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Standing At The Back Of The Bar, Lawrance Cuellar

Open Access Theses & Dissertations

Standing at the Back of the Bar is a collection of semi-autobiographical literary pieces, a hybrid of lyrical essays, poetry, and short stories, that are based on life experiences of the author, Lawrance Cuellar. The book begins with stories of the narrator growing up as a gay Latino in the very conservative, West Texas town of Amarillo in the 1960s and 1970s. The narrator describes and expresses the normalized and internalized homophobia and racism he experienced in the city. As the title for the manuscript implies, he is expected to “stand at the back of the bar” in deference to …

The Perpetuation Of Hiv Risk In Latinx Immigrations: A Cross-National Perspective, J. M. Aleman

Open Access Theses & Dissertations

Research indicates that migration is a social determinant of health that increases the risk of acquiring HIV. What is less understood, however, are the pathways through which immigration influences HIV risk. This study employed a cross-national perspective and utilized a social determinants of health framework to understand how structural factors, such as economic conditions and immigration policies and their enforcement, influence HIV risk among migrants. While mobility, migration and displacement are associated with increased HIV risk, they are not inherently the cause but rather a condition under which vulnerability is increased indicating that other distal, upstream, or structural forces are …

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 …

Sheprep: Examining The Influence Of The Messaging And The Messenger Associated With Prep Uptake Among African American Women, Christian C. Spears

Electronic Theses and Dissertations

African American Women (AAW) make up less than 15% of the female population in the United States but account for over 50% of new HIV diagnoses among females. This largely preventable health disparity can be mitigated by advocating and prescribing Pre-exposure Prophylaxis (PrEP), a preventive HIV medication, to persons at risk. Despite advances in medication options, there are less than 13% of Black people who could benefit from having been prescribed PrEP, and limited research and promotion on the effectiveness of PrEP for AAW. The “ShePrEP Study” aimed to assess awareness, perceptions, and receptivity toward PrEP among AAW. This study …

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, …

Metabolic Alterations And Cardiovascular Risk After Hepatitis C Cure In Subjects With Or At Risk For Hiv, Christophe Maxime Fokoua Dongmo

Legacy Theses & Dissertations (2009 - 2024)

Background. Hepatitis C virus (HCV) infection engenders substantial metabolic changes. These changes are altered when the virus is cleared after successful treatment. We measured these metabolic alterations that occur after HCV cure; further, we assessed whether these alterations differed in subgroups defined by patients’ characteristics.

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 …

Cultivating Compassion In Catholic Teachings: An Invitation To Relationship With Immigrants And Refugees With Hiv/Aids, Anna Salvestrin

Undergraduate Honors Theses

In 1989 the United States Conference of Catholic Bishops released Called to Compassion and Responsibility. This document, which articulates the official Catholic Church teaching on HIV/AIDS, emphasizes personal responsibility in limiting the spread of HIV and calls for compassion toward the sick. The bishops direct their document to Catholic clergy and parishioners and offer recommendations for government policy and parish actions that affirm human dignity. This thesis argues that the document's recommendations do not adequately consider the experiences of immigrants and refugees with HIV/AIDS and neglect sufficient attention to their lived experiences. In future documents, the bishops should use the …

Examining Resilience In Women Living With Hiv/Aids Through A Photo Narrative Lens, Mary Bell

Expressive Therapies Capstone Theses

Women living with HIV/AIDS (WLH) and poverty face numerous challenges to survival. Typically, WLH in the United States have been exposed to more than just a deadly virus; they have often experienced or witnessed drug addiction, poverty, abuse, mental health disorders, homelessness, abandonment, involvement in the sex industry, racism, sexism, prejudice, social injustice, chronic hunger, generational trauma, and violence – community, domestic, cultural, police enforced, etc. The literature reviewed suggests that treating HIV/AIDS requires a holistic approach that pays close attention to the biopsychosocial needs of the individual. In addition to the physical and economic toll the disease takes on …

“I Think It's Male Privilege”: A Qualitative Study Of Personal, Behavioral, And Socio-Environmental Factors Influencing High Risk Sexual Behavior And Hiv Transmission Among Heterosexual Adult Males In Ghana., Nana Ama Aya Erzuah Bullock

