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Health Care Providers' Attributions Of Blame For Unintended Pregnancy And Hiv Acquisition Among Cisgender Women, Alison J. Goldberg

Dissertations, Theses, and Capstone Projects

Unintended pregnancy and HIV are both possible but preventable outcomes of vaginal sex, and both can be prevented in similar ways (condoms, daily oral medication, etc.). Despite these similarities, providers more readily prescribe contraception to cisgender women, compared to PrEP (Guttmacher Institute, 2021; Raifman et al., 2019). Providers’ differential willingness to prescribe each medication cannot be attributed merely to differences in women’s need for pregnancy prevention vs. HIV prevention, as women account for nearly 20% of new HIV infections (CDC, 2021). Through three studies, I examined whether perceivers’ support for harm reduction (i.e., prescribing PrEP/contraception) and behavior reduction (i.e., discouraging …

The Grindr Complex: The Behavioral Health Impact Of Sexual Racism On Latinx Men Who Have Sex With Men, Luisalfredo Plascencia

Doctoral Dissertations

Given the social history surrounding the issue of HIV/AIDS in the LGBTQ+ community and the unique and intersectional experiences that Latinx Men who have Sex Men (MSM) have in their community, this dissertation’s research will contribute to the growing work on sexual racism and how it correlates with various elements of behavioral health. The study investigated the moderation impact of Latinx cultural values of caballerismo and familismo on the relationship between experiences sexual racism to mental health symptoms. The study also examined the moderation of caballerismo and familismo and psychological flexibility on the relationship between experiences of sexual racism to …

Still, We Thrive: Understanding How Gay, Bisexual, Transgender, And Other Men Who Have Sex With Men (Gbtmsm) Experience Structural Barriers & Facilitators To Wellness, Lucas Gergyek

Theses and Dissertations (Comprehensive)

Historically and concurrently, structural violence has been a significant force influencing the sexual health and broader health of gay, bisexual, transgender and other men who have sex with men (GBTMSM). Yet to date, the majority of projects exploring the health inequities facing GBTMSM have focused on intrapsychic and behavioural factors as most related to poor health outcomes. As well, these studies are sometimes deficits focused, and fail to evaluate how GBTMSM continue to thrive, and maintain positive health. As a result, the ways in which systems and policies underlie and perpetuate health inequities facing GBTMSM have been somewhat obscured. Connectedly, …

Hiv And Early Life Stress On Neuroimaging And Risky Behavior, Paola Garcia Egan

Dissertations

This study examined the interactive effects of early life stress (ELS) and HIV on brain morphometry, diffusion-basis-spectrum-imaging (DBSI), risky decision-making, and sex-risk behavior. 122 people with HIV (PWH) and 113 people without HIV (PWoH), free of major psychiatric illness and neurological confounds, were stratified into high (≥ 3 events) vs. low (< 3 events) ELS [PWoH/low ELS (n = 57), PWoH/high ELS (n =56), PWH/low ELS (n = 43), PWH/high ELS (n = 79)] and underwent structural magnetic resonance imaging, DBSI, neuropsychological, and risky-behavior assessment; all PWH were virologically controlled. Compared to PWoH, PWH had smaller orbitofrontal cortex (OFC), parietal lobes, insula, caudate and anterior cingulate. No ELS effects were detected in volumetric measures. Significant interactions were found between HIV serostatus and ELS on the OFC and on cellularity of the inferior fronto-occipital fasciculus after multiple comparisons adjustment. Specifically, PWH/high ELS exhibited significantly smaller OFC and PWoH/high ELS show significantly larger OFC than the other groups. PWoH/high ELS exhibited higher DBSI cellularity (neuroinflammation proxy) of the inferior-occipital-fasciculus compared to PWoH/high ELS. Regardless of HIV status, executive function moderated the relationship between the OFC and sex-risk behavior such that individuals within the sample who performed above average on a measure of executive function and had a larger OFC reported fewer sex partners in past six months than individuals with smaller volumes. No interaction was found between HIV serostatus and ELS on risky behavior measures. Clustering analyses defined ELS subgroups in PWH that were determined by demographic characteristics, duration of infection, recent CD4+ T-cell count, nadir CD4+ T-cell count and high/low ELS.Even in PWH that are virologically controlled, without major current psychiatric comorbidities, there is evidence of a synergistic impact of ELS and HIV on OFC volumes. Higher volumes in the OFC were detrimental when associated with lower executive function scores or advantageous when associated with higher executive function. Findings suggest that ELS is associated with different brain signatures among PWoH and virally suppressed PWH. However, ELS was not directly associated with risky behaviors, and subgroups in PWH were characterized by demographic variables, past substance use and HIV clinical variables.

