Mean and total CVL provide markers of access to care and treatment, are indicators of the population's viral burden, and are useful in assessing trends in local HIV/AIDS epidemics. Measurement of CVL is a novel tool for assessing the potential impact of population-level HIV prevention and treatment interventions.
This study estimated the prevalence of chronic medical conditions and risk predictors of 759 newly admitted inmates in two New York State maximum-security prisons. The most prevalent conditions were respiratory (34.1%), cardiovascular (17.4%), and sexually transmitted diseases (STD; 16.1%); least prevalent were HIV (3.6%), cancer (1.7%), and kidney disease (1.7%). Results of the multivariable logistic regression showed that females had higher risk for all conditions except cardiovascular and liver disease; individuals aged 40 years and older had significantly higher risk for all conditions except asthma and STD; non-Hispanic Black inmates had higher risk for respiratory disease and STD; cigarette smoking was associated with asthma; and obesity was significantly associated with diabetes, asthma, and cardiovascular conditions. These findings highlight the heavy burden of chronic illnesses among newly admitted inmates and the need to address adequate screening, prevention, and treatment services.
We describe the sexual behaviors of women at elevated risk of HIV acquisition who reside in areas of high HIV prevalence and poverty in the US. Participants in HPTN 064, a prospective HIV incidence study, provided information about participants’ sexual behaviors and male sexual partners in the past 6 months at baseline, 6- and 12-months. Independent predictors of consistent or increased temporal patterns for three high-risk sexual behaviors were assessed separately: exchange sex, unprotected anal intercourse [UAI] and concurrent partnerships. The baseline prevalence of each behavior was >30% among the 2,099 participants, 88% reported partner(s) with > one HIV risk characteristic and both individual and partner risk characteristics decreased over time. Less than high school education and food insecurity predicted consistent/increased engagement in exchange sex and UAI, and partner's concurrency predicted participant concurrency. Our results demonstrate how interpersonal and social factors may influence sustained high-risk behavior by individuals and suggest that further study of the economic issues related to HIV risk could inform future prevention interventions.
Summary
Previous studies have reported decreasing hepatitis C virus (HCV) infection rates in the general population. However, differential susceptibility in institutionalized populations suggest that HCV infection is even more prevalent in prison populations than previously reported yet, routine screening for HCV infection among prisoners is not generally available. We estimated the HCV prevalence and identified associated exposures at two maximum-security prisons using data obtained from 2788 inmates from the Risk Factors for Spread of Staphylococcus aureus in Prisons Study in New York, which recruited participants from January 2009 and January 2013. HCV prevalence was 10.1% (n = 295); injection drug use, injection drug use sex partners, and HIV diagnosis exhibited the strongest associations with HCV infection in multivariable models, adjusting for covariates. Taken together, the ?ndings of the present study provide an updated estimate of HCV prevalence and suggest that incarcerated populations represent a declining yet significant portion of the hepatitis epidemic.
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