Anna L Hotton

Anna L Hotton
Cook County Health and Hospitals System · Division of Infectious Diseases, Chicago D-CFAR and WIHS

PhD, MPH

About

61
Publications
5,229
Reads
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1,274
Citations

Publications

Publications (61)
Article
Purpose: Even with an efficacious vaccine, protective behaviors (social distancing, masking) are essential for preventing COVID-19 transmission and could become even more important if current or future variants evade immunity from vaccines or prior infection. Methods: We created an agent-based model representing the Chicago population and conduc...
Article
Objective(s) Getting to Zero (GTZ) is an Illinois-based HIV elimination initiative. GTZ identifies younger Black men who have sex with men (YBMSM) as a population who have experienced disproportionate HIV incidence. Rising stimulant use among YBMSM has been determined to impede engagement in the HIV prevention and treatment continua for reducing on...
Article
Full-text available
We analyzed data from a cohort of Black and Latino men who have sex with men (MSM) in order to identify correlates of prevalent and incident incarceration, including potential predictors related to their status as sexual and gender minorities (SGMs). Baseline and follow-up self-administered survey data were examined from Los Angeles County particip...
Article
Political affiliation, racial attitudes, and opioid stigma influence public support for public health responses to address opioid use disorders (OUD). Prior studies suggest public perceptions of the opioid epidemic are less racialized and less politically polarized than were public perceptions of the crack cocaine epidemic. Analyzing a cross-sectio...
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Although the HIV epidemic in Athens, Greece has reemerged and spread in men who have sex with men (MSM), state-supported PrEP programs have not been instituted. A PrEP intervention was implemented building upon an existing network cohort of MSM (308 participants; 1212 network members). A PrEP intervention cohort of 106 participants was selected bas...
Article
Objectives: We examined whether molecular cluster membership was associated with public health identification of HIV transmission potential among named partners in Chicago. Design: Historical cohort study. Methods: We matched and analyzed HIV surveillance and partner services data from HIV diagnoses (2012-2016) prior to implementation of clust...
Article
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Protective behaviors such as mask wearing and physical distancing are critical to slow the spread of COVID-19, even in the context of vaccine scale-up. Understanding the variation in self-reported COVID-19 protective behaviors is critical to developing public health messaging. The purpose of the study is to provide nationally representative estimat...
Preprint
Objective(s): Young Black men who have sex with men (YBMSM) are a key population identified in the Illinois Getting to Zero (GTZ) initiative who have experienced disproportionate HIV incidence. Rising stimulant use has been determined to impede the effectiveness of ART and pre-exposure prophylaxis for suppressing HIV transmission in populations. Th...
Article
In the United States, transgender women are disproportionately affected by HIV. However, few evidence-based prevention interventions exist for this key population. We describe two promising, locally developed interventions that are currently being implemented and evaluated through the Centers for Disease Control and Prevention Combination HIV Preve...
Article
Background: COVID-19 has disproportionately impacted vulnerable populations, including Black men who have sex with men (BMSM) and transgender women (BTW). We investigated associations of COVID-19 stressors and sex behaviors with pre-exposure prophylaxis (PrEP) and antiretroviral therapy (ART) among BMSM and BTW. Methods: As part of the Neighborh...
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The TransLife Care (TLC) project was developed to address the structural factors that act as barriers to HIV care among transgender women of color. The purpose of this study was to evaluate the feasibility and initial efficacy of the TLC project; primary HIV care outcomes included linkage to HIV care, engagement in care, retention in care, use of A...
Article
Black men who have sex with men (BMSM) and Black transgender women (BTW) are impacted by dual epidemics of HIV and incarceration. We advanced understanding of the relationship between criminal justice involvement, HIV, and other key HIV-related characteristics among these key populations in the US. We conducted a systematic review up to 2018 and 47...
Article
Objectives: Getting to Zero (GTZ) initiatives focus on expanding use of antiretroviral treatment (ART) and pre-exposure prophylaxis (PrEP) to eliminate new HIV infections. Computational models help inform policies for implementation of ART and PrEP continuums. Such models, however, vary in their design, and may yield inconsistent predictions. Using...
Article
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The role of HIV in COVID-19 acquisition is not yet understood. Among 1862 patients, including 349 PLWHIV, most virally suppressed, and 308 recently using PrEP, we compared rates of positive PCR results. Positivity was higher among PLWHIV (10.6%) compared to HIV negative patients (7.1%) but not significant in adjusted models.
Article
