Publications by authors named "Anne F McIntyre"

11 Publications

  • Page 1 of 1

Key Population Hotspots in Nigeria for Targeted HIV Program Planning: Mapping, Validation, and Reconciliation.

JMIR Public Health Surveill 2021 02 22;7(2):e25623. Epub 2021 Feb 22.

Division of Global HIV & TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, GA, United States.

Background: With the fourth highest HIV burden globally, Nigeria is characterized as having a mixed HIV epidemic with high HIV prevalence among key populations, including female sex workers, men who have sex with men, and people who inject drugs. Reliable and accurate mapping of key population hotspots is necessary for strategic placement of services and allocation of limited resources for targeted interventions.

Objective: We aimed to map and develop a profile for the hotspots of female sex workers, men who have sex with men, and people who inject drugs in 7 states of Nigeria to inform HIV prevention and service programs and in preparation for a multiple-source capture-recapture population size estimation effort.

Methods: In August 2018, 261 trained data collectors from 36 key population-led community-based organizations mapped, validated, and profiled hotspots identified during the formative assessment in 7 priority states in Nigeria designated by the United States President's Emergency Plan for AIDS Relief. Hotspots were defined as physical venues wherein key population members frequent to socialize, seek clients, or engage in key population-defining behaviors. Hotspots were visited by data collectors, and each hotspot's name, local government area, address, type, geographic coordinates, peak times of activity, and estimated number of key population members was recorded. The number of key population hotspots per local government area was tabulated from the final list of hotspots.

Results: A total of 13,899 key population hotspots were identified and mapped in the 7 states, that is, 1297 in Akwa Ibom, 1714 in Benue, 2666 in Cross River, 2974 in Lagos, 1550 in Nasarawa, 2494 in Rivers, and 1204 in Federal Capital Territory. The most common hotspots were those frequented by female sex workers (9593/13,899, 69.0%), followed by people who inject drugs (2729/13,899, 19.6%) and men who have sex with men (1577/13,899, 11.3%). Although hotspots were identified in all local government areas visited, more hotspots were found in metropolitan local government areas and state capitals.

Conclusions: The number of key population hotspots identified in this study is more than that previously reported in similar studies in Nigeria. Close collaboration with key population-led community-based organizations facilitated identification of many new and previously undocumented key population hotspots in the 7 states. The smaller number of hotspots of men who have sex with men than that of female sex workers and that of people who inject drugs may reflect the social pressure and stigma faced by this population since the enforcement of the 2014 Same Sex Marriage (Prohibition) Act, which prohibits engaging in intimate same-sex relationships, organizing meetings of gays, or patronizing gay businesses.
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http://dx.doi.org/10.2196/25623DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7939933PMC
February 2021

Identification of Presymptomatic and Asymptomatic Cases Using Cohort-Based Testing Approaches at a Large Correctional Facility-Chicago, Illinois, USA, May 2020.

Clin Infect Dis 2021 03;72(5):e128-e135

Cermak Health Services, Chicago, Illinois, USA.

Background: Coronavirus disease 2019 (COVID-19) continues to cause significant morbidity and mortality worldwide. Correctional and detention facilities are at high risk of experiencing outbreaks. We aimed to evaluate cohort-based testing among detained persons exposed to laboratory-confirmed cases of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in order to identify presymptomatic and asymptomatic cases.

Methods: During 1-19 May 2020, 2 testing strategies were implemented in 12 tiers or housing units of the Cook County Jail, Chicago, Illinois. Detained persons were approached to participate in serial testing (n = 137) and offered tests at 3 time points over 14 days (day 1, days 3-5, and days 13-14). The second group was offered a single test and interview at the end of a 14-day quarantine period (day 14 group) (n = 87).

Results: 224 detained persons were approached for participation and, of these, 194 (87%) participated in ≥1 interview and 172 (77%) had ≥1 test. Of the 172 tested, 19 were positive for SARS-CoV-2. In the serial testing group, 17 (89%) new cases were detected, 16 (84%) on day 1, 1 (5%) on days 3-5, and none on days 13-14; in the day 14 group, 2 (11%) cases were identified. More than half (12/19; 63%) of the newly identified cases were presymptomatic or asymptomatic.

Conclusions: Our findings highlight the utility of cohort-based testing promptly after initiating quarantine within a housing tier. Cohort-based testing efforts identified new SARS-CoV-2 asymptomatic and presymptomatic infections that may have been missed by symptom screening alone.
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http://dx.doi.org/10.1093/cid/ciaa1802DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7799274PMC
March 2021

Correction: Estimating the Size of Key Populations in Kampala, Uganda: 3-Source Capture-Recapture Study.

