Despite the proven effectiveness of human immunodeficiency virus (HIV) pre-exposure prophylaxis (PrEP), its use remains low in high-incidence areas. This study examined knowledge and barriers to PrEP among individuals at risk in Southern California. From September 2022 to April 2023, we recruited adult men who have sex with men, residing in San Bernardino and Riverside counties, who were not living with HIV and not using PrEP.
View Article and Find Full Text PDFLos Angeles County has a high prevalence of chronic hepatitis C virus (HCV) infection, but resources and infrastructure to notify and increase treatment uptake among county residents are absent. Through an innovative academic-public partnership, we developed a linkage-to-cure program utilizing the Department of Public Health's HCV surveillance registry. Case workers contacted reported cases via phone, to offer education, and treatment referral.
View Article and Find Full Text PDFBackground: The monkeypox (mpox) outbreak disproportionately affected sexually active gay, bisexual, and other men who have sex with men. To understand community-level changes in sexual behavior, we surveyed individuals in a semi-urban area in Southern California.
Methods: Participants were recruited between October 2022 and April 2023, using palm cards and geolocation-focused online advertisements on social media and dating apps.
Following the underutilization of pre-exposure prophylaxis (PrEP) among Latinx men who have sex with men (MSM) and transgender women in Southern California and the growing use of the delivery of PrEP through telemedicine, the California Department of Public Health implemented a telemedicine component to their already existing assistance program. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to identify and characterize factors inhibiting the successful implementation of the telemedicine program through in-depth, online stakeholder interviews and online community focus groups with Latinx MSM and trans women in southern California. Obstacles reported by stakeholders were complicated enrollment process, preference for in-person care, more appealing private sector models of PrEP, while community members reported low awareness of the program, fear of complications due to immigration status, challenges to fulfill enrollment requirements.
View Article and Find Full Text PDFWith growing maternal and congenital syphilis epidemics and shortages of benzathine penicillin, alternative syphilis treatments are needed. Linezolid has shown efficacy against syphilis in animal models. This review found no teratogenic effects.
View Article and Find Full Text PDFEpidemiologic surveillance of circulating SARS-CoV-2 variants is essential to assess impact on clinical outcomes and vaccine efficacy. Whole genome sequencing (WGS), the gold-standard to identify variants, requires significant infrastructure and expertise. We developed a digital droplet polymerase chain reaction (ddPCR) assay that can rapidly identify circulating variants of concern/interest (VOC/VOI) using variant-specific mutation combinations in the Spike gene.
View Article and Find Full Text PDFBackground: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants with different infectivity, transmission potential, and morbidity change the characteristics of local epidemics and affect vaccine effectiveness. As part of the University of Southern California COVID-19 Pandemic Research Center's efforts to understand, control, and inform local community on coronavirus disease 2019 (COVID-19), we implemented a SARS-CoV-2 surveillance program among students, employees, and USC Keck Medical Center patients. We present the epidemiology and distribution of SARS-CoV-2 and its variants among the population.
View Article and Find Full Text PDFBackground: Social media sites, dating apps, and information search sites have been used to reach individuals at high risk for HIV infection. However, it is not clear which platform is the most efficient in promoting home HIV self-testing, given that the users of various platforms may have different characteristics that impact their readiness for HIV testing.
Objective: This study aimed to compare the relative effectiveness of social media sites, dating apps, and information search sites in promoting HIV self-testing among minority men who have sex with men (MSM) at an increased risk of HIV infection.
Background: The COVID-19 pandemic illuminated the benefits of telemedicine. Self-collected specimens are a promising alternative to clinician-collected specimens when in-person testing is not feasible. In this study, we assessed the adequacy of self-collected pharyngeal and rectal specimens for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae among individuals undergoing chlamydia and gonorrhea screening.
View Article and Find Full Text PDFSafe and efficacious alternative treatment options for syphilis are necessary. This randomized, 2-arm, noncomparative pilot study evaluated the efficacy of oral cefixime 400 mg in achieving a ≥4-fold rapid plasma reagin titer decrease by 3 or 6 months after treatment. The proportion of cefixime arm participants treated successfully was 87% (95% confidence interval, 69%-100%; 13/15).
