Grace Reynolds | California State University Long Beach (original) (raw)

Papers by Grace Reynolds

Jordan W. Edwards, MA, Dennis G. Fisher, PhD,and Grace L. Reynolds, DPAData on HIV risk were coll... more Jordan W. Edwards, MA, Dennis G. Fisher, PhD,and Grace L. Reynolds, DPAData on HIV risk were collectedwith the Countywide Risk Assess-ment Survey from 2126 participants;92 were male-to-female transgen-der persons (i.e., cross-dressers,and those who identify with the op-posite sex), and 9 were male-to-female transsexual individuals (i.e.,those who have undergone gender-reassignment surgery or other pro-cedures). Transgender-identified in-dividuals were more likely than therest of the sample to have receivedhormone injections, offensive com-ments, and HIV testing; injected hor-mones with a used needle; beenAsian or American Indian; been paidfor sexual intercourse; and livedin unstable housing but less likelyto have used heroin. Transgender-identified individuals are at high riskfor HIV infection because of reuseof needles and being paid for sexualintercourse. (

Home Health Care Management & Practice, 2020

This study explored differences in postacute disposition for total hip arthroplasty (THA) and tot... more This study explored differences in postacute disposition for total hip arthroplasty (THA) and total knee arthroplasty (TKA) with a focus on whether Asian Americans (AS) experience joint replacement disparities observed in other racial/ethnic minorities compared with majority white patients. We used data from the Nationwide Inpatient Sample for 2009 through 2012. We looked at disposition to home health care (HHC) and transfer to another facility for postacute care (e.g., skilled nursing facility, rehabilitation facility) for each of the 4 years under study. Findings for AS were mixed. There were differences in discharge to postacute facilities other than HHC for AS compared with whites for THA for 2011 and 2012. For TKA, there were differences in disposition to HHC for Asians compared with whites for 2009 and 2012; for disposition to postacute facilities other than HHC for TKA, there were differences for 2011 and 2012 only. Differences for AS in postacute disposition to facilities ot...

Drug and Alcohol Dependence, 2015

Journal of substance abuse treatment, Feb 1, 2017

Among substance abusers in the US, the discrepancy in the number who access substance abuse treat... more Among substance abusers in the US, the discrepancy in the number who access substance abuse treatment and the number who need treatment is sizable. This results in a major public health problem of access to treatment. The purpose of this study was to examine characteristics of Persons Who Use Drugs (PWUDs) that either hinder or facilitate access to treatment. 2646 participants were administered the Risk Behavior Assessment (RBA) and the Barratt Impulsiveness Scale. The RBA included the dependent variable which was responses to the question "During the last year, have you ever tried, but been unable, to get into a drug treatment or detox program?" In multivariate analysis, factors associated with being unable to access treatment included: Previously been in drug treatment (OR=4.51), number of days taken amphetamines in the last 30days (OR=1.18), traded sex for drugs (OR=1.53), homeless (OR=1.73), Nonplanning subscale of the Barratt Impulsiveness Scale (OR=1.19), age at inte...

Journal of Community Medicine & Health Education, 2016

Background: Uncontrolled hypertension is a problem among many sub-populations of U.S. adults. Obj... more Background: Uncontrolled hypertension is a problem among many sub-populations of U.S. adults. Objective: To investigate hypertension in a low-income community sample of adults with a high proportion reporting homelessness. Methods: Respondents (N = 478) completed a cardiovascular risk assessment (CVRA) with five subscales (social support, nutrition, physical activity, control and negative emotions) and the Risk Behavior Assessment (RBA) which collects demographic information as well as drug use and sexual risk behaviors. Results: Findings showed that homeless individuals, and those who are married, divorced, or separated as opposed to being single, African-Americans, and women are at high risk for hypertension. A mediational model was developed using hypertension as the main outcome and the nutrition subscale of the CVRA as the mediator for homeless individuals. Results indicate that good nutrition (higher scores on the nutrition subscale) act as a protective mediator against hypertension for those who are homeless. The total mediated effect of nutrition on hypertension for the homeless was significant. Conclusions: Improved nutrition may help prevent/reduce risk of hypertension among low income adults, especially those who are homeless.

