scholarly journals Prevalence and Acquisition of MRSA During Incarceration at a Large Inner-city Jail

2017 ◽  
Vol 4 (suppl_1) ◽  
pp. S45-S46
Author(s):  
Kyle J Popovich ◽  
Chad Zawitz ◽  
Alla Aroutcheva ◽  
Darjai Payne ◽  
Michael Schoeny ◽  
...  
Keyword(s):  
Skin Infection ◽  
Cook County ◽  
Hiv Status ◽  
Acquisition Rate ◽  
Healthcare Facilities ◽  
Methamphetamine Use ◽  
Clinical Trial Research ◽  
Race Ethnicity ◽  
Sex With Men ◽  
Mrsa Colonization

Abstract Background USA300 MRSA is endemic in certain communities, with congregate settings such as urban jails potentially facilitating spread. The extent of MRSA transmission in jail is unclear, a controversy that impacts prevention strategies. We determined the prevalence of MRSA colonization at jail entrance and defined the acquisition rate during incarceration. Methods Men incarcerated at the Cook County Jail, one of the largest US single-site jails, were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify predictors of colonization. Detainees still in jail at Day30 had cultures repeated to determine MRSA acquisition rate. Univariate and multivariate analysis was performed to identify predictors of MRSA colonization. Results A total o 402 men (447 unique incarcerations) have so far been enrolled (77% AA, 11% Hispanic) with 92% previously in jail (20% in past 6 months). The prevalence of MRSA colonization at intake was 18.6% (83/447), with 39% of those colonized solely in the throat or groin. At 30 days: 10% (9/92) of initially negative men acquired MRSA; 14 admission positives remained colonized while 11 lost colonization. On univariate (Table), predictors of MRSA colonization at entrance to the jail were: methamphetamine use (METH), unstable housing, current skin infection, and care at an outpatient Clinic A that emphasizes comprehensive care to the LGBTQ community. In this cohort, METH use was associated with reporting being a man who has sex with men vs. not (35% vs. 9%, P < 0.001) and was common among men with care at Clinic A (18% vs. 3%, P < 0.001). On multivariate with adjustment for race/ethnicity and HIV status, current skin infection and care at clinic A were associated with MRSA. Preliminarily, sharing personal items was associated with MRSA acquisition at Day30 (OR = 5.6, 95% CI,1.3, 23.3, P = 0.02). Conclusion We found that a relatively high proportion of individuals enter the jail colonized with MRSA and the jail may amplify rates. Entrance colonization risk factors point to possible community reservoirs. Enrollment is ongoing but results suggest an intervention in jail could impact MRSA rates in the jail and in the surrounding community. Disclosures M. K. Hayden, Sage, Inc: Sage is contributing product to healthcare facilities participating in a regional collaborative on which I am a co-investigator. Neither I nor my hospital receive product., Sage is contributing product to healthcare facilities participating in a regional collaborative on which I am a co-investigator. Neither I nor my hospital receive product.; Clorox, Inc.: I have received funding from Clorox for an investigator-initiated clinical trial., Research support; CDC: Grant Investigator, Research grant

scholarly journals 1229. Prevalence and Acquisition of MRSA in Females During Incarceration at a Large Inner-City Jail

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S373-S373
Author(s):  
Kyle J Popovich ◽  
Chad Zawitz ◽  
Alla Aroutcheva ◽  
Darjai Payne ◽  
Michael Schoeny ◽  
...  
Keyword(s):  
High Risk ◽  
Illicit Drugs ◽  
Cook County ◽  
Acquisition Rate ◽  
Unstable Housing ◽  
Exchange Sex ◽  
High Risk Populations ◽  
Race Ethnicity ◽  
Mrsa Colonization ◽  
Gender Specific

