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- Access to Care (1)
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- Risk (1)
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- Sex Factors (2)
- Social Stigma (6)
- Stroke (1)
- Substance Abuse (8)
- Telehealth (2)
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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
1 to 22 of 22 Research Studies DisplayedRich KM, Zubiago J, Murphy M
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
The authors sought to assess the relationship between gender and needle sharing with injection drug use. Using data from the 2010-2019 National Survey on Drug Use and Health (NSDUH) datasets, they found that women were more likely in comparison with men to share needles both through receptive and distributive means. They concluded that expansion of interventions, including syringe service programs, to increase access to sterile injection equipment, is of great importance.
AHRQ-funded; HS026008.
Citation: Rich KM, Zubiago J, Murphy M .
The association of gender with receptive and distributive needle sharing among individuals who inject drugs.
Harm Reduct J 2022 Sep 30;19(1):108. doi: 10.1186/s12954-022-00689-3..
Keywords: Human Immunodeficiency Virus (HIV), Substance Abuse, Behavioral Health, Sex Factors
Korthuis PT, Cook RR, Lum PJ
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Opioid Use Disorder (OUD) treatment medications can improve outcomes for human immunodeficiency virus (HIV) and also reduce opioid use. The purpose of the study was to determine if outpatient naltrexone treatment could also reduce opioid use and improve outcomes for HIV. The researchers reported that enrollment was stopped early because of slower than expected recruitment, resulting in 114 final participants with untreated OUD and HIV, with 62% positive for fentanyl, 60% positive for cocaine, and 47% positive for other opioids at the baseline. The intervention compared treatment as usual (TAU) of methadone or buprenorphine with extended-release naltrexone (XR-NTX) on group differences in viral suppression at 24 weeks and past 30-day use of opioids at 24 weeks. The study reported that at 24 weeks the outcome of viral suppression was similar for TAU and XR-NTX, and that fewer XR-NTX participants initiated medication than TAU participants. The outcome of previous 30-day use of opioids was similar for TAU as compared to XR-NTX. Of those participants who did initiate medication, those administered XR-NTX experienced less days of opioid use when compared with TAU in the prior 30 days. The researchers reported that the study evidence was not conclusive but did support that XR-NTX is not inferior to TAU for HIV viral suppression, and that study participants who started XR-NTX used less opioids at 24 weeks than participants who were administered TAU.
AHRQ-funded; HS026370.
Citation: Korthuis PT, Cook RR, Lum PJ .
HIV clinic-based extended-release naltrexone versus treatment as usual for people with HIV and opioid use disorder: a non-blinded, randomized non-inferiority trial.
Addiction 2022 Jul;117(7):1961-71. doi: 10.1111/add.15836..
Keywords: Human Immunodeficiency Virus (HIV), Opioids, Substance Abuse, Behavioral Health, Medication, Treatments, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
Wyse JJ, McGinnis KA, Edelman EJ
Twelve-month retention in opioid agonist treatment for opioid use disorder among patients with and without HIV.
Although opioid agonist therapy (OAT) is associated with positive health outcomes, including improved HIV management, long-term retention in OAT remains low among patients with opioid use disorder (OUD). The investigators concluded that history of homelessness was associated with a lower likelihood of retention. Predictors of retention were largely distinct between patients with HIV and patients without HIV. Findings highlighted the need for clinical, systems, and research initiatives to better understand and improve OAT retention.
AHRQ-funded; HS026370.
Citation: Wyse JJ, McGinnis KA, Edelman EJ .
Twelve-month retention in opioid agonist treatment for opioid use disorder among patients with and without HIV.
AIDS Behav 2022 Mar;26(3):975-85. doi: 10.1007/s10461-021-03452-0..
