Farzana Kapadia

Farzana Kapadia
Farzana Kapadia
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Professor of Epidemiology

Professional overview

Dr. Farzana Kapadia is Professor of Epidemiology and Population Health at the NYU School of Global Public Health and at the NYU Grossman School of Medicine, Department of Population Health. Dr. Kapadia is also affiliated with the Institute of Human Development and Social Change and Population Center at NYU.

Dr. Kapadia has long standing research interests in understanding the social and structural drivers of HIV/STIs as well as sexual and reproductive health outcomes in underserved and marginalized populations. Dr. Kapadia has over 20 years of experience in the design, development, and implementation of observational studies and HIV/STI intervention and prevention trials in underserved and marginalized populations in urban settings, both in the US and in Africa (Ghana and Kenya).

Dr. Kapadia has a passion for teaching and mentoring. She teaches the core Epidemiology for in-coming MPH students and has also taught key epidemiology courses, including Intermediate Epidemiology and Outbreak Epidemiology at GPH as well as an HIV-related course at NYU London. The overarching goal of Dr. Kapadia’s teaching is to train students to become epidemiologists and public health practitioners who are critical and creative thinkers as well as champions and advocates for inclusive solutions to our local and global public health challenges.

In addition to her research and teaching responsibilities, Dr. Kapadia serves as the Deputy Editor for the American Journal of Public Health.

Education

BS, Biology and History, SUNY Binghamton, Binghamton, NY
MPH, Community Public Health, New York University, New York, NY
PhD, Epidemiology, Columbia University, New York, NY

Honors and awards

Excellence in Public Health Faculty Award, New York University (2012)
Steinhardt Goddard Award (2011)
Community Collaborative Award, Steinhardt School of Culture, Education and Human Development (2009)
Elected Member, American College of Epidemiology (2007)

Areas of research and study

Behavioral Determinants of Health
Behavioral Science
Epidemiology
HIV/AIDS
Reproductive Health
Social Behaviors
Social Determinants of Health
Social epidemiology
Substance Abuse

Publications

Publications

A mixed-methods evaluation of an HIV pre-exposure prophylaxis educational intervention for healthcare providers in a NYC safety-net hospital-based obstetrics and gynecology clinic

Oot, A., Kapadia, F., Moore, B., Greene, R. E., Katz, M., Denny, C., & Pitts, R. (n.d.).

Publication year

2024

Journal title

AIDS Care - Psychological and Socio-Medical Aspects of AIDS/HIV

Volume

36

Issue

10

Page(s)

1537-1544
Abstract
Abstract
Cisgender women and transgender men are less likely to be assessed for PrEP eligibility, prescribed PrEP, or retained in PrEP care. Thus, this pilot PrEP educational intervention was tailored for healthcare providers (HCPs) in obstetrics/gynecology who provide care to cisgender women and transgender men in an academically-affiliated, public hospital women’s health clinic. The three-lecture educational curriculum designed for HCPs focused on PrEP eligibility and counseling, formulations and adherence, and prescription and payment assistance programs. Pre- and post-intervention surveys assessed HCP knowledge and barriers to PrEP counseling and prescription. Among n = 49 participants (mean age = 32.8 years; 85.7% cisgender women, mean years practicing = 4.2 years) pre-intervention, 8.7% had prior PrEP training and 61.2% felt very/somewhat uncomfortable prescribing PrEP. Post-intervention, knowledge of PrEP contraindications, eligibility, follow-up care, and assistance programs all increased. HCPs identified key barriers to PrEP care including lack of a dedicated PrEP navigator, culturally and linguistically appropriate patient materials on PrEP resources/costs, and PrEP-related content integrated into EHRs. Ongoing PrEP educational sessions can provide opportunities to practice PrEP counseling, including information on financial assistance. At the institutional level, incorporating PrEP screening in routine clinical practice via EMR prompts, facilitating PrEP medication monitoring, and enhancing telehealth for follow-up care could enhance PrEP prescription.

Adolescent Mental Health and Well-Being: A Public Health of Consequence, February 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

2

Page(s)

158-160

Adult Attachment Anxiety Is Protective Against the Effects of Internalized Homophobia on Condomless Sex Among Young Sexual Minority Men: The P18 Cohort Study

Cook, S. H., Wood, E. P., Kapadia, F., & Halkitis, P. N. (n.d.).

