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Relationship Between Treatment Comorbidities And Hiv Viral Suppression Among People Who Live With Aids In Johannesburg., Nwogo Immaculata Ekeji, Tolulope A. Osoba, Hebatullah Tawfik, Mehdi Agha

Journal of Social, Behavioral, and Health Sciences

HIV has globally infected over 37.9 million people, of which 28.2 million (73%) are on antiretroviral treatment, and 66% of those on treatment are virally suppressed. In South Africa, however, low rate of viral suppression (47%) among people living with HIV is a major health problem that has continued to fuel HIV prevalence. A cross-sectional quantitative research design was used to investigate the relationship between treatment comorbidities and viral suppression among HIV-infected adults aged 18–49 who were diabetic, had cancer, or tuberculosis in Johannesburg. HIV Care Continuum formed the theoretical framework for this research. An existing HIV-infected patient de-identifiable dataset …

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 …

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 …

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 …

Hiv Testing Among Nigerian Men Who Have Sex With Men After Criminalization Of Homosexuality, Gerald Onyeka Ileka

Walden Dissertations and Doctoral Studies

Men who have sex with men (MSM) are at high risk of HIV in Nigeria. However, African countries like Nigeria, Botswana, Mali, and Mozambique have laws that prohibit homosexuality, making it a punishable crime in these countries. For example, the Nigerian government signed the anti-gay law in 2014. Laws like these affect the health status and outcomes among Nigerian MSM. The purpose of this qualitative study was to examine the influence criminalization of homosexuality has on the willingness to test for HIV among MSM in Abuja, Nigeria. Guided by the socio-political theory (SP) as the theoretical framework, a qualitative approach …

Hiv Risk-Reduction In Nonmarital Sexual Behavior Among Young Maldivian Males, Mohamed Elmunir Ahmed Safieldin

Walden Dissertations and Doctoral Studies

The low HIV prevalence in Maldives coupled with low HIV comprehensive knowledge presents a challenge to the consistency of the hypothesized HIV knowledge-prevention paradigm. Researchers had not explained why HIV prevalence in Maldives is low despite the low levels of HIV knowledge. The purpose of this qualitative case study was to investigate factors beyond HIV knowledge that contribute to the low HIV prevalence among Maldivian male youth. The research questions focused on the risk-reduction factors in the nonmarital sexual behavior of young Maldivian males that contribute to protecting them from contracting HIV and the predictors of safe and unsafe nonmarital …

Effect Of Model Of Care And Comorbidities On Multiple-Drug-Resistant Tuberculosis Treatment In Nigeria, Oluremilekun Comfort Kusimo

Walden Dissertations and Doctoral Studies

Multidrug-resistant tuberculosis (MDR-TB) is a public health problem in several countries such as Angola, India, China, Kenya, and Nigeria. Due to the increasing high burden of MDR-TB, most of these countries do not have adequate capacities to manage MDR-TB patients effectively. This study investigated the effect of model of care; human immunodeficiency virus comorbidity; and demographic factors such as age, gender, and marital status on the treatment outcomes of MDR-TB patients in Nigeria. The study was based on the analysis of secondary data of 402 MDR-TB patients accessed from the data systems of the National Tuberculosis, Buruli Ulcer, and Leprosy …

Maintaining Confidentiality Among Hiv Infected Couples: Physicians' Patterns Of Decision In Nigeria, Francess Uju Ayaebene

Walden Dissertations and Doctoral Studies

Policies mandating HIV status disclosure to decrease incidence create ethical challenges for physicians on whether to breach or maintain infected patients' confidentiality. In Sub-Saharan Africa where HIV incidence is high, there is a need for clear guidelines/policies on making confidentiality decisions. The purpose of this quantitative quasi experiment was to determine whether the gender, gender orientation, and sexual relationship of an infected patient and physicians' demographics predicted physicians' decisions to breach confidentiality. In Plateau State, Nigeria, 222 physicians were given vignette questionnaires containing 6 different descriptions of gender, gender orientation, and sexual relationships of a hypothetical patient. Each physician decided …

