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Topics
- Care Management (1)
- Children/Adolescents (1)
- Chronic Conditions (2)
- Clinical Decision Support (CDS) (1)
- Clinician-Patient Communication (1)
- Communication (1)
- Comparative Effectiveness (1)
- Depression (1)
- Diagnostic Safety and Quality (3)
- Disparities (3)
- Education: Continuing Medical Education (1)
- Elderly (1)
- Emergency Department (1)
- Emergency Medical Services (EMS) (2)
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- Guidelines (2)
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- Health Insurance (1)
- Heart Disease and Health (1)
- Hepatitis (1)
- Hospitalization (1)
- (-) Human Immunodeficiency Virus (HIV) (23)
- Lifestyle Changes (1)
- Medicaid (1)
- Medicare (1)
- Medication (2)
- Mortality (1)
- Pain (1)
- Patient-Centered Outcomes Research (2)
- Patient Adherence/Compliance (6)
- Patient Self-Management (2)
- Pregnancy (2)
- Prevention (1)
- Quality of Life (1)
- Racial and Ethnic Minorities (5)
- Risk (1)
- Screening (3)
- Simulation (1)
- Sleep Problems (1)
- Social Determinants of Health (1)
- Social Stigma (1)
- Uninsured (1)
- Urban Health (2)
AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedTuran B, Stringer KL, Onono M
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
The investigators examined associations between linkage to HIV care, postpartum depression, and internalized stigma in a population with a high risk of depression: newly diagnosed HIV-positive pregnant women. They found that, in this study group of women from rural Kenya, at 6 weeks postpartum, those who had not linked to HIV care after testing positive at their first antenatal visit had higher levels of depression and internalized stigma, compared to women who had linked to care. Internalized stigma mediated the effect of linkage to care on depression. Furthermore, participants who had both linked to HIV care and initiated antiretroviral therapy reported the lowest levels of depressive symptoms.
AHRQ-funded; HS013852.
Citation: Turan B, Stringer KL, Onono M .
Linkage to HIV care, postpartum depression, and HIV-related stigma in newly diagnosed pregnant women living with HIV in Kenya: a longitudinal observational study.
BMC Pregnancy Childbirth 2014 Dec 3;14:400. doi: 10.1186/s12884-014-0400-4.
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Keywords: Depression, Human Immunodeficiency Virus (HIV), Pregnancy, Social Stigma
Merlin JS, Walcott M, Ritchie C
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
The researchers’ objective was to explore HIV-infected patients’ perspectives on psychological aspects of chronic pain using in-depth qualitative interviews. Key themes that emerged included the close relationship between mood and pain; mood and pain in the context of living with HIV; use of alcohol/drugs to self-medicate for pain; and the challenge of receiving prescription pain medications while dealing with substance use disorders.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Ritchie C .
'Two pains together': patient perspectives on psychological aspects of chronic pain while living with HIV.
PLoS One 2014 Nov 3;9(11):e111765. doi: 10.1371/journal.pone.0111765..
Keywords: Care Management, Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient-Centered Outcomes Research, Patient Self-Management
Haukoos JS, Lyons MS, White DA
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
This editorial discusses a study in the same journal issue that contributes substantially to the understanding of HIV screening in EDs by reporting programmatic results of nontargeted opt-out screening in a high-volume, urban ED. This study is unique in that it reports, for the first time in an ED setting, the use of fourth-generation HIV testing which improves detection of acute HIV infection.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, White DA .
Acute HIV infection and implications of fourth-generation HIV screening in emergency departments.
Ann Emerg Med 2014 Nov;64(5):547-51. doi: 10.1016/j.annemergmed.2014.07.004..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Emergency Department, Urban Health
Abara WE, Smith L, Zhang S
The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS.
