Publications by authors named "Amy Baugher"

Background: Medications for opioid use disorder (MOUD) are key to preventing opioid overdose. Despite the high risk of opioid overdose among recently incarcerated people who use drugs, missed opportunities for engagement in MOUD treatment persist in this population. We examined the association between unmet need for MOUD and non-fatal opioid overdose among recently incarcerated people who inject drugs (PWID) and assessed prevalence of non-fatal opioid overdose by selected characteristics.

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Background: Transgender women continue to face a significant burden of health disparities with HIV infection as a critical public health concern. Substance use is higher among transgender women than among cisgender women. However, little is known about transgender women who inject drugs and risk for HIV in the United States.

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Objective: This study is to compare socio-demographic, HIV testing, and prevention factors experienced by insured low-income heterosexual Black women and men.

Methods: We examined cross-sectional data from Black women and men (n = 5837) recruited in 23 U.S.

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Article Synopsis
  • The study aimed to identify social determinants of health (SDOH) that explain racial/ethnic differences in adherence to antiretroviral therapy (ART) and sustained viral suppression (SVS) among HIV-positive men who have sex with men (MSM) in the U.S.
  • Researchers used data from the Medical Monitoring Project (2017-2021) to compare the prevalence of ART adherence and SVS between Black (BMSM), Hispanic/Latino (HMSM), and White MSM (WMSM).
  • Results showed that adjusting for factors like age, poverty, food insecurity, and homelessness significantly reduced the disparities in ART adherence and SVS, suggesting that addressing these factors could enhance health equity for MSM
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Transgender women experience high prevalence of homelessness, which can affect their likelihood of acquiring HIV infection and can lead to poor medical outcomes. CDC analyzed data from the National HIV Behavioral Surveillance Among Transgender Women to identify whether personal characteristics and social factors affecting transgender women were associated with duration of homelessness during the past 12 months. Longer duration and chronic homelessness might indicate greater unmet needs, which increases their likelihood for acquiring HIV infection.

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Transgender women experience discrimination in many settings, including in employment. Because employment and health insurance are intertwined in the United States, employment discrimination might be related to lower health insurance coverage and health care use, including gender-affirming care. This analysis used data from transgender women (N = 1,608) in seven urban areas in the United States collected during 2019-2020 to present the prevalence of six discrimination types (employment, housing, bathroom, businesses, health care, and abuse) and to measure the association between employment discrimination (defined as trouble getting a job or fired due to being transgender) and sociodemographic characteristics, health care access, and health care use.

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Article Synopsis
  • Experiences of stigma and discrimination in healthcare settings significantly negatively impact the health outcomes of persons with HIV (PWH), particularly those with multiple marginalized identities.
  • A study using data from the Medical Monitoring Project found that nearly 25% of PWH reported intersectional discrimination linked to various characteristics like race, sexual orientation, and socioeconomic status.
  • Those facing intersectional discrimination were less likely to engage with regular HIV care providers, trust healthcare information, or adhere to antiretroviral treatment, suggesting the need for further research on these experiences to improve care and intervention strategies.
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Importance: HIV self-testing (HIVST) is a promising strategy to expand the HIV care continuum, particularly among priority populations at high risk of HIV infection. However, little is known about HIVST uptake among men who have sex with men (MSM) outside of clinical trial settings.

Objective: To evaluate HIVST use among urban MSM in the US who reported testing within the past 12 months.

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National prevalence of physical and sexual violence and its relationship to sexual behaviors are unknown among men who have sex with men (MSM). We estimated 12-month prevalence of physical and sexual violence and assessed relationships between violence and sexual behaviors among MSM. Data were obtained from National HIV Behavioral Surveillance 2017 that used time-space sampling methods to recruit and interview MSM in 22 U.

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Sexuality disclosure among men who have sex with men (MSM) is key in access to HIV prevention services. We used weighted 2017 data from National HIV Behavioral Surveillance to investigate prevalence of, and racial/ethnic differences in, sexuality disclosure among MSM. Of 10,753 MSM, 89.

