scholarly journals The association of recent incarceration and health outcomes among HIV-infected adults receiving care in the United States

2016 ◽  
Vol 12 (3) ◽  
pp. 135-144 ◽  
Author(s):  
Muazzam Nasrullah ◽  
Emma Frazier ◽  
Jennifer Fagan ◽  
Felicia Hardnett ◽  
Jacek Skarbinski
Keyword(s):  
Health Outcomes ◽  
Healthcare Utilization ◽  
Viral Suppression ◽  
Geometric Mean ◽  
The United States ◽  
Hiv Care ◽  
Cross Sectional ◽  
Content Type ◽  
Factors Associated ◽  
The Past

Purpose The purpose of this paper is to describe factors associated with incarceration as well as the association between recent incarceration and HIV-related sexual risk behaviors, access to insurance, healthcare utilization (emergency department (ED) and hospital use), antiretroviral therapy (ART) prescription, and viral suppression. Design/methodology/approach Using 2009-2010 data from a cross-sectional, nationally representative three-stage sample of HIV-infected adults receiving care in the USA, the authors assessed the demographic characteristics, healthcare utilization, and clinical outcomes of HIV-infected persons who had been recently incarcerated (detention for>24 hours in the past year) using bivariate analyses. The authors used multivariable logistic regression to examine associations of recent incarceration with insurance status as well as clinical and behavioral outcomes. Findings An estimated 22,949 (95 percent confidence interval (CI) 19,062-26,836) or 5.4 percent (CI: 4.7-6.1) of all HIV-infected persons receiving care were recently incarcerated. Factors associated with recent incarceration were age <50 years, being a smoker, having high school diploma or less, being homeless, income at or below the poverty guidelines, having a geometric mean of CD4 count <500 cells/μL, and using drugs in the past 12 months. Results from multivariable modeling indicated that incarcerated persons were more likely to use ED services, and to have been hospitalized, and less likely to have achieved viral suppression. Originality/value Recent incarceration independently predicted worse health outcomes and greater use of emergency services among HIV-infected adults currently in HIV care. Options to improve the HIV continuum of care, including pre-enrollment for healthcare coverage and discharge planning, may lead to better health outcomes for HIV-infected inmates post-release.

Influenza Vaccination of Healthcare Workers in the United States, 1989-2002

2006 ◽  
Vol 27 (3) ◽  
pp. 257-265 ◽  
Author(s):  
Frances J. Walker ◽  
James A. Singleton ◽  
Pengjun Lu ◽  
Karen G. Wooten ◽  
Raymond A. Strikas
Keyword(s):  
United States ◽  
Influenza Vaccination ◽  
Healthcare Workers ◽  
Pneumococcal Vaccination ◽  
The United States ◽  
Hepatitis B Vaccination ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past ◽  
History Of

Objectives.We sought to estimate influenza vaccination coverage among healthcare workers (HCWs) in the United States during 1989-2002 and to identify factors associated with vaccination in this group. The Advisory Committee on Immunization Practices (ACIP) recommends annual influenza vaccination for HCWs to reduce transmission of influenza to patients at high risk for serious complications of influenza.Design.Analysis of cross-sectional data from 1989-2002 surveys conducted by the National Health Interview Survey (NHIS). The outcome measure was self-reported influenza vaccination in the past 12 months. Bivariate and multivariate analysis of 2002 NHIS data.Setting.Household interviews conducted during 1989-2002, weighted to reflect the noninstitutionalized, civilian US population.Participants.Adults aged 18 years or older participated in the study. A total of 2,089 were employed in healthcare occupations or settings in 2002, and 17,160 were employed in nonhealthcare occupations or settings.Results.The influenza vaccination rate among US HCWs increased from 10.0% in 1989 to 38.4% in 2002, with no significant change since 1997. In a multivariate model that included data from the 2002 NHIS, factors associated with a higher rate of influenza vaccination among HCWs aged 18-64 years included age of 50 years or older (odds ratio [OR], 1.6; 95% confidence interval [CI], 1.1-2.1), hospital employee status (OR, 1.5; 95% CI, 1.2-1.9), 1 or more visits to the office of a healthcare professional in the past 12 months (OR, 1.5; 95% CI, 1.1-2.2), receipt of employer-provided health insurance (OR, 1.5; 95% CI, 1.1-2.1), a history of pneumococcal vaccination (OR, 3.9; 95% CI, 2.5-6.1), and history of hepatitis B vaccination (OR, 1.9; 95% CI, 1.4-2.4). Non-Hispanic black persons were less likely to be vaccinated (OR, 0.6; 95% CI, 0.5-0.9) than non-Hispanic white persons. There were no significant differences in vaccination levels according to HCW occupation category.Conclusions.Influenza immunization among HCWs reached a plateau during 1997-2002. New strategies are needed to encourage US HCWs to receive influenza vaccination to prevent influenza illness in themselves and transmission of influenza to vulnerable patients.

