scholarly journals Trends in Women With an HIV Diagnosis at Delivery Hospitalization in the United States, 2006-2014

2020 ◽  
Vol 135 (4) ◽  
pp. 524-533
Author(s):  
Maria Vyshnya Aslam ◽  
Kwame Owusu-Edusei ◽  
Steven R. Nesheim ◽  
Kristen Mahle Gray ◽  
Margaret A. Lampe ◽  
...  
Keyword(s):  
Black Women ◽  
Hiv Infection ◽  
White Women ◽  
Hiv Transmission ◽  
The United States ◽  
Sociodemographic Characteristics ◽  
Adjusted Relative Risk ◽  
Hiv Diagnosis ◽  
Mother To Child ◽  
Privately Insured

Objectives The risk of mother-to-child HIV transmission can be reduced to ≤0.5% if the mother’s HIV status is known before delivery. This study describes 2006-2014 trends in diagnosed HIV infection documented on delivery discharge records and associated sociodemographic characteristics among women who gave birth in US hospitals. Methods We analyzed data from the 2006-2014 National Inpatient Sample and identified delivery discharges and women with diagnosed HIV infection by using International Classification of Diseases, Ninth Revision, Clinical Modification codes. We used a generalized linear model with log link and binomial distribution to assess trends and the association of sociodemographic characteristics with an HIV diagnosis on delivery discharge records. Results During 2006-2014, an HIV diagnosis was documented on approximately 3900-4400 delivery discharge records annually. The probability of having an HIV diagnosis on delivery discharge records decreased 3% per year (adjusted relative risk [aRR] = 0.97; 95% CI, 0.94-0.99), with significant declines identified among white women aged 25-34 (aRR = 0.93; 95% CI, 0.88-0.97) or those using Medicaid (aRR = 0.93; 95% CI, 0.90-0.97); among black women aged 25-34 (aRR = 0.95; 95% CI, 0.92-0.99); and among privately insured women who were black (aRR = 0.96; 95% CI, 0.92-0.99), Hispanic (aRR = 0.92; 95% CI, 0.86-0.98), or aged 25-34 (aRR = 0.96; 95% CI, 0.92-0.99). The probability of having an HIV diagnosis on delivery discharge records was greater for women who were black (aRR = 8.45; 95% CI, 7.56-9.44) or Hispanic (aRR = 1.56; 95% CI, 1.33-1.83) than white; for women aged 25-34 (aRR = 2.33; 95% CI, 2.12-2.55) or aged ≥35 (aRR = 3.04; 95% CI, 2.79-3.31) than for women aged 13-24; and for Medicaid recipients (aRR = 2.70; 95% CI, 2.45-2.98) or the uninsured (aRR = 1.87; 95% CI, 1.60-2.19) than for privately insured patients. Conclusion During 2006-2014, the probability of having an HIV diagnosis declined among select sociodemographic groups of women delivering neonates. High-impact prevention efforts tailored to women remaining at higher risk for HIV infection can reduce the risk of mother-to-child HIV transmission.

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

scholarly journals Epidemiological factors associated with recent HIV infection among newly-diagnosed cases in Singapore, 2013–2017

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Li Wei Ang ◽  
Carmen Low ◽  
Chen Seong Wong ◽  
Irving Charles Boudville ◽  
Matthias Paul Han Sim Toh ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
Risk Groups ◽  
Newly Diagnosed ◽  
Hiv Diagnosis ◽  
Factors Associated ◽  
Epidemiological Factors ◽  
Voluntary Testing ◽  
Recent Hiv Infection

