Publications by authors named "Gladys E Ibañez"

46 Publications

Change in marijuana use and its associated factors among persons living with HIV (PLWH) during the COVID-19 pandemic: Findings from a prospective cohort.

Drug Alcohol Depend 2021 May 21;225:108770. Epub 2021 May 21.

Department of Epidemiology, The University of Florida, United States.

Background: Emerging literature shows increased drug use during the COVID-19 pandemic. However, limited research has examined the change in marijuana use among persons living with HIV (PLWH). This study aimed to investigate how marijuana use changed in a cohort of PLWH during the first year of the pandemic and identify factors associated with the change.

Method: 222 PLWH (mean age = 50.2 ± 11.2, 50.9 % female, 14.5 % Hispanic, 64.7 % Black, 15.8 % White, 5 % other, 80.2 % persons using marijuana [at least weekly use], 19.8 % persons not using marijuana) completed a baseline survey on demographics and behavioral/health characteristics between 2018 and 2020 and a brief phone survey between May and October 2020 that assessed changes in marijuana use and overall/mental health, and perceived risks/benefits of marijuana use during the COVID-19 pandemic.

Results: During the pandemic, 64/222(28.8 %) of the whole sample reported increased marijuana use, 36(16.2 %) reported decreased use, and 122(55 %) reported no change. Multinomial logistic regression results indicated that: Compared to those reporting no change, increased marijuana use during the pandemic was associated with more frequent marijuana use and PTSD symptoms at baseline, worsened mental health during the pandemic, and not perceiving marijuana use as a risk factor for COVID-19 infection. More frequent marijuana use at baseline was the only factor significantly associated with decreased marijuana use during the pandemic.

Conclusion: The COVID-19 pandemic has resulted in changes in marijuana use among a considerable proportion (45 %) of PLWH. Future research is needed to understand the temporality of the increases in marijuana use with worsening mental health.
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http://dx.doi.org/10.1016/j.drugalcdep.2021.108770DOI Listing
May 2021

Incarceration History and HIV Care Among Individuals Living with HIV in Florida, 2014-2018.

AIDS Behav 2021 May 6. Epub 2021 May 6.

Department of Epidemiology, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA.

The present study examines the HIV continuum of care outcomes among people living with HIV (PLWH) who have either recent (< 12-months) or distal (> 12-months) incarceration history compared to those without an incarceration history. A self-administered survey (as part of the Florida Cohort Study (n = 932)) was used to collect data on demographic information, linkage to care, retention in care, HIV medication adherence, viral suppression, and incarceration history. Those with recent incarceration history were least likely to report HIV medication adherence greater than or equal to 95% of the time (χ = 8.79; p = 0.0124), always take their medications as directed (χ = 15.29; p = 0.0005), and to have durable viral suppression (χ = 16.65; p = 0.0002) compared to those distally or never incarcerated. In multivariable analyses, those never and distally incarcerated had greater odds of care linkage ([vs recently incarcerated] AOR = 2.58; CI: 1.31, 5.07; p = 0.0063, AOR = 2.09; CI: 1.11, 3.95; p = 0.0228, respectively). Those never incarcerated had greater odds of taking ART as directed ([vs recently incarcerated] AOR = 2.53; CI: 1.23 - 5.19; p = 0.0116). PLWH with an incarceration history may need more on-going monitoring and follow-up HIV care than those without previous incarceration regardless of when incarceration occurred.
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http://dx.doi.org/10.1007/s10461-021-03250-8DOI Listing
May 2021

Development and Validation of the Community PrEP-Related Stigma Scale (Community-PSS).

AIDS Educ Prev 2021 04;33(2):120-128

Department of Epidemiology, Florida International University, Miami, Florida.

Despite increasing availability of pre-exposure prophylaxis (PrEP), HIV prevention efforts have stalled. It is important to study potential barriers to HIV prevention methods, such as pre-exposure prophylaxis stigma. This study aims to develop and validate the Community PrEP-related Stigma Scale (Community-PSS) to address gaps in the literature. Participants were 108 sexual and gender minority men recruited through virtual and community-posted advertisements in Florida. The authors assessed reliability using Cronbach's alpha analysis, determined scale components using principal component analysis, and assessed construct validity based on five a priori hypotheses. The scale had high internal consistency (α = 0.86) and four components (stigma of actions outside of sex, stigma of sexual actions, extreme stigma perceptions, and positive community perception). The Community-PSS was valid, supporting four out of five hypotheses and in the expected directions. The Community-PSS was a valid and reliable tool in the sample and correlates with a previously validated PrEP stigma scale, HIV knowledge, PrEP knowledge, and likelihood of condom use with a partner on PrEP.
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http://dx.doi.org/10.1521/aeap.2021.33.2.120DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8054770PMC
April 2021

Condom use likelihood within the context of PrEP and TasP among men who have sex with men in Florida: a short report.