Experiences Of Stigma, Social Support, And Anxiety In People Living With Hiv In South Carolina, Sarah J. Miller

Theses and Dissertations

People living with HIV (PLHIV) experience numerous psychosocial stressors, including HIV-related stigma and heightened prevalence of mental health disorders such as depression, substance use disorders, and anxiety. However, limited research has investigated predictors of anxiety within this population. This study aimed to explore the relationship between HIV-related stigma and anxiety symptoms among PLHIV in South Carolina (SC) and to examine the role of social support as a mediator for this relationship. A total of 402 PLHIV receiving HIV care at large immunology center in SC completed a paper and pencil survey, reporting sociodemographic variables, as well as experiences of HIV-related …

S-Equol: A Novel Therapeutic For Hiv-1 Induced Gut Dysbiosis, Mason T. Rodriguez

Theses and Dissertations

HIV-1 infection affects approximately 38 million people around the world. The advent of cART has greatly improved the quality of life of infected individuals; however, roughly 50% of these individuals will still experience HIV-1 associated neurocognitive disorders (HAND). Additionally, the gut microbiome has been reported to be dysbiotic in HIV-1 infected individuals, regardless of adherence to cART. Current research has pointed to the gut-brain-microbiota axis as a potential target to treat both cognitive deficits and microbial changes. The present study investigated S-equol (SE) as a potential therapeutic for HAND by modulating the gut microbiome. The study included 21 HIV-1 Tg …

Escitalopram Treatment To The Hiv-1 Transgenic Rat: Spine Dynamics, Telomere Quantification And Neurogenesis, Adam Ray Denton

Theses and Dissertations

HIV is a serious viral infection that persists in the brain despite treatment. Approximately half of all seropositive patients will experience some degree of comorbid depression, as well as HIV associated neurocognitive disorders. The present research sought to evaluate the therapeutic efficacy of escitalopram, a selective serotonin reuptake inhibitor in ameliorating neuroanatomical and biochemical markers associated with HIV infection. The central purpose of this research is to characterize the effects of escitalopram treatment upon dendritic spine proliferation in the nucleus accumbens. Previous research has consistently demonstrated impaired synaptodendritic integrity in this region, with underlying mechanisms remaining unclear. A secondary focus …

Application Of The “Idisco” Full-Brain Tissue Clearing Method: A View Of Dopamine And Inflammation In The Hiv-1 Transgenic Rat, Kristin Nickole Kirchner

Theses and Dissertations

The iDISCO (immunolabeling-enabled three-dimensional imaging of solvent-cleared organs) method is a quick, inexpensive, and easily adaptable tissue staining and clearing procedure that allows neuroscientists to study a protein of interest in a whole, unaltered tissue sample. While the iDISCO method was initially tested and validated for mice embryos and brains, the current experiment sought to adapt the method for use in the rat using HIV-1 transgenic (Tg) rat brain tissue. Antibodies for tyrosine hydroxylase and Iba-1 were validated in the HIV-1 Tg rat and in F344/N control rats using iDISCO. Confocal images were taken of tyrosine hydroxylase positive neurons in …

The Role Of Attentional Processes In The Associations Between Syndemics And Hiv Risk, Raymond L. Moody

