Sherry Deren

Beth Israel Medical Center, New York City, New York, United States

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Publications (105)211.84 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: For Latinas with fasting plasma glucose (FPG) levels in the prediabetes and diabetes ranges, early detection can support steps to optimize their health. Data collected in 2009-2010 indicate that 36.7% of Latinas in the United States had elevated FPG levels. Latinas with elevated FPG who were unaware of their diabetes status were significantly less likely than non-Hispanic White and non-Hispanic Black women to have seen a health care provider in the past year (75.8%, 92.9%, and 90.2%, respectively; p = .018). With almost 1 million Latinas in the United States with elevated FPG unaware of their diabetes risk, and less likely than other at-risk women to see health care providers, there is an urgent need to establish alternate sites of opportunity for their diabetes screening.
    Hispanic Health Care International 01/2014; 12(1):16-23.
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    ABSTRACT: There are now an estimated 16 million people who inject drugs (PWID) throughout the world, 3 million of whom are estimated to be infected with HIV. In many countries, substantial proportions of PWID belong to racial/ethnic/nationality minority groups, and are at increased likelihood of being infected with HIV. This article reviews current evidence on ethnic disparities in HIV infection among PWID and assesses the issues that would need to be addressed to reduce these disparities. An ongoing systematic review of ethnic disparities has found that, in a pooled weighted odds ratio, ethnic minority PWID are twice as likely to be HIV seropositive than ethnic majority, PWID from the same geographic area. If implemented with sufficient quality and coverage, current HIV prevention programs probably have the capability of ending HIV transmission among both ethnic majority and minority PWID. Large-scale, evidence-based prevention programs need to be implemented in the contexts of patterns of injecting drug use that continue to evolve-with injecting practices spreading to new areas, changes in drugs injected, and some transitions from injecting to noninjecting drug use. Lack of financial resources and policies against evidence-based programming are increasingly important problems that are likely to have particularly adverse effects on ethnic minority PWID. Racial/ethnic/nationality disparities in HIV infection are quite common among PWID. Addressing these disparities will be a fundamental challenge within a human rights approach to public health.
    Current opinion in HIV and AIDS 04/2012; 7(4):354-61. · 4.75 Impact Factor
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    ABSTRACT: To quantify the effect of opiate substitution treatment in relation to HIV transmission among people who inject drugs. Systematic review and meta-analysis of prospective published and unpublished observational studies. Search of Medline, Embase, PsychINFO, and the Cochrane Library from the earliest year to 2011 without language restriction. We selected studies that directly assessed the impact of opiate substitution treatment in relation to incidence of HIV and studies that assessed incidence of HIV in people who inject drugs and that might have collected data regarding exposure to opiate substitution treatment but not have reported it. Authors of these studies were contacted. Data were extracted by two reviewers and pooled in a meta-analysis with a random effects model. Twelve published studies that examined the impact of opiate substitution treatment on HIV transmission met criteria for inclusion, and unpublished data were obtained from three additional studies. All included studies examined methadone maintenance treatment. Data from nine of these studies could be pooled, including 819 incident HIV infections over 23 608 person years of follow-up. Opiate substitution treatment was associated with a 54% reduction in risk of HIV infection among people who inject drugs (rate ratio 0.46, 95% confidence interval 0.32 to 0.67; P<0.001). There was evidence of heterogeneity between studies (I(2)=60%, χ(2)=20.12, P=0.010), which could not be explained by geographical region, site of recruitment, or the provision of incentives. There was weak evidence for greater benefit associated with longer duration of exposure to opiate substitution treatment. Opiate substitution treatment provided as maintenance therapy is associated with a reduction in the risk of HIV infection among people who inject drugs. These findings, however, could reflect comparatively high levels of motivation to change behaviour and reduce injecting risk behaviour among people who inject drugs who are receiving opiate substitution treatment.
