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
Defining Neighborhood Boundaries for Urban Health Research
AbstractWeiss, L., Ompad, D. C., Galea, S., & Vlahov, D. (n.d.).Publication year
2007Journal title
American journal of preventive medicineVolume
32Issue
6 SUPPL.Page(s)
S154-S159AbstractAbstract: The body of literature exploring neighborhood effects on health has increased rapidly in recent years, yet a number of methodologic concerns remain, including preferred methods for identification and delineation of study neighborhoods. In research combining census or other publicly available data with surveys of residents and/or street-level observations, questions regarding neighborhood definition take on added significance. Neighborhoods must be identified and delineated in such a way as to optimize quality and availability of data from each of these sources. IMPACT (Inner-City Mental Health Study Predicting HIV/AIDS, Club and Other Drug Transitions), a multilevel study examining associations among features of the urban environment and mental health, drug use, and sexual behavior, utilized a multistep neighborhood definition process including development of census block group maps, review of land use and census tract data, and field visits and observation in each of the targeted communities. Field observations were guided by a preidentified list of environmental features focused on the potential for recruitment (e.g., pedestrian volume), characteristics commonly used to define neighborhood boundaries (e.g., obstructions to pedestrian traffic, changes in land use), and characteristics that have been associated in the literature with health behaviors and health outcomes (such as housing type and maintenance and use of open spaces). This process, implemented in February through July 2005, proved feasible and offered the opportunity to identify neighborhoods appropriate to study objectives and to collect descriptive information that can be used as a context for understanding study results.Identifying Injection Drug Users at Risk of Nonfatal Overdose
AbstractCoffin, P. O., Tracy, M., Bucciarelli, A., Ompad, D. C., Vlahov, D., & Galea, S. (n.d.).Publication year
2007Journal title
Academic Emergency MedicineVolume
14Issue
7Page(s)
616-623AbstractObjectives: Drug overdose is the second leading cause of accidental deaths among U.S. adults aged 15-64 years. Emergency physicians have a unique opportunity to provide overdose prevention interventions, because habitual drug users are in frequent need of medical care. The authors evaluated associations between individual-level risk factors and experiencing an overdose in the past six months to determine which characteristics and behaviors may be most predictive of overdose. Methods: The authors used data from a sample of street-recruited habitual drug users who participated in face-to-face interviews about overdose from November 2001 to February 2004. This analysis was restricted to 772 respondents who had been injecting for at least one year and who had injected heroin within the past two months. Results: A total of 16.6% of participants had overdosed in the past six months. Characteristics and behaviors that were independently associated with an increased risk of a recent overdose were having had a prior overdose (odds ratio [OR], 28.58; 95% confidence interval [CI] = 14.10 to 57.96), using cocaine/crack in the past six months (OR, 2.07; 95% CI = 1.25 to 3.45), using alcohol in the past six months (OR, 1.90; 95% CI = 1.01 to 3.57), experiencing serious withdrawal symptoms in the past two months (OR, 2.70; 95% CI = 1.58 to 4.61), and younger age. Conclusions: Drug users who have previously experienced a nonfatal overdose are at very high risk of experiencing future overdoses. Further longitudinal studies are needed to identify robust predictors of overdose risk over time in habitual drug users, but these data suggest that drug users who have overdosed warrant aggressive prevention efforts such as agonist maintenance treatment or provision of take-home naloxone.Impact of social network characteristics on high-risk sexual behaviors among non-injection drug users
AbstractPilowsky, D. J., Hoover, D., Hadden, B., Fuller, C., Ompad, D. C., Andrews, H. F., De Leon, C. L., Hoepner, L., Xia, Q., & Latkin, C. (n.d.).Publication year
2007Journal title
Substance Use and MisuseVolume
42Issue
11Page(s)
1629-1649AbstractSexually active non-injection drug users in New York City and their sexual partners or fellow drug users (N = 264) were recruited from 2002 to 2005, and associations between social network characteristics and sexual risk behaviors were examined. We assessed social networks, sexual practices, and drug use. Results suggest having a drug-centered social network, i.e., a network that includes a high proportion of individuals who provide, receive, or use drugs, increases the risk of engaging in high-risk sexual behaviors. The study's limitations are noted and longitudinal studies are needed to ascertain whether these associations are causal. Funding was provided by the National Institute on Drug Abuse.Our cities, our health, our future : acting on social determinants for health equity in urban settings : report to the WHO Commission on Social Determinants of Health from the Knowledge Network on Urban Settings
AbstractOmpad, D. C. (n.d.).Publication year
2007Abstract~Pandemic preparedness and hard to reach populations.
