Danielle C Ompad
Danielle C. Ompad
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Professor of Epidemiology
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Professional overview
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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.
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Education
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BS, Biology, Bowie State University, Bowie, MDMHS, Epidemiology, Johns Hopkins University, Baltimore, MDPhD, Epidemiology, Johns Hopkins University, Baltimore, MD
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Honors and awards
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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)
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Areas of research and study
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EpidemiologyHIV/AIDSInfectious DiseasesSocial Determinants of HealthSTIsSubstance AbuseVaccines
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Publications
Publications
Smoking and HIV-related health issues among older HIV-positive gay, bisexual, and other men who have sex with men
AbstractOmpad, D. C., Kingdon, M., Kupprat, S., Halkitis, S. N., Storholm, E. D., & Halkitis, P. N. (n.d.).Publication year
2014Journal title
Behavioral MedicineVolume
40Issue
3Page(s)
99-107AbstractThe prevalence of cigarette smoking and the relations between smoking and HIV clinical markers, HIV medication adherence, and opportunistic infections (OIs) were examined in a sample of 199 HIV-positive, gay, bisexual, and other men who have sex with men (MSM) aged 50 and older. Overall, 35.7% were current smokers, 35.7% were former smokers, and 28.6% were never smokers. In the final multivariable polytomous logistic regression model controlling for age, income, and illicit drug use, current smokers were less likely to report an undetectable viral load as compared to never and former smokers. Relative to never smokers, former smokers were more likely to report respiratory OIs, and current smokers were more likely to report gastrointestinal OIs. This study demonstrates high prevalence of cigarette smoking among aging, HIV-positive MSM and provides additional evidence for a relationship between smoking and poorer HIV clinical markers. Targeted and tailored smoking cessation programs within the context of HIV care services are warranted. © 2014The Impact of the Good Behavior Game, a Universal Classroom-Based Preventive Intervention in First and Second Grades, on High-Risk Sexual Behaviors and Drug Abuse and Dependence Disorders into Young Adulthood
AbstractKellam, S. G., Wang, W., Mackenzie, A. C. L., Brown, C. H., Ompad, D. C., Or, F., Ialongo, N. S., Poduska, J. M., & Windham, A. (n.d.).Publication year
2014Journal title
Prevention ScienceVolume
15Page(s)
6-18AbstractThe Good Behavior Game (GBG), a method of teacher classroom behavior management, was tested in first- and second-grade classrooms in 19 Baltimore City Public Schools beginning in the 1985-1986 school year. The intervention was directed at the classroom as a whole to socialize children to the student role and reduce aggressive, disruptive behaviors, confirmed antecedents of a profile of externalizing problem outcomes. This article reports on the GBG impact on the courses and interrelationships among aggressive, disruptive behavior through middle school, risky sexual behaviors, and drug abuse and dependence disorders through ages 19-21. In five poor to lower-middle class, mainly African American urban areas, classrooms within matched schools were assigned randomly to either the GBG intervention or the control condition. Balanced assignment of children to classrooms was made, and teachers were randomly assigned to intervention or control. Analyses involved multilevel growth mixture modeling. By young adulthood, significant GBG impact was found in terms of reduced high-risk sexual behaviors and drug abuse and dependence disorders among males who in first grade and through middle school were more aggressive, disruptive. A replication with the next cohort of first-grade children with the same teachers occurred during the following school year, but with minimal teacher mentoring and monitoring. Findings were not significant but generally in the predicted direction. A universal classroom-based prevention intervention in first- and second-grade classrooms can reduce drug abuse and dependence disorders and risky sexual behaviors.Understanding Prolonged Cessation from Heroin Use: Findings from a Community-Based Sample
AbstractWeiss, L., Gass, J., Egan, J. E., Ompad, D. C., Trezza, C., & Vlahov, D. (n.d.).Publication year
2014Journal title
Journal of Psychoactive DrugsVolume
46Issue
2Page(s)
