Digital Commons Network^™

Access To Hiv Prevention, Care, And Treatment Services In The Us: The Role Of Primary Care, Jessica S. Kiernan

Theses and Dissertations

This dissertation examines the role of access to primary care in benefitting HIV outcomes through increased access to HIV prevention, care, and treatment services, among populations disproportionately affected by HIV in the US. Over 30,000 individuals are newly diagnosed with HIV annually in the US and diagnoses are concentrated in specific populations. At an individual-level, ~ 70% of new diagnoses are among gay and bisexual men and of those diagnoses, 70% are among Non-Hispanic Black and Hispanic gay and bisexual men. At a community-level, over 50% of new HIV diagnoses occur in less than 2% of US counties (48), Washington, …

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 …

Cellular Mechanisms By Which Alcohol Promotes Hiv Protease Inhibitor-Induced Hepatotoxicity, Michael Hinton

Theses and Dissertations

CELLULAR MECHANISMS BY WHICH ALCOHOL PROMOTES HIV PROTEASE INHIBITOR-INDUCED HEPATOTOXICITY

Michael Hinton, B.S.

A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University

Virginia Commonwealth University, 2019

Major Director: Huiping Zhou

Professor, Department of Microbiology and Immunology

The development of highly-active-antiretroviral therapy(HAART) has allowed management of HIV and extended the lives of those infected. Alcohol abuse, which is very common in HIV-1 infected patients, is one of the most important co-morbid risk factors for liver injury and has been associated with the occurrence of serious metabolic syndrome and subsequent discontinuation …

The Effects Of The Hiv-1 Tat Protein And Morphine On The Structure And Function Of The Hippocampal Ca1 Subfield, William D. Marks

Theses and Dissertations

HIV is capable of causing a set of neurological diseases collectively termed the HIV Associated Neurocognitive Disorders (HAND). Worsening pathology is observed in HIV+ individuals who use opioid drugs. Memory problems are often observed in HAND, implicating HIV pathology in the hippocampus, and are also known to be exacerbated by morphine use. HIV-1 Tat was demonstrated to reduce spatial memory performance in multiple tasks, and individual subsets of CA1 interneurons were found to be selectively vulnerable to the effects of Tat, notably nNOS+/NPY- interneurons of the pyramidal layer and stratum radiatum, PV+ neurons of the pyramidal layer, and SST+ neurons …

An Evaluation Of The Raise 5 Project: Preventing Hiv And Substance Abuse Among African American College Students, Joshua K. Brevard

Theses and Dissertations

African Americans have been disproportionately affected by HIV since the beginning of the epidemic and the disparities have worsened over time (CDC, 2013a). African Americans comprise about 12% of the U.S. population but represented about 44% of all new HIV infections in 2010 (CDC, 2014a). Young people (age 13–24) accounted for 26% of all new HIV infections in 2010, despite persons in this age range comprising just 17% of the population (CDC, 2014c). Young African Americans (age 13-24) are affected in particular. In 2010, they comprised 57% of infections in this age range (CDC, 2014c). Substance use is a major …

Enhancement Of The Placental Transmission Of Lopinavir Using A Transporter Targeted Prodrug Strategy, Meng Wang

Theses and Dissertations

Lopinavir (LPV) is a potent protease inhibitor specific for HIV-1. However, LPV has poor placental penetration due to substrate activity for efflux transporter by P-glycoprotein (P-gp). Since fatty acid transporters are highly expressed in the placenta during pregnancy, we designed fatty acid ester prodrug of lopinavir as substrates of fatty acid transporter in order to improve their uptake into placenta. Seven dicarboxylic acid esters of lopinavir have been made in our lab. The structures were characterized by ¹H-NMR, ¹³C-NMR, LC-MS/MS, HRMS, IR and melting points. After making the prodrugs, an LC-MS/MS method with high specificity and sensitivity, as …

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 …

The Role Of P2x Receptors In Hiv And Opiate-Related Neurotoxicity, Mary Sorrell

Theses and Dissertations

Emerging evidence suggests that opioid drugs can exacerbate neuroAIDS. Microglia are the principal neuroimmune effectors thought to be responsible for neuron damage in HIV-infected individuals, and evidence suggests that drugs acting via opioid receptors in microglia aggravate the neuropathophysiological effects of HIV. The P2X family of ATP activated ligand-gated ion channels regulates key aspects of microglial function. In addition, opioid-dependent microglial activation has been reported to be mediated through P2X4 signaling, prompting us to investigate P2X receptors contribution to the neurotoxic effects of HIV and morphine. In vitro experiments showed treatment with TNP-ATP prevented the neurotoxic effects of morphine and/or …

Platinum Complexes And Zinc Finger Proteins: From Target Recognition To Fixation, Samantha Tsotsoros

Theses and Dissertations

Bioinorganic chemistry strives to understand the roles of metals in biological systems, whether in the form of naturally occurring or addition of non-essential metals to natural systems. Metal ions play vital roles in many cellular functions such as gene expression/regulation and DNA transcription and repair. The study of metal-protein-DNA/RNA interactions has been relatively unexplored. It is important to understand the role of metalloprotein interactions with DNA/RNA as this enhanced knowledge may lead to better understanding of diseases and therefore more effective treatments. A major milestone in the development of this field was the discovery of the cytotoxic properties of cisplatin …

Hiv And Opiates-Mediated Neurotoxicity: Gsk3Β Is A Potential Therapeutic Target, Ruturaj Masvekar

