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
Sexual Orientation- and Race-Based Discrimination and Sexual HIV Risk Behavior Among Urban MSM
AbstractFrye, V., Nandi, V., Egan, J., Cerda, M., Greene, E., Van Tieu, H., Ompad, D. C., Hoover, D. R., Lucy, D., Baez, E., & Koblin, B. A. (n.d.).Publication year
2015Journal title
AIDS and BehaviorVolume
19Issue
2Page(s)
257-269AbstractUnderstanding what social factors are associated with risk of HIV acquisition and transmission among gay, bisexual and other men who have sex with men (MSM) is a critical public health goal. Experiencing discrimination may increase risk of HIV infection among MSM. This analysis assessed relations between experiences of sexual orientation- and race-based discrimination and sexual HIV risk behavior among MSM in New York City. 1,369 MSM completed a self-administered computerized assessment of past 3-month sexual behavior, experience of social discrimination and other covariates. Regression models assessed relations between recent experience of discrimination and sexual HIV risk behavior. Mean age was 32 years; 32 % were white; 32 % Latino/Hispanic; 25 % African American/Black. Of MSM who self-reported HIV-positive or unknown status (377), 7 % (N = 27) reported having unprotected insertive anal intercourse with an HIV-negative or unknown status partner (“HIV transmission risk”). Of MSM who self-reported HIV-negative status (992), 11 % (110) reported unprotected receptive anal intercourse with an HIV-positive or unknown status partner (“HIV acquisition risk”). HIV acquisition risk was positively associated with sexual orientation-based discrimination in home or social neighborhoods, but not race-based discrimination. We observed that sexual orientation-based discrimination was associated with sexual HIV risk behavior among urban-dwelling MSM. Addressing environmental sources of this form of discrimination, as well as the psychological distress that may result, should be prioritized in HIV prevention efforts.The CHANGE Study : Methods and Sample Description for a Cross-Sectional Study of Heroin Cessation in New York City
AbstractOmpad, D. C., Benjamin, E. O., Weiss, L., Palamar, J. J., Galea, S., Wang, J., & Vlahov, D. (n.d.).Publication year
2015Journal title
Journal of Urban HealthVolume
92Issue
5Page(s)
955-965AbstractThe CHANGE (Cessation of Heroin: A Neighborhood Grounded Exploration) Study aimed to understand factors associated with the initiation and maintenance of sustained heroin cessation from the perspective of users themselves and specifically set out to document the correlates of natural recovery. The CHANGE Study was a case-control study conducted in New York City from 2009 to 2011. Cases were former heroin users, abstinent for 1–5 years in the past 5 years. Controls used heroin at least weekly during the past 5 years and were (1) continuous heroin users without a quit attempt of ≥2 weeks’ duration or (2) relapsed heroin users who were currently using and had a quit attempt of ≥2 weeks’ duration during the past 5 years. Recruitment and data collection methods are described along with limitations and a brief description of the study sample. In contrast to many studies of drug use and cessation, the CHANGE Study was designed to model success (i.e., initiation and maintenance of heroin cessation) and not failure.The Flawed Reliance on Randomized Controlled Trials in Studies of HIV Behavioral Prevention Interventions for People Who Inject Drugs and Other Populations
AbstractFriedman, S. R., Perlman, D. C., & Ompad, D. C. (n.d.).Publication year
2015Journal title
Substance Use and MisuseVolume
50Issue
8-9Page(s)
1117-1124AbstractThis article discusses ways in which randomized controlled trials do not accurately measure the impact of HIV behavioral interventions. This is because: 1. Such trials measure the wrong outcomes. Behavior change may have little to do with changes in HIV incidence since behavior change in events between HIV-concordant people have no impact on incidence. Even more important, the comparison of HIV incidence rates between study arms of individual-level RCTs does not measure the true outcome of interest-whether or not the intervention reduces HIV transmission at the community level. This is because this comparison cannot measure the extent to which the intervention stops transmission by HIV-infected people in the study to those outside it. (And this is made even worse if HIV-infected are excluded from the evaluation of the intervention.) 2. There are potential harms implicit in most cognitively oriented behavioral interventions that are not measured in current practice and may not be measurable using RCTs. Intervention trials often reinforce norms and values of individual self-protection. They rarely if ever measure whether doing this reduces community trust, solidarity, cohesion, organization, or activism in ways that might facilitate HIV transmission. 3. Many interventions are not best conceived of as interventions with individuals but rather with networks, cultures of risks, or communities. As such, randomizing individuals leads to effective interventions that diffuse protection through a community; but these are evaluated as ineffective because the changes diffuse to the control arm, which leads to systematic and erroneous reductions in the evaluated effectiveness as RCTs measure it. The paper ends by discussing research designs that are superior to individual-level RCTs at measuring whether an intervention reduces or increases new HIV transmission."I didn't think I could get out of the fucking park." Gay men's retrospective accounts of neighborhood space, emerging sexuality andmigrations