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In 2019, heterosexual sex accounted for 23% of new HIV diagnoses in the United States and six dependent areas (1). Although preexposure prophylaxis (PrEP) can safely reduce the risk for HIV infection among heterosexual persons, this group is underrepresented in PrEP research (2). CDC analyzed National HIV Behavioral Surveillance (NHBS) data to describe PrEP awareness among heterosexually active adults in cities with high HIV prevalence.

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Objectives: To examine the association between HIV laws, perceived community stigma, and behaviors and to compare differences between and within Black and White men who have sex with men (MSM).

Design/methods: National HIV Behavioral Surveillance conducted interviews and HIV testing with MSM in 23 U.S.

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Introduction: Intimate partner violence is associated with adverse health consequences among people with diagnosed HIV, which could have implications for disease progression and transmission. However, nationally representative estimates of intimate partner violence among people with diagnosed HIV are lacking. Investigators used nationally representative data to estimate the prevalence of physical violence by an intimate partner among adults with diagnosed HIV and examine the differences by selected characteristics.

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To compare health care coverage and utilization between men who have sex with men (MSM) in Medicaid expansion versus nonexpansion states. We used cross-sectional weighted data from the National HIV Behavioral Surveillance system, which used venue-based methods to interview and test MSM in 22 US cities from June through December, 2017 (n = 8857). We compared MSM in Medicaid expansion versus nonexpansion states by using the Rao-Scott χ test stratified by HIV status.

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Objectives: To determine the prevalence of four forms of sexual identity discrimination among MSM in 23 US metropolitan statistical areas, examine racial/ethnic and socioeconomic disparities in each form of discrimination.

Methods: We examined interview data collected during 2017 for National HIV Behavioral Surveillance (n = 10 029 respondents) and used generalized linear models to assess the association between the prevalence of reported discrimination during the previous 12 months and selected sociodemographic groups.

Results: Overall, 34% of participants reported experiencing verbal discrimination; 16%, discrimination in a workplace, school, or a healthcare setting; and 8%, physical assault.

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Background: Medicaid expansion under the Affordable Care Act increased insurance coverage, access to healthcare, and substance use disorder treatment, for many Americans. We assessed differences in healthcare access and utilization among persons who inject drugs (PWID) by state Medicaid expansion status.

Methods: In 2018, PWID were interviewed in 22 US cities for National HIV Behavioral Surveillance.

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The rate of diagnosis of human immunodeficiency virus (HIV) infection among American Indians and Alaska Natives (AI/ANs) in 2016 (10.2 per 100,000 population) was the fourth highest among seven racial/ethnic groups in the United States (1); the number of diagnoses of HIV infection among AI/AN persons increased by 70%, from 143 in 2011 to 243 in 2016 (1). However, little has been published about the sociodemographic, behavioral, and clinical characteristics of AI/AN patients with HIV infection in care because small sample sizes have led to infrequent analysis of AI/AN-specific estimates (2) and because of underestimation of AI/AN race/ethnicity in surveillance and other data sources (3).

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The prevalence of discrimination in healthcare settings among HIV patients in the United States is unknown. The Medical Monitoring Project (MMP) is a complex sample survey of adults receiving HIV medical care in the United States. We analyzed nationally representative MMP data collected 2011-2015.

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: Discrimination in healthcare settings is a barrier to healthcare engagement. We analyzed two nationally representative datasets to assess change in discrimination in healthcare settings reported by HIV patients from 1996 to 2011-2013. Perceived discrimination in healthcare settings significantly decreased over time, from 24% in 1996 to 15% in 2011-2013.

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HIV-infected U.S. adults have reported internalized HIV-related stigma; however, the national prevalence of stigma is unknown.

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Introduction: Annually eight million emergency department (ED) visits are attributable to alcohol use. Screening ED patients for at-risk alcohol and substance use is an integral component of screening, brief intervention, and referral to treatment programs, shown to be effective at reducing substance use. The objective is to evaluate ED patients' acceptance of and willingness to disclose alcohol/substance use via a computer kiosk versus an in-person interview.

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