AbstractBackgroundEarly diagnosis is crucial in securing optimal outcomes in the HIV care cascade. Recent HIV infection (RHI) serves as an indicator of early detection in the course of HIV infection. Surveillance of RHI is important in uncovering at-risk groups in which HIV transmission is ongoing. The study objectives are to estimate the proportion of RHI among persons newly-diagnosed in 2013–2017, and to elucidate epidemiological factors associated with RHI in Singapore.MethodsAs part of the National HIV Molecular Surveillance Programme, residual plasma samples of treatment-naïve HIV-1 positive individuals were tested using the biotinylated peptide-capture enzyme immunoassay with a cutoff of normalized optical density ≤ 0.8 for evidence of RHI. A recent infection testing algorithm was applied for the classification of RHI. We identified risk factors associated with RHI using logistic regression analyses.ResultsA total of 701 newly-diagnosed HIV-infected persons were included in the study. The median age at HIV diagnosis was 38 years (interquartile range, 28–51). The majority were men (94.2%), and sexual route was the predominant mode of HIV transmission (98.3%). Overall, 133/701 (19.0, 95% confidence interval [CI] 16.2–22.0%) were classified as RHI. The proportions of RHI in 2015 (31.1%) and 2017 (31.0%) were significantly higher than in 2014 (11.2%). A significantly higher proportion of men having sex with men (23.4, 95% CI 19.6–27.6%) had RHI compared with heterosexual men (11.1, 95% CI 7.6–15.9%). Independent factors associated with RHI were: age 15–24 years (adjusted odds ratio [aOR] 4.18, 95% CI 1.69–10.31) compared with ≥55 years; HIV diagnosis in 2015 (aOR 2.36, 95% CI 1.25–4.46) and 2017 (aOR 2.52, 95% CI 1.32–4.80) compared with 2013–2014; detection via voluntary testing (aOR 1.91, 95% CI 1.07–3.43) compared with medical care; and self-reported history of HIV test(s) prior to diagnosis (aOR 1.72, 95% CI 1.06–2.81).ConclusionAlthough there appears to be an increasing trend towards early diagnosis, persons with RHI remain a minority in Singapore. The strong associations observed between modifiable behaviors (voluntary testing and HIV testing history) and RHI highlight the importance of increasing the accessibility to HIV testing for at-risk groups.

Determinants of Racial Disparities in Female Incarceration Rates, 2000–2018

2021 ◽  
pp. 003464462110510
Author(s):  
Samuel L. Myers ◽  
William J. Sabol ◽  
Man Xu
Keyword(s):  
Black Women ◽  
Racial Disparities ◽  
African American Women ◽  
White Women ◽  
National Research Council ◽  
The United States ◽  
White Female ◽  
Opioid Use ◽  
Incarceration Rate ◽  
Women In Prison

In The Growth of Incarceration in the United States, the National Research Council documents the large and persistent racial disparities in imprisonment that accompanied the more than quadrupling of the U.S. incarceration rate since the 1980s. Largely unnoticed by policy makers and opinion leaders in recent years is an unprecedented decrease in the number of African American women incarcerated at the same time that the number of white women in prison has grown to new heights. The result of these recent changes is a near convergence in black-white female incarceration rates from 2000 to 2016. In some states, the changes occurred abruptly and almost instantaneously. In other states, the convergence has been gradual. We find that changes in the population composition—the fraction of the population that is black—was the major contributor to the decline in the disparity among women. We also find that race-specific differences in drug overdose deaths stemming from the recent increases in opioid use lowered the disparity by increasing the white female imprisonment rate and lowering it for black women.

An Application of the Theory of Representative Bureaucracy, Gender Concordance, and Symbolic Representation in the Health Care Context

2021 ◽  
pp. 027507402110493
Author(s):  
Kenicia Wright
Keyword(s):  
Health Care ◽  
Black Women ◽  
Health Outcomes ◽  
White Women ◽  
The United States ◽  
Symbolic Representation ◽  
Representative Bureaucracy ◽  
Female Physicians ◽  
Individual Level ◽  
Gender Concordance

Although the United States spends more on health care than comparable nations, many Americans suffer from poor health. Many factors are emphasized as being important for improved health outcomes, including social and economic indicators, living and working conditions, and individual-level behavior. However, I argue the overwhelming attention to male health outcomes—compared to female health outcomes—and focus on factors that are “traditionally understood” as important in shaping health are two limitations of existing health-related research. I adopt an innovative approach that combines the theory of representative bureaucracy, gender concordance, and symbolic representation to argue that increase in female physicians contribute to improved female health outcomes. Using an originally collected dataset that contains information on female physicians, health outcomes, and state and individual-level factors, I study how female physicians influence the health outcomes of non-Hispanic White women, non-Hispanic Black women, and Latinas in the United States from 2000 to 2012. The findings suggest female physicians contribute to improved health outcomes for non-Hispanic White women and non-Hispanic Black women, but not Latinas. Supplemental Analysis bolsters confidence that the findings are not the result of increased access to health care professionals. This study highlights the importance of applying the theory of representative bureaucracy and symbolic representation to health care, the promise of greater female representation in health, and the insight gleaned from incorporating intersectionality in public administration research.

