Women’s Health
Permanent URI for this collectionhttps://hdl.handle.net/20.500.12503/21747
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Browsing Women’s Health by Author "Igenoza, Oluwatosin"
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Item Pregnancy Outcomes Among Women in Substance Abuse Treatment(2015-03) Felini, Martha; Raines-Milenkov, Amy; Alexander, Brian; Ukpaka, Kelechi; Bangara, Saritha; Igenoza, Oluwatosin; Jegede, Opeyemi; Anderson, Ralph; Qualls-Hampton, RaquelPurpose Pregnancy outcomes are powerfully influenced by what occurs long before pregnancy begins. Providing preconception care is a critical component to decreasing rates of adverse pregnancy and birth outcomes, as reflected in the Healthy People 2020 objectives. To help promote progress on these objectives, improvements in birth outcomes must be made in our highest risk and most disparate populations. Using self-reported reproductive history data from an ongoing cervical cancer prevention services project delivered to substance abusing women in treatment, we examined the reproductive history and frequency of pregnancy outcomes. Further analysis explored whether previous trauma and risky sexual activity were associated with adverse pregnancy outcomes. Methods Study participants included women aged ≥18 years attending our cancer prevention education seminars at Nexus Recovery Center – the largest female only substance abuse recovery center in DFW. Demographics, past trauma, risky sexual activity, and birth histories (preterm births, miscarriages, abortions, number of children) were collected using self-administered questionnaires. Chi-square tests were used to assess differences between birth outcomes, trauma, and risky sexual activity. Results A total of 286 women with a median age of 32 years were included in this study. The majority of women were white (68%). Two-thirds reported histories of physical abuse, 50% reported sexual abuse, and 42% sold sex for drugs. Nearly nine out of 10 women reported previously being pregnant. A total of 809 pregnancies were observed among 237 pregnant women. Among pregnancies reported, 506 (63%) ended with childbirth (437 full term delivery, 69 preterm delivery), 123 (15%) with miscarriage, 148 (18%) with abortion, while the outcome was unknown for 32 (4%). Pre-term births were higher among women with histories of physical abuse (p=0.02) and more miscarriages were reported among victims of sexual abuse (p=0.02). No differences in poor birth outcomes were observed with high risk sexual activity. Conclusion Our findings suggest adverse pregnancy outcomes are high for substance abusing women in treatment compared to the general population. An exceptional window of opportunity exists to integrate preconception care interventions within treatment recovery centers, but the key challenge will be determining the best delivery mechanism within the context of significant trauma histories.Item Prevalence of high-risk human papillomavirus types among substance abusing women screened for cervical and anal cancer.(2015-03) Felini, Martha; Tod, Nicole; Kremer, Timothy; Bangara, Saritha; Igenoza, Oluwatosin; Jegede, Opeyemi; Anderson, Ralph; Qualls-Hampton, Raquel Y.Purpose Prevalence studies of HPV in the general US population have provided important baseline data for monitoring HPV vaccination efforts. As the field of HPV progresses, funders are calling for HPV studies to be conducted in more meaningful and high risk populations to uncover new leads in HPV infection. Our primary objective in this cross-sectional study was to estimate the seroprevalence of high-risk HPV (hr-HPV) among a high risk population - substance abusing women. Further investigation was conducted to assess concordance of hr-HPV infection between cervical and anal sites. Methods Women were recruited from Nexus Recovery Center – the largest female only substance abuse recovery center in DFW. Cervical and anal pap smears were used to collect samples for hr-HPV co-testing. HPV results were received from 318 cervical samples and 243 anal samples. Chi-square and t-tests were used to determine differences in hr-HPV status by age, race, smoking, high risk sexual activity, cytology, and concordance. Results Seropositivity for cervical hr-HPV was 29%. Anal hr-HPV was observed significantly more often (32%) compared to cervical sites. Seropositivity for hr-HPV among women with abnormal cervical cytology was 63%; for those with normal cervical cytology hr-HPV was 47%. However, only 39% of abnormal anal cytology tested seropositive for hr-HPV. hr-HPV status differed by age and cervical cytology, but not by race, smoking, sexual activity, or anal cytology. Of those testing positive for either cervical or anal hr-HPV, nearly half (46%) had infection concurrently at both sites. Conclusion Our study population demonstrated higher rates of cervical and anal hr-HPV infections compared to US women (23% and 19%, respectively). As expected, hr-HPV status differed by cervical cytology results. Contrary to our hypothesis, hr-HPV status was similar regardless of anal cytology results. This unexpected finding may suggest a different ability of anal hr-HPV clearance, or it could reflect the younger age of our study group given the older age predilection of anal dysplasia. Concordance of hr-HPV between cervical and anal sites is generating a separate study of type-specific hr-HPV at cervical, anal, and oral sites. Our findings lend importance to determining whether anal Pap smears and/or anal hr-HPV testing should be included in well woman exams and also presents baseline HPV prevalence for the first time in this high risk population.