JMIR Public Health Surveill 2020 05 12;6(2):e19893. Epub 2020 May 12.

Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV and TB, Atlanta, GA, United States.

[This corrects the article DOI: 10.2196/12118.].
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http://dx.doi.org/10.2196/19893DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7351262PMC
May 2020

Estimating the Size of Key Populations in Kampala, Uganda: 3-Source Capture-Recapture Study.

JMIR Public Health Surveill 2019 Aug 12;5(3):e12118. Epub 2019 Aug 12.

Centers for Disease Control and Prevention, Center for Global Health, Division of Global HIV and TB, Atlanta, GA, United States.

Background: Key populations, including people who inject drugs (PWID), men who have sex with men (MSM), and female sex workers (FSW), are disproportionately affected by the HIV epidemic. Understanding the magnitude of, and informing the public health response to, the HIV epidemic among these populations requires accurate size estimates. However, low social visibility poses challenges to these efforts.

Objective: The objective of this study was to derive population size estimates of PWID, MSM, and FSW in Kampala using capture-recapture.

Methods: Between June and October 2017, unique objects were distributed to the PWID, MSM, and FSW populations in Kampala. PWID, MSM, and FSW were each sampled during 3 independent captures; unique objects were offered in captures 1 and 2. PWID, MSM, and FSW sampled during captures 2 and 3 were asked if they had received either or both of the distributed objects. All captures were completed 1 week apart. The numbers of PWID, MSM, and FSW receiving one or both objects were determined. Population size estimates were derived using the Lincoln-Petersen method for 2-source capture-recapture (PWID) and Bayesian nonparametric latent-class model for 3-source capture-recapture (MSM and FSW).

Results: We sampled 467 PWID in capture 1 and 450 in capture 2; a total of 54 PWID were captured in both. We sampled 542, 574, and 598 MSM in captures 1, 2, and 3, respectively. There were 70 recaptures between captures 1 and 2, 103 recaptures between captures 2 and 3, and 155 recaptures between captures 1 and 3. There were 57 MSM captured in all 3 captures. We sampled 962, 965, and 1417 FSW in captures 1, 2, and 3, respectively. There were 316 recaptures between captures 1 and 2, 214 recaptures between captures 2 and 3, and 235 recaptures between captures 1 and 3. There were 109 FSW captured in all 3 rounds. The estimated number of PWID was 3892 (3090-5126), the estimated number of MSM was 14,019 (95% credible interval (CI) 4995-40,949), and the estimated number of FSW was 8848 (95% CI 6337-17,470).

Conclusions: Our population size estimates for PWID, MSM, and FSW in Kampala provide critical population denominator data to inform HIV prevention and treatment programs. The 3-source capture-recapture is a feasible method to advance key population size estimation.
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http://dx.doi.org/10.2196/12118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771531PMC
August 2019

Outcomes of infants born to women with influenza A(H1N1)pdm09.

Birth Defects Res 2019 01 9;111(2):88-95. Epub 2019 Jan 9.

Centers for Disease Control and Prevention, Atlanta, Georgia.

Background: Pregnant women with influenza are more likely to have complications, but information on infant outcomes is limited.

Methods: Five state/local health departments collected data on outcomes of infants born to pregnant women with 2009 H1N1 influenza reported to the Centers for Disease Control and Prevention from April to December 2009. Collaborating sites linked information on pregnant women with confirmed 2009 H1N1 influenza, many who were severely ill, to their infants' birth certificates. Collaborators also collected birth certificate data from two comparison groups that were matched with H1N1-affected pregnancies on month of conception, sex, and county of residence.

Results: 490 pregnant women with influenza, 1,451 women without reported influenza with pregnancies in the same year, and 1,446 pregnant women without reported influenza with prior year pregnancies were included. Women with 2009 H1N1 influenza admitted to an intensive care unit (ICU; n = 64) were more likely to deliver preterm infants (<37 weeks), low birth weight infants, and infants with Apgar scores <=6 at 5 min than women in comparison groups (adjusted relative risk, aRR = 3.9 [2.7, 5.6], aRR = 4.6 [2.9, 7.5], and aRR = 8.7 [3.6, 21.2], for same year comparisons, respectively). Women with influenza who were not hospitalized and hospitalized women not admitted to the ICU did not have significantly elevated risks for adverse infant outcomes.

