Background: CDC guidelines recommend annual screening for Neisseria gonorrhoeae (GC) and Chlamydi... more Background: CDC guidelines recommend annual screening for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) at extra-genital (pharyngeal and anal) sites for at-risk MSM, preferably using validated nucleic acid amplification tests (NAAT). For HIV+ MSM, detection and treatment of co-occurring STIs is a priority due to increased morbidity and risk of HIV transmission. Callen-Lorde Community Health Center (CLCHC) predominantly cares for LGBT communities and people living with HIV. In 2012 the center provided care to 2397 HIV+MSM. That year, CLCHC partnered with The New York City STD/HIV Prevention Training Center and Public Health Solutions to assess extra-genital screening rates among HIV+ MSM. We determined that that although urethral CT/GC screening rates were high (70% tested in the last year), only 35% of our sample had been screened at all recommended urethral, pharyngeal and anal sites. Description: Clinicians identified barriers to screening: forgetfulness, prioritizatio...
Among adult women of reproductive age, research has focused on depression symptoms after unintend... more Among adult women of reproductive age, research has focused on depression symptoms after unintended pregnancy, or associated with hormonal contraceptive method use, with little focus on depression as a predictor of unintended pregnancy. This study was conducted to identify mental and behavioral health characteristics associated with use of less effective contraceptive methods. Choosing a less effective method of contraception places sexually active women who are not seeking pregnancy at increased risk of unintended pregnancy. Analysis was conducted using administrative data from family planning visits of 2,476 predominantly Latina and black women who received standardized behavioral and mental health screening as part of clinical care at eight reproductive health centers in New York City serving low-income women. Sociodemographic characteristics, method choice, and behavioral and mental health characteristics were compared between patients who screened positive for depression (using the PHQ-9) and those who did not. The primary outcome measure, contraceptive method choice, was dichotomized into two groups: more effective method or less effective method. In a multivariate logistic regression model adjusting for all behavioral health characteristics (binge drinking, illicit drug use, smoking, anxiety, and childhood or adult physical or sexual abuse) and birthplace, women screening positive for depression had significantly lower odds of choosing a more effective method of contraception (adjusted OR = 0.56, 95% CI: 0.36-0.87). These findings suggest that screening positive for depression may have an effect on contraceptive choice. Contraceptive counseling strategies should be individually tailored to promote decision-making and appropriate contraceptive choice, particularly among women with depression.
Background: CDC guidelines recommend annual screening for Neisseria gonorrhoeae (GC) and Chlamydi... more Background: CDC guidelines recommend annual screening for Neisseria gonorrhoeae (GC) and Chlamydia trachomatis (CT) at extra-genital (pharyngeal and anal) sites for at-risk MSM, preferably using validated nucleic acid amplification tests (NAAT). For HIV+ MSM, detection and treatment of co-occurring STIs is a priority due to increased morbidity and risk of HIV transmission. Callen-Lorde Community Health Center (CLCHC) predominantly cares for LGBT communities and people living with HIV. In 2012 the center provided care to 2397 HIV+MSM. That year, CLCHC partnered with The New York City STD/HIV Prevention Training Center and Public Health Solutions to assess extra-genital screening rates among HIV+ MSM. We determined that that although urethral CT/GC screening rates were high (70% tested in the last year), only 35% of our sample had been screened at all recommended urethral, pharyngeal and anal sites. Description: Clinicians identified barriers to screening: forgetfulness, prioritizatio...
Among adult women of reproductive age, research has focused on depression symptoms after unintend... more Among adult women of reproductive age, research has focused on depression symptoms after unintended pregnancy, or associated with hormonal contraceptive method use, with little focus on depression as a predictor of unintended pregnancy. This study was conducted to identify mental and behavioral health characteristics associated with use of less effective contraceptive methods. Choosing a less effective method of contraception places sexually active women who are not seeking pregnancy at increased risk of unintended pregnancy. Analysis was conducted using administrative data from family planning visits of 2,476 predominantly Latina and black women who received standardized behavioral and mental health screening as part of clinical care at eight reproductive health centers in New York City serving low-income women. Sociodemographic characteristics, method choice, and behavioral and mental health characteristics were compared between patients who screened positive for depression (using the PHQ-9) and those who did not. The primary outcome measure, contraceptive method choice, was dichotomized into two groups: more effective method or less effective method. In a multivariate logistic regression model adjusting for all behavioral health characteristics (binge drinking, illicit drug use, smoking, anxiety, and childhood or adult physical or sexual abuse) and birthplace, women screening positive for depression had significantly lower odds of choosing a more effective method of contraception (adjusted OR = 0.56, 95% CI: 0.36-0.87). These findings suggest that screening positive for depression may have an effect on contraceptive choice. Contraceptive counseling strategies should be individually tailored to promote decision-making and appropriate contraceptive choice, particularly among women with depression.
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