Public Health Youth Ambassador Program: Educating and Empowering the Next Generation of Public Health Leaders to Build Thriving Communities.

Through a collaboration among Fairfax County Health Department (FCHD), Fairfax County Public Schools (FCPS), Morehouse School of Medicine (MSM), George Mason University College of Public Health, federally qualified health centers, hospital systems, non-profits, and other agencies, this initiative targets underserved high school students as a way to increase diversity among community health professionals, build generational health, and provide participants with tools to enhance their post-secondary educational and career opportunities.

Risk Factors for Human Papillomavirus-Associated Cancers Among People Living with HIV in Washington, District of Columbia.

District of Columbia (DC) has high rates of HIV infection and human papillomavirus (HPV)-associated cancers. People living with HIV (PLWH) are at risk for developing HPV-associated cancers. Previous studies identified factors that may further increase the risk of HPV-associated cancer among PLWH such as age, race/ethnicity, sex, risk factor for HIV transmission, stage of HIV infection, and age at HIV diagnosis.

Ending the HIV epidemic using National HIV Behavioral Surveillance (NHBS): Recommendations based on DC model.

Introduction: Social network strategies have been used by health departments to identify undiagnosed cases of HIV. Heterosexual cycle (HET4) of National HIV Behavioral Surveillance (NHBS) is a social network strategy implemented in jurisdictions. The main objectives of this research are to 1) evaluate the utility of the NHBS HET cycle data for network analysis; 2) to apply statistical analysis in support of previous HIV research, as well as to develop new research results focused on demographic variables and prevention/intervention with respect to heterosexual HIV risk; and 3) to employ NHBS data to inform policy with respect to the EHE plan.

Examining Retention in HIV Care and HIV Suppression on Housing Services Intake at a Washington, DC Community Based Organization.

In Washington, DC, 2% of residents are living with HIV, with 15.3% of them experiencing homelessness. Additionally, over half of DC-area renters are paying over 30% of their income for housing.

A Spatial Approach for Ending the Human Immunodeficiency Virus Epidemic for the United States-A DC Model.

Background: Mode of transmission-based hotspots is a smart approach to HIV mitigation, yet remains poorly evaluated and implemented in the United States. The primary aim was to identifying mode of transmission-based hotspots and populations at risk of lower viral suppression to assist in targeted planning and implementation of programs.

Methods: We implemented spatial statistics to identify global-local hotspots and regression analysis to find populations at risk of lower viral suppression within hotspots.

Geographic Core Areas of Coinfections in Washington, District of Columbia: Recommendations for Planning Prevention-Intervention to Mitigate Human Immunodeficiency Virus Burden.

Background: Research suggests that human immunodeficiency virus (HIV)-positive individuals with a sexually transmitted infection (STI) may be at increased risk of transmitting HIV to someone else through unprotected sex. The primary aim of the analysis is to identify the high-risk geographic areas of transmission of coinfections and factors that may be associated with poor outcomes of viral suppression within these higher-risk geographic areas, thus important in transmission prevention.

Methods: We used surveillance data reported by all providers and laboratories in the District of Columbia (DC).

Comparison of Clinical Outcomes of Persons Living With HIV by Enrollment Status in Washington, DC: Evaluation of a Large Longitudinal HIV Cohort Study.

Background: HIV cohort studies have been used to assess health outcomes and inform the care and treatment of people living with HIV disease. However, there may be similarities and differences between cohort participants and the general population from which they are drawn.

Objective: The objective of this analysis was to compare people living with HIV who have and have not been enrolled in the DC Cohort study and assess whether participants are a representative citywide sample of people living with HIV in the District of Columbia (DC).

Detecting Spatial Cores and Temporal Trends of Repeat STIs to Plan Pre-exposure Prophylaxis (PrEP) Scale-up in DC.

Background: Repeat sexually transmitted infections (STIs) in DC primarily results from untreated sexual partners. This analysis aims to identify high-risk areas and temporal trends of repeat STIs for pre-exposure prophylaxis scale-up and STI mitigation in DC.

Methods: We identified repeat infections in the DC Department of Health STI and HIV data management systems, diagnosed from 2014 to 2018.

Detecting spatial clusters of HIV and hepatitis coinfections.

