partnerships, and 5) rapid outbreak response. This national commitment to syphilis elimination was not the first effort, and like others before it too did not succeed. However, the lessons learned from this most recent campaign can inform the way forward to a more comprehensive approach to the prevention and control of STIs and improvement in the nation's health. |
MRSA and multidrug-resistant Staphylococcus aureus in U.S. retail meats, 2010–2011
Ge B , Mukherjee S , Hsu CH , Davis JA , Tran TTT , Yang Q , Abbott JW , Ayers SL , Young SR , Crarey ET , Womack NA , Zhao S , McDermott PF . Food Microbiol 2017 62 289-297 Methicillin-resistant Staphylococcus aureus (MRSA) has been detected in retail meats, although large-scale studies are scarce. We conducted a one-year survey in 2010–2011 within the framework of the National Antimicrobial Resistance Monitoring System. Among 3520 retail meats collected from eight U.S. states, 982 (27.9%) contained S. aureus and 66 (1.9%) were positive for MRSA. Approximately 10.4% (107/1032) of S. aureus isolates, including 37.2% (29/78) of MRSA, were multidrug-resistant (MDRSA). Turkey had the highest MRSA prevalence (3.5%), followed by pork (1.9%), beef (1.7%), and chicken (0.3%). Whole-genome sequencing was performed for all 66 non-redundant MRSA. Among five multilocus sequence types identified, ST8 (72.7%) and ST5 (22.7%) were most common and livestock-associated MRSA ST398 was assigned to one pork isolate. Eleven spa types were represented, predominately t008 (43.9%) and t2031 (22.7%). All four types of meats harbored t008, whereas t2031 was recovered from turkey only. The majority of MRSA (84.8%) possessed SCCmec IV and 62.1% harbored Panton-Valentine leukocidin. Pulsed-field gel electrophoresis showed that all ST8 MRSA belonged to the predominant human epidemic clone USA300, and others included USA100 and USA200. We conclude that a diverse MRSA population was present in U.S. retail meats, albeit at low prevalence. |
Toward achieving health equity: Emerging evidence and program practice
Dicent Taillepierre JC , Liburd L , O'Connor A , Valentine J , Bouye K , McCree DH , Chapel T , Hahn R . J Public Health Manag Pract 2016 22 Suppl 1 S43-9 Health equity, in the context of public health in the United States, can be characterized as action to ensure all population groups living within a targeted jurisdiction have access to the resources that promote and protect health. There appear to be several elements in program design that enhance health equity. These design elements include consideration of sociodemographic characteristics, understanding the evidence base for reducing health disparities, leveraging multisectoral collaboration, using clustered interventions, engaging communities, and conducting rigorous planning and evaluation. This article describes selected examples of public health programs the Centers for Disease Control and Prevention (CDC) has supported related to these design elements. In addition, it describes an initiative to ensure that CDC extramural grant programs incorporate program strategies to advance health equity, and examples of national reports published by the CDC related to health disparities, health equity, and social determinants of health. |
Estimating the total annual direct cost of providing sexually transmitted infection and HIV testing and counseling for men who have sex with men in the United States
Owusu-Edusei K Jr , Gift TL , Patton ME , Johnson DB , Valentine JA . Sex Transm Dis 2015 42 (10) 586-9 BACKGROUND: The Centers for Disease Control and Prevention recommends annual sexually transmitted infection (STI) and HIV testing and counseling for men who have sex with men (MSM) in the United States. We estimated the annual total direct medical cost of providing recommended STI and HIV testing and counseling services for MSM in the United States. METHODS: We included costs for 9 STI (including anatomic site-specific) tests recommended by the Centers for Disease Control and Prevention (HIV, syphilis, gonorrhea, chlamydia, hepatitis B viral infection, and herpes simplex virus type 2), office visits, and counseling. We included nongenital tests for MSM with exposure at nongenital sites. All cost data were obtained from the 2012 MarketScan outpatient claims database. Men were defined as MSM if they had a male sex partner within the last 12 months, which was estimated at 2.9% (2.6%-3.2%) of the male population in a 2012 study. All costs were updated to 2014 US dollars. RESULTS: The estimated average costs were as follows: HIV ($18 [$9-$27]), hepatitis B viral infection ($23 [$12-$35]), syphilis ($8 [$4-$11]), gonorrhea and chlamydia ($45 [$22-$67]) per anatomic site), herpes simplex virus type 2 ($27 [$14-$41]), office visit ($100 [$50-$149]), and counseling ($29 [$15-$44]). We estimated that the total annual direct cost of a universal STI and HIV testing and counseling program was $1.1 billion ($473 million-$1.7 billion) for all MSM and $756 (range, $338-$1.2 billion) when excluding office visit cost. CONCLUSIONS: These estimates provide the potential costs associated with universal STI and HIV testing and counseling for MSM in the United States. This information may be useful in future cost and/or cost-effectiveness analyses that can be used to evaluate STI and HIV prevention efforts. |
Full genome characterization of human Rotavirus A strains isolated in Cameroon, 2010-2011: diverse combinations of the G and P genes and lack of reassortment of the backbone genes.
