Farzana Kapadia
Farzana Kapadia
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Professor of Epidemiology
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Professional overview
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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.
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Education
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BS, Biology and History, SUNY Binghamton, Binghamton, NYMPH, Community Public Health, New York University, New York, NYPhD, Epidemiology, Columbia University, New York, NY
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Honors and awards
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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)
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Areas of research and study
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Behavioral Determinants of HealthBehavioral ScienceEpidemiologyHIV/AIDSReproductive HealthSocial BehaviorsSocial Determinants of HealthSocial epidemiologySubstance Abuse
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Publications
Publications
A randomized intervention trial to reduce the lending of used injection equipment among injection drug users infected with hepatitis C
AbstractLatka, M. H., Hagan, H., Kapadia, F., Golub, E. T., Bonner, S., Campbell, J. V., Coady, M. H., Garfein, R. S., Pu, M., Thomas, D. L., Thiel, T. K., & Strathdee, S. A. (n.d.).Publication year
2008Journal title
American journal of public healthVolume
98Issue
5Page(s)
853-861AbstractObjectives. We evaluated the efficacy of a peer-mentoring behavioral intervention designed to reduce risky distributive injection practices (e.g., syringe lending, unsafe drug preparation) among injection drug users with hepatitis C virus (HCV) infection. Methods. A randomized trial with a time-equivalent attention-control group was conducted among 418 HCV-positive injection drug users aged 18 to 35 years in 3 US cities. Participants reported their injection-related behaviors at baseline and at 3- and 6-month follow-ups. Results. Compared with the control group, intervention-group participants were less likely to report distributive risk behaviors at 3 months (odds ratio [OR]=0.46; 95% confidence interval [CI]=0.27, 0.79) and 6 months (OR=0.51; 95% CI=0.31, 0.83), a 26% relative risk reduction, but were no more likely to cite their HCV-positive status as a reason for refraining from syringe lending. Effects were strongest among intervention-group participants who had known their HCVpositive status for at least 6 months. Peer mentoring and self-efficacy were significantly increased among intervention-group participants, and intervention effects were mediated through improved self-efficacy. Conclusions. This behavioral intervention reduced unsafe injection practices that may propagate HCV among injection drug users.Impact of drug abuse treatment modalities on adherence to ART/HAART among a cohort of HIV seropositive women
AbstractKapadia, F., Vlahov, D., Wu, Y., Cohen, M. H., Greenblatt, R. M., Howard, A. A., Cook, J. A., Goparaju, L., Golub, E., Richardson, J., & Wilson, T. E. (n.d.).Publication year
2008Journal title
American Journal of Drug and Alcohol AbuseVolume
34Issue
2Page(s)
161-170AbstractMethadone maintenance is associated with improved adherence to antiretroviral therapies among HIV-positive illicit drug users; however, little information exists on whether adherence is associated with different drug abuse treatment modalities. Using longitudinal data from the Women's Interagency HIV Study, we evaluated the relationship between drug abuse treatment modality and adherence to antiretroviral therapies. In prospective analyses, individuals who reported accessing any drug abuse treatment program were more likely to report adherence to antiretroviral regimens ≥ 95% of the time (AOR = 1.39, 95% CI = 1.01-1.92). Involvement in either a medication-based or medication-free program was similarly associated with improved adherence. Drug abuse treatment programs, irrespective of modality, are associated with improved adherence to antiretroviral therapies among drug users. Concerted efforts to enroll individuals with drug use histories in treatment programs are warranted to improve HIV disease outcomes.The female condom: Effectiveness and convenience, not "female control," valued by U.S. urban adolescents
