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Papers by JENNIFER WAGMAN
Drug and Alcohol Dependence, Feb 1, 2017
SSM-Population Health, Sep 1, 2023
Aids Education and Prevention, Dec 1, 2017
Social Science & Medicine, Jul 1, 2018
Culture, Health & Sexuality, Nov 13, 2018
7th Biennial National Conference on Health and Domestic Violence, Mar 21, 2015
Global qualitative nursing research, 2017
Social Science Research Network, 2019
Journal of Interpersonal Violence, Sep 8, 2021
Journal of American College Health, Jul 9, 2021
Violence Against Women, Jun 17, 2021
AIDS, Oct 8, 2020
Objectives:In high-income countries, hazardous alcohol use is associated with reduced receipt of ... more Objectives:In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries.Design:We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC).Methods:Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use.Results:Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006).Conclusion:Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.
Addiction, Sep 15, 2020
Background:Harmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Afric... more Background:Harmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Africa (sSA); however, the effects of non-pharmacological alcohol interventions in this region are unknown.Design:A systematic review and meta-analysis of the available literature through March 14, 2019 was undertaken. Two authors extracted and reconciled relevant data and assessed risk of bias. Meta-analyses were conducted. The review protocol is registered on PROSPERO (CRD42019094509).Setting:Studies conducted in sSA were eligible for inclusion.Participants:Individuals participating in interventions aimed at reducing alcohol use.Interventions:Randomized and non-randomized controlled trials testing non-pharmacological interventions (psychosocial and structural) on alcohol consumption in sSA.Measurements:Eligible outcomes included the Alcohol Use Disorders Identification Test (AUDIT) scores; alcohol abstinence; measures of drinking quantity and frequency; and biomarkers of alcohol consumption.Findings:Nineteen intervention trials (18 scientific manuscripts) testing psychosocial interventions (no structural intervention included), judged of moderate quality, were included in meta-analyses. A beneficial effect was identified for psychosocial interventions on alcohol abstinence at 3–6 months (OR=2.05, 95% CI=1.20–3.48, k=5, n=2,312, I2 = 79%) and 12–60 months (OR=1.91, 95% CI=1.40–2.61, k=6, n=2,737, I2 = 63%) follow-up. There were no statistically significant effects found for AUDIT score (2–3 month: MD= −1.13, 95% CI: −2.60–0.34, k=6, n=992, I2=85%; 6 month: MD= −0.83, 95% CI= −1.92–0.26, k=6, n=1081, I2=69%; 12 month: MD= −0.15, 95% CI = −1.66–1.36, k=4; n=677; I2 = 75%), drinks per drinking day (3 months: MD: −0.22, 95% CI = −2.51–2.07, k=2, n=359, I2=82%; 6–36 months: MD= −0.09, 95% CI= −0.49–0.30, k=3, n=1450, I2=60%), or percent drinking days (3 months: MD= −4.60, 95%= −21.14–11.94; k=2; n=361; I2 = 90%; 6–9 months: MD=1.96, 95% CI= −6.54–10.46; k=2; n=818; I2 = 88%).Conclusion:Psychosocial interventions show promise at increasing self-reported alcohol abstinence in sSA, but clinical, methodological, and statistical heterogeneity across meta-analytic outcomes suggests results should be interpreted with caution.
Journal of Acquired Immune Deficiency Syndromes, Aug 15, 2021
Background:Mediated and moderated processes that lead to intervention efficacy may underlie resul... more Background:Mediated and moderated processes that lead to intervention efficacy may underlie results of trials ruled as non- efficacious. The overall purpose of this study was to examine such processes to explain the findings of one of the largest, rigorously conducted behavioral intervention randomized controlled trials, EXPLORE.Methods:4,295 HIV-negative MSM in the U.S. were randomized in a two-armed trial. Participants completed follow-up and an HIV test every 6 months up to 48-months. We used multiple and causal mediation analysis to test five mediators, including safer sex self-efficacy and condomless receptive anal sex with HIV-positive or status unknown partners on our primary outcome (HIV seroconversion). We also examined whether intervention effects on the mediators would be moderated by robust correlates of HIV among MSM, including stimulant use.Results:There were significant effects of the intervention on all hypothesized mediators. Stimulant use moderated the effect on condomless receptive anal sex. In stratified, multiple mediation models we found that among MSM with low stimulant use, the intervention significantly prevented HIV by reducing condomless receptive anal sex with HIV- positive or status unknown partners. Among MSM with higher stimulant use, there were no indirect effects of the intervention on HIV through any of the hypothesized mediators.Conclusion:The results suggest that the null effect found in the original EXPLORE trial might have occurred as a function of previously unexplored mediated and moderated processes. This study illustrates the value of testing mediated and moderated pathways in randomized trials, even in trials ruled as non-efficacious.