In this article, the investigators examined whether the timely initiation of antiretroviral therapy (ART) differed by race and comorbidity among older (>/= 50 years) people living with HIV/AIDS (PLWHA). The investigators concluded that comorbidities affected timely ART initiation in older PLWHA. They asserted that older PLWHA may benefit from integrating and coordinating HIV care with care for other comorbidities and the development of ART treatment guidelines specific to this population.
AHRQ-funded; HS019470.
Citation: Abara WE, Smith L, Zhang S .
The influence of race and comorbidity on the timely initiation of antiretroviral therapy among older persons living with HIV/AIDS.
Am J Public Health 2014 Nov;104(11):e135-41. doi: 10.2105/ajph.2014.302227..
Keywords: Elderly, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities
Sentell T, Marten L, Ahn HJ
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
This study investigated characteristics and disparities in hospitalizations among HIV positive individuals for Asian American subgroups and Native Hawaiians using data from all hospitalizations in Hawai‘i between December 2006 and December 2010. It concluded that disparities appear to exist in rates of hospitalizations among HIV positive individuals for Native Hawaiians and Asians, as well as in the demographic and, to some degree, the clinical characteristics of those hospitalized.
AHRQ-funded; HS019990.
Citation: Sentell T, Marten L, Ahn HJ .
Disparities in hospitalizations among HIV positive individuals for native Hawaiians and Asians compared to whites in Hawaii.
Hawaii J Med Public Health 2014 Oct;73(10):308-14..
Keywords: Hospitalization, Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Patient-Centered Outcomes Research
Yehia BR, Fleishman JA, Agwu AL
AHRQ Author: Fleishman JA
Health insurance coverage for persons in HIV care, 2006-2012.
The authors examined trends in health insurance coverage at 11 US HIV clinics between 2006 and 2012. They found that Medicaid coverage was more prevalent among women than men; blacks and Hispanics than whites; and individuals with injection drug use risk compared with other transmission risk factors, with Hispanics and younger age groups more likely to be uninsured than other racial/ethnic and older age groups, respectively.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Fleishman JA, Agwu AL .
Health insurance coverage for persons in HIV care, 2006-2012.
J Acquir Immune Defic Syndr 2014 Sep 1;67(1):102-6. doi: 10.1097/qai.0000000000000251.
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Keywords: Health Insurance, Human Immunodeficiency Virus (HIV), Medicare, Racial and Ethnic Minorities, Uninsured
Haines CF, Fleishman JA, Yehia BR
AHRQ Author: Fleishman JA
Increase in CD4 count among new enrollees in HIV care in the modern antiretroviral therapy era.
The authors sought to determine whether the CD4 count at presentation, a surrogate for time to presentation, increased from 2003 to 2011. They demonstrated a small, but statistically significant, increase in CD4 at presentation after the 2006 CDC HIV-screening guideline revision.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Haines CF, Fleishman JA, Yehia BR .
Increase in CD4 count among new enrollees in HIV care in the modern antiretroviral therapy era.
J Acquir Immune Defic Syndr 2014 Sep 1;67(1):84-90. doi: 10.1097/qai.0000000000000228.
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Keywords: Diagnostic Safety and Quality, Human Immunodeficiency Virus (HIV)
Kelly JD, Hartman C, Graham J
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
The researchers studied 168 persons newly diagnosed with AIDS to determine if social support contributes to various aspects of HIV care. They found that higher social support scores were associated with earlier HIV diagnosis, linkage to care, and adherence to antiretroviral therapy (ART). However, social support did not contribute to use of ART or retention in HIV care.
AHRQ-funded; HS016093
Citation: Kelly JD, Hartman C, Graham J .
Social support as a predictor of early diagnosis, linkage, retention, and adherence to HIV care: results from the steps study.
J Assoc Nurses AIDS Care. 2014 Sep-Oct;25(5):405-13. doi: 10.1016/j.jana.2013.12.002..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Diagnostic Safety and Quality
Yehia BR, Herati RS, Fleishman JA
AHRQ Author: Fleishman JA
Hepatitis C virus testing in adults living with HIV: a need for improved screening efforts.
