Danielle C Ompad

Director of Doctorate of Philosophy in Public Health Program

Vice Dean for Academic Affairs

Professor of Epidemiology

Professional overview

Dr. Danielle Ompad is an epidemiologist whose work is focused in the areas of urban health, HIV, illicit drug use, and adult access to vaccines. With respect to illicit drug use, her work has spanned the entire natural history of addiction – from initiation to cessation, with particular attention paid to risk for infectious diseases such as HIV, hepatitis B and C, and STIs.  She has primarily worked with people who use heroin, crack, cocaine, and/or club drugs.  

In New York City, she has been examining heroin cessation among current, former, and relapsed heroin users. Working with Alliance for Public Health and the Ukrainian Institute on Public Health Policy, she analyzes harm reduction service utilization among people who inject drugs, in order to optimize service delivery in Ukraine.  Since 2013, she has served as faculty for the Fogarty-funded New York State International Training and Research Program with the goal of building research capacity in Ukraine.

Dr. Ompad’s National Institute of Allergy and Infectious Diseases-funded study aims to determine if herpes simplex 1 and 2 infections explain racial disparities in HIV incidence among a cohort of young gay, bisexual, and other men who have sex with men (YMSM).  In addition, Dr. Ompad and colleagues are assessing HPV infection prevalence, persistence, and clearance among this same cohort.

Education

BS, Biology, Bowie State University, Bowie, MD

MHS, Epidemiology, Johns Hopkins University, Baltimore, MD

PhD, Epidemiology, Johns Hopkins University, Baltimore, MD

Honors and awards

Excellence in Public Health Teaching Award, New York University (2014)

Excellence in Public Health Teaching Award, New York University (2013)

National Hispanic Science Network on Drug Abuse Scientific Development Travel Fellowship (2010)

Delta Omega Honorary Society, Alpha Chapter (2002)

Areas of research and study

Epidemiology

HIV/AIDS

Infectious Diseases

Social Determinants of Health

STIs

Substance Abuse

Vaccines

Publications

Publications

How the rural risk environment underpins hepatitis C risk: Qualitative findings from rural southern Illinois, United States

I Don’t Believe a Person Has to Die When Trying to Get High: Overdose Prevention and Response Strategies in Rural Illinois

Conceptualizing the Socio-Built Environment: An Expanded Theoretical Framework to Promote a Better Understanding of Risk for Nonmedical Opioid Overdose Outcomes in Urban and Non-Urban Settings

Tempalski, B., Williams, L. D., Kolak, M., Ompad, D. C., Koschinsky, J., & McLafferty, S. L. (n.d.).

Publication year

2022

Journal title

Journal of Urban Health

Volume

99

Issue

4

Page(s)

701-716

10.1007/s11524-022-00645-3

Abstract

Abstract

Nonmedical opioid (NMO) use has been linked to significant increases in rates of NMO morbidity and mortality in non-urban areas. While there has been a great deal of empirical evidence suggesting that physical features of built environments represent strong predictors of drug use and mental health outcomes in urban settings, there is a dearth of research assessing the physical, built environment features of non-urban settings in order to predict risk for NMO overdose outcomes. Likewise, there is strong extant literature suggesting that social characteristics of environments also predict NMO overdoses and other NMO use outcomes, but limited research that considers the combined effects of both physical and social characteristics of environments on NMO outcomes. As a result, important gaps in the scientific literature currently limit our understanding of how both physical and social features of environments shape risk for NMO overdose in rural and suburban settings and therefore limit our ability to intervene effectively. In order to foster a more holistic understanding of environmental features predicting the emerging epidemic of NMO overdose, this article presents a novel, expanded theoretical framework that conceptualizes “socio-built environments” as comprised of (a) environmental characteristics that are applicable to both non-urban and urban settings and (b) not only traditional features of environments as conceptualized by the extant built environment framework, but also social features of environments. This novel framework can help improve our ability to identify settings at highest risk for high rates of NMO overdose, in order to improve resource allocation, targeting, and implementation for interventions such as opioid treatment services, mental health services, and care and harm reduction services for people who use drugs.

