Roger Detels's research while affiliated with University of California, Los Angeles and other places

Publications (669)

Article
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Background To assess the long-term biological coefficient of variation within individuals (CVI) and between individuals (CVG), effect of aging and cholesterol lowering drugs on blood levels of lipids in HIV-1-infected and -uninfected men. Methods Bloods were analyzed every six months over 17 years for total cholesterol (TC), triglycerides (TGs), h...
Article
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For aging adults living with HIV (AALH) who have complex medical care needs, vision impairment may be an added burden that may lead individuals to disengage from their own medical care. We examined the relationships of self-reported vision difficulty with indicators of care engagement: 1) adherence to HIV antiretroviral therapy (ART; defined as tak...
Chapter
Developing countries are asserting tremendous efforts to achieve universal health coverage (UHC) through primary healthcare-led approaches. Quality primary healthcare (PHC) is essential for improving health, social stability, sound national economies, and health security for all countries, rich or poor. Appropriate and competent training for public...
Article
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We investigated the longitudinal relationship between erectile dysfunction (ED) drug use with behavioral factors, including substance use and sexual activities in men who have sex with men from the Multicenter AIDS Cohort Study during 1998–2016 ( n = 1636). We used a bivariate random-intercept model to evaluate ED drug use along with other behavior...
Article
In 2019, NIH combined the Multicenter AIDS Cohort Study and the Women's Interagency HIV Study into the MACS/WIHS Combined Cohort Study (MWCCS). Participants completing a visit October 2018-September 2019 (targeted for MWCCS enrollment) are described by HIV serostatus and compared to people living with HIV (PLWH) in the U.S. Participants include 211...
Article
Rationale Loneliness is associated with negative health outcomes, such as cardiovascular disease, cognitive impairment, dementia, physical functional decline, depression, and increased mortality risk, among HIV- positive and HIV-negative older men who have sex with men (MSM). Given these negative health outcomes, it is imperative to identify factor...
Article
The present study was designed to identify social support classes across time among midlife (40–64 years) and older (65+ years) gay, bisexual, and other men who have sex with men (MSM), and whether social support protects against depressive symptoms in this population. This study applied longitudinal latent class analysis across five visits on 1,32...
Article
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Background: With potent antiretroviral therapy and simplified regimens, people living with HIV (PWH) are achieving near-normal lifespans but not necessarily a normal health span or healthy aging. PWH have a higher than expected risk of developing a number of non-AIDS comorbidities, coinfections, and complications (CCC), often against a background...
Article
Background SARS-CoV-2 infection among People Living With HIV (PLWH) is not well-described. Objective To study COVID-19 symptoms and SARS-CoV-2 PCR-based swab testing among participants of the Multicenter AIDS Cohort Study (MACS) and Women’s Interagency HIV Study (WIHS). Methods A telephone survey was collected April-June 30, 2020. Symptom and tes...
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Background: In Los Angeles County, the tuberculosis (TB) disease incidence rate is seven times higher among non-U.S.-born persons than U.S.-born persons and varies by country of birth. But translating these findings into public health action requires more granular information, especially considering that Los Angeles County is more than 4000 mile2....
Article
Background The prevalence of marijuana use is increasing in the United States. Marijuana smoking has been shown to impair the microbicidal activity of alveolar macrophages and decrease the number of ciliated epithelial cells in the bronchi with a parallel increase in the number of mucus-secreting surface epithelial cells, which may increase the ris...
Article
Purpose Despite well-known ocular complications of HIV-related immune suppression, few studies have examined the prevalence and consequences of visual impairment among aging long term survivors of HIV. Design Retrospective cohort study Methods Aging HIV-infected (HIV+) men who have sex with men (MSM) and –uninfected (HIV-) MSM controls reported t...
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Nearly 17 years ago China launched its National HIV/AIDS Response Program, yet the epidemic still is not slowing. New cases and new deaths increase every year-in 2005, 40,711 people living with HIV (PLWH) were diagnosed and 5,729 died whereas in 2019, 148,598 PLWH were diagnosed and 31,522 died . Moreover, the estimated PLWH population in China has...
Book
With HIV becoming the leading cause of infectious-disease mortality in Mainland China, this book focuses on tackling HIV/AIDS in the face of rapid political and economic change in China. Featuring contributions by over a dozen leading figures in the field, this book is the go-to text for any student or reader interested in how national and internat...
Chapter
China has made remarkable achievements in advancing its HIV/AIDS prevention and treatment programs. Infrastructure for surveillance, laboratory testing, voluntary counseling and testing, outreach, intervention, and harm reduction for key populations, and antiretroviral therapy (ART) services for people diagnosed with HIV have been well developed. M...