AbstractFrye, V., Egan, J. E., Tieu, H. V., Cerdá, M., Ompad, D. C., & Koblin, B. A. (n.d.).Publication year
2014Journal title
Social Science and MedicineVolume
104Page(s)
6-14AbstractYoung, African American and Latino gay, bisexual and other men who have sex with men (MSM) are disproportionately represented among new HIV cases according to the most recent national surveillance statistics. Analysts have noted that these racial/ethnic disparities in HIV among MSM exist within the wider context of sexual, mental and physical health disparities between MSM and heterosexuals. The intercorrelation of these adverse health outcomes among MSM, termed syndemics, has been theorized to be socially produced by a heterosexist social system that marginalizes lesbian, gay, bisexual, MSM and other sexual minorities. African American and Latino MSM experience overlapping systems of oppression that may increase their risk of experiencing syndemic health outcomes. In this paper, using data from twenty in-depth qualitative interviews with MSM living in four New York City (NYC) neighborhoods, we present accounts of neighborhood space, examining how space can both physically constitute and reinforce social systems of stratification and oppression, which in turn produce social disparities in sexual health outcomes. By analyzing accounts of emerging sexuality in neighborhood space, i.e. across time and space, we identify pathways to risk and contribute to our understanding of how neighborhood space is experienced by gay men, adding to our ability to support young men as they emerge in place and to shape the social topography of urban areas.Adverse psychosocial outcomes associated with drug use among US high school seniors : A comparison of alcohol and marijuana
AbstractPalamar, J. J., Fenstermaker, M., Kamboukos, D., Ompad, D. C., Cleland, C. M., & Weitzman, M. (n.d.).Publication year
2014Journal title
American Journal of Drug and Alcohol AbuseVolume
40Issue
6Page(s)
438-446AbstractObjectives: There is debate about whether marijuana (cannabis) use is more dangerous than alcohol use. Although difficult to make objective comparisons, research is needed to compare relative dangers in order to help inform preventive efforts and policy. Methods: Data were analyzed from a nationally representative sample of high school seniors in the Monitoring the Future study (2007-2011; Weighted n=7437; modal age: 18) who reported lifetime use of alcohol or marijuana. Students were asked to indicate whether they experienced various adverse psychosocial outcomes resulting from use of each substance. We examined which outcomes were more prevalent for each substance. Results: Compared to alcohol use, marijuana use was more commonly reported to compromise relationships with teachers or supervisors, result in less energy or interest, and result in lower school or job performance. Compared to marijuana use, alcohol was more commonly reported to compromise relationships with friends and significant others; it was also reported to lead to more regret (particularly among females), and driving unsafely. Marijuana users were more likely to report no adverse outcomes. Females and white students were more likely to report various adverse outcomes and higher frequency use of each substance also increased occurrences of reported adverse outcomes. Conclusions: Marijuana and alcohol are associated with unique adverse psychosocial outcomes. Outcomes differ by sex and race/ethnicity, and perception or experience of outcomes may also be related to legal status and associated stigma. Public health interventions may be more effective by focusing on harm reduction strategies for these drug-specific outcomes.Concurrent partnerships and HIV risk among men who have sex with men in New York City
AbstractTieu, H. V., Nandi, V., Frye, V., Stewart, K., Oquendo, H., Bush, B., Cerda, M., Hoover, D. R., Ompad, D. C., & Koblin, B. A. (n.d.).Publication year
2014Journal title
Sexually Transmitted DiseasesVolume
41Issue
3Page(s)
