A5051039244- HIV/AIDS Research and Interventions
- HIV, Drug Use, Sexual Risk
- HIV-related health complications and treatments
- Opioid Use Disorder Treatment
- Adolescent Sexual and Reproductive Health
- HIV Research and Treatment
- LGBTQ Health, Identity, and Policy
- Maternal Mental Health During Pregnancy and Postpartum
- Substance Abuse Treatment and Outcomes
- HIV/AIDS drug development and treatment
- Diabetes Management and Education
- Sex work and related issues
- Sexuality, Behavior, and Technology
- Medication Adherence and Compliance
- Prenatal Substance Exposure Effects
- Family Caregiving in Mental Illness
- Alcohol Consumption and Health Effects
- Homelessness and Social Issues
- Chronic Disease Management Strategies
- Patient-Provider Communication in Healthcare
- Intimate Partner and Family Violence
- Mental Health Treatment and Access
- Poxvirus research and outbreaks
- Adolescent and Pediatric Healthcare
- Smoking Behavior and Cessation
University of Washington
2016-2025
Seattle University
2018-2024
Harborview Medical Center
2012-2023
AIDS United
2012-2022
Indiana University – Purdue University Indianapolis
2019
University of Alabama at Birmingham
2019
Richard L. Roudebush VA Medical Center
2019
Washington Center
2017-2018
Johns Hopkins University Center for AIDS Research
2010
Boston University
2010
Background: Because HIV viral suppression is essential for optimal outcomes and prevention efforts, understanding trends predictors imperative to inform public health policy. Objective: To evaluate in people living with (PLWH), including the relationship of associated factors, such as demographic characteristics integrase strand transfer inhibitor (ISTI) use. Design: Longitudinal observational cohort study. Setting: 8 clinics across United States. Participants: PLWH receiving clinical care....
To characterize and address the opioid crisis disproportionately impacting rural U.S. regions.The Rural Opioid Initiative (ROI) is a two-phase project to collect harmonize quantitative qualitative data develop tailored interventions use. The baseline survey from people who use drugs (PWUD) characterizes current epidemic (2018-2020) in eight geographically diverse regions.Among 3,084 PWUD, 92% reported ever injecting drugs, 86% using opioids (most often heroin) 74% methamphetamine get high...
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...
Providers routinely under diagnose at risk behaviors and outcomes, including depression, suicidal ideation, substance abuse, poor medication adherence. To address this, we developed a web-based, self-administered patient-reported assessment tool integrated it into routine primary care for HIV-infected adults. Printed results were delivered to providers social workers immediately prior patient appointments. The included brief, validated instruments measuring clinically relevant domains use,...
Abstract Background In recent years, stimulant use has increased among persons who opioids in the rural U.S., leading to high rates of overdose and death. We sought understand motivations contexts for a large, geographically diverse sample drugs (PWUD) settings. Methods conducted semi-structured individual interviews with PWUD at 8 U.S. sites spanning 10 states 65 counties. Content areas included general substance use, injection drug changes harm reduction practices. used an iterative...
We sought to understand how HIV-infected patients, their providers, and HIV care researchers prioritize self-reported domains of clinical care. Participants rank-ordered two lists domains. A modified Delphi process was used for providers researchers. Approximately 25% patients were interviewed discuss rationale rank order choices. List 1 included anger, anxiety, depression, fatigue, physical function, pain, sleep disturbance. 2 alcohol abuse, cognitive stigma, treatment symptoms, medication...
Objective To describe disparities along the depression treatment cascade, from indication for antidepressant to effective treatment, in HIV-infected individuals by gender and race/ethnicity. Methods The Center AIDS Research (CFAR) Network of Integrated Clinical Systems (CNICS) cohort includes 31,000 adults routine clinical care at 8 sites. Individuals were included analysis if they had a depressive symptoms measure within one month establishing HIV CNICS site. Depressive measured using...
Background: The relationship of internalized HIV stigma to key care cascade metrics in the United States is not well established using large-scale, geographically diverse data. Setting: Center for AIDS Research Network Integrated Clinical Systems (CNICS) cohort study. Methods: Beginning February 2016, we administered a yearly, validated 4-item scale (response 1 = strongly disagree 5 agree, Cronbach's alpha 0.91) at 7 CNICS sites and obtained data through November 2017. We compared mean...
Abstract Introduction Since its global reemergence in 2022, monkeypox (mpox) has demonstrated increased incidence and severity among people with human immunodeficiency virus (HIV [PWH]). Predictors of mpox diagnosis, vaccination, outcomes PWH are limited. Methods We included primary care visits after 1 January 2022 at 9 US sites participating the Centers for AIDS Research Network Integrated Clinic Systems Network. identified diagnosed between June 31 May 2023, through a combination...
National US data on the burden and risks for hepatitis C virus (HCV) infection in people with human immunodeficiency (HIV) during direct-acting antiviral (DAA) era are limited. These important to understand current progress guide future efforts toward HCV microelimination. We evaluated (1) prevalence (2011-2013, 2014-2017, 2018-2022) using a serial cross-sectional design (2) correlates viremia (2018-2022) adult HIV (PWH) within Centers AIDS Research Network of Integrated Clinic Systems...
The PROgress study assessed the value and feasibility of implementing web-based patient-reported outcomes assessments (PROs) within routine HIV care at two North American outpatient clinics. People with (PWH) completed PROs on a tablet computer in clinic before their visit. Data collection included from 1632 unique PWH, 596 chart reviews, 200 patient questionnaires, 16 provider/staff questionnaires. During an initial setup phase involving patients, PRO results were not delivered to...
Strong evidence suggests that patient-reported outcomes (PROs) aid in managing chronic conditions, reduce omissions care, and improve patient–provider communication. However, provider acceptability of PROs their use clinical HIV care is not well known. We interviewed providers (n = 27) from four geographically diverse community clinics the US have integrated into routine querying perceived value, challenges, PRO data. Perceived benefits included ability to identify less-observable behaviors...
Low perceived social support (SS) negatively impacts health outcomes. We developed a measure of SS for use in HIV care. sought and categorized legacy items, selecting strongest items within categories. elicited concepts from patients English/Spanish, coded transcripts to match item pool content, new salient unrepresented content. In focus groups, prioritized highly-matched items. conducted cognitive interviews on high-priority validity testing final against two measures. From (n = 32), we...
Substance use in the U.S. varies by geographic region. Opioid prescribing practices and marijuana, heroin, methamphetamine availability are evolving differently across regions. We examined self-reported substance among people living with HIV (PLWH) care at seven sites from 2017-2019 to understand current regional patterns. calculated percentage standardized of PLWH reporting drug at-risk binge alcohol Census Bureau region associations adjusted logistic regression analyses. Among 7,686 PLWH,...
Background Depression affects 20–30% of HIV-infected patients and is associated with worse HIV outcomes. Although effective depression treatment available, largely untreated or undertreated in this population. Methods We quantified gaps antidepressant treatment, adjustments, outcomes among US routine care the nationally distributed CNICS observational clinical cohort. This cohort combines detailed data regular, self-reported depressive severity assessments (Patient Health Questionnaire-9,...