The impact of HIV infection and socioeconomic factors on the incidence of gonorrhea: A county-level, US-wide analysis

AbstractBackgroundThe effect of socioeconomic factors, ethnicity, and other variables, on the frequency of COVID-19 cases [morbidity] and induced deaths [mortality] at sub-population, rather than at individual levels, is only partially understood.ObjectiveTo determine which county-level features best predict COVID-19 morbidity and mortality for a given county in the U.S.DesignA Machine-Learning model that predicts COVID-19 mortality and morbidity using county-level features, followed by a SHAP-values-based importance analysis of the predictive features.SettingPublicly available data from various American government and news websites.Participants3,071 U.S. counties, from which 53 county-level features, as well as morbidity and mortality numbers, were collected.MeasurementsFor each county: Ethnicity, socioeconomic factors, educational attainment, mask usage, population density, age distribution, COVID-19 morbidity and mortality, air quality indicators, presidential election results, ICU beds.ResultsA Random Forest classifier produced an AUROC of 0.863 for morbidity prediction and an AUROC of 0.812 for mortality prediction. A SHAP-values-based analysis indicated that poverty rate, obesity rate, mean commute time to work, and proportion of people that wear masks significantly affected morbidity rates, while ethnicity, median income, poverty rate, and education levels, heavily influenced mortality rates. The correlation between several of these factors and COVID-19 morbidity and mortality, from 4/2020 to 11/2020 shifted, probably due to COVID-19 being initially associated with more urbanized areas, then with less urbanized ones.LimitationsData are still coming in.ConclusionsEthnicity, education, and economic disparity measures are major factors in predicting the COVID-19 mortality rate in a county. Between-counties low-variance factors (e.g., age), are not meaningful predictors.Differing correlations can be explained by the COVID-19 spread from metropolitan to less metropolitan areas.Primary Funding SourceNone.

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285: The Impact of Socioeconomic Factors on Prostate Cancer Outcomes in a Large Series of African-American Patients

The Journal of Urology ◽

10.1016/s0022-5347(18)30550-0 ◽

2007 ◽

Vol 177 (4S) ◽

pp. 95-95

Author(s):

Atreya Dash ◽

Peng Lee ◽

Qin Zhou ◽

Aaron D. Berger ◽

Jerome Jean-Gilles ◽

...

Keyword(s):

Prostate Cancer ◽

African American ◽

Socioeconomic Factors ◽

Large Series ◽

Cancer Outcomes ◽

The Impact

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Faculty Opinions recommendation of Metaanalysis and metaregression in interpreting study variability in the impact of sexually transmitted diseases on susceptibility to HIV infection.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.720848439.793514023 ◽

2016 ◽

Author(s):

David Leitsch

Keyword(s):

Hiv Infection ◽

Sexually Transmitted Diseases ◽

Sexually Transmitted ◽

The Impact

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AB0602 IMPACT OF SOCIOECONOMIC FACTORS ON PAIN AND FUNCTION IN KNEE OSTEOARTHRITIS: A SYSTEMATIC LITERATURE REVIEW

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2021-eular.3634 ◽

2021 ◽

Vol 80 (Suppl 1) ◽

pp. 1337.2-1337

Author(s):

T. W. Swinnen ◽

M. Willems ◽

I. Jonkers ◽

F. P. Luyten ◽

J. Vanrenterghem ◽

...

Keyword(s):

