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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 25 of 28 Research Studies DisplayedFredericksen RJ, Walcott M, Yang FM
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
In this study, the investigators interviewed primary care patients living with and without HIV, regarding circumstances surrounding sexual risk behavior, to identify opportunities for providers to address and reduce STI risk. The investigators found that circumstances surrounding perceived STI exposure risk were diverse, often overlapping, and dependent on internal, environmental, and partner-related factors and inadequate communication. They suggest that meaningful care-based interventions regarding HIV/STI transmission behavior must address the diversity and interplay of these factors.
AHRQ-funded; HS022242.
Citation: Fredericksen RJ, Walcott M, Yang FM .
Circumstances surrounding high-risk sexual experiences among primary care patients living with and without HIV.
J Gen Intern Med 2018 Dec;33(12):2163-70. doi: 10.1007/s11606-018-4675-4..
Keywords: Human Immunodeficiency Virus (HIV), Primary Care, Risk, Sexual Health
Crockett KB, Turan B
Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study.
In this study, the investigators used an experience sampling method (also called Ecological Momentary Assessment) to assess moment-to-moment experiences of pain and social support 3 times a day for 7 days in a sample of 109 men living with HIV. They found that within-persons, experiences of daily social support reduced experiences of pain. Between-persons, attachment style may have influenced how individuals make use of social support in coping with experiences of pain.
AHRQ-funded; HS013852.
Citation: Crockett KB, Turan B .
Moment-to-moment changes in perceived social support and pain for men living with HIV: an experience sampling study.
Pain 2018 Dec;159(12):2503-11. doi: 10.1097/j.pain.0000000000001354..
Keywords: Human Immunodeficiency Virus (HIV), Pain, Quality of Life
Grover S, Desir F, Jing Y
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
A cohort of persons with HIV (PWH) who had AIDS-defining illness (ADI) at the time of cancer diagnosis were compared to those without HIV and ADI with cancer diagnosis at the same stages. Those with ADI had a higher mortality rate (30-70%) with lung cancer statistically significant. This finding is related with HIV-related immune suppression.
AHRQ-funded; 90047713.
Citation: Grover S, Desir F, Jing Y .
Reduced cancer survival among adults with HIV and AIDS-defining illnesses despite no difference in cancer stage at diagnosis.
J Acquir Immune Defic Syndr 2018 Dec 1;79(4):421-29. doi: 10.1097/qai.0000000000001842..
Keywords: Cancer, Diagnostic Safety and Quality, Human Immunodeficiency Virus (HIV), Outcomes
Renfro T, Johnson E, Lambert DN
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
This article describes an effort to train lay community members within predominantly Black churches in Atlanta, GA, to implement an HIV-prevention intervention using digital media. Lay educators were trained by translating a face-to-face Training of Facilitators (TOF) to a digital platform using the MEDIA (Motivate-Engage-Digitize-Implement-Assess) model. The research team worked with topical experts and a production company to develop storyboards for core curriculum activities, which were scripted and filmed. A user guide, toolkit, and program website were also developed as supplemental materials to accompany the video training. The article concludes that creating digital media can be a time-consuming process, that pilot testing in the new format is necessary even for previously tested interventions, and that the structure provided by facilitators in face-to-face training must be embedded within the format of the digitized trainings.
AHRQ-funded; HS022059.
Citation: Renfro T, Johnson E, Lambert DN .
The MEDIA model: an innovative method for digitizing and training community members to facilitate an HIV prevention intervention.
Transl Behav Med 2018 Nov 21;8(6):815-23. doi: 10.1093/tbm/iby012..
Keywords: Health Promotion, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities, Women
McManus KA, McManus K, Dillingham R
National survey of United States human immunodeficiency virus medical providers' knowledge and attitudes about the Affordable Care Act.
The objective of the study was to explore HIV medical providers' knowledge and attitudes about the Affordable Care Act (ACA). The investigators concluded that: medical providers in Medicaid expansion states were more optimistic about the ACA's likelihood to improve their patients' HIV outcomes; there are gaps in HIV medical providers' understanding of the ACA; and education could enhance systems-based practice.
AHRQ-funded; HS024196.
Citation: McManus KA, McManus K, Dillingham R .
National survey of United States human immunodeficiency virus medical providers' knowledge and attitudes about the Affordable Care Act.
Clin Infect Dis 2018 Oct 15;67(9):1403-10. doi: 10.1093/cid/ciy296..
Keywords: Policy, Human Immunodeficiency Virus (HIV), Medicaid, Provider
Schnall R, Cho H, Mangone A
Mobile health technology for improving symptom management in low income persons living with HIV.
This study aimed to examine the impact of an mHealth application (app), comprised of evidence-based self-care strategies, on the symptom experience of persons living with HIV (PLWH). In this 12-week trial, an mHealth app, mobile Video Information Provider (mVIP), was associated with improved symptom burden and increased medication adherence in PLWH.
