scholarly journals University of North Carolina/Emory Center for Innovative Technology (iTech) for Addressing the HIV Epidemic Among Adolescents and Young Adults in the United States Concerning the Prevention and Care Continuum: Protocol and Rationale for Center Development (Preprint)

2018 ◽  
Author(s):  
Lisa Hightow-Weidman ◽  
Kathryn Muessig ◽  
Eli Rosenberg ◽  
Travis Sanchez ◽  
Sara LeGrand ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
North Carolina ◽  
Young Adults ◽  
Hiv Prevention ◽  
Hiv Infections ◽  
The United States ◽  
Innovative Technology ◽  
Care Continuum ◽  
Hiv Epidemic

BACKGROUND Over a fifth of all new HIV infections in the United States occur among persons aged 13 24 years, with most of these diagnoses occurring among gay and bisexual males (81%). While the epidemic of HIV in the United States has leveled off for many age groups, the annual number of new HIV diagnoses among young men who have sex with men (YMSM; 13-24 years old) remains high. Traditional approaches to continuum improvement for youth have been insufficient, and targeted interventions are urgently needed for young people at risk for or infected with HIV. Interventions delivered through mHealth technology represent a promising approach for improving outcomes in this population. Mobile phones have nearly reached saturation among youth, making mobile technology a particularly promising tool for reaching this population. OBJECTIVE The University of North Carolina/Emory Center for Innovative Technology (iTech) is a National Institutes of Health cooperative agreement as part of the Adolescent Medicine Trials Network for HIV/AIDS Interventions. iTech aims to impact the HIV epidemic by conducting innovative, interdisciplinary research on technology-based interventions across the HIV prevention and care continuum for adolescents and young adults in the United States, particularly YMSM, by providing the following: (1) Evaluation of novel approaches to identifying youth with undiagnosed HIV infections; (2) evaluation of multilevel, combination prevention approaches, particularly relevant to gender- and sexual-minority youth facing co-occurring health risks; (3) evaluation of uptake of and adherence to biomedical prevention modalities; and 4) evaluation of interventions designed to promote or optimize engagement in care and antiretroviral therapy adherence in HIV-positive youth, to optimize viral load suppression. METHODS iTech brings together multidisciplinary experts in the fields of adolescent HIV treatment and prevention, development and evaluation of technology-based interventions, HIV surveillance and epidemiology, and intervention design and evaluation. This initiative will support 8 efficacy trials and 2 exploratory projects, each led by 2 principal investigators. Taken together, the studies address all of the key steps of the HIV prevention and care continuum for youth in the United States. Each proposal uses technology in a scientifically rigorous and innovative way to access, engage, and impact at-risk or infected youth. Nine iTech subject recruitment venues are spread across 8 US cities. Three cores (management, analytic, and technology) support all iTech activities and form the research network’s infrastructure, facilitating all aspects of study implementation and evaluation. RESULTS Formative work has already begun on many of the above-mentioned iTech trials. We expect the first randomized controlled trials to begin in mid-2018. Additional details can be found in the individual intervention protocol papers in this issue. CONCLUSIONS Through its comprehensive research portfolio, iTech aims to effectively advance HIV prevention and care for youth through technology-based, youth-relevant interventions that maximize adaptability and sustainability.

scholarly journals University of North Carolina/Emory Center for Innovative Technology (iTech) for Addressing the HIV Epidemic Among Adolescents and Young Adults in the United States: Protocol and Rationale for Center Development

10.2196/10365 ◽  
2018 ◽  
Vol 7 (8) ◽  
pp. e10365 ◽  
Author(s):  
Lisa B Hightow-Weidman ◽  
Kathryn Muessig ◽  
Eli Rosenberg ◽  
Travis Sanchez ◽  
Sara LeGrand ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
North Carolina ◽  
Young Adults ◽  
Hiv Prevention ◽  
Hiv Infections ◽  
The United States ◽  
Innovative Technology ◽  
Care Continuum ◽  
Hiv Epidemic