Risk Factors ◽

Literature Review ◽

Knee Osteoarthritis ◽

Socioeconomic Factors ◽

Systematic Literature Review ◽

Intervention Effects ◽

Socioeconomic Outcomes ◽

And Function ◽

The Impact

Background:The personal and societal burden of knee osteoarthritis (KOA) urges the research community to identify factors that predict its onset and progression. A mechanistic understanding of disease is currently lacking but needed to develop targeted interventions. Traditionally, risk factors for KOA are termed ‘local’ to the joint or ‘systemic’ referring to whole-body systems. There are however clear indications in the scientific literature that contextual factors such as socioeconomic position merit further scientific scrutiny, in order to justify a more biopsychosocial view on risk factors in KOA.Objectives:The aims of this systematic literature review were to assess the inclusion of socioeconomic factors in KOA research and to identify the impact of socioeconomic factors on pain and function in KOA.Methods:Major bibliographic databases, namely Medline, Embase, CINAHL, Web of Science and Cochrane, were independently screened by two reviewers (plus one to resolve conflicts) to identify research articles dealing with socioeconomic factors in the KOA population without arthroplasty. Included studies had to quantify the relationship between socioeconomic factors and pain or function. Main exclusion criteria were: a qualitative design, subject age below 16 years and articles not written in English or Dutch. Methodological quality was assessed via the Cochrane risk of bias tools for randomized (ROB-II) and non-randomized intervention studies (ROBIN-I) and the Newcastle-Ottawa Scale for assessing the quality of non-randomised studies. Due to heterogeneity of studies with respect to outcomes assessed and analyses performed, no meta-analysis was performed.Results:Following de-duplication, 7639 articles were available for screening (120 conflicts resolved without a third reader). In 4112 articles, the KOA population was confirmed. 1906 (25%) were excluded because of knee arthroplasty and 1621 (21%) because of other issues related to the population definition. Socioeconomic factors could not be identified in 4058 (53%) papers and were adjusted for in 211 (3%) articles. In the remaining papers covering pain (n=110) and/or function (n=81), education (62%) and race (37%) were most frequently assessed as socioeconomic factors. A huge variety of mainly dichotomous or ordinal socioeconomic outcomes was found without further methodological justification nor sensitivity analysis to unravel the impact of selected categories. Although the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) was the most popular instrument to assess pain and function, data pooling was not possible as socioeconomic factors estimates were part of multilevel models in most studies. Overall results showed that lower education and African American race were consistent predictors of pain and poor function, but those effects diminished or disappeared when psychological aspects (e.g. discrimination) or poverty estimates were taken into account. When function was assessed using self-reported outcomes, the impact of socioeconomic factors was more clear versus performance-based instruments. Quality of research was low to moderate and the moderating or mediating impact of socioeconomic factors on intervention effects in KOA is understudied.Conclusion:Research on contextual socioeconomic factors in KOA is insufficiently addressed and their assessment is highly variable methodologically. Following this systematic literature review, we can highlight the importance of implementing a standardised and feasible set of socioeconomic outcomes in KOA trials1, as well as the importance of public availability of research databases including these factors. Future research should prioritise the underlying mechanisms in the effect of especially education and race on pain and function and assess its impact on intervention effects to fuel novel (non-)pharmacological approaches in KOA.References:[1]Smith TO et al. The OMERACT-OARSI Core Domain Set for Measurement in Clinical Trials of Hip and/or Knee Osteoarthritis J Rheumatol 2019. 46:981–9.Disclosure of Interests:None declared.

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COVID-19 restrictions and changing sexual behaviours in HIV-negative MSM at high risk of HIV infection in London, UK

Sexually Transmitted Infections ◽

10.1136/sextrans-2020-054768 ◽

2021 ◽

pp. sextrans-2020-054768

Author(s):

Iain Hyndman ◽

Diarmuid Nugent ◽

Gary George Whitlock ◽

Alan McOwan ◽

Nicolò Girometti

Keyword(s):

