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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 25 of 32 Research Studies DisplayedEaton EF, Kulczycki A, Saag M
Immunization costs and programmatic barriers at an urban HIV clinic.
This study estimated costs of providing Gardasil, Prevnar, and Zostavax to eligible patients at a US Ryan White Part C academically affiliated HIV clinic in 2013. Its cost analysis of 3 vaccines showed great variation in insurance coverage, with potential losses of almost $100 000 for one HIV clinic if eligible patients received vaccinations in one calendar year.
AHRQ-funded; HS013852.
Citation: Eaton EF, Kulczycki A, Saag M .
Immunization costs and programmatic barriers at an urban HIV clinic.
Clin Infect Dis 2015 Dec;61(11):1726-31. doi: 10.1093/cid/civ637.
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Keywords: Human Immunodeficiency Virus (HIV), Healthcare Costs, Medication, Vaccination
Hellinger FJ
AHRQ Author: Hellinger FJ
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
This study examines the influence of the Affordable Care Act's optional state Medicaid expansion on insurance coverage and health outcomes for hospitalized patients with HIV. It found that the percentage of hospitalizations of uninsured people with HIV in the four expansion states fell from 13.7 percent to 5.5 percent in the study period, while the percentage in the two nonexpanding states increased from 14.5 percent to 15.7 percent.
AHRQ-authored.
Citation: Hellinger FJ .
In four ACA expansion states, the percentage of uninsured hospitalizations for people with HIV declined, 2012-14.
Health Aff 2015 Dec;34(12):2061-8. doi: 10.1377/hlthaff.2015.0718..
Keywords: Policy, Healthcare Cost and Utilization Project (HCUP), Hospitalization, Human Immunodeficiency Virus (HIV), Medicaid, Uninsured
Graham JL, Shahani L, Grimes RM
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
The present study was designed to determine if trust in physicians and the healthcare system among persons newly diagnosed with HIV infection was predictive of patients' subsequent linkage, retention, and adherence to HIV care. No significant association was found between trust-in-physicians and linkage to care or adherence to antiretroviral therapy.
AHRQ-funded; HS016093.
Citation: Graham JL, Shahani L, Grimes RM .
The influence of trust in physicians and trust in the healthcare system on linkage, retention, and adherence to HIV care.
AIDS Patient Care STDS 2015 Dec;29(12):661-7. doi: 10.1089/apc.2015.0156..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Outcomes, Healthcare Utilization
Whittle HJ, Palar K, Napoles T
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
The researchers investigated the perceived effects of food insecurity on risky sexual behaviors among a population of low-income people living with HIV/AIDS (PLHIV) in San Francisco and Alameda County, California. Their study demonstrated that food insecurity contributes to transactional and unprotected sex among urban poor individuals in a resource-rich setting, including among men who have sex with men.
AHRQ-funded; HS000046.
Citation: Whittle HJ, Palar K, Napoles T .
Experiences with food insecurity and risky sex among low-income people living with HIV/AIDS in a resource-rich setting.
J Int AIDS Soc 2015 Nov 4;18:20293. doi: 10.7448/ias.18.1.20293..
Keywords: Human Immunodeficiency Virus (HIV), Nutrition, Lifestyle Changes, Low-Income, Social Determinants of Health
Culbert GJ, Earnshaw VA, Wulanyani NM
Correlates and experiences of HIV stigma in prisoners living with HIV in Indonesia: a mixed-method analysis.
This mixed-method study explores HIV stigma in prisoners living with HIV in Jakarta, Indonesia. Results found four groups of HIV-infected prisoners with significantly higher HIV stigma levels and results highlighted the prominent role of HIV stigma in decisions to disclose HIV status to family members, partners, and other prisoners.
AHRQ-funded; HS022986.
Citation: Culbert GJ, Earnshaw VA, Wulanyani NM .
Correlates and experiences of HIV stigma in prisoners living with HIV in Indonesia: a mixed-method analysis.
J Assoc Nurses AIDS Care 2015 Nov-Dec;26(6):743-57. doi: 10.1016/j.jana.2015.07.006.
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Keywords: Human Immunodeficiency Virus (HIV), Social Stigma
Buscher AL, Kallen MA, Suarez-Almazor ME
Development of an "Impact of HIV" instrument for HIV survivors.