Article
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To assess the intra-individual and inter-individuals biological variation and the effect of aging on lymphocyte T-cells subsets.We assessed lymphocyte phenotypes (CD3, CD4, and CD8 T-cells) in 89 HIV-1-infected and 88 uninfected white non-Hispanic men every 6 months, to examine the biological variation for those measurements, and the average change...
Article
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Background: Cytokines, chemokines, adipocytokines, soluble cell receptors, and immune activation markers play an important role in immune responsiveness and can provide prognostic value since they reflect underlying conditions and disease states. This study was undertaken to investigate the components of biological variation for various laboratory...
Article
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Background: Although increasingly studied in high-income countries, there is a paucity of data from the Chinese population on the patterns of cancer among people living with HIV (PLHIV). Methods: We conducted a nationwide follow-up study using routinely collected data for adult PLHIV diagnosed on or before 31 December 2011 and alive and in care...
Article
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Over past three decades, many prevention strategies have been proven effective in reducing human immunodeficiency virus (HIV) transmission. However, none of these strategies alone are effective to stop the spread of HIV. This review discusses a few key prevention strategies, including testing, harm reduction, prevention, prophylaxis, and modern com...
Article
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Background Why some persons living with human immunodeficiency virus (HIV) (PLWH) progress quickly and others remain “healthy” for a decade or more without treatment remains a fundamental question of HIV pathology. We aimed to assess the epidemiological characteristics of HIV long-term nonprogressors (LTNPs) based on a cohort of PLWH in China obser...
Article
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Background: Myanmar has adopted point-of-care (POC) HIV testing for its prevention of mother-to-child transmission of HIV program, and was initiated in 84 townships in 2013. This study assessed the progress of HIV testing uptake from 2012, one year prior to POC testing, to 2015, and the challenges faced by service providers during the rapid rollou...
Article
Background An anal histological high‐grade squamous intraepithelial lesion (hHSIL) is an anal cancer precursor. Experts recommend Dacron swab anal cytology as a primary screen for anal hHSILs, especially among human immunodeficiency virus–infected and –uninfected men who have sex with men (MSM). Studies have shown that Dacron cytology inaccurately...
Article
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Objective To examine the trends of HIV prevalence, risk behaviours and HIV testing among men who have sex with men (MSM) in Nanjing. Design Five consecutive cross-sectional surveys. Setting Nanjing, China. Primary and secondary outcome measures HIV and syphilis prevalence, HIV testing rate and factors associated with HIV infection; demographic c...
Data
Quick guide to population estimates by country of birth. (DOCX)
Data
TB Incidence rates among Non-U.S.-born persons by demographic characteristic, los angeles county 2005–2011. (DOCX)
Article
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Background Among U.S. residents, tuberculosis (TB) disease disproportionally affects non-U.S.-born persons and varies substantially by country of birth. Yet TB disease incidence rates by country of birth are not routinely reported despite these large, known health disparities. This is in part due to the technical challenges of using standard regres...
Data
OpenBUGS model code and r packages used. (DOCX)
Data
TB Incidence rates among selected country of birth by year, los angeles county 2005–2011. (DOCX)
Article
Background: HIV infection is associated with increased susceptibility to common pathogens, which may trigger chronic antigenic stimulation and hyperactivation of B cells, events known to precede the development of AIDS-associated non-Hodgkin lymphoma (AIDS-NHL). Methods: To explore whether cumulative exposure to infectious agents contributes to...
Article
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Background and Objectives People living with HIV/AIDS are at an increased risk of de-veloping cancer. The goals of this study were to obtain data on the prevalence of HIV in the cancer population and vice versa at a major tertiary cancer and HIV center in North India. Methods This cross-sectional study was conducted over a 3-year period from July...
Article
Background: The use of anticoagulants may influence the composition of blood cells and interfere with plasma levels of IL-1ra when unprocessed EDTA blood samples are stored for long periods of time. Methods: Blood was drawn into EDTA and heparinized blood collection tubes from 11 HIV-1 negative men participating in the Multicenter AIDS Cohort St...
Article
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Background: HIV-1 set point viral load (SPVL) is a highly variable trait that influences disease progression and transmission risk. Men who are exclusively insertive (EI) during anal intercourse require more sexual contacts to become infected than exclusively receptive (ER) men. Thus, we hypothesize that EIs are more likely to acquire their viruse...
