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Article: HIV in adolescents and young adults: half of all new infections in the United States.

Futterman, Donna C

Topics in HIV medicine : a publication of the International AIDS Society, USA

2005 Volume 13, Issue 3, Page(s) 101–105

Abstract: ... counseling and testing to young people. This article summarizes a presentation by Donna Futterman, MD ...

Abstract	Half of new HIV infections in the United States are in individuals aged 13 to 24 years, accounting for 20,000 new infections annually, or 1 every hour. Two thirds of infected youth contract HIV sexually, and more than 60% of new infections are in young women. Approximately 75% of infected youth are in racial or ethnic minority groups. More than one third of HIV-infected young people have not been tested for HIV infection, and the majority of homosexual HIV-infected youth are unaware of their infection status. Increased efforts are needed in comprehensive sex education, including safer sex practices, bringing young people into health care networks, increasing health care provider awareness of risk, and extending counseling and testing to young people. This article summarizes a presentation by Donna Futterman, MD, at the 7th Annual Clinical Conference for Ryan White CARE Act Title I, II, III, and IV Grantees, held in August 2004 in Washington, DC.
MeSH term(s)	Adolescent ; Adolescent Behavior ; Adult ; Ethnic Groups ; Female ; HIV Infections/epidemiology ; HIV Infections/ethnology ; HIV Infections/transmission ; Humans ; Male ; Minority Groups ; Risk Factors ; Risk-Taking ; Sex Education ; Sexual Behavior ; United States/epidemiology
Language	English
Publishing date	2005-08
Publishing country	United States
Document type	Journal Article
ISSN	1542-8826
ISSN	1542-8826
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Article: HIV and AIDS in adolescents.

Futterman, Donna C

Adolescent medicine clinics

2004 Volume 15, Issue 2, Page(s) 369–391

Abstract: HIV infection in adolescents continues to challenge health providers, policymakers, and advocates for youth. There will be no relief from its complexities soon. Primary care providers are in a unique position to use effective HIV prevention and care ... ...

Abstract	HIV infection in adolescents continues to challenge health providers, policymakers, and advocates for youth. There will be no relief from its complexities soon. Primary care providers are in a unique position to use effective HIV prevention and care interventions. Successful programs move beyond moralism to realism. They show a willingness to engage young people and their families in a sensitive dialogue about the needs of youthful sexual development. Youth at high risk for HIV should be identified and referred to comprehensive care and counseling as soon as possible. HIV-positive youth need intensive individual and group interventions to remain healthy and reduce transmission to others. To protect their patient population, health care providers will need to commit time and effort to making adolescents services visible, flexible, affordable, confidential, culturally appropriate, and universally available.
MeSH term(s)	AIDS Serodiagnosis ; AIDS Vaccines ; Adaptation, Psychological ; Adolescent ; Anti-HIV Agents/therapeutic use ; Counseling ; Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/psychology ; HIV Infections/therapy ; Humans ; Male ; Patient Compliance ; Risk Factors ; United States/epidemiology
Chemical Substances	AIDS Vaccines ; Anti-HIV Agents
Language	English
Publishing date	2004-09-25
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2146389-X
ISSN	1547-3368
ISSN	1547-3368
DOI	10.1016/j.admecli.2004.02.009
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Article ; Online: Expanded HIV Testing Strategy Leveraging the Electronic Medical Record Uncovers Undiagnosed Infection Among Hospitalized Patients.

Felsen, Uriel R / Cunningham, Chinazo O / Heo, Moonseong / Futterman, Donna C / Weiss, Jeffrey M / Zingman, Barry S

Journal of acquired immune deficiency syndromes (1999)

2017 Volume 75, Issue 1, Page(s) 27–34

Abstract: Background: Routine HIV testing of hospitalized patients is recommended, but few strategies to expand testing in the hospital setting have been described. We assessed the impact of an electronic medical record (EMR) prompt on HIV testing for ... ...

