Publications by authors named "MCFARLAND W"

Chronic diseases such as osteoporosis and low bone mineral density (BMD) are significant public health concerns for people living with HIV (PLWH), especially with the increased life expectancy because of antiretroviral therapy (ART). This study evaluated the prevalence and associated factors of low BMD among 94 PLWH in Kerman, Iran, from September 2021 to February 2022. Using dual-energy X-ray absorptiometry, BMD was measured, with low BMD defined by specific T-scores and Z-scores.

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Background: Men who have sex with men (MSM) are disproportionately affected by sexually transmitted infections, a disparity that has only worsened in recent years. During the COVID-19 pandemic, an overall increasing trend remained.

Methods: We utilized data from the MSM cycle of the National HIV Behavioral Surveillance (NHBS) study in San Francisco, California, conducted from June 2021 through December 2021, to identify socio-ecological disruptions during the COVID-19 pandemic that were associated with sexually transmitted infections.

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The COVID-19 pandemic has exacerbated prevalence of alcohol use and violence, including gender-based violence (GBV); however, little is understood about the pandemic's impact on the relationship between the two. Data were collected from January 2021-April 2023 with adults who drink alcohol (N = 565) in the San Francisco Bay Area. Questions assessed prevalence of heavy alcohol use (≥4 drinks on one occasion ≥4 times a month) in the past 3 months and violence/GBV exposure before and during the pandemic.

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Background Men who have sex with men (MSM) represent a disproportionate total of incident HIV cases. Oral pre-exposure prophylaxis (PrEP) has contributed to significant declines in total HIV incidence. Barriers to PrEP include individual and structural factors that can prevent PrEP adherence and persistence.

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Background: The introduction of antiretroviral therapy (ART) has significantly improved the life expectancy of people living with HIV (PLHIV), leading to an increased prevalence of age-related comorbidities such as osteoporosis. This study investigates the incidence and characteristics of low bone mineral density (BMD) and the treatment effectiveness of low BMD participants among PLHIV in Kerman, Iran.

Methods: A longitudinal study utilized dual-energy X-ray absorptiometry (DEXA) to screen 94 PLHIV in Kerman, Iran, for low BMD.

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Introduction: Understanding levels of HIV testing among populations at risk for acquisition is essential to meeting the goal of the United Nations that 95% of individuals living with HIV know their status. This study assessed HIV testing prevalence among men who had sex with men (MSM), characteristics of MSM who have never tested for HIV, and missed testing opportunities in Hanoi, Vietnam.Methods: We measured the prevalence of never testing for HIV and missed opportunities for testing in the baseline data of a cohort study of MSM recruited in 2017-2019 in Hanoi.

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During the COVID-19 pandemic, the sampling method for the National HIV Behavioral Surveillance (NHBS) in San Francisco changed from physical venue time-location sampling (TLS) to online or virtual venue TLS for men who have sex with men (MSM). We present differences in the samples of MSM recruited using physical venue TLS in 2017 and virtual venue TLS in 2021. We further assess changes in preventive and risk behaviors from 2017 to 2021 after controlling for differences in the sample compositions with multivariable Poisson models using GLM with robust standard errors.

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Objective: To assess the previous history of syphilis in transgender women and travestis (TWTs) and identify factors associated with treatment incompleteness.

Methods: : This was a multicenter cross-sectional study conducted between 2019 and 2021, with participants recruited through respondent-driven sampling, in five Brazilian capitals. Dependent variable: "reported syphilis treatment in the last year", "no/incomplete" or "complete".

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We assessed the uptake of COVID-19 vaccination in a community-recruited sample of people who inject drugs (PWID) in San Francisco in 2022. Overall, 72.4% (95% CI 64.

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Objectives: To examine if point-of-care (POC) urine tenofovir testing-informed counseling could be used to improve virologic suppression (VS) among participants with virologic failure (VF) after ≥1 prior round of enhanced adherence counseling (EAC).

Methods: Participants were enrolled from 42 clinics across Namibia. At each monthly medication pick-up, participants completed the POC urine test and received EAC informed by this testing (EAC+).

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Background: Drug overdose deaths increased by 50 % between 2017 and 2021 in San Francisco. Little is known about non-fatal overdose, which heralds future risk for morbidity and overdose death. We assessed non-fatal overdose, access to drug treatment, and overdose prevention service utilization among people who inject drugs (PWID) in San Francisco in 2022.

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Article Synopsis
  • HIV drug resistance (HIVDR) can decrease the effectiveness of antiretroviral drugs, and this study focused on assessing HIV-1 subtypes and drug resistance among key populations in Vietnam during 2018 and 2020.
  • The study recruited participants from hotspots for men who have sex with men (MSM) and female sex workers (FSW) in various provinces, and 42.5% of HIV-positive samples had a viral load indicating the need for further testing for drug resistance.
  • The results showed that CRF01_AE was the most common subtype, and 16.7% of participants had drug resistance mutations, with the majority being associated with NNRTI and NRTI classes, suggesting
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Background: Transgender women (hereafter "trans women") face social marginalization, stigma, and discrimination and experience a high burden of HIV. More recently, trans women have been identified as having a high risk for hepatitis C (HCV) infection. The interaction between these two diseases and the risks for HIV/HCV co-infection among trans women are understudied.