AbstractVlahov, D., Coady, M. H., Galea, S., Ompad, D. C., & Barondess, J. A. (n.d.).Publication year
2007Journal title
American journal of disaster medicineVolume
2Issue
6Page(s)
281-283Abstract~Perceived stress among a workforce 6 months following hurricane Katrina
AbstractLeon, K. A., Hyre, A. D., Ompad, D. C., DeSalvo, K. B., & Muntner, P. (n.d.).Publication year
2007Journal title
Social psychiatry and psychiatric epidemiologyVolume
42Issue
12Page(s)
1005-1011AbstractTo determine stress levels among a workforce 6 months after hurricane Katrina made landfall, a web-based survey that included the four-item Perceived Stress Scale was administered to employees of the largest employer in New Orleans. An overall Perceived Stress Scale score was obtained by pooling responses for the four items. Among 1,542 adult respondents, 24.1% stated they felt that they were "fairly often" or "very often" unable to control the important things in their life and 21.4% considered that their difficulties were "fairly often" or "very often" piling up so high that they could not overcome them. Also, 6.1% reported that they "almost never" or "never" felt confident about their ability to handle their personal problems and 15.2% indicated that things were "almost never" or "never" going their way. The overall mean Perceived Stress Scale score was 6.3 (standard deviation = 3.1; range = 0-16). Higher stress scale scores, indicating more stress, were present for women, and for participants with lower income, displaced longer than 3 months, who were more afraid of losing their life during hurricane Katrina and its immediate aftermath, and who knew someone that died during the storm. Additionally, participants who were living in a relative of friend's house or in a temporary trailer at the time of the survey had higher stress scores compared to their counterparts who had returned to live in their pre-hurricane residence. There was a direct association between higher stress scores and symptoms of post-traumatic stress disorder. Employers and health care providers should be apprised of the need for monitoring stress and offering counseling opportunities for returning workforces following future large-scale disasters.Rapid vaccine distribution in nontraditional settings : lessons learned from project VIVA
AbstractCoady, M. H., Weiss, L., Galea, S., Ompad, D. C., Glidden, K., & Vlahov, D. (n.d.).Publication year
2007Journal title
Journal of Community Health NursingVolume
24Issue
2Page(s)
79-85AbstractWith growing fear of a worldwide influenza pandemic, programs that can rapidly vaccinate a broad range of persons are urgently needed. Vaccination rates are low among disadvantaged and hard-to-reach populations living within urban communities, and delivering vaccines to these groups may prove challenging. Project VIVA1 (Venue-Intensive Vaccination for Adults), staffed by teams of nurses and outreach workers, aimed to deliver vaccines rapidly within disadvantaged neighborhoods in New York City. Project VIVA nurses offered free influenza vaccine door-to-door and on street corners over 10 days in October, 2005. A total of 1,648 people were vaccinated, exceeding expectation. Careful selection and training of project staff, community involvement in project development, community outreach, and prioritizing street-based distribution may be key factors in an effective rapid vaccination program. In conclusion, this project may be replicated in other communities and utilized for annual vaccination campaigns and in the event of a pandemic.Risk factors for methadone outside treatment programs : Implications for HIV treatment among injection drug users
AbstractOmpad, D. C., Vlahov, D., O'Driscoll, P., Mehta, S. H., Ompad, D. C., Gern, R., Galai, N., & Kirk, G. D. (n.d.).Publication year
2007Journal title
AddictionVolume
102Issue
5Page(s)
771-777AbstractBackground: Diversion of methadone outside treatment programs occurs, yet reasons for use of 'street methadone' are characterized poorly. Self-medication for withdrawal symptoms is one plausible hypothesis. Among HIV-infected drug users, some antiretroviral medications can reduce potency of methadone, yet any association between such effects and the use of supplemental methadone sources remains undetermined. Objective: To estimate the frequency and risk factors for use of street methadone. Methods: Injection drug users (IDUs) recruited through extensive community outreach in 1988-89 and 1994 were followed semi-annually with questionnaires about health history, use of