Biomedical subjects

Lisa V Smith

Publications and source records attributed to Lisa V Smith.

5 recordsLinked to original sources

PubMed2006

Client satisfaction with rapid HIV testing: comparison between an urban sexually transmitted disease clinic and a community-based testing center.

Rapid HIV testing allows same-day results, increasing the number of persons who learn their HIV status. Understanding how clients in different settings perceive rapid testing may increase acceptance of this technology. From June 1999 to August 2001 we interviewed 256 clients at a publicly funded urban sexually transmitted disease (STD) clinic and 1201 clients at a community- based HIV counseling, testing, and referral center (Los Angeles Gay and Lesbian Center; LAGLC) about their posttest satisfaction with rapid HIV testing. HIV prevalence was 3.9% at the STD clinic and 5.3% at the LAGLC. In multivariate analysis, adjusting for age, sexual orientation, race/ethnicity, history of STDs, self-perceived HIV risk, prior HIV test and HIV testing results, clients at the STD clinics (versus LAGLC) were more likely to find testing stressful (adjusted odds ratio [AOR]: 1.75, 95% confidence limits [CL]: 1.27, 2.42) and feel that they received their results too quickly (AOR: 2.05, 95% CL: 1.39, 3.03). Latinos (versus whites) were more likely to report that they received their results too quickly (AOR: 4.99, 95% CL: 3.48, 7.14) and that it would be better to wait a week for HIV test results (AOR: 2.48, 95% CL: 1.51, 4.09). Further research may elucidate the reasons why some groups prefer to wait for results, and enable policymakers to better design strategies to reach high-risk groups with rapid HIV testing.

AIDS Serodiagnosis↗

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↗

PubMed2005

Characterization of frequent douchers attending a community clinic primarily serving African-American women.

OBJECTIVE: The purpose of this study is to characterize African-American women attending a community clinic who report frequent douching (douching > or = 2 times per week). METHODS: A consecutive sample of 115 black women attending a community clinic were interviewed face-to-face about their douching practices. Logistic regression was used to control for age and compute odds ratios and 95% confidence intervals. RESULTS: Of the 115 women interviewed, 93% (107) had douched sometime during their lifetime; 16% (18) reported douching > or = 2 times per week. Frequent douchers compared with women who douche < 2 times per month were more likely to report douching after sex [89% (n=16) vs. 49% (n=32), odds ratio (OR): 5.35, 95% confidence interval (CI): 1.09, 26.2] or after discharge [89% (n=1 6) vs. 58% (n=38), OR: 8.11, 95% CI: 1.64, 40.1], and self-report a history of gonorrhea [28% (n=5) vs. 8% (n=5), OR: 4.87, 95% CI: 1.07, 22.2]. CONCLUSION: Further research should be done to understand the use of douching as an STD/HIV prevention method and the association between sexual risk behaviors and douching practices.

Adolescent↗

PubMed2002

Chlamydia trachomatis in older Los Angeles County residents, 1991-1998: implications and recommendations for the detection of sexually transmitted infections in older age groups.

OBJECTIVES: This study examined the incidence and implications of reported chlamydia cases in Los Angeles County residents aged 50 and older. DESIGN: Observational study of passive surveillance data submitted to the Los Angeles County Sexually Transmitted Disease Program. SETTINGS: Private and public health facilities in Los Angeles County. PARTICIPANTS: Los Angeles County residents aged 50 and older. MEASUREMENTS: Chlamydia cases were identified from the Los Angeles County Sexually Transmitted Disease Program passive surveillance system reports received from 1991 to 1998. RESULTS: Between 1991 and 1998, 1,421 cases of chlamydia were reported in persons aged 50 and older in Los Angeles County, accounting for 1% of total chlamydia cases. The average annual incidence rate for this period was 9.3 per 100,000, and appeared relatively stable. The mean age +/- standard deviation was 59.0 +/- 9.2 years, with a range of 50 to 96 years. Rates for older women were 1.1 to 3.0 times higher than in older men, similar to rate ratios for 20- to 35-year-olds. Rates among older African Americans appear to be substantially higher than any other older racial/ethnic group. CONCLUSIONS: Our data show that there are no age barriers for sexually transmitted infections. Although this population is highly unlikely to experience adverse reproductive outcomes, transmission to younger sex partners and contribution to the overall chlamydia epidemic are serious concerns. Surveillance and prevention strategies aimed at older persons will be needed as this population continues to grow.

Aged↗