Publications by authors named "Jeffrey Wiener"
Article Synopsis
- Male-to-male sexual transmission is the leading cause of new HIV diagnoses in the U.S., highlighting the need for updated data on men who have sex with men (MSM) to inform public health strategies.
- This analysis estimated the number and percentage of MSM in the U.S. using data from five population-based surveys, focusing on sexual behavior and self-reported identity over different time periods.
- The findings revealed that approximately 4.2 million MSM reside in the U.S., with varying percentages reporting sexual activity with other men over the past year, five years, and their lifetime, indicating the necessity for targeted health interventions.
Article Synopsis
- Many young women globally experience the dual challenges of HIV and unintended pregnancies, highlighting the need for multipurpose prevention technologies.
- A study involving 312 healthy women aged 18-34 randomized participants to use either a tenofovir/levonorgestrel (TFV/LNG), TFV-only, or placebo intravaginal ring to assess safety and effectiveness.
- Results showed that both TFV IVR groups demonstrated significant increases in HIV inhibition in cervicovaginal fluid, with no serious adverse effects linked to the products, indicating their potential as safe prevention methods.
Article Synopsis
- In 2012, the CDC set goals to eliminate perinatal HIV transmission in the US, aiming for less than one case per 100,000 live births and a transmission rate of under 1%.
- From 2010 to 2019, the number of live births to HIV-positive women and perinatally acquired HIV cases both significantly declined, with diagnosis rates dropping from 1.9 to 0.9 per 100,000 live births.
- Despite progress, racial and ethnic disparities in HIV diagnosis still existed but improved, highlighting the need for ongoing coordinated healthcare efforts to sustain these gains and expand the model to other public health challenges.
Article Synopsis
- The study focused on the impact of HIV prevention services on Hispanic/Latino men who have sex with men (MSM) and transgender women (TGW) as part of a larger project called THRIVE, which ran from 2015 to 2020.
- Results showed that health services tailored to Hispanic/Latino populations improved access to pre-exposure prophylaxis (PrEP), with higher prescription rates found at sites offering these focused services compared to others.
- The overall conclusion suggests that creating Hispanic/Latino-oriented clinical settings can significantly enhance HIV prevention efforts within these communities.
We developed an ad hoc method to estimate the number of excess deaths among persons with HIV (PWH) during the coronavirus disease 2019 (COVID-19) pandemic in the United States. Using this method, we estimated approximately 1448 excess deaths from COVID-19 among PWH in 2020 in the United States. We also developed an Excel workbook for use as a tool to quickly assess excess deaths among PWH in settings with limited surveillance data.
View Article and Find Full Text PDFBackground And Setting: From 2015 to 2020, the THRIVE project supported 7 US health departments to improve HIV prevention services for Black or African American (Black) and Hispanic or Latino gay, bisexual, and other men who have sex with men (GBM) and transgender women (TGW).
Methods: We described services provided in the THRIVE PrEP continuum. Using Poisson regression models, we estimated associations between race or ethnicity and age and PrEP screening, linkage, and prescription.
HIV Services and Outcomes During the COVID-19 Pandemic - United States, 2019-2021.
MMWR Morb Mortal Wkly Rep
December 2022
Increasing HIV testing, preexposure prophylaxis (PrEP), and antiretroviral therapy (ART) are pillars of the federal Ending the HIV Epidemic in the U.S. (EHE) initiative, with a goal of decreasing new HIV infections by 90% by 2030.
View Article and Find Full Text PDFArticle Synopsis
- Black and Hispanic/Latino men who have sex with men (MSM) are significantly affected by HIV, prompting the creation of the THRIVE project, which provides targeted prevention services in seven community collaboratives.
- Analysis of HIV diagnosis data from 2014 to 2019 showed that those in THRIVE areas experienced greater declines in HIV diagnoses compared to similar areas without THRIVE funding, particularly among Black and Hispanic/Latino MSM.
- The results underline the effectiveness of the THRIVE model, suggesting that to meet the US goal of ending the HIV epidemic, more focus is needed on increasing preexposure prophylaxis (PrEP) among Black and Hispanic/Latino MSM.
Few studies investigating daily oral preexposure prophylaxis (PrEP) focus on transgender persons. The Sustainable Health Center Implementation PrEP Pilot (SHIPP) Study included a large observational cohort of transgender persons with implications for PrEP in the United States. We examined data from SHIPP's observational cohort and its Medication Adherence Substudy (MAS) to understand adherence among transgender participants in Chicago, IL.
View Article and Find Full Text PDFObjective: To assess disruption in healthcare services for HIV treatment by national emergency in response to the coronavirus disease 2019 (COVID-19) pandemic in the United States.
Design: Time-series analysis.
Methods: We analyzed the IQVIA Real World Data-Longitudinal Prescriptions Database and calculated time trends in the weekly number of persons with active antiretroviral prescriptions for HIV treatment, and of persons who obtained antiretroviral prescriptions during January 2017-March 2021.
In a phase-IIa trial, we investigated the influence of 90 days continuous-delivery tenofovir (TFV) intravaginal rings (IVRs) with/without levonorgestrel (LNG) on the genital microbiota of Kenyan women. Eligible women (n = 27; 18-34 years; negative for HIV, sexually transmitted infections, and Amsel-bacterial vaginosis) were randomized 2:2:1 to use of IVRs containing TFV, TFV/LNG, or placebo. Using vaginal wall and IVR swabs at IVR insertion and removal, the genital microbial composition was determined using 16S rRNA gene sequencing.
