bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ensuring a Public Health Impact of Programs to Reduce HIV Transmission From Mothers to Infants: The Place of Voluntary Counseling and Testing
Authors: Bassett Mary Travis 
Published: December 2008

Since 1999, many African governments have launched programs to offer short-course antiretroviral drug regimens to reduce mother-to child transmission of HIV. HIV testing in prenatal care is the gateway to these antiretroviral regimens. Pilot projects in Africa show an uptake of antiretroviral drugs in 8% to 50% of pregnant women presumed to be HIV infected; often, a minority of eligible women in care received these regimens. Use of lay counselors and rapid onsite HIV testing may alleviate health service barriers. Community education to promote voluntary counseling and testing, which involves men, is the long-term solution. In the short term, possibilities to enhance delivery of an effective intervention include group pretest counseling, universal offer of testing with women having the right to “opt out,” universal treatment (mass treatment for those whose HIV status is not determined by voluntary counseling and testing), universal testing with women having the right to “opt out” of learning their test results, and mass treatment for all without testing.
Effect of Nevirapine Toxicity on Choice of Perinatal HIV Prevention Strategies
Authors: Stringer Jeffrey S. A. , Sinkala Moses , Rouse Dwight J. , Goldenberg Robert L. , Vermund Sten H. 
Published: December 2008

Objectives. This study evaluated the validity of concerns about the toxicity of nevirapine (NVP) that have delayed its implementation as a perinatal HIV prevention strategy. Methods. A decision analysis model compared 3 strategies: single-dose NVP, short-course zidovudine (ZDV), and no intervention. Results. NVP would prevent more deaths than ZDV and no intervention as long as the rate of NVP toxicity did not exceed, respectively, 9 times that observed in the earlier NVP clinical trial and 42 times that observed in the clinical trial. NVP would be economically preferable to ZDV as long as the rate of toxicity did not exceed 22 times that observed in the clinical trial. Conclusions. Field implementation of NVP should not be delayed by concerns about its toxicity. (Am J Public Health. 2002;92:365–366)
Relationships of Stigma and Shame to Gonorrhea and HIV Screening
Authors: Fortenberry J. Dennis , McFarlane Mary , Bleakley Amy , Bull Sheana , Fishbein Martin , Grimley Diane M. , Malotte C. Kevin , Stoner Bradley P. 
Published: December 2008

Objectives. The purpose of this study was to assess the relationships between stigma and shame associated with seeking treatment for sexually transmitted diseases (STDs) and undergoing testing for gonorrhea and HIV. Methods. Participants were 847 males and 1126 females (mean age: 24.9 years) in 7 cities. Two scales assessed STD-related stigma and STD-related shame. Results. Rates of stigma and shame were higher among participants without a gonorrhea test in the past year and among those without an HIV test. Sex, age, health service use, previous suspicion of gonorrhea, and low levels of stigma were independently associated with gonorrhea testing. Age, enrollment site, use of health services, gonorrhea testing, and low levels of stigma were independently associated with HIV testing. Conclusions. Shame is part of the experience of seeking STD-related care, but stigma may be a more powerful barrier to obtaining such care. (Am J Public Health. 2002;92:378–381)
What Factors Hinder Women of Color From Obtaining Preventive Health Care?
Authors: Cornelius Llewellyn J. , Smith Pamela L. , Simpson Gaynell M. 
Published: December 2008

This commentary examines how women of color fare on the use of preventive care. Logistic regression models of women's use of preventive care were computed with data from the 1994 Commonwealth Fund Minority Health Survey. It was found that having a regular doctor was the most consistent predictor of the use of preventive care, irrespective of the women's racial/ethnic background, socioeconomic circumstances, or place of residence. These findings reinforce the importance of physicians in the delivery of preventive care. Suggestions for improving the use of preventive services by women of color are provided.
Toward a Strategic Approach for Reducing Disparities in Infant Mortality
Authors: Hogue Carol J. Rowland , Vasquez Cynthia 
Published: December 2008

