Digital Commons Network^™

Stigma, Social Norms, And Culture As Mediators Of Hiv And Aids Incidence In South Africa, Skyeisha Swain

Public Health Capstone Projects

Human Immunodeficiency Virus (HIV) is a significant global public health issue with 38.4 million individuals living with the virus in 2021. South Africa has experienced the world’s largest HIV epidemic across all regions, with 7.5 million individuals living the virus, 210,000 new infections and 51,000 related deaths, in 2021. Interventions have focused on targeting sexual behaviors and addressing mediators of HIV transmission, such as poverty, age, socioeconomic status, education, and gender. Despite a drop in HIV incidence, the virus is still having a negative impact on the continent. This paper highlights overlooked but essential mediators of HIV transmission in South …

The God In Hiv: How The Perceived Influence Of Christianity On Sex Education Impacts Black Men Who Have Sex With Men’S Knowledge Of Hiv, Victor Sledge

Africana Studies Theses

Black men who have sex with men (BMSM) are disproportionately affected by HIV in Atlanta, GA. The purpose of this study is to explore BMSM’s experience with how they have perceived Christianity’s influence on sex education curriculum in Atlanta, GA and how that has possibly impacted their knowledge of HIV. This study is conducted through participant interviews of BMSM between the ages of 18-30 in Atlanta, GA. This study is significant to Africana Studies because it interrogates how Anglo-Christian doctrine and its hegemony over the American South has impacted a city where sexuality, race, and religion have historically intersected. Also, …

Hiv And Hcv Outcomes Among People Who Inject Drugs: Identifying Those At Most Risk For Transmission And Opportunities For Prevention, Kimberly N. Evans

Public Health Dissertations

Injection drug use (IDU) behavior has increased in the U.S. during the past decade largely due to the on-going opioid epidemic. People who inject drugs (PWID) have substantial risk for HIV and hepatitis C virus (HCV) infections. This dissertation consists of three studies to understand risk for HIV and HCV among PWID and people living with HIV (PLWH) in Georgia, as well as missed opportunities to address these infections.

In study 1, we constructed a retrospective longitudinal cohort using clinical encounters with patients who had probable recent IDU behavior based on diagnostic codes in electronic medical records at a metro …

Examining The Relationship Between Perceived Neighborhood Context On Sexual Risk Behaviors Among Black Men Who Have Sex With Men In The South, Terrika Barham

Public Health Dissertations

Background: The burden of HIV in the South remains disproportionate among Black MSM, who account for 48% of HIV diagnoses among MSM. Reasons for these disparities include higher-level structural and social factors, as well as psychosocial factors, that influence individual sexual risk behaviors, including neighborhood conditions, discrimination, depression, resilience, and religiosity/spirituality. The purpose of this dissertation is to examine the relationship between perceived neighborhood context and sexual risk behaviors among Black MSM in the South.

Methods: The dissertation utilized data from the MARI study, which included 412 Black MSM from Jackson, MS and Atlanta, GA. The theoretical framework was …

Predictors Of Tb-Mortality Among Hospitalized Hiv-Infected Children In Kenya, Henry Sohre Kitiabi Mr., Lisa Marie Cranmer Dr.

Public Health Theses

Abstract

Background: Tuberculosis (TB) is a bacterial disease caused by Mycobacterium tuberculosis, resulting in an estimated one million new cases and over 200,000 deaths annually among children. TB is the leading cause of death in HIV-infected children globally (Swaminathan & Rekha, 2010), but few studies have evaluated cofactors of pediatric TB mortality the era ART. We evaluated predictors of TB mortality in a cohort of HIV-infected hospitalized Kenyan children initiating antiretroviral therapy (ART).

Methods: HIV-infected children age(PUSH) trial. Children were ART-naïve and started ART within 2 weeks of enrollment. All children underwent intensified TB case finding at enrollment and were …

A Resource Guide On The Epidemiology, Prevention, And Treatment Of Opioid And Other Substance Use., Anthony F. Rotoloni

Public Health Capstone Projects

In the wake of the opioid epidemic, there is a need to provide sound educational materials that provide succinct and consolidated information on substance use and their disorders. Substance abuse is a public health epidemic and rates of substance abuse in the United States has been growing substantially. Childhood trauma has been shown to be a predictor of engagement in risky behaviors, like substance abuse and risky sexual behaviors later in life. The rates of HIV/STDs have been increasing alongside increases in substance use. Substance use has been found to raise the risk of a person engaging in risky sexual …

Hepatitis C Virus (Hcv) And Human Immunodeficiency Virus (Hiv) Opt-Out Testing In A Southern Federally Qualified Health Center (Fqhc), Leah Pinholster

Public Health Capstone Projects

INTRODUCTION The CDC recommends one-time HCV screening of all baby boomers and those at high risk for infection. Despite HCV being the most common blood-borne virus in the US, routine HCV testing is not uniformly practiced.

