New York City

纽约市
  • 文章类型: Journal Article
    调查纽约市(NYC)的社区移民服务组织(MSO),了解他们在COVID-19大流行期间的早期经历以及对学术合作的看法。
    我们开发了一项调查,并通过Qualtrics(12/2020-1/2021)通过电子邮件发送给纽约市的122个MSO,收集有关组织的数据;COVID-19带来的挑战;以及对潜在部门间合作的兴趣。描述性分析侧重于大流行对服务提供的影响,MSO的类型,和组织能力。
    38个MSO参加(RR=31%)。与COVID-19相关的挑战包括工作人员能力有限,组织资助,以及社区的技术和资源限制。组织能力与所提供的服务类型相关:较小的组织提供卫生和社会服务,而更大的组织专注于教育和就业。MSO表示有兴趣在移民政策宣传和交流方面进行合作,接触实习生,以及有关最佳做法和政策的资源。
    纽约市的MSO一直在努力筹集资金,人员配备,和服务提供。他们指定了与学术研究机构合作的富有成果的领域。
    以学术为基础的移民卫生资源中心的开发将满足纽约市MSO中确定的需求。
    UNASSIGNED: To survey community-based migrant-serving organizations (MSOs) in New York City (NYC) regarding their early experiences during the COVID-19 pandemic and perspectives on academic collaborations.
    UNASSIGNED: We developed and emailed a survey via Qualtrics (12/2020-1/2021) to 122 MSOs in NYC collecting data about the organizations; challenges posed by COVID-19; and interest in potential intersectoral collaboration. Descriptive analysis focused on the pandemic\'s impact on service provision, type of MSO, and organizational capacity.
    UNASSIGNED: Thirty-eight MSOs participated (RR=31%). COVID-19-related challenges included limited staff capacity, organizational funding, and technological and resource limitations of communities served. Organizational capacity correlated with types of services offered: smaller organizations offered health and social services, while larger organizations focused on education and employment. MSOs indicated interest in collaboration on migrant policy advocacy and communications, access to interns, and resources regarding best practices and policies.
    UNASSIGNED: MSOs in NYC have struggled with funding, staffing, and service provision. They specified fruitful areas for collaboration with academic research institutions.
    UNASSIGNED: Development of an academic-based migrant health resource hub will serve an identified need among MSOs in NYC.
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  • 文章类型: Journal Article
    背景:颗粒物暴露(PM)是全球呼吸消化疾病的原因。世界贸易中心(WTC)的破坏使纽约市的第一响应者和居民暴露于WTC-PM,并导致阻塞性气道疾病(OAD)。胃食管反流病(GERD)和Barrett食管(BE)。GERD不仅会降低与健康相关的生活质量,还会引起超出BE范围的并发症。GERD会引起或加剧过敏,鼻窦炎,支气管炎,和哮喘。呼吸消化轴的疾病特征可以重叠,通常需要更具侵入性的诊断测试和治疗方式。这表明需要开发新的GERD的非侵入性生物标志物,BE,气道高反应性(AHR),治疗功效,和症状的严重程度。
    方法:我们的观察性病例队列研究将利用纽约消防局(FDNY)-WTC暴露的纵向表型队列来确定气道疾病的生物标志物,巴雷特和未诊断的非侵入性回流(坏烧伤)。我们的研究人群由n=4,192个人组成,我们从中随机选择了一个子队列对照组(n=837)。然后,我们将招募i。AHR仅II的子组。只有GERDiii.BEiv.GERD/BE和AHR重叠或v.无GERD或AHR,来自亚队列对照组。然后我们将表型并检查这些亚组的非侵入性生物标志物,以鉴定诊断不足和/或治疗功效。这些发现可能进一步有助于未来生物合理疗法的发展,最终提高患者的护理和生活质量。
    结论:尽管许多研究表明气道和消化系统疾病之间存在相互依存关系,致病因素和具体机制尚不清楚.常规GERD诊断程序的侵入性和疾病特异性生物标志物的有限可用性使疾病的检测进一步复杂化。反流的管理很重要,因为它直接增加患癌症的风险,并对生活质量产生负面影响。因此,至关重要的是开发新的非侵入性疾病标记,可以有效的表型,促进癌前疾病的早期诊断,并确定潜在的治疗目标,以改善患者护理。