AIDS Care 2021 Feb 10:1-7. Epub 2021 Feb 10.

Department of Epidemiology, Florida International University, Miami, FL, USA.

Despite the development of targeted interventions for men who have sex with men, this population continues to comprise the majority of new HIV diagnoses. Though condoms are highly efficacious, some sexually active MSM use sero-sorting as a method of HIV prevention. This study aimed to characterize: (1) differences between partner sero-status and condom use likelihood, and (2) demographic, behavioral, and knowledge-related factors influencing condom use likelihood with varying sero-status partners. Using convenience sampling, 150 sexual and gender minority men completed a survey on PrEP and sexual behaviors. The majority of participants identified as racial/ethnic minorities (51.7%), having 4 years of college or more (52.0%), and being HIV-negative (not on PrEP) (68.8%). Our sample reported the lowest average condom use likelihood with a partner on PrEP (2.93 ± 1.39) and the highest average likelihood with an HIV-positive partner (unknown VL) (4.57 ± 0.98). Age, race/ethnicity, education, HIV-status, and HIV and PrEP knowledge were significantly associated with differences in condom use likelihood. Our findings elucidate the complexity of sero-sorting scenarios and decision-making processes in the context of biomedical HIV prevention. These results may provide insight for future condom use and sero-sorting interventions in the context of biomedical HIV prevention.
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http://dx.doi.org/10.1080/09540121.2021.1883515DOI Listing
February 2021

HIV-related stigma and life goals among people living with HIV (PLWH) in Florida.

Qual Life Res 2021 Mar 31;30(3):781-789. Epub 2020 Oct 31.

Department of Epidemiology, Florida International University, 11200 SW 8th St. AHC5-505, Miami, FL, 33199, USA.

Purpose: Goals are an important component of quality of life (QoL) as they provide motivation to accomplish tasks we strive to achieve. Stigma has been identified as a factor that may be deleterious to achieving personal goals. People living with HIV(PLWH) continue to face HIV-related stigma. As HIV prevalence continues to grow in the U.S., it is important to focus on factors that can help improve the health and QoL of PLWH. This study aims to examine the association between HIV-related stigma and goal-setting behaviors among PLWH in Florida.

Methods: We used baseline data collected from the Marijuana and Potential Long-term Effects (MAPLE) observational cohort study. We collected life goals data using an abbreviated version of the Personal Projects Analysis inventory. Participants listed up to three goals in five domains and were asked about each goal's difficulty and importance. HIV-related stigma was measured using an abbreviated version of the Herek HIV-related stigma scale. Relative risk estimates and 95% confidence intervals were estimated using multivariate linear regression models.

Results: The overall sample (n = 232) was majority male (52.4%), Black (72.4%), and non-Latino (84.9%). HIV-related stigma was positively associated with the total number of listed goals (β = 0.042[0.003, 0.082]; p = 0.037) and perceived goal difficulty (β = 0.010[0.003, 0.017]; p = 0.004), but not significantly associated with perceived goal importance (β = 0.001[- 0.002, 0.004]; p = 0.562).

Conclusion: The results suggest that HIV-related stigma may be affecting the pursuit of goals among PLWH. There is a need to develop and evaluate QoL interventions that are tailored to PLWH and focused on achieving goals in the face of HIV-related stigma.
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http://dx.doi.org/10.1007/s11136-020-02687-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7954852PMC
March 2021

A tai chi/qigong intervention for older adults living with HIV: a study protocol of an exploratory clinical trial.

Trials 2020 Sep 22;21(1):804. Epub 2020 Sep 22.

Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, The University of California, Los Angeles (UCLA), 760 Westwood Plaza, Los Angeles, CA, 90095, USA.

Background: Almost half of people living with HIV (PLWH) in the USA are over 50 years of age; this is expected to increase to 70% by 2020. Yet, few interventions exist for older PLWH that address psychological and physical symptoms combined, both prevalent in this population. There is a need to find innovative and accessible interventions that can help older PLWH to manage their symptoms. Mind-body interventions, like tai chi/qigong (TCQ), improve both physical and psychological health. TCQ is a series of slow, low-impact meditative movements that integrates breathwork, meditation, and stances.