licit and illicit drugs including methadone and HIV-related assays. Analyses were performed using generalized estimating equation logistic regression. Results: Of 2811 IDUs enrolled and eligible for analysis, 493 people reported use of street methadone over 12 316 person-years of follow-up (4.0/100 person-years). In multivariate analyses, street methadone use was more common among women, whites, those 40-59 years old, those who reported withdrawal symptoms, past methadone program attendance (6-12 months before visit), recent heroin injection with or without cocaine (but not cocaine alone), smoking or sniffing heroin and reported trading sex. Street methadone was not associated with HIV infection or treatment. Conclusion: The results suggest that older IDUs still using heroin may be using street methadone to treat signs of withdrawal. The absence of a higher rate of street methadone use in HIV seropositive IDUs reveals that antiretroviral/ methadone interactions are not a primary determinant of use outside of treatment settings.Social determinants of the health of urban populations : Methodologic considerations
AbstractOmpad, D. C., Galea, S., Caiaffa, W. T., & Vlahov, D. (n.d.).Publication year
2007Journal title
Journal of Urban HealthVolume
84Issue
SUPPL. 1Page(s)
i42-i53AbstractA full understanding of the role of the urban environment in shaping the health of populations requires consideration of different features of the urban environment that may influence population health. The social environment is key to understanding the way in which cities affect the health of populations. Social determinants of health (SDH) are important, generally, yet can have different effects in different settings from urban to rural, between countries, between cities, and within cities. Failure to acknowledge, and more importantly, to understand the role of SDH in health and access to health and social services will hamper any effort to improve the health of the population. In this paper, we will briefly summarize a few key SDH and their measurement. We will also consider methodologic tools and some methodologic challenges. The concepts presented here are broadly applicable to a variety of settings: developed and developing countries, slum areas, inner cities, middle income neighborhoods, and even higher income neighborhoods. However, our focus will be on some of the more vulnerable urban populations who are most profoundly affected by SDH.Strategies for improving influenza immunization rates among hard-to-reach populations
AbstractVlahov, D., Coady, M. H., Ompad, D. C., & Galea, S. (n.d.).Publication year
2007Journal title
Journal of Urban HealthVolume
84Issue
4Page(s)
615-631AbstractWhereas considerable attention has been devoted to achieving high levels of influenza immunization, the importance of this issue is magnified by concern over pandemic influenza. Most recommendations for vaccine administration address high risk groups such as the elderly and those with chronic diseases, but coverage for hard-to-reach (HTR) populations has had less attention. HTR populations include minorities but also include other primarily urban groups such as undocumented immigrants, substance users, the homeless, and homebound elderly. Obstacles to the provision of immunization to HTR populations are present at the patient, provider, and structural levels. Strategies at the individual level for increasing immunization coverage include community-based educational campaigns to improve attitudes and increase motivation for receiving vaccine; at the provider level, education of providers to encourage immunizations, improving patient-provider interactions, broadening the provider base to include additional nurses and pharmacists, and adoption of standing orders for immunization administration; and at the structural level, promoting wider availability of and access to vaccine. The planning process for an influenza pandemic should include community engagement and extension of strategies beyond traditional providers to involve community-based organizations addressing HTR populations.Symptoms of posttraumatic stress disorder in a New Orleans workforce following Hurricane Katrina
AbstractDeSalvo, K. B., Hyre, A. D., Ompad, D. C., Menke, A., Tynes, L. L., & Muntner, P. (n.d.).Publication year
2007Journal title
Journal of Urban HealthVolume
84Issue
2Page(s)