scholarly journals Food access among people who inject drugs in West Virginia

2021 ◽  
Vol 18 (1) ◽  
Author(s):  
Saba Rouhani ◽  
Sean T. Allen ◽  
Sara Whaley ◽  
Rebecca Hamilton White ◽  
Allison O’Rourke ◽  
...  
Keyword(s):  
Drug Use ◽  
West Virginia ◽  
Disease Transmission ◽  
Food Access ◽  
People Who Inject Drugs ◽  
The United States ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past ◽  
Adequate Food

Abstract Background The substance use epidemic in the United States continues to drive high levels of morbidity and mortality, particularly among people who inject drugs (PWID). Poor access to food often co-occurs with drug use and contributes to associated sequelae, such as risks for HIV and diabetes. The objective of this study was to examine factors associated with adequate food access among PWID in a rural Appalachian community. Methods Cross-sectional surveys were used to collect data among PWID aged 18 and older in Cabell County, West Virginia. Frequency of hunger and sociodemographic, structural and drug use characteristics were measured. Adequate food access was defined as reporting ‘never’ going to bed hungry at night in the past six months. Pearson’s χ2 and t-tests and multivariable logistic regression were used to identify factors associated with food access. Results Only 71 individuals (17%) reported never going to bed hungry at night in the past six months. Adjusted odds of having adequate food access were higher among PWID who completed high school (aOR 2.94; P = 0.010) and usually used drugs alone (aOR 1.97; P = 0.025), and lower among PWID who were female (aOR 0.51; P = 0.037), experienced homelessness (aOR 0.23, P < 0.001), were recently arrested (aOR 0.50 P = 0.047), and engaged in receptive sharing of injection equipment (aOR 0.52, P = 0.035). Conclusions We found extremely low food access in a population of PWID in Appalachia who are vulnerable to overdose and infectious disease transmission. Integrated interventions promoting food access are needed to improve the public health and wellbeing of people who inject drugs in Appalachia.

scholarly journals Food Security among People who Inject Drugs in West Virginia

2021 ◽  
Author(s):  
Saba Rouhani ◽  
Sean T Allen ◽  
Sarah Whaley ◽  
Rebecca H White ◽  
Allison O'Rourke ◽  
...  
Keyword(s):  
Food Security ◽  
Drug Use ◽  
West Virginia ◽  
Disease Transmission ◽  
People Who Inject Drugs ◽  
The United States ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past ◽  
Poor Access

