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Enrique R Pouget

Publications and source records attributed to Enrique R Pouget.

7 recordsLinked to original sources

Contextual determinants of condom use among female sex exchangers in East Harlem, NYC: an event analysis.

Recent studies have revealed a variety of contexts involving HIV risk behaviors among women who exchange sex for money or drugs. Event analysis was used to identify the individual, relationship, and contextual factors that contribute to these high-risk sex exchange practices. Analyses were conducted on data obtained from 155 drug-using women who reported details of their most recent sex exchange event with male clients. The majority of sex exchange encounters (78%) involved consistent condom use. In multivariable analysis, protective behavior was associated primarily with situational and relationship variables, such as exchange location, substance use, sexual practices, and respondent/client discussion and control. In order to inform HIV prevention programs targeted to women sex exchangers, further research is needed on the contextual determinants of risk, especially with regard to condom-use negotiation and factors involving substance use that adversely affect women's ability to manage protective behavior in the context of sex exchange.

Adult↗

A guide for multilevel modeling of dyadic data with binary outcomes using SAS PROC NLMIXED.

In the social and health sciences, data are often structured hierarchically, with individuals nested within groups. Dyads constitute a special case of hierarchically structured data with variation at both the individual and dyadic level. Analyses of data from dyads pose several challenges due to the interdependence between members within dyads and issues related to small group sizes. Multilevel analytic techniques have been developed and applied to dyadic data in an attempt to resolve these issues. In this article, we describe a set of analyses for modeling individual- and dyad-level influences on binary outcomes using SAS statistical software; and we discuss the benefits and limitations of such an approach. For illustrative purposes, we apply these techniques to estimate individual-dyad-level predictors of viral hepatitis C infection among heterosexual couples in East Harlem, New York City.

Journal Article↗

Receptive syringe sharing among injection drug users in Harlem and the Bronx during the New York State Expanded Syringe Access Demonstration Program.

BACKGROUND: Effective on January 1, 2001, New York State enacted the Expanded Syringe Access Demonstration Program (ESAP), which allows syringes to be sold in pharmacies without a prescription or dispensed through doctors, hospitals, and clinics to persons 18 years of age or older and permits the possession of those syringes for the purposes of injecting drugs. OBJECTIVE: To assess changes in receptive syringe sharing since the inception of the ESAP. METHODS: Sociodemographic characteristics and syringe use data regarding the last injection episode were combined from 3 projects (n = 1181) recruiting injection drug users in ongoing studies in Harlem and the Bronx in New York City from January 2001 through June 2003. These data were analyzed as serial cross sections by calendar quarter. RESULTS: Receptive sharing decreased significantly over time, from 13.4% in the first quarter to 3.6% in the last quarter. Obtaining the last injection syringe from an ESAP source (mostly pharmacies) increased significantly over time, from 7.5% in the first quarter to 25.0% in the last quarter. In multiple logistic regression analysis, variables that were significantly associated with less receptive sharing were syringe exchange and ESAP syringe source as well as time since ESAP inception. Female gender and white race/ethnicity were significantly associated with greater receptive sharing. CONCLUSIONS: The increase in the use of pharmacies and other ESAP syringe sources in this sample has been accompanied by a decline in receptive sharing.

Adult↗

Sharing of noninjection drug-use implements as a risk factor for hepatitis C.

This study examined sharing noninjection drug implements as a risk factor for hepatitis C (HCV) infection among women drug users (n = 123) with no history of drug injection. Participants were street-recruited from East Harlem, New York City, between October 1997 and June 1999. Participants were administered a survey measuring risk factors for HCV. Prevalence of HCV and HIV infections was 19.5% and 14.6%, respectively. Multiple logistic regression determined significant associations between sharing noninjection drug-use implements and HCV infection. "Ever shared both oral and intranasal noninjection drug implements" was independently associated with HCV infection [Odds ratio (OR) 2.83; Confidence interval (CI) 1.04, 7.72; p = 0.04]; "ever shared noninjected heroin implements with an injector" was a trend (OR 3.06; CI .85, 10.79; p = 0.08). The strongest association between sharing noninjection drug-use implements and HCV infection was found among HIV positive individuals (chi2 = 8.8, 1 d.f., p < 0.01). These findings, if supported by future research, indicate a need to reassess policies regarding HCV infection.

Administration, Intranasal↗

Recruitment of heterosexual couples in public health research: a study protocol.

BACKGROUND: Public health research involving social or kin groups (such as sexual partners or family members), rather than samples of unrelated individuals, has become more widespread in response to social ecological approaches to disease treatment and prevention. This approach requires the development of innovative sampling, recruitment and screening methodologies tailored to the study of related individuals. METHODS: In this paper, we describe a set of sampling, recruitment and screening protocols developed to enlist urban, drug-using, heterosexual couples into a public health research study. This population is especially hard to reach because they are engaged in illegal and/or stigmatized behaviors. The protocols were designed to integrate adaptive sampling, street- and referral-based recruitment, and screening procedures to verify study eligibility and relationship status. DISCUSSION: Recruitment of heterosexual couples through one partner, preferably the female, can be an effective enlistment technique. Verification of relationship status is an important component of dyadic research. Comparison of parallel questionnaires administered to each member of a dyad can aid in the assessment of relationship status. However, multiple independent sources of information should be used to verify relationship status when available. Adaptive sampling techniques were effective in reaching drug-using heterosexual couples in an urban setting, and the application of these methods to other groups of related individuals in clinical and public health research may prove to be useful. However, care must be taken to consider potential sources of sampling bias when interpreting and generalizing study results.

Adult↗

Prediction of treatment response in geriatric depression from baseline folate level: interaction with an SSRI or a tricyclic antidepressant.

Depressed geriatric patients have lower levels of folate (FOL) than controls. Also, FOL supplement can reduce depressive morbidity. One hypothesis consistent with this is that FOL deficiency causes a lowering of CNS serotonin that contributes to depression. The present report is from one site of a multicenter study that compared an SSRI (sertraline) with a nonspecific tricyclic antidepressant (nortriptyline) in geriatric depressed patients. We added measures of FOL at baseline and outcome for 22 depressed patients older than 60 years. Both treatments were effective. At baseline, FOL levels were within the normal range. Higher FOL levels at baseline predicted greater improvement. Further study of FOL interaction with SSRI is warranted. For the group treated with the SSRI, baseline FOL level was a more efficient predictor of improvement, especially for results on a self-rating depression scale (POMS).

Aged↗

A comparison of clinical ratings with vocal acoustic measures of flat affect and alogia.

In this report we compare clinical ratings of flat affect and alogia with objective measures of the patient's speech prosody and productivity. Thirty schizophrenic patients were evaluated with the Scale for the Assessment of Negative Symptoms (SANS) and the St. Hans Rating Scale for extra pyramidal side effects. Their speech was recorded and analyzed acoustically for measures of prosody and productivity. Correlations between pairs of SANS items and acoustic measures (e.g. Vocal Inflection and Fundamental Frequency Variance) were weak. The SANS item and global ratings were strongly related. Ratings of bradykinesia overlapped with the SANS ratings but not with the acoustic measures. The SANS ratings appear to be derived from global impressions, with diffuse confounding of flat affect with alogia, and with bradykinesia. Acoustic analysis has the potential to provide objective measures that may help develop operational definitions of these constructs and enhance clinical assessment.

Adult↗