High Risk ◽

Hiv Infection ◽

Sexual Activity ◽

Sexual Behaviour ◽

Well Being ◽

Categorical Variables ◽

Cross Sectional ◽

The Impact ◽

Mental Well Being ◽

Hiv Negative

ObjectivesThe COVID-19 pandemic and its related restrictions have affected attendance to and delivery of UK sexual healthcare services (SHS). We surveyed the impact on sexual behaviour of men having sex with men (MSM) to inform future SHS provision.MethodsWe conducted a cross-sectional, anonymous, web-based survey among HIV-negative MSM at high risk of HIV infection who attended 56 Dean Street, a sexual health and HIV clinic. The survey was conducted over a 7-day period in August 2020. Data on sociodemographic characteristics, sexual behaviour and related mental well-being experienced during lockdown (defined as 23 March–30 June 2020) were extracted. Categorical and non-categorical variables were compared according to HIV pre-exposure prophylaxis (PrEP) use.Results814 MSM completed the questionnaire: 75% were PrEP users; 76% reported they have been sexually active, of which 76% reported sex outside their household. 75% reported fewer partners than prior to lockdown. Isolation/loneliness (48%) and anxiety/stress (27%) triggered sexual activity, and 73% had discussed COVID-19 transmission risks with their sexual partners. While 46% reported no change to emotions ordinarily experienced following sex, 20% reported guilt for breaching COVID-19 restrictions. 76% implemented one or more changes to their sexual behaviour, while 58% applied one or more steps to reduce COVID-19 transmission during sex. 36% accessed SHS and 30% reported difficulties in accessing testing/treatment. Of those who accessed SHS, 28% reported an STI diagnosis. PrEP users reported higher partner number, engagement in ‘chemsex’ and use of SHS than non-PrEP users.ConclusionsCOVID-19 restrictions had a considerable impact on sexual behaviour and mental well-being in our survey respondents. High rates of sexual activity and STI diagnoses were reported during lockdown. Changes to SHS provision for MSM must respond to high rates of psychological and STI-related morbidity and the challenges faced by this population in accessing services.

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Assessing the Economic and Environmental Impacts of Alternative Renewable Portfolio Standards: Winners and Losers

Energies ◽

10.3390/en14113319 ◽

2021 ◽

Vol 14 (11) ◽

pp. 3319

Author(s):

Jamal Mamkhezri ◽

Leonard A. Malczynski ◽

Janie M. Chermak

Keyword(s):

New Mexico ◽

Environmental Impacts ◽

The State ◽

Policy Implications ◽

Renewable Portfolio Standard ◽

County Level ◽

Renewable Portfolio Standards ◽

Energy Potential ◽

Output Analysis ◽

The Impact

State-mandated renewable portfolio standards affect substantial portions of the total U.S. electricity supply. Renewable portfolio standards are environmentally motivated policies, yet they have the potential to greatly impact economy. There is not an agreement in the literature on the impact of renewable portfolio standards policies on regional economies, especially on job creation. By integrating various methodologies including econometrics, geographic information system, and input–output analysis into a unique system dynamics model, this paper estimates the economic and environmental impacts of various renewable portfolio standards scenarios in the state of New Mexico, located in Southwestern U.S. The state is endowed with traditional fossil fuel resources and substantial renewable energy potential. In this work we estimated and compared the economic and environmental tradeoffs at the county level under three renewable portfolio standards: New Mexico’s original standard of 20% renewables, the recently adopted 100% renewables standard, and a reduced renewable standard of 10%. The final one would be a return to a more traditional generation profile. We found that while the 20% standard has the highest market-based economic impact on the state as a whole, it is not significantly different from other scenarios. However, when environmental impacts are included, the 100% standard yields the highest value. In addition, while the state level economic impacts across the three scenarios are not significantly different, the county-level impacts are substantial. This is especially important for a state like New Mexico, which has a high reliance on energy for economic development. A higher renewable portfolio standard appears to be an economic tool to stimulate targeted areas’ economic growth. These results have policy implications.

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Adolescent, Pregnant, and HIV-Infected: Risk of Adverse Pregnancy and Perinatal Outcomes in Young Women from Southern Mozambique

Journal of Clinical Medicine ◽

10.3390/jcm10081564 ◽

2021 ◽

Vol 10 (8) ◽

pp. 1564

Author(s):

Clara Pons-Duran ◽

Aina Casellas ◽

Azucena Bardají ◽

Anifa Valá ◽

Esperança Sevene ◽

...

Keyword(s):