    BMJ (online) 01/2012; 345:e5945. · 17.22 Impact Factor
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    ABSTRACT: The need for expansion of health services provided in drug treatment programs has been widely discussed since the beginning of the HIV epidemic among drug users. Service expansion has focused on various types of services including medical services (eg, primary care) and harm-reduction services (eg, provision of sterile syringes). A staff survey was conducted in 8 methadone maintenance clinics in the New York/New Jersey area to assess attitudes toward the provision of harm reduction and other services in methadone clinics, and the relationship of these attitudes to other variables. A total of 114 staff members in 8 methadone maintenance clinics completed the survey. The majority of staff was supportive of adding services, over 90% supported medical services, and the majority supported harm-reduction services such as syringe access and disposal services. Higher education and HIV knowledge levels were significant correlates of favorable attitudes toward service provision. Support for providing harm-reduction services in methadone maintenance clinics was found. Enhancing knowledge of staff regarding various types of health services, and engaging them in how best to institute new services, should be undertaken when new services are planned.
    Journal of Addiction Medicine 12/2011; 5(4):289-92. · 1.73 Impact Factor
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    ABSTRACT: Many barriers to the use of HIV medications have been identified. Research findings have also shown a gender disparity in HIV care behaviors. However, interaction effects of gender with the potential barriers to use of HIV medications among HIV-positive minority drug users remain under-studied. This study examined interaction effects of gender with potential moderating factors (i.e., individual and network characteristics) on the use of HIV medications. Analyses were based on 260 HIV-positive Puerto Rican heroin and cocaine users, recruited in New York (N=178) and Puerto Rico (N=82) in 1998-2003. HIV status was assessed using OraSure, and heroin or cocaine use was verified by urinalysis. All participants were tested and interviewed at baseline and six-month follow-up (183 males; 77 females). In predicting use of HIV medications at follow-up (HIVMEDF), use of HIV medications at baseline (HIVMED), individual characteristics (e.g., depression), network characteristics (e.g., having an intravenous drug user [IDU] sex partner), recruitment site, and interaction effects of these variables with gender, were examined in multiple logistic regression analysis. Use of HIV medications was low (29% at baseline; 40% at follow-up). HIVMED, recruitment site, gender, and depression had significant main effects on HIVMEDF. Depression also had a significant interaction effect with gender on HIVMEDF. Unlike men, women with depression were less likely than women without depression to use the medications. The findings indicate that gender-specific issues should be addressed by treatment programs for HIV-positive drug users, with particular efforts needed to enhance use of medications for depressed women.
    AIDS Care 11/2011; 23(11):1467-71. · 1.60 Impact Factor
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    ABSTRACT: Participating in civic activities has been found to be related to positive health outcomes. This study examines associations between injection drug use health variables (sharing paraphernalia, using shooting galleries) and political/civic engagement (identifying with any political party, attention paid to politics and being registered to vote). Participants (N = 162) were recruited at 6 New York City (NYC) methadone programs as part of an HIV intervention (86% male). In the bivariate analysis, being registered to vote and political party identification were related to lower paraphernalia sharing; higher levels of attention paid to politics were associated with lower shooting gallery use. In the multivariate analysis, political party identification was associated with lower paraphernalia sharing and higher levels of attention paid to politics was related to lower shooting gallery use. Findings suggest that maintaining connections with mainstream civic activities can be related to reduced health risks, including HIV risk behaviors. This study contributes to understanding the relationships between involvement in civic/political participation and health, an area in which few studies have been conducted.
    The American Journal of Drug and Alcohol Abuse 08/2011; 37(6):520-4. · 1.55 Impact Factor
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    ABSTRACT: Peer outreach models have been successful in addressing HIV risk behaviors of drug users. Patients in methadone maintenance treatment programs who were migrants from Puerto Rico and/or familiar with drug use there were trained to conduct HIV-related peer outreach. A group randomized design was implemented; patients in the Experimental (E) condition (n = 80) received training and conducted 12 weeks of outreach. Half of the patients completed the training and outreach. At follow-up, patients in the E condition who conducted outreach felt they were more helpful to their community, showed a trend for engaging in more vocational activities, and were more likely to talk with others about HIV, compared to those who did not conduct outreach and those in the Control condition (n = 78). Drug treatment patients who are migrants can be trained as peer outreach workers and short-term benefits were found. Longer term maintenance of benefits should be assessed.