BackgroundOver a fifth of all new HIV infections in the United States occur among persons aged 13 24 years, with most of these diagnoses occurring among gay and bisexual males (81%). While the epidemic of HIV in the United States has leveled off for many age groups, the annual number of new HIV diagnoses among young men who have sex with men (YMSM; 13-24 years old) remains high. Traditional approaches to continuum improvement for youth have been insufficient, and targeted interventions are urgently needed for young people at risk for or infected with HIV. Interventions delivered through mobile health technology represent a promising approach for improving outcomes in this population. Mobile phones have nearly reached saturation among youth, making mobile technology a particularly promising tool for reaching this population.ObjectiveThe University of North Carolina/Emory Center for Innovative Technology (iTech) is a National Institutes of Health cooperative agreement as part of the Adolescent Medicine Trials Network for HIV/AIDS Interventions. iTech aims to impact the HIV epidemic by conducting innovative, interdisciplinary research on technology-based interventions across the HIV prevention and care continuum for adolescents and young adults in the United States, particularly YMSM, by providing the following: (1) evaluation of novel approaches to identifying youth with undiagnosed HIV infections; (2) evaluation of multilevel, combination prevention approaches, particularly relevant to gender- and sexual-minority youth facing co-occurring health risks; (3) evaluation of uptake of and adherence to biomedical prevention modalities; and 4) evaluation of interventions designed to promote or optimize engagement in care and antiretroviral therapy adherence in HIV-positive youth, to optimize viral load suppression.MethodsiTech brings together multidisciplinary experts in the fields of adolescent HIV treatment and prevention, development and evaluation of technology-based interventions, HIV surveillance and epidemiology, and intervention design and evaluation. This initiative will support 8 efficacy trials and 2 exploratory projects, each led by 2 principal investigators. Taken together, the studies address all of the key steps of the HIV prevention and care continuum for youth in the United States. Each proposal uses technology in a scientifically rigorous and innovative way to access, engage, and impact at-risk or infected youth. Nine iTech subject recruitment venues are spread across 8 US cities. Three cores (management, analytic, and technology) support all iTech activities and form the research network’s infrastructure, facilitating all aspects of study implementation and evaluation.ResultsFormative work has already begun on many of the above-mentioned iTech trials. We expect the first randomized controlled trials to begin in mid-2018. Additional details can be found in the individual intervention protocol papers in this issue.ConclusionsThrough its comprehensive research portfolio, iTech aims to effectively advance HIV prevention and care for youth through technology-based, youth-relevant interventions that maximize adaptability and sustainability.Registered Report IdentifierRR1-10.2196/10365

scholarly journals Characteristics and Reach Equity of Policies Restricting Flavored Tobacco Product Sales in the United States

2020 ◽  
Vol 21 (1_suppl) ◽  
pp. 44S-53S ◽  
Author(s):  
Shyanika W. Rose ◽  
Michael S. Amato ◽  
Andrew Anesetti-Rothermel ◽  
Brittany Carnegie ◽  
Zeinab Safi ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Young Adults ◽  
American Indians ◽  
Low Socioeconomic Status ◽  
The United States ◽  
Tobacco Product ◽  
Native Hawaiians ◽  
Same Sex ◽  
Flavored Tobacco

In 2009, flavored cigarettes (except menthol) were banned in the United States, but other flavored tobacco products (FTPs) were allowed. Women, populations of color, youth, sexual minority, and low–socioeconomic status populations disproportionately use FTPs. Localities have passed sales restrictions on FTPs that may reduce disparities if vulnerable populations are reached. This study assessed the extent to which FTP restrictions reached these subgroups (“reach equity”). We identified 189 U.S. jurisdictions with FTP policies as of December 31, 2018. We linked jurisdictions with demographics of race/ethnicity, gender, age, partnered same-sex households and household poverty, and stratified by policy strength. We calculated Reach Ratios (ReRas) to assess reach equity among subgroups covered by FTP policies relative to their U.S. population representation. Flavor policies covered 6.3% of the U.S. population (20 million individuals) across seven states; 0.9% were covered by strong policies (12.7% of policies). ReRas indicated favorable reach equity to young adults, women, Hispanics, African Americans, Asians, partnered same-sex households, and those living below poverty. Youth, American Indians/Alaska Natives (AIAN) and Native Hawaiians/Pacific Islanders (NHPI) were underrepresented. Strong policies had favorable reach equity to young adults, those living below poverty, Asians, NHPIs, individuals of 2+ races, and partnered same-sex households, but unfavorable reach equity to women, youth, Hispanic, AIAN, and African American populations. U.S. flavor policies have greater reach to many, but not all, subgroups at risk of FTP use. Increased enactment of strong policies to populations not covered by flavor policies is warranted to ensure at-risk subgroups sufficiently benefit.