The United States' international ranking for infant mortality slipped from 19th in the 1980s to 27th in 1997. This slippage may be related to the segregation of priorities that occurred early in the 1990s, when national concern was diverted from infant mortality to minority health. To rekindle concern about infant mortality to the level of effective action, public health professionals must refocus the public's attention on assuring that all women are provided adequate education and services to help them avoid unintended pregnancies, that all pregnant women receive services in appropriate facilities, and that the causes of preterm deliveries are discovered. Effective action in these areas would not only improve infant mortality overall; it would also reduce racial and ethnic disparities in infant health.
Mobilizing Women for Minority Health and Social Justice in California
Authors: Littlefield Diane , Robison Connie Chan , Engelbrecht Luz , González Belma , Hutcheson Heather 
Published: December 2008

Women's Health Leadership is building the leadership capacity of diverse community leaders in California committed to promoting health and social justice in their communities. This program provides opportunities for cross-cultural exchanges of ideas, resources, and expertise. Graduates continue to receive technical support and to engage in peer learning via an alumnae network. The network is dedicated to advancing social justice issues and to addressing health disparities. It is also a way to mobilize trained grassroots leaders to provide expertise to influence policy decisions, to provide technical support and resources to local communities, and to foster new partnerships across the state.
Safety-Net Institutions Buffer the Impact of Medicaid Managed Care: A Multi-Method Assessment in a Rural State
Authors: Waitzkin Howard , Williams Robert L. , Bock John A. , McCloskey Joanne , Willging Cathleen , Wagner William 
Published: December 2008

Objectives. This project used a long-term, multi-method approach to study the impact of Medicaid managed care. Methods. Survey techniques measured impacts on individuals, and ethnographic methods assessed effects on safety-net providers in New Mexico. Results. After the first year of Medicaid managed care, uninsured adults reported less access and use (odds ratio [OR] = 0.46; 95% confidence interval [CI] = 0.34, 0.64) and worse barriers to care (OR = 6.60; 95% CI = 3.95, 11.54) than adults in other insurance categories. Medicaid children experienced greater access and use (OR = 2.11; 95% CI = 1.21, 3.72) and greater communication and satisfaction (OR = 3.64; 95% CI = 1.13, 12.54) than children in other insurance categories; uninsured children encountered greater barriers to care (OR = 6.29; 95% CI = 1.58, 42.21). There were no consistent changes in the major outcome variables over the period of transition to Medicaid managed care. Safety-net institutions experienced marked increases in workload and financial stress, especially in rural areas. Availability of mental health services declined sharply. Providers worked to buffer the impact of Medicaid managed care for patients. Conclusions. In its first year, Medicaid managed care exerted major effects on safety-net providers but relatively few measurable effects on individuals. This reform did not address the problems of the uninsured.
A Multilevel Analysis of the Relationship Between Institutional and Individual Racial Discrimination and Health Status
Authors: Gee Gilbert C. 
Published: December 2008

Objectives. This study examined whether individual (self-perceived) and institutional (segregation and redlining) racial discrimination was associated with poor health status among members of an ethnic group. Methods. Adult respondents (n = 1503) in the cross-sectional Chinese American Psychiatric Epidemiologic Study were geocoded to the 1990 census and the 1995 Home Mortgage Disclosure Act database. Hierarchical linear modeling assessed the relationship between discrimination and scores on the Medical Outcomes Study Short-Form 36 and revised Symptom Checklist 90 health status measures. Results. Individual and institutional measures of racial discrimination were associated with health status after control for acculturation, sex, age, social support, income, health insurance, employment status, education, neighborhood poverty, and housing value. Conclusions. The data support the hypothesis that discrimination at multiple levels influences the health of minority group members.
Increasing Use of Mammography Among Older, Rural African American Women: Results From a Community Trial
Authors: Earp Jo Anne , Eng Eugenia , O'Malley Michael S. , Altpeter Mary , Rauscher Garth , Mayne Linda , Mathews Holly F. , Lynch Kathy S. , Qaqish Bahjat 
Published: December 2008