International Journal of STD & AIDS, 2019

This study examined the comparative health risk behaviors of women who (a) traded sex for money, ... more This study examined the comparative health risk behaviors of women who (a) traded sex for money, (b) traded sex for drugs, (c) traded sex for both drugs and money, or (d) did not trade sex. Self-report data were collected from 2369 women who received services through HIV and sexually transmitted infection (STI) testing programs and a subset were tested for HIV, hepatitis B, hepatitis C, and syphilis. Results revealed those women who traded sex only for money used condoms, were tested for HIV, and received the HIV test results more often than the other women. Women who traded sex for both drugs and money reported a significantly higher prevalence of gonorrhea, hepatitis B, and syphilis; were more likely to test positive for hepatitis B, syphilis, and HIV; engaged more often in sex acts without condoms; and were incarcerated for significantly more days. Based on these findings, the targets with greatest potential for STI prevention interventions are female sex workers who trade sex fo...

Evaluation & the Health Professions, May 10, 2010

International Journal of Std & Aids, Sep 11, 2020

Rectal douching (RD) may be a vector for sexually transmitted infection (STI) acquisition. The ai... more Rectal douching (RD) may be a vector for sexually transmitted infection (STI) acquisition. The aim of this study was to describe the relationship between RD, and the prevalence of various STIs and sexual behaviors in a sample of women and men in Long Beach, California. Five hundred and forty-seven men (mean age 42.8 years) and 530 women (mean age 37 years) recruited from a community-based setting between April 2010 and August 2014 completed the Risk Behavior Assessment and a questionnaire eliciting information on use of lubricants and enemas for vaginal intercourse (VI) and anal intercourse (AI). Participants were screened for high-risk behaviors for human immunodeficiency virus infection including injection drug use. Bivariate analyses were conducted separately for women and men. Based on the empirical results, separate logistic regression models for women and men were constructed. Sensitivity analysis was conducted to assess model fit for reduced samples of only those men and women who reported AI. For men, RD was associated with a lower odds of being hepatitis C antibody positive, greater odds of being positive for hepatitis B virus surface antigen, syphilis, and using lubricants for receptive anal intercourse (RAI). RD in women was associated with higher odds of a positive test for syphilis, ever vaginally douching for VI, and using lubricants for RAI. Men and women who practice RD report positive syphilis test results and use of lubricants for RAI. RD should not be perceived as preventing STIs.

PubMed, 2014

Timely provision of medical services among communities at increased risk of HIV infection is cruc... more Timely provision of medical services among communities at increased risk of HIV infection is crucial to detect the infection and to further prevent the spread of HIV. In the US, about one third of HIV cases were identified in the later stage of infection. The current study utilized the Gelberg-Andersen behavioral model for predicting medical service use among people who were at risk of HIV infection. The candidate variables included: social support, attitudinal, and behavioral variables. The data were collected from clients of HIV prevention agencies in Los Angeles County in 2004 who participated in the Countywide Risk Assessment Survey (CRAS). Using a logistic regression model, the study suggested that factors that were positively associated with use of medical services included living in a treatment center/halfway house or mission/shelter, experience of physical/sexual abuse, and ever receiving HIV testing/counseling. Factors inversely associated with medical service use were male gender, education, and consumption of alcohol. Analysis was conducted using SAS 9.3. Most of the findings are consistent with the Gelberg-Andersen model. The exception was that victims of physical or sexual abuse were more likely to use services instead of less likely as predicted by the model.

International Journal of Std & Aids, Dec 19, 2016

Even with technological advances in point-of-care rapid testing for HIV, hepatitis, and syphilis,... more Even with technological advances in point-of-care rapid testing for HIV, hepatitis, and syphilis, individuals may still find the experience of submitting to testing, and receiving results, to be stressful. Participants completed the rapid test experience questionnaires to assess stress both prior to and after the specimen collection. Participants completed the risk behavior assessment, the coping strategies indicator, and the Barratt impulsivity scale. Participants chose which rapid tests they wanted using a list administered via computer. Logistic regression analysis was used to model self-reported stress prior to testing and after testing. A total of 1097 individuals completed testing. Individuals who scored high on avoidance reported a stressful experience at pretest (OR ¼ 1.15, CI ¼ 1.04, 1.26) while higher educational attainment was associated with no stress at both time points. Injection drug users, avoidant, and impulsive individuals experience stress either before or after rapid testing. Education appears to be protective against stressful testing.

