Emma Spencer
A5101851839- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- Sex work and related issues
- HIV Research and Treatment
- Cardiac, Anesthesia and Surgical Outcomes
- Primary Care and Health Outcomes
- Syphilis Diagnosis and Treatment
- SARS-CoV-2 and COVID-19 Research
- Opioid Use Disorder Treatment
- Diabetes Management and Education
- Ethics in Clinical Research
- Mechanical Circulatory Support Devices
- Congenital Heart Disease Studies
- SARS-CoV-2 detection and testing
- Hospital Admissions and Outcomes
- HIV/AIDS oral health manifestations
- COVID-19 Clinical Research Studies
- Brucella: diagnosis, epidemiology, treatment
- Forensic Toxicology and Drug Analysis
- Surgical Simulation and Training
- Burkholderia infections and melioidosis
- Diabetes, Cardiovascular Risks, and Lipoproteins
- Diabetes Management and Research
- Female Genital Mutilation/Cutting Issues
- Healthcare Policy and Management
Nottingham University Hospitals NHS Trust
2024
Florida Department of Health
2018-2022
University of Otago
2022
University College Hospital
2021
University College London
2021
Queen's Medical Centre
2019
In 2017, preliminary data show that gay, bisexual, and other men who have sex with (MSM) accounted for 67% of new diagnoses human immunodeficiency virus (HIV) infection, MSM inject drugs an additional 3%, African American/black (black) Hispanic/Latino (Hispanic) were disproportionately affected (1). During 2010-2015, racial/ethnic disparities in HIV incidence increased among MSM; 2015, rates black Hispanic 10.5 4.9 times as high, respectively, the rate white (compared 9.2 3.8 2010) (2)....
In February 2019, the U.S. Department of Health and Human Services proposed a strategic initiative to end human immunodeficiency (HIV) epidemic in United States by reducing new HIV infections 90% during 2020-2030* (1). Phase 1 Ending Epidemic focuses on Washington, DC; San Juan, Puerto Rico; 48 counties where majority diagnoses infection 2016 2017 were concentrated seven states with disproportionate occurrence rural areas relative other states.† One four pillars is protecting persons at risk...
Sexually transmitted diseases (STDs) disproportionately affect gay, bisexual, and other men who have sex with (MSM) in the United States (1). Because chlamydia gonorrhea at extragenital (rectal pharyngeal) anatomic sites are often asymptomatic, these serve as a reservoir of infection, which might contribute to gonococcal antimicrobial resistance (2) increased risk for human immunodeficiency virus (HIV) transmission acquisition (3). To ascertain prevalence STDs, MSM attending community venues...
Abstract Prevention of HIV outbreaks among people who inject drugs remains a challenge to ending the epidemic in United States. The first legal syringe services program (SSP) Florida implemented routine screening 2018 leading identification ten anonymous seroconversions. SSP collaborated with Department Health conduct an epidemiologic investigation. All seven acute seroconversions were linked care (86% within 30 days) and achieved viral suppression (mean 70 days). Six individuals are...
In the United States, 10% of HIV infections diagnosed in 2018 were attributed to unsafe injection drug use or male-to-male sexual contact among persons who inject drugs (PWID) (1). 2017, PWID men have sex with and (MSM-ID), 76% those received a diagnosis infection lived urban areas* (2). To monitor prevalence associated behaviors reported injecting past 12 months, including MSM-ID, CDC's National Behavioral Surveillance (NHBS) conducts interviews testing populations at high risk for (MSM,...
Abstract Background Medicaid expansion under the Affordable Care Act increased insurance coverage, access to healthcare, and substance use disorder treatment, for many Americans. We assessed differences in healthcare utilization among persons who inject drugs (PWID) by state status. Methods In 2018, PWID were interviewed 22 US cities National HIV Behavioral Surveillance. analyzed data from aged 18–64 years reported illicit of opioids (n = 9957) past 12 months. Poisson regression models with...