200-208AbstractBackground: Concurrent partnerships are a significant public health concern among men who have sex with men (MSM). This study describes the prevalence of concurrency and its association with serodiscordant/serostatus unknown unprotected anal or vaginal intercourse (SDUI) among MSM in New York City. METHODS: A total of 1458 MSM completed a social and sexual network inventory about their male and female sex partners, including concurrency, in the last 3 months. Logistic regression identified factors associated with SDUI. RESULTS: Median age was 29 years. The proportion of participants who reported being HIV+ was 23.5%. The men reported a mean of 3.2 male partners in the last 3 months. The proportion of MSM who reported having recent SDUI was 16.6%. More than half (63.2%) described having concurrent sex partners (individual concurrency based on overlapping dates of relationships); 71.5% reported having partners whom they believed had concurrent partners (perceived partner concurrency); and 56.1% reported that both they and their partners had concurrent partners (reciprocal concurrency). Among HIV+ men by self-report, having SDUI was positively associated with individual concurrency, any alcohol use during sex, having more male sex partners, and not having a main partner. Among self-reported HIV- men, having SDUI was positively associated with perceived partner concurrency, lower education level, any alcohol and drug use during sex, having more male sex partners, and having an anonymous partner. CONCLUSIONS: Concurrency was common among MSM. The association of SDUI with individual and perceived partner concurrency, along with substance use during sex, having an anonymous partner, and having many sex partners likely further increases HIV acquisition and transmission risk among MSM. HIV prevention interventions should address concurrency among MSM.Correlates of intentions to use cannabis among US high school seniors in the case of cannabis legalization
AbstractPalamar, J. J., Ompad, D. C., & Petkova, E. (n.d.).Publication year
2014Journal title
International Journal of Drug PolicyVolume
25Issue
3Page(s)
424-435AbstractBackground: Support for cannabis ("marijuana") legalization is increasing in the United States (US). Use was recently legalized in two states and in Uruguay, and other states and countries are expected to follow suit. This study examined intentions to use among US high school seniors if cannabis were to become legally available. Methods: Data from the last five cohorts (2007-2011) of high school seniors in Monitoring the Future, an annual nationally representative survey of students in the US were utilized. Data were analyzed separately for the 6116 seniors who reported no lifetime use of cannabis and the 3829 seniors who reported lifetime use (weighted Ns). We examined whether demographic characteristics, substance use and perceived friend disapproval towards cannabis use were associated with (1) intention to try cannabis among non-lifetime users, and (2) intention to use cannabis as often or more often among lifetime users, if cannabis was legal to use. Results: Ten percent of non-cannabis-using students reported intent to initiate use if legal and this would be consistent with a 5.6% absolute increase in lifetime prevalence of cannabis use in this age group from 45.6% (95% CI=44.6, 46.6) to 51.2% (95% CI=50.2, 52.2). Eighteen percent of lifetime users reported intent to use cannabis more often if it was legal. Odds for intention to use outcomes increased among groups already at high risk for use (e.g., males, whites, cigarette smokers) and odds were reduced when friends disapproved of use. However, large proportions of subgroups of students normally at low risk for use (e.g., non-cigarette-smokers, religious students, those with friends who disapprove of use) reported intention to use if legal. Recent use was also a risk factor for reporting intention to use as often or more often. Conclusion: Prevalence of cannabis use is expected to increase if cannabis is legal to use and legally available.Correlates of self-efficacy for condom use among male clients of female sex workers in Tijuana, Mexico
AbstractVolkmann, T., Wagner, K. D., Strathdee, S. A., Semple, S. J., Ompad, D. C., Chavarin, C. V., & Patterson, T. L. (n.d.).Publication year
2014Journal title
Archives of Sexual BehaviorVolume
43Issue
4Page(s)
719-727AbstractMale clients of female sex workers (FSWs) in Tijuana, Mexico engage in high levels of unprotected sex. While behavioral change theories posit that self-efficacy predicts condom use, correlates of self-efficacy for condom use remain largely unstudied. We examined these correlates among male clients of FSWs in Tijuana. Eligible male clients were at least 18 years of age, HIV-negative, lived in Tijuana or San Diego, reported unprotected sex with a Tijuana FSW at least once in the past 4 months, and agreed to be treated for sexually transmitted infections (STIs). Participants completed an interviewer-administered questionnaire including demographics, substance use, psychosocial and psychosexual characteristics (e.g., outcome expectancies for negotiation of safer sex, social support, and sexual sensation seeking), and sexual behaviors. Participants also underwent HIV/STI testing. A stepwise hierarchical multiple regression analysis identified correlates of self-efficacy for condom use. Of 393 male clients, median age was 37 years. Participants were mostly Spanish-speaking and employed. Factors independently associated with higher self-efficacy for condom use were higher positive outcome expectancies for negotiation of safer sex, lower sexual sensation seeking scores, and higher social support scores. Both psychosocial and psychosexual factors may influence self-efficacy for condom use among male clients of FSWs. These factors represent central constructs in sociocognitive models that explain behavioral change and could be intervention targets for improving self-efficacy for condom use and, ultimately, safer sex behavior.Demographic and socioeconomic correlates of powder cocaine and crack use among high school seniors in the United States