    背景:主要注册名称:“气道疾病的生物标志物,巴雷特和诊断不足的非侵入性回流(BADBURN)。“试验识别号:NCT05216133。注册日期:2022年1月31日。
    BACKGROUND: Particulate matter exposure (PM) is a cause of aerodigestive disease globally. The destruction of the World Trade Center (WTC) exposed first responders and inhabitants of New York City to WTC-PM and caused obstructive airways disease (OAD), gastroesophageal reflux disease (GERD) and Barrett\'s Esophagus (BE). GERD not only diminishes health-related quality of life but also gives rise to complications that extend beyond the scope of BE. GERD can incite or exacerbate allergies, sinusitis, bronchitis, and asthma. Disease features of the aerodigestive axis can overlap, often necessitating more invasive diagnostic testing and treatment modalities. This presents a need to develop novel non-invasive biomarkers of GERD, BE, airway hyperreactivity (AHR), treatment efficacy, and severity of symptoms.
    METHODS: Our observational case-cohort study will leverage the longitudinally phenotyped Fire Department of New York (FDNY)-WTC exposed cohort to identify Biomarkers of Airway Disease, Barrett\'s and Underdiagnosed Reflux Noninvasively (BAD-BURN). Our study population consists of n = 4,192 individuals from which we have randomly selected a sub-cohort control group (n = 837). We will then recruit subgroups of i. AHR only ii. GERD only iii. BE iv. GERD/BE and AHR overlap or v. No GERD or AHR, from the sub-cohort control group. We will then phenotype and examine non-invasive biomarkers of these subgroups to identify under-diagnosis and/or treatment efficacy. The findings may further contribute to the development of future biologically plausible therapies, ultimately enhance patient care and quality of life.
    CONCLUSIONS: Although many studies have suggested interdependence between airway and digestive diseases, the causative factors and specific mechanisms remain unclear. The detection of the disease is further complicated by the invasiveness of conventional GERD diagnosis procedures and the limited availability of disease-specific biomarkers. The management of reflux is important, as it directly increases risk of cancer and negatively impacts quality of life. Therefore, it is vital to develop novel noninvasive disease markers that can effectively phenotype, facilitate early diagnosis of premalignant disease and identify potential therapeutic targets to improve patient care.
    BACKGROUND: Name of Primary Registry: \"Biomarkers of Airway Disease, Barrett\'s and Underdiagnosed Reflux Noninvasively (BADBURN)\". Trial Identifying Number: NCT05216133 . Date of Registration: January 31, 2022.
