Our investigation of this cluster documents the transmission of West Nile virus by organ transplantation. Organ recipients receiving immunosuppressive drugs may be at high risk for severe disease after West Nile virus infection. Blood transfusion was the probable source of the West Nile virus viremia in the organ donor.

The purpose of this retrospective cohort study was to identify individual-level demographic and communitylevel socioeconomic and health care resource factors associated with late diagnosis of HIV in rural and urban areas of Florida. Multilevel modeling was conducted with linked 2007-2011 Florida HIV surveillance, American Community Survey, Area Health Resource File, and state counseling and testing data. Late diagnosis (defined as AIDS diagnosis within 3 months of HIV diagnosis) was more common in rural than urban areas (35.8% vs. 27.4%) ( p < 0.0001). This difference persisted after controlling for age, sex, race/ethnicity, HIV transmission mode, country of birth, and diagnosis year (adjusted OR 1.39; 95% CI 1.17-1.66). In rural areas, older age and male sex were associated with late HIV diagnosis; zip code-level socioeconomic and county level health care resource variables were not associated with late diagnosis in rural areas. In urban areas only, Hispanic and non-Hispanic black race/ethnicity, foreign birth, and heterosexual mode of transmission were additionally associated with late HIV diagnosis. These findings suggest that, in rural areas, enhanced efforts are needed to target older individuals and men in screening programs and that studies of psychosocial and structural barriers to HIV testing in rural and urban areas be pursued.

Objectives More than 10 % of pregnant women in the United States (U.S.) suffer from depression, which has far-reaching consequences on maternal and fetal well-being. There is conflicting evidence regarding the prevalence of antenatal depression among different race and ethnic groups. This systematic review aimed to summarize the existing literature concerning racial/ethnic disparities in the prevalence and correlates of antenatal depression in the U.S. Methods PubMed, CINAHL and PsycINFO databases were searched online for research studies published in English in peer-reviewed journals until March 2015, using a pre-designed search strategy. Eligibility was determined using pre-specified criteria; and quality was assessed. Results Forty-one (41) articles met the criteria; 13 were cross-sectional, and 21 were longitudinal studies. Overall, the prevalence of antenatal depression was 10-30 %; it was higher among non-Hispanic blacks (NHBs) and Hispanics, compared to non-Hispanic whites (NHWs). Few studies looked at the correlates of depression by race/ethnicity. Among employed women, higher depression scores were observed among NHBs, compared to NHWs; while there was no racial difference among unemployed women. Racial difference and race-employment interaction disappeared once discrimination was accounted for. In another study, higher parity, higher stress, and lower self-esteem were significant correlates of depression among NHBs, while less satisfaction with social support, and higher stress predicted higher depression scores among NHWs and Hispanics respectively. Conclusions The findings of our review suggest that not only is antenatal depression a major public health issue that needs to be addressed, but different racial/ethnic groups seem to differ in their vulnerability and risk factors.

Background Emerging research suggests that some bariatric surgery patients are at a heightened risk for developing substance use problems, especially alcohol use problems. Methods An exhaustive literature review was conducted in January 2015 to investigate all articles published that included data on post-operative alcohol use, alcohol use disorders, and illicit drug use among bariatric surgery patients. Results Twenty-three studies reported on alcohol and/or substance use among bariatric patients. Six studies longitudinally assessed alcohol use behaviors; three of these studies found an increase in alcohol use following surgery. Six studies were cross-sectional, and two studies assessed medical records. Five studies investigated the prevalence of admissions to substance abuse treatment, and three studies combined alcohol and drug use data in a single index. Six studies reported on illicit drug use and reported low-post-operative use. The studies' samples were primarily non-Hispanic white females in their upper 40s, and only 11 of the 23 studies utilized validated assessment instruments. Conclusions Studies employing longitudinal designs and large sample sizes indicate that bariatric patients who had the gastric bypass procedure are at an elevated risk for alcohol use problems post-operatively. Research also indicates that bariatric surgery patients might be over-represented in substance abuse treatment facilities. Risk factors for problematic post-operative alcohol use include regular or problematic alcohol use pre-surgery, male gender, younger age, tobacco use, and symptoms of attention deficient and hyperactivity disorder. As a whole, however, studies indicate bariatric surgery patients demonstrate a low prevalence of problematic alcohol use, and studies about gastric bypass patients are not entirely conclusive. Prospective, longitudinal studies are needed, utilizing standardized and validated alcohol assessment instruments that follow post-operative bariatric patients well beyond 2 years, and account for types of bariatric procedure. Finally, study samples with greater racial/ethnic diversity and wider age ranges are needed.

Objective Identifying and understanding determinants of alcohol use behavior among Hispanic immigrants is an increasingly significant public health concern. Although prior research has examined associations of cultural stressors with alcohol use among Hispanics, few studies have tested these associations among recent adult immigrants. As such, this study aimed to (a) examine the association of immigration stress on alcohol use severity among recently immigrated Hispanic adults (≤ 1 year in the U.S.); and (b) examine the moderating effects of gender, immigration status, and social support. Method A hierarchical multiple regression and moderation analyses were conducted on a sample of 527 participants in South Florida. Results Results indicated that after controlling for demographic variables, pre-immigration drinking behavior, and dimensions of social support, the association of higher immigration stress with higher alcohol use severity was statistically significant. Moderation analyses indicated that immigration stress had a statistically significant association with alcohol use severity among men, but not among women. Also, dimensions of social support consistently reduced the deleterious effect of immigration stress on alcohol use severity. Conclusion This study adds to the scarce literature on cultural stressors and alcohol use among recent Hispanic immigrants. Findings suggest that it may be important to design gender-specific interventions and that increasing levels of social support may offset the effects of immigration stress on alcohol use.