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1.  Sexually Transmitted Infection Prevalence and Behavioral Risk Factors among Latino and Non-Latino Patients Attending the Baltimore City STD Clinics 
Sexually transmitted diseases  2010;37(3):191-196.
Background
Many studies have evaluated factors influencing STD/HIV disparities between African-American and white populations, but fewer have explicitly included Latinos for comparison.
Methods
We analyzed demographic and behavioral data captured in electronic medical records of patients first seen by a clinician in one of two Baltimore City public STD clinics between 2004 and 2007. Records from white, African-American, and Latino patients were included in the analysis.
Results
There were significant differences between Latinos and other racial/ethnic groups for several behavioral risk factors studied, with Latino patients reporting fewer behavioral risk factors than other patients. Latinos were more likely to have syphilis, but less likely to have gonorrhea than other racial/ethnic groups. English-proficient Latina (female) patients reported higher rates of infection and behavioral risk factors than Spanish-speaking Latina patients. After adjustment for gender and behavioral risk factors, Spanish-speaking Latinas also had significantly less risk of sexually transmitted infections than did English-speaking Latinas.
Conclusions
These results are consistent with other studies showing that acculturation (as measured by language proficiency) is associated with increases in reported sexual risk behaviors among Latinos. Future studies on sexual risk behavior among specific Latino populations characterized by country of origin, level of acculturation, and years in the U.S. may identify further risk factors and protective factors to guide development of culturally appropriate STD/HIV interventions.
doi:10.1097/OLQ.0b013e3181bf55a0
PMCID: PMC2828531  PMID: 19910863
Hispanic/Latino; sexually transmitted disease clinic; racial/ethnic disparities; acculturation; gonorrhea; chlamydia; syphilis; HIV
2.  Utilization patterns and correlates of retention among clients of the needle exchange program in Baltimore, Maryland 
Drug and alcohol dependence  2009;103(3):93-98.
NEP effectiveness at a population level depends on several factors, including the number of IDUs retained, or consistently accessing services. Patterns of retention in the Baltimore Needle Exchange Program (BNEP) from 1994 to 2006 were calculated using enrollment surveys and client records. We used Andersen’s Behavioral Model of Health Services Use to frame our examination of factors associated with retention. Client retention was measured in two ways: whether a client returned to the exchange within twelve months of enrollment and how many times a client returned within these twelve months. BNEP clients (N=12,388) were predominantly male (69%), African-American (73%), and ≥ age 30 (86%). Nearly two-thirds (64%) of clients returned within twelve months of their first BNEP visit. The median number of return visits per client within twelve months was one (IQR 0–5). Young age (<30), being married, having an injection drug use history of less than twenty years, and living farther from the BNEP site were characteristics independently associated with both measures of low retention in multivariate analysis. Among younger injectors, geographical proximity was a particularly important predictor of retention. Further insight into the influence of these factors may help in developing programmatic changes that will be effective in increasing retention.
doi:10.1016/j.drugalcdep.2008.12.018
PMCID: PMC2744092  PMID: 19464827
needle exchange; syringe exchange; injection drug user; retention; behavioral model of health services use; african-american; youth; neighborhood
3.  Increases in Oral and Anal Sexual Exposure among Youth Attending STD Clinics in Baltimore, Maryland. 
We examined reports of receptive oral or anal sex among clinic patients age 12−25 over time. Odds of reporting oral sex were approximately three times higher in 2004 than in 1994; odds of anal sex were twice as high. Providers should be aware of increased risk behavior among young people.
doi:10.1016/j.jadohealth.2007.09.015
PMCID: PMC2350224  PMID: 18295140

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