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  • 文章类型: Journal Article
    纽约市(NYC)的地铁系统每天可容纳550万通勤者,已知地铁内的环境具有高浓度的细颗粒物(PM2.5)污染。自然,地铁空气污染因人而异,在PM2.5暴露中引入不平等的可能性。本研究旨在评估个人和社区水平对地铁PM2.5的暴露。我们使用纵向雇主-家庭动态(LEHD)记录模拟了四个行政区(曼哈顿,布鲁克林,皇后区,和纽约的布朗克斯)。我们纳入了整个地铁系统的平台上和火车上测量的PM2.5浓度数据。城市的平均地下平台浓度为139μg/m3,标准偏差为25μg/m3,而地下时的火车上浓度为99μg/m3,标准偏差为21μg/m3。使用网络模型,我们确定了通勤者在日常回家旅行中的暴露情况。通过考虑街区内依赖地铁通勤的工人比例,我们量化了人口普查街区级别的人均平均暴露量。结果表明,地铁PM2.5暴露量升高与经济上处于不利地位和种族少数群体之间具有统计学意义的弱正相关。
    The New York City (NYC) subway system accommodates 5.5 million daily commuters, and the environment within the subway is known to have high concentrations of fine particulate matter (PM2.5) pollution. Naturally, subway air pollution varies among individuals according to their mobility patterns, introducing the possibility of inequality in PM2.5 exposure. This study aims to evaluate individual and community-level exposure to subway PM2.5. We simulated the intracity home-to-work trip patterns using the Longitudinal Employer-Household Dynamics (LEHD) records of 3.1 million working commuters across 34,169 census blocks in four boroughs (Manhattan, Brooklyn, Queens, and the Bronx) of NYC. We incorporated the on-platform and on-train measured PM2.5 concentration data for the entire subway system. The mean underground platform concentration in the city was 139 μg/m3 with a standard deviation of 25 μg/m3, while the on-train concentration when underground was 99 μg/m3 with a standard deviation of 21 μg/m3. Using a network model, we determined the exposure of individual commuters during their daily home-work trips. We quantified the mean per capita exposure at the census block level by considering the proportion of workers within the blocks who rely on the subway for their work commute. Results indicate statistically significant weak positive correlation between elevated subway PM2.5 exposure and economically disadvantaged and racial minority groups.
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  • 文章类型: Journal Article
    我们使用交叉方法对纽约市患有多种慢性疾病(MCC)的老年人的合并症特征和心脏代谢危险因素进行了表征。电子健康记录数据来自INSIGHT临床研究网络,涉及367,901名年龄在50岁或以上的MCC纽约市居民。合并症分布是不均匀的。性别,种族和族裔群体中最常见的情况是同时发生的高血压和高脂血症;这两种情况的患病率在各组之间有所不同(仅同时发生4.7%-7.3%,65.1%-88.0%与其他条件)。观察到显著的性别和种族和民族差异,这可能反映了整个生命过程中风险因素和医疗保健获取方面的累积差异。
    We characterized comorbidity profiles and cardiometabolic risk factors among older adults with multiple chronic conditions (MCCs) in New York City using an intersectionality approach. Electronic health record data were obtained from the INSIGHT Clinical Research Network on 367,901 New York City residents aged 50 years or older with MCCs. Comorbidity profiles were heterogeneous. The most common profile across sex and racial and ethnic groups was co-occurring hypertension and hyperlipidemia; prevalence of these 2 conditions differed across groups (4.7%-7.3% co-occurrence alone, 65.1%-88.0% with other conditions). Significant sex and racial and ethnic differences were observed, which may reflect accumulated disparities in risk factors and health care access across the life course.
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  • 文章类型: Journal Article
    即使儿童血液中的铅含量很低也与发育迟缓有关,学习困难,和行为问题。成年人也容易受到铅暴露的有害健康影响。纽约市(NYC)卫生和精神卫生部收到纽约市居民的血铅测试结果,并对铅中毒病例进行调查。2012年对一名4岁儿童进行血铅检测,发现该儿童以及其他四名家庭成员在11年的时间内发现血铅水平高于CDC血铅参考值3.5μg/dL,包括孩子的母亲和三个出生在2012-2016年的弟弟妹妹。在所有病例中确定的唯一潜在铅暴露源是使用Surma,传统的眼部化妆品,被发现含有390,000ppm的铅。本报告中的案例突出了当文化习俗根深蒂固时风险沟通的挑战,比如使用Surma,尽管有健康警告,但仍坚持。此外,他们强调了这种做法的代际性质,以及一旦确定一名成员有风险,就需要全面的家庭后续行动。这些产品将继续在全球范围内销售。即使在美国等禁止销售的地方。涉及地方和全球参与的多方利益攸关方努力可以促进在原产国重新制定这些产品,以消除铅作为一种成分。
    Even low levels of lead in children\'s blood are associated with developmental delays, difficulty learning, and behavioral issues. Adults are also vulnerable to the detrimental health effects of lead exposure. The New York City (NYC) Department of Health and Mental Hygiene receives blood lead test results for NYC residents and conducts investigations of lead poisoning cases. Blood lead testing of a child aged 4 years in 2012 led to the discovery of blood lead levels above the CDC blood lead reference value of 3.5 μg/dL in the child as well as four other family members over a period of 11 years, including the child\'s mother and three younger siblings born during 2012-2016. The only potential source of lead exposure identified for all cases was the use of surma, a traditional eye cosmetic, which was found to contain 390,000 ppm lead. The cases in this report highlight the challenges of risk communication when deeply ingrained cultural practices, such as the use of surma, persist despite health warnings. Moreover, they highlight the intergenerational nature of such practices and the need for comprehensive family follow-up once a member is identified as being at risk. These products continue to be available globally, even in places such as the United States where sales are prohibited. Multistakeholder efforts involving local and global engagement could promote reformulation of these products at the countries of origin to eliminate lead as an ingredient.
