Incarceration African Americans and HIV: Advancing a Research Agenda

Incarceration is a crisis among African-Americans, and the prevalence of HIV/AIDS in incarcerated men and women is three to five times that of the general population. We explore the potential implications of the widespread incarceration of African Americans on HIV risk and HIV outcomes in 1) the current and formerly incarcerated, 2) their sexual partners, and 3) the communities impacted by incarceration. We set forth a research agenda for understanding and ameliorating the negative impacts incarceration and conclude that African-American populations’ ability to successfully address the HIV/AIDS epidemic requires a coordinated and evidence-based response to the challenge of effectively preventing, managing, and treating HIV in populations affected by incarceration

Concurrent Partnerships, Nonmonogamous Partners, and Substance Use Among Women in the United States

Objectives. We determined the prevalence, distribution, and correlates of US women's involvement in concurrent sexual partnerships, a sexual-network pattern that speeds population-wide HIV dissemination. Methods. We used sexual partnership dates reported by 7643 women in the 2002 National Survey of Family Growth to determine prevalence of concurrent sexual partnerships during the preceding 12 months. We examined associations between concurrency and sociodemographic characteristics and risk behaviors. Results. Prevalence of concurrent partnerships was 5.7% based on reported partnerships and 8.3% after adjustment for possible underreporting. Concurrency was associated with younger age (22 to 24 years: prevalence odds ratio [POR]=2.44) versus older age (40 to 44 years); marital status (formerly married: POR=6.56; never married: POR=3.81; vs married); Black race/ethnicity (POR=1.78); younger age at first sexual intercourse (12 to 13 years: POR=2.89) versus 18 years or older); having a nonmonogamous sexual partner (POR=6.96); having intercourse while ‘‘high’’ on drugs or alcohol (POR=1.61); binge drinking (POR=1.70); and crack or cocaine use (POR=2.72). Conclusions. The association of concurrency with nonmonogamous sexual partners and substance use suggests the existence of extensive sexual networks that link people at higher risk for HIV infection with increased opportunities for disseminating infection

Efficacy and clinical effectiveness of influenza vaccines in HIV-infected individuals: a meta-analysis

Abstract Background Though influenza vaccines are the cornerstone of medical interventions aimed at protecting individuals against epidemic influenza, their effectiveness in HIV infected individuals is not certain. With the recent detection of influenza strains in countries with high HIV prevalence rates, we aimed at evaluating the current evidence on the efficacy and clinical effectiveness of influenza vaccines in HIV-infected individuals. Methods We used electronic databases to identify studies assessing efficacy or effectiveness of influenza vaccines in HIV patients. We included studies that compared the incidence of culture- or serologically-confirmed influenza or clinical influenza-like illness in vaccinated to unvaccinated HIV infected individuals. Characteristics of study participants were independently abstracted and the risk difference (RD), the number needed to vaccinate to prevent one case of influenza (NNV) and the vaccine effectiveness (VE) computed. Results We identified six studies that assessed the incidence of influenza in vaccinated HIV-infected subjects. Four of these studies compared the incidence in vaccinated versus unvaccinated subjects. These involved a total of 646 HIV-infected subjects. In all the 4 studies, the incidence of influenza was lower in the vaccinated compared to unvaccinated subjects with RD ranging from -0.48 (95% CI: -0.63, -0.34) to -0.15 (95% CI: -0.25, 0.05); between 3 and 7 people would need to be vaccinated to prevent one case of influenza. Vaccine effectiveness ranged from 27% to 78%. A random effects model was used to obtain a summary RD of -0.27 (95%CI: -0.42, -0.11). There was no evidence of publication bias. Conclusion Current evidence, though limited, suggests that influenza vaccines are moderately effective in reducing the incidence of influenza in HIV-infected individuals. With the threat of a global influenza pandemic, there is an urgent need to evaluate the effectiveness of influenza vaccines in trials with a larger number of representative HIV-infected persons

Diversity in the US Infectious Diseases Workforce: Challenges for Women and Underrepresented Minorities

Research documents significant gender-based salary inequities among physicians and ongoing inadequacies in recruitment and promotion of physicians from underrepresented minority groups. Given the complexity of the social forces that promote these disparities, their elimination will likely require quantitative and qualitative research to understand the pathways that lead to them and to develop effective solutions. Interventions to combat implicit bias will be required, and structural interventions that hold medical school leadership accountable are needed to achieve and maintain salary equity and racial and gender diversity at all levels

Condom Use and Duration of Concurrent Partnerships Among Men in the United States

This analysis of male respondents in the 2002 National Survey of Family Growth describes features of concurrent sexual partnerships including duration, patterns, and condom use

Remdesivir and COVID-19

The Panel on Antiretroviral Guidelines for Adults and Adolescents with HIV and the American Association for the Study of Liver Diseases guidelines for hepatitis C virus treatment suggest that combination therapy for severe acute respiratory syndrome coronavirus 2 infection will outperform single drugs

Sexual Mixing Patterns and Heterosexual HIV Transmission Among African Americans in the Southeastern United States

Heterosexually transmitted HIV infection rates are disproportionately high among African Americans. HIV transmission is influenced by sexual network characteristics, including sexual partnership mixing patterns among sub-populations with different prevalences of infection

Ending the Epidemic of Heterosexual HIV Transmission Among African Americans

This article examines factors responsible for the stark racial disparities in HIV infection in the U.S. and the now concentrated epidemic among African Americans. Sexual network patterns characterized by concurrency and mixing among different subpopulations, together with high rates of other sexually transmitted infections, facilitate dissemination of HIV among African Americans. The social and economic environment in which many African Americans live shapes sexual network patterns and increases personal infection risk almost independently of personal behavior. The African American HIV epidemic constitutes a national crisis whose successful resolution will require modifying the social and economic systems, structures, and processes that facilitate HIV transmission in this population

Measuring Concurrency Attitudes: Development and Validation of a Vignette-Based Scale

Concurrent sexual partnerships (partnerships that overlap in time) may contribute to higher rates of HIV transmission in African Americans. Attitudes toward a behavior constitute an important component of most models of health-related behavior and behavioral change. We have developed a scale, employing realistic vignettes that appear to reliably measure attitudes about concurrency in young African American adults