142-152AbstractOn August 29, 2005, Hurricane Katrina made landfall resulting in catastrophic damage and flooding to New Orleans, LA, and the Gulf Coast, which may have had significant mental health effects on the population. To determine rates and predictors of symptoms consistent with a diagnosis of posttraumatic stress disorder (PTSD) in New Orleans residents following Hurricane Katrina, we conducted a web-based survey 6 months after Hurricane Katrina made landfall. Participants included 1,542 employees from the largest employer in New Orleans. The prevalence of PTSD symptoms was 19.2%. Predictors of PTSD symptoms in a multivariate-adjusted regression model included female sex, non-black race, knowing someone who died in the storm, not having property insurance, having had a longer evacuation, a much longer work commute compared to before Hurricane Katrina, and currently living in a newly purchased or rented house or in a temporary trailer. Despite universal health coverage and the benefits of an employee assistance program for all employees, only 28.5% of those with PTSD symptoms had talked to a health professional about the events of Hurricane Katrina or issues encountered since the storm. A significant burden of PTSD symptoms was present 6 months following Hurricane Katrina among a large group of adults who had returned to work in New Orleans. Given their key role in the economic redevelopment of the region, there is a tremendous need to identify those in the workforce with symptoms consistent with PTSD and to enhance treatment options. The strong relationship between displacement from ones' pre-Katrina residence and symptoms of PTSD suggests a need to focus resource utilization and interventions on individuals living in temporary housing.Urban as a determinant of health
AbstractVlahov, D., Freudenberg, N., Proietti, F., Ompad, D. C., Quinn, A., Nandi, V., & Galea, S. (n.d.).Publication year
2007Journal title
Journal of Urban HealthVolume
84Issue
SUPPL. 1Page(s)
i16-i26AbstractCities are the predominant mode of living, and the growth in cities is related to the expansion of areas that have concentrated disadvantage. The foreseeable trend is for rising inequities across a wide range of social and health dimensions. Although qualitatively different, this trend exists in both the developed and developing worlds. Improving the health of people in slums will require new analytic frameworks. The social-determinants approach emphasizes the role of factors that operate at multiple levels, including global, national, municipal, and neighborhood levels, in shaping health. This approach suggests that improving living conditions in such arenas as housing, employment, education, equality, quality of living environment, social support, and health services is central to improving the health of urban populations. While social determinant and multilevel perspectives are not uniquely urban, they are transformed when viewed through the characteristics of cities such as size, density, diversity, and complexity. Ameliorating the immediate living conditions in the cities in which people live offers the greatest promise for reducing morbidity, mortality, and disparities in health and for improving quality of life and well being.Urbanicity, urbanization, and the urban environment
AbstractOmpad, D. C., Galea, S., & Vlahov, D. (n.d.).Publication year
2007Page(s)
53-69AbstractWe live in an increasingly interconnected world, as some like to say, a "global village." As in any village, social, economic and biophysical environments shape individual action and interaction, which, in turn, influence the quality of life and the health of inhabitants. Technology, information, media, food, goods and services, as well as environmental pollution and diseases are shared among villages, cities, countries and continents. Not only are these exchanges great in scope, but the magnitude and speed of interaction among individuals and populations is also increasing. For example, international trade grew 8.6% per year during the decade 1990-1999 (World Trade Organization, 2000a, b), with an estimated US$1.7 trillion in daily global trading (Lee, 2000). An estimated 760 million people traveled to international destinations in 2004 (World Trade Organization, 2005), and circumnavigation of the globe is now possible in a mere 36 hours (Smolinski, Hamburg, & Lederberg, 2003). Immigration contributes to global exchanges, with an estimated 175 million individuals spending at least one year in another country (United Nations, 2002). Additionally, approximately 17 million refugees and internally displaced persons migrate from their homes every year (United Nations High Commissioner for Refugees, 2004). These trends of growing interactions on the global scale shape the environments in which we live and which influence our well-being and our health.Determinants of influenza vaccination in hard-to-reach urban populations