IntroductionHIV-related stigma continues to serve as a major barrier to HIV care. HIV stigma reduction interventions are urgently needed to promote and protect the health of persons living with HIV (PLWH). Resilience has been identified as a potential leverage to mitigate the impact of HIV-related stigma among PLWH.Methods We examined whether two r...
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Transgender women are disproportionately affected by HIV and experiences of social adversity that may interfere with engagement in care and viral suppression. We used latent class analysis to examine patterns of social adversity and their impact on HIV care continuum outcomes in an urban sample of transgender women of color. Participants (n = 224)...
Article
Background: Increased pre-exposure prophylaxis (PrEP) uptake among Black men who have sex with men and Black transgender women (BMSM/TW) is needed to end the HIV epidemic. Embedding a brief intervention in network services that engage individuals in HIV transmission networks for HIV/STI testing may be an important strategy to accelerate PrEP uptak...
Article
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The House and Ball Community (HBC), a tight-knit social and cultural network comprised primarily of Black sexual and gender minorities (SGM), offers unique opportunities for HIV prevention that leverage naturally occurring social support networks. However, experiences of socioeconomic marginalization, stigma, violence, and trauma may impede HIV pre...
Article
Young black men who have sex with men (YBMSM) and young black transgender women (TGW) have experienced a stark disparity in HIV prevention and care. Resilience, collective resources to adapt stressors or adversities, may improve HIV prevention and care outcomes. The present study investigated the association of resilience-based factors with PrEP up...
Article
Black men who have sex with men (MSM) and transgender women are disproportionately affected by criminal justice involvement (CJI) and HIV. This study recruited 618 young Black MSM and transgender women in Chicago, IL, using respondent-driven sampling between 2013 and 2014. Random effects logistic regression evaluated predictors of incident CJI over...
Article
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Black gay men must navigate identities and stigmas related to being gay and Black, and report higher HIV incidence relative to their White male counterparts although they report lower rates of drug use and risky sexual behaviors. This study examined whether closeness to the gay or Black community correlated with HIV-related risk and protective beha...
Article
Objectives: We evaluated the Veterans Aging Cohort Study (VACS) Index score, an index composed of age, CD4 count, viral load, hemoglobin, Hepatitis C (HCV) co-infection, Fibrosis Index-4 (FIB-4), and estimated glomerular filtration rate (EGFR), and psychosocial and clinical risk factors for all-cause hospitalization among HIV-infected women on HAA...
Article
Younger Black men who have sex with men (YBMSM) have the highest rates of HIV incidence in the U.S. and are also exposed to high life stressors (e.g., unemployment, incarceration, and exposure to communality). This study assessed whether life stressors were related to drug use and sexual risk behaviors among a representative sample of YBMSM. The So...
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POWER is a theory-based, on-line HIV prevention intervention developed specifically for Black men who have sex with men and women (BMSMW), an understudied group significantly impacted by HIV. To test its efficacy, we recruited 224 BMSMW using chain referral methods and randomly assigned 108 to POWER and 103 to a health information comparison condit...
Article
African American youth bear a disproportionate burden of sexually transmitted infections. A growing number of studies document that youth exposure to community violence and sexual behaviors are highly correlated. Despite such growing evidence, only a few studies have empirically tested conceptually-driven pathways that may account for such relation...
Article
Medication adherence among HIV-infected individuals is critical to limit disease progression and onward transmission. Evidence indicates that among youth living with HIV (YLH), adherence is suboptimal and related to co-morbid psychosocial conditions. Cross-sectional data from 212 YLH, ages 16-29, collected between 2011-2014 in Chicago were analyzed...
Article
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Unlabelled: Women account for 1 in 5 new HIV infections in the US, make up 24% of people living with HIV, and represent a quarter of AIDS diagnoses. Despite the need for continued prevention among young women living with HIV, there is very little in the literature on how best to reduce sexual risk and increase the health and well-being of young wo...
Article
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Background: Colonization of the female lower genital tract with Lactobacillus provides protection against STIs and adverse pregnancy outcomes. Growth of genital Lactobacillus is postulated to depend on epithelial cell-produced glycogen. However, the amount of cell-free glycogen in genital fluid available for utilization by Lactobacillus is not kno...
Data
Relationships between free glycogen and glucose, pH, progesterone, and estrogen. Spearman correlations between glycogen and glucose (A), pH (B), progesterone (C), and estrogen (D) were calculated using samples that exhibited values for both x and y. (XLSX)
Article