Challenges Of Aging With The Hiv Virus And Comorbidities, Rommie Navylia Abele

Walden Dissertations and Doctoral Studies

Since the introduction of antiretroviral therapy, the survival rate of infected HIV patients has been on the rise with a predicted increase by 2030. The longer a person lives with the virus, the more prone to HIV-associated chronic diseases he or she becomes, but it is not clear whether these diseases are solely from aging with the virus or from long-term use of antiretroviral therapy. Scientists demonstrated that the introduction of antiretroviral therapy led to an increased life expectancy yet early onset of comorbidities; however, they failed to address the challenges that people 50 years old or older face, as …

Effects Of Stigma On The Use Of Spirituality By Older Black Men Living With Hiv, Warren Lee Miller

Walden Dissertations and Doctoral Studies

Previous research on HIV stigma and the use of spirituality by people living with HIV/AIDS is scarce. Moreover, the research with older Black men who have sex with men (BMSM) is scant. The focus of this qualitative transcendental phenomenological study was to examine the lived experiences of BMSM living with HIV aged 50 and older with encounters of HIV stigma on the use of spirituality. The research questions were designed to explore the lived experiences of aging, HIV stigma, and spirituality. Conceptually, this study was framed within the minority stress theory and the HIV stigma framework. Data were collected through …

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 …

The Relationship Between Hispanics/Latino Men Who Have Sex With Men And Women Cultural Beliefs, Risk Behaviors And Self-Disclosure, Donnalee Maria Lawson-Williams

Walden Dissertations and Doctoral Studies

The purpose of this study was to investigate the relationships among cultural/spiritual beliefs, risk behaviors, and disclosure among Hispanic/Latino men who have sex with men and women (MSMW). Minority men who have sex with men are disproportionately affected by HIV, in particular MSM who are Hispanic/Latino or African American. Limited research is available on the link between Hispanic/Latino MSMW, their cultural/spiritual beliefs, risk behavior, and disclosure about risk behaviors to friends and family. The data were obtained from the SJS Project, which used survey methods to gather data on participants from all 50 states and Puerto Rico. Among the participants …

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 …

Puerto Rican Women Living With Hiv And Experiencing Intimate Partner Violence, Sharon Danesa Cuba-Rodriguez

Walden Dissertations and Doctoral Studies

Puerto Rican women experience increased risk of bio-psychosocial challenges due to their ethnicity. This phenomenological study examined Puerto Rican HIV-positive women's perceptions of intimate partner violence (IPV), which consists of physical, sexual, verbal, and psychological abuse. Although HIV-positive status and IPV have been a focus of previous research, specific research examining the phenomenological experiences of HIV-positive Puerto Rican women who experienced IPV has not been studied. The basis of the study was feminist intersectionality theory, which supported the process used to explore and understand the essence of the participants' experiences. Feminist intersectionality theory examines intersecting social systems including gender, ethnicity, …

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 …

Issues Affecting Sexual Decisions Among Black Women In The Era Of Hiv/Aids, Saecilia Jackson

Walden Dissertations and Doctoral Studies

HIV/AIDS became a significant concern in the United States (U.S.) during the 1980s and in recent years has increased the most among people living in underserved urban areas, particularly impacting Black women ages 24-35. Guided by the social learning theory, this phenomenological study explored the lived experiences and behaviors of Black women in the south in order to understand their sexual health decisions and how those decisions impact the spread of HIV/AIDS among this group. The central research question focused on understanding the sexual decision making of Black women in Georgia, from the perspective of the client and provider. Convenience …

Stigma And Hiv Testing Among African American Women In New Jersey, Mirriam Limage-Pierre

Walden Dissertations and Doctoral Studies

African American women are 18 times more likely to contract HIV than are European American women, yet they are less likely to be tested for HIV. Lack of HIV testing leads to late diagnosis and increased mortality from HIV-related illnesses. Based on the health belief model, this correlational study analyzed the extent to which HIV stigma mediated the relationship between perceived benefits or perceived severity of HIV and the uptake of HIV testing among African American women in New Jersey. A total of 93 African American women aged 18 and older who resided in New Jersey completed online questionnaires. Data …