11 research outputs found
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Self-reported sex partner dates for use in measuring concurrent sexual partnerships: correspondence between two assessment methods.
Although prevalence of concurrent sexual partnerships is increasingly investigated as a driver of HIV epidemics, its measurement varies and its role in transmission dynamics remains contested. Relying on different methods of obtaining self-reported partnership histories may lead to significant differences in prevalence. This study examined the reliability of two methods for assessing dates of sex and the implications for measuring concurrent sexual partnerships. We conducted a cross-sectional reliability study using self-reported survey data from 650 women ages 18-65 years, recruited online nationwide for human papillomavirus natural history studies from 2007 to 2012. Intermethod reliability of first and last sex with the most recent partner was assessed using weighted kappa. Intraclass correlation coefficient was estimated for intramethod reliability across two consecutive questionnaires administered 4 months apart. Point prevalence of concurrent sexual partnerships at 6 months prior to the questionnaire date was similar between the two question formats (10.5 % for categorical and 10.9 % for continuous). The range between the minimum and maximum cumulative prevalence for 12 months was larger when using the categorical questions (17.0-29.6 % compared to 27.6-28.6 % using the continuous questions). Agreement between the two question formats was moderate for the date of first sex with the most recent partner (κ = 0.56, 95 % CI 0.48-0.64) and almost perfect for the date of last sex (κ = 0.93, 95 % CI 0.91-0.94). Longitudinal agreement for date of first sex was high for the continuous date question (ICC = 0.89, 95 % CI 0.86-0.92). Results of this reliability study can be used to inform the design of future studies of concurrent sexual partnerships and their association with HIV
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Time From HIV Diagnosis to Viral Load Suppression: 2007-2013.
BackgroundUS guidelines now recommend that all HIV-infected persons receive antiretroviral therapy). HIV prevention is increasingly focused on ensuring that infected persons are diagnosed soon after HIV acquisition and quickly link to care and initiate antiretroviral therapy. We examined trends in time from HIV diagnosis to viral load suppression in King County, WA, to gauge improvement in our HIV care continuum over time.MethodsWe used HIV surveillance data and Cox proportional hazards to evaluate how the time from diagnosis to viral suppression changed among persons newly diagnosed as having HIV in King County, WA, between 2007 and 2013.ResultsA total of 1490 (84%) of 1766 newly diagnosed persons achieved viral suppression in a median time of 213 days (95% confidence interval, 203-229). Thirty-six percent of all persons diagnosed in 2007 and 77% in 2013 were virally suppressed within 12 months of HIV diagnosis (P < 0.0001). Differences in time to suppression by calendar year persisted when stratifying by CD4 count at diagnosis. Race was not significantly associated with time to viral suppression.ConclusionsTime from HIV diagnosis to viral suppression dramatically declined between 2007 and 2013, and more than three quarters of recently HIV-diagnosed individuals in King County, WA, now achieve viral suppression within a year of diagnosis. This improvement was evident among all persons newly diagnosed as having HIV, regardless of race/ethnicity or CD4 count at time of diagnosis
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WaSH insecurity and anxiety among people who inject drugs in the Tijuana-San Diego border region
BackgroundWater, sanitation, and hygiene (WaSH) insecurity increases the risk of water-related diseases. However, limited research has been conducted on psychosocial distress as it relates to WaSH insecurity, especially among people who inject drugs (PWID). We examined the relationship between WaSH insecurity and related anxiety among PWID living in different housing conditions along the US-Mexico border region.MethodsFrom 2020-2021, a cross-sectional study was conducted among 585 people who injected drugs within the last month in Tijuana (N = 202), San Diego (N = 182), and in both Tijuana and San Diego (N = 201). Participants underwent interviewer-administered surveys related to WaSH access, substance use, and generalized anxiety disorder (GAD-7). Quasi-Poisson regressions were used to assess associations between WaSH insecurity and anxiety in the prior 6-months.ResultsParticipants were 75% male, 42% were unhoused and 91% experienced WaSH insecurity in the prior 6-months. After adjusting for housing status, gender, and age, lack of access to basic drinking water (Adj RR: 1.28; 95% CI: 1.02-1.58), sanitation (Adj RR:1.28; 95% CI: 1.07-1.55), and a daily bath/shower (Adj RR: 1.38; 95% CI: 1.15-1.66) were associated with mild-severe anxiety. The number of WaSH insecurities was independently associated with a 20% increased risk of experiencing anxiety per every additional insecurity experienced (Adj RR: 1.20; CI: 1.12-1.27). We also found a significant interaction between gender and housing status (p = 0.003), indicating that among people experiencing sheltered/unsheltered homelessness, women had a higher risk of mild-severe anxiety compared to men (Adj RR: 1.55; 95% CI: 1.27-1.89). At the same time, among women, those who are unhoused have 37% increased risk of anxiety than those who live in stable housing conditions (Adj RR: 1.37; 95% CI: 1.01-1.89).ConclusionThe lack of specific WaSH services, particularly lack of drinking water, toilets, and daily showers were associated with higher levels of anxiety among PWID in the Tijuana-San Diego border region. Women experiencing homelessness were especially vulnerable. WaSH interventions that provide safe, 24-h access may help to reduce anxiety and health risks associated with WaSH insecurity