Evaluation of multiple data sources for predicting increased need for HIV prevention among cisgender women: understanding missed opportunities for Pre-exposure Prophylaxis (PrEP).
Evaluation of multiple data sources for predicting increased need for HIV prevention among cisgender women: understanding missed opportunities for Pre-exposure Prophylaxis (PrEP).
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DOI：
10.1186/s12879-023-08719-6
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发表时间：
2023-11-09
影响因子：
3.7
通讯作者：
Ridgway, Jessica
中科院分区：
文献类型：
--
作者：
Johnson, Amy K.;Devlin, Samantha;Haider, Sadia;Oehler, Cassandra;Rivera, Juan;Alvarez, Isa;Ridgway, Jessica
与男性相比，在艾滋病毒预防暴露前预防（PrEP）使用者中，顺性别女性所占比例低得不成比例。尽管PrEP有效，但女性服用PrEP的可能性比男性低5.25倍。确定有更多理由预防艾滋病毒的妇女，并向这些妇女提供PrEP，这对减少艾滋病毒传播和整体健康公平至关重要。然而，确定感染艾滋病毒风险最高的妇女的最佳方法仍然未知。本研究旨在确定常见的艾滋病毒风险因素和用于确定这些常见因素的数据来源（例如，电子病历数据，开源社区数据），以及潜在的干预点和错过的PrEP联系机会。我们对多个数据源进行了评估：半结构化定性访谈、电子病历（EMR）图表抽象和开源数据抽象。我们访问了登记参与者的EMR，所有参与者都签署了一份标准的医疗信息发布（ROI）表格，这些表格适用于他们在艾滋病毒诊断前五年内接受医疗护理的所有机构。使用标准化程序提取数据。结构化和非结构化字段（即，免费笔记的叙述性文本）进行了检查，并纳入分析。最后，开放数据源（例如，按芝加哥的社区区域检查STI病例、HIV流行率）。开放数据源被用来检查几个因素，有助于整体经济困难指数（EHI）得分。我们使用这些计算出的分数来评估参与者社区的经济困难。共有18名感染艾滋病毒的顺性别妇女参加了我们的研究。参与者主要是黑人/非洲裔美国人（55.6%）和年轻人（中位年龄为34岁）。我们的分析确定了两个主要的主题影响艾滋病毒的风险参与者：上下文因素和关系因素。此外，在生殖健康/产前访视、行为/心理健康访视和常规性传播感染检测期间，确定了潜在的诊断前干预点和错失的机会。我们对多个数据源的评估包括调查EMR中是否存在信息（STI历史，HIV检测，物质使用等）。以及是否可以从开放获取来源收集相关信息。最近被诊断出感染艾滋病毒的女同性恋者发现了许多共同的经历，包括精神疾病和药物滥用等综合性疾病，与男同性恋者发生性关系，以及在诊断前经常在艾滋病毒高发地区移动。除了标准化的问题外，提供者还必须询问患者的社会历史，有关伴侣的信息和其他关键变量。研究结果可用于更好地识别最容易感染艾滋病毒的顺式女性，并为她们提供PrEP，减少艾滋病毒传播。在线版本包含补充材料，可通过10.1186/s12879-023-08719-6获得。
Ciswomen constitute a disproportionately low percentage of pre-exposure prophylaxis for HIV prevention (PrEP) users compared to men. Despite PrEP’s effectiveness, women are 5.25 times less likely to take PrEP than men. Identifying women who have increased reasons for HIV prevention and educating and offering PrEP to these women is crucial to reducing HIV transmission and overall health equity. However, the best method of identifying women at highest risk of acquiring HIV remains unknown. This study aimed to identify common HIV risk factors and data sources for identifying these common factors (e.g., electronic medical record data, open source neighborhood data), as well as potential intervention points and missed opportunities for PrEP linkage. We conducted an evaluation of multiple data sources: semi-structured qualitative interviews, electronic medical record (EMR) chart abstraction, and open source data abstraction. We accessed EMRs for enrolled participants and all participants signed a standard release of medical information (ROI) form for all institutions at which they had received medical care for the five-year period preceding their HIV diagnosis. Data were abstracted using a standardized procedure. Both structured and unstructured fields (i.e., narrative text of free notes) within the EMR were examined and included for analysis. Finally, open data sources (e.g., STI cases, HIV prevalence) were examined by community area of Chicago. Open data sources were used to examine several factors contributing to the overall Economic Hardship Index (EHI) score. We used these calculated scores to assess the economic hardship within participants’ neighborhoods. A total of 18 cisgender women with HIV participated in our study. Participants were mostly Black/African American (55.6%) and young (median age of 34). Our analysis identified two main themes influencing HIV risk among participants: contextual factors and relationship factors. Further, potential pre-diagnosis intervention points and missed opportunities were identified during reproductive health/prenatal visits, behavioral/mental health visits, and routine STI testing. Our evaluation of multiple data sources included investigating the presence or absence of information in the EMR (STI history, HIV testing, substance use, etc.) as well as whether pertinent information could be gathered from open access sources. Ciswomen recently diagnosed with HIV identified many shared experiences, including syndemic conditions like mental illness and substance abuse, sex with men who have sex with men, and frequent moving in areas with high HIV incidence prior to their diagnosis. It is imperative that providers ask patients about social history, information about partners, and other key variables, in addition to the standardized questions. Findings can be used to better recognize ciswomen most vulnerable to HIV and offer PrEP to them, reducing HIV transmission. The online version contains supplementary material available at 10.1186/s12879-023-08719-6.
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影响因子：
3.2
作者：
Hsieh, HF;Shannon, SE
通讯作者：
Shannon, SE
DOI：
10.1097/qai.0000000000002548
发表时间：
2021-02-01
期刊：
Journal of acquired immune deficiency syndromes (1999)
影响因子：
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作者：
Teixeira da Silva D;Bouris A;Ramachandran A;Blocker O;Davis B;Harris J;Pyra M;Rusie LK;Brewer R;Pagkas-Bather J;Hotton A;Ridgway JP;McNulty M;Bhatia R;Schneider JA
通讯作者：
Schneider JA
DOI：
10.1093/jamia/ocab199
发表时间：
2021-12-28
期刊：
Journal of the American Medical Informatics Association : JAMIA
影响因子：
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作者：
Cook LA;Sachs J;Weiskopf NG
通讯作者：
Weiskopf NG
影响因子：
5.5
作者：
Gottlieb, Laura M.;Tirozzi, Karen J.;Sandel, Megan T.
通讯作者：
Sandel, Megan T.
影响因子：
3.9
作者：
Pyra M;Johnson AK;Devlin S;Uvin AZ;Irby S;Stewart E;Blum C;Green M;Haider S;Hirschhorn LR;Ridgway JP
通讯作者：
Ridgway JP