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HIV incidence and associated risk factors among key populations accessing routine testing through the national health coverage system in Thailand: A nationwide real-world study 泰国通过国家健康覆盖系统获得常规检测的关键人群中的艾滋病毒发病率和相关风险因素:一项全国性的现实世界研究
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-10 DOI: 10.1016/j.annepidem.2025.09.006
Sadiporn Phuthomdee , Sirinya Teeraananchai , Rattaphon Triamwichanon , Patchara Benjarattanaporn , David C. Boettiger , Nittaya Phanuphak

Purpose

To assess HIV incidence and associated factors among key populations (KPs) including men who have sex with men (MSM), transgender women (TGW), sex workers (SW), and people who inject drugs (PWID) using data from the Universal Health Coverage program.

Methods

HIV testing data were collected from KP individuals aged ≥ 15 years diagnosed HIV-negative at least once between 2015 and 2022. Flexible parametric survival analysis was used to estimate HIV incidence and identify associated factors.

Results

Among 373,300 individuals tested, 65 % were MSM, 26 % SW, 8 % PWID, and 2 % TGW. HIV incidence rates were highest among MSM (2.23 per 100 person-years, PYs), followed by TGW (2.06 per 100 PYs), PWID (0.46 per 100 PYs), and SW (0.41 per 100 PYs). In multivariable analysis, MSM had significantly higher risk compared to PWID (adjusted hazard ratio (aHR 0.13), SW (aHR 0.20), and TGW (aHR 0.77). Youth among KPs had a 7.30-fold higher risk compared to those aged ≥ 50 years. A decline in incidence was observed in more recent years.

Conclusions

HIV incidence is declining all KPs but remains highest among MSM and TGW, particularly youth, highlighting the need for targeted prevention to end HIV in Thailand.
目的利用全民健康覆盖计划的数据,评估包括男男性行为者(MSM)、变性女性(TGW)、性工作者(SW)和注射吸毒者(PWID)在内的关键人群(KPs)的HIV发病率及其相关因素。方法收集2015年至2022年期间至少一次诊断为hiv阴性的年龄≥ 15岁KP个体的hiv检测数据。使用灵活参数生存分析来估计HIV发病率并确定相关因素。结果在37.33万人中,MSM占65 %,SW占26 %,PWID占8 %,TGW占2 %。HIV感染率最高的是MSM(2.23 / 100人年),其次是TGW(2.06 / 100人年)、PWID(0.46 / 100人年)和SW(0.41 / 100人年)。在多变量分析中,MSM与PWID(校正危险比(aHR 0.13))、SW (aHR 0.20)和TGW (aHR 0.77)相比具有显著更高的风险。与年龄≥ 50岁的青少年相比,青少年的风险高7.30倍。近年来,发病率有所下降。结论艾滋病毒感染率在所有KPs中都在下降,但在MSM和TGW中仍然是最高的,特别是年轻人,这突出了泰国需要有针对性的预防来结束艾滋病毒。
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引用次数: 0
Corrigendum to ‘Estimating the population need for preexposure prophylaxis for HIV in the United States’ [Ann Epidemiol 106 (2025) 48–54] “估计美国人群对HIV暴露前预防的需求”的勘误表[Ann epidemiology 106 (2025) 48-54]
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-06 DOI: 10.1016/j.annepidem.2025.09.005
Athena P. Kourtis , Jeffery Wiener , Weiming Zhu , Minttu M. Rönn , Joshua Salomon , Ya-Lin A. Huang , Cynthia Lyles , Rupa R. Patel , Karen W. Hoover , Robyn Neblett Fanfair , Jonathan Mermin
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引用次数: 0
Association between maternal sexually transmitted diseases and birth defects in the United States: A nationwide population-based study 在美国,孕产妇性传播疾病与出生缺陷之间的关系:一项基于全国人口的研究。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-04 DOI: 10.1016/j.annepidem.2025.09.004
Wangnan Cao , Chunrong Li , Feng Sun , Valery A. Danilack , Ian J. Saldanha , Yuhui Shi , Ying Ji , Hao Lin , Mojun Ni , Ruiyi Liu , Shengzhi Sun , Chun Chang

Purpose

We estimated the association between maternal sexually transmitted diseases (STDs) and the risk of specific birth defects among live singleton births in the United States (US).

Methods

We conducted a population-based study using data from birth certificates for 14,602,822 live singleton births occurring from 2016 to 2019 in the US. We used logistic regression to estimate the associations between three maternal STDs (chlamydia, gonorrhea, and syphilis) and the risk of four specific birth defects (gastroschisis, cleft lip with or without cleft palate, spina bifida, and hypospadias), adjusting for socio-demographic and pregnancy-related factors.