Dissertations, Theses, and Capstone Projects

Sexual minority men (SMM) remain the group most affected by HIV in the United States. The term “syndemic” has been used to describe high levels of comorbidity and additive effects that some factors—childhood sexual abuse, intimate partner violence, sexual compulsivity, substance use, and depression—have on HIV transmission risk behavior (TRB). Previous research provides support for an HIV syndemic among SMM, but mechanisms linking syndemic factors and driving the association between the factors and TRB are less understood. Some research suggests that executive attention and emotion dysregulation are linked with several syndemic factors. As such, the aims of this dissertation were …

Structural Magnetic Resonance Imaging As A Diagnostic Biomarker Of Hiv-Associated Neurocognitive Disorders (Hand), Mikki Schantell

Capstone Experience

Objective: The goal of this study was to do an exploratory analysis to determine if gray matter brain volumes and cortical thickness measures obtained from structural magnetic resonance imaging (sMRI) can discriminate people with HIV-associated neurocognitive disorders (HAND), neurocognitively unimpaired people with HIV (NU PWH), and HIV-negative controls (HIV- controls) using linear discriminant analyses.

Methods: A total of 231 participants, including 110 PWH and 121 HIV- controls, completed a neuropsychological (NP) battery and an sMRI protocol. The bilateral gray matter volumes and cortical thickness brain regions were analyzed using 18 linear discriminant models to assess the discriminability of gray matter …

Culture And Hiv/Aids-Related Psychological Distress, Ndayiziveyi Constance Scott

Walden Dissertations and Doctoral Studies

The over-representation of HIV infections among Black populations relative to the mainstream population continues to be documented in Canada. Previous research has implicated cultural factors in the transmission of HIV in addition to linking HIV/AIDS to psychological distress. Some studies established a link between awareness of increased HIV/AIDS risk and vulnerability to distress, and others indicated cultural differences in the experiences of cognitive dissonance as a function of cultural variations in beliefs and practices. The purpose of this quantitative study was to examine cultural variables associated with cognitive dissonance (dependent variable) arousal as a function of cultural sexual gender-role socialization …

Traditional Latinx Gender Role Norms And Exposure To Sexual Health Programming For Latinx Men Who Have Sex With Men (Lmsm), Austin Connor Eklund

Legacy Theses & Dissertations (2009 - 2024)

Latinx men who have sex with men (LMSM) are at significantly greater risk for HIV infection than their non-Latinx peers. One important way of helping prevent the spread of HIV is exposing vulnerable populations to HIV prevention programming. Little is known about what factors predict exposure to HIV prevention programming for LMSM. Given extant links between traditional masculine gender role norms and health outcomes, this study sought to examine possible relations between constructs of machismo, caballerismo, and heterosexual self-presentation, along with demographic covariates, and exposure to HIV prevention programming among LMSM. Among the 530 LMSM in our sample, 89% reported …

“May I Be Kind To Myself”: A Study On Self-Compassion And Shame On A Hiv Nightline, Lauren Swansick

Master's Projects and Capstones

Purpose: The purpose of this study was to strengthen San Francisco Suicide Prevention’s HIV Nightline (NL) communication with worried well callers. As a result, this study focused on identifying any covert emotions this population experienced, such as shame, guilt, and judgement. In addition, precursors to worried well behavior were explored, such as the influence of sex act and sexual partner. A needs assessment was conducted with hotline staff and volunteers, with a brief self-compassion intervention piloted over a two-week period.