Archives of Sexual Behavior, Nov 7, 2014

This study used qualitative methods to assess why women engage in heterosexual anal (receptive) i... more This study used qualitative methods to assess why women engage in heterosexual anal (receptive) intercourse (AI) with a male partner. Four focus groups which comprised women from diverse ethnicities were conducted. All groups were digitally recorded for transcription; transcripts were analyzed using the methods of grounded theory to determine themes. Women's reasons for engaging in anal intercourse with a male partner can be described in broad categories including that the women wanted to have anal intercourse, either because of their own desire, to please a male partner, or they were responding to a quid pro quo situation. The riskiness of AI was assessed within relationship contexts. Past experience with AI including emotional and physical reactions was identified. Among the negative physical experiences of AI were pain and disliking the sensation, and uncomfortable side effects, such as bleeding of the rectum. Negative emotional experiences of AI included feelings of shame, disgust, and being offended by something her male partner did, such as spitting on his penis for lubrication. Positive physical experiences included liking the sensation. Many of the women also endorsed positive emotional experiences of AI, including that it was more intimate than vaginal sex,andthatitwassomethingtheyreservedonlyfor specialpartners. The majority of AI episodes were unplanned and not discussed prior to initiation. Pain during AI was mitigated by the use of lubricants or illicit drugs. Even those women who found pleasure in AI expressed a preference for vaginal intercourse.

Health Care for Women International, Jul 23, 2020

Chlamydia Trachomatis (CT) is a global problem. We compared the risk taking behaviors for CT infe... more Chlamydia Trachomatis (CT) is a global problem. We compared the risk taking behaviors for CT infection between men and women. Adults (2299 females, 5559 males) were administered the Risk Behavior Assessment. In women, CT was associated with candidiasis, in men with gonorrhea, genital warts, and syphilis. Risk factors for both genders were trading sex for money, use of marijuana for women, and use of Ecstasy and Viagra for men. Those with CT had higher risk perception for HIV infection and were more likely to obtain HIV testing. Patient teaching and concurrent testing for HIV and CT are imperative.

Journal of Hiv/aids & Social Services, Apr 1, 2014

The aim of this project was to examine factors associated with substance use treatment participat... more The aim of this project was to examine factors associated with substance use treatment participation among individuals using illicit drugs who were also receiving other health and social services. Data were collected from 1,189 respondents sampled in the Countywide Risk Assessment Survey in Los Angeles County, California. A binary logistic regression was used to examine behavioral model indicators and HIV risk behaviors associated with treatment use. Differences were found with regard to predisposing and need variables and to HIV risk behaviors between those who accessed treatment and those who did not. There are implications for targeted prevention strategies and triangulated service integration.

Evaluation & the Health Professions, Dec 1, 2006

Prevalence of hepatitis C (HCV) in injection drug users (IDUs) is high and once HCV has been dete... more Prevalence of hepatitis C (HCV) in injection drug users (IDUs) is high and once HCV has been detected, follow-up medical care is essential. Six hundred and one current and former IDUs who tested positive for HCV antibodies received referrals for medical care. Twenty-four percent (147) of participants returned to be interviewed regarding their medical follow-ups. Of these, only 42% (61) had sought additional medical care in the form of further liver or blood tests or liver ultrasound. Four variables predicted seeking medical care: (a) ever being in residential drug treatment, (b) ever trading sex for money, (c) self-reported homelessness, and (d) living in one's own apartment or house. Having income from a job was inversely associated with seeking medical care. Knowledge of HCV infection alone does not mean that IDUs will seek medical care. Additional education concerning medical care and treatment options are needed to address IDU needs.

Community Mental Health Journal, Jul 7, 2009

The concept of recovery can be operationalized from either the point of view of the consumer, or ... more The concept of recovery can be operationalized from either the point of view of the consumer, or from the perspective of the agency providing services. The Milestones of Recovery Scale (MORS) was created to capture aspects of recovery from the agency perspective. Evidence establishing the psychometric properties of the MORS was obtained in three efforts: Inter-rater reliability using staff at The Village, a multi-service organization serving the homeless mentally ill in Long Beach, California; inter-rater reliability was also obtained from Vinfen Corporation, a large provider of housing services to mentally ill persons in Boston, Massachusetts. A test-retest reliability study was conducted using staff rating of clients at The Village, and evidence for validity was obtained using the Level of Care Utilization System (LOCUS) as a validity measure. The intra-class correlation coefficient for the inter-rater reliability study was r = .85 (CI .81, .89) for The Village and r = .86 (CI .80, .90) for Vinfen Corporation; test-retest reliability was r = .85 (CI .81, .87); and validity coefficients for the LOCUS were at or above r = .49 for all subscales except one. There is sufficient evidence for the reliability and validity of the MORS.