    Journal of Immigrant and Minority Health 04/2011; 14(2):251-8. · 1.16 Impact Factor
  • Milton Mino, Sherry Deren, Hector M Colón
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    ABSTRACT: This paper presents findings from the Alliance for Research in El Barrio and Bayamón (ARIBBA) research study, which compared HIV-related risk behaviors, HIV infection rates, and mortality rates of 800 Puerto Rican injection drug users and crack smokers in East Harlem, New York, with 399 of their counterparts in Bayamón, Puerto Rico. The study was conducted from 1996 to 2004 and is among the most comprehensive ever undertaken on HIV risk behaviors of drug users in Puerto Rico. This paper presents the main findings, many of which have been published in scientific journals. The study found that drug users in Puerto Rico became infected with HIV at a rate almost 4 times higher than Puerto Rican drug users in New York, and they died at a rate that was more than 3 times as high. The findings indicate that drug users in Puerto Rico are more likely than Puerto Rican drug users in New York to engage in injection drug use and sexual behaviors that put them at risk of becoming infected with HIV. In addition, they have fewer prevention resources available to them. HIV prevention programs are scarce in Puerto Rico and the availability of drug treatment programs in Puerto Rico declined by over one third during the period examined. Additionally, significantly fewer HIV-positive drug users in Puerto Rico were taking HIV-related medications than in New York. The paper concludes with recommendations and lessons learned from the study.
    Journal of the International Association of Physicians in AIDS Care (JIAPAC) 03/2011; 10(4):248-59.
  • Sherry Deren, Holly Hagan
    Substance Use &amp Misuse 01/2011; 46(2-3):129-30. · 1.11 Impact Factor
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    ABSTRACT: As we begin the fourth decade of the epidemic, it is clear that, as demonstrated by the articles in this Special Issue, much has been learned about factors contributing to the decline in HIV prevalence among drug users in New York. However, there are a number of outstanding research questions that remain or are emerging. Following is a summary of some of the topics requiring further research. While this summary does not represent a comprehensive list, it is based on many of the questions raised in the articles in this Special Issue and identifies some of the directions to be investigated during the next decade.
    Substance Use &amp Misuse 01/2011; 46(2-3):316-9. · 1.11 Impact Factor
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    ABSTRACT: The importance of identifying differences in HIV risk between Hispanic subgroups is the focus of this article. Data are drawn from two New York?based HIV-related studies: among Puerto Rican drug users and among new immigrants from Central America, the Dominican Republic, and Mexico. Results indicated that intercultural individuals (i.e., those involved in both Puerto Rican and mainland cultures) were less risky in terms of injection- and sex-related risk behaviors and that geographic and other contextual factors, along with cultural norms, influence risk behaviors for immigrants. Both studies indicate the need to differentiate subgroup factors affecting HIV risk and prevention behaviors to develop appropriate and effective community-based interventions. The study's limitations are noted.
    Substance Use &amp Misuse 01/2011; 46(2-3):254-63. · 1.11 Impact Factor
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    ABSTRACT: Men who have sex with men (MSM) and use drugs are at high risk for HIV. This study assessed drug and sex-related risk behaviours and sexual identities for MSM drug injectors and crack smokers. One hundred and forty four MSM drug injectors and crack smokers from five USA cities were interviewed. One-third of the men were current injectors, twice as many reported lifetime injection. Most (56%) reported sex with women in the prior year; sex trading was reported by 32% with males and 53% with females. There were significant differ- ences between private and public sexual identities. For example, while 31% reported being behaviourally bisexual, only 17% identified themselves to others as bisexual. Drug using MSM are clearly a heterogenous group and prevention messages addressing this diversity are needed.
    Culture Health & Sexuality 11/2010; 3(3). · 1.55 Impact Factor
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    ABSTRACT: Hispanic patients were recruited from methadone maintenance treatment programs in 2005-2008 to be trained as peer outreach workers, targeting migrant drug users from Puerto Rico. Goals of the outreach focused on reducing HIV-related risk behaviors. A total of 80 peers were recruited from 4 clinics in New York and New Jersey. Following training, they conducted outreach in their communities for 12 weeks. This paper describes the challenges encountered during the recruitment, training, and outreach phases of the project, from the field perspective. Recommendations for future efforts in training drug treatment patients as outreach workers are provided.
