Dataset Information

HIV acquisition among women from selected areas of the United States: a cohort study.

ABSTRACT:

Background

Women account for 23% of newly diagnosed HIV infections in the United States, but there are few recent, well-characterized cohorts of U.S. women in whom behavior characteristics and HIV acquisition have been well-described.

Objective

To evaluate HIV incidence and describe behaviors among U.S. women residing in areas of high HIV prevalence.

Design

Multisite, longitudinal cohort of women who had HIV rapid testing and audio computer-assisted self-interviews at baseline and every 6 months for up to 12 months. (ClinicalTrials.gov: NCT00995176)

Setting

10 urban and periurban communities with high HIV prevalence and poverty rates, located in the northeastern and southeastern United States.

Patients

Venue-based sampling was used to recruit women aged 18 to 44 years who recently had unprotected sex and had 1 or more additional personal or partner risk factors and no self-reported previous HIV diagnosis.

Measurements

HIV prevalence and incidence, frequency of HIV risk behaviors, and health status perceptions.

Results

Among 2099 high-risk women (85.9% black and 11.7% of Hispanic ethnicity), 32 (1.5%) were diagnosed with HIV infection at enrollment. Annual HIV incidence was 0.32% (95% CI, 0.14% to 0.74%). Older age, substance use, and knowing a partner had HIV were associated with HIV prevalence. Ten women died during the study (0.61% per year).

Limitations

Longitudinal assessment of risk behaviors was limited to a maximum of 12 months. There were few incident HIV infections, precluding identification of characteristics predictive of HIV acquisition.

Conclusion

This study enrolled a cohort of women with HIV incidence substantially higher than the Centers for Disease Control and Prevention national estimate in the general population of U.S. black women. Concerted efforts to improve preventive health care strategies for HIV and overall health status are needed for similar populations.

Primary funding source

National Institutes of Health.

SUBMITTER: Hodder SL

PROVIDER: S-EPMC4033695 | biostudies-literature | 2013 Jan

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

HIV acquisition among women from selected areas of the United States: a cohort study.

Hodder Sally L SL Justman Jessica J Hughes James P JP Wang Jing J Haley Danielle F DF Adimora Adaora A AA Del Rio Carlos C Golin Carol E CE Kuo Irene I Rompalo Anne A Soto-Torres Lydia L Mannheimer Sharon B SB Johnson-Lewis Letanya L Eshleman Susan H SH El-Sadr Wafaa M WM

Annals of internal medicine 20130101 1

<h4>Background</h4>Women account for 23% of newly diagnosed HIV infections in the United States, but there are few recent, well-characterized cohorts of U.S. women in whom behavior characteristics and HIV acquisition have been well-described.<h4>Objective</h4>To evaluate HIV incidence and describe behaviors among U.S. women residing in areas of high HIV prevalence.<h4>Design</h4>Multisite, longitudinal cohort of women who had HIV rapid testing and audio computer-assisted self-interviews at basel ...[more]

PMID: 23277896

Similar Datasets

Project description:BackgroundIn the United States, transgender women (TW) are disproportionately burdened by HIV infection. Cohort studies are needed to evaluate factors driving HIV acquisition among TW over time. These will require implementation strategies that are acceptable to the TW community and feasible to implement.ObjectiveThis study aims to investigate the rate and correlates of HIV acquisition and other health outcomes among TW in eastern and southern United States.MethodsLITE is a multisite prospective cohort in 6 eastern and southern US cities, which will be followed across 24 months of technology-enhanced biobehavioral follow-up. Adult TW, regardless of HIV status, are recruited via convenience sampling (eg, peer referrals, social media, and dating apps). Participants are enrolled in a baseline study visit, complete a sociobehavioral survey, and test for HIV and sexually transmitted infections. Participants who are not living with HIV at baseline are offered enrollment into the cohort (N=1100); follow-up assessments occur quarterly.ResultsCohort assembly was informed by synchronous Web-based focus group discussions with TW (n=41) and by continuing engagement with community advisory board members from each site. Enrollment launched in March 2018. The study is underway in the Atlanta; Baltimore; Boston; Miami; New York City; and Washington, DC, metro areas. As of March 2019, 795 TW completed a baseline visit (mean age 35 years). The majority of the participants are racial/ethnic minorities, with 45% of the TW identifying as black and 28% of the TW identifying as Hispanic/Latinx. More than one-quarter (28%) of the TW are living with HIV infection (laboratory-confirmed). Online recruitment methods support engagement with TW, although peer referral and referral through trusted health facilities and organizations remain most effective.ConclusionsThis study is responsive to increasing research interest in technology-enhanced methods for cohort research, particularly for hard-to-reach populations. Importantly, the diversity of literacy, technology use, and overall socioeconomic situations in this sample of TW highlights the need to leverage technology to permit a flexible, adaptive methodology that enhances engagement of potential participants living in marginalized contexts while still ensuring rigorous and sound study design.International registered report identifier (irrid)DERR1-10.2196/14704.