A newly created Impact of HIV Survey, modified from Zebrack's Impact of Cancer Scale, was developed and completed by 356 HIV-infected patients on antiretroviral therapy. Factor analyses confirmed seven scales within 38 items: Health Awareness, Positive Self-Evaluation, Positive Outlook, Value of Relationships, Negative Self-Evaluation-Outlook, Health Anxiety, and Body Change.
AHRQ-funded; HS016093.
Citation: Buscher AL, Kallen MA, Suarez-Almazor ME .
Development of an "Impact of HIV" instrument for HIV survivors.
J Assoc Nurses AIDS Care 2015 Nov-Dec;26(6):720-31. doi: 10.1016/j.jana.2015.08.002.
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Keywords: Human Immunodeficiency Virus (HIV), Quality of Life, Health Status
Silverberg MJ, Lau B, Achenbach CJ
Cumulative incidence of cancer among persons with HIV in North America: a cohort study.
The primary objective of the study was to compare time trends in cumulative cancer incidence in persons with and without HIV. It concluded that the high cumulative incidences by age 75 years for Kaposi sarcoma, non-Hodgkin lymphoma, and lung cancer support early and sustained antiretroviral therapy and smoking cessation.
AHRQ-funded; 90047713/PHS.
Citation: Silverberg MJ, Lau B, Achenbach CJ .
Cumulative incidence of cancer among persons with HIV in North America: a cohort study.
Ann Intern Med 2015 Oct 6;163(7):507-18. doi: 10.7326/m14-2768..
Keywords: Cancer, Human Immunodeficiency Virus (HIV), Tobacco Use
Nijhawan AE, Kitchell E, Etherton SS
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
The researchers assessed whether readmissions among HIV-infected patients were potentially preventable using both published criteria and detailed chart review, how readmissions might have been prevented, and the phase of care deemed suboptimal (inpatient care, discharge planning, post-discharge). They found that among 130 individuals experiencing 30-day readmissions, about half were determined to be potentially preventable using published criteria (53 percent) or implicit chart review (48 percent).
AHRQ-funded; HS022418.
Citation: Nijhawan AE, Kitchell E, Etherton SS .
Half of 30-day hospital readmissions among HIV-infected patients are potentially preventable.
AIDS Patient Care STDS 2015 Sep;29(9):465-73. doi: 10.1089/apc.2015.0096..
Keywords: Human Immunodeficiency Virus (HIV), Hospital Readmissions, Electronic Health Records (EHRs), Patient-Centered Outcomes Research, Prevention
Beach MC, Roter DL, Saha S
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
The authors designed this study to improve patient-provider communication about HIV medication adherence. They found that brief provider training, combined with patient coaching sessions, improved provider communication behaviors and increased dialogue regarding medication adherence.
AHRQ-funded; HS013903; 290010012.
Citation: Beach MC, Roter DL, Saha S .
Impact of a brief patient and provider intervention to improve the quality of communication about medication adherence among HIV patients.
Patient Educ Couns 2015 Sep;98(9):1078-83. doi: 10.1016/j.pec.2015.05.011.
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Keywords: Human Immunodeficiency Virus (HIV), Medication, Patient Adherence/Compliance, Patient and Family Engagement, Clinician-Patient Communication
Wang D, Le XH, Luque AE
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
The investigators analyzed correlations between promotional activities and usage of a guideline-driven interactive case simulation tool (ICST) for insomnia screening and treatment in a statewide HIV-HCV-STD clinical education program. They found that promotional activities were strongly correlated with the number of audience as well as the intensity of use of the target resource, with strong correlations identified between the sending of email newsletters and the intensity of resource use by promotion recipients, by new users, and through the most convenient access channel associated with the promotion.
AHRQ-funded; HS022057.
Citation: Wang D, Le XH, Luque AE .
Identifying effective approaches for dissemination of clinical evidence--correlation analyses on promotional activities and usage of a guideline-driven interactive case simulation tool in a statewide HIV-HCV-STD clinical education program.
Stud Health Technol Inform 2015;216:515-9.
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Keywords: Human Immunodeficiency Virus (HIV), Education: Continuing Medical Education, Simulation, Guidelines, Evidence-Based Practice, Health Promotion, Screening, Sleep Problems, Training
Viswanathan S, Justice AC, Alexander GC
Adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy.
