Farzana Kapadia
Farzana Kapadia
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Professor of Epidemiology
Director of Undergraduate Programs
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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
Examination of spatial polygamy among young gay, bisexual, and other men who have sex with men in New York City : The P18 cohort study
AbstractDuncan, D. T., Kapadia, F., & Halkitis, P. N. (n.d.).Publication year
2014Journal title
International journal of environmental research and public healthVolume
11Issue
9Page(s)
8962-8983AbstractThe few previous studies examining the influence of the neighborhood context on health and health behavior among young gay, bisexual, and other men who have sex with men (YMSM) have predominantly focused on residential neighborhoods. No studies have examined multiple neighborhood contexts among YMSM or the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, health behaviors, and neighborhood concordance. In this study, we assessed spatial polygamy by determining the amount of concordance between residential, social, and sex neighborhoods (defined as boroughs) in addition to examining individual-level characteristics that may be associated with neighborhood concordance. These data come from the baseline assessment of Project 18, a cohort of racially and ethnically diverse YMSM residing in the New York City metropolitan area. Participants (N = 598) provided information on their residential, social, and sex boroughs as well as information on their sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors (e.g., substance use and condomless sex). Descriptive analyses were conducted to examine the distribution of boroughs reported across all three contexts, i.e., residential, social, and sex boroughs. Next, concordance between: (1) residential and social boroughs; (2) residential and sex boroughs; (3) social and sex boroughs; and (4) residential, social, and sex boroughs was assessed. Finally, bivariable analyses were conducted to examine the relationships between sociodemographic characteristics, psychosocial factors, social support network characteristics, and health behaviors in relation to borough concordance. Approximately two-thirds of participants reported concordance between residential/socializing, residential/sex, and sex/socializing boroughs, whereas 25% reported concordance between all three residential/socializing/sex boroughs. Borough concordance varied by some individual-level characteristics. For example, White YMSM and YMSM reporting lower perceived socioeconomic status were significantly more likely to report residential/socializing/sex borough concordance (p < 0.001). With regard to psychosocial factors, YMSM who reported experiencing gay-related stigma in public forums were more likely to report discordant socializing/sex and residential/socializing/sex boroughs (p < 0.001). Greater frequency of communication with network members (≥weekly) was associated with less residential/social borough concordance (p < 0.05). YMSM who reported residential/socializing/sex borough concordance were more likely to report recent (last 30 days) alcohol use, recent marijuana use, and recently engaging in condomless oral sex (all p < 0.05). These findings suggest that spatial polygamy, or an individual moving across and experiencing multiple neighborhood contexts, is prevalent among urban YMSM and that spatial polygamy varies by multiple individual-level characteristics. Future research among YMSM populations should consider multiple neighborhood contexts in order to provide a more nuanced understanding of how and which neighborhood contexts influence the health and well-being of YMSM. This further examination of spatial polygamy (and individual-level characteristics associated with it) may increase understanding of the most appropriate locations for targeted disease prevention and health promotion interventions (e.g., HIV prevention interventions).Modeling substance use in emerging adult gay, bisexual, and other YMSM across time : The P18 cohort study
AbstractHalkitis, P. N., Siconolfi, D. E., Stults, C. B., Barton, S., Bub, K., & Kapadia, F. (n.d.).Publication year
2014Journal title
Drug and alcohol dependenceVolume
145Page(s)
209-216AbstractObjective: To examine patterns of substance use over time in a new generation of emerging adult gay, bisexual, and other young men who have sex with men (YMSM). Methods: Data were drawn from the first four waves of on ongoing prospective cohort study of YMSM who were ages 18 to 19 at baseline and were assessed each 6 months for substance use via calendar based methods. Latent growth curve modeling was utilized to assess changes over time for four drug use categories: alcohol, marijuana, inhalant nitrates, and other drugs (e.g., cocaine, ecstasy) and between groups (race/ethnicity, perceived familial socioeconomic status; SES). Results: Use of all substances increased steadily across the follow-up period. White YMSM demonstrated higher levels of alcohol use at the 18-mo follow-up visit compared to other racial/ethnic groups, while rates of change across groups were similar. Marijuana use at 18 months was highest for Hispanics who also indicated the highest rate of change. Finally, YMSM who reported higher perceived SES reported the lowest use and lowest rates of change for other drug use. Controlling for perceived SES, differences in patterns of drug use by race/ethnicity were evident but differences were not as large. Conclusions: Increases in substance use in the emerging adulthood of YMSM indicate the need for structural and behavioral interventions tailored to address substance use in these young men before chronic patterns of use develop. Differences in patterns of drug use across racial/ethnic and SES groups suggest that interventions need to consider person-level differences.Risk factors for adult-onset recurrent respiratory papillomatosis
AbstractRuiz, R., Achlatis, S., Verma, A., Born, H., Kapadia, F., Fang, Y., Pitman, M., Sulica, L., Branski, R. C., & Amin, M. R. (n.d.).Publication year
2014Journal title
LaryngoscopeVolume
124Issue
10Page(s)