Abstract	Background: Routine HIV testing of hospitalized patients is recommended, but few strategies to expand testing in the hospital setting have been described. We assessed the impact of an electronic medical record (EMR) prompt on HIV testing for hospitalized patients. Methods: We performed a pre-post study at 3 hospitals in the Bronx, NY. We compared the proportion of admissions of patients 21-64 years old with an HIV test performed, characteristics of patients tested, and rate of new HIV diagnoses made by screening while an EMR prompt recommending HIV testing was inactive vs. active. The prompt appeared for patients with no previous HIV test or a high-risk diagnosis after their last HIV test. Results: Among 36,610 admissions while the prompt was inactive, 9.5% had an HIV test performed. Among 18,943 admissions while the prompt was active, 21.8% had an HIV test performed. Admission while the prompt was active was associated with increased HIV testing among total admissions [adjusted odds ratio (aOR) 2.78, 95% confidence interval (CI): 2.62 to 2.96], those without a previous HIV test (aOR 4.03, 95% CI: 3.70 to 4.40), and those with a previous negative test (aOR 1.52, 95% CI: 1.37 to 1.68) (P < 0.0001 for all). Although the prompt was active, testing increased across all patient characteristics. New HIV diagnoses made by screening increased from 8.2/100,000 admissions to 37.0/100,000 admissions while the prompt was inactive and active, respectively (OR 4.51 95% CI: 1.17 to 17.45, P = 0.03). Conclusions: An EMR prompt for hospitalized patients was associated with a large increase in HIV testing, a diversification of patients tested, and an increase in diagnoses made by screening.
MeSH term(s)	Adult ; Diagnostic Tests, Routine/statistics & numerical data ; Electronic Health Records ; Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Hospitalization ; Humans ; Male ; Mass Screening/statistics & numerical data ; Middle Aged ; New York City/epidemiology ; Non-Randomized Controlled Trials as Topic ; Prospective Studies ; Young Adult
Language	English
Publishing date	2017-01-31
Publishing country	United States
Document type	Journal Article
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000001299
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Article: HIV in Adolescents.

Catallozzi, Marina / Futterman, Donna C

Current infectious disease reports

2005 Volume 7, Issue 5, Page(s) 401–405

Abstract: Adolescence is a time of dramatic physical, emotional, cognitive, and social change that brings new vulnerabilities. Youth represent half of all new HIV infections in the United States and the rest of the world. The number of newly infected adolescents ... ...

Abstract	Adolescence is a time of dramatic physical, emotional, cognitive, and social change that brings new vulnerabilities. Youth represent half of all new HIV infections in the United States and the rest of the world. The number of newly infected adolescents who acquire the disease behaviorally and the number of perinatally infected children surviving into adolescence have both contributed to this growth. This article reviews the most recent epidemiology of HIV/AIDS in adolescents, gives guidance on clinical practice, including medical and psychosocial care, and examines prevention issues, including counseling and testing, which are needed to make programs effective for youth.
Language	English
Publishing date	2005-08-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	2019948-X
ISSN	1534-3146 ; 1523-3847
ISSN (online)	1534-3146
ISSN	1523-3847
DOI	10.1007/s11908-005-0015-z
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Article ; Online: An expanded HIV screening strategy in the Emergency Department fails to identify most patients with undiagnosed infection: insights from a blinded serosurvey.

Felsen, Uriel R / Torian, Lucia V / Futterman, Donna C / Stafford, Stephen / Xia, Qiang / Allan, David / Esses, David / Cunningham, Chinazo O / Weiss, Jeffrey M / Zingman, Barry S

AIDS care

2019 Volume 32, Issue 2, Page(s) 202–208

Abstract: Screening for HIV in Emergency Departments (EDs) is recommended to address the problem of undiagnosed HIV. Serosurveys are an important method for estimating the prevalence of undiagnosed HIV and can provide insight into the effectiveness of an HIV ... ...

