A5021619667- Syphilis Diagnosis and Treatment
- Cervical Cancer and HPV Research
- Reproductive tract infections research
- Colorectal and Anal Carcinomas
- HIV/AIDS Research and Interventions
- Sex work and related issues
- Genital Health and Disease
- COVID-19 Impact on Reproduction
- COVID-19 and healthcare impacts
- Prenatal Screening and Diagnostics
- Data-Driven Disease Surveillance
- COVID-19 epidemiological studies
- Pregnancy and preeclampsia studies
- Child Abuse and Trauma
- Cleft Lip and Palate Research
- Innovations in Medical Education
- Healthcare Systems and Technology
- Surgical Simulation and Training
- Maternal and fetal healthcare
- Migration, Health and Trauma
- SARS-CoV-2 detection and testing
- HIV, Drug Use, Sexual Risk
- Simulation-Based Education in Healthcare
- Thyroid Disorders and Treatments
- Adolescent Sexual and Reproductive Health
University of California, San Francisco
2020-2025
California Department of Public Health
2018-2023
Mount Sinai Hospital
2017
University of Pennsylvania
2007
US Department of Health and Human Services/Centers for Disease Control Prevention to mask wearing, physical distancing, hand hygiene).To ensure accurate surveillance, it is important that health care providers departments assure follow-up infants, children, adolescents, young adults infected with or exposed SARS-CoV-2 document report underlying medical conditions cause death related COVID-19.Health departments, in collaboration school districts the communities they serve, can evaluate...
Abstract The International Anal Neoplasia Society (IANS) developed consensus guidelines to inform anal cancer screening use among various high‐risk groups. incidence estimates by age risk groups provided the basis identify thresholds recommend screening. Guided thresholds, initiation at 35 years was recommended for men who have sex with (MSM) and transgender women (TW) HIV. For other people HIV MSM TW not HIV, 45 recommended. solid organ transplant recipients, beginning from 10...
We explored links between childhood sexual abuse (CSA), physical (CPA), posttraumatic stress disorder (PTSD)/depression, and women injection drug users' (IDUs') risk in 113 recruited from two syringe exchange sites. More than half (56%) reported CSA, 68% CPA, 23% likely were depressed‐only, 53% had PTSD/depression. CSA was associated with (p = 0.003) 0.05); CPA not. PTSD/depression 0.03); < 0.01) 0.03) risk. After adjustment, no longer or These results suggest that IDUs' CSA‐to‐risk path...
Background: Syphilis is re-emerging, with recent increases in congenital infections. While cerebrospinal fluid (CSF) evaluation can inform management, specimen collection requires technical skill and the interpretation of indices nuanced. We sought to understand practical value CSF as an tool among neonates exposed syphilis utero. Methods: performed chart reviews infants <30 days old born birthing parents infection, delivered between January 2000 October 2020. treatment information for...
HIV prevalence among Thai men who have sex with (MSM) and transgender women (TG) are 9.15% 11.8%, respectively, compared 1.1% in the general population. To better understand early adopters of pre-exposure prophylaxis (PrEP) Thailand, we analyzed biobehavioral sociodemographic characteristics PrEP-eligible MSM TG.Four urban community clinics between October 2015 February 2016.Sociodemographics, risk characteristics, PrEP knowledge attitudes were association initiation eligible TG. Adjusted...
As public health personnel and resources are redirected to COVID-19, sexually transmitted diseases (STD) programs have been unable sustain pre-COVID-19 activities.We used California (CA) surveillance data describe trends in case reporting for gonorrhea, chlamydia, syphilis of any stage the pre- versus post-COVID-19 eras (January-June 2019 January-June 2020). We also analyzed from an electronic survey administered by CA STD Control Branch local jurisdictions April, June, September 2020,...
Syphilis and congenital syphilis (CS) are increasing in California (CA). From 2015 through 2019, for example, CA cases of early among reproductive-age females (15−44) CS each increased by >200%. Certain populations—including people experiencing homelessness, using drugs, and/or belonging to certain racial/ethnic groups—have been disproportionately impacted. We hypothesized that geospatial social determinants health (SDH) contribute such inequities. To demonstrate this, we geospatially...