Objectives. A community trial was undertaken to evaluate the effectiveness of the North Carolina Breast Cancer Screening Program, a lay health advisor network intervention intended to increase screening among rural African American women 50 years and older. Methods. A stratified random sample of 801 African American women completed baseline (1993–1994) and follow-up (1996–1997) surveys. The primary outcome was self-reported mammography use in the previous 2 years. Results. The intervention was associated with an overall 6 percentage point increase (95% confidence interval [CI] = –1, 14) in communitywide mammography use. Low-income women in intervention counties showed an 11 percentage point increase (95% CI = 2, 21) in use above that exhibited by lowincome women in comparison counties. Adjustment for potentially confounding characteristics did not change the results. Conclusions. A lay health advisor intervention appears to be an effective public health approach to increasing use of screening mammography among low-income, rural populations.
Hepatitis C Virus Infection in Young, Low-Income Women: The Role of Sexually Transmitted Infection as a Potential Cofactor for HCV Infection
Authors: Page-Shafer Kimberly A. , Cahoon-Young Barbara , Klausner Jeffrey D. , Morrow Scott , Molitor Fred , Ruiz Juan , McFarland Willi 
Published: December 2008

Objectives. We evaluated risk for hepatitis C virus (HCV) infection in women residing in low-income neighborhoods of northern California. Methods. A population-based sample of 1707 women, aged 18 to 29, were surveyed and screened for sexually transmitted infections and HCV. Results. Women infected with HCV (2.5%) were more likely to have a history of injection and noninjection drug use, to exchange sex for money or drugs, and to have sexually transmitted infections. HCV was independently associated with history of injection drug use, herpes simplex virus type 2 (HSV-2) infection, and heroin and cocaine use. Conclusions. Injection drug use is the highest risk exposure for HCV, but HSV-2 and noninjection drug use contribute significantly to increased risk. HCV prevention programs in impoverished areas should integrate drug treatment and sexually transmitted infection control.
The Human Right to Adequate Housing: A Tool for Promoting and Protecting Individual and Community Health
Authors: Thiele Bret 
Published: December 2008

The human right to adequate housing is enshrined in international law. The right to adequate housing can be traced to the Universal Declaration of Human Rights, which was unanimously adopted by the world community in 1948. Since that time, the right to adequate housing has been reaffirmed on numerous occasions and further defined and elaborated. A key component of this right is habitability of housing, which should comply with health and safety standards. Therefore, the right to adequate housing provides an additional tool for advocates and others interested in promoting healthful housing and living conditions and thereby protecting individual and community health.
Role of Black Churches in Health Promotion Programs: Lessons From the Los Angeles Mammography Promotion in Churches Program
Authors: Markens Susan , Fox Sarah A. , Taub Bonnie , Gilbert Mary Lou 
Published: December 2008

Objectives. This article assesses pastor-level factors that affect the successful recruitment and implementation of community-based health promotion programs in Black churches. Methods. Semistructured interviews with 16 pastors of Black churches were analyzed for content. Results. We found that although the involvement of Black pastors in an array of secular activities makes them open to participate in health programs, their overcommitment to other issues can negatively influence their ability to participate. Second, although Black pastors appreciate being included in and benefiting from health research, minorities' history of being underserved and exploited can lead to suspiciousness and reluctance to participate. Conclusions. Our findings suggest that those interested in developing church-based health programs in the Black community must be attuned to how the same factors can both facilitate and hinder a program's development.
Relationship Between Patients' Perceptions of Disadvantage and Discrimination and Listing for Kidney Transplantation
Authors: Klassen Ann C. , Hall Allyson G. , Saksvig Brit , Curbow Barbara , Klassen David K. 
Published: December 2008