Abstract Background. The substance use epidemic in the United States continues to drive high levels of morbidity and mortality, particularly among people who inject drugs (PWID). Poor access to food co-occurs with illicit drug use and contributes to associated sequelae, such as HIV and diabetes. The objective of this study was to examine factors associated with food security among PWID in a rural Appalachian community. Methods. Cross-sectional surveys were used to collect data in a sample of 420 PWID aged 18 and older Cabell County, West Virginia. Frequency of food access and sociodemographic, structural and drug use characteristics were measured. Food security was defined as reporting ‘never’ going to bed hungry at night in the past six months. Pearson’s χ2 and t-tests were used to identify factors associated with food security. Multivariable logistic regression was employed to estimate adjusted odds of being food secure.Results. Only 71 individuals (17%) reported never going to bed hungry night in the past six months. Adjusted odds of being food secure were higher among PWID who completed high school (aOR 2.94; P=0.010) and usually using drugs alone (aOR 1.97; P=0.025), and lower among PWID who were female (aOR 0.51; P=0.037), experienced homelessness (aOR 0.23, P<0.001), were recently arrested (aOR 0.50 P=0.049), and engaged in receptive sharing of injection equipment (aOR 0.52, P=0.035).Conclusions. We found extremely low levels of food security in a population of PWID in Appalachia who are vulnerable to overdose and infectious disease transmission. Integrated interventions that approach food provision as harm reduction are needed to address the overlapping factors that jeopardize the health and wellbeing of people who inject drugs.

scholarly journals Factors Associated With Peripartum Virologic Suppression in Eastern Cape Province, South Africa: A Retrospective Cross-Sectional Analysis

2021 ◽  
Author(s):  
Oladele Vincent Adeniyi ◽  
Chikwelu Larry Obi ◽  
Daniel Ter Goon ◽  
Benson Iweriebor ◽  
Nonkosi Selanto-Chairman ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Virologic Suppression ◽  
Eastern Cape Province ◽  
Eastern Cape ◽  
Child Transmission ◽  
Cross Sectional ◽  
Factors Associated ◽  
Undetectable Viremia ◽  
Sectional Analysis ◽  
Mother To Child

Abstract Background This study describes the characteristics of pregnant women on antiretroviral therapy (ART) and the rate of peripartum virologic suppression in a large prevention of mother-to-child transmission cohort who delivered in some selected maternity centers in Eastern Cape Province, South Africa. In addition, the study examines the factors associated with virologic suppression in the cohort. Methods This multicenter, retrospective cross-sectional analysis included medical data of 1709 women with human immunodeficiency virus between September 2015 and May 2016 in Eastern Cape Province. The main outcome measure was the rate of peripartum virologic suppression, defined as viral load (VL) &lt;1000 copies/mL and undetectable viremia (VL &lt;20 copies/mL). Correlates of peripartum virologic suppression and undetectable viremia were examined by fitting logistic regression model analysis. Results Of 1463 women with available VL results, the overall rate of peripartum suppression was 82%, and undetectable viremia was 56.9%. Being aged 24 years or younger (adjusted odds ratio [AOR], 0.68 [95% confidence interval {CI}, .48–.94]), smoking during pregnancy (AOR, 0.50 [95% CI, .28–.90]), and starting ART in the first trimester were associated with lower odds of viral suppression (&lt;1000 copies/mL). Women who had never defaulted ART had an increased odds of having an undetectable VL (AOR, 3.09 [95% CI, 2.12–4.49]) and virologic suppression (AOR, 3.88 [95% CI, 2.62–5.74]) compared to those who defaulted. Conclusions More than half of the women achieved undetectable VL, and 4 in 5 women achieved viral suppression at delivery in the region. Early antenatal booking, combined with enhanced adherence support for pregnant women on ART, would be crucial toward achieving the goal of elimination of mother-to-child transmission in the region.

scholarly journals Violence and discrimination among Ugandan residents during the COVID-19 lockdown

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Elizabeth Katana ◽  
Bob Omoda Amodan ◽  
Lilian Bulage ◽  
Alex R. Ario ◽  
Joseph Nelson Siewe Fodjo ◽  
...  
Keyword(s):  
Law Enforcement ◽  
Control Measures ◽  
Sub Saharan Africa ◽  
World Health ◽  
Vulnerable Groups ◽  
Transport Systems ◽  
Outcome Variable ◽  
Cross Sectional ◽  
Factors Associated ◽  
The Past

