National Healthcare Quality and Disparities Report
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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
51 to 75 of 126 Research Studies DisplayedDarney BG, Fuentes-Rivera E, Saavedra-Avendaño B
Contraceptive receipt among first-trimester abortion clients and postpartum women in urban Mexico.
The objective of this retrospective cohort study was to compare uptake of contraception prior to discharge between abortion clients in Mexico City's public abortion program and postpartum women from urban settings. Data were taken from clinical records of abortion clients in Mexico City and from a population-based survey of urban women on their adoption of contraception immediately postpartum. The results showed that women who received abortions in Mexico City's public abortion program were more likely to receive a reversible modern contraceptive method before leaving the facility than urban postpartum women. The authors concluded that women should be offered the full range of contraceptive methods after any obstetric event to help prevent unintended pregnancies and avoid short interpregnancy intervals.
AHRQ-funded; HS022981.
Citation: Darney BG, Fuentes-Rivera E, Saavedra-Avendaño B .
Contraceptive receipt among first-trimester abortion clients and postpartum women in urban Mexico.
Int Perspect Sex Reprod Health 2020 Dec 14; 46(Suppl 1):35-43. doi: 10.1363/46e0720..
Keywords: Sexual Health, Women, Maternal Care
Fan T, Palma M
AHRQ Author: Fan T
Behavioral counseling interventions to prevent sexually transmitted infections.
This case study of a 24-year-old cisgender woman presents three questions with answers concerning USPSTF recommendations about sexually transmitted infections and counseling.
AHRQ-authored.
Citation: Fan T, Palma M .
Behavioral counseling interventions to prevent sexually transmitted infections.
Am Fam Physician 2020 Nov 15;102(10):623-24..
Keywords: U.S. Preventive Services Task Force (USPSTF), Sexual Health, Infectious Diseases, Public Health, Prevention, Case Study, Guidelines
Dalton VK, Moniz MH, Bailey MJ
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
Researchers evaluated changes in birth rates by income level among commercially insured women before (2008-2013) and after (2014-2018) the elimination of cost sharing for contraception under the Patient Protection and Affordable Care Act (ACA). The analytic sample included over 4.5 million women enrolled in 47,721 health plans. In this cross-sectional study, the researchers found that the elimination of cost sharing for contraception under the ACA was associated with improvements in contraceptive method prescription fills and a decrease in births among commercially insured women. Women with low income had more precipitous decreases than women with higher income, suggesting that enhanced access to contraception may address well-documented income-related disparities in unintended birth rates.
AHRQ-funded; HS025465; HS023784.
Citation: Dalton VK, Moniz MH, Bailey MJ .
Trends in birth rates after elimination of cost sharing for contraception by the Patient Protection and Affordable Care Act.
JAMA Netw Open 2020 Nov 2;3(11):e2024398. doi: 10.1001/jamanetworkopen.2020.24398..
Keywords: Policy, Health Insurance, Women, Healthcare Costs, Pregnancy, Sexual Health
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
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
Bonawitz K, Wetmore M, Heisler M
Champions in context: which attributes matter for change efforts in healthcare?
The authors sought to identify and describe champion attributes influencing outcomes of healthcare change efforts. Using postpartum contraceptive care as a case study, they found that effective champions appear to leverage six key attributes to facilitate healthcare change efforts. They concluded that prospective evaluations of the interactions among champion attributes, context, and outcomes may further elucidate how champions exert their effects.
AHRQ-funded; HS025465.
Citation: Bonawitz K, Wetmore M, Heisler M .
Champions in context: which attributes matter for change efforts in healthcare?
Implement Sci 2020 Aug 6;15(1):62. doi: 10.1186/s13012-020-01024-9..
Keywords: Implementation, Sexual Health, Women, Maternal Care
Darney BG, Jacob RL, Hoopes M
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
This study examined whether Medicaid expansion under the Affordable Care Act increased contraceptive use for women who are underserved in the US health care safety net. The authors used electronic health record (EHR) data from a clinical research network of community health centers across 24 states. The sample included all female patients ages 15 to 44 years at risk for pregnancy with an ambulatory care visit. The study compared receipt of contraception before (2013) vs immediately after (2014) and then in 2016 after a longer period of Medicaid expansion. The sample included 310,132 women from expansion states and 234,508 women from nonexpansion states. There was an associated increase in long-acting reversible contraceptive method prescriptions among women in the expansion states, with adolescents having the largest increase.
AHRQ-funded; HS025155.
Citation: Darney BG, Jacob RL, Hoopes M .
Evaluation of Medicaid expansion under the Affordable Care Act and contraceptive care in US community health centers.
JAMA Netw Open 2020 Jun;3(6):e206874. doi: 10.1001/jamanetworkopen.2020.6874..