Abstract	Screening for HIV in Emergency Departments (EDs) is recommended to address the problem of undiagnosed HIV. Serosurveys are an important method for estimating the prevalence of undiagnosed HIV and can provide insight into the effectiveness of an HIV screening strategy. We performed a blinded serosurvey in an ED offering non-targeted HIV screening to determine the proportion of patients with undiagnosed HIV who were diagnosed during their visit. The study was conducted in a high-volume, urban ED and included patients who had blood drawn for clinical purposes and had sufficient remnant specimen to undergo deidentified HIV testing. Among 4752 patients not previously diagnosed with HIV, 1403 (29.5%) were offered HIV screening and 543 (38.7% of those offered) consented. Overall, undiagnosed HIV was present in 12 patients (0.25%): six among those offered screening (0.4%), and six among those not offered screening (0.2%). Among those with undiagnosed HIV, two (16.7%) consented to screening and were diagnosed during their visit. Despite efforts to increase HIV screening, more than 80% of patients with undiagnosed HIV were not tested during their ED visit. Although half of those with undiagnosed HIV were missed because they were not offered screening, the yield was further diminished because a substantial proportion of patients declined screening. To avoid missed opportunities for diagnosis in the ED, strategies to further improve implementation of HIV screening and optimize rates of consent are needed.
MeSH term(s)	AIDS Serodiagnosis/methods ; Adolescent ; Adult ; Aged ; Emergency Service, Hospital/statistics & numerical data ; Female ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; Hospitals, Urban ; Humans ; Male ; Mass Screening/methods ; Mass Screening/organization & administration ; Middle Aged ; Prevalence ; Seroepidemiologic Studies ; Serologic Tests ; Young Adult
Language	English
Publishing date	2019-05-30
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	1012651-x
ISSN	1360-0451 ; 0954-0121
ISSN (online)	1360-0451
ISSN	0954-0121
DOI	10.1080/09540121.2019.1619663
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Article ; Online: Adolescents and HIV: prevention and clinical care.

Spiegel, Hans M L / Futterman, Donna C

Current HIV/AIDS reports

2009 Volume 6, Issue 2, Page(s) 100–107

Abstract: The incidence of HIV infection has increased to alarming proportions among minority youth, in particular among young men who have sex with men and among teenage girls. The unique socioeconomic, behavioral, and emotional vulnerability of adolescents for ... ...

Abstract	The incidence of HIV infection has increased to alarming proportions among minority youth, in particular among young men who have sex with men and among teenage girls. The unique socioeconomic, behavioral, and emotional vulnerability of adolescents for sexually transmitted diseases, including HIV, requires early identification of HIV infection for linkage to care. Differences in the clinical and psychosocial presentations of youth with perinatally versus behavioral acquired HIV infection are important and influence the acceptance of illness, self-efficacy, and antiretroviral treatment adherence. The ideal multidisciplinary team approach of culturally sensitive services for youth integrates clinical care, psychosocial and peer support interventions, transition planning, primary and secondary prevention, as well as comprehensive reproductive adolescent health services.
MeSH term(s)	Adolescent ; Adolescent Behavior ; Female ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; HIV Infections/virology ; HIV-1 ; Humans ; Male ; Prevalence ; Psychology ; Sexual Behavior ; Sexually Transmitted Diseases/drug therapy ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; United States/epidemiology
Language	English
Publishing date	2009-04-09
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2151206-1
ISSN	1548-3576 ; 1548-3568
ISSN (online)	1548-3576
ISSN	1548-3568
DOI	10.1007/s11904-009-0015-y
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Article ; Online: Increased Antiretroviral Therapy Use and Virologic Suppression in the Bronx in the Context of Multiple HIV Prevention Strategies.