Ndze VN , Esona MD , Achidi EA , Gonsu KH , Doro R , Marton S , Farkas S , Ngeng MB , Ngu AF , Obama-Abena MT , Bányai K . Infect Genet Evol 2014 28 537-60 Over the past few years whole genome sequencing of rotaviruses has become a routine laboratory method in many strain surveillance studies. To study the molecular evolutionary pattern of representative Cameroonian Rotavirus A (RVA) strains, the semiconductor sequencing approach was used following random amplification of genomic RNA. In total, 31 RVA strains collected during 2010-2011 in three Cameroonian study sites located 120 to 1240km from each other were sequenced and analyzed. Sequence analysis of the randomly selected representative strains showed that 18 RVAs were Wa-like, expressing G1P[6], G12P[6], or G12P[8] neutralization antigens on the genotype 1 genomic constellation (I1-R1-C1-M1-A1-N1-T1-E1-H1), whereas 13 other strains were DS-1-like, expressing G2P[4], G2P[6], G3P[6], and G6P[6] on the genotype 2 genomic constellation (I2-R2-C2-M2-A2-N2-T2-E2-H2). No inter-genogroup reassortment in the backbone genes was observed. Phylogenetic analysis of the Cameroonian G6P[6] strains indicated the separation of the strains identified in the Far North region (Maroua) and the Northwest region (Bamenda and Esu) into two branches that is consistent with multiple introductions of G6P[6] strains into this country. The present whole genome based molecular characterization study indicates that the emerging G6P[6] strain is fully heterotypic to Rotarix, the vaccine introduced during 2014 in childhood immunization program in Cameroon. Continuous strain monitoring is therefore needed in this area and elsewhere to see if G6s, besides genotype G1 to G4, G8, G9 and G12, may become a new, regionally important genotype in the post vaccine licensure era in Africa. |
Molecular characterization of Staphylococcus aureus and influenza virus coinfections in patients with fatal pneumonia
Denison AM , Deleon-Carnes M , Blau DM , Shattuck EC , McDougal LK , Rasheed JK , Limbago BM , Zaki SR , Paddock CD . J Clin Microbiol 2013 51 (12) 4223-5 Molecular techniques were used to characterize genetic features of Staphylococcus aureus in 66 fatal cases of pneumonia caused by S. aureus and influenza A or B viruses. Nucleic acids were extracted from formalin-fixed, paraffin-embedded tissues. The majority of cases revealed genetic markers for Panton-Valentine leukocidin, mecA, and spa type t008. |
One year survey of human rotavirus strains suggests the emergence of genotype G12 in Cameroon.
Ndze VN , Papp H , Achidi EA , Gonsu KH , Laszlo B , Farkas S , Kisfali P , Melegh B , Esona MD , Bowen MD , Banyai K , Gentsch JR , Odama AM . J Med Virol 2013 85 (8) 1485-90 In this study the emergence of rotavirus A genotype G12 in children <5 years of age is reported from Cameroon during 2010/2011. A total of 135 human stool samples were P and G genotyped by reverse transcriptase PCR. Six different rotavirus VP7 genotypes were detected, including G1, G2, G3, G8, G9, and G12 in combinations with P[4], P[6] and P[8] VP4 genotypes. Genotype G12 predominated in combination with P[8] (54.1%) and P[6] (10.4%) genotypes followed by G1P[6] (8.2%), G3P[6] (6.7%), G2P[4] (5.9%), G8P[6] (3.7%), G2P[6] (0.7%), G3P[8] (0.7%), and G9P[8] (0.7%). Genotype P[6] strains in combination with various G-types represented a substantial proportion (N = 44, 32.6%) of the genotyped strains. Partially typed strains included G12P[NT] (2.2%); G3P[NT] (0.7%); G(NT)P[6] (1.5%); and G(NT)P[8] (0.7%). Mixed infections were found in five specimens (3.7%) in several combinations including G1 + G12P[6], G2 + G3P[6] + P[8], G3 + G8P[6], G3 + G12P[6] + P[8], and G12P[6] + P[8]. The approximately 10% relative frequency of G12P[6] strains detected in this study suggests that this strain is emerging in Cameroon and should be monitored carefully as rotavirus vaccine is implemented in this country, as it shares neither G- nor P-type specificity with strains in the RotaTeq(R) and Rotarix(R) vaccines. These findings are consistent with other recent reports of the global spread and increasing epidemiologic importance of G12 and P[6] strains. |
Evaluation of the impact of direct plating, broth enrichment, and specimen source on recovery and diversity of methicillin-resistant Staphylococcus aureus among HIV-infected outpatients
