HIV Infection in Women in the United States

Hader, Shannon; Smith, Dawn K.; Moore, Janet; Holmberg, Scott D.

doi:10.1001/jama.285.9.1186

Cited by 233 publications

(177 citation statements)

References 45 publications

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“…23 Psychosocial factors, such as the position of many women as the primary caregiver for others, are other possible differences that could lead to higher rates of discontinuation in females. 13,21,[23][24][25] These findings highlight the need for further investigation regarding the pharmacokinetic differences and psychosocial factors leading females to be more likely to discontinue HAART regimens so that effective interventions may be developed.…”

Section: Robison Et Al 1352mentioning

confidence: 99%

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

Robison

Westfall

Mugavero

et al. 2008

AIDS Research and Human Retroviruses

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The durability of HAART regimens is often limited by antiretroviral toxicity and nonadherence, which lead to virologic failure. We sought to determine sociodemographic and psychosocial patient factors predictive of shortterm discontinuation of HAART regimens overall and stratified by the reason for discontinuation. A retrospective cohort study of the UAB 1917 Clinic Cohort evaluated short-term HAART regimen discontinuation (within 12 months of regimen initiation) between 1/1995 and 8/2004 classified as (1) gastrointestinal (GI) toxicity, (2) non-GI toxicity, (3) virologic failure or nonadherence (VF/NA), (4) loss to follow-up, and (5) other. Multivariable multinomial logistic regression models accounting for dependent observations were fit to assess the relationship between patient factors and type-specific regimen discontinuation. Among the 738 study participants, 1026 of 1852 HAART regimens (55%) were discontinued within 12 months of initiation. In multivariable analysis, discontinuation for GI toxicity was more common in patients lacking private health insurance and those with a history of intravenous (IV) drug use, whereas non-GI toxicity was more common in younger patients and females. African-American patients and those with a history of IV drug use were more likely to stop a regimen due to VF/NA. Loss to follow-up was more common in younger patients, individuals who were uninsured, and those with a history of IV drug use. Short-term discontinuation of HAART regimens is more common in vulnerable populations that bear a disproportionate burden of the U.S. HIV/AIDS epidemic. More vigilant monitoring of patient populations at higher risk of toxicity and virologic failure may allow for improved HAART regimen durability. 1347

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Section: Robison Et Al 1352mentioning

confidence: 99%

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

Robison

Westfall

Mugavero

et al. 2008

AIDS Research and Human Retroviruses

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“…Among sexually active women, a woman's risk for HIV infection is often related to behaviors beyond her direct control, such as the sex-or drug-related behavior of a sexual partner (Hader, Smith, Moore, & Holmberg, 2001). …”

mentioning

confidence: 99%

Willingness to use microbicides varies by race/ethnicity, experience with prevention products, and partner type.

Morrow¹,

Fava²,

Rosen³

et al. 2007

Health Psychology

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Objective-To investigate women's willingness to use vaginal microbicides to reduce/prevent HIV infection, using measures grounded in the individual, behavioral, and social contexts of sex.Design-A cross-sectional study that enrolled a sample (N = 531) of 18−55 year old Latina, AfricanAmerican, and White women in the U.S. between October, 2004, andJuly, 2005. Main Outcome Measures-Willingness to use microbicides and individual-and context-related variables (e.g., demographics, relationship status).Results-Exploratory and confirmatory factor analyses supported a one-dimensional, 8-item scale, with high internal consistency (α = .91). Subgroup analyses within the Latina (n = 166), AfricanAmerican (n = 193), and White sub-samples (n = 172) also supported a unidimensional scale with strong internal validity and high reliability. Race/ethnicity as a contextual factor, a woman's history of using prevention products, and the nature of the sexual partnership were predictive of willingness to use microbicides (R = .41). That is, women with greater frequencies of condom use, a history of spermicide use, and non-main sexual partners had higher predicted Willingness to Use Microbicides scale scores, while White women had lower predicted scores. Conclusion-TheWillingness to Use Microbicides scale serves as the first psychometrically validated measure of factors related to microbicide acceptability. Developing and implementing psychometrically validated and contextualized microbicide acceptability measures, in an effort to understand microbicide users and circumstances of use, is crucial to both clinical trials and future intervention studies.

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“…Moore [29] describes that women face barriers such as having to find accessible and affordable child care that might prevent them from initiating care. Furthermore, women who are newly diagnosed with HIV have been found to be more likely to experience depressive symptoms than men [30], and depression is independently associated with lower rates of presentation to care [9]. This finding has particular implications in our setting, where the proportion of new infections among women is increasing [29].…”

Section: Discussionmentioning

confidence: 99%

Assessing Timely Presentation to Care Among People Diagnosed with HIV During Hospital Admission: A Population-Based Study in Ontario, Canada

et al. 2018

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Timely presentation to care for people newly diagnosed with HIV is critical to optimize health outcomes and reduce onward HIV transmission. Studies describing presentation to care following diagnosis during a hospital admission are lacking. We sought to assess the timeliness of presentation to care and to identify factors associated with delayed presentation. We conducted a population-level study using health administrative databases. Participants were all individuals older than 16 and newly diagnosed with HIV during hospital admission in Ontario, Canada, between April 1, 2007 and March 31, 2015. We used modified Poisson regression models to derive relative risk ratios for the association between sociodemographic and clinical variables and the presentation to out-patient HIV care by 90 days following hospital discharge. Among 372 patients who received a primary HIV diagnosis in hospital, 83.6% presented to care by 90 days. Following multivariable analysis, we did not find associations between patient sociodemographic or clinical characteristics and presentation to care by 90 days. In a secondary analysis of 483 patients diagnosed during hospitalization but for whom HIV was not recorded as the principal reason for admission, 73.1% presented to care by 90 days. Following multivariable adjustment, we found immigrants from countries with generalized HIV epidemics (RR 1.265, 95% CI 1.133-1.413) were more likely to present to care, whereas timely presentation was less likely for people with a mental health diagnosis (RR 0.817, 95% CI 0.742-0.898) and women (RR 0.748, 95% CI 0.559-1.001). Future work should evaluate mechanisms to facilitate presentation to care among these populations.

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HIV Infection in Women in the United States

Cited by 233 publications

References 45 publications

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

Short-Term Discontinuation of HAART Regimens More Common in Vulnerable Patient Populations

Willingness to use microbicides varies by race/ethnicity, experience with prevention products, and partner type.

Assessing Timely Presentation to Care Among People Diagnosed with HIV During Hospital Admission: A Population-Based Study in Ontario, Canada

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