The authors sought to understand hepatitis C virus (HCV) testing practices in people living with HIV (PLWH) in order to improve compliance with guidelines and help identify areas for future intervention. They concluded that additional efforts to improve compliance with HCV testing guidelines are needed.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Herati RS, Fleishman JA .
Hepatitis C virus testing in adults living with HIV: a need for improved screening efforts.
PLoS One 2014 Jul 17;9(7):e102766. doi: 10.1371/journal.pone.0102766.
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Keywords: Guidelines, Healthcare Utilization, Hepatitis, Human Immunodeficiency Virus (HIV), Screening
Laws MB, Lee Y, Rogers WH
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
This study directly examined differences in provider–patient communication about anti-retroviral therapy (ART) adherence by patient race or ethnicity. It found more ART adherence dialogue with Black and Hispanic patients than with White patients, even after controlling for indications, and a tendency for adherence dialogue to be more directive in Hispanics than in Whites.
AHRQ-funded; 290010012.
Citation: Laws MB, Lee Y, Rogers WH .
Provider-patient communication about adherence to anti-retroviral regimens differs by patient race and ethnicity.
AIDS Behav 2014 Jul;18(7):1279-87. doi: 10.1007/s10461-014-0697-z..
Keywords: Human Immunodeficiency Virus (HIV), Clinician-Patient Communication, Patient Adherence/Compliance, Racial and Ethnic Minorities
Hsieh YH, Haukoos JS, Rothman RE
Validation of an abbreviated version of the Denver HIV Risk Score for prediction of HIV infection in an urban ED.
The researchers sought to evaluate the performance of a short version of the Denver HIV Risk Score in 2 urban emergency departments. They found that external validation resulted in good discrimination. The study cohort included 15,184 patients with newly diagnosed HIV infection.
AHRQ-funded; HS017526
Citation: Hsieh YH, Haukoos JS, Rothman RE .
Validation of an abbreviated version of the Denver HIV Risk Score for prediction of HIV infection in an urban ED.
Am J Emerg Med. 2014 Jul;32(7):775-9. doi: 10.1016/j.ajem.2014.02.043..
Keywords: Emergency Medical Services (EMS), Human Immunodeficiency Virus (HIV), Risk, Urban Health
Zhang SM, McGoy SL, Dawes D
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
This study explored racial/ethnic disparities in the initiation of antiretroviral treatment among HIV-infected Medicaid enrollees in 14 Southern States. It found no significant differences between blacks and non-Hispanic whites but Hispanic/Latino persons were significantly less likely to receive antiretroviral treatment.
AHRQ-funded; HS022444; HS019470
Citation: Zhang SM, McGoy SL, Dawes D .
The potential for elimination of racial-ethnic disparities in HIV treatment initiation in the Medicaid population among 14 southern states.
PLoS One. 2014 Apr 25;9(4):e96148. doi: 10.1371/journal.pone.0096148..
Keywords: Human Immunodeficiency Virus (HIV), Disparities, Racial and Ethnic Minorities, Medicaid
Crane HM, Heckbert SR, Drozd DR
Lessons learned from the design and implementation of myocardial infarction adjudication tailored for HIV clinical cohorts.
In this study, a team of researchers developed, implemented, and evaluated a myocardial infarction (MI) adjudication protocol for cohort research of human immunodeficiency virus. They found that central adjudication is crucial and that clinical diagnoses alone are insufficient for ascertainment of MI. Over half the events ultimately determined to be MIs were not identified by clinical diagnoses.
AHRQ-funded; HS019515
Citation: Crane HM, Heckbert SR, Drozd DR .
Lessons learned from the design and implementation of myocardial infarction adjudication tailored for HIV clinical cohorts.
Am J Epidemiol. 2014 Apr 15;179(8):996-1005. doi: 10.1093/aje/kwu010..
