Ann Elizabeth Kurth

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Publications

Publications

Survey finds that many prisons and jails have room to improve HIV testing and coordination of postrelease treatment

Solomon, L., Montague, B. T., Beckwith, C. G., Baillargeon, J., Costa, M., Dumont, D., Kuo, I., & Kurth, A. (2014). Health Affairs, 33(3), 434-442. 10.1377/hlthaff.2013.1115

Abstract

Abstract

Early diagnosis of HIV and effective antiretroviral treatment are key elements in efforts to reduce the morbidity and mortality associated with HIV. Incarcerated populations are disproportionately affected by HIV, with the disease's prevalence among inmates estimated to be three to five times higher than among the general population. Correctional institutions offer important opportunities to test for HIV and link infected people to postrelease treatment services. To examine HIV testing and policies that help HIV-positive people obtain treatment in the community after release, we administered a survey to the medical directors of the fifty state prison systems and of forty of the largest jails in the United States. We found that 19 percent of prison systems and 35 percent of jails provide opt-out HIV testing, which is recommended by the Centers for Disease Control and Prevention (CDC). Additionally, fewer than 20 percent of prisons and jails conform to the CDC's recommendations regarding discharge planning services for inmates transitioning to the community: making an appointment with a community health care provider, assisting with enrollment in an entitlement program, and providing a copy of the medical record and a supply of HIV medications. These findings suggest that opportunities for HIV diagnosis and linking HIV-positive inmates to community care after release are being missed in the majority of prison systems and jails

Value of management education to enhance health systems

Pfeffermann, G., & Kurth, A. (2014, January 1). In The Lancet Global Health (Vols. 2, Issues 9, pp. e504-e504). 10.1016/S2214-109X(14)70272-4

Vitamin, mineral, and multivitamin supplements for the primary prevention of cardiovascular disease and cancer: U.S. Preventative Services Task Force recommendation statement

Moyer, V., & Kurth, A. (2014). Annals of Internal Medicine, 160(8), 558-564.

Addressing unmet need for HIV testing in emergency care settings: A role for computer-facilitated rapid HIV testing?

Kurth, A. E., Severynen, A., & Spielberg, F. (2013). AIDS Education and Prevention, 25(4), 287-301. 10.1521/aeap.2013.25.4.287

Abstract

Abstract

HIV testing in emergency departments (EDs) remains underutilized. The authors evaluated a computer tool to facilitate rapid HIV testing in an urban ED. Randomly assigned nonacute adult ED patients were randomly assigned to a computer tool (CARE) and rapid HIV testing before a standard visit (n = 258) or to a standard visit (n = 259) with chart access. The authors assessed intervention acceptability and compared noted HIV risks. Participants were 56% nonWhite and 58% male; median age was 37 years. In the CARE arm, nearly all (251/258) of the patients completed the session and received HIV results; four declined to consent to the test. HIV risks were reported by 54% of users; one participant was confirmed HIV-positive, and two were confirmed false-positive (seroprevalence 0.4%, 95% CI [0.01, 2.2]). Half (55%) of the patients preferred computerized rather than face-to-face counseling for future HIV testing. In the standard arm, one HIV test and two referrals for testing occurred. Computer-facilitated HIV testing appears acceptable to ED patients. Future research should assess cost-effectiveness compared with staff-delivered approaches.

A career in HIV research

Kurth, A. (2013). In G. LoBiondo-Wood & J. Haber (Eds.), Nursing research (8th eds., 1–). Elsevier.

Daily short message service surveys to measure sexual behavior and pre-exposure prophylaxis use among kenyan men and women

Curran, K., Mugo, N. R., Kurth, A., Ngure, K., Heffron, R., Donnell, D., Celum, C., & Baeten, J. M. (2013). AIDS and Behavior, 17(9), 2977-2985. 10.1007/s10461-013-0510-4

Abstract

Abstract

Pre-exposure prophylaxis (PrEP) is a novel HIV prevention strategy which requires high adherence. We tested the use of daily short message service (i.e., SMS/text message) surveys to measure sexual behavior and PrEP adherence in Kenya. Ninety-six HIV-uninfected adult individuals, taking daily oral PrEP in a clinical trial, received daily SMS surveys for 60 days. Most participants (96.9 %) reported taking PrEP on ≥80 % days, but 69.8 % missed at least one dose. Unprotected sex was reported on 4.9 % of days; however, 47.9 % of participants reported unprotected sex at least once. Unprotected sex was not correlated with PrEP use (OR = 0.95). Participants reporting more sex were less likely to report PrEP non-adherence and those reporting no sex were most likely to report missing a PrEP dose (adjusted OR = 1.87). PrEP adherence was high, missed doses were correlated with sexual abstinence, and unprotected sex was not associated with decreased PrEP adherence.