AbstractPalamar, J. J., & Ompad, D. C. (n.d.).Publication year
2014Journal title
American Journal of Drug and Alcohol AbuseVolume
40Issue
1Page(s)
37-43AbstractObjectives: Rates of powder cocaine and crack use have fluctuated among adolescents over recent decades. Little attention has been paid to recent trends, particularly regarding differences between users of powder cocaine and crack-Two forms of the substance that are commonly reported together as "cocaine" use, despite having different effects and rates of adverse outcomes. Methods: We examined data from nationally representative samples of high school seniors who participated in the Monitoring the Future study during years 2005-2011 (weighted N=65717). Results: Many demographic and socioeconomic variables were similarly correlated with lifetime use of powder cocaine and crack. Income of >50/week from job increased the odds for use, and income of >50/week from sources other than a job more than doubled the odds for use. High religiosity, high parent education, identifying as black, and residing with one or two parents reduced odds for use. Hispanic students were at higher odds for use of crack and females were at lower odds for using powder cocaine. Among cocaine users, residing with one or two parents lowered odds for using both forms, and more religious students and Hispanics were at higher odds for crack-only use. Conclusions: Those interested in preventing initiation and adverse consequences of cocaine use should take into account the overlapping, yet different risk profiles of powder cocaine and crack users when developing programming. This is particularly important when considering differences in legal consequences for these pharmacologically similar forms of cocaine.HPV vaccination : Are we initiating too late?
AbstractHofstetter, A. M., Stockwell, M. S., Al-Husayni, N., Ompad, D. C., Natarajan, K., Rosenthal, S. L., & Soren, K. (n.d.).Publication year
2014Journal title
VaccineVolume
32Issue
17Page(s)
1939-1945AbstractBackground: Human papillomavirus (HPV) vaccination is recommended in early adolescence. While limited data suggest that patients frequently delay initiation of the three-dose series, age-based variability in initiation of HPV vaccination and its clinical relevance are not well described. Thus, this study aims to characterize HPV vaccination delay among adolescent and young adult females. Methods: This retrospective cohort study examined age at HPV vaccination initiation and missed opportunities for receipt of the first vaccine dose (HPV1) among 11-26 year-old females (n=22,900) receiving care at 16 urban academically-affiliated ambulatory care clinics between 2007 and 2011. Predictors of timely vaccination and post-licensure trends in age at HPV1 receipt were assessed using multivariable logistic regression and a generalized linear mixed model, respectively. Chlamydia trachomatis and Papanicolaou screening before HPV vaccination initiation, as markers of prior sexual experience and associated morbidity, were examined in a subcohort of subjects (n=15,049). Results: The proportion of 11-12 year-olds who initiated HPV vaccination increased over time (44.4% [2007] vs. 74.5% [2011], pNeighborhood Characteristics and Sexual Intimate Partner Violence Against Women Among Low-Income, Drug-Involved New York City Residents : Results From the IMPACT Studies
AbstractFrye, V., Blaney, S., Cerdá, M., Vlahov, D., Galea, S., & Ompad, D. C. (n.d.).Publication year
2014Journal title
Violence Against WomenVolume
20Issue
7Page(s)
799-824AbstractWe assessed relations among neighborhood characteristics and sexual intimate partner violence against women (SIPVAW), among low-income, drug-involved, women (n = 360) and men (n = 670) in New York City between 2005 and 2009. Six percent of women (n = 22) and 5% of men (n = 33) reported experiencing and perpetrating SIPVAW in the past year with a main partner. In adjusted mixed models among women, neighborhood ethnic heterogeneity was significantly negatively associated with SIPVAW victimization. In adjusted logistic models among men, neighborhood collective efficacy was significantly positively associated with SIPVAW perpetration. Novel theoretical frameworks are needed to guide research on neighborhoods and partner violence.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., Brown, C. H., Ompad, D. C., Or, F., Ialongo, N. S., Poduska, J. M., & Windham, A. (n.d.).Publication year
2014Journal title
Prevention ScienceVolume
15Issue
S1Page(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
AbstractOmpad, D. C., Bond, 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
1-3Page(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
2-3Page(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
2-3Page(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. C., 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
AbstractOmpad, D. C., Quinn, A., Vlahov, D., Ompad, D., & Galea, S. (n.d.).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.