Methods: Data collection included 1.) a focus group with hotline staff and volunteers 2.) a volunteer survey to learn about …

How Women Navigate Safety In The Dominican Bateyes, Mary Margaret Tull

College of Science and Health Theses and Dissertations

Research has demonstrated that individuals of Haitian descent in the Dominican Republic are at high risk of violence and experience multiple levels of structural oppression. However, less research exists specifically for women of Haitian descent, who are at unique risk of violence due to the complex political history between Haiti and the Dominican Republic, as well as structural and gendered violence. I use frameworks of socio-ecological systems, intersectionality, structured violence, and gendered violence to consider how women of Haitian descent in the Dominican Republic construct safety and prioritize different needs for their survival. I used thematic analysis to analyze life …

Coercive And Deceptive Predictors Of Sexual Risk: The Moderating Role Of Self-Esteem, Morgan Barker

Undergraduate Honors Theses

Risky sexual practices can lead to concerning public health issues, including sexually transmitted infections (STIs) and unintended pregnancy. Coercive or deceptive behaviors by one’s partner to engage in risky practices may be one factor contributing to sexual risk. This study examined experiences of sexual risk coercion and deception, including partner sexual infidelity, coerced condom nonuse, and fear of negative partner reaction to condom request, as predictors of engagement in sexual risk behaviors, including condom use, safer sex communication, and lifetime number of sexual partners. Self-esteem was examined as a moderator. College students (N = 216) were recruited through the …

Behavioral And Voltammetric Analysis Of Chronic Escitalopram Treatment To The Hiv-1 Transgenic Rat: Implications For Comorbid Hiv-1 And Clinical Depression, Adam R. Denton

Theses and Dissertations

HIV-1 infection is a serious condition affecting approximately 37 million individuals. Between 30% and 60% of seropositive individuals will develop symptoms of clinical depression. These individuals are five times more likely to commit suicide than non-seropositive clinically depressed patients. Dysfunction in serotonergic and dopaminergic transmission has consistently been implicated in the pathogenesis of depression. Specifically, dysfunction in the prefrontal cortex and in the nucleus accumbens core region have been shown to be underlying factors in the trajectory of depression. Given these underlying neurological features, the present research employed behavioral testing and electrochemical recording in an attempt to elucidate the therapeutic …

Developing An Evidence-Based Hiv Testing Message For Young African American Women, Melanie P. Moore

Theses and Dissertations

African American women have the highest rates of HIV infection among women of all racial/ethnic groups in the United States, and over 50% of HIV infected young adults are unaware of their infection. HIV testing is a cost-effective mechanism for reducing HIV transmission. Despite this, limited research has been devoted to developing interventions specifically promoting HIV testing. This two-part study proposed to address this gap through developing a culturally tailored HIV testing message aimed at increasing HIV test intentions among young African American women. Study 1 was a quantitative study that examined predictors of HIV testing history and future HIV …

A Novel Mhealth Application For Improving Hiv And Hepatitis C Knowledge In Individuals With Opioid Use Disorder, Taylor A. Ochalek

Graduate College Dissertations and Theses

Aims: Untreated opioid use disorder (OUD) is associated with overdose, premature death and infectious disease, including human immunodeficiency virus (HIV) and Hepatitis C (HCV). While prior studies have shown that educational interventions are associated with improvements in HIV and HCV knowledge and reductions in risk behaviors, those examined to date have typically been time- and resource-intensive. We recently developed an HIV+HCV Education intervention which aims to improve HIV and HCV knowledge in a single visit using an automated iPad platform. In this project, we examined its ability, using a within-subject evaluation, to improve knowledge of HIV and HCV transmission and …

Exploring Restorative Factors For Trafficked And Sexually Exploited Women, Carol C. Chilaka

Walden Dissertations and Doctoral Studies

Abstract

Many women who survived sex trafficking continue to suffer from severe and persistent psychological distress even after the traditional treatment and rehabilitation program. The lingering psychological symptoms that these survivors suffer make reintegration into their families and communities difficult. This phenomenological study identified the restorative factors that helped some women who were earlier engaged in sex trafficking to recover, readjust, and reintegrate into their families and communities. Six female survivors of human trafficking and six program directors/counselors at different rehabilitation centers were individually interviewed in in-depth with semi-structured questionnaires and audio recorded. I kept diary of my readings and …