123-132AbstractBackground: There is abundant literature describing heroin initiation, co-morbidities, and treatment. Few studies focus on cessation, examining the factors that motivate and facilitate it.Methods: The CHANGE study utilized mixed methods to investigate heroin cessation among low-income New York City participants. This paper describes findings from qualitative interviews with 20 former and 11 current heroin users. Interviews focused on background and current activities, supports, drug history, cessation attempts, and motivators and facilitators to cessation. Results: Participants found motivation for cessation in improved quality of life, relationships, and fear of illness, incarceration and/or death. Sustained cessation required some combination of treatment, strategic avoidance of triggers, and engagement in alternative activities, including support groups, exercise, and faith-based practice. Several reported that progress toward goals served as motivators that increased confidence and facilitated cessation. Ultimatums were key motivators for some participants. Beyond that, they could not articulate factors that distinguished successful from unsuccessful cessation attempts, although data suggest that those who were successful could describe more individualized and concrete-rather than general-motivators and strategies. Conclusions: Our findings indicate that cessation may be facilitated by multifaceted and individualized strategies, suggesting a need for personal and comprehensive approaches to treatment.Men who purchase sex, who are they? an interurban comparison
AbstractOmpad, D. C., Bell, D. L., Amesty, S., Nyitray, A. G., Papenfuss, M., Lazcano-Ponce, E., Villa, L. L., & Giuliano, A. R. (n.d.).Publication year
2013Journal title
Journal of Urban HealthVolume
90Issue
6Page(s)
1166-1180AbstractMost research concerning clients of commercial sex workers (CSWs) relies upon CSW reports of client characteristics and behavior. We describe correlates of ever purchasing sex among 3,829 men from three cities: Sao Paulo, Brazil; Cuernavaca, Mexico; and Tampa, USA. A computer-assisted self-interview collected data on demographics and sexual behavior. There were significant site differences26.5 % paid for sex in Sao Paulo, 10.4 % in Cuernavaca, and 4.9 % in Tampa. In all cities, men who had sex with men and women (versus sex with women only) were more likely to have ever paid for sex. In Sao Paulo and Cuernavaca, CSW clients were older, had higher educational attainment, and were less likely to be married. In Tampa, older age was associated with being a CSW client but not education and marital status. In Sao Paulo and Cuernavaca, CSW clients had more partners than men who had never paid for sex. In Sao Paulo, CSW clients initiated vaginal sex at an earlier age, while in Cuernavaca they were more likely to self-report a sexually transmitted infection. CSW clients varied with respect to demographics across the three cities while the association between paying for sex and risky sexual behavior seems to be somewhat conserved. These findings suggest that interventions among CSW clients should focus on condom use with commercial and non-commercial partners as these men may be at increased risk for transmitting and acquiring sexually transmitted infections to and from their sex partners. Better understanding of client characteristics is needed for targeting interventions and creating culturally appropriate content.Methods to Measure the Impact of Home, Social, and Sexual Neighborhoods of Urban Gay, Bisexual, and Other Men Who Have Sex with Men
AbstractKoblin, B. A., Egan, J. E., Rundle, A., Quinn, J., Tieu, H. V., Cerdá, M., Ompad, D. C., Greene, E., Hoover, D. R., & Frye, V. (n.d.).Publication year
2013Journal title
PloS oneVolume
8Issue
10AbstractMen who have sex with men (MSM) accounted for 61% of new HIV diagnoses in the United States in 2010. Recent analyses indicate that socio-structural factors are important correlates of HIV infection. NYCM2M was a cross-sectional study designed to identify neighborhood-level characteristics within the urban environment that influence sexual risk behaviors, substance use and depression among MSM living in New York City. The sample was recruited using a modified venue-based time-space sampling methodology and through select websites and mobile applications. This paper describes novel methodological approaches used to improve the quality of data collected for analysis of the impact of neighborhoods on MSM health. Previous research has focused predominately on residential neighborhoods and used pre-determined administrative boundaries (e.g., census tracts) that often do not reflect authentic and meaningful neighborhoods. This study included the definition and assessment of multiple neighborhoods of influence including where men