Publications by authors named "B Enns"

Article Synopsis
  • The US "Ending the HIV Epidemic" initiative targets four counties in the Atlanta area to significantly decrease HIV cases by 2030, necessitating a closer look at local resources and needs related to HIV services.
  • A mixed-methods study was conducted using 2021 data to identify disparities in HIV prevalence and service distribution, including an online survey of local health stakeholders to measure service availability and organizational readiness.
  • The results highlighted significant racial and geographic inequities, particularly in HIV testing and PrEP access, with several counties not prioritized by the initiative reporting high unmet needs for various HIV-related services.
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Introduction: Improving the delivery of existing evidence-based interventions to prevent and diagnose HIV is key to Ending the HIV Epidemic in the United States. Structural barriers in the access and delivery of related health services require municipal or state-level policy changes; however, suboptimal implementation can be addressed directly through interventions designed to improve the reach, effectiveness, adoption or maintenance of available interventions. Our objective was to estimate the cost-effectiveness and potential epidemiological impact of six real-world implementation interventions designed to address these barriers and increase the scale of delivery of interventions for HIV testing and pre-exposure prophylaxis (PrEP) in three US metropolitan areas.

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Background: Despite significant progress in HIV treatment and prevention, the US remains far from its goal of 'Ending the HIV Epidemic' by 2030. Economic models using local data can synthesise the evidence to help policymakers allocate HIV resources efficiently, but persistent research-to-practice gaps remain. Little is known about how to facilitate the use of economic modelling data among local public health policymakers in real-world settings.

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Background: Instrumental variable (IV) analysis provides an alternative set of identification assumptions in the presence of uncontrolled confounding when attempting to estimate causal effects. Our objective was to evaluate the suitability of measures of prescriber preference and calendar time as potential IVs to evaluate the comparative effectiveness of buprenorphine/naloxone versus methadone for treatment of opioid use disorder (OUD).

Methods: Using linked population-level health administrative data, we constructed five IVs: prescribing preference at the individual, facility, and region levels (continuous and categorical variables), calendar time, and a binary prescriber's preference IV in analyzing the treatment assignment-treatment discontinuation association using both incident-user and prevalent-new-user designs.

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Article Synopsis
  • The US initiative wants to cut down new HIV cases by 90% by 2030 and help different racial and ethnic groups who are more affected by HIV.
  • In Miami-Dade County, researchers used a model to see how different strategies could help reduce new HIV infections by 2030, especially by providing more access to testing and treatment.
  • They found that focusing on Hispanic/Latinx men who have sex with men and encouraging them to use preventive medicine could reduce new infections a lot, but more work is needed to fully reach their goals.
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