Copycat and lookalike edible cannabis product packaging in the United States

Ompad, D. C., Snyder, K. M., Sandh, S., Hagen, D., Collier, K. J., Goldmann, E., Goodman, M. S., & Tan, A. S. (n.d.).

Publication year

2022

Journal title

Drug and alcohol dependence

Volume

235

10.1016/j.drugalcdep.2022.109409

Abstract

Abstract

Background: Recent media reports have highlighted copycat/lookalike cannabis edibles as a public health concern. No empirical papers have described this phenomenon. Methods: From May 2020-August 2021, we collected photos of cannabis products via an online survey of cannabis users and through personal contacts. Copycat/lookalike products are defined as those that use the same or similar brand name, logo, and/or imagery as an existing commercial non-cannabis counterpart (CNCC). We assessed each package for similarities with its CNCC with respect to brand name, product name, font, color, flavors, and brand/promotional characters. We examined cannabis content indicators including: THC content per package and serving, cannabis leaf symbol, product warnings, cannabis terms, cannabis motifs, activation time, and guidance on edible use. Results: We collected photos of 731 cannabis products; 267 (36%) were edibles of which 22 (8%) represented 13 unique copycat/lookalike products. Eight used exact brand/product names as existing CNCCs, and five used similar names. Packages copied or imitated a mean of 3.9 of six features and indicated cannabis content with a mean of 4.1 of eight features. Thirteen packages indicated a mean THC content of 459 mg/package. Four reported THC dose per serving, with a mean dose of 47.5 mg. Conclusions: Our content analysis highlights three key concerns. First, copycat/lookalike edibles subtly indicate cannabis content while using high fidelity replication or imitation of their CNCC. Second, THC content is high and there were multiple 10 mg THC doses in the equivalent of 1 serving of a CNCC. Third, these products may be attractive to children.

No Good Time Without Drugs: Qualitative Study Among Nightlife Attendees in Tbilisi, Georgia

Predictors of Anal High-Risk HPV Infection Across Time in a Cohort of Young Adult Sexual Minority Men and Transgender Women in New York City, 2015–2020

PrEP Care Continuum Engagement Among Persons Who Inject Drugs: Rural and Urban Differences in Stigma and Social Infrastructure

Presence of Content Appealing to Youth on Cannabis-Infused Edibles Packaging

Tan, A. S., Weinreich, E., Padon, A., Sanchez, M., Snyder, K. M., Vasilyeva, A., Sandh, S., Goldmann, E., Goodman, M., & Ompad, D. C. (n.d.).

Publication year

2022

Journal title

Substance Use and Misuse

Volume

57

Issue

8

Page(s)

1215-1219

10.1080/10826084.2022.2069268

Abstract

Abstract

Background: There is a lack of consistent regulation of cannabis edibles packaging to restrict youth-appealing content in the United States. Objective: To describe content appealing to youth on U.S. cannabis-infused edibles packaging. Methods: We analyzed 256 photos of cannabis-infused edibles packaging collected from U.S. adults from 25 states, District of Columbia, and Puerto Rico between May 2020 to August 2021. We coded the presence of product knockoffs, human and non-human creatures, images indicating flavor, text indicating flavor, and the number of colors. We compared these codes across states’ legalization status (medical and non-medical cannabis, medical cannabis only, or limited cannabis legalization). Results: Overall, 15% of packages resembled product knockoffs, 23% contained human/non-human creatures, 35% contained flavor images, 91% contained flavor text, and median number of colors was 5 (range from 1 to 10+). Packages purchased in states with medical and non-medical cannabis, medical cannabis only, or limited cannabis legalization differed significantly on product knockoffs (11%, 26%, 38%, p = 0.007), human/non-human creatures (19%, 33%, 63%, p = 0.002), flavor text (93%, 81%, 100%, p = 0.046), and number of colors (median of 5, 5, and 10, p = 0.022). Conclusions: Existing laws have not adequately limited content appealing to youth on U.S. cannabis-infused edibles packaging. Robust and consistent regulations in the U.S. are needed to ensure that the packaging of such products does not contain content that appeal to youth and lead to initiation or inadvertent ingestion.