AHRQ-funded; HS023963.
Citation: Schnall R, Cho H, Mangone A .
Mobile health technology for improving symptom management in low income persons living with HIV.
AIDS Behav 2018 Oct;22(10):3373-83. doi: 10.1007/s10461-017-2014-0..
Keywords: Chronic Conditions, Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Low-Income, Vulnerable Populations
Cho H, Porras T, Baik D
Understanding the predisposing, enabling, and reinforcing factors influencing the use of a mobile-based HIV management app: a real-world usability evaluation.
In this study, the authors conducted an in-depth analysis of users' experiences using an HIV self-management app. Usability evaluation in a real-world setting enabled the investigators to measure users' actual experiences when interacting with the app during their everyday lives. They suggest that their work highlighted the importance of using mobile technology for persons living with HIV, specifically those with low income/housing instability.
AHRQ-funded; HS023963.
Citation: Cho H, Porras T, Baik D .
Understanding the predisposing, enabling, and reinforcing factors influencing the use of a mobile-based HIV management app: a real-world usability evaluation.
Int J Med Inform 2018 Sep;117:88-95. doi: 10.1016/j.ijmedinf.2018.06.007..
Keywords: Health Information Technology (HIT), Human Immunodeficiency Virus (HIV), Patient-Centered Outcomes Research, Patient Self-Management
Rice WS, Logie CH, Napoles TM
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
This study conducted 76 interviews with diverse women with HIV from varied socioeconomic backgrounds in Birmingham AL, Jackson MI, Atlanta GA, and San Francisco CA, who were enrolled in the Women's Interagency HIV Study (WIHS). The purpose was to examine perceptions of intersectional stigma among women living with HIV. The women interviewed shared their perceptions of the various forms of stigma and discrimination they had experienced, most commonly related to gender, race, income level, as well as their incarceration histories and weight. The study’s findings highlight the complexity of the social processes of marginalization, and the need for public health strategies to promote wellbeing among women living with HIV and to reduce social structural and health disparities.
AHRQ-funded; HS013852.
Citation: Rice WS, Logie CH, Napoles TM .
Perceptions of intersectional stigma among diverse women living with HIV in the United States.
Soc Sci Med 2018 Jul;208:9-17. doi: 10.1016/j.socscimed.2018.05.001..
Keywords: Disparities, Human Immunodeficiency Virus (HIV), Racial and Ethnic Minorities, Social Stigma, Women
Haukoos JS, Lyons MS, Rothman RE
The evolving landscape of HIV screening in the emergency department.
This article is a summary of two studies that appear in the same edition of the journal. The two studies describe the value of using targeted vs. non-targeted screening for HIV in emergency departments (EDs). New diagnosis rates were relatively small, which suggested that the use of targeted screening may be need to be refined more in terms of selection criteria.
AHRQ-funded; HS021749.
Citation: Haukoos JS, Lyons MS, Rothman RE .
The evolving landscape of HIV screening in the emergency department.
Ann Emerg Med 2018 Jul;72(1):54-56. doi: 10.1016/j.annemergmed.2018.01.041..
Keywords: Diagnostic Safety and Quality, Emergency Department, Human Immunodeficiency Virus (HIV), Prevention, Screening
Marconi VC, Duncan MS, So-Armah K
Bilirubin is inversely associated with cardiovascular disease among HIV-positive and HIV-negative individuals in VACS (Veterans Aging Cohort Study).
In this prospective cohort study, the investigators assessed whether bilirubin independently predicted the risk of CVD events among HIV(+) and uninfected participants in VACS (Veterans Aging Cohort Study. The investigators found that VACS participants (regardless of HIV status) with elevated bilirubin levels had a lower risk of incident total CVD, acute myocardial infarction, heart failure, and ischemic stroke events after adjusting for known risk factors.
AHRQ-funded; HS018372.
Citation: Marconi VC, Duncan MS, So-Armah K .
Bilirubin is inversely associated with cardiovascular disease among HIV-positive and HIV-negative individuals in VACS (Veterans Aging Cohort Study).
J Am Heart Assoc 2018 May 2;7(10). doi: 10.1161/jaha.117.007792..
Keywords: Human Immunodeficiency Virus (HIV), Cardiovascular Conditions, Risk
Crockett KB, Rice WS, Turan B
Associations between multiple forms of discrimination and tobacco use among people living with HIV: the mediating role of avoidance coping.
This study examined the use of tobacco among people living with HIV (PLWH) and their use of it as a coping mechanism for multiple forms of discrimination. Many PLWH face stigma and discrimination associated with HIV and race and sexual orientation. This cohort study recruited 202 PLWH from a HIV primary care clinic in Birmingham, AL between 2013 and 2015. Participants were surveyed on their tobacco use and it showed an association with avoidance coping.