Article
Background: Clinicians often use population-based reference intervals (RIs) when interpreting patient results. However, this method can present problems if the analyte in question has wide variability from person to person. Methods: We examined the biological variation of routine hematologic markers in 82 white non-Hispanic men every 6 months du...
Article
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Background: People living with HIV (PLWH) are still being diagnosed late, rendering the benefits of "early" antiretroviral therapy (ART; based on CD4 count) unattainable. Therefore, we aimed to evaluate the benefits of "immediate" ART (based on the time interval between diagnosis and treatment, regardless of CD4 count). Methods: A nationwide coh...
Article
AIDS-related Kaposi's sarcoma (AIDS-KS) risk remains substantially elevated compared with the general population, even among patients who receive effective combination antiretroviral therapy. This study investigated the role of inflammatory and immune activating biomarkers in AIDS-KS in men who have sex with men in the Multicenter AIDS Cohort study...
Article
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Events leading to and propagating neurocognitive impairment (NCI) in HIV-1-infected (HIV+) persons are largely mediated by peripheral blood monocytes. We previously identified expression levels of individual genes and gene networks in peripheral blood monocytes that correlated with neurocognitive functioning in HIV+ adults. Here, we expand upon tho...
Article
Background: Factors affecting kidney function and proteinuria among HIV+ and HIV- persons need better characterization. Methods: We evaluated estimated glomerular filtration rate (eGFR, mL/min per 1.73 m) changes, proteinuria prevalence (a urine protein-to-creatinine ratio [UPCr] of ≥0.2 at two consecutive visits) and associated factors among HI...
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Certain “protective” major histocompatibility complex class I (MHC-I) alleles, such as B*57 and B*27, are associated with long-term control of HIV-1 in vivo mediated by the CD8⁺ cytotoxic-T-lymphocyte (CTL) response. However, the mechanism of such superior protection is not fully understood. Here we combined high-throughput fitness profiling of mut...
Article
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Background: Clinical trials have demonstrated that immediate initiation of antiretroviral therapy (ART) reduces AIDS-related morbidity and mortality. We tested the hypothesis that initiating ART ≤30 days after HIV diagnosis would be associated with reduced mortality among people living with HIV (PLWH) with CD4 counts >500 cells/mm3. Methods: PLW...
Article
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Purpose: Helping children living with HIV (CLH) to attain an optimum quality of life is an important goal for HIV programs around the world. Our principal objectives were to determine the association of HIV infection with different domains of health-related quality of life (HRQoL) among 8- to 15-year-old CLH in India and to compare the HRQoL param...
Article
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Background: Multistage, stepwise HIV testing and treatment procedures can result in lost opportunities to provide timely antiretroviral therapy (ART). Incomplete engagement of patients along the care cascade translates into high preventable mortality. We aimed to identify whether a structural intervention to streamline testing and linkage to HIV h...
Article
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Background The high rate of attrition along the care cascade of infection with human immunodeficiency virus (HIV) results in lost opportunities to provide timely antiretroviral therapy (ART) and to prevent unnecessarily high mortality. This study aims to assess the effectiveness of a structural intervention, the one-stop (“One4All”) strategy that s...
Article
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Background: Migration has been linked to the spread of HIV epidemic from the urban areas of western India to the rural areas of north India. Objectives: This is the first population-based study among the wives of migrant workers of Muzaffarpur district in Bihar with objectives to describe their sexual behavior within marriage, estimate the preva...
Article
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Background: Patients who are newly screened HIV positive by EIA are lost to follow-up due to complicated HIV testing procedures. Because this is the first step in care, it affects the entire continuum of care. This is a particular concern in rural China. Objective(s): To assess the routine HIV testing completeness and treatment initiation rates...
Article
In-depth interviews and focus group discussions were conducted to inform the development of an instrument to measure the health-related quality of life of children living with HIV. The QOL-CHAI instrument consists of four generic core scales of the “Pediatric Quality of Life Inventory” and two HIV-targeted scales—“symptoms” and “discrimination.” A...
Article
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A total of 2768 MSM participated in a survey in southern Vietnam. Univariate and multivariate logistic regression analyses were performed to determine predictors of HIV infection. The prevalence of HIV among MSM was 2.6 %. HIV infection was more likely in MSM who were older, had a religion, had engaged in anal sex with a foreigner in the past 12 mo...
Article
Children living with HIV (CLH) face several physical and psychological challenges. The impact of the disease is not limited to the affected CLH, but also affects their caregivers and family members. We qualitatively explored the experiences, knowledge, concerns, and perceptions of primary caregivers and triangulated those aspects with those express...
