National Healthcare Quality and Disparities Report
Latest available findings on quality of and access to health care
Data
- Data Infographics
- Data Visualizations
- Data Tools
- Data Innovations
- All-Payer Claims Database
- Healthcare Cost and Utilization Project (HCUP)
- Medical Expenditure Panel Survey (MEPS)
- AHRQ Quality Indicator Tools for Data Analytics
- State Snapshots
- United States Health Information Knowledgebase (USHIK)
- Data Sources Available from AHRQ
Search All Research Studies
Topics
- Access to Care (1)
- Antibiotics (1)
- Children/Adolescents (2)
- COVID-19 (1)
- Diagnostic Safety and Quality (2)
- Disparities (1)
- Elderly (1)
- Electronic Health Records (EHRs) (1)
- Healthcare Costs (3)
- Health Information Technology (HIT) (1)
- Health Promotion (1)
- Health Status (1)
- (-) Human Immunodeficiency Virus (HIV) (21)
- (-) Infectious Diseases (21)
- Long-Term Care (1)
- Low-Income (1)
- Medicare (1)
- Men's Health (3)
- Nursing Homes (1)
- Nutrition (1)
- Pregnancy (2)
- Prevention (10)
- Primary Care (1)
- Public Health (1)
- Quality Measures (1)
- Quality of Care (1)
- Racial and Ethnic Minorities (3)
- Risk (1)
- Screening (4)
- Sexual Health (9)
- Social Determinants of Health (1)
- Substance Abuse (1)
- Vulnerable Populations (1)
- Women (6)
- Young Adults (2)
AHRQ Research Studies
Sign up: AHRQ Research Studies Email updates
Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 21 of 21 Research Studies DisplayedTeixeira da Silva D, Makeneni S, Wall H
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
The purpose of this study was to develop and apply a cross-setting, sexually transmitted infection (STI) Care Continuum to improve STI care quality, to assess adherence to guideline-recommended care, and to standardize progress measurement toward National Strategic goals. Review of the CDC STI treatment guidelines identified seven distinct steps of care for gonorrhea, chlamydia, and syphilis; researchers used Youth Risk Behavior Surveillance Survey data to estimate step 1, and electronic health record data for steps 2, 3, 4, 6 and 7. The researchers concluded that local application of an STI Care Continuum identified STI testing, retesting, and HIV testing as areas for improvement. Similar methods may be applied to target resources, standardize data collection and reporting, and improve STI care quality.
AHRQ-funded; HS026116.
Citation: Teixeira da Silva D, Makeneni S, Wall H .
Measuring quality STI care among adolescent female primary care patients in Philadelphia.
Sex Transm Infect 2023 Jun; 99(4):272-75. doi: 10.1136/sextrans-2022-055623..
Keywords: Children/Adolescents, Sexual Health, Infectious Diseases, Primary Care, Women, Human Immunodeficiency Virus (HIV), Quality Measures, Quality of Care
Van Gerwen OT, Talluri R, Camino AF
Human immunodeficiency virus/sexually transmitted infection testing preferences for young Black men who have sex with men in the Southeastern United States: implications for a post-COVID-19 era.
Study researchers used a discrete choice experiment to assess the preferences of Young Black Men Who Have Sex with Men (YBMSM) in the Southeastern U.S. regarding their preferences for human immunodeficiency virus (HIV)/ sexually transmitted infection (STI) testing locations, staffing, cost, and hours of operation. Between June 2018 and December 2019, 213 YBMSM between the ages of 16-35 years, located in Birmingham, Alabama and Jackson, Mississippi completed online surveys evaluating their preferences. Traditional, stationary testing locations were preferred by both groups over mobile testing vans. The most significant difference in preference was for local health departments in Alabama, and STI testing-only clinics in Mississippi. Both groups preferred clinician-performed testing over technician-performed testing or self-testing, with additional preferences for free testing and phone results notification (versus text). The most preferred combination among all participants was the $5 clinician-performed testing at the health department. The study concluded that YBMSM in the Southeastern United States prefer traditional testing locations staffed by experienced personnel. The study researchers advise that more research is needed to inform the best ways to approach HIV/STI testing services for YBMSM, especially in the post-COVID-19 era when delivery models are shifting toward health-focused strategies which are home-based and remote.
AHRQ-funded; HS013852.
Citation: Van Gerwen OT, Talluri R, Camino AF .