live (home neighborhood), socialize (social neighborhood) and have sex (sexual neighborhood). Furthermore, making use of technological advances in mapping, we collected geo-points of reference for each type of neighborhood and identified and constructed self-identified neighborhood boundary definitions. Finally, this study collected both perceived neighborhood characteristics and objective neighborhood conditions to create a comprehensive, flexible and rich neighborhood-level set of covariates. This research revealed that men perceived their home, social and sexual neighborhoods in different ways. Few men (15%) had the same home, social and sexual neighborhoods; for 31%, none of the neighborhoods was the same. Of the three types of neighborhoods, the number of unique social neighborhoods was the lowest; the size of sexual neighborhoods was the smallest. The resultant dataset offers the opportunity to conduct analyses that will yield context-specific and nuanced understandings of the relations among neighborhood space, and the well-being and health of urban MSM.Resources and interest among faith based organizations for influenza vaccination programs
AbstractBond, K. T., Jones, K., Ompad, D. C., & Vlahov, D. (n.d.).Publication year
2013Journal title
Journal of Immigrant and Minority HealthVolume
15Issue
4Page(s)
758-763AbstractIn the United States, annual influenza vaccination rates are suboptimal and are well below the national health objectives. Project VIVA mobilized community members and organizations to implement an influenza vaccination program in Harlem by administering vaccines in "non-traditional" venues, such as community-based organizations, pharmacies, and faith-based organizations (FBOs). FBOs have been recognized as important venues for health promotion initiatives within medically underserved communities. However, data regarding the extent of resources and interest in health promotion programs among FBOs are sparse. We conducted a telephone survey among 115 FBOs in three New York City neighborhoods with histories of low influenza immunization rates to identify the congregation's health concerns, interest in serving as a community-based venue for influenza vaccinations, and existing resources for health programming. Twenty-six percent of the FBOs had an established health ministry, while 45 % expressed interest in developing one. Seven percent included nurses among their health activities and 16.5 % had contact with the local health department. Most FBOs expressed interest in common health promotions programs; 60 % expressed interest in providing on-site influenza vaccination programs within their organization. Health programs within FBOs can be a point of access that may improve the health of their congregants as well as the larger community.Beyond income: Material resources among drug users in economically-disadvantaged New York City neighborhoods
AbstractOmpad, D. C., Nandi, V., Cerdá, M., Crawford, N., Galea, S., & Vlahov, D. (n.d.).Publication year
2012Journal title
Drug and alcohol dependenceVolume
120Issue
1Page(s)
127-134AbstractBackground: Little is known about material resources among drug users beyond income. Income measures can be insensitive to variation among the poor, do not account for variation in cost-of-living, and are subject to non-response bias and underreporting. Further, most do not include illegal income sources that may be relevant to drug-using populations. Methods: We explored the reliability and validity of an 18-item material resource scale and describe correlates of adequate resources among 1593 current, former and non-drug users recruited in New York City. Reliability was determined using coefficient α, ω h, and factor analysis. Criterion validity was explored by comparing item and mean scores by income and income source using ANOVA; content validity analyses compared scores by drug use. Multiple linear regression was used to describe correlates of adequate resources. Results: The coefficient α and ω h for the overall scale were 0.91 and 0.68, respectively, suggesting reliability was at least adequate. Legal income >$5000 (vs. ≤$5000) and formal (vs. informal) income sources were associated with more resources, supporting criterion validity. We observed decreasing resources with increasing drug use severity, supporting construct validity. Three factors were identified: basic needs, economic resources and services. Many did not have their basic needs met and few had adequate economic resources. Correlates of adequate material resources included race/ethnicity, income, income source, and homelessness. Conclusions: The 18-item material resource scale demonstrated reliability and validity among drug users. These data provide a different view of poverty, one that details specific challenges faced by low-income communities.Evidence for a syndemic in aging hiv-positive gay, bisexual, and other msm: Implications for a holistic approach to prevention and health care
