Abstract:
IMPORTANCE:Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. OBJECTIVE:To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. DESIGN & PARTICIPANTS:Longitudinal study of 1,235 HIV infected and 508 uninfected women of the Women's Interagency HIV Study (WIHS) cohort, from New York City, NY, Chicago, IL, Washington D.C., and San Francisco, CA, 1994-2012. MAIN MEASURES:Primary exposures are sexual identity (heterosexual, bisexual, lesbian/gay) and sexual behavior (male, female, or male & female partners). Primary outcomes are sexual abuse, intimate partner violence (IPV) and physical violence; high-risk sex and substance use were examined as mediators. KEY RESULTS:Bisexual women were at increased odds for sexual abuse [aOR 1.56 (1.00, 2.44)], IPV [aOR 1.50 (1.08, 2.09)], and physical violence [aOR 1.77 (1.33, 2.37)] compared to heterosexual women. In a separate analysis, women who reported sex with men and women (WSMW) had increased odds for sexual abuse [aOR 1.65 (0.99, 2.77], IPV [aOR 1.50 (1.09, 2.06)] and physical violence [aOR 2.24 (1.69, 2.98)] compared to women having sex only with men (WSM). Using indirect effects, multiple sex partners, cocaine and marijuana were significant mediators for most forms of abuse. Transactional sex was only a mediator for bisexual women. Women who reported sex only with women (WSW) had lower odds of sexual abuse [aOR 0.23 (0.06, 0.89)] and physical violence [aOR 0.42 (0.21, 0.85)] compared to WSM. CONCLUSIONS:Women who identify as bisexual or report both male and female sex partners are most vulnerable to violence; multiple recent sex partners, transactional sex and some types of substance use mediate this relationship. Acknowledging sexual identity and behavior, while addressing substance use and high-risk sex in clinical and psychosocial settings, may help reduce violence exposure among women with and at-risk for HIV.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Pyra M,Weber K,Wilson TE,Cohen J,Murchison L,Goparaju L,Cohen MHdoi
10.1007/s11606-014-2832-ysubject
Has Abstractpub_date
2014-08-01 00:00:00pages
1131-8issue
8eissn
0884-8734issn
1525-1497journal_volume
29pub_type
杂志文章,多中心研究abstract:OBJECTIVES:We examined the presence and correlates of Black/White racial disparities in adherence to guidelines for colorectal cancer screening (CRCS). METHODS:The sample included 328 Black and 1827 White patients age 50-75 from 24 VA medical facilities who responded to a mailed survey with phone follow-up (response r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-010-1575-7
更新日期:2011-03-01 00:00:00
abstract:BACKGROUND:Since the 2011 Accreditation Council of Graduate Medical Education (ACGME) work hour rules for residents were implemented, 24-30 h call for interns has been replaced by shift work, including night-float. The impact of these changes on undergraduate medical education experiences in internal medicine has not b...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3405-4
更新日期:2015-09-01 00:00:00
abstract:BACKGROUND:Fluid resuscitation is a widely used intervention that is mandated in the management of sepsis. While its use can be life-saving, its overuse is associated with harm. Despite this, the best means of assessing a need for fluid resuscitation in an acute medical setting is unclear. OBJECTIVE:To assess studies ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05073-9
更新日期:2019-09-01 00:00:00
abstract:BACKGROUND:Disparities can be caused by minorities receiving care in low-quality settings. The patient-centered medical home (PCMH) has been identified as a model of high-quality primary care that can eliminate disparities. However, Latinos are less likely to have PCMHs. OBJECTIVE:To identify Latino subgroup variation...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1119-1
更新日期:2009-11-01 00:00:00
abstract::Decision analysis is a tool that clinicians can use to choose an option that maximizes the overall net benefit to a patient. It is an explicit, quantitative, and systematic approach to decision making under conditions of uncertainty. In this article, we present two teaching tips aimed at helping clinical learners unde...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0918-8
更新日期:2009-05-01 00:00:00
abstract::Attempts to explain the high cost of care in teaching hospitals have yielded conflicting results. This study was conducted to compare hospital charges and lengths of stay for two groups of patients: one cared for by a resident team and the other cared for by attending physicians. The study was conducted at a universit...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02602350
更新日期:1989-03-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between gender, background, and brief training and physicians' detection of and treatment for woman abuse. DESIGN:Quasi-experimental and correlational designs, plus control for background factors. SETTING:Two residency training programs: general internal medicine and family practi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599714
更新日期:1993-11-01 00:00:00
abstract:OBJECTIVE:To study an office-based strategy for increasing influenza vaccine delivery to high-risk patients at a university hospital general medicine practice. DESIGN:Historically controlled study of physician practices in an outpatient general medicine setting. SETTING:A group practice with two separate offices: a f...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599008
更新日期:1994-12-01 00:00:00
abstract:OBJECTIVE:To examine changes in the quality of primary care experienced and reported by Medicare beneficiaries from 1998 to 2000. DESIGN:Longitudinal observational study. SETTING:Thirteen states with large, mature Medicare HMO markets. PARTICIPANTS:Probability sample of noninstitutionalized Medicare beneficiaries ag...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2004.30381.x
更新日期:2004-10-01 00:00:00
abstract::This perspective describes federal efforts in the United States (U.S.) to integrate care for an especially complex, vulnerable, and costly patient population: adults eligible for both Medicare and Medicaid insurance. The goal of the paper is to demystify for clinical policy leaders and practicing clinicians the origin...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05914-y