scholarly journals IMMIGRANT FAMILY SEPARATION, FEAR, AND THE U.S. DEPORTATION REGIME

2018 ◽  
pp. 0
Author(s):  
Elizabeth ARANDA ◽  
Elizabeth VAQUERA
Keyword(s):  
United States ◽  
At Risk ◽  
Young Adults ◽  
Immigration Policy ◽  
The United States ◽  
Immigrant Family ◽  
Family Separation ◽  
Undocumented Status ◽  
Depth Interviews ◽  
The U.S

In 2018, President Trump changed a long-standing policy of keeping families who cross the United States border together; instead, he ordered that parents be detained separately from children, drawing a national outcry that led to his administration walking back the practice. Drawing on 50 in-depth interviews with undocumented young adults in the state of Florida, USA, we argue that the practice of family separation through immigration policy is not new. We illustrate how our sample’s undocumented status puts them at risk for family separation under the current ‘deportation regime’ that creates a heightened and all-encompassing fear about the possibility of family separation.

Results from a PrEP Demonstration Project for At-Risk Cisgender Women in the United States

2021 ◽  
Author(s):  
Jill Blumenthal ◽  
Sonia Jain ◽  
Feng He ◽  
K Rivet Amico ◽  
Ryan Kofron ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Text Messaging ◽  
Hiv Infections ◽  
The United States ◽  
Dried Blood Spots ◽  
Demonstration Project ◽  
Open Label ◽  
Drug Concentrations ◽  
Hiv Acquisition

Abstract Background Daily oral tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) is effective for reducing HIV acquisition among cisgender women. We report results from the first United States observational open-label demonstration project of PrEP among at-risk cisgender women. Methods Adherence Enhancement Guided by Individualized Texting and Drug Levels (AEGiS) was a 48-week single-arm open-label demonstration study of daily oral TDF/FTC in cisgender women ≥18 years old at-risk for HIV. Adherence was supported using two-way text messaging and titrated adherence counseling based on rapid-turnaround tenofovir diphosphate concentrations from dried blood spots. Study visits occurred at baseline, and at weeks 4, 12, and quarterly through week 48. Outcomes included TDF/FTC adherence, retention and persistence. Results From June 2016 to October 2018, 136 cisgender women enrolled [mean age 40 (SD 11); 38% non-Hispanic (NH) Black and 19% Latina]. At 48 weeks, 84 (62%) participants were retained and 62 (46%) remained on PrEP. Over one-third (12/31) of those on study but off PrEP throughout study discontinued TDF/FTC due to side effects, and one adverse event led to study discontinuation. Of 120 participants with drug concentrations measured, 67 (56%) had at least one concentration consistent with ≥6 doses/week (d/w); 22 (18%) had consistent ≥6 d/w across all study visits attended. There were no incident HIV infections and 4 incident bacterial STIs. Conclusion Adequate PrEP adherence for protective drug concentrations was not achieved for most study participants. More work needs to be done to fully explicate the reasons for non-adherence and low retention in cisgender women.

scholarly journals Human Immunodeficiency Virus (HIV) Subtype Surveillance of African‐Born Persons at Risk for Group O and Group N HIV Infections in the United States