A Case Study Of A Mature Appalachian Hiv Negative Homosexual Man On Hiv Positive Homosexual Men, Jacob Lee Nelson

Masters Theses

Because of the lack of study, little is known about how members of the gay community immersed in rural areas relate to one another especially relative to the AIDS Crisis and those gay men living with HIV (Eldridge, Mack, & Swank, 2008). The purpose of this study was to investigate features of attitude (fears, threats, preconceived notions, and convictions) of a mature HIV negative homosexual man from rural Appalachia on HIV positive homosexual men (Thurstone, 1928). The central research question asked was, “How do you relate to HIV positive gay men as a HIV negative gay man having been raised …

Peer Rejection And Emotion Development: The Role Of Peer Rejection And Coming Out On Emotional Health Among Gay And Bisexual Men, Joseph A. Carter

Theses and Dissertations

Gay and bisexual men experience a higher prevalence of negative mental health outcomes than their heterosexual counterparts. This study examines sexual identity milestone achievement—the age of first coming out to friends—for mediation on the association between childhood experiences of peer rejection and levels of emotion dysregulation in adulthood.

A Comparison Of Neuropathic Pain In Hiv Disease And Diabetes Mellitus, Mary Catherine George

Walden Dissertations and Doctoral Studies

Neuropathy is a nerve disorder found in HIV disease and diabetes mellitus that indicates damage in the peripheral nervous system. Burning, tingling, stabbing, shooting, and painful sensations in the hands and feet are common symptoms of this chronic disorder, and no treatments are available that repair the nerves. The approved pain treatments are few and only available for the diabetic neuropathy population. A mixed-methods study of archival data was performed to compare patients with painful neuropathy (PN) associated with 2 diseases: HIV (HIV-PN) and diabetes mellitus (DPN). This study examined the similarities and differences of the pain narratives and common …

Living And Loving: A Qualitative Exploration Of The Dating And Sexual Relationships Of Hiv-Positive Young Black Gay, Bisexual, And Other Men Who Have Sex With Men, Darnell N. Motley

College of Science and Health Theses and Dissertations

Infection with HIV is a global pandemic that continues to have particular impacts on Black men who have sex with men. Accordingly, researchers have examined risk behaviors in order to inform interventions that seek to decrease transmission. However, there has been relatively little research that has examined the dating and sexual experiences of Black GBMSM living with HIV absent a particular focus on sexual risk and potential transmission. The present study seeks to better understand the dating and sexual experiences of a sample of young Black GBMSM living with HIV. Twenty young Black GBMSM living with HIV were interviewed using …

The Role Of Harm, Detectability, And Knowledge Of Hiv Non-Disclosure Laws In Affecting Punishment Recommendations For Hiv Law Violators, Christina Marie Dodson

Psychology Theses & Dissertations

Many U.S. states have passed HIV non-disclosure laws that criminalize sexual behavior on the part of HIV-positive persons who do not disclose their HIV status to sexual partners. This study broadly focused on the impact of two major philosophical approaches for meting out punishment to law violators: the just deserts and the deterrence perspectives. The study examined how these two approaches may influence laypersons’ motivations for punishing someone with HIV who violates an HIV non-disclosure law. In addition, the study examined how knowledge or no knowledge of an HIV non-disclosure law by the law violator influenced punishment recommendations. A 2 …

Hiv-Positive Status Disclosure Barriers In Stable Heterosexual Partners In Warri, Nigeria., Edith Nkechinyere Ogbozor

Walden Dissertations and Doctoral Studies

Nondisclosure of positive status drives the secondary transmission of human immunodeficiency virus (HIV) infection. This cross sectional quantitative survey study grounded by the consequence theory evaluates fear of stigma, lack of social support, and level of HIV-related knowledge as barriers to self-disclosure of HIV-positive status to stable heterosexual partners. A sample of 303 HIV-infected respondents (111 men and 192 women) accessing antiretroviral therapy at 4 designated centers in Warri, Nigeria, completed the self-administered questionnaires. Logistic regression analysis was used to assess the association between these factors and spousal HIV-positive status disclosure. Results demonstrated: (a) social support availability significantly predicted HIV …