Psychology of Addictive Behaviors, Sep 1, 2008

The University of Rhode Island Change Assessment (URICA; McConnaughty, Prochaska & Velicer, 1983)... more The University of Rhode Island Change Assessment (URICA; McConnaughty, Prochaska & Velicer, 1983), the Stage of Change Readiness and Treatment Eagerness Scale (SOCRATES; Miller & Tonigan, 1996), and the Readiness to Change Questionnaire (RCQ; Rollnick, Heather, Gold & Hall, 1992) are commonly used multi-dimensional measures of stage of change. The present study examined the convergent and discriminant validity of drug-use versions of these three measures through multi-trait multi-method analysis (MTMM) in a population of indigent out-of-treatment drug users (N = 377). Agreement in stage-of-change assignment and the relationship between stage of change and drug-use behaviors also were examined. Confirmatory Factor Analysis (CFA) suggests that the SOCRATES may have questionable convergent validity with the URICA and RCQ. There was moderate agreement in stage assignment. The analysis of behavior did provide some support for the construct validity of the measures. The results suggest that these drug-use stage-of-change measures may not be equivalent. Keywords Readiness to change; Stages of change; Substance use; Drug abuse The Transtheoretical Model (TTM) of Behavior Change (Prochaska & DiClemente, 1986,1992) has provided an increasingly popular model for understanding how people intentionally modify addictive behaviors. This model suggests that, as an individual changes a given behavior, he or she progresses through discrete stages

Open Forum Infectious Diseases, 2015

Background. Hepatitis C is one of the most prevalent blood-borne diseases in the United States. D... more Background. Hepatitis C is one of the most prevalent blood-borne diseases in the United States. Despite the benefits of early screening, among 3.2 million Americans who are infected with hepatitis C virus (HCV), 50%-70% are unaware of their infection status. Methods. Data were collected between 2011 and 2014, from 1048 clients who were in the following groups: (1) injection drug users, (2) women at sexual risk, (3) gay and bisexual men, and (4) transgender individuals. The sensitivity and specificity of point-of-care tests included (1) the MedMira rapid human immunodeficiency virus (HIV)/ HCV antibody test, (2) MedMira hepatitis B (HBV)/HIV/HCV antibody test, (3) Chembio HCV Screen Assay used with both whole blood and (4) oral specimens, (5) Chembio HIV-HCV Assay also used with both whole blood and (6) oral specimens, (7) Chembio HIV-HCV-Syphilis Assay, and (8) OraSure HCV Rapid Antibody Test used with whole blood. The gold standard for the HCV tests were HCV enzyme immunoassay (EIA) 2.0. Results. OraSure had the highest sensitivity at 92.7% (95% confidence interval [CI] = 88.8%-96.5%) followed closely by Chembio's 3 blood tests at 92.1% (95% CI = 87.7%-96.4%), 91.5% (95% CI = 87.2%-95.7%), and 92.3% (95% CI = 88.4%-96.2%). The sensitivities of MedMira HIV/HCV and MedMira HIV/HCV/HBV tests were the lowest, at 79.1% (95% CI = 72.6%-85.5%), and 81.5% (95% CI = 75.2%-87.8%), respectively. Specificity for the OraSure was 99.8% (95% CI = 99.4%-100%); specificity for the Chembio blood tests was 99.2% (95% CI = 98.6%-99.9%), 99.4% (95% CI = 98.8%-99.9%), and 99.3% (95% CI = 98.8%-99.9%); and specificity for the MedMira was100% and 100%. False-negative results were associated with HIV and hepatitis B core antibody serostatus. Conclusions. The OraSure and Chembio blood tests (including those multiplexed with HIV and syphilis) appear to good performance characteristics. This study has identified potential limitations of rapid testing in those testing positive for HIV and HBcAb. There should be discussion of updates to the 2013 CDC guidance.