Abstract Background In March 2020, the World Health Organization (WHO) declared COVID-19 a pandemic. Many countries in Sub-Saharan Africa, Uganda inclusive, implemented lockdowns, curfew, banning of both private and public transport systems, and mass gatherings to minimize spread. Social control measures for COVID-19 are reported to increase violence and discrimination globally, including in Uganda as some may be difficult to implement resulting in the heavy deployment of law enforcement. Media reports indicated that cases of violence and discrimination had increased in Uganda’s communities following the lockdown. We estimated the incidence and factors associated with experiencing violence and discrimination among Ugandans during the COVID-19 lockdown to inform control and prevention measures. Methods In April 2020, we conducted a secondary analysis of cross-sectional data under the International Citizen Project (ICP) to assess adherence to public health measures and their impact on the COVID-19 outbreak in Uganda. We analyzed data on violence and discrimination from the ICP study. We performed descriptive statistics for all the participants’ characteristics and created a binary outcome variable called experiencing violence and/or discrimination. We performed logistic regression analysis to identify the factors associated with experiencing violence and discrimination. Results Of the 1726 ICP study participants, 1051 (58.8%) were males, 841 (48.7%) were currently living with a spouse or partner, and 376 (21.8%) had physically attended work for more than 3 days in the past week. Overall, 145 (8.4%) experienced any form of violence and/or discrimination by any perpetrator, and 46 (31.7%) of the 145 reported that it was perpetrated by a law enforcement officer. Factors associated with experiencing violence or discrimination were: being male (AOR = 1.60 CI:1.10–2.33), having attended work physically for more than 3 days in the past week (AOR = 1.52 CI:1.03–2.23), and inability to access social or essential health services since the epidemic started (AOR = 3.10 CI:2.14–4.50). Conclusion A substantial proportion of Ugandan residents experienced violence and/or discrimination during the COVID-19 lockdown, mostly perpetrated by law enforcement officers. We recommend mitigation of the collateral impact of lockdowns with interventions that focus on improving policing quality, ensuring continuity of essential services, and strengthening support systems for vulnerable groups including males.

scholarly journals Association between food insecurity and access to a mental health professional: cross-sectional analysis of NHANES 2007–2014

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nina Camille Burruss ◽  
Marina Girgis ◽  
Karen Elizabeth Green ◽  
Lingyi Lu ◽  
Deepak Palakshappa
Keyword(s):  
Mental Health ◽  
Health Professional ◽  
Food Insecurity ◽  
Mental Health Professional ◽  
The United States ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
The Past ◽  
Cross Sectional Analysis ◽  
Sectional Analysis

Abstract Background To determine if individuals with food insecurity (FI) were less likely to have seen a mental health professional (MHP) within the past year than individuals without FI. Methods This is a cross-sectional analysis of data from the National Health and Nutrition Examination Survey (NHANES) conducted in the United States between 2007 and 2014. All participants 20 years of age or older were eligible for this study. We excluded participants who were pregnant, missing FI data, or missing data from the Patient Health Questionnaire (PHQ-9). The primary outcome was self-reported contact with a MHP in the past 12 months. We used multivariable logistic regression models to test the association between FI and contact with a MHP, controlling for all demographic and clinical covariates. Results Of the 19,789 participants, 13.9% were food insecure and 8.1% had major depressive disorder (MDD). In bivariate analysis, participants with FI were significantly more likely to have MDD (5.3% vs 2.8%, p < 0.0001) and to have been seen by a MHP in the preceding 12 months (14.0% vs 6.9%, p < 0.0001). In multivariable models, adults with FI had higher odds of having seen a MHP (OR = 1.32, CI: 1.07, 1.64). Conclusions This study demonstrates that individuals with FI were significantly more likely to have seen a MHP in the preceding 12 months compared to individuals without FI. Given the growing interest in addressing unmet social needs in healthcare settings, this data suggests that visits with MHPs may be a valuable opportunity to screen for and intervene on FI.