Principles and Metrics for Evaluating Oregon’s Innovative Drug Decriminalization Measure

Netherland, J., Kral, A. H., Ompad, D. C., Davis, C. S., Bluthenthal, R. N., Dasgupta, N., Gilbert, M., Morgan, R., & Wheelock, H. (n.d.).

Publication year

2022

Journal title

Journal of Urban Health

Volume

99

Issue

2

Page(s)

328-331

10.1007/s11524-022-00606-w

Structural and community changes during COVID-19 and their effects on overdose precursors among rural people who use drugs: a mixed-methods analysis

Walters, S. M., Bolinski, R. S., Almirol, E., Grundy, S., Fletcher, S., Schneider, J., Friedman, S. R., Ouellet, L. J., Ompad, D. C., Jenkins, W., & Pho, M. T. (n.d.).

Publication year

2022

Journal title

Addiction Science and Clinical Practice

Volume

17

Issue

1

10.1186/s13722-022-00303-8

Abstract

Abstract

Background: Drug overdose rates in the United States have been steadily increasing, particularly in rural areas. The COVID-19 pandemic and associated mitigation strategies may have increased overdose risk for people who use drugs by impacting social, community, and structural factors. Methods: The study included a quantitative survey focused on COVID-19 administered to 50 people who use drugs and semi-structured qualitative interviews with 17 people who use drugs, 12 of whom also participated in the quantitative survey. Descriptive statistics were run for the quantitative data. Qualitative coding was line-by-line then grouped thematically. Quantitative and qualitative data were integrated during analysis. Results: Findings demonstrate how COVID-19 disruptions at the structural and community level affected outcomes related to mental health and drug use at the individual level. Themes that emerged from the qualitative interviews were (1) lack of employment opportunities, (2) food and housing insecurity, (3) community stigma impacting health service use, (4) mental health strains, and (5) drug market disruptions. Structural and community changes increased anxiety, depression, and loneliness on the individual level, as well as changes in drug use patterns, all of which are likely to increase overdose risk. Conclusion: The COVID-19 pandemic, and mitigation strategies aimed at curbing infection, disrupted communities and lives of people who use drugs. These disruptions altered individual drug use and mental health outcomes, which could increase risk for overdose. We recommend addressing structural and community factors, including developing multi-level interventions, to combat overdose. Trial registration Clinicaltrails.gov: NCT04427202. Registered June 11, 2020: https://clinicaltrials.gov/ct2/show/NCT04427202?term=pho+mai&draw=2&rank=3.

The Impact of the COVID-19 Pandemic on Drug Use Behaviors, Fentanyl Exposure, and Harm Reduction Service Support among People Who Use Drugs in Rural Settings

Bolinski, R. S., Walters, S., Salisbury-Afshar, E., Ouellet, L. J., Jenkins, W. D., Almirol, E., Van Ham, B., Fletcher, S., Johnson, C., Schneider, J. A., Ompad, D., & Pho, M. T. (n.d.).

Publication year

2022

Journal title

International journal of environmental research and public health

Volume

19

Issue

4

10.3390/ijerph19042230

Abstract

Abstract

Background: The COVID-19 pandemic has worsened the opioid overdose crisis in the US. Rural communities have been disproportionately affected by opioid use and people who use drugs in these settings may be acutely vulnerable to pandemic-related disruptions due to high rates of poverty, social isolation, and pervasive resource limitations. Methods: We performed a mixed-methods study to assess the impact of the pandemic in a convenience sample of people who use drugs in rural Illinois. We conducted 50 surveys capturing demographics, drug availability, drug use, sharing practices, and mental health symptoms. In total, 19 qualitative interviews were performed to further explore COVID-19 knowledge, impact on personal and community life, drug acquisition and use, overdose, and protective substance use adaptations. Results: Drug use increased during the pandemic, including the use of fentanyl products such as gel encapsulated “beans” and “buttons”. Disruptions in supply, including the decreased availability of heroin, increased methamphetamine costs and a concomitant rise in local methamphetamine production, and possible fentanyl contamination of methamphetamine was reported. Participants reported increased drug use alone, experience and/or witness of overdose, depression, anxiety, and loneliness. Consistent access to harm reduction services, including naloxone and fentanyl test strips, was highlighted as a source of hope and community resiliency. Conclusions: The COVID-19 pandemic period was characterized by changing drug availability, increased overdose risk, and other drug-related harms faced by people who use drugs in rural areas. Our findings emphasize the importance of ensuring access to harm reduction services, including overdose prevention and drug checking for this vulnerable population.