Human immunodeficiency virus/sexually transmitted infection testing preferences for young Black men who have sex with men in the Southeastern United States: implications for a post-COVID-19 era.
Sex Transm Dis 2022 Mar;49(3):208-15. doi: 10.1097/olq.0000000000001559..
Keywords: COVID-19, Human Immunodeficiency Virus (HIV), Infectious Diseases, Racial and Ethnic Minorities, Men's Health
Magee LA, Fortenberry JD, Nelson T
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Using justice and public health sexually transmitted infections (STIs) /HIV data in Marion County (Indianapolis), Indiana, during an 18-year period, the authors assessed the overall association of area-level prostitution and drug-related arrests and STI/HIV, and mediators and moderators of the relationship. Results indicated a positive relationship between numbers of prostitution arrests and area-level STI rates. There was a dose-response relationship between prostitution arrests and STI rates when accounting for drug-related arrests. The authors stated that these findings inform public health agencies and community-based organizations that conduct outreach in these areas to expand their efforts to include harm reduction and HIV/STI testing for both sex workers and individuals experiencing substance use disorder.
AHRQ-funded; HS023318.
Citation: Magee LA, Fortenberry JD, Nelson T .
Sexually transmitted infections in association with area-level prostitution and drug-related arrests.
Sex Transm Dis 2021 Jul;48(7):508-14. doi: 10.1097/olq.0000000000001345..
Keywords: Sexual Health, Human Immunodeficiency Virus (HIV), Infectious Diseases
Van Gerwen OT, Tamhane A, Westfall AO
Prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women in HIV care in the United States, 2005 to 2016.
This retrospective cohort analysis included transgender women living with HIV enrolled in the US Centers for AIDS Research Network of Integrated Clinical Systems cohort between January 2005 and December 2016 with chlamydia or gonorrhea testing performed in HIV clinic. The investigators concluded that among transgender women living with HIV, testing rates for chlamydia and gonorrhea were inadequate, particularly at extragenital sites where most infections occur.
AHRQ-funded; HS013852.
Citation: Van Gerwen OT, Tamhane A, Westfall AO .
Prevalence of and factors associated with genital and extragenital chlamydia and gonorrhea among transgender women in HIV care in the United States, 2005 to 2016.
Sex Transm Dis 2021 Jun 1;48(6):410-16. doi: 10.1097/olq.0000000000001335.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Sexual Health, Infectious Diseases, Women
Rodriguez PJ, Roberts DA, Meisner J
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Dual HIV and syphilis testing might help to prevent mother-to-child transmission (MTCT) of HIV and syphilis through increased case detection and treatment. In this study, the investigators aimed to model and assess the cost-effectiveness of dual testing during antenatal care in four countries with varying HIV and syphilis prevalence. The authors concluded that incorporating dual rapid diagnostic tests in antenatal care could be cost-saving across countries with varying HIV prevalence.
AHRQ-funded; HS013853.
Citation: Rodriguez PJ, Roberts DA, Meisner J .
Cost-effectiveness of dual maternal HIV and syphilis testing strategies in high and low HIV prevalence countries: a modelling study.
Lancet Glob Health 2021 Jan;9(1):e61-e71. doi: 10.1016/s2214-109x(20)30395-8..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Prevention, Pregnancy, Women, Diagnostic Safety and Quality, Healthcare Costs
Iribarren S, Lentz C, Sheinfil AZ
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
Researchers explored attitudes and preferences among HIV-negative men who have sex with men and HIV-negative transgender women using an HIV self-testing (HIVST) kit to test partners. They found that most preferred gum swab over fingerprick tests, but would prefer a blood test if it gave results for other sexually transmitted infections (STIs). They concluded that efforts to improve HIVST uptake should focus on incorporating testing for other STIs, reducing test kit size, and reducing cost.
AHRQ-funded; HS026383.
Citation: Iribarren S, Lentz C, Sheinfil AZ .
Using an HIV self-test kit to test a partner: attitudes and preferences among high-risk populations.
AIDS Behav 2020 Nov;24(11):3232-43. doi: 10.1007/s10461-020-02885-3..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Infectious Diseases, Prevention
Lentz C, Iribarren S, Giguere R
Broaching the topic of HIV self-testing with potential sexual partners among men and transgender women who have sex with men in New York and Puerto Rico.