Abstract Background USA300 MRSA is endemic in the community, with congregate settings such as urban jails potentially facilitating spread. It has been reported previously that males have a higher risk for MRSA carriage and bacteremia than females. However, it is unclear if there is differential risk for MRSA based on gender in high-risk populations. We determined the prevalence of MRSA colonization at jail entrance in females and defined an acquisition rate during incarceration. Methods Females incarcerated at the Cook County Jail, one of the largest US single-site jails, were enrolled within 72 hours of intake. Surveillance cultures (nares, throat, groin) were collected to determine prevalence of MRSA colonization. A survey was administered to identify predictors of colonization. Detainees in jail at Day30 had cultures repeated to determine MRSA acquisition. Univariate and multivariate analyses were performed to identify predictors of MRSA colonization. Results 250 women were enrolled (70% AA, 15% Hispanic) with 70% previously in jail (21% in the past 6 months). The prevalence of MRSA colonization at intake was 20% (50/250), with 42% of those colonized solely in the throat or groin. This intake prevalence is comparable to the 19% for male detainees in a parallel study. 9% (2/23) of initially negative women who remained in jail for 30 days acquired MRSA; five remained colonized and no one lost colonization. Univariate predictors (table) of MRSA at entrance to the jail were: illicit drug use (including using needles), unstable housing, engaging in anal sex, and recent exchange of sex for drugs/money. Women who exchange sex for drugs/money (vs. not) reported higher rates of needle use (35% vs. 4%, P < 0.001) and unstable housing (80% vs. 20%, P < 0.001). With multivariate adjustment for race/ethnicity, needles for illicit drugs was a significant predictor of MRSA (OR 5.89, 95% CI, 1.66, 20.94, P = 0.006). Conclusion We found that a high proportion (20%) of females entered jail colonized with MRSA, comparable to rates in males, suggesting that previously reported gender disparities in MRSA may not exist in high-risk populations. Entrance colonization risk factors suggest high-risk activities or venues in the community, with potential for directing gender-specific interventions. Disclosures All authors: No reported disclosures.

scholarly journals Primary and secondary supportive partnerships among HIV-positive and HIV-negative middle-aged and older gay men

PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0245863
Author(s):  
Matthew Statz ◽  
Deanna Ware ◽  
Nicholas Perry ◽  
David Huebner ◽  
Christopher Cox ◽  
...  
Keyword(s):  
Gay Men ◽  
Healthy Aging ◽  
Hiv Positive ◽  
Hiv Status ◽  
Significant Difference ◽  
Partnership Status ◽  
Race Ethnicity ◽  
Sex With Men ◽  
Older Gay Men ◽  
Hiv Negative

This study describes the primary and secondary partnerships of aging gay men participating in the Understanding Patterns of Healthy Aging Among Men Who Have Sex with Men substudy of the Multicenter AIDS Cohort Study and examines differences in the prevalence of these relationship structures by HIV status while adjusting for age, education, and race/ethnicity. Relationships were compared within the following structural categories: “only a primary partnership”, “only a secondary partnership”, “both a primary and secondary relationship”, or “neither a primary nor secondary relationship”. There were 1,054 participants (51.9% HIV negative/48.1% HIV positive) included in the study. Participants had a median age of 62.0 years (interquartile range: 56.0–67.0) and most reported being non-Hispanic white (74.6%) and college educated (88.0%). Of the 1,004 participants with available partnership status data, 384 (38.2%) reported no primary or secondary partnerships, 108 (10.8%) reported secondary-only partnership, 385 (38.3%) reported primary-only partnership, and 127 (12.6%) reported both primary and secondary partnerships. Of participants who reported primary partnerships only, the prevalence rates (PRs) were lower among those 62 years and older, HIV positive, black non-Hispanic and Hispanics. Of participants who reported only having a secondary partnership, the PRs were higher among those 62 years and older and HIV positive. Of participants who did not report having either a primary or secondary partnership, the PRs were higher among those 62 years and older, HIV positive, and black non-Hispanic compared with their respective referent groups. There was no significant difference in PRs of having both primary and secondary partnerships by age category, HIV status, race/ethnicity, and education. This study aimed to fill a knowledge gap in the literature regarding both primary and secondary supportive partnerships among aging HIV-positive and HIV-negative gay men.

Sexual Health Communication of Black Men Who Have Sex With Men Who Met On or Offline: A Secondary Data Analysis (Preprint)

2020 ◽  
Author(s):  
Jacob D Gordon ◽  
Andre L Brown ◽  
Darren L Whitfield
Keyword(s):  
Sexual Health ◽  
Health Communication ◽  
Black Men ◽  
Sexual Partner ◽  
Secondary Data ◽  
Sexual Partners ◽  
Hiv Status ◽  
Sexual Health Communication ◽  
Sex With Men ◽  
Traditional Masculinity