The researchers examined trends in adherence to highly active antiretroviral therapy (HAART) and HIV RNA suppression. They found that, although all HIV-infected persons should be instructed to achieve perfect adherence, concerns of slightly lower adherence should not hinder prescribing new HAART regimens early in HIV infection.
AHRQ-funded; HS018372.
Citation: Viswanathan S, Justice AC, Alexander GC .
Adherence and HIV RNA suppression in the current era of highly active antiretroviral therapy.
J Acquir Immune Defic Syndr 2015 Aug 1;69(4):493-8. doi: 10.1097/qai.0000000000000643..
Keywords: Human Immunodeficiency Virus (HIV), Patient Adherence/Compliance, Medication
Palar K, Kushel M, Frongillo EA
Food insecurity is longitudinally associated with depressive symptoms among homeless and marginally-housed individuals living with HIV.
The researchers assessed the longitudinal association of food insecurity with symptoms of depression using validated measures among participants living with HIV from the Research on Access to Care in the Homeless cohort in San Francisco. They found that over half of participants (55.0 percent) were food insecure and 35.8 percent had symptoms of depression.
AHRQ-funded; HS00046.
Citation: Palar K, Kushel M, Frongillo EA .
Food insecurity is longitudinally associated with depressive symptoms among homeless and marginally-housed individuals living with HIV.
AIDS Behav 2015 Aug;19(8):1527-34. doi: 10.1007/s10461-014-0922-9..
Keywords: Human Immunodeficiency Virus (HIV), Depression, Vulnerable Populations
Earnshaw VA, Smith LR, Cunningham CO
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
The researchers examined whether the relationship between internalized HIV stigma and depressive symptoms is moderated by internalized substance use stigma. They found that participants who internalized HIV stigma experienced greater depressive symptoms only if they also internalized substance use stigma.
AHRQ-funded; HS022986.
Citation: Earnshaw VA, Smith LR, Cunningham CO .
Intersectionality of internalized HIV stigma and internalized substance use stigma: implications for depressive symptoms.
J Health Psychol 2015 Aug;20(8):1083-9. doi: 10.1177/1359105313507964..
Keywords: Depression, Human Immunodeficiency Virus (HIV), Behavioral Health, Social Stigma, Substance Abuse
Eckerle MD, Namde M, Holland CK
Opportunities for earlier HIV diagnosis in a pediatric ED.
The researchers sought to determine whether there were opportunities for earlier HIV diagnosis in the PED for a cohort of young adults diagnosed with HIV. They concluded that there are opportunities for earlier diagnosis of HIV in PEDs, affirming the importance of HIV screening implementation in these settings. However, PEDs are unlikely to have the same frequency of contact with undiagnosed individuals as do adult EDs.
AHRQ-funded; HS021749.
Citation: Eckerle MD, Namde M, Holland CK .
Opportunities for earlier HIV diagnosis in a pediatric ED.
Am J Emerg Med 2015 Jul;33(7):917-9. doi: 10.1016/j.ajem.2015.04.006..
Keywords: Human Immunodeficiency Virus (HIV), Diagnostic Safety and Quality, Screening, Children/Adolescents, Emergency Medical Services (EMS)
Yehia BR, Stephens-Shields AJ, Fleishman JA
AHRQ Author: Fleishman JA
The HIV care continuum: changes over time in retention in care and viral suppression.
The researchers followed individual patients over a three-year period to determine how retention in care and viral suppression statuses interact and change over time. Overall, 65.8 percent of patients were retained/suppressed, 17.4 percent retained/not-suppressed, 10.0 percent not-retained/suppressed, and 6.8 percent not-retained/not-suppressed in 2010. 59.5 percent of patients maintained the same status in 2011 and 53.3 percent maintained the same status in 2012.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Yehia BR, Stephens-Shields AJ, Fleishman JA .
The HIV care continuum: changes over time in retention in care and viral suppression.
PLoS One 2015 Jun 18;10(6):e0129376. doi: 10.1371/journal.pone.0129376..
Keywords: Human Immunodeficiency Virus (HIV), Outcomes
Merlin JS, Westfall AO, Chamot E
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
The researchers assessed the construct validity of the two-question Brief Chronic Pain Questionnaire (BCPQ) in HIV-infected patients by assessing the association between BCPQ responses and known correlates of chronic pain. Their study provides preliminary evidence for the BCPQ as a brief questionnaire to identify the presence of chronic pain in HIV care settings.
