Prevention and control of hepatitis C in rhode island.

Concern about the morbidity and mortality of hepatitis C infection is increasing. Persons born from 1945 to 1965 are most significantly affected, with the majority unaware of their infection, and will otherwise go untreated. Up to three-fourths of hepatitis C-related deaths occur in this population of "baby boomers." Since 2007, mortality from hepatitis C has exceeded that from HIV, nationally and in Rhode Island. New treatment options for hepatitis C emphasize the potential for cure of hepatitis C that is distinct from HIV. Financial resources and integration of hepatitis C partners and services in Rhode Island will be instrumental in reducing hepatitis C infections and increasing the number of cases cured. We describe public health investments in the past, present, and future to implement strategies for effectively addressing hepatitis C in the state.

Bundling Human Papillomavirus Vaccination and Rapid Human Immunodeficiency Virus Testing for Young Gay and Bisexual Men.

This study explored the feasibility and acceptability of a bundled human papillomavirus (HPV) vaccine and human immunodeficiency virus (HIV) testing program for young gay and bisexual men (YGBM). YGBM aged 18-26 years (N=55) were recruited to receive HPV vaccine with optional HIV testing and personalized counseling. Sexual risk behaviors and knowledge were assessed at three study visits. By visit 3, about 98% had received an HIV test with HPV vaccination; 59% received repeat HIV testing. Findings support the bundling of HPV vaccination with HIV testing among YGBM. Future directions include examining the scalability of integrating clinic-based HIV and HPV healthcare services.

Validation of decisional balance and self-efficacy measures for HPV vaccination in college women.

PURPOSE: Women younger than 25 years are at greatest risk for human papillomavirus (HPV) infection, including high-risk strains associated with 70% of cervical cancers. Effective model-based measures that can lead to intervention development to increase HPV vaccination rates are necessary. This study validated Transtheoretical Model measures of Decisional Balance and Self-Efficacy for seeking the HPV vaccine in a sample of female college students. DESIGN: Cross-sectional measurement development. Setting. Online survey of undergraduate college students. SUBJECTS: A total of 340 female students ages 18 to 26 years. MEASURES: Stage of Change, Decisional Balance, and Self-Efficacy. ANALYSIS: The sample was randomly split into halves for exploratory principal components analyses (PCAs), followed by confirmatory factor analyses (CFAs) to test measurement models. Multivariate analyses examined relationships between constructs. RESULTS: For Decisional Balance, PCA indicated two 4-item factors (Pros -α = .90; and Cons -α = .66). CFA supported a two-factor correlated model, χ(2)(19) = 39.33; p < .01; comparative fit index (CFI) = .97; and average absolute standardized residual statistic (AASR) = .03; with Pros α = .90 and Cons α = .67. For Self-Efficacy, PCA indicated one 6-item factor (α = .84). CFA supported this structure, χ(2)(9) = 50.87; p < .05; CFI = .94; AASR = .03; and α = .90. Multivariate analyses indicated significant cross-stage differences on Pros, Cons, and Self-Efficacy in expected directions. CONCLUSION: Findings support the internal and external validity of these measures and their use in Transtheoretical Model-tailored interventions. Stage-construct relationships suggest that reducing the Cons of vaccination may be more important for HPV than for behaviors with a true Maintenance stage.