Results

Maternal chlamydia infection was associated with a higher risk of gastroschisis (adjusted odds ratio [aOR], 1.23; (95 % CI: 1.03, 1.46), cleft lip with or without cleft palate (aOR, 1.26; 95 % CI: 1.08, 1.47), and hypospadias (aOR, 1.26; 95 % CI: 1.08, 1.47). It was not associated with an increased risk of spina bifida. These associations were consistent across subgroups defined by maternal age, race and ethnicity, education, body mass index, and infant sex. We found no evidence of an association between gonorrhea or syphilis infections and the studied birth defects.

Conclusions

Among live singleton births in the US, maternal chlamydia infection may be associated with increased risks of gastroschisis, cleft lip with or without cleft palate, and hypospadias.
目的:我们估计了美国活产单胎中母亲性传播疾病(STDs)与特定出生缺陷风险之间的关系。方法:我们进行了一项基于人群的研究,使用了2016年至2019年美国14,602,822例活产单胎出生证明的数据。我们使用逻辑回归来估计三种母体性传播疾病(衣原体、淋病和梅毒)与四种特定出生缺陷(胃裂、伴有或不伴有腭裂的唇裂、脊柱裂和尿道下裂)风险之间的关联,并对社会人口统计学和妊娠相关因素进行了调整。结果:母体衣原体感染与胃裂(校正优势比[aOR], 1.23; (95% CI: 1.03, 1.46)、唇裂合并或不合并腭裂(aOR, 1.26; 95% CI: 1.08, 1.47)和尿道下裂(aOR, 1.26; 95% CI: 1.08, 1.47)的高风险相关。它与脊柱裂的风险增加无关。这些关联在由母亲年龄、种族和民族、教育程度、体重指数和婴儿性别定义的亚组中是一致的。我们没有发现淋病或梅毒感染与所研究的出生缺陷之间存在关联的证据。结论:在美国的活产单胎中,母体衣原体感染可能与胃裂、唇裂伴或不伴腭裂和尿道下裂的风险增加有关。
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引用次数: 0
Validation of data in the Veteran health administration electronic medical record for identification of tobacco use 退伍军人健康管理局电子病历中烟草使用识别数据的验证。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-03 DOI: 10.1016/j.annepidem.2025.09.001
Brian J. Douthit PhD, RN, NI-BC , Julie Kim PharmD , Amber J. Hackstadt PhD , Daniel Park BS , Robert Winter BS , Jessica Deere PN, BSN, MSN , Lucy B. Spalluto MD, MPH , Sally J. York MD, PhD , Fred Hendler MD, PhD , Robert S. Dittus MD, MPH , Dana E. Christofferson PhD , Michael E. Matheny MD, MS, MPH , Hilary A. Tindle , Christianne L. Roumie MD, MPH , Jennifer A. Lewis MD, MS, MPH

Purpose

Tobacco use is not commonly represented as computable information in the electronic health record (EHR). We developed an algorithm in the Veterans Health Administration (VHA) to identify tobacco ever-use among Veterans.

Methods

We used the VHA corporate data warehouse to develop an algorithm comprised of multiple data types (health factors [semi-structured template data entry and decision support tools], billing, orders, medication, and encounter codes) to identify tobacco ever-use (current or former) versus never use. Algorithm accuracy was compared to two reference standards: (1) EHR abstraction cohort and (2) Veteran self-reported survey cohort. We calculated the sensitivity and positive predictive values (PPV) for the algorithm and stratified by its data types for the EHR abstraction cohort. We calculated the sensitivity, specificity, PPV, and negative predictive value (NPV) for the algorithm and stratified by its data types for the survey cohort.

Results

The algorithm correctly identified 424 of 426 individuals with tobacco ever-use when compared to data abstracted from the EHR: sensitivity 1.00 (95 % CI 0.98–1.00); PPV 1.00 (95 % CI 0.98–1.00). Compared to survey data, the algorithm correctly identified 514 of 547 participants with tobacco ever-use: sensitivity 0.94 (95 % CI 0.92–0.96); PPV 0.88 (95 % CI 0.85–0.91). The specificity was 0.53 (95 % CI 0.45–0.62), and NPV of 0.70 (95 % CI 0.61–0.79). Of all data types, health factors had the highest sensitivity in both cohorts.