Hiv Infection ◽

Maternal Morbidity ◽

Low Birthweight ◽

Negative Binomial ◽

Perinatal Outcomes ◽

Sub Saharan Africa ◽

P Value ◽

Increased Risk ◽

Adverse Pregnancy ◽

The Impact

Sub-Saharan Africa concentrates the burden of HIV and the highest adolescent fertility rates. However, there is limited information about the impact of the interaction between adolescence and HIV infection on maternal health in the region. Data collected prospectively from three clinical trials conducted between 2003 and 2014 were analysed to evaluate the association between age, HIV infection, and their interaction, with the risk of maternal morbidity and adverse pregnancy and perinatal outcomes in women from southern Mozambique. Logistic regression and negative binomial models were used. A total of 2352 women were included in the analyses; 31% were adolescents (≤19 years) and 29% HIV-infected women. The effect of age on maternal morbidity and pregnancy and perinatal adverse outcomes was not modified by HIV status. Adolescence was associated with an increased incidence of hospital admissions (IRR 0.55, 95%CI 0.37–0.80 for women 20–24 years; IRR 0.60, 95%CI 0.42–0.85 for women >25 years compared to adolescents; p-value < 0.01) and outpatient visits (IRR 0.86, 95%CI 0.71–1.04; IRR 0.76, 95%CI 0.63–0.92; p-value = 0.02), and an increased likelihood of having a small-for-gestational age newborn (OR 0.50, 95%CI 0.38–0.65; OR 0.43, 95%CI 0.34–0.56; p-value < 0.001), a low birthweight (OR 0.40, 95%CI 0.27–0.59; OR 0.37, 95%CI 0.26–0.53; p-value <0.001) and a premature birth (OR 0.42, 95%CI 0.24–0.72; OR 0.51, 95%CI 0.32–0.82; p-value < 0.01). Adolescence was associated with an increased risk of poor morbidity, pregnancy and perinatal outcomes, irrespective of HIV infection. In addition to provision of a specific maternity care package for this vulnerable group interventions are imperative to prevent adolescent pregnancy.

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Exploring the impact of HIV infection and antiretroviral therapy on placenta morphology

Placenta ◽

10.1016/j.placenta.2020.12.004 ◽

2021 ◽

Vol 104 ◽

pp. 102-109

Author(s):

Michael Yampolsky ◽

Oleksandr Shlakhter ◽

Dianna Deng ◽

Smriti Kala ◽

Sharon L. Walmsley ◽

...

Keyword(s):

Antiretroviral Therapy ◽

Hiv Infection ◽

The Impact

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Racial Disparities in Virologic Failure and Tolerability During Firstline HIV Antiretroviral Therapy

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz022 ◽

2019 ◽

Vol 6 (2) ◽

Cited By ~ 1

Author(s):

Priya Bhagwat ◽

Shashi N Kapadia ◽

Heather J Ribaudo ◽

Roy M Gulick ◽

Judith S Currier

Keyword(s):

Antiretroviral Therapy ◽

Adverse Events ◽

Socioeconomic Factors ◽

Ethnic Groups ◽

Virologic Failure ◽

Virologic Suppression ◽

Factors Associated ◽

Race Ethnicity ◽

The Impact ◽

Racial Ethnic

Abstract Background Racial/ethnic disparities in HIV outcomes have persisted despite effective antiretroviral therapy. In a study of initial regimens, we found viral suppression varied by race/ethnicity. In this exploratory analysis, we use clinical and socioeconomic data to assess factors associated with virologic failure and adverse events within racial/ethnic groups. Methods Data were from AIDS Clinical Trial Group A5257, a randomized trial of initial regimens with either atazanavir/ritonavir, darunavir/ritonavir, or raltegravir (each combined with tenofovir DF and emtricitabine). We grouped participants by race/ethnicity and then used Cox-proportional hazards regression to examine the impact of demographic, clinical, and socioeconomic factors on the time to virologic suppression and time to adverse event reporting within each racial/ethnic group. Results We analyzed data from 1762 participants: 757 self-reported as non-Hispanic black (NHB), 615 as non-Hispanic white (NHW), and 390 as Hispanic. The proportion with virologic failure was higher for NHB (22%) and Hispanic (17%) participants compared with NHWs (9%). Factors associated with virologic failure were poor adherence and higher baseline HIV RNA level. Prior clinical AIDS diagnosis was associated with virologic failure for NHBs only, and unstable housing and illicit drug use for NHWs only. Factors associated with adverse events were female sex in all groups and concurrent use of medications for comorbidities in NHB and Hispanic participants only. Conclusions Clinical and socioeconomic factors that are associated with virologic failure and tolerability of antiretroviral therapy vary between and within racial and ethnic groups. Further research may shed light into mechanisms leading to disparities and targeted strategies to eliminate those disparities.

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