A5022089901- Syphilis Diagnosis and Treatment
- Reproductive tract infections research
- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Poxvirus research and outbreaks
- Herpesvirus Infections and Treatments
- HIV Research and Treatment
- Bacillus and Francisella bacterial research
- Adolescent Sexual and Reproductive Health
- Sex work and related issues
- Bacterial Infections and Vaccines
- Rabies epidemiology and control
- HIV, TB, and STIs Epidemiology
- Bladder and Urothelial Cancer Treatments
- Healthcare Operations and Scheduling Optimization
- Rheumatoid Arthritis Research and Therapies
- HIV/AIDS drug development and treatment
- Blood groups and transfusion
- Infectious Encephalopathies and Encephalitis
- Cancer, Lipids, and Metabolism
- LGBTQ Health, Identity, and Policy
- Ferroptosis and cancer prognosis
- Systemic Lupus Erythematosus Research
- Virology and Viral Diseases
- Homelessness and Social Issues
Public Health – Seattle & King County
2021-2025
University of Washington
2018-2025
AIDS United
2025
Seattle University
2021-2024
Harborview Medical Center
2023-2024
Sexual Health Clinic
2024
University of California, San Francisco
2024
San Francisco General Hospital
2024
Emory University
2024
Christ University
2024
Doxycycline postexposure prophylaxis (doxy-PEP) reduces sexually transmitted infections (STIs) in men who have sex with (MSM) and transgender women (TGW). In a clinical trial of doxy-PEP, we sought to assess acceptability, impact, meaning doxy-PEP use among MSM/TGW. We conducted semistructured, in-depth 1:1 interviews MSM TGW enrolled the intervention arm Doxy-PEP study. queried motivations for use, attitudes, beliefs, adherence, effect on sexual behaviors, partner, community, structural...
Doxycycline post-exposure prophylaxis (doxy PEP) is increasingly used among men who have sex with (MSM). Its impact on antimicrobial resistance and the microbiome uncertain. We Neisseria gonorrhoeae (NG) surveillance data from King County, WA joinpoint regression to investigate trends in NG-tetracycline (tetR), 2017-2024 and, sexual health clinic (SHC) patients, evaluated association of NG-tetR doxy PEP use. nasopharyngeal colonization Staphylococcus aureus Group A Streptococcus (GAS) 703...
Data on modified Vaccinia Ankara (MVA) vaccine effectiveness against mpox in real-world settings are limited.We performed a retrospective cohort analysis using Cox proportional hazards regression to estimate the association between vaccination and laboratory-confirmed incidence. Study subjects included all men who have sex with seen sexual health clinic Seattle, Washington, 1 January 2020 31 December 2022. Subjects' receipt of diagnosis were ascertained from public registry surveillance...
Abstract Background Data on tecovirimat effectiveness for human mpox are limited. We conducted a retrospective cross-sectional interview-based study to identify associations between treatment and the clinical course. Methods Using public health surveillance data from King County, Washington, we recruited interviewed persons diagnosed with during May–October 2022. calculated descriptive statistics demographics, vaccination status, comorbidities, symptoms including 3 self-reported dates...
Abstract Treating Neisseria gonorrhoeae infection in patients with cephalosporin allergy represents a significant challenge and highlights urgent need for alternative therapies. This patient case details use of antimicrobials to cure urogenital pharyngeal gonorrhea severe ceftriaxone the outpatient clinical setting.
Abstract Background The CDC recommends treating latent syphilis of late/unknown duration (LSUD) with three doses intramuscular benzathine penicillin G (BPG) or twenty-eight days oral doxycycline. This recommendation lacks high-quality evidence. Methods Using public health surveillance data from King County, Washington, we conducted a retrospective cohort study comparing rates serological cure ( > 2-titer RPR decline) among persons LSUD following receipt one regimens: dose BPG, and...
Most non-clinic based HIV pre-exposure prophylaxis (PrEP) programs require fingersticks to self-collect blood specimens for laboratory monitoring, a technique that often results in inadequate volume quantitative syphilis and serological testing. We evaluated the acceptability feasibility of using Tasso OnDemand™ device as self-sampling method PrEP monitoring tests compared from samples obtained clinician-collected samples.We enrolled study subjects online sexual health clinic Seattle, WA,...
