Chelsea L Shover
Biographic Data
| ID | 5158295 |
|---|---|
| NAME | Chelsea L Shover |
| GIVEN NAMES | Chelsea L |
| FAMILY NAME | Shover |
| SIGNATURE | SHOVER C L |
| AFFILIATIONS | University of California, Los Angeles |
| ORCID | 0000-0002-0728-4101 |
| VERIFIED | Yes |
| TOTAL WORKS | 17 |
| TOTAL CITATIONS | 7 |
| AUTHOR COUNT | 17 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2017 |
| LATEST PUBLICATION YEAR | 2026 |
| H-INDEX | 2 |
What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles
Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis gro…
US overdose mortality saw first drop below the Jalal-Burke exponential growth curve in 2024
BACKGROUND: Between 1979 and 2016, US overdose death rates rose in a smooth fashion, described by Jalal and Burke using an exponential growth curve that fit observed data nearly perfectly. Fluctuations above this curve have subsequently been seen during shocks related to drug supply and the COVID-19 pandemic. However, large-magnitude dips below the curve have never been demonstrated. Given that overdose mortality began sharply falling during 2023…
Policy recommendations for overdose response hotlines and applications as a harm reduction tool
To enhance the effectiveness and sustainability of overdose response technologies, a comprehensive policy or standards framework is needed. This includes guidance on data privacy, service equity, public education, capacity-building, and outcome evaluation, laying the groundwork for safer, scalable, and more accessible overdose prevention interventions
Leveraging pooled medical examiner records to surveil complex and emerging patterns of polysubstance use in the United States
Exploring potential underestimates in fatal overdose mortality across major metropolitan areas in Mexico between 2005 and 2019
In Mexico, low numbers of overdose deaths reported by government agencies, coupled with evidence of increased substance use in certain regions, suggest underreporting of overdose mortality. We explore the potential miscoding and underreporting of overdose deaths. We assembled a mortality dataset using a combination of publicly available data and systematic freedom of information requests to Mexican state jurisdictions. Using data from post-mortem…
High variation in purity of consumer-level illicit fentanyl samples in Los Angeles, September 2023–April 2025
We found high variation in IMF purity among samples sold as fentanyl, even among samples obtained on the same day, in the same location. This volatility likely plays a role in high overdose risk, even among people with opioid tolerance, in the fentanyl era. Further research is needed to compare these findings to other locations across the United States
Decreasing Stigma Toward People Who Inject Drugs
Covid-19 public health data reporting and homelessness
Data on COVID-19 among people experiencing homelessness has been extremely limited, despite known unique risks faced by this population. Gaps in data collection, monitoring, and reporting across multiple systems and government levels create challenges to understanding how COVID-19 is impacting people experiencing homelessness. This article examines these challenges and gaps in public health data on homelessness, presents examples of best practice…
A Covid-19 Vaccination Program to Promote Uptake and Equity for People Experiencing Homelessness in Los Angeles County
People experiencing homelessness (PEH) have been disproportionately affected by COVID-19, yet their vaccination coverage is lower than is that of the general population. We implemented a COVID-19 vaccination program that used evidence-based and culturally tailored approaches to promote vaccine uptake and equity for PEH in Los Angeles County, California. From February 2021 through February 2022, 33 977 doses of vaccine were administered at 2658 cl…
Responding to the opioid crisis in North America and beyond
Long-Acting Injectable Therapy for People with HIV
Long-acting injectable antiretroviral medications are new to HIV treatment. People with HIV may benefit from a treatment option that better aligns with their preferences, but could also face new challenges and barriers. Authors from the fields of HIV, substance use treatment, and mental health collaborated on this commentary on the issues surrounding equitable implementation and uptake of LAI ART by drawing lessons from all three fields. We emplo…
Covid-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County
Unhoused people have higher COVID-19 mortality and lower vaccine uptake than housed community members. Understanding vaccine hesitancy among unhoused people is key for developing programs that address their unique needs. A three-round, rapid, field-based survey was conducted to describe attitudes toward COVID-19 vaccination. Round 1 assessed vaccine brand preference, round 2 assessed intention to accept a financial incentive for vaccination, and …
Age at first HIV test for MSM at a community health clinic in Los Angeles
