Biomedical subjects

Getahun Aynalem

Publications and source records attributed to Getahun Aynalem.

5 recordsLinked to original sources

PubMed2006

Epidemiologic investigation of a cluster of workplace HIV infections in the adult film industry: Los Angeles, California, 2004.

BACKGROUND: Adult film production is a legal, multibillion dollar industry in California. In response to reports of human immunodeficiency virus (HIV) transmission by an adult film worker, we sought to determine the extent of HIV infection among exposed workers and to identify means of improving worker safety. METHODS: The Los Angeles County Department of Health Services initiated an outbreak investigation that included interviews of infected workers to elicit information about recent sex partners, review of the testing agency's medical records and laboratory results, molecular analysis of HIV isolates from the 4 infected workers, and a risk assessment of HIV transmission in the adult film industry. RESULTS: Many adult film workers participate in a monthly program of screening for HIV infection by means of polymerase chain reaction-based technology to detect HIV DNA in blood. A male performer tested negative for HIV on 12 February 2004 and 17 March 2004, then tested positive for HIV on 9 April 2004. During the period between the negative test results, he experienced a flulike illness after performing unprotected vaginal and anal intercourse for an adult film produced outside the United States by a US company. After returning to California, he performed unprotected sex acts for adult films with 13 female partners who had all tested negative for HIV in the preceding 30 days; 3 subsequently tested positive for HIV (a 23% attack rate). Contact tracing identified no reasonable sources of infection other than the male index patient. CONCLUSION: Although current testing methods may shorten the window period to diagnosis of new HIV infection, they fail to prevent occupational acquisition of HIV in this setting. A California Occupational Safety and Health Administration-approved written health and safety program that emphasizes primary prevention is needed for this industry.

Adult↗

PubMed2005

Use of the serologic testing algorithm for recent HIV seroconversion (STARHS) to identify recently acquired HIV infections in men with early syphilis in Los Angeles County.

BACKGROUND: Syphilis outbreaks among men who have sex with men (MSM) in the United States, many of whom are HIV infected, have prompted increased concern for HIV transmission. METHODS: To identify whether men are acquiring HIV concomitantly or within the critical period of syphilis infection, banked Treponema pallidum particle agglutination-positive serum specimens from men with early syphilis infection were screened for HIV-1 antibody. Samples that were positive for HIV antibody were then tested with a less sensitive (LS) HIV-1 antibody enzyme immunoassay (serologic testing algorithm for recent HIV seroconversion [STARHS]) to identify HIV infections that occurred on average within the previous 6 months. RESULTS: Of the 212 specimens banked from men with early syphilis, 74 (35%) were HIV-positive. Of these, 15 tested non-reactive by the LS assay. Twelve of these 15 were considered to be recent infections by the LS assay and testing history. Eleven (92%) of the recent infections were among MSM. One man had primary syphilis, 6 (50%) had secondary syphilis, and 5 (42%) had early latent syphilis. Eight men (67%) reported sex with anonymous partners, and 3 (25%) reported consistent condom use. The estimated HIV incidence was 17% per year (95% confidence interval [CI]: 12%-22%) among all men with early syphilis, and it was 26% per year (95% CI: 91%-33%) among MSM. CONCLUSIONS: Syphilis epidemics in MSM may be contributing to HIV incidence in this population. The STARHS can be applied as a surveillance tool to assess HIV incidence in various at-risk populations, but further studies are necessary for validation.

Adult↗

PubMed2005

Sexually transmitted disease testing protocols, sexually transmitted disease testing, and discussion of sexual behaviors in HIV clinics in Los Angeles County.

OBJECTIVE/GOAL: The objective of this study was to evaluate the use of written protocols for sexually transmitted disease (STD) screening, the frequency and types of STD tests performed, and the occurrence and frequency of obtaining sexual risk assessments among HIV clinics. STUDY: A survey was administered to 36 medical directors, clinic directors, and HIV providers representing 48 HIV healthcare clinics in Los Angeles. RESULTS: The use of a written or electronic protocol for STD testing was reported by 50% of clinics. Clinics with written or electronic STD protocols were significantly more likely to report questioning patients at each visit regarding their sexual practices (prevalence ratio, 2.2; 95% confidence interval, 1.4-3.4). Clinics with written or electronic protocols were not more likely to report more frequent STD testing. CONCLUSIONS: Written or electronic protocols for STD testing may promote sexual risk assessment questioning among HIV healthcare providers and may help to ensure STD testing per Centers for Disease Control and Prevention/IDSA guidelines for HIV-positive persons at sexual risk.

Ambulatory Care Facilities↗

PubMed2004

Who and why? HIV-testing refusal during pregnancy: implication for pediatric HIV epidemic disparity.

To identify characteristics of pregnant women who refuse HIV testing and determine predictive factors and the reasons for refusal, we conducted face-to-face interviews of pregnant women at prenatal clinics of public and private hospitals. We found 8% (n=65) of 826 pregnant women interviewed refused HIV testing. In bivariate analysis, foreign-born pregnant women residing in Los Angeles County were twice more likely to refuse HIV testing than U.S.-born pregnant women (odds ratio [OR] = 1.97, 95% confidence interval [CI] 1.11-3.49, p <.05). In a multivariate stepwise logistic regression model analysis, variables that were independent predictors of HIV testing refusal during pregnancy were being foreign-born (OR = 2.11, 95% CI 1.07-4.38), not receiving general information about HIV (OR = 7.48, 95% CI 1.86-30.01), and not receiving specific information about HIV and pregnancy (OR = 3.54, 95% CI 1.91-6.57). The most common reasons for testing refusal were being in a monogamous relationship for foreign-born women (41%) and already being tested for U.S.-born women (65%).

Adolescent↗

PubMed2004

Correlates of Internet use to meet sex partners among men who have sex with men diagnosed with early syphilis in Los Angeles County.

OBJECTIVE: The objective of this study was to evaluate use of the Internet to solicit sex partners by men who have sex with men (MSM) who were diagnosed with early syphilis infection. STUDY: Field interview records for syphilis patients were reviewed for factors associated with Internet use. RESULTS: Internet users were more likely to be of white race (prevalence ratio [PR], 1.6; 95% confidence interval [CI], 1.4-1.8), to report anal insertive sex (PR, 1.1; 95% CI, 1.1-1.2), sex with anonymous partners (PR, 1.2; 95% CI, 1.1-1.3), intravenous drug use (PR, 2.7; 95% CI, 1.1-6.7), and nonintravenous drug use (PR, 1.4; 95% CI, 1.1-1.8). Controlling for race and sexual risk behaviors, white race (odds ratio [OR], 2.8; 95% CI, 1.8-4.6), having anonymous sex partners (OR, 3.4; 95% CI, 1.6-7.0), and nonintravenous drug use (OR, 1.6; 95% CI, 1.1-2.6) were associated with meeting sex partners through the Internet. CONCLUSIONS: Effective sexually transmitted disease risk reduction interventions using the Internet are needed to reach Internet-using, sex-seeking MSM populations engaging in high-risk behaviors.

Adult↗