Publication year

2024

Journal title

Journal of Sex Research

Volume

61

Issue

5

Page(s)

742-749
Abstract
Abstract
Internalized homophobia, or the internalization of negative attitudes toward one’s sexual minority identity, is associated with sexual risk behaviors among young sexual minority men (YSMM). However, the formation and maintenance of secure or insecure socio-emotional bonds with friends, family members, and intimate partners (i.e., adult attachment) may mitigate or exacerbate the negative effects of exposure to internalized homophobia. Nevertheless, little is known about how adult attachment influences the association between internalized homophobia and sexual risk behaviors (e.g., condomless anal sex) among YSMM. Thus, this study examined the potential moderating effect of adult attachment on the association between internalized homophobia and condomless anal sex (CAS) behaviors (i.e., insertive CAS and receptive CAS) among a sample of N = 268 YSMM who participated in the study between June 2015-March 2017 using zero-inflated Poisson regression models. We found that adult attachment anxiety, but not adult attachment avoidance, significantly moderated the association between internalized homophobia and receptive CAS behaviors such that those higher on adult attachment anxiety and internalized homophobia had fewer receptive CAS events over the preceding 30 days as compared to those lower on adult attachment anxiety and internalized homophobia. Research efforts should focus on unpacking the complex associations between adult attachment, internalized homophobia, and sexual risk behaviors among YSMM.

Life Expectancy in the United States: A Public Health of Consequence, June 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

6

Page(s)

556-558

Our Public Health Workforce, Our Future: A Public Health of Consequence, May 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

5

Page(s)

461-462

Protecting Immigrant Children: A Public Health of Consequence, March 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

3

Page(s)

267-269

Safeguarding the Health of Mothers: A Public Health of Consequence, July 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

7

Page(s)

672-673

School-Based Health Centers Are a Critical Component of Health Care for Children: A Public Health of Consequence, August 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

8

Page(s)

769-771

Social Justice and Public Health: A Public Health of Consequence, April 2024

Kapadia, F. (n.d.).

Publication year

2024

Journal title

American journal of public health

Volume

114

Issue

4

Page(s)

364-365

Climate Justice and Health Equity: A Public Health of Consequence, October 2023

Kapadia, F. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Issue

10

Page(s)

1053-1054

Environmental Justice From Pennsylvania to Paris: A Public Health of Consequence, January 2023

Kapadia, F. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Issue

1

Page(s)

12-14

EquiPrEP: An implementation science protocol for promoting equitable access and uptake of long-acting injectable HIV preexposure prophylaxis (LAI-PrEP)

Kaul, C. M., Moore, B. E., Kaplan-Lewis, E., Casey, E., Pitts, R. A., Pirallo, P. P., Lim, S., Kapadia, F., Cohen, G. M., Khan, M., & Mgbako, O. (n.d.).

Publication year

2023

Journal title

PloS one

Volume

18

Issue

9
Abstract
Abstract
Background Long-acting injectable HIV pre-exposure prophylaxis (LAI-PrEP) was approved by the U.S. Food and Drug Administration in December 2021. This initial phase of implementation represents a prime opportunity to ensure equitable LAI-PrEP provision to communities often underrepresented in PrEP care before disparities in access and uptake emerge. Herein, we describe the EquiPrEP Project which utilizes an equity-oriented implementation science framework to optimize LAI-PrEP rollout in an urban safety-net clinic in New York City. Methods The primary objectives of this project are to: (1) increase LAI-PrEP initiation overall; (2) increase uptake among groups disproportionately impacted by the HIV epidemic; (3) preserve high PrEP retention while expanding use; and (4) identify barriers and facilitators to LAI-PrEP use. EquiPrEP will enroll 210 PrEP-eligible participants into LAI-PrEP care with planned follow-up for one year. We will recruit from the following priority populations: Black and/or Latine men who have sex with men, Black and/or Latine cisgender women, and transgender women and nonbinary individuals. To evaluate implementation of LAI-PrEP, we will utilize equity-focused iterations of the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework and the Consolidated Framework for Implementation Research (CFIR), in addition to longitudinal surveys and qualitative interviews. Discussion Novel LAI-PrEP formulations carry tremendous potential to revolutionize the field of HIV prevention. Implementation strategies rooted in equity are needed to ensure that marginalized populations have access to LAI-PrEP and to address the structural factors that hinder initiation and retention in care.