AHRQ-funded; HS013852.
Citation: Crockett KB, Rice WS, Turan B .
Associations between multiple forms of discrimination and tobacco use among people living with HIV: the mediating role of avoidance coping.
J Acquir Immune Defic Syndr 2018 May 1;78(1):9-15. doi: 10.1097/qai.0000000000001636..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Tobacco Use
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
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.
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Keywords: Healthcare Costs, Healthcare Costs, Human Immunodeficiency Virus (HIV), Infectious Diseases, Screening
de Montigny S, Adamson BJS, Masse BR
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
In this paper, the authors estimated the potential epidemiological and economic impact of HIV vaccine campaigns compared to continuous vaccination, assuming that vaccine efficacy was transient and dependent on immune response. The investigators concluded that results suggested a partially effective HIV vaccine would have substantial impact on the HIV epidemic in South Africa and offer good value if priced less than $105 for a five-dose series. They suggested that vaccination campaigns every two years may offer greater value for money than continuous vaccination reaching the same coverage level.
AHRQ-funded; HS013853.
Citation: de Montigny S, Adamson BJS, Masse BR .
Projected effectiveness and added value of HIV vaccination campaigns in South Africa: a modeling study.
Sci Rep 2018 Apr 17;8(1):6066. doi: 10.1038/s41598-018-24268-4..
Keywords: Health Services Research (HSR), Healthcare Costs, Human Immunodeficiency Virus (HIV), Public Health, Vaccination
Calabrese SK, Earnshaw VA, Krakower DS
A closer look at racism and heterosexism in medical students' clinical decision-making related to HIV pre-exposure prophylaxis (PrEP): implications for PrEP education.
In this survey study of 115 US medical students, researchers examined associations between biases (racism and heterosexism) and PrEP clinical decision-making and explored prior PrEP education as a potential buffer. They concluded that prior PrEP education did not buffer any indirect effects. Also, heterosexism may compromise PrEP provision to MSM and should be addressed in PrEP-related medical education.
AHRQ-funded; HS022986.
Citation: Calabrese SK, Earnshaw VA, Krakower DS .
A closer look at racism and heterosexism in medical students' clinical decision-making related to HIV pre-exposure prophylaxis (PrEP): implications for PrEP education.
AIDS Behav 2018 Apr;22(4):1122-38. doi: 10.1007/s10461-017-1979-z.
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Keywords: Decision Making, Education: Academic, Human Immunodeficiency Virus (HIV), Prevention, Racial and Ethnic Minorities
Kay ES, Rice WS, Crockett KB
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
This study examined the effects of HIV-related stigma in 203 patients at a Southeastern US urban HIV clinic. Psychosocial and health outcomes related to stigma in community and health care settings was investigated. The study showed that stigma was associated with subclinical outcomes such as viral nonsuppression, poor mental health and interpersonal outcomes. Interventions to address stigma in health care settings were recommended to help these patients.
AHRQ-funded; HS013852.
Citation: Kay ES, Rice WS, Crockett KB .
Experienced HIV-related stigma in health care and community settings: mediated associations with psychosocial and health outcomes.
J Acquir Immune Defic Syndr 2018 Mar;77(3):257-63. doi: 10.1097/qai.0000000000001590..
Keywords: Human Immunodeficiency Virus (HIV), Social Stigma, Urban Health
Behler RL, Cornwell BT, Schneider JA
Patterns of social affiliations and healthcare engagement among young, black, men who have sex with men.
This study investigates how individuals’ social affiliations affect their knowledge of and engagement with public health services. A sample of 618 young black men who have sex with men (YBMSM) in Chicago were used to identify connections within their social networks. Men who had stronger affiliations with the Chicago gay community had more knowledge of pre-exposure prophylaxis (PrEP), while men who had stronger affiliations with the black community had improved HIV treatment outcomes.
AHRQ-funded; HS024167.
Citation: Behler RL, Cornwell BT, Schneider JA .
Patterns of social affiliations and healthcare engagement among young, black, men who have sex with men.
AIDS Behav 2018 Mar;22(3):806-18. doi: 10.1007/s10461-016-1668-3..
Keywords: Disparities, Healthcare Delivery, Human Immunodeficiency Virus (HIV), Men's Health, Racial and Ethnic Minorities
Adam GP, Di M, Cu-Uvin S
Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map.
This work aims to identify and characterize empirical studies of strategies for the comprehensive management of women over 40, including transgender women, who live with HIV/AIDS. Few of the 37 eligible studies focused on women facing obvious challenges, such as immigrants, transgender, physically abused, or those recently released from prison. No studies focused on women caring for dependents, including children and grandchildren, or those diagnosed after age 40.