Young MSM, especially ethnic and racial minority young MSM, bear a disproportionate burden of new HIV infections. This group also has the highest rates of undiagnosed infection and lowest rates of viral suppression. Previous research indicates that young MSM are testing for HIV too late, which may explain why rates of new HIV infection are rising in young Hispanic MSM and not falling in young Black and White MSM despite advances in preventive med…
Mind the gaps
HIV Preexposure Prophylaxis Initiation at a Large Community Clinic
Objectives. To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk. Methods. We conducted a cross-sectional study of 19 587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and Februar…
Using Sexual Orientation and Gender Identity to Monitor Disparities in HIV, Sexually Transmitted Infections, and Viral Hepatitis
Objectives. To quantify sexual orientation and gender identity (SOGI) disparities in incidence of HIV, other sexually transmitted infections (STIs), and viral hepatitis. Methods. We performed a records-based study of 19 933 patients visiting a federally qualified health center in Los Angeles, California, between November 2016 and October 2017 that examined HIV, STIs, and viral hepatitis incidence proportions. We created multivariable logistic reg…
Are Partner Race and Intimate Partner Violence Associated with Incident and Newly Diagnosed HIV Infection in African-American Men Who Have Sex with Men
Using Sexual Orientation and Gender Identity to Monitor Disparities in HIV, Sexually Transmitted Infections, and Viral Hepatitis
Objectives. To quantify sexual orientation and gender identity (SOGI) disparities in incidence of HIV, other sexually transmitted infections (STIs), and viral hepatitis. Methods. We performed a records-based study of 19 933 patients visiting a federally qualified health center in Los Angeles, California, between November 2016 and October 2017 that examined HIV, STIs, and viral hepatitis incidence proportions. We created multivariable logistic reg…
Are Partner Race and Intimate Partner Violence Associated with Incident and Newly Diagnosed HIV Infection in African-American Men Who Have Sex with Men
Covid-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County
Unhoused people have higher COVID-19 mortality and lower vaccine uptake than housed community members. Understanding vaccine hesitancy among unhoused people is key for developing programs that address their unique needs. A three-round, rapid, field-based survey was conducted to describe attitudes toward COVID-19 vaccination. Round 1 assessed vaccine brand preference, round 2 assessed intention to accept a financial incentive for vaccination, and …
HIV Preexposure Prophylaxis Initiation at a Large Community Clinic
Objectives. To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk. Methods. We conducted a cross-sectional study of 19 587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and Februar…
Are Partner Race and Intimate Partner Violence Associated with Incident and Newly Diagnosed HIV Infection in African-American Men Who Have Sex with Men
HIV Preexposure Prophylaxis Initiation at a Large Community Clinic
Objectives. To characterize uptake of HIV preexposure prophylaxis (PrEP) in a community setting and to identify disparities in PrEP use by demographic and behavioral factors associated with increased HIV risk. Methods. We conducted a cross-sectional study of 19 587 men who have sex with men and transgender people visiting a Los Angeles, California, clinic specializing in lesbian, gay, bisexual, and transgender care between August 2015 and Februar…
Using Sexual Orientation and Gender Identity to Monitor Disparities in HIV, Sexually Transmitted Infections, and Viral Hepatitis
Objectives. To quantify sexual orientation and gender identity (SOGI) disparities in incidence of HIV, other sexually transmitted infections (STIs), and viral hepatitis. Methods. We performed a records-based study of 19 933 patients visiting a federally qualified health center in Los Angeles, California, between November 2016 and October 2017 that examined HIV, STIs, and viral hepatitis incidence proportions. We created multivariable logistic reg…
Mind the gaps
Age at first HIV test for MSM at a community health clinic in Los Angeles
Young MSM, especially ethnic and racial minority young MSM, bear a disproportionate burden of new HIV infections. This group also has the highest rates of undiagnosed infection and lowest rates of viral suppression. Previous research indicates that young MSM are testing for HIV too late, which may explain why rates of new HIV infection are rising in young Hispanic MSM and not falling in young Black and White MSM despite advances in preventive med…
Responding to the opioid crisis in North America and beyond
Long-Acting Injectable Therapy for People with HIV