AHRQ-funded; HS021694.
Citation: Merlin JS, Westfall AO, Chamot E .
Quantitative evaluation of an instrument to identify chronic pain in HIV-infected individuals.
AIDS Res Hum Retroviruses 2015 Jun;31(6):623-7. doi: 10.1089/aid.2014.0362..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain
Weiss SM, Tobin JN, Lopez M
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
The researchers explored the pathways to effectively transfer promising research accomplishments into effective and sustainable service programs within the health care delivery system. Their study confirmed (a) the translatability of the Stress Management And Relaxation Training/Emotional Supportive Therapy (SMART/EST) Women's Program, from academic to community health center settings in two geographic regions with high HIV prevalence among women, (b) the ability of local staff to successfully achieve program fidelity and clinical outcomes, and (c) the sustainability the program beyond the auspices of research support, through supportive community health center leadership securing continued program funding.
AHRQ-funded; HS021667.
Citation: Weiss SM, Tobin JN, Lopez M .
Translating an evidence-based behavioral intervention for women living with HIV into clinical practice: the SMART/EST Women's Program.
Int J Behav Med 2015 Jun;22(3):415-24. doi: 10.1007/s12529-014-9399-1.
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Keywords: Behavioral Health, Evidence-Based Practice, Healthcare Delivery, Human Immunodeficiency Virus (HIV), Implementation
Brouwer ES, Napravnik S, Eron JJ, Jr.
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
The investigators aimed to validate claims-based myocardial infarction (MI) algorithms in a Medicaid population using an HIV clinical cohort as the gold standard. Studying 1063 individuals over 2.5 years, 17 had an MI. Specificity ranged from 0.979 to 0.993 with the highest specificity obtained using the ICD-9 code 410.xx in the primary or secondary position and a length of stay greater than 3 days. Sensitivity of MI ascertainment varied from 0.588 to 0.824 depending on algorithm. They recommended that the type of algorithm used be prioritized based on study question and maximization of specific validation parameters that will minimize bias while also considering precision.
AHRQ-funded; HS018731.
Citation: Brouwer ES, Napravnik S, Eron JJ, Jr. .
Validation of Medicaid claims-based diagnosis of myocardial infarction using an HIV clinical cohort.
Med Care 2015 Jun;53(6):e41-8. doi: 10.1097/MLR.0b013e318287d6fd.
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Keywords: Comparative Effectiveness, Human Immunodeficiency Virus (HIV), Medicaid, Heart Disease and Health, Research Methodologies
Burkholder GA, Tamhane AR, Appell LE
Short communication: Viral suppression is associated with increased likelihood of colorectal cancer screening among persons living with HIV/AIDS.
This retrospective longitudinal study evaluated patient characteristics associated with colorectal cancer (CRC) screening in an HIV cohort. During a median follow-up time of 1.7 years, only 30 percent of patients underwent CRC screening. The majority of screened patients received endoscopic screening (colonoscopy, 86 percent; sigmoidoscopy, 8 percent); results were available for 68 of the 75 patients, and adenomatous polyps were found in 13 percent. No cases of CRC were reported.
AHRQ-funded; HS013852.
Citation: Burkholder GA, Tamhane AR, Appell LE .
Short communication: Viral suppression is associated with increased likelihood of colorectal cancer screening among persons living with HIV/AIDS.
AIDS Res Hum Retroviruses 2015 May;31(5):519-24. doi: 10.1089/aid.2014.0256..
Keywords: Human Immunodeficiency Virus (HIV), Screening, Colonoscopy
Haukoos JS, Bucossi MM, Lyons MS
Validation of a quantitative HIV risk prediction tool using a national HIV testing cohort.
The goal of the study was to validate the Denver HIV Risk Score using a national cohort from the Centers for Disease Control and prevention. Patients of 13 years and older were included, 4,830,941 HIV tests were performed, and 0.6 percent newly diagnosed infections were identified. The study concluded that the Denver HIV Risk Score accurately categorized patients into different HIV risk groups.
AHRQ-funded; HS017526; HS021749.
Citation: Haukoos JS, Bucossi MM, Lyons MS .
Validation of a quantitative HIV risk prediction tool using a national HIV testing cohort.
