Publications by authors named "Feelemyer J"

We used results from an optimization randomized controlled trial which tested five behavioral intervention components to support HIV antiretroviral adherence/HIV viral suppression, grounded in the multiphase optimization strategy and using a fractional factorial design to identify intervention components with cost-effectiveness sufficiently favorable for scalability. Results were incorporated into a validated HIV computer simulation to simulate longer-term effects of combinations of components on health and costs. We simulated the 32 corresponding long-term trajectories for viral load suppression, health related quality of life (HRQoL), and costs.

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Background: Black sexual minority men and Black transgender women (BSMM/BTW) experience disproportionate levels of HIV/STI-related risk factors as well as police harassment (PH). PH is linked to psychiatric risk and could play a role in substance use, sexual risk behavior, and HIV/STI risk.

Methods: We used data from the HIV Prevention Trials Network 061(HPTN 061) study to examine associations between PH and HIV/STI-related outcomes.

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Background: Given the disproportionate rates of incarceration and lower life expectancy (LE) among Black sexual minority men (BSMM) and Black transgender women (BTW) with HIV, we modeled the impact of decarceration and screening for psychiatric conditions and substance use on LE of US BSMM/BTW with HIV.

Methods: We augmented a microsimulation model previously validated to predict LE and leading causes of death in the US with estimates from the HPTN 061 cohort and the Veteran's Aging Cohort Studies. We estimated independent associations among psychiatric and substance use disorders, to simulate the influence of treatment of one condition on improvement on others.

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Background: The co-occurrence of substance use disorder and mental disorder, known as dual diagnosis, has a distressingly high prevalence among individuals grappling with either of these conditions. Mood disorders, especially depression, constitute a substantial burden for People Who Inject Drugs (PWID) and a significant public health concern in Vietnam. Identifying risk factors for depression in PWID is imperative for the development of targeted interventions.

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Incarceration can lead to different risk behaviors often due to increased distress and disruption of social networks. It is not well known, however, how these associations may differ by age. In this study, we measure age differences in longitudinal associations between incarceration and substance use, sex risk, and sexually transmitted infection (STI) among Black sexual minority men and Black transgender women (BSMM/BTW).

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Article Synopsis
  • - The study evaluated the effectiveness of self-reported adherence to antiretroviral therapy (ART) as a substitute for HIV viral load testing among people who inject drugs (PWID) in Hai Phong, Vietnam.
  • - Researchers analyzed data from 792 PWID over two years, focusing on the accuracy of self-reporting ART adherence and its correlation with actual HIV viral load levels, finding a positive predictive value (PPV) above 90%.
  • - The findings indicate that in settings lacking access to viral load testing, self-reported ART adherence could help prioritize which PWID may need viral load testing, with high adherence generally suggesting effective HIV suppression regardless of recent methamphetamine use.
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US correctional facilities operate under a binary interpretation of gender, which can yield inherent risks and conflicts for incarcerated transgender people. We conducted a scoping literature review on challenges unique to transgender individuals within US correctional settings. Online databases were searched to identify papers that addressed the challenges of incarcerated transgender adults age 18 + within US correctional institutions.

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Background: Towards hepatitis C elimination among people who inject drugs (PWID), we assessed the effectiveness of a strategy consisting of a community-based respondent-driven sampling (RDS) as wide screening, a simplified and integrated hospital-based care, and prevention of reinfection supported by community-based organisations (CBO), in Hai Phong, Vietnam.

Methods: Adults who injected heroin were enrolled in a RDS survey implemented in two CBO premises. Rapid HIV and HCV tests were done on site, and blood was taken for HCV RNA testing.

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Objective: Evaluate associations between racialized and homophobia-based police harassment (RHBPH) and healthcare distrust and utilization among Black Sexual Minority Men (BSMM).

Methods: We utilized data from a longitudinal cohort study from HIV Prevention Trials Network (HPTN) 061 with baseline, six and 12 month follow-up assessments. Using multivariable analysis, we evaluated associations between RHBPH and healthcare distrust and utilization reported at the 6 and 12 month visits.

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Background: We examined non-fatal drug overdoses during the COVID-19 pandemic among persons who inject drugs (PWID) in New York City (NYC).

Methods: We recruited 275 PWID through respondent driven sampling and staff outreach from Oct. 2021-Sept.

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This study aimed to field tested the "Avoid the Needle" (AtN) intervention to reduce transitions from non-injecting to injecting drug use in two different epidemiological settings. Respondent driven sampling was used to recruit current non-injecting drug users (NIDUs) in Tallinn, Estonia in 2018-19 and in New York City (NYC) in 2019-20. Both persons who had never injected and persons who had previously injected but not in the last 6 months were eligible; a structured interview was administered, a blood sample collected, and the intervention administered by trained interventionists.

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Background: To examine COVID-19 vaccination and HIV transmission among persons who inject drugs (PWID) during the COVID-19 pandemic (2020-2022) in New York City (NYC).

Methods: Two hundred and seventy five PWID were recruited from October 2021 to September 2022. A structured questionnaire was used to measure demographics, drug use behaviors, overdose experiences, substance use treatment history, COVID-19 infection, vaccination, and attitudes.

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Objective: To compare COVID-19 stigmatization at two pandemic time points (1) August 2020-during lockdowns and prior to vaccine rollout, and (2) May 2021-during vaccine rollout, when approximately half of U.S. adults were vaccinated.

