About

Christine M. Khosropour is an Associate Professor in the Department of Epidemiology at the University of Washington, affiliated with the School of Public Health. Her work involves both research and applied epidemiology in the fields of HIV and sexually transmitted infection (STI) prevention. Her research focuses on behavioral risks for HIV and STI infection, the epidemiology of rectal chlamydia among men and women, and the implementation of PrEP and HIV care engagement programs in the Southern United States. Since 2015, she has collaborated with over 20 state and local health departments, primarily in the Southeastern US, providing expertise and guidance on the implementation and evaluation of public health programs related to HIV and STIs. Dr. Khosropour is also a core faculty member in the Implementation Science Core of the UW/Fred Hutch Center for AIDS Research (CFAR). Her background includes a PhD in Epidemiology from the University of Washington, an MPH from Emory University, and a BS in Microbiology & Immunology from the University of Wisconsin (Madison).

Research topics

• Medicine
• Family medicine
• Immunology
• Internal medicine
• Surgery
• Demography
• Nursing
• Gynecology

Selected publications

• The Duration of Pharyngeal Gonorrhea: A Natural History Study

  Clinical Infectious Diseases · 2021 · 55 citations

  • Medicine
  • Internal medicine
  • Surgery

  BACKGROUND: Pharyngeal gonorrhea is relatively common. However, the duration of untreated pharyngeal gonorrhea is unknown. METHODS: From March 2016 to December 2018, we enrolled 140 men who have sex with men in a 48-week cohort study. Participants self-collected pharyngeal specimens and completed a survey weekly. Specimens were tested using a nucleic acid amplification test at the conclusion of the study. We estimated the incidence and duration of infection. We defined incident infections as 2 consecutive positive tests, and clearance as 2 consecutive negative tests; and, after visual inspection of the data, we reclassified up to 2 weeks of missing or negative tests as positive if they occurred between 2 episodes of infections. We used Kaplan-Meier estimates to define duration of infection. Finally, we report on the frequency of single-positive tests and the time between the last negative test and the positive test. RESULTS: Nineteen (13.6%) of 140 participants experienced 21 pharyngeal infections (incidence, 31.7/100 person-years; 95% confidence interval, 20.7-48.6/100 person-years). The estimated median duration of pharyngeal gonorrhea was 16.3 weeks (95% confidence interval, 5.1-19.7 weeks). Twenty-two men had 25 single-positive specimens, a median of 7 days (interquartile range, 7-10 days) after their last negative test. CONCLUSIONS: The median duration of untreated pharyngeal gonorrhea is 16 weeks, more than double previous estimates. This long duration of infection likely contributes to high levels of gonorrhea transmission.

  DOI

• Decreases in Reported Sexually Transmitted Infections During the Time of COVID-19 in King County, WA: Decreased Transmission or Screening?

  Sexually Transmitted Diseases · 2021 · 58 citations

  • Medicine
  • Demography
  • Gynecology

  BACKGROUND: In response to the COVID-19 pandemic, Washington State's Stay Home, Stay Healthy (SHSH) order was implemented on March 24, 2020. We hypothesized that pandemic mitigation measures might reduce sexually transmitted infection (STI) screening and/or transmission. METHODS: We used King County, WA STI surveillance and sexual health clinic (SHC) data from January 1, 2019, to July 31, 2020. We calculated mean weekly case counts for gonorrhea, primary and secondary (P&S) syphilis, male urethral gonorrhea, and early latent (EL) syphilis for 3 periods in 2020: pre-SHSH (January 1-March 23), SHSH (March 24-June 5), and reopening (June 6-July 31). Primary and secondary syphilis and male urethral gonorrhea were used as proxies for sexual behavior, and EL syphilis was used as a proxy for STI screening. We compared SHC visits (2019 vs. 2020) and SHC gonorrhea treatment practices (across 2020 periods). RESULTS: Compared with January to July 2019, from January to July 2020, reported cases of gonorrhea, male urethral gonorrhea, P&S syphilis, and EL syphilis decreased by 9%, 5%, 16%, and 22%, respectively. Mean weekly case counts of gonorrhea, male urethral gonorrhea, and EL syphilis decreased pre-SHSH to SHSH, but all returned to pre-SHSH levels during reopening. Sexual health clinic visits during SHSH were 55% lower in 2020 than in 2019. In the SHC during SHSH, ceftriaxone treatment of gonorrhea decreased, whereas cefixime/cefpodoxime treatment and gonorrhea treatment with no testing increased. CONCLUSIONS: Decreases in reported STIs concurrent with COVID-19 SHSH may reflect a true decline in STI transmission. However, the larger decreases in asymptomatic infections indicate that much of the observed decrease was likely due to decreased screening.

  DOI

• A Pharmacist-Led, Same-Day, HIV Pre-Exposure Prophylaxis Initiation Program to Increase PrEP Uptake and Decrease Time to PrEP Initiation

  AIDS Patient Care and STDs · 2020 · 96 citations

  1st authorCorresponding
  • Medicine
  • Family medicine
  • Nursing

  Mississippi has one of the highest rates of HIV in the United States, but has low pre-exposure prophylaxis (PrEP) uptake, particularly among black men who have sex with men (MSM) and women. From November 2018 to May 2019, patients at high risk of HIV who tested negative for HIV at a nonclinical testing center in Jackson, Mississippi, were referred to an on-site clinical pharmacist for same-day PrEP initiation. The pharmacist evaluated patients for medical contraindications to PrEP, but no baseline labs were obtained. The pharmacist provided a PrEP prescription and scheduled a clinical appointment for patients within 6 weeks, at which time they were evaluated by a clinician and completed baseline labs. The pharmacist evaluated 69 patients for PrEP; 57% were MSM, 77% were black, and 65% were uninsured. All patients received a PrEP prescription; 83% received the prescription the same day and 97% received it within 5 days. Fifty-three (77%) of 69 clients filled the prescription; 87% of whom filled it within 1 week. Only 23 (43%) of 53 clients who filled their prescription attended their initial clinical appointment within 6 weeks of obtaining PrEP. There were no differences in PrEP initiation or retention by patient sex/gender. This pilot program suggests that an on-site pharmacist working in a nonclinical testing center in the southern United States can successfully initiate PrEP among predominately low-income black MSM. Future efforts should seek to better integrate laboratory testing into this demedicalized model of PrEP and to improve retention in care.

  DOI

Recent grants

• Determining the effectiveness of a new model of PrEP initiation in Mississippi

  NIH · $430k · 2020–2023

Frequent coauthors

• Matthew R. Golden

  AIDS United

  110 shared

• Lisa E. Manhart

  University of Washington

  78 shared

• Lindley A. Barbee

  University of Washington

  66 shared

• Julia C. Dombrowski

  Public Health – Seattle & King County

  44 shared

• James P. Hughes

  University of Washington

  34 shared

• Leandro Mena

  34 shared

• Olusegun O. Soge

  University of Washington

  26 shared

• Patricia Kissinger

  Tulane University

  25 shared

Labs

• Department of EpidemiologyPI

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