Maternal health and maternal health service utilization among female sex workers: A scoping review

Moore, B. E., Govaerts, L., & Kapadia, F. (n.d.).

Publication year

2023

Journal title

Women's Health

Volume

19
Abstract
Abstract
Background: High proportions of female sex workers (FSWs) become pregnant and have children. Many FSWs are at increased risk of maternal health complications due to factors such as poverty, violence, and healthcare barriers. Despite this, FSWs’ maternal health and use of maternal health services (MHS) receive limited attention. Objectives: The objectives of this scoping review are to (1) synthesize existing data on FSWs’ maternal health and MHS utilization and (2) assess the state of peer-reviewed literature on FSWs’ maternal health in regard to methodological approaches and reported outcomes. Eligibility criteria: Included articles were peer-reviewed, published in English, and reported empirical data on FSWs for outcomes related to antenatal care, pregnancy, and labor complications, postnatal and delivery care, and/or barriers to MHS. Sources of evidence: Article searches were conducted in PubMed, Web of Science, Global Health, Sociological Abstracts, Sociological Index, PsychInfo, and CINAHL Charting methods: Information extracted from eligible articles included publication year, study design, location, sample size, outcome measures, and findings. The “Three Delays” model was used to synthesize findings on barriers to MHS as relevant to phase I, II, or III delays. Results: Eighteen publications met the eligibility criteria. Studies were conducted in 11 countries and primarily reported quantitative data from cross-sectional surveys. The most frequently reported outcome was antenatal care utilization (n = 14), whereas few studies reported findings related to postnatal care and breastfeeding counseling (n = 2). Across publications, there was a substantial range in the proportion of FSWs who reported accessing different types of MHS. Conclusion: Literature on FSWs’ maternal health is limited and heterogenous. More research is needed that specifically focuses on measuring outcomes related to FSWs’ maternal health and examines associated factors. Such work can inform future research directions and public health interventions for FSWs—a population of marginalized women whose maternal health has been overlooked in existing efforts.

Mental health burdens among North American Asian adults living with chronic conditions: a systematic review

Islam, J. Y., Parikh, N. S., Lappen, H., Venkat, V., Nalkar, P., & Kapadia, F. (n.d.).

Publication year

2023

Journal title

Epidemiologic Reviews

Volume

45

Issue

1

Page(s)

82-92
Abstract
Abstract
Asians are likely to experience a high burden of chronic conditions, including, but not limited to, diabetes, cardiovascular disease, and cancer, due to differences in biologic, genetic, and environmental factors across Asian ethnic groups. A diagnosis of any chronic condition can contribute to increased mental health burdens, including depression, psychological distress, and posttraumatic stress disorder (PTSD). However, few studies have examined these comorbid conditions across distinct Asian ethnic groups—an important limitation given the differences in social, cultural, and behavioral drivers of mental health burdens within and across Asian ethnicities. To understand the disparities in mental health burdens among Asians living with a chronic health condition, we conducted a systematic literature review of relevant, peer-reviewed publication databases to identify studies reporting on mental health burdens (e.g., depression, anxiety, distress, PTSD) in distinct Asian ethnic groups in North America. Thirteen studies met the inclusion criteria for this review and collectively demonstrated a high burden of depression, psychological distress, and PTSD among Asians living with chronic conditions. Moreover, there were distinct disparities in mental health burdens across chronic conditions and across Asian ethnic groups. Despite the detrimental impact of poor mental health on chronic disease–specific outcomes, such as death and poor quality of life, few data exist that characterize mental health outcomes among Asian ethnicities living in North America with chronic conditions. Future work should prioritize estimating the national prevalence of mental health outcomes among adults with chronic conditions, by Asian ethnicities, to inform culturally tailored interventions to address this public health burden.

PREVALENCE AND CORRELATES OF HIV-ASSOCIATED HEALTH BEHAVIORS IN A POPULATION-BASED SAMPLE OF PUERTO RICAN ADULTS, 2019

Rivera-Castellar, G., Moore, B. E., & Kapadia, F. (n.d.).

