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Search All Research Studies
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- Behavioral Health (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 15 of 15 Research Studies DisplayedTracer H, Lorei NC
AHRQ Author: Tracer H
Preexposure prophylaxis to prevent acquisition of HIV.
This case study described a 28-year-old woman presented to a community health clinic for sexually transmitted infection (STI) testing. Case study questions related to the USPSTF recommendation on Preexposure Prophylaxis (PrEP) to prevent acquisition of HIV, guidelines for candidacy for PrEP, guidelines for the use of PrEP for the primary prevention of HIV in adults.
AHRQ-authored.
Citation: Tracer H, Lorei NC .
Preexposure prophylaxis to prevent acquisition of HIV.
Am Fam Physician 2023 Dec; 108(6):617-18..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Prevention, Evidence-Based Practice
Chou R, Spencer H, Bougatsos C
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
This article updates research used in the 2019 US Preventive Services Task Force final recommendation on use of oral preexposure prophylaxis (PrEP) to prevent HIV in adults at increased risk. The summary includes newer PrEP regimens that were not available for the 2019 final recommendation. A literature review was conducted that included randomized clinical trials of PrEP vs placebo or no PrEP or newer vs older PrEP regimens and diagnostic accuracy studies of instruments for predicting incident HIV infection. Thirty-two studies were included in the review (20 randomized clinical trials [n = 36,543] and 12 studies of diagnostic accuracy [n = 5,544,500]). Eleven trials in the 2019 review found oral PrEP associated with decreased HIV infection risk vs placebo or no PrEP. One new trial (n = 5335) found oral tenofovir alafenamide/emtricitabine (TAF/FTC) to be noninferior to tenofovir disoproxil fumarate/emtricitabine (TDF/FTC) in men who have sex with men. Two new trials found long-acting injectable cabotegravir associated with decreased risk of HIV infection vs oral TDF/FTC in cisgender men who have sex with men and transgender women [n = 4490] and RR, 0.11 in cisgender women [n = 3178]). Discrimination of instruments for predicting incident HIV infection was found to be moderate in men who have sex with men (5 studies; n = 25,488) and moderate to high in general populations of persons without HIV (2 studies; n = 5,477,291).
AHRQ-funded; 75Q80120D00006.
Citation: Chou R, Spencer H, Bougatsos C .
Preexposure prophylaxis for the prevention of HIV: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2023 Aug 22; 330(8):746-63. doi: 10.1001/jama.2023.9865..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Prevention, Medication, Evidence-Based Practice
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
Cedillo G, George MC, Deshpande R
Toward safer opioid prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial.
Healthcare and behavioral health providers are lacking a methodology to implement the 2016 U.S. Centers for Disease Control and Prevention Opioid Prescribing Guideline (CDC Guideline), measure prescriber adherence to it, and systematically test its effect on patient and public health outcomes. The Guideline is currently being reviewed and revised due to concern that it may be harmful to people with chronic pain on long-term opioid therapy (CP-LTOT). The purpose of the study was to develop and test a CDC Guideline implementation strategy termed “TOWER,” focused on an outpatient HIV primary care setting with patients with CP-LTOT. The TOWER strategy included: 1) a patient-facing app for opioid management (OM-App); 2) a template for progress notes (OM-Note) intended to guide the patient’s office visit; and 3) a primary care provider (PCP) training. TOWER was developed in a multi-step, stakeholder-engaged process within a behavioral change framework. The researchers evaluated the TOWER strategy in a randomized-controlled trial of HIV-PCPs (N=11) and their patients with HIV and CP-LTOT (N=40). The main outcome was CDC Guideline adherence based on electronic health record (EHR) documentation and measured by the Safer Opioid Prescribing Tool (SOPTET). Qualitative data was also collected, including one-on-one PCP interviews. The study found that the PCPs randomized to utilize the TOWER strategy were 48% more CDC Guideline adherent. Qualitative data reflected high levels of intervention provider confidence in administering the TOWER processes, and that the OM-Note supported provider efforts, but experience with the patient-facing OM-App was mixed. The study concluded that adherence to the 2016 CDC Guidelines is not associated with worsening of outcomes for people with HIV with CP-LTOT, and adherence to the CDC Guidelines can be promoted and measured. The researchers recommend additional research into the scalability of these results and the impact of CDC Guideline adherence on public health.
AHRQ-funded; HS025641.
Citation: Cedillo G, George MC, Deshpande R .
Toward safer opioid prescribing in HIV care (TOWER): a mixed-methods, cluster-randomized trial.
Addict Sci Clin Pract 2022 May 16;17(1):28. doi: 10.1186/s13722-022-00311-8..
Keywords: Opioids, Medication, Human Immunodeficiency Virus (HIV), Guidelines, Evidence-Based Practice
Koh MJ, Merrill MH, Koh MJ
Comparative outcomes for mature T and NK/T-cell lymphomas in people with and without HIV and to AIDS-defining lymphomas.
Citation: Koh MJ, Merrill MH, Koh MJ .
Comparative outcomes for mature T and NK/T-cell lymphomas in people with and without HIV and to AIDS-defining lymphomas.
Blood Adv 2022 Mar 8;6(5):1420-31. doi: 10.1182/bloodadvances.2021006208.
AHRQ-funded; 90051652..
AHRQ-funded; 90051652..