AbstractHalkitis, P. N., Kupprat, S. A., Hampton, M. B., Perez-Figueroa, R., Kingdon, M., Eddy, J. A., & Ompad, D. C. (n.d.).Publication year
2012Journal title
Annals of Anthropological PracticeVolume
36Issue
2Page(s)
365-386AbstractThe theory of syndemics has been widely applied in HIV-prevention studies of gay, bisexual, and other MSM (men who have sex with men) over the last decade. Our investigation is the first to consider the applicability of the theory in a sample of aging (ages 50 and over) HIV-positive MSM, which is a growing population in the United States. A sample of 199 men were actively recruited and assessed in terms of mental health and drug-use burden, as well as sexual risk behaviors. Bivariate and multivariable analyses indicate a high level of association between psychosocial burdens (i.e., drug use and mental health) and same-sex unprotected sexual behaviors, providing initial support for the applicability of the theory of syndemics to this population. Further support can be seen in participants' narratives. Findings suggest the mutually reinforcing nature of drug use, psychiatric disorders, and unprotected sexual behavior in older, HIV-positive, gay, bisexual, and other MSM, highlighting the need for holistic strategies to prevention and care among this population of older and sexually active individuals. In short, the generation of gay men who came of age in the late 1970s and 1980s, "the AIDS Generation," are continuing to mature such that further efforts must be enacted to meet the multidimensional nature of these men's physical, mental, and sexual health needs.Factors associated with differential uptake of seasonal influenza immunizations among underserved communities during the 2009-2010 influenza season
AbstractVlahov, D., Bond, K. T., Jones, K. C., & Ompad, D. C. (n.d.).Publication year
2012Journal title
Journal of Community HealthVolume
37Issue
2Page(s)
282-287AbstractInfluenza vaccination coverage remains low and disparities persist. In New York City, a communitybased participatory research project (Project VIVA) worked to address this issue in Harlem and the South Bronx by supplementing existing vaccination programs with non-traditional venues (i.e., community-based organizations). We conducted a 10 min survey to assess access to influenza vaccine as well as attitudes and beliefs towards influenza vaccination that could inform intervention development for subsequent seasons. Among 991 participants recruited using street intercept techniques, 63% received seasonal vaccine only, 11% seasonal and H1N1, and 26% neither; 89% reported seeing a health care provider (HCP) during the influenza season. Correlates of immunization among those with provider visits during the influenza season included being US-born, interest in getting the vaccine, concern about self or family getting influenza, an HCP's recommendation and comfort with government. Among those without an HCP visit, factors associated with immunization included being US born, married, interest in getting the vaccine, understanding influenza information, and concern about getting influenza. Factors associated with lack of interest in influenza vaccine included being born outside the US, Black and uncomfortable with government. In medically underserved areas, having access to routine medical care and understanding the medical implications of influenza play an important role in enhancing uptake of seasonal influenza vaccination. Strategies to improve vaccination rates among Blacks and foreign-born residents need to be addressed. The use of non-traditional venues to provide influenza vaccinations in underserved communities has the potential to reduce health disparities.Comparison of HIV risk by duration of injection drug use
AbstractVlahov, D., Ompad, D. C., Fuller, C. M., & Nandi, V. (n.d.).Publication year
2011Journal title
Substance Use and MisuseVolume
46Issue
2Page(s)
181-91AbstractEarly studies documented an inverse association between the HIV risk and duration of injection among injection drug users (IDUs). Results from subsequent studies have been inconsistent. To examine this issue, we conducted interviews with 395 street-recruited active IDUs from 38 neighborhoods in New York City during 2005 and 2008. We observed no significant differences in drug or risky sex behaviors by duration of drug use among these IDUs. Despite this, continuing to tailor HIV prevention programs for these recent-onset IDUs is prudent. The study's limitations are noted.HIV risk behaviors among young drug using women who have sex with women (WSWs) in New York city