Conclusions

This novel tool had excellent sensitivity and PPV for tobacco ever-use in two cohorts. Future research should study this tool to support preventive healthcare services.
目的:烟草使用通常不被表示为电子健康记录(EHR)中的可计算信息。我们在退伍军人健康管理局(VHA)开发了一种算法来识别退伍军人中的烟草使用情况。方法:我们使用VHA公司数据仓库开发了一种由多种数据类型(健康因素[半结构化模板数据输入和决策支持工具]、账单、订单、药物和遇到代码)组成的算法,以识别曾经使用(当前或以前)与从未使用过的烟草。将算法准确率与两个参考标准(1)EHR抽象队列和(2)退伍军人自述调查队列进行比较。我们计算了该算法的敏感性和阳性预测值(PPV),并根据其数据类型对EHR抽象队列进行了分层。我们计算了该算法的敏感性、特异性、PPV和阴性预测值(NPV),并根据其数据类型对调查队列进行了分层。结果:与从电子病历中提取的数据相比,该算法正确识别了426名曾经使用过烟草的人中有424人:灵敏度1.00 (95% CI 0.98-1.00);PPV 1.00 (95% ci 0.98-1.00)。与调查数据相比,该算法正确识别出547名参与者中有514名曾经使用过烟草:灵敏度0.94 (95% CI 0.92-0.96);PPV 0.88 (95% ci 0.85-0.91)。特异性为0.53 (95% CI 0.45-0.62), NPV为0.70 (95% CI 0.61-0.79)。在所有数据类型中,健康因素在两个队列中都具有最高的敏感性。结论:在两个队列中,该新工具对曾经使用过烟草的人群具有极好的敏感性和PPV。未来的研究应研究这一工具,以支持预防保健服务。
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引用次数: 0
Diverse social environments and 10-year all-cause mortality in a cohort of historically excluded racial/ethnic older adults: A latent class analysis of social integration 在历史上被排除的种族/民族老年人队列中,不同的社会环境和10年全因死亡率:社会融合的潜在阶级分析。
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.08.037
Melissa Flores Ph.D. , Savannah M. Boyd M.S. , Riley M. O'Neill M.A. , James J. García Ph.D. , Sei Eun Kim Ph.D. , Da'Mere Wilson Ph.D. , Kelly N.B. Palmer Ph.D.

Purpose

The association between social integration and mortality in older adults from historically excluded groups may not align with the patterns observed in predominately white samples. We modeled latent groups of social integration and their association with 10-year all-cause mortality in a cohort of older adults from historically excluded racial/ethnic groups.

Methods

In a sub-sample of a national cohort study of older adults, we used latent class analysis to model social integration using ten item indicators spanning couple status, network characteristics, and neighborhood and community connections. Using a 3-step process, we estimated the relative odds (OR) of mortality over 10 years given membership in each latent class.

Results

Among 873 historically excluded racial/ethnic older adults, a four-class solution was optimal given model fit indices, reduced entropy, interpretability, class sizes below 5 % of the sample, and model parsimony. We named these classes "One Family Connection", "Small, Interconnected Family", "Large, Interconnected Family", and "Large, Balanced, Friends and Family". Contrary to our hypothesis, there were no differences in the odds of mortality across latent classes.

