AIDS and behavior
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To assess the reproducibility of respondent-driven sampling (RDS) in obtaining comparable samples across two survey rounds, we conducted integrated bio-behavioral surveillance surveys (IBBSS) using RDS in 2007 and 2011 among men who have sex with men (MSM) on Unguja island in Zanzibar. Differences in the two rounds were assessed by comparing RDS-adjusted population estimates, stratified estimates, and bottleneck plots. Participants in the 2011 survey round were younger (31.4 vs. 9.9% under 19 years old, p < 0.001), more likely to have tested for HIV in the last year (53.7 vs. 10.6%, p < 0.001), and less likely to have injected drugs in the last 3 months (1.0 vs. 23.2%, p < 0.001) compared to participants in the 2007 round. ⋯ Bottleneck plots suggest that recruitment chains were "trapped" in the social networks of MSM who injected drugs to a greater extent in 2007 than in 2011. We conclude that the two rounds of RDS sampled different subsets of the MSM population on Unguja, particularly with respect to inclusion of MSM within the social networks of people who inject drugs. Findings underscore the need to evaluate the reproducibility of RDS in repeated rounds of IBBSS and to develop new sampling methods for key populations at high risk for HIV in order to track the epidemic, develop evidence-based prevention and care programs, and assess their impact.
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Since 2001 the UNAIDS Secretariat has retained the responsibility for monitoring progress towards global commitments on HIV/AIDS. Key critical characteristics of the reporting system were assessed for the reporting period from 2004 to 2014 and analyses were undertaken of response rates and core indicator performance. ⋯ The Global AIDS reporting system has improved substantially over time and has provided key trend data on responses to the HIV epidemic, serving as the global accountability mechanism and providing reference data on the global AIDS response. It will be critical that reporting systems continue to evolve to support the monitoring of the Sustainable Development Goals, in view of ending the AIDS epidemic as a public health threat by 2030.
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We conducted an in-person survey of New York City (NYC) pharmacies to assess the availability, accessibility, and price of the over-the-counter, rapid HIV self-test kit. NYC pharmacies were stratified into high, moderate and low morbidity neighborhoods by the HIV diagnosis rate of the neighborhood in which the pharmacy was located. A random sample of 500 pharmacies was taken [250 from high morbidity neighborhoods (HighMN) and 250 from low morbidity neighborhoods (LowMN)]. ⋯ Median price was US $42.99 without variability across neighborhoods. The rapid HIV self-test had limited availability and access in retail pharmacies. The high median price measured suggests that cost remained a barrier.
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Comparative Study Observational Study
Validation of a New Three-Item Self-Report Measure for Medication Adherence.
Few self-report measures of medication adherence have been rigorously developed and validated against electronic drug monitoring (EDM). Assess the validity of the 3-item self-report scale by comparing it with a contemporaneous EDM measure. We conducted an observational study in which adherence assessments were done monthly for up to 4 months for 81 patients with HIV who were taking antiretroviral medications. ⋯ This 3-item adherence self-report scale showed good psychometric characteristics and good construct validity when compared with an EDM standard, for both HIV and non-HIV medications. In clinical care it can be a useful first-stage screener for non-adherence. In clinical research and quality improvement settings it can be a useful tool when more complex and expensive methods such as EDM or pharmacy claims are impractical or unavailable.
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Significant health disparities exist for transgender female (trans*female) youth. We assessed differences in mental health outcomes based on exposure to discrimination among transgender female youth in the San Francisco Bay Area aged 16-24 years. Youth were recruited using a combination of respondent driven sampling with online and social media methods. ⋯ Parental closeness was related to significantly lower odds of all four mental health outcomes measured, and intrinsic resiliency positively reduced risk for psychological stress, PTSD, and stress related to suicidal thoughts. Transgender and racial discrimination may have deleterious effects on the mental health of trans*female youth. Interventions that address individual and intersectional discrimination and build resources for resiliency and parental closeness may have success in preventing mental health disorders in this underserved population.