Methods: The present study is an exploratory clinical trial that will evaluate the acceptability and feasibility of a 12-week, small group TCQ intervention (n = 24), a sham qigong control condition (n = 24), and a standard of care control condition (n = 24) for older people living with HIV/AIDS. It will also explore any preliminary associations between the TCQ intervention and symptom alleviation. Participants will be recruited from community-based health and social services organizations in Miami, FL, and randomized to one of the 3 conditions.

Discussion: We will assess feasibility and acceptability through questionnaires and adherence to TCQ. We will assess preliminary associations with symptoms such as depression, anxiety, social support, chronic HIV-related fatigue, and clinical outcomes. These will be described through proportions, means, and changes over time through graphing techniques. Outcomes will be assessed at baseline, at post-intervention, and at 3 months follow-up. These preliminary analyses also will provide information necessary to estimate effect size and power needed for a larger clinical trial.

Trial Registration: ClinicalTrials.gov NCT03840525 . Registered on 16 July 2018.
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http://dx.doi.org/10.1186/s13063-020-04728-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7506206PMC
September 2020

Health Care-Specific Enacted HIV-Related Stigma's Association with Antiretroviral Therapy Adherence and Viral Suppression Among People Living with HIV in Florida.

AIDS Patient Care STDS 2020 07;34(7):316-326

Department of Epidemiology, Florida International University, Miami, Florida, USA.

Among people living with HIV (PLWH) in Florida, <2/3 are virally suppressed (viral load <200 copies/mL). Previous theoretical frameworks have pointed to HIV-related stigma as an important factor for viral suppression; an important outcome related to the HIV continuum of care. This study aims to analyze the association between enacted HIV-related stigma and antiretroviral therapy (ART) adherence and viral suppression among a sample of PLWH in Florida. The overall sample ( = 932) was male (66.0%), majority greater than 45 years of age (63.5%), black (58.1%), and non-Hispanic (79.7%). Adjusted odds ratios (AOR) and 95% confidence intervals (CI) were estimated using logistic regression models. The odds of nonadherence to ART was not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 1.30, CI: (0.87-1.95),  = 0.198; AOR = 1.17, CI: (0.65-2.11),  = 0.600, respectively]. Moreover, the odds of nonviral suppression were not significantly greater for those reporting low/moderate or high levels of general enacted HIV-related stigma (vs. no stigma) [AOR = 0.92, CI: (0.60-1.42),  = 0.702; AOR = 1.16, CI: (0.64-2.13),  = 0.622, respectively]. However, ever experiencing health care-specific enacted HIV-related stigma was associated with both nonadherence [AOR = 2.29, CI: (1.25-4.20),  = 0.008] and nonsuppression [AOR = 2.16, CI: (1.19-3.92),  = 0.011]. Despite limitations, the results suggest that the perpetuation of stigma by health care workers may have a larger impact on continuum of care outcomes of PLWH than other sources of enacted stigma. Based on the results, there is a need to develop and evaluate interventions for health care workers intended to reduce experienced stigma among PLWH and improve health outcomes.
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http://dx.doi.org/10.1089/apc.2020.0031DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7370977PMC
July 2020

Enacted HIV-Related Stigma's Association with Anxiety & Depression Among People Living with HIV (PLWH) in Florida.

AIDS Behav 2021 Jan;25(1):93-103

Department of Epidemiology, Florida International University, 11200 SW 8th St. AHC5-505, Miami, FL, 33199, USA.

Research has shown that HIV-related stigma contributes to people living with HIV having a higher risk of mental health disorders. Our study examines the association between enacted HIV-related stigma and symptoms of anxiety and depression among PLWH. We used baseline data from 932 PLWH collected from the Florida Cohort study between 2014 and 2018. The sample was majority 45 + years of age (63.5%), male (66.0%), and Black (58.1%). The majority had previously experienced enacted HIV-related stigma (53.1%). Additionally, 56.6% and 65.2% showed mild to moderate/severe levels of anxiety and depression, respectively. Those who experienced any levels of enacted HIV-related stigma (vs none) had significantly greater odds of mild and moderate/severe levels of anxiety (vs no/minimal) (AOR[CI] 1.54[1.13, 2.10], p = 0.006; AOR[CI] 3.36[2.14, 5.26], p < 0.001, respectively) and depression (AOR[CI] 1.61[1.19, 2.18], p = 0.002; AOR[CI]  3.66[2.32, 5.77], p < 0.001, respectively). Findings suggest a need to evaluate interventions for PLWH to reduce the deleterious effects of enacted HIV-related stigma on mental health.
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http://dx.doi.org/10.1007/s10461-020-02948-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7749818PMC
January 2021

HIV testing intentions and cognitive reappraisal among Latino emerging adults.