Theses and Dissertations

HIV-1 enters the CNS soon after initial systemic infection. HIV-1 can induce a wide range of neurological deficits, collectively known as HIV-1-associated neurocognitive disorders (HAND). Mature neurons are not infected by HIV-1; instead, infected and/or activated glial cells release various viral and cellular factors that induce direct and/or indirect neuronal toxicity, leading to HAND. Injection drug abuse is a significant risk factor for HIV-infection, and opiate drug abusers show increased HIV-neuropathology, even with anti-retroviral treatments. Our previous work has largely modeled HIV-neuropathology using the individual viral proteins Tat or gp120, with murine striatal neurons as targets. To model disease processes …

The Seeds Of Mistrust: The Relationship Between Perceived Racism, Hiv Conspiracy Theories And Hiv Testing Attitudes, Joshua Brevard

Theses and Dissertations

Although the number of HIV infected peaked in the late 1980’s, HIV remains a major concern within the African American community (CDC, 2008). African Americans are disproportionately affected, comprising 14% of the U.S. population but representing 44% of new HIV infections in 2009 (CDC, 2011). It is vital to identify barriers to positive health behaviors like consistent condom use and HIV testing. This study focus on factors impacting attitudes towards HIV testing, including mistrust of the healthcare system, measured by support for HIV conspiracy theories (Thomas & Quinn, 1991). It also examined the prevalence of HIV conspiracy beliefs among African …

Development Of Antagonists Targeting Chemokine Receptor Ccr5 And The Chemokine Receptor Ccr5 – Mu Opioid Receptor Heterodimer, Christopher Kent Arnatt

Theses and Dissertations

The chemokine receptor CCR5 (CCR5) plays an integral role within the inflammatory network of cells. Importantly, CCR5 is a mediator in several disease states and can be targeted using small molecule antagonists. Within this work, CCR5’s role in prostate cancer and HIV/AIDS has been exploited in order to develop potential therapeutics and probes. First, a series of novel compounds was designed by using pharmacophore-based drug design based upon known CCR5 antagonists and molecular modeling studies of the CCR5 receptor’s three-dimensional conformation. Once synthesized, these compounds were tested for their CCR5 antagonism and their anti-proliferative effects in several prostate cancer cell …

Living With Hiv: Views Through The Blog, Linda Eastham

Theses and Dissertations

The purpose of this qualitative descriptive study was to develop a greater clarity of how HIV infected individuals live and work within the sphere of HIV infection as represented through unsolicited, personal narratives posted on blogs. Existing, single author, personal blogs were identified via a search engine. Blogs were defined as the blog author's postings and all responses, whether written by the blog author or a reader respondent. Inclusion and exclusion criteria were developed to respect indicators of bloggers' intentions for privacy, e.g., blogs which required a password were excluded. A total of 14 blogs met inclusion criteria. Actions to …

Regional Heterogeneity And Diversity Of Astrocytes In Response To Hiv-1 Proteins And Morphine, Wen Chen

Theses and Dissertations

HIV-infected individuals who abuse opiates have been found to have a higher incidence and a faster progression of HIV encephalitis. Astrocytes, the major support cells in the CNS, are known to play a critical role in the HIV neuropathy. Although astrocytes tend not to be productively infected by the HIV-1 virus, dysregulation of their pro- and anti- inflammatory cytokines/chemokines secretion is usually neurotoxic. Glutamate transport in astrocytes is reported to be impaired as well, which result in extrasynaptic excitatory neurotransmitter accumulation and over stimulation of postsynaptic neurons. It is long known that astrocytes from different brain regions have diverse responses …

Machismo As A Determinant For Hiv/Std Risk Behavior Among Latino Msm, Jacqueline L. Sears

Theses and Dissertations

Objective: Male-to-male sexual contact is the most common mode of transmission for HIV among Latino men. Psychosocial factors such as machismo, homophobic discrimination, and internalized homophobia have been hypothesized to greatly impact sexual behaviors among Latinos. However, studies investigating the relationship between these psychosocial factors and risky sexual behaviors are limited. This study examined the impact of machismo on risky sexual behaviors among Latino Male who have Sex with Men (MSM).Methods: This study utilized data collected from 254 Latino MSM in 1999 from selected cities within Virginia. The analysis focused on respondent demographic characteristics, psychosocial factors, acculturation, and sexual risky …

Lack Of Knowledge Of Mother-To-Child Transmission In Kenya Among Women Ages 15-49, Nisha Warrier

Theses and Dissertations

Purpose: The epidemic of mother-to-child transmission (MTCT) of HIV/AIDS in resource-poor countries is dramatic; it is responsible for nearly 90% of childhood infections. The primary purpose of analysis was to understand the distribution of factors and their association with lack of knowledge of MTCT in Kenya. In parallel, another aim was to identify the relationship between media, particularly frequency of radio exposure, and lack of knowledge.Methods: This study used the 2003 Kenya Demographic and Health Survey (DHS) collected for 8,195 women, ages 15-49. Descriptive analysis, univariate analysis, and logistic regression were completed on SPSS 14 software.Results: In the sample, 1151 …

Factors Associated With High Sexual Risk Behavior In Single Women, Thomas B. M. Leecost

Theses and Dissertations

Objective: This study was to identify factors associated with High Sexual Risk Behavior (HSRB) in single Afro American women seen in an Epidemiology/Sexual transmitted disease (EPID/STD) Clinic in Richmond, Virginia from January 2006 through April 2006.Method: Participants were 154 single women (no history of marriage) between the ages of 18-30 visiting the EPID/STD clinic for the first time.Demographic information was obtained from their records. A volunteer interview was given that contained 101 variables to evaluate for High Sexual Risk Behavior (HSRB). HSRB was defined to response 'yes' to the question, "During the past 3 months did you have sex with …