View Article and Find Full Text PDFArticle Synopsis
- - The study investigated how the COVID-19 pandemic affected HIV pre-exposure prophylaxis (PrEP) prescriptions in the U.S. from March 2020 to March 2021, using data to project expected prescriptions without the pandemic.
- - It found that the pandemic led to a 22% decrease in PrEP prescriptions and a 25% drop in new PrEP users compared to predicted numbers.
- - The impact was particularly significant among younger individuals and those with commercial insurance, emphasizing the need for better access to HIV prevention during public health crises.
Article Synopsis
- The highest number of new HIV diagnoses occurs in the South, where many at-risk individuals are not engaging with pre-exposure prophylaxis (PrEP) care.
- A study of National HIV Behavioral Surveillance data showed low awareness and use of PrEP, especially among heterosexuals (7%) compared to men who have sex with men (85%).
- Overall, PrEP use was low (≤ 35%) across all groups, with no significant differences found between individuals in the South and those in other regions, highlighting a need for increased efforts to promote PrEP use.
Background: The suppression of viremia among persons with HIV (PWH) using antiretroviral therapy has been hypothesized to reduce HIV incidence at the population level. We investigated the impact of state level viral suppression among PWH in the United States on estimated HIV incidence between 2010 and 2015.
Methods: Viral suppression data and HIV incidence estimates from the National HIV Surveillance System were available from 29 states and the District of Columbia.
Poor access to HIV viral load (VL) testing prevents the timely monitoring of HIV treatment adherence and efficacy. Factors enabling clinical benefits of VL testing when added to local standards of care, can inform the development of more cost-effective routine VL scale-up plans. We compared antiretroviral therapy (ART) switch practices in 13 clinics across 6 countries, with full ( = 8), phasing-in ( = 3) or no onsite access ( = 2) to VL.
View Article and Find Full Text PDFArticle Synopsis
- Men and women of color have shown low uptake of pre-exposure prophylaxis (PrEP), with awareness and attitudes toward PrEP influenced by trusted sources of health information.
- A study conducted surveys across community health centers in different U.S. cities, revealing a significant lack of awareness of PrEP among participants, primarily Black and heterosexual individuals.
- Those who relied on health experts and community organizations for PrEP information displayed less negative attitudes towards it, suggesting that improving awareness and attitudes could enhance PrEP usage in communities with high HIV rates.
Objective: To evaluate whether out-of-pocket (OOP) costs reduced HIV pre-exposure prophylaxis (PrEP) persistence.
Data Source: Participants from five urban community health centers (CHCs) in four US cities enrolled in a PrEP demonstration project from September 2014 to August 2017.
Study Design: Patients initiating PrEP were followed quarterly until they withdrew from PrEP care or the study ended.
Background: Progestin contraception has been linked to higher risk of female to male sexual HIV transmission.
Setting: A clinical trial among HIV-infected women in Lilongwe, Malawi, randomized to initiation of depomedroxyprogesterone acetate injectable or levonorgestrel implant, and followed for up to 33 months, with the outcome of HIV shedding in the genital tract.
Methods: We compared the frequency and magnitude of HIV genital shedding before and after initiation of contraception and between study arms among women receiving antiretroviral therapy (ART).
Background: To investigate potential risk factors for perinatal (intrauterine and intrapartum) mother-to-child transmission (MTCT) of HIV in women unexposed to antiretroviral therapy (ART) during pregnancy.
Methods: We compared factors according to perinatal MTCT outcome among 2275 ART-naive (until the onset of labor) HIV-infected women in the Breastfeeding, Antiretrovirals and Nutrition study (2004-2010) in Lilongwe, Malawi. Factors included HIV viral load during pregnancy, food security, demographic characteristics, hematologic and blood chemistry measures, medical history and physical factors.
The effects of maternal tenofovir use on infant bone mineral content (BMC) and bone mineral density (BMD) were evaluated in a pilot study of HIV/Hepatitis B-coinfected pregnant women in China. BMD and BMC were assessed at age 6 months of life in 14 tenofovir-exposed and 13 unexposed infants. Trends toward lower BMC and BMD were observed in infants exposed to maternal tenofovir but were not statistically significant.
View Article and Find Full Text PDFObjective: The United States Public Health Service released clinical practice guidelines for daily oral preexposure prophylaxis (PrEP) in May 2014. Local health departments (LHDs) are expected to play a critical role in PrEP implementation. We surveyed LHDs to assess awareness of and interest in supporting PrEP implementation, what roles they were taking, or believed they should take, in supporting PrEP, and what resources would be required to do so.
View Article and Find Full Text PDFObjectives: To assess the effect of the depot medroxyprogesterone acetate injectable (DMPA) and of the levonorgestrel (LNG) implant on genital HIV shedding among women receiving antiretroviral therapy (ART).
Methods: We randomized HIV-infected Malawian women to either DMPA or LNG implant from May 2014 to April 2015. HIV RNA was measured in cervicovaginal lavage (CVL) fluid and TearFlo Strips (TFS), and HIV DNA was measured in cells collected by CVL.
Objectives: To assess potentially missed sexually transmitted infections (STIs), we compared clinically diagnosed STIs to laboratory-confirmed diagnoses of gonorrhoea (GC), chlamydia (CT) and trichomonas (Tvag).
Design: Secondary analysis of a randomised controlled trial.
Setting: We used data and specimens previously collected for the Sino-Implant Study in Kingston, Jamaica.