Publications by authors named "Buchacz K"

Article Synopsis
  • - The study aimed to evaluate the effects of the COVID-19 pandemic on the health of people who inject drugs (PWID) using a collaborative data-sharing model established in 2021, which pooled data from multiple studies across North America.
  • - Researchers analyzed data on various health indicators (like substance use treatment and mental health conditions) over four different time periods: pre-pandemic, early-pandemic, mid-pandemic, and late-pandemic, involving 6,213 PWID participants.
  • - The results showed minimal changes in health indicators throughout the pandemic, suggesting stability possibly due to policy adjustments and resilience in support services for PWID, highlighting the potential of the data-sharing model for better health insights.
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  • * Data from the Medical Monitoring Project (2017-2022) shows that among PWH aged 50 and older, significant gaps remain in achieving these goals, with only hunger reduction meeting the 2025 target thus far.
  • * To hit the 2025 QoL objectives, there needs to be a coordinated effort to enhance access to essential resources like housing, job opportunities, food, and mental health services
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Data from the CDC's Medical Monitoring Project indicate that the United States is on track to meet one of five National HIV/AIDS Strategy (NHAS) Quality of Life goals among cisgender Black women, specifically, hunger/food insecurity. Substantial work needs to be done to improve self-rated health and to decrease unmet need for mental health services. Enhanced and coordinated action are necessary to reach all Quality of Life goals in this NHAS priority population.

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  • People with HIV have a higher prevalence of hypertension (66%) compared to those without HIV (54%), with a statistically significant adjusted prevalence ratio of 1.14.
  • Among those with hypertension, people with HIV are more likely to have controlled hypertension compared to those without, indicating better management of the condition.
  • The study also highlights geographic and racial disparities, showing that Black individuals with HIV are less likely to have controlled hypertension and those from the Southern U.S. have higher hypertension rates compared to those from the Northeast.
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This article aimed at analyzing the acute impact and the longer-term recovery of COVID-19 pandemic effects on clinical encounter types, HIV viral load (VL) testing, and suppression (HIV VL < 200 copies/mL). This study was a longitudinal cohort study of participants seen during 2019-2022 at nine HIV Outpatient Study (HOPS) sites. Generalized linear mixed models (GLMMs) estimated monthly rates of all encounters, office and telemedicine visits, and HIV VL tests using 2010-2022 data.

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People with human immunodeficiency virus (PWH) are disproportionately affected by depression, but the recent national estimates for US PWH encompassing both current symptoms and clinical diagnoses to assess missed diagnoses and lack of symptom remission are lacking. We used data from CDC's Medical Monitoring Project (MMP) to report nationally representative estimates of diagnosed and undiagnosed depression among US adult PWH. During June 2021 to May 2022, MMP collected interview data on symptoms consistent with major or other depression and depression diagnoses from medical records of 3928 PWH.

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  • This study evaluated the connection between self-rated health (SRH) and care outcomes in U.S. adults with HIV, analyzing data from a nationally representative sample of 3,692 individuals.
  • The results showed that 72% reported "good or better" SRH, but certain factors like missed appointments, depression and anxiety symptoms, unstable housing, and food insecurity were linked to lower SRH.
  • The authors suggest that addressing these non-physical health needs, along with improving mental health and housing stability, could enhance SRH among people living with HIV in the U.S.
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Background: Approximately 2 in 5 persons with HIV (PWH) in the United States are aged 55 years or older. HIV ancillary services, such as case management and transportation services, can help older PWH remain engaged in care. We used data from the Medical Monitoring Project (MMP) to describe the prevalence of unmet needs for ancillary services among persons with diagnosed HIV aged 55 years or older.

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Current U.S. guidelines recommend integrase strand transfer inhibitor (INSTI)-based antiretroviral therapy (ART) as initial treatment for people with HIV (PWH).

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People with HIV (PWH) can now enjoy longer, healthier lives due to safe and highly effective antiretroviral therapy (ART), and improved care and prevention strategies. New drug formulations such as long-acting injectables (LAI) may overcome some limitations and issues with oral antiretroviral therapy and strengthen medication adherence. However, challenges and questions remain regarding their use in aging populations.

