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Article ; Online: Field Services-Facilitated Treatment and Prevention: Challenges and Opportunities.

Bachmann, Laura H / Kerani, Roxanne P

2022 Volume 50, Issue 8S Suppl 1, Page(s) S48–S52

Abstract: Abstract: Assisted partner services (APS) is a longstanding public health strategy to reduce transmission of sexually transmitted infection (STI) and human immunodeficiency virus in the United States. However, with rapidly increasing rates of STI, ... ...

Abstract	Abstract: Assisted partner services (APS) is a longstanding public health strategy to reduce transmission of sexually transmitted infection (STI) and human immunodeficiency virus in the United States. However, with rapidly increasing rates of STI, innovations to APS are needed to allow health departments to conserve limited public health resources while improving the effectiveness of APS. Disease Intervention Specialists (DIS), public health staff who conduct APS, have a wealth of experience in identifying, locating, and interviewing index patients and their sexual partners, but are currently limited in the services that they are able to provide in the field. Although several state and local health departments are working to expand the role of DIS to incorporate less traditional APS activities, such programs are uncommon. We discuss several services that DIS could conceivably provide in the field, such as STI testing, treatment, and vaccination, and identify critical issues to be addressed to implement these changes in DIS activities on a larger scale. Broadening the scope of DIS activities may result in multiple benefits to health departments, including more effectively delivering STI testing and treatment to hard-to-reach populations, imparting more responsibility to DIS, thereby potentially increasing job satisfaction, and building a workforce that is better prepared for public health crises. Effective approaches to address variable state level regulations governing DIS scope of practice are needed.
MeSH term(s)	Humans ; United States/epidemiology ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/drug therapy ; Sexually Transmitted Diseases/prevention & control ; Public Health ; Sexual Partners ; Contact Tracing ; HIV Infections/drug therapy ; HIV Infections/prevention & control ; HIV Infections/epidemiology
Language	English
Publishing date	2022-12-17
Publishing country	United States
Document type	Journal Article
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001757
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Article ; Online: A Participatory Approach to Identifying Gaps in and Recommendations for Sexually Transmitted Infection and Preexposure Prophylaxis Clinical Services in Pierce County, Washington.

Zinsli, Kaitlin / Means, Arianna Rubin / Barbee, Lindley A / Rodriguez, Evelyn Manley / Kerani, Roxanne P

Sexually transmitted diseases

2024 Volume 51, Issue 6, Page(s) 425–430

Abstract: Background: Pierce County, Washington, has a high burden of sexually transmitted infections (STIs) relative to Washington State and the United States. We used a participatory approach to identify gaps in STI and preexposure prophylaxis (PrEP) service ... ...

Abstract	Background: Pierce County, Washington, has a high burden of sexually transmitted infections (STIs) relative to Washington State and the United States. We used a participatory approach to identify gaps in STI and preexposure prophylaxis (PrEP) service provision in Pierce County and generate recommendations to address these gaps. Methods: In collaboration with the Tacoma-Pierce County Health Department (TPCHD), we conducted 14 key informant interviews with local STI/PrEP providers from varied clinical settings. Using rapid qualitative analysis, we identified key gaps and strengths in service provision. Local, state, and national HIV/STI subject matter experts (SMEs) prioritized the gaps and recommendations to address them via an online survey. Results: The primary 6 gaps ranked by SMEs (N = 32) in order of importance included the following: (1) inadequate availability of STI and PrEP services, (2) lack of awareness of STI and PrEP services, (3) need for free/low cost STI and PrEP care, (4) need for stronger relationships among providers and TPCHD, (5) reduced accessibility related to geographically distributed population and centralized services, and (6) frequent referrals pose a service barrier. Subject matter experts prioritized recommendations for each gap as follows: (1) create an STI specialty clinic, (2) implement an STI/PrEP service availability outreach campaign, (3) strengthen referral relationships between TPCHD and free/low-cost providers, (4) develop a provider support network, (5) create a mobile STI clinic, and (6) develop an STI specialty clinic. Conclusions: Sexually transmitted infection specialty clinics were prioritized by SMEs to improve access to STI and PrEP care in Pierce County, and to serve as a resource for local providers.
MeSH term(s)	Humans ; Washington/epidemiology ; Pre-Exposure Prophylaxis ; Sexually Transmitted Diseases/prevention & control ; Male ; Female ; Health Services Accessibility ; HIV Infections/prevention & control ; HIV Infections/epidemiology
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, N.I.H., Extramural
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001961
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Article ; Online: Lessons learned from community engagement regarding phylodynamic research with molecular HIV surveillance data.

