New York State's Paid Family Leave Program is Associated with More Equitable and Increased Use of Paid Leave Following Childbirth.

OBJECTIVES: This study aimed to assess changes in paid maternity leave before and after New York's (NY) Paid Family Leave (PFL) law went into effect (1/1/2018) and changes in disparities by maternal characteristics. METHODS: We used specific data collected on maternity leaves by women who gave birth in 2016-2018 in NY State (outside NY City) participating in the Pregnancy Risk Assessment Monitoring System survey. Multiple logistic regressions were conducted to evaluate the effect of the PFL law on prevalence of paid leave taken by women after childbirth. RESULTS: After NY's PFL law went into effect, there was a 26% relative increase in women taking paid leave after childbirth. Use of paid leave after childbirth increased among all racial and ethnic groups. The increases were greater among Black non-Hispanic or other race non-Hispanic women, compared to white non-Hispanic women, suggesting that NY's law was associated with more equitable use of paid leave following childbirth. CONCLUSIONS FOR PRACTICE: Wider implementation and greater utilization of paid maternity leave policies would promote health equity and help reduce racial/ethnic disparities in maternal and child health outcomes.

Effects of New York state paid family leave on early immunizations.

OBJECTIVE: To test whether introduction of New York Paid Family Leave (NY PFL) in 2018 is associated with the timeliness of immunizations among infants whose mothers reside in NY in one of the 57 counties outside of New York City (NYC). METHODS: We use difference-in-difference methods, comparing immunization outcomes before and after NY PFL went into effect among infants born to mothers who were employed during pregnancy, and thus likely to be affected by NY PFL, vs. mothers who were not employed during pregnancy and thus unlikely to be affected. Data come from two administrative sources: (1) NYS Vital Statistics birth data; and (2) the NYS Immunization Information System (NYSIIS). RESULTS: Our findings suggest that NY PFL is associated with small increases in the probability that firstborn infants have had all immunizations on time at the ages of two and four months. We do not find statistically significant effects of NY PFL on immunization outcomes among higher birth order children. CONCLUSIONS: Our findings suggest that NY PFL led to small improvements in the timeliness of early immunizations among firstborn infants.

First-Year Enrollment and Utilization of New York State Paid Family Leave: 2018.

CONTEXT: The New York Paid Family Leave (NYPFL) law was passed in April 2016 and took effect January 1, 2018. Expanding paid family leave (PFL) coverage has been proposed as a public health strategy to improve population health and reduce disparities. OBJECTIVE: To describe first-year enrollment in NYPFL and to evaluate utilization of NYPFL benefits. DESIGN: Observational study. SETTING: New York State. PARTICIPANTS: Employees enrolled in the NYPFL program (N = 8 528 580). METHODS: We merged NYPFL enrollment and claim data sets for 2018. Descriptive analysis and multiple logistic regression models were used to assess utilization by demographic variables and business size. MAIN OUTCOME MEASURES: Utilization and duration of NYPFL to bond with a newborn or care for a family member differed by employees' age, sex, race and ethnicity, residence, income, and business size. RESULTS: Approximately 90% of working New Yorkers (N = 8 528 580) were enrolled in NYPFL. First-year utilization of PFL for newborn bonding and family care (9.4 and 4.0 per 1000 employees, respectively) was higher than comparable state PFL programs in California, New Jersey, or Rhode Island. An estimated 38.5% of employed women in New York utilized PFL for newborn bonding. Employees who worked at small businesses (1-49 employees) had lower utilization of PFL. Employees with lower incomes were more likely to claim PFL and employees of color or with lower incomes were more likely to take the maximum 8 weeks of PFL. CONCLUSIONS: These findings suggest that state PFL programs increase equity in employment benefits. Wider adoption of state/federal PFL programs could help reduce health disparities and improve maternal and infant health outcomes.

Sexual risk behavior among HIV-positive persons in Jamaica.

BACKGROUND: HIV/AIDS remains a global public health challenge, especially in sub-Saharan Africa and the Caribbean. Sexual risk behaviors among HIV-positive persons place their partners at risk for HIV transmission and other sexually transmitted infections. Stopping transmission acts among HIV-positive people is crucial in reversing HIV incidence. OBJECTIVE: This study aimed to assess the prevalence and predictors of sexual risk behaviors among HIV-positive individuals in clinical care in Northwestern Jamaica. METHODS: A cross-sectional survey of 118 (33 males and 85 females) HIV-positive individuals was used to assess demographic and health characteristics, HIV/AIDS knowledge, attitudes, and beliefs and sexual risk behaviors. RESULTS: About 12% of the study population stated that they had unprotected anal or vaginal sex without disclosing their HIV status. Participants who agreed that condoms reduce the risk of HIV transmission were 13.1 times more likely to use condoms during their last sexual encounters(95% CI: 2.1-79.0) than those who disagreed. About 75% of participants reported using a condom every time they had sexual intercourse in the past year, while 25% used condoms irregularly. Participants who had unprotected anal or vaginal sex without disclosing their status were less likely to have used condoms during the last sexual encounter (OR=0.1; 95% CI: 0.02-0.5). CONCLUSION: The prevalence of unsafe sex remains high among sexually active people living with HIV/AIDS in Jamaica. Study participants who engaged in unprotected sex without disclosing their HIV-positive status potentially place their partners at risk for HIV transmission and other sexually transmitted infections. The study findings highlight the need to promote safe sexual behaviors and a positive social environment for people living with HIV/AIDS in Jamaica.

Factors associated with the uptake of cervical cancer screening among women in portland, Jamaica.

BACKGROUND: Cervical cancer is the second most common cancer among women worldwide and is the leading cause of deaths in developing countries. Despite the strong evidence that cervical cancer screening results in decreased mortality from this disease, the uptake for cervical screening among Jamaican women remains low. AIMS: This study was carried out to identify factors associated with Jamaican women's decisions to screen for cervical cancer. MATERIALS AND METHODS: Cross-sectional descriptive study of 403 women aged 19 years and older from Portland, Jamaica. An interviewer-administered questionnaire assessed the women's cervical cancer screening history, as well as their knowledge, attitudes, and practices regarding the disease and screening. RESULTS: Of the 403 women interviewed, 66% had a Papanicolaou (Pap) smear and only 16% had a Pap test within the past year. Significant predicators of uptake of screening were being married, age, parity, discussing cancer with health provider, perception of consequences of not having a Pap smear, and knowing a person with cervical cancer. Women who did not know where to go for a Pap smear were 85% less likely to have been screened (prevalence odds ratio (POR): 0.15, 95% confidence interval (CI): 0.04, 0.52). CONCLUSIONS: This study showed suboptimal uptake of cervical cancer screening among Jamaican women. Multipronged approaches are needed to address barriers to screening, as well as identify and support conditions that encourage women's use of reproductive health services, thereby reducing incidence and mortality rates from cervical cancer.