Chase Brexton Health Care

Objectives:To determine associations between primary provider specialty and thecontraceptive care that patients receive in a Federally Qualified HealthCenter setting in Maryland.Methods:A study of reproductive-age patients and their providers was performed fromJanuary 2018 to December 2021. A pooled crosssectional survey of electronicmedical record data for 44 127 encounters of 22 828 patients was performedto calculate the odds of contraceptive care being addressed by patients whohad General Practitioner, OB/GYN, pediatrician, or infectious disease (ID)specialists as their primary providers.Results:In 19 041 encounters (43%), contraception was addressed through eithercounseling alone, documentation of a contraceptive prescription, orlong-acting reversible contraceptive (LARC) placement procedure. Afteradjusting for insurance status and race/ethnicity, the odds ratio (OR) ofcontraceptive care delivery was statistically significantly higher forOB/GYN providers compared to General Practitioners—OR 2.42 (CI 2.29-2.53)and statistically significantly lower for ID providers—OR 0.69 (CI0.61-0.79). There was a non-statistically significant difference forPediatricians—OR 0.88 (CI 0.77-1.01).Conclusion:The provision of contraceptive care, a critical aspect of comprehensiveprimary care delivered in an FQHC setting, varies by provider specialty, andmay be negatively influenced by Ryan White funding related structures. Thereis a need to intentionally design robust referral and tracking systems toensure contraceptive care is equitably accessible to all, regardless ofassigned primary care provider specialty or HIV status.

Black transgender women are disproportionately affected by violence and poor care-delivery, contributing to poor mental health. Little is known regarding the effect of transgender and gender diverse (TGD) community connection (TCC) on health. This analysis (a) explores relationships between TCC, polyvictimization, and mental health and (b) analyzes how TCC influenced help-seeking following violent experiences among Black transgender women. Mixed-methods data from 19 Black transgender women were analyzed using correlational and thematic content analyses. Findings suggest that TCC is associated with improved help-seeking and mental health among Black transgender women, highlighting a need for longitudinal research to identify approaches for leveraging TCC.

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) individuals are at elevated risk for violent victimization and often experience increased health disparities compared to their non-LGBTQ counterparts. The present study examined associations between polyvictimization and mental and physical health in an LGBTQ sample. Participants included 385 LGBTQ individuals involved in a larger health-needs assessment of LGBTQ individuals living in the southeastern United States. The sample primarily identified as gay/lesbian (63.4%), cisgender (78.7%), and White (66.5%), and the mean participant age was 34.82 years (SD = 13.45). A latent class analysis (LCA) was conducted on seven items assessing different types of violence exposure. The LCA identified a three-class model, with classes characterized by low trauma exposure (71.4%), nondiscriminatory violence (15.1%), and high trauma exposure (13.5%). Differences in demographic characteristics, perceptions of mental and physical health, and diagnoses of specific health conditions were assessed across classes. The high-trauma class reported poorer perceived physical and mental health compared to the other two classes, with mean differences in past-month poor health days ranging from 11.38 to 17.37. There were no differences between the classes regarding specific physical health conditions; however, the high-trauma and nondiscriminatory violence classes had significantly higher rates of anxiety, depression, drug abuse, and suicidality than the low-trauma class, ORs = 2.39-23.83. The present findings suggest that polyvictimization is an important risk factor for poor health among LGBTQ individuals. These results have implications for addressing health disparities among the broader LGBTQ community.

Background. Sexual transmission of hepatitis C virus (HCV) among human immunodeficiency virus (HIV)-infected men who have sex with men (MSM) is an emerging issue. Studies addressing the temporal trends and risk factors associated with incident HCV in HIV-infected MSM in the community-based primary care settings in the United States are scarce. Methods. Using a retrospective cohort study design, HCV incidence, defined as HCV antibody seroconversion, was determined in 1147 HIV-infected men receiving care at Chase Brexton Health Care clinics in Baltimore, Maryland between 2004 and 2014. Multivariate regression analyses were used to identify factors associated with incident HCV. Results. There were 42 incident HCV infections during 5242 person-years (PY) of follow up (incidence rate [IR], 8.01/1000 PY). Thirty-seven (88%) of the incident infections were in MSM, of whom 31 (84%) reported no injection-drug use (IDU). The annual IRs for MSM were 13.1-15.8/1000 PY between 2004 and 2007, decreased to 2.7-6.2/1000 PY between 2008 and 2011, and increased to 10.4/1000 PY and 13.3/1000 PY in 2013 and 2014, respectively. Injection-drug use was strongly associated with incident HCV among all MSM (IR ratio [IRR], 14.15; P = .003); however, among MSM without IDU, entering care between 2010 and 2013 (IRR, 3.32; P = .01), being employed (IRR, 3.14; P = .03), and having a history of ulcerative sexually transmitted infections (IRR, 3.70; P = .009) or of polydrug use (IRR, 5.54; P = .01) independently predicted incident HCV. Conclusions. In this cohort of HIV-infected men, a re-emerging HCV epidemic was observed from 2011 to 2014 among MSM. In addition to IDU, high-risk sexual behaviors, favorable socioeconomic status, and polydrug use fueled this increase in HCV infections.

This study examined 36 Black therapists’ experiences working with Black clients in hospital, school, college, and community counseling settings. Findings of this interpretative phenomenological analysis suggest these therapists most often feel a distinct sense of solidarity with their Black clients, as evidenced by having a better understanding of the context of Black clients’ lives, creating easier and faster therapeutic connections with Black clients, and feeling especially committed to these clients’ well-being. Participants also acknowledged the potential pitfalls and having insufficient boundaries and acknowledged the limitations of their formal training in learning to work with Black clients. How participant responses differed according to years of experience, practice setting, and gender are also explored. This study also suggests implications to increase the quality of training provided to therapist trainees of African descent.

This study investigated the difference between episodic memory for verbal information presented in an oral format versus equivalent material presented in a written format. The study utilized the Logical Memory subtest of the Wechsler Memory Scales-Fourth Edition and the recently validated Morris Revision-IV Paragraphs. In a sample of 97 normal participants, auditory and visual memory performances were found to be significantly correlated (r = .651, p < .001). Post-hoc analysis revealed a slight though not clinically significant preference for retention in the visual modality. The results demonstrate a high-degree correlation for retention of episodic memory for these two sensory modalities in normal participants.