scholarly journals African American Women and Domestic Violence: Addressing their Voice of Silence

2019 ◽  
Author(s):  
Bernice Kennedy ◽  
Chalice Rhodes (Former Jenkins)
Keyword(s):  
United States ◽  
Domestic Violence ◽  
African American ◽  
Black Women ◽  
African American Women ◽  
White Women ◽  
The United States ◽  
Slave Owner ◽  
American Women ◽  
Strong Black Women

Abstract Historically, during slavery, the international slave trade promoted normalization of violence against African American women. During slavery, African American women endured inhuman conditions because of the majority race views of them as being over-sexualized, physically strong, and immoral. This perception of the African American women as being highly sexual and more sexual than white women results in slave owner justifying their sexual violation and degrading of the African American women. The stereotypical representations of African American women as strong, controlling, dangerous, fearless, and invulnerable may interfere with the African American women receiving the needed services for domestic violence in the community. The Strong Black Women Archetype has been dated back to slavery describing their coping mechanism in dealing with oppression by developing a strong, less traditionally female role. The authors developed a model: The Multidimensional Perspectives of Factors Contributing to Domestic Violence of African American Women in the United States. This model depicts historically, the factors contributing to domestic violence of African American women in the United States. Also, this model addressed the African American women subscribing to the Strong Black Women Archetype to cope with domestic violence. Despite the increase in domestic violence in African American women, they focused more on the issue of racism instead of sexism in America. African American women have experienced the two obstacles of racism and sexism in America. However, African American women and men believe racism is more critical than sexism. Therefore, domestic violence in the African American population may remain silent because of cultural loyalty. However, the voice of silence of African American females is gradually changing with the upcoming generations.

scholarly journals National-level effectiveness of ART to prevent early mother to child transmission of HIV in Namibia

PLoS ONE ◽  
2020 ◽  
Vol 15 (11) ◽  
pp. e0233341
Author(s):  
Andrew Agabu ◽  
Andrew L. Baughman ◽  
Christa Fischer-Walker ◽  
Michael de Klerk ◽  
Nicholus Mutenda ◽  
...  
Keyword(s):  
Hiv Transmission ◽  
National Level ◽  
Prevalence Ratio ◽  
Dried Blood Spots ◽  
Test Results ◽  
Hiv Diagnosis ◽  
Hiv Exposed Infants ◽  
Hiv Test ◽  
Hiv Exposed ◽  
Mother To Child

