American journal of preventive medicine
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Understanding the role of sociologic, structural, and biomedical factors that influence the length of time from HIV infection to diagnosis and reducing the time from infection to diagnosis are critical for achieving the goals of the Ending the HIV Epidemic initiative. In a retrospective analysis, the length of time from HIV infection to diagnosis and its association with individual- and facility-level attributes are determined. ⋯ Providing access to expanded testing, including rapid testing in nonclinical settings, is likely to result in a decrease in the length of time a person is unaware of their HIV infection and thus reduce onward transmission of HIV infection.
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Review Meta Analysis
Long-Acting Reversible Contraception, Condom Use, and Sexually Transmitted Infections: A Systematic Review and Meta-analysis.
Given mixed findings regarding the relationship between long-acting reversible contraception and condom use, this systematic review and meta-analysis synthesizes studies comparing sexually transmitted infection‒related outcomes between users of long-acting reversible contraception (intrauterine devices, implants) and users of moderately effective contraceptive methods (oral contraceptives, injectables, patches, rings). ⋯ Promoting condom use specifically for sexually transmitted infection prevention may be particularly important among long-acting reversible contraception users at risk for sexually transmitted infections, including adolescents and young adults.
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Despite the growing recognition of the importance of neighborhood conditions for cardiometabolic health, causal relationships have been difficult to establish owing to a reliance on cross-sectional designs and selection bias. This is the first natural experiment to examine the impact of neighborhood revitalization on cardiometabolic outcomes in residents from 2 predominantly African American neighborhoods, one of which has experienced significant revitalization (intervention), whereas the other has not (comparison). ⋯ Investing in disadvantaged neighborhoods has been suggested as a strategy to reduce health disparities. Using a natural experiment, findings suggest that improving neighborhood conditions may have a mixed impact on certain aspects of cardiometabolic health. Findings underscore the importance of examining the upstream causes of health disparities using rigorous designs and longer follow-up periods that provide more powerful tests of causality.
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Although risk factors often co-occur, previous studies examining lifestyle or psychosocial factors often treat these factors as individual predictors of health. This study aims to identify the underlying subgroups of women characterized by distinct lifestyle and psychosocial risk patterns and to investigate the prospective associations between risk patterns and mortality among postmenopausal women. ⋯ The class with concurrent risky lifestyle and psychosocial factors conveyed the greatest risk of all types of mortality than a low-risk ref group. Health promotion should address both behavioral and psychosocial risks concurrently.
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Regional partnerships between public health organizations and telehealth programs have the potential to expand access to HIV pre-exposure prophylaxis in rural and small urban areas. However, little is known about the best practices for such partnerships. Iowa TelePrEP, a regional public health‒partnered telehealth model created by the Iowa Department of Public Health and the University of Iowa, expanded statewide between 2017 and 2019. This qualitative evaluation assessed the barriers and facilitators to statewide expansion and the lessons learned. ⋯ Partnerships between regional telehealth programs and local health departments can expand to the state level and increase the capacity to implement pre-exposure prophylaxis in rural and small urban settings. Partnerships should consider how to balance program adaptability to local public health partners with standardization and scalability.