Tordoff, Diana M / Minalga, Brian / Trejo, Alfredo / Shook, Alic / Kerani, Roxanne P / Herbeck, Joshua T

Journal of the International AIDS Society

2023 Volume 26 Suppl 1, Page(s) e26111

Abstract: Introduction: The widespread implementation of molecular HIV surveillance (MHS) has resulted in an increased discussion about the ethical, human rights and public health implications of MHS. We narrate our process of pausing our research that uses data ... ...

Abstract	Introduction: The widespread implementation of molecular HIV surveillance (MHS) has resulted in an increased discussion about the ethical, human rights and public health implications of MHS. We narrate our process of pausing our research that uses data collected through MHS in response to these growing concerns and summarize the key lessons we learned through conversations with community members. Methods: The original study aimed to describe HIV transmission patterns by age and race/ethnicity among men who have sex with men in King County, Washington, by applying probabilistic phylodynamic modelling methods to HIV-1 pol gene sequences collected through MHS. In September 2020, we paused the publication of this research to conduct community engagement: we held two public-facing online presentations, met with a national community coalition that included representatives of networks of people living with HIV, and invited two members of this coalition to provide feedback on our manuscript. During each of these meetings, we shared a brief presentation of our methods and findings and explicitly solicited feedback on the perceived public health benefit and potential harm of our analyses and results. Results: Some community concerns about MHS in public health practice also apply to research using MHS data, namely those related to informed consent, inference of transmission directionality and criminalization. Other critiques were specific to our research study and included feedback about the use of phylogenetic analyses to study assortativity by race/ethnicity and the importance of considering the broader context of stigma and structural racism. We ultimately decided the potential harms of publishing our study-perpetuating racialized stigma about men who have sex with men and eroding the trust between phylogenetics researchers and communities of people living with HIV-outweighed the potential benefits. Conclusions: HIV phylogenetics research using data collected through MHS data is a powerful scientific technology with the potential to benefit and harm communities of people living with HIV. Addressing criminalization and including people living with HIV in decision-making processes have the potential to meaningfully address community concerns and strengthen the ethical justification for using MHS data in both research and public health practice. We close with specific opportunities for action and advocacy by researchers.
MeSH term(s)	Male ; Humans ; Homosexuality, Male ; HIV Infections/drug therapy ; HIV Infections/epidemiology ; Phylogeny ; Sexual and Gender Minorities ; HIV Seropositivity
Language	English
Publishing date	2023-07-05
Publishing country	Switzerland
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2467110-1
ISSN	1758-2652 ; 1758-2652
ISSN (online)	1758-2652
ISSN	1758-2652
DOI	10.1002/jia2.26111
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Article ; Online: The Pre-exposure Prophylaxis (PrEP) Care Continuum Among English-Speaking Latino Sexual Minority Men in the United States (2014-2020).

Lee, Jane J / Barry, Michael P / Kerani, Roxanne P / Sanchez, Travis H / Katz, David A

Journal of acquired immune deficiency syndromes (1999)

2023 Volume 93, Issue 3, Page(s) 199–207

Abstract: Background: There is limited understanding of the pre-exposure prophylaxis (PrEP) care continuum specific to Latino/x gay, bisexual, and other sexual minority men (SMM) that encompasses the population residing outside of large metropolitan or urban ... ...

Abstract	Background: There is limited understanding of the pre-exposure prophylaxis (PrEP) care continuum specific to Latino/x gay, bisexual, and other sexual minority men (SMM) that encompasses the population residing outside of large metropolitan or urban areas. Setting: We examined trends and characteristics associated with the PrEP care continuum with data from the 2014-2020 cycles of the American Men's Internet Survey, an annual online cross-sectional behavioral survey of cisgender SMM in the United States. Methods: We calculated PrEP continuum outcomes overall and by year among Hispanic/Latino SMM (n = 9010). We used generalized estimating equations with Poisson links to examine (1) temporal trends (2014-2020) in each step of the PrEP continuum and PrEP use in the past year stratified by PrEP eligibility and (2) correlates of each step of the PrEP continuum in 2020 using multivariable models. Results: Among 2283 Latino SMM in 2020, 84% reported PrEP awareness, 30% discussed PrEP with a provider, 15% used PrEP in the past year, and 12% were currently using PrEP. PrEP awareness increased from 52% in 2014 to 84% in 2020; and PrEP use in the past year increased from 4% in 2014 to 15% in 2020. In the multivariable models, age and PrEP eligibility were associated with PrEP use in the past year, and urban-rural classification was associated with current PrEP use. Conclusions: While most of the Latino SMM are aware of PrEP, significant gaps remain in this population in discussing PrEP with a provider and using PrEP that require tailored strategies to enhance access to HIV prevention services.
MeSH term(s)	Male ; Humans ; United States ; Homosexuality, Male ; Pre-Exposure Prophylaxis ; Cross-Sectional Studies ; HIV Infections/drug therapy ; Sexual and Gender Minorities ; Hispanic or Latino
Language	English
Publishing date	2023-03-14
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; 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.0000000000003187
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Article ; Online: Reasons for Migration and Their Associations with HIV Risk and Prevention Among Cisgender Sexual Minority Men: A Latent Class Analysis.