Background Namibia introduced the prevention of mother to child HIV transmission (MTCT) program in 2002 and lifelong antiretroviral therapy (ART) for pregnant women (option B-plus) in 2013. We sought to quantify MTCT measured at 4–12 weeks post-delivery. Methods During Aug 2014-Feb 2015, we recruited a nationally representative sample of 1040 pairs of mother and infant aged 4–12 weeks at routine immunizations in 60 public health clinics using two stage sampling approach. Of these, 864 HIV exposed infants had DNA-PCR HIV test results available. We defined an HIV exposed infant if born to an HIV-positive mother with documented status or diagnosed at enrollment using rapid HIV tests. Dried Blood Spots samples from HIV exposed infants were tested for HIV. Interview data and laboratory results were collected on smartphones and uploaded to a central database. We measured MTCT prevalence at 4–12 weeks post-delivery and evaluated associations between infant HIV infection and maternal and infant characteristics including maternal treatment and infant prophylaxis. All statistical analyses accounted for the survey design. Results Based on the 864 HIV exposed infants with test results available, nationally weighted early MTCT measured at 4–12 weeks post-delivery was 1.74% (95% confidence interval (CI): 1.00%-3.01%). Overall, 62% of mothers started ART pre-conception, 33.6% during pregnancy, 1.2% post-delivery and 3.2% never received ART. Mothers who started ART before pregnancy and during pregnancy had low MTCT prevalence, 0.78% (95% CI: 0.31%-1.96%) and 0.98% (95% CI: 0.33%-2.91%), respectively. MTCT rose to 4.13% (95% CI: 0.54%-25.68%) when the mother started ART after delivery and to 11.62% (95% CI: 4.07%-28.96%) when she never received ART. The lowest MTCT of 0.76% (95% CI: 0.36% - 1.61%) was achieved when mother received ART and ARV prophylaxis within 72hrs for infant and highest 22.32% (95%CI: 2.78% -74.25%) when neither mother nor infant received ARVs. After adjusting for mother’s age, maternal ART (Prevalence Ratio (PR) = 0.10, 95% CI: 0.03–0.29) and infant ARV prophylaxis (PR = 0.32, 95% CI: 0.10–0.998) remained strong predictors of HIV transmission. Conclusion As of 2015, Namibia achieved MTCT of 1.74%, measured at 4–12 weeks post-delivery. Women already on ART pre-conception had the lowest prevalence of MTCT emphasizing the importance of early HIV diagnosis and treatment initiation before pregnancy. Studies are needed to measure MTCT and maternal HIV seroconversion during breastfeeding.

Settings and Models of AIDS Psychiatric Care

2010 ◽  
Author(s):  
Harold W. Goforth ◽  
Sami Khalife
Keyword(s):  
Hiv Infection ◽  
Mental Health Professionals ◽  
Hiv Transmission ◽  
The United States ◽  
Hiv And Aids ◽  
Easy Access ◽  
Full Description ◽  
Psychiatric Illnesses ◽  
Adolescents And Adults ◽  
Primary Physicians

From primary prevention to end-of-life care, AIDS psychiatry can make significant contributions to preventing risk behaviors and HIV transmission, mitigating suffering, and improving adherence to risk reduction and medical care. Early in the epidemic, stigma and discrimination magnified suffering and excluded persons known to have HIV and AIDS from many settings in the United States and throughout the world. Such treatment of persons with AIDS was described (Cohen, 1989) as a new form of discrimination called “AIDSism.” As we approach the end of the third decade of the HIV pandemic, in most countries education, training, and experience have mitigated AIDSism, and persons with HIV and AIDS are now seen in varieties of medical and nonmedical settings. The multimorbid medical and psychiatric illnesses associated with HIV infection have complicated the care of persons with HIV and AIDS. A primary care guideline for the care of persons with HIV is available in print (Aberg et al., 2009) and online and is updated regularly at: http://www.journals.uchicago.edu/page/cid/IDSAguidelines.html. AIDS psychiatrists, psychosomatic medicine psychiatrists, as well as child, adult, and geriatric psychiatrists and other mental health professionals are in a unique position to intervene and provide both preventive and treatment interventions for children, adolescents, and adults who are vulnerable to, infected with, or affected by HIV infection. Psychiatrists generally make long-term and trusting relationships with their patients and take complete histories including sexual histories and substance use histories. Primary physicians, pediatricians, obstetricians, and HIV specialists as well as parents and teachers may also have unique opportunities to intervene throughout the life cycle. In this chapter, we provide a list of settings where educational opportunities abound and can lead to an improved understanding of how to prevent HIV transmission. These settings are summarized in Table 1.1. Since a full description of every setting with potential for intervention is beyond the scope of this chapter, we provide more specific descriptions of settings where providing education and easy access to testing, condoms, and drug and alcohol treatment can be therapeutic and lifesaving.

