scholarly journals Multilevel modelling and multiple group analysis of disparities in continuity of care and viral suppression among adolescents and youths living with HIV in Nigeria

2020 ◽  
Vol 5 (11) ◽  
pp. e003269
Author(s):  
Okikiolu Badejo ◽  
Christiana Noestlinger ◽  
Toyin Jolayemi ◽  
Juliette Adeola ◽  
Prosper Okonkwo ◽  
...  
Keyword(s):  
Young Adults ◽  
Viral Suppression ◽  
Group Analysis ◽  
Age Groups ◽  
Multilevel Modelling ◽  
Retention In Care ◽  
Healthcare Facilities ◽  
Individual Level ◽  
Multiple Group ◽  
Facility Level

IntroductionSubstantial disparities in care outcomes exist between different subgroups of adolescents and youths living with HIV (AYLHIV). Understanding variation in individual and health facility characteristics could be key to identifying targets for interventions to reduce these disparities. We modelled variation in AYLHIV retention in care and viral suppression, and quantified the extent to which individual and facility characteristics account for observed variations.MethodsWe included 1170 young adolescents (10–14 years), 3206 older adolescents (15–19 years) and 9151 young adults (20–24 years) who were initiated on antiretroviral therapy (ART) between January 2015 and December 2017 across 124 healthcare facilities in Nigeria. For each age group, we used multilevel modelling to partition observed variation of main outcomes (retention in care and viral suppression at 12 months after ART initiation) by individual (level one) and health facility (level two) characteristics. We used multiple group analysis to compare the effects of individual and facility characteristics across age groups.ResultsFacility characteristics explained most of the observed variance in retention in care in all the age groups, with smaller contributions from individual-level characteristics (14%–22.22% vs 0%–3.84%). For viral suppression, facility characteristics accounted for a higher proportion of variance in young adolescents (15.79%), but not in older adolescents (0%) and young adults (3.45%). Males were more likely to not be retained in care (adjusted OR (aOR)=1.28; p<0.001 young adults) and less likely to achieve viral suppression (aOR=0.69; p<0.05 older adolescent). Increasing facility-level viral load testing reduced the likelihood of non-retention in care, while baseline regimen TDF/3TC/EFV or NVP increased the likelihood of viral suppression.ConclusionsDifferences in characteristics of healthcare facilities accounted for observed disparities in retention in care and, to a lesser extent, disparities in viral suppression. An optimal combination of individual and health services approaches is, therefore, necessary to reduce disparities in the health and well-being of AYLHIV.

scholarly journals Multi-level modeling and multiple group analysis of disparities in continuity of care and viral suppression among Nigerian adolescents and youths living with HIV

2020 ◽  
Author(s):  
Okikiolu Abimbola Badejo ◽  
Christiana Noestlinger ◽  
Toyin Jolayemi ◽  
Juliet Adeola ◽  
Prosper Okonkwo ◽  
...  
Keyword(s):  
Young Adults ◽  
Viral Suppression ◽  
Group Analysis ◽  
Age Groups ◽  
Retention In Care ◽  
List Type ◽  
Healthcare Facilities ◽  
Individual Level ◽  
New Findings ◽  
Living With Hiv