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  • 文章类型: Journal Article
    Latinx(西班牙裔)社会结构掩盖了此类人群中过量风险水平的差异。当国家数据被分类时,美国波多黎各人的死亡率成倍增加,如此之多,以至于这个社区多年来的过量死亡率最高。由设在布朗克斯的波多黎各人开发,Narcanazo是一项有能力的支持者运动,该运动使用当地的过量用药数据动员社区成员作为经过训练的纳洛酮分配器。这项健康促进运动以反种族主义流行病学分析为基础。(AmJ公共卫生。2024;114(S6):S463-S466。https://doi.org/10.2105/AJPH.2024.307605)[公式:见正文]。
    The Latinx (Hispanic) social construct obscures differences in the overdose risk levels of groups within this category. When national data are disaggregated, stateside Puerto Rican mortality increases exponentially, so much that this community has the highest rates of overdose deaths across years. Developed by Bronx-based Puerto Ricans, Narcanazo is an empowered upstander campaign that uses local overdose data to mobilize community members as trained naloxone dispensers. This health promotion campaign was grounded in antiracist epidemiological analysis. (Am J Public Health. 2024;114(S6):S463-S466. https://doi.org/10.2105/AJPH.2024.307605) [Formula: see text].
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  • 文章类型: Journal Article
    无家可归,影响了50多万美国人,显著提高了精神和身体健康问题的风险,因此,与普通人群相比,预期寿命缩短。无家可归是一个关键的公共卫生问题,并且需要努力解决缺乏住房作为健康的社会决定因素的问题。过渡性住房(TH)计划成为重要的干预措施,提供各种支持服务的住宿场所,以促进向永久居留权的过渡。该国近一半的无住房人口和纽约超过90%的人口居住在TH或庇护所。尽管TH的利用率很高,对支持服务的参与和改进机会仍然知之甚少。这项研究旨在通过对纽约市TH居民进行半结构化访谈来研究影响支持服务使用的因素和增强的机会,以捕捉他们的生活经历和观点,从而填补这一空白。对访谈的分析(n=20)揭示了影响服务参与的五个主要因素,这些因素与社会生态模型的构建相一致:内省(自我效能感,慢性健康状况,心理健康),人际关系(有特殊需要的儿童的父母身份和福祉,个人员工互动,和通信),制度(官僚挑战,行政负担,和生活设施),社区(社会隔离和教育机会),和政策(挑战满足基本需求和无证状态)。弥合服务差距的建议主要出现在机构和社区层面,为管理员提供关键见解,以更有效地根据TH居民的需求定制服务,从而有助于促进无住房者之间健康公平的更广泛目标。
    Homelessness, affecting over half a million Americans, significantly elevates the risks of mental and physical health issues, consequently diminishing life expectancy when compared with the general population. Homelessness is a critical public health issue, and efforts are needed to address lack of housing as a social determinant of health. Transitional housing (TH) programs emerge as vital interventions, offering a place to stay with various support services to facilitate the transition to permanent residency. Nearly half of the unhoused population in the country and over 90% in New York live in TH or shelters. Despite the high utilization rates of TH, engagement with support services and opportunities for improvement remain poorly understood. This study aimed to fill this gap by examining the factors influencing support service usage and opportunities for enhancement through semi-structured interviews with TH residents in New York City to capture their lived experiences and perspectives. Analysis of the interviews (n = 20) revealed five main factors affecting service engagement that aligned with constructs of the socioecological model: intrapersonal (self-efficacy, chronic health conditions, mental health), interpersonal (parenthood and well-being of children with special needs, individual staff interactions, and communication), institutional (bureaucratic challenges, administrative burden, and living facilities), community (social isolation and educational opportunity), and policy (challenge meeting basic needs and undocumented status). Recommendations for bridging service gaps primarily arose at the institutional and community levels, offering critical insights for administrators to tailor services more effectively to TH residents\' needs, thus contributing to the broader goal of advancing health equity among the unhoused.