Acceptability and Effectiveness of Hepatitis C Care at Syringe Service Programs for People Who Inject Drugs in New York City

Dominican Provider Attitudes Towards HPV Testing for Cervical Cancer Screening and, Current Challenges to Cervical Cancer Prevention in the Dominican Republic: a Mixed Methods Study

Liebermann, E., Van Devanter, N., Frías Gúzman, N., Hammer, M. J., & Ompad, D. (n.d.).

Publication year

2021

Journal title

Journal of Cancer Education

Volume

36

Issue

6

Page(s)

1170-1185

10.1007/s13187-020-01746-w

Abstract

Abstract

Creating effective programs for cervical cancer prevention is essential to avoid premature deaths from cervical cancer. The Dominican Republic has persistently high rates of cervical cancer, despite the availability of Pap smear screening. This study explored Dominican provider attitudes towards human papillomavirus (HPV) testing and current challenges to effective cervical cancer prevention. In this Consolidated Framework for Implementation Research (CFIR)–driven mixed methods study, we conducted in-depth interviews (N = 21) and surveys (N = 202) with Dominican providers in Santo Domingo and Monte Plata provinces regarding their perspectives on barriers to cervical cancer prevention and their knowledge and attitudes towards HPV testing as an alternative to Pap smear. Providers believed the main barrier to cervical cancer prevention was lack of cervical cancer awareness and resulting inadequate population screening coverage. Providers felt that Pap smear was widely available to women in the Dominican Republic and were unsure how a change to HPV testing for screening would address gaps in current cervical cancer screening programs. A subset of providers felt HPV testing offered important advantages for early detection of cervical cancer and were in favor of more widespread use. Cost of the HPV test and target age for screening with HPV testing were the main barriers to acceptability. Providers had limited knowledge of HPV testing as a screening test. The group was divided in terms of the potential impact of a change in screening test in addressing barriers to cervical cancer prevention in the Dominican Republic. Findings may inform interventions to disseminate global evidence-based recommendations for cervical cancer screening.

Dominican Provider Practices for Cervical Cancer Screening in Santo Domingo and Monte Plata Provinces

How urban and rural built environments influence the health attitudes and behaviors of people who use drugs

Racial and ethnic disparities in "stop-and-frisk" experience among young sexual minority men in New York City

The effectiveness of malaria camps as part of the Durgama Anchalare Malaria Nirakaran (DAMaN) program in Odisha, India: study protocol for a cluster-assigned quasi-experimental study

"they look at us like junkies": Influences of drug use stigma on the healthcare engagement of people who inject drugs in New York City

Muncan, B., Walters, S. M., Ezell, J., & Ompad, D. C. (n.d.).

Publication year

2020

Journal title

Harm Reduction Journal

Volume

17

Issue

1

10.1186/s12954-020-00399-8

Abstract

Abstract

Background: People who inject drugs (PWID) are a medically and socially vulnerable population with a high incidence of overdose, mental illness, and infections like HIV and hepatitis C. Existing literature describes social and economic correlations to increased health risk, including stigma. Injection drug use stigma has been identified as a major contributor to healthcare disparities for PWID. However, data on this topic, particularly in terms of the interface between enacted, anticipated, and internalized stigma, is still limited. To fill this gap, we examined perspectives from PWID whose stigmatizing experiences impacted their views of the healthcare system and syringe service programs (SSPs) and influenced their decisions regarding future medical care. Methods: Semi-structured interviews conducted with 32 self-identified PWID in New York City. Interviews were audio recorded and transcribed. Interview transcripts were coded using a grounded theory approach by three trained coders and key themes were identified as they emerged. Results: A total of 25 participants (78.1%) reported at least one instance of stigma related to healthcare system engagement. Twenty-three participants (71.9%) reported some form of enacted stigma with healthcare, 19 participants (59.4%) described anticipated stigma with healthcare, and 20 participants (62.5%) reported positive experiences at SSPs. Participants attributed healthcare stigma to their drug injection use status and overwhelmingly felt distrustful of, and frustrated with, medical providers and other healthcare staff at hospitals and local clinics. PWID did not report internalized stigma, in part due to the availability of non-stigmatizing medical care at SSPs. Conclusions: Stigmatizing experiences of PWID in formal healthcare settings contributed to negative attitudes toward seeking healthcare in the future. Many participants describe SSPs as accessible sites to receive high-quality medical care, which may curb the manifestation of internalized stigma derived from negative experiences in the broader healthcare system. Our findings align with those reported in the literature and reveal the potentially important role of SSPs. With the goal of limiting stigmatizing interactions and their consequences on PWID health, we recommend that future research include explorations of mechanisms by which PWID make decisions in stigmatizing healthcare settings, as well as improving medical care availability at SSPs.