Keywords: Medicaid, Women, Policy, Sexual Health
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
Rinehart DJ, Leslie S, Durfee MJ
Acceptability and efficacy of a sexual health texting intervention designed to support adolescent females.
The purpose of this study was to evaluate the feasibility, acceptability, and initial efficacy of a pilot texting intervention ("t4she") in primary care designed to increase sexual health knowledge and promote dual protection strategies to reduce unintended pregnancies and sexually transmitted infections among adolescent females. The investigators concluded that the pilot t4she sexual health intervention significantly improved knowledge and use of short-acting prescription birth control among young females in primary care and was acceptable by youth and feasible to implement.
AHRQ-funded; HS022143.
Citation: Rinehart DJ, Leslie S, Durfee MJ .
Acceptability and efficacy of a sexual health texting intervention designed to support adolescent females.
Acad Pediatr 2020 May-Jun;20(4):475-84. doi: 10.1016/j.acap.2019.09.004..
Keywords: Children/Adolescents, Sexual Health, Women, Health Information Technology (HIT), Health Promotion
Darney BG, Biel FM, Rodriguez MI
Payment for contraceptive services in safety net clinics: roles of Affordable Care Act, Title X, and state programs.
This study examined trends in uninsured contraceptive visits before and after Medicaid expansion under the Affordable Care Act (ACA) in a large network of safety-net clinics. Their sample included 237 safety net clinics in 11 states with a common electronic health record. The authors identified 162,666 contraceptive visits in 219 clinics and found a significant decline in uninsured visits. There was a slightly greater decline in expansion states than in non-expansion states.
AHRQ-funded; HS022981; HS025155.
Citation: Darney BG, Biel FM, Rodriguez MI .
Payment for contraceptive services in safety net clinics: roles of Affordable Care Act, Title X, and state programs.
Med Care 2020 May;58(5):453-60. doi: 10.1097/mlr.0000000000001309..
Keywords: Sexual Health, Policy, Uninsured, Women
Sun CJ, Seloilwe ES, Magowe M
Association of adolescent- and parent-reported relationship functioning with HIV sexual risk among adolescents in Botswana.
Globally, adolescents in sub-Saharan Africa are the youth most affected by HIV. Parent-adolescent relationships can be protective in child and adolescent development and may be implicated in lowered adolescent HIV sexual risk. This dyadic study simultaneously assessed both parents' and adolescents' perceptions of family functioning and their relationships with adolescent sexual behaviors in Botswana.
AHRQ-funded; HS022981.
Citation: Sun CJ, Seloilwe ES, Magowe M .
Association of adolescent- and parent-reported relationship functioning with HIV sexual risk among adolescents in Botswana.
AIDS Behav 2020 Mar;24(3):975-83. doi: 10.1007/s10461-019-02429-4..
Keywords: Children/Adolescents, Human Immunodeficiency Virus (HIV), Risk, Sexual Health
Birru Talabi M, Clowse MEB, Blalock SJ
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
This qualitative study sought to assess rheumatologists' perspectives, attitudes, and practices regarding family planning counseling and reproductive health care (FPCC). A geographically diverse sample of U.S. rheumatologists were interviewed and the transcripts of the interviews developed into a code book based on their content. Findings showed that rheumatologists feel a sense of responsibility to provide some aspects of FPCC to reproductive-age female patients. However, their own apprehensions about managing complicated pregnancies may negatively influence how they advise patients about pregnancy planning or avoidance. Future work should focus on eliminating barriers and identifying solutions that support rheumatologists' efforts to provide high-quality FPCC to patients.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Clowse MEB, Blalock SJ .
Perspectives of adult rheumatologists regarding family planning counseling and care: a qualitative study.
Arthritis Care Res 2020 Mar;72(3):452-58. doi: 10.1002/acr.23872..
Keywords: Arthritis, Pregnancy, Sexual Health, Provider: Physician, 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)
Muzny CA, Van Gerwen OT, Kissinger P
Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity.
The purpose of this review was to update information on treatment of Trichomonas vaginalis. T. vaginalis is estimated to be the most common treatable sexually transmitted infection in the world and is associated with poor birth outcomes, cervical cancer, sperm motility and morphology issues, and HIV acquisition and transmission.
AHRQ-funded; HS013852.
Citation: Muzny CA, Van Gerwen OT, Kissinger P .
Updates in trichomonas treatment including persistent infection and 5-nitroimidazole hypersensitivity.
Curr Opin Infect Dis 2020 Feb;33(1):73-77. doi: 10.1097/qco.0000000000000618..
Keywords: Infectious Diseases, Sexual Health, Treatments
Giguere R, Lopez-Rios J, Frasca T
Use of HIV self-testing kits to screen clients among transgender female sex workers in New York and Puerto Rico.