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  • 文章类型: Journal Article
    背景:最近的研究表明,因COVID-19住院的患者在出院后长达一年的时间内可能会受到“长期COVID”症状的影响。
    目的:我们的研究目的是识别数据驱动的患者群,无监督机器学习技术。
    方法:该研究使用了2020年3月3日至5月15日在纽约市住院的437名患者的数据。所使用的数据是从医疗记录中提取的,并从住院后长达一年的随访调查中收集。住院数据包括人口统计,合并症,和住院并发症。调查收集了长期的COVID症状,和一般健康信息,社会孤立,和孤独。要执行分析,我们通过将数据投影到八个主成分(PC)并运行K最近邻算法来创建图形。然后,我们使用Louvain的算法将该图划分为不重叠的簇。
    结果:聚类分析产生了四个具有不同健康和社会连接模式的集群。第一组(n=141)由患有长期COVID神经症状(74%)和社交孤立/孤独的患者组成。第二组(n=137)由健康患者组成,他们也更有社交联系且不孤独。第三组(n=96)包含有神经系统症状的患者,他们与社会有联系但孤独,第四组(n=63)完全由患有创伤性COVID住院的患者组成,插管,有症状,但与社会有联系,经历了康复。
    结论:聚类分析确定社会隔离和孤独感是与长期COVID症状和住院后恢复相关的重要特征。这也证实了社会孤立和孤独,虽然连接,不一定是一样的。医生需要意识到社会特征与长期COVID和患者应对由此产生的症状的能力之间的关系。
    BACKGROUND: Recent studies have demonstrated that individuals hospitalized due to COVID-19 can be affected by \"long-COVID\" symptoms for as long as one year after discharge.
    OBJECTIVE: Our study objective is to identify data-driven clusters of patients using a novel, unsupervised machine learning technique.
    METHODS: The study uses data from 437 patients hospitalized in New York City between March 3rd and May 15th of 2020. The data used was abstracted from medical records and collected from a follow-up survey for up to one-year post-hospitalization. Hospitalization data included demographics, comorbidities, and in-hospital complications. The survey collected long-COVID symptoms, and information on general health, social isolation, and loneliness. To perform the analysis, we created a graph by projecting the data onto eight principal components (PCs) and running the K-nearest neighbors algorithm. We then used Louvain\'s algorithm to partition this graph into non-overlapping clusters.
    RESULTS: The cluster analysis produced four clusters with distinct health and social connectivity patterns. The first cluster (n = 141) consisted of patients with both long-COVID neurological symptoms (74%) and social isolation/loneliness. The second cluster (n = 137) consisted of healthy patients who were also more socially connected and not lonely. The third cluster (n = 96) contained patients with neurological symptoms who were socially connected but lonely, and the fourth cluster (n = 63) consisted entirely of patients who had traumatic COVID hospitalization, were intubated, suffered symptoms, but were socially connected and experienced recovery.