Long-acting injectable antiretroviral medications are new to HIV treatment. People with HIV may benefit from a treatment option that better aligns with their preferences, but could also face new challenges and barriers. Authors from the fields of HIV, substance use treatment, and mental health collaborated on this commentary on the issues surrounding equitable implementation and uptake of LAI ART by drawing lessons from all three fields. We emplo…
Covid-19 Vaccine Acceptability and Financial Incentives among Unhoused People in Los Angeles County
Unhoused people have higher COVID-19 mortality and lower vaccine uptake than housed community members. Understanding vaccine hesitancy among unhoused people is key for developing programs that address their unique needs. A three-round, rapid, field-based survey was conducted to describe attitudes toward COVID-19 vaccination. Round 1 assessed vaccine brand preference, round 2 assessed intention to accept a financial incentive for vaccination, and …
A Covid-19 Vaccination Program to Promote Uptake and Equity for People Experiencing Homelessness in Los Angeles County
People experiencing homelessness (PEH) have been disproportionately affected by COVID-19, yet their vaccination coverage is lower than is that of the general population. We implemented a COVID-19 vaccination program that used evidence-based and culturally tailored approaches to promote vaccine uptake and equity for PEH in Los Angeles County, California. From February 2021 through February 2022, 33 977 doses of vaccine were administered at 2658 cl…
Decreasing Stigma Toward People Who Inject Drugs
Covid-19 public health data reporting and homelessness
Data on COVID-19 among people experiencing homelessness has been extremely limited, despite known unique risks faced by this population. Gaps in data collection, monitoring, and reporting across multiple systems and government levels create challenges to understanding how COVID-19 is impacting people experiencing homelessness. This article examines these challenges and gaps in public health data on homelessness, presents examples of best practice…
Leveraging pooled medical examiner records to surveil complex and emerging patterns of polysubstance use in the United States
Exploring potential underestimates in fatal overdose mortality across major metropolitan areas in Mexico between 2005 and 2019
In Mexico, low numbers of overdose deaths reported by government agencies, coupled with evidence of increased substance use in certain regions, suggest underreporting of overdose mortality. We explore the potential miscoding and underreporting of overdose deaths. We assembled a mortality dataset using a combination of publicly available data and systematic freedom of information requests to Mexican state jurisdictions. Using data from post-mortem…
High variation in purity of consumer-level illicit fentanyl samples in Los Angeles, September 2023–April 2025
We found high variation in IMF purity among samples sold as fentanyl, even among samples obtained on the same day, in the same location. This volatility likely plays a role in high overdose risk, even among people with opioid tolerance, in the fentanyl era. Further research is needed to compare these findings to other locations across the United States
What does 'polysubstance' really mean? Comparing drug-involved deaths in CDC records vs. detailed medical examiner data from Los Angeles
Although concordance is high for single-substance involvement rates, CDC WONDER fails to capture the majority of polysubstance deaths adequately, as about three-quarters of these deaths are incompletely described using its 2-drug limit. This limitation has worsened as deaths increasingly involve more drugs on average. We illustrate a huge variety of polysubstance combinations that can be seen in medical examiner deaths. As the overdose crisis gro…
US overdose mortality saw first drop below the Jalal-Burke exponential growth curve in 2024
BACKGROUND: Between 1979 and 2016, US overdose death rates rose in a smooth fashion, described by Jalal and Burke using an exponential growth curve that fit observed data nearly perfectly. Fluctuations above this curve have subsequently been seen during shocks related to drug supply and the COVID-19 pandemic. However, large-magnitude dips below the curve have never been demonstrated. Given that overdose mortality began sharply falling during 2023…
Policy recommendations for overdose response hotlines and applications as a harm reduction tool
To enhance the effectiveness and sustainability of overdose response technologies, a comprehensive policy or standards framework is needed. This includes guidance on data privacy, service equity, public education, capacity-building, and outcome evaluation, laying the groundwork for safer, scalable, and more accessible overdose prevention interventions
Medicine (11 works) · Opioid Use Disorder Treatment (8 works) · HIV, Drug Use, Sexual Risk (7 works) · Public health (7 works) · HIV/AIDS Research and Interventions (6 works) · Psychology (6 works) · Family medicine (5 works) · Demography (4 works) · Environmental health (4 works) · Internal Medicine (4 works)