AbstractLatka, M. H., Kapadia, F., & Fortin, P. (n.d.).Publication year
2008Journal title
AIDS Education and PreventionVolume
20Issue
2Page(s)
160-170AbstractData on adolescents' views regarding the female condom are limited. We conducted seven single-gender focus groups with 47 New York City boys and girls aged 15-20 years (72% African American; 43% ever on public assistance; 72% sexually active; 25% had either been pregnant or fathered a pregnancy). Conceptual mapping was performed by participants to reveal the characteristics of protective methods deemed important to them. During analysis we specifically evaluated how the female condom was mapped. Girls consistently organized methods by, and thus were concerned about, contraceptive effectiveness, side effects, and availability (over the counter vs. provider controlled). Participants tended to classify the female condom with the male condom rather than as "female controlled." Maps varied among boys but contraceptive effectiveness was an important theme. Boys, but not girls, consistently and variously articulated an awareness of sexual pleasurewhen discussing this topic. Emphasizing the female condom's contraceptive effectiveness, lack of side effects, and availabilitymay be important when counseling adolescents.A peer-education intervention to reduce injection risk behaviors for HIV and hepatitis C virus infection in young injection drug users
AbstractGarfein, R. S., Golub, E. T., Greenberg, A. E., Hagan, H., Hanson, D. L., Hudson, S. M., Kapadia, F., Latka, M. H., Ouellet, L. J., Purcell, D. W., Strathdee, S. A., & Thiede, H. (n.d.).Publication year
2007Journal title
AIDSVolume
21Issue
14Page(s)
1923-1932AbstractOBJECTIVES: To evaluate whether a behavioral intervention, which taught peer education skills, could reduce injection and sexual risk behaviors associated with primary HIV and hepatitis C virus infection (HCV) among young injection drug users (IDU). DESIGN: We conducted a randomized controlled trial involving HIV and HCV antibody-negative IDU, aged 15-30 years, recruited in five United States cities. A six-session, small-group, cognitive behavioral, skills-building intervention in which participants were taught peer education skills (n = 431) was compared with a time-equivalent attention control (n = 423). Baseline visits included interviews for sociodemographic, psychosocial, and behavioral factors during the previous 3 months; HIV and HCV antibody testing; and pre/posttest counselling. Procedures were repeated 3 and 6 months postintervention. RESULTS: The intervention produced a 29% greater decline in overall injection risk 6 months postintervention relative to the control [proportional odds ratio 0.71; 95% confidence limit (CL) 0.52, 0.97], and a 76% decrease compared with baseline. Decreases were also observed for sexual risk behaviors, but they did not differ by trial arm. Overall HCV infection incidence (18.4/100 person-years) did not differ significantly across trial arms (relative risk 1.15; 95% CL 0.72, 1.82). No HIV seroconversions were observed. CONCLUSION: Interventions providing information, enhancing risk-reduction skills, and motivating behavior change through peer education training can reduce injection risk behaviors, although risk elimination might be necessary to prevent HCV transmission.Closing the gaps
Kapadia, F. (n.d.).Publication year
2007Journal title
American journal of public healthVolume
97Issue
5Page(s)
783Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities
AbstractKapadia, F., Latka, M. H., Hudson, S. M., Golub, E. T., Campbell, J. V., Bailey, S., Frye, V., & Garfein, R. S. (n.d.).Publication year
2007Journal title
Drug and alcohol dependenceVolume
91Page(s)