View Article and Find Full Text PDFBackground: Prophylactic administration of doxycycline is regarded as a potential new public health strategy to combat the rising rates of Chlamydia trachomatis infections and syphilis among men who have sex with men. We conducted a survey-based study to evaluate how community members and health care providers in Southern California would perceive doxycycline preexposure/postexposure prophylaxis (PrEP/PEP) to predict its acceptability and identify potential areas of concern.
Methods: We conducted an online cross-sectional survey among community members who identify as men who have sex with men and health care providers with prescribing authority in Southern California to investigate the current attitudes toward doxycycline PrEP/PEP, including their willingness to accept.
Background: Syphilis rates have been increasing both in the USA and internationally with incidence higher among men-who-have-sex-with-men and people living with human immunodeficiency virus (HIV) infection. Currently, benzathine penicillin is the recommended treatment for syphilis in all patients. Global shortages and cost increases in benzathine penicillin call for alternative treatment options.
View Article and Find Full Text PDFBackground: The majority of those living with HIV in the United States are men who have sex with men (MSM), and young, minority MSM account for more new HIV infections than any other group. HIV transmission can be reduced through detection and early treatment initiation or by starting pre-exposure prophylaxis (PrEP), but rates of testing are lower than recommended among MSM, and PrEP uptake has been slow. Although promoting HIV testing and PrEP uptake by placing advertisements on web-based platforms - such as social media websites and dating apps - is a promising approach for promoting HIV testing and PrEP, the relative effectiveness of HIV prevention advertising on common web-based platforms is underexamined.
View Article and Find Full Text PDFBackground: Sexually transmitted infections (STI), such as chlamydial, gonorrheal, and trichomonal infections, are prevalent in pregnant women in many countries and are widely reported to be associated with increased risk of poor maternal and neonatal outcomes. Syndromic STI management is frequently used in pregnant women in low- and middle-income countries, yet its low specificity and sensitivity lead to both overtreatment and undertreatment. Etiologic screening for chlamydial, gonorrheal, and/or trichomonal infection in all pregnant women combined with targeted treatment might be an effective intervention.
View Article and Find Full Text PDFTrials
July 2020
Background: HIV disproportionately affects men who have sex with men (MSM) in the USA, and new infections continue to increase, particularly among African American (AA) and Hispanic/Latino (H/L) MSM. Rates of HIV testing are particularly low among AA and H/L MSM, and innovative approaches to encourage testing may help address high incidence in these men. HIV self-testing (HST) may be an important tool for increasing rates and frequency of testing.
View Article and Find Full Text PDFBackground: The syphilis epidemic continues to cause substantial morbidity and mortality worldwide, particularly in low- and middle-income countries, despite several recent disease control initiatives. Though our understanding of the pathogenesis of this disease and the biology of the syphilis agent, Treponema pallidum subsp. pallidum has improved over the last two decades, further research is necessary to improve clinical diagnosis and disease management protocols.
View Article and Find Full Text PDFAs the group with the highest risk and the lowest pre-exposure prophylaxis (PrEP) utilization, black and Hispanic young men who have sex with men (MSM) face the brunt of the current human immunodeficiency virus (HIV) epidemic within the United States. In this narrative review, we summarized recent interventions that utilize technology (telemedicine) to improve HIV PrEP uptake. We examined the general model of those telemedicine programs and evaluated their success and limitations in addressing PrEP accessibility for at-risk individuals.
View Article and Find Full Text PDFJ Subst Abuse Treat
March 2020
The application of digital technologies to better assess, understand, and treat substance use disorders (SUDs) is a particularly promising and vibrant area of scientific research. The National Drug Abuse Treatment Clinical Trials Network (CTN), launched in 1999 by the U.S.
View Article and Find Full Text PDFBackground: Human immunodeficiency virus (HIV) self-testing could overcome barriers associated with traditional HIV testing and increase people's awareness of their serostatus. Mobile health, which utilizes mobile wireless technology, could alleviate concerns associated with HIV self-testing and increase access to this screening test.
Methods: We conducted a PubMed, Google Scholar, and Google search to identify research studies and public health programs in the United States that used mobile health to provide HIV self-testing kits for participants.