    Substance Use &amp Misuse 04/2010; 45(12):1892-908. · 1.11 Impact Factor
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    ABSTRACT: From 2005 to 2008, the Bienvenidos Project trained Puerto Rican patients of New York City and New Jersey Methadone Maintenance Treatment Programs to conduct peer-based community outreach to migrant Puerto Rican drug users to reduce migrants' HIV risk behaviors. Ethnographic research, including focus groups, individual interviews, and observations, was conducted with a subset of the patients trained as peers (n = 49; 67% male; mean age 40.3 years) to evaluate the self-perceived effects of the intervention. Results of the ethnographic component of this study are summarized. The role of ethnographic methods in implementing and evaluating this kind of intervention is also discussed.
    Substance Use &amp Misuse 02/2010; 45(3):414-36. · 1.11 Impact Factor
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    Sung-Yeon Kang, Sherry Deren
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    ABSTRACT: This study examined factors that mediate and moderate the relationship between gender and utilization of mental health and medical services in the past year among Puerto Rican drug users (308 females; 892 males) recruited in New York City. Experience of sexual or physical abuse, injection drug use, relationship variables (e.g., having a sexual partner who is an injection drug user), and serious or chronic mental/medical conditions were used as potential mediators and moderators. Both sexual and physical abuse mediated gender effects on use of mental health services. Having chronic medical problems mediated the relationship between gender and utilization of medical and mental health services. Significant interaction effects of gender by depression, physical abuse, and HIV sero-status on utilization of medical services were found. Health (particularly mental health) care was under-utilized by both women and men, despite high rates of depression and chronic medical conditions. The finding of under-use of medical services by HIV-positive drug users (particularly by HIV-positive women) indicates a need for further efforts to engage all HIV-positive persons in care. The findings also indicate an on-going need for mental and other health services for drug users who have been victims of abuse.
    Drug and alcohol dependence 05/2009; 102(1-3):138-43. · 3.60 Impact Factor
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    ABSTRACT: Biculturality refers to two independent processes of acculturation, one to the host society's culture and another to the culture of origin. This study examined the relationship between biculturality and HIV-related risk behaviors in a sample of injecting and noninjecting Puerto Rican drug users (N = 259), recruited in New York City in 2005-2006. Biculturality was measured by two scales: involvement in (i) American culture (AMBIC) and (ii) Puerto Rican culture Biculturality (PRBIC). The majority (78%) of the participants were males, with a mean age of 42 years. About half were born in Puerto Rico, and the average length of stay in the United States was 26 years. In multiple logistic-regression analysis, AMBIC was significantly related to lower injection risk after controlling for other factors including gender, age, and MMTP enrollment, while PRBIC was a significant predictor of higher sex risk. Involvement in the host culture and the culture of origin differed in their relationship to risk behaviors, indicating that incorporating assessments of biculturality may be useful in assessing and addressing migrants' behaviors, including HIV-risk behaviors. The study's limitations have been noted.
    Substance Use &amp Misuse 02/2009; 44(4):578-92. · 1.11 Impact Factor
  • Sung-Yeon Kang, Sherry Deren, Hector Colón
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    ABSTRACT: This study examined gender-specific effects of social bonds, network characteristics, and other factors on drug treatment enrollment among Puerto Rican drug users. Participants (425 women; 1,374 men) were recruited in New York and Puerto Rico in 1998-2003. Gender differences were found: education (< high school/GED) and having a sex partner who is an injection drug user (IDU) were significantly related to current enrollment in drug treatment (EDT) for women; for men, having an IDU friend (negatively) had a main effect on EDT, and having an IDU friend also had a significant interaction effect with their own injection drug use on EDT. For both women and men, recruitment site (New York), having health insurance, and prior methadone treatment were significant predictors of EDT. The findings may be useful in developing gender-differentiated drug counseling and treatment efforts that engage women's sex partners and men's friendship networks to build support for drug treatment.