Lee, Jane J / Kerani, Roxanne P / Robles, Gabriel / Sanchez, Travis H / Katz, David A

AIDS and behavior

2023 Volume 28, Issue 3, Page(s) 974–984

Abstract: The immigrant population in the United States (U.S.) is rapidly growing; yet there is limited knowledge about how reasons for migrating to the U.S. are associated with HIV prevention behaviors. Using data from the American Men's Internet Survey (2018- ... ...

Abstract	The immigrant population in the United States (U.S.) is rapidly growing; yet there is limited knowledge about how reasons for migrating to the U.S. are associated with HIV prevention behaviors. Using data from the American Men's Internet Survey (2018-2020), we performed a Latent Class Analysis (LCA) to identify patterns in reasons for migration among cisgender gay, bisexual, and other sexual minority men (SMM) who born outside the U.S. We used multivariable logistic regression controlling for demographic characteristics to assess class associations with the following in the past 12 months: condomless anal sex (CAS), illicit drug use, marijuana use, HIV testing, and PrEP use. LCA identified six distinct patterns in reasons for migration among the sample (n = 1,657): (1) Family and friends (14%); (2) Financial (17%); (3) Personal freedom related to being gay (10%); (4) Pursuit of opportunities while living openly as SMM (12%); (5) Educational purposes (18%); (6) Not my decision (29%). While HIV testing (range = 57.6-65.4%) and PrEP use (range = 15.6-21.4%) did not vary by class (p > .05 for all), CAS and illicit drug use were significantly different (p < .05). SMM who migrated to pursue opportunities while living openly and whose reasons were not their decision had greater odds of CAS than SMM who migrated for educational purposes (aOR:1.72, 95% confidence interval [95%CI]:1.15-2.59; 1.57, 1.13-2.19, respectively). Reasons for migration among SMM were associated with behaviors that can increase HIV risk, but not testing or PrEP. Push and pull factors related to migration should be considered when developing behavioral HIV interventions for immigrant SMM.
MeSH term(s)	Male ; Humans ; United States/epidemiology ; Homosexuality, Male ; Latent Class Analysis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Sexual and Gender Minorities ; Sexual Behavior ; Substance-Related Disorders/epidemiology ; Illicit Drugs
Chemical Substances	Illicit Drugs
Language	English
Publishing date	2023-10-09
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/s10461-023-04204-y
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Article ; Online: A Pilot TB Screening Model in a U.S. Prison Population Using Tuberculin Skin Test and Interferon Gamma Release Assay Based on Country of Origin.

Kerani, Roxanne P / Shapiro, Adrienne E / Strick, Lara B

Journal of correctional health care : the official journal of the National Commission on Correctional Health Care

2021 Volume 27, Issue 4, Page(s) 259–264

Abstract: The objective of this study was to compare tuberculosis (TB) screening results before and after implementation of a stratified testing strategy screening pilot study, incorporating interferon gamma release assay (IGRA) and tuberculin skin test (TST), ... ...

Abstract	The objective of this study was to compare tuberculosis (TB) screening results before and after implementation of a stratified testing strategy screening pilot study, incorporating interferon gamma release assay (IGRA) and tuberculin skin test (TST), based on country of origin. In 2015, the Washington State Department of Corrections began screening people born outside of the United States for TB with IGRA, while U.S.-born people continued screening by TST. Of 405 (75%) foreign-born men screened with IGRA, 403 had valid test results and IGRA screening positivity was 10.4% (
MeSH term(s)	Humans ; Interferon-gamma Release Tests ; Latent Tuberculosis/diagnosis ; Latent Tuberculosis/epidemiology ; Male ; Mass Screening ; Pilot Projects ; Prisons ; Tuberculin Test ; United States/epidemiology
Language	English
Publishing date	2021-10-14
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	2233559-6
ISSN	1940-5200 ; 1078-3458
ISSN (online)	1940-5200
ISSN	1078-3458
DOI	10.1089/jchc.19.07.0056
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Article ; Online: STI partner services outcomes before and during the SARS-CoV-2 pandemic in King County, WA.

