Dataset Information

Evidence of Local HIV Transmission in the African Community of King County, Washington.

ABSTRACT: Little is known about the frequency of ongoing HIV transmission within U.S. African immigrant communities. We used HIV surveillance and partner services data to describe African-born persons newly reported with HIV infection in King County (KC), WA from 1/1/2010 to 12/31/2013. We performed phylogenetic clustering analysis of HIV-1 pol to identify putative transmission events within this population. From 2010 to 2013, 1148 KC adults were reported with HIV, including 102 (9 %) born in Africa. Forty-one African-born cases were interviewed and reported diagnosis after arrival in the U.S. Fourteen (34 %) reported ?1 negative test prior to diagnosis, and 9 (26 %) reported ?1 negative test after U.S. arrival. Pol genotypes were available for seven of these nine. For two of these seven, a KC case was the nearest phylogenetic neighbor; two others were infected with subtype B virus. We found substantial evidence of ongoing HIV transmission in the African community of KC.

SUBMITTER: Kerani RP

PROVIDER: S-EPMC5738028 | biostudies-literature | 2017 Aug

REPOSITORIES: biostudies-literature

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Evidence of Local HIV Transmission in the African Community of King County, Washington.

Kerani Roxanne P RP Herbeck Joshua T JT Buskin Susan E SE Dombrowksi Julia C JC Bennett Amy A Barash Elizabeth E Barbee Lindley A LA Golden Matthew R MR

Journal of immigrant and minority health 20170801 4

Little is known about the frequency of ongoing HIV transmission within U.S. African immigrant communities. We used HIV surveillance and partner services data to describe African-born persons newly reported with HIV infection in King County (KC), WA from 1/1/2010 to 12/31/2013. We performed phylogenetic clustering analysis of HIV-1 pol to identify putative transmission events within this population. From 2010 to 2013, 1148 KC adults were reported with HIV, including 102 (9 %) born in Africa. Fort ...[more]

PMID: 27395379

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Project description:BackgroundRacial and ethnic disparities in COVID-19 infection and outcomes have been documented, but few studies have examined disparities in access to testing.MethodsWe conducted a mixed methods study of access to COVID-19 testing in the Somali immigrant community in King County, Washington, USA, early during the COVID-19 pandemic. In September 2020-February 2021, we conducted quantitative surveys in a convenience sample (n = 528) of individuals who had accessed PCR testing, recruited at King County testing sites near Somali population centers and through social media outreach in the Somali community. We compared self-identified Somali and non-Somali responses using Chi-square and Wilcoxon rank sum tests. We also conducted three Somali-language focus groups (n = 26) by video conference to explore Somali experiences with COVID-19 testing, and in-depth interviews with King County-based policymakers and healthcare workers (n = 13) recruited through the research team's professional network to represent key demographics and roles. Data were analyzed using qualitative rapid analysis to explore the county's COVID-19 testing landscape.ResultsAmong 420 survey respondents who had received COVID-19 testing in the prior 90 days, 29% of 140 Somali vs. 11% of 280 non-Somali respondents tested because of symptoms (p = 0.001), with a trend for longer time from symptom onset to testing (a measure of testing access) among Somali respondents (median 3.0 vs. 2.0 days, p = 0.06). Focus groups revealed barriers to testing, including distrust, misinformation, stigma, language, lack of awareness, and transportation. Stakeholders responding from all sectors highlighted the importance of community partnership to improve access.ConclusionSomali communities experience barriers to COVID-19 testing, as evidenced by the longer time from symptom onset to testing and corroborated by our qualitative findings. These barriers, both structural and community-derived, may be overcome through partnerships between government and community to support community-led, multilingual service delivery and racial representation among medical staff.

Project description:Determining the causes of biological impairment in urban stream settings presents unique challenges because there are many potential stressors associated with human development. A rigorous, scientifically based process is more likely to identify influential stressors that can be reduced to improve stream condition. We used the U.S. Environmental Protection Agency's (U.S. EPA) CADDIS (Causal Analysis/Decision Information System) stressor identification process to assess eight candidate causes in the urban Soos Creek Basin in Washington State. The eight candidate causes capable of negatively affecting the abundance and diversity of benthic macroinvertebrates are: flow alteration, increased fine sediments, reduced habitat complexity, elevated water temperature, low dissolved oxygen, elevated nutrients, increased ionic concentration, and toxic pollutants. We assembled multiple lines of evidence, as well as the consistency of that evidence and agreement with other assessments. We evaluated the influence of natural and cumulative anthropogenic stressors on macroinvertebrate communities by comparing various chemical, physical, and biological measures at sites in the Soos Creek Basin with regional reference sites. Of the stressors evaluated, flow alteration, increased fine sediments, and loss of habitat complexity were the most probable causes of biological impairment, with multiple biological metrics responding predictably across levels of impairment. Key findings from this study include: the use of specific community alterations as evidence in causal assessment, demonstration of links in a complete causal pathway, and the use of multiple models to show which pathway is likely stronger. In addition to the value to the specific case, the analyses increased our understanding of the responses of stream invertebrate communities in urban environments. Ultimately, demonstrating the utility of causal assessment in a practical situation provides greater confidence that mitigation efforts aimed at improving biological health of urban stream communities will have detectable desired effects while also providing a baseline from which the effectiveness of management practices can be evaluated.

Dataset Information

Evidence of Local HIV Transmission in the African Community of King County, Washington.

Publications

Evidence of Local HIV Transmission in the African Community of King County, Washington.

Similar Datasets

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