Information and communication technology to link criminal justice reentrants to HIV care in the community

Kurth, A., Kuo, I., Peterson, J., Azikiwe, N., Bazerman, L., Cates, A., & Beckwith, C. G. (2013). AIDS Research and Treatment, 2013. 10.1155/2013/547381

Abstract

Abstract

The United States has the world's highest prison population, and an estimated one in seven HIV-positive persons in the USA passes through a correctional facility annually. Given this, it is critical to develop innovative and effective approaches to support HIV treatment and retention in care among HIV-positive individuals involved in the criminal justice (CJ) system. Information and communication technologies (ICTs), including mobile health (mHealth) interventions, may offer one component of a successful strategy for linkage/retention in care. We describe CARE+ Corrections, a randomized controlled trial (RCT) study now underway in Washington, that will evaluate the combined effect of computerized motivational interview counseling and postrelease short message service (SMS) text message reminders to increase antiretroviral therapy (ART) adherence and linkage and retention in care among HIV-infected persons involved in the criminal justice system. In this report, we describe the development of this ICT/mHealth intervention, outline the study procedures used to evaluate this intervention, and summarize the implications for the mHealth knowledge base.

A pilot study of the feasibility of a vaginal washing cessation intervention among Kenyan female sex workers

Masese, L., McClelland, R. S., Gitau, R., Wanje, G., Shafi, J., Kashonga, F., Ndinya-Achola, J. O., Lester, R., Richardson, B. A., & Kurth, A. (2013). Sexually Transmitted Infections, 89(3), 217-222. 10.1136/sextrans-2012-050564

Abstract

Abstract

Background: Intravaginal practices including vaginal washing have been associated with HIV-1 acquisition. This association may be mediated by mucosal disruption, changes in vaginal flora or genital tract inflammatory responses. Reducing vaginal washing could lower women's risk of HIV-1 acquisition. Methods: 23 HIV-1 seronegative women who reported current vaginal washing were recruited from a prospective cohort study of high-risk women in Mombasa, Kenya. A theoretical framework including information-motivation -behavioural skills and harm reduction was implemented to encourage participants to reduce or eliminate vaginal washing. At baseline and after 1 month, we evaluated vaginal epithelial lesions by colposcopy, vaginal microbiota by Nugent 's criteria and vaginal cytokine milieu using ELISA on cervicovaginal lavage specimens. Results: The most commonly reported vaginal washing substance was soap with water (N=14, 60.9%). The median frequency of vaginal washing was 7 (IQR 7-14) times per week. After 1 month, all participants reported cessation of vaginal washing (p=0.01). The probability of detecting cervicovaginal epithelial lesions was lower (OR 0.48; 95% CI 0.20 to 1.16; p=0.10) and the likelihood of detecting Lactobacillus by culture was higher (OR 3.71, 95% CI 0.73 to 18.76, p=0.11) compared with baseline, although these results were not statistically significant. There was no change in the prevalence of bacterial vaginosis. Most cytokine levels were reduced, but these changes were not statistically significant. Conclusions: A theory-based intervention appeared to have a positive effect in reducing vaginal washing over 1 month. Larger studies with longer follow-up are important to further characterise the effects of vaginal washing cessation on biological markers.

Strengthening 21st century global health systems

DeLuca, M., Hagopian, A., & Kurth, A. (2013). In M. DeLuca & A. Soucat (Eds.), Transforming the global health workforce: Investing strategically in the health care workforce (1–, pp. 3-60). New York University, College of Nursing.

Sustainable nursing human resources systems

Squires, A., Kovner, C., & Kurth, A. (2013). In M. Delucca & A. Soucat (Eds.), Transforming the global health workforce (1–, pp. 159-177). New York University, College of Nursing.