S56-S63AbstractThis paper examined correlates of consistent condom use with a main partner among heterosexual male injection drug users (IDUs). Using data from a multi-site sample of young IDUs, we identified 1770 sexually active men of whom 24% (429/1770) reported an exclusive main female sex partner and 49% (862/1770) reported both main and casual female sex partners. Consistent condom use with a main partner was low among men with an exclusive main partner and those with multiple partners (12% and 17%, respectively). In multivariate analysis, consistent condom use with a main partner across partnership patterns was directly associated with anticipating a positive response to requests for condom use and by partner support of condom use; consistent condom use was inversely associated with a main partner's pregnancy desires. Among men with an exclusive main partner, consistent condom use was also inversely associated with needle sharing with a main partner. Among men with multiple partners, consistent condom use with a main partner was inversely associated with injecting with a used needle and intimate partner violence. The low prevalence of consistent condom use with main female partners among heterosexually active male IDUs indicates an increased risk for HIV transmission between men and their primary sex partners. Interventions for heterosexual males that are geared toward increasing condom use in primary relationships are warranted.Design and feasibility of a randomized behavioral intervention to reduce distributive injection risk and improve health-care access among hepatitis C virus positive injection drug users: The Study to Reduce Intravenous Exposures (STRIVE)
AbstractKapadia, F., Latka, M. H., Hagan, H., Golub, E. T., Campbell, J. V., Coady, M. H., Garfein, R. S., Thomas, D. L., Bonner, S., Thiel, T., & Strathdee, S. A. (n.d.).Publication year
2007Journal title
Journal of Urban HealthVolume
84Issue
1Page(s)
99-115AbstractHepatitis C virus (HCV) is hyperendemic among injection drug users (IDUs). However, few scientifically proven interventions to prevent secondary transmission of HCV from infected IDUs to others exist. This report describes the design, feasibility, and baseline characteristics of participants enrolled in the Study to Reduce Intravenous Exposure (STRIVE). STRIVE was a multisite, randomized-control trial to test a behavioral intervention developed to reduce distribution of used injection equipment (needles, cookers, cottons, and rinse water) and increase health-care utilization among antibody HCV (anti-HCV) positive IDUs. STRIVE enrolled anti-HCV positive IDU in Baltimore, New York City, and Seattle; participants completed behavioral assessments and venipuncture for HIV, HCV-RNA, and liver function tests (LFTs) and were randomized to attend either a six-session, small-group, peer-mentoring intervention workshop or a time-matched, attention-control condition. Follow-up visits were conducted at 3 and 6 months. At baseline, of the 630 HCV-positive IDUs enrolled (mean age of 26 years, 60% white, 76% male), 55% reported distributive needle sharing, whereas 74, 69, and 69% reported sharing cookers, cottons, and rinse water, respectively. Health-care access was low, with 41% reporting an emergency room as their main source of medical care. Among those enrolled, 66% (418/630) were randomized: 53% (222/418) and 47% (196/418) to the intervention and control conditions, respectively. Follow-up rates were 70 and 73% for the 3- and 6-month visits, respectively. As distributive sharing of used injection equipment was common while reports of receiving HCV care were low, these findings indicate an urgent need for HCV-related interventions with IDUs and demonstrate the acceptability and feasibility to do so.Housing status and associated differences in HIV risk behaviors among young injection drug users (IDUs)
AbstractCoady, M. H., Latka, M. H., Thiede, H., Golub, E. T., Ouellet, L., Hudson, S. M., Kapadia, F., & Garfein, R. S. (n.d.).Publication year
2007Journal title
AIDS and BehaviorVolume
11Issue
6Page(s)