AbstractOmpad, D. C., Friedman, S. R., Hwahng, S. J., Nandi, V., Fuller, C. M., & Vlahov, D. (n.d.).Publication year
2011Journal title
Substance Use and MisuseVolume
46Issue
2Page(s)
274-284AbstractPrevious research has suggested that multiple stressors may work in tandem to affect the health of women who have sex with women (WSWs). WSWs have been a part of the HIV epidemic in New York City since the beginning, making it an ideal setting to further explore these women's risk. Among a sample of 375 heroin, crack and/or cocaine using women recruited from economically disadvantaged communities in New York City, we examined HIV seroprevalence and risk behaviors among WSWs as compared to women who have sex with men only (WSMOs). We also explore differences between WSWs and WSMOs with respect to potential stressors (i.e., decreased access to resources and health care utilization and violence victimization) that might contribute overall HIV risk. The study's limitations are noted.Individual- and neighborhood-level characteristics associated with support of in-pharmacy vaccination among ESAP-registered pharmacies: Pharmacists role in reducing racial/ethnic disparities in influenza vaccinations in New York city
AbstractCrawford, N. D., Blaney, S., Amesty, S., Rivera, A. V., Turner, A. K., Ompad, D. C., & Fuller, C. M. (n.d.).Publication year
2011Journal title
Journal of Urban HealthVolume
88Issue
1Page(s)
176-185AbstractNew York State (NYS) passed legislation authorizing pharmacists to administer immunizations in 2008. Racial/socioeconomic disparities persist in vaccination rates and vaccine-preventable diseases such as influenza. Many NYS pharmacies participate in the Expanded Syringe Access Program (ESAP), which allows provision of non-prescription syringes to help prevent transmission of HIV, and are uniquely positioned to offer vaccination services to low-income communities. To understand individual and neighborhood characteristics of pharmacy staff support for in-pharmacy vaccination, we combined census tract data with baseline pharmacy data from the Pharmacies as Resources Making Links to Community Services (PHARM-Link) study among ESAP-registered pharmacies. The sample consists of 437 pharmacists, non-pharmacist owners, and technicians enrolled from 103 eligible New York City pharmacies. Using multilevel analysis, pharmacy staff who expressed support of in-pharmacy vaccination services were 69% more likely to support in-pharmacy HIV testing services (OR, 1.69; 95% CI 1.39-2.04). While pharmacy staff who worked in neighborhoods with a high percent of minority residents were less likely to express support of in-pharmacy vaccination, those in neighborhoods with a high percent of foreign-born residents were marginally more likely to express support of in-pharmacy vaccination. While educational campaigns around the importance of vaccination access may be needed among some pharmacy staff and minority community residents, we have provided evidence supporting scale-up of vaccination efforts in pharmacies located in foreign-born/immigrant communities which has potential to reduce disparities in vaccination rates and preventable influenza-related mortality.Intimate partner violence perpetration and condom use-related factors: Associations with heterosexual men's consistent condom use
AbstractFrye, V., Ompad, D., Chan, C., Koblin, B., Galea, S., & Vlahov, D. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
1Page(s)
153-162AbstractIntimate partner violence victimization has been linked to sexual HIV risk behavior among heterosexual women. The unique role of perpetration of intimate partner violence (IPV) in sexual risk behavior among men has not been studied as well. Based on interviews with 518 heterosexual men recruited via street-intercept between 2005 and 2007 in New York City, we assessed the relationship between perpetration of IPV against a main female partner and inconsistent condom use with that same partner, while controlling for condom use-related factors. Multivariate logistic regression revealed that men who perpetrated physical IPV were half as likely to report consistent condom use as compared with men who did not use violence, while controlling for sociodemographic, condom use-related and other factors. Physical IPV perpetration by heterosexual men makes an independent contribution to consistent condom use. Designing interventions for heterosexual men that simultaneously address both IPV and sexual risk behaviors is critical.Physical Urban Environment
AbstractQuinn, A., Vlahov, D., Ompad, D., & Galea, S. (n.d.). In Encyclopedia of Environmental Health (1–).Publication year
2011Page(s)