Publication year

2023

Journal title

Ethnicity and Disease

Volume

33

Issue

1

Page(s)

17-25
Abstract
Abstract
Introduction: High incidence and prevalence of HIV persist in Puerto Rico. To inform HIV prevention efforts, this study examines factors linked to HIV-associated behaviors in the territory. Methods: Using data from the 2019 Behavioral Risk Factor Surveillance System, multivariable logistic regression models were constructed to explore factors related to HIV-associated behaviors. Results: Among Puerto Rican residents (n¼4446), 5.6% reported engaging in ≥1 HIV-associated behavior (past 12 months), and 39.2% had never been tested for HIV. Reporting HIV-associated behaviors was associated with male sex (adjusted odds ratio [aOR], 1.74; 95% confidence interval [CI], 1.30-2.33), higher household income (aOR, 1.71; 95% CI, 1.14-2.58), heavy alcohol use (aOR, 2.67; 95% CI, 1.68-4.25), and ever receiving an HIV test (aOR, 2.00; 95% CI, 1.40-2.86) in a multivariable model. Conversely, being married (aOR, 0.51; 95% CI, 0.35-0.72), having a recent routine checkup (aOR, 0.48; 95% CI, 0.32-0.72), and reporting 0 days of poor mental health (aOR, 0.61; 95% CI, 0.45-0.81) were associated with decreased odds of engaging in HIV-associated behaviors. Conclusions: Future surveys should incorporate measures of social and structural determinants that would provide greater context for understanding behavioral factors associated with HIV vulnerability as well as for developing appropriate HIV interventions in Puerto Rico.

Public Health Data of the People, by the People, for the People: A Public Health of Consequence, June 2023

Kapadia, F. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Issue

6

Page(s)

618-619

Public Health Practice and Health Equity for Vulnerable Workers: A Public Health of Consequence, May 2023

Kapadia, F. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Issue

5

Page(s)

480-481

Structural Racism and Health Inequities: Moving From Evidence to Action

Kapadia, F., & Borrell, L. N. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Page(s)

S6-S9

Structural Racism and Public Health

Kapadia, F., & Borrell, L. N. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Page(s)

S4

Sustaining PrEP Prescriptions at a Safety-Net Hospital in New York City During COVID-19: Lessons Learned

Pitts, R. A., Ban, K., Greene, R. E., Kapadia, F., & Braithwaite, R. S. (n.d.).

Publication year

2023

Journal title

AIDS and Behavior

Volume

27

Issue

8

Page(s)

2507-2512
Abstract
Abstract
To understand the impact of COVID-19-related disruptions on PrEP services, we reviewed PrEP prescriptions at NYC Health + Hospitals/Bellevue from July 2019 through July 2021. PrEP prescriptions were examined as PrEP person-equivalents (PrEP PE) in order to account for the variable time of refill duration (i.e., 1–3 months). To assess “PrEP coverage”, we calculated PrEP medication possession ratios (MPR) while patients were under study observation. Pre-clinic closure, mean PrEP PE = 244.2 (IQR 189.2, 287.5; median = 252.5) were observed. Across levels of clinic closures, mean PrEP PE = 247.3, (IQR 215.5, 265.4; median = 219.9) during 100% clinic closure, 255.4 (IQR 224, 284.3; median = 249.0) during 80% closure, and 274.6 (IQR 273.0, 281.0; median = 277.2) during 50% closure were observed. Among patients continuously prescribed PrEP pre-COVID-19, the mean MPR mean declined from 83% (IQR 72–100%; median = 100%) to 63% (IQR 35–97%; median = 66%) after the onset of COVID-19. For patients newly initiated on PrEP after the onset of COVID-19, the mean MPR was 73% (IQR 41–100%; median = 100%). Our ability to sustain PrEP provisions, as measured by both PrEP PE and MPR, can likely be attributed to our pre-COVID-19 system for PrEP delivery, which emphasizes navigation, same-day initiation, and primary care integration. In the era of COVID-19 as well as future unforeseen healthcare disruptions, PrEP programs must be robust and flexible in order to sustain PrEP delivery.

Women, Life, Freedom: A Public Health of Consequence, February 2023

Kapadia, F. (n.d.).