854-863AbstractUsing cross-sectional analysis we examined residential status and associated differences in HIV risk behaviors among 3266 young IDUs enrolled in an HIV prevention trial. A three-level outcome (homeless (37%), equivocally housed (17%), housed (46%)) was defined based on responses to two questions assessing subjective and objective criteria for homelessness: "equivocally housed" participants were discordant on these measures. In multivariate analysis, antecedents of homelessness were having lived in an out-of-home placement, been thrown out of the home or in juvenile detention, and experienced childhood abuse; while correlates included receiving income from other and illegal sources, drinking alcohol or using methamphetamine at least daily, using shooting galleries, backloading, and sex work. A subset of these variables was associated with being equivocally housed. HIV risk varies by housing status, with homeless IDUs at highest risk. Programs for IDUs should utilize a more specific definition of residential status to target IDUs needing intervention.Illicit drug use, depression and their association with highly active antiretroviral therapy in HIV-positive women
AbstractCook, J. A., Grey, D. D., Burke-Miller, J. K., Cohen, M. H., Vlahov, D., Kapadia, F., Wilson, T. E., Cook, R., Schwartz, R. M., Golub, E. T., Anastos, K., Ponath, C., Goparaju, L., & Levine, A. M. (n.d.).Publication year
2007Journal title
Drug and alcohol dependenceVolume
89Issue
1Page(s)
74-81AbstractBackground: We examined the interaction of illicit drug use and depressive symptoms, and how they affect the subsequent likelihood of highly active antiretroviral therapy (HAART) use among women with HIV/AIDS. Methods: Subjects included 1710 HIV-positive women recruited from six sites in the U.S. including Brooklyn, Bronx, Chicago, Los Angeles, San Francisco/Bay Area, and Washington, DC. Cases of probable depression were identified using depressive symptom scores on the Center for Epidemiologic Studies Depression Scale. Crack, cocaine, heroin, and amphetamine use were self-reported at 6-month time intervals. We conducted multivariate random logistic regression analysis of data collected during 16 waves of semiannual interviews conducted from April 1996 through March 2004. Results: We found an interaction effect between illicit drug use and depression that acted to suppress subsequent HAART use, controlling for virologic and immunologic indicators, socio-demographic variables, time, and study site. Conclusions: This is the first study to document the interactive effects of drug use and depressive symptoms on reduced likelihood of HAART use in a national cohort of women. Since evidence-based behavioral health and antiretroviral therapies for each of these three conditions are now available, comprehensive HIV treatment is an achievable public health goal.Methods to recruit and retain a cohort of young-adult injection drug users for the Third Collaborative Injection Drug Users Study/Drug Users Intervention Trial (CIDUS III/DUIT)
AbstractGarfein, R. S., Swartzendruber, A., Ouellet, L. J., Kapadia, F., Hudson, S. M., Thiede, H., Strathdee, S. A., Williams, I. T., Bailey, S. L., Hagan, H., Golub, E. T., Kerndt, P., Hanson, D. L., & Latka, M. H. (n.d.).Publication year
2007Journal title
Drug and alcohol dependenceVolume
91Page(s)
S4-S17AbstractBackground: New injection drug users (IDUs) are at high risk for blood-borne viral infections. Given U.S. policy to only fund proven-effective HIV prevention interventions, insights into conducting intervention trials among young IDUs are provided here by describing methods and participants' characteristics in the CIDUS III/DUIT study. Methods: In 2002-2004, 15-30-year-old IDUs in Baltimore, Chicago, Los Angeles, New York, and Seattle were recruited through community outreach, advertising and coupon-based participant referrals. Baseline interviews assessed sociodemographics, injection, and sexual behaviors. Antibody tests for HIV and hepatitis A, B, and C viruses (HAV, HBV, and HCV) were conducted. IDUs who were HIV and HCV antibody negative at baseline were eligible to participate in a randomized controlled HIV/HCV prevention trial. Follow-up assessments were conducted 3 and 6 months post-intervention. Data were analyzed to identify participant differences at baseline by city, trial enrollment, and trial retention. Results: Baseline assessments were completed by 3285 IDUs. Participants were mean age 23.8 years, 69% male, 64% White, 17% Hispanic, and 8% Black. Seroprevalence of HIV, HCV, HBV, and HAV antibodies were 2.9, 34.4, 22.4, and 19.3%, respectively. Of the 2062 (62.7%) baseline participants who were HIV and HCV antibody negative, 859 (41.7%) were randomized. At least one follow-up assessment was completed by 712 (83%) randomized participants. Contextual factors, primarily homelessness, were associated with lower enrollment and retention. Conclusions: Recruitment and retention of young-adult IDUs for complex intervention trials is complicated, yet feasible. Risk behaviors among participants enrolling in and completing the trial reflected those eligible to enroll.Prevalence and correlates of indirect sharing practices among young adult injection drug users in five U.S. cities
