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  1. Article ; Online: Bending the Curve on Human Immunodeficiency Virus Transmission.

    Doshi, Rupali Kotwal

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2019  Volume 71, Issue 2, Page(s) 301–303

    MeSH term(s) Cohort Studies ; HIV Infections/transmission ; HIV-1 ; Humans ; Infectious Disease Transmission, Vertical ; United Nations
    Language English
    Publishing date 2019-08-14
    Publishing country United States
    Document type Journal Article ; Comment
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciz805
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: Association of Substance Use Disorders with Engagement in Care and Mortality among a Clinical Cohort of People with HIV in Washington, DC.

    Doshi, Rupali Kotwal / Byrne, Morgan / Levy, Matthew / Varga, Leah / Kuo, Irene / Horberg, Michael A / Castel, Amanda D / Monroe, Anne K

    AIDS and behavior

    2021  Volume 25, Issue 7, Page(s) 2289–2300

    Abstract: Substance use disorders (SUDs) are common among people with HIV and can prevent achievement of optimal health outcomes. Using data from a longitudinal HIV cohort study in the District of Columbia (2011-2018), we calculated the prevalence and correlates ... ...

    Abstract Substance use disorders (SUDs) are common among people with HIV and can prevent achievement of optimal health outcomes. Using data from a longitudinal HIV cohort study in the District of Columbia (2011-2018), we calculated the prevalence and correlates of SUD (alcohol, stimulant, and/or opioid use disorders) and determined the association of SUD with engagement in HIV care, ART prescription, viral suppression, and mortality. Of 8420 adults, 3168 (37.6%) had a history of any SUD, most commonly history of alcohol use disorder (29.6%). SUDs disproportionately affected Black individuals (aOR 1.33) and heterosexuals (aOR 1.18), and women had a lower risk of SUD (aOR 0.65). SUD was not associated with engagement in care, ART prescription, or viral suppression. SUD was associated with mortality (aHR 1.31). Addressing alcohol use disorder and preventable causes of death among people with HIV and substance use disorders should be priorities for clinical care and public health.
    MeSH term(s) Adult ; Alcoholism/epidemiology ; Cohort Studies ; District of Columbia/epidemiology ; Female ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Humans ; Opioid-Related Disorders/complications ; Opioid-Related Disorders/epidemiology ; Substance-Related Disorders/epidemiology
    Language English
    Publishing date 2021-02-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1339885-4
    ISSN 1573-3254 ; 1090-7165
    ISSN (online) 1573-3254
    ISSN 1090-7165
    DOI 10.1007/s10461-021-03157-4
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  3. Article ; Online: Knowledge, Attitudes, and Behaviors Related to Hepatitis C Screening and Treatment among Health Care Providers in Washington, DC.

    Doshi, Rupali Kotwal / Ruben, Max / Drezner, Kate / Lachmann, Alexandra / Kuo, Irene / Chanes-Mora, Paola / Varga, Leah / Saafir-Callaway, Brittani / Visconti, Adam / Kharfen, Michael

    Journal of community health

    2020  Volume 45, Issue 4, Page(s) 785–794

    Abstract: Elimination of chronic hepatitis C (HCV) will require scaling up treatment, including possible HCV treatment by primary care providers. The District of Columbia (DC) has a substantial population living with untreated hepatitis C, and treatment expansion ... ...

    Abstract Elimination of chronic hepatitis C (HCV) will require scaling up treatment, including possible HCV treatment by primary care providers. The District of Columbia (DC) has a substantial population living with untreated hepatitis C, and treatment expansion would benefit the resident population. The aim of this study was to assess the knowledge, attitudes, and behaviors of primary care providers and specialists related to hepatitis C screening and treatment. We conducted a prospective, online survey of physicians and nurse practitioners (n = 153) in DC on their knowledge, attitudes, and behaviors related to hepatitis C screening and treatment, as well as referral patterns, interest in learning, and preferred learning modalities. We compared responses by provider type. Key findings indicated that HCV screening and treatment knowledge was higher among specialty physicians as compared to primary care providers. The most common reported facilitators of HCV screening included a prompt in the electronic medical record (63%), patient education (57%), and support staff (41%). While 71% reported that HCV treatment was important in the community they serve, only 26% indicated that access to HCV specialist expertise and consultation was a major area of need. Additionally, 59% reported that they refer all HCV patients to specialists for treatment. Primary care providers in DC had moderate interest in learning how to treat chronic hepatitis C, but they need additional training. Patients are typically referred to gastroenterology, infectious diseases, and hepatology specialists who may have limited capacity to expand treatment.
    MeSH term(s) Attitude of Health Personnel ; District of Columbia ; Electronic Health Records ; Female ; Health Personnel ; Hepacivirus ; Hepatitis C/diagnosis ; Hepatitis C, Chronic ; Humans ; Male ; Mass Screening ; Middle Aged ; Nurse Practitioners ; Physicians ; Prospective Studies ; Referral and Consultation ; Surveys and Questionnaires
    Language English
    Publishing date 2020-03-03
    Publishing country Netherlands
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ZDB-ID 426631-6
    ISSN 1573-3610 ; 0094-5145
    ISSN (online) 1573-3610
    ISSN 0094-5145
    DOI 10.1007/s10900-020-00794-z
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    Zs.A 1386: Show issues Location:
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  4. Article ; Online: Health care and HIV testing experiences among Black men in the South: implications for "Seek, Test, Treat, and Retain" HIV prevention strategies.