526-535AbstractAs the world's urban population begins to outnumber the rural population, the health effects of urbanization and urban living have recently been studied in greater depth. The physical urban environment has been singled out as one of the many determinants of urban health. The predominant features of the urban physical environment - housing, neighborhoods, roads and other transportation, and urban infrastructure - have been associated with health impacts. Because of the diversity of cities, and the great contrasts between cities of the less developed and developed worlds it is necessary to consider the impact on health in these cities separately. In the urban developed world, impacts of the urban environment on health are not always negative. In the urban less developed world, many issues, such as a lack of water and sanitation, have been noted as having significant impacts on a large proportion of the world's population. As the world continues to urbanize, both developed and less developed world cities will need to adapt to the pressures of climate change to reduce negative health impacts. Finally, specific interventions and best practices are discussed as examples for a potentially healthy urban future.Physical Urban Environment
AbstractQuinn, A., Vlahov, D., Ompad, D., & Galea, S. (n.d.). In Encyclopedia of Environmental Health, Volume 1-5 (1–).Publication year
2011Volume
4Page(s)
V4-526-V4-535AbstractAs the world's urban population begins to outnumber the rural population, the health effects of urbanization and urban living have recently been studied in greater depth. The physical urban environment has been singled out as one of the many determinants of urban health. The predominant features of the urban physical environment – housing, neighborhoods, roads and other transportation, and urban infrastructure – have been associated with health impacts. Because of the diversity of cities, and the great contrasts between cities of the less developed and developed worlds it is necessary to consider the impact on health in these cities separately. In the urban developed world, impacts of the urban environment on health are not always negative. In the urban less developed world, many issues, such as a lack of water and sanitation, have been noted as having significant impacts on a large proportion of the world's population. As the world continues to urbanize, both developed and less developed world cities will need to adapt to the pressures of climate change to reduce negative health impacts. Finally, specific interventions and best practices are discussed as examples for a potentially healthy urban future.Roundtable on urban living environment research (RULER)
AbstractVlahov, D., Agarwal, S. R., Buckley, R. M., Caiaffa, W. T., Corvalan, C. F., Ezeh, A. C., Finkelstein, R., Friel, S., Harpham, T., Hossain, M., De Faria Leao, B., Mboup, G., Montgomery, M. R., Netherland, J. C., Ompad, D. C., Prasad, A., Quinn, A. T., Rothman, A., Satterthwaite, D. E., … Watson, V. J. (n.d.).Publication year
2011Journal title
Journal of Urban HealthVolume
88Issue
5Page(s)
793-857AbstractFor 18 months in 2009-2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO's Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health - namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.Comparison of injection drug users accessing syringes from pharmacies, syringe exchange programs, and other syringe sources to inform targeted HIV prevention and intervention strategies
AbstractRudolph, A. E., Crawford, N. D., Ompad, D. C., Benjamin, E. O., Stern, R. J., & Fuller, C. M. (n.d.).Publication year
2010Journal title
Journal of the American Pharmacists AssociationVolume
50Issue
2Page(s)
140-147AbstractObjective: To describe injection drug users (IDUs) who access syringes through different outlets to help inform the prevention needs of IDUs who underuse safe syringe sources in New York City (NYC), where syringe availability is high compared with other U.S. cities. Design: Cross sectional. Setting: NYC, 2005-2007. Participants: 285 IDUs. Intervention: Participants were recruited using random street-intercept sampling in 36 socioeconomically disadvantaged neighborhoods. Main outcome measures: IDUs using syringe exchange programs (SEPs), pharmacies, or other outlets as a primary syringe source were compared based on sociodemographic characteristics, injection practices, and medical service use. Results: Chi-square tests and polytomous logistic regression were used to compare IDUs with different self-reported primary syringe sources used in the 6 months preceding study entry. Compared with IDUs using other syringe sources, those primarily using SEPs were less likely to be black (adjusted odds ratio 0.26 [95% CI 0.11-0.57]), more likely to inject daily (3.32 [1.58-6.98]), and more likely to inject with a new syringe (2.68 [1.30-5.54]). Compared with IDUs using other syringe sources, those primarily using pharmacies were less likely to be black (0.39 [0.17-0.90]). Conclusion: These data suggest that pharmacies and SEPs may be reaching different populations of IDUs and highlight a subpopulation of highly marginalized IDUs (i.e., black race, infrequent injectors) who are underusing safe syringe sources in NYC. Targeted interventions are needed to reduce racial disparities and increase use of safe syringe outlets.Healthy urban governance