AIDS Care 2021 04 14;33(4):548-552. Epub 2020 May 14.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.

Negative emotions related to HIV testing may influence an individual's intentions to test for HIV. However, emotion regulation strategies such as which involves reframing the meaning of an event to modify one's emotional response to it may potentially help to regulate these emotions and facilitate decisions to get tested for HIV. In this exploratory study, we examined the association between cognitive reappraisal and HIV testing intentions and whether this association differs by gender. Cross-sectional data were collected from a convenience sample of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida through an online survey. Hierarchical logistic regression models were used to analyze the data. Results indicated that cognitive reappraisal was significantly associated with HIV testing intentions (aOR: 1.44, 95% CI:1.04-1.99) and that this association was specific to females (aOR: 2.48, 95% CI: 1.39-4.43). Our results demonstrate the potential of cognitive reappraisal to facilitate HIV testing intentions among females. HIV prevention interventions should incorporate cognitive reappraisal training to regulate and adapt to the negative emotions associated with HIV testing in efforts to increase HIV testing.
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http://dx.doi.org/10.1080/09540121.2020.1763905DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666005PMC
April 2021

Facilitators and barriers to a contingency management alcohol intervention involving a transdermal alcohol sensor.

Heliyon 2020 Mar 26;6(3):e03612. Epub 2020 Mar 26.

Department of Epidemiology, University of Florida, Gainesville, FL, USA.

Research on contingency management is limited due to feasibility issues with monitoring adherence. Incentives usually depend on objective measures to verify compliance; therefore, biological markers for identifying alcohol use are not as dependable for the use of financial contingency studies. The Secure Continuous Remote Alcohol Monitor (SCRAM) is an objective alcohol biosensor that can be locked onto a person's ankle to address these limitations. In preparation for a large, contingency management study for HIV-positive and HIV-negative persons with heavy drinking, the aims for the study were to (1) explore barriers and facilitators to participating in a contingency management intervention using the SCRAM ankle monitor as the potential alcohol measure for the intervention; (2) explore levels of appropriate compensation for using the SCRAM and for study assessments as part of a contingency management intervention study; and (3) attitudes and beliefs on lifestyle changes as a consequence of wearing the SCRAM among HIV-positive and HIV-negative heavy drinkers in Florida. Five focus groups were conducted and we collected qualitative data from thirty-seven individuals (18 men; 19 women). During the analysis, six themes were identified as barriers and facilitators for participation in a contingency management intervention using the SCRAM sensor to measure alcohol use: (1) health assessment, (2) monetary incentives including payment structure and levels of compensation, (3) stigma associated with wearing the SCRAM sensor, (4) aesthetics and other related concerns with wearing the SCRAM sensor, (5) motivation to stop drinking, and (6) social support. Stigma was a major barrier for wearing the SCRAM sensor; however, if participants were motivated to change their behavior then the monetary incentives became a facilitator to wearing the sensor. In addition to the financial contingency method, social support may further increase the odds for participants to change their behaviors.
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http://dx.doi.org/10.1016/j.heliyon.2020.e03612DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7103775PMC
March 2020

The Florida Cohort study: methodology, initial findings and lessons learned from a multisite cohort of people living with HIV in Florida.

AIDS Care 2021 04 3;33(4):516-524. Epub 2020 Apr 3.

Department of Epidemiology, University of Florida, Gainesville, FL, USA.

In 2013, Florida had the highest rate of new HIV infections and only 56% of persons living with HIV (PLWH) were virally suppressed. In response, we initiated a new HIV cohort in Florida to better understand issues affecting HIV health outcomes. This manuscript will describe the procedures of the Florida Cohort; summarize information regarding enrollment, follow-up, and findings to date; and discuss challenges and lessons learned during the establishment of a multisite cohort of PLWH. Florida Cohort participants were enrolled from eight clinics and community-based organizations geographically diverse counties across Florida. Data were obtained from participant questionnaires, medical records, and state surveillance data. From 2014-2018, 932 PLWH (44% ≥50 years, 64% male, 55% black, 20% Latinx) were enrolled. At baseline, 83% were retained in care and 75% were virally suppressed. Research findings to date have focused on outcomes such as the HIV care continuum, HIV-related comorbidities, alcohol and drug use, and mHealth interventions interest. Strengths included the diversity of the sample and the linkage of participant surveys with existing surveillance data. However, the study had several challenges during planning and follow-up. The lessons learned from this study can be helpful when initiating a new longitudinal cohort study.
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http://dx.doi.org/10.1080/09540121.2020.1748867DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7541483PMC
April 2021

HIV Testing Among Latino Emerging Adults: Examining Associations with Familism Support, Nativity, and Gender.