AbstractOmpad, D. C., Bryant, W. K., Ompad, D. C., Sisco, S., Blaney, S., Glidden, K., Phillips, E., Vlahov, D., & Galea, S. (n.d.).Publication year
2006Journal title
Preventive MedicineVolume
43Issue
1Page(s)
60-70AbstractObjective.: Influenza vaccination rates among disadvantaged minority and hard-to-reach populations are lower than in other groups. We assessed the barriers to influenza vaccination in disadvantaged urban areas. Methods.: We conducted a cross-sectional study, using venue-based sampling, collecting data on residents of eight neighborhoods throughout East Harlem and the Bronx, New York City. Results.: Of 760 total respondents, 461 (61.6%) had received influenza vaccination at some point in their life. In multivariable models, having access to routine medical care, receipt of health or social services, having tested positive for HIV, and current interest in receiving influenza vaccination were significantly associated with having received influenza vaccination in the previous year. Of participants surveyed, 79.6% were interested in receiving an influenza vaccination at the time of survey. Among participants who had never previously received influenza vaccination in the past, 73.4% were interested in being vaccinated; factors significantly associated with an interest in being vaccinated were minority race, lower annual income, history of being homeless, being uninsured/underinsured, and not having access to routine medical care. Conclusions.: Participants who are unconnected to health or social services or government health insurance are less likely to have been vaccinated in the past although these persons are willing to receive vaccine if it were available.Distribution of influenza vaccine to high-risk groups
AbstractOmpad, D. C., Galea, S., & Vlahov, D. (n.d.).Publication year
2006Journal title
Epidemiologic ReviewsVolume
28Issue
1Page(s)
54-70AbstractVaccine distribution programs have historically targeted individuals at high risk of complications due to influenza. Despite recommendations from the Advisory Committee on Immunization Practices, vaccination coverage among high-risk populations has been generally low. This review systematically summarizes the recent literature evaluating programs in different settings, from within medical settings to venue-based and community-based approaches, in an effort to identify successful program components. The published literature was identified by using the MEDLINE database from 1990 to 2006 covering studies that reported on interventions or programs aimed at vaccinating high-risk populations. The authors reviewed 56 studies. In the United States, the Healthy People 2010 goals included 90% vaccination coverage for adults aged ≥65 years and 60% for high-risk adults aged 18-64 years. Only a handful of the studies reviewed managed to meet those goals. Interventions that increased vaccination coverage to Healthy People 2010 goals included advertising, provider and patient mailings, registry-based telephone calls, patient and staff education, standing orders coupled with standardized forms, targeting of syringe exchange customers, and visiting nurses. Few studies evaluated the impact of vaccination programs by race/ethnicity and socioeconomic status. Few studies targeted individuals outside of the health-care and social services sectors. Given the growing disparities in health and health-care access, understanding the way in which interventions can remedy disparities is crucial.Gender differences in sexual behaviors, sexual partnerships, and HIV among drug users in New York City
AbstractAbsalon, J., Fuller, C. M., Ompad, D. C., Blaney, S., Koblin, B., Galea, S., & Vlahov, D. (n.d.).Publication year
2006Journal title
AIDS and BehaviorVolume
10Issue
6Page(s)
707-715AbstractWe compared sexual behaviors/partnerships and determined sexual risk correlates associated with HIV by gender among street-recruited drug users using chi-square tests and logistic regression. Men reported higher risk sexual behaviors, yet fewer high-risk sexual partners than women. After adjustment, HIV seropositive men were more likely than seronegatives to be older, MSM, use condoms, and have an HIV-infected partner. HIV seropositive women were more likely to be older, have an HIV-infected partner, and not use non-injected heroin. IDU was not associated with HIV. Prospective studies are needed to determine how gender-specific sexual behaviors/partnerships among drug users affect HIV acquisition.Heroin and cocaine dependence and the risk of accidental non-fatal drug overdose