This randomized controlled trial examined whether access to free HIV self-testing (ST) kits had an impact on use of condoms during anal intercourse for 272 transgender women and men who have sex with men in New York City and San Juan, Puerto Rico. The trial included 136 persons in an intervention group and 136 persons in a control group. The intervention group had 32% fewer condomless anal intercourse (CAI) encounters- with the New York City group being statistically significant. In San Juan the results were non-significant, but two hurricanes may have impacted results in unmeasured ways.
AHRQ-funded; HS026383.
Citation: Lentz C, Iribarren S, Giguere R .
Broaching the topic of HIV self-testing with potential sexual partners among men and transgender women who have sex with men in New York and Puerto Rico.
AIDS Behav 2020 Nov;24(11):3033-43. doi: 10.1007/s10461-020-02851-z..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Sexual Health, Prevention, Screening
Skaathun B, Pho MT, Pollack HA
Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States.
This analysis compared the effectiveness and cost of three HIV testing strategies in a high HIV burden area in the U.S. in identifying new HIV infections. The investigators performed a cost analysis comparing three HIV testing strategies in Chicago: (1) routine screening (RS) in an inpatient and outpatient setting, (2) modified partner services (MPS) among networks of the recently HIV infected and diagnosed, and (3) a respondent drive sampling (RDS)-based social network (SN) approach targeting young African-American men who have sex with men.
AHRQ-funded; HS000084.
Citation: Skaathun B, Pho MT, Pollack HA .
Comparison of effectiveness and cost for different HIV screening strategies implemented at large urban medical centre in the United States.
J Int AIDS Soc 2020 Oct;23(10):e25554. doi: 10.1002/jia2.25554..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Healthcare Costs, Prevention, Infectious Diseases
Sheinfil AZ, Giguere R, Dolezal C
Information and motivation predict HIV-serostatus among a population of high-risk men and transgender women who have sex with men.
In this study, two constructs from the information-motivation-behavioral skills model were used to predict HIV-serostatus among a sample of men and transgender women who have sex with men. Hypotheses were that lower levels of HIV knowledge and lower levels of motivation to remain HIV-negative would be associated with an increased likelihood of receiving a positive HIV test result at a study eligibility-screening session.
AHRQ-funded; HS026383.
Citation: Sheinfil AZ, Giguere R, Dolezal C .
Information and motivation predict HIV-serostatus among a population of high-risk men and transgender women who have sex with men.
AIDS Behav 2020 Oct;24(10):2863-71. doi: 10.1007/s10461-020-02835-z..
Keywords: Human Immunodeficiency Virus (HIV), Sexual Health, Infectious Diseases, Risk
Jackman KP, Murray S, Hightow-Weidman
Digital technology to address HIV and other sexually transmitted infection disparities: intentions to disclose online personal health records to sex partners among students at a historically Black college.
Among an online survey sample of co-ed students, the authors described latent constructs and other variables associated with perceived behavioral intentions to disclose sexually transmitted infection (STI) test history using patient portals. They found that latent constructs representing communication valuation beliefs and practices were not associated with intentions, while self-reporting prior STI diagnosis was associated with intentions to disclose. They concluded that point-of-care messages focused on improvements to validating test results, communication, and empowerment, may be an effective strategy to support the adoption of patient portals for STI prevention among populations of college-aged Black youth.
AHRQ-funded; HS023057.
Citation: Jackman KP, Murray S, Hightow-Weidman .
Digital technology to address HIV and other sexually transmitted infection disparities: intentions to disclose online personal health records to sex partners among students at a historically Black college.
PLoS One 2020 Aug 21;15(8):e0237648. doi: 10.1371/journal.pone.0237648..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Electronic Health Records (EHRs), Health Information Technology (HIT), Young Adults, Racial and Ethnic Minorities, Prevention
Carballo-Dieguez A, Giguere R, Balan IC
Use of rapid HIV self-test to screen potential sexual partners: results of the ISUM study.
This randomized controlled trial examined whether access to free HIV self-testing (ST) kits had an impact on use of condoms during anal intercourse for 272 transgender women and men who have sex with men in New York City and San Juan, Puerto Rico. The trial included 136 persons in an intervention group and 136 persons in a control group. The intervention group had 32% fewer condomless anal intercourse (CAI) encounters- with the New York City group being statistically significant. In San Juan the results were non-significant but two hurricanes may have impacted results in unmeasured ways.
AHRQ-funded; HS026383.
Citation: Carballo-Dieguez A, Giguere R, Balan IC .
Use of rapid HIV self-test to screen potential sexual partners: results of the ISUM study.