2338-2344AbstractObjectives/Hypothesis: To evaluate risk factors strongly associated with adult-onset recurrent respiratory papillomatosis (AO-RRP). Study Design: Prospective, age- and sex-matched, case control. Methods: Patients with AO-RRP and controls completed a computer-based, 89-item questionnaire across three academic institutions. Results: Forty-eight AO-RRP patients were compared to 73 controls; 43 of the 48 AO-RRP patients were male (89.5%). The difference in the median number of lifetime sexual partners between AO-RRP (15) and controls (10) was significant (P = 0.0387). Additionally, an increased number of lifetime sexual partners (≥ 26) was associated with AO-RRP. No significant difference for the number of lifetime oral sex partners was observed between groups. Increased comorbidity, as quantified by the Charlson Comorbidity Index, was observed in patients with AO-RRP. AO-RRP and control groups were similar across many other variables, including birth history, smoking history, alcohol use, drug use, education, income, and the Short Form Health Survey scores. Conclusions: AO-RRP was not associated with previously proposed risk factors for juvenile-onset RRP and may be associated with an increased number of lifetime sexual partners.Individual, psychosocial, and social correlates of unprotected anal intercourse in a new generation of young men who have sex with men in New York City
AbstractHalkitis, P. N., Kapadia, F., Siconolfi, D. E., Moeller, R. W., Figueroa, R. P., Barton, S. C., & Blachman-Forshay, J. (n.d.).Publication year
2013Journal title
American journal of public healthVolume
103Issue
5Page(s)
889-895AbstractObjectives: We examined associations of individual, psychosocial, and social factors with unprotected anal intercourse (UAI) among young men who have sex with men in New York City. Methods: Using baseline assessment data from 592 young men who have sex with men participating in an ongoing prospective cohort study, we conducted multivariable logistic regression analyses to examine the associations between covariates and likelihood of recently engaging in UAI with same-sex partners. Results: Nineteen percent reported recent UAI with a same-sex partner. In multivariable models, being in a current relationship with another man (adjusted odds ratio [AOR] = 4.87), an arrest history (AOR = 2.01), greater residential instability (AOR = 1.75), and unstable housing or homelessness (AOR = 3.10) was associated with recent UAI. Although high levels of gay community affinity and low internalized homophobia were associated with engaging in UAI in bivariate analyses, these associations did not persist in multivariable analyses. Conclusions: Associations of psychosocial and socially produced conditions with UAI amonganew generation ofyoung men who have sex with men warrant that HIV prevention programs and policies address structural factors that predispose sexual risk behaviors.Sexual health screening among racially/ethnically diverse young gay, bisexual, and other men who have sex with men
AbstractSiconolfi, D. E., Kapadia, F., Halkitis, P. N., Moeller, R. W., Storholm, E. D., Barton, S. C., Solomon, T. M., & Jones, D. (n.d.).Publication year
2013Journal title
Journal of Adolescent HealthVolume
52Issue
5Page(s)
620-626AbstractPurpose: Screening for sexually transmitted infections (STIs) is a crucial element of improving health and reducing disparities, and young men who have sex with men (YMSM) face high rates of both STIs and human immunodeficiency virus. We examined sexual health screening among a diverse sample of adolescent YMSM living in New York City. Methods: Between 2009 and 2011, cross-sectional data were collected from 590 YMSM in New York City. Separate multivariable logistic regression models were used to assess the relationship between sociodemographic, psychosocial, and health and healthcare related factors and two main outcomes: having sought a recent sexual health screening (past 6 months) and having a rectal sexual health screening (lifetime). Results: Overall, 46% reported a sexual health screening in the prior 6 months, but only 16% reported ever having a rectal screening for STIs. Rates were higher among ethnic minority YMSM and men who accessed care at clinics. Multivariable results indicated that gay community affiliation, recent unprotected anal sex, and number of lifetime male partners were also associated with seeking a recent screening. Conclusions: Though half of the sample reported recent general screening, rates of lifetime rectal screening are low. Efforts to increase screening may focus on improving provider knowledge and guideline adherence, and educating and encouraging YMSM to access sexual health check-ups.Social support network characteristics and sexual risk taking among a racially/ethnically diverse sample of young, urban men who have sex with men
AbstractKapadia, F., Kapadia, F., Siconolfi, D. E., Barton, S., Olivieri, B., Lombardo, L., & Halkitis, P. N. (n.d.).Publication year
2013Journal title
AIDS and BehaviorVolume
17Issue
5Page(s)
1819-1828AbstractAssociations between social support network characteristics and sexual risk among racially/ethnically diverse young men who have sex with men (YMSM) were examined using egocentric network data from a prospective cohort study of YMSM (n = 501) recruited in New York City. Bivariate and multivariable logistic regression analyses examined associations between social support network characteristics and sexual risk taking behaviors in Black, Hispanic/Latino, and White YMSM. Bivariate analyses indicated key differences in network size, composition, communication frequency and average relationship duration by race/ethnicity. In multivariable analyses, controlling for individual level sociodemographic, psychosocial and relationship factors, having a sexual partner in one's social support network was associated with unprotected sexual behavior for both Hispanic/Latino (AOR = 3.90) and White YMSM (AOR = 4.93). Further examination of key network characteristics across racial/ethnic groups are warranted in order to better understand the extant mechanisms for provision of HIV prevention programming to racially/ethnically diverse YMSM at risk for HIV.The health of sexual minorities : a new frontier.