    The American Journal of Drug and Alcohol Abuse 02/2009; 35(2):73-9. · 1.55 Impact Factor
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    ABSTRACT: Puerto Rican drug users recruited in NY who previously used drugs in Puerto Rico (PR) have been found to have higher HIV injection and sex-related risk behaviors than those who had not used in PR. This study examined predictors of risk among migrant Puerto Rican drug users. (For the purpose of this paper, the term "migrant" was used to designate Puerto Rican drug users who had used drugs in Puerto Rico and were recruited in New York or New Jersey). A total of 290 drug users who had previously used drugs in PR were recruited in NY and New Jersey and interviewed regarding drug use history and HIV risk behaviors. Participants engaged in high risk behaviors, e.g., 39% shared injection paraphernalia and 62% reported unprotected sex. Multivariate analyses found that predictors of injection-related risk included being born in PR and purchasing drugs jointly with other drug users; predictors of sex-related risk included younger age and homelessness. Addressing risk reduction among those drug users who were born in Puerto Rico and are younger or homeless was indicated, and efforts to reach those at highest risk through NEPs was recommended.
    Journal of Immigrant and Minority Health 01/2009; 12(2):179-86. · 1.16 Impact Factor
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    ABSTRACT: Reducing sex risk behaviors among high-risk injection drug users (IDUs) and crack smokers is a continuing challenge for HIV prevention. Based on a longitudinal study of sexually active Puerto Rican IDUs and crack smokers in New York (n = 573) and Puerto Rico (n = 264), baseline predictors of changes in sex risk (number of unprotected sex acts) at 6- and 36-month follow-up interviews were examined. In New York, predictors of higher sex risk were being younger, having primary partners, having more other sex partners, never exchanging sex, having lower self-efficacy for reducing sex risk behaviors and being HIV-negative, and these predictors were significant at both postbaseline periods. In Puerto Rico, short-term predictors included being male, having primary partners, never exchanging sex, lower sex risk norms and lower self-efficacy. However, only having primary partners was significant in longer-term behaviors. Results indicated the need for enhancing self-efficacy and for developing risk reduction strategies related to community differences.
    AIDS Education and Prevention 09/2008; 20(4):325-37. · 1.59 Impact Factor
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    ABSTRACT: Gender differences were examined in health status and HIV care among HIV-infected minority drug users. More women than men reported having HIV-related symptoms and other health conditions, such as asthma and allergies. Hepatitis B or C was more often reported by men. As compared to men, women delayed HIV care and fewer attended HIV support groups. Delayed entry into HIV treatment was also significantly related to being Hispanic and being diagnosed with HIV in the pre-HAART era. No significant gender difference was found in current use of HIV medications. Use of HIV medications was significantly related to being married, no history of childhood sexual abuse, enrollment in an HIV clinic and attending HIV support groups. The findings demonstrate the importance of family and social support for HIV-positive drug users and also suggest a need for special attention to those who have childhood sexual abuse experience.
    AIDS Care 07/2008; 20(9):1146-51. · 1.60 Impact Factor

Publication Stats

1k Citations
211.84 Total Impact Points

Institutions

  • 2012
    • Beth Israel Medical Center
      • Department of Medicine
      New York City, New York, United States
  • 2011
    • CUNY Graduate Center
      New York City, New York, United States
    • New York University
      New York City, New York, United States
    • New York City Department of Health and Mental Hygiene
      New York, United States
  • 1993–2011
    • National Development and Research Institutes, Inc.
      New York City, New York, United States
  • 2007
    • New York Academy of Medicine
      New York City, New York, United States
  • 2006
    • NDRI-USA, Inc.
      New York City, New York, United States
  • 2000–2005
    • New York State Energy Research and Development Authority
      Westmere, New York, United States
    • Medical College of Wisconsin
      • Center for AIDS Intervention Research
      Milwaukee, Wisconsin, United States
  • 2004
    • Columbia University
      • Department of Epidemiology
      New York City, NY, United States
  • 2003
    • Harvard Medical School
      • Department of Psychiatry
      Boston, MA, United States
  • 2001
    • Central University of the Caribbean
      • School of Medicine
      Bayamon, Cidra, Puerto Rico
    • National Institute on Drug Abuse
      Maryland, United States
  • 1998
    • California State University, Long Beach
      Long Beach, California, United States
  • 1977
    • New York State Office of Children and Family Services
      New York City, New York, United States