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Background: Young gay, bisexual, and other men who have sex with men (YMSM) in Latin America experience disproportionately high rates of HIV. While new case numbers have stabilised in other demographics, the incidence of HIV in this particular group continues to rise. We estimated the prevalence of HIV and sexually transmitted infections (STI) and identified correlates of new HIV diagnoses among YMSM in Brazil.

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Introduction: Little is known about differences in HIV risk for trans women by partner gender, particularly with respect to social determinants and partner-level circumstances that affect behavior. We examined differences in demographic, social determinants, and HIV-related risk behaviors for trans women with cis men and trans women sexual partners.

Materials And Methods: Data are from a cross-sectional survey of trans women and their sexual partners conducted between April 2020 and January 2021.

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Article Synopsis
  • Young adults who inject drugs in San Francisco face significant challenges in accessing hepatitis C treatment, with a high rate of infection and instability in housing creating barriers.
  • A dynamic HCV transmission model was developed, revealing a projected 83.3% decrease in HCV incidence among people who inject drugs by 2030, but the likelihood of meeting elimination goals varies with only a 54.8% probability among young adults and 67.6% among unstably housed individuals.
  • Increasing testing and treatment access to pre-pandemic levels would minimally impact elimination probabilities, emphasizing the need for enhanced interventions, particularly around opioid use medication and housing support for young adult PWID.
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Due to stigma or legal issues, populations with higher HIV risk are often hard to reach, which impedes accurate population estimation of HIV burden. To better sample hard-to-reach populations (HTRPs) for HIV surveillance, various sampling methods have been designed and/or used since HIV epidemic following the first reported AIDS cases in 1981. This paper describes the development and the assessment (i.

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HIV disproportionately affects Black/African Americans (AA), while PrEP is under-utilized by Black/AA, women, and people who inject drugs (PWID). In San Francisco, California's National HIV Behavioral Surveillance among PWID in 2022, Black/AA women were the least likely to be tested for HIV among all groups by sex and race/ethnicity and the least likely to be aware of PrEP among women. Yet, Black/AA women were no less likely to see a healthcare provider in the last year.

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Clinical trials provide evidence that pre-exposure prophylaxis (PrEP) prevents HIV acquisition including through sharing of injection equipment among people who inject drugs (PWID). However, uptake among many populations at risk for HIV has been slow, particularly among PWID. We examined data from the National HIV Behavioral Surveillance (NHBS) from San Francisco in 2022 to measure PrEP uptake and identify factors associated with PrEP awareness among PWID.

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The Health Officer of the City and County of San Francisco, California, issued the order that all decedents were required to have a documented COVID-19 test effective from June 2020 to June 2021. The justification for the requirement was that complete data on COVID-19 status at the time of death were needed to help protect first responders and funeral home workers, identify missed cases, and characterize the places of death for otherwise unknown COVID-19 cases. To fill the gap in COVID-19 testing for all decedents, particularly among persons dying outside of hospitals, a specialized Decedent Testing Unit was created along with an increased capacity of the Office of the Chief Medical Examiner.

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The capture-recapture method is a common tool used in epidemiology to estimate the size of "hidden" populations and correct the underascertainment of cases, based on incomplete and overlapping lists of the target population. Log-linear models are often used to estimate the population size yet may produce implausible and unreliable estimates due to model misspecification and small cell sizes. A novel targeted minimum loss-based estimation (TMLE) model developed for capture-recapture makes several notable improvements to conventional modeling: "targeting" the parameter of interest, flexibly fitting the data to alternative functional forms, and limiting bias from small cell sizes.

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Introduction: We assessed trends in HIV and syphilis prevalence, HIV incidence, related risk factors, and preventive behaviors among men who have sex with men (MSM) in Vietnam from 2015 to 2020.

Methods: Data originated from the HIV Sentinel Surveillance Plus system, which sampled MSM at venues and hotspots in seven of Vietnam's 63 provinces in 2015, 2016, 2018, and 2020 ( = 1100-1445 per year; ∼150-300 per province per year).

Results: HIV prevalence estimates increased from 6.

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Background: Many people with high-risk sexual or injection behaviors use harm reduction services with different identities and are therefore counted more than once in client databases. This practice results in inaccurate statistics on the number of clients served and the effective reach of these services. This study aimed to determine the levels of double counting of clients of harm reduction services, including needle and syringe programs, condom distribution, HIV testing and counseling, and methadone maintenance in five cities in Iran.

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Introduction: Young transgender women (trans women) experience poor health in part due to discrimination. Factors that promote resilience may help young trans women positively adapt to discrimination, resulting in attenuation of poor health outcomes. While religion is sometimes a source of stigma and transphobia, qualitative studies have identified religiosity as an important resilience resource for young trans women.

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Article Synopsis
  • Ever MSM-IDU in San Francisco have a high burden of hepatitis C virus (HCV), and current testing and treatment efforts are crucial to meet the WHO's 2030 elimination target.
  • A dynamic transmission model indicates that HCV incidence among this group could decrease by nearly 85% from 2015 to 2030, despite a significant drop in testing and treatment due to COVID-19 lockdowns.
  • If HCV testing and treatment rates recover by 2022 or 2025, even greater reductions in HCV incidence are projected, supporting achievement of the WHO target for HCV elimination.
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