Kenneth A Freedberg
Dados Biográficos
| ID | 5536038 |
|---|---|
| NOME | Kenneth A Freedberg |
| PRENOMES | Kenneth A |
| SOBRENOME | Freedberg |
| ASSINATURA | FREEDBERG K A |
| AFILIAÇÕES | Harvard University |
| ORCID | 0000-0001-6471-7930 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 25 |
| TOTAL DE CITAÇÕES | 2 |
| TOTAL COMO AUTOR | 25 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1994 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2024 |
| ÍNDICE H | 1 |
The impact of tobacco smoking and smoking cessation on lung cancer and stroke incidence among people with HIV on antiretroviral therapy in South Africa
INTRODUCTION: With declining HIV-related mortality, over 20% of people with HIV (PWH) in South Africa are now over age 50 years, and tobacco-related non-communicable disease burden is increasing. We quantified the impact of smoking and smoking cessation on lung cancer and stroke incidence among PWH in South Africa. METHODS: Using a microsimulation model, we simulated 18 cohorts of initially virologically suppressed PWH over their lifetime, catego…
HIV-related stigma and psychological distress in a cohort of patients receiving antiretroviral therapy in Nigeria
Psychological distress is increasingly recognized as a barrier to engagement in HIV care, resulting in poor HIV outcomes. HIV-related stigma is a potential driver of distress in people living with HIV (PLWH). We conducted a prospective cohort study in 288 PLWH who newly initiated ART in a Nigeria. We assessed overall stigma (range 40–160) and four stigma subtypes (personalized, disclosure, negative self-image, and public stigma) at enrollment, an…
Projected Life Expectancy for Adolescents With HIV in the US
This adolescent-focused microsimulation modeling analysis projected that youth with HIV would have shorter life expectancy than youth without HIV. Projected differences were larger for youth with NPHIV compared with youth with PHIV. Differences in mortality by sex at birth, sexual behavior, and injection drug use contributed to lower projected life expectancy among youth with NPHIV. Interventions focused on HIV care and social factors are needed …
Public Health Impact of FDA’s Request for Additional Safety Data on Cytisine for Tobacco Cessation
Smoking cessation generates large gains in life expectancy. This mathematical model demonstrated that immediate cytisine availability, even if used successfully by only a small fraction of people who smoke, could produce major public health benefits. Given the need for new tobacco cessation pharmacotherapy options, the magnitude of cytisine's potential public health benefits, and the morbidity and mortality associated with delay in its availabili…
Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil
Targeting PrEP to young MSM and minimizing discontinuation could substantially increase PrEP's impact
Modeling Adherence Interventions Among Youth with HIV in the United States
The Adolescent Medicine Trials Network for HIV/AIDS Interventions is evaluating treatment adherence interventions (AI) to improve virologic suppression (VS) among youth with HIV (YWH). Using a microsimulation model, we compared two strategies: standard-of-care (SOC) and a hypothetical 12-month AI that increased cohort-level VS in YWH in care by an absolute ten percentage points and cost $100/month/person. Projected outcomes included primary HIV t…
Cure” Versus “Clinical Remission”
HIV testing in a large community health center serving a multi-cultural patient population
In the United States, 15% of HIV-positive individuals do not know their HIV serostatus. While CDC guidelines recommend HIV testing for individuals age 13-64 years, racial and ethnic minorities continue to experience delays in HIV diagnosis. We assessed providers' perspectives on HIV testing at an urban community health center serving racial/ethnic minority populations of low socioeconomic status. We conducted five focus groups from January 2017 t…
Cost-effectiveness of integrating buprenorphine-naloxone treatment for opioid use disorder into clinical care for persons with HIV/hepatitis C co-infection who inject opioids
Foreign-born status as a predictor of engagement in HIV care in a large US metropolitan health system
We sought to determine the linkage to and retention in HIV care after HIV diagnosis in foreign-born compared with US-born individuals. From a clinical data registry, we identified 619 patients aged ≥18 years with a new HIV diagnosis between 2000 and 2012. Timely linkage to care was the proportion of patients with an ICD-9 code for HIV infection (V08 or 042) associated with a primary care or infectious disease physician within 90 days of the index…
Clinical outcomes of HIV care delivery models in the US
Finding HIV in Hard to Reach Populations
The Lifetime Medical Cost Savings From Preventing HIV in the United States