Keywords: Opioids, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV)
Cook RR, Torralva R, King C
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
This study examined the associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder (OUD) among people living with uncontrolled HIV disease. Data from a multisite clinical trial was used to compare extended-release naltrexone (XR-NTX) with treatment as usual (TAU: buprenorphine or methadone) to achieve HIV viral suppression among people with OUD and uncontrolled HIV disease. Exposure to fentanyl use was measured by urine drug screening. The cohort was 11 participants had an average age of 47 years, were 62% male, 57% Black and 13% Hispanic. Baseline fentanyl use was 64% for participants. Participants with baseline fentanyl use were 11 times less likely to initiative XR-NTX than those negative for fentanyl, but there was no evidence that fentanyl use impacted the likelihood of TAU initiation.
AHRQ-funded; HS026370.
Citation: Cook RR, Torralva R, King C .
Associations between fentanyl use and initiation, persistence, and retention on medications for opioid use disorder among people living with uncontrolled HIV disease.
Drug Alcohol Depend 2021 Nov 1;228:109077. doi: 10.1016/j.drugalcdep.2021.109077..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Human Immunodeficiency Virus (HIV), Chronic Conditions
Sico JJ, Kundu S, So-Armah K
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
Background HIV infection and depression are each associated with increased ischemic stroke risk. Whether depression is a risk factor for stroke within the HIV population is unknown. In this study the investigators examined depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study. The investigators concluded that depression is associated with an increased risk of stroke among HIV-positive people after adjusting for sociodemographic characteristics, traditional cerebrovascular risk factors, and HIV-specific factors.
AHRQ-funded; HS023464.
Citation: Sico JJ, Kundu S, So-Armah K .
Depression as a risk factor for incident ischemic stroke among HIV-positive veterans in the veterans aging cohort study.
J Am Heart Assoc 2021 Jul 6;10(13):e017637. doi: 10.1161/jaha.119.017637..
Keywords: Depression, Behavioral Health, Risk, Human Immunodeficiency Virus (HIV), Stroke, Cardiovascular Conditions
Tsui JI, Akosile MA, Lapham GT
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV. The objective of this retrospective observational cohort study was to describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.
AHRQ-funded; HS026369.
Citation: Tsui JI, Akosile MA, Lapham GT .
Prevalence and medication treatment of opioid use disorder among primary care patients with hepatitis C and HIV.
J Gen Intern Med 2021 Apr;36(4):930-37. doi: 10.1007/s11606-020-06389-7..
Keywords: Opioids, Medication, Substance Abuse, Behavioral Health, Hepatitis, Human Immunodeficiency Virus (HIV), Primary Care
Baik D, Liu J, Cho H
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
Investigators conducted a secondary analysis of data collected from four projects focused on improving health outcomes in persons living with HIV (PLWH). They found that male patients displayed negative association between depression and engagement with healthcare providers and positive association between engagement with healthcare providers and medication adherence, while female patients showed no association between any of these factors. Anxiety and stigma were not significantly associated with medication adherence. They concluded that adherence interventions for PLWH should be tailored by biological sex.
AHRQ-funded; HS025071.
Citation: Baik D, Liu J, Cho H .
Factors related to biological sex differences in engagement with healthcare providers in persons living with HIV.
AIDS Behav 2020 Sep;24(9):2656-65. doi: 10.1007/s10461-020-02823-3..
Keywords: Human Immunodeficiency Virus (HIV), Sex Factors, Patient and Family Engagement, Patient Adherence/Compliance, Depression, Behavioral Health, Medication
Crockett KB, Entler KJ, Brodie E
Brief report: linking depressive symptoms to viral nonsuppression among women with HIV through adherence self-efficacy and ART adherence.
The authors examined a longitudinal sequential path model of the association between depressive symptoms and viral non-suppression in women with HIV (WWH) through adherence self-efficacy beliefs and antiretroviral treatment (ART) adherence behavior mechanisms. Their findings supported depressive symptoms' association with adherence self-efficacy that in turn lead to suboptimal ART adherence and ultimately to viral non-suppression for WWH. They recommended tailoring of interventions aimed at addressing depressive symptoms, substance use, and adherence self-efficacy among WWH to help close the gap between ART prescription and viral suppression on the HIV care continuum.
AHRQ-funded; HS013852.
Citation: Crockett KB, Entler KJ, Brodie E .
Brief report: linking depressive symptoms to viral nonsuppression among women with HIV through adherence self-efficacy and ART adherence.