Introduction: The HIV epidemic continues to disproportionately affect men who have sex with men (MSM) in the US, with over a third of new infections in MSM occurring in younger men. Very few studies have reported on HIV and STI incidence and related risks among younger MSM, particularly among minors under 18 years of age. Methods: Data analyzed...
Article
Few studies have examined risk-reduction alternatives to consistent condom use for HIV prevention among heterosexual young adults. We used qualitative methodology to explore risk reduction strategies and contextual factors influencing attempts to reduce risk in an urban, high morbidity sexually transmitted infection (STI) clinic. Focus groups were...
Article
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Background: Relatively high plasma levels of soluble urokinase-type plasminogen activator receptor (suPAR) have been associated with focal segmental glomerulosclerosis and poor clinical outcomes in patients with various conditions. It is unknown whether elevated suPAR levels in patients with normal kidney function are associated with future declin...
Article
Three groups of CMV seropositive women (total n=164) were selected from the Chicago Women's Interagency HIV-1 Study to investigate the association between CMV co-infection and immune activation: 1) HIV-1 viremic; 2) HIV-1 aviremic; and 3) HIV-1 uninfected. Quantitative measures of CMV serum IgG, CMV DNA, and serum biomarkers IL-6, soluble CD163 (sC...
Article
Adding gender-related modifiable characteristics or behaviors to the Veterans Aging Cohort Study (VACS) Index might improve the accuracy of predicting mortality among HIV-infected women on treatment. We evaluated the VACS Index in women with HIV, determined whether additional variables would improve mortality prediction, and quantified the potentia...
Article
Improved retention-in-care may enhance health outcomes for people living with HIV/AIDS (PLWHA). Although laboratory surveillance data may be used to gauge retention, no previous reports have compared laboratory surveillance vs. clinic visit-based measures of retention-in-care. We compared laboratory surveillance vs. clinic visit-based approaches fo...
Article
Introduction: HIV transmission cluster analyses can inform HIV prevention efforts. We describe the first such assessment for transmission clustering among HIV patients in Chicago. Methods: We performed transmission cluster analyses using HIV pol sequences from newly diagnosed patients presenting to Chicago's largest HIV clinic between 2008 and 2011...
Article
Introduction: HIV transmission cluster analyses can inform HIV prevention efforts. We describe the first such assessment for transmission clustering among HIV patients in Chicago. Methods: We performed transmission cluster analyses using HIV pol sequences from newly diagnosed patients presenting to Chicago's largest HIV clinic between 2008 and 2...
Article
Black young men who have sex with men (BYMSM) are the group most disproportionately impacted by HIV in the USA and most in need of efficacious interventions to address community-level factors that increase their vulnerability to HIV. The House Ball Community (HBC) is a distinct social network within the larger BYMSM community that may be particular...
Article
Full-text available
An exigent need exists for HIV prevention intervention research targeting young men who have sex with men (MSM)-a group of young adults that, despite composing the highest and most racially disproportionate rates of HIV incidence, have been least often the focus of behavioral intervention research. This pilot study tested a group-based HIV primary...
Article
Full-text available
Objective Lactobacillus dominates the lower genital tract microbiota of many women, producing a low vaginal pH, and is important for healthy pregnancy outcomes and protection against several sexually transmitted pathogens. Yet, factors that promote Lactobacillus remain poorly understood. We hypothesized that the amount of free glycogen in the lumen...
Article
Full-text available
Purpose: Study objectives were to measure awareness of general antitobacco messages in LGBT-focused and general media outlets among LGBT (lesbian, gay, bisexual, and transgender) individuals and to examine associations between sociodemographic characteristics and awareness levels. Method: Data were based on cross-sectional survey data from a rac...
Article
Reverse sequence screening for syphilis, in which an automatable treponemal assay (enzyme immunoassay [EIA]/chemiluminescence assay [CIA]) is performed first and followed by a nontreponemal test for reactive specimens, has been used increasingly in the United States. The EIA is objective, efficient, and believed to be more sensitive than the rapid...
Article
In April of 2011, the Cook County Jail initiated opt-out screening of all women for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) at the time of intake. In this retrospective review, we assess the impact of opt-out protocol on rates of testing, diagnoses, and successful treatment. We collected the results of all CT and GC tests ordered...
Article
Lesbian women may perceive themselves to be at lower risk for sexually transmitted infections (STIs) and use reproductive health care at lower rates compared with heterosexual women. Therefore, STIs in sexual minority women may go undetected. The prevalence and risk factors of urogenital STIs in women of different sexual orientations were investiga...
Article
The study examined whether witnessing verbal parental aggression (VPA) was related to sexual activity among mostly low income African American youth, and whether psychological symptoms mediated this relationship. Five hundred and sixty-three African American high school adolescents (ages 13–19) completed self-administered questionnaires, which asse...