AIM To evaluate the prevalence of HIV/HCV screening prior to and following the implementation of a dual routine opt-out program, the linkage to care practices for positive patients, and the demographic characteristics of positive patients in a southern FQHC.

METHODSWe conducted a retrospective, cross-sectional study using electronic health record data from patients receiving care at SMC in Atlanta.

RESULTS Pre-implementation: Of the 68 …

An Evaluation Study Examining The Understandability Of Sti/Hiv Health Education Print Materials Provided By Health Clinics Serving Hispanic And Latino Populations Of Dekalb County, Georgia, Rebecca Butler

Public Health Theses

The prevalence of Human Immunodeficiency Virus (HIV) in Hispanic and Latino populations in the United States is on the rise. In 2015, 26% of all HIV diagnoses in the United States were among Hispanic and Latinos. To effectively combat the prevalence of HIV in this population, it is necessary to examine the efficacy and accessibility of current interventions. Printed educational materials (i.e. pamphlets, brochures, and fact sheets) are low-cost and effective intervention strategies if the material is clear to the reader. This study aims to provide further evidence of the understandability of printed educational resources on safe sex practices and …

Attitudes And Risky Sexual Behavior Among Youth In Kampala, Uganda: Empirical Analyses Of Risk Factors By Gender, Alaina M. Whitton

Public Health Theses

Purpose: The majority of HIV-infected individuals live in sub-Saharan Africa and youth account for the largest sub-population with new infections. Because the highest proportion of new infections is among girls, research is needed to understand the risk factors and context by gender. An analysis of peer and parental approval perceptions can elucidate the gender differences in this large, susceptible population in risky behaviors, including histories of sexually transmitted infections (STIs) and HIV. Methods: Using the cross-sectional Kampala Youth Survey (2014) based in Kampala, Uganda (n=1,134), descriptive statistics were used to explore gender differences in demographics, peer and parental influence variables, …

Understanding Integrase-Dna Interactions In Retroviruses Through 3'-Processing, Zachary E. Ferris, Markus W. Germann

Chemistry Theses

Retroviral integrase is one of the key enzymes needed to integrate viral DNA into a host cell’s genome for many retroviruses including HIV. Integrase’s role is three-fold. It prepares the ends of the DNA so that they can successfully bind to the target genomic DNA via 3’-processing, it creates a complex with the viral DNA that is capable of transporting it into the nucleus, and it facilitates the insertion of the viral DNA into the host genome. The goal of this research is to help determine what sequence and structural characteristics of the viral DNA terminus are responsible for successful …

Hepatitis C And Risk Of Adverse Treatment Outcomes Among Patients With Hiv And Multidrug-Resistant Tuberculosis, Aung Aung

Public Health Theses

BACKGROUND

Multidrug-resistant (MDR) tuberculosis (TB) is a public health emergency that causes substantial morbidity and mortality. Treatment of MDR-TB requires 9-24 months of second-line regimens, has poor success rates, and frequently results in harmful side effects. Hepatitis C virus (HCV) co-infection is a common comorbidity among patients with MDR-TB/HIV and contributes to acute and chronic liver conditions, potentially increasing the risk of hepatotoxicity and adverse treatment outcomes. The aim of this study was to estimate the association between HCV co-infection and adverse MDR-TB treatment outcomes among patients with MDR-TB and HIV.

METHODS

We conducted a retrospective cohort study among MDR-TB …

Associations Of Sociodemographic Characteristics And Pmtct Knowledge Among A Sample Of Women Of Childbearing Age In Zimbabwe By Childbirth Status: A Descriptive Epidemiologic Analysis, Laura Nguyen

Public Health Theses

Introduction: Associations of knowledge and sociodemographic characteristics of individuals for risk of HIV have been documented; however, it remains to be clarified whether these relationships apply to examining women’s knowledge regarding vertical transmission risk of HIV on the basis of having delivered a child. The present study explores associations of sociodemographic risk and prevention of mother-to-child transmission (PMTCT) knowledge among a sample of women of childbearing age in Zimbabwe stratified by childbirth status.

