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

All-Cause and Cause-Specific Mortality Among Black and White North Carolina State Prisoners, 1995–2005

We compared mortality rates among state prisoners and other state residents to identify prisoners’ healthcare need

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

Effects of aggregation of drug and diagnostic codes on the performance of the high-dimensional propensity score algorithm: an empirical example

BACKGROUND: The High-Dimensional Propensity Score (hd-PS) algorithm can select and adjust for baseline confounders of treatment-outcome associations in pharmacoepidemiologic studies that use healthcare claims data. How hd-PS performance is affected by aggregating medications or medical diagnoses has not been assessed. METHODS: We evaluated the effects of aggregating medications or diagnoses on hd-PS performance in an empirical example using resampled cohorts with small sample size, rare outcome incidence, or low exposure prevalence. In a cohort study comparing the risk of upper gastrointestinal complications in celecoxib or traditional NSAIDs (diclofenac, ibuprofen) initiators with rheumatoid arthritis and osteoarthritis, we (1) aggregated medications and International Classification of Diseases-9 (ICD-9) diagnoses into hierarchies of the Anatomical Therapeutic Chemical classification (ATC) and the Clinical Classification Software (CCS), respectively, and (2) sampled the full cohort using techniques validated by simulations to create 9,600 samples to compare 16 aggregation scenarios across 50% and 20% samples with varying outcome incidence and exposure prevalence. We applied hd-PS to estimate relative risks (RR) using 5 dimensions, predefined confounders, ≤ 500 hd-PS covariates, and propensity score deciles. For each scenario, we calculated: (1) the geometric mean RR; (2) the difference between the scenario mean ln(RR) and the ln(RR) from published randomized controlled trials (RCT); and (3) the proportional difference in the degree of estimated confounding between that scenario and the base scenario (no aggregation). RESULTS: Compared with the base scenario, aggregations of medications into ATC level 4 alone or in combination with aggregation of diagnoses into CCS level 1 improved the hd-PS confounding adjustment in most scenarios, reducing residual confounding compared with the RCT findings by up to 19%. CONCLUSIONS: Aggregation of codes using hierarchical coding systems may improve the performance of the hd-PS to control for confounders. The balance of advantages and disadvantages of aggregation is likely to vary across research settings

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

Area Disadvantage and Intimate Partner Homicide: An Ecological Analysis of North Carolina Counties, 2004–2006

Using data from the North Carolina Violent Death Reporting System and other sources, we examined ecologic relationships between county (n=100) disadvantage and intimate partner homicide (IPH), variability by victim gender and county urbanicity, and potential mediators. County disadvantage was related to female-victim homicide only in metropolitan counties (incidence rate ratio [IRR] 1.25); however, disadvantage was associated with male-victim IPH regardless of county urbanicity (IRR 1.17). None of the potential intervening variables examined (shelter availability, intimate partner violence services’ funding), was supported as a mediator. Results suggest disparities across North Carolina counties in IPH according to county disadvantage. Future research should explore other potential mediators (i.e., service accessibility and law enforcement responses), as well as test the robustness of findings using additional years of data

Family and school socioeconomic disadvantage: Interactive influences on adolescent dating violence victimization

Although low socioeconomic status has been positively associated with adult partner violence, its relationship to adolescent dating violence remains unclear. Further, few studies have examined the relationship between contextual disadvantage and adolescent dating violence, or the interactive influences of family and contextual disadvantage. Guided by Social Disorganization Theory, Relative Deprivation Theory, and Gendered Resource Theory, we analyzed data from the U.S. National Longitudinal Study of Adolescent Health (1994-1996) to explore how family and school disadvantage relate to dating violence victimization. Psychological and minor physical victimization were self-reported by adolescents in up to six heterosexual romantic or sexual relationships. Family and school disadvantage were based on a principal component analysis of soecioeconomic indicators reported by adolescents and parents. In weighted multilevel random effects models, between-school variability in dating violence victimization was proportionately small but substantive: 10% for male victimization and 5% for female victimization. In bivariate analyses, family disadvantage was positively related to victimization for both males and females; however, school disadvantage was only related to males’ physical victimization. In models adjusted for race/ethnicity, relative age within the school, and mean school age, neither family nor school disadvantage remained related to males’ victimization. For females, family disadvantage remained significantly positively associated with victimization, but was modified by school disadvantage: family disadvantage was more strongly associated with dating violence victimization in more advantaged schools. Findings support gendered resource theory, and suggest that status differentials between females and their school context may increase their vulnerability to dating violence victimization

Herpes Simplex Virus Type 2 Seroprevalence and Ultrasound-Diagnosed Uterine Fibroids in a Large Population of Young African-American Women

For decades reproductive tract infections (RTIs) have been hypothesized to play a role in uterine fibroid development. The few previous studies conducted used self-reported history of RTIs and had inconsistent findings. We investigated this hypothesis further using serological analysis, an immunological measure of past exposure. We focused on herpes simplex virus type 2 (HSV-2) because prior published data have suggested a possible association with fibroids, and serology for HSV-2 is much more sensitive than self-report. We used cross-sectional enrollment data from African-American women enrolled in a prospective study of fibroid incidence and growth (recruited 2010–2012) in the Detroit, Michigan, area. The women were aged 23–34 years and were screened for fibroids using a standardized ultrasound examination at their enrollment. Age- and multivariable-adjusted logistic regression models were used to estimate odds ratios. Of 1,696 participants, 1,658 had blood samples and HSV-2 serology results; 22% of participants with serology results had fibroids. There was no significant association between HSV-2 seropositivity and the presence of fibroids (multivariable-adjusted odds ratio = 0.94, 95% confidence interval: 0.73, 1.20), nor were there any associations with size of the largest fibroid, number of fibroids, or total fibroid volume. Our data provide no evidence for an influence of HSV-2 exposure on fibroid risk in young African-American women. Further study of other serologically measured RTIs is warranted