Project description:ImportanceViral suppression of HIV is an important treatment goal to decrease morbidity, mortality, and risk of transmission to others.ObjectiveTo characterize longitudinal HIV viral load outcomes among women enrolled in the Women's Interagency HIV Study (WIHS).Design, setting, and participantsA prospective cohort study of HIV-positive women with semiannual study visits and a minimum of 5 follow-up visits was conducted from 1994 to 2017. The WIHS sites included in this analysis are in Brooklyn and Bronx, New York; Chicago, Illinois; San Francisco, California; and Washington, DC.Main outcomes and measuresWomen were categorized into groups based on their probability of achieving viral load suppression below 200 copies/mL using logistic trajectory modeling. Multinomial regression analysis was used to identify factors associated with placement in the group with the highest probability of viremia.ResultsAt baseline, the mean (SD) age of the 1989 women was 36.9 (8.0) years, mean CD4+ T-lymphocyte count was 467/mm3, median (interquartile range) HIV RNA was 6200.0 (384.5-41 678.0) copies/mL, and 1305 women (65.6%) were African American. Three trajectory groups were identified with low (568 [28.6%]), intermediate (784 [39.4%]), and high (637 [32.0%]) probability of viremia above 200 copies/mL. The mean (SD) cumulative years of viral suppression were 18.7 (4.0) years, 12.2 (3.1) years, and 5.8 (2.9) years in the respective groups. Factors associated with high probability of viremia included younger age (odds ratio [OR]. 0.99; 95% CI, 0.98-0.99; P = .03), African American race (odds ratio [OR], 2.43; 95% CI, 1.75-3.37), P < .001), Hispanic race/ethnicity (OR, 1.50; 95% CI, 1.03-2.19; P = .04), increased levels of depressive symptoms (OR, 1.17; 95% CI, 1.01-1.36; P = .03), drug use (OR, 1.23; 95% CI, 1.01-1.51; P = .04), lower CD4+ T-lymphocyte counts (OR, 95% CI, 0.82; 0.80-0.85; P < .001), and unstable housing (OR, 1.25, 95% CI, 1.03-1.50; P = .02). Between 2015 and 2017, 71.2% of women demonstrated sustained viral suppression: 89.6% (310 of 346) of those with low viremia, 83.4% (346 of 415) with intermediate, and 35.2% (112 of 318) with high probability of viremia.Conclusions and relevanceThis longitudinal approach suggested that the probability of viremia decreased substantially over time for most participants, including among women with earlier histories of incomplete viral suppression. The findings from this study suggest that continued efforts are needed to address mental health, social, behavioral and structural factors that were identified as associated with high probability of HIV viremia over time.

Dataset Information

HIV acquisition among women from selected areas of the United States: a cohort study.

Background

Objective

Design

Setting

Patients

Measurements

Results

Limitations

Conclusion

Primary funding source

Publications

HIV acquisition among women from selected areas of the United States: a cohort study.

Similar Datasets

OmicsDI is part of the ELIXIR infrastructure

Tweets