AbstractThiede, H., Hagan, H., Campbell, J. V., Strathdee, S. A., Bailey, S. L., Hudson, S. M., Kapadia, F., & Garfein, R. S. (n.d.).Publication year
2007Journal title
Drug and alcohol dependenceVolume
91Page(s)
S39-S47AbstractBackground: Sharing of drug paraphernalia to prepare, measure and divide drugs for injection remains an important residual risk factor for hepatitis C and other blood-borne infections among injection drug users (IDUs) especially as sharing of syringes for injection decreases. Methods: We analyzed data from five U.S. cities to determine the prevalence and independent correlates of non-syringe paraphernalia-sharing (NSPS) and syringe-mediated drug-splitting (SMDS) among 15-30-year-old IDUs who reported not injecting with others' used syringes (receptive syringe-sharing, RSS). Results: NSPS was reported by 54% of IDUs who did not practice RSS and was independently associated (p < 0.05) with having ≥5 injection partners, injecting with sex partners or regular injection partners, injecting in shooting galleries, peers' sharing behaviors, lower self-efficacy for avoiding NSPS, and less knowledge of HIV and HCV transmission. SMDS was reported by 26% of IDUs who did not practice RSS, and was independently associated with having ≥5 injection partners, injecting in shooting galleries, and inversely associated with unknown HIV status. Conclusions: NSPS and SMDS were common among young adult IDUs. Increased efforts to prevent these risky practices should address social and environmental contexts of injection and incorporate knowledge and skills building, self-efficacy, and peer norms.Eligibility for treatment of hepatitis C virus infection among young injection drug users in 3 US cities
AbstractHagan, H., Latka, M. H., Campbell, J. V., Golub, E. T., Garfein, R. S., Thomas, D. A., Kapadia, F., & Strathdee, S. A. (n.d.).Publication year
2006Journal title
Clinical Infectious DiseasesVolume
42Issue
5Page(s)
669-672AbstractAmong 404 injection drug users aged 18-35 who tested positive for hepatitis C virus (HCV) RNA, 96% had conditions that are potentially unwarranted contraindications for HCV treatment (e.g., problem drinking, moderate-to-severe depression, and recent drug injection). Restrictive eligibility criteria may deny treatment to a large proportion of patients who could benefit from it.Self-reported hepatitis C virus antibody status and risk behavior in young injectors
AbstractHagan, H., Campbell, J., Thiede, H., Strathdee, S., Ouellet, L., Kapadia, F., Hudson, S., & Garfein, R. S. (n.d.).Publication year
2006Journal title
Public Health ReportsVolume
121Issue
6Page(s)
710-719AbstractObjective. This study was conducted to assess the accuracy of self-reported hepatitis C virus (HCV) antibody (anti-HCV) serostatus in injection drug users (IDUs), and examine whether self-reported anti-HCV serostatus was associated with recent injection risk behavior. Methods. In five U.S. cities (Baltimore, Chicago, Los Angeles, New York, and Seattle), 3,004 IDUs from 15 to 30 years old were recruited for a baseline interview to determine eligibility for a randomized controlled trial of a behavioral intervention. HIV and HCV antibody testing were performed, and subject data (e.g., demographics, drug and sexual risk behavior, and history of HIV and HCV testing) were collected via audio computer-administered self-interview. Risk behavior during the previous three months was compared to self-reported anti-HCV serostatus. Results. Anti-HCV prevalence in this sample of young IDUs was 34.1%. Seventy-two percent of anti-HCV-positive and 46% of anti-HCV-negative