Article
Background: Biomarkers such as cytokines, chemokines, and soluble activation markers can be unstable when processing of blood is delayed. The stability of various biomarkers in serum and plasma was investigated when unprocessed blood samples were stored for up to 24h at room and refrigerator temperature. Methods: Blood was collected from 16 heal...
Article
Objective: Uncontrolled HIV infection progresses to the depletion of systemic and mucosal CD4 and AIDS. Early HIV infection may be associated with increases in the concentration of MIP-3α in the blood and gut fluids. MIP-3α/CCL20 is the only chemokine known to interact with CCR6 receptors which are expressed on immature dendritic cells and both ef...
Article
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Background There is limited scientific evidence on the relationship of job stress with quality of life (QoL). Purpose This study aims to explore different domains of job stress affecting IT/ITES professionals and estimate the levels of stress that these professionals endure to reach positive levels of QoL given that other determinants operating be...
Article
Introduction: Informing the children living with HIV (CLH) about their disease (disclosure) is important from the perspective of disease treatment and overall psychosocial development. There are no published studies that qualitatively explored HIV disclosure-related issues among CLH in India. Our aim was to provide insights into the perceptions of...
Article
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Background: HIV prevalence has increased rapidly among men who have sex with men (MSM) in China reaching alarmingly high levels in some cities. Bisexual MSM have potential to transmit HIV and syphilis to their female partners through condomless vaginal intercourse (CVI). Thus, estimation of the burden of CVI and identification of its associates se...
Article
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Introduction HIV incidence is an important measure for monitoring the development of the epidemic, but it is difficult to ascertain. We combined serial HIV prevalence and mortality data to estimate HIV incidence among key affected populations (KAPs) in China. Methods Serial cross-sectional surveys were conducted among KAPs from 2010 to 2014. Trend...
Article
John Fahey was one of the first investigators to study the then-new acquired immune deficiency syndrome (AIDS). He made major contributions to the design of the Multicenter AIDS Cohort Study (MACS), and vigorously promoted novel and high-quality science as the MACS evolved. His contributions are highly valued.
Article
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Background: Gait speed predicts functional decline, disability, and death and is considered a biomarker of biological aging. Changes in gait speed in persons aging with HIV may provide an important method of gauging health and longevity in an under assessed population. The objective of this study was to evaluate and quantify the rate of gait speed...
Article
We retrospectively examined the timing of antiretroviral therapy (ART) initiation and CD4+ T-cell recovery over 36 months among recent human immunodeficiency virus (HIV) infections using BED (HIV-1 subtypes B, E and D) immunoglobulin G capture enzyme immunoassay (BED-CEIA). Regardless of baseline CD4+ counts, individuals (n = 393) who initiated ART...
Article
Full-text available
Background: Multistage stepwise HIV testing and treatment initiation procedures can result in lost opportunities to provide timely antiretroviral therapy (ART). Incomplete patient engagement along the continuum of HIV care translates into high levels of preventable mortality. We aimed to evaluate the ability of a simplified test and treat structur...
Article
Full-text available
There is limited research on occupational stress and its relation to health from developing countries such as India. This study was done to evaluate work conditions of professionals in two highly productive sectors: the information technology (IT) sector, also known as software development, and Information Technology Enabled Services (ITES), also k...
Article
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ABSTRACT: Background There is a high prevalence of HIV/syphilis among male sex workers (MSWs) but no formal study has ever been conducted focus on male clients of MSWs (MCM). A detailed investigation was thus called for, to determine the burden and socio-behavioral determinants of HIV and syphilis among these MCM in China. Methods As part of a mult...
Article
Full-text available
HIV-infected patients receiving antiretroviral therapy have increased risk of metabolic syndrome, including dyslipidemia. In this study, we determined whether individual nutritional counseling reduced dyslipidemia, particularly low-density lipoprotein (LDL) cholesterol, among HIV-infected patients with dyslipidemia not currently taking lipid-loweri...
Article
Background: There is a high prevalence of HIV/syphilis among male sex workers (MSWs) but no formal study has ever been conducted focusing on male clients of MSWs (MCM). A detailed investigation was thus called for, to determine the burden and socio-behavioral determinants of HIV and syphilis among these MCM in China. Methods: As part of a multi-cen...
Conference Paper
Background There is a high prevalence of HIV/syphilis among male sex workers (MSWs) but no formal study has ever been conducted focus on male clients of MSWs (MCM). A detailed investigation was thus called for, to determine the burden and socio-behavioral determinants of HIV and syphilis among these MCM in China. Methods As part of a multi-cente...