    Doshi, Rupali Kotwal / Malebranche, David / Bowleg, Lisa / Sangaramoorthy, Thurka

    AIDS patient care and STDs

    2012  Volume 27, Issue 2, Page(s) 123–133

    Abstract: Few studies have explored how overall general health care and HIV/STI testing experiences may influence receipt of "Seek, Test, Treat, and Retain" (STTR) HIV prevention approaches among Black men in the southern United States. Using in-depth qualitative ... ...

    Abstract Few studies have explored how overall general health care and HIV/STI testing experiences may influence receipt of "Seek, Test, Treat, and Retain" (STTR) HIV prevention approaches among Black men in the southern United States. Using in-depth qualitative interviews with 78 HIV-negative/unknown Black men in Georgia, we explored factors influencing their general health care and HIV/STI testing experiences. The Andersen behavioral model of health care utilization (Andersen model) offers a useful framework through which to examine the general health care experiences and HIV testing practices of Black men. It has four primary domains: Environment, Population characteristics, Health behavior, and Outcomes. Within the Andersen model framework, participants described four main themes that influenced HIV testing: access to insurance, patient-provider communication, quality of services, and personal belief systems. If STTR is to be successful among Black men, improving access and quality of general health care, integrating HIV testing into general health care, promoting health empowerment, and consumer satisfaction should be addressed.
    MeSH term(s) Adult ; African Americans ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/psychology ; Health Behavior ; Health Knowledge, Attitudes, Practice ; Health Promotion ; Health Services Accessibility ; Health Status Disparities ; Humans ; Male ; Mass Screening ; Middle Aged ; Patient Acceptance of Health Care ; Power, Psychological ; Qualitative Research ; Sexual Behavior/psychology ; Sexual Behavior/statistics & numerical data ; United States/epidemiology
    Language English
    Publishing date 2012-12-26
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1326868-5
    ISSN 1557-7449 ; 0893-5068 ; 1087-2914
    ISSN (online) 1557-7449
    ISSN 0893-5068 ; 1087-2914
    DOI 10.1089/apc.2012.0269
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  5. Article ; Online: Correlates of antiretroviral utilization among hospitalized HIV-infected crack cocaine users.

    Doshi, Rupali Kotwal / Vogenthaler, Nicholas S / Lewis, Sarah / Rodriguez, Allan / Metsch, Lisa / del Rio, Carlos

    AIDS research and human retroviruses

    2012  Volume 28, Issue 9, Page(s) 1007–1014

    Abstract: Despite the availability of antiretroviral therapy (ART), HIV-infected drug users, particularly crack cocaine users, continue to have high HIV-related morbidity and mortality. We conducted a cross-sectional analysis of the baseline data for hospitalized ... ...