Keywords: Human Immunodeficiency Virus (HIV), Comparative Effectiveness, Outcomes, Evidence-Based Practice
Nijhawan AE, Bhattatiry M, Chansard M
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
Hospitalization represents an opportunity to re-engage out-of-care individuals, improve HIV outcomes, and reduce health disparities. The authors reviewed electronic health records of HIV-positive individuals hospitalized at an urban, public hospital between September 2013 and December 2015. They found that hospitalized patients with HIV had low rates of engagement in care, retention in care, and virologic suppression, though all three outcomes improved after hospitalization. A multidisciplinary transitions team improved care engagement and virologic suppression in those who received the intervention.
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Bhattatiry M, Chansard M .
HIV care cascade before and after hospitalization: impact of a multidisciplinary inpatient team in the US South.
AIDS Care 2020 Nov;32(11):1343-52. doi: 10.1080/09540121.2019.1698704.
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Keywords: Human Immunodeficiency Virus (HIV), Transitions of Care, Inpatient Care, Teams, Hospitalization, Patient and Family Engagement, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Outcomes, Evidence-Based Practice
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
Chou R, Dana T, Grusing S
Screening for HIV infection in asymptomatic, nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
Untreated HIV infection can result in significant morbidity, mortality, and HIV transmission. A 2012 review for the US Preventive Services Task Force (USPSTF) found antiretroviral therapy (ART) associated with improved clinical outcomes and decreased transmission risk in persons with CD4 cell counts less than 500/mm3. The objective of this study was to update the 2012 review on HIV screening to inform the USPSTF.
AHRQ-funded; 290201500009I.
Citation: Chou R, Dana T, Grusing S .
Screening for HIV infection in asymptomatic, nonpregnant adolescents and adults: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Jun 18;321(23):2337-48. doi: 10.1001/jama.2019.2592..
Keywords: U.S. Preventive Services Task Force (USPSTF), Children/Adolescents, Human Immunodeficiency Virus (HIV), Screening, Prevention, Evidence-Based Practice
Selph SS, Bougatsos C, Dana T
Screening for HIV Infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
Prenatal screening for HIV can inform use of interventions to reduce the risk of mother-to-child transmission. The US Preventive Services Task Force (USPSTF) previously found strong evidence that prenatal HIV screening reduced risk of mother-to-child transmission. The previous evidence review was conducted in 2012. The objective of this study was to update the 2012 review on prenatal HIV screening to inform the USPSTF.
AHRQ-funded; 290201500009I.
Citation: Selph SS, Bougatsos C, Dana T .
Screening for HIV Infection in pregnant women: updated evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Jun 18;321(23):2349-60. doi: 10.1001/jama.2019.2593..
Keywords: U.S. Preventive Services Task Force (USPSTF), Human Immunodeficiency Virus (HIV), Screening, Pregnancy, Women, Evidence-Based Practice
Chou R, Evans C, Hoverman A
Preexposure prophylaxis for the prevention of HIV infection: evidence report and systematic review for the US Preventive Services Task Force.
The purpose of this study was to synthesize evidence on the benefits and harms of PrEP (preexposure prophylaxis), instruments for predicting incident HIV infection, and PrEP adherence, to inform the US Preventive Services Task Force. The study found that in adults at increased risk of HIV infection, PrEP with oral tenofovir disoproxil fumarate monotherapy or tenofovir disoproxil fumarate/emtricitabine was associated with decreased risk of acquiring HIV infection compared with placebo or no PrEP, with effectiveness decreasing with suboptimal adherence. Most adverse events were mild and reversible.
AHRQ-funded; 290201500009I.
Citation: Chou R, Evans C, Hoverman A .
Preexposure prophylaxis for the prevention of HIV infection: evidence report and systematic review for the US Preventive Services Task Force.
JAMA 2019 Jun 11;321(22):2214-30. doi: 10.1001/jama.2019.2591..
Keywords: Evidence-Based Practice, Human Immunodeficiency Virus (HIV), Medication, Prevention, U.S. Preventive Services Task Force (USPSTF)
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
Cho H, Iribarren S, Schnall R
Technology-mediated interventions and quality of life for persons living with HIV/AIDS. A systematic review.
The aim of this review was to assess the impact of technology-mediated interventions on quality of life (QoL) and to identify the instruments used to measure the QoL of persons living with HIV/AIDS (PLWH). It identified four types of technology-mediated interventions and two types of QoL instruments used to examine the impact of technology-mediated interventions on PLWH. However, the evidence to support the improvement of QoL using technology-mediated interventions was insufficient.
AHRQ-funded; HS023963.
Citation: Cho H, Iribarren S, Schnall R .
Technology-mediated interventions and quality of life for persons living with HIV/AIDS. A systematic review.
Appl Clin Inform 2017 Apr 12;8(2):348-68. doi: 10.4338/aci-2016-10-r-0175.
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Keywords: Evidence-Based Practice, Human Immunodeficiency Virus (HIV), Patient-Centered Outcomes Research, Quality of Life
Wang D, Le XH, Luque AE
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
The investigators analyzed correlations between promotional activities and usage of a guideline-driven interactive case simulation tool (ICST) for insomnia screening and treatment in a statewide HIV-HCV-STD clinical education program. They found that promotional activities were strongly correlated with the number of audience as well as the intensity of use of the target resource, with strong correlations identified between the sending of email newsletters and the intensity of resource use by promotion recipients, by new users, and through the most convenient access channel associated with the promotion.
AHRQ-funded; HS022057.
Citation: Wang D, Le XH, Luque AE .
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
Stud Health Technol Inform 2015;216:515-9.
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Keywords: Human Immunodeficiency Virus (HIV), Education: Continuing Medical Education, Simulation, Guidelines, Evidence-Based Practice, Health Promotion, Screening, Sleep Problems, Training
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
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