J Acquir Immune Defic Syndr 2020 Apr;83(4):340-44. doi: 10.1097/qai.0000000000002268..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Behavioral Health, Women, Patient Adherence/Compliance
Hill LM, Golin CE, Gottfredson NC
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
The purpose of this study was to identify the mechanisms involved with antiretroviral therapy (ART) non-adherence among people living with HIV (PLHIV) after release from prison. Results showed that, on average, study participants achieved 79% ART adherence. Greater symptoms of depression were associated with greater drug use, which was in turn associated with lower adherence. Lower adherence self-efficacy was associated with depressive symptoms, but not with adherence. Results suggested that depression screening and targeted mental health and substance use services for depressed individuals at risk of substance use constitute important steps to promote adherence to ART after prison release.
AHRQ-funded; HS000032.
Citation: Hill LM, Golin CE, Gottfredson NC .
Drug use mediates the relationship between depressive symptoms and adherence to ART among recently incarcerated people living with HIV.
AIDS Behav 2019 Aug;23(8):2037-47. doi: 10.1007/s10461-018-2355-3..
Keywords: Behavioral Health, Depression, Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Substance Abuse, Vulnerable Populations
Lipira L, Williams EC, Huh D
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
Investigators recruited a sample of African-American women living with HIV to participate in a stigma-reduction intervention. The women lived in Chicago and Birmingham from 2013 to 2015. The relationship between HIV-related stigma and viral suppression was evaluated and the role of depression and nonadherence to antiretroviral therapy (ART) was assessed. Among 100 women who participated 95% reported some level of HIV-related stigma. Those who reported higher levels of stigma did have lower odds of being virally suppressed. The indirect effects of depression and ART nonadherence were not statistically significant.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Huh D .
HIV-related stigma and viral suppression among African-American women: exploring the mediating roles of depression and ART nonadherence.
AIDS Behav 2019 Aug;23(8):2025-36. doi: 10.1007/s10461-018-2301-4..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Racial and Ethnic Minorities, Social Stigma, Women
Lipira L, Williams EC, Nevin PE
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
The objective of this study was to evaluate whether religiosity, social support, and ethnic identity moderate the effects of HIV-related stigma on depression among African-American women living with HIV. Results showed that the protective effects of religiosity may be leveraged in interventions for African-American women living with HIV struggling with HIV-related stigma.
AHRQ-funded; HS013853.
Citation: Lipira L, Williams EC, Nevin PE .
Religiosity, social support, and ethnic identity: exploring "resilience resources" for African-American women experiencing HIV-related stigma.
J Acquir Immune Defic Syndr 2019 Jun;81(2):175-83. doi: 10.1097/qai.0000000000002006..
Keywords: Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women, Depression, Behavioral Health
Belenky N, Pence BW, Cole SR
Impact of Medicare Part D on mental health treatment and outcomes for dual eligible beneficiaries with HIV.
This study examined the potential effects on mental health treatment and outcomes for dual Medicare-Medicaid eligible women with HIV when Medicare Part D was implemented in 2006. Data from the Women’s Interagency HIV Study from 2003-2008 was used. No disruptive effects were found with changes in antidepressant use, depressive symptoms or hospitalization.
AHRQ-funded; HS024858; HS000032.
Citation: Belenky N, Pence BW, Cole SR .
Impact of Medicare Part D on mental health treatment and outcomes for dual eligible beneficiaries with HIV.
AIDS Care 2019 Apr;31(4):505-12. doi: 10.1080/09540121.2018.1516283..
Keywords: Behavioral Health, Human Immunodeficiency Virus (HIV), Medicare, Medication
Aggarwal R, Pham M, Dillingham R
Expanded HIV clinic-based mental health care services: association with viral suppression.
This study compared two cohorts of people living with HIV (PLWH) who were receiving clinic-based mental health services. Cohort A received the services before or during 2012, and Cohort B from 2013-2014. Cohort A had three times as many participants with a CD4 count <200. Cohort B were more likely to also have a substance abuse diagnosis. The researchers concluded that the later cohort may not have as much benefit from increased access to co-located mental health services and substance use services.