J Immigr Minor Health 2020 Oct;22(5):1039-1048

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, AHC 5-488, Miami, FL, 33199, USA.

Research examining factors associated with low uptake of HIV testing among Latino emerging adults is scarce. Thus, this study examined the association between familism support and lifetime history of HIV testing among Latino emerging adults, and whether nativity status and gender moderated this association. A cross-sectional online survey of 157 Latino emerging adults aged 18-25 years living in Arizona and Florida was conducted and data were analyzed using robust Poisson regression models. Results indicated that 59.9% of participants reported a lifetime history of HIV testing. Higher familism support was associated with a decreased prevalence of lifetime history of HIV testing (aPR  =  0.81, 95% CI: 0.68- 0.95). Nativity status moderated the association between familism support and lifetime history of HIV testing, with this negative association, only found among immigrants (aPR = 0.46, 95% CI: 0.28-0.74). Gender did not moderate this association. Familism support plays a role in HIV testing behaviors, and thus should be considered when developing programs to increase HIV testing among Latinos.
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http://dx.doi.org/10.1007/s10903-020-01000-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7442717PMC
October 2020

Estimating the size of HIV-negative MSM population that would benefit from pre-exposure prophylaxis in Florida.

Ann Epidemiol 2020 04 14;44:52-56. Epub 2020 Feb 14.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami; Research Center in Minority Institutions, Florida International University, Miami.

Purpose: This study aimed to estimate the size of the population of men who have sex with men (MSM) in Florida with high-risk behaviors that would indicate eligibility for pre-exposure prophylaxis (PrEP) use.

Methods: Three methods were used to estimate the MSM population. Estimates from the three methods were averaged, and the number of MSM living with HIV in each zone improvement plan (ZIP) code was subtracted.

Results: The average MSM estimate was 1-2184 men (1.5-22.9%) by ZIP code. The size of the MSM population with indications for PrEP use was highest when using estimates of MSM with more than one sex partner in the past year obtained from the National HIV Behavioral Surveillance system and lowest when the MSM estimate was multiplied by 24.7% (percentage of MSM with PrEP indications from other studies).

Conclusion: Areas with high numbers of MSM with PrEP indications could be targeted with information to reduce HIV acquisition.
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http://dx.doi.org/10.1016/j.annepidem.2020.02.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7190453PMC
April 2020

Self-efficacy and HIV testing among Latino emerging adults: examining the moderating effects of distress tolerance and sexual risk behaviors.

AIDS Care 2020 12 4;32(12):1556-1564. Epub 2020 Mar 4.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.

Latino emerging adults in the United States are at a high risk of HIV and have a low prevalence of HIV testing. This study examined the association between self-efficacy for HIV testing, distress tolerance and lifetime history of HIV testing, and tested the moderating effect of distress tolerance and sexual risk behaviors on the association between self-efficacy and lifetime history of HIV testing. Data were collected from a cross-sectional sample of 157 Latino emerging adults aged 18-25 using an online survey and were analyzed using hierarchical logistic regression and moderation analyses. We found that 62.8% of those engaging in sexual risk behaviors had ever been tested for HIV. Participants that reported higher levels of self-efficacy (aOR=3.49, 95%CI: 1.78-6.83) were more likely to have ever been tested for HIV in their lifetime. There was a statistically significant three-way interaction among self-efficacy for HIV testing, distress tolerance and sexual risk behaviors (=2.76, 95%CI: .52, 5.00, =.016). This interaction suggests that among those that reported any sexual risk behaviors, higher levels of self-efficacy were associated with lifetime history of HIV testing only at higher levels of distress tolerance. Further research is warranted to determine how self-efficacy and distress tolerance work together among high-risk groups to promote HIV testing.
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http://dx.doi.org/10.1080/09540121.2020.1736259DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7483176PMC
December 2020

PrEP awareness among people living with HIV in Florida: Florida Cohort study.