Aim: The purpose of this study was to examine differences of sociodemographic characteristics and knowledge of HIV transmission among women of child-bearing age included in …

Examining The Community Outreach Efforts Of Local African American Religious Organizations In Relation To Drug Use And Hiv Transmission, Alyshia Jackson

Public Health Capstone Projects

Examining the Community Outreach Efforts of Local African American Religious Organizations in Relation to Drug Use and HIV Transmission

By Alyshia Jackson

04/26/2018

INTRODUCTION:

Faith-based organizations, such as churches, are pillars of the community that provide inspiration in times of need. Often serving as a gathering place for those seeking hope and refuge, the church is heavily relied on by the community. African Americans are considerably more religious compared to other races in the U.S. population as a whole in terms of level of affiliation, attendance to religious services, frequency of prayer, and religion’s importance in life (Liu, 2009). Aside …

Human Immunodeficiency Virus Prevention Education On Knowledge And Condom Use Among African American Males In Clayton County, Ga, Charles Jenkins

Nursing Doctoral Projects (DNP)

Purpose: Georgia remains fourth in the nation for new HIV cases. Young African American adults are responsible for 49% of the new cases in Georgia. The purpose of this project was to explore the effectiveness of a nurse led HIV prevention education program on increasing knowledge of HIV prevention and increasing the frequency of condom use among males between the ages of 18-30 years old in Clayton County, Georgia.

Methods: This educational intervention was implemented in a primary care clinic. Data on knowledge and condom use as well as sexual health, sexual behavior, sexual communication, and perceptions of risk for …

The Association Between Internalized Homophobia, Stigma, Racism, Religion And Sexual Risk Behaviors In Young African American Men Who Have Sex With Men In Jackson, Ms, Dorian Freeman

Public Health Theses

INTRODUCTION: The HIV/AIDS epidemic has had a troubling affect across all racial/ethnic groups but has disproportionately exacted its greatest toll on African Americans, specifically, African American men who have sex with men (AAMSM), inclusive of any man who has had sexual contact with another man. In 2015, among all gay and bisexual men who received an HIV diagnosis in the U.S., African Americans accounted for the highest number (10,315; 39%), followed by whites (7,570; 29%) and Hispanics/Latinos (7,013; 27%)(CDC, 2017). Despite an overall decline in HIV diagnoses in African Americans between 2005-2014, conversely a 22% increase in HIV diagnosis was …

Beyond An Epidemic: Examining The Syndemic Relationship Between Alcohol, Violence And Hiv Among Youth Living In The Slums Of Kampala, Malikah Waajid

Public Health Dissertations

Background. The HIV epidemic continues to be a major global health challenge. The interconnected relationship between HIV, alcohol use and violence contributes to an increased burden among vulnerable populations. Youth in sub-Saharan Africa are disproportionately impacted by the synergistic effects of these co-occurring conditions. However, there is limited empirical knowledge regarding the nature of these bi-directional interactions in this population. These studies aim to fill a gap in the literature by describing the mechanisms through which HIV, alcohol and violence intersect among Ugandan youth living in slums by: (1) identifying socio-cognitive correlates of sexual activity among older adolescents; (2) examining …

Intimate Partner Violence Victimization And The Increased Risk Of Hiv Among Young Black Men Who Have Sex With Other Men In Jackson, Ms 6-Month Follow-Up, Ryan Wilkerson

Public Health Theses

Introduction: Intimate Partner Violence (IPV), also called domestic violence, is defined as any physical, psychological, or sexual violence, and emotional violence perpetrated by an intimate partner (CDC, 2016). Sexual violence or rape is defined as a sexual act committed against someone without that person’s freely-given consent (CDC, 2017). IPV is experienced among heterosexual women globally, although this phenomenon is not unique to this population. IPV also disproportionately affects young gay, bisexual, and other men who have sex with men (MSM) (Stults et al., 2016). The purpose of this study is to examine the association between IPV victimization and the increased …

Rates Of Smoking And Visitations To Healthcare Facilities Among People Living With Hiv In Higher-Risk Vs. Lower-Risk Areas In Atlanta, Georgia, Brittani Carter

Public Health Theses

INTRODUCTION: The rate of smoking is significantly higher among people living with HIV (PLWH) in comparison to the general population (CDC, 2017b; Humfleet et al., 2009). Tobacco use among PLWH heightens the risk for HIV-related symptoms and is a pertinent public health issue. Smokers living with HIV are also more likely to develop non-AIDS-related illness in comparison to non-smokers living with HIV. Smoking cessation interventions are desperately needed to cater towards PLWH. This warrants the need for patient-provider interactions in healthcare facilities regarding smoking cessation.