AHRQ-funded; HS024196.
Citation: Aggarwal R, Pham M, Dillingham R .
Expanded HIV clinic-based mental health care services: association with viral suppression.
Open Forum Infect Dis 2019 Apr;6(4):ofz146. doi: 10.1093/ofid/ofz146..
Keywords: Access to Care, Behavioral Health, Community-Based Practice, Human Immunodeficiency Virus (HIV), Substance Abuse
Turan B, Crockett KB, Buyukcan-Tetik A
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
One mechanism through which social stigma of HIV affects health outcomes for people living with HIV (PLWH) is through internalization of stigma. However, this transformation of social stigma in the community into internalized stigma may not be of the same magnitude for all PLWH. In this study, the investigators examined the moderating effects of 3 personality traits-fear of negative social evaluation, attachment-related anxiety, and dispositional resilience-in transforming perceived stigma in the community into internalized stigma. They also investigated downstream effects of these moderated associations on depressive symptoms and antiretroviral treatment (ART) adherence.
AHRQ-funded; HS013852.
Citation: Turan B, Crockett KB, Buyukcan-Tetik A .
Buffering internalization of HIV stigma: implications for treatment adherence and depression.
J Acquir Immune Defic Syndr 2019 Mar;80(3):284-91. doi: 10.1097/qai.0000000000001915..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Social Stigma
Bassett SM, Cohn M, Cotten P
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
Positive affect has unique beneficial effects on psychological and physical health, independent of the effects of negative affect. Interventions that explicitly target positive affect show promise for improving health outcomes in a number of chronic illnesses. In this article, the investigators present pilot data on the acceptability and feasibility of an online intervention to increase positive affect in those living with comorbid human immunodeficiency virus (HIV) and depression.
AHRQ-funded; HS000084.
Citation: Bassett SM, Cohn M, Cotten P .
Feasibility and acceptability of an online positive affect intervention for those living with comorbid HIV depression.
AIDS Behav 2019 Mar;23(3):753-64. doi: 10.1007/s10461-019-02412-z..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Behavioral Health, Chronic Conditions, Telehealth, Health Information Technology (HIT), Outcomes
Lipira L, Nevin PE, Frey S
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
The purpose of thisstudy was to implement the first three steps (information gathering, preliminary design, preliminary testing) in the development of a culturally-adapted multimedia behavioral intervention to reduce HIV-related stigma among African-immigrant PLWH. The investigators concluded that input from key stakeholders and observed decreases in depressive symptoms post-intervention indicated that a multimedia behavioral intervention such as The Positive Living Program could be an effective way to address poor psychosocial outcomes associated with HIV-related stigma among African-immigrant PLWH.
AHRQ-funded; HS013853.
Citation: Lipira L, Nevin PE, Frey S .
The positive living program: development and pilot evaluation of a multimedia behavioral intervention to address HIV-related stigma and depression among African-immigrant people living with HIV in a large, Northwestern U.S. metropolitan area.
J Assoc Nurses AIDS Care 2019 Mar-Apr;30(2):224-31. doi: 10.1097/jnc.0000000000000037..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Depression, Behavioral Health, Racial and Ethnic Minorities
Payan DD, Derose KP, Fulcar MA
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
An HIV diagnosis may be associated with severe emotional and psychological distress, which can contribute to delays in care or poor self-management. In this study, the investigators conducted in-depth interviews with 30 women living with HIV in the Dominican Republic to explore the emotional, psychological, and psychosocial impacts of an HIV diagnosis on women in low-resource settings.
AHRQ-funded; HS000046.
Citation: Payan DD, Derose KP, Fulcar MA .
"It was as though my spirit left, like they killed me": the disruptive impact of an HIV-positive diagnosis among women in the Dominican Republic.