AbstractIntroductionSubstantial disparities in care outcomes exist between different sub-groups of adolescents and youths living with HIV(ALHIV). Understanding variation in individual and health-facility characteristics could be key to identifying targets for interventions to reduce these disparities. We modeled variation in ALHIV retention in care and viral suppression, and quantified the extent to which individual and facility characteristics account for observed variations.MethodsWe included 1,177 young adolescents (10-14 years), 3,206 older adolescents (15-19 years) and 9,151 young adults (20-24 years) who were initiated on antiretroviral therapy (ART) between January 2015 and December 2017 across 124 healthcare facilities in Nigeria. For each age-group, we used multilevel modeling to partition observed variation of main outcomes(retention in care and viral suppression at 12 months post ART initiation) by individual (level one) and health facility (level two) characteristics. We used multiple group analysis to compare the effects of individual and facility characteristics across age-groups.ResultsFacility characteristics explained most of the observed variance in retention in care in all the age-groups, with smaller contributions from individual-level characteristics (14-22.22% vs 0 - 3.84%). For viral suppression, facility characteristics accounted for a higher proportion of variance in young adolescents (15.79%), but not in older adolescents (0%) and young adults(3.45%). Males were more likely to not be retained in care(aOR=1.28; p<0.001 young adults) and less likely to achieve viral suppression (aOR=0.69; p<0.05 older adolescent). Increasing facility-level viral load testing reduced the likelihood of non-retention in care, while baseline regimen TDF/3TC/EFV or NVP increased the likelihood of viral suppression.ConclusionsDifferences in characteristics of healthcare facilities accounted for observed disparities in retention in care and, to a lesser extent, disparities in viral suppression. An optimal combination of individual and health-services approaches is, therefore, necessary to reduce disparities in the health and wellbeing of ALHIV.Key MessagesWhat is already known?Adolescents and youths living with HIV have worse care and treatment outcomes compared to other groupsSignificant disparity in care and treatment outcomes exist between different adolescent and youth subgroupsWhat are the new findings?Differences in characteristics of healthcare facilities delivering services are associated with disparities in outcomes within and across adolescent and youth age-groups.What do the new findings imply?An optimal combination of individual and health-services approaches is necessary to reduce disparities in the health and wellbeing of adolescent and youths living with HIV.

scholarly journals The Impact of Illicit Drug Use on Viral Suppression and Retention in Care among HIV-Positive Adolescents and Young Adults

2016 ◽  
Vol 3 (suppl_1) ◽  
Author(s):  
Amelia Thompson ◽  
Scott E. Gillespie ◽  
Jasper Hood ◽  
Lateshia Seaton ◽  
Andres Camacho-Gonzalez
Keyword(s):  
Young Adults ◽  
Drug Use ◽  
Viral Suppression ◽  
Illicit Drug ◽  
Illicit Drug Use ◽  
Retention In Care ◽  
Adolescents And Young Adults ◽  
Hiv Positive ◽  
The Impact

scholarly journals Individual and neighborhood predictors of retention in care and viral suppression among Florida youth (aged 13–24) living with HIV in 2015

2019 ◽  
Vol 30 (11) ◽  
pp. 1095-1104
Author(s):  
Merhawi T Gebrezgi ◽  
Diana M Sheehan ◽  
Daniel E Mauck ◽  
Kristopher P Fennie ◽  
Gladys E Ibanez ◽  
...  
Keyword(s):  
Viral Suppression ◽  
Age Groups ◽  
Retention In Care ◽  
Population Based ◽  
Hiv Care ◽  
Foreign Born ◽  
Perinatal Hiv ◽  
Retention In Hiv Care ◽  
Older Youth ◽  
Sex With Men

Youth aged 13‒24 are less likely to be retained in HIV care and be virally suppressed than older age groups. This study aimed to assess predictors of retention in HIV care and viral suppression among a population-based cohort of youth (N = 2872) diagnosed with HIV between 1993 and 2014 in Florida. We used generalized estimating equations to estimate prevalence ratios (PRs). Retention in care was defined as evidence of engagement in care (at least one laboratory test, physician visit, or antiretroviral therapy prescription refill), two or more times, at least three months apart during 2015. Viral suppression was defined as having evidence of a viral load <200 copies/ml among those in care during 2015. Among the 2872 youth, 65.4% were retained in care, and among those in care, 65.0% were virally suppressed. Older youth (18‒24 years old) and non-Hispanic Blacks (NHBs) were less likely to be retained in care, whereas those men who have sex with men, perinatal HIV transmission, living in low socioeconomic neighborhoods, and those diagnosed with AIDS before 2016 were more likely to be retained in care. Those diagnosed with AIDS before 2016 and NHBs were less likely to be virally suppressed, whereas those men who have sex with men and foreign-born persons were more likely to be virally suppressed. Results suggest the need for targeted retention and viral suppression interventions for NHB youth and older youth (18‒24 years-age).