IDUs in this sample were not aware of their HCV serostatus. Drug treatment or needle exchange use was associated with increased awareness of HCV serostatus. Anti-HCV-negative IDUs who knew their serostatus were less likely than those unaware of their status to inject with a syringe used by another IDU or to share cottons to filter drug solutions. Knowledge of one's positive anti-HCV status was not associated with safer injection practices. Conclusions. Few anti-HCV-positive IDUs in this study were aware of their serostatus. Expanded availability of HCV screening with high quality counseling is clearly needed for this population to promote the health of chronically HCV-infected IDUs and to decrease risk among injectors susceptible to acquiring or transmitting HCV.Factors associated with interest in initiating treatment for hepatitis C virus (HCV) infection among young HCV-infected injection drug users
AbstractStrathdee, S. A., Latka, M., Campbell, J., O’Driscoll, P. T., Golub, E. T., Kapadia, F., Pollini, R. A., Garfein, R. S., Thomas, D. L., & Hagan, H. (n.d.).Publication year
2005Journal title
Clinical Infectious DiseasesVolume
40Page(s)
S304-S312AbstractObjective. We sought to identify factors associated with interest in receiving therapy for hepatitis C virus (HCV) infection among HCV-infected injection drug users (IDUs) in 3 United States cities. Methods. IDUs aged 18-35 years who were HCV-infected and seronegative for human immunodeficiency virus underwent surveys on behaviors, experience, and interest in treatment for HCV infection and readiness to quit drug use. Results. Among treatment-naive IDUs (n = 216), 81.5% were interested in treatment for HCV infection, but only 27.3% had seen a health-care provider since receiving a diagnosis of HCV infection. Interest in treatment for HCV infection was greater among IDUs with a high perceived threat of progressive liver disease, those with a usual source of care, those without evidence of alcohol dependence, and those with higher readiness scores for quitting drug use. Interest in treatment for HCV infection was 7-fold higher among IDUs who were told by their health-care provider that they were at risk for cirrhosis or liver cancer. Conclusions. Improving provider-patient communication and integrating treatments for substance abuse and HCV may increase the proportion of IDUs who initiate treatment for HCV infection.The relationship between non-injection drug use behaviors on progression to AIDS and death in a cohort of HIV seropositive women in the era of highly active antiretroviral therapy use
AbstractKapadia, F., Cook, J. A., Cohen, M. H., Sohler, N., Kovacs, A., Greenblatt, R. M., Choudhary, I., & Vlahov, D. (n.d.).Publication year
2005Journal title
AddictionVolume
100Issue
7Page(s)
990-1002AbstractAims: To evaluate the effects of longitudinal patterns and types of non-injection drug use (NIDU) on HIV progression in the highly active antiretroviral therapy (HAART) era. Design: Women's Interagency HIV Study (WIHS), a prospective cohort study conducted at six US sites. Methods: Data were collected semi-annually from 1994 to 2002 on 1046 HIV+ women. Multivariate Cox proportional hazards modeling was used to estimate relative hazards for developing AIDS and for death by pattern and type of NIDU. Findings: During follow-up, 285 AIDS events and 287 deaths, of which 177 were AIDS-related, were reported. At baseline, consistent and former NIDU was associated with CD4+ counts of < 200 cells/μl (43% and 46%, respectively) and viral load > 40 000 copies/ml (53% and 55%, respectively). Consistent NIDU reported less HAART use (53%) compared with other NIDU patterns. Stimulant use was associated with CD4+ cell counts of < 200 cells/μl (53%) and lower HAART initiation (63%) compared with other NIDU types. In multivariate analyses, progression to AIDS was significantly higher among consistent (RH = 2.52), inconsistent (RH = 1.63) and former (RH = 1.56) users compared with never users; and for stimulant (RH = 2.04) and polydrug (RH = 1.65) users compared with non-users. Progression to all-cause death was higher only among former users (RH = 1.48) compared with never users in multivariate analysis. NIDU behaviors were not associated with progression to AIDS-related death. Conclusions: In this study, pattern and type of NIDU were associated with HIV progression to AIDS and all-cause mortality. These differences were associated with lower HAART utilization among consistent NIDU and use of stimulants, and poor baseline immunological and virological status among former users.The role of substance abuse in HIV disease progression: Reconciling differences from laboratory and epidemiologic investigations