AbstractKapadia, F., & Landers, S. (n.d.).Publication year
2013Journal title
American Journal of Public HealthVolume
103Issue
10Page(s)
1735Abstract~Health and wellness across the life span.
AbstractKapadia, F. (n.d.).Publication year
2012Journal title
American journal of public healthVolume
102Issue
11Page(s)
2009Abstract~Perceived peer safer sex norms and sexual risk behaviors among substance-using latino adolescents
AbstractKapadia, F., Frye, V., Bonner, S., Emmanuel, P. J., Samples, C. L., & Latka, M. H. (n.d.).Publication year
2012Journal title
AIDS Education and PreventionVolume
24Issue
1Page(s)
27-40AbstractWe investigated the association between perceived peer norms and safer sexual behaviors among substance using Latino youth. Between 2005 and 2006, cross-sectional data were collected from 92 Latino adolescents recruited from clinic- and community-based settings in two U.S. cities. Separate multivariate logistic regression models were used to assess the relationship between perceived peer norms around safer sex and two different outcomes: Consistent condom use and multiple sexual partnerships. Among these participants, perceived peer norms encouraging safer sex were associated with consistent condom use even after controlling for individualand partner-related factors. Perceived peer norms supporting safer sex were inversely associated with recently having two or more sexual partners after controlling for demographic characteristics. Perceived peer norms around safer sexual behavior contribute to a lower likelihood of engaging in two HIV/STI risk behaviors: inconsistent condom use and multiple partnering. These findings suggest that further development of peer-based interventions for Latino youth is warranted.Associations Between Perceived Partner Support and Relationship Dynamics With Timing of Pregnancy Termination
AbstractKapadia, F., Finer, L. B., & Klukas, E. (n.d.).Publication year
2011Journal title
Women's Health IssuesVolume
21Issue
3Page(s)
S8-S13AbstractBackground Little is known about partner- and relationship-level characteristics that may affect the timing of pregnancy termination. The present study sought to address this issue by examining women's perceptions of social support and relationship-level dynamics for their association with timing of pregnancy termination. Methods Data on partner characteristics and relationship dynamics were collected from 373 women receiving abortions at clinics in two large East Coast cities via a brief, self-administered survey. These surveys collected information on individual and partner characteristics as well as perceived emotional, financial, and material support and relationship dynamics. Results Forty-six percent of women (mean age, 25 years; 52% African American, 27% Latina, 9% White; 34% currently in school; 37% employed full time) in this study were terminating a pregnancy at more than 9 weeks’ gestation (mean, 9.6; median, 8; interquartile range, 6–12). On bivariate analysis, we found that women terminating early (Lifting boatswithout closing gaps : Child health outcomes in distressed us cities from 1992-2002
AbstractSilver, D. R., Mijanovich, T., Uyei, J., Kapadia, F., & Weitzman, B. C. (n.d.).Publication year
2011Journal title
American journal of public healthVolume
101Issue
2Page(s)
278-284AbstractObjectives. We compared cause-specific mortality and birth rates for children and youths aged younger than 18 years in 100 US cities from 1992 through 2002. Methods. We used 5 census indicators to categorize the 100 most populous US cities in 1990 as economically distressed or nondistressed. We used Poisson regression to calculate rate ratios for cause-specific mortality and birth rates, comparing distressed cities to nondistressed cities overall and by race/ethnicity from 1992 through 2002. We also calculated rates of change in these variables within each city over this period. Results. Despite improvements in health for the study population in all cities, disparities between city groups held steady or widened over the study period. Gaps in outcomes between Whites and Blacks persisted across all cities. Living in a distressed city compounded the disparities in poor outcomes for Black children and youths. Conclusions. A strong national economy during the study period may have facilitated improvements in health outcomes for children and youths in US cities, but these benefits did not close gaps between distressed and nondistressed cities.Longitudinal determinants of consistent condom use by partner type among young injection drug users : The role of personal and partner characteristics