AIDS Behav 2020 Jun;24(6):1929-41. doi: 10.1007/s10461-019-02763-7..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Sexual Health, Prevention
Sun CJ, Anderson KM, Kuhn T
A sexual health promotion app for transgender women (Trans Women Connected): development and usability study.
HIV severely impacts the transgender communities in the United States, and transgender women have the highest HIV incidence rates among any identified risk group. Guided by formative research with transgender women and by an expert advisory panel of transgender women, the investigators designed a prototype mobile app to promote HIV prevention among transgender women. This study aimed to develop and test the usability and acceptability of the prototype Trans Women Connected mobile app.
AHRQ-funded; HS022981.
Citation: Sun CJ, Anderson KM, Kuhn T .
A sexual health promotion app for transgender women (Trans Women Connected): development and usability study.
JMIR Mhealth Uhealth 2020 May 12;8(5):e15888. doi: 10.2196/15888..
Keywords: Human Immunodeficiency Virus (HIV), Health Promotion, Sexual Health, Infectious Diseases, Prevention, Women
Gravett RM, Westfall AO, Overton ET
Sexually transmitted infections and sexual behaviors of men who have sex with men in an American Deep South PrEP clinic.
This study examines the behavior of men who have sex with men (MSM) who use HIV pre-exposure prophylaxis (PrEP). A higher incidence of sexually transmitted infections (STIs) has been associated with PrEP use. A retrospective analysis of MSM in the Deep South was conducted at a PrEP clinic to calculate the prevalence and incidence of bacterial STIs and identify associated risk factors. There was an 11% STI prevalence out of 139 MSM who accessed the clinic between 2014 and 2018. Higher proportions of high PrEP adherence, multiple sexual partners, and inconsistent condom use were associated with incident STI.
AHRQ-funded; HS023009.
Citation: Gravett RM, Westfall AO, Overton ET .
Sexually transmitted infections and sexual behaviors of men who have sex with men in an American Deep South PrEP clinic.
Int J STD AIDS 2020 Feb;31(2):127-35. doi: 10.1177/0956462419886228..
Keywords: Infectious Diseases, Sexual Health, Men's Health, Prevention, Human Immunodeficiency Virus (HIV)
Brault MA, Spiegelman D, Hargreaves J
Treatment as prevention: concepts and challenges for reducing HIV incidence.
This paper reviews the results and lessons learned from four large-scale HIV antiretroviral therapy (ART) clinical trials that were held in sub-Saharan Africa to reduce HIV transmission. These trials used treatment as prevention (TasP) to improve overall health and protect HIV-uninfected sexual partners from infection. There were seemingly inconsistent findings in the major TasP trials held in South African, Kenya, Uganda, Botswana, and Zambia. The review highlighted implementation challenges and identified approaches to optimize programs and incentivize uptake and engagement in HIV testing and ART-based care.
AHRQ-funded; HS023000.
Citation: Brault MA, Spiegelman D, Hargreaves J .
Treatment as prevention: concepts and challenges for reducing HIV incidence.
J Acquir Immune Defic Syndr 2019 Dec 1;82 Suppl 2:S104-s12. doi: 10.1097/qai.0000000000002168..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Infectious Diseases, Public Health, Screening
Zullo AR, Adams JW, Gantenberg JR
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
The purpose of the study was to estimate the effect of exposure to neighborhood poverty in adolescence on HIV/STI prevalence in early adulthood. The investigators found that strong evidence for neighborhood poverty-based differences in HIV/STI prevalence was not observed. They suggest that researchers should continue to investigate the effect of neighborhood-level socioeconomic position measures and, if warranted, identify etiologically relevant exposure periods.
AHRQ-funded; HS022998.
Citation: Zullo AR, Adams JW, Gantenberg JR .
Examining neighborhood poverty-based disparities in HIV/STI prevalence: an analysis of Add Health data.
Ann Epidemiol 2019 Nov;39:8-14.e4. doi: 10.1016/j.annepidem.2019.09.010..
Keywords: Children/Adolescents, Low-Income, Vulnerable Populations, Disparities, Social Determinants of Health, Human Immunodeficiency Virus (HIV), Infectious Diseases, Young Adults, Health Status
Sun CJ, Anderson KM, Bangsberg D
Access to HIV pre-exposure prophylaxis in practice settings: a qualitative study of sexual and gender minority adults' perspectives.