Conclusions: Severely ill women with 2009 H1N1 influenza during pregnancy were more likely to have adverse birth outcomes than women without influenza, providing more support for influenza vaccination during pregnancy.
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http://dx.doi.org/10.1002/bdr2.1445DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6771262PMC
January 2019

Place of influenza vaccination among children--United States, 2010-11 through 2013-14 influenza seasons.

Vaccine 2016 Mar 2;34(10):1296-303. Epub 2016 Feb 2.

Centers for Disease Control and Prevention, 1600 Clifton Road, NE, Atlanta, GA 30329-4027, United States.

Background: Studies are published on settings adults receive influenza vaccination but few have reported on settings children are vaccinated and how this might be changing over time or vary by socio-demographics.

Methods: Data from the National Immunization Survey-Flu were analyzed to assess place of influenza vaccination among vaccinated children 6 months-17 years during the 2010-11, 2011-12, 2012-13, and 2013-14 influenza seasons. The percentage of children vaccinated at each place was calculated overall and by age, race/ethnicity, income, and Metropolitan Statistical Area (MSA).

Results: The places children received influenza vaccination varied little over four recent influenza seasons. From the 2010-11 through 2013-14 influenza seasons the percentage of vaccinated children receiving influenza vaccination at a doctor's office was 64.1%, 65.1%, 65.3%, and 65.3%, respectively with no differences from one season to the next. Likewise, for vaccination at clinics or health centers (17.8%, 17.5%, 17.0%. 18.0%), health departments (3.2%, 3.6%, 3.0%, 2.8%), and other non-medical places (1.6%, 1.4%, 1.2%, 1.1%), there were no differences from one season to the next. There were some differences for vaccinations at hospitals, pharmacies, and schools. There was considerable variability in the place of influenza vaccination by age, race/ethnicity, income, and MSA. Fewer Hispanic children were vaccinated at a doctor's office than black, white, and other or multiple race children and fewer black children and children of other or multiple races were vaccinated at a doctor's office than white children. More children at or below the poverty level were vaccinated at a clinic or health center than all of the other income groups.

Conclusion: Most vaccinated children receive their influenza vaccination at a doctor's office. Place of vaccination changed little over four recent influenza seasons. Large variability in place of vaccination exists by age, race/ethnicity, income, and MSA. Monitoring place of vaccination can help shape future immunization programs.
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http://dx.doi.org/10.1016/j.vaccine.2016.01.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5751425PMC
March 2016

CDC Pregnancy Flu Line: monitoring severe illness among pregnant women with influenza.

Matern Child Health J 2014 Sep;18(7):1578-82

National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention (CDC), 1600 Clifton Road, MS E-86, Atlanta, GA, 30333, USA.

The Centers for Disease Control and Prevention implemented the Pregnancy Flu Line (PFL) during the influenza A(H1N1)pdm09 (pH1N1) pandemic and continued operation through the 2010-2011 influenza season to collect reports of intensive care unit (ICU) admissions and deaths among pregnant women with influenza. The system documented the severe impact of influenza on pregnant women during both seasons with 181 ICU/survivals and 37 deaths reported during the 2009 fall pandemic wave and 69 ICU/survivals and ten deaths reported in the subsequent influenza season (2010-2011). A health department survey suggests PFL participants perceived public health benefits and minimum time burdens.
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http://dx.doi.org/10.1007/s10995-013-1415-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4498262PMC
September 2014

Seasonal influenza vaccination coverage - United States, 2009-10 and 2010-11.

MMWR Suppl 2013 Nov;62(3):65-8

Infection with influenza viruses can cause severe morbidity and mortality among all age groups. Children, particularly those aged <5 years, have the highest incidence of infection during epidemic periods; however, the highest rates of influenza-associated hospitalizations and deaths are among the elderly (aged ≥65 years), children aged <2 years, and those of any age with underlying medical conditions. Each year, influenza-related complications are estimated to result in more than 226,000 hospitalizations. During 1976-2006, estimates of influenza-associated deaths in the United States ranged from approximately 3,000 to an estimated 49,000 persons. Annual vaccination is the most effective strategy for preventing influenza virus infection and its complications.
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November 2013

Potential influence of seasonal influenza vaccination requirement versus traditional vaccine promotion strategies on unvaccinated healthcare personnel.

Vaccine 2013 Aug 8;31(37):3915-21. Epub 2013 Jul 8.

Influenza Division, Centers for Disease Control and Prevention (CDC), Atlanta, GA, USA.