AIDS Care 2021 04 21;33(4):428-433. Epub 2020 Jan 21.

Department of Epidemiology, Florida International University, Miami, FL, USA.

In 2017, Florida ranked 2nd nationally in prevalence and incidence rates of HIV infections in the United States. Due to the high burden of HIV and low viral suppression in Florida, it is of increased importance to study methods of HIV prevention such as preexposure prophylaxis(PrEP) in this state. Our study aimed to examine correlates of PrEP awareness among PLWH in Florida and describe patterns of PrEP awareness/information sources. Using data collected from the Florida Cohort study between 2014 and 2018, 530 PLWH answered items that were hypothesized to be correlated with PrEP awareness. Of our sample, 53.8% were aware of PrEP. Urban location of recruitment, sexual partner's use of PrEP, use of viral suppression as an HIV prevention strategy, and engagement in transactional sex were all significantly associated with higher odds of PrEP awareness. Care providers and HIV/AIDS support groups were the most frequently listed sources of PrEP awareness, sources of future PrEP information, and most trusted sources for PrEP information. Findings from this study could inform future interventions that aim to increase PrEP awareness among PLWH to increase PrEP awareness and uptake among their HIV-negative social and sexual networks.
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http://dx.doi.org/10.1080/09540121.2020.1717421DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7371495PMC
April 2021

Population-based methods for estimating the number of men who have sex with men: a systematic review.

Sex Health 2019 11;16(6):527-538

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, 11200 SW 8th Street, Miami, FL 33199, USA; and Corresponding author. Email:

The objective of this systematic review was to summarise population-based methods (i.e. methods that used representative data from populations) for estimating the population size of men who have sex with men (MSM), a high-risk group for HIV and other sexually transmissible infections (STIs). Studies using population-based methods to estimate the number or percentage of MSM or gay men were included. Twenty-eight studies met the inclusion criteria. Seven studies used surveillance data, 18 studies used survey data, and six studies used census data. Sixteen studies were conducted in the US, five were conducted in European countries, two were conducted in Canada, three were conducted in Australia, one was conducted in Israel, and one was conducted in Kenya. MSM accounted for 0.03-6.5% of men among all studies, and ranged from 3.8% to 6.4% in the US, from 7000 to 39100 in Canada, from 0.03% to 6.5% in European countries, and from 127947 to 182624 in Australia. Studies using surveillance data obtained the highest estimates of the MSM population size, whereas those using survey data obtained the lowest estimates. Studies also estimated the MSM population size by dimensions of sexual orientation. In studies examining these dimensions, fewer people identified as MSM than reported experience with or attraction to other men. Selection bias, differences in recall periods and sampling, or stigma could affect the estimate. It is important to have an estimate of the number of MSM to calculate disease rates, plan HIV and STI prevention efforts, and to allocate resources for this group.
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http://dx.doi.org/10.1071/SH18172DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7085112PMC
November 2019

Individual and neighborhood predictors of retention in care and viral suppression among Florida youth (aged 13-24) living with HIV in 2015.

Int J STD AIDS 2019 10 24;30(11):1095-1104. Epub 2019 Sep 24.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA.

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http://dx.doi.org/10.1177/0956462419857302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7089851PMC
October 2019

Hepatitis C Virus and Hispanic Criminal Justice Clients: A Missed Opportunity.

J Immigr Minor Health 2020 Aug;22(4):701-707

Department of Epidemiology, Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, 33199, USA.

To compare the willingness for HCV testing, HCV-knowledge, socio economic status, and HCV related risky behavior among male and female Latino offenders. Participants (n = 201) were recruited from the corrections system in Miami and interviewed. Backward stepwise logistic regression was conducted to compare gender-associated risk. Females (n = 81) were more likely to be engaged in risky sexual and drug behavior compared to males (n = 120). Overall, around 70% of the study population were interested to be tested for HCV if offered with no gender difference (OR 1.4, 95% CI 0.4-4.9). However, females were more likely to have lower income (OR 0.6, 95% CI 0.5-0.9) and engage in more HCV related risky sexual behaviors (OR 2.9, 95% CI 1.3-6.2), despite having better HCV related knowledge in five out of six items (OR 1.5-3.2), but had less crime activity (OR 0.6, 95% CI 0.5-0.8). HCV screening among Latino offenders would offer an efficient opportunity to reduce its burden as well as increase knowledge among vulnerable and high-risk population.
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http://dx.doi.org/10.1007/s10903-019-00931-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7061066PMC
August 2020

Age, Sex, Race, Ethnicity, Sexual Orientation: Intersectionality of Marginalized-Group Identities and Enacted HIV-Related Stigma Among People Living with HIV in Florida.