Article
Exposure to community violence and HIV sexual risks are two major public health concerns among youth. This study tests various pathways linking exposure to community violence and sexual behaviors among African American adolescents. Using a sample of 563 (61 % females) African American youth attending high school we examined whether problematic psyc...
Article
Introduction: Scaling up routine HIV testing represents a key component of the National HIV/AIDS Strategy. Barriers to routine HIV testing have limited widespread adoption. Although many patients visit specialty care providers, few efforts to increase routine HIV testing in specialty care settings have been made. We report on use of a survey of ba...
Conference Paper
Background: Vitamin D (vit D) deficiency is common in HIV+ adults and has been associated with increased inflammatory markers. Data on the impact of vit D supplementation on inflammatory markers are sparse. Methods: Prospective study conducted 2010 -2012 among HIV+ women at 3 Chicago WIHS sites. Vit D was measured at baseline, and results and rec...
Conference Paper
Full-text available
Background: Vitamin D (Vit D) deficiency is common among HIV-infected adults; however recommendations on screening and Vit D supplementation remain sparse and controversial. Methods: We examined vitamin D testing and prescribing patterns among HIV-infected adults in primary care at the Ruth M. Rothstein CORE Center in Chicago from January 2010 to...
Article
This study prospectively examined associations among multiple theoretically informed risk (e.g., depression, sexual sensation seeking, and risky peers norms) and protective factors (e.g., social support, STI knowledge, and refusal to have sex self efficacy) on unsafe sex among 715 African American adolescent females aged 15-21 who participated in a...
Article
In 2009, the Howard Brown Health Center received funding from the US Department of Health and Human Services, and Health Resources and Services Administration to develop and disseminate a peer-reviewed, six-module curriculum entitled, Health Education about LGBT (lesbian, gay, bisexual and transgender) Elders (HEALE). The HEALE curriculum targets n...
Article
This study examined whether life stress was associated with elevated sexual risk among young transgender women and whether this relationship was mediated by alcohol and substance use. The analysis was based on data collected from 116 transgender women aged 16 to 25 as part of a baseline assessment for an HIV prevention intervention. The median age...
Article
Serosorting, selecting sex partners of the same HIV status, may be associated with increased risk of sexually transmitted infection (STI). We examined the association between unprotected anal intercourse (UAI) with a seroconcordant partner and STIs among HIV-negative men who have sex with men (MSM) at an urban lesbian, gay, bisexual, and transgende...
Article
Background Serosorting, preferentially engaging in unprotected anal intercourse (UAI) with partners of the same HIV status, is practiced by some MSM as a risk reduction strategy. Methods May through November 2010, we assessed serosorting practices and beliefs among MSM seeking STI testing at an urban LGBT health center. We compared serosorting prac...
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Full-text available
Background Continued increases in HIV among men who have sex with men (MSM) underscore the need for intervention strategies that target those at highest risk of infection. Methods January–December 2010, we collected information on demographic and behavioural risks in the past 12 months from MSM seeking anonymous HIV testing. We examined risks for H...
Article
Background Transgender women are an underserved and understudied population with unique medical and behavioural risk profiles. High rates of STIs and HIV in this population have been reported, although accurately quantifying STI rates and associated risks is difficult because of limitations in measurement of gender identity, lack of standardised re...
Article
Demographic, psychosocial, and contextual correlates of tobacco use among sexual minority women (SMW) were assessed using data from a larger lesbian, gay, bisexual, and transgender (LGBT) study. Of the 171 participants, 42% (n = 71) were smokers. However, 61% of smokers reported a recent quit attempt, and 39% were taking action toward or planning t...
Article
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The Centers for Disease Control and Prevention (CDC) recommends clinical and serologic re-evaluation at 6 and 12 months after diagnosis with early syphilis, to determine treatment efficacy. This was a retrospective cohort study of men who have sex with men enrolled in primary care at a lesbian, gay, bisexual, and transgender health center. We used...

Projects

Project (1)
Project
Keeping it LITE will use electronic recruitment to engage young men who have sex with men and transgender women in an innovative cohort designed to monitor HIV risk and prevention behaviors and explore the socioecological factors that influence behavior and attitudes with minimal interaction. This low interaction strategy will allow us to describe ongoing infection trends across the Chicago area and characterize individual and community level factors that enhance HIV risk. Social network and phylogenetic analysis of HIV seroconverters will further articulate the ongoing epidemic of HIV acquisition among young MSM and TGW.