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There is strong evidence linking stimulant use, namely methamphetamine use, to sexual risk behavior among sexual minority men (SMM); we do not, however, have a good understanding of this relationship among other at-risk populations. In this study, we systematically reviewed associations between stimulant use (i.e.

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Incarceration among Black sexual minority men and Black transgender women (BSMM/BTW) is disproportionately high in the United States. Limited research has documented the disruptive effect of incarceration on sexual networks and sexual partnership exchange among BSMM/BTW. We estimate the influence of incarceration on selling sex and mediating pathways among 1169 BSMM/BTW enrolled in the HIV Prevention Trials Network (HPTN) 061 cohort to assess this relationship.

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Background: People who inject drugs (PWID) are a key population for the prevention and care of HIV infection.

Methods: This scoping review covers recent (post-2010) systematic reviews on engagement of PWID in sequential stages of HIV care from uptake, to achieving viral suppression, and to avoiding AIDS-related mortality.

Results: We found that data on engagement of PWID into antiretroviral therapy (ART) were particularly scarce, but generally indicated very low engagement in ART.

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Background: There has been a significant increase in methamphetamine use among persons who use drugs in Vietnam in the last 5-10 years. We examined the degree to which adherence to antiretroviral therapy (ART) mediates the relationship between recent methamphetamine use and unsuppressed HIV viral load among people who inject drugs (PWID) in Hai Phong, Vietnam.

Methods: We recruited PWID from October 2016-October 2018 and enrolled HIV positive PWID into a cohort, with up to three years of total follow-up.

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Article Synopsis
  • A study in Hai Phong, Vietnam, analyzed gender differences among people who inject drugs (PWID) from 2016 to 2018, recruiting 3146 participants, including 155 female PWID, using respondent-driven-sampling surveys.
  • The average age of female PWID was 36.3 years, and most had low education levels (90.9% without high school) and unemployment (51.3%).
  • While there was no gender difference in HIV and HCV positivity, women showed distinct risk behaviors, such as higher unemployment, involvement in sex work, unstable housing, shorter drug use duration, methamphetamine use, and less access to methadone treatment, indicating a need for targeted interventions.
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HIV/HCV prevention among people who inject drugs (PWID) is of key public health importance. We aimed to assess the impact of COVID-19 and associated response measures on HIV/HCV prevention services and socio-economic status of PWID in high-HIV-risk sites. Sites with recent (2011-2019) HIV outbreaks among PWID in Europe North America and Israel, that had been previously identified, were contacted early May 2020.

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People who inject drugs (PWID) are a population exposed to many genotoxicants and with a high prevalence of HCV infection. Direct-acting antiviral (DAA) regimens are now widely used to treat chronic HCV infection. Although side effects to treatment are currently rare, the long-term effects such as suspicions of de novo hepatocellular carcinoma (HCC) occurrence or HCC recurrence and cardiac defects are still up for debate.

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Background: After the emergence of COVID-19, a one-month strict lockdown was imposed in April 2020 in Vietnam, followed by lighter social distancing restrictions over the year. We investigated whether those measures affected people who inject drugs (PWID) in terms of risk behaviors for HIV and HCV and access to prevention and care in the city of Haiphong, a historic hotspot for HIV and drug use.

Methodology: We carried out a 'before-after' study from 2019 to 2020 using respondent-driven sampling method to enroll PWID.

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Support from social networks buffers against negative effects of stress but is disrupted by incarceration. Few studies examine incarceration, social support networks, and health among Black sexual minority men (BSMM) and Black transgender women (BTW). We conducted a secondary analysis using HIV Prevention Trials Network 061 (HPTN 061), a sample of BSMM/BTW recruited from six US cities.

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Many syringe services programs (SSPs) have established trusting, long-term relationships with their clients and are well situated to provide COVID-19 vaccinations. We examined characteristics and practices of SSPs in the United States that reported providing COVID-19 vaccinations to their clients and obstacles to vaccinating people who inject drugs (PWID). We surveyed SSPs in September 2021 to examine COVID-19 vaccination practices through a supplement to the 2020 Dave Purchase Memorial survey.

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Article Synopsis
  • The study analyzed HIV incidence rates among people who inject drugs (PWID) in New York City from 2012 to 2019, noting that incidence was very low (<0.1/100 person-years) even as prevention services were disrupted by the COVID-19 pandemic.
  • An Agent-Based model was used to simulate syringe sharing behavior and measure the impact on HIV transmission risk, incorporating data from ongoing substance use treatment studies in NYC, which found that about 15% of participants were still sharing syringes.
  • Findings indicated that while HIV incidence remained low, potential disruptions due to COVID-19 could significantly increase the risk of an outbreak, highlighting the need to quickly restore HIV prevention services to manage the risk among PWID.
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Article Synopsis
  • In low-to-middle-income countries, HIV control among people who inject drugs (PWID) is challenging, and this study aimed to improve identification and treatment of HIV-positive PWID in Haiphong, Vietnam.
  • The intervention involved mass HIV screening through three annual respondent-driven sampling surveys and peer support to enhance access to treatment, resulting in a significant decrease in HIV viremia among screened individuals.
  • The findings indicated that 41.2% of previously untreated HIV-positive PWID achieved viral suppression, demonstrating that community-based screening and support can effectively link these individuals to essential healthcare.
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