AIDS Behav 2019 Nov;23(11):2992-3001

Department of Epidemiology, Florida International University, 11200 SW 8th St., AHC5-505, Miami, FL, 33199, USA.

HIV-related stigma is associated with many negative health outcomes among people living with HIV (PLHIV). The theory of intersectionality suggests that the interactions of social identities affect PLHIV's experiences of stigma. This study aims to identify individual and interactive marginalized-group identities correlated with enacted HIV-related stigma among PLHIV in Florida. The sample (n = 932) was majority male (66.6%), Black (58.5%), and non-Latino (80.2%) with 53% reporting experiences of HIV-related stigma. In multinomial regression models, the interaction between race and ethnicity was significant where non-White Latinos had higher odds of experiencing high levels of enacted stigma [AOR (CI) 7.71 (2.41, 24.73), p < 0.001] compared to white non-Latinos. Additionally, racial minorities were less likely to have experienced moderate or high levels of enacted stigma [AOR (CI) 0.47 (0.31, 0.72), p < 0.001; AOR (CI) 0.39 (0.22, 0.70), p = 0.002, respectively]. Moreover, women had higher odds of experiencing high levels of enacted stigma [AOR (CI) 2.04 (1.13, 3.67), p = 0.018]. The results suggest that intersectionality is important to consider in HIV-related stigma research and future interventions.
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http://dx.doi.org/10.1007/s10461-019-02629-yDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6803104PMC
November 2019

Letter Response: Yoga, Tai Chi, Qigong, and Health Disparities.

Am J Public Health 2019 09;109(9):e5

Gladys E. Ibañez, Angel Algarin, and Tanjila Taskin are with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.

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http://dx.doi.org/10.2105/AJPH.2019.305238DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6687244PMC
September 2019

The Pre-exposure Prophylaxis (PrEP) Continuum of Care and Correlates to Initiation Among HIV-Negative Men Recruited at Miami Gay Pride 2018.

J Urban Health 2019 12;96(6):835-844

Department of Epidemiology; Robert Stempel College of Public Health & Social Work, Florida International University, Miami, FL, USA.

While the national HIV infection rate is decreasing, the highest rates of infections continue among men who have sex with men (MSM), particularly minority MSM. It is important to understand attitudes, knowledge, and behaviors surrounding HIV prevention methods, such as pre-exposure prophylaxis (PrEP). In the present study, we created a snapshot of the PrEP continuum of care and identified participant demographic and sources of PrEP awareness factors that were associated with PrEP initiation. Data were collected using anonymous paper-based surveys employing a venue intercept procedure. A total of 188 HIV-negative men completed the survey at Miami Gay Pride 2018. Participants answered questions regarding demographics, PrEP use, and sources of PrEP awareness. The sample was majority Hispanic (55.4%), gay (83.0%), and single (57.7%). The constructed PrEP continuum revealed that a low proportion of those identified as PrEP naïve (n = 143) for HIV infection had PrEP interest (49/143). Moreover, among those who initiated PrEP (n = 45), a high proportion were retained in a PrEP program (37/45), with approximately half achieving medication adherence (25/45). Age group, PrEP knowledge, and source of PrEP awareness were all significantly associated with PrEP initiation. In areas with high HIV infection rates, studies like these offer crucial insight on how public health practitioners should proceed in the goal of decreasing HIV transmission rates. More research is needed to increase PrEP uptake and adherence.
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http://dx.doi.org/10.1007/s11524-019-00362-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6904709PMC
December 2019

Qigong as a promising mind-body exercise for cognitive functioning: Letter to Editor.

J Am Geriatr Soc 2019 07 26;67(7):1533-1534. Epub 2019 Apr 26.

College of Nursing and Health Innovations, Arizona State University, Phoenix, Arizona.

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http://dx.doi.org/10.1111/jgs.15953DOI Listing
July 2019

Gender, age, and ethnic differences in offending behavior among Hispanic/Latino criminal justice clients.

J Ethn Crim Justice 2019 19;17(4):339-360. Epub 2019 Sep 19.

University of Delaware.