BACKGROUND Black men who have sex with men (BMSM) continue to experience disproportionate rates of HIV/STI infection despite advances in effective prevention tools. Over the last decade the method of finding sexual partners has evolved, with BMSM increasingly using geospatial dating applications to find sexual partners. Sexual health communication between partners has been associated with safer sex practices by previous scholars, but it is unclear how sexual health communication of BMSM differs for sex partners found on or offline. OBJECTIVE The current study explored sexual health communication in relationship to how one found their last sexual partner and factors associated with poorer sexual health communication. METHODS This study used secondary data in the form of a self-administered national survey. BMSM were recruited online and in-person and answered questions about their sexual health behaviors regarding their last sexual partner. RESULTS In total, 403 individuals were included in the analysis. The majority of respondents 55.8% (225/403) were more likely to have found their last sexual partner through geospatial dating applications and online websites than offline venues 44.3% (178/225). There was not a significant difference in scores of sexual health communication between those who found their last sexual partner on or offline (P=.49). Additionally, sexual health communication was also not significantly associated (P = .25) based on the venue of their last sexual partner after controlling for covariates. Significant predictors of lower sexual health communication of BMSM were found: positive HIV status (P = .003), a casual partner type (P < .001), and endorsement of traditional masculinity ideologies (P = .01). CONCLUSIONS Findings from this study confirm high rates of sexual partner seeking via online venues among BMSM. The significant predictors of lower sexual health communication, endorsement of traditional masculinity ideologies and positive HIV status, suggest that stigma is a barrier to effective sexual health communication of BMSM.

Pharyngeal gonorrhoea in men who have sex with men

2021 ◽  
pp. 095646242097562
Author(s):  
Daniel Richardson ◽  
Alice Pickering ◽  
Daniel Trotman ◽  
Kayleigh Nichols ◽  
Zoe Buss ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Sore Throat ◽  
Routine Screening ◽  
Transmission Dynamics ◽  
Hiv Status ◽  
Sex With Men ◽  
Culture Positive

Pharyngeal gonorrhoea is important in the transmission dynamics of gonorrhoea, and generation of antimicrobial resistance and the performing of culture remains vital. We reviewed the notes of men who have sex with men (MSM) presenting to our clinic with a positive pharyngeal NAAT for gonorrhoea between January and December 2019. There were 383 cases of NAAT-positive pharyngeal gonorrhoea, and 28 (7%, 95% CI = 5.11–10.36) reported sore throat at presentation. Pharyngeal cultures were taken from 270/383 (70%), and 73/270 (27%) were culture positive with available antimicrobial sensitivities. Overall, the presence of pharyngeal symptoms was not associated with pharyngeal chlamydia (OR = 1.6, CI = 0.19–13.32, p = 0.7), HIV status (OR = 1.1, CI = 0.47–2.57, p = 0.8), positive cultures (OR = 1.9, CI = 0.78–4.62, p = 0.2) or age ( p = 0.3). Routine screening of MSM for pharyngeal gonorrhoea is important to maintain surveillance and measures need to be taken to improve pharyngeal culture sampling from MSM.

scholarly journals Findings From the Understanding Patterns of Healthy Aging Among Men Who Have Sex With Men Project

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 823-824
Author(s):  
Mark Brennan-Ing ◽  
Michael Plankey ◽  
Deborah Gustafson
Keyword(s):  
Los Angeles ◽  
Urban Areas ◽  
Healthy Aging ◽  
Research Policy ◽  
Disease Risk ◽  
Well Being ◽  
Hiv Status ◽  
Gay Community ◽  
Regulatory Strategies ◽  
Sex With Men

Abstract In 1984, the Multicenter AIDS Cohort Study (MACS) was started to identify factors in the HIV epidemic related to disease risk and treatment progression among gay, bisexual, and other men who have sex with men (MSM) in four urban areas in the US: Baltimore, MD/Washington, D.C.; Chicago, IL; Pittsburgh, PA, and Los Angeles, CA. MACS participants complete biannual study visits involving HIV testing, biometric screenings, and psychosocial data collection. In 2015 a MACS sub-study, the Understanding Patterns of Healthy Aging among MSM Project (HAMSM), was started to better understand resiliencies promoting well-being among MSM age 40 and older, including those with HIV. HAMSM has helped us to understand aging trajectories among MSM, and provides a unique combination of physiological and psychosocial data that can inform efforts to support MSM in healthy aging. This symposium will present emerging findings from the HAMSM study. Our first paper examines the relationships between psychological connection to the gay community (PSOC) and developmental regulatory strategies associated with health behaviors and more positive self-appraisals. The second paper examines how PSOC is related to HIV risk reduction behaviors, and if there are differences in such behaviors based on HIV status. Our third paper considers how self-perceptions of aging (age discrepancy, aging satisfaction) are related to frailty and frailty transitions, and if these relationships differ by HIV status. The final paper examines the relationship of social support to frailty among MSM by HIV status. Implications of these findings for research, policy, and programs targeting MSM will be discussed.

scholarly journals 1655. Extrapulmonary Tuberculosis in a Large Healthcare System