AbstractKapadia, F., Vlahov, D., Donahoe, R. M., & Friedland, G. (n.d.).Publication year
2005Journal title
Clinical Infectious DiseasesVolume
41Issue
7Page(s)
1027-1034AbstractFrom the onset of the HIV/AIDS epidemic, the use of licit and illicit drugs has been investigated for its potential impact on HIV disease progression. Findings from a large number of laboratory-based studies indicate that drug abuse may exacerbate HIV disease progression; however, epidemiological studies have shown mixed results. This article presents a review of findings from both laboratory-based and epidemiologic investigations. In addition, we provide a careful evaluation of methodological strengths and limitations inherent to both study designs in order to provide a more nuanced understanding of how these findings may complement one another.Screening for depressive symptoms among HCV-infected injection drug users: Examination of the utility of the CES-D and the Beck Depression Inventory
AbstractGolub, E. T., Latka, M., Hagan, H., Havens, J. R., Hudson, S. M., Kapadia, F., Campbell, J. V., Garfein, R. S., Thomas, D. L., & Strathdee, S. A. (n.d.).Publication year
2004Journal title
Journal of Urban HealthVolume
81Issue
2Page(s)
278-290AbstractThe prevalence of depression is high among injection drug users (IDUs) and among those infected with the hepatitis C virus (HCV). Moreover, one of the drugs used in the standard treatment for HCV infection (interferon) has been known to exacerbate underlying psychiatric disorders such as depression and has been associated with the development of major depressive disorder among HCV-infected patients. For these reasons, the most recent National Institutes of Health consensus statement on the management of HCV infection recommends the identification and treatment of depression prior to the start of HCV treatment. This study aimed to examine the extent of current moderate/severe depressive symptoms in a cohort of HCV-infected IDUs as measured by two screening tools, the Center for Epidemiologic Studies Depression Scale (CES-D) and the Beck Depression Inventory (BDI). Subjects were participants in a multisite behavioral intervention trial among HCV-seropositive, human immunodeficiency virus-negative IDUs aged 18-35 years; the trial was designed to prevent secondary transmission of HCV and to enhance uptake of HCV treatment. Baseline data on demographics, risk behaviors, depression, alcohol use, and health care utilization were measured via audio computer-assisted self-interview. A factor analysis was conducted on each scale to examine the clustering of items used in each to measure depressive symptoms. Baseline depressive symptoms, as measured via the CES-D and the BDI, were also compared using Pearson's correlation coefficient. Of 193 HCV-infected individuals enrolled to date, 75.6% were male, and 65.3% were white. Median age was 25.8 years. Factor analyses revealed that these scales measured depression differently; a distinct somatic component was present in the BDI, but not the CES-D. Using cutoff scores of 23 for the CES-D and 19 for the BDI, 44.0% and 41.5% of the participants were identified as having moderate/severe depressive symptoms, respectively. Over half (56.0%) were identified as having depressive symptoms by either scale. However, there was only moderate agreement between the two scales (κ=0.46). Depressive symptoms were highly prevalent in this cohort of HCV-infected IDUs. Results indicated that both scales should be used in tandem to have the most sensitive detection of depressive symptoms, thereby maximizing the potential for HCV treatment success.Does bleach disinfection of syringes help prevent hepatitis C virus transmission?