AIM: To document rates of smoking and visitations to healthcare facilities among persons living with …

Analysis Of Anti-Retroviral Procurement For Hiv-Affected Countries From Fiscal Years 2012 To 2014, Dejene' Marshall

Public Health Capstone Projects

ABSTRACT

BACKGROUND:

In 2015, the World Health Organization expanded eligibility for anti-retroviral therapy (ART) to all individuals affected with HIV, regardless of CD4 count. Although, anti-retroviral drugs (ARVs) are essential to HIV/AIDS treatment and therapy, ARVs may also pose a financial burden on low-income countries affected by a high prevalence of HIV. Programs funded by global donor organizations such as the President’s Emergency Plan for AIDS Relief (PEPFAR) may provide assistance to these HIV-affected populations through the procurement of ARVs. The objective of this analysis was to determine total ARV expenditures for SCMS participating countries from fiscal years 2012 to …

A Grant Proposal To Fund Prevention Education For Teen Pregnancy, Hiv, And Other Sexually Transmitted Infections In Targeted High Schools In Gwinnett County, Georgia, Connie Lynn Russell

Public Health Capstone Projects

INTRODUCTION: This capstone project is a grant proposal to provide prevention services to adolescents using a comprehensive risk reduction approach modeled after the federal Personal Responsibility Education Program that supports abstinence and also provides medically accurate information regarding the use of birth control and condoms for the prevention of pregnancy and sexually transmitted infections, including HIV.

NEED: Teen births result in poorer outcomes for babies and mothers and have a negative impact on our economy. There are disparities in teen birth rates among racial and ethnic population groups, with young Hispanic and black girls having rates that are three to …

Access To Care And Social/Community Characteristics And For People Diagnosed And Living With Hiv In California, 2014, William H. Wheeler

Public Health Dissertations

Advances in HIV care and treatment continue to prolong the lives of people diagnosed and living with HIV (PDLWH). The National HIV/AIDS Strategy mobilizes national, state, and local efforts toward ensuring equitable access to care, reducing disparities, and improving continuum of HIV care outcomes. A social/community-based factor that contributes to sub-optimal HIV outcomes for PDLWH – all of whom require regular visits to a medical facility – is access to accommodating, affordable, and acceptable HIV care providers. Employing case surveillance data to analyze relationships between social/community-based factors and HIV disease outcomes is an opportunity to identify underserved PDLWH. This analytic …

Community Stigma And Discrimination Against Persons Living With Hiv/Aids In Kenya, Catherine Muthoni

Public Health Theses

Introduction: HIV/AIDS is a significant public health problem. An estimated 36.7 million people in the world are living with HIV/AIDS, and the largest burden of HIV/AIDS is in sub-Saharan Africa, where approximately 25.6 million people are living with HIV/AIDS, accounting for approximately 70% of the people infected with HIV/AIDS worldwide. The purpose of this study is to examine associated factors among persons who exhibit stigma and discrimination against people living with HIV/AIDS in Kenya.

Methods: Secondary data with a probability sample of 11,909 participants who took part in the 2008-2009 Kenya Demographic Health Survey were analyzed. Logistic regression models and …

The Effects Of Hiv Disease And Lifestyle Factors On Cellular Aging In Trangender Women, Scott S. Sohn

Nutrition Theses

ABSTRACT

THE EFFECTS OF HIV DISEASE AND LIFESTYLE FACTORS ON CELLULAR AGING IN TRANSGENDER WOMEN by Scott Stephen Sohn

Background: Telomeres are short tandem repeats of nucleotides at the ends of chromosomes. These specialized structures serve as caps on the end of the chromosomes, which protect DNA integrity. Telomeres get shorter each time a cell replicates, but the DNA remains intact as long as the telomere caps are a sufficient length. In time, telomeres become too short to protect DNA, which leads to cellular death. Previous research has shown that disease and negative lifestyle factors play a role in accelerated …

Cultural Influences On Hiv Prevention Among Hispanics In Atlanta, Georgia, Amira Abdulhafid

Public Health Theses

According to the CDC (2015), Hispanics/Latinos in the United States accounted for 23% of all new HIV infections in the year 2013. Undocumented individuals are likely underrepresented in this statistic. There are many that may be wary of talking to researchers and therefore are not represented when data is collected. The focus of this pilot study is to understand the level and type of knowledge of HIV preventative strategies for Hispanic men and women. An ethnographical qualitative method, using in-depth interviews, with participants was performed to gather this information. Ten participants were interviewed in and around Atlanta, Georgia. An ethnographic …

Gender Discrimination Effects On Health Outcomes And Behaviors Among African-American Transgender Women In Atlanta, Megan Smallwood Early

Public Health Theses

INTRODUCTION: Transgender women’s experiences of violence and transphobia can negatively affect health outcomes and influence health behavior. Transgender women and especially African-American transgender women suffer a disproportionate burden of HIV and may have unique experiences around both race and gender, which involves an added layer of discrimination. According to the gender affirmation framework, the stigma associated with being a transwoman of color could be a primary driver for engaging in high-risk behavior.