Barriers to Cervical Cancer Screening and Treatment in the Dominican Republic: Perspectives of Focus Group Participants in the Santo Domingo Area

Pandemic preparedness and hard to reach populations

Vlahov, D., Coady, M. H., Galea, S., Ompad, D. C., & Barondess, J. A. (n.d.).

Publication year

2020

Journal title

American journal of disaster medicine

Volume

14

Issue

4

Page(s)

308-310

10.5055/ajdm.2019.0344

Parent-Level Barriers and Facilitators to HPV Vaccine Implementation in Santo Domingo, Dominican Republic

Liebermann, E., Devanter, N. V., Frías Gúzman, N., Ompad, D., Shirazian, T., & Healton, C. (n.d.).

Publication year

2020

Journal title

Journal of Community Health

Volume

45

Issue

5

Page(s)

1061-1066

10.1007/s10900-020-00830-y

Abstract

Abstract

Cervical cancer is the second leading cause of cancer death for women in the Dominican Republic. Vaccination against human papillomavirus (HPV) could reduce mortality from cervical cancer globally by as much as 90%. The purpose of our study was to explore multi-level barriers and facilitators to implementation of a national HPV vaccine program in the Dominican Republic; this article focuses on parent-level barriers and facilitators. In this qualitative study, we conducted six focus groups (N = 64) with parents of school-age children in the Santo Domingo area of the Dominican Republic, representing diverse socioeconomic groups and geographic settings. Thematic content analysis, using inductive and deductive approaches, was done following transcription and translation of audio-recordings from focus group discussions. Among this group of parents in the Santo Domingo area, facilitators to vaccine uptake were favorable attitudes towards vaccines in general and concern about cervical cancer as a health issue. Barriers found were low to moderate knowledge of HPV and cervical cancer, especially in the rural and suburban groups, and cost and lack of public awareness of the vaccine. This study identified key barriers and facilitators to HPV vaccine implementation in the Dominican Republic. Health messaging, incorporating specialist providers as opinion leaders, will need to be tailored to broad audiences with varying levels of information and awareness, anticipating misinformation and concerns, and will need to emphasize HPV vaccine as a method to prevent cancer.

The Opioid/Overdose Crisis as a Dialectics of Pain, Despair, and One-Sided Struggle

Friedman, S. R., Krawczyk, N., Perlman, D. C., Mateu-Gelabert, P., Ompad, D. C., Hamilton, L., Nikolopoulos, G., Guarino, H., & Cerdá, M. (n.d.).