J Int Assoc Provid AIDS Care 2019 Jan-Dec;18. doi: 10.1177/2325958219849042..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Women, Social Stigma, Depression, Behavioral Health
Stringer KL, Azuero A, Ott C
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
The purpose of this study was to present feasibility and acceptability data on the use of an electronic adherence monitor (EAM) among African American women in remote areas of the Southeastern United States with HIV and co-occurring depression. EAM and self-reported antiretroviral therapy (ART) adherence was monitored among 25 participants recruited at four HIV clinics in Alabama. Intra-class correlation showed a low degree of concordance between EAM and self-reported adherence. 83% of data collected via EAM was transmitted in real-time; the remainder was delayed though technological failures or was lost entirely. The authors conclude that EAM monitoring is feasible in a rural US setting but that technological difficulties may impede the device's usefulness for just-in-time adherence interventions.
AHRQ-funded; HS013852.
Citation: Stringer KL, Azuero A, Ott C .
Feasibility and acceptability of real-time antiretroviral adherence monitoring among depressed women living with HIV in the deep south of the US.
AIDS Behav 2018 May;23(5):1306-14. doi: 10.1007/s10461-018-2322-z..
Keywords: Depression, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Medication, Behavioral Health, Patient Adherence/Compliance, Rural Health, Telehealth, Women
Saag LA, Tamhane AR, Batey DS
Mental health service utilization is associated with retention in care among persons living with HIV at a university-affiliated HIV clinic.
The researchers sought to determine if mental health (MH) service utilization would be associated with improved retention in care for patients with HIV and MH comorbidities. They concluded that even in the absence of documented MH comorbidities, improved retention in care was observed with increasing MH service utilization.
AHRQ-funded; HS023009.
Citation: Saag LA, Tamhane AR, Batey DS .
Mental health service utilization is associated with retention in care among persons living with HIV at a university-affiliated HIV clinic.
AIDS Res Ther 2018 Jan 16;15(1):1. doi: 10.1186/s12981-018-0188-9.
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Keywords: Healthcare Utilization, Human Immunodeficiency Virus (HIV), Behavioral Health, Patient-Centered Outcomes Research
Earnshaw VA, Smith LR, Cunningham CO
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
The researchers examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. They found that participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Smith LR, Cunningham CO .
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
J Health Psychol 2015 Aug;20(8):1083-9. doi: 10.1177/1359105313507964..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Behavioral Health, Social Stigma, Substance Abuse
Weiss SM, Tobin JN, Lopez M
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
The researchers explored the pathways to effectively transfer promising research accomplishments into effective and sustainable service programs within the health care delivery system. Their study confirmed (a) the translatability of the Stress Management And Relaxation Training/Emotional Supportive Therapy (SMART/EST) Women's Program, from academic to community health center settings in two geographic regions with high HIV prevalence among women, (b) the ability of local staff to successfully achieve program fidelity and clinical outcomes, and (c) the sustainability the program beyond the auspices of research support, through supportive community health center leadership securing continued program funding.
AHRQ-funded; HS021667.
Citation: Weiss SM, Tobin JN, Lopez M .
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
Int J Behav Med 2015 Jun;22(3):415-24. doi: 10.1007/s12529-014-9399-1.
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Keywords: Behavioral Health, Evidence-Based Practice, Healthcare Delivery, Human Immunodeficiency Virus (HIV), Implementation
Crowell TA, Berry SA, Fleishman JA
AHRQ Author: Fleishman JA
Impact of hepatitis coinfection on healthcare utilization among persons living with HIV.
The purpose of this study is to characterize the impact of hepatitis coinfection on utilization of primary HIV care, mental health, and inpatient services. It found no difference in primary HIV care utilization according to hepatitis serostatus. However, patients with HIV/HCV coinfection demonstrated higher rates of mental health visits than any of the other groups examined.
AHRQ-authored; AHRQ-funded; ; 290201100007C.
Citation: Crowell TA, Berry SA, Fleishman JA .
Impact of hepatitis coinfection on healthcare utilization among persons living with HIV.
J Acquir Immune Defic Syndr 2015 Apr;68(4):425-31. doi: 10.1097/qai.0000000000000490..
Keywords: Human Immunodeficiency Virus (HIV), Hepatitis, Healthcare Utilization, Behavioral Health