Hanna, David B / Felsen, Uriel R / Ginsberg, Mindy S / Zingman, Barry S / Beil, Robert S / Futterman, Donna C / Strickler, Howard D / Anastos, Kathryn

AIDS research and human retroviruses

2016 Volume 32, Issue 10-11, Page(s) 955–963

Abstract: Multiple population-based HIV prevention strategies from national, state, local, and institutional levels have been implemented in the Bronx, which has one of the highest HIV prevalences in the U.S. We examined changes in antiretroviral therapy (ART) use ...

Abstract	Multiple population-based HIV prevention strategies from national, state, local, and institutional levels have been implemented in the Bronx, which has one of the highest HIV prevalences in the U.S. We examined changes in antiretroviral therapy (ART) use and associated outcomes between 2007 and 2014 among patients seen at one of >20 outpatient clinics affiliated with the largest Bronx HIV care provider. Among eligible HIV-infected patients age ≥13 years, we examined annual trends in ART use, mean HIV RNA level, and virologic suppression (<200 copies/ml) overall and among prespecified subgroups. In a subset with suppressed HIV RNA at the end of each year, we determined the percentage whose levels remained suppressed within the next year. Regression models assessed disparities in outcomes. Among 7,196 patients (median age 50, 47% Hispanic, 45% black), we identified consistent increases over time in the percent prescribed ART (78% in 2007 to 93% in 2014) and with virologic suppression (58% to 80%), as mean HIV RNA decreased (351 to 73 copies/ml) (all p < .001). Sustained virologic suppression improved markedly beginning in 2011, coinciding with local test-and-treat initiatives and adoption of expanded treatment guidelines. While disparities among population groups were most pronounced for sustained virologic suppression, those aged 13-24 fared relatively poorly for all outcomes examined (e.g., rate ratio 0.57 for virologic suppression, 95% confidence interval 0.52-0.62, vs. age 65+). Population-wide HIV prevention strategies coincided with improvements in virologic suppression among most population groups. However, more attention is needed to address continued disparities in the HIV care continuum among young people.
Language	English
Publishing date	2016-10
Publishing country	United States
Document type	Journal Article
ZDB-ID	639130-8
ISSN	1931-8405 ; 0889-2229
ISSN (online)	1931-8405
ISSN	0889-2229
DOI	10.1089/AID.2015.0345
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Article: HIV self-testing and STI self-collection via mobile apps: experiences from two pilot randomized controlled trials of young men who have sex with men.

Biello, Katie B / Horvitz, Casey / Mullin, Shelby / Mayer, Kenneth H / Scott, Hyman / Coleman, Kenneth / Dormitzer, Julian / Norelli, Jenna / Hightow-Weidman, Lisa / Sullivan, Patrick / Mimiaga, Matthew J / Buchbinder, Susan / Bojan, Kelly / Futterman, Donna / Emmanuel, Patricia / Liu, Albert

mHealth

2021 Volume 7, Page(s) 26

Abstract: Background: Young men who have sex with men (YMSM) are disproportionately impacted by HIV and other sexually transmitted infections (STIs) in the United States (US) and have low rates of HIV/STI testing. Provision of HIV self-testing and STI self- ... ...