Publication year

2020

Journal title

Frontiers in Public Health

Volume

8

10.3389/fpubh.2020.540423

Abstract

Abstract

The opioid/overdose crisis in the United States and Canada has claimed hundreds of thousands of lives and has become a major field for research and interventions. It has embroiled pharmaceutical companies in lawsuits and possible bankruptcy filings. Effective interventions and policies toward this and future drug-related outbreaks may be improved by understanding the sociostructural roots of this outbreak. Much of the literature on roots of the opioid/overdose outbreak focuses on (1) the actions of pharmaceutical companies in inappropriately promoting the use of prescription opioids; (2) “deaths of despair” based on the deindustrialization of much of rural and urban Canada and the United States, and on the related marginalization and demoralization of those facing lifetimes of joblessness or precarious employment in poorly paid, often dangerous work; and (3) increase in occupationally-induced pain and injuries in the population. All three of these roots of the crisis—pharmaceutical misconduct and unethical marketing practices, despair based on deindustrialization and increased occupational pain—can be traced back, in part, to what has been called the “one-sided class war” that became prominent in the 1970s, became institutionalized as neo-liberalism in and since the 1980s, and may now be beginning to be challenged. We describe this one-sided class war, and how processes it sparked enabled pharmaceutical corporations in their misconduct, nurtured individualistic ideologies that fed into despair and drug use, weakened institutions that created social support in communities, and reduced barriers against injuries and other occupational pain at workplaces by reducing unionization, weakening surviving unions, and weakening the enforcement of rules about workplace safety and health. We then briefly discuss the implications of this analysis for programs and policies to mitigate or reverse the opioid/overdose outbreak.

The role of access to integrated services at opioid agonist treatment sites in reaching 90-90-90 cascade in people who inject drugs in Ukraine: Country-level data

Meteliuk, A., Prokhorova, T., Filippovych, S., Ompad, D. C., & Zaller, N. (n.d.).

Publication year

2020

Journal title

Drug and alcohol dependence

Volume

216

10.1016/j.drugalcdep.2020.108216

Abstract

Abstract

INTRODUCTION: Opioid agonist treatment (OAT) is an effective means to prevent HIV transmission. Ukraine started integrating HIV services into OAT sites to improve people who inject drugs' (PWID) access to treatment.METHODS: Data from the national registry of OAT patients (n = 9,983) were analyzed. These data are collected from all 179 OAT sites countrywide. For the cascade, HIV-positive OAT patients (n = 4,084) were stratified into two categories: OAT alone (received OAT at one site and antiretroviral therapy (ART) at different location, n = 1,789) and integrated care (received OAT and ART at one location, n = 2,295) for comparison.RESULTS: Most HIV-positive OAT patients in Ukraine are male (85.6 %) and the mean age is 40.3 years old. The mean length of injecting before OAT is 17.2 years and the mean length on OAT is 4.2 years. All HIV-positive OAT clients are aware of their HIV status. The proportion of HIV-positive clients receiving ART was higher at integrated care sites compared to OAT alone sites (84.2 vs. 73.1 %, p- = 0.012); distribution of viral suppression among those receiving ART across the strata were 79.4 and 59.2 % for 'integrated care sites' vs. 'OAT only sites' respectively (p < 0.001).CONCLUSIONS: This analysis clearly demonstrates much better progress towards the 90-90-90 goals among those OAT patients who receive integrated care services (both OAT and ART) at one site at each stage of the HIV care cascade as compared to receiving OAT and ART at different sites. There is an urgent need to further expand the integration of OAT and HIV services in Ukraine.

A New Generation of Drug Users in St. Petersburg, Russia? HIV, HCV, and Overdose Risks in a Mixed-Methods Pilot Study of Young Hard Drug Users

Meylakhs, P., Friedman, S. R., Meylakhs, A., Mateu-Gelabert, P., Ompad, D. C., Alieva, A., & Dmitrieva, A. (n.d.).

Publication year

2019

Journal title

AIDS and Behavior

Volume

23

Issue

12

Page(s)

3350-3365

10.1007/s10461-019-02489-6

Abstract

Abstract

Russia has a widespread injection drug use epidemic with high prevalence of HIV and HCV among people who inject drugs (PWID). We conducted a mixed methods study of young (age 18–26) hard drug users in St. Petersburg. Thirty-nine structured and 10 semi-structured interviews were conducted. No HIV cases and two HCV cases were detected among the PWID subsample (n = 29). Amphetamine and other stimulants were common (70%), opioid use was rare and episodic. Consistent condom use was 10%. No PWID reported syringe-sharing, 51% reported other drug paraphernalia sharing. Most (89%) never or rarely communicated with older (30 +) opiate users. A new cohort of drug users in St. Petersburg may have emerged, which is much safer in its injection practices compared to previous cohorts. However, risky sexual practices among this new cohort may expose them to the possibility of sexual transmission of HIV and widespread drug paraphernalia sharing to the HCV epidemic.

Construction trade and extraction workers: A population at high risk for drug use in the United States, 2005–2014