McAllister SK , Albrecht VS , Fosheim GE , Lowery HK , Peters PJ , Gorwitz R , Guest JL , Hageman J , Mindley R , McDougal LK , Rimland D , Limbago B . J Clin Microbiol 2011 49 (12) 4126-30 We compared recovery of Staphylococcus aureus and methicillin-resistant S. aureus (MRSA) from nasal and groin swabs of 600 HIV-infected outpatients by selective and non-selective direct plating and broth enrichment. Swabs were collected at baseline, 6-month and 12-month visits, cultured by direct plating to Mannitol Salt Agar (MSA), CHROMagar MRSA (CM), and overnight broth enrichment with sub-culture to MSA (Broth). MRSA isolates were characterized by pulsed-field gel electrophoresis (PFGE), SCCmec typing and PCR for the Panton-Valentine leukocidin. At each visit 13-15% of patients were colonized with MRSA and 30-33% with methicillin-susceptible S. aureus (MSSA). Broth, CM and MSA detected 95%, 82% and 76% of MRSA-positive specimens, respectively. MRSA recovery was significantly higher from Broth compared to CM (p ≤ 0.001) or MSA (p ≤ 0.001); there was no significant difference in recovery between MSA and CM. MSSA recovery also increased significantly using Broth compared to MSA (p ≤ 0.001). Among specimens collected from the groin, Broth, CM, and MSA detected 88%, 54%, and 49% of the MRSA-positive isolates, respectively. Broth enrichment had a greater impact on recovery of MRSA from the groin than from the nose compared to both CM (p ≤ 0.001) and MSA (p ≤ 0.001). Overall, 19% of MRSA-colonized patients would have been missed with nasal culture only. USA500/Iberian and USA300 were the most common MRSA strains recovered, and USA300 was more likely than other strain types to be recovered from the groin than from the nose (p=0.05). |
Seroprevalence of herpes simplex virus 2 among Hispanics in the USA: National Health and Nutrition Examination Survey, 2007-2008
Molina M , Romaguera RA , Valentine J , Tao G . Int J STD AIDS 2011 22 (7) 387-90 To examine the seroprevalence of herpes simplex virus type 2 (HSV-2) among Hispanics in the USA, we used the cross-sectional, nationally representative National Health and Nutrition Examination Survey to compare the seroprevalence of HSV-2 between Hispanic persons of Mexican heritage and non-Mexican heritage aged 14-44 years, from survey years 2007-2008. The overall HSV-2 seroprevalence among Hispanics aged 14-44 years was 17.5% (95% confidence interval [CI], 15.2, 20.1) in the USA. HSV-2 seroprevalence was significantly lower among Mexican Americans than among other Hispanics (11.7% vs. 27.8%, P < 0.01). Prevalence of HSV-2 was also significantly associated with gender and age. The significant difference in HSV-2 seroprevalence between Hispanic persons of Mexican heritage and non-Mexican heritage suggested that targeting specific subgroups of Hispanics for preventive interventions may be a strategy to reduce the transmission of HSV-2 and HIV among Hispanics in the USA. |
Methicillin-resistant Staphylococcus aureus carriage and risk factors for skin infections, Southwestern Alaska, USA
Stevens AM , Hennessy T , Baggett HC , Bruden D , Parks D , Klejka J . Emerg Infect Dis 2010 16 (5) 797-803 Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) infections are common in southwestern Alaska. Outbreak strains have been shown to carry the genes for Panton-Valentine leukocidin (PVL). To determine if carriage of PVL-positive CA-MRSA increased the risk for subsequent soft tissue infection, we conducted a retrospective cohort study by reviewing the medical records of 316 persons for 3.6 years after their participation in a MRSA nasal colonization survey. Demographic, nasal carriage, and antimicrobial drug use data were analyzed for association with skin infection risk. Skin infections were more likely to develop in MRSA carriers than in methicillin-susceptible S. aureus carriers or noncarriers of S. aureus during the first follow-up year, but not in subsequent years. Repeated skin infections were more common among MRSA carriers. In an area where PVL-containing MRSA is prevalent, skin infection risk was increased among MRSA nasal carriers compared with methicillin-susceptible S. aureus carriers and noncarriers, but risk differential diminished over time. |
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