AIM: The present study aims to determine how gender discrimination relates to HIV status, affects quality of life, and influences engaging in risky sexual behaviors or substance use. …

Correlation Between Nutritional Indicators And Low Cd4 Count (<200 Cells/Mm3 ) Among Hiv Positive Adults In Kapiri, Zambia 2008-2009, Kadija C. Fofana

Public Health Theses

ABSTRACT

Correlation Between Nutritional Indicators and Low CD4 Count (<200 cells/mm³ ) among HIV Positive Adults in Kapiri, Zambia 2008-2009

By Kadija C. Fofana

Background

The co-morbidity of malnutrition and HIV is highly prevalent in sub-Saharan Africa due to the pervasiveness of HIV/AIDS and food insecurity in this region. Limited research has been done to assess the association between nutritional indicators and CD4 count among ART-naïve populations in resource scarce settings. It was specifically of our interest to assess various nutritional indicators as factors correlated with low CD4 cell count (< 200 cells/mm³).

Methods

From 2008-2009, HIV positive adult males …

Preventing Hiv In Adolescents Affected By Maternal Hiv Infection: The Ms. Now! Program, Nicholas Tarantino

Psychology Dissertations

Young people in the United States, particularly African American youth, are at heightened risk for HIV infection. One proven prevention strategy is to enhance family processes through a group-based behavioral intervention. Such interventions have garnered considerable evidence for their effectiveness. Moreover, they have become increasingly culturally-informed in order to engage specific vulnerable populations and more effectively address their unique risk factors. A group overlooked by these efforts is adolescent children of mothers living with HIV (MLH). The current study therefore investigated the structured adaptation of an evidence-based HIV prevention intervention for this population. Two main phases of the study were …

An Evaluation Of The Costs And Health Benefits Associated With An Overseas Voluntary Hiv Screening Program For Refugees Undergoing Ressettlement To The United States, Michelle Canady

Public Health Capstone Projects

Since 2010, HIV screening is no longer required as part of the overseas medical examination for U.S.-bound refugees. Estimated HIV prevalence for U.S-bound refugees range from 0% to 9%, with an average of 2.2%. Based on this data, many refugees may be at high risk for HIV and HIV-associated infections and sequelae when compared to the 0.4% to 0.9% prevalence range in the U.S. population.

This capstone is an economic analysis of costs associated with an overseas voluntary HIV screening and treatment program for refugees undergoing resettlement to the U.S. This study seeks to answer the following question:

• Will HIV …

Dissonance And Accord Between Black Faith Leaders’ And Community Members’ Perceptions Of Structural And Institutional Barriers In Hiv, Jennifer Phillips

Public Health Theses

Historically, the Black church has acted as the leader and social service provider in the black community. Despite the church’s successes in providing support to alleviate health disparities, the HIV/AIDS epidemic has remained largely ignored. Research has shown that rather than just providing information about high risk HIV behavior, underlying inequities also need to be addressed. This analysis contains data from four separate qualitative focus groups containing faith leaders and community members and preliminary quantitative data from community members. Responses from community members and faith leaders are compared and reported relating poverty, violence, HIV, and other inequities within their neighborhoods. …

The Association Of Major Depression And Selected Health Behaviors Among Hiv-Positive Adults Receiving Medical Care In Georgia: Findings From The Georgia Medical Monitoring Project, 2009-2012, Rachel Culbreth

Public Health Theses

Introduction: Currently there are approximately 1.2 million people in the United States living with HIV and it is estimated that 25.6% of HIV-positive adults suffer from depression. The purpose of this study is to examine the contribution of depression on substance use and medication adherence specifically among HIV-positive adult Georgians receiving medical care for HIV.

Methods: Secondary data with a probability sample of 608 HIV-positive adults who took part in the 2009-2012 Georgia Medical Monitoring Project (MMP) were analyzed. Descriptive analysis and multivariate logistic regression models were conducted to assess relationships between depression with current cigarette smoking, injection drug use, …