Stigma, Community Connectedness, And Social Support Among Trans Women Living With Hiv In Ontario: Findings From The Trans Pulse Project, Tanya D'Amours

Theses and Dissertations (Comprehensive)

Trans (transgender, transsexual, transitioned) individuals face numerous challenges to their health and well-being (Bauer, Hammond, Travers, Kaay, Hohenadel & Boyce, 2009). Trans women in particular face disproportionately high rates of negative health outcomes, including HIV. Trans women face intersecting stigmas, which result in transphobia, trans erasure, isolation, and other systemic barriers to their well-being (Logie, James, Tharao, & Loutfy, 2012a). Despite their elevated risk, trans women, particularly those living with HIV, are invisible, neglected or underrepresented in research (Logie, et al., 2012a). Research suggests that community connectedness and social support are factors that impact the wellness of marginalized people (Kertzner, …

Health-Related Quality Of Life And Positive Mental Health Indicators In Youth With Human Immunodeficiency Virus, Sim Yin Tan

USF Tampa Graduate Theses and Dissertations

Human Immunodeficiency Virus (HIV) is a chronic health condition that is increasingly affecting both children and adolescents (Center for Disease Control and Prevention, 2011). Although many studies have investigated the impact of HIV on cognitive, physical, academic, and psychosocial functioning, little is known about the self-perception of health-related quality of life, subjective well-being, social-emotional well-being, and psychopathology risks of youth who are infected with HIV. This study is one of first to examine the presence of these positive and negative health indicators and the relationship among these factors in youth with HIV and a community-based sample.

A total of 84 …

Providers' Socioecological Perspectives On The Supports For And Challenges To Engagement In Care For Latino Youth Living With Hiv: A Qualitative Study, Diana Lemos

College of Science and Health Theses and Dissertations

INTRODUCTION: Among youth, marginalized groups, such as Latino YLWH (LYLWH), may face multiple social stigmas, including such concerns as limited English-language proficiency, sexual-minority status, and immigration status that impact engagement across the continuum of HIV care (van Servellen, Chang, & Lombardi, 2002). One necessary step toward increasing understanding of the facilitators and barriers to this group’s engagement in HIV care is to examine engagement in care through a socioecological framework to better understand each of the multiple factors impacting Latino youth’s engagement in HIV care (Bronfenbrenner, 1986; Hosek, Harper, Lemos et al., 2005; Mugavero, Norton & Saag, 2011). Through the …

Attention In Hiv, Kathleen Marie Van Dyk

Dissertations, Theses, and Capstone Projects

In contrast to the striking benefit of advances in antiretroviral therapy on longevity and health in the HIV+ population, mild cognitive disorders persist (Heaton, Clifford et al., 2010). Additional factors that may be related to cognitive decline and warrant consideration in this population are aging and physical health status. Among cognitive domains affected, attention and processing speed have emerged as particularly vulnerable to the effects of HIV. There are also age effects observed in these domains, and we proposed that reduced physical health can also impact cognition in these areas, comparably to pain. Sensitive measures of attention that vary attentional …

Sexual Behavior And Hiv Risk In Black College Women: The Influence Of Gender, Peer, And Relationship Beliefs, Melanie P. Moore

Theses and Dissertations

Black women in the United States disproportionately represent 64% of women with an HIV infection (CDC, 2013). Research is needed to better understand gender and culturally-specific factors that contribute to Black women’s HIV risk. The Theory of Gender and Power and the Theory of Planned behavior were used as theoretical frameworks in examining the effect of attitudinal beliefs (gender related beliefs), subjective norm beliefs (peer norms), and perceived behavioral control beliefs (relationship power) on sexual behavior in Black college women. Condom use and assertiveness in sexual communication were the dependent variables. Participants included 136 Black college women recruited through the …