Keywords: Human Immunodeficiency Virus (HIV), Heart Disease and Health, Clinical Decision Support (CDS), Diagnostic Safety and Quality
Agwu AL, Neptune A, Voss C
CD4 counts of nonperinatally HIV-infected youth and young adults presenting for HIV care between 2002 and 2010.
This study of nonperinatally HIV-infected 12- to 24-year-olds presenting for care at HIV Research Network (HIVRN) sites between 2002 and 2010 sought to determine if fewer nPHIV–infected youth are presenting for care at lower CD4 counts. It found that the proportion of nPHIV-infected youth presenting to HIVRN sites with a CD4 count less than 350 cells/mm3 remained essentially unchanged between 2002 and 2010.
AHRQ-funded; 290010012.
Citation: Agwu AL, Neptune A, Voss C .
CD4 counts of nonperinatally HIV-infected youth and young adults presenting for HIV care between 2002 and 2010.
JAMA Pediatr 2014 Apr;168(4):381-3. doi: 10.1001/jamapediatrics.2013.4531..
Keywords: Human Immunodeficiency Virus (HIV), Children/Adolescents, Evidence-Based Practice
Yehia BR, French B, Fleishman JA
AHRQ Author: Fleishman JA
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
The investigators evaluated whether the association between retention in care and viral suppression differed by HIV disease severity. They found that retention in care is more strongly associated with viral suppression in patients with lower CD4 counts. They concluded that their results have important implications for improving the health of patients with advanced HIV disease and for test and treat approaches to HIV prevention.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, French B, Fleishman JA .
Retention in care is more strongly associated with viral suppression in HIV-infected patients with lower versus higher CD4 counts.
J Acquir Immune Defic Syndr 2014 Mar;65(3):333-9. doi: 10.1097/qai.0000000000000023.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance
Norton BL, Person AK, Castillo C
Barriers to using text message appointment reminders in an HIV clinic.
The researchers conducted a randomized, controlled trial of text message reminders in a large HIV clinic. They found that there were no differences in clinic attendance rates between the group that received text reminders versus the group that did not (72 versus 81 percent). They concluded that barriers must be addressed before they are used as a universal approach to improve clinic attendance.
AHRQ-funded; HS000079.
Citation: Norton BL, Person AK, Castillo C .
Barriers to using text message appointment reminders in an HIV clinic.
Telemed J E Health 2014 Jan;20(1):86-9. doi: 10.1089/tmj.2012.0275..
Keywords: Communication, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance
Haukoos JS, Campbell JD, Conroy AA
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
The researchers estimated the total direct costs associated with performing nontargeted opt-out rapid HIV screening in the emergency department per newly-identified HIV-infected patients and compared such costs to those associated with diagnostic rapid HIV testing. They found that compared to diagnostic testing, nontargeted opt-out rapid HIV screening was more costly but identified more HIV infections.
AHRQ-funded; HS017526
Citation: Haukoos JS, Campbell JD, Conroy AA .
Programmatic cost evaluation of nontargeted opt-out rapid HIV screening in the emergency department.
PLoS One. 2013 Dec 31;8(12):e81565. doi: 10.1371/journal.pone.0081565..
Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Emergency Medical Services (EMS), Healthcare Costs
Samji H, Cescon A, Hogg RS
Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.
The researchers estimated changes in life expectancy among HIV-positive adults on antiretroviral therapy (ART) from 2000–2007 in the U.S. and Canada. They concluded that a 20-year-old HIV-positive adult on ART in the U.S. or Canada is expected to live into their early 70s, a life expectancy approaching that of the general population. Differences by sex, race, HIV transmission risk group, and CD4 count remain.
AHRQ-funded; 290010012.
Citation: Samji H, Cescon A, Hogg RS .
Closing the gap: increases in life expectancy among treated HIV-positive individuals in the United States and Canada.
PLoS One 2013 Dec 18;8(12):e81355. doi: 10.1371/journal.pone.0081355..