Sexual and gender minority (SGM) populations remain at disproportionate risk of HIV infection. Despite the effectiveness of pre-exposure prophylaxis (PrEP) in preventing HIV, PrEP uptake has been slow. The objective of this study was to identify barriers and facilitators of PrEP access by examining SGM patients' experiences with accessing health care systems and engaging with providers about PrEP in a variety of practice settings.
AHRQ-funded; HS022981.
Citation: Sun CJ, Anderson KM, Bangsberg D .
Access to HIV pre-exposure prophylaxis in practice settings: a qualitative study of sexual and gender minority adults' perspectives.
J Gen Intern Med 2019 Apr;34(4):535-43. doi: 10.1007/s11606-019-04850-w..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Infectious Diseases, Sexual Health, Racial and Ethnic Minorities, Access to Care
Muzny CA, Tamhane AR, Eaton EF
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population.
AHRQ-funded; HS023009.
Citation: Muzny CA, Tamhane AR, Eaton EF .
Incidence and predictors of reinfection with trichomoniasis based on nucleic acid amplification testing results in HIV-infected patients.
Trichomonas vaginalis infection contributes to HIV transmission. The purpose of this retrospective cohort study was to determine the incidence and predictors of T. vaginalis reinfection among HIV-infected women in Birmingham, Alabama. The investigators indicated that T. vaginalis reinfection was high among HIV-infected women in the sample, necessitating enhanced disease control efforts in this high-risk population..
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Women
Olivieri-Mui B, McGuire J, Cahill S
People living with HIV in U.S. nursing homes in the fourth decade of the epidemic.
This study described the sociodemographic characteristics as well as the antiretroviral therapy treatment and physical and mental health among Medicare-eligible persons living with HIV (PLWH) in nursing homes (NHs). Of the newer admissions, results showed that they were older, had higher prevalence of viral hepatitis and anemia, but had less pneumonia and dementia. NH nurses can better anticipate health care needs of PLWH using these health profiles, understanding that there have been changes in the health of PLWH at admission over time.
AHRQ-funded; HS025662.
Citation: Olivieri-Mui B, McGuire J, Cahill S .
People living with HIV in U.S. nursing homes in the fourth decade of the epidemic.
J Assoc Nurses AIDS Care 2019 Jan-Feb;30(1):20-34. doi: 10.1097/jnc.0000000000000033..
Keywords: Human Immunodeficiency Virus (HIV), Nursing Homes, Long-Term Care, Elderly, Infectious Diseases, Medicare
Wynn A, Ramogola-Masire D, Gaolebale P
Prevalence and treatment outcomes of routine Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing during antenatal care, Gaborone, Botswana.
AHRQ-funded; HS000046.
Citation: Wynn A, Ramogola-Masire D, Gaolebale P .
Prevalence and treatment outcomes of routine Chlamydia trachomatis, Neisseria gonorrhoeae and Trichomonas vaginalis testing during antenatal care, Gaborone, Botswana.
Sex Transm Infect 2018 May;94(3):230-35. doi: 10.1136/sextrans-2017-053134..
Keywords: Antibiotics, Human Immunodeficiency Virus (HIV), Infectious Diseases, Pregnancy, Women
Eaton EF, Joe W, Kilgore ML
Reverse syphilis screening algorithm fails to demonstrate cost effectiveness in persons living with HIV.
This paper compares the reverse syphilis screening algorithm to the traditional algorithm and the costs for health systems serving persons living with HIV needing annual syphilis screening.
AHRQ-funded; HS023009.
Citation: Eaton EF, Joe W, Kilgore ML .
Reverse syphilis screening algorithm fails to demonstrate cost effectiveness in persons living with HIV.
Int J STD AIDS 2018 May;29(6):563-67. doi: 10.1177/0956462417743409.
.
.
Keywords: Healthcare Costs, Healthcare Costs, Human Immunodeficiency Virus (HIV), Infectious Diseases, Screening
Palar K, Laraia B, Tsai AC
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
The researchers examined the population-level association between food insecurity, HIV risk factors, and HIV serostatus among men. They found that food insecurity is associated with prevalent HIV, STIs, and illicit drug use among men in the United States.
AHRQ-funded; HS000046.
Citation: Palar K, Laraia B, Tsai AC .
Food insecurity is associated with HIV, sexually transmitted infections and drug use among men in the United States.
AIDS 2016 Jun 1;30(9):1457-65. doi: 10.1097/qad.0000000000001095.
.
.
Keywords: Human Immunodeficiency Virus (HIV), Infectious Diseases, Men's Health, Nutrition, Substance Abuse