AbstractGalea, S., Nandi, A., Coffin, P. O., Tracy, M., Piper, T. M., Ompad, D. C., & Vlahov, D. (n.d.).Publication year
2006Journal title
Journal of Addictive DiseasesVolume
25Issue
3Page(s)
79-87AbstractThe relation between illicit drug dependence and the likelihood of drug overdose is unclear. We recruited 1,066 habitual drug users for this analysis through street-based outreach in New York City. In this sample, 99.3% of respondents used heroin in the past year and 87.1% of respondents used cocaine; 819 (77.5%) heroin users and 735 (79.2%) cocaine users were severely dependent on either drug respectively. In multivariable models, among heroin users, persons who were severely heroin dependent were less likely (OR = 0.6; 95% CI = 0.4-0.9) to have overdosed on any drug in the past year; among cocaine users, those who were severely cocaine dependent were more likely (OR = 1.6; 95% CI = 1.0-2.6) to have overdosed in the past year. The relation between illicit drug dependence and risk of overdose may vary for different patterns of drug dependence. These observations suggest that overdose prevention interventions, perhaps even those specifically targeting opiate overdose, may be more efficiently directed at individuals exhibiting cocaine dependence.Period and birth-cohort effects on age of first phencyclidine (PCP) use among drug users in New York City, 1960 to 2000
AbstractBryant, W. K., Ompad, D. C., Ahern, J., Wu, Y., Vlahov, D., & Galea, S. (n.d.).Publication year
2006Journal title
Annals of EpidemiologyVolume
16Issue
4Page(s)
266-272AbstractPURPOSE: The aim of the study is to determine period and birth-cohort effects in the early initiation of phencyclidine (PCP) use in drug users in New York City (NYC). METHODS: We analyzed data collected from two surveys of street-recruited drug users in NYC. We used survival analysis and proportional hazards modeling to assess period and birth-cohort effects on risk for early initiation of PCP use. RESULTS: Of 787 participants, 292 (37.1%) had used PCP by the age of 23 years. Before 1987, there was a greater risk for initiation of PCP use through the age of 23 years (hazard ratio [HR] = 34.77; 95% confidence interval [CI], 21.45-56.36). Proportional hazards modeling showed that those born in the 1971 to 1975 birth cohort compared with those born in 1976 to 1980 had a lower risk for initiation of PCP use through age 23 years (HR = 0.58; 95% CI, 0.37-0.91). Other significant predictors of PCP use by age 23 included white race and having been in a juvenile detention center. CONCLUSIONS: There are period and birth-cohort differences in the likelihood of early initiation of PCP use. Changes in drug culture and social norms may influence the likelihood of initiation of PCP use. This may have implications for interventions aimed at slowing the nationwide increase in use of PCP.Predictors of early initiation of vaginal and oral sex among urban young adults in Baltimore, Maryland
AbstractOmpad, D. C., Strathdee, S. A., Celentano, D. D., Latkin, C., Poduska, J. M., Kellam, S. G., & Ialongo, N. S. (n.d.).Publication year
2006Journal title
Archives of Sexual BehaviorVolume
35Issue
1Page(s)
53-65AbstractOver the past three decades, most research on adolescent sexual behavior has focused on vaginal intercourse and related behaviors, including contraception and unintended pregnancy. In this study, we describe the prevalence and correlates of vaginal, oral, and anal sex in an epidemiologically defined population in Baltimore, Maryland. Young adults (ages 18-24), who had been enrolled in a behavioral intervention trial during elementary school, were interviewed by telephone between 1998 and 2002 to assess their sexual behavior. Of 1679 respondents interviewed, 70.8% were Black and 55% were women. Overall, 93% of the young adults reported vaginal intercourse, 78% reported receiving oral sex, 57% reported performing oral sex, and 10% reported receptive anal intercourse. Among men, 27% reported insertive anal intercourse. Blacks initiated vaginal intercourse at an earlier age thanWhites; White women performed oral sex earlier than Black women. Significant interactions were observed between age of first vaginal partner and both gender and race/ethnicity. Blacks with older partners initiated sex at an earlier age than both Blacks with a partner the same age or younger andWhites.We also observed a relationship between older female sex partners and earlier vaginal sex initiation among men. We conclude that older sex partners play an important role in sexual initiation among young adults. In light of the rates of oral and anal sex, sexual education and intervention programs should address the risk for unintended consequences of these behaviors.Sexual and drug risk behaviors among women who have sex with women