Vlahov, D., Ompad, D., & Burris, S. (n.d.). In Urban Health: Global Perspectives (1st ed., 1–).Publication year
2010Page(s)
355-370Household density among undocumented mexican immigrants in New York City
AbstractStandish, K., Nandi, V., Ompad, D. C., Momper, S., & Galea, S. (n.d.).Publication year
2010Journal title
Journal of Immigrant and Minority HealthVolume
12Issue
3Page(s)
310-318AbstractBackground High household density increases exposure to communicable diseases, psychological distress in adults, and poor long-term health in children. High residential density, which may be a mediator of poor health, is common among immigrants. Methods We used data from a pilot survey among Mexican immigrants in New York City. Respondents were recruited through venue-based sampling in neighborhoods with large Mexican populations. Results Among respondents that reported being undocumented (N = 404), the mean number of people per room (PPR) of residence was 2.2. In multivariate analyses, living in conditions of >2 PPR was positively associated with living with one's children (OR = 2.3, 95% CI = 1.4-3.9), having experienced food insecurity in the past 6 months (OR = 2.0, 95% CI = 1.1-3.6), and language discrimination (OR = 2.3 compared to other forms of discrimination, 95% CI = 1.2-4.4). Conclusions Undocumented Mexican immigrants, particularly those who are linguistically marginalized and experience food insufficiency, live in conditions of marked household density in NYC.Intimate partner violence and consistent condom use among drug-using heterosexual women in New York City
AbstractPanchanadeswaran, S., Frye, V., Nandi, V., Galea, S., Vlahov, D., & Ompad, D. (n.d.).Publication year
2010Journal title
Women and HealthVolume
50Issue
2Page(s)
107-124AbstractThe present study examined the associations of relationship factors, partner violence, relationship power, and condom-use related factors with condom use with a main male partner among drug-using women. Over two visits, 244 heterosexual drug-using women completed a cross-sectional survey. Multivariate logistic regression models indicated that women who expected positive outcomes and perceived lower condom-use barriers were more likely to report condom use with their intimate partners. The findings suggest that future interventions aiming at reducing HIV risk among drug-using women should focus on women's subjective appraisals of risks based on key relationship factors in addition to the occurrence of partner violence.Reducing drug use, human immunodeficiency virus risk, and recidivism among young men leaving jail: Evaluation of the real men re-entry program
AbstractFreudenberg, N., Ramaswamy, M., Daniels, J., Crum, M., Ompad, D. C., & Vlahov, D. (n.d.).Publication year
2010Journal title
Journal of Adolescent HealthVolume
47Issue
5Page(s)
448-455AbstractPurpose: This study assesses the impact of REAL MEN (Returning Educated African-American and Latino Men to Enriched Neighborhoods), an intervention designed to reduce drug use, risky sexual behavior and criminal activity among 16-18-year-old males leaving New York City jails. Methods: Participants (N = 552) were recruited in city jails and randomly assigned to receive an intensive 30-hour jail/community-based intervention or a single jail-based discharge planning session. All participants were also referred to optional services at a community-based organization (CBO). One year after release from jail, 397 (72%) participants completed a follow-up interview. Logistic and ordinary least squares regression was used to evaluate the impact of the intervention on drug use, risky sexual behavior, criminal justice involvement, and school/work involvement post release. Results: Assignment to REAL MEN and, independently, use of CBO services, significantly reduced the odds of substance dependence (odds ratio [OR] = .52, p ≤ .05; OR = .41, p ≤ .05, respectively) 1 year after release. Those assigned to the intervention spent 29 fewer days in jail compared with the comparison group (p ≤ .05). Compared to non-CBO visitors, those who visited the CBO were more likely to have attended school or found work in the year after release (OR = 2.02, p ≤ .01). Conclusions: Jail and community services reduced drug dependence 1 year after release and the number of days spent in jail after the index arrest. While these findings suggest that multifaceted interventions can improve outcomes for young men leaving jail, rates of drug use, risky sexual behavior, and recidivism remained high for all participants after release from jail, suggesting the need for additional policy and programmatic interventions.Sexual risk reduction among non-injection drug users: Report of a randomized controlled trial