Correct and consistent condom use human immunodeficiency virus (HIV) preexposure prophylaxis (PrEP) are protective against sexual transmission of HIV (1,2). The incidence infection among Hispanic/Latino men who have sex with (MSM) in the United States is increasing (3). risk MSM differs based on their place birth years U.S. residence (4). Data from CDC's National Behavioral Surveillance (NHBS)* for 2011-2017 were analyzed to assess changes behaviors by residence. Overall, condomless anal...
Importance HIV self-testing (HIVST) is a promising strategy to expand the care continuum, particularly among priority populations at high risk of infection. However, little known about HIVST uptake men who have sex with (MSM) outside clinical trial settings. Objective To evaluate use urban MSM in US reported testing within past 12 months. Design, Setting, and Participants A cross-sectional study adult 2017 National Behavioral Surveillance system, which used venue-based sampling methods...
Florida is considered an epicenter of HIV in the United States. The U.S. federal plan for Ending Epidemic (EHE) within 10 years prioritizes seven Florida's 67 counties intervention. We applied molecular epidemiology methods to characterize infection networks state and infer whether results support EHE. sequences (N = 34,446) associated clinical/demographic metadata diagnosed people with (PWH), during 2007 2017, were retrieved from Department Health. genetic investigated using MicrobeTrace....
The objective of this study was to estimate disparities in linkage human immunodeficiency virus (HIV) care among Latinos by country/region birth, HIV testing site, and neighborhood characteristics. A retrospective conducted using Florida surveillance records Latinos/Hispanics aged ≥13 diagnosed during 2014–2015. Linkage defined as a laboratory test (HIV viral load or CD4) within 3 months diagnosis. Multi-level Poisson regression models were used adjusted prevalence ratios (aPR) for...
Background: Men who have sex with men (MSM) using HIV pre-exposure prophylaxis (PrEP) may be at high risk for bacterial sexually transmitted infections (STIs). We examined the prevalence of extragenital gonorrhea and chlamydia by PrEP status among a multisite sample US MSM. Methods: MSM aged ≥18 years were recruited through venue-based sampling to participate in 2017 National Behavioral Surveillance. In 5 cities (San Francisco, Washington DC, New York City, Miami, Houston), participants...
Objectives As, cases of congenital syphilis (CS) and infectious among women more than doubled in Florida across the nation during 2013–2019, we sought to understand what may be contributing these increases Florida. Design A two time-period observational study. Setting Pregnant with reported infections their pregnancy outcomes (2013–2014 2018–2019) Participants 1213 pregnant living 341 infants meeting CS case definition. Outcome measures We assessed proportion increase was from maternal...
Data-to-Care (D2C) programming is an important strategy in locating and relinking persons with HIV who are not care (NIC), back to care. However, Health Department D2C programs have found a large proportion of individuals seem NIC living outside their jurisdiction. Jurisdictions limited ability cross-communicate regarding such individuals.Two [New York State (NYS) Florida (FL)] funded through the Partnerships-for-Care Demonstration Project, partnered conduct feasibility pilot project test...
The study objective was to classify women with newly diagnosed HIV into patterns of retention in care (≥2 visits ≥3 months apart) and viral suppression over time identify factors associated class membership. Florida HIV/AIDS surveillance data were used conduct Latent Class Analysis patterns, multinomial regression compare the prevalence membership by demographic clinical factors. Four classes selected based on model fit parameters: (Class 1) consistently retained suppressed (>90% probability...
<h3>Objectives</h3> Obesity is a key public health priority. established in adolescence often continues into adulthood.<sup>1</sup> Young people with epilepsy have risk factors for developing obesity, such as being prescribed an obesogenic medication and limitations on exercise independence related to their diagnosis. The aim of this project was assess the identification obesity use medications sample young epilepsy. <h3>Methods</h3> As part quality improvement we undertook retrospective...