ABSTRACT Background Home-based sampling could create accessible testing opportunities for men who have sex with (MSM) use pre-exposure prophylaxis (PrEP). Blood collection is required the most reliable laboratory results HIV and syphilis testing. An innovative blood-collection method (Tasso+) creates a vacuum semi-automatically collects larger volumes of blood from upper arm. This study aims to assess acceptability feasibility this device among PrEP-using MSM performance blood-collection....
Background: Sexual health clinics (SHCs) serve large numbers of patients who might benefit from preexposure prophylaxis (PrEP). Integrating longitudinal PrEP care into SHCs can overburden clinics. We implemented an SHC program that task shifted most operations to nonmedical staff, disease intervention specialists (DIS). Methods: conducted a retrospective cohort analysis in Seattle, WA, 2014 2020 assess the number served and factors associated with discontinuation. Clinicians provide same-day...
Background How often mpox causes asymptomatic infections, particularly among persons who have received the Modified Vaccinia Ankara (MVA) vaccine, is unknown. Methods We performed polymerase chain reaction testing on rectal and pharyngeal specimens collected from symptomatic patients at a sexual health clinic in Seattle, WA, between May 2022 2023. Analyses evaluated prevalence of or subclinical infection and, with reaction–positive tests, association MVA vaccination status infection. Results...
HIV prevention is a public health priority. Despite progress in recent years, pre-exposure prophylaxis (PrEP) use remains suboptimal especially among groups disproportionately impacted by new diagnoses such as gender and sexual minorities of color. Multiple barriers including lack PrEP providers challenges with attending quarterly monitoring visits contribute to low uptake retention. Home-based (HB-PrEP) services could reduce stigma, increase convenience, expand system capacity for care, improve
Abstract Doxycycline post-exposure prophylaxis (doxy-PEP) reduces the risk of bacterial sexually transmitted infections (STIs) among men who have sex with and transgender women. In United States, doxy-PEP is in an early stage integration into clinical practice, national guidelines for its use were recently released. The goal this manuscript to provide practical guidance clinicians are considering or currently prescribing doxy-PEP. We address five questions using post hoc analyses data from...
Hyperammonemia syndrome, with high levels of ammonia and neurologic dysfunction, is a syndrome historically mortality that may occur after solid organ transplantation. Recently, this has been associated infection due to Ureaplasma, mostly following lung We describe the first case hyperammonemia Ureaplasma liver-kidney Our patient rapidly recovered specific antibiotic treatment. It important consider these infections in differential diagnosis for encephalopathy post-transplant, as organisms...
Preexposure prophylaxis (PrEP) discontinuations are common and associated with subsequent HIV acquisition. The population-level impact of PrEP is unknown.Public health staff routinely asked men who have sex (MSM) newly diagnosed infection about their history use as part partner notification interviews in King County, WA, from 2013 to 2021. We assessed trends the proportion MSM ever took described reasons for discontinuation.A total 1098 were during study period; whom, 797 (73%) interviewed,...
Sexual health clinics were frontline providers in the 2022 US mpox public response, though data on clinic-based vaccine scale-up, diagnoses, and treatment are limited. We describe role of a sexual clinic (SHC) King County's between 5/23/22-10/31/22.
In an era of steadily increasing rates syphilis, dramatic rises in congenital and intermittent scarcity first line benzathine penicillin G (BPG), providers health jurisdictions are more frequently turning to alternative treatment options.The authors conducted a systematic review meta-analysis summarize evidence from clinical trials cohort studies through August 2023 comparing three non-penicillin antibiotics with BPG for the syphilis. 1he includes 5 that evaluated azithromycin as monotherapy...
We characterized the rapid increase in syphilis among cisgender women King County, Washington, and compared it with trends men who have sex men.We used surveillance data from 2007 to 2022, describe incidence stratified by stage, gender, gender of partners; pregnant cases congenital syphilis; plasma reagin titer at diagnosis late/unknown duration cases. joinpoint regression analyze trends.Among women, all-stage remained stable 2010 but then increased 16.3% per year (95% CI, 12.0%-20.7%) 2020...
In this brief case series, we outline issues with some online sexually transmitted infection services and delayed reporting of results. Commercial entities providing testing should ensure that all results are reported to local public health jurisdictions procedures exist link persons appropriate treatment follow-up.