AbstractCastor, D., Pilowsky, D. J., Hadden, B., Fuller, C., Ompad, D. C., De Leon, C. L., Neils, G., Hoepner, L., Andrews, H. F., Latkin, C., & Hoover, D. R. (n.d.).Publication year
2010Journal title
AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIVVolume
22Issue
1Page(s)
62-70AbstractWe conducted a randomized controlled trial of a sexual risk-reduction intervention targeting non-injection drug users (NIDUs) and members of their drug-use/sexual networks (N=270). The intervention was based primarily on the social-influencing approach, and was delivered in four sessions. Sexual risk behaviors were examined at baseline, and 3, 6, 9, and 12 months after the completion of the intervention using the vaginal equivalent episodes (VEE), a weighted sexual risk behavior index. VEE scores decreased in both the active and control conditions in the first six months post-intervention and continued to decline in the control group. However, in the active condition, VEE scores increased after the nine-month assessment and approached baseline levels by the 12-month assessment. There was no evidence of significant differences in high-risk sexual behaviors between the intervention and control conditions. Future studies are needed to improve behavioral interventions in this population.Vaccinating high-risk patients against influenza: Doing more to protect patients with asthma
Ompad, D., Rohde, G., Wisnivesky, J., Van Essen, G., & Barnes, B. (n.d.).Publication year
2010Journal title
Annals of Respiratory MedicinePage(s)
11-17Neighborhood characteristics and disability in older adults
AbstractBeard, J. R., Blaney, S., Cerda, M., Frye, V., Lovasi, G. S., Ompad, D., Rundle, A., & Vlahov, D. (n.d.).Publication year
2009Journal title
Journals of Gerontology - Series B Psychological Sciences and Social SciencesVolume
64Issue
2Page(s)
252-257AbstractObjective To characterize the influence of the residential neighborhood of older adults on the prevalence of disability.MethodsWe combined Census data on disability in older adults living in New York City with environmental information from a comprehensive geospatial database. We used factor analysis to derive dimensions of compositional and physical neighborhood characteristics and linear regression to model their association with levels of disability. Measures of neighborhood collective efficacy were added to these models to explore the impact of the social environment.ResultsLow neighborhood socioeconomic status, residential instability, living in areas with low proportions of foreign born and high proportions of Black residents, and negative street characteristics were associated with higher prevalence of both "physical" disability and "going outside the home" disability. High crime levels were additionally associated with physical disability, although this relationship disappeared when misdemeanor arrests were removed from the crime variable. Low levels of collective efficacy were associated with more going-outside-the-home disability, with racial/ethnic composition dropping out of this model to be replaced by an interaction term.ConclusionThe urban environment may have a substantial impact on whether an older adult with a given level of functional impairment is able to age actively and remain independent.Protection of racial/ethnic minority populations during an influenza pandemic
AbstractHutchins, S. S., Fiscella, K., Levine, R. S., Ompad, D. C., & McDonald, M. (n.d.).Publication year
2009Journal title
American journal of public healthVolume
99Page(s)
S261-S270AbstractRacial/ethnic minority populations experience worse health outcomes than do othergroups during and after disasters. Evidence for a differential impact from pandemic influenza includes both higher rates of underlying health conditions in minority populations, increasing their risk of influenza-related complications, and larger socioeconomic (e.g., access to health care), cultural, educational, and linguistic barriers to adoption of pandemic interventions. Implementation of pandemic interventions could be optimized by (1) culturally competent preparedness and response that address specific needs of racial/ethnic minority populations, (2) improvements in public health and community health safety net systems, (3) social policies that minimize economic burdens and improve compliance with isolation and quarantine, and (4) relevant, practical, and culturally and linguistically tailored communications.