Electronic Theses and Dissertations

There are roughly 340,000 adults and children living with HIV. Despite the progress in the global response and the lowing of infections, HIV rates in Ghana remain stable. Cultural and societal norms that exist at a given time and place influence masculine socialization and behavior. These norms promote heterosexual men’s engagement in high-risk sexual behaviors which result in HIV infections. Factors such as HIV knowledge, risk perception, male condom use, HIV testing, and counseling which minimize the risk of HIV, are also influenced by these norms. Men have been identified as assets and advocates for behavior change and social responsibility …

Emerging Viral Diseases: Generation Z'S Outlook, Ian Mcwhorter

Honors Projects

Generation Z differs notably from previous generations like Baby Boomers or Generation X. In recent years, young adults have been persisting through the COVID-19 pandemic, though not unscathed. This paper seeks to answer the following question: How does Generation Z differ in its outlook on Viral diseases compared to previous generations? Using a series of three surveys conducted on three seperate Viral diseases (HIV, Zika, and COVID 19), it was found that while Generation Z has improved in its ability to combat Viral outbreaks due to factors like high digital literacy, other factors such as poorer mental health show that …

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 …

Understanding The Process Of Health Goal Achievement Among Black Men Who Have Sex With Men (Msm) In Chicago: An Exploratory Qualitative Study, Anthony Johnson

Dissertations

Background: Over the last 30 years, Black men who have sex with men (MSM) have been disproportionately affected by HIV/AIDS while accounting for only approximately 1% of the population of the United States. The majority of research with Black MSM has focused on HIV infection risk factors, but very little attention has been given to their overall health and well-being. The breadth of HIV-health related research that includes Black MSM tends to demonstrate high levels of racial, environmental, and economic disparities that need to be addressed. However, more research must be conducted to explicate the process of exercising strength and …

Relationship Dynamics, Sexual Practices, And Hiv Risk Of Black Behaviorally Bisexual Women, Dajaneil S. Mccree

Walden Dissertations and Doctoral Studies

The human immunodeficiency virus (HIV) risk that exists among women who have sex with women and men (WSWM) is influenced by behavioral factors related to condom use and penetrative sex with sex toys and body parts. Although women represent a large percentage in HIV diagnoses, research has lacked in determining the sexual behaviors that exist behind health-related risks of young women who have sex with women (WSW) and HIV. This study fills the gap in literature in HIV prevention and testing interventions for WSWM by representing Black young adult WSWM in behavioral research, identifying how their lived experiences in relationships …

Queer Survival Amidst Hiv/Aids, Covid-19 And Homelessness, Julia Young

Pitzer Senior Theses

The treatment and survival of a society's marginalized peoples reveal the true impacts of a pandemic. An analysis of homeless queer youth during the HIV/AIDS and SARS-CoV-2 crises lays bare the systemic failure of the United States government to provide equitable healthcare.

I compare the HIV/AIDS and COVID-19 pandemics in queer homeless youth to demonstrate the dangers of disease moralization via a sociocultural analyses of disease stigma and responsibility politics. Utilizing syndemic theory I draw on the synergistic relationship between disease and illness to describe the unique challenges queer homeless youth face. A syndemic framework is applied to address common …

The Criminalization Of Hiv And Hiv Stigma, Deanna Cann

Theses and Dissertations

In an effort to contain the HIV epidemic, lawmakers implemented various pieces of legislation across the United States, including laws that prohibit people living with HIV (PLHIV) from engaging in various behaviors without first disclosing their HIV-status. Public health scholars claim that this criminalization of HIV serves to increase stigma toward PLHIV, rather than prevent its transmission. Limited research has supported a connection between HIV exposure laws and increased stigma toward PLHIV. Still, researchers have yet to establish a causal relationship, and we know little regarding the mechanisms through which these laws serve to reproduce stigma. This study aims to …

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 …

Std Prevention: An Educational Intervention For Exotic Dancers, Maria Delurdes Dehoyos

Electronic Theses and Dissertations

The Centers for Disease Control and prevention reported nearly 2.3 million STD cases diagnosed in 2017, and the number is continuing to rise. San Antonio, Texas, is ranked third in the state of Texas with the highest STD rates and leading in the state with congenital syphilis. There is an increased risk for contracting STDs working in the sex industry. There are little to no studies pertaining to any educational interventions offered to exotic dancers to increase personal knowledge on STDs. This research has focused on an educational intervention offered by a nurse practitioner to exotic dancers in two adults-only …

Prevention In Context: An Examination Of Factors Associated With Recent Hiv Testing Among Men In New York City, Anthony Freeman

Dissertations, Theses, and Capstone Projects

Using intersectionality, Critical Race Theory and Quare theory as theoretical frameworks, this dissertation employs hierarchical logistic regression and data from New York City’s Department of Health and Mental Hygiene (DOHMH) Community Health Survey (CHS) to examine the relative association of key variables and domains -- demographics, sexual characteristics, risk factors and engagement in medical care variables -- on recent HIV testing for a sample of 3997 men. Further, this study explores these effects separately for White, Black, Latino and Asian men.