J Acquir Immune Defic Syndr 2015 Apr 15;68(5):599-603. doi: 10.1097/qai.0000000000000518..
Keywords: Human Immunodeficiency Virus (HIV), Risk
Crowell TA, Berry SA, Fleishman JA
AHRQ Author: Fleishman JA
Impact of hepatitis coinfection on healthcare utilization among persons living with HIV.
The purpose of this study is to characterize the impact of hepatitis coinfection on utilization of primary HIV care, mental health, and inpatient services. It found no difference in primary HIV care utilization according to hepatitis serostatus. However, patients with HIV/HCV coinfection demonstrated higher rates of mental health visits than any of the other groups examined.
AHRQ-authored; AHRQ-funded; ; 290201100007C.
Citation: Crowell TA, Berry SA, Fleishman JA .
Impact of hepatitis coinfection on healthcare utilization among persons living with HIV.
J Acquir Immune Defic Syndr 2015 Apr;68(4):425-31. doi: 10.1097/qai.0000000000000490..
Keywords: Human Immunodeficiency Virus (HIV), Hepatitis, Healthcare Utilization, Behavioral Health
Hellinger FJ
AHRQ Author: Hellinger FJ
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
The author comments on a review of cost-effectiveness studies of four types of HIV prevention interventions in the US. He agrees with the primary conclusion of the review that more cost-effectiveness research is needed to fill the knowledge gaps of interventions related to prevention for HIV-positives, condom distribution, and policy initiatives, in order to help guide the most efficient use of resources.
AHRQ-authored.
Citation: Hellinger FJ .
Measuring the cost effectiveness of HIV prevention interventions in the US: pitfalls and problems.
Appl Health Econ Health Policy 2015 Apr;13(2):129-33. doi: 10.1007/s40258-015-0158-5..
Keywords: Human Immunodeficiency Virus (HIV), Prevention, Healthcare Costs
Merlin JS, Walcott M, Kerns R
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
The objective of this investigation is to develop an understanding of self-management strategies already used by persons living with these conditions. It found that the primary pain self-management strategies articulated by participants were: physical activity; cognitive and spiritual strategies; spending time with family and friends and social support; avoidance of physical/social activity; medication-centric pain management; and substance use.
AHRQ-funded; HS021694.
Citation: Merlin JS, Walcott M, Kerns R .
Pain self-management in HIV-infected individuals with chronic pain: a qualitative study.
Pain Med 2015 Apr;16(4):706-14. doi: 10.1111/pme.12701..
Keywords: Chronic Conditions, Human Immunodeficiency Virus (HIV), Pain, Patient Self-Management
Schackman BR, Fleishman JA, Su AE
AHRQ Author: Fleishman JA
The lifetime medical cost savings from preventing HIV in the United States.
The researchers sought to estimate the medical cost saved by averting 1 HIV infection in the United States. They found that the estimated discounted lifetime cost for persons who become HIV infected at age 35 is $326,500 (60% for antiretroviral medications, 15% for other medications, 25% nondrug costs.
AHRQ-authored; AHRQ-funded; 290201100007C.
Citation: Schackman BR, Fleishman JA, Su AE .
The lifetime medical cost savings from preventing HIV in the United States.
Med Care 2015 Apr;53(4):293-301. doi: 10.1097/mlr.0000000000000308..
Keywords: Medical Expenditure Panel Survey (MEPS), Healthcare Costs, Human Immunodeficiency Virus (HIV), Prevention
King JT, Perkal MF, Rosenthal RA
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
The researchers explored the current relationship between perioperative mortality and indicators of immune function, anemia, and hypoalbuminemia among HIV-infected and uninfected individuals. Among HIV-infected patients receiving antiretroviral therapy, modern postoperative mortality rates are low and lower CD4 cell counts are associated with increased mortality, but characteristics other than HIV status, such as age and hypoalbuminemia, are also important determinants of outcome.
AHRQ-funded; HS021112.
Citation: King JT, Perkal MF, Rosenthal RA .
Thirty-day postoperative mortality among individuals with HIV infection receiving antiretroviral therapy and procedure-matched, uninfected comparators.
JAMA Surg 2015 Apr;150(4):343-51. doi: 10.1001/jamasurg.2014.2257..
Keywords: Healthcare Cost and Utilization Project (HCUP), Mortality, Human Immunodeficiency Virus (HIV), Hospitalization, Surgery