Publications
IWRI
Publications
2010
Iralu, J.; Duran, B.; C Pearson, Jiang; Foley, K.; Harrison, M.
Risk Factors for HIV Disease Progression in a Rural Southwest American Indians Population Journal Article
In: Public health reports, vol. 125, no. Suppl 4, pp. 43-50, 2010, ISSN: 0033-3549.
Abstract | BibTeX | Tags: Pearson C. R.
@article{*Iralu2010,
title = {Risk Factors for HIV Disease Progression in a Rural Southwest American Indians Population},
author = {Iralu, J. and Duran, B. and Pearson, C, Jiang, Y. and Foley, K. and Harrison, M.},
issn = {0033-3549},
year = {2010},
date = {2010-07-16},
journal = {Public health reports},
volume = {125},
number = {Suppl 4},
pages = {43-50},
abstract = {OBJECTIVES:
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community.
METHODS:
From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome.
RESULTS:
Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of < $1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p < 0.05), household income of < $1,000/month (p < 0.05), and provider-assessed alcohol abuse (p < 0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p < 0.05) and use of traditional medicine (p < 0.05).
CONCLUSIONS:
Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.},
keywords = {Pearson C. R.},
pubstate = {published},
tppubtype = {article}
}
OBJECTIVES:
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community.
METHODS:
From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome.
RESULTS:
Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of < $1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p < 0.05), household income of < $1,000/month (p < 0.05), and provider-assessed alcohol abuse (p < 0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p < 0.05) and use of traditional medicine (p < 0.05).
CONCLUSIONS:
Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Risk factors for human immunodeficiency virus (HIV) disease progression among American Indians (AIs) have been poorly characterized. We assessed the impact of socioeconomic factors and use of traditional healing on HIV disease progression in a rural AI community.
METHODS:
From January 2004 through December 2006, we interviewed 36 HIV-positive AIs regarding their socioeconomic status, incarceration, and use of traditional healing. We also collected chart-abstracted adherence and substance-abuse data. Through bivariate analysis, we compared these factors with the CD4-cell counts and log HIV-1 viral loads (VLs). Using a simple regression model, we assessed interactions between the significant associations and the outcome.
RESULTS:
Participant characteristics included being male (58.3%), being transgender (13.9%), having ever been incarcerated (63.9%), having a household income of < $1,000/month (41.7%), being unemployed (61.1%), being diagnosed with alcohol abuse (50.0%), and using traditional medicine (27.8%) in the last 12 months. Higher VLs were associated with recent incarceration (p < 0.05), household income of < $1,000/month (p < 0.05), and provider-assessed alcohol abuse (p < 0.05). We found an interaction between incarceration and alcohol abuse, and alcohol abuse was the factor more strongly associated with higher VLs. A lower CD4 count was associated with recent incarceration (p < 0.05) and use of traditional medicine (p < 0.05).
CONCLUSIONS:
Alcohol abuse is an important contributor to HIV disease progression, and participants with lower CD4 counts were more likely to use traditional medicine. HIV care among this rural AI population should focus on addressing alcohol abuse and other socioeconomic risk factors and promote collaboration between Western medical and Navajo traditional practitioners.
Cassels, S.; Pearson, C. R.; Walters, K. L.; Simoni, J. M.; Morris, M
Sexual Partner Concurrency and Sexual Risk Among Gay, Lesbian, Bisexual, and Transgender American Indian/Alaska Natives Journal Article
In: 2010.
Abstract | Links | BibTeX | Tags: Pearson C. R.
@article{Cassels2010,
title = {Sexual Partner Concurrency and Sexual Risk Among Gay, Lesbian, Bisexual, and Transgender American Indian/Alaska Natives},
author = {Cassels, S. and Pearson, C. R. and Walters, K. L. and Simoni, J. M. and Morris, M},
url = {http://www.ncbi.nlm.nih.gov/pubmed/20051930},
year = {2010},
date = {2010-04-01},
abstract = {Disproportionately high rates of HIV infection are among the “pervasive health disparities” found among American Indian and Alaska Natives, wrote the authors, who noted, “Sexual network dynamics, including concurrency and sexual mixing patterns, are key determinants of HIV disparities.” Data from the first national study of gay, lesbian, bisexual, and transgender American Indian and Alaska Natives were analyzed to study the prevalence of concurrency, sex and race of partners, and level of risk across different partnership patterns. “Egocentric network data were analyzed at the level of respondents, who were grouped according to the sex of their last three partners,” the authors wrote. In this population, the researchers noted overall high rates of HIV and concurrency. Men who had sex with men exclusively had the highest HIV prevalence (34 percent) and cumulative prevalence of concurrency (55 percent). Concurrency and HIV prevalence were lower among women who had sex with women exclusively. HIV prevalence of 15 percent was found among women who had sex with women and men. These women also had a slightly higher concurrency risk and low rates of condom use, “making them effective bridge populations,” the authors wrote. “The uniformly high rates of Native partner selection creates the potential for amplification of disease spread within this small community, while the high rates of selecting partners of other races creates the potential for bridging to other groups in the transmission network,” the researchers concluded. “These findings provide some of the first insights into sexual networks and concurrency among Native gay, lesbian, bisexual, and transgender populations and suggest that both men and women deserve attention in HIV prevention efforts at individual, dyadic, and populations levels.”},
keywords = {Pearson C. R.},
pubstate = {published},
tppubtype = {article}
}
Disproportionately high rates of HIV infection are among the “pervasive health disparities” found among American Indian and Alaska Natives, wrote the authors, who noted, “Sexual network dynamics, including concurrency and sexual mixing patterns, are key determinants of HIV disparities.” Data from the first national study of gay, lesbian, bisexual, and transgender American Indian and Alaska Natives were analyzed to study the prevalence of concurrency, sex and race of partners, and level of risk across different partnership patterns. “Egocentric network data were analyzed at the level of respondents, who were grouped according to the sex of their last three partners,” the authors wrote. In this population, the researchers noted overall high rates of HIV and concurrency. Men who had sex with men exclusively had the highest HIV prevalence (34 percent) and cumulative prevalence of concurrency (55 percent). Concurrency and HIV prevalence were lower among women who had sex with women exclusively. HIV prevalence of 15 percent was found among women who had sex with women and men. These women also had a slightly higher concurrency risk and low rates of condom use, “making them effective bridge populations,” the authors wrote. “The uniformly high rates of Native partner selection creates the potential for amplification of disease spread within this small community, while the high rates of selecting partners of other races creates the potential for bridging to other groups in the transmission network,” the researchers concluded. “These findings provide some of the first insights into sexual networks and concurrency among Native gay, lesbian, bisexual, and transgender populations and suggest that both men and women deserve attention in HIV prevention efforts at individual, dyadic, and populations levels.”