OBJECTIVE: Enhanced HIV prevention interventions, such as preexposure prophylaxis for high-risk individuals, require substantial investments. We sought to estimate the medical cost saved by averting 1 HIV infection in the United States. METHODS: We estimated lifetime medical costs in persons with and without HIV to determine the cost saved by preventing 1 HIV infection. We used a computer simulation model of HIV disease and treatment (CEPAC) to p…
Depressive Symptoms and Their Impact on Health-seeking Behaviors in Newly-diagnosed HIV-infected Patients in Durban, South Africa
Late diagnosis of HIV infection at two academic medical centers
Over the last decade, there has been increased attention to the role of earlier HIV testing in the United States. Our objective was to determine if this has translated into changes in the proportion of inpatients with advanced disease at the time of initial HIV diagnosis. We identified inpatients discharged with a new diagnosis of HIV infection or AIDS between 1994 and 2004 at two academic medical centers. We examined trends in initial CD4 count …
Late presentation for HIV care in central Haiti
OBJECTIVE: Many patients with HIV infection present for care late in the course of their disease, a factor which is associated with poor prognosis. Our objective was to identify factors associated with late presentation for HIV care among patients in central Haiti. METHODS/DESIGN: Thirty-one HIV-positive adults, approximately 10% of the HIV-infected population followed at a central Haiti hospital, participated in this research study. A two-part r…
Variations in Self-Rated Health Among Patients with HIV Infection
Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison
Assessing the Impact of Federal HIV Prevention Spending on HIV Testing and Awareness
Objectives. The United States allocates more than $900 million annually for the prevention of HIV infection. We assessed the impact of this funding on HIV testing and knowledge. Methods. We linked data from the Behavioral Risk Factor Surveillance System with tracking of Centers for Disease Control and Prevention (CDC) HIV prevention funding. We developed and validated regression models of the relation between HIV prevention funding to a responden…
The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States
OBJECTIVE: We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. METHODS: Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not avai…
Effective HIV Case Identification Through Routine HIV Screening at Urgent Care Centers in Massachusetts
Think HIV offered HIV counseling, testing, and referral to patients at 4 Massachusetts urgent care centers from January to September 2002. We compared the positive diagnosis yield of Think HIV with that of state-funded HIV counseling, testing, and referral sites. Think HIV found an HIV prevalence of 2.0% compared with 1.9% identified by self-referral testing. Urgent care center–based routine HIV counseling, testing, and referral programs are feas…
Validity and responsiveness of the EuroQol as a measure of health-related quality of life in people enrolled in an Aids clinical trial
State Aids Drug Assistance Programs
BACKGROUND: The 54 state AIDS Drug Assistance Programs (ADAP) provide medications to HIV-infected persons with limited resources. Eligibility and coverage vary, raising concerns about health inequities. OBJECTIVE: To compare the relative clinical and economic performance of ADAP programs. RESEARCH DESIGN: A state-transition simulation model of HIV disease was used to explore the clinical consequences and lifetime costs associated with selected st…
Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults
Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and …
Screening for childhood lead poisoning
Decision analysis was used to compare the costs of three screening strategies for childhood lead poisoning: (1) venipuncture; (2) capillary sample with venipuncture confirmation if the blood lead level is elevated; (3) stratification by risk, with venipuncture for high-risk children and capillary sample for low-risk children. Under baseline conditions, the cost of screening by the venipuncture, stratification, and capillary strategies is $22, $25…
Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison
Assessing the Impact of Federal HIV Prevention Spending on HIV Testing and Awareness
Objectives. The United States allocates more than $900 million annually for the prevention of HIV infection. We assessed the impact of this funding on HIV testing and knowledge. Methods. We linked data from the Behavioral Risk Factor Surveillance System with tracking of Centers for Disease Control and Prevention (CDC) HIV prevention funding. We developed and validated regression models of the relation between HIV prevention funding to a responden…
Screening for childhood lead poisoning