    CONCLUSIONS: The cluster analysis identified social isolation and loneliness as important features associated with long-COVID symptoms and recovery after hospitalization. It also confirms that social isolation and loneliness, though connected, are not necessarily the same. Physicians need to be aware of how social characteristics relate to long-COVID and patient\'s ability to cope with the resulting symptoms.
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  • 文章类型: Journal Article
    随着城市努力实现树冠覆盖率的大幅增加和人为挥发性有机化合物(AVOC)排放的减少,准确评估生物VOCs(BVOCs)对空气质量的影响变得越来越重要。在这项研究中,我们旨在量化未来城市绿化对臭氧产生的影响。密集城市地区的BVOC排放通常在区域模型中得到粗略表示。我们建立了高分辨率(30m)MEGAN(《自然》3.2版的气体和气溶胶排放模型),以估算纽约市都会区(NYC-MEGAN)的夏季生物异戊二烯排放。将受观测约束的箱模型与NYC-MEGAN异戊二烯排放耦合成功地再现了城市核心中观测到的异戊二烯浓度。然后,我们从可能的城市绿化情景中估算了未来的异戊二烯排放量,并评估了对未来臭氧生产的潜在影响。NYC-MEGAN预测,在炎热的夏季,纽约市的异戊二烯排放量是粗分辨率(1.33km)生物排放清单系统3.61版(BEIS)的两倍。我们发现BVOCs在炎热的夏季驱动臭氧产生,即使在市中心,尽管AVOC排放量很大。如果高异戊二烯排放物种(例如,橡树)种植,未来城市核心地区的异戊二烯排放量可能增加1.4-2.2倍,在当前的NOx浓度下,这将导致臭氧超标日的峰值臭氧增加8-19ppbv。我们建议在氮氧化物浓度较高的城市种植非异戊二烯或低异戊二烯排放的树木,以避免未来臭氧超标事件的频率和严重程度增加。
    As cities strive for ambitious increases in tree canopy cover and reductions in anthropogenic volatile organic compound (AVOC) emissions, accurate assessments of the impacts of biogenic VOCs (BVOCs) on air quality become more important. In this study, we aim to quantify the impact of future urban greening on ozone production. BVOC emissions in dense urban areas are often coarsely represented in regional models. We set up a high-resolution (30 m) MEGAN (The Model of Emissions of Gases and Aerosols from Nature version 3.2) to estimate summertime biogenic isoprene emissions in the New York City metro area (NYC-MEGAN). Coupling an observation-constrained box model with NYC-MEGAN isoprene emissions successfully reproduced the observed isoprene concentrations in the city core. We then estimated future isoprene emissions from likely urban greening scenarios and evaluated the potential impact on future ozone production. NYC-MEGAN predicts up to twice as much isoprene emissions in NYC as the coarse-resolution (1.33 km) Biogenic Emission Inventory System version 3.61 (BEIS) on hot summer days. We find that BVOCs drive ozone production on hot summer days, even in the city core, despite large AVOC emissions. If high isoprene emitting species (e.g., oak trees) are planted, future isoprene emissions could increase by 1.4-2.2 times in the city core, which would result in 8-19 ppbv increases in peak ozone on ozone exceedance days with current NOx concentrations. We recommend planting non- or low-isoprene emitting trees in cities with high NOx concentrations to avoid an increase in the frequency and severity of future ozone exceedance events.