AbstractKapadia, F., Kapadia, F., Latka, M. H., Wu, Y., Strathdee, S. A., Mackesy-Amiti, M. E., Hudson, S. M., Thiede, H., & Garfein, R. S. (n.d.).Publication year
2011Journal title
AIDS and BehaviorVolume
15Issue
7Page(s)
1309-1318AbstractWe investigated the longitudinal influence of individual-, relationship- and social-level factors on condom use by partner typeamong young injections drug users (IDUs) enrolled in the Collaborative Injection Drug Users Study-III/ Drug Users Intervention Trial (CIDUS-III/DUIT) from 2002 to 2004. Based on longitudinal analysis using generalized estimating equations (GEE), consistent condom use with main partnerswasmorecommonly reported amongmales and those with greater self-efficacy for condom use; main partner's desire for pregnancy and needle sharing were negatively associated with consistent condom use. Among those with casual partners, having fewer sex partnerswas associated with consistent condom use. Positive attitudes toward condom use and partner norms supporting condom use were associated with greater consistent condom use with both partner types. These findings suggest that intervention strategies targeting individual- and partner-level factors may provide avenues for intervening upon sexual risks among young IDUs.Predictors and effects of alcohol use on liver function among young HCV-infected injection drug users in a behavioral intervention
AbstractDrumright, L. N., Hagan, H., Thomas, D. L., Latka, M. H., Golub, E. T., Garfein, R. S., Clapp, J. D., Campbell, J. V., Bonner, S., Kapadia, F., Thiel, T. K., & Strathdee, S. A. (n.d.).Publication year
2011Journal title
Journal of HepatologyVolume
55Issue
1Page(s)
45-52AbstractBackground & Aims: Hepatitis C virus (HCV) screening can provide opportunities to reduce disease progression through counseling against alcohol use, but empirical data on this issue are sparse. We determined the efficacy of a behavioral intervention in reducing alcohol use among young, HCV-infected injection drug users (IDUs) (n = 355) and assessed whether changes in liver enzymes were associated with changes in alcohol consumption. Methods: Both the intervention and attention-control groups were counseled to avoid alcohol use, but the intervention group received enhanced counseling. Logistic regression, ANOVA, and continuous time Markov models were used to identify factors associated with alcohol use, changes in mean ALT and AST levels, and change in alcohol use post-intervention. Results: Six months post-intervention, alcohol abstinence increased 22.7% in both groups, with no difference by intervention arm. Transition from alcohol use to abstinence was associated with a decrease in liver enzymes, with a marginally greater decrease in the intervention group (p = 0.05 for ALT; p = 0.06 for AST). In multivariate Markov models, those who used marijuana transitioned from alcohol abstinence to consumption more rapidly than non-users (RR = 3.11); those who were homeless transitioned more slowly to alcohol abstinence (RR = 0.47); and those who had ever received a clinical diagnosis of liver disease transitioned more rapidly to abstinence (RR = 1.88). Conclusions: Although, behavioral counseling to reduce alcohol consumption among HCV-infected IDUs had a modest effect, reductions in alcohol consumption were associated with marked improvements in liver function. Interventions to reduce alcohol use among HCV-infected IDUs may benefit from being integrated into clinical care and monitoring of HCV infection.Scarcity amidst abundance : challenges for public health.
AbstractKapadia, F. (n.d.).Publication year
2010Journal title
American journal of public healthVolume
100Issue
6Page(s)
973Abstract~Resolving conflict
AbstractBalcazar, H., Northridge, M. E., Benjamin, G. C., Kapadia, F., & Hann, N. E. (n.d.).Publication year
2009Journal title
American journal of public healthVolume
99Issue
3Page(s)
394-396Abstract~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
AbstractKapadia, F. (n.d.).Publication year
2007Journal title
American journal of public healthVolume
97Issue
5Page(s)
783Abstract~Correlates of consistent condom use with main partners by partnership patterns among young adult male injection drug users from five US cities
AbstractKapadia, F., Kapadia, 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
91Issue
SUPPL. 1Page(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
91Issue
SUPPL. 1Page(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.