    Abstract Despite the availability of antiretroviral therapy (ART), HIV-infected drug users, particularly crack cocaine users, continue to have high HIV-related morbidity and mortality. We conducted a cross-sectional analysis of the baseline data for hospitalized HIV-infected crack cocaine users recruited for Project HOPE (Hospital Visit Is an Opportunity for Prevention and Engagement with HIV-Positive Crack Users) in Atlanta and Miami who were eligible for ART (reported any lifetime use of ART or CD4 <350 cells/μl). Among 350 eligible participants, whose mean age was 44.9 years (SD 7.0), 49% were male, 90% were black, and 81% were heterosexual. The median CD4 count was 144 cells/μl, and 78 of 350 (22%) were taking ART. We conducted a multivariable logistic regression to examine individual, interpersonal, and structural factors as potential correlates of ART use. Reporting ≥2 visits to outpatient HIV care in the past 6 months (AOR 7.55, 95% CI 3.80-14.99), drug or alcohol treatment in the past 6 months (AOR 2.29, 95% CI 1.06-4.94), and study site being Miami (AOR 2.99, 95% CI 1.56-5.73) were associated with ART use. Current homelessness (AOR 0.41, 95% CI 0.20-0.84) and CD4 <200 cells/μl (AOR 0.29, 95% CI 0.15-0.55) were negatively associated with ART use. Among those taking ART, 60% had an HIV-1 viral load <400 copies/ml; this represented 9% of the eligible population. For HIV-infected crack cocaine users, structural factors may be as important as individual and interpersonal factors in facilitating ART utilization. Few HIV(+) crack cocaine users had viral suppression, but among those on ART, viral suppression was achievable.
    MeSH term(s) Adult ; Anti-HIV Agents/administration & dosage ; CD4 Lymphocyte Count ; Cocaine-Related Disorders/epidemiology ; Crack Cocaine ; Drug Users ; Female ; HIV Seropositivity/drug therapy ; HIV Seropositivity/epidemiology ; Healthcare Disparities ; Humans ; Inpatients/statistics & numerical data ; Logistic Models ; Male ; Patient Compliance ; Socioeconomic Factors ; Substance Abuse, Intravenous/epidemiology ; United States/epidemiology
    Chemical Substances Anti-HIV Agents ; Crack Cocaine
    Language English
    Publishing date 2012-03-02
    Publishing country United States
    Document type Journal Article ; Research Support, N.I.H., Extramural
    ZDB-ID 639130-8
    ISSN 1931-8405 ; 0889-2229
    ISSN (online) 1931-8405
    ISSN 0889-2229
    DOI 10.1089/AID.2011.0329
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    Zs.A 1928: Show issues Location:
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  6. Article ; Online: High rates of retention and viral suppression in the US HIV safety net system: HIV care continuum in the Ryan White HIV/AIDS Program, 2011.

    Doshi, Rupali Kotwal / Milberg, John / Isenberg, Deborah / Matthews, Tracy / Malitz, Faye / Matosky, Marlene / Trent-Adams, Sylvia / Parham Hopson, Deborah / Cheever, Laura W

    Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

    2015  Volume 60, Issue 1, Page(s) 117–125

    Abstract: Background: In the human immunodeficiency virus (HIV) care continuum, retention in HIV medical care and viral suppression are key goals to improve individual health outcomes and reduce HIV transmission. National data from clinical providers are lacking.! ...

    Abstract Background: In the human immunodeficiency virus (HIV) care continuum, retention in HIV medical care and viral suppression are key goals to improve individual health outcomes and reduce HIV transmission. National data from clinical providers are lacking.
    Methods: HIV providers funded by the Ryan White HIV/AIDS Program (RWHAP) annually report demographic, service, and clinical data using encrypted unique client identifiers, and data are processed and de-duplicated to create a single record for each client. We calculated retention and viral suppression for clients who received RWHAP-funded HIV medical care in 2011. We conducted multivariate logistic regression to identify factors associated with these outcomes.
    Results: In 2011, an estimated 512 911 HIV-infected clients received at least 1 RWHAP-funded non-AIDS Drug Assistance Program service. Of these, 317 458(61.8%) were seen for at least 1 HIV medical care visit. Of these, 82.2% were retained in HIV medical care, and 72.6% achieved viral suppression. Viral suppression was higher among retained clients (77.7%) vs clients who were not retained (58.3%). The lowest levels of retention and viral suppression were among individuals aged 13-34 years.
    Conclusions: The RWHAP provides HIV medical care and support services for more than half a million poor and underinsured individuals living with HIV in the United States. Rates of retention and viral suppression are relatively high compared with other national estimates but demonstrate room for improvement, especially among youth and racial minorities. Additional improvements in retention and viral suppression will contribute to achieving the goals of the National HIV/AIDS Strategy and improve individual and public health.
    MeSH term(s) Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; Continuity of Patient Care ; Female ; HIV Infections/drug therapy ; HIV Infections/virology ; Humans ; Infant ; Infant, Newborn ; Male ; Medication Adherence ; Middle Aged ; United States ; Viral Load ; Young Adult
    Language English
    Publishing date 2015-01-01
    Publishing country United States
    Document type Journal Article
    ZDB-ID 1099781-7
    ISSN 1537-6591 ; 1058-4838
    ISSN (online) 1537-6591
    ISSN 1058-4838
    DOI 10.1093/cid/ciu722
    Database MEDical Literature Analysis and Retrieval System OnLINE

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