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  • 文章类型: Journal Article
    背景:在美国,暴露前预防(PrEP)的使用存在显著的种族和性别差异。2022年,美国黑人占PrEP用户的14%,但在2021年和南方,黑人占新艾滋病毒诊断的42%。在2021年,黑人占新的艾滋病毒诊断的48%,但在2022年,只有21%的PrEP用户。使用药物的女性可能比不使用药物的女性发起PrEP的可能性更小。此外,参与社区监督计划(CSP)的妇女不太可能发起或使用PrEP,需要更多的PrEP干预措施,重点是最近在CSP中使用药物的黑人妇女,以减少PrEP摄取的不平等。
    方法:我们从一项随机临床试验中进行了二次分析,对来自母体研究(E-WORTH)的全部(N=352)参与者进行了子样本(n=336)。基线时HIV检测阴性的患者被认为符合PrEP标准.黑人妇女是从纽约市(NYC)的CSP招募的,最近的物质使用。参与者被随机分配到E-WORTH(n=172)和HIV检测加,收到5个会议,文化定制,以小组为基础的艾滋病毒预防干预,与HIV检测对照组相比(n=180)。这5场会议包括对PrEP和访问的介绍。本文报告了提高PrEP意识的结果,愿意使用PrEP,和PrEP摄取在12个月的随访期间。在以前的一篇论文中报道了艾滋病毒的结果。
    结果:与对照参与者相比,这项研究中被分配到E-WORTH的参与者意识到PrEP作为一种生物医学HIV预防策略的可能性明显更大(OR=3.25,95%CI=1.64-6.46,p=0.001),并且表明在整个12个月的随访期内,使用PrEP作为HIV预防方法的意愿更大(b=0.19,95%CI=0.06-0.32,p=0.004)。
    结论:这些发现强调了在CSP环境中对黑人妇女进行文化定制干预的有效性,并打算启动PrEP。这两个部门对PrEP的吸收都很低,这突出表明需要提供更强有力的按需PrEP战略,将其纳入药物滥用治疗等其他服务。
    背景:ClinicalTrials.gov标识符:NCT02391233。
    BACKGROUND: In the U.S. there are significant racial and gender disparities in the uptake of pre-exposure prophylaxis (PrEP). Black Americans represented 14% of PrEP users in 2022, but accounted for 42% of new HIV diagnoses in 2021 and in the South, Black people represented 48% of new HIV diagnoses in 2021 but only 21% of PrEP users in 2022. Women who use drugs may be even less likely than women who do not use drugs have initiated PrEP. Moreover, women involved in community supervision programs (CSP) are less likely to initiate or use PrEP, More PrEP interventions that focus on Black women with recent history of drug use in CSPs are needed to reduce inequities in PrEP uptake.
    METHODS: We conducted a secondary analysis from a randomized clinical trial with a sub-sample (n = 336) of the total (N = 352) participants from the parent study (E-WORTH), who tested HIV negative at baseline were considered PrEP-eligible. Black women were recruited from CSPs in New York City (NYC), with recent substance use. Participants were randomized to either E-WORTH (n = 172) an HIV testing plus, receive a 5-session, culturally-tailored, group-based HIV prevention intervention, versus an HIV testing control group (n = 180). The 5 sessions included an introduction to PrEP and access. This paper reports outcomes on improved awareness of PrEP, willingness to use PrEP, and PrEP uptake over the 12-month follow-up period. HIV outcomes are reported in a previous paper.
    RESULTS: Compared to control participants, participants in this study assigned to E-WORTH had significantly greater odds of being aware of PrEP as a biomedical HIV prevention strategy (OR = 3.25, 95% CI = 1.64-6.46, p = 0.001), and indicated a greater willingness to use PrEP as an HIV prevention method (b = 0.19, 95% CI = 0.06-0.32, p = 0.004) over the entire 12-month follow-up period.
    CONCLUSIONS: These findings underscore the effectiveness of a culturally-tailored intervention for Black women in CSP settings in increasing awareness, and intention to initiate PrEP. Low uptake of PrEP in both arms highlight the need for providing more robust PrEP-on-demand strategies that are integrated into other services such as substance abuse treatment.
    BACKGROUND: ClinicalTrials.gov Identifier: NCT02391233 .
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