Introduction

ESC CardioMed ◽  
2018 ◽  
pp. 1185-1186
Author(s):  
Nombulelo P. Magula ◽  
Akira Singh
Keyword(s):  
Black Women ◽  
Hiv Infection ◽  
The United States ◽  
Sub Saharan Africa ◽  
Middle Income ◽  
High Burden ◽  
Immunodeficiency Virus ◽  
Widespread Availability ◽  
Sub Saharan ◽  
Young Black Women

Life expectancy has increased significantly with the widespread availability of antiretroviral therapy. Despite this, new human immunodeficiency virus (HIV) infection rates in low- to middle-income, high-burden countries remain a cause for concern. The greatest impact of infection remains in sub-Saharan Africa, among young black women. However, the majority of studies investigating cardiovascular disease associated with HIV infection have been conducted in the United States and Europe, in predominantly male cohorts.

scholarly journals Epidemiology of Human Immunodeficiency Virus in the United States

2007 ◽  
Vol 20 (3) ◽  
pp. 478-488 ◽  
Author(s):  
Susan Hariri ◽  
Matthew T. McKenna
Keyword(s):  
United States ◽  
Human Immunodeficiency Virus ◽  
Hiv Infection ◽  
Hiv Transmission ◽  
The United States ◽  
Population Based ◽  
True Incidence ◽  
Immunodeficiency Virus ◽  
Sex With Men ◽  
Fundamental Shift

SUMMARY The human immunodeficiency virus (HIV) epidemic emerged in the early 1980s with HIV infection as a highly lethal disease among men who have sex with men and among frequent recipients of blood product transfusions. Advances in the treatment of HIV infection have resulted in a fundamental shift in its epidemiology, to a potentially chronic and manageable condition. However, challenges in the prevention of this infection remain. In particular, increasing evidence suggests that transmission of drug-resistant virus is becoming more common and that the epidemic is having a profound impact on morbidity and mortality in ethnic and racial minority subgroups in the United States. New population-based data collection systems designed to describe trends in behaviors associated with HIV transmission and better methods for measuring the true incidence of transmission will better elucidate the characteristics of HIV infection in the United States and inform future public health policies.

scholarly journals Cardiovascular Health Score and Lifetime Risk of Cardiovascular Disease

2020 ◽  
Vol 13 (7) ◽  
Author(s):  
Joshua D. Bundy ◽  
Hongyan Ning ◽  
Victor W. Zhong ◽  
Amanda E. Paluch ◽  
Donald M. Lloyd-Jones ◽  
...  
Keyword(s):  
Cardiovascular Disease ◽  
Black Women ◽  
Black Men ◽  
White Women ◽  
Cardiovascular Health ◽  
United States Public Health ◽  
The United States ◽  
Lifetime Risk ◽  
Men And Women ◽  
Risk Of Death

Background: Long-term risks of cardiovascular disease (CVD) according to levels of cardiovascular health (CVH) have not been characterized in a diverse, representative population. Methods and Results: We pooled individual-level data from 30 447 participants (mean [SD] age, 55.0 [13.9] years; 60.6% women; 31.8% black) from 7 US cohort studies. We defined CVH based on levels of 7 American Heart Association health metrics, scored as ideal (2 points), intermediate (1 point), or poor (0 points). The total CVH score was used to quantify overall CVH as high (12–14 points), moderate (9–11 points), or low (0–8 points). We used a modified Kaplan-Meier analysis, accounting for the competing risk of death, to estimate the lifetime risk of CVD (composite of incident myocardial infarction, stroke, heart failure, or CVD death) separately in white and black men and women free of CVD at index ages of <40, 40 to 59, and ≥60 years. High CVH was more prevalent among women compared with men, white compared with black participants, and in younger compared with older participants. During 538 477 person-years of follow-up, we observed 6546 CVD events. In women aged 40 to 59 years, those with high CVH had lower lifetime risk (95% CI) of CVD (white women, 12.6% [2.6%–22.6%]; black women, 0.0%) compared with moderate (white women, 16.6% [13.0%–20.2%]; black women, 12.7% [6.8%–18.5%]) and low (white women, 33.8% [30.6%–37.1%]; black women, 34.7% [30.4%–39.0%]) CVH strata. Patterns were similar for men and individuals <40 and ≥60 years of age. Conclusions: Higher baseline CVH at all ages in adulthood is associated with substantially lower lifetime risk for CVD compared with moderate and low CVH, in white and black men and women in the United States. Public health and healthcare efforts aimed at maintaining and restoring higher CVH throughout the life course could provide substantial benefits for the population burden of CVD.

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