AHRQ-funded; 290201500002I.
Citation: Adam GP, Di M, Cu-Uvin S .
Strategies for improving the lives of US women aged 40 and above living with HIV/AIDS: an evidence map.
Syst Rev 2018 Feb 2;7(1):25. doi: 10.1186/s13643-018-0684-y.
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Keywords: Evidence-Based Practice, Human Immunodeficiency Virus (HIV), Vulnerable Populations, Women
Sun CJ, Sutfin E, Bachmann LH
Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: implications for recruitment and health promotion.
This paper seeks to identify differences in men who have sex with men (MSM) and transgender women who use the Grindr app and those who use other similar apps. It found significant differences in the sociodemographic characteristics by app use, including age, race/ethnicity, sexual orientation, and outness. After adjusting for the sociodemographic characteristics associated with app use, there were significant differences in HIV risk and substance use between the groups.
AHRQ-funded; HS022981.
Citation: Sun CJ, Sutfin E, Bachmann LH .
Comparing men who have sex with men and transgender women who use Grindr, other similar social and sexual networking apps, or no social and sexual networking apps: implications for recruitment and health promotion.
J AIDS Clin Res 2018;9(2). doi: 10.4172/2155-6113.1000757.
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Keywords: Health Promotion, Human Immunodeficiency Virus (HIV), Risk, Social Determinants of Health, Vulnerable Populations
Sun CJ, Seloilwe ES, Magowe M
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
The HIV epidemic continues in sub-Saharan Africa and Botswana and adolescents there have borne the brunt. This analysis assessed gender differences in sexual and reproductive health protective and risk factors in 228 Batswana adolescents. Although three-quarters of adolescents prefer to have their parents teach them about sex, it is the fourth most common source of information.
AHRQ-funded; HS022981.
Citation: Sun CJ, Seloilwe ES, Magowe M .
Gender differences in sexual and reproductive health protective and risk factors of Batswana adolescents: implications for parent and adolescent interventions.
AIDS Educ Prev 2018 Feb;30(1):35-46. doi: 10.1521/aeap.2018.30.1.35..
Keywords: Caregiving, Children/Adolescents, Human Immunodeficiency Virus (HIV), Prevention, Risk, Sex Factors, Sexual Health
Skaathun B, Khanna AS, Morgan E
Network viral load: a critical metric for HIV elimination.
Associations have been observed between an aggregate viral load measure, the community viral load, and new HIV diagnoses. The community viral load aggregates viral loads within chosen geographic areas, restricting inferences about HIV acquisition risk to these areas. In this study, the investigators develop a more precise metric, the network viral load (NVL), to measure the composite viral load within a risk network of a HIV-negative individual.
AHRQ-funded; HS000084.
Citation: Skaathun B, Khanna AS, Morgan E .
Network viral load: a critical metric for HIV elimination.
J Acquir Immune Defic Syndr 2018 Feb;77(2):167-74. doi: 10.1097/qai.0000000000001584..
Keywords: Human Immunodeficiency Virus (HIV)
Derose KP, Rios-Castillo I, Fulcar MA
Severe food insecurity is associated with overweight and increased body fat among people living with HIV in the Dominican Republic.
To explore the association between food insecurity and overweight and obesity among PLHIV in the Dominican Republic, the researchers conducted a cross-sectional study of 160 HIV-infected adults between March-December 2012. After controlling for age, gender, income, having children at home, education, and anti-retroviral therapy status, severe food insecurity was associated with increased body mass index (BMI) and body fat.
AHRQ-funded; HS000046.
Citation: Derose KP, Rios-Castillo I, Fulcar MA .
Severe food insecurity is associated with overweight and increased body fat among people living with HIV in the Dominican Republic.
AIDS Care 2018 Feb;30(2):182-90. doi: 10.1080/09540121.2017.1348597.
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Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Obesity, Obesity: Weight Management, Social Determinants of Health
Eaton EF, Tamhane A, Davy-Mendez T
Trends in antiretroviral therapy prescription, durability and modification: new drugs, more changes, but less failure.
The purpose of this retrospective follow-up study was to evaluate the real world durability of contemporary antiretroviral therapy (ART) for treatment-naive people living with HIV (PLWH). The investigators found that in treatment-naive PLWH, NNRTI and InSTI-based ART were most durable, relative to protease inhibitor and InSTI/protease inhibitor-based ART, and were least likely to be modified/discontinued.
AHRQ-funded; HS023009.
Citation: Eaton EF, Tamhane A, Davy-Mendez T .
Trends in antiretroviral therapy prescription, durability and modification: new drugs, more changes, but less failure.
AIDS 2018 Jan 28;32(3):347-55. doi: 10.1097/qad.0000000000001708..
Keywords: Human Immunodeficiency Virus (HIV), Medication
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