Fenelon, Hannah T / Berzkalns, Anna / Amiya, Rachel M / Barbee, Lindley A / Dombrowski, Julia C / Golden, Matthew R / Kerani, Roxanne P

Sexually transmitted diseases

2024

Abstract: Background: SARS-CoV-2 pandemic mitigation efforts resulted in reallocation of public health personnel, likely impacting provision of timely sexually transmitted infection (STI) partner services (PS). We describe PS outcomes before and during the ... ...

Abstract	Background: SARS-CoV-2 pandemic mitigation efforts resulted in reallocation of public health personnel, likely impacting provision of timely sexually transmitted infection (STI) partner services (PS). We describe PS outcomes before and during the pandemic in King County, WA. Methods: We examined PS outcomes for syphilis and gonorrhea cases diagnosed in 2019 and three periods in 2020 (pre-lockdown:1/1/2020-3/23/2020; lockdown: 3/24/2020-6/5/2020, post-lockdown: 6/6/2020-12/31/20). We described changes over time in three PS outcomes: cases initiated, interviewed, and with named sex partners. We calculated adjusted prevalence ratios (aPRs) with Poisson regression comparing these outcomes in the 2020 periods to 2019. Results: Reported gonorrhea (4,611 vs. 4,179) and syphilis (665 vs. 586) cases declined from 2019 to 2020. In 2019, 60.7% of cases were initiated, compared with 42.1% before lockdown (aPR:0.74, 95% CI:0.70-0.78%), 41.7% during lockdown (aPR:0.79; 95% CI:0.73-0.85), and 41.7% after lockdown (aPR:0.81, 95% CI:0.77-0.85). Among initiated cases, the proportion interviewed also appeared to drop in the three lockdown periods (52.4%, 41.0%, 44.1%) compared to 2019 (55.7%). However, in adjusted analyses, the prevalence of interview among case patients was only lower pre-lockdown (aPR:0.91; 95% CI:0.85-0.99), and higher during (aPR:1.10; 95% CI:1.01-1.20) and after (aPR:1.12; 95% CI:1.06-1.19). Interviewed patients named partners more often during (21.4%, aPR:1.35; 95% CI:1.05-1.74) and less often after lockdown (16.0%, aPR:0.63; 95% CI:0.51-0.79), compared to 2019 (26.6%). Conclusions: These results underscore the need for a trained public health worker reserve, and plans for deployment of existing workers and prioritization of cases to continue essential STI public health activities during public health crises.
Language	English
Publishing date	2024-02-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001960
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Article ; Online: Scaring Undocumented Immigrants Is Detrimental to Public Health.

Kerani, Roxanne P / Kwakwa, Helena A

American journal of public health

2018 Volume 108, Issue 9, Page(s) 1165–1166

MeSH term(s)	Fear ; Health Services Accessibility ; Health Status Disparities ; Humans ; Public Health ; Undocumented Immigrants/psychology
Language	English
Publishing date	2018-08-07
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural
ZDB-ID	121100-6
ISSN	1541-0048 ; 0090-0036 ; 0002-9572
ISSN (online)	1541-0048
ISSN	0090-0036 ; 0002-9572
DOI	10.2105/AJPH.2018.304596
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Article: The Syphilis Epidemic Among Heterosexuals Is Accelerating: Evidence From King County, Washington.

Berzkalns, Anna / Ramchandani, Meena S / Cannon, Chase A / Kerani, Roxanne P / Dombrowski, Julie C / Golden, Matthew R

Open forum infectious diseases

2023 Volume 10, Issue 10, Page(s) ofad481

Abstract: Background: We characterized the rapid increase in syphilis among cisgender women in King County, Washington, and compared it with trends among cisgender men who have sex with men.: Method: We used surveillance data from King County, 2007 to 2022, to ...