This research focused on the use of HIV self-testing (HIVST) kits given to transgender female sex workers (TFSW) to screen sexual partners. Ten TFSWs were given ten HIVST kits each and they complete an online questionnaire 3 months later or underwent an interview. Eight of them reported using the test kit with potential clients or partners. The majority who were asked to test were clients (84%). Out of those 50 potential partners or clients, 34 out of 50 accepted and 16 refused. Participants felt empowered but the market cost of these kits is prohibitive and could only be implemented if the costs were lowered or subsidized.
AHRQ-funded; HS026383.
Citation: Giguere R, Lopez-Rios J, Frasca T .
Use of HIV self-testing kits to screen clients among transgender female sex workers in New York and Puerto Rico.
AIDS Behav 2020 Feb;24(2):506-15. doi: 10.1007/s10461-019-02730-2..
Keywords: Human Immunodeficiency Virus (HIV), Vulnerable Populations, Diagnostic Safety and Quality, Sexual Health, Patient Self-Management, Women
Henderson JT, Senger CA, Henninger M
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
This updated evidence report and systematic review accompanied the USPSTF final recommendation for behavioral counseling interventions to prevent sexually transmitted infections (STIs) in adults and adolescents, which was published in August 2020. Studies from the previous 2014 review and literature from January 2013 through May 2019 was reviewed to find good- and fair-quality randomized and nonrandomized controlled intervention studies conducted in primary care settings. The review included 37 randomized trials and 2 nonrandomized controlled intervention studies. The study populations were mostly heterosexual adolescents and young adults, females, and racial and ethnic minorities at increased risk for STIs. Thirty-four trials reported behavioral change outcomes after interventions. The largest reductions in STI incidence were reported after group or individual counseling sessions lasting more than 2 hours. Evidence was limited on interventions of shorter duration persisting beyond 1 year.
AHRQ-funded; 2902015000017I.
Citation: Henderson JT, Senger CA, Henninger M .
Behavioral counseling interventions to prevent sexually transmitted infections: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2020 Aug 18;324(7):682-99. doi: 10.1001/jama.2020.10371..
Keywords: U.S. Preventive Services Task Force (USPSTF), Infectious Diseases, Sexual Health, Evidence-Based Practice, Guidelines
Mullins BT, Basak R, Broughman JR
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
This study compares the effects of different types of radical prostatectomy and radiotherapy on sexual function. A population-based cohort of 835 men with newly diagnosed prostate cancer from 2011 through 2013 was recruited in collaboration with the Rapid Case Ascertainment system of the North Carolina Central Cancer Registry. They were enrolled prior to treatment and followed retrospectively using the validated Prostate Cancer Symptom Indices (PCSI) instrument. The sexual function scores were compared among patients who received the following treatment types: external-beam RT (EBRT), EBRT with androgen deprivation therapy (ADT), brachytherapy, nerve-sparing radical prostatectomy (RP), and non-nerve-sparing RP. The cohort was surveyed at 24 months post-therapy, and RT alone was found to result in the best preservation of sexual function with brachytherapy, RT with ADT, and nerve-sparing RP yielding similar outcomes. Patients treated with non-nerve-sparing RP experienced the worst sexual function outcome.
AHRQ-funded.
Citation: Mullins BT, Basak R, Broughman JR .
Patient-reported sexual quality of life after different types of radical prostatectomy and radiotherapy: analysis of a population-based prospective cohort.
Cancer 2019 Oct 15;125(20):3657-65. doi: 10.1002/cncr.32288..
Keywords: Quality of Life, Sexual Health, Surgery, Treatments, Comparative Effectiveness, Patient-Centered Outcomes Research, Outcomes, Cancer: Prostate Cancer, Cancer, Evidence-Based Practice
Van Gerwen OT, Muzny CA
Recent advances in the epidemiology, diagnosis, and management of Trichomonas vaginalis infection.
Trichomonas vaginalis is the most common, curable non-viral sexually transmitted infection (STI) worldwide. Despite this burden of disease, it is not currently a reportable disease in the United States. Recent advances in the epidemiology, diagnosis, and management of T. vaginalis infection are described in this article.
AHRQ-funded; HS013852.
Citation: Van Gerwen OT, Muzny CA .
Recent advances in the epidemiology, diagnosis, and management of Trichomonas vaginalis infection.
F1000Res 2019 Sep 20;8. doi: 10.12688/f1000research.19972.1..
Keywords: Sexual Health, Women
Campbell AD, Turok DK, White K
Fertility intentions and perspectives on contraceptive involvement among low-income men aged 25 to 55.