AbstractBell, A. V., Ompad, D. C., & Sherman, S. G. (n.d.).Publication year
2006Journal title
American journal of public healthVolume
96Issue
6Page(s)
1066-1072AbstractObjectives. We examined risk behaviors of female drug users, comparing those who reported recently having had sex with women (recent WSW), those who reported previously having had sex with women (former WSW), and those who reported never having had sex with women (never WSW). Methods. We used data from the Risk Evaluation and Assessment of Community Health III Study. Adjusted odds for predictors of WSW status were determined via multinomial logistic regression analyses. Results. Of the participants, 75% were never WSW, 12% were former WSW, and 13% were recent WSW. In comparison with never WSW status, significant predictors of recent WSW status were living away from one's parents as a child (adjusted odds ratio [OR] = 3.05; 95% confidence interval [CI] = 1.07,8.67) and recently having been paid for sex by men (adjusted OR = 4.02; 95% CI = 1.67, 9.68). Also, recently having been paid for sex by men was a significant predictor of former WSW status as opposed to never WSW status (adjusted OR = 3.97; 95% CI = 1.65, 9.59). Conclusions. The recency with which they had sex with women is one of the facets influencing the risk profile of WSW. The diverse characteristics of the WSW population need to be incorporated into future studies and risk interventions targeting this group.A comparison of HIV seropositive and seronegative young adult heroin- and cocaine-using men who have sex with men in New York City, 2000-2003
AbstractFuller, C. M., Absalon, J., Ompad, D. C., Nash, D., Koblin, B., Blaney, S., Galea, S., & Vlahov, D. (n.d.).Publication year
2005Journal title
Journal of Urban HealthVolume
82Issue
SUPPL. 1Page(s)
i51-i61AbstractThe purpose of this analysis was to determine the prevalence and correlates of HIV infection among a street-recruited sample of heroin- and cocaine-using men who have sex with men (MSM). Injection (injecting ≤3 years) and non-injection drug users (heroin, crack, and/or cocaine useAssociation of sex, hygiene and drug equipment sharing with hepatitis C virus infection among non-injecting drug users in New York City
AbstractHowe, C. J., Fuller, C. M., Ompad, D. C., Galea, S., Koblin, B., Thomas, D., & Vlahov, D. (n.d.).Publication year
2005Journal title
Drug and alcohol dependenceVolume
79Issue
3Page(s)
389-395AbstractBackground: Hepatitis C virus (HCV) rates are higher in non-injecting drug users (NIDUs) than general population estimates. Whether this elevated HCV rate is due to drug use or other putative risk behaviors remains unclear. Methods: Recent non-injection drug users of heroin, crack and/or cocaine were street-recruited from 2000 to 2003 and underwent an interview and venipuncture for HCV antibody assays. Multiple logistic regression analyses were used to assess correlates for HCV infection. Results: Of 740 enrollees, 3.9% were HCV positive. The median age (intraquartile range) was 30 (35-24) years, 70% were male and 90% were Black or Hispanic. After adjustment, HCV seropositives were significantly more likely than seronegatives to be older than 30 [adjusted odds ratio (AOR) = 5.71], tattooed by a friend/relative/acquaintance [AOR = 3.61] and know someone with HCV [AOR = 4.29], but were less likely to have shared nail or hair clippers, razors or a toothbrush [AOR = 0.32]. Conclusions: Non-commercial tattooing may be a mode of HCV transmission among NIDUs and education on the potential risk in using non-sterile tattooing equipment should be targeted toward this population. While no evidence was found for HCV transmission through NIDU equipment sharing or sexual risk behavior, further research is still warranted.Childhood sexual abuse and age at initiation of injection drug use
AbstractOmpad, D. C., Ikeda, R. M., Shah, N., Fuller, C. M., Bailey, S., Morse, E., Kerndt, P., Maslow, C., Wu, Y., Vlahov, D., Garfein, R., & Strathdee, S. A. (n.d.).Publication year