Abstract	Background: Young men who have sex with men (YMSM) are disproportionately impacted by HIV and other sexually transmitted infections (STIs) in the United States (US) and have low rates of HIV/STI testing. Provision of HIV self-testing and STI self-collection can increase testing rates, and access to these kits through mobile applications (apps) could help facilitate YMSM using HIV self-testing and STI self-collection. Methods: Data for this study comes from two pilot randomized controlled trials (RCTs) of mobile apps within the Adolescent Trials Network-LYNX and MyChoices-aimed to increase HIV/STI testing among YMSM (age 15-24) who had not recently tested for HIV and were at high risk for HIV acquisition across five US cities. Both apps include the ability to order a HIV self-test with rapid results and a kit for STI self-collection and mailing of samples for syphilis, gonorrhea and chlamydia to a lab for testing. Using assessments of app users (n=80) at pre-randomization and at 3- and 6-months post-randomization and online interview data from a purposive sample of app users (n=37), we report on experiences and lessons learned with HIV self-testing and STI self-collection kits ordered via the apps. Results: Participants were on average 20.7 years of age (SD =2.4), and 49% were non-White or multiple race/ethnicity. Sixty-three percent had a prior HIV test. Over half (58%) had a prior STI test, but only 3% had tested within the past 3 months. Nearly two-thirds ordered an HIV self-testing kit; of whom, 75% reported using at least one self-test kit over the study period. STI self-collection kit ordering rates were also high (54%); however, STI self-collection kit return rates were lower (13%), but with a high positivity rate (5.3%). Both HIV self-testing and STI self-collection kits were highly acceptable, and 87% reported that it was extremely/very helpful to be able to order these kits through the apps. The most common reason for not ordering the HIV/STI kits was preferring to test at a clinic. In interviews, participants expressed feeling empowered by being able to test at home; however, they also raised concerns around STI sample collection. Conclusions: HIV self-testing and STI self-collection kit ordering via mobile apps is feasible, acceptable and may show promise in increasing testing rates among YMSM. The LYNX and MyChoices apps are currently being tested in a full-scale efficacy trial, and if successful, these innovative mobile apps could be scaled up to efficiently increase HIV/STI testing among youth across the US.
Language	English
Publishing date	2021-04-20
Publishing country	China
Document type	Journal Article
ISSN	2306-9740
ISSN	2306-9740
DOI	10.21037/mhealth-20-70
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Article ; Online: Qualitative Study on the Acceptability of and Adherence to a Vaginal Ring for HIV Prophylaxis Among Adolescent Girls.

Baker, Zoë / Javanbakht, Marjan / Moore, Janell / Brosnan, Hannah / Squires, Kathleen / Bunge, Katherine / Zimet, Gregory / Mensch, Barbara / Soto-Torres, Lydia / Kapogiannis, Bill / Levy, Lisa / Hoesley, Craig / Reirden, Daniel / Gaur, Aditya / Mayer, Kenneth / Futterman, Donna / Gorbach, Pamina

Journal of acquired immune deficiency syndromes (1999)

2021 Volume 87, Issue 3, Page(s) 944–950

Abstract: Objective: This study aims to assess the product-related, relationship-related, and sex-related factors that act as facilitators and barriers to the acceptability of a vaginal ring (VR) for HIV prevention among adolescent girls.: Design: Qualitative ... ...

Abstract	Objective: This study aims to assess the product-related, relationship-related, and sex-related factors that act as facilitators and barriers to the acceptability of a vaginal ring (VR) for HIV prevention among adolescent girls. Design: Qualitative study. Methods: Ninety-six girls aged 15-17 years from 6 urban US sites were enrolled in MTN-023/IPM 030, a 24-week randomized controlled trial, for assessing the safety and acceptability of a dapivirine VR for HIV prevention. At week 24, 21 girls were randomly selected to participate in in-depth interviews. Interviews were transcribed verbatim and data analyzed using a thematic analysis approach. Facilitators and barriers to VR acceptability related to participants' relationships, sexual activity, and characteristics of the VR product were identified. Results: Factors related to relationships rarely seemed to act as barriers to VR acceptability; most participants disclosed VR use to sexual partners, and positive reactions from sexual partners, which were common, seemed to facilitate VR acceptability. Emotional and/or physical discomfort surrounding VR use during sex was mentioned occasionally as a barrier to VR acceptability. Product characteristics were most frequently mentioned as barriers to VR acceptability. Many participants reported concerns about the large size of the VR on first impression. Although most found the VR comfortable, some reported pain with VR insertion. Several participants were concerned about VR cleanliness, particularly during menstruation. Conclusion: Product considerations, specifically size and use during menstruation, were the most commonly reported barriers to VR acceptability in this study. Adolescent girls may require additional counseling to assuage product concerns regarding a VR for HIV prevention.
MeSH term(s)	Administration, Intravaginal ; Adolescent ; Anti-HIV Agents/administration & dosage ; Anti-HIV Agents/adverse effects ; Anti-HIV Agents/therapeutic use ; Contraceptive Devices, Female ; Female ; HIV Infections/prevention & control ; HIV-1 ; Humans ; Medication Adherence ; Pre-Exposure Prophylaxis/methods
Chemical Substances	Anti-HIV Agents
Language	English
Publishing date	2021-03-03
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial ; Research Support, N.I.H., Extramural
ZDB-ID	645053-2
ISSN	1944-7884 ; 1077-9450 ; 0897-5965 ; 0894-9255 ; 1525-4135
ISSN (online)	1944-7884 ; 1077-9450
ISSN	0897-5965 ; 0894-9255 ; 1525-4135
DOI	10.1097/QAI.0000000000002674
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Article ; Online: Pre-vaccination prevalence of anogenital and oral human papillomavirus in young HIV-infected men who have sex with men.