Drug and Alcohol Dependence, Nov 1, 2021
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, May 11, 2023
Journal of School Violence, Oct 6, 2022
Drug and Alcohol Dependence, Feb 1, 2017
SSM-Population Health, Sep 1, 2023
Aids Education and Prevention, Dec 1, 2017
Social Science & Medicine, Jul 1, 2018
Culture, Health & Sexuality, Nov 13, 2018
7th Biennial National Conference on Health and Domestic Violence, Mar 21, 2015
Global qualitative nursing research, 2017
Social Science Research Network, 2019
Journal of Interpersonal Violence, Sep 8, 2021
Journal of American College Health, Jul 9, 2021
Violence Against Women, Jun 17, 2021
AIDS, Oct 8, 2020
Objectives:In high-income countries, hazardous alcohol use is associated with reduced receipt of ... more Objectives:In high-income countries, hazardous alcohol use is associated with reduced receipt of antiretroviral therapy (ART) and viral suppression among people living with HIV (PLHIV) who inject drugs. These associations are less understood in lower middle-income countries (LMIC) and upper middle-income countries.Design:We examined associations between hazardous alcohol use, ART receipt, and viral suppression among PLHIV who reported current or former injection drug use. Participants were from nine studies in the United States (high-income country), India (LMIC), Russia (upper middle-income country), and Vietnam (LMIC).Methods:Hazardous alcohol use was measured via Alcohol Use Disorders Identification Test. Outcomes were HIV viral suppression (viral load of <1000 RNA copies/ml) and self-reported ART receipt. Logistic regression assessed associations between hazardous alcohol use and both outcome variables, controlling for age and sex, among participants with current and former injection drug use.Results:Among 2790 participants, 16% were women, mean age was 37.1 ± 9.5 years. Mean Alcohol Use Disorders Identification Test scores were 4.6 ± 8.1 (women) and 6.2 ± 8.3 (men); 42% reported ART receipt; 40% had viral suppression. Hazardous alcohol use was significantly associated with reduced ART receipt in India (adjusted odds ratio = 0.59, 95% confidence interval: 0.45–0.77, P < 0.001); and lower rates of viral suppression in Vietnam (adjusted odds ratio = 0.51, 95% confidence interval: 0.31–0.82, P = 0.006).Conclusion:Associations between hazardous alcohol use, ART receipt, and viral suppression varied across settings and were strongest in LMICs. Addressing hazardous alcohol use holds promise for improving HIV continuum of care outcomes among PLHIV who inject drugs. Specific impact and intervention needs may differ by setting.
Addiction, Sep 15, 2020
Background:Harmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Afric... more Background:Harmful alcohol use is a leading cause of morbidity and mortality in sub-Saharan Africa (sSA); however, the effects of non-pharmacological alcohol interventions in this region are unknown.Design:A systematic review and meta-analysis of the available literature through March 14, 2019 was undertaken. Two authors extracted and reconciled relevant data and assessed risk of bias. Meta-analyses were conducted. The review protocol is registered on PROSPERO (CRD42019094509).Setting:Studies conducted in sSA were eligible for inclusion.Participants:Individuals participating in interventions aimed at reducing alcohol use.Interventions:Randomized and non-randomized controlled trials testing non-pharmacological interventions (psychosocial and structural) on alcohol consumption in sSA.Measurements:Eligible outcomes included the Alcohol Use Disorders Identification Test (AUDIT) scores; alcohol abstinence; measures of drinking quantity and frequency; and biomarkers of alcohol consumption.Findings:Nineteen intervention trials (18 scientific manuscripts) testing psychosocial interventions (no structural intervention included), judged of moderate quality, were included in meta-analyses. A beneficial effect was identified for psychosocial interventions on alcohol abstinence at 3–6 months (OR=2.05, 95% CI=1.20–3.48, k=5, n=2,312, I2 = 79%) and 12–60 months (OR=1.91, 95% CI=1.40–2.61, k=6, n=2,737, I2 = 63%) follow-up. There were no statistically significant effects found for AUDIT score (2–3 month: MD= −1.13, 95% CI: −2.60–0.34, k=6, n=992, I2=85%; 6 month: MD= −0.83, 95% CI= −1.92–0.26, k=6, n=1081, I2=69%; 12 month: MD= −0.15, 95% CI = −1.66–1.36, k=4; n=677; I2 = 75%), drinks per drinking day (3 months: MD: −0.22, 95% CI = −2.51–2.07, k=2, n=359, I2=82%; 6–36 months: MD= −0.09, 95% CI= −0.49–0.30, k=3, n=1450, I2=60%), or percent drinking days (3 months: MD= −4.60, 95%= −21.14–11.94; k=2; n=361; I2 = 90%; 6–9 months: MD=1.96, 95% CI= −6.54–10.46; k=2; n=818; I2 = 88%).Conclusion:Psychosocial interventions show promise at increasing self-reported alcohol abstinence in sSA, but clinical, methodological, and statistical heterogeneity across meta-analytic outcomes suggests results should be interpreted with caution.
Journal of Acquired Immune Deficiency Syndromes, Aug 15, 2021
Background:Mediated and moderated processes that lead to intervention efficacy may underlie resul... more Background:Mediated and moderated processes that lead to intervention efficacy may underlie results of trials ruled as non- efficacious. The overall purpose of this study was to examine such processes to explain the findings of one of the largest, rigorously conducted behavioral intervention randomized controlled trials, EXPLORE.Methods:4,295 HIV-negative MSM in the U.S. were randomized in a two-armed trial. Participants completed follow-up and an HIV test every 6 months up to 48-months. We used multiple and causal mediation analysis to test five mediators, including safer sex self-efficacy and condomless receptive anal sex with HIV-positive or status unknown partners on our primary outcome (HIV seroconversion). We also examined whether intervention effects on the mediators would be moderated by robust correlates of HIV among MSM, including stimulant use.Results:There were significant effects of the intervention on all hypothesized mediators. Stimulant use moderated the effect on condomless receptive anal sex. In stratified, multiple mediation models we found that among MSM with low stimulant use, the intervention significantly prevented HIV by reducing condomless receptive anal sex with HIV- positive or status unknown partners. Among MSM with higher stimulant use, there were no indirect effects of the intervention on HIV through any of the hypothesized mediators.Conclusion:The results suggest that the null effect found in the original EXPLORE trial might have occurred as a function of previously unexplored mediated and moderated processes. This study illustrates the value of testing mediated and moderated pathways in randomized trials, even in trials ruled as non-efficacious.
Drug and Alcohol Dependence, Nov 1, 2021
Aids Care-psychological and Socio-medical Aspects of Aids/hiv, May 11, 2023
Journal of School Violence, Oct 6, 2022