2005Journal title
American journal of public healthVolume
95Issue
4Page(s)
703-709AbstractObjectives. We examined the relation between childhood sexual abuse and injection drug use initiation among young adult injection drug users. Methods. We used mixed effect linear models to compare age at first injection among 2143 young injection drug users by first sexual abuse age categories. Results. The participants were predominantly male (63.3%) and White (52.8%). Mean age and age at first injection were 23.7 and 19.6 years, respectively; 307 participants (14.3%) reported childhood sexual abuse. After adjustment for gender, race/ethnicity, noninjection drug use before first injection drug use, and recruitment site, childhood sexual abuse was independently associated with younger age at first injection. Conclusions. Childhood sexual abuse was associated with earlier initiation of injection drug use. These data emphasize the need to integrate substance abuse prevention with postvictimization services for children and adolescents.Circumstances of witnessed drug overdose in New York City : Implications for intervention
AbstractTracy, M., Piper, T. M., Ompad, D. C., Bucciarelli, A., Coffin, P. O., Vlahov, D., & Galea, S. (n.d.).Publication year
2005Journal title
Drug and alcohol dependenceVolume
79Issue
2Page(s)
181-190AbstractDrug users frequently witness the nonfatal and fatal drug overdoses of their peers, but often fail to intervene effectively to reduce morbidity and mortality. We assessed the circumstances of witnessed heroin-related overdoses in New York City (NYC) among a predominantly minority population of drug users. Among 1184 heroin, crack, and cocaine users interviewed between November 2001 and February 2004, 672 (56.8%) had witnessed at least one nonfatal or fatal heroin-related overdose. Of those, 444 (67.7%) reported that they or someone else present called for medical help for the overdose victim at the last witnessed overdose. In multivariable models, the respondent never having had an overdose her/himself and the witnessed overdose occurring in a public place were associated with the likelihood of calling for medical help. Fear of police response was the most commonly cited reason for not calling or delaying before calling for help (52.2%). Attempts to revive the overdose victim through physical stimulation (e.g., applying ice, causing pain) were reported by 59.7% of respondents, while first aid measures were attempted in only 11.9% of events. Efforts to equip drug users to manage overdoses effectively, including training in first aid and the provision of naloxone, and the reduction of police involvement at overdose events may have a substantial impact on overdose-related morbidity and mortality.Correlates of initiation of injection drug use among young drug users in baltimore, Maryland : The need for early intervention
AbstractSherman, S. G., Fuller, C. M., Shah, N., Ompad, D. C., Vlahov, D., & Strathdee, S. A. (n.d.).Publication year
2005Journal title
Journal of Psychoactive DrugsVolume
37Issue
4Page(s)
437-443AbstractThis article examines individual and social factors associated with initiation of illicit drug injection, with a focus on racial differences. Data were derived from a cross-sectional survey of young injection and noninjection drug users in Baltimore, Maryland. Participants were aged 15 to 30 and had initiated use of heroin, cocaine, and/or crack within the prior five years. Bivariate and multivariate logistic regression models were used to identify correlates of injection initiation. Of 579 drug users, 73% were injectors, 56% were male, and 41% were African American. In a multivariate model controlling for age, correlates of injection initiation were: being an African American male [Adjusted Odds Ratio (AOR): 0.08; 95% Confidence Interval (CI): 0.04, 0. 17] or female (AOR = 0.12; 95%CI: 0.06, 027) compared to being a White male; younger age of first use of alcohol, marijuana, or inhalants (AOR=0.73; 95%CI: 0.65, 0.82); shorter time between first use of alcohol, marijuana, or inhalants and first use of heroin, crack, or cocaine (per year decrease, AOR=0.63, 95%CI: 0.40, 0.87); parental drug use (AOR=0.54, 95%CI: 0.32, 0.92); seeing someone inject prior to injection, AOR=1.96, 95%CI: 1.0 1, 3.50); and crack smoking (AOR=1.77, 95%CI: 1.07, 2.99). Early drug use panems and drug expos we factors are associated with initiation injection. Interventions are needed that target noninjection drug users to prevent transition to injection drug use.