Inadequate Therapy for Asthma Among Children in the United States

PEDIATRICS ◽  
2000 ◽  
Vol 105 (Supplement_2) ◽  
pp. 272-276
Author(s):  
Jill S. Halterman ◽  
C. Andrew Aligne ◽  
Peggy Auinger ◽  
John T. McBride ◽  
Peter G. Szilagyi
Keyword(s):  
Severe Asthma ◽  
Asthma Management ◽  
The United States ◽  
Asthma Therapy ◽  
National Guidelines ◽  
Cross Sectional ◽  
Asthma Morbidity ◽  
The Past ◽  
Maintenance Medication ◽  
Inadequate Therapy

Objective. Childhood asthma morbidity and mortality are increasing despite improvements in asthma therapy. We hypothesized that a substantial number of children with moderate to severe asthma are not taking the maintenance medications recommended by national guidelines. The objective of this study was to describe medication use among US children with asthma and determine risk factors for inadequate therapy. Methods. The National Health and Nutrition Examination Survey (NHANES) III 1988–1994 provided cross-sectional, parent-reported data for children 2 months to 16 years of age. Analysis focused on children with moderate to severe asthma (defined as having any hospitalization for wheezing, ≥2 acute visits for wheezing, or ≥3 episodes of wheezing over the past year). We defined these children as adequately treated if they had taken a maintenance medication (inhaled corticosteroid, cromolyn, or theophylline) during the past month. Demographic variables were analyzed for independent associations with inadequacy of therapy. The statistical analysis used SUDAAN software to account for the complex sampling design. Results. A total of 1025 children (9.4%) had physician-diagnosed asthma. Of those with moderate to severe asthma (n = 524), only 26% had taken a maintenance medication during the past month. Even among children with 2 or more hospitalizations over the previous year, only 32% had taken maintenance medications. In a logistic regression analysis, factors significantly associated with inadequate therapy included: age ≤5 years, Medicaid insurance, and Spanish language. Children surveyed after 1991, when national guidelines for asthma management became available, were no more likely to have taken maintenance medications than children surveyed before 1991. Conclusion. Most children with moderate to severe asthma in this nationally representative sample, including those with multiple hospitalizations, did not receive adequate asthma therapy. These children may incur avoidable morbidity. Young children, poor children, and children from Spanish-speaking families appear to be at particularly high risk for inadequate therapy.

So you want to work in sports? An exploratory study of sport business employability

2021 ◽  
Vol ahead-of-print (ahead-of-print) ◽  
Author(s):  
David J. Finch ◽  
Norm O'Reilly ◽  
David Legg ◽  
Nadège Levallet ◽  
Emma Fody
Keyword(s):  
United States ◽  
Emotional Intelligence ◽  
Labor Market ◽  
Exploratory Study ◽  
Design Methodology ◽  
Sport Management ◽  
The United States ◽  
Content Type ◽  
The Past ◽  
Analytical Thinking

PurposeAs an industry, sport business (SB) has seen significant growth since the early 2000s. Concurrently, the number of postsecondary sport management programs has also expanded dramatically. However, there remain concerns about whether these programs are meeting the demands of both employers and graduates. To address these concerns, this study examines the credential and competency demands of the SB labor market in the United States.Design/methodology/approachResearchers conducted an analysis using a broad sample of employment postings (N = 613) for SB positions from two different years, 2008 and 2018.FindingsResults support that a complex set of SB qualifications exist, and the credentials and competencies included in SB employment postings have evolved over the past decade.Originality/valueA noteworthy finding is that meta-skills are found to be particularly important for employability, including items such as communication, emotional intelligence and analytical thinking and adaptability.