Abstract	Background: We characterized the rapid increase in syphilis among cisgender women in King County, Washington, and compared it with trends among cisgender men who have sex with men. Method: We used surveillance data from King County, 2007 to 2022, to describe incidence trends stratified by syphilis stage, gender, and gender of sex partners; trends in pregnant cases and congenital syphilis; and trends in rapid plasma reagin titer at diagnosis among late/unknown duration cases. We used joinpoint regression to analyze trends. Results: Among cisgender women, all-stage syphilis incidence remained stable from 2007 to 2010 but then increased by 16.3% per year (95% CI, 12.0%-20.7%) from 2010 to 2020 and 90.1% per year (95% CI, 26.4%-185.9%) from 2020 to 2022. Early syphilis rates rose gradually from 2007 to 2017 (18% per year; 95% CI, 7.4%-29.6%) and then rapidly from 2017 to 2022 (62.5% per year; 95% CI, 24.1%-112.9%). In contrast, the increase in late/unknown duration syphilis incidence was delayed. Among cisgender men who have sex with women, all-stage syphilis remained stable from 2007 to 2014 and increased 25.0% per year (95% CI, 14.0%-37.0%) from 2014 to 2022. Syphilis incidence increased steadily among men who have sex with men, with all-stage incidence increasing 7.0% per year (95% CI, 4.8%-9.2%) from 2007 to 2022. Median rapid plasma reagin titer among late/unknown duration cases increased significantly over the analysis period. Conclusions: An explosive epidemic of syphilis is ongoing in King County. The delayed increase in asymptomatic late/unknown duration cases relative to early symptomatic cases suggests that there is a large and growing reservoir of recently acquired undiagnosed syphilis in women. New clinical and public health activities are urgently needed to control the growing epidemic.
Language	English
Publishing date	2023-09-23
Publishing country	United States
Document type	Journal Article
ZDB-ID	2757767-3
ISSN	2328-8957
ISSN	2328-8957
DOI	10.1093/ofid/ofad481
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Article ; Online: Previous Sexually Transmitted Infections and Partner Services Interviews as Predictors of Subsequent Interview Completion Among Cisgender MSM: Partner Services Fatigue?

Barry, Michael P / Thibault, Christina S / Berzkalns, Anna / Spellman, Dawn R / Rowlinson, Emily / Barbee, Lindley A / Golden, Matthew R / Kerani, Roxanne P

Sexually transmitted diseases

2023 Volume 50, Issue 8, Page(s) 506–511

Abstract: Background: Anecdotal reports suggest that partner services (PS) are less successful among people with repeat sexually transmitted infection (STI) diagnoses and/or previous PS interactions. We examine whether having repeated STI diagnoses and/or PS ... ...

Abstract	Background: Anecdotal reports suggest that partner services (PS) are less successful among people with repeat sexually transmitted infection (STI) diagnoses and/or previous PS interactions. We examine whether having repeated STI diagnoses and/or PS interactions is associated with PS outcomes among men who have sex with men (MSM). Methods: With STI surveillance and PS data for MSM diagnosed with gonorrhea, chlamydia, and/or syphilis from 2007 to 2018, in King County, WA, we used Poisson regression models to examine the relationships between PS outcomes (e.g., completing a PS interview and providing identifying information for a contact) with (1) number of previous STI case episodes and (2) number of previous PS interviews completed. Results: Of the 18,501 MSM STI case patients initiated for interview in the analytic period (2011-2018), 13,232 (72%) completed a PS interview, and 8,030 (43%) had at least 1 prior PS interview. The proportion of initiated cases successfully interviewed declined from 71% among those with no previous PS interview to 66% among those with ≥3 prior interviews. Similarly, the proportion of interviews with ≥1 partner identified declined with greater numbers of previous PS interviews (from 46% [0 interviews] to 35% [≥3 interviews]). In multivariate models, having ≥1 prior PS interview was negatively associated with completing a subsequent interview and providing partner locating information. Conclusions: Having a history of STI PS interviews is associated with less PS engagement among MSM. New approaches to PS should be explored to address the growing epidemic of STIs among MSM.
MeSH term(s)	Male ; Humans ; Homosexuality, Male ; Sexual Partners ; Sexual and Gender Minorities ; Sexually Transmitted Diseases/diagnosis ; Sexually Transmitted Diseases/epidemiology ; Sexually Transmitted Diseases/prevention & control ; Gonorrhea/diagnosis ; Gonorrhea/epidemiology ; Gonorrhea/prevention & control ; Fatigue ; HIV Infections/diagnosis ; HIV Infections/epidemiology ; HIV Infections/prevention & control ; Chlamydia Infections/diagnosis ; Chlamydia Infections/epidemiology ; Chlamydia Infections/prevention & control
Language	English
Publishing date	2023-05-20
Publishing country	United States
Document type	Journal Article ; Research Support, U.S. Gov't, P.H.S.
ZDB-ID	435191-5
ISSN	1537-4521 ; 0148-5717
ISSN (online)	1537-4521
ISSN	0148-5717
DOI	10.1097/OLQ.0000000000001822
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