scholarly journals Age group differences in association between IADL decline and depressive symptoms in community-dwelling elderly

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Eri Kiyoshige ◽  
Mai Kabayama ◽  
Yasuyuki Gondo ◽  
Yukie Masui ◽  
Hiroki Inagaki ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Group Analysis ◽  
Age Groups ◽  
Depression Scale ◽  
Information Criterion ◽  
Community Dwelling ◽  
Group Differences ◽  
Age Group ◽  
Multiple Group ◽  
Solitary Living

Abstract Background Instrumental Activities of Daily Living (IADL) is an indicator of whether a community-dwelling elderly can live independently. IADL decline was reported to be associated with aging and depression. The present study aimed to investigate whether the association between IADL decline and depressive symptoms differs with aging, using two age groups of community-dwelling Japanese elderly in their 70s and 80s. Methods We conducted longitudinal analysis among participants in their 70s and 80s at the baseline from Septuagenarians, Octogenarians, Nonagenarians Investigation with Centenarians (SONIC) study. IADL was assessed by The Tokyo Metropolitan Institute of Gerontology (TMIG) index of competence. As a main predictor, depressive symptoms were measured by the five-item version of the Geriatrics Depression Scale (GDS-5). As possible confounders, we considered cognitive function, body mass index, solitary living, education, economic status, medical history of stroke and heart disease, hypertension, dyslipidemia, diabetes, and sex. We obtained odds ratios (ORs) of IADL decline for having depressive symptoms in each age group (70s/80s) and tested interactions between depressive symptoms and age groups in relation to IADL decline in 3 years by logistic regression. Additionally, to confirm age group differences, we conducted multiple group analysis. Results There were 559 participants in their 70s and 519 in their 80s. Compared to participants without depressive symptoms, those with depressive symptoms had higher OR of IADL decline in 70s (OR [95% CI] = 2.33 [1.13, 4.78]), but not in 80s (OR [95% CI] = 0.85 [0.46, 1.53]). There were significant interactions between depressive symptoms and age groups in relation to IADL decline (p-value = 0.03). Multiple group analyses showed differences between the age groups by Akaike information criterion (AIC), and ORs (95%CI) decline for depressive symptoms was 2.33 (1.14, 4.77) in 70s and 0.85 (0.47, 1.54) in 80s. Conclusion The association of depressive symptoms and IADL decline during the 3 years was significantly different between the 70s and 80s age groups, and significant association was found only in people in their 70s. Detecting depressive symptoms may be a key for preventing IADL decline in people in their 70s and not for those in their 80s.

scholarly journals Clinic-level and individual-level factors that influence HIV viral suppression in adolescents and young adults

AIDS ◽  
2020 ◽  
Vol 34 (7) ◽  
pp. 1065-1074 ◽  
Author(s):  
Irene Njuguna ◽  
Jillian Neary ◽  
Caren Mburu ◽  
Danae Black ◽  
Kristin Beima-Sofie ◽  
...  
Keyword(s):  
Young Adults ◽  
Viral Suppression ◽  
Adolescents And Young Adults ◽  
Individual Level ◽  
Hiv Viral Suppression

It Is Your Decision to Date Interracially: The Influence of Family Approval on the Likelihood of Interracial/Interethnic Dating

2021 ◽  
pp. 0192513X2199413
Author(s):  
Byron Miller ◽  
Savanah Catalina ◽  
Sara Rocks ◽  
Kathryn Tillman
Keyword(s):  
College Students ◽  
Young Adults ◽  
Romantic Relationships ◽  
Family Members ◽  
Individual Level ◽  
Interracial Romance ◽  
Using Data ◽  
Do So