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S816-S816
Author(s):  
Travis Denmeade ◽  
William Smith ◽  
Banks Kooken ◽  
Michael Leonard
Keyword(s):  
Health System ◽  
Healthcare System ◽  
Extrapulmonary Tuberculosis ◽  
Retrospective Chart Review ◽  
The United States ◽  
Primary Objective ◽  
Hiv Positive ◽  
Hiv Status ◽  
Southeastern Us ◽  
Race Ethnicity

Abstract Background The US has seen a rise in the proportion of patients with extrapulmonary tuberculosis (TB) even though the yearly incidence of new TB cases has been in decline. The purpose of this study was to analyze incidence of extrapulmonary TB at Atrium Health, a large non-profit health system in the Southeastern US. Methods Retrospective chart review of 94 adult patients with culture confirmed extrapulmonary TB between 2008-2019. Individuals younger than 18 years were excluded from analysis. The primary objective was to examine incidence of extrapulmonary TB and compare it to that reported in the literature. Secondary objectives included determination of sites of extrapulmonary disease and associated patient characteristics including HIV status, race, ethnicity, and birthplace. Results 237 patients were identified as having confirmed TB infection from 2008-2019 in a retrospective analysis within the Atrium Health System. 94 (40%) were found to have extrapulmonary disease; 42 (45%) with concomitant pulmonary disease. The patients were 55% male, 40% African American, 21% Hispanic or Latino, and 51% US-born. Median age was 44 years (range 20-62). The most common sites of extrapulmonary TB were lymphatic (35%), pleural (24%), GI/Peritoneal (12%), CNS (10%), and Bone/Joint (10%). Lymphatic involvement was 40% cervical, 19% intrathoracic, and 16% axillary. 66% of skeletal disease was vertebral. Other sites included GU, pericardial, skin, and disseminated disease (5%). 37% were HIV positive, 18% with unknown HIV status as they were never tested. Information regarding patient’s race, ethnicity, and birthplace were unknown for 2 patients. The percentage of extrapulmonary cases were 29% in 2008, 39% in 2012, 38% in 2016, and 49% in 2019. Conclusion Lymphatic and pleural involvement were the most common extrapulmonary sites. Of those tested, 37% were HIV positive but there was a significant portion never tested showing a need for increased testing. The proportion of extrapulmonary TB cases since 2008 is higher at 40% compared to the 31% reported in the United States. There has been a rise in the proportion of extrapulmonary TB within our healthcare system and deserves further analysis. Disclosures All Authors: No reported disclosures

scholarly journals Structural Bridging Network Position is Associated with HIV Status in a Younger Black Men Who Have Sex with Men Epidemic

2013 ◽  
Vol 18 (2) ◽  
pp. 335-345 ◽  
Author(s):  
Nirav S. Shah ◽  
James Iveniuk ◽  
Stephen Q. Muth ◽  
Stuart Michaels ◽  
Jo-Anne Jose ◽  
...  
Keyword(s):  
Black Men ◽  
Hiv Status ◽  
Network Position ◽  
Sex With Men

scholarly journals P3.107 Rates of primary and secondary syphilis by state and race/ethnicity among men who have sex with men: united states, 2014

2017 ◽  
Author(s):  
Jeremy A Grey ◽  
Hillard Weinstock ◽  
Sarah Kidd ◽  
Eli S Rosenberg ◽  
Thomas L Gift ◽  
...  
Keyword(s):  
United States ◽  
Secondary Syphilis ◽  
Race Ethnicity ◽  
Sex With Men

scholarly journals Toward a Better Understanding of Non-Addicted, Methamphetamine-Using, Men who Have Sex with Men (MSM) in Atlanta

2010 ◽  
Vol 4 (1) ◽  
pp. 141-147 ◽  
Author(s):  
Brian J Dew
Keyword(s):  
Risk Behaviors ◽  
Culturally Specific ◽  
Two Phase ◽  
Initial Development ◽  
Methamphetamine Use ◽  
Social Marketing Campaign ◽  
Public Health Officials ◽  
Facilitators And Barriers ◽  
Sex With Men ◽  
Depth Interviews

Methamphetamine use has increasingly become linked with sexual risk behaviors among men have sex with men (MSM). Yet, the majority of research has been done with methamphetamine dependent MSM or with samples in which addiction to the substance was not evaluated. Furthermore, research with methamphetamine-using MSM in the Southern U.S. is lacking. In this study, focus groups and in-depth interviews were conducted in order to understand the motives, context, and other facilitators and barriers of methamphetamine use among non-addicted MSM residing in Atlanta. Participants included 30 non-addicted, methamphetamine-using MSM and 16 local mental and public health officials. Findings from the first of this two-phase formative research project will result in the initial development of a community-tested, culturally-specific social marketing campaign and an individual-based intervention based in HIV-testing facilities.

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