Findings shows that respondents who were 18-24 years old, 45-64 years old, residing in Queens or Staten Island, employed, …

Challenges To Successful Health Care Transition Among Hiv Positive Youth With Perinatal Acquisition, Tyler Andrew Termeer

Walden Dissertations and Doctoral Studies

To ensure stability in the continuum of health care for HIV-positive youth with perinatal acquisition, there is a need for a successful transition from pediatric to adult primary care. However, there are a growing number of perinatally infected HIV-positive young persons remaining in pediatric care beyond the age of 21. Using Mohr’s program theory and a phenomenological approach, the lived experiences of Ohio HIV clinicians were examined to determine why many perinatally infected HIV-positive youths are remaining in pediatric care beyond the age of 21. Audio recorded video interviews via SKYPE were conducted with 12 participants, transcribed, underwent thematic analysis, …

Canadian Policymaker Experiences On Reducing Syndemic Stigma For Hiv And Substance Use Disorder, Nickolas James Cherwinski

Walden Dissertations and Doctoral Studies

People living with HIV (PLWH) and substance use disorder (SUD) experience highly stigmatized lives fraught by influences such as criminal law and stigmatizing public policies. Despite free access to antiretroviral therapy (ART) and mental health services for all Canadian citizens, suboptimal adherence to ART and administratively cumbersome mental health interventions still exist. Many researchers have found the health services for both HIV and SUD to be dynamic, costly, and difficult to maintain; as such, the purpose of this study was to explore the knowledge gap related to the policy implications of syndemic stigma experienced by PLWH and SUD in Canada. …

Exploring Barriers To Care: Provider Efforts To Improve Retention In Urban-Rural Clusters, Kenyata M. Fletcher

Walden Dissertations and Doctoral Studies

AbstractOver the years, the infection rates for HIV in the United States has changed partly due to lack of engagement and medication adherence which can lead to substantial declines in individual health. Factors that contribute to the individual’s adherence can include transportation cost, childcare, and lack of finances to name a few. These barriers can often be decreased with the help of supportive service providers and improvement in the patient-provider relationship. Currently, there is limited research that explores how to reduce patient barriers to care, specifically in rural areas. This qualitative study examines how Illinois health care providers help HIV-positive …

The Gay Men Who Play With Their Hiv Status., Matthew I. Euzarraga

Capstones

• Since the 90’s a group of individuals known as Bug Chasers, predominately gay men have been playing a game of cat and mouse actively wanting to be caught and infected with HIV. This is a dive into the world of bug chasing.

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 …

Impact Of 2012 Spanish Health Care Reform On Hiv-Positive Immigrants: A Mixed Methods Approach, Megi Gogishvili

Dissertations and Theses

Background: The financial crisis of 2008 hit Spain hard. As a consequence, the government took multiple austerity measures, including reforms in the healthcare system in 2012. Specifically, the government reduced the budget for health and social services by 13.7% in 2012.The reduction was further followed with structural changes via the 2012 Royal Decree Law (RDL) and Royal Decree (RD).The 2012 RDL and RD entailed broad areas of action,but most importantly the Spanish National Health System (SNS) no longer covered undocumented immigrants. The 2012 RDL and RD excluded approximately 500,000 undocumented immigrants from SNS.

The number of immigrants in Spain has …

The Aids Virus And The Galvanization Of The Lgbtq Movement For Equality, Michael Ernest Wachowski

Graduate Theses

The LGBTQ community was greatly altered by the AIDS crisis and the organizations that were founded in the 1980s. AIDS would become associated with those of the gay community during the early years of the crisis. The government and leading health officials perpetuated the public’s ignorance about the relativity new disease leading to more misunderstandings and mishandlings of the HIV/AIDS crisis. The disease did not discriminate among people, however, and quickly spread throughout many of the communities in the U.S. Organizations with roots in the LGBTQ community established themselves during the 1980s to deal with not only the AIDS crisis, …

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 …