Background: People with HIV infection in the United States are often affected by chronic viral hepatitis. These coinfected people with either HBV or HCV are at increased risk for serious, life-threatening complications. Coinfections with viral hepatitis may also complicate the delivery of anti-retroviral therapy (ART) by escalating the risk of drug-related hepatoxicity.

Cross-Jurisdictional Data Exchange Impact on the Estimation of the HIV Population Living in the District of Columbia: Evaluation Study.

Background: Accurate HIV surveillance data are essential to monitor trends to help end the HIV epidemic. Owing to strict policies around data security and confidentiality, HIV surveillance data have not been routinely shared across jurisdictions except a biannual case-by-case review process to identify and remove duplicate cases (Routine Interstate Duplicate Review, RIDR). HIV surveillance estimates for the District of Columbia (DC) are complicated by migration and care seeking throughout the metropolitan area, which includes Maryland and Virginia.

Geographic patterns of poor HIV/AIDS care continuum in District of Columbia.

Background: Concurrent with the UNAIDS 90-90-90 and NHAS plans, the District of Columbia (DC) launched its 90/90/90/50 plan (Plan) in 2015. The Plan proposes that by 2020, 90% of all DC residents will know their HIV status; 90% of residents living with HIV will be in sustained treatment; 90% of those in treatment will reach "Viral Suppression" and DC will achieve 50% reduction of new HIV cases. To achieve these goals targeted prevention strategies are imperative for areas where the relative risk (RR) of not being linked to care (NL), not retained in any care (NRC) and low viral suppression (NVSP) are highest in the District.

Improving HIV Surveillance Data for Public Health Action in Washington, DC: A Novel Multiorganizational Data-Sharing Method.

Background: The National HIV/AIDS Strategy calls for active surveillance programs for human immunodeficiency virus (HIV) to more accurately measure access to and retention in care across the HIV care continuum for persons living with HIV within their jurisdictions and to identify persons who may need public health services. However, traditional public health surveillance methods face substantial technological and privacy-related barriers to data sharing.

Objective: This study developed a novel data-sharing approach to improve the timeliness and quality of HIV surveillance data in three jurisdictions where persons may often travel across the borders of the District of Columbia, Maryland, and Virginia.

The relation of FIMR programs and other perinatal systems initiatives with maternal and child health activities in the community.

Objectives: To evaluate the association of the presence of a fetal and infant mortality review (FIMR) program, other perinatal systems initiative (PSI), or both in a community with the performance of essential maternal and child health (MCH) services by local health departments (LHDs).

Methods: Data were obtained from telephone interviews with professionals from LHDs across the United States. Logistic regression was used to estimate the odds of a LHD conducting each essential MCH service in communities with and without FIMR programs or with and without PSIs, adjusted for geographic area.

The nationwide evaluation of fetal and infant mortality review (FIMR) programs: development and implementation of recommendations and conduct of essential maternal and child health services by FIMR programs.

Objective: An evaluation of fetal and infant mortality review (FIMR) programs nationwide was conducted to characterize their unique role in improving the system of perinatal health care. The aim of this paper is to examine intermediate outcomes of the FIMR, in particular the development and implementation of recommendations produced by the FIMRs and the conduct of essential MCH services by the FIMRs.

Methods: We report on 74 FIMRs whose communities were selected for the nationwide evaluation and for whom we had data from the FIMR director or comparable respondent.

Local health department perspectives on linkages among birthing hospitals.

Objectives: To describe perinatal linkages among hospitals, changes in their numbers and their impact on relationships among high-risk providers in local communities.

Study Design: Data were obtained about the organization of perinatal services in 1996-1999 from a cross-sectional study evaluating fetal and infant mortality review (FIMR) programs nationwide. Geographic areas were sampled based on region, population density, and the presence of a FIMR.

Integrated perinatal health framework. A multiple determinants model with a life span approach.

Background: Despite great strides in improving prenatal care utilization among American women, key perinatal indicators have remained stagnant or worsened in the past decade, and the United States continues to rank near the bottom compared to other developed countries. A new approach is needed if we are to achieve improvements in perinatal health.

Methods: To propose a new framework that integrates a "life span" approach with a multiple determinants model.