2000 ◽  
Vol 181 (2) ◽  
pp. 463-469 ◽  
Author(s):  
Patrick S. Sullivan ◽  
Ann N. Do ◽  
Dennis Ellenberger ◽  
Chou‐Pong Pau ◽  
Sindy Paul ◽  
...  
Keyword(s):  
United States ◽  
At Risk ◽  
Human Immunodeficiency Virus ◽  
Hiv Infections ◽  
The United States ◽  
Immunodeficiency Virus

scholarly journals A spatial approach for Ending the HIV Epidemic for the United States – A DC Model

2020 ◽  
Author(s):  
Suparna Das ◽  
Adam Allston ◽  
Jenevieve Opoku ◽  
Michael Kharfen
Keyword(s):  
United States ◽  
At Risk ◽  
Viral Suppression ◽  
The United States ◽  
Hiv Positive ◽  
Population At Risk ◽  
Hiv Epidemic ◽  
Spatial Approach ◽  
Mode Of Transmission ◽  
Sex With Men

Abstract Background Mode of transmission based hotspots is a smart approach to HIV mitigation yet remains poorly evaluated and implemented in the United States. The primary aim of the analysis is identifying mode of transmission based hotspots and population at risk of lower viral suppression to assist in targeted planning and implementation of programs. Methods We implemented spatial statistics to identify global-local hotspots and regression to find population at risk of lower viral suppression within the hotspots. Data was obtained from DC’s active surveillance system which were geocoded based on address of current residence. Results The analysis identified 6001 HIV positive men-who-have-sex with men (MSMs) and 6077 HIV positives non-MSMs (n=12078) living in DC, end of 2018. The hotspots for MSMs were central DC and non-MSM in south DC. Trends of viral suppression within MSM hotspots shows plateauing and among non-MSMs showed decline. The regression analysis showed MSM aged 21 – 25 (RR: 3.199, 95% CI: 1.832, 5.586) and not linked to care (8.592; 2.907, 25.398) were at higher risk of being virally unsuppressed within the hotspots. For non-MSMs we found that aged 12 – 18 (9.025; 3.314, 2.581) and unknown linkages (6.087; 3.346, 13.848) were at higher risk of being virally unsuppressed within the hotspots. Conclusion Our analysis provides a model that may be used by other jurisdictions to identify areas of priorities and plan treatment adherence programs using surveillance data. Attaining viral suppression is crucial in reducing new diagnoses and spatial approach can be an important tool Ending the HIV Epidemic.

The Informal Norms of HIV Prevention: The Emergence and Erosion of the Condom Code

2017 ◽  
Vol 45 (4) ◽  
pp. 518-530 ◽  
Author(s):  
Byron Carson
Keyword(s):  
United States ◽  
Hiv Prevention ◽  
Gay Men ◽  
The United States ◽  
Hiv Treatment ◽  
Normative Beliefs ◽  
Digital Communities ◽  
Condom Usage ◽  
Treatment And Prevention ◽  
Hiv Epidemic

The response many gay men took to the HIV epidemic in the United States was largely informal, especially given distant state and federal governments. The condom code, a set of informal norms that encouraged the use of condoms, is one instance of this informal response, which was wholly uncoordinated. Yet, it is not clear why these informal norms emerged or why they have since eroded. This paper explores how gay men in particular generated expectations and normative beliefs regarding condom usage, which helped to establish the condom code as an informal norm. Furthermore, the erosion of the condom code is viewed as a result of changing expectations, which change as bio-medical means of HIV treatment and prevention develop and as online and digital communities facilitate serosorting, all of which provide alternatives to condoms as a means of prevention and their associated informal norms. Future HIV prevention campaigns should recognize the extent to which informal norms coordinate and encourage preventative behavior, as well as how beliefs and expectations alter the informal norms people adopt.

Exploring Diaphragm Use as a Potential HIV Prevention Strategy Among Women in the United States at Risk

2008 ◽  
Vol 20 (2) ◽  
pp. 135-147 ◽  
Author(s):  
S. Marie Harvey ◽  
Meredith R. Branch ◽  
Sheryl Thorburn ◽  
Jocelyn Warren ◽  
America Casillas
Keyword(s):  
United States ◽  
At Risk ◽  
Hiv Prevention ◽  
The United States ◽  
Prevention Strategy
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