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:The care of patients with complex illnesses requires careful management, but systems of care management (CM) vary in their structure and effectiveness. OBJECTIVE:To create a framework identifying components of broad-based CM interventions and validate the framework, including using this framework to evaluat...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0138-z
更新日期:2007-06-01 00:00:00
abstract:OBJECTIVE:To assess a new technique for the detection of free pleural fluid. DESIGN:118 consecutive inpatients with radiologic evidence of free pleural fluid and a control group of 175 randomly selected inpatients were examined over a three-year period in a prospective blind study by auscultatory percussion (AP) for e...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02600204
更新日期:1994-02-01 00:00:00
abstract:BACKGROUND:Prevalence of unhealthy alcohol use among medical inpatients is high. OBJECTIVE:To characterize the course and outcomes of unhealthy alcohol use, and factors associated with these outcomes. DESIGN:Prospective cohort study. PARTICIPANTS:A total of 287 medical inpatients with unhealthy alcohol use. MAIN ME...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1382-1
更新日期:2010-10-01 00:00:00
abstract:BACKGROUND:Many patient education materials (PEMs) available on the internet are written at high school or college reading levels, rendering them inaccessible to the average US resident, who reads at or below an 8(th) grade level. Currently, electronic health record (EHR) providers partner with companies that produce P...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-012-2046-0
更新日期:2012-09-01 00:00:00
abstract:BACKGROUND:Few patient-centered interventions exist to improve year-end residency clinic handoffs. AIM:Our purpose was to assess the impact of a patient-centered transition packet and comic on clinic handoff outcomes. SETTING:The study was conducted at an academic medicine residency clinic. PARTICIPANTS:Participants...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-3009-4
更新日期:2015-02-01 00:00:00
abstract::Using survey items from Kern et al. (1985), 192 former residents rated their preparation in, and the importance of, three content areas of their residency training ("basic skill and knowledge areas," "allied medical disciplines," and "areas related to the practice of medicine"). Mean ratings replicated those reported ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02597402
更新日期:1989-07-01 00:00:00
abstract:BACKGROUND:As the Veterans Health Administration (VHA) reorganizes providers into the patient-centered medical home, questions remain whether this model of care can demonstrate improved patient outcomes and cost savings. OBJECTIVE:We measured adoption of medical home features by VHA primary care clinics prior to wides...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2405-5
更新日期:2013-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Patient-provider language barriers may play a role in health-care disparities, including obtaining colorectal cancer (CRC) screening. Professional interpreters and language-concordant providers may mitigate these disparities. DESIGN, SUBJECTS, AND MAIN MEASURES: We performed a retrospective coh...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1512-9
更新日期:2011-02-01 00:00:00
abstract:OBJECTIVE:In 1996, the Health Care Financing Administration (HCFA) introduced new evaluation and management (E&M) guidelines mandating more intensive supervision and documentation by attending physicians. We assessed the effects of the guidelines on inpatient teaching. DESIGN:Pretest-posttest, nonequivalent control gr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1046/j.1525-1497.2000.07001.x
更新日期:2000-07-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0234-0
更新日期:2007-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.00057.x
更新日期:1997-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:
更新日期:2001-01-01 00:00:00
abstract:OBJECTIVE:To determine time allocation and the perceived value to education and patient care of the weekday activities of internal medicine housestaff on inpatient rotations and to compare the work activities of interns and residents. DESIGN:An observational study. We classified activities along five dimensions (assoc...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00164.x
更新日期:1998-08-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3608-3
更新日期:2016-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1662-4
更新日期:2011-08-01 00:00:00
abstract:BACKGROUND:Thirty-day readmission penalties implemented with the Hospital Readmission Reduction Program (HRRP) place a larger burden on safety-net hospitals which treat a disproportionate share of racial minorities, leading to concerns that already large racial disparities in readmissions could widen. OBJECTIVE:To exa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-04841-x
更新日期:2019-06-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06569-5
更新日期:2021-01-19 00:00:00
abstract:BACKGROUND:Standardized means to identify patients likely to benefit from language assistance are needed. OBJECTIVE:To evaluate the accuracy of the U.S. Census English proficiency question (Census-LEP) in predicting patients' ability to communicate effectively in English. DESIGN:We investigated the sensitivity and sp...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0693-y
更新日期:2008-10-01 00:00:00
abstract::In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-3161-x
更新日期:2015-05-01 00:00:00
abstract:BACKGROUND:Patients who leave hospitals against medical advice (AMA) may be at risk for adverse health outcomes. Their decision to leave may not be clearly understood by providers. This study explored providers' experiences with and attitudes toward patients who leave the hospital AMA. OBJECTIVE:To explore providers' ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-008-0728-4
更新日期:2008-10-01 00:00:00