Objectives. This study explored wait-listing decisions among African American and White men and women eligible for kidney transplants, focusing on lifetime experiences of race and sex discrimination as a possible influence. Methods. Patient records from 3 Baltimore-area hemodialysis units were reviewed, and semistructured face-to-face interviews were conducted with transplant-eligible patients and with unit staff members. Results. African American patients reported more racial discrimination, and women reported more sex discrimination. Women and older patients were less likely to be placed on the waiting list, as were patients with previous experiences of racial discrimination. Discrimination measures predicted list access more strongly than patient race. Conclusions. Lifetime experience of and response to discrimination may contribute to race and sex differences in access to care and should be included in research on health care disparities.
HIV and AIDS Risk Behaviors Among Female Jail Detainees: Implications for Public Health Policy
Authors: McClelland Gary Michael , Teplin Linda A. , Abram Karen M. , Jacobs Naomi 
Published: December 2008

Objectives. We examined the sexual and injection drug use HIV and AIDS risk behaviors of female jail detainees. Methods. The sample (n = 948) was stratified by charge type (felony vs misdemeanor) and race/ethnicity (African American, non-Hispanic White, Hispanic, other). Results. Non-Hispanic White women, women arrested for less serious charges, women who had prior arrests, women arrested on drug charges, and women with severe mental disorders were at especially high risk for sexual and injection drug transmission of HIV and AIDS. Conclusions. Many women at risk for HIV and AIDS—women who use drugs, women who trade sex for money or drugs, homeless women, and women with mental disorders—eventually will cycle through jail. Because most jail detainees return to their communities within days, providing HIV and AIDS education in jail must become a public health priority.
Tuberculosis Screening Among Foreign-Born Persons Applying for Permanent US Residence
Authors: Saraiya Mona , Cookson Susan T. , Tribble Paul , Silk Benjamin , Cass Robert , Poonja Shameer , Walting Marva , Howland Noelle , Paz Edwin A. , Cochran Jennifer , Moser Kathleen S. , Oxtoby Margaret J. , Binkin Nancy J. 
Published: December 2008

Objectives. This study sought to determine adherence of physicians to tuberculosis (TB) screening guidelines among foreign-born persons living in the United States who were applying for permanent residency. Methods. Medical forms of applicants from 5 geographic areas were reviewed, along with information from a national physician database on attending physicians. Applicant and corresponding physician characteristics were compared among those who were and were not correctly screened. Results. Of 5739 applicants eligible for screening via tuberculin skin test, 75% were appropriately screened. Except in San Diego, where 11% of the applicants received no screening, most of the inappropriate screening resulted from the use of chest x-rays as the initial screening tool. Conclusions. Focused physician education and periodic monitoring of adherence to screening guidelines are warranted.
Association of Medical Insurance and Other Factors With Receipt of Antiretroviral Therapy
Authors: Keruly Jeanne C. , Conviser Richard , Moore Richard D. 
Published: December 2008

Objectives. This study was designed to assess sociodemographic and medical insurer factors associated with receipt of highly active antiretroviral therapy (HAART). Methods. Patients included (n = 959) were enrolled in the Johns Hopkins HIV Clinic after April 1, 1996, received ≥ 90 days of care, and had a CD4 count ≥ 500 cells/mm3 or HIV-1 RNA > 20 000 copies/mL. We assessed the associations of sociodemographic factors and medical insurance with receipt of HAART, stratified by 2 time periods (April 1996 through March 1997 versus April 1997 through March 1999). Results. HAART was more likely to be used in patients who were > 39 years, White, had CD4 counts < 350 cells/mm3, had fewer missed clinic visits, and did not have intravenous drug use as their risk factor for HIV transmission. In period 1 (April 1996 through March 1997), HAART was more likely to be used in patients who were commercially insured than in other payer groups; differences between payers narrowed in period 2 (April 1997 through March 1999), however, as did differences by race. Conclusions. Differences in use of HAART on the basis of payer have narrowed since 1996. This encouraging finding may demonstrate the importance of programs that lower economic barriers to medical care.
Smoking Among Chinese Americans: Behavior, Knowledge, and Beliefs
Authors: Yu Elena S. H. , Chen Edwin H. , Kim Katherine K. , Abdulrahim Sawsan 
Published: December 2008