Keywords: Human Immunodeficiency Virus (HIV), Mortality
Hellinger FJ
AHRQ Author: Hellinger FJ
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
In order to assess the cost-effectiveness of pre-exposure prophylaxis for HIV prevention in the U.S., the author evaluates various studies and finds that they yield widely varying estimates of the cost per quality-adjusted life year (QALY) gained, and that this variations reflects the substantial uncertainty surrounding the determinants of HIV transmission as well as different approaches to translating a reduction in HIV cases into an estimate of the increase in the number of QALYs.
AHRQ-authored.
Citation: Hellinger FJ .
Assessing the cost effectiveness of pre-exposure prophylaxis for HIV prevention in the US.
Pharmacoeconomics. 2013 Dec;31(12):1091-104. doi: 10.1007/s40273-013-0111-0..
Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Quality of Life, Healthcare Costs, Prevention
Zhang S, Senteio C, Felizzola J
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
The purpose of this study was to describe racial/ethnic disparities in ARV treatment of low-income Medicaid-eligible HIV-infected women, with a focus on minority populations in southern states. It found that Hispanic or Latino women are a specific subgroup at risk for inadequate ARV therapy in pregnancy. The researchers point out a specific policy issue with regard to the systematic exclusion of many immigrants from Medicaid-covered care during the prenatal period.
AHRQ-funded; HS019470.
Citation: Zhang S, Senteio C, Felizzola J .
Racial/ethnic disparities in antiretroviral treatment among HIV-infected pregnant Medicaid enrollees, 2005-2007.
Am J Public Health 2013 Dec;103(12):e46-53. doi: 10.2105/ajph.2013.301328..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Pregnancy, Social Determinants of Health
Soeters HM, Napravnik S, Zakharova OM
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
The researchers had two aims: to examine patterns of nonadherence, high-risk sexual behavior, detectable HIV viraemia and antiretroviral drug resistance, and to identify factors associated with potential transmission of drug-resistant HIV among patients engaged in HIV care. They found that a small but significant proportion of clinic patients with viraemia and documented resistant HIV continue to engage in sexual behaviors that place others at risk for transmitted drug resistance.
AHRQ-funded; HS018731.
Citation: Soeters HM, Napravnik S, Zakharova OM .
Opportunities for sexual transmission of antiretroviral drug resistance among HIV-infected patients in care.
AIDS 2013 Nov 28;27(18):2873-81. doi: 10.1097/01.aids.0000433240.78739.30..
Keywords: Human Immunodeficiency Virus (HIV), Lifestyle Changes, Patient Adherence/Compliance
Galarraga O, Genberg BL, Martin RA
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
This review summarizes various theories from micro- and behavioral-economics to social and clinical psychology that may help to understand how conditional economic incentives (CEI) work, and how they may be integrated with theories of health behavior that focus more on internal motivation. It concluded that appropriate CEI can help patients adhere to HIV treatment in the short-term, while incentives are in place.
AHRQ-funded; HS019657
Citation: Galarraga O, Genberg BL, Martin RA .
Conditional economic incentives to improve HIV treatment adherence: literature review and theoretical considerations.
AIDS Behav. 2013 Sep;17(7):2283-92. doi: 10.1007/s10461-013-0415-2..
Keywords: Human Immunodeficiency Virus (HIV), Patient Self-Management, Chronic Conditions, Medication, Patient Adherence/Compliance
Le XH, Luque AE, Wang D
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
The researchers report the preliminary results from a study to assess the usage of a guideline-driven insomnia screening and treatment case simulation tool. Using system usage diagrams as an instrument, they quantified visit frequency and length of stay for different types of system resources. Preliminary results have shown that both recommendations and interactive decision diagrams were frequently used, with the former having a longer length of stay but fewer visits.
AHRQ-funded; HS022057.
Citation: Le XH, Luque AE, Wang D .
Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.
Stud Health Technol Inform 2013;192:323-7..
Keywords: Education: Continuing Medical Education, Guidelines, Human Immunodeficiency Virus (HIV), Screening, Simulation, Sleep Problems