In this study the authors examined the pregnancy-related attitudes and behaviors among men older than 24, who are involved in the majority of pregnancies ending in a birth. Between December 2015 and August 2016, in-depth interviews were conducted with 26 low-income men in Alabama who were aged 25-55, were sexually active and did not want more children. The investigators found that some low-income adult men were uncertain about their pregnancy desires, and many lacked contraceptive knowledge that would help them avoid unwanted pregnancy.
AHRQ-funded; HS013852.
Citation: Campbell AD, Turok DK, White K .
Fertility intentions and perspectives on contraceptive involvement among low-income men aged 25 to 55.
Perspect Sex Reprod Health 2019 Sep;51(3):125-33. doi: 10.1363/psrh.12115..
Keywords: Sexual Health, Low-Income, Men's Health, Pregnancy
Wang D
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
This study compared in-person and online training for dissemination of clinical evidence of HIV, HCV, and STD. The study used 250 clinicians completing four training courses in dual formats over a three-month period. Online training was the preferred format by clinicians.
AHRQ-funded; HS022057.
Citation: Wang D .
A comparison of in-person and online training in a statewide clinical education program for dissemination of HIV, HCV and STD clinical evidence.
Stud Health Technol Inform 2019 Aug 21;264:2003-04. doi: 10.3233/shti190756..
Keywords: Human Immunodeficiency Virus (HIV), Hepatitis, Sexual Health, Evidence-Based Practice, Training, Patient-Centered Outcomes Research
Birru Talabi M, Cllowse MEB, Blalock SJ
Contraception use among reproductive-age women with rheumatic diseases.
The purpose of this study was to determine contraception use among a cohort of reproductive-age women with rheumatic diseases. Women who had one of 21 possible rheumatic disease diagnoses, and had at least two outpatient rheumatology visits, were included. Findings revealed low use of prescription contraception, and the authors recommended urgent efforts to improve contraceptive care and access for some women with rheumatic diseases.
AHRQ-funded; HS022989.
Citation: Birru Talabi M, Cllowse MEB, Blalock SJ .
Contraception use among reproductive-age women with rheumatic diseases.
Arthritis Care Res 2019 Aug;71(8):1132-40. doi: 10.1002/acr.23724..
Keywords: Arthritis, Chronic Conditions, Women, Sexual Health
Sun CJ, Tobin K, Spikes P
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
Disclosure of same-sex behavior to health care providers (HCPs) by men who have sex with men (MSM) has been argued to be an important aspect of HIV prevention. However, Black MSM are less likely to disclose compared to white MSM. This analysis of data collected in the United States from 2006-2009 identified individual and social network characteristics of Black MSM that were associated with disclosure that may be leveraged to increase disclosure.
AHRQ-funded; HS022981.
Citation: Sun CJ, Tobin K, Spikes P .
Correlates of same-sex behavior disclosure to health care providers among Black MSM in the United States: implications for HIV prevention.
AIDS Care 2019 Aug;31(8):1011-18. doi: 10.1080/09540121.2018.1548753..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Sexual Health, Men's Health, Prevention
von Hippel C, Adhia A, Rosenberg S
Sexual function among women in midlife: findings from the Nurses' Health Study II.
This study sought to assess the prevalence of recent sexual activity and sexual dysfunction symptoms among middle-aged women and evaluate the associations of partner status, menopause, and health status factors with sexual dysfunction. The investigators concluded that difficulty with sexual function is common among women in midlife, but less so than previously estimated.
AHRQ-funded; HS023680.
Citation: von Hippel C, Adhia A, Rosenberg S .
Sexual function among women in midlife: findings from the Nurses' Health Study II.
Womens Health Issues 2019 Jul - Aug;29(4):291-98. doi: 10.1016/j.whi.2019.04.006..
Keywords: Sexual Health, Women
Cottrell E, Darney BG, Marino M
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
In this paper, the authors describe a 5-year, mixed-methods study comparing women's contraceptive, preventive, prenatal and postpartum care before and after ACA implementation and between Medicaid expansion and non-expansion states. They conclude that the findings will be relevant to policy and practice, informing efforts that enhance the provision of timely, evidence-based reproductive care, to improve health outcomes, and to reduce disparities among women. Patient, provider and practice-level interviews will serve to contextualize their findings and to develop subsequent studies and interventions to support women's healthcare provision in community health center settings.
AHRQ-funded; HS025155.
Citation: Cottrell E, Darney BG, Marino M .
Study protocol: a mixed-methods study of women's healthcare in the safety net after Affordable Care Act implementation - EVERYWOMAN.
Health Res Policy Syst 2019 Jun 11;17(1):58. doi: 10.1186/s12961-019-0445-y..
Keywords: Women, Access to Care, Medicaid, Policy, Prevention, Maternal Care, Sexual Health