Objectives. This report describes and examines factors significantly associated with smoking among Chinese Americans, using multiple logistic regression methods. Methods. We conducted a population-based survey (n = 644, age = 40–69 years) in Chicago's Chinatown using a Chinese questionnaire based on the National Health Interview Survey (NHIS). Results. Smoking prevalence was 34% for males and 2% for females. Some 93% of current smokers had smoked regularly for 10 or more years. Low education (odds ratio [OR] = 2.41; 95% confidence interval [CI] = 1.31, 4.46), use of a non-Western physician or clinic for health care (OR = 2.64; 95% CI = 1.46, 4.80), and no knowledge of early cancer warning signs and symptoms (OR = 2.52; 95% CI = 1.35, 4.70) were significantly associated with smoking among men. Conclusions. The male prevalence of smoking is higher than those reported in California, the NHIS, and the Behavioral Risk Factor Surveillance System (BRFSS); exceeds the rate for African Americans aged 18 years and older; is comparable with the rate for African American males aged 45 to 64 years; and is far above the Healthy People 2010 target goal of less than 12%. Multisite surveys and smoking cessation campaigns in Chinese are needed.
Maternal Smoking During Pregnancy and Severe Antisocial Behavior in Offspring: A Review
Authors: Wakschlag Lauren S. , Pickett Kate E. , Cook Edwin , Benowitz Neal L. , Leventhal Bennett L. 
Published: December 2008

Objectives. Recent research suggests that in utero exposure to maternal smoking is a risk factor for conduct disorder and delinquency. We review evidence of causality, a controversial but important public health question.Methods. We analyzed studies of maternal prenatal smoking and offspring antisocial behavior within a causal framework.Results. The association is (1) independent of confounders, (2) present across diverse contexts, and (3) consistent with basic science. Methodological limitations of existing studies preclude causal conclusions.Conclusions. Existing evidence provides consistent support for, but not proof of, an etiologic role for prenatal smoking in the onset of antisocial behavior. The possibility of identifying a preventable prenatal risk factor for a serious mental disorder makes further research on this topic important for public health.
Critical Policy Challenges in the Third Decade of the HIV/AIDS Epidemic
Authors: Kates Jennifer , Sorian Richard , Crowley Jeffrey S. , Summers Todd A. 
Published: December 2008

Numerous policy challenges continue to face the United States in the third decade of the HIV/AIDS pandemic, in both the health and foreign policy arenas. They include long-standing questions about care, treatment, prevention, and research, as well as new ones introduced by the changing nature of the epidemic itself and the need to balance demands for limited resources. These challenges concern the United States not only in its role as a world leader in combating a global epidemic, but in its decisions and focus at home, where the epidemic continues to take a toll.
Alternatives to a National System of Population-Based State Cancer Registries
Authors: Thomas David B. 
Published: December 2008

To support cancer control efforts, the National Program of Cancer Registries was established to enhance or develop cancer registries in every state. But there is an alternative. State cancer control programs could be adequately planned and evaluated without a cancer registry, and federal support of cancer registration could be selectively provided to registries that provide data needed to monitor cancer incidence and survival for the nation or that serve as a resource for population-based etiologic and cancer control research. The funds saved could be redirected to support the continued collection of high-quality cancer incidence and survival data for the nation as such efforts become more costly and complex in the future, and to expand support of population-based cancer research efforts. (Am J Public Health. 2002;92:1064–1066)
Increasing the Use of Child Restraints in Motor Vehicles in a Hispanic Neighborhood
Authors: Istre Gregory R. , McCoy Mary A. , Womack Katie N. , Fanning Linda , Dekat Laurette , Stowe Martha 
Published: December 2008

The use of restraints in motor vehicles is less common in minority and low-income populations than in the general population. A preliminary survey of Hispanic preschool-aged children in west Dallas, Tex, conducted in 1997 showed much lower child restraint use (19% of those surveyed) than among preschool children of all races in the rest of the city (62%). Because there are few reports of successful programs to increase child restraint use among Hispanics, we undertook to implement and evaluate such a program. The program was conducted by bilingual staff and was tailored for this community. It was successful in increasing both child restraint use and driver seat belt use.