Hispanic/Latinos are disproportionately represented in the criminal justice system. Using convenience sampling, the present study examined the lifetime and recent offending behavior of Hispanic/Latinos involved in community corrections in Miami, Florida. Descriptive statistics and multivariable logistic regression analyses were conducted. Participants were mostly male (59.7%), less than 40 years old (84.1%), and almost half were of Cuban descent (48.5%). Women were less likely to manufacture or sell drugs than men (AOR=.42, p<.03), and more likely to report recent prostitution (AOR=7.34, p< .001) and stealing from houses or shops (AOR=2.68, p<.01). Central Americans were less likely to report alcohol and drug related offenses than Cubans. Findings suggest that criminality among Hispanic/Latinos may vary by gender and by sub-groups. Prevention programs should be tailored accordingly.
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http://dx.doi.org/10.1080/15377938.2019.1661058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7053219PMC
September 2019

Understanding the Possible Nonmedical Risks of Preexposure Prophylaxis Prescription in Adolescents.

JAMA Pediatr 2018 04;172(4):391

Department of Epidemiology, Florida International University, Miami.

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http://dx.doi.org/10.1001/jamapediatrics.2017.5596DOI Listing
April 2018

Panic in a (Zika) hot zone.

J Epidemiol Community Health 2018 04 24;72(4):269. Epub 2018 Jan 24.

Robert Stempel College of Public Health and Social Work, Florida International University, Miami, Florida, USA.

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http://dx.doi.org/10.1136/jech-2017-210198DOI Listing
April 2018

PrEP-ared Against HIV, but Not Sexually Transmitted Infections.

Am J Public Health 2018 01;108(1):e1

Angel B. Algarin and Gladys E. Ibañez are with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.

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http://dx.doi.org/10.2105/AJPH.2017.304171DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5719698PMC
January 2018

Interest in using mobile technology to help self-manage alcohol use among persons living with the human immunodeficiency virus: A Florida Cohort cross-sectional study.

Subst Abus 2018 01 1;39(1):77-82. Epub 2017 Sep 1.

b Department of Epidemiology , College of Public Health and Health Professions, College of Medicine, University of Florida , Gainesville , Florida , USA.

Background: Alcohol consumption at hazardous levels is more prevalent and associated with poor health outcomes among persons living with the human immunodeficiency virus (HIV; PLWH). Although PLWH are receptive to using technology to manage health issues, it is unknown whether a cell phone app to self-manage alcohol use would be acceptable among PLWH who drink. The objectives of this study were to determine factors associated with interest in an app to self-manage drinking and to identify differences in baseline mobile technology use among PLWH by drinking level.

Methods: The study population included 757 PLWH recruited from 2014 to 2016 into the Florida Cohort, an ongoing cohort study investigating the utilization of health services and HIV care outcomes among PLWH. Participants completed a questionnaire examining demographics, substance use, mobile technology use, and other health behaviors. Multivariable logistic regression was used to identify factors significantly associated with interest in an app to self-manage drinking. We also determined whether mobile technology use varied by drinking level.

Results: Of the sample, 40% of persons who drink at hazardous levels, 34% of persons who drink at nonhazardous levels, and 19% of persons who do not drink were interested in a self-management app for alcohol use. Multivariable logistic regression analysis indicated that nonhazardous drinking (adjusted odds ratio [AOR] = 1.78; confidence interval [CI 95%]: 1.10-2.88) and hazardous drinking (AOR = 2.58; CI: 1.60-4.16) were associated with interest, controlling for age, gender, education, and drug use. Regarding mobile technology use, most of the sample reported smartphone ownership (56%), text messaging (89%), and at least one cell phone app (69%).

Conclusions: Regardless of drinking level, overall mobile technology use among PLWH was moderate, whereas PLWH who consumed alcohol expressed greater interest in a cell phone app to self-manage alcohol use. This indicates that many PLWH who drink would be interested in and prepared for a mobile technology-based intervention to reduce alcohol consumption.
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http://dx.doi.org/10.1080/08897077.2017.1356793DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5775061PMC
January 2018

Barriers to Engaging Transgender Women in HIV Observational Research.

Am J Public Health 2017 06;107(6):e9

Both authors are with the Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami.

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http://dx.doi.org/10.2105/AJPH.2017.303776DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5425877PMC
June 2017

Behind the figures: High active tuberculosis cases among Eritrean asylum seekers in Germany.

Int J Hyg Environ Health 2017 07 22;220(5):886. Epub 2017 Apr 22.

Department of Epidemiology, Robert Stempel College of Public Health and Social Work, Florida International University, Miami, FL, USA. Electronic address:

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http://dx.doi.org/10.1016/j.ijheh.2017.04.004DOI Listing
July 2017