Although attitudes toward interracial romantic relationships (IRRs) have generally improved over the years, many Americans still disapprove of their family members being in IRRs. Prior studies have examined correlates of individual-level attitudes about interracial romance, but less is known about whether family members’ attitudes are directly associated with young people’s decisions to date interracially. Using data collected from 790 romantically involved college students at two large public four-year universities, we find that young adults who believe their siblings, parents, and grandparents approve of IRRs have greater odds of dating interracially. Compared to Whites, Blacks and Hispanics are more likely to be interracially involved but their decision to do so is much less dependent on the approval of their parents and grandparents. We also find young adults are more likely to date interracially if they have five or more relatives with IRR experience themselves. The findings and their implications are discussed.

scholarly journals Determinants of alcohol consumption and marijuana use among young adults in the Republic of Palau

2021 ◽  
Vol 26 (1) ◽  
Author(s):  
Mizuki Sata ◽  
Renzhe Cui ◽  
Chifa Chiang ◽  
Singeru Travis Singeo ◽  
Berry Moon Watson ◽  
...  
Keyword(s):  
Young Adults ◽  
Alcohol Consumption ◽  
Age Groups ◽  
Marijuana Use ◽  
Cross Sectional Study ◽  
Cross Sectional ◽  
Education Levels ◽  
The Status ◽  
The Republic ◽  
Republic Of Palau

Abstract Background This study aimed to describe the status of alcohol consumption and drug use among young adults as well as their determinants. Methods We conducted a cross-sectional study of 356 young adults (aged 18 to 24 years) living in Palau in 2013. The prevalence of self-reported alcohol and marijuana usage were compared within and between sexes, age groups, ethnicities, and education levels. Results The proportion of current drinking was higher in people aged 21–24 than in those aged 18–20 (73.2% vs. 60.9%, p = 0.09 in men and 48.3% vs. 30.0%, p = 0.02 in women), while that of marijuana use did not differ between the age groups. The proportions of current drinking and marijuana use were higher in Palauan than in other ethnicities (current drinking: 70.6% vs. 40.6%, p = 0.005 in men and 38.8% vs. 16.6%, p = 0.04 in women; lifetime marijuana use: 80.0% vs. 52.9%, p = 0.02 in men and 56.1% vs. 30.6%, p = 0.09 in women). The proportion of frequent (3 times or more) marijuana users was higher for the lower educated than for the higher educated (62.5% vs. 32.1%, p < 0.001 in men and 33.9% vs. 24.4%, p = 0.12 in women). Conclusions Sex, age, ethnicity, and education were significant determinants of alcohol and marijuana use.

scholarly journals Coronal STIR sequence, a simple adjustment to routine MRI protocol for extra-spinal sciatica and sciatica-like symptoms

2019 ◽  
Vol 50 (1) ◽  
Author(s):  
Rania Zeitoun ◽  
Mohammed Saleh Ali Mohieddin
Keyword(s):  
Young Adults ◽  
Soft Tissue ◽  
Mr Imaging ◽  
Age Groups ◽  
Field Of View ◽  
Mri Protocol ◽  
Stir Sequence ◽  
Tissue Abnormalities ◽  
Additional Value ◽  
Bone Abnormalities

Abstract Background The value of adding coronal STIR images to MR imaging of sciatica aiming to detect extra-spinal abnormalities. Results Additional coronal STIR images detected extra-spinal abnormalities in 20% of the patients, thereby downgraded the normal studies from 21 to 13%. The extra-spinal abnormalities included bone abnormalities (36.4%), soft tissue abnormalities (4.5%), neurological abnormalities (2.3%), gynecological abnormalities (50%), and miscellaneous (6.8%). In 6.9% of patients, the extra-spinal abnormalities explained the patients’ pain and influenced their management. Extra-spinal causes of pain significantly correlated to positive trauma and neoplasm history, normal routine protocol images, and absent nerve root impingement. Extra-spinal abnormalities were more prevalent in age groups (20–39 years). Conclusion Coronal STIR images (field of view: mid abdomen to the lesser trochanters) identify extra-spinal abnormalities that maybe overlooked on routine MRI protocol. It is of additional value in young adults, trauma, neoplasm, and negative routine images.

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