In a prospective cohort study of 1670 healthcare personnel (HCP) providing direct patient care at Scott & White Healthcare in Texas and Kaiser Permanente Northwest in Oregon and Washington, we examined the potential impact of twelve vaccine promotion strategies on the likelihood of being vaccinated. Internet-based surveys were conducted at enrollment (Fall, 2010) and at post-season (Spring, 2011), which asked HCP whether twelve vaccination promotion strategies would make them "much less" to "much more" likely to be vaccinated next season (on a 5-point Likert scale). Overall, 366 of 1670 HCP (22%) were unvaccinated. Half (50%) of unvaccinated HCP self-reported that a vaccination requirement would make them more likely to be vaccinated and most (62%) identified at least one strategy other than a vaccination requirement that would make them more likely to be vaccinated. In sub-groups of unvaccinated HCPs with specific barriers to vaccination, about one in three (range=27-35%) indicated that interventions targeting specific vaccination barrier would increase the likelihood they would be vaccinated. However, in all cases, significantly more unvaccinated HCP reported that a vaccination requirement would increase the likelihood of vaccination than reported a targeted intervention would have this effect (range in difference scores=+11-23%).
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http://dx.doi.org/10.1016/j.vaccine.2013.06.045DOI Listing
August 2013

Factors associated with newly diagnosed HIV among persons with concomitant sexually transmitted diseases.

Sex Transm Dis 2008 Aug;35(8):731-7

Ruth M Rothstein CORE Center, Cook County Bureau of Health, Rush University Medical Center, Chicago, Illinois, USA.

Objective: We evaluated Illinois and Chicago Departments of Public Health surveillance databases to determine risk factors associated with newly diagnosed HIV among persons with bacterial sexually transmitted diseases (STDs).

Methods: Test results for Chlamydia, gonorrhea, early syphilis (primary, secondary, and early latent), and HIV from public health clinics in Illinois in 2002 were merged with demographic and behavioral survey data collected during patient visits. STD was defined as any positive non-HIV result.

Results: Among 43,517 patient encounters, 5814 (13.4%) had positive STD test results. There were 308 (0.7%) positive new HIV test results, of which 71 (23.1%) had concomitant infection with an STD. Compared with STD-positive, HIV-negative cases, age >30 years (OR = 1.9, 95% CI, 1.0,4.4), men who have sex with men (MSM) (OR = 22.2, 95% CI 11.3-43.7), and bisexual male (OR = 22.4, 95% CI 7.8-64.8) were independently associated with STD and HIV coinfections. Among distinct STDs, syphilis (n = 438) was the least frequent (7.5%), but was reported in the highest proportion (10.1%) of all new HIV infections and conferred the greatest risk (OR = 11.0, 95% CI 7.7-15.8) for newly diagnosed HIV.

Conclusions: MSM were at increased risk for newly diagnosed HIV with STD coinfection. Persons with a concomitant STD and HIV were older than US populations that generally constitute the greatest proportion of STD cases. These results highlight the role in particular of syphilis among populations at high risk for HIV transmission. Public health interventions targeting MSM and older adults for effective testing and prevention strategies are critically needed within high-risk networks for cotransmission of STDs and HIV.
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http://dx.doi.org/10.1097/OLQ.0b013e31817f97a0DOI Listing
August 2008

STD, HIV/AIDS, and hepatitis services in Illinois County Jails.

Sex Transm Dis 2009 Feb;36(2 Suppl):S37-40

Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, Illinois, USA.

Objective: : To assess the availability of STD, HIV/AIDS, and hepatitis services provided at Illinois adult county jails.

Goal: : Identify opportunities and barriers to service provision.

Study Design: : Telephone survey to those providing medical services in Illinois county jails.

Results: : Eighty-one (89%) of 91 Illinois jails responded. Half (49.3%) of the facilities offered on-site testing for STD, HIV/AIDS, and hepatitis on demand/with symptoms, although only 4 offered routine screening. Discharge planning services were offered in only 40% of facilities. Cost (43.2%) and limited staff (14.8%) were cited as primary barriers to service provision.

Conclusions: : Screening, treatment, and discharge planning services for STD, HIV/AIDS, and hepatitis are not universal in Illinois jails. Despite current levels of funding and staffing assistance from health departments to jails, further collaboration is needed to improve case identification and treatment in this high-risk population. Needs assessments are useful in identifying opportunities and barriers to service provision.
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http://dx.doi.org/10.1097/OLQ.0b013e31815e4167DOI Listing
February 2009
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