Kahn, Jessica A / Belzer, Marvin / Chi, Xiaofei / Lee, Jeannette / Gaur, Aditya H / Mayer, Kenneth / Martinez, Jaime / Futterman, Donna C / Stier, Elizabeth A / Paul, Mary E / Chiao, Elizabeth Y / Reirden, Daniel / Goldstone, Steven E / Ortiz Martinez, Ana P / Cachay, Edward R / Barroso, Luis F / Da Costa, Maria / Wilson, Craig M / Palefsky, Joel M

Papillomavirus research (Amsterdam, Netherlands)

2019 Volume 7, Page(s) 52–61

Abstract: The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9- ... ...

Abstract	The aims of this study were to: 1) determine prevalence of anogenital and oral HPV, 2) determine concordance between HPV at anal, perianal, scrotal/penile, and oral sites; and 3) describe factors associated with anogenital HPV types targeted by the 9-valent vaccine. Data were collected from 2012 to 2015 among men who have sex with men 18-26 years of age enrolled in a vaccine trial (N = 145). Penile/scrotal, perianal, anal, and oral samples were tested for 61 HPV types. Logistic regression was used to identify factors associated with types in the 9-valent vaccine. Participants' mean age was 23.0 years, 55.2% were African-American, and 26.2% were Hispanic; 93% had anal, 40% penile, and 6% oral HPV. Among those with anogenital infection, 18% had HPV16. Concordance was low between anogenital and oral sites. Factors independently associated with a 9-valent vaccine-type HPV were: race (African-American vs. White, OR=2.67, 95% CI=1.11-6.42), current smoking (yes vs. no, OR=2.37, 95% CI=1.03-5.48), and number of recent receptive anal sex partners (2+ vs. 0, OR=3.47, 95% CI=1.16-10.4). Most MSM were not infected with HPV16 or HPV18, suggesting that they may still benefit from HPV vaccination, but anogenital HPV was very common, highlighting the importance of vaccinating men before sexual initiation. CLINICAL TRIAL NUMBER: NCT01209325.
MeSH term(s)	Adolescent ; Adult ; Anal Canal/virology ; Genitalia, Male/virology ; HIV Infections/complications ; Homosexuality, Male ; Humans ; Male ; Mouth/virology ; Papillomaviridae/classification ; Papillomaviridae/isolation & purification ; Papillomavirus Infections/epidemiology ; Prevalence ; Young Adult
Language	English
Publishing date	2019-01-15
Publishing country	Netherlands
Document type	Clinical Trial, Phase II ; Journal Article ; Multicenter Study ; Research Support, N.I.H., Extramural
ZDB-ID	2837553-1
ISSN	2405-8521 ; 2405-8521
ISSN (online)	2405-8521
ISSN	2405-8521
DOI	10.1016/j.pvr.2019.01.002
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