Medical students’ perception of sexual orientation in Sagamu, southwestern Nigeria: implications for access to HIV care

2018 ◽  
Vol 11 (5) ◽  
pp. 347-355 ◽  
Author(s):  
Oluwafolahan Oluwagbemiga Sholeye ◽  
Victor Jide Animasahun ◽  
Abimbola A. Oyelekan
Keyword(s):  
Sexual Orientation ◽  
Medical Students ◽  
Health Workers ◽  
Medical Curriculum ◽  
Public Hospitals ◽  
Hiv Care ◽  
Southwestern Nigeria ◽  
Cross Sectional ◽  
Content Type ◽  
Sex With Men

Purpose The prevalence of Human Immunodeficiency Virus (HIV) is about four times higher among individuals with same-sex orientation as against the general population. This may be partly due to judgmental, heteronormative attitudes among health workers, thereby affecting access to care. Therefore, the purpose of this paper is to assess the perception of final-year medical students of Olabisi Onabanjo University, Nigeria on sexual orientation and its implications on access to HIV care and support services. Design/methodology/approach A cross-sectional descriptive study was conducted among final-year medical students. Data were collected using an interviewer-administered questionnaire and analyzed using SPSS 20. Relevant descriptive and inferential statistics were calculated. Participation was fully voluntary. Findings More males (70 percent) were aware of the concept of sexual orientation than females (60.4 percent). Most (94 percent) males and all female respondents felt homosexuality was against the order of nature. More males (76 percent) than females (62.3 percent) felt men having sex with men and homosexuality were synonymous. More females (50.9 percent) than males (48 percent) felt gay doctors should not be employed in public hospitals. Originality/value Respondents had a poor perception of sexual orientation and there were no significant differences between genders. This could contribute to existing stigmatization against individuals with minority sexual orientations. It should be addressed in the medical curriculum.

scholarly journals Implementing a Data to Care Strategy to Improve Health Outcomes for People With HIV: A Report From the Care and Prevention in the United States Demonstration Project

2018 ◽  
Vol 133 (2_suppl) ◽  
pp. 60S-74S ◽  
Author(s):  
Patricia Sweeney ◽  
Tamika Hoyte ◽  
Mesfin S. Mulatu ◽  
Jacquelyn Bickham ◽  
Antoine D. Brantley ◽  
...  
Keyword(s):  
United States ◽  
Health Outcomes ◽  
Medical Care ◽  
Treatment Adherence ◽  
Viral Suppression ◽  
The United States ◽  
Health Departments ◽  
State Health ◽  
Improve Health

Objectives: The Care and Prevention in the United States Demonstration Project included implementation of a Data to Care strategy using surveillance and other data to (1) identify people with HIV infection in need of HIV medical care or other services and (2) facilitate linkages to those services to improve health outcomes. We present the experiences of 4 state health departments: Illinois, Louisiana, Tennessee, and Virginia. Methods: The 4 state health departments used multiple databases to generate listings of people with diagnosed HIV infection (PWH) who were presumed not to be in HIV medical care or who had difficulty maintaining viral suppression from October 1, 2013, through September 29, 2016. Each health department prioritized the listings (eg, by length of time not in care, by viral load), reviewed them for accuracy, and then disseminated the listings to staff members to link PWH to HIV care and services. Results: Of 16 391 PWH presumed not to be in HIV medical care, 9852 (60.1%) were selected for follow-up; of those, 4164 (42.3%) were contacted, and of those, 1479 (35.5%) were confirmed to be not in care. Of 794 (53.7%) PWH who accepted services, 694 (87.4%) were linked to HIV medical care. The Louisiana Department of Health also identified 1559 PWH as not virally suppressed, 764 (49.0%) of whom were eligible for follow-up. Of the 764 PWH who were eligible for follow-up, 434 (56.8%) were contacted, of whom 269 (62.0%) had treatment adherence issues. Of 153 PWH who received treatment adherence services, 104 (68.0%) showed substantial improvement in viral suppression. Conclusions: The 4 health departments established procedures for using surveillance and other data to improve linkage to HIV medical care and health outcomes for PWH. To be effective, health departments had to enhance coordination among surveillance, care programs, and providers; develop mechanisms to share data; and address limitations in data systems and data quality.

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