Publication year

2023

Journal title

American journal of public health

Volume

113

Issue

2

Page(s)

144-145

Abortion Care Is Health Care: A Public Health of Consequence, September 2022

Kapadia, F. (n.d.).

Publication year

2022

Journal title

American journal of public health

Volume

112

Issue

9

Page(s)

1242-1244

Bringing an Equity Lens to Address the Evolving Overdose Crisis: A Public Health of Consequence, April 2023

Kapadia, F. (n.d.).

Publication year

2022

Journal title

American journal of public health

Volume

113

Issue

4

Page(s)

359-360

Capturing missed HIV pre-exposure prophylaxis opportunities—sexually transmitted infection diagnoses in the emergency department

Mclaughlin, S. E., Kapadia, F., Greene, R. E., & Pitts, R. (n.d.).

Publication year

2022

Journal title

International Journal of STD and AIDS

Volume

33

Issue

3

Page(s)

242-246
Abstract
Abstract
The United States Centers for Disease Control and Prevention (CDC) recommends HIV pre-exposure prophylaxis (PrEP) be considered for all patients diagnosed with a sexually transmitted infection (STI). Emergency departments (EDs) are an important site for diagnosis and treatment of STIs for under-served populations. Consequently, we identified 377 patients diagnosed with a bacterial sexually transmitted infection (gonorrhea, chlamydia, and/or syphilis) at a major New York City emergency department between 1/1/2014 and 7/30/2017 to examine associations between key sociodemographic characteristics and missed opportunities for PrEP provision. In this sample, 299 (79%) emergency department patients missed their medical follow-up 90 days after STI diagnosis, as recommended. Results from adjusted generalized estimating equation regression models indicate that patients >45 yo (aOR = 2.2, 95% CI 1.2–3.9) and those with a primary care provider in the hospital system (aOR = 6.8, 95% CI 3.8–12.0) were more likely to return for follow-up visits, whereas Black patients (aOR = 0.44, 95% CI 0.25–0.77) were less likely to return for follow-up visits. These findings indicate that lack of STI treatment follow-up visits are significantly missed opportunities for PrEP provision and comprehensive human immunodeficiency virus prevention care.

Chronic comorbidities in persons living with HIV within three years of exposure to antiretroviral therapy at Pantang Antiretroviral Center in Ghana: a retrospective study

Kotey, M., Alhassan, Y., Adomako, J., Nunoo-Mensah, G., Kapadia, F., & Sarfo, B. (n.d.).

Publication year

2022

Journal title

Pan African Medical Journal

Volume

42

Issue

294

Page(s)

1-21
Abstract
Abstract
Introduction: uptake of antiretroviral therapy (ART) and retention in care are associated with increased life expectancy but increased the risk of comorbid conditions in persons living with HIV (PLWH) and taking antiretroviral drugs. This study describes comorbid conditions among PLWH in Ghana. Methods: PLWH (n=222) out of a sample population of 900, randomly selected at Pantang ART Center participated in the study from June to July of 2020. Socio-demographic characteristics, HIV biomarkers, medication type and adherence, and diagnostic confirmed chronic conditions were extracted from medical records of PLWH. Cox proportional-hazard models and Kaplan-Meier curves graphing risk of experiencing comorbid conditions were performed. Log-rank test was performed at p<0.05. Results: fifty three point two percent of PLWH (222) experienced a comorbid condition including, respiratory conditions (17.6%), anaemia (12.2%), hypertension (12.2%), cardiovascular diseases (10.8%),and neurological conditions (10.8%).Factors associated with some of these conditions were medication adherence (aHR=0.43, 95% CI: 0.21-0.90) and visual changes (aHR=2.64, 95% CI: 1.08-6.45) for respiratory conditions, age (aHR=10.03, 95% CI; 1.22-82.37) for hypertension, and World Health Organization (WHO) clinical stages (stage II (aHR=13.36, 95% CI=1.54-115.63) and III (aHR=11.71, 95% CI=1.41-97.26))for peripheral neuropathy. Kaplan-Meier curves show significant risk of comorbid conditions for age, CD4 count ≤350 cells/mm³, WHO clinical stages III and IV, and ART non-adherence. Conclusion: understanding the types of comorbidities in PLWH is integral to providing feedback to primary care providers to monitor.

Contact

farzana.kapadia@nyu.edu 708 Broadway New York, NY, 10003