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  • The study focused on assessing HIV risk behaviors in men who have sex with men (MSM) to evaluate their eligibility for blood donation based on individual risk assessments.
  • Conducted in eight U.S. cities, the research involved surveys and blood tests for HIV and tenofovir, a PrEP drug, among sexually active MSM aged 18-39.
  • Results showed that about 50% of the participants were not using PrEP, and many reported lower-risk sexual behaviors, suggesting that a significant portion could be eligible to donate blood based on their risk profiles.
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The Centers for Disease Control and Prevention Minority HIV Research Initiative (MARI) funded 8 investigators in 2016 to develop HIV prevention and treatment interventions in highly affected communities. We describe MARI studies who used community-based participatory research methods to inform the development of interventions in Black/African American and Hispanic/Latinx communities focused on sexual minority men (SMM) or heterosexual populations. Each study implemented best practice strategies for engaging with communities, informing recruitment strategies, navigating through the impacts of COVID-19, and disseminating findings.

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Background: People who inject drugs (PWID) have likely borne disproportionate health consequences of the COVID-19 pandemic. PWID experienced both interruptions and changes to drug supply and delivery modes of harm reduction, treatment, and other medical services, leading to potentially increased risks for HIV, hepatitis C virus (HCV), and overdose. Given surveillance and research disruptions, proximal, indirect indicators of infectious diseases and overdose should be developed for timely measurement of health effects of the pandemic on PWID.

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Background: The timing and magnitude of antiretroviral therapy-associated weight change attributions are unclear.

Setting: HIV Outpatient Study participants.

Methods: We analyzed 2007-2018 records of virally suppressed (VS) persons without integrase inhibitor (INSTI) experience who switched to either INSTI-based or another non-INSTI-based ART, and remained VS.

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Background: In 2012, the US Department of Health and Human Services updated their HIV treatment guidelines to recommend antiretroviral therapy (ART) for all people with HIV (PWH) regardless of CD4 count. We investigated recent trends and disparities in early receipt of ART prescription and subsequent viral suppression (VS).

Methods: We examined data from ART-naïve PWH newly presenting to HIV care at 13 North American AIDS Cohort Collaboration on Research and Design clinical cohorts in the United States during 2012-2018.

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Objective: Describe engagement in HIV care over time after initial engagement in HIV care, by gender identity.

Design: Observational, clinical cohort study of people with HIV engaged in routine HIV care across the United States.

Methods: We followed people with HIV who linked to and engaged in clinical care (attending ≥2 visits in 12 months) in cohorts in the North American Transgender Cohort Collaboration, 2000-2018.

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Background: Public health data signal increases in the number of people who inject drugs (PWID) in the United States during the past decade. An updated PWID population size estimate is critical for informing interventions and policies aiming to reduce injection-associated infections and overdose, as well as to provide a baseline for assessments of pandemic-related changes in injection drug use.

Methods: We used a modified multiplier approach to estimate the number of adults who injected drugs in the United States in 2018.

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The U.S. Public Health Service (PHS) has periodically published recommendations about reducing the risk for transmission of HIV, hepatitis B virus (HBV), and hepatitis C virus (HCV) through solid organ transplantation (1-4).

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Persons who inject drugs (PWID) and exchange sex face disproportionate HIV rates. We assessed prevalence of exchange sex (receiving money/drugs for sex from ≥ 1 male partner(s) during the past year) among cisgender PWID, separately for women and men with a history of sex with men (MSM). We examined factors associated with exchange sex, including sociodemographic characteristics, sexual and drug use behaviors, and healthcare access/utilization.

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Pre-exposure prophylaxis (PrEP) is highly effective in preventing new HIV infection, but uptake remains challenging among Black and Hispanic/Latino persons. The purpose of this review was to understand how studies have used electronic telecommunication technology to increase awareness, uptake, adherence, and persistence in PrEP care among Black and Hispanic/Latino persons and how it can reduce social and structural barriers that contribute to disparities in HIV infection. Of the 1114 articles identified, 10 studies were eligible.

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Attention to non-AIDS comorbidities is increasingly important in the HIV care and management in the United States. We sought to assess comorbidities before and after antiretroviral therapy (ART) initiation among persons with HIV (PWH). Using the 2008-2018 HIV Outpatient Study (HOPS) data, we assessed changes in prevalence of physical and psychiatric comorbidities, by sex, among participants initiating ART.

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During 2007-2019, the percentage of HIV Outpatient Study participants reporting anal or vaginal condomless sex in the past 6 months ranged from a low of 17% among heterosexual males to 59% for men who have sex with men (MSM). MSM reported having had condomless sex more frequently than heterosexual males and females and were the only group in which an increase in condomless sex was observed during the study period (from 39 to 59%). Although persons with undetectable HIV viral load have effectively no risk of transmitting HIV sexually (U = U), there is still the potential risk of transmission or acquisition of other sexually transmitted infections (STIs) when engaging in condomless sex.

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