Congenital syphilis (CS)-the preventable transmission of Treponema pallidum from infected mother to fetus-remains a significant problem worldwide.From July through November 2017, 239 articles relevant CS prevention were identified via keyword searches in PubMed and Google Scholar, ancestry searches, expert recommendation. Articles then assessed for (1) measurement specified or adverse pregnancy outcomes (APOs) (2) geographic setting high/upper middle income countries according United Nations...
This study explores provider preferences regarding anal cancer screening indications, initiation age, tools, and referral threshold to high resolution anoscopy (HRA).International Anal Neoplasia Society affiliates were invited complete an online survey. Options for age tools delineated by sub-groups. HRA thresholds separately queried recommendations patient immune status.One hundred forty respondents participated. Although consensus was lacking with regard specific more recommended younger...
Abstract Background and Objectives Congenital syphilis (CS) is increasing in the United States associated with intersecting social structural determinants of health. This study aimed to delineate birthing parent characteristics CS an adjusted model. Methods ( n = 720) People diagnosed during pregnancy from 2017 2018 who were interviewed linked infants California state surveillance system included (herein, “birthing parents”). Sociodemographic clinical risk factors informed a stepwise...
Maternal severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the second and third trimesters of pregnancy may impact fetal development via vertical transmission, complications disease 2019 (COVID-19), or placental injury. However, potential associations between prenatal SARS-CoV-2 loss are not well understood. This case series thirteen trimester losses reported by local public health departments to California's state surveillance included maternal clinical demographic...
Background Reportable sexually transmitted infections (STIs) have increased in California, with dramatic rises prenatal and congenital syphilis. In response, 2018 Planned Parenthood Northern California implemented 2 opt-out screening protocols: (1) HIV, chlamydia, gonorrhea, syphilis co-screening for pregnant patients at pregnancy diagnosis (2) linking HIV all patients. Methods Using qualitative analyses, we explored implementation barriers facilitators that can be addressed by clinical...
Accurate reporting of neurosyphilis diagnoses is important to quantify and monitor severe outcomes associated with infection Treponemal pallidum. This analysis compared the demographic distribution in sexually transmitted disease surveillance data administrative hospital California Project Area from 2016 2018. Although morbidity was similar, significant differences were noted by sex, age group, race/ethnicity, region. Both may be imperfect systems understand true neurosyphilis.
The national Sexually Transmitted Diseases (STD) Clinical Consultation Network receives requests regarding complex STD cases. A total of 927 from Western states, 2017 to 2019, were analyzed for inquiry and syphilis-specific subtopics. Syphilis accounted most queries, the number proportion syphilis-related increased significantly over time.
Guidelines recommend that pregnant patients with syphilis of late/unknown duration be treated benzathine penicillin G, dosed as 3 weekly intramuscular injections (BPGx3) given ideally at strict 7-day intervals. Given limited pharmacokinetic data, it is unknown whether more flexible BPG treatment intervals might effective in preventing congenital (CS).We used California surveillance data to identify birthing parent/infant dyads wherein the parent had between January 1, 2016 - June 30, 2019....
<h3>Background</h3> In California, congenital syphilis (CS) increased for the fifth consecutive year in 2017, and contributed one third of CS cases United States. response, state local STD programs implemented prevention strategies. A Prevention Cascade monitors impact, assesses prenatal care (PNC) gaps, estimates averted. <h3>Methods</h3> This analysis used 2017 California Project Area surveillance data women diagnosed with during pregnancy or at delivery. Cases were assessed following,...
<h3>Background</h3> Anal cancer incidence is high among people with HIV (PWH), men who have sex (MSM), and women lower genital tract disease (LGTD). preceded by persistent high-risk human papillomavirus infection subsequent high-grade squamous intraepithelial lesions (HSIL). Emerging screening practices may reduce anal incidence. However, no national or international guidance exists. The International Neoplasia Society (IANS) solicited expert opinion to understand preferred current...