Kapadia, F., Garfein, R. S., & Vlahov, D. (n.d.). In Epidemiology (1–).Publication year
2003Volume
14Issue
5Does bleach disinfection of syringes help prevent hepatitis C virus transmission? [1] (multiple letters)
Hagan, H., Thiede, H., Kapadia, F., Garfein, R. S., & Vlahov, D. (n.d.). In Epidemiology (1–).Publication year
2003Volume
14Issue
5Page(s)
628-629Low response rate schools in surveys of adolescent risk taking behaviours: Possible biases, possible solutions
AbstractWeitzman, B. C., Guttmacher, S., Weinberg, S., & Kapadia, F. (n.d.).Publication year
2003Journal title
Journal of Epidemiology and Community HealthVolume
57Issue
1Page(s)
63-67AbstractStudy objective: To examine the potential biases introduced when students in low response rate schools are dropped from classroom based surveys of adolescent risk taking behaviour. Design: Self administered confidential surveys were conducted in classrooms, with follow up visits to each school to survey students absent during the initial survey administration. Data on students in schools that achieved a 70% response rate are compared with data on students in schools that did not achieve this level of response. Setting: New York City, United States. Participants: 1854 10th graders in 13 public (state supported) high schools. Main results: Students in schools with low response rates resulting from high rates of absenteeism have different demographic characteristics and engage in more risk behaviours than students in schools with low absenteeism and high response rates. Excluding schools with low rates of response can have an effect on estimates of risk behaviour, even after data are weighted for individual absences. The potential for bias is greatest when, in sampling schools, the proportion of schools with low response rates is large, and when such schools represent a large share of the students in the area under study. Conclusions: Excluding schools with poor response rates from survey samples using a classroom based approach does not improve, and may, under some circumstances, underestimate risky behaviour among adolescent populations.Classroom-based surveys of adolescent risk-taking behaviors: Reducing the bias of absenteeism
AbstractGuttmacher, S., Weitzman, B. C., Kapadia, F., & Weinberg, S. L. (n.d.).Publication year
2002Journal title
American journal of public healthVolume
92Issue
2Page(s)
235-237AbstractObjectives. This investigation examined the effectiveness of intensive efforts to include frequently absent students in order to reduce bias in classroom-based studies. Methods. Grade 10 students in 13 New York City high schools (n=2049) completed self-administered confidential surveys in 4 different phases: a 1-day classroom capture, a 1-day follow-up, and 2 separate 1-week follow-ups. Financial incentives were offered, along with opportunities for out-of-classroom participation. Results. Findings showed that frequently absent students engaged in more risk behaviors than those who were rarely absent. Intensive efforts to locate and survey chronically absent students did not, however, significantly alter estimates of risk behavior. Weighting the data for individual absences marginally improved the estimates. Conclusions. This study showed that intensive efforts to capture absent students in classroom-based investigations are not warranted by the small improvements produced in regard to risk behavior estimates.Does bleach disinfection of syringes protect against hepatitis C infection among young adult injection drug users?
AbstractKapadia, F., Vlahov, D., Des Jarlais, D. C., Strathdee, S. A., Ouellet, L., Kerndt, P., Morse E., E. V., Williams, I., & Garfein, R. S. (n.d.).Publication year
2002Journal title
EpidemiologyVolume
13Issue
6Page(s)
738-741AbstractBackground. Hepatitis C virus (HCV) has emerged as a major public health problem among injection drug users. In this analysis we examine whether disinfection of syringes with bleach has a potentially protective effect on anti-HCV seroconversion. Methods. We conducted a nested case-control study comparing 78 anti-HCV seroconverters with 390 persistently anti-HCV seronegative injection drug users. These data come from the Second Collaborative Injection Drug Users Study, a prospective cohort study that recruited injection drug users from five U.S. cities between 1997 and 1999. We used conditional logistic regression to determine the effect of bleach disinfection of syringes on anti-HCV seroconversion. Results. Participants who reported using bleach all the time had an odds ratio (OR) for anti-HCV seroconversion of 0.35 (95% confidence interval = 0.08-1.62), whereas those reporting bleach use only some of the time had an odds ratio of 0.76 (0.21-2.70), when compared with those reporting no bleach use. Conclusions. These results suggest that bleach disinfection of syringes, although not a substitute for use of sterile needles or cessation of injection, may help to prevent HCV infection among injection drug users.Abortion Reform in South Africa: A Case Study of the 1996 Choice on Termination of Pregnancy Act
Guttmacher, S., Kapadia, F., Naude, J. T. W., & De Pinho, H. (n.d.).Publication year
1998Journal title
International Family Planning PerspectivesVolume
24Issue
4Page(s)
191-194