Conclusion

Older adults from historically excluded racial/ethnic groups have diverse social environments that, when modeled holistically, include aspects that may confer resilience against the risk of social isolation.
目的:在历史上被排除在外的老年人群体中,社会融合与死亡率之间的关系可能与在以白人为主的样本中观察到的模式不一致。我们在一组历史上被排除的种族/民族的老年人队列中建立了社会整合的潜在群体及其与10年全因死亡率的关系模型。方法:在一项全国老年人队列研究的子样本中,我们使用潜在阶级分析来模拟社会整合,使用十项指标,包括夫妻状态、网络特征、邻里和社区联系。采用三步法,我们估计了每个潜在分类中10年内死亡率的相对几率(OR)。结果:在873名历史上被排除的种族/民族老年人中,考虑到模型拟合指数、减少熵、可解释性、类别规模低于样本的5%和模型简约性,四类解决方案是最优的。我们将这些课程命名为“一个家庭联系”、“小型互联家庭”、“大型互联家庭”和“大型平衡朋友和家庭”。与我们的假设相反,潜在类别之间的死亡率没有差异。结论:来自历史上被排斥的种族/族裔群体的老年人拥有多样化的社会环境,从整体上建模时,包括可能赋予抵御社会孤立风险的复原力的方面。
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引用次数: 0
Who gets left behind? Family doctor access gaps among Chinese immigrants in Canada and implications for health equity 谁被落下了?加拿大华人移民家庭医生就诊差距及其对健康公平的影响
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.08.003
Suky Zheng , Nan Lei , Lisa Fang , Angela Xu , Vita Huang , Irene Jia , Peter (PeiZhong) Wang
{"title":"Who gets left behind? Family doctor access gaps among Chinese immigrants in Canada and implications for health equity","authors":"Suky Zheng ,&nbsp;Nan Lei ,&nbsp;Lisa Fang ,&nbsp;Angela Xu ,&nbsp;Vita Huang ,&nbsp;Irene Jia ,&nbsp;Peter (PeiZhong) Wang","doi":"10.1016/j.annepidem.2025.08.003","DOIUrl":"10.1016/j.annepidem.2025.08.003","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Page 177"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Trauma and depression symptoms in refugee children across displacement phases 流离失所阶段难民儿童的创伤和抑郁症状
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.07.048
Rawan Iriqat, Zhaomei Geng, Wael Al-Delaimy
{"title":"Trauma and depression symptoms in refugee children across displacement phases","authors":"Rawan Iriqat,&nbsp;Zhaomei Geng,&nbsp;Wael Al-Delaimy","doi":"10.1016/j.annepidem.2025.07.048","DOIUrl":"10.1016/j.annepidem.2025.07.048","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Page 195"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332293","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Central line associated bloodstream infections and social determinants of health associated with the location of Colorado acute care hospitals 中心静脉相关血流感染和健康的社会决定因素与科罗拉多州急症护理医院的位置有关
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.07.036
Johnna Bakalar MPH , Amy Fitzgibbons MS , Helen Johnston MPH , Alyssa Beck MPH , Alison Abraham PhD, MS, MHS , Katherine James PhD, MS, MSPH , Rebecca Conway PhD, MPH, MA , Christopher Czaja MD, DrPH
{"title":"Central line associated bloodstream infections and social determinants of health associated with the location of Colorado acute care hospitals","authors":"Johnna Bakalar MPH ,&nbsp;Amy Fitzgibbons MS ,&nbsp;Helen Johnston MPH ,&nbsp;Alyssa Beck MPH ,&nbsp;Alison Abraham PhD, MS, MHS ,&nbsp;Katherine James PhD, MS, MSPH ,&nbsp;Rebecca Conway PhD, MPH, MA ,&nbsp;Christopher Czaja MD, DrPH","doi":"10.1016/j.annepidem.2025.07.036","DOIUrl":"10.1016/j.annepidem.2025.07.036","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Page 213"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332294","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Evaluating the impact of telehealth payment parity policies on substance use disorder treatment utilization in Medicaid: A quasi-experimental study, 2018–2022 评估远程医疗支付平价政策对医疗补助中物质使用障碍治疗利用的影响:一项准实验研究,2018-2022
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.07.008
Akshaya Srikanth Bhagavathula
{"title":"Evaluating the impact of telehealth payment parity policies on substance use disorder treatment utilization in Medicaid: A quasi-experimental study, 2018–2022","authors":"Akshaya Srikanth Bhagavathula","doi":"10.1016/j.annepidem.2025.07.008","DOIUrl":"10.1016/j.annepidem.2025.07.008","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Pages 166-167"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Impact of local flavored tobacco bans on youth electronic nicotine delivery system use in California: A dynamic difference-in-differences analysis 加州地方风味烟草禁令对青少年电子尼古丁输送系统使用的影响:一项动态差异分析
IF 3 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-09-01 DOI: 10.1016/j.annepidem.2025.07.028
Giovanni Appolon MPH , Eric Leas PhD , Heather Pines PhD , David Strong PhD , Dennis Trinidad PhD , Wilton Choi PhD , Eyal Oren PhD
{"title":"Impact of local flavored tobacco bans on youth electronic nicotine delivery system use in California: A dynamic difference-in-differences analysis","authors":"Giovanni Appolon MPH ,&nbsp;Eric Leas PhD ,&nbsp;Heather Pines PhD ,&nbsp;David Strong PhD ,&nbsp;Dennis Trinidad PhD ,&nbsp;Wilton Choi PhD ,&nbsp;Eyal Oren PhD","doi":"10.1016/j.annepidem.2025.07.028","DOIUrl":"10.1016/j.annepidem.2025.07.028","url":null,"abstract":"","PeriodicalId":50767,"journal":{"name":"Annals of Epidemiology","volume":"109 ","pages":"Page 169"},"PeriodicalIF":3.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145332402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Annals of Epidemiology
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