Decision analysis was used to compare the costs of three screening strategies for childhood lead poisoning: (1) venipuncture; (2) capillary sample with venipuncture confirmation if the blood lead level is elevated; (3) stratification by risk, with venipuncture for high-risk children and capillary sample for low-risk children. Under baseline conditions, the cost of screening by the venipuncture, stratification, and capillary strategies is $22, $25…
Cost-Effectiveness of Earlier Initiation of Antiretroviral Therapy for Uninsured HIV-Infected Adults
Objectives. This study was designed to examine the societal cost-effectiveness and the impact on government payers of earlier initiation of antiretroviral therapy for uninsured HIV-infected adults. Methods. A state-transition simulation model of HIV disease was used. Data were derived from the Multicenter AIDS Cohort Study, published randomized trials, and medical care cost estimates for all government payers and for Massachusetts, New York, and …
Validity and responsiveness of the EuroQol as a measure of health-related quality of life in people enrolled in an Aids clinical trial
State Aids Drug Assistance Programs
BACKGROUND: The 54 state AIDS Drug Assistance Programs (ADAP) provide medications to HIV-infected persons with limited resources. Eligibility and coverage vary, raising concerns about health inequities. OBJECTIVE: To compare the relative clinical and economic performance of ADAP programs. RESEARCH DESIGN: A state-transition simulation model of HIV disease was used to explore the clinical consequences and lifetime costs associated with selected st…
Effective HIV Case Identification Through Routine HIV Screening at Urgent Care Centers in Massachusetts
Think HIV offered HIV counseling, testing, and referral to patients at 4 Massachusetts urgent care centers from January to September 2002. We compared the positive diagnosis yield of Think HIV with that of state-funded HIV counseling, testing, and referral sites. Think HIV found an HIV prevalence of 2.0% compared with 1.9% identified by self-referral testing. Urgent care center–based routine HIV counseling, testing, and referral programs are feas…
Variations in Self-Rated Health Among Patients with HIV Infection
Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison
Assessing the Impact of Federal HIV Prevention Spending on HIV Testing and Awareness
Objectives. The United States allocates more than $900 million annually for the prevention of HIV infection. We assessed the impact of this funding on HIV testing and knowledge. Methods. We linked data from the Behavioral Risk Factor Surveillance System with tracking of Centers for Disease Control and Prevention (CDC) HIV prevention funding. We developed and validated regression models of the relation between HIV prevention funding to a responden…
The Lifetime Cost of Current Human Immunodeficiency Virus Care in the United States
OBJECTIVE: We sought to project the lifetime cost of medical care for human immunodefiency virus (HIV)-infected adults using current antiretroviral therapy (ART) standards. METHODS: Medical visits and hospitalizations for any reason were from the HIV Research Network, a consortium of high-volume HIV primary care sites. HIV treatment drug regimen efficacies were from clinical guidelines and published sources; data on other drugs used were not avai…
Late presentation for HIV care in central Haiti
OBJECTIVE: Many patients with HIV infection present for care late in the course of their disease, a factor which is associated with poor prognosis. Our objective was to identify factors associated with late presentation for HIV care among patients in central Haiti. METHODS/DESIGN: Thirty-one HIV-positive adults, approximately 10% of the HIV-infected population followed at a central Haiti hospital, participated in this research study. A two-part r…
Late diagnosis of HIV infection at two academic medical centers
Over the last decade, there has been increased attention to the role of earlier HIV testing in the United States. Our objective was to determine if this has translated into changes in the proportion of inpatients with advanced disease at the time of initial HIV diagnosis. We identified inpatients discharged with a new diagnosis of HIV infection or AIDS between 1994 and 2004 at two academic medical centers. We examined trends in initial CD4 count …
Depressive Symptoms and Their Impact on Health-seeking Behaviors in Newly-diagnosed HIV-infected Patients in Durban, South Africa
Finding HIV in Hard to Reach Populations
The Lifetime Medical Cost Savings From Preventing HIV in the United States
OBJECTIVE: Enhanced HIV prevention interventions, such as preexposure prophylaxis for high-risk individuals, require substantial investments. We sought to estimate the medical cost saved by averting 1 HIV infection in the United States. METHODS: We estimated lifetime medical costs in persons with and without HIV to determine the cost saved by preventing 1 HIV infection. We used a computer simulation model of HIV disease and treatment (CEPAC) to p…
Clinical outcomes of HIV care delivery models in the US
Foreign-born status as a predictor of engagement in HIV care in a large US metropolitan health system
We sought to determine the linkage to and retention in HIV care after HIV diagnosis in foreign-born compared with US-born individuals. From a clinical data registry, we identified 619 patients aged ≥18 years with a new HIV diagnosis between 2000 and 2012. Timely linkage to care was the proportion of patients with an ICD-9 code for HIV infection (V08 or 042) associated with a primary care or infectious disease physician within 90 days of the index…
HIV testing in a large community health center serving a multi-cultural patient population
In the United States, 15% of HIV-positive individuals do not know their HIV serostatus. While CDC guidelines recommend HIV testing for individuals age 13-64 years, racial and ethnic minorities continue to experience delays in HIV diagnosis. We assessed providers' perspectives on HIV testing at an urban community health center serving racial/ethnic minority populations of low socioeconomic status. We conducted five focus groups from January 2017 t…
Cost-effectiveness of integrating buprenorphine-naloxone treatment for opioid use disorder into clinical care for persons with HIV/hepatitis C co-infection who inject opioids
Cure” Versus “Clinical Remission”
Modeling Adherence Interventions Among Youth with HIV in the United States
The Adolescent Medicine Trials Network for HIV/AIDS Interventions is evaluating treatment adherence interventions (AI) to improve virologic suppression (VS) among youth with HIV (YWH). Using a microsimulation model, we compared two strategies: standard-of-care (SOC) and a hypothetical 12-month AI that increased cohort-level VS in YWH in care by an absolute ten percentage points and cost $100/month/person. Projected outcomes included primary HIV t…
Impact of pre-exposure prophylaxis uptake among gay, bisexual, and other men who have sex with men in urban centers in Brazil
Targeting PrEP to young MSM and minimizing discontinuation could substantially increase PrEP's impact
The impact of tobacco smoking and smoking cessation on lung cancer and stroke incidence among people with HIV on antiretroviral therapy in South Africa
INTRODUCTION: With declining HIV-related mortality, over 20% of people with HIV (PWH) in South Africa are now over age 50 years, and tobacco-related non-communicable disease burden is increasing. We quantified the impact of smoking and smoking cessation on lung cancer and stroke incidence among PWH in South Africa. METHODS: Using a microsimulation model, we simulated 18 cohorts of initially virologically suppressed PWH over their lifetime, catego…
HIV-related stigma and psychological distress in a cohort of patients receiving antiretroviral therapy in Nigeria
Psychological distress is increasingly recognized as a barrier to engagement in HIV care, resulting in poor HIV outcomes. HIV-related stigma is a potential driver of distress in people living with HIV (PLWH). We conducted a prospective cohort study in 288 PLWH who newly initiated ART in a Nigeria. We assessed overall stigma (range 40–160) and four stigma subtypes (personalized, disclosure, negative self-image, and public stigma) at enrollment, an…
Projected Life Expectancy for Adolescents With HIV in the US
This adolescent-focused microsimulation modeling analysis projected that youth with HIV would have shorter life expectancy than youth without HIV. Projected differences were larger for youth with NPHIV compared with youth with PHIV. Differences in mortality by sex at birth, sexual behavior, and injection drug use contributed to lower projected life expectancy among youth with NPHIV. Interventions focused on HIV care and social factors are needed …
Public Health Impact of FDA’s Request for Additional Safety Data on Cytisine for Tobacco Cessation
Smoking cessation generates large gains in life expectancy. This mathematical model demonstrated that immediate cytisine availability, even if used successfully by only a small fraction of people who smoke, could produce major public health benefits. Given the need for new tobacco cessation pharmacotherapy options, the magnitude of cytisine's potential public health benefits, and the morbidity and mortality associated with delay in its availabili…
Medicine (24 obras) · HIV/AIDS Research and Interventions (20 obras) · Environmental health (14 obras) · Family medicine (13 obras) · Internal Medicine (12 obras) · Population (9 obras) · HIV, Drug Use, Sexual